Latest / StartUp Health NOW Podcast / Surviving the Pivot: How Two Founders Re-Shaped Their Business to Thrive in a Post-COVID World

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Surviving the Pivot: How Two Founders Re-Shaped Their Business to Thrive in a Post-COVID World · StartUp Health NOW Podcast

• 0:00
  [on-hold music] Okay. Right now, we're in the midst of COVID. Everything's shut down.
• 0:06
  But this isn't gonna last forever, and eventually, people are gonna have to come back to the office, and hospitals are gonna have to reopen, and that's gonna happen in a couple months' time, and what then?
• 0:16
  And who's gonna have problems then, and what are their problems going to be? So we started thinking a little bit differently about, like, what are the new problems in the new world? Mm-hmm.
• 0:25
  And how does that relate to what we've built? [upbeat music] Welcome to Startup Health Now, the podcast about the entrepreneurs shaping the future of health and the health moonshots they're working to achieve.
• 0:41
  I'm Logan Plaster, editor-in-chief at Startup Health.
• 0:44
  For some health tech startups, like those providing telemedicine services, the COVID-19 pandemic offered an incredible shot of adrenaline, increasing user adoption by 100X, even 1,000X in some cases.
• 0:56
  For many other startups, however, the pandemic was a moment of reckoning. Deals dried up, and clients went dark on any deal that wasn't COVID-specific. Today's podcast is pulled from a conversation I had with Dr.
• 1:07
  Jennifer Meller and Kavita Mangal, co-founders of Navimize, who fall under that latter category.
• 1:13
  Speaking during a Startup Health expert office hour, Meller and Mangal shared how the pandemic did more than force them to rethink their value proposition.
• 1:21
  It inspired them to go back to the drawing board and pick up the phone to understand the true needs of their clients and partners. They share their story, the good and the bad, with honesty, humor, and wisdom.
• 1:31
  Hope you enjoy. [upbeat music] Let's go ahead and dive in. I w- I wanted to start with your story, with your narrative. Take us back to the end of 2019.
• 1:47
  Give us a flyover of where the company was at, where Navimize was at coming into the new year.
• 1:52
  Uh, this can be your chance to, to describe the platform, what you've built, um, and then we'll talk about the impact of COVID, uh, over in the beginning of 2020. So take it away. Sure.
• 2:04
  So, uh, thanks again for, for inviting us to speak. Um, so, um, so anyone who doesn't know me, hi. Nice to, to meet everybody here. Um, I'm Jennifer Meller.
• 2:14
  I'm actually a physician, and I've been in practice for a very long time and, um, unfortunately, always kept patients waiting in my waiting room over the years despite my best efforts not to.
• 2:25
  And so that's kind of where the inspiration for Navimize came in. Um,
• 2:29
  you know, realized that things were changing, um, realized that, um, you know, the status quo wasn't gonna fly as patients started going online and leaving reviews.
• 2:38
  I started seeing my patients going down the block to CVS MinuteClinic instead of coming to my office.
• 2:43
  And so the inspiration for Navimize was really to build a platform that could predict delays in the schedule and automate text messaging to patients to let them know when doctors like me were running behind to really improve the patient experience.
• 2:58
  And so, um, you know, s- really, uh, uh, formed the company when we were in business school, when we had the idea for it in 2016. 2017, started raising some funds, started building the platform.
• 3:10
  By 2019, we had built out the platform, pilot it, um, and the big breakthrough really came, came that year when we partnered with athenahealth and were able to integrate with athena and get onto their marketplace.
• 3:21
  And so by end of 2019, we had gotten some early customers on board. Things were looking good. Um, there were a couple of very...
• 3:29
  So we, we had started with focusing on smaller practices and then shifted to focus on larger practices. And by early 2020, we had these two very large practices lined up. One was, like, over 500 providers.
• 3:41
  One was about 200 providers. Um, had an investor who was gonna come in, and all of this was kind of set to start in early March. Um, and enter COVID.
• 3:51
  [laughs] So COVID came in, and one of those large practices said, "Sorry, we have to freeze. We're literally furloughing everyone and just keeping a skeleton crew at an urgent care center."
• 4:01
  And the other one said, um, you know, "We are going 100% to telemedicine. Um, we'll get back to you when we can get back to you."
• 4:09
  And the investors said, "Well, you know, everybody's really nervous about putting money anywhere, so we're gonna... We're, we're just gonna halt."
• 4:17
  So really, COVID presented this great challenge, and when we went out and tr- tried to s- you know, tried to continue the sales process to, to other, um, groups, it, it was like no, you know, nobody was interested.
• 4:27
  Everybody was focused on, you know, how are we gonna stay safe, how are we not gonna get sick, how are we gonna get PPE, and so nobody was really interested in a platform that could improve patient satisfaction. Hmm.
• 4:38
  Uh, take us to that moment, because I know that, that others will be able to relate, uh, where you knew things were gonna have to shift or really suffer. I mean, i- it's...
• 4:48
  You're, in some ways you're, you're through it, uh, now, uh, to some respect, but at the moment I can only imagine it was, it was anxiety producing and a bit dark.
• 4:57
  So, so take us there just because we're all in this together. [laughs] All right. So yeah, I mean, um, Jennifer mentioned, so we had a lead investor who had agreed to come on board with the business.
• 5:07
  This was end of February. Um, first week of March, New York City, COVID hit. By, by second week of March, this investor emailed us and said, "We're gonna withdraw our investment because we cannot move forward with this."
• 5:20
  At the same time, the two major health systems that we had, uh, withdrew, like Jennifer mentioned again. They, they said, "We're closing shop. We cannot worry about, uh, patient wait time anymore."
