Through a Local’s Lens: Tech startup improves dementia care
By Julie Ellison
Buckrail, November 29, 2022
Dementia is the seventh-leading cause of death worldwide. Photo: Nick Sulzer // Buckrail
JACKSON, Wyo. — When Remo Health went live three months ago, it fulfilled a promise that Jackson resident Matt LeKrey made to his father four years ago.
After years of navigating the complex world of being a caregiver to his father, who suffered from a rare form of dementia, LeKrey made a commitment to his dad to make the experience better for anyone else who had to go through it. Along with co-founders Will Poe and Jason DeCastro, LeKrey created Remo Health, a comprehensive digital platform that supports and engages caregivers of dementia patients.
According to the World Health Organization (WHO), more than 55 million people suffer from dementia worldwide, and 10 million new cases are diagnosed every year.
Dementia is currently the seventh leading cause of death among all diseases and one of the major causes of disability and dependency among older people worldwide. Dementia has physical, psychological, social and economic impacts, not only for people living with dementia, but also for their carers, families and society at large. There is often a lack of awareness and understanding of dementia, resulting in stigmatization and barriers to diagnosis and care.
—World Health Organization; who.int
Despite those high numbers, Poe, who is an internist in San Francisco with a masters in public health, has treated dementia patients on the clinical side and says many cases go undiagnosed because primary care providers (PCPs) shy away from an actual diagnosis.
“Only 1 in 4 cases gets diagnosed…often the PCP doesn’t know what to do after the diagnosis,” Poe said. Having had a grandparent with dementia, Poe describes the disease as a one-way train ride. “With Remo, we figure out which train you’re on and how long the track is. We talk with patients about their kids and family and what’s important to them. We want to save people emotional pain, stress and money.”
Since dementia doesn’t have standard treatments and medicines like other diseases, it can be a particularly challenging experience for the patient and their loved ones, who are often saddled with questions of what the diagnosis means, getting to and from medical appointments, dealing with confusing cognitive symptoms and figuring out how to pay for everything.
Prior to creating Remo, LeKrey had spent the previous decade building apps for families struggling with chronic illness, so he had the technical background to supplement his personal experience as a dementia caregiver. Through these past projects, LeKrey met Poe, whose grandmother had dementia. The two connected over the “problem hiding in plain sight,” which is how Poe described the lack of centralized care and support for dementia patients and their families.
They brought on DeCastro as co-founder and chief technical officer. A devoted coder since the age of 13, DeCastro had been building digital products for the previous decade but felt the work he was doing didn’t have much meaning.
“I’ve been a caregiver 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 doctors help clarify a diagnosis and then stay with the person every step of the way, including prescribing and deprescribing medications, preventing slips, trips and falls, handling memory, movement and mood and evaluating home safety.
Building the business
In October 2022, Remo Health won the Panelist Choice Award, the top prize at Silicon Couloir’s Pitch Day, where entrepreneurs present their businesses to a panel of judges. It’s the culmination of a three-month process where startups develop their business plan, pitch and marketing through coaching and practice from top business leaders in the region.
Matt LeKrey is working to provide comprehensive, accessible dementia care. Photo: Silicon Couloir
Silicon Couloir is a Jackson nonprofit that aims to “align entrepreneurship with community vision to promote a diverse economy and a healthy environment for current and future generations.” Their annual Pitch Day awards money and resources to the winners so they can continue to expand their business.
“Silicon Couloir was a wonderful community for us to be able to find a way not just to meet individuals who had built companies, but also who helped us address the Intermountain West and helped us shape our story,” LeKrey said. Previously, LeKrey had taken Remo through gBeta Wyoming, an accelerator program that brings together entrepreneurs, investors, job seekers and other individuals to create advancement opportunities in business.
LeKrey says Jackson is a special and supportive place for entrepreneurs, where large names in business who have 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 more friendly, helpful attitude.
“Everyone comes from a ‘How can we help?’ mentality, providing access to money, customers, talent and mentorship,” LeKrey said. “People have come out of the woodwork trying to help provide opportunities…in a way that’s without pretension or arrogance or extreme bias that might come from bigger cities.”
How Remo works
Using telemedicine, Remo hopes to bring world-class healthcare to every part 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 guidance are integral to Remo’s framework of care.
Seeing doctors virtually removes the obstacle of getting patients to the doctor for in-person visits, which is difficult when caregivers must rearrange their own schedules and take time off work. Supporting and engaging caregivers—who experience burnout at a high rate with dementia—is a key to making the last years of a patient’s life more healthy and balanced overall.
“It takes a village to take care of a dementia patient,” Poe said. “We bring that interdisciplinary village to patients and families virtually so the ethos of Remo—it’s an empathy service.”
Dementia is a tough diagnosis because unlike cancer or heart failure, there are no medicines to treat the disease. The reality is that all patients will die from the disease or associated complications, so priorities shift from treating the illness itself to constructing what the patient and their family want those last years to look like.
“There’s only one real medicine at Remo: truth with compassion. We’re in a world mostly beyond medicines. This is not diabetes. This is not heart failure. We do not have effective medicines or cures for dementia,” Poe said. “What we do have is the courage to step up to the plate and give clarity on the diagnosis and give agency and empowerment back to families. They get to decide how the last chapter of life wants to be lived.”
By bringing timely, specialized care into a patient’s home, Remo also helps to another problem among patients with dementia: reducing needless trips to the emergency room. Often patients come in with cognitive impairment and no true medical reason for the visit, and a burned-out caregiver 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 for Nevada, Arizona and beyond, with the goal of closing gaps in healthcare for rural populations, including Wyoming.
“I would love 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 alone,” LeKrey said. “We’re here to help. This is a promise we made to our loved ones and one we intend to keep.”