Joe Kahn's parents were anti-apartheid activists who impressed on him the importance of fighting unjust systems from which he, himself, benefited. Kahn planned to follow their example by studying economics at Harvard and then returning to his native South Africa to improve early-childhood education.
But the year before leaving for college, Kahn got sick. "I was on my back for about a month with an extremely high fever, diarrhea, and vomiting," he says. "I never really got better." Undiagnosed, weak, and depressed, he went to Harvard anyway, hoping to avail himself of Boston medical facilities. But he was bounced around, unable to get answers. Hard as navigating the health care system was for him, Kahn thought, it must be far worse for those without his education and financial resources.
Kahn met Yasyf Mohamedali, an MIT student, through a pre-seed investment fund called the Dorm Room Fund. Mohamedali's parents were physicians in rural Canada. "They practiced very relationship-based, community-based medicine," Kahn says. "Everyone knows everyone else. You text the doctor when you need help." The two discussed replacing the complexity and frustration of patient management that Kahn had experienced with the kind of simple, personal interactions Mohamedali's parents were used to.
They zeroed in on Medicaid recipients, a patient population that often struggles to get consistent care because of language barriers and financial hurdles. Medicaid patients rely on the roughly 500,000 care managers in the U.S. employed by social-service agencies, community-based organizations, physician groups, and others to coordinate everything from scheduling their appointments to arranging their transportation to doctors' visits. A single care manager may be responsible for 250 such patients, whom they track with spreadsheets and sticky notes, often reaching out through phone calls that never get picked up. Last March, Kahn and Mohamedali launched Karuna Health, an online platform designed to more efficiently coordinate every element of a patient's care in one place.
Karuna (that's "compassion" in Sanskrit) integrates with customers' electronic medical record systems and lets users schedule appointments, organize transportation, and repeat messages to patients automatically, such as reminders to take medication. Patients can send and receive messages through email, text, phone, WhatsApp--how ever they are comfortable communicating. "For the care team, it is like a shared inbox to manage every single touch point with patients," Kahn says. "For the patient it is like texting a friend."
To date, the company has raised $1.3 million from First Round Capital and several other VCs. Phin Barnes, a partner at First Round Capital, says his firm is excited by the San Francisco-based company's potential micro- and macroeffects. "Karuna has the opportunity to have tremendous impact on the individual patient's experience of the health care system," Barnes says. "But also at the scale of the economy it has the ability to take cost out of the system by making it more efficient."
Karuna will initially pursue provider organizations, charging by the number of care managers. (It also plans to sell to insurance companies, for which use of the platform will be priced per patient.) Its first customer is Coordinated Behavioral Care, a nonprofit. The group provides support for more than 50 New York City health and human-services agencies that collectively serve more than 100,000 Medicaid recipients, many with mental illness. "Part of what we are trying to do with Karuna is to allow our care-management staff to be real-time connected to their folks as best as possible," says Jorge Petit, CEO and president of CBC.
Petit also expects the system, which will be implemented in the coming months initially on a limited basis, will make CBC more responsive. "If all this information being gathered on folks is residing in one place, we can intervene more quickly, better understand what is going on with that individual, and not be looking at data retroactively," he says.
The health care industry's shift from fee-for-service (which rewards volume) to value-based care (which rewards efficiency and quality) should help Karuna's prospects. But the fate of the Affordable Care Act remains unclear and the potential for new regulatory hurdles--particularly those related to privacy--could slow progress. "You can imagine a regulation that tries to force more and more communication to happen through secure patient portals," says Kahn.
Kahn's own health, meanwhile, remains uneven. "It does flare up, and it has an impact on my productivity and my mood and my energy," he says. "But I have an amazing support team."
Correction: An earlier version of this article misstated the origin of the company name, Karuna. It means "compassion" in Sanskrit, not Swahili.