• 5:32
  So, so it was pretty dire. We had about, I would say, eight weeks of cash, maybe 12 weeks of cash left in runway. Uh, we decided to, um, uh, really cut costs.
• 5:42
  That was like the one big thing we did was we got very, very, very, very thrifty with our money. And, uh, we, we were cold calling sales, uh, customers 'cause that had worked in the past.
• 5:55
  N- There, people weren't even in the office to take our phone calls. It was that bad. And so we were at a point where we were like, "We have no money. We have no customers.
• 6:04
  Maybe we should pull out our resumes, brush them up, and find jobs and, uh, and, and that's, and, and shut down this business."
• 6:11
  So we were very close to really just not moving forward with this business 'cause we didn't know what to do.
• 6:18
  Um, and, and so, so the, the biggest shift I think was us, Jennifer and I sitting down to each other and saying honestly to each other, "We reallMaybe is this is not working. We, we maybe want to shut this down.
• 6:31
  We have this money left. We need to be very sensible with our money. What are the cheap, thrifty things we can do, and what is it that we're learning and listening? And what should...
• 6:41
  That should drive what we do next in the little eight weeks of runway we have, and then make a decision from there to go or no go. So that's kind of where we were. Yeah. Okay. Okay, so you had that, that conversation.
• 6:52
  Mm-hmm. Uh, what, what came out of that? I mean, how did you kind of pull yourself out of that moment? Yeah. Yeah.
• 6:59
  So, uh, I mean, some of it was a little bit, um, you know, fortuitous and just kind of, uh, things that happened.
• 7:06
  So, you know, I, I was still seeing patients, like, two mornings a week in my practice, really tiny practice, and I had shifted to telemedicine for the few patients I was still seeing, and, um...
• 7:17
  But I knew that, you know, some of the patients still had to be seen in person.
• 7:21
  And then Kavita had a personal experience where she had to be seen in person for, for an office visit, and then I had to take my daughter to the pediatrician.
• 7:29
  So there were a couple of these, like, in-person visits that had to happen, and we suddenly started looking at, you know, what's happening when the patients are coming in in person, and what are the challenges that the practices are dealing with?
• 7:41
  And then a little more time went on, and we, we sort of moved... We started thinking about how, like, you know, um, y- in a few... Okay, right now we're in the midst of COVID. Everything's shut down.
• 7:53
  But this isn't gonna last forever, and eventually people are gonna have to come back to the office, and hospitals are gonna have to reopen, and that's gonna happen in a couple months' time, and what then?
• 8:03
  And who's gonna have problems then, and what are their problems going to be? So we started thinking a little bit differently about, like, what are the new problems in the new world? Mm.
• 8:11
  And how does that relate to what we've built? Mm. And we kinda had this...
• 8:15
  You know, we started having these conversations, and we kinda had this aha moment where we said, "You know, we kept focusing on, we built this platform to reduce wait times to improve patient satisfaction.
• 8:25
  Nobody cares about patient satisfaction." But we had to shift our thinking and say, "Well, what have we really built?" Like, let's take a step back and look at what have we really built.
• 8:33
  Well, we've really built a platform that empties out a waiting room. And suddenly there was this kinda moment where, like, hey, we can empty out a waiting room.
• 8:42
  That's really important to people now, not because it's gonna improve patient satisfaction.
• 8:46
  That's gonna be important as health systems and hospitals and doctors' offices try to reopen, and they just try to bring patients in, right? Mm.
• 8:53
  Right now they're only seeing a few scattered patients who are emergencies, but eventually people wanna come back, but what's that gonna look like, and how are they gonna do that, and how are they gonna manage that?
• 9:02
  Because the old days of squishing patients into waiting rooms can't happen anymore. Mm.
• 9:07
  So I think that was our real kind of aha moment, when we realized, when we stopped thinking about, you know, we built this platform for patient satisfaction, to take a step back, what did we build and why is it important for people today?
• 9:20
  What are the problems they're having? And that's how the first shift in focus and first pivot, uh, uh, happened.
• 9:26
  Do you feel, do you feel like there was a- anything specific about your, your, um, collaborative relationship that sort of made it possible to, to be mentally nimble in that moment, when you could've been a little paralyzed by fear with the lack of runway?
• 9:41
  Um, yeah. I mean, we've had... You know, we've been working together for four years.
• 9:46
  Like, we started in business school as friends in business school, and this started as all, like, a fun project in business school initially, where we, you know, entered innovation tournaments, and we got into the, the campus venture initiation program.
• 9:57
  So we kind of have had this long relationship also of, um... When we work together, we're, one of the r- kind of the key things that, that has always held us together is that we are brutally honest with each other. Mm.
• 10:09
  Like, we say what's on our mind. There's no, like, if somebody's upset about something, there's no harboring. It's, we talk, we have it out, we bring it out in the open.
• 10:17
  So the conversations, the tough conversations around, "Hey, do we have to close this down?" had to happen with both of us saying how we were feeling about this. Mm. And then these...
• 10:25
  I think that that allowed us to kind of have this other conversation of, "Wait, hang on a second," you know? Like, what do we have here, and kinda put our brains together and think about how can...
• 10:35
  You know, step outside of ourselves a little bit and look at this from a different perspective. I don't know, Kavita, do you have anything else to add to that? Yeah. Yeah. Yeah. 100% agreed.
• 10:44
  I think, I think it also helps that Jennifer's a doctor. She was approaching this whole COVID crisis from a very different perspective. She's on doctor forum, so that helps.
• 10:53
  And then when I went in as a patient, uh, I, I saw it from a very different perspective. And, um, I was going to see this physician at Northwell, and I was sitting...
