Healthcare startups turn to ‘coaches’ to help patients deal with and monitor

In 2011, San Duffy and Adrian James were sitting in Dolores Park, San Francisco, arguing over what to say to some Omada Health employees of the company they founded.

Omada, which was launched that year, provides virtual therapy for chronic conditions. The company solves the situation through a team of employees – some traditional healers and others encourage patients to manage high blood pressure, pre-diabetes and other conditions on a daily basis. This second group was important, they thought. The founders asked patients what title to use.

Was this person a “doorman”? Patients thought he sounded like someone who had helped with the bill. A guide “? In what destination? The founders settled in” Trainer. “Patients liked the term: it suggested someone who could help and make them” feel less alone, “Duffy said as they tackled their health challenges. .

This decision was the ultimate indicator of a final technology company trend. Since then, dozens of similar startups have emerged focusing on health coaching, often backed by big money. A KHN review – sites like News Publishing, Industry Database Crunchbase, and LinkedIn – found about 50 companies with about $ 7 billion in venture capital funding.

These startups offer people or software to provide motivation, guidance, or moral support for managing problems with the human body, including chronic conditions, muscle disorders, obesity – and even attention deficit / hyperactivity disorder and eczema. Business models change. Some startups take payments directly from customers; The “anti-diet” app Wellory wants $ 45 a month. Other startups receive monthly funding per member from companies to offer regular coaching for their employees. Some services have 24/7 access and the average connection time is 60 seconds. With some, the trainer raises serious issues to more highly qualified physicians.

The motivation behind coaching is, in his face, a curious turn for an industry that likes to boast of its billion-dollar pills and ghostly-sophisticated artificial intelligence.

“As these digital health startups continue to grow, they realize that technology is not enough to drive change,” explained Michael Young, managing partner at investor OMRS Ventures, who has invested in coaching startups. Patients may need to eat better, follow a physical therapy plan, talk through emotional turmoil, and more.

Instructors – whether they are human or software – can assist patients in formal visits to the doctor. This kind of motivation can be important for sticking to a care plan – an important issue in a world where good habits mean a lot to keep healthy. Whether a team needs a team to help with the physical aspects of a patient recovering from orthopedic surgery or to help avoid triggers for behavioral health conditions, these coaching companies are far from an app or a website.

“The model has become extremely innocuous,” Young said. In many startups, trainers are “doing the lion’s share of the work.”

Still, many in the healthcare industry are skeptical of this trend. Some think it adds a human touch to a part of the economy that can be defined by Brassk doctors and understandable bills. Others wonder if this is just a way to get cheap labor.

Proponents say the coaches are deeply involved, even performing tasks that would otherwise go unnoticed. “We need an alternative workforce to fill some of these gaps,” said Omada’s Duffy. At Omada, coaches wear lots of hats: they review glucose data while tracking patients’ lifestyle changes and can provide empathy in a way that other people in the healthcare system do not. The trainers are “people who ask questions before giving a verdict,” Duffy said.

Duffy said people with diabetes – or others with a chronic condition – need far more staff than the healthcare system to take care of the book. So a trainer – whose salary is usually in the tens instead of a few thousand dollars – seems like a solution for many startups.

“Coaching is a way to avoid having a clinical license or FDA approval,” wrote Bob Kochhar, an investor in Wenrock, in an email. “It allows you to quickly start serving patients.”

The trainers are already playing a role in the established organization.

Dr. Pushpa Raja, a psychiatrist at the Greater Los Angeles System of the Department of Veterans Affairs, says colleagues play a significant role in VA. Often, people with a given condition interact with veterans of the same disease. “They can relate to patients differently,” he said. “They can cheerleaders towards patient goals. They can train patients in planning and strategizing.”

They’ve teamed up with psychiatrists and primary care physicians, which means they can pass observations – for example, if someone’s depression gets worse over time.

Some observers of health coaching startups are concerned that they do not have the same capabilities. Liz Chiarello, a sociologist at St. Louis University in Missouri, says trainers can do “a lot of things that are frustrating” for doctors, but the increase in these workers could “further disrupt our health care”. One issue may need to be pointed out – and it is often unclear whether startup coaches have strong relationships with organizations that offer next-level skills.

What’s more, coaches may not be well-trained – and may serve many patients to do much better.

“When I find startups that are like, ‘We’ll hire 100 people and train them for two weeks,'” Young said. “You’re not going to learn anything in two weeks.” For some companies ’training,“ it’s pretty scary, lacking in rigor and depth, ”he said.

Coaching qualifications may not be everything they show.

Wellory promises that users will match a nutrition coach after taking a quiz. Those coaches, in turn, recommend healthier foods for users. But some quiz recipients – such as Dr. Seth Trigger, an emergency room doctor at Northwestern Medicine; And a KHN reporter – met with an instructor who described himself as “RDE”, abbreviated as “Registered Dietitian Qualified.” This is a term for nutritionists who have fulfilled most, but not all, of the requirements required to qualify as a registered dietitian.

But according to the Dietetic Registration Commission, RDE is not a professional term, and anyone using it should stop “immediately”. The Commission is a certified body of the Academy of Nutrition and Dietetics, a trade group for food and nutrition professionals. KHN removed the Valerie reference after contacting the company about the issue.

Young said some startups think of coaches almost as a “call center model,” with plans to hire dozens of coaches to help thousands of patients.

Some startups are actually using smaller teams. Take HomeTree, a new company that has raised 20 million to care for elderly adults or other patients. The company’s goal is to use a combination of technical equipment and social workers to provide everything from emotional support and connectivity to caregivers to recommendations for wheelchairs and walkers.

David Grabowski, a professor at Harvard Medical School who specializes in aging and long-term care, says there is a huge openness to fill these institutions. Supervisors may not be sure how to complete certain daily tasks, such as bathing or lifting patients. But, just as much, “it’s loneliness, it’s the feeling that you’re in it yourself,” he said.

Even so, owning one is still beyond the reach of the average person. Co-founder Dave Jacobs said the company serves about 20,000 members. It currently employs 40 social workers who provide “episodic” assistance in “the most acute” situations, such as deciding whether to take patients home, Jacobs said. In everyday situations, it relies on technology to connect patients to resources.

Grabowski has questions about such models. “I certainly think 40 social workers are enough to handle such a situation,” he said.

Coaching startups is a very different field. Young says he has seen startups that do well coaching but he’s not sure how much the public is benefiting. “Are we providing a good service to the population at the end of the day?”

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