Startup Insider: Hometeam

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Fresh off of a $27 million funding round, Hometeam, a New York-based startup offering personalized in-home senior care, plans to more than double its size in 2016.

Beyond focusing on empowering caregivers and individualizing care for older adults, Hometeam operates with the goal of connecting families with their loved ones, something that is often overlooked due to distance and time constraints, but plays a big role in quality of life. All of these factors contribute to Hometeam's efforts to bring about the senior care industry they believe older adults deserve.

"If you'd have asked me five years ago would I be working with older adults and in healthcare — there's no way I would've guessed that," says Josh Bruno, founder and CEO of Hometeam. "I think these kinds of changes always come from a personal experience, and for me that was my grandfather."

Mr. Bruno was working as an investor when he became involved in trying to find care solutions for his grandfather, who lived to be 98 years old.

"For the last five years of his life, my family really struggled to find a way to keep him safe and healthy, but also happy and enjoying life and thriving," Mr. Bruno says. "Nursing homes weren't a good fit — there was always a revolving door of caregivers — and we became frustrated with all of the options we looked into."

Mr. Bruno took time to speak with Becker's Hospital Review about taking matters into his own hands to come up with a better solution for the aging population and the issues plaguing the senior care industry.

Question: How did you go about determining the source of those frustrations your family experienced?

Josh Bruno: I spent about three months volunteering in a couple dozen home care agencies, nursing homes and other companies just to understand why this industry wasn't able to deliver on the promise it should be delivering on. I found that yes, there's a technology problem; there's not a lot of efficient technology in this industry. Yes, maybe there aren't a lot of companies that have scale; there are 40,000 mom-and-pop companies that serve the industry. But ultimately, there's a workforce empowerment issue.

The caregivers who are doing all of the labor, all of the human-to-human caring work, are not supported by the companies that should be there supporting them. That means there are issues with training, fair pay, regular work, the tools those workers need to succeed, mentorship. All of these are really important for any career and we need to be providing this for our home health aides. So that was the vision and mission for the company.

I left my job to start Hometeam about two and a half years ago and joined up with some incredible investment partners and team members — we're almost 300 strong now — to deliver on this mission. It comes back to creating that beautiful day for an older adult and we do so by empowering the workforce.

Q: What sort of impact do you expect a solution like Hometeam to have on healthcare?

JB: The first piece of it is what happens in the home and how that affects health outcomes. One component of Hometeam is what is called our Beautiful Days Program, where we take a lot of time to understand who each older adult is, what makes them happy, what they used to be able to do a few years ago and wish they could do [now], but maybe they aren't as active and can't do that anymore. We try to make that come alive. That can be gardening, getting to church regularly, seeing family and friends, playing games, getting out and being physically and mentally stimulated.

When you take someone who was previously just sitting in a recliner watching The Price Is Right and enable them to be active, suddenly you reduce hospital readmissions by 50 percent, you reduce incidence of depression by 70 percent, you're doing a lot of very valuable things by using some very standard techniques to create happiness. So the impact on the healthcare system is around delivering non-traditional techniques in the home along with the traditional medical techniques you might see. So we're still doing transfers into a shower, injections and medications, but we're combining that with other activities. Where we're starting to see value already is we've integrated with a number of rehab facilities, hospital systems and insurers to allow them to track their clients as they go from a hospital stay to post-discharge in a rehab facility, and because of the services we offer, they are able to move that patient along much more quickly and release them into our care earlier. It enables patients to heal and get better in their own homes, lowering costs and improving outcomes.

Q: How does the Hometeam University program work?

JB: The way we address that workforce empowerment issue is by matching each caregiver in a home with an older adult whose needs match that worker's skill and training. When a caregiver comes onto our platform, the first thing we do is assess the current level of their skills among about 20 dimensions and with medical equipment as well. Then when we bring older adults onto our platform we can either link up directly with the medical records from that facility or send in one of our own nurses to make an assessment to understand their needs. We have an algorithm that then matches patients and caregivers based on skill and personality and the likelihood that they'll build a great relationship and be active together.

HometeamUniversity is then there to allow caregivers to upgrade these skills, to gain understanding about different illnesses and how to treat them and to increase their expertise. It focuses on that empowerment issue because as they advance through the university not only do their skills increase, but so does their pay and they advance their career. In this industry, that's a big problem, there's career stagnancy for trained caregivers and many make the same amount of money even after years of working.

Q: What has it been like to move into healthcare and start this company?

JB: Starting a company in healthcare after working in other fields has been incredibly rewarding in that we work directly with our customers and clients and the harder we work, the bigger positive impact we see in their lives. A lot of our team is from hospitality or technology or service industry backgrounds. We do have some clinical health expertise but everyone else comes from other industries and I think they that kind of feedback is rewarding in a way you don't often get outside of healthcare.

Q: What do you see in the coming year for Hometeam?

JB: We're expanding from the four offices we serve today to eight to 10 by the end of this year. Next, we're really expanding our research and development and our engineering team. We have 20 individuals today working in software development and we plan to expand that to about 60 over 2016. The reason for that is there's so much more we can be doing to integrate our platform into the healthcare system. So we're going to be integrating directly with hospitals, directly with payers and directly with rehab facilities and as patients go in and out of the home, we're coordinating all of that care and direction and that's really important for overall outcomes for older adults. Another thing we'll be doing is developing more applications for the home where we can connect the family, connect the older adults to their community, allow for video physician visits and things like that. Lastly, we're using our funding to expand our clinical programs. HometeamUniversity is in its infancy and there's so much more we can do, we want to be training our home health aides to be acting more like RNs and doing the work they do in the home. We believe it's possible for this workforce to do so much more and we want to be the first to show that that's possible.

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