• 11:02
  So he had this clinic, and they wouldn't let you inside the waiting room, 'cause they would allow only two patients at a time. So you were sitting in this outside lobby area. And as a patient, I felt incredibly unsafe.
• 11:12
  Uh, and so I think, yes, we, we, we, we are friends, and we are very radically honest, but we also approach healthcare from very different perspectives. I think that helped also. Exactly. Gotcha.
• 11:24
  So together we were able to put our brains together. Okay, let's talk process.
• 11:29
  You, you have the moment where you're not sure if it's, if you need to brush up your resumes or not, then you have this idea, this aha moment.
• 11:36
  Uh, but in order to be nimble to pivot, you really have to do your homework and really figure out where that real opportunity is and what to do next.
• 11:43
  So what did you do really practically speaking, uh, over the month after that to test it and to figure it out, can we do this? Yeah. So, so we did a couple things.
• 11:53
  Um, I think, think the first thing we did was kind of rebrand our look. So we redid our website, right? We tw- we changed our entire website. It was all built around improving patient satisfaction.
• 12:03
  We just repurposed what we had and worked with our marketing person to redo the website to really talk about a virtual waiting room and, and keeping patients safe, and, and a whole, you know, landing page about COVID-19.
• 12:15
  Um, so that was one thing.
• 12:17
  Um, the other thing that happened was that our current customers came to us and started to bring some of these problems to us, and say, "You know, we're still seeing patients in person, but we might have to telehealth.
• 12:28
  We're having all these problems with telehealth." And they started telling us what their issues were, and then we started thinking about, hmm, you know, we had this idea, we wanna pivot.
• 12:36
  Let's try it out here with these small group practices and see what happens.And so we were able to, you know, without changing the c- the, the actual platform or code, we changed the timing of the messages we sent out.
• 12:47
  We changed the language of the messages that were going out.
• 12:50
  Um, we, we set up a whole, um, um, messaging, or a whole bunch of messaging around telehealth and supporting telehealth, and, "Hey, here's the link to the telehealth," and, "Here's how you log into telehealth," and, "Here's how you turn your camera on," to make sure the patients were on, 'cause these were problems that the, the customers were having.
• 13:06
  Hmm. And so we came up with this whole other, you know, approach and, and way to use what we'd built.
• 13:13
  Um, and so we really just listened to the customers, heard what they were saying, and then we went out and said, "Okay, if they're having this issue, others are having this issue."
• 13:20
  At the same time as we were kind of figuring out who are we gonna target? Are we gonna go back to these big groups? Are we gonna go back to health systems? Are we gonna go to smaller groups?
• 13:28
  We suddenly started getting some inbound leads from very large health systems. So groups that we... Health systems we'd spoken to in the past came back to us and said, "We wanna take another look."
• 13:37
  Or other people- Hmm... you know, on the Athena marketplace came to us suddenly and said, "We wanna look at what you have." And so we started seeing...
• 13:43
  And then we started thinking about where are these leads coming from and what does it tell us? So most of the leads were from these large health systems, and what we learned...
• 13:52
  And we asked a lot of questions, is the other thing we did. So we went to them, we said, "Why did you come to us?" Like, "What's your... What are the problems you're having? What are the issues you're having?"
• 13:58
  'Cause if they're having it, other people are having it. And basically what we learned is, you know, um, health systems are in trouble now.
• 14:06
  We rely on elective procedures and all these outpatient visits and patient scheduling procedures to make our money. Um, we've had to move away from that to pure acute care of COVID. Um, we need to bring patients back in.
• 14:18
  We're under tremendous financial pressure to bring people in. But then on the other hand, how are we gonna do that? We always had these crowded waiting rooms, so we have this, this problem.
• 14:27
  And so we took that and realized that those are really the groups that are having the biggest problem.
• 14:32
  It's not the smaller groups who can maybe manage with manual phone calls or put somebody outside their office, but you can't have 30 people standing out- outside a health system saying, "Oh, I'm for ortho.
• 14:42
  I'm for urology. I'm for, you know, endocrinology, and here's where you wait, and here's where you go, and call..." It just doesn't work. It falls apart. Hmm.
• 14:49
  So that's how we, we also shifted not just what we were doing, but who we were targeting. Hmm. So from these group practices over to health systems.
• 14:58
  Uh, I, I, I love how it caused you to refocus, uh, double down on understanding your clients' challenges and really ask those great questions. We've got a, uh, question from Rachel from Upside Health.
• 15:10
  Uh, Rachel, you wanna come off mute and ask it? Sure. Well, first I just wanna, uh, say, and Jennifer didn't give herself enough credit. No.
• 15:18
  While she was also dealing with all of this strain around her business, she was helping me through my own COVID crisis, like virtually, on the phone. So like it just shows like the power of the community.
• 15:31
  But she didn't put o- she didn't take off her doctor hat even during this whole crisis.
• 15:36
  Um, and I think that that helped her, I don't know, I, I think that she was able to see things from a, a different perspective, which she always has.
• 15:44
  Um, but she was seeing this problem like firsthand and, uh, so just first of all, kudos to Jennifer for that. Um- You look good now. [laughs] What? Oh, thank you. Yes. She's a great doctor. [laughs] It was all her. No.
• 16:01
  Uh, just the, the... So my question though is you, you at- attributed to being able to change your messaging and change your outreach.
• 16:12
  Um, were those contacts that you had previously had that you were reworking the messaging to, or were these newer health systems? Um, and then the second question is, you said you got some inbound, right?
• 16:25
  And where, where were these, those inbounds coming through, like LinkedIn Marketing, or were you going to, um, like plu- like startup health events or plu- plug and play events? Yeah.
