Care at Hand Co-Founder & CEO, Dr. Andrey Ostrovsky, and Stanford d.school scholar, Karen Matsuoka, give insight into how entrepreneurs can best tackle the challenge of working with government organizations, particularly when focusing on underserved populations.

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GUEST: Dr. Andrey Ostrovsky, Care at Hand and Karen Matsuoka, Stanford d.school

HOST: Steven Krein and Unity Stoakes

LOCATION: StartUp Health Studios, New York, NY

IN THIS EPISODE:

• Connecting over shared passions
• Tackling entrepreneurial challenges when working with government
• Creating a solution for underserved populations

Key Takeaways in this StartUp Health Now Episode

Connecting Over a Shared Venture
[1:41] Dr. Ostrovsky: Karen and I met over this past year, because I’m originally from Maryland. I have a bit of a pulse on the Maryland healthcare ecosystem. Maryland has always been doing interesting things in terms of reimbursing care. There is even more interesting things evolving now in terms of how hospitals are being reimbursed.

[2:03] Dr. Ostrovsky: I was really looking to understand more about what those changes mean for community health workers, for community organizations, for hospitals. I reached out to some of my mentors and they directed me to a few folks, and a final common pathway of, I think, two to three people led to Karen Matsuoka.

[2:26] Dr. Ostrovsky: That’s how we got connected. I really approached Karen to get a better understanding of how do I as an entrepreneur, identify the problems that consumers that various entities in Maryland are facing, and to try to also understand how are the policy implications shaping the opportunity that emerges.

[4:19] Karen: I’ve been thinking for a really long time about policy, and how policies can be used as effective levers for public private, funded public private partnerships. It was in the course of working in Maryland as healthcare reform and implementation has gathered steam, a lot of the movement has been towards getting closer to the ground where the implementation is happening, which is what led me to move from federal level to state level, which is where I had the pleasure of meeting Andrey.

Tackling Changes Brought On By New Health Care Policies
[3:09] Dr. Ostrovsky: Maryland, like several other states, is experiencing very rapid changes. Those changes are downstream effects of either the Affordable Care Act or the Affordable Care Act plus some interesting local policy and regulatory changes that were already going on before the Affordable Care Act.

[3:32] Dr. Ostrovsky: When you have the Affordable Care Act layered with local nuances, the regulatory environment is incredibly hard to be expert in. I’m well versed in regulatory environments, but at the state level, I’m not an expert in Maryland. Karen is an expert, and so I wanted to pick her brain to understand where can we solve problems that people are going to pay money to help me solve them?

[9:19] Dr. Ostrovsky: I was going in with a very specific intent. My goal is, if Maryland had an opportunity to utilize non‑clinical workers to prevent readmissions, they should be using my software, period.

[9:32] Dr. Ostrovsky: Now, I didn’t go in and open with that, but that’s ultimately my goal. In order for me to do that, I need to understand the ecosystem. I need to understand who are the entities that could be using my software, and I need to know when they would even be ready, so that’s what I need to learn from Karen.

[10:38] Dr. Ostrovsky: I came to Karen saying, “Here are multiple ways, multiple technologies that may be useful, how can I help you connect with those?”

Joining Forces
[4:49] Karen: Really at this point in time, I’m really looking to help entrepreneurs like Andrey think through the proven approach of Stanford and other organizations I’ve taken to human‑centered design, to design the kinds of models and solutions that really get to what end users ‑‑ in this case, we’re talking about underserved populations ‑‑ really need. It just so happens that policy shifts have created a situation now where, financially, that’s now very viable and very lucrative I would say.

[6:01] Karen: I would say that, and for all the entrepreneurs out there, I would say there’s probably a lot more appetite and desire for folks like me in government to have more direct relationships and interactions with entrepreneurs on the ground, and unfortunately I would say, Andrey is one of the only startups that has reached out to me directly at the state level, and even at the federal level.

[6:54] That environment layered on top of all of the opportunities that the Affordable Care Act brings, I think the more we can get entrepreneurs talking to people in government and having them share insights and best practices, the better it will be for government, for the entrepreneurs, and then ultimately the patients that we’re trying to reach.

[7:25] Dr. Ostrovsky: Along those lines, just so all of the state, federal, and local officials don’t get bombarded by every single entrepreneur with an email, a cold email, there is an emerging science behind how you get to someone like Karen.

[8:13] Dr. Ostrovsky: Understanding how to identify the folks in the regulatory setting, what are the specific asks of those folks, and then leveraging whatever your network is.

[9:03] Dr. Ostrovsky: You actually have to come in there and say, “How can I help you?” I came in taking that approach, and I learned quickly that like most governments, and I have worked in governments before…

[15:20] Karen: I personally was very excited to hear from Andrey. I will say, just to piggyback on what Andrey said, what made the partnership so viable to me, is in addition to not kind of doing the hard sell about the technology, I feel like what made Andrey really effective, and what I would say about any entrepreneur that I’ve ever been approached by while I was working in the federal government, for example, is the ability to engage, not on the financial level of financial transactions and how I can essentially get money from you, but also to act as a thought partner.

Care at Hand’s Solution

[11:00] Dr. Ostrovsky: Very simply, it’s a technology that, it’s smart surveys that accurately predict 30‑day hospitalizations, using the observations of non‑clinical workers. People like community health workers, homecare workers, van drivers, Meals on Wheels providers…

[11:13] Dr. Ostrovsky: Lay caregivers, not doctors.

[11:41] Dr. Ostrovsky: There are so many ways to drive down readmissions, it’s a matter of, “Here’s your menu of options. What are your needs? I trust these people, so I can bring them to the table.”

Resources, web sites and tools mentioned:

• [00:13] Care at Hand
• [00:13] Stanford D. School
• [01:10] Robert Wood Johnson Foundation

Related and Recommended StartUp Health Now! Episodes:

1. StartUp Health NOW #6: Commercializing in Underserved Communities
2. StartUp Health NOW #8: The ACA and Underserved Communities
3. StartUp Health NOW #9: Unlocking Grants and Underserved Communities
4. StartUp Health NOW! #26: Designing Digital Health for Impact in Underserved Communities

Read the full transcript of this episode here.