CareHive Origin Story

CareHive Origin Story

CareHive is an evolutionary story two decades in the making. It is the relentless pursuit of digital healthcare innovation, converging with best-in-class customer experience. At its core, CareHive starts with its visionaries.

Dr. Ronald Dixon is a pioneer and innovator in the health tech industry. Throughout his career, he has viewed healthcare with laser focus and clarity. In the early days of email when most of us were uncertain of its potential, Ron had incorporated its use into his medical practice to follow-up with patients asynchronously. He developed telemedicine booths 20+ years ago to allow communities to visit with their doctors without coming to the office. All the while, he leveraged the value of data to improve healthcare outcomes. Prior to CareHive, Ron was the inaugural Director at Massachusetts General Hospital’s Virtual Practice Project as well as the Director for its Center of Integration of Medicine and Innovative Technology. His work led to the development of Healthcare 360, a technology platform that continues to aid physicians in monitoring and managing large patient populations.

Health Tech Innovator

While other industries have taken the forefront on technology advancements, improving healthcare and its inherent complexities have tended to lag. The pandemic shone a light on one aspect of health tech – the virtual visit and telemedicine – which catalyzed momentum and acceptance, both from the population at large but also public regulators. But “telemedicine” is just the tip of the iceberg; there is a full continuum of technology-enabled, data- and AI-driven health tech on our horizon which can address chronic, long-term, and post-acute care – not just after-hours urgent care. Done right, these technologies, processes, and services improve provider-patient conversations and relationships, deliver robust data and risk assessment, and create better patient outcomes – cost effectively. CareHive is leading this charge. 

As an innovator, Dr. Dixon has always been intrigued by the capability of technology to disrupt industry and put more control in the hands of people. Banking, travel, dining, retail, and the list goes on. When Ron finished residency in 2001, his thinking was “Why not healthcare?” And he set off to do something about it. Here is some of the background Ron shared:

Step 1

Working as an outpatient internal medicine doc at MGH, I took over a bunch of patients from a retiring doctor and started to grow my practice. I noted that a lot of the patients I inherited had visits every few months or so for blood pressure checks, diabetes follow-ups, thyroid follow ups that I felt did not require an office visit. We exchanged email addresses, and I started emailing these patients at certain intervals instead of them coming in (no portals at the time). This was highly effective, so effective that when my administrator discovered what I was doing, I was told to stop as it was costing us fee-for-service revenue.

Step 2

Emailing patients series of questions that I would otherwise ask in the office was helpful in understanding their status but adding data would be even more powerful. I was already prescribing home blood pressure cuffs but believed that remote physiologic data that tracked activity surrogates could positively help those with risk factors for chronic disease. I partnered with BodyMedia to pilot remote activity monitoring in patients with prehypertension or prediabetes to reduce risk of disease progression. 

Step 3

In-office visits and email were polar opposite ends of the delivery spectrum. Videoconferencing provided a middle ground. Skype launched in 2003, and by 2008 commercial webcams were readily available. I began using Skype with select patients, and the one case that stood out was for a Stage 4 lung cancer patient who I was able to keep at home with pain control and hydration with the help of a visiting nurse and frequent “virtual visits”.

Step 4

Electronic Medical Records with portal functionality eliminated the need for email. Asynchronous contact could take place through the portal. Combining EMR functionality, remote monitoring, and videoconferencing seemed like a logical step in 2006, and led to the virtual practice project. The Virtual Practice White Paper / Virtual Visits Pilot Paper

Step 5

The virtual visits pilot paper was well received and called for more rigorous evidence if we were to get adoption. I raised grant funding to do a randomized crossover trial of video-conferenced visits. Bottom line, videoconferencing was a good way to evaluate primary care problems and the evaluation and management decisions made over video vs in person were the same. There were no time savings for providers, but patients did see value and were willing to pay for these interactions.  Randomized Virtual Visit Trial / PC Willingness to Pay for VV / Primary Care online communication

Step 6

There seemed to be commercial potential in this work. A European investor heard me speak on Big Think (link below) and invited me to lunch. He basically said that the work was impressive and important, but it would be hard to get traction without commercialization. He encouraged me to start a company and said he would like to seed it. He wanted nothing in return. He deposited 20K into a business account for what would become HealthCare 360 and the entity was developed. Big Think Interview 2009

Step 7

While growing virtual visits, it became clear that remote monitoring was important, and mass remote monitoring in the community via kiosk had significant potential. An engineer and I got a CIMIT grant from DOD to develop a beta version of a kiosk that combined remote monitoring data with question sets. We licensed this to Singapore through ASTAR, and after years of development built a scalable version with evidence behind it. Kiosk Development / CIMIT / Kiosk outcome paper

Step 8

The virtual visit studies and remote monitoring work led me to believe in the strength of asynchronous visits, quantitative data collection and analysis as having more potential for outcome improvement than video alone given there was no time savings and lack of quantitative data gathering. The portal alone was not nimble enough for the automation and data integration required. I made a proposal to build a tool called HealthCare 360 that would allow patients with chronic diseases to be followed up by their practice asynchronously instead of coming to the office. We were starting to do more value-based care for the Medicare population and the CFO felt that this was a way forward. A beta version of the software was built and tested. It proved effective, plus added an 80% time savings over in-office visits. Asynchronous virtual visits paper

Step 9

The beta-software worked and was effective for managing patients with chronic disease. A commercial software firm was brought in to professionalize the stack and the platform grew to manage over 60 conditions in chronic, urgent, and post-acute care, was licensed externally, and to date has had over 50,000 visits performed on it. An analysis of a subset of visits showed reduction in office visits for those who used the platform. Async visits for HTN

Step 10

EPIC EMR launched at MGH and was going to replace 360 functionality. I left MGH to go to Google Verily/Onduo to work on digital diabetes care and continuous glucose monitoring. 