• 16:37
  So, so the, um, the inbounds were definitely... Were, some were, were health systems we'd spoken to before, who came back to us. Hmm. Right? They came back and said, "We spoke to you."
• 16:47
  University Hospitals is one we're talking to. Hmm. They came back to us. They spoke to us two years ago, and we're, we had a, a whole series of conversations, got very close with them, and then it, it ended. Hmm.
• 16:56
  And then they came back and they said, you know, "We still talk about you sometimes. We're still interested, but now we really need this." Hmm. And so those conversations started over, and those are ongoing.
• 17:04
  Um, you know, another one was one that we went out to. So it was, it was, it was customers that we'd...
• 17:09
  Mostly the people we went out to were people that we had relationships with, that we'd spoken to in the past, who showed interest but ultimately didn't pull the trigger.
• 17:17
  And we went back to them now and said, "Hey, you know, we know that you were interested before. Now it's an even bigger problem because of COVID. You know, do you wanna reopen discussions?"
• 17:28
  And a number of them said yes, and those discussions were reopened. Hmm. So that was the other piece. Um, we did get a couple of new inbound leads.
• 17:36
  I would say that the, the, the business we've got is not, um, w- people like we've gone out to and sought out.
• 17:44
  I mean, we're, we're kind of gearing up to do that now, to do a big marketing push to like new health systems and just introduce ourselves.
• 17:51
  We went out to people we have relationships with, who knew us, who showed some interest, and tried to pull them back in. Success- were successful in some cases.
• 17:58
  There was one of our, of our big customers now who is brand new. They came to us really just through the Athena Marketplace, found us and said, "We have this problem.
• 18:07
  You know, we've been, we've been making a big push in the last six months, pre-COVID, to implement new technologies. This is something we talked about before, but now beco- became an even bigger problem."
• 18:17
  So they came to us. So it's sort of a little bit of a mix of mostly people we'd spoken to in the past. Some new coming just really through like the Athena Marketplace.
• 18:25
  We actually had some investors come to us saying, "We saw you're on Startup Health." Um, so Startup Health actually has been super helpful too. Yeah. Yeah, we've got some interest through there.
• 18:35
  Um-Yeah, but now the, the next shift or kinda next phase that, that we wanna enter into is, okay, so now we know this works, we know people are interested, we know w- with the problem that we're trying to...
• 18:48
  you know, the problem that we're solving now, and we know where the interest is now.
• 18:51
  And then now, now our next challenge is gonna be how do we, you know, go out after the right health systems who will be feeling this problem most acutely?
• 19:01
  And we have ideas around that, but right now they're, they're untested. But, but we have plans. Can I ask one follow-up in regards to this?
• 19:08
  So, so you said that you found these health systems that were eager or they found-- they, they have this urgent problem, but did they have budgets because it's an urgent problem? Like, I've, I...
• 19:21
  that's one challenge that we've seen with health systems. We really wanna use it. Mm-hmm. Um, we see the value, but, like, whose budget does this come out of?
• 19:31
  And how quickly they can deploy it when the next budget cycle hasn't happened yet or something. Yeah. It's a good question.
• 19:39
  So I think, you know, one of the big customers that came in, I, I think the story with them is they had a budget-- they, they had budgeted to add innovative solutions to their system over the next year.
• 19:50
  'Cause they had just gone to Athena in December 2019, and they, like, literally had just gone to Athena, were just settling into that, and then their, their kind of next plan of action was to go through the marketplace and pull in some new innovative solutions.
• 20:03
  So they had some budget for that, and then they just shifted it to what are our urgent needs now and who do we wanna bring in now?
• 20:09
  So there was this kind of long-term vision, but then had to fold in the short-term, what do we need today, and then how does that fit with our long-term vision? So that was one system.
• 20:17
  Um, I would say another system that we signed a contract with, um, we signed a contract with the ENT department at Jefferson.
• 20:23
  So there basically they said to us, "We don't have a budget right now because of COVID, but what's worked for us in the past is we'll do a three-month free pilot, and then after three months when we show...
• 20:34
  like, let's collect metrics before and after, and then we can go to our leadership team and say, 'Okay, here's how we increased volume and we did so safely.'
• 20:41
  And so it's, it's a no-brainer to pay for this because it helps us increase our volume." So that's, that's the plan there. Um, then, you know, eh, the, the third big health system we're working with,
• 20:54
  um, it's interesting because I read in Becker's that they l- they lowered their, I think they lowered everybody's salaries by, like, 10% across their leadership team.
• 21:04
  But they seem-- they told us they have a budget specifically for COVID-19 related initiatives, so they're funneling this through there. Um, so I think it's a little different for, for everyone.
• 21:16
  Um, I, I think the, the, the thing that kind of, um, helps us today, which we actually had more trouble with pre-COVID, was selling the ROI story, right?
• 21:27
  So before I think a lot of people saw us as like, "Oh, this is a great idea, it would improve patient satisfaction," but it's really hard to measure that and put numbers on it.
• 21:36
  Whereas now we can say to them, "Hey, you can only bring in X number of patients because you can only have X number of people in your waiting room.
• 21:42
  Well, if we increase your volume by 10%, you know what that number looks like for you.
• 21:46
  So if you pay us this little amount, you know, if, if you bring in one more patient per month based on what, what, you know, you're, you're breaking even. And we're gonna bring you, you know, five more patients a day."
• 21:56
  So it's a much easier sell, I guess- Yeah... in this, this environment. Yeah. The only thing I wanna add to that, Rachel, is it's not just about the budget.
• 22:06
  The, the process where we always got stuck as with health system was the internal approval process.
