August 30, 2017
Alexandra Bohigian

Enola Labs creates custom strategy and products for mobile and web.

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Technology companies are quickly innovating within the healthcare industry, working to solve some of medicine’s costliest and longest held problems. These elegant solutions are changing the way we think about healthcare and technology, providing new and interesting ways for businesses to enter the space. Enola Labs is highly involved in the healthtech space, using our healthtech expertise to guide healthcare and technology companies in creating solutions that will save the healthcare system money while working to improve patient outcomes.

One of these technology companies making a splash in the healthtech scene is care.coach. Care.coach is a healthtech company that is working to improve patient outcomes in hospital settings through the use of an avatar software platform. Patient falls in hospitals cost the average hospital about 1.6 Million dollars each year (Over $30 Billion nationally). Many of these falls are avoidable and can be attributed to a lack of enough hospital staff to constantly attend to the needs of older or otherwise high-risk patients. Older patients also have a very high likelihood of becoming delirious during their hospital stay, which causes falls and other complications. With a care.coach avatar that provides social support for the patient, cognitively engages and monitors the patient to reduce delirium risk, and alerts medical staff if the patient needs to go to the bathroom or is uncomfortable, a clinical study found a whopping 85% reduction in falls, and significant mitigation of delirium. The company’s avatars are also used by health plans to coach high-risk patients at home to take their medications, avoid emergency department visits, and so on.

Enola Labs’ CTO and Chief Architect, Marcus Turner, is consulting with care.coach, advising on technology and clinical utilization as an Advisory Board Member on their team. Providing his expertise and guidance to this quickly growing company has allowed care.coach to continue to grow and make smart decisions as they mature.

We sat down with the CEO of care.coach, Victor Wang, to learn more about his inspiration to start care.coach and to gain some insight on what real collaboration in healthcare and technology looks like, hopefully to inspire other technology companies to enter the health space.

The following has been lightly edited for clarity and length.

Can you explain your motivations behind starting care.coach?

“In grad school at MIT I worked on telerobotics and was interested in solving problems through the use of teleoperation and telepresence. Considering my family’s experience in trying to support and care for my grandmother remotely in Taiwan, I started the company “GeriJoy”. GeriJoy helps solve loneliness and social isolation among older adults by connecting them with a remote human caregiver. At the time there was some new research being published about how loneliness leads to poor health and early death, and is statistically speaking similar to obesity or smoking. So, we figured we could get senior care providers and consumers to see the business value in our solution. Since then, we have evolved the company into what it is known as today, care.coach. GeriJoy remains care.coach’s consumer brand, while the care.coach service for healthcare providers builds on our psychosocial support and personal relationships that we have with patients to drive coaching of evidence-based protocols to mitigate health risk factors both in the hospital and at home.


It is so interesting to see what a huge difference something as seemingly simple as preventing patient isolation can make for patient outcomes. Why do you think it is important for the tech industry to innovate within the healthcare space? Have you always had an interest in healthcare?

“Initially, we stayed away from “healthcare” in favor of less regulated (non-medical) senior care and consumer markets. Now that we work with hospitals and health plans serving the highest-risk, highest-need patients, we feel we are in a position to deliver far more value. It is important for the tech industry to dedicate resources toward innovation in the healthcare space because healthcare is where technology can have the greatest immediate societal impact. However, this space is notoriously behind when it comes to technology, keeping in mind that it is usually not the case that a technologist on the outside can just come up with an “innovation” and make an impact here. As Dr. Pearl, the past CEO of Kaiser Permanente, once said, one of the main reasons healthcare is behind the tech curve is that many new technologies don’t even address a real problem for the industry. Even when a technology does address a real problem, there are usually a lot of reasons why the technology might end up going nowhere. The healthcare space is tremendously complex, and requires a significant investment of effort to understand well enough to develop an innovation that sticks and makes a real impact. But it’s well worth the effort.”


What Victor said here is so important. Many tech companies are trying to innovate the healthcare space. However, they are not taking the time to learn the ins and outs of a doctor’s day-to-day life, what the hospital system’s main issues are, or in what situations patients experience the most negative outcomes. Instead, many technology companies are unfortunately laser focused on creating a piece of technology that is exciting and flashy, a technology in which healthcare providers simply do not have a great need for or worse, it adds more complexity to the clinical care workflows. It is important for tech companies and entrepreneurs to spend time diving into the needs of the healthcare industry and revolving innovation around those needs, instead of creating a self-serving technologies.

With significant “unknowns” in the healthcare community right now, how can technology help fill the gaps and ensure patients are receiving optimal care?

“While the short term outlook can always contain a lot of unknowns, I think what is quite certain is that the healthcare industry in the US is on an inevitable shift toward value-based care, in which healthcare providers are rewarded based on outcomes and even patient satisfaction, rather than the amount of procedures done. So, there are certainly opportunities for using technology to help patients get optimal care. These include telehealth, remote monitoring, patient risk stratification/prediction, or clinical workflow solutions that free up administrative time for providers to instead spend with patients face to face.”

