Determined Health Is Reimagining Geriatric Care; Building a Collaborative Ecosystem with Authentic Human Connection as the Cornerstone
Scott Kaiser, MD, and Katherine Steinberg, MPP, MBA, health innovators with deep expertise in geriatrics and care transformation, have developed a new platform to address loneliness and other critical social determinants of health. Their approach leverages digital technology to deliver data-driven and scalable solutions while keeping authentic human connection front and center.
Challenge
Within the Healthy Longevity & Aging Moonshot, we often write about the simple-but-profound math of changing demographics and our aging population. By 2030, a quarter of the US population will be over 65, approaching the first time in history that there will be more people over the age of 65 than under 18. Meanwhile, something on the order of 40% of healthcare dollars are spent on people over 65.
As a physician specializing in geriatric medicine, and through a career leading care innovation efforts, these demographic realities have always been front of mind for Determined Health co-founder, Dr. Scott Kaiser. Anticipating the needs of an aging population, Dr. Kaiser points out that “if you consider the many things that influence how people age, social connectivity stands out as one of the most profoundly impactful, and potentially modifiable, factors.”
Not only do loneliness and social isolation have devastating impacts upon health and wellbeing — with research indicating adverse health effects equivalent to smoking 15 cigarettes per day — but they are key cost drivers as well. Social isolation is associated with increased risks of emergency department visits, hospitalization, nursing home placement, and conditions such as dementia (50% increased risk) that bear a devastating human and economic toll. By one AARP analysis, $6.7B in annual Medicare spending alone is attributable to isolation.
What this all amounts to is the somewhat shocking realization that one of the greatest predictors of poor health, functional decline, and even premature mortality for older adults is something clinical teams may be overlooking all together. Loneliness and social isolation aren’t tangential to health; social connection is primary.
To quote US Surgeon General Dr. Vivek Murthy, “It is more important than ever that we rethink and harness the power of relationships and recognize that they are not just nice to have but they are necessary to have.” Kaiser, along with Determined Health co-founder Katherine Steinberg, MPP, MBA — a seasoned healthcare transformation and innovation specialist — heeded this call, setting out to create new tools to combat the loneliness epidemic across diverse communities and bringing social connection into the core of high-quality care.
Origin Story
Incubated within a 100-year-old non-profit, the Motion Picture & Television Fund (MPTF) — which supports members of the entertainment community, including 60,000+ entertainment industry retirees — Determined Health was born out of a community of storytellers. And in true Hollywood form, the Determined Health origin story brings together a passionate cast of characters, introducing a steady flow of existential threats (a global pandemic, for example), as they set out on a quest to overcome seemingly insurmountable challenges. Enter Kaiser and Steinberg, healthcare innovators, determined to reimagine aging and transform care.
Appreciating the degree to which healthcare all too often may be “shooting at the wrong target, overlooking the non-clinical factors that so profoundly drive outcomes,” Kaiser and Steinberg aligned to found Determined Health, with the conviction that “everyone deserves access to personalized, high-quality, well-coordinated care — supported by a team that understands them and their values.”
Eager to develop and scale the impact of the most promising innovations in geriatric care and population health, the duo drew key insights from their work at MPTF that they believed could provide the seeds of such transformation. In particular, seeing the profound impact of MPTF’s nationally recognized social call program — developed under Kaiser’s leadership with the support of AARP — they set out to better understand what made this approach so successful. The key differentiator of the approach was prioritizing human-to-human connection first and foremost. The calls weren’t automated, the volunteers weren’t running down a checklist or doing surveys to determine healthcare needs. Instead the goal was to have a friendly, engaging conversation, with the person on the receiving end of the call driving that conversation.
Kaiser and Steinberg leveraged a grant from The Eisner Foundation to build a prototype for a social connection platform. Their Connection1st CallHub platform was designed to facilitate connections between people, safely and easily. Those two priorities — ease and safety — meant they wanted the platform to meet the users where they were in terms of technology by using ordinary phone calls, and it meant de-risking the platform by protecting people’s privacy and routing all calls through a trusted phone number. This was especially important for the older population with whom they were working, often the target of phone scams and fraud.
Fueled by an urgent need to combat isolation exacerbated by the pandemic, Kaiser and Steinberg were approached by organizations across the country to use their platform. This beta testing fueled the iterative development of a platform forged by real-world demand and directly meeting the needs of key end-users. Through this process, the Determined Health team not only found an effective solution to reduce social isolation, loneliness, anxiety, and depression, but recognized that these calls could prove to be the key entry point to influence overall health and wellbeing. Once again, the secret ingredient: creating genuine connections and building trust.
