The gateway to specialty patient journey

Chris:

Hello digital health community today our guest is Yishai Knobel, CEO and Co-founder of HelpAround, that's helparound.co. Helparound is described as a gateway that's used to help patients that need specialty drugs get the support they need to fill specialty prescriptions and stay on their therapy. They do this by streamline and streamlining what I've recently learned is often a frustrating patient experience that leads to a lot of patients getting lost without the help they need. Yishai. Welcome to the pod.

Yishai:

Thank you, Chris. Great to see where to see you and gonna be here.

Chris:

Yes, thank you. So before we unpack specialty patients, I'd love to understand how you came to start HelpAround many founders, we talked about personal stories or inspiration to start a company or unique experiences that led to them starting a specific startup. I know in your case, you've led an M health platform, you served at Microsoft startup lab, and were recognized for your, I believe, cyber warfare systems for the Israeli army. What led you into healthcare? And then what led you to start HelpAround?

Yishai:

So as you mentioned, I grew up in Israel. So at the age of, you know, in my late 20s, I moved to the US. And to get my master's degree at MIT. And, and, and one of the things that after MIT, you know, I passed through Microsoft startup Lab, which was a lot of fun in Boston. But then I joined, I joined Agamatrix, which is the company that invented the first smartphone glucometer. So it was the first glucose monitor that tested blood sugar into the iPhone. But very in the early days, it was this before Bluetooth LE on the iPhone, so physical connector. And I joined them to think about connectivity, and connectivity and interoperability, and how would the fact that you have now a plug in glucose monitor into the iPhone, how can that connect to all the rest of the services that that type one diabetes patients consume. And what I was blown away by was how, like how fragmented the American healthcare system is. So unlike the Israeli healthcare system, where I grew up, where you are, you know, you have one organization that you choose, that manages your health, and provides the services, and also insures you so there are, it's all aligned. Whereas in the US, you know, a patient with type one diabetes, can all of the sudden be switched to a different insulin because their insurance company has a better deal with another manufacturer, which for me, I just couldn't get my head around it. And just to see how many different entities patients have to interact with here, was very depressing, but also very kind of encouraging. And it made me start HelpAround with my co-founder. It was started as a diabetes support network, where patients who were not type one diabetes patients who were not able to access supplies for diabetes management, were able to rely on peers. And it was a fascinating journey, we have, you know, 10s of 1000s of type one diabetes patients that are community supporting each other, but we were not able to monetize, right, you know, first time entrepreneurs kind of going, it will also when it was very fashionable to go direct to consumer, don't worry about revenue, just, you know, just get the users. And in 2018, we turned around the company, we figured out that, you know, that alignment was missing with the with, you know, sponsors, and the industry, and we were able to transition the company to focus on the specialty patient journey. So not just making sure patients get access to therapy, but helping them get on therapy. And as we'll discuss in a bit more than a quarter of patients, and especially treatments, they get the prescription, but they don't get the therapy. They don't, they don't get the drug.

Chris:

Right. Yeah, that's an amazing stat to me. And gosh, congrats on that pivot . Yeah, I know that that's a big moment for every entrepreneur. And it's a lot easier when you have zero traction. I'm sure when you have this 10,000 strong community. You know, it's really hard to turn or take a detour from your initial vision but also the people that you've been serving. So really good job on that. But of course,

Yishai:

It was painful, because you know, we had a lot of People who were really grateful to us as a company that, you know, really helped them when they were in a bind. I'm stuck with a supplies, I can't afford my supplies, I have a specific pump and I need a specific fixture that I can't afford right now. And boom, I find someone who can help me with that. And it was a great story, it was a great feel good experience. We even, you know, built the first emergency button for the Apple Watch, that was specifically around like, Hey, I mean, distress help. And, you know, there's a lot of kind of entrepreneurial experiments, but at the end of the day, it wasn't a business. And, and, you know, if other entrepreneurs are here, and it's today, here is, follow the money, you know, follow your passion, but follow the money and do that earlier, rather than later. You don't want to be in that position where you're like, you know what, we're doing something great, but that's not sustainable.

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Chris:

Right, right. So you navigated the market, where the business was, until you have the current iteration of HelpAround. And I'm curious how your personal journey helped you now that you're encountering or really tackling head on these problems of things like interoperability, et cetera?

