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Startup Spotlight: Care Daily
LF13 | Can this customizable AI platform solve the paradox of agetech?
Looking Forward’s Startup Spotlight profiles an emerging innovator operating in the healthy longevity, impact and / or Web3 space. Looking Forward Premium subscribers can access bonus material here. Note: David Moss is a premium subscriber to Looking Forward - no other disclosures.
The promise of technology to keep people living at home longer on their own terms is a Northstar for many, myself included. This goal is nearly universal, vitally important, and largely missed.
The agetech paradox
For decades now, companies have tried their hands at techifying homes for ‘aging in place’, mostly just burning money and goodwill. A CEO of a struggling US senior-focused sensor company told me about 10 years ago that his company and this sector was doomed, because it wasn’t until someone had their first major fall that they could be convinced to (allow their kids to) install the gadgets. And then they would have too limited a “lifetime value” for the service-based business model to work.
This is the paradox of agetech. If a product is clearly designed for an older adult, they don’t want it. There are various ways around this. The ideal is probably to make your solution both incredibly well designed and incredibly easy to use, making ownership aspirational. This is hard to pull off, and those who win here (e.g. Apple) subtly sell billions to the older demographic in addition to other demographics, while mostly avoiding the stigma. Another way around it is to dive into healthcare - a doctor’s recommendation generally overcomes qualms, or for customers struggling with cognitive impairment, the buying and installing decisions are largely made by others. Care Daily has chosen a third way.
Delegating marketing to the channel
Care Daily has taken this paradox to heart, and is not trying to be a B2C play, instead working with channel partners who do the heavy lifting around marketing and distribution. Its brand partners can each decide how they want to make the product sound aspirational, not a chore.
For example, Quil, a JV between Comcast and Independence Health, is one of Care Daily’s channel partners - they white label the Care Daily product. Quil’s B2C marketing videos smartly aim to make this about regaining control, not losing it. They position Quil as the way in which older adults can be more independent, sending the message that their overly attentive kids should ‘stop hovering and start Quilling’. This allows Care Daily to avoid the expense - and possibly stigma - of building a B2C brand in this space and relying on consumer education or behavior change to happen on someone else’s dime. Care Daily has a number of other as yet unannounced brand partnerships - currently their B2B customers “are directly targeting or have access to over 31M homes”.
An agetech quintuple threat
In terms of the product itself, Care Daily is a “customizable home health AI platform that combines AI with Internet of Things products, to deeply personalize the delivery of senior care services through large brands.” There’s quite a lot there to unpack….
As a platform play, Care Daily doesn’t lend itself to easy categorization. Point solutions, like fall detectors and wearable monitors, do one thing, but Care Daily is building a platform to aggregate data and turn it into insights designed to help someone stay at home. The company ticks a lot of ‘Ideal Agetech Product’ boxes: Keeping people at home longer: ✅ AI: ✅ Personalized offering: ✅ SaaS: ✅ Open platform: ✅ Channel partnerships: ✅.
This may seem like a lot of buzzwords, but the company is more than just the sum of its parts. Led by its affable and long-serving CEO David Moss, the company comes across as authentic, mission-driven and genuinely collaborative, not just out to make a quick buck. And more importantly, the company can point to impact on the stress and sleep quality of caregivers (see below), and have traction and endorsements from influential brands in the space such as Comcast and Georgia Tech.
A recent pivot to age-tech
David Moss got into agetech by accident. An app he’d developed that turned smartphones into security cameras was being used by a small number of customers to keep tabs on their elderly relatives. The life-changing nature of the stories he encountered convinced him to pivot his IoT AI company (called People Powered at the time) fully to ‘age-tech’. While David, the company and the team has been around since 2009, it’s only in the last few months that they’ve rebranded as Care Daily.
I found out about them because they won the Aging2.0 OPTIMIZE Global Innovation Search in Louisville, KY last October. David presents well - he’s a dyed-in-the wool technologist who can geek out on AI stacks but grounds his narrative in humanity. He focuses on the Why; why it matters for older adults, their caregivers and society. His Why is about helping people remain independent as they age - not just surviving but thriving atop Maslow’s pyramid. As far as categories go, rather than aging in place, he prefers ‘living at home’.