• 22:12
  And I think we had very motivated customers, uh, who were feeling the pressing need for something in COVID, and I think that allowed us to go through these processes, uh, internal approval processes that would take six, eight months in the past pre-COVID, we were able to get through them in two, three weeks.
• 22:29
  So it just speaks to the motivation of customers, and that also reflects in the budget. I, I have a question.
• 22:35
  Um, we talked at the top about this idea of staying nimble, uh, being nimble while staying true to your health moonshot and your, um, your primary objective or the DNA of your company.
• 22:46
  Um, y- y- you both did a really good job of reframing the company with, uh, your marketing message on the site, uh, when you went through this, this pivot. Um, was it a challenge?
• 22:57
  Uh, and if so, sort of how did you meet that challenge? Was it a challenge to, to stay true to what you felt like was the core and essence of what Navimize was in the midst of that? Yes and no.
• 23:09
  So the one thing is, again, we were very [laughs] desperate, right? [laughs] At, at the point you're talking about, there was going to be no Navimize.
• 23:17
  So there was a lot more motivation on our end to be agile than we ever were, to be fully transparent with this community.
• 23:26
  Um, a- and, and if you think about it, the only thing that has stayed the same in some sense is the core product we built. Everything else about the business has changed. Our customers used to be small practices.
• 23:38
  They have changed. Our business model has changed. Our marketing messages, sales approach, everything has changed.
• 23:45
  Um, and, and I think at the end of the day, the mission of Navimize was to help patients, uh, have a better healthcare experience, and I think we're staying true to that.
• 23:54
  Uh, how we're doing it is a little bit differently because the world we live in has shifted. Um, so we've covered sort of the, the process.
• 24:03
  Actually, I was gonna ask you a bit more, to getting a little bit more granular into how you tested. Um, you know, you had a sense that there was some inbound interest.
• 24:12
  Um, what was some of your process of making sure, um, this was actually gonna land, um, in terms of marketing, advertising? How did you get out there and do some testing on a budget? Yeah. So
• 24:26
  I, I would say-You know, um, w- that's still, like, TBD in a, [laughs] in a way because we're...
• 24:33
  a, a lot of what we've accomplished to date was, again, these sort of, um, inbound leads, people we'd spoken to in the past coming in.
• 24:42
  I, I think the big kind of testing we did was asking a lot of questions around, okay, you know, w- what, what is your objective? Like, what are your goals here? Like, what, what's going on, what's...
• 24:53
  what are the discussions that are happening internally at the health system around COVID-19? Mm-hmm. Is this something you're interested in for COVID-19, or are you interested in keeping us on board way past COVID-19?
• 25:03
  Like, I asked some of those tough questions that wasn't sure I wanted the answers to, [laughs] but needed to know, right?
• 25:10
  So I think that's a piece of it, is, like, understanding, you know, what are your immediate needs and what are your long-term needs?
• 25:17
  And then figuring out, um, how to message what we have moving forward based on understanding what these health systems are saying in terms of, "These are my immediate needs, but here are my long-term needs."
• 25:29
  So, um, again, we're kind of gearing up now to do that sort of big outbound marketing push and sales push, so I'll tell you how it goes after, in a couple of months. Look forward to it.
• 25:38
  But, um, but that, that's what we've been doing to try to understand how to position ourselves and, and what to appeal to. So I think there's still a ton of focus on today, right?
• 25:48
  There's still a lot of focus from these health systems on, "I have this problem today, I need it solved, and I need it solved fast."
• 25:55
  I think the key is when we go in and we have these conversations and talk to the health systems about how we're gonna solve your problem fast, we also talk about, you know, how...
• 26:04
  why we're gonna stick around tomorrow, and why this is gonna be good for you in the long run, and what are the other things we can bring to the table, and what are the other features we can develop, and what else are your needs in your int- in your long-term vision so that we can be there as your kind of partner to help you build these things out or fill those needs.
• 26:21
  So that's sort of how we're, we're looking at this, is we have this opportunity to get in there and fulfill this acute need, but also always keeping an eye on their long-term vision and where our long-term vision should be.
• 26:33
  That's awesome. Uh, Natalie Hodge has a question. Natalie, wanna come off of, of mute and ask it? Hey, guys. It's, uh, Dr. Davis from PreventScript. I just was taking a look at your website, and it looks fantastic.
• 26:46
  Um, I was curious about your hosting and your CRM setup and marketing software. And I'll go ahead and throw another question in while we're at it.
• 26:55
  Talking about front end, uh, what does your dev team look like for your, for your product? So our website, honestly, was, uh, what we created with...
• 27:04
  We, we hired somebody who was a marketing professional, and she helped us create this website. It's hosted on HostGator. Um, for, uh, for our marketing software and CRM setup, both we use HubSpot.
• 27:18
  Um, the, the jury is out if that's the right product for us. I think it's a D2... it's a really good D2C CRM software. We're still learning it to know if it's a good B2B CRM software. Uh, so that's what we do.
• 27:31
  But, but I think that, that, that website really came from the support of our marketing person. She's really the brain behind it, and Jennifer and I gave her feedback as she was working on it.
• 27:41
  We hired a offshore person to build this website, um, who then, who then just created what she had, uh, envisioned.
• 27:49
  Um, in terms of our dev team, like I said, uh, to be nimble on costs, we really let go of, like, our engineer that we had in New York City.
• 27:57
  He, we, we actually helped him transition to his previous employer, so it wasn't like we had let go in middle of the crisis, but we helped him go back to his old employer. So, so that's what we did.
• 28:05
  We are, we were using a offshore development team. We have still been using an offshore development team. They're based in Ukraine, so it's a little bit cheaper.