Yishai:

Yeah, so Well, interoperability was always a theme in my career, even back in the cyber unit in the Israeli army, interoperability is always something that is, you know, key. Because, because, you know, we are still dealing with systems that are siloed, we're dealing with them everywhere, and especially in healthcare. So for me thinking about connecting silos is a second nature, in my career, and maybe a little bit, also my personality. So you know, it's not a coincidence that, you know, we look at the patient journey, and we look at it as a collection of silos that need to be connected, and need to be bridged. And today, you know, part of that challenge that many drug manufacturers are facing is trying to help the patient, get the therapy pay for it, learn how to use it, and stay on therapy, because there are so many vendors who are involved in that process. And some of them are, you know, more patient friendly, some of them are less, some of them still require you to fax, some of them are a little more friendly, you know, they will text back and forth. But at the end of the day, for most drugs, for most patient journeys, there are multiple vendors involved. Okay, and that means that any vendor would be nursing support, copay support, Patient Assistance, program, hub support, that would be all these have nothing to talk about the pharmacies, especially pharmacy involved. And all of these are first time interactions for the patient with an organization they're not familiar with. And each one of them has their own rules of engagement. And each one of them has different, you know, compliance requirements under HIPAA, under the Telephone Consumer Protection Act. Yeah, there are different consents required. So there is a very, very complex puzzle, that, you know, if and then if, if one company really spent the time to look at it and say, how do we connect all of these? How do we make this easy for the patients and even for the brands, then we can help millions of patients get on life saving therapies.

Chris:

Right, that makes sense. And so those silos and all kinds of different vendors, that's just a difference in the reality, I believe of the specialty, drug and patient journey versus the retail patient journey. But can you synthesize that for us, like from the patient's perspective? Like what is the difference between, you know, the CVS Walgreens that a lot of people know and the specialty patient journey?

Yishai:

So let's start with retail, retail. You know, it's something that we've all been through, we learn a prescription for we get I don't know, you know, I have muscle ache, I go to the doctor, the doctor checks it maybe does X ray, okay, here's a cream, go to the doctor, go to the pharmacy, and which pharmacy would you like me to send this prescription to right? Oh, CVS or Rite Aid, Oh, you want CVS on that corner or that corner? Because they're both hopefully send it to the right corner because if not, you're going to have to spend a lot of time chasing them but I go to CVS I stood in line I pay $5 with pay and I go home and they put the cream on, right to experience for specialty drugs to way different story. Imagine God forbid someone, you know a parent, going with a child the child is having, you know, difficulties so Following or or digestions or god forbid, and they go there to do a lot of tests a long time and eventually they get diagnosed, and they get diagnosed with a rare disease or they get a diagnosis with with, you know, with Crohn's syndrome, Crohn's disease or with with inflammatory or any collection of life changing conditions. Okay. The doctor sits there and said, Well, you know, the good news, the bad news. First, the good news, we know what do we have, the bad news is that we have a pretty life changing condition. And the good news is that there's a drug for it. The bad news, again, is that the drug costs about $300,000 a year. But the good news is that your insurance may cover it. And there's a lot of good news, bad news, and it's like a maze right now that the patient doesn't know what to do. Like, who they're gonna call once they're out of pocket? Who's going to call them? What, especially pharmacy? Why can't they get it as a CVS around the corner? Why is it shipped from some remote location? When will they call me? You know, how much am I going to have to pay? Who do I pay? You know, is my insurance gonna, we're going to cover this, to what extent? You know, if I switch in the workplace, am I going to lose this coverage? And what are the side effects? Is my child going to live? Right? Are we going to have to wake up every night and inject something? I don't know how to inject. So just imagine the experience of someone who is just having the life just went upside down? Right? That's a specialty experience. And for that you need that help to navigate. And it's not just financial,financial is one piece of it. But as with clinical navigation, there's financial navigation, there is, you know, Nurse support, there's, you know, affordability, are you eligible for this program. Is there a foundation that supports this? There's so many questions. And this is the core of the difference in the experience. Now we're only talking about, you know, it's less than 2% of prescriptions, less than 2% of prescriptions. But in terms of drug spending, it's more than 55%. Of all drug spending, he said from a drug manufacturer point of view, this is the number one revenue driver, not the cream that you put on your shoulder, it's the number one revenue drivers are those drugs. And that's why pharma invests so much in trying to help patients going to therapy. And still, it's so siloed.