“Aging in place is what I’d do to a block of cheese or a nice steak, but not my grandmother”. - David Moss
This neatly highlights the inherent passivity of ‘aging in place’; all too common, the idea that we need to do things to older people, not design with them.
IoT is more about people than tech
For David, the tech is there to serve a purpose, keeping people as high up the Pyramid as feasible. To do this often requires social connection.
“The Internet of Things is actually not really about the things it turns out, it's, it's really about bringing people together and adding what feels like a virtual assistant to their team. So when I think about senior care services, this virtual assistant is actually an AI caregiver. And it really feels like there's somebody there who can talk with you who's observing what's happening behind closed doors, and letting you know who to focus on and why.”- David Moss
The AI bot starts small and evolves with needs
The core ‘product’ of Care Daily is really the interaction with the AI bot, which they call Arti, but can be renamed to suit. It’s not a fancy talking avatar, but a chat-based tool, guided by insights from the gathered data. Care Daily aims to start off simple, as a text message conversation partner, and then build up with sensor integration when the client is ready.
Scores on the doors
The AI engine develops personalized insights from the interactions - whether they’re conversations via text or feeds from Apple watch or movement sensors - and uses them to provide insights to the individual, the family and the care team, all of which can be tailored as relevant to the needs of the situation.
It builds up an overall Wellness Score, comprised of multiple subscores (see below) which can be used by a provider in a dashboard to prioritize clients, or by the individual or family themselves to better understand the situation.
A proven impact on caregiver stress and sleep
The company has raised over $7m from the NIH, and some of that went towards a randomized controlled trial in 2018 by UC Berkeley. This study found that the technology demonstrated a statistically significant improvement in caregiver stress and sleep.
“This is the first rigorous controlled study to see if we could keep the mental health of the caregivers from declining. What we found, after about 3 months with the system, is that the anxiety in the active group declined whereas the anxiety level in the controlled increased. These results were statistically reliable and fairly clinically significant.” - Bob Levenson, Ph.D., Director of the Psychophysiology Department at UC Berkeley
Customizable platform - an ‘App Store for places’
There are any number of AI-powered point solutions out there, whether for predicting falls, tracking motion or engaging in conversation, yet every home is different. Creating a one-size-fits-one is much easier with a system that can be personalized, designed to be an extendable platform in the way Microsoft or Apple have core operating system and developer partners creating apps.
The burden is often on the family to become expert systems integrators, stitching together disparate systems, most of which would not recognize that other products existed, let alone share data with them and provide a holistic view. David believes this could become a "platform for places", and has a Github library of ‘bots’ accessing their open APIs. He says their model allows people to build solutions “16x faster” than with non-SaaS methods. They calculate this from being able to “commercialize a new AI service from start to finish complete with mobile app and web UI support in less than 1 business week”, saying that this would normally have taken 3 months to build using traditional methods. David notes that their record is creating a complete tailored commercial solution for a client in one business day, and recounts one anecdote that should intrigue developers (and those paying their bills):
In fact, I personally created a new "stove safety" service to demonstrate to one of our partners. It would detect if the stove has been left on too long, start talking to people about it over SMS messages, send out push notifications, deliver in-app messages with conversational capabilities, it would escalate notifications outside of the home, optionally trigger the emergency call center, and eventually turn off the stove if someone confirmed they wanted it off or if nobody replied. I didn't fully commercialize it, but it only took less than 2 hours to put together. I'm the CEO - I shouldn't be doing this stuff - but it's that easy. The large company I demo'd this too was in shock, claiming they hired someone to do exactly this and that person has been working on it for "the past several months" without results.
