Solv Health | Delivering Same-Day Healthcare

Hey, everyone. Welcome to Gray Matter. I'm Heather Mack. Today we're diving back into our series focused on health technology startups. This sector is among those that has grown significantly during the Coronavirus pandemic. We've been talking with the leaders of these startups to learn not only how entrepreneurs can adapt to sudden surges in business, but also how to do so while working remotely. Our guest today is Heather Fernandez, who is the CEO and co founder of Solve Health. The company provides a platform to facilitate a range of healthcare services, from appointment booking and virtual visits to digital paperwork and payments. Since the pandemic hit, Solve has seen a huge uptick in user growth and has quickly expanded its services to keep up with demand. Prior to Solve, Heather was on the early team at real estate tech startup Trulia, which was acquired by Zillow in 2015 for $2.5 billion. Now let's give Heather a chance to talk more about her experience as CEO during this wild moment in time.

Heather Fernandez, thanks so much for joining us. Welcome to Gray Matter.

Thank you so much for inviting me. I'm pumped to be here.

So before we get into all the specifics about your business right now with coronavirus and 2020 and everything that is crazy about the world right now, can you first give us a one minute company introduction? What is Solve Health?

Absolutely. Solve is very simple. Solve is an app where consumers can get access to convenient same day, next day healthcare, which is powered by a network of doctors who are running our software to deliver a modern patient experience. And that's both in their office as well as virtually. It's worth saying our mission is also very simple, which is to empower consumers to simplify their day to day healthcare needs and answer three really simple questions. Which is one, where should I go for the problem I have? Number two, when can I be seen? And number three, how much does it cost?

So you started the company in 2016 and what was going on in the world that made you want to get into this field in the first place?

Well, the biggest thing that led to the creation of Solve was the sale of Trulia to Zillow. So I was an early employee and part of the very early team at Trulia. And after almost a decade long run, we were acquired by Zillow for $2.5 billion. During that time at Trulia, I had three kids. I was incredibly heads down trying to be a great mom and employee and team member and wife and friend to the few people who I could still maintain relationships with. And so the biggest thing that happened was to me personally, which was I got to look up for the first time after a decade and really ask the question, where do I want to spend my time? It just so happens that I love to build through the process of really looking around. Once I made the decision to leave the merged company, I found myself talking again to a number of startups and my personal energy was really focusing me on working on something that mattered. Building a big business, but solving a really hard consumer problem.

Tell us about what the first few years from launching and then getting the company up and running.

So my co founder is Daniele Farnetti. He was my partner in crime at Trulia for that time. He ran the technology team and I ran a lot of the go to market teams. And the core of what we built at Trulia, I think it's important to say this, is we built an incredible consumer app and mobile experience focused on empowering consumers to make better real estate decisions. But probably 80% of our headcount in team at any time was really servicing the supply side of that market, which were real estate agents and brokers. Right. And empowering them with software and tools to deliver a better consumer experience. And so that alone really, that sort of that paradigm of a marketplace is really what we were looking to bring to healthcare. So the first year was not let's build solve. The first year was can we bring our talents into healthcare and solve a really hard consumer problem and build a business working with the innovators in the space. It was sort of that broad. So year number one was let's figure that out. Year number two, once we'd figured out the business model for solve and importantly figured out the entry point. So many challenges in digital health are not around having good or bad technology, but it's around where do you start within the category, because it is such a challenging category. You know, once we did that, you know, that was about building the early products launching in our first market, which was Dallas, Texas, and really trying to validate some of the value prop, both for the providers, the innovative providers we had on the platform, as well as some of the consumer behavior.

When did you really start to find a lot of traction?

I mean, I guess I'll answer that on both sides of what we do, both the provider side as well as on the consumer side. On the consumer side, we realized very early, and this was part of the core thesis of the company, that consumers had been disaggregating their care. This traditional notion of one physician that I have for my lifetime, that's going to ensure that I have all of this preventative care and know my family is great. But there are real challenges in the US health system which had made that not the reality. And so as a mom, I had become a frequent visitor to urgent cares, in addition to our visits to our pediatrician for the care in between. What we realized very early was I wasn't alone. Right. And that there was a massive consumer Trend Dating back 10 years of consumers really optimizing around convenience and access. And then this one particular incredible category of urgent care, really delivering on that need, oftentimes in partnership with a primary care physician or pediatrician or within a health system. But really, as the compelling entry point, what was so interesting about that was, you know, we came into this category as healthcare novices, but all of the media that we were reading was about telemed. The reality is telemed was an inconsequential percentage of overall healthcare visits at the time, right? 1, 2, 3%. However, out of the billion ambulatory visits, 150 million of those roughly were within this convenient care category, where urgent care was the sort of the biggest player. So the first area where we got traction was really building up a consumer audience using a lot of the tools that came from Trulia so that we could help consumers identify where should I go that is near me that takes my insurance or ultimately I want to book an appointment? That was sort of the consumer side. And I would say that really started ramping probably the same time as the provider side. So that was roughly 20, probably late 2017, where we really started to see growth in the consumer site.