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Chris:

Right, right. Yeah, I think I read in an article you wrote that it's something like $76 billion per year, that's lost revenue, just because there's so much friction. And I guess you answered one of my questions is, are they trying to do anything about it? Because clearly, that moves the needle? And I'm curious as to why aren't they successful in breaking the silos or where Yeah, breaking people out of these silos.

Yishai:

So I part of it is structural, from a regular regulatory point of view, Pharma is bound by regulation, that, to a large extent, prevents them from even interacting with with the patient, okay, unless they get explicit consent from another word, you know, structurally, especially pharmacy does not you know, they have a certain contract with a drug manufacturer, but also have a contract with a payer. Right? So, these are two separate entities. And the drug company has only so much leverage over specialty pharmacies to make sure that they provide the patient with the Resources Division the eligible for, right. So that's just another one. Now, look at copay card. Copay card is another program that the pharma company can put out there. But next to it, there's a patient assistance program, that's a completely separate program that still is sponsored by the pharma company, but only those who are eligible. Okay, so and, and pharma companies that the patient system program means money that basically the farmer pays for just sells drugs for free to certain eligible patients. So there are a lot of, there's a lot of work here that needs to be done. And, and in connecting the different programs. And as a pharma company that launches one drug with this permutation of vendors, and the next drug with that permutation of vendors because this drug is designed more for a population of migraine users, right and other patients. The other one is for rare diseases. The third one is for HIV, different populations. So the drug company in a way is now kind of coming to the place where it's like, okay, we need infrastructure for this. We need infrastructure to allow us to build any patient journey in a way that doesn't require us to reinvent the wheel.

Chris:

Right, right. Yeah, each and every time with all the different various vendors. And so and then from the patient's perspective, what happens? Are they just kind of lost in the sea of consents and diagnostics and waiting and then more consents. And I mean, I don't know, I am not a specialty patient founder, how many times I feel like I'm signing the same form a few times anyways, just as a being passed around, is that what is happening.

Yishai:

So that's why that's what you would want to happen. But the patient what you're experiencing, again, as a retail patient, is that you go to the doctor and the doctor gives you forms, or maybe you use a certain digital platform at the doctor's office, the farmer doesn't have that handshake with you, right? They don't have that opportunity. If you don't come into the GlaxoSmithKline headquarters and say, Hello, I would like to buy a drug and . Okay, fine. Here. Now, there's no that kind of interaction. So the hurdle is higher for the drug manufacturer, because there's no direct touch point. There's the provider, there is the the pharmacist. And that's it. So, so yeah, I think that's a challenge. But the challenge is, like, if you digitize it, then there are ways to get that signature, and to unlock all the services for the patient and create that handshake between the drug manufacturer and the patient.

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Chris:

Okay, right. And let's talk about helparound and how does it help with that specialty patient journey or to build those.

Yishai:

So we basically built infrastructure, it's a connectivity infrastructure that allows any of any drug company to connect the patient journey, you have, as I mentioned earlier, you have this different combinations of, of support vendors, call centers, copay providers, hubs, all these kinds of different combinations of vendors for each drug. And you basically have infrastructure that you can put in place and basically connect the dots wire it digitally, in a way that doesn't require you to reinvent the wheel. So that's what basically help around us: help run comes and creates that one, connector bridge, we call the patient journey gateway, okay, that's to connect all the vendors and B centralizes the communication to the patient. So the patient has a very predictable step by step roadmap to get on therapy. And it's not that one patient sends them a text message and not sorry, one vendor sends that patient a text message while another vendor calls them and other vendor sends them a DocuSign. No, it's all centralized. It's all consistent. It's branded for that specific drug. And for the patient, it makes sense. I went home, I got a text message that said, you don't need to download an app, of course, you get a text message that says, hey, you know, your doctor just prescribed this drug for you. We need your consent to provide you the following services, check, check, check, check, and you're done. And from a patient point of view, I'm looking to build a relationship with a drug company, I'm not looking to build a relationship with anyone, all I want is my child to be healthy. So just tell me what I need to do in order to get this drug as cheaply as possible. And that's it and just get me the drug. 

Chris:

Yeah, exactly. And, and can you like to break down? I think you mentioned earlier about a quarter of patients who receive a prescription don't even fill it for the first time about how to help a round build an experience for that.

