Like many innovative technology solutions leaders in healthcare, Raj Mehra has a deeply personal story that motivated him to enter the space – and keeps him there.
Mehra, CEO of Sage, co-founded the company in 2020 following his grandmother's death from complications related to a fall at her Atlanta home. Despite five years of vigilant care, the family's reliance on 1980s-era LifeAlert pendants and baby monitors failed to prevent the fall.
"Everything in the system when you got to the aging process was very manual and wasn't tech-enabled," he said. "It burned out both family members and licensed caregivers while creating poor outcomes for older adults that you could delay through manual interventions, but ultimately couldn't prevent."
The personal loss was particularly striking for Mehra, who has spent nearly two decades working on technology solutions for healthcare challenges. At Palantir, he worked with major providers to improve clinical outcomes using data and technology—often years ahead of the digital health boom. Later, as part of Cedar's founding team, he helped scale the company into one of the larger healthcare payments processors.
"I loved how technology could have a mission-oriented purpose in healthcare," Mehra explained. But his grandmother's experience exposed a glaring gap in an underserved market.
When he explored the aging care technology landscape in 2019, he found minimal investment activity—just one or two established startups serving a rapidly growing population with critical needs. The COVID-19 pandemic crystallized the opportunity when senior living communities became daily front-page news.
"I wondered if these licensed communities that you'd expect to have better technology were facing the same infrastructure problems, that the embracing of technology was far behind where it should be," he said.
Mehra partnered with Sage co-founders Ellen Johnston and Matt Lynch, both experienced technologists, and confirmed their hypothesis. "We found that a lot of these communities were plagued by legacy systems— pull cords on walls and flashing nurse call lights after a resident pushes a button for help," he said. “We can do a lot better.”
A featured speaker at SLIF, we sat down with Mehra to get his take on the current state of technology in senior living.
This transcript has been edited for length and clarity
Raj: What we're seeing right now—and some of our peers are doing this too—is that AI is passively monitoring rooms and helping identify critical events like falls, and in the future, even capable of catching events like strokes, which are really challenging to catch in real-time. It's alerting staff within minutes, which is incredible.
The fact that AI can automatically detect these situations without a human in the loop, without anyone actively watching the feed—that's happening automatically based on training modules and large language models. That's truly amazing.
When I see our AI picking up falls every day in communities, that's a level of technology that represents a massive change. It's the most significant leap forward I've seen in my career in impacting health outcomes.
Raj: That's exactly the problem I'm seeing in the market right now. The market is finally open to technology, resulting in increased activity. Some companies are building really great solutions and taking an incremental approach, attracting top talent. But then you have other solutions coming to market that are advertising the moon when they haven't built the moon yet.
The challenge for operators right now is separating those two approaches, because everyone's building right now—nothing is truly done. And it shouldn't be, because we're literally building the foundation and scale for operators in an industry that hasn't been touched by technology for a long time. So if anyone tells you they've built everything, that's not true.
One of our rules is that if it's not live and shipped with a customer, we can't publicly announce it. We will never announce a product unless it's live and shipped to a customer, because it's not fair to operators who think they're going to get that from us. There's a lot that happens between 'I want to do this' and actually shipping and going live.
Even after we ship and go live at one, two, or three sites, we tell operators: 'This is in beta. We'd love for you to take this on, but please note that it's not yet perfect. If you want to be an early adopter and help us refine this product, we encourage you to do so. If you want something that's fully baked, we should ship this to you in a year.'
Some companies are building real products, and other companies are saying, "I'm gonna do this too because it seems like a cool thing to do." You have to watch out for that because we're not talking about the next, say, fintech app. We're talking about people's lives.
Raj: If you're building a technology company in this space, you have to attract people who aren't just joining because they want to be in a cool tech company that hopefully gets acquired quickly. That's not why people are joining our company.
Most people at our company—and we filter for this in our process—have real stories and real understanding. Some of them were family caregivers. Some have loved ones in care right now. They want to improve this space because they have personal experiences that showed them this industry needs support, and they want to be part of that change. That's what motivates them and why we push so hard.
This space is challenging—none of these things are easy to do, for anyone at any level. Servicing people on the front lines is hard. Supporting them when they're dealing with all kinds of situations every day is equally challenging.
To keep people motivated, they have to have an intrinsic 'why am I here?' If they have that ‘why,’ they're going to be very empathetic to these folks, which is what we need. And they're going to push the envelope because they expect more.
Obviously, everyone has to support their families and all that, but as long as you take care of those basics, they will push much farther because they genuinely care. When we talk about innovation, it's not just a buzzword. It should be: Do you genuinely care about the end user and the outcome? Are you building every day to innovate for them? When things go wrong, do you care enough to jump on a plane and help them?
Raj: You need a couple of things from a tech perspective. Operators have CRMs—they have systems to acquire people into their communities.
The EHR is your clinical record—you have to have an EHR. I think many people say, 'Well, I have my EHR,' but then complain that no one's using it. The reality is that most EHRs are large databases. No caregiver is trying to navigate most EHRs, right?
So you have a CRM, you have an EHR. You may get frustrated because your caregivers aren't using the EHR, but most people are realizing they need something on top of the EHR—an operating system. The operating system is quickly becoming something people realize they need.
Do you have a workflow for caregivers? Does it connect to devices that are going to increase over time? Does it connect to things that replace nurse call systems? Does it connect to AI cameras? Motion sensors? Wander management solutions? Does that all give caregivers a feed of what they need to do and when? And then does it pull the correct information from the EHR at the right time?