Tech startup improves dementia care

JACKSON, Wyo – When Remo Health went live three months ago, it fulfilled a promise Jackson resident Matt LeKrey made to his father four years ago.

After years of navigating the complex world of caring for his father, who suffered from a rare form of dementia, LeKrey made a commitment to his father to improve the experience for everyone else going through it. Together with co-founders Will Poe and Jason DeCastro, LeKrey created Remo Health, a comprehensive digital platform that supports and engages dementia caregivers.

According to the World Health Organization (WHO), more than 55 million people worldwide suffer from dementia and 10 million new cases are diagnosed each year.

Dementia is currently the seventh leading cause of death among all diseases and a leading cause of disability and dependency among older people worldwide. Dementia has physical, psychological, social and economic implications, not only for people living with dementia, but also for their caregivers, families and society at large. There is often a lack of awareness and understanding of dementia, leading to stigma and barriers to diagnosis and care.

-World Health Organization; who.int

Despite these high numbers, Poe, a San Francisco internist with a master’s in public health, has treated dementia patients clinically and says many cases go undiagnosed because primary care physicians (PCPs) shy away from an actual diagnosis.

“Only 1 in 4 cases is diagnosed … often the GP doesn’t know what to do after the diagnosis,” Poe said. Having had a grandparent with dementia, Poe describes the illness as a one-way train ride. “With Remo we find out which train you are on and the length of the route. We talk to patients about their children and family and what is important to them. We want to save people emotional pain, stress and money.”

Because there are no standard treatments and medications for dementia like other diseases, it can be a particularly challenging experience for the patient and their loved ones, who are often faced with questions about the diagnosis, how to get to and from doctor’s appointments, and how to manage cognitive issues Confusing symptoms and figuring out how to pay for everything.

Prior to founding Remo, LeKrey had spent the past decade building apps for families struggling with chronic illnesses, giving him the technical background to complement his personal experience as a dementia caregiver. Through these past projects, LeKrey met Poe, whose grandmother suffered from dementia. The two bonded over the “problem that hides in plain sight,” as Poe described the lack of centralized care and support for dementia patients and their families.

They brought in DeCastro as co-founder and chief technical officer. A devoted programmer since he was 13, DeCastro had been developing digital products for the past decade but found the work he was doing didn’t matter much.

“I’ve cared for family members with illnesses, so I understand the issues,” DeCastro said. He wanted his work to make the world a better place, and Remo was a good fit.

Poe describes Remo as a “virtual geriatric center of excellence” where a group of brain health physicians help clarify a diagnosis and then stay with the person every step of the way, including prescribing and rejecting medications, avoiding slips, tripping and falling, handling memory, movement and mood, and assessing home safety.

building the business

In October 2022, Remo Health won the Panelist Choice Award, the grand prize at Silicon Couloir’s Pitch Day, where entrepreneurs pitch their companies to a panel of judges. It is the culmination of a three month process in which startups develop their business plan, pitch and marketing through coaching and practice from top business leaders in the region.

Matt LeKrey works to provide comprehensive, accessible dementia care. Photo: Silicon Couloir

Silicon Couloir is a Jackson-based nonprofit organization that aims to “align entrepreneurship with community vision to foster a diverse economy and healthy environment for current and future generations.” Their annual Pitch Day awards money and resources to winners so they can continue to grow their businesses.

“Silicon Couloir has been a wonderful community for us to find a way to not only meet people who have built businesses, but who have also helped us tackle the Intermountain West and shaped our history,” said LeKrey. Previously, LeKrey led Remo through gBeta Wyoming, an accelerator program that brings together entrepreneurs, investors, job seekers and others to create advancement opportunities in the business.

According to LeKrey, Jackson is a special and supportive place for entrepreneurs, where big names in business with access to money and resources live down the street. LeKrey also points out that many of the moguls who live in the Tetons have a friendlier, more supportive attitude.

“Everyone comes from a ‘How can we help?’ mentality that provides access to money, customers, talent and mentorship,” said LeKrey. “People have come out of nothing and tried to create opportunity … in a way that is without pretentiousness or arrogance or extreme bias that might come from bigger cities.”

This is how Remo works

Through the use of telemedicine, Remo hopes to bring world-class healthcare to all parts of the country, from rural areas to densely populated cities. Remo also hopes to support caregivers who are often overlooked in the current healthcare landscape. Online forums, mental health professionals and treatment guidelines are an integral part of Remo’s approach to care.

Physician visitation virtually eliminates the barrier of taking patients to the doctor for in-person visits, which is difficult when caregivers need to change their own schedules and take time off work. The support and involvement of caregivers – who often experience burnout with dementia – is key to making a patient’s final years healthier and more balanced overall.

“It takes a whole village to take care of one person with dementia,” Poe said. “We’re bringing this interdisciplinary village to patients and families virtually, so the ethos of Remo — it’s an empathy service.”

Dementia is a difficult diagnosis because, unlike cancer or heart failure, there are no drugs to treat the disease. The reality is that all patients will die from the disease or its associated complications. Therefore, priorities are shifting from treating the disease itself to constructing what the patient and their family will be like in their final years.

“With Remo, there is only one true medicine: truth with compassion. We are in a world that is largely beyond drugs. That’s not diabetes. This is not heart failure. We don’t have any effective drugs or cures for dementia,” Poe said. “What we have is the courage to step up to the plate and bring clarity to the diagnosis and give families agency and empowerment back. You decide how to live the final chapter of life.”

By bringing timely, specialized care to a patient’s home, Remo also helps with another problem faced by patients with dementia: reducing unnecessary trips to the emergency room. Often patients with cognitive impairment come in for the visit with no real medical reason, and a burned-out nurse doesn’t know what else to do.

While Remo Health is fully operational in California with 11 full-time employees, the company has expansion plans into Nevada, Arizona and beyond, aiming to fill health care gaps for rural populations, including Wyoming.

“I would appreciate it for people to know that if you or someone you love is struggling with dementia, you are not alone. You don’t have to do everything by yourself,” LeKrey said. “We are here to help. This is a promise we made to loved ones and we intend to keep it.”

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