Yishai:

So one of the biggest reasons why patients don't pick up the prescription is because, A: they don't know what to pick it up. They don't know where to get , B:they hear the cost. And they're like, I can't pay for this Goodbye. I'm just not going to take the drug. Which can you imagine having a life changing condition and I just can't pay for this, no matter what. And, by the way, some fantastic organizations and companies that are focused specifically on that financial navigation and allow even the health system to look for the right affordability path for this specific patient based on their profile. Okay, so, so that really helps in the abandonment rate, but still more than a quarter of patients abandon their prescription because A: they don't know how to pay for it to be ordered. They get phone calls, and they never answer the phone because they don't recognize the number. It's as simple as that. So, there are a lot of friction points like that, that are peppered throughout the journey, and the patient can fall through the cracks in every one of those unless it's made really, really easy.

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Chris:

Got it? Yeah. And speaking of making things easy, I've also seen you speak about one of the topics to zero, which is omni channel, and meeting people where they expect to be met or whatever in ways that can actually be reached. Could you explain what omni channel means in the context of helparound? And, And maybe both retail and specialty?

Yishai:

Yeah, absolutely. So you know that the landscape of patient engagement, if you will, has changed quite a bit. It's been, it started with, you know, this avalanche of apps in, you know, in the first or the second five years of the previous decade. And then at some point, people just became tired of apps. And very few of them actually are willing to download an app, especially the younger generation, like downloading an app, add one. And this is a really interesting stat, that I mentioned that about 79% of consumers general, stop a transaction, if they're being prompted to download an app. So if I'm at a restaurant, and they're telling me please pay your check, right? Pay your bill, pay a bill with this and download an app to pay your bill. Why? Take my credit card, leave me alone. Right, right. Or if I, if it's a one off transaction, I'm not going to download any app, I expect a frictionless very lightweight experience. Okay, unless this is Tik-tok, which I engage a lot, unless this is Uber that I engage a lot and get, unless this is something an organization that I really have an ongoing relationship with. Okay, the problem here that, who am I who is the patient really having a relationship with, with the doctor, maybe with the with that doctor or with that doctor, with a primary care or with a specialist with a farm with a pharmacy, but that's not the pharmacy, that's a specialty pharmacy, it's a whole another organization, with with a drug with the manufacturer of the drug, who aren't they I don't know, that I don't have really is a patient, I don't have a relationship with anyone here. So I'm looking for a very lightweight experience, just text me because text is king. Give me a link. Let me sign. And goodbye. Now, for a certain subsets, especially when we work in rare disease, launched some, you know, some, some great, some programs that support phenomenal treatments, really just life changing treatments in pediatric liver, liver disease, pediatric neurology. And those parents actually want to have a relationship with a case manager. For those we do offer the app, an app option, but it's, it's whatever you choose. And that's what I mean by omni channel. If you want to meet the patient where they are, if they want phone calls, they should get phone calls. If they want text, they should get texts, if they want app, they should get app. And it's easy enough today. That's what we know: we build the infrastructure, so that any drug company can come and say, I want this combination of engagements, because that's right for my population. Right. Right. And for another drug I don't really need. Don't worry about it. Right? So oncology is different from Rare Disease. It's really It's different from neurology is different from migraine. And you need to have that flexibility because every patient is different. One of my favorite quotes that I heard once was about the CEO of Sanofi, the pharma companies, okay. I've never seen a global customer in my life. Meaning every customer there's no one customer that you know, is no, every customer has their own specific, you know, wrinkles, Sona. Yeah, but it's your job to be there in the specific way that they like to consume the service.

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Chris:

Right. Yeah, I love that perspective. And I guess I should have clarified earlier for our audience. specialty drugs. You've mentioned rare diseases. You mentioned oncology. What are the use cases for specialty drugs as opposed to what I go to Walgreens for?

Yishai:

Yeah, so these are really the life change, disease, a life changing dying diagnoses, and these are the most potent drugs. So for example, for asthma, you can have an inhaler, which is very affordable. Or you can have an injection if you have severe asthma. Okay, or bone density, you can take a pill which is usually retail or you go and get an injection that is really going to you know, it's a much stronger intervention. Okay. Oncology, very often specialty, and when specialty is a certain designation of drugs that typically require a special handling, usually the more expensive, there are more steps that need to be handled. And the key is that, you know, because the population is not that widespread, then it's not that your CVS or Walgreens is going to have it at every store. Because you have maybe you know, for rare diseases, you may have only 1000 patients throughout the country. Right for another disease, you even may have 50,000 or 100,000 patients around the country, that still doesn't justify having that drug stored in all these retail patients. So that's why there's a set entire entirely different sets of pharmacies that are called specialty pharmacies that handle these types of drugs. So hopefully, most of our audience has not had the need to interact with any specialty prescriptions. First of all, from a health point of view, and second moment, administrative point of view is just a nightmare.

