One of the biggest challenges facing assisted-living facilities is de-escalating and preventing behaviors exhibited by patients with Alzheimers or dementia. The high turnover of staff in these facilities makes it extremely difficult to learn the behavioral patterns of patients, which makes it harder to prevent or abate without the use of sedative medicines. 

To solve the problem, Scarlett Spring and Linda Buscemi created TapRoot, an automated platform and mobile application that uses artificial intelligence and behavioral pattern analysis to allow caregivers to de-escalate and prevent Alzheimers and dementia behaviors. 

Scarlett, CEO, and Linda, chief clinical officer, launched TapRoot in 2019 and were making tremendous progress. When Covid hit, however, it had a major impact on assisted-living facilities –– and therefore, TapRoot. Holding steadfast to their mission, to improve the lives of patients, their families and caregivers, they adapted, making necessary pivots to continue to fulfill the vision.

In this edition of Collective Conversations, Linda and Scarlett explained how TapRoot works, how they were forced to pivot during Covid-19, and how the StartupAZ Collective has been a huge help along the way. 


What is TapRoot?

Scarlett: TapRoot is an automated platform that provides a mobile application allowing caregivers to de-escalate and prevent Alzheimer and dementia behaviors. Our first target is related to behaviors within assisted-living facilities because that's predominantly where Alzheimers and dementia patients reside. But we do have aspirations one day of having an in-home version as well. 

The benefit of being able to automate is that we can run all kinds of outcomes, data, and demonstrate return on investment because data like this has not been available within the senior and assisted living community, even for insurance companies. So we see it as a real benefit for both the residents and their families, as well as insurance companies that could give this data to facilities so they can better care for their residents.

What prompted you to create TapRoot?

Linda: I have been doing this for about 10 years from a consulting standpoint. I actually worked for a health plan prior where we would see escalated behaviors from someone who has Alzheimer's or dementia. And what would end up happening is we'd have to send them out to a higher level of care. So if they're at home, we'd have to put them in assisted living or even a hospital. That costs a lot of money from a health plan perspective. 

We were looking at ways to decrease that cost. So, we developed these behavior programs where we train staff on non-pharmaceutical methods to prevent or decrease Alzheimer's adverse behaviors based on 25 behaviors we identified. 

There are things that you can say and do to help prevent and reduce those types of behaviors in patients. Overtime we started noticing there's patterns and there's ways that you can actually inform a caregiver on things to say, or not say to prevent these behaviors. This was all being done manually and I thought we could do it from an algorithm standpoint and train the algorithm to ask questions like a therapist does. For someone with Alzheimer's dementia, we ask questions like,”Where is it happening? What are they doing? Are they yelling? Are they kicking?”

All of those things are indications for what they're trying to tell you but can’t express because they don't have a short-term memory. We've been able to see that type of pattern and come up with an intervention that has successfully prevented or reduced these types of behaviors. So we're now taking this manual process that I've been doing for a decade and automating it.

There's a very high turnover of caregivers within these assisted-living facilities. It’s a modest paying role and there is a high degree of burnout. So you don't get a lot of knowledge transfer that goes on with the patient. That’s why we are providing a digital assistant in the form of a mobile application, which could store this information so even if you hired a brand new caregiver, they very quickly could come up to speed on the most common behaviors this particular individual displays and the best techniques to calm them down, and de-escalate that behavior so that they can provide the best care possible.

How long have you been building the company?

Scarlett: During the first quarter of 2019, we began working on a proof of concept. After about eight months of loading in data, our first proof of concept point demonstrated the behavior of resisting showers, and we had about a 98% likelihood of selecting the proper intervention to de-escalate the behavior. That gave us some confidence going into early 2020, which we needed to continue to go forward. Fast forward into the first quarter of 2020, we looked again at the data and saw that we had been able to reduce psychotropic medications by 13% in this patient population.

That gave us our second target that we knew we were on track. And from that we've really been going as fast as we can. We launched our MVP into assisted living facilities and got our first user feedback. We’ve since started developing our second-generation mobile application, which we plan to deploy in 2021.

Has Covid-19 had any impact on TapRoot’s growth?

Linda: There's no doubt about it. Around March, I wasn't able to go into the facilities any longer, which was fine because I trained the caregivers via Zoom or phone. It's all about the caregivers and they got a lot of phone calls from the families, saying, “We can't go in. We don't know what's happening with our loved one.” You always want to be able to give an appropriate update to the family member. So we actually created a family update within our mobile app that will send a push notification to the family that tells them how their loved one is doing and what activities they did each day. For example, it might say they ate 90% of their meal, things like that. 

What was one of the biggest challenges that you've had to overcome in growing and scaling the business?

Scarlett: I will say COVID was tough. We unfortunately did lose some patients during that process, which is  always very, very, very tough. You really get to know these patients via the caregivers who are interacting with them every day. The caregivers were extremely stressed.

Second, facilities have been overwhelmed. So it's very hard to have additional conversations right now. Facilities are just starting to be willing to pick up the phone, so we are finally able to have a little bit more of a dialogue with them. If Linda had not already had such a reputation in the space and facilities that she was working with, it would be very difficult to get new facilities since they're totally overwhelmed. 

What's been one of the best things that has happened so far?

Our tech team is just outstanding. During the summer, we made a decision to build the second-generation mobile app. We're very happy about that. Not only were we able to get our mobile app, we were able to get the web application and a whole series of reports designed, which will be a part of our product offering. That part has been a real opportunity for us.

What prompted you to join the StartupAZ Collective?

Scarlett:  I feel so fortunate to be a part of this group. My background has really been in big pharma medical devices and diagnostics. The opportunity to be in this group, which is very technical based, very SaaS based, has been a blessing for me because the business is different. So I'm a little bit of a hybrid. We're really at the intersection of health care, AI behavior health, and clinical management. 

It has been so helpful to have colleagues in the Collective who I can learn from. I can share the knowledge that I've acquired over my career and develop some real friendships. I'm just thrilled to be a part of it.

What is one of the best things that has come from being a part of the Collective?

Scarlett: The people, by far. If you send out a note to this group asking for a suggestion, you get five to seven responses very quickly that are exactly what you're looking for. It is so valuable when you have people that are in the trenches. Secondly, the individuals who are in mature companies, who have either had an exit or are well down the path of scaling their companies, have opened doors for me. They have reached out to me personally to see how they can help me. I've never had anything like that. I'm in what I'd like to consider the middle part of my career but I’ve never had people send me an email saying, “Scarlett, let me know how I can help you. Just shoot me a time and we can talk for 20 minutes.” And that is fabulous when you have those kinds of people who have done it –– or are doing it right now –– open their Rolodex and open time. I love it.

What’s next for TapRoot?

Linda: We’ll be deploying the mobile app in all five of our facilities, which is really exciting. We're working with the company right now to have our training library up and ready to go. We have the training ready, but I'm actually showing the caregivers and the executive directors how to really utilize that, which helps them save costs because it’s really hard to send staff out to trainings. So we made these training sessions into three-to-five minute vignettes, so they’ll have it right at the palm of their hand. 

What advice do you have for other Arizona startup founders? 

Scarlett: First, surround yourself with talent. When you're a startup, you don't have any money to go hire that talent. So look for groups that you can surround yourself with and create camaraderie with people who are talented in the space. And recruit an advisory board.

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