Watershed Health, a platform facilitating real-time care coordination, has teamed up with stakeholders in Austin and Travis County in Texas. 

Partners in the coordination initiative include Dell Medical School at UT-Austin; Central Health, Travis County’s taxpayer-funded hospital district; Austin Public Health; Integral Care, a community behavioral health provider; the Travis County Sheriff’s Office; health systems; payers; and health information exchanges. Watershed plans to expand more broadly across the state.

The initiative is free for most providers to join. Payers, governments and at-risk provider groups fund the project. Watershed is already live in four other states with 9 million lives on the platform, which facilitates transitions of care, referrals for services and more. Organizations interested in joining should contact Texas@watershedhealth.com. 

“We are a city of innovation focused on improving the quality of healthcare for our population with this pioneering endeavor,” Austin Mayor Kirk Watson said in an announcement. “Our community is tapping the power of technology to improve people’s health and save lives across Central Texas. Austin will be a model for other communities committed to bettering patient care by working together.”   

Unlike an HIE, Watershed doesn’t just aggregate or store data: it operationalizes sharing in real time. It brings together electronic health records, paper-based data and nontraditional systems and allows them to communicate. “Data alone doesn’t move the needle,” Watershed CEO Effie Carlson told Fierce Healthcare. “It’s more about coordination.” 

These documents could encompass health records, social determinants of health needs and contact information. This helps enable care partners to holistically understand a patient’s needs and implement appropriate care plans. Any party can customize real-time alerts, workflows and collaboration tools within Watershed. Austin is the first example of an entire region working in this way, executives say.

The platform is a fully clinical app, meaning the data can only be used for HIPAA-allowed purposes. Watershed was founded by Chip Grant, M.D., an interventional cardiologist who recognized the importance of data sharing for good health outcomes.

At the end of 2024, a Watershed client—a health system—reported a 10% reduction in readmission rates compared to the past two quarters. Not only does this mean cost savings, but also keeping mortality lower. “Keeping people home and healthy is good universally both clinically and financially,” Carlson said.

Uncoordinated care costs greater Austin an estimated $2.2 billion in wasted resources, according to a press release about the initiative. The city discovered the power of data-sharing during COVID-19, when Austin Public Health convened a group of partners to have meetings and share data. After the effort, Travis County saw a significant reduction in mortality, the partners say. They wanted to continue the momentum and put out a call for a platform like Watershed, which ultimately won the RFP.

The platform is highly scalable and customizable, Carlson said. For instance, a mental health follow-up might be dictated by quality measures or utilization management criteria. Watershed can create a workflow and corresponding alert taking into account those elements for specific patients. Referrals or notifications to providers are automated—a user need only choose the protocol. 

“I live to eliminate clicks,” Carlson said. “As we enter a more resource-constrained environment, we just don’t have the time and bodies for that anymore.” What limits resources, in Carlson’s view, includes demographic shifts, people living longer, provider burnout and financial constraints. 

The reason the Travis County Sheriff’s Office is participating is to facilitate quicker specialized care for people in custody. “Oftentimes, people who are booked into the Travis County Jail are in some form of crisis,” Sheriff Sally Hernandez said in a press release. “It can be particularly challenging for our medical staff to obtain medical history ... Quick access to verified medical information would allow our doctors and nurses to offer effective medical treatment much faster.” 

Watershed’s effort in Texas will also ensure a smoother transition to healthcare services for newly released people. "Previously incarcerated individuals face numerous challenges upon re-entering their communities,” Travis County Judge Andy Brown said in the announcement.  

“Including the Travis County jail system in this program will help bridge gaps in healthcare, ensuring better access to life-saving care, addiction treatment, resources and tracking of vital medical records.”

“This will become a blueprint for how other communities can come together and do the smart thing,” Carlson said.

Watershed is backed by Create Health Ventures, a VC firm launched in 2024. Create Health Ventures exclusively focuses on early-stage digital health startups with founders from the healthcare industry.