The Map, the Thumbtacks, and the $100K Nurses: Why Adam Stansell Pivoted Axle Health
Slice of Healthcare Team
08/15/2025
When Adam Stansell saw a sophisticated home health operator managing $100K nurses with thumbtacks on a wall map, he knew something was broken, and he knew he could fix it.
What Axle Health Actually Does
Axle Health builds scheduling and operations software for home healthcare providers. It's the tech stack that lets nurses, clinicians, and providers get to patients’ homes efficiently. It's not sexy, but it’s foundational: replacing the makeshift systems like maps, spreadsheets, and Google Calendar hacks that still dominate the industry.
How It All Started
Adam’s path to healthcare wasn’t linear. He cut his teeth in operations at Uber and Motive, then pivoted to home health during the pandemic. His first version of Axle, “Axle 1.0,” was a full-service in-home care provider. The team built their own tech stack to run it, dispatching clinicians on behalf of telehealth companies needing in-home support.
Turns out, being a provider is brutally hard.
Despite having “best-in-class” technology, the service side was messy, expensive, and operationally intense. “It’s not sufficient to just have the best tech,” Adam admits. The real insight? They were excellent at software, but service delivery wasn't their strength. That led to Axle 2.0.
Why It Stands Out
Axle isn’t just another healthtech startup pitching efficiency. The team lived the chaos firsthand. They tried to be a provider, failed at scale, and pivoted into licensing the software they’d built for themselves.
That makes a difference. When Adam saw a thumbtack-based scheduling system in a well-run agency, it wasn’t a joke. It was validation. “This provider that's so sophisticated in so many ways is literally using a map and thumbtacks,” he said. “And they’re paying nurses $100K a year!”
It's a stark contrast to the logistics precision at Uber or UPS, where not making left turns can shave millions off costs. “You can’t imagine these problems being unsolved in other industries,” Adam said.
A Customer Story (Sort Of)
The customer with the thumbtack map wasn’t just a funny anecdote. It became the catalyst for Axle’s pivot. It showed that even well-run home health businesses were held together with duct tape and grit. They didn’t need a new service. They needed real tools.
Who It Helps
Axle is built for home health providers, especially those overwhelmed by logistical complexity and clinician scarcity. These are operators with deep clinical talent but no software infrastructure to support it. Axle gives them the tools to run more like Uber and less like a bulletin board.
Where It’s Going
Axle just closed a Series A led by F-Prime, with backing from Lightbank, Y Combinator, and Pair. F-Prime’s Carl Byers, who helped Athenahealth through a similar services to software evolution, is joining the board. Julia McDowell, who previously ran in-home delivery at Galileo, “got it immediately,” said Adam. She had needed this software herself, two years earlier.
They’re hiring across product, sales, and engineering, especially in LA. “I’m old school,” Adam jokes. “None of this remote nonsense.”
Conclusion
From thumbtacks to tenfold revenue growth, Axle Health’s evolution is a masterclass in startup humility. The company isn’t just building software. It’s solving for a reality they’ve lived. And as home health continues to grow, Axle’s ops brain might be just what the industry needs.
