Karuna

Karuna’s teams of remote patient guides free families from the administrative burdens of navigating the healthcare system.

In 2013, Joe became seriously ill. When Yasyf and Joe met in 2015, it became clear that their shared experiences could become a platform for helping others.

Yasyf is the son of a surgeon, and has seen what it’s like to navigate the healthcare system with a doctor in the family. Joe is a South African, far from home, who has seen what it’s like to navigate the system alone.

But what if no patient had to be alone? What if every patient could have a guide like Yasyf’s father? Someone to cut through the administrative burden, support clinical decision making, and get them back to health?

The worst part of being seriously ill is the helplessness and isolation. Of being passed around a system that doesn’t understand us, our values, or our preferences. That treats us like just another broken-down car on a production line.

And it doesn’t help that when we’re at our most vulnerable we’re told to wait on hold, fill out yet another form, or fight with our insurance plans.

Karuna's teams of remote patient guides free families from the administrative burdens of navigating the healthcare system. Behind the scenes, we leverage automation and a proprietary CRM to achieve unparalleled labor efficiency, patient engagement, and improved health outcomes.

You can think of Karuna like a customer service layer for the entire healthcare system. Rather than coordinating separately with all of the different groups involved in their care, patients and families can rely on us to manage those relationships for them. We handle the administrative burden of being sick so that patients don’t have to.

If there’s something the patient needs done (e.g. scheduling an appointment, ordering a refill, or negotiating a claim) we’ll do it for them. If they don’t know what they need, we’ll guide them (e.g. by routing them to the appropriate healthcare services or explaining research). And if they just need someone to watch over them, we’ll be there (e.g. by getting to know each patient as an individual and building relationships with them).

Healthcare is changing. Hospitals and independent practices are being disaggregated, medicine is becoming increasingly personalized, and we’re seeing unprecedented levels of verticalization. Which begs the question: who will own the entry point to consumer healthcare spending? As the complexity and number of decisions we make about our health explodes, who will route patients to the right care at the right time?

We believe that earning the right to guide patients through the healthcare system of tomorrow requires beautifully aligned incentives, trust, and human connection.

Today we’re focused on freeing patients from the administrative burden of being sick. That positions us as a layer of aggregation between patients and the healthcare services they need. Tomorrow, we’ll be the trusted guide for every patient. The first solution to ever aggregate market power and advocacy on behalf of patients.

On its own, this model isn’t unique. Care coordination is widely used throughout the healthcare system and has a proven, meaningful impact on cost and quality.

What makes Karuna different is that we’re scaling this model by leveraging automation, workflow tools, and human-in-the-loop AI, to support our guides. All of our technology is devoted to making our guides as efficient as possible so that they can maximize time interacting with patients and minimize time doing back-office work, filling out forms, or waiting on hold.

The key components of our tech include:

1. HIPAA-compliant text messaging, video, email, and chat for patients to communicate with their guides.

2. NLP to programmatically structure text, record important information, and triage requests..

3. A CRM which includes data on the patient’s preferences, goals, insurance plan, care team, and medical history.

4. Queues which intelligently route tasks from patients to the most appropriate guides.

5. Templating tools for dealing with common requests.

6. A predictive engine which highlights likely queries ahead of time and generates appropriate answers.

7. Automation tools which handle common workflows such as scheduling appointments, waiting on hold and filling out forms.

We will run a pilot with up to 1000 patients, leveraging online advertising, paid patient influencers, and referrals from specialists and primary care physicians. We’ll be focused on acute surgical procedures, recently-diagnosed chronic patients with multiple comorbidities, and pediatric autoimmune, cardiovascular, neurological, and oncological disorders.  

What matters right now is showing that we can get patients to engage deeply with the service, minimize churn, and maintain an incredible net-promoter score.

Once we deliver an incredible experience and demonstrate the potential for decreasing costs and increasing quality, we’ll be positioned to fundamentally change the way patients interact with the healthcare system.

Once we’ve built up meaningfully sized member populations in local geographies, we’ll be able to subsidize direct-to-consumer patients and make the price accessible to all. We hope to one day offer the full suite of Karuna’s services for free to those in need. This can happen once we have sufficient data (so that we can appropriately automate) and market power.

As we grow and expand, we'll tackle clinical burdens as well as administrative. In the limit, we aim to aggregate patient advocacy, and force patient-centered care on health systems worldwide. We will be the solution to misaligned incentives in healthcare.

To acquire our first 1000 patients we’ll be leveraging online advertising, paid patient influencers, and referrals from specialists and primary care physicians. We then move to distribution partnerships, with self-insured employers, integrated health systems and ACOs, and/or payors. In all cases where we’re accessing patients through a partner, maintaining the relationship and incentive alignment is key. The degree to which we can become an aggregator in the long term will be determined by the trust we earn, and the transparency and integrity we display.

We are currently piloting the hands-on human care coordinator design with a handful of patients. It has not yet been long enough to measure the impact. In the interim, we refer to the many studies, including those of David Meltzer, which conclude that higher-touch engagements with patients involving care coordination results in better outcomes across the board.

Within 12 months, we hope to be working with 1000 patients. We will be serving as their concierge care coordinator for any administrative task. If there’s something the patient needs done (e.g. scheduling an appointment, ordering a refill, or negotiating a claim) we’ll do it for them. If they don’t know what they need, we’ll guide and route them.

We’ll be focused initially on on pediatric autoimmune, cardiovascular, neurological, and oncological disorders.  

Within 3 years, we will have done a public launch, and will be serving hundreds of thousands of patients across multiple geographies, handling both administrative and clinical coordination. 

Joe is a computer scientist by training, but has extensive experience and background in health IT and health policy consulting, as well as product management. Yasyf has years of engineering experience, including building automation tools and data pipelines in several industries that are similar to healthcare. Both Yasyf and Joe has started companies in social good spaces in the past, and have experience growing teams beyond the initial founders. We have an incredible network of hospital administrators, policy leaders, investors, founders, and physicians to draw knowledge and inspiration from.

We’ll start as a direct-to-consumer subscription service. Direct to consumer healthcare is unbelievably difficult, as patients aren’t used to (or able to) pay for services, the cost of acquiring customers at the right point in time is high, and the need isn’t often recurring. Howevr, it allows us to learn as quickly as possible without navigating the sales cycles or perverse incentives of working with payers or providers in a fee-for-service world.

Ultimately we want to be able to route patients to the right health services and providers for them.  If we’re able to take a percentage of revenue for successful referrals of our patients to the right services, and tie that revenue to the real world health outcomes of our patients, we’ll be able to generate an extraordinary level of revenue.

Before we’re able to get to the scale necessary for lead-gen, we’ll be well positioned to offer brokerage services. In these cases, patients can list us as a broker in Medicare Advantage and commercial markets, effectively allowing us to receive a percentage of their premiums and provide our services at a subsidized cost or for free. This requires that we also assist patients in finding the right plans.

After witnessing the incredible work the Solve community is working on at the recent event, we were inspired to apply. We want so desperately to change this slice of the healthcare world, to force the system to return to a patient-centric model, and to fix the user experience of care. This is an enormous undertaking, and we could use all the support we can get. The ability for the Solve community to help us, with brand, connections, and finances is an incredible opportunity to make our dream a reality.

Our biggest struggle is finding a sustainable business model at every stage. We know how to get things off the ground on day 1, and we know what the business looks like in the limit, but in between that, we would love to be able to serve a wide, diverse population, at an accessible price and with integrity that reflects the trust instilled in us. However, we need to do all this while continuing to grow the business. Guidance as we go through this would be invaluable, and the Solve network has the experts to help us do it!