Digital Health For The Whole Person: Wellframe Co-founder and CEO Jake Sattelmair

Welcome to the GrowthCap podcast where we chat with CEOs, investors and other key industry leaders to uncover insights and strategies for accelerating growth and succeeding in business. I am your host RJ Lumba, managing partner of GrowthCap.

In this episode, we chat with Jake Sattelmair, co-founder and CEO of Wellframe, a leading provider of digital health solutions that dramatically improves the patient and provider experience.

Jake is a Harvard and Oxford trained public health scientist and technologist, making him a unique person to tackle the task of improving the way healthcare is delivered.

Jake shares with us his journey building Wellframe and insight into how the company’s solutions are addressing today’s healthcare needs particularly in light of the current pandemic.

We hope you enjoy the show.

Listen on iTunes or Google Podcasts.

RJ: So, Jake, thanks so much for taking the time to chat with us today, very excited for this, particularly in light of what’s going on with the current pandemic.  But maybe to kick off, could you share with us a little bit of background of yourself as well as Wellframe?

Jake: Yeah, for sure, great to speak with you, RJ.  Yeah, so a little bit of context.  I’m Jake Sattelmair, one of the co-founders and the CEO of Wellframe.  A little bit of background, I’m an epidemiologist by training, coming from the Harvard School of Public Health and my research focused on characterizing the relationship between lifestyle behavior and chronic disease, risk, and prevention, and management.  And was ultimately drawn to the technology world based on an ambition to figure out ways to close the gap between what we know and what people do in the real world.  And  fell in love with the idea that technology could be used as a factor to influence people’s day-to-day health behaviors and healthcare decision-making that ultimately enabled them to get,  better outcomes and get higher value for the healthcare system.

A little bit of context on Wellframe, we’re a Boston based organization, or at least we were before we all became virtual.  And we were founded really with a passion to advance new ways of using technology and data to better organize healthcare resources around the needs of people outside of the four walls or in between formal interaction.  And our core business right now focuses on working with risk bearing organizations, primarily health plans but some providers as well.   I’d say broadly speaking the goal is to help re-imagine the  relationship that our clients have between their staff and members or patients using digital as a critical enabler of achieving that.  And our  core initial focus has been in the context of clinical care management services where we’ve been able to help our clients to digitally enable these clinical support services for high risk members with more intensive physical or behavioral health needs.  And really enhance the relationship between these care management teams and individuals that are going through periods of vulnerability and looking for some support in terms of how they navigate that day-to-day.

And then from there we’ve been  expanding the reach of our offering, the scope of our partnerships to enable our clients to deliver more integrated advocacy and navigation like services.  And the idea here is positioning health plans to offer more holistic support to more of their members through a mobile and digital channel.  To make it more convenient for members to get support across health and clinical issues, as well as benefits and customer service type issues, as well as support in the navigating healthcare system.  So that’s the path that we’re on and,  we have the privilege of working with a growing number of healthcare plan clients across all lines of business, so working across,  commercial, Medicare, Medicaid and exchange businesses at this point.

That’s helpful.  And you have a deep background in the medical sciences, but glossed over it a little bit.  But maybe if you could go a little bit further into that, your educational background.  And how that’s played a role in Wellframe and shaping  the solutions you offer.  And I ask that because there’s,  quite a few companies out there in the healthcare technology space that aim to do something similar.  So I’m curious as to how  your background and  deep knowledge base in this area has played into the company.