“But there is also the fast-growing concept of person-centered care, in which we need to understand patients as people, and healthcare is merely an instrument toward the achievement of our goals as human beings. A medical intervention that keeps someone alive and on life support for several more months could be considered a positive outcome, but it is not beneficial if that person has already lived a full life, and would have rather passed away peacefully on their own terms—I am referring to what are called advance directives, around which entire companies have been built. So there are opportunities not just in helping to deliver optimal care, but also in engaging patients to identify what, in a person-centered way, that optimal care should look like. This class of solutions can also include patient engagement technologies that actually help people to change their understanding of how health and wellness fits in, and is important to their other goals and desires in life. In this way, people can live healthier lives and hopefully not need the healthcare system at all, other than for preventative services—that is truly optimal care!”

Those are all excellent points—especially when speaking on the importance of using healthtech to manage the administrative ends of care in order to allow for more face-to-face time between doctor and patient. I think that when the general population thinks about healthtech, they assume it means a robot will be providing your yearly physical. In reality, healthtech can ensure patients have more quality time with their physician and in turn receive an overall higher quality of care.

What kind of response are you getting from healthcare professionals when pitching your product? Do you feel they are opening their arms to technologies like care.coach, or are they hesitant to embrace the technology?

“The reception to care.coach has been very strong because unlike a lot of other solutions that are really focused on the technology, we provide avatars that are a fusion of the best of human beings (compassionate conversational ability, with a true understanding of what the patient is saying and expressing) and the best of software (automation of clinical protocols, reporting, etc). Geriatricians, nurse leaders, and other clinicians that work directly with patients often have an intuitive understanding of the importance of this “human touch” in any kind of patient-facing interaction. It also helps that we have been collaborating with academics to conduct studies and publish literature validating our avatar system and the outcomes that we can help drive both in the hospital and at home.”

“I have not seen significant hesitation to embrace our technology per se, but it does seem like every IT department is always busy with some kind of work on their electronic health record system! Fortunately for us, we generally do not need any help from the IT department for deployment, and we have already put in the work of ensuring that our organization is compliant with HIPAA and other expectations of hospitals and health plans that we serve. We have even worked to embed a lot of workflow protocols into the avatar itself, so that staff training is very simple, and other than the usual technology, information security, and legal reviews, we can get started very quickly and easily. We have actually seen hospital CNA’s who skipped our 30 minute training course still manage to deploy our avatars successfully to help prevent falls and delirium in hospitalized elders.”

It’s excellent to hear that so many healthcare professionals are open to embracing Care.Coach technology—that speaks to the gap you are able to fill in patient care in these settings. What kind of response are you getting from patients who use this technology? Are patients generally open to utilizing your product?

“Because our avatars support the highest risk, highest need patients, most of our patients are elderly and some have cognitive issues such as dementia. The younger patients often have functional impairments, so we have put a lot of design effort into making sure our technology doesn’t require any technology skills and only a minimum in cognitive and physical ability to successfully benefit from the technology. We do get patients who have an aversion to technology, but most of the time all it takes to change their mind is an initial conversation with our avatar. We make the avatar fun and engaging— it’s literally just a talking dog or cat in a picture frame. You talk with it, and you can pet it if you want to. Through this simple, intuitive interface, we can perform any non-physical aspect of care—anything that involves talking with patients, showing images, and playing audio.”

“Last we measured, our Net Promoter Score was +75, which is extremely good, and 95% of our patients would recommend us to a friend. Sometimes patients will say they would not recommend their avatar to a friend, because they have a unique friendship with their avatar and don’t want to share it with anyone else!”


What is the ideal collaboration you would like to see between healthcare professionals and technology leaders?

“I don’t know how I would define an ideal collaboration, as the field of healthcare is so broad and so complex, and technology has so many applications. The key is for everyone to keep an open mind. Because healthcare so regulated and seemingly opposed to change (in favor of patient safety), it is natural for people in technology to think this advice is directed at people in healthcare. But in fact, people in technology need to drop their egos —technology is likely to be only a small piece of any successful solution—and make a concerted effort to truly understand and learn from people in healthcare, before and throughout the innovation process.”


Looking Forward

Thank you, Victor, for taking the time to speak with us about the experience you have had bringing a piece of healthtech to market. Technology absolutely has a huge place in the future of the healthcare industry, as long as technology companies are willing to listen to the needs of the healthcare industry. For more information on care.coach, visit their website. For more information on the healthtech consulting expertise provided by Enola Labs, contact us today for a free consultation. Our healthtech consultants will discuss your technology idea with you and provide the expert insight you need to be successful in healthtech. From attaining compliance to determining the needs of the healthcare space, Enola Labs has helped guide countless successful healthtech projects.