Start-up No More

A merger brings promises of expansion for Humboldt's revolutionary, patient-centered palliative care company


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Resolution Care, Humboldt County's groundbreaking palliative care company, has been sold to Vynca, an advanced care planning technology company, in a merger that Resolution Care founder Michael Fratkin hopes will ultimately allow for a national expansion of the patient-centered care the company has prided itself on providing.

Founded in 2014, Resolution Care's palliative care teams rely heavily on telemedicine to help people live out their lives comfortably and on their own terms in the face of serious — often fatal — illness. With patients and quality of life as its focus, Resolution Care provides a litany of services, viewing healthcare not as a simple matrix of treatments and medications, but of desired outcomes with the goal of giving people the highest quality of life. As such, the company does everything from helping its patients fight housing insecurity to getting to the grocery store to navigating healthcare services and making end-of-life plans.

Vynca, meanwhile, was founded in 2013 to create technology and analytics to help patients and providers document and share end-of-life planning documents, reducing medical errors, adverse efforts and unwanted healthcare utilization, according to a press release.

Fratkin said he's confident the merging of Vynca's engineering and software know-how, as well as the deep relationships the company has forged with healthcare systems throughout the country, with Resolution Care's model for the delivery of patient-centered care will be a perfect marriage, allowing more people to get the personalized care they deserve.

"The hope is to partner and collaborate with hospices around the country, as well as other palliative care programs," he said. "What we bring is the ability to take care of the actual people who have the actual illness and the actual challenges to their lived experiences. What they bring is business intelligence, relationships and a hunger and thirst to finance growth."

Ironically, Fratkin said the COVID-19 pandemic has pushed Resolution Care forward and, to some extent, proven the efficacy of its model.

Since its inception, Fratkin said Resolution Care did about 40 percent of its contact with clients through video conferencing, mostly out of necessity as it worked to reach patients across the region, some of whom live in remote areas. At the time, it was groundbreaking.

"Nobody had used telemedicine for home-based palliative care delivery — we were the first," Fratkin said, adding that it was an idea he "stumbled across" after noticing "this smart phone in my pocket might be a really good tool for treating people." Over time, Fratkin came to believe video was often more than just a "really good" tool for treating seriously ill patients — it was a happy medium between the clinical confines of medical offices that left patients feeling like numbers and the in-home visits that could impose additional stresses on their lives and leave providers emotionally drained.

When shelter in place became the law of the land last March, almost all of Resolution Care's client contacts shifted to video. Fratkin said the company found the model to be both more efficient and equally effective.

"Allowing people to be in their home and reaching them through technology allows them to stay put and not to burn gas and to actually be in their natural habitat, and that's a big deal," he said. "From an organizational perspective, not having our staff driving from place to place to place — that's also enormously valuable in building a workable, sustainable and efficient system."

Connecting with clients through a digital "window" also allows care providers into patients' homes without invading their space or dragging them into a clinical environment, both of which can cause undue stress, Fratkin said.

"We've taught our staff to be extremely nuanced and intentional in how they use the time they have with the people we care for, so we get a lot of intimacy without the breakdown of the boundary between us and them," Fratkin said, adding that it also allows staff in a profession with extraordinarily high burnout rates to work from spaces they find nurturing, relaxing and sustaining. "That's been better for our staff members as they cope with the challenges and stress of working with sick people that, for the most part, they really, really like. It's a safe and sustainable way to approach people who are going through unbelievable amounts of crisis and difficulty."

Over the past year, Fratkin said the company has expanded to caring for about 180 people to 230 with essentially the same staff, while its two main measures of quality — patient satisfaction and the avoidance of unwanted acute care — have held steady or even improved.

Fratkin said its been "validating" to watch the use of telemedicine expand exponentially in response to the pandemic, saying it's also opened up some teaching opportunities for him locally. One of those came as Open Door looked to expand its video care, both to serve its patients and retain revenue streams.

Open Door CEO Tory Starr said it already had the technology to do so but needed to learn from experienced care teams the best practices of treating patients remotely.

"Resolution Care conducted a series of 'lunch and learn' presentations with our care teams to provide their learnings from doing this type of service delivery," Starr said in an email to the Journal. "They spent time with our teams in question-and-answer sessions so that they could help coach our teams with the challenges they identified through their own experiences doing this work."

From the outset of the pandemic, Fratkin said he began talking regularly with Vynca co-founder Ryan Van Wert, an old friend, about "what a serious illness management platform would look like if it had optimized technology and analytics" that helped a foundation of human-centered care providers.

"These two things together — human beings taking care of human beings with the best possible tools — is an idea where one plus one equals three," he said.

Resolution Care President Brian Mistler, who joined the company two years ago after working as a local hospital and healthcare administrator, was similarly bullish about the prospects moving forward.

"We're excited about the opportunity this offers to increase access to care for those living with serious illness, Mistler said. "By leveraging innovative technology, we can bring more care to individuals in need here in rural Northern California, across the state and beyond."

Under the deal announced last week, Fratkin will become Vynca's chief medical officer. And, Fratkin stressed, all local employees will be retained and the 230 or so current patients of Resolution Care will not see any changes.

"Everyone stays," Fratkin said, adding that the company will also be looking to make some new hires. "That was really important — that everyone who has been part of bringing us to this moment gets to stay and, I would say, their future is both brighter and more solid than it has been. It's nice not to be a start-up anymore."

Thadeus Greenson (he/him) is the Journal's news editor. Reach him at 442-1400, extension 321, or [email protected]. Follow him on Twitter @thadeusgreenson.



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