The driving insight, and in a way an ode to their Hollywood heritage, Steinberg points out, “when you’re able to connect with someone and build trust, getting to know their unique story, understanding them and appreciating what really moves them, you can develop meaningful engagement as a powerful force to positively influence health and wellbeing” This type of engagement is often the missing ingredient, especially when it comes to identifying and addressing unmet needs and filling critical care gaps. As Kaiser explains, “We’ve seen countless examples where, despite robust screenings, real needs are still going undetected. Then, through friendly calls with simple conversations about sports, movies, etc. people begin to confide, sharing their deepest concerns, like ‘I just don’t know what to do, it’s the end of the month and I’m going to have to choose where to cut back, food or medicine.’ With this, the full picture begins to emerge and we’re able to route this critical information back to the care team to intervene.”
Under the Hood
At its core, Determined Health exists to form meaningful connections between people and between organizations to create the best possible care for older adults. They leverage community-partnered networks to drive engagement and reach high-risk, high-need populations.
“There are just too many gaps people are getting lost in,” says Steinberg. “We work with Community Based Organizations (CBOs), health systems, and health plans to bridge these gaps and provide a stronger ecosystem of care.”
Let’s say a health plan wants to address more social determinants of health (SDoH) among its members. Health plans don’t tend to have established volunteer networks that can reach out to their populations, but by partnering with Determined Health, they can create and train a network of volunteers through CBOs who can then reach out to folks, make calls, collect data, and most importantly, create trusted points of connection that identify needs all while reducing loneliness and its related health issues.
This partnership approach helps leverage new resources for a community. For example, one of Determined Health’s initial partners is Meals on Wheels. If a health plan partnered with the MoW volunteer network for these calls, they might identify people in need of regular meal services. Thanks to Determined Health’s safe, HIPAA-compliant platform, these different types of organizations can be married together to meet the needs of a shared population.
The person behind the technology to make this all possible is Charles Johnson II, Determined Health’s third co-founder. Johnson came from a more consumer-focused space but was won over by the mission-driven culture and determination to take on the biggest challenges in healthcare and solve them.
Johnson shaped the tech driving Determined Health to be almost invisible to the end user receiving the phone call, keeping the focus on the connection with another person. It’s a backwards-compatible approach, so that anyone comfortable using a phone can have the same access to resources as someone more comfortable with digital apps. This layered method lets them reach more people, particularly those at highest risk of isolation.
Their approach to technology mirrors their approach to care. Start with a simple phone call and build out analytic systems and interventions from there. Start with the connection first, and then as trust builds, the opportunities to assess health, coordinate care, and provide specialized medical help emerge. Determined Health flips the stack so that the person receiving care remains the focal point. It’s person-centered care born out of a real relationship, with a real person, and not just tacked on to an existing care model.
This past year, Determined Health built out its version 2 platform, signed deals with health plans and systems, and was awarded a Phase 1 SBIR grant to develop tools for people with dementia. As they head into autumn, they are looking to raise funds for commercial expansion in 2023 and to create virtual tools for the $39B dementia care space.
“We are going to have more people over the age of 65 than under the age of 18 for the first time in history,” says Kaiser. “This presents a great opportunity but we have to be aware of the challenges. We’re thinking big about how to meet the needs of this aging population, but starting small, with the individual. We want to know each person well with a broad base of connectivity and then layer on care so that people can live better and age better.”
Why We’re Proud to Invest
StartUp Health is thrilled to welcome Determined Health to our family of global entrepreneurs for several reasons. First, their strong co-founder team includes the right mix of expertise to meet the enormous challenge of the loneliness epidemic, especially for an aging population. By combining Dr. Kaiser and Steinberg’s deep health innovation expertise with Johnson’s consumer-focused tech experience, Determined Health is poised to meet the problem of loneliness with know-how and agility.
We’re also proud to invest because the solution Determined Health offers has already proven itself nimble, able to adapt to the needs of different populations across varied environments. Whether being utilized by community-based organizations, health systems, or health plans — from Hawaii to Maine — its emphasis on community partnerships means it utilizes and maximizes resources that already exist in a community, instead of having to build from the ground up every time. It easily scales up or down so it’s as useful to a small community as it is to a large health system.
Finally, we’re proud to back Determined Health because of how they put people front and center. This is authentic, person-centered care that understands the power of relationship in regards to wellbeing. From its simple design that allows anyone who can answer a phone call to participate, to the time spent building trust, to the customized care solutions it provides, Determined Health always comes back to the simple and transformative idea of building human connections.
And to that we say, welcome to the StartUp Health family, Determined Health!
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