Can this startup fix pediatric care?

When Danish Qureshi’s daughter was diagnosed with an autoimmune disorder in 2023, navigating the pediatric healthcare system was overwhelming.

Qureshi told Healthcare Brew his daughter’s primary care doctor and specialists didn’t have the time, technology, or funding to communicate effectively, leaving him and his wife to manage care.

“The burden of care coordination fell on our shoulders, and we were constantly…in this state of fear that we were failing,” he said.

About 36 million US children needed pediatric care coordination between 2016–22, but only about 70% received it, according to an analysis of the 2016–22 National Survey of Children’s Health published in the Journal of Pediatrics.That number fell to about 59% for children with special healthcare needs, like the use of medication or specialized therapies.

Determined to address these gaps, Qureshi—an entrepreneur who co-founded multibillion-dollar mental health provider LifeStance Health in 2017—founded Zarminali Health in July 2024. The company opened its first practice in November in Michigan, and hopes to expand to 30 states within three years.

With $40 million in seed funding from General Catalyst, Qureshi wants Zarminali to become a national pediatric multispecialty group that coordinates care and reduces stress for families and clinicians alike.

But is this the best solution to a pressing issue?

Fragmented care

Experts agree pediatric healthcare is fragmented.

Neal DeJong, a pediatrician and associate professor at the University of North Carolina School of Medicine, told Healthcare Brew that pediatric specialists typically work at urban children’s hospitals or academic centers, while primary care pediatricians are often in smaller community practices.

Some primary care doctors lack the resources for care coordination or for more expensive electronic health records (EHRs) that bigger systems use, he said. There are hundreds of different EHR systems, and not all are interoperable.

“It’s just not that feasible to communicate through the record systems that we’ve invested in,” DeJong said.

Thomas Lacy, chief of Florida Primary Care at pediatric health system Nemours Children’s Health, Florida, echoed this issue.

“While the healthcare industry has made great strides in this area, there is still a tremendous opportunity to enhance integration between primary and specialty pediatric care,” Lacy wrote in an email to Healthcare Brew.

Zarminali’s solution

Zarminali aims to address these challenges by integrating specialists, primary care providers, and urgent care centers into one network, all using the same EHR.

Its “hub-and-spoke” model places centrally located specialist clinics (hubs) with primary and urgent care clinics (spokes) in metro areas, Qureshi said. The primary care and urgent care clinics would be bundled together at the same physical locations, with specialists at a central location where other doctors can send patients.

He also plans to offer telehealth visits, so parents can have the option to message providers with nonurgent questions. On top of that, there will be a dedicated team of care coordinators, Qureshi said.

“Effective care coordination is not a side-function of a practice or a simple administrative task. It needs to be ingrained in every aspect of a practice’s operating model,” he said.

Skepticism from the field

But some experts wonder whether this approach is addressing the need.

Jesse Hackell, retired pediatrician and chair of the American Academy of Pediatrics’s pediatric workforce committee, believes Zarminali’s approach may be redundant.

“To some degree, this looks like a solution in search of a problem,” Hackell told Healthcare Brew.

He noted that there are pediatric health systems that already operate with similar models, integrated EHRs, and care coordinators. Qureshi countered that, in general, care coordinators at primary care practices don’t have enough staff to do the job well.

Lacy said the pediatric health system where he works, Nemours, does this well already across its 70+ locations.

Hackell added that many of the problems with securing subspecialist appointments are workforce issues, and this model doesn’t fix that.

For instance, parents of kids in rural areas sometimes have to drive several hours to get care because there aren’t enough specialists or sick kids to make it financially or physically feasible to put a specialist in each of those rural areas. When they do find a provider, they can face months-long waits.

“There’s not enough subspecialists to go around,” Hackell said.

Though a 2020 analysis in JAMA Pediatrics found the number of pediatric subspecialists increased from 2003 to 2019, this wasn’t balanced among subspecialties or regions. The analysis found millions of kids live 1.5 hours or more from necessary subspecialist care.

Qureshi acknowledged these challenges but emphasized plans to expand into suburban and then rural areas over time, even though the practices will start in metro areas.

He said he aims to cut down on long wait times for appointments by investing in more tech and staffing. This, he believes, will help specialists spend less time on administrative work, thus freeing up time for them to see more patients.

“Our goal is to build an experience for both our patients and families, as well as our clinicians, that is very unique and seamless,” he said.