When you are discharged home from the hospital, you get a whole lot of information: a list of calls to make, visits to schedule, and prescriptions to fill.
All of a sudden, you go from this big machine, with case management handling the insurance calls and the home modifications, and therapists working on getting patients in and out of the house and the car, to one person now being case management, therapy, and nursing.
Dr. Ashley Blackington saw this handover again and again during her years as an occupational therapist in acute care and acute rehab, and watched the demands on caregivers rise. It led her to found Dovetail.
Tackling Caregiver Burnout with Dovetail Founder Dr. Ashley Blackington – Women Disrupting Tech
In this episode, she describes how the funnel to one person and the ongoing demand that follows lead to caregiver burnout, and how Dovetail tries to spread that load across a flock of helpers.
You’ll also hear how her Canadian upbringing influences how she builds Dovetail and Dr. Blackington’s recipe for involving more men in care duties.
In the end, our conversation is about much more than just helping people arrange the right care at home. It’s also about how solving the care problem benefits not only caregivers but also employers and society at large.
You can listen to the episode by pressing play below. Or keep reading for practical takeaways, highlights, and trends from the episode.
Practical Takeaways for Founders
Dr. Blackington is building Dovetail based in part on conversations she had with caregivers as part of her consulting business, Home Field Advantage. And the proceeds of Dovetail go to a foundation that enables people who lost their job or health plan to use the app. In that sense, she’s building a system where one component feeds into the next. Here are three things founders can take from how she’s building.
Giving people control makes helping easier
Dr. Blackington shares how her background helps her put the people who need care in control of what they ask for help with. One way this is visible is how information is shared only on a need-to-know basis inside Dovetail. This makes it easier for care recipients to ask for help as smaller tasks require limited information sharing. For helpers, it becomes easier to accept a task because they’re not overloaded with information either. In the end, that is also what makes it easier to share the care burden.
Put a knowledgeable human in the AI loop
When she explains how the AI output is checked, Dr. Blackington says that since she is both a founder and a clinician, it is easier for her to flag hallucinations by AI models. In her words: “If I read something that sounds like clinical language, but it’s completely fabricated, or completely hallucinated, I can tell the difference.” The founder lesson is to put someone who knows the domain in the review seat for AI output if they want to keep the quality high.
Start thinking about funding two steps before you need it
When I ask her for her views on FundingCoach, Dr. Blackington compares fundraising with caregiving, where people notice small signs before the need for caregiving arises. The signs that funding will be needed are often visible some time before the need for cash becomes acute. Founders can use those signals to set a goal and work their way backward on what steps they need to take to get there.
The takeaway for founders is to ask themselves these questions about what they’re building: who holds the most context at each step, and is that person in the room?
🤗 Know a founder or manager who is trying to normalize conversations around women’s health in the office but doesn’t know where to start? Use the share buttons below to share the episode with them.
Or scroll down for magic moments.
Highlights and timestamps
| Time | Highlight |
|---|---|
| 00:00 | Introduction |
| 02:05 | Dr. Ashley Blackington’s path into occupational therapy |
| 04:21 | What occupational therapists actually do |
| 07:52 | Canadian and U.S. healthcare perspectives |
| 09:29 | Why family caregiving is reaching a breaking point |
| 15:33 | Moving from crisis care to sustainable support |
| 18:11 | The growing care gap and caregiver shortage |
| 22:03 | What happens when someone comes home from the hospital |
| 25:11 | Caregiver burnout and the “single point person” problem |
| 30:19 | How Dovetail helps families coordinate care |
| 41:17 | AI summaries for caregivers and clinicians |
| 48:40 | How Dovetail is available today and where it’s headed |
| 52:03 | Prevention, parenting, and the future of caregiving |
| 55:58 | Why occupational therapy should be more proactive |
| 58:46 | The caregiver foundation and making support accessible |
| 1:02:35 | Home Field Advantage and the And Both podcast |
| 1:06:30 | Getting more men involved in caregiving |
| 1:08:58 | Dr. Blackington’s advice for building prevention and community |
| 1:11:41 | Where to learn more about Dr. Ashley Blackington and Dovetail |
The Episode in an Infographic
3 Magic Moments In The Episode
When Dr. Blackington recalls how many people told her that they don’t need an occupational therapist because they are retired, it highlights the classic misunderstanding about her profession. Here are three magic moments that show what being an occupational therapist is really about.
