The link between social isolation and health problems among seniors has been well-documented, and the Covid-19 pandemic has only worsened the issue. One startup that is attempting to tackle the problem with a round-the-clock virtual companion providing social support and access to care when needed is care.coach, which recently won the health IT track of Pitch Perfect contest at the MedCity INVEST virtual conference.
The company offers a tablet with a virtual avatar that can be used in a couple of different ways to support seniors and others in need, like the developmentally disabled, at home.
First, the user can initiate an interaction with the avatar, a puppy or kitten, by tapping its head on the tablet screen, said Victor Wang, founder and CEO of the Millbrae, California-based company, in a phone interview. Historically, this initiated a phone call to the care.coach team, where a health advocate answered. Though these advocates do not provide clinical diagnoses, they can offer general health-related information, like exercises for diabetics, and link users to resources, he said. They can also play games with the users via the platform.
Now, the company has started training AI models to automate these care-focused conversations. Though only a subset are using the company’s conversational AI at the moment, care.coach plans to automate as many healthcare protocol-based conversations as possible, Wang said. These protocols could be around exercise to relieve common ailments like back or joint pain.
There is also a pre-determined escalation pathway where more serious cases — a senior who has fallen for example — are connected to emergency services and medical care. To better facilitate these escalations, care.coach launched a video visit solution in 2020.
“The avatar is kind of like a family member,” Wang said. “[But] the avatar cannot provide a medical diagnosis outside of pre-arranged protocols. So, there are times…where you need to escalate to a PCP or care management team, and when that happens, it’s very helpful to have that doctor come into the loop of that escalation and start a video visit with that patient on the same avatar device.”
Second, care.coach can begin an interaction on behalf of a payer, provider or caregiver. The tablet can be customized to check-in on patients every day or remind them to take certain medications at the same time, Wang said. These are already automated and can be as simple as asking the user how they are doing that day.
This is an especially useful tool when caring for people with chronic conditions, and it is one of the reasons Pitch Perfect Contest judge Liz Rockett felt the company was deserving of the top prize.
“Care.coach made a strong case for the impact that their digital avatar is having today in the lives of people with high-risk chronic conditions,” said Rockett, managing director of Kaiser Permanente Ventures. “With players across the US healthcare system seeking ways to support more care in the home, care.coach’s years of conversational AI development and user experience design could be well-positioned to take off in this market.”
The startup was born out of Wang’s master’s thesis at the Massachusetts Institute of Technology, where he was working on telepresence, telerobotics and teleoperations research for a space program.
“I was reading these articles about loneliness and the health impact of loneliness and people were talking about the caregiver crisis,” he said.
Seeing the vast need for caregivers at home, as well as the experience of his grandmother in Taiwan who was also suffering from loneliness, Wang decided in 2012 to focus on a solution that would allow seniors to receive the support they need at the touch of a button.
The avatar idea came to Wang when he was thinking about how to solve one of the primary issues involved with providing 24/7 care and support — a fragmented user experience.
“In order to provide round-the-clock home care services to a single person reliably, in practice…you need seven or eight different people,” he said. “And you have people doing and talking about very private things when it comes to senior care and sharing that with eight different people in a week — it’s a major reason people don’t get the care they need.”
The avatar collapses the personalities of all the health advocates on care-coach’s team into a single persona and a single voice. Making the persona a pet also lends a non-judgmental aura to the interaction, Wang said.
Currently, the company’s main customers are health plans and senior care programs, which are using the technology to provide wraparound services to their members at home.
It was the ease of use of the solution and the consistent persona that attracted one such program — Gary and Mary West PACE in San Marcos, California.
Part of a national network of elderly care programs, West PACE provides all-inclusive, interdisciplinary care for seniors to allow them to age at home for as long as possible, said Dr. Russ Colt, medical director, in a phone interview.
The program began its partnership with care.coach before the pandemic, but accelerated it once Covid-19 cases started surging and lockdowns proliferated across the country.
“[The care.coach platform] is elegant in its simplicity,” Colt said. “On the tablet, there is only one button. You just turn it on. And then there is a support structure in place.”
The avatar provides consistency for program participants as well as an outlet for social interaction, and the option of drop-in video visits allows West PACE to care for patients without taking them out of their homes, he added.
About 30 of the program participants are currently using the tablets.
“It provides a compassionate window into the homes of our participants,” Colt said.
As the pandemic has made painfully clear, healthcare needs to extend well beyond the physical to be truly impactful for seniors. With care.coach’s platform, seniors have access to companionship alongside healthcare support, helping fulfill both medical and social needs.