Beyond annual checkups: A different approach to chronic care screening

Hypertension remains one of the most common and least visible chronic conditions in the US. Roughly half of adults have high blood pressure (1), and around 44% are unaware of it (2) - a gap that becomes especially costly in self-insured health plans, where chronic conditions account for the majority of claims and a relatively small segment of members drives a disproportionate share of spending.

That was the starting point for a recent conversation between Remi Koscielny, CEO of Shen AI, and Harry Soza, CEO of CAREMINDr: how do you identify people who need intervention before they become expensive emergencies?

Traditional screening approaches reach many of the already engaged. But they often miss the workers least likely to visit a doctor regularly, wear a device, or actively participate in wellness programs, especially in industries with distributed, mobile, or shift-based workforces.

The approach discussed in the webinar combines camera-based health monitoring with chronic care management workflows, turning a smartphone into a low-friction screening tool. The goal is not to replace clinical care, but to make early detection accessible to populations that traditional healthcare systems often struggle to reach.

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A system built for the visible

Almost 70% of covered workers in the US are enrolled in self-funded health plans (3), meaning employers and unions bear the financial risk of healthcare claims directly. Chronic conditions such as hypertension, diabetes, and cardiovascular disease are a major part of that burden. According to the CDC, 90% of annual healthcare expenditures are associated with people living with chronic and mental health conditions (4). 

The challenge isn't knowing how to treat hypertension. As Harry Soza put it: "We can fix hypertension if we get there earlier. There are protocols, there are care plans, it can work." The challenge is finding the people who need help before they become expensive emergencies.

Traditional tools like annual health checkups, questionnaires, or wearables reach only a fraction of the population, and rarely the ones who need them most. The 200 out of 1,000 who don't know their numbers tend to be exactly the people who don't show up to checkups and don't wear a fitness tracker. In some industries, like construction or trucking, the nature of the work means workers are constantly moving between job sites, never establishing a routine that includes healthcare.

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Smartphone as a health tool

This is where the combination of Shen AI's camera-based health monitoring and CAREMINDr's chronic care management platform changes the equation. Instead of dispatching hardware to every worker or hoping they'll show up to a clinic, the technology sits inside an app, and all it needs is a smartphone camera and 30 seconds.

Harry Soza said:

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"The thing that Shen's capability really unlocked was the opportunity to go population-wide. It would be impossible otherwise. What would you do - loan everybody a blood pressure cuff and have them return it?"

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That's the operational challenge many wellness and chronic care programs quietly run into. Wearables can work well for highly engaged users, but population-wide deployment is a different problem entirely. Employers and unions need something that works across thousands of people with different routines, income levels, schedules, and levels of health engagement, without requiring additional hardware, charging, calibration, or setup.

The first scan in the CAREMINDr program is completely anonymous. No name, no email, no personal information required. That's by design. Many of the people who most need to know their numbers are precisely the ones who are most reluctant to engage with healthcare. The anonymous scan removes the barrier. If the number concerns them, they can choose to enroll in a management program. If not, they can check again in a few weeks. The decision stays with them.

"These are grown-ups," Harry said. "They're holding down jobs, doing real stuff. If they choose to do things, that's their call."

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Privacy by architecture

One of the most common concerns when introducing health technology into a workplace is data privacy - and rightly so. Remi was clear about how Shen AI handles this: all processing happens in real time, on the user's device. Nothing is stored permanently, no information is shared. The facial image disappears the moment the scan is complete.

For workers who may already be skeptical of their employer's intentions, this matters. Trust doesn't come from policy documents. It comes from architecture that makes misuse structurally impossible.

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Measuring what matters

Once someone enrolls in the management program, CAREMINDr checks in every two days. The goal is simple and consistent: move people from above 140/90 (what they call the red zone) to below it (the green zone), and report that progress to the plan every month. As Harry described it:

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"We don't say we reduced hypertension by 11 millimeters of mercury systolic. We say there's a line. The line's been established by people who know why it's important. We're measured against that line."

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That clarity - one goal, one metric, reported consistently - is part of what makes the approach workable for employers and unions trying to understand whether a program is actually improving outcomes.

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A new default

What the conversation ultimately points to is a shift in how population health screening can work. Not annual checkups that miss the people who don't show up. Not wearables that mostly reach the already health-conscious. But something as simple and frictionless as checking your numbers the same way you'd check the weather - on the phone that's already in your pocket. Harry said:

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"Every adult should know their number. Even if they've never had a problem, they should be able to check once every couple of months just to make sure."

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For the 200 out of 1,000 who don't know they have a problem, those 30 seconds may be the first meaningful interaction with preventative healthcare they've had in years.

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Sources:

(1) NCHS Data Briefs, No. 511 Hypertension Prevalence, Awareness, Treatment, and Control Among Adults Age 18 and Older: United States, August 2021–August 2023

(2) WHO, Hypertension fact sheet

(3) Statista, Percentage of U.S. workers covered by self-funded health insurance plans from 1999 to 2025

(4) CDC Foundation, The costs of getting sick