The grout between the tiles
When I ask her what an occupational therapist does, she compares physical therapy, speech, medicine and nursing to tiles on a wall. In her words: “They’re kind of like tiles on the wall and we’re like the grout that gets in between everything.” Her focus is the occupation of living a life: getting up in the morning, brushing teeth, getting dressed, managing the day and going to the grocery store. Things you do even when you’re retired.
AI to give clinicians the full picture
Her app contains an AI summary feature. When I ask her about it, she describes what happens when a clinician wants to know how the last three or six months have been. Nine times out of ten, the answer is that things are going okay, because summarizing months of care is overwhelming. Dovetail’s clinical summary turns a caregiver’s notes into a summary that can be sent to the provider before the appointment, so the visit can start with the full picture and less time catching up.
Caregiver support in the back pocket
Imagine what it feels like when you’re standing in the emergency room and feeling like the last line of defense for the person you care for. That is what Dr. Blackington hopes to prevent for caregivers with Dovetail and the foundation. In her words: “I want them to feel like in their back pocket, where their phone is, they have a piece of technology that can help support them and that can help them figure out a path forward.”
These three moments show how the broad perspective of being an occupational therapist can support caregivers and patients at all stages of their lives.
🗣 What was your magic moment of the episode? Was it occupational therapy as the grout between the tiles, how AI can help give clinicians the full picture, the caregiver support in the back pocket, or another moment entirely? Let me know by sharing your favorite moment in the comments.
Or scroll down for my favorite quote from the episode.
The Quote from the Episode
When I ask her how to get more men involved in caregiving, Dr. Blackington answers with an example from her children’s school. The volunteers were all women, and the tasks on offer were mostly baking cookies at bake sales. Nothing men could really associate with.
Her answer is to change the list. Care covers a wide variety of tasks, and not all of them involve helping someone in the bathroom.
“If we focus on the list and less on the identity of the person who shows up for that, we’re gonna get to a better place, and we’re gonna get to a more collaborative place quicker than saying you should get involved because we need more men in it.”
— Dr. Ashley Blackington, founder and CEO of Dovetail
Dovetail applies that idea by letting a person share a specific task with a specific helper, making asking for help easier in the process.
💡 Feeling inspired to help someone you know with a specific task? Tell them, and discuss what information you need to execute it.
Or learn about 3 trends I noticed across episodes below.
3 Trends I’m Seeing Across Conversations
It’s easy to see this episode as one about a founder who is building an app to help people deal with caregiving duties. But if you listen carefully, there are several themes that sound familiar. Here are three of them.
More care duties equal lower income
Dr. Blackington highlights that most people she speaks to are women. She shares that many of them, over time, scale down working hours or change jobs to be able to do the care work. They also lose their benefits in the process. Back in episode 65, Pal co-founder Nara Moripen also mentioned that most caregivers are women, while Raju Joshi estimated in episode 112 that women represent 70% of the care hours associated with their loved ones and delay asking for help for themselves. And in episode 157, Ana Herrero-Wallace highlighted that most of that care work is unpaid and therefore has downstream impact on women’s income and (later) pensions.
A founder who understands the problem deeply
Dr. Blackington knows from many kitchen table conversations as an OT and consultant what caregivers run into when they accept the care responsibility. In that sense, she is the archetypal founder with deep domain expertise that many investors are looking for. Mirjam Weemhoff shares in episode 164 how she researched the pelvic floor of her patients to understand why existing pessaries don’t work and how to build a new one. And in episode 166, we heard how Dr. Hannah Allen combines backgrounds as a clinician and a startup founder to help Heidi build an AI partner for clinicians that increases human interaction between doctor and patient.
Reimbursement decides what gets built
We also talk about how billing codes determine what is reimbursed, and how that impacts both patients and caregivers. At the start, Dr. Blackington highlights that knee surgery is now done as an outpatient procedure, meaning people return home the same day. When I ask why, she shares that this has to do with reimbursement, billing codes and billing hours. Back in episode 163, Dr. Robin Blackstone told us that most of the reimbursement is done based on a system that rewards treatment over prevention. Also, as we learned in episode 146 from Faviola Brugger-Dadis, reimbursement codes are not always available for new treatments and apps. With that, I think a lack of codes is effectively blocking people from using them.
Perhaps the most important trend we see is the relative absence of men in the care picture. That is not because they are not caring or bad caregivers. But for some reason, they have different assumptions about what it looks like to be a caregiver. If anything, this episode should therefore be an invitation to them to ask themselves this question: “What assumptions am I making about what it means to take care?”