We successfully implemented and published several papers confirming the promise of digital-first specialty care. HC360 was to be retired by EPIC, but physicians refused to transition, and it continues in use due to clinician demand. Digital Diabetes Clinic Paper

Step 11

Joe Cunningham from Sante asked if I would be willing to bring the HealthCare 360 vision and technology to CareHive/Remedy.  HC360 was acquired by CareHive as the base platform for CareHive360. Its impact will be significant as a full-fledged platform with new innovation and functionality being brought to bear by CareHive’s leadership and development teams. 

In 2020, Ron partnered with Dr. Jeremy Gabrysch, the founder of Remedy, a high-growth, digital health acute care company in Austin, TX. From triage to virtual visits to house calls, Remedy has received several awards in its industry for clinical excellence and customer service, and is loved in the communities it serves. Guiding patients to the lightest, most appropriate care with industry-leading customer experience was in Remedy’s DNA, and a perfect complement to Ron’s 360 tech and vision. 

Health Care Continuum with CareHive360
Healthcare continuum. CareHive is leading healthcare further along the continuum, driving better provider-patient relationships, more engagement, frequency, and rich data – helping to lower costs, enhance accessibility and increase convenience.
Health Care Continuum with CareHive360
Healthcare continuum. CareHive is leading healthcare further along the continuum, driving better provider-patient relationships, more engagement, frequency, and rich data – helping to lower costs, enhance accessibility and increase convenience.

The team at CareHive understand that for every individual’s health there is a corresponding utilization and cost of health care that ensures the proper treatment and/or prevention of chronic conditions. Algorithms can help calculate risk based on population specific diseases, identifying individual risk over time, intervention, and the measurement of intervention impact. CareHive has also created over-utilization risk scores that identify the best candidates for intervention regardless of magnitude of their risk – this had the ability to bend projected healthcare utilization and cost.

Along the way, Ron’s vision and leadership, plus Remedy’s class-leading clinical care, navigation, and customer experience under Jeremy, attracted some of the best people in their fields to what would become CareHive. 

Dr. Dan Moloney – SVP Data & Analytics

Dr. Moloney earned a Ph.D in Psychology from the University of Minnesota with an emphasis on Behavior Genetics, Statistics and Organizational Psychology. He started a successful Business Intelligence software analytics consulting services company (acquired), started the Data Science practice at RedBrickHealth (where he met Mike Erickson – RedBrick also acquired) where he took on Engineering, Product, Strategic Content and Data & Analytics while launching the new enterprise wellness platform. He then joined Onduo’s executive team as Head of Data & Analytics. It is there he met Ron and recognized their mutual interest in augmenting clinical and claim information with devices and surveys, leveraging this rich data for analytics to stratify and cluster patients, and recognize distinct digital phenotypes. CareHive is the next step in robust data analytics helping drive the appropriate utilization of health care.

Michael Erickson – SVP Engineering

Mike’s background is in product development and software in the semiconductor and medical space. After his military service (Airborne) and earning his computer science degree, he dove into the start-up environment and developed deep experience maturing technical strategy, operational processes, and business development. He met and worked with Ron and Dan at Onduo, and instantly understood and appreciated the vision for a more sensible, connected, satisfying health care experience. In moving to CareHive, Mike continued to see the prospect of “using technology for good”: increasing access, improving outcomes, and lowering costs and the burden placed on providers. He clearly saw that helping more providers effectively take on value-based populations would be a win for providers, the market, and society as a whole. CareHive is providing that opportunity to craft a platform that supports this vision alongside a world-class patient experience.

Dr. Suneet Singh – Medical Director

Dr. Singh is a physician who received his MD from Virginia Commonwealth University School of Medicine and then completed his residency training at University of Texas Southwestern Parkland Health & Hospital System. He is an Assistant Professor at UT Austin Dell Medical School where he helped create the Value-Based Healthcare-centric Leading EDGE curriculum. He has been teaching medical students and residents for over two decades with a focus on building efficient, systems-wide processes and creating value by decreasing waste and redundancy in healthcare. In this capacity, he has received several awards for leadership, patient safety, and clinical education. In addition, he has led several hospital-based multidisciplinary care review and process improvement committees. With a passion for patient care, efficiency, and value, Suneet brings CareHive a focus on improving outcomes via resource utilization, technology improvements, and creating meaningful engagements.

From a tech and data perspective, CareHive is continuing this trajectory, expanding to include async interventions as additional levers with digital interventions (telemed and devices) along the healthcare continuum, as well as expand into all chronic, post-acute and acute conditions. The goal is to identify the sub-populations of individuals who not only are at risk but are also impactable and then match them to the appropriate “dose” of healthcare escalating and/or de-escalating as needed and as the data presented to us from a rich array of clinical, device and deviceless sources is continuously leveraged. Add to this a robust clinical care delivery model, urgent and wraparound care, navigation and guidance, and patient follow-up through resolution, and the result is a unique hybrid of capabilities at CareHive.

The union of 360 and Remedy created CareHive as a true evolution of health care. Building on momentum years in the making around digital health, it is the realization of a vision to create a next generation health-tech platform coupled with the power of sophisticated navigational and clinical services. With experienced, multidimensional, innovation-focused leaders, and a team that are best in class on all fronts, CareHive is a data-driven healthcare company that creates high-value savings while maximizing convenience and satisfaction. 

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