Chris:

Right? And so you've been working with a number of customers to improve this patient experience. But I'm curious as to your business or when you're serving them? How do you measure the impact or success of helparound?

Yishai:

So the two main metrics are, first of all, how many patients actually get on therapy, succeed in getting a therapy? And the second is the speed of therapy. Speed. So how long does it take to get a patient on therapy, and it's as ridiculous as a person who got a prescription, and it took three months to get no therapy. Now, some, some drug companies, right manufacturers say, well, it's insurance, we started the insurance coverage process prior off, and the insurance company puts all these you know, you got to go through step therapy, meaning first you need to go through another job, or first denial, and you got to prove XYZ before you eligible for this, because these are very expensive drugs. But the reality is that there's a lot that can be done in parallel. And the proof is in the pudding. You know, when we launched, we launched, we helped run, supports a rare disease therapy, that for an equivalent one with our help round, I think it took like two months to get on therapy. And we shaved 45 days from that period, so we took only two weeks instead of two months. And that just shows that if you just connect the wires correctly, then you're going to have you then you can really get patients on therapy much faster. And that's a win win. It's a win for the patient. Of course, it's a win for the drug manufacturer. It's also a win, of course for the pharmacy. But it also weighed for the insurance company. And the reason is that if a patient is eligible, from the point of view of the insurance company, if the patient is eligible for certain treatments, get them on that treatment ASAP. Because if you wait and that patient ends up in the hospital, one day of hospitalization is going to cost you more than the whole.

Chris:

Right, right. Gosh, yeah, I know. And I love you putting that out because as you know, in health care there often so many misaligned incentives in this mix of patients, providers, payers and pharma. And just love that you're tackling a problem where truly everyone's incentives are aligned,

Yishai:

which is a very unusual, you know, a combination of, you know, circumstances, as you mentioned, this is one of the biggest, I think tragedies of our healthcare system is that there are misalignments. The patient ends up being the one in the middle that is left holding the back.

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Chris:

Right, right and left on the side when it comes to their patient experience. And now, yeah, it'd be kind of ironic that your product is a platform that helps build these better patient experiences. And it just works because of these aligned incentives. Now speaking of connecting the wires, help around is a gateway really a platform, like who are the customers that adopt the platform and what do they need to do to adopt it?

Yishai:

So if drug companies, when they launch either when they launch a drug or when they noticed that they're losing patients, so you know, and patients, you know, receive the prescription, but only and you know, only 75% of them actually get the therapy goes to drug manufacturers. Work with us to deploy a suite of tools that monitor assets, and  those are connected to one gateway , that one gateway also messages the patient, make sure that the patient is kept fully informed to in regards to where they are in the process, and what they have to do in terms of next steps. So are we partnered with the drug manufacturers. But then of course, we also have links to the prescribed platforms to pharmacies, a lot of other stakeholders that are reaching out to the patient and also want to get the patient on therapy, and to really create that win win.

Chris:

Right, turn it in. So you guys had built I guess, probably a bunch of easy ways or connectors, ways to plug and play with your system. And then, and, I believe, also create a custom patient facing experience, whether that's branding, or that's workflow. Both is that right?

Yishai:

Okay. That's exactly right. So when we work with, with a drug manufacturer, we look very closely at the patient journey. And we work with them to figure out what are the best ways like which hooks are right for them. And we have a suite of hooks, if you will, of API's that basically allow us to connect to the different vendors. And we are already connected to most of the vendors that you would have heard about, we already worked with, and we're already compatible with them. And they're compatible with us, meaning as a pharma company, they come and say, you know, and I'll, I'll come and say, Hey, I have this copay vendor and this new one, it's already already already wired into the health run gateway, you actually don't even need to do anything, just turn it off.