Yeah and,  if you look at our founding team, I was an epidemiologist turned health tech product manager.  My co-founder, Trishan Panch is a primary care physician who had a lot of practice in London under the NHS.  And then come to the States to do work in research and areas of data science and health system improvement.  And we have partnered with a couple of  tech and data co-founders as well, so with very complementary backgrounds and different ways of thinking about the problem.  And I think that’s  what made it interesting to us is that we can think about some of the challenges that were persistent for people, especially those with chronic conditions and those with multiple chronic conditions.  Where the day-to-day of just managing what’s needed across so many different domains can be really hard and sometimes overwhelming.  And then mapping that to a healthcare system that was,  primarily built for episodic engagement, but who has been investing in resources and service lines.  Whose job it is to provide support to those individuals,  between clinical encounters, but had struggled to do so effectively at scale, right.  It’s really hard to know what people’s day-to-day needs are and anticipate those needs, let alone, provide that support in any  intimate way of scale.  And so you look at these programs that evolve to have,  telephonic programs or home visit programs.  And there’s certainly a lot of value there.

But looking at things like mobile and machine learning emerging that offered new opportunities to extend therapeutic relationships and enable high touch support, both from an impact and a support perspective.  But also from a data capture perspective to just really understand people’s evolving needs and pick up signals of risk or de-compensation or where people need additional attention, there’s a lot of opportunity there.  So that was a little bit of the context.

And I think from a,  from a background perspective, we were all  coming at it initially thinking about the human need more than any particular business model.  And it actually took us a good number of years before,  we  landed on a business model and a growth path that made sense.  But I think our intense focus on understanding that human need and thinking about technology in the context of caring relationships, and about how technology could be used to advance and extend those relationships as opposed to replace them.  I think positioned us well to make an impact on the lives of end users as well healthcare staff that were using our platform, and ultimately create value that we could measure for our clients.

And so from an educational perspective a lot of my research had been focused on drawing causal inference from observational datasets.  So where you’re trying to tease apart your best estimate of cause and effect without randomizing.  And at one point going into the technology world I had  assumed that I wouldn’t get to use that so much.  I think it’s a great grounding but not specifically.  And it turns out that if you look at programs like care management one of the biggest challenges has been just being able to measure the value and the impact of these services.  So from the start we’ve been able to advance the most  robust and rigorous methods that we can find with our clients.  But not only enable their services and engage more people and increase the capacity of their teams but also to look at what  impact that’s having on clinical outcomes and financial outcomes and to work collaboratively with our clients to evaluate that rigorously and use that to drive continuous improvement.  So in that sense I think that some of my  educational and research background has actually been really important and that commitment to rigorous evaluation continues to be a cornerstone of our partnerships.  And one that we continue to invest in and now thankfully we have folks in our team who have taken the methods and the approach that we use beyond where I was ever able to get.  And it’s been great to see that move forward.

And I would imagine that in addition to  the impact that technology is having both on the care providers and as well as the patients, that the users and the patients in particular get a sense of peace of mind from, and have the more frequent interaction.  And just maybe the feeling of being on top of their health plan or their health path I should say.  Is that what you’re finding among the user base?

Yeah, a 100%, so if you think about life for someone with,  living with clinical complexities or multiple chronic conditions, especially those that are not well managed, there’s a lot to keep track of, right?  And what we saw was that,  people would generally get pretty good care when they’re in front of a physician or in the hospital, but then,  they go home and 99 point whatever amount of the time, percent of the time they’re on their own, right.  And that’s where we saw people tended to feel overwhelmed, to feel scared, to feel uncertain.  To feel denial about what they needed to do to not want to think about it, to not have the access or the resources to understand what they needed.  And so the goal with the technology was to evolve from intermittent interactions, whether there was a physician or a care manager, or otherwise, to have a sense of ongoing connection, and support, and care, and through our platform people will interact with their daily mobile care plan.  That gives them iterative guidance on what they need to do each day to reinforce educational concepts, to remind them about things that are important, whether it’s taking medications or going to appointments.  And also we’ll list information from them about things like symptoms, or risk factors, or biometrics, or behaviors.  And all that data, it’s parsed through and prioritized and shared with a care team.

