Deal Flow

Care Thread weaves a new circle of connected care

Patients are connected to providers, who are also connected to the patients’ team of caregivers – and family, in real time, on a mobile device

PHOTO BY Scott Kingsley

Nick Adams, left, co-founder and president of Care Thread, Renee S.Bessette, vice president of Marketing and Operations, and Andrew Shearer, co-founder and chief technical officer, at their offices in downtown Providence.

Posted 1/13/14
Care Thread, a Rhode Island startup, has a disruptive model to unify the way that a patient and his or her caregivers communicate, in real time, with the patient at the center.
The model can serve to create a virtual network of patient-centered medical care, connecting the team of caregivers to the patient and his or her family, in real time. It also changes the dynamic of how a patient can become engaged in the decision-making about care, creating a patient-centric ecosystem with access to data in real time.
Enormous amounts of money have been invested in health IT – but most systems are being built and designed with the provider and hospital in mind, not the patient. Will the new EPIC health IT platforms being built at Rhode Island’s two largest hospital systems, Care New England and Lifespan, be able to adapt and adopt to Care Thread’s patient-centric model? How will the state’s health information exchange, known as Currentcare, being managed by the R.I. Quality Institute, which has its own current problems with interoperability between software systems, be able to integrate with Care Thread’s innovative approach? What happens to the brick-and-mortar structure of health care delivery when a virtual, mobile patient-centered medical home is created, connecting the team of care providers, the patient, and the patient’s family, in real time?
If there were to be a remake of The Graduate today, odds are that instead of the Dustin Hoffman’s character, Benjamin, being told by his next door neighbor, “I have one word for you – plastics,” today’s version would be “I have one phrase for you – population health analytics.”
Controlling the flow of information – and the analysis of data – will be key to all future reimbursements under Medicare, Medicaid and private insurance. The digital, mobile, virtual world of communication presents a real-time threat to the powers that be in health care. Making information transparent changes the equation. So does consumer and community access to information, and the ability to make decisions for themselves.

PROVIDENCE – In carving out a niche in the health care communications market, the premise of Care Thread’s platform is simple and direct: to connect patients to caregivers, creating an interactive community of care, in real time, that is secure, encrypted and not tied to a physical space or a computer terminal.

Instead of clinical systems that connect computers to computers, or a person to a computer, Care Thread has built its system with the patient – and the patient’s family and community of caregivers – at its center, explained Nick Adams, co-founder and president of the Rhode Island startup.

“What Care Thread is really focused on is connecting people with other people who are taking care of people,” said Adams in a recent interview. He and Renee S. Bessette, vice president of Marketing and Operations, sat down with ConvergenceRI to talk about the R.I. startup firm’s strategic plans in the coming year.

Adams’ tautology of connecting people has a big potential upside in the health care market. “The market opportunity for us, when we’re said and done, it’s going to be a low of $5-6 billion and a high of $15-20 billion over the next five years, and that’s being conservative,” he said.

The imbedded costs and inefficiencies in health care delivery due to discordant connections between providers and patients, according to Adams, was estimated to be in excess of $150 billion.

Care Thread’s mobile platform would replace the mishmash of archaic technologies still often in place at hospitals, such as pagers.

“Nurses often spend about 20 percent of their day” just trying to facilitate the interaction between provider, the patient and different care givers, Bessette said. By connecting the team of caregivers and the patient and his or her family on the Care Thread platform, she continued, discharges from a hospital, with everyone having access to the data, in real time, can help to prevent unnecessary readmissions.

Promising start
Care Thread is off to a good start, having secured $250,000 in initial financing from the Slater Technology Fund and having secured “convertible debt” financing for another $400,000. The company is a recent graduate of the BetaSpring incubator.

The company has also gained traction with clients, including the Eastern Connecticut Health Network, now affiliated with Yale New Haven Health Systems and Vanguard Health Systems, a Tennessee-based for-profit health system.

They are currently working on a pilot program with South County Hospital in Wakefield. They also have been awarded two research grants, one from the Patient-Centered Outcomes Research Institute, another from the Gordon and Betty Moore Foundation. In addition, they are in the midst of negotiating a deal with a large primary care provider, a health insurer and a hospital system in Rhode Island, with the goal of creating a virtual patient-centered medical home for all of the primary care provider’s patients.

Care Thread has a non-provisional patent application filed for the architecture of its system, protecting the “architecture of the system that nobody else does,” Adams said. “Our platform is not open source,” he continued, but it is built upon open source libraries of software.”

In setting up its corporate structure, Care Thread decided to become a Delaware C corporation, primarily because Care Thread will operate in more than one state. At some point, Care Thread will look to raise venture capital to grow and accelerate, but not at this time.

Disruptive model
By bringing together a connected network of caregivers, with the patient at the center, Bessette and Adams said that they were well aware that they were creating a disruptive model. “We’re bring together the patient’s entire culture of care system – the patient’s ecosystem, as we call it. We’re putting the patient at the center, and everyone around it is connected,” she said.

Are you opening up Pandora’s box, enabling the patients to talk back? ConvergenceRI asked.

“Oh, yeah, that’s really what we’re doing. [The future of health care communications] is really going to be a two-way street,” Adams said. But the first order of business, he continued, is to connect all the providers who are members of a patient’s care team, and once all the providers are connected, let the conversations flow – within the limits permitted under privacy and professional guidelines, he quickly added.

Adams said that there was also an ability to “push” from Care Thread’s publishing platform, to remind patients, to provide encouragement, targeted at patients beset by chronic diseases. He busily made a note when ConvergenceRI asked if he was familiar with a telemedicine pilot for senior citizens in New York City that recorded voices of a patient’s grandchildren, asking if they had taken their meds.

Future opportunities in analytics
Adams and Bessette also discussed Care Thread’s potential opportunity in population health management analytics, where bundled payments handled by accountable care organizations would be made on the basis of outcomes and benchmarks.

“We think of that as a huge opportunity,” Adams said. “When you think back at the technologies that have been deployed – pagers, emails, faxes, notes, text messaging – none of it is unified. Because we are a communications platform, and we can integrate the data, we can map the communications of all of the care team.”

When we talk with hospital CFOs and COOs, Adams continued, “I ask them to tell me about physician response times to their calls. They go, ‘What?’”

Adams then described how Care Thread’s system would enable hospitals and primary care practices to map out the times when physicians may not be as prompt in response time, identifying a need for more coverage by caregivers.

“It all comes back to answering the question: what are we going to do for the care of this patient,” Adams said.


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