Chris:

Right? Gosh, that's an amazing place to get to, as a company, when you find that the majority of conversations are easy ones, because, oh, hey, this really will work relatively out of the box. And I'm sure it was quite a journey to get to that point. But once you do, man, that is such a huge moat, because we know integration projects go to die when you start working with a bunch of different vendors. And everyone's trying to coordinate and not everyone's as aligned. But that's awesome. Now, on the other side of the equation for the, we talked about the patient experience in those improvements. Now, on the pharma side, what additional insights into their patients do they get once they've adopted help around?

Yishai:

So one of the things that drug manufacturers crave the most is data about their patient journey, okay. And typically, what drug manufacturers get is the historical data that they get from either the data aggregators that connects all the pharmacies and tell them, Okay, we got x, we got X prescriptions, but only x minus actually picked it up, we actually were delivered actually paid, but then they don't know where they lost the patient. They don't know whether these patients, you know, gave up because of price, did they give up because the, you know, the farmer, the pharmacy called them and didn't pick up, maybe the authorization process is still stuck somewhere and depends on hold. So all the sudden, we are unlocking this view to the patient journey that the pharma company has never had before. And we tell it, guys, you had all these assumptions about your population. For example, one of my favorite ones is like how old people don't use mobile phones. Right? Wrong. Completely wrong. All right, people, my parents and your parents and like everybody's parents, that's how they get the pictures of the grandkids. They get text messages, they click through it. And yes, that sometimes they hit the dial. But, but the pharma doesn't know that. They have a lot of market research, but they don't know this information about their own patients. Right. I'll give you another another example. You know, let's say that a drug company that makes a drug for, for oncology, okay. Could be breast cancer could be could be something other than they have, you know, under the variety, right? People can get women to get breast cancer at the age of 30-40. Or they can be 50 or 60 or 70. who interacts with the Patient Support Program, the patient or the caregiver? They don't know. They don't know. Suddenly, they can know suddenly they know. I'll give another example. We have a rare disease, pediatric rare disease program that we're supporting. Okay. How many caregivers manage more than one sibling? It's a genetic rare disease. How many of them have siblings that have the exact same condition? Now that's kind of is actually difficult to measure unless you have one view of the patient journey. Right. And in that case, you can actually see, see that data. So it really puts the control in the hands of the people who developed this drug that is changing so many lives, and is now out there really in the real world. And they actually get a firsthand view to their patients and to the actual patient journey, and where patients engage and where to disengage.

Chris:

Right. Yeah, I think that's brilliant. Yeah, I mean, a lot of the applications we build, you start with an MVP, and then you let product analytics like Google Analytics Mixpanel really drive you in knowing what's actually working. And as you experiment with new things, is it improving or not, and tracking all these different cohorts write down their funnels, like checking out of your, let's say, retail shop. And I can't imagine flying a startup without that kind of insight. And now I'm thinking from a pharmar's perspective, where instead of a two step checkout process, it's a 10 step checkout process. Yeah, what?

Yishai:

You are the retailer, you're not the retailer. So you don't know, right? You put a product out there. But you have all these intermediaries. Now, I will tell you more than that. I think it's the you know, the tide is shifting even more. Because there are a few gatekeepers, okay, that stand between any business and the consumer. And that's apple. Right, right. Now, you know, they own, they own our experience now, right. And, you know, Amazon, on the shopping side, the stands between retailers and the consumer, Google on the Android side, you have all these internet gatekeepers that constrain the way that you can interact with the patient, or with the consumer. And that is yet another barrier between the drug manufacturer and the patient. So you got to be smart, when you build a gateway to a patient journey. The Gateway has to take into account what iOS, Apple iOS allows you to do and what it doesn't allow you to do. For example, remember the whole like, ask the app not to track, you know, the whole privacy campaign that Apple put out there. It's a real thing. It's a real thing. And if you're just going to build an app out there, and hopefully the best, you know, Apple is changing the requirements of apps all the time. Even text messages are, you know, starting to be trickier and trickier to get to consumers. So this is why Farmar This is why drug manufacturers need to think first of all, look at the whole patient journey holistically. And engage instead of silo by silo by silo oh, I need a hub check. I need a copay check. I need a pharmacy check. Really? Are you really just going to shoot the patient in all directions? And hope for the best?