Yeah, that's when people were thinking of Solve as like an open table for healthcare.

Realistically, you know, what is great about that analogy is if it is as easy for me to identify where should I go to look at this mole on my neck or where should I go for my son sore throat? And it's as easy as saying, I want to go to Italian food for five people at 8 o'. Clock. Of course, in the world, when we all used to go to restaurants, if we can make it that easy, then of course that's a win. I would say on the provider side, the trend that we really were able to catch was just this shift to online. Frankly, we started the company with a real focus on one market, thinking that we would go market to market. And very early on, again within the first year of operation, it became clear to us that this trend of moving online, this trend that's effectively a more consumer centric trend within healthcare was really taking off. And so it was important for us to actually work with providers across the country versus market by market.

It's crazy to think about how long it took telemedicine to get to where it is today. These companies like Teladoc that have been around for more than, I think, like 20 years now, something like that, and people were still barely using it. And then was it today or yesterday? Teladoc livongo acquisition of $18.5 billion.

Nice work, everyone. It's almost not accurate to say how long it took. Right, because you had. Yes, it started 20 years ago and it's been a slow, slow build. And then COVID 19 happened. Right. And that it's a transformational moment in so many ways, which I think everyone universally has believed. And when I say everyone, policymakers, health systems, plans, startups, everyone believes that sort of this digital wave was coming. It was just so much slower than anyone fathomed. And then you had this particular moment in time. I mean, as one data point, part of the SOLVE platform is telemedicine. And when we launched, we launched it in 2018, and it became very obvious that telemedicine was a list on someone's innovation board across every hospital system and provider group across the country. But no one was really acting on it because there was no incentive on the provider side. The plans had not fully pushed into that game and even consumers weren't demanding it. That was 2018. We effectively had it as part of our offering, but not something that we were aggressively trying to get out there because frankly, we thought that would happen, but it would take longer. I look at 2019, total visits on telemed on solve were 9,000. When we look at 2020. And so realistically, we're talking about, call it mid March through today, I think we've had 500,000 telemedicine visits in that period.

Wow.

Just to give you some data, if you look at, from when we launched in 2016 to today, there have been over 14 million patient visits consummated on Solve. Right. And so that's either in person or virtual, the vast majority of which has been in person. Right. That's 14 million. If you look at all of 2019, we had 9,000 telemedicine visits. And then you look at 2020. And again during that discrete period, we're now at half a million telemed. And so one last data point on this, through Covid, we went from effectively 0% of our visits to 50% during the phase when it was the only way that people could actually the primary way where people were seeing patients, now it's normalized at around 15%. That's massive. If across the country, 15% of visits shift to digital, that represents a number of things around our ability to access populations, you know, ensure high quality care. Add that as part of the care continuum. So it's a pretty fascinating time to be in the space.

Absolutely. So let's talk about like the very beginning of 2020 and you probably had a different plan in place and then this happened and you were able to meet this demand and really rapidly iterate and expand it. Like how did you do that? How did you get organized and delegate on who's going to work on this project?

I will say being overwhelmed with all of it, sort of emotionally and physically and everything else. It's helpful to feel like you're part of the solution. And I think that in many ways is what motivated the team at SOLVE in those sort of the beginning of the pandemic when we really saw that in the United States, you know, to paint a picture for you. Unlike most startups, you know, our job is to connect consumers with care. And so our day to day is looking at, you know, what their symptoms are or what their chief complaint is and then connecting them with providers. And so we have a really good pulse of what's happening across the country. Until the middle to end of February, there was nothing. Right. And then the last week of February we got a call from Multicare Health System, an incredible partner to us. And if you recall that first nursing home where the news broke in the United States, where there was a COVID 19 outbreak that was within a mile of their facilities.

Wow.