• 28:14
  We've been very thoughtful of using their time right now because we were still figuring out what the product would look like. Mm.
• 28:20
  But now, now I think we're at a point where we are hiring our team in the US, and, uh, we are ready to grow our development team. So it's gonna look very differently hopefully in three months.
• 28:30
  But it's hard to hire talent, so anybody out there who has people, engineers, please send it our way. [laughs] Uh, it's the hardest thing I've done. [laughs] Even harder than pivoting. [laughs] Yeah.
• 28:40
  That's, that's great. Kavita, who's, who's managing dev then? You're managing dev? I manage the dev, yes. Yes. Yeah, I ha- I manage the dev- Awesome...
• 28:48
  and what I have done is, over a period of time, created a, like, a, a group of mentors who guide us, um, who we reach out to on a periodic basis. So that's very helpful, but I really manage it on a day-to-day basis.
• 29:00
  Um, you know, I'm really interested in the fact, uh, that both of you have spent, have been so, um, targeted at really learning what the new needs are in the market in a telemedicine, uh, paradigm.
• 29:12
  What do you, what do these, uh, hospitals, clinics, systems, what do they really need?
• 29:17
  And so I, I wonder if you have any thoughts, uh, words on, uh, how it's changed the landscape of opportunity, even outside of where Navimize fits in, since you've been asking so many targeted questions.
• 29:29
  How have you seen this shifting landscape? Yeah, I mean, uh, for us it's been... You know, again, it presented another opportunity because, um,
• 29:39
  w- you know, what we heard from our customers is they, they moved very quickly to choose their telehealth platform.
• 29:45
  So, and anyone who had not, uh, uh, set up telemedicine pre-COVID suddenly had to make some very quick decisions about which platform they were gonna use.
• 29:54
  So people went very quickly to platforms, and then they weren't always the best fit.
• 29:58
  And a lot of times there were a lot of issues with, you know, the patients not knowing how to log on or how to use the camera or, like, you know, thinking when they logged on that...
• 30:06
  just logging off after five minutes thinking that the doctor wasn't gonna be with them 'cause the doctor's running behind.
• 30:10
  So that's how we fit in and helped our customers with, you know, sending out the information, giving patients instructions, making sure they were logged on, and then after the...
• 30:18
  you know, once they were logged in, making sure they stayed logged in waiting for the doctor and didn't drop off. So we helped them preserve visit volumes. That's what we did.
• 30:25
  Now, past kind of Navimize, um, I, I think that, you know, you know, as we all know, there are a lot of reasons that, that everyone went to telemedicine. I mean, we... there was just this, this need, right?
• 30:35
  But there were a lot of things that changed that allowed that to happen, right?
• 30:38
  They, they rolled back H- the government rolled back HIPAA laws, and they rolled back all the geographic restrictions, and they instituted pay parity.
• 30:45
  And these were really important things to, to allow, uh, people to adopt telehealth and make it worth their while to use it, right, from the provider and from the health system perspective.I think how this is all gonna fall out post-COVID is gonna depend a lot on those government regulations.
• 31:02
  How much is HIPAA gonna come back and interfere with the ability to use telehealth, right? How much is, uh, pay parity gonna be removed? Uh, are the geographic restrictions gonna come back?
• 31:13
  Like, these are all things that are gonna determine how much telehealth is utilized post-COVID. I think there's a real interest in using it. Um, I don't think...
• 31:21
  I- I still see, like, that a lot of patients wanna come back to the office in person, and I see that there are a lot of doctors who wanna come back to the office to see their patients.
• 31:31
  It can't completely replace everything, but I do think there are definitely use cases for telehealth. I think that it's great for, um,
• 31:40
  you know, a big chunk of what we do in the office today, and I think, um, if, um, you know, the, the laws allow and make it, make it, um,
• 31:52
  um, uh, appealing for health systems and for doctors to use telehealth, I- I think it's around to stay, and I think we're gonna see a real hybrid model of people mixing, uh, in-person visits and then having openings in their schedule where they fill in with telehealth visits, or just, just moving completely to s- doing certain things via telehealth.
• 32:10
  You know, preparing for a colonoscopy, you know, reviewing results after a biopsy. These are things we don't need to examine patients. You can easily do it over telehealth, right?
• 32:18
  So I think you're gonna see a lot of these types of appointments crop up that just get shifted completely to telehealth 'cause it's more efficient. Um, you know, that- that's my take. That's good stuff.
• 32:29
  Kavita, anything you wanna add there? Um, yeah.
• 32:33
  The only thing I think where our technologies can be helpful with telehealth is, yes, there's the telehealth platforms, but no physician, uh, has figured out how to have a day where you have, uh, telehealth visits interspersed with in-person visits.
• 32:48
  And I think that's one thing where we are helping, but that's an area that will challenge physicians because so far, the...
• 32:54
  if there were a- any telehealth being done in the past, it was morning 8:00 to 10:00 I do my telehealth, 10:00 p- uh, 10:00 AM onwards I do in-person visits. The...
• 33:03
  I- if we do adopt telehealth the way we want to adopt telehealth, it has to be 9:00 AM in person, 9:30 telehealth, 10:00 o'clock in person. And how we make that work is going to be interesting.
• 33:14
  So f- f- health systems are figuring it out. That's really interesting. Yeah. Uh, S- Sumeet from Wellbrain has a question. Wanna come off mute? Hi, guys.
• 33:23
  Uh, think I agree with, uh, everything you guys are saying because, uh, we're at Wellbrain and, uh, we work with a lot of practices, and what you guys identified, uh, a lot of them have shifted to one day of telehealth and, uh, other days of procedures.