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Chris:

Yeah, no, no that that's a great analogy that I'm glad you brought up these tech Titans that are entering the healthcare industry. And I'm just curious what impact you think they'll have on the healthcare industry? I mean, I think Amazon is probably in its early days. And then Google and Apple control different segments of mobile and wearables. What do you think about them getting into the market?

Yishai:

So I think, you know, Apple and Google are gatekeepers, gatekeepers on the patient experience. They have the front line to patient, they control control, and mainly curate. They basically throw your, your your whatever offering health care vendors, healthcare providers, or drug companies have. Now Apple is going to look at it or Google will come and say, okay, but you're just one, you know, what do I have on my phone? What does a consumer have an iPhone, they have Netflix, they have Uber, they have tick tock they have, I'm afraid to say Facebook, then Twitter. Oh, they also have this health care app from the provider. What's more important, right? Are you going to be categorized as needed service or you have an airline right boarding pass? Okay, so now you basically have Apple sitting there, you know, and hearing, oh, I'm gonna, you know, I'm gonna allow these apps to collect data, not collect data, what permission shins, is the patient going to have to collect? You know, am I'm going to allow the app to send, you know, messages? Or do they have to collect explicit permission from the patient? Oh, by the way, Apple, and this is one of my favorite examples is we just, we just wrote about it. And recently on, Mets on mesiti. Okay, Apple just took functionality that was a favorite on drug manufacturer, and made it native to iOS. And that's medication tracking. So you're medication reminders, there used to be a lot of apps, still are a lot of apps that help you remember to take medications, guess what, now it's built into iOS native. So think of that as like this is the role of, of the gatekeepers between you, whatever service provider you are, and the patient. Now, how do you navigate that? You navigate that by thinking about this through all the touch points that you could potentially have? Mobile is the number one. Right? Number one, if you look at any drug company, the website 80% of the traffic is mobile. Okay, 80% of the traffic is mobile comes from mobile phones. So that has a huge change now, so that Android and you know, Apple, that's that gatekeeper. Now, what's Amazon gonna do? Amazon is going to do what it's best as with retail, they bought a pharmacy, right? They bought, they bought pillpack. They, they bought  whole foods, they buy retail, they expand in retail, and when people shop the shops, with Amazon? How is that gonna affect you, as someone who sell something directly consumer or service over the consumer? Google, we will search, right? I mean, that's all that's all views of you know, how ZocDoc became a big, big venue, you know, after WebMD and had to deal with the gatekeeper, which was doable. So they're all of these are the gatekeepers, they're here to stay, they're not going anywhere. And I encourage any entrepreneur who's thinking about a new service offering in the healthcare space to really consider the gatekeepers that they have to deal with, because it could be make or break.

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Chris:

Okay, got it, and given these new gatekeepers are coming in and evolving, but also, you know, you're demonstrating the impact on the patient experience that you can have, if you're very intentional about it. What do you think the future of the digital patient experience looks like?

Yishai:

So there's a big question, what does it look like? I'll tell you, you know, one of my, one of the most famous quotes, was by Jack Dorsey, from Twitter, who said, technology needs eventually to disappear. What does it mean? And I think it was talking about the iPhone or the iPad, instead of when you're sitting on the iPad, you're not realizing that you're sitting on an iPad, you're just consuming content, and you're watching a show, and you'll get regular don't notice that technology hasn't disappeared. And if we do our job, right, if we do a good job, we the health tech industry, we would get closer to having the systems disappear from the health care experience. You know, just like, hey, I go and talk to the doctor today, in an age after COVID, I go to the doctor on my street, I'm not thinking to myself, Oh, I'm gonna log into that telemedicine portal. In order to talk to my doctor, I just go to talk to the doctor. Right, it's on my screens, technology disappeared. And telemedicine today, you know, finally was able to get there because you know, because of COVID. So the same thing is going to be with my Apple Watch and my phone. If services really do a good job handshaking with a patient engaging them, the patient is not going to think, oh, I need to download the app that would get me to that tracking. Right? The patient is just going to engage the service. And imagine a world where Digital Therapeutics is gonna do such a good job, will you wake up in the morning? And it's like, okay, well, here's your sleep metric. And I don't even remember what technology I'm using for that. I'm just going to be there. 

