Great coaching depends on presence. It lives in the moments when a coach feels grounded, connected, and fully present with the person on the line. When we built our health coaching care management platform, Gladstone, that was the goal: to create a workspace that supported human connection and coaching workflows that drive behavior change at scale.
Before this work, we couldn’t find anything on the market that truly fit what we needed. EHRs were built for billing. CRMs were built for pipelines. And none of them were designed for the daily realities of remote patient monitoring (RPM) or the kind of biometric-to-conversation flow our coaches needed. We explored RPM-specific platforms, but none were designed around conversation, trust, and patient-centered change.
So we built our own.
Together, these changes would later drive a 300% increase in coach efficiency, a nearly 70% increase in engagement, 96% participant satisfaction, and sustained net churn below 2%.
How it started
The original care management platform that the coaches were using worked, but only just. It was slow, glitchy, and full of tabs within tabs. Coaches had to fight the interface to stay present, and the whole experience made conversations feel more like checklists than real human moments. You could hear it in the recordings… long pauses, disrupted flow, and questions that skimmed the surface because the platform wasn’t supporting deeper connection.
Coaches were doing their best inside a system that wasn’t built for the kind of care they were trying to deliver. They needed clarity, not friction.
It became clear that the problem wasn’t one screen or one workflow. It was the foundation.
Rebuilding the platform from the inside out
We didn’t try to patch things. We rebuilt Gladstone from the ground up.
A new database.
A new architecture.
A new mental model for how coaching should flow.
A completely reimagined UI and UX.
We started with how real conversations unfold… what coaches need in the moment, what helps them stay present, and what gives them confidence. Then we designed every feature around simplicity and clarity so the technology supported the relationship instead of interrupting it.
The result wasn’t an update. It was an entirely new platform.
A communication system built for connection
One of the earliest changes was creating a communication environment that let coaches stay in one flow. The Omnichannel Engagement Center brought together phone, SMS, email, and in-app messaging into a single workspace that matched the cadence of coaching.
It unified:
- Phone calls
- Text messaging
- Secure in-app chat
Coaches could reach patients through any channel without switching tools. Automations handled reminders and check ins, but everything still sounded like a human because coaches wrote the templates in their own voice. If a patient replied, automation stopped instantly and the coach stepped back in.
It scaled outreach without losing authenticity. Conversations felt warmer, and follow-through became easier. Overall engagement increased by 67%, and patient touch points grew by 50%… without adding manual work for care teams.
A RPM dashboard that feels intuitive
To truly support people with chronic conditions, coaches needed a clear view of each patient’s health over time… not scattered numbers across different systems.
Gladstone integrates:
- Verified clinical data through national Health Information Exchange Networks
- Real-time device readings from cellular BP cuffs, glucometers, weight scales, and pulse oximeters
Everything shows up in one clean dashboard. Coaches can see:
- Daily and weekly averages
- Meaningful trends
- Out of range values
- Patterns that need attention
This shifted our team from reactive to proactive care. Coaches could spot changes early, ask the right questions, and help patients understand what was driving the pattern behind the numbers.
It’s simple, data-driven, and designed around human conversation.
A HEDIS Goals Service that translates clinical complexity
Most coaches aren’t clinicians, but they guide behavior change that directly affects clinical outcomes. They needed a way to prioritize the right things without becoming overwhelmed.
The HEDIS Goals Service pulls together:
- Electronic health record data
- Insurance claims data
- RPM readings
- Self-reported information
The system calculates which measures are off track and surfaces exactly what action will help. Before each session, coaches can see:
- Which screenings are due
- Whether blood pressure or A1c control is slipping
- Where medication adherence may be a concern
It makes every session more focused and aligned with provider expectations while still feeling personal and patient-centered.
And those who engaged in the program for 2+ years, this system enabled health coaches to help 85% of hypertensive patients achieve blood pressure control and drive a 1.7-point reduction in HbA1c among patients with diabetes… achieving HEDIS performance that surpassed national averages.
SMART Goals that connect behavior to outcomes
Progress doesn’t come from one big change. It comes from a thousand small ones.
Gladstone includes a SMART Goals module that prompts coaches to guide patients through setting goals that are thoughtful, achievable, and meaningful. The structure helps coaches ask better questions, align goals with what matters most to the patient, and facilitate a more focused, productive conversation rather than a checklist exercise.
Patients can track progress in the app, message their coach, and reflect on what moves them forward. Coaches can see updates directly in the workspace, making each session more connected to the last.
Behavior change becomes visible and encouraging… not abstract.
An alerting model that keeps people safe and supported
Monitoring thousands of device readings means nothing if you don’t respond well. We built an alerting system that balances safety with calm.
Every reading is evaluated automatically. From there the system determines if it’s:
- A critical alert requiring immediate clinical action
- A sustained trend that needs coaching support
Critical Alerts
Clinicians are notified instantly, with provider information and patient context. Patients receive an immediate message with simple instructions… what the number means, what to do, and what to expect. No one waits in uncertainty.
Sustained trends
If someone’s two-week average drifts out of a healthy range, coaches see it in the Global Patients View and the RPM dashboard. They get the full pattern… not just a red flag. It guides targeted conversations and earlier intervention.
Together, this approach, paired with ongoing guidance from a board-certified health coach, contributed to 28% fewer emergency room visits and reduced acute utilization through proactive intervention.
A single view that lets coaches manage care at scale
The Global Patients View is the coach’s home base. It centralizes:
- Every patient
- Every message
- Every reading that needs attention
- Every reminder
- Every sign of disengagement
Coaches can instantly see who needs outreach, who hasn’t tested recently, who has a concerning trend, and who is thriving. It’s how a complex caseload becomes manageable, predictable, and human.
Complex caseloads become manageable, predictable, and human. With the right signals in one place, coach efficiency increased by more than 300% without sacrificing connection or care quality.
The Impact
Rebuilding Gladstone changed how coaching felt.
Calls became deeper.
Coaches felt supported instead of stretched thin.
Patients felt understood and guided.
Coach efficiency increased by more than 3×, with care teams able to support larger, more complex caseloads while increasing patient touch points by 50%, without sacrificing presence or connection. And in doing so, they delivered measurable improvements in population health outcomes.
And the numbers reflected it:
- NPS: 82
- Participant satisfaction: 96%
- Net churn: <2%
- Blood pressure controlled: 85% of hypertensive patients
- HbA1c reduction: 1.7-point decrease among diabetic patients
- Estimated total cost of care reduction: ~$7,000 PMPY
Gladstone didn’t just streamline workflows. It reshaped the patient and clinician experience around clarity, trust, and presence… creating a foundation that allows coaches to do their best work and supports better health outcomes at scale, across patients, programs, and partnerships nationwide.