And then we open up a secure mobile communication channel back and forth so that, that patient gets guidance and feedback and support and encouragement from their care team.  And that everything they do on that mobile care plan matters in the context of that relationship.  And so because of that, unlike an approach where you say, “Here’s an app or here’s a portal or here’s a device, and you’re on your own.”  It’s really about opening up that relationship and helping people feel a sense of continuous care and support.  And I think that that’s been critical to our ideology as we work with healthcare organizations and it’s also, I think, been critical to the success that we’ve had, making the value equation for folks make sense.  And giving them enough through that channel so it makes sense for them to continue to engage, to continue to learn, to continue to share how they’re doing, because they’re getting more back in return.  And there’s no silver bullet here, and a lot of the populations that we support our clients in serving are challenging populations to engage and have different vulnerabilities and a lot of constraints outside of healthcare that might make things harder.  And so it’s never perfect but I think taking that approach has certainly helped a lot.

And Covid-19 obviously has exacerbated maybe the stress on the healthcare system.  And I can imagine a communication tool comes in very handy.  But what are some of the things that Wellframe has done in light of the pandemic and in light of,  trying to keep the communication lines open with its users?

So a lot we could touch on here, but I think as you pointed out, the healthcare organizations with whom we work have, as you might expect, in response to Covid said, “What can we do to provide extra support especially to higher risk more vulnerable populations?”  Tend to be the people that we’re enabling and to support to begin with.  And so in general, you see these organizations doubling down on digital as a channel to extend support to high risk populations in more convenient ways and in safe ways for those individuals.  And obviously there’s been a lot of press around the massive push to telemedicine, as in person visits have been unsafe in many cases, but the need to provide support to people in between those short episodic interactions with physicians persist.  And I think as more people start to lean on digital as a channel to get clinical support, leaning on digital as a channel to get support in between those  clinical encounters becomes more and more natural.  And we’ve been able to do a number of things with our partners to help focus our platform there.  So while better managing chronic conditions will help no matter what, we have also developed some programs and content that focus on prevention and awareness and guidance for people who are looking to reduce their risk of Covid.

We have launched assessments for our higher risk members on our platform.  We also are helping our clients to better understand what people are thinking about and what they care about and where they focus.  So as an example, using natural language processing, and a lot of the messages that go back and forth between patients and care teams, we’re able to pick up trends in the population about whether people are talking about concerns around Covid or flu symptoms or stress and anxiety, or looking for telemedicine.  And that’s been able to help our clients be more responsive to the needs of their higher risk members and patients as they evolve.  And so I think that there are different  phases obviously.  And as we’ve seen our clients shift from some of the immediate response to the more of the longer strategic investments, I think it’s pretty clear that this has accelerated the shift to  all things digital as an imperative to be able to provide high quality care in more convenient settings.  And,  we continue to invest in ways to help our clients do that across more people and to help them in more different ways.

And I guess sitting where you sit, do you and your team have a certain view of how long some of these conditions will last in the environment and how long, particularly the folks that are at risk will have to remain  somewhat supported or very mindful about social distancing?

Yeah.  We did a survey of individuals living with chronic conditions to better understand some of the behaviors that you’re alluding to.  And it was not totally surprising, but really telling that a majority of people had avoided physician visits for chronic conditions, that there is increased levels of stress and concern about managing conditions.  There’s increased motivation to be proactive about various chronic conditions and in part, in order to better manage risk from a Covid or infectious disease perspective, and that there was a concern about not knowing what to do all the time.  And so a lot of the trends that you might expect, now, how long those persist I think depends on a lot of factors.  And I think even right now in the US, it’s probably pretty different across geographies given how different the experience is in different states and regions.

I think that over time we will see  a leveling out of telemedicine or virtual care to leverage digital a lot more where it makes sense, but to start to go back to in person visits where certain physical interaction or diagnostics or otherwise are necessary.  But I do think that this has catalyzed a lot of changes that will persist from a consumer expectation perspective and from a behavioral perspective for both care providers as well as patients, and from a regulatory perspective, right.  As we hear from plans and you see some of the messages coming out of the federal government about their plans to persistently support more virtual care options.  Yeah, I think this has certainly catalyzed changes that will persist for a good amount of time.