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Chris:

Yeah, no, I love that vision of the future. And I as you know, Yishai a lot of our audience are entrepreneurs or entrepreneurs that are trying to create that future digital experience. And I would love to just end with a few questions that I have on therapy Half sure in. So I guess my first question is at Persimmon, we work with healthcare startups across their journey, we generally break it into kind of three stages showing proof that an idea has value to achieving a viable product to attaining scale with more customers or offerings once you know you have a viable product, and I love that the beginning of help around, you had something that yes, it had value. But was it ever going to be a viable business? I'm curious what's different now? Or really? When did you know that you had a viable product in a viable product market fit business? Without helparound?

Yishai:

That is such a difficult question at the core of every entrepreneurial journey, which is, which is why you guys exist, right? Because it is. So it is so hard to put your finger on the right place. And it's especially difficult in a network effects type of business, where you need buy-in from different parts of the ecosystem in order to notice things like, oh, wait, that is clicking. And this is a clacking, right? This is like, there's that network on both sides. Working here, so. So I wouldn't, I don't know if I can put my finger on the you know, on the one plate in a moment to many, many different moments. But I think  key, one of the key moments was where we were able to look at the data. Okay, and say 123. In this case, we picked up the benchmark. In this case the benchmark in this case would be the benchmark. That's a moment where frankly, this is also what you the investor is looking for. Investors want to come and say, show me that it's working. Show me that it's working. The second piece, and I might flip the order. The first piece is someone who's willing to pay. Someone is willing to pay if someone is offering you a free pilot and the conversation, right? They're just like, Okay, there's no value. No, if you can't, if someone is not going to pay you for whatever you offer them. You're barking up the wrong tree.

Chris:

Got it, Yeah, no, I know. And it's easy to get intoxicated with that promise or those mou’s that. Okay, yeah, I find your idea really interesting. And then some people find out the hard way that that's only slightly a better signal than your mom telling you that you have a good idea. Right?

Yishai:

And so, yeah, pretty much and I would I would encourage, you know, I would encourage any entrepreneur, first time entrepreneur, to map out the path from the from someone saying yes to the customer pain. Okay? Because there's a big, big gap between someone saying yes, and someone paying. Now, map that out step by step by step and do it with the customer. And until then, you have nothing.

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Chris:

Right. Got it. Yeah. And that's funny. That's what help around does for this specialty, too. Right. Right. Printer. Yeah. Right. Right. So awesome. So final question. And, you know, I think every entrepreneur finds out how important it is to have a great team. I'm curious what you look for in your team members, and is there anyone you'd like to highlight that kind of has those qualities?

Yishai:

So my team is, that's always always hard, right? Because, you know, on the journey, you have different parts of the journey. And the company changes and people change and, but there are some, some people that, you know, have been there from the beginning, my co founder, my co founder, CTO, Shlomi. I mean, it was a long, long journey, and we both changed our life, our personal life changed, right now we're in different countries, we're now in different different worlds, and we have different commitments, different obligations. I would point out the person who actually today has her five year anniversary, in help around that Kenzi Lindsey Talador. Hopefully listening to us, and and has her adaptability, her ability to adapt and to reinvent herself. And I think Lindsay basically went from having zero technical background To being our To being our point product person. And she runs basically our product development. And with all the, you know the teams and development, so it is just a huge growth. So look for people that demonstrate growth, that they're looking for growth, that they're always looking to change the order that they adapted, if that person is an entrepreneur, and it doesn't matter if it succeeded or not, if they gave it a shot, you want them. And I'll also give big props to people who moved countries, because moving in country is a very intrapreneurial experience. And that shows a lot of adaptability. But you know, other than that, I think if you're looking for, you know, as you build a team, as the who, who method says, first of all, write down what you're looking for, before we start talking to you. What is it that you're looking for? Why, and How are you going to probe for these tricks? 

Chris:

Got it. Yeah, no, that makes sense. And of course, the life of a startup, as you discover with help around is you're going to need to adapt. Or, as Mike Tyson famously said, everyone has a plan until they get punched in the face. That's who you are, who you want around you is the people that are talented and can adapt with you, and are along for that journey. You're shy. Thank you for being on the pod. Thank you for all of your fighting for better patient experience. I learned a lot. I'll be rooting for you. And I'm betting our audience learned a lot and we'll be rooting for you too.

Yishai:

Thank you so much, Chris. Thank you, Bimal.  really had a lot of fun. And thank you for letting us, letting me share our journey.

Chris:

Awesome. Well, thank you. Have a great day. 

Yishai:

Thanks bye bye

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