Serenity
Nurse-Led Case Management for Smarter Care Decisions

Rita Matias, Co-founder and Managing Partner and Michael Averbukh, MD, Co-founder and CEO

Why has coordinating modern healthcare become increasingly difficult for patients navigating multiple specialists

Healthcare information, subspecialties and treatment possibilities have multiplied to a point where managing them has become a major challenge. The number of options continues to grow, requiring physicians to narrow their focus to specific domains. That depth strengthens clinical precision. It also creates a fragmented system.

Patients are left to coordinate multiple specialists, diagnostics and opinions across disconnected touchpoints. Even well-informed individuals struggle to sequence care. The issue is not access. It is the ability to responsibly manage expanding possibilities.

How does nurse-led case management add accountability to complex healthcare decision-making processes

Serenity was founded in response to that reality. With locations in Portugal, United Kingdom and Spain, the nurse-led healthcare concierge provider was built on a clear belief articulated by its leadership: everyone deserves better managed care.

“Today, the AI models are much more sophisticated, and yet they are not mistake-proof,” says Michael Averbukh, MD, co-founder and CEO. “They still need human eyes. They need to be humanly verified and managed because the tools are improving, but that improvement does not remove the need for someone to take responsibility.”

That relationship begins with structured onboarding. New members meet with their assigned nurse to review medical history, current concerns and preventative priorities. From that foundation, the nurse conducts triage as new issues arise and determines whether diagnostics, specialist selection or physician review should occur before any appointment is arranged.

A Continuum of Care

How can clinical triage before specialist visits improve efficiency and outcomes in patient care pathways

In a traditional concierge model, a request drives the process. A patient asks to see a specialist. An appointment is scheduled, and the interaction ends.

Serenity approaches the same moment differently.

A request to see a gynaecologist for perimenopausal symptoms, for instance, is not treated as an automatic scheduling decision. The conversation begins with questions. What symptoms are present? How long have they persisted? What previous diagnostics have been completed?

By evaluating the situation before the visit is arranged, preliminary laboratory work or imaging can often be completed in advance. The consultation then becomes decisive, and one visit replaces two. From triage through preparation and follow-up, clinical judgment guides both medical and administrative decisions.

“Because our case managers understand the healthcare system from within, every interaction moves towards a better outcome,” says Rita Matias, co-founder and managing partner. “The same nurse who knows a member’s clinical history also coordinates logistics, communicates directly with providers and supports the person behind the patient.”

This matters because many patients request the wrong specialist. Others arrive at consultations without preliminary diagnostics, only to be sent away for testing and asked to return weeks later.

Structured Clinical Oversight, Not Informal Coordination

Serenity does not operate as a booking intermediary. It operates as a clinically governed case management service.

Each member’s care is managed by licensed nurses who work within formal regulatory frameworks in their respective jurisdictions. Recommendations are grounded in evidence-based medicine, and decisions are made under clinical responsibility. The objective is not to replace specialist physicians or digital tools. It is to ensure that both are properly aligned, sequenced and carried forward with accountability.

Oversight extends beyond conversation. Clinical discussions, referrals and follow-up plans are documented in secure systems that are fully compliant with the General Data Protection Regulation (GDPR) and national standards.

Serenity reinforces this discipline internally through what it calls the “Book of Wisdom,” a codified framework of behavioural and operational standards designed to ensure consistency without sacrificing personalisation. Its guidance is precise: maintain continuity across every stage of care and verify each step rather than rely on assumptions.

Why does independence from provider incentives strengthen trust in healthcare navigation and referral decisions

Trust in care decisions depends on structural independence from provider bias.

Serenity does not maintain commercial referral agreements with hospitals or physicians, ensuring that provider selection is driven first by clinical suitability. When insurance limitations affect available options, those constraints are discussed openly and alternatives are evaluated transparently rather than embedded within the recommendation itself.

Advocacy in the Moments that Matter

In one instance, a couple was driving to a major clinic in Portugal for a time-sensitive consultation that could not be postponed. Unfamiliar with the roads and increasingly anxious as the appointment time approached, they realised they were lost and were far from the clinic.

They called their case manager.

For nearly an hour, she remained on the phone. She guided them turn by turn through unfamiliar streets. She calmed the rising frustration between them. At the same time, she contacted the clinic to explain the situation and reinforce the clinical urgency of the visit, ensuring the physician would still see them if they arrived late.

She ended the call only once they had parked outside the entrance.

The episode illustrates the model in practice. The same nurse who understands the clinical context also manages logistics, communication and emotional reassurance. The role shifts seamlessly, from triage to advocate to navigator, without fragmentation.

Members often describe this relationship as feeling closer to family than to a service provider. That response reflects design, not accident. Serenity’s model integrates professional competence with human presence, particularly when stress threatens clarity.

Scaling Clinical Continuity across Borders

Over five years, Serenity has primarily served expatriate communities in Portugal, supporting thousands of members across more than 16 nationalities, with a significant base of American clients navigating unfamiliar healthcare systems. Its leadership team recognised that the underlying need extended beyond expatriate communities.

While relocation amplifies uncertainty, fragmentation is not confined to those crossing borders. Even within their home systems, many individuals struggle to correctly sequence care, balance preventative health with emerging symptoms or navigate competing specialist recommendations. Time constraints, professional demands and information overload compound the difficulty.

This realisation has shaped Serenity’s next phase of growth.

Serenity is expanding into Spain and the United Kingdom. In Spain, the initial focus will mirror Portugal’s expatriate base. In London, the strategy broadens deliberately to include professionals, executives and defined population segments such as women’s health, where complex care pathways and time constraints frequently intersect.

The same nurse-led case management framework will operate in both markets, adapted to local regulatory and provider environments. Leadership believes that if structured clinical oversight can restore continuity in one fragmented system, it can do so in others.

To support expansion across markets, Serenity is developing a proprietary digital platform designed to centralise and standardise its existing documentation processes. The system will consolidate triage decisions, diagnostics and follow-up plans into a unified interface, creating structured visibility across members, case managers and providers as the organisation grows. The objective is not automation for its own sake, but infrastructure that strengthens clinical oversight and continuity at scale.

As healthcare systems grow more complex, Serenity offers structured continuity in place of fragmentation, reinforcing its role not as a convenience service, but as a clinically governed partner in navigating care. That approach underpins its recognition as Top Healthcare Concierge Services 2026 by Healthcare Business Review Europe, reflecting the company’s commitment to placing accountable clinical guidance at the centre of the patient journey.