David goes on to expand his vision of personalization - where each brand can create a unique ecosystem:
The future of healthcare is individualized healthcare. Our "AI Caregivers" can actually learn new tricks and obtain new personalities from our channel partners, each of whom want to provide completely differentiated services from every other brand. In other words, it's not just personalization for each patient or family, but we're enabling even broader personalization of the AI Caregiver and its supporting device ecosystem for each brand we serve. Our differentiator is to enable our partners to differentiate
Powering Georgia Tech’s care research
The Georgia Tech researchers are using Care Daily’s platform's ability to connect up devices and invent new AI bot services on top so they can test out solutions to problems they observe with aging in homes. Care Daily works with the following groups:
AwareHome - invent, deploy, and test new technologies and services
According to David, Georgia Tech are using Care Daily to “connect up devices, divide participants up into different organizations to support different researchers / data visibility, collect lots of data they can later analyze, create and deploy new AI Bot services for specific audiences, and validate outcomes that will lead to better aging”. They’re operating as full research partners and are helping Care Daily develop and refine their product.
Comparing it to an agetech benchmark, Lively
Picking startup success is hard, but it’s perhaps instructive to compare this to Lively, a promising, well-designed, professionally run, VC-backed, sensor-based aging in place solution who assets were sold to GreatCall in 2015 (disclosure: Aging2.0 was an investor). Care Daily has several advantages over Lively’s implementation:
No hardware. A huge reduction in logistics and costs.
B2B not B2C. Another huge reduction in costs for educating, behavior change and channel development.
A platform rather than a product. This can be extensible and rely on people outside the company to move innovation forward.
Emergency / falls alerts baked in from the start. Lively didn’t include them at the beginning, and its absence meant they didn’t have a core proposition.
AI. We’re a decade further along so this is unfair, but it’s likely that AI and machine learning will enable more useful insights and more usable data than Lively had to play with.
A decade of experience. Lively was one of the first startups to tackle this in the space, at a time when awareness of the issue and tech adoption was far lower than it is today.
Hindsight is 20:20 and this isn’t to say Lively made the wrong call at the time, but ten years of lessons shouldn’t be ignored. Lively had an excellent ‘voice’ and design ethic, and their LivelyGram - personalised printed messages from the family sent to the older adult - was, and still is, a genius idea. [As an aside, it would be great if previous innovators in the space had a place to share their hard won lessons learned…]
So, will it solve the agetech paradox?
Only time will tell, and a retrospective in 10 years will have the advantage of hindsight. What’s clear is that even in the last few months AI (e.g. via Open AI’s chatbot) has galloped into the mainstream, and it will be no time before we expect our tech to be smart, interactive and connected, and help us live our lives on our terms. Care Daily is aligned with these trends.
So as technology becomes increasingly seamless and commoditized the key risk is probably marketing - how successful they are at striking B2B channel partnerships with a differentiated product offer, and in turn how successful those partners are at overcoming the paradox. They’re raising funds now, and are now looking at another paradox - they won’t need the funds once they’re successful, but that’s when the VCs will be falling over themselves to fund them. I’m excited for their journey over the past few years, their elevating of the caregiver, and look forward to seeing them grow, and potentially overcoming both of those paradoxes.
Note: Premium subscribers to Looking Forward can access bonus material about Care Daily, including the deck, transcript, audio and video here.
Final note: Looking Forward to AI and caregiving…
David is focused on the here and now, and hasn’t shared his roadmap, but looking at the intersection of AI and caregiving, I’m excited for what we’re going to be seeing in the near future. A few scenarios could include:
AI bots collaborating and negotiating on behalf of you and your family
AI bots coaching and supporting you
AI bots befriending lonely people
The emergence of a new class of workers - OTs with coding skills to code bots in real time to meet the needs of their patients
This technology becoming a ubiquitous and invisible feature of buildings - making it available for all (so no stigma) and interoperable (so very cheap)
Development of a learning engine so you can see what kinds of recipes work for other people, and better-than-Amazon style recommendations for other people like you do this.
We should have a roundtable at some stage on the future of AI and caregiving, and David will surely be part of that. Let me know if you’d like to be part.
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