🗣️ Let me know your answer in the comments, or slide into the DMs on LinkedIn or Instagram.
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Coming Up On Women Disrupting Tech
When a model built on posed expressions from a narrow group of people met audiences with different skin tones, lighting and camera setups, the confidence of its emotional readings was “not high at all.” In the words of Vanessa Williams Saleh, founder of Attenlyx: “The system might give you an answer, but it doesn’t mean that it’s been validated for that audience.”
Attenlyx is event technology built on Emotion AI. Cameras and AI read audience response during keynotes and panels, and organizers receive a report within 48 hours. Episode 174 follows Vanessa from 12 years in global event strategy, where leadership kept asking what landed after an event, to building Attenlyx. Along the way she explains why emotion frameworks differ per region and what AI leadership asks of her when she gives her team the autonomy to teach her about AI.
The clip above is the moment she describes what happened when her team tested a model built on someone else’s dataset. It ends at the point where the human review layer comes in, and the full episode covers who reviews what the AI reads.
Curious how emotion AI can improve events by giving organizers real, meaningful feedback? Leave your email address below and episode 174 lands in your feed on 29 October at 8:00 CEST.
Until then, as always, keep being awesome,
Dirkjan
What I Want to Leave You With
While listening to this episode, I realized that this episode is not as much about caregiving as it is about a handover that requires people to ask for and give help. And exactly that handover part is where things go wrong.
That is probably obvious when you listen to what happens when people are discharged from the hospital. But it also goes wrong once a patient is back home. The real problem of caregiver overload is caused by the fact that the care load cannot easily be spread to other people.
That, in part, is because caregivers are overloaded with information, putting them in crisis mode. And that makes it difficult to ask for help to begin with. After all, it is unclear what type of help is needed and who is in the best position to provide it.
As a result, they start believing that this is just the way it is and stay stuck with the problems. The fact that people live further away from each other is not helping, of course.
This is what makes Dovetail so interesting. It solves for friction that will always surface when tasks and information are handed over. In the process, it touches on a whole slew of other problems, from information security to loneliness.
What aspiring founders can learn is to look for handover points in processes, because handover points are where friction sits. Therefore, solutions that reduce or even eliminate friction meet the biggest pain points of customers.
Finally, it is important to recognize that Dovetail is part of a bigger ecosystem. Its insights are fed by the work that Dr. Blackington does with Home Field Advantage. And, in keeping with what she refers to as her “Canadian side”, its proceeds feed into a foundation that expands access to those who don’t have the benefit of working for an employer who offers health insurance as part of the employee benefits. In that sense, it is also a solution that builds on solidarity, something our society can use a lot more of.dd your perspective in the comments or on one of the Women Disrupting Tech socials.
Listen to the full conversation with Dr. Ashley Blackington on Spotify, Apple Podcasts, or YouTube.
And if you are a female founder navigating a funding conversation, take a look at FundingCoach.ai.
About Dr. Ashley Blackington
Dr. Ashley Blackington is a board-certified occupational therapist with more than 14 years of experience in hospital, rehab and home settings. In acute care and acute rehab, she worked mostly with older adults and their families, and she grew up in Canada before settling in the U.S. She is the founder and CEO of Dovetail, a care coordination platform for family caregivers, and she runs Home Field Advantage, a consulting practice that started with home assessments and supports families and employers in planning for aging and care. She also hosts the AND/BOTH podcast, with conversations mostly with women who are navigating care and career. Across all three, her focus is the infrastructure behind what she calls the invisible work of family caregivers.
Want to connect with Dr. Blackington? Find her on LinkedIn or visit her website for links to Home Field Advantage and her podcast.
About Dovetail
Dovetail is a care coordination platform for family caregivers. Caregivers use it to document what they observe, share specific tasks with the people around them, and prepare for provider appointments. Access is set by task, so a helper sees only the information the task needs. An AI summary feature turns caregiver notes into a summary for the care circle and a clinical summary to send to a provider before an appointment. The app is available on iOS, Android and macOS, and is offered directly to consumers, with employers, providers and insurers as the next channels.
Dovetail grew out of Dr. Ashley Blackington’s years as an occupational therapist and, according to its website, months of conversations with more than 100 family caregivers before anything was built. The company was named a finalist in the FamTech Startup Showcase.
Want to learn more or download the app? Visit Dovetail’s website or follow the company on LinkedIn or Instagram.
Listen to Episode 173 on Spotify, Apple or YouTube
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