And so very quickly it became very clear to us that this was going to spread rapidly and no longer be a problem that we're reading about in the New York Times, but rather be one that we are facing day to day. And so that weekend and then that Monday, we opened a war room. We got on the phone with our team and everything from ensuring that we had a Covid bot to triage patients to the right place first to prevent infection among staff. Because as we all know, staff across the United States healthcare staff were not prepared for the outbreak. Then enabling telemedicine, creating all the documentation, ultimately powering the testing that they were doing and high throughput testing across their sites. We in effect had a head start in Seattle and at that point we then proactively notified our partners and frankly our databrace across the country with here are the Best practices based on our learnings. And now let's partner with you. What that kicked off for us, frankly, there was a lot of things, but really that's when telemedicine effectively just skyrocketed.

Were there things that you had to like, stop working on?

We did all of this great first half of the year planning. We effectively burned all of that. But what it really did is just it enabled us to accelerate things that we were planning to do later in the year and into next year, namely telemedicine payments and then increasingly expansion to other specialties. And so all of those things were accelerated in the COVID moment. So it's not that we had to pivot. There was very high incentive and adoption of the things that we wanted to do. So as I look back on that time, it was certainly stressful for the team, but the team was very motivated because we could see every day that we were enabling people to get care who otherwise wouldn't. We were helping to keep essential workers and healthcare staff safe through our core technology, whether that's telemed or SMS based communications. And the reality is that's motivating.

And where is Solve Health today as a company? Where are all your employees?

Well, we're all over the place like everyone else. Um, in February we had our headquarters in San Francisco, we have an office in Denver, and then we have a handful of folks across the team that are distributed. Today, like everyone else, we're fully distributed. In fact, I think it was the second week of March. Again, based on what we were already seeing, we made the call to send everyone home. And then a month after that we made the call that we would be fully work from home through the end of 2020. So as a result, our team has distributed even further. Right. And so we've got folks in Hawaii, we've got folks in, you know, Washington D.C. and like everyone else, we're figuring out the operational rhythms of this new world.

What was the hardest part about that?

You know, I think for us we were already really well suited to be a distributed team. Everything's in the cloud, you know, our security measures are all in place. We're a slack first organization, you know, so in some ways we were already equipped. And the biggest reason why we had not been more distributed previously was that it was hard to imagine a hybrid situation and having the same level of efficiency and engagement. You know, now with 100% remote in many ways, everything worked. The pieces that you lack in an entirely remote world and the parts that I personally struggle with are not productivity and efficiency. The areas I think of struggle are those meaty, strategic, cross functional challenges that you want to work through are just harder on a four hour long zoom, where a four hour long meeting in person is actually much easier. The other thing that I really miss is sort of the magic moments that aren't scheduled where you have that insight in between meetings or walking, you know, to go pick up lunch. And something that's been on your mind or on your colleague's mind is all of a sudden surfaced and it becomes very clear that that issue is now an opportunity or a big priority. Like I missed the serendipity. Once you talk to someone, Heather, who sorted out how to get serendipity back, let me know because that's the one we're still trying to work out.

No one has figured that out yet and it's what everybody wants. We've been doing a whole podcast series on specifically on remote working and new tools. And literally that's what every single person says that they really want. And no one's figured it out yet. And I don't think anyone's going to start wearing VR headsets or anything. Let's talk about your customer base, like who are your customers and what's changed about the ways you're interacting with them or what are they from you? That's different. It sounds fun where you are. I hear a lot of laughter.

Do you hear the laughing in the background? I apologize.

No, it's totally fine.

Life though, that's a 6 year old, a 9 year old, and probably a 12 year old looking at them with a really annoyed face right now. Can I pause and I can go ask them to keep it down. Can we pause for a sec?

Sure. No, it's really not that big of a problem. But like if. Let me go a tiny bit.

Yeah, let me go to. Hold on. Hey guys, I'm on a podcast. I need you to keep it down. Okay. How's that crisis potentially averted, but no guarantee on the longevity. It's fine, it's fine. I mean, if I can highlight one, I think. Interesting thing that I personally enjoy about the fully remote thing, both with our own team as well as partners and customers, is everyone is forced to be a bit more real. The authenticity quotient has just gone up because we have no other choice. And there's something kind of magical about that.

Yeah, no, it's. It's great.

Okay, so your question on what has changed? Let me highlight the biggest thing for you. You asked a question earlier about our roadmap and we in