And I mean it’s interesting, switching gears a little bit into viewing the business dynamics of the healthcare industry and healthcare technology in particular and the rise of telemedicine.  But do you, and not to be insensitive about the broader  environment.  But has this been, I guess business wise, has this increased the amount of activity that you’re seeing?  And does this  in some regards, increase the value of the solutions you provide, both currently and into the future?

Yeah.  So I think even going into the Covid pandemic we saw a number of temporal trends that as you might expect were pushing consumers as well as healthcare organizations in the direction of some of the solutions that we offer.  I think that the consumer expectation to use mobile and digital, to access support and resources is only going up.  And I think that some of the market dynamics have put more pressure on incumbents to accelerate their pace of investment in services, in experience and in digital relative to new entrants among plans, providers and other third party service providers.  And so I think that we already saw trends that were moving in a direction of increasing demand for some of the things that we do as well as a number of other digital health companies, and in Covid certainly accelerated a number of those trends.  And so we see this as an opportunity for our clients to step up to invest and doing more to help vulnerable populations and for us to be able to step up to enable them to do that at increasing scale and with increasing effectiveness.  And so it’s been – I think it’s been helpful for the team here to feel like amidst all of the tumult and uncertainty, we’re able to focus on doing something where we can be part of the solution, and,  and to make impact at greater and greater scale.

And where do you see the company in three to five years?  Do you find that your solution has the potential to be somewhat ubiquitous across all the potential users in the US or maybe even globally?

Well, I think it’s been very encouraging over the last several years to see consistent significant growth in the number of individuals that we’re enabling support for and the ways that we’re enabling support for them.  And I see that continuing over the coming years.  And part of that is as we work with more and more healthcare organizations that have reach to more and more people.  The other part is as we invest in our  digital health management platform, we’re enabling different service lines and different resources to support more people in more different ways.  So while we started more specifically focused in clinical care management, as we’re starting to expand that to enable broader advocacy type services that are relevant for a lot more people and enable support for them in new and different ways.  I think the opportunity for impact gets larger and larger.  And then the other part of the investment is trying to break down some of the silos that have existed relative to how supportive services have been offered to high risk individuals to make it easier for them to get their needs met in simpler ways.  And to not have to go  chasing information or go chasing resources across different organizations, or even different service lines within an organization.  So we’re pretty excited about some of the investments that we’re making with our partners and the opportunity for impact that we see overhead.  And maybe ubiquitous is a little bit aggressive, but certainly pointing towards reaching a larger and larger proportion of the total population here for sure.

And we’re coming up on time here, but I would like to ask a question that I ask quite a few of our guests in that the entrepreneurial journey is a very challenging one, and one that not many experience, having gone through  your time, helping to build and scale Wellframe.  Is there a piece of advice or an insight that you’ve  come upon and have really internalized which you think would be helpful to others that are either thinking about,  starting their business or currently,  on their own journey?

Yeah, I mean maybe two things in terms of deciding to start their journey; I’d say it’s important to follow something that you’re so passionate about, you can’t not do.  Given all of the challenges to overcome and the effort that you need to put in, I think it’s important that you’re doing something you really feel passionate about and where you feel you can make an impact that matters.  And then I’d say that to be most helpful was shared with me long ago by a coach I had when I was younger and it was, don’t,  in the pursuit of a long term goal, don’t let your highs be too high or your lows be too low.  And I think that is guidance that I’ve used more than I can count along the way, and it  helps keep a level perspective as,  we’re pushing the rock up the hill and pursuing  long term impact with a lot of ups and downs along the way.  But overall it’s been incredibly rewarding and a real privilege to have the opportunity to take this journey.

Well, Jake, really appreciate you joining us, you’ve been generous with your time, spending it with us.  So thank you.

Thank you very much.  It’s great to speak with you.

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