• 33:37
  It's making them more efficient, and, uh, it, it's interesting how that's evolving. And it seems like you guys are a second order application in telehealth as opposed to just simple video conferencing.
• 33:49
  But, uh, my other question was, now that you guys have mentioned all these things with respect to the investment horizon, how has the outlook looked now with your discussions with investors given the pivot you guys have made and the traction you guys have, uh, received?
• 34:05
  Yeah. So, um, it's been positive. So we, uh, basically, you know, again, we, we had this eight weeks of runway, uh, when COVID hit, or 12 weeks about of runway.
• 34:17
  And, uh, when these contracts started coming through and all of a sudden, you know, these large health systems, uh, were interested and, and, you know, we also got a PPP loan to, to last a, a little bit longer, we were able to kind of stretch it just far enough that we were able to, you know, go back to investors that we've spoken to in past, and re- in the past and re-engage, and also speak to some new investors.
• 34:38
  So some of it was going back to the people who invested previously.
• 34:42
  Some of it was going back to people we'd spoken to over the last year but who said, "You're too early," and then we came back and said, "Okay, now we have a health system contract."
• 34:50
  Um, and some of it was actually, um, again, inbound. So I think there are a lot of, um, VCs... or not a lot, but some VCs that invest early stage, they invest seed stage, and they're looking for healthcare startups.
• 35:04
  Like, they, they wanna invest in, you know... They have a fund to deploy. Retail is dead. All these other things are dead. They wanna invest in healthcare because it's what's hot now.
• 35:13
  And, and any solution that has an application for COVID, there are some VCs that are just out there looking.
• 35:19
  So we had some inbound leads from VCs, and those conversations actually moved, and there's one who, believe it or not, from an inbound came through and, and is investing.
• 35:28
  So we were able to raise, uh, funds, um, pretty quickly in the last month or so, I'd say six weeks, um, which is, you know, a new experience for us. It was...
• 35:39
  Uh, I mean, fundraising is painful, but this is the first time that I think there was a lot more excitement because there's this, "Oh, you really filled this," you know... The, the...
• 35:49
  It's very clear to people that this is a problem, and it's very clear that we have a so- a good solution for it, and we're getting the contracts to prove that health systems are interested. So, um,
• 36:00
  it's been a, a new experience [laughs] for fundraising. It's actually been a little bit la- you know, i- it's still tough, but it's, it's been better, I would say. Okay. Thanks. Nice.
• 36:13
  Uh, we've got a question from Richard Hanbury from Sana. Richard, if you wanna come off mute. Um, yeah, sorry. The... I just had a question, um, around, uh, telemedicine,
• 36:24
  um, reimbursement codes and how they've changed since COVID, especially with regards to rehab.
• 36:31
  I heard there was codes, but I'm, I'm having difficulty finding new things that have arrived, so I wonder if you had any knowledge about that. Yeah, that's definitely out of my wheelhouse.
• 36:40
  I mean, I know the codes for just regular office visits. I don't know... Uh, I don't know s- too much about the new codes, uh, specifically for rehab.
• 36:49
  Um, I, I would say probably to get that information, your best bet might be to just go, go to some, you know, call up some of these physical therapy places or call up an orthopedics office that does PT and maybe just ask and say, "Where can I get this information?"
• 37:06
  You know, "What are you guys using for codes to bill?"Good stuff. Good stuff. Okay, Alan Gale, um, Amy Health, you've got a question. Go for it. Um, sure. So, um, congratulations on your successful pivot, first of all.
• 37:20
  Um, second, I was wondering to what extent have you considered partnering with other companies that might have a solution that would be valued by your current customer base and, you know, that would enhance your existing offering?
• 37:38
  Um, you know, that could include anything from as simple as a referral type of relationship or even a deeper integration where you have, you know, different options that include, you know, additional services, for example.
• 37:52
  Yeah. Yeah. It's a great question. Um, so definitely has been... partnerships are something that have been on our radar for a long time. Um, we spoke to a couple of companies.
• 38:01
  We had sort of ongoing conversations with or numerous conversations with pre-COVID. One in particular where we identified a pilot site, and we're gonna work together, and then, uh, the site pulled out just before COVID.
• 38:14
  Um, but definitely something on our radar.
• 38:16
  We've been super busy with just, um, the fundraising and, um, you know, getting these contracts nailed down and then starting the rollout for these contracts with these health systems.
• 38:26
  Um, but definitely one of the things we're looking ahead towards, uh, in the coming months, in addition to, you know, more business development, is also looking at potential partnerships.
• 38:36
  So yes, that's definitely something that's on our radar.
• 38:38
  Uh, we have some thoughts around, um, you know, the, the types of solutions that health systems are looking for that we could potentially, if we found companies offering those solutions, uh, would be, you know, complementary to what we offer and, and would offer great synergies.
• 38:54
  So definitely on our radar.
• 38:56
  Um, if it's something that you have a specific idea about, always, you know, or anyone in the community does, always willing to have a conversation, talk about it, see if there's an opportunity. Sure.
• 39:06
  Uh, Natalie, you mentioned a, a follow-up question in the chat.
• 39:10
  I was curious, your relationship with athena are, do you resell through athena, or do you contract directly with customers, uh, and just have the athena integration as a feature? Yeah. It's the latter.
• 39:21
  So athe- well, I, I would say it's the latter. athena traditionally has been very much, um, you know, kind of once you're integrated, you're on your own. You have to sell to their customers. Mm-hmm. Yep.
• 39:31
  With COVID, they've been making some changes. So one of the things they did was they identified companies within their, uh, within their part- so they have, I don't even know how many partners at this point.
• 39:42
  200 plus partners- Yeah... at this point. Yeah. So they identified... They created like a phase one, phase two, phase three with COVID. One was around, I think, getting PPE.
• 39:52
  Another one was around revenues, and their kind of third phase for, for third wave for June was around, um, solutions that would help get patients back in the office.
• 40:01
  And so they chose about 20 companies to kind of highlight to their, um, to their, uh, customers, and, and we were one of the companies they chose. So we were able to participate in a panel.
• 40:12
  They're putting on another panel in a couple of months, and they're doing something else. They sent out some marketing on behalf of the companies they chose to highlight. Um- Mm-hmm... although it hasn't been, um...
• 40:24
  I, I would say that hasn't yielded as, you know... I, I don't... And they also don't share with us what they're doing.
• 40:30
  So they'll tell us that they're gonna highlight us to their customers, but they don't share how that's done, you know, who they're targeting, how many emails are going out, what the emails look like, what the marketing...
• 40:40
  I, like, none of that is shared. [laughs] So I haven't gotten a lot of leads through there. The leads we've gotten through athena have more been either word of mouth or the panel that I w- that I did with them.
• 40:52
  Some people saw that and then came through. Um- Yeah... so for what that's worth. Mo- mostly it's up to us.
• 40:59
  Um, I wanna know, y- put on your, uh, your wise sage hat and share with us the sort of the lessons learned, even though you're still in the middle of this, we know, uh, the lessons you've learned having to go through the crucible of, uh, pivoting and, uh, shifting your m- your messaging through a period of uncertainty.
• 41:20
  Uh, what kind of clarity did that bring you, and, and what advice would you give to others on the call? Yeah. It's a good question. I mean, I, I think the kind of one hard truth that the two of us learned was that
• 41:32
  the level of interest we have now from customers and the enthusiasm we get when we speak with customers, they're much more engaged and interested now than they were in the past.
• 41:43
  And in kind of taking a really cold hard look at the business, I, I think that sort of pre-COVID, while, you know, not keeping patients waiting was something near and dear to my heart and something that we all kind of felt like as patients should- shouldn't happen, and there should be a better solution, from a business perspective, the health systems were not looking at it as a must-have.
• 42:05
  They really would all get interested and say, and, and they all talked about improving the patient experience, and, "Oh, we should improve the patient experience. Improve the...
• 42:11
  Well, I'm gonna hire a patient experience officer." But they really weren't putting big money into really doing anything abou- about that in a, in a real scale. And then with COVID, it suddenly became something like a...
• 42:24
  we became a must-have, right?
• 42:26
  Because suddenly crowded waiting rooms, it's not just about satisfying the patient, it's about complying with mandates and regulation and preventing disease spread, and not wanting to be the hospital where you go in because, you know, you need a mammogram, and then you come out with COVID, right?
• 42:42
  Right. So, so that's, that's really what's driving it. So there's a much higher level of engagement and enthusiasm when they meet with us, and this, this sort of w- we hear and feel the need in their voices much more.
• 42:53
  And so the tough lesson was, I think in reality we were more of a nice to have, and now we've become a must-have.
• 42:59
  So if you're a company out there and you're struggling to get customers, you're getting some, you get some, you know, some come in, and some people are really excited, but you're really not getting that enthusiasm when you go out there, I think that's one of the things, you know, sort of...
• 43:12
  that's one of the lessons I've learned, is I really have to kind... Like, if we come and bring a new-...
• 43:17
  solution, a new feature, and we try to put it out there, if we don't get a lot of interest and excitement, we really have to take a cold, hard look at, is this really something that's a must-have?
• 43:24
  And before we build more solutions, we'll think about that. Like, okay, this is a, this is a good thing and people should care, but do they really care? Is, is it a must?
• 43:33
  And I think that's, that's one of the big lessons that I've learned. Kavita, any other? Good stuff. Yeah. Yeah, no, I think that's, that sums it up. That's like getting back to business 101, right? Yeah. Yeah. 100%.
• 43:46
  Nice. Well, I, I really appreciate you sharing with us this, uh, your narrative, your story, uh, going through the, the, the, the trough of [laughs] uncertainty and all the work that you've done.
• 43:58
  Uh, I know there's still much more work to, to be done to, to really bring this to fruition. Um, so I wanna open it up to the floor for, uh, biggest insights and positive focus.
• 44:10
  There's an opportunity to share kind of what resonated with you, but really this is a chance to show love back to, um, [lips smack] Jennifer and Kavita. Yeah, I'll, I'll, I'll, I'll add something here.
• 44:21
  Uh, this is Sumeet Maniara from Wellbrain. So you guys make me remember, and, uh, we were down to eight weeks. This is a previous startup 10 years ago.
• 44:30
  And it's good you guys stuck it through, because we came to the same decision point, do we go or no go, and at that time we, uh, pulled through. And this time around, I'm in unfortunate situation.
• 44:39
  I don't have any partners, but I think if all of you other Startup Health Transformers, if you have at least two co-founders, I know you can do it.
• 44:46
  So if you guys can stretch it out, but it's a good example of, you know, when you have two people, it is, uh, uh, a... It, it makes a, a lot easier to make a pivot and, uh, last through things, whereas, yeah.
• 44:59
  So just wanted to comment on that and that's, uh, good insights just to see that being, uh, refocused. Yeah. Yeah. I, I wanna add to that. It's, it's so much better to have one more person sharing your misery- Yep...
• 45:11
  than wallowing in it yourself. [laughs] I 100% agree. I, I don't know if I would have been able to do it. [laughs] I think that's a good note to end on today. M- m- misery loves company.
• 45:22
  No, the power of community and collaboration. Yeah. [laughs] You, you, you, you, you heard it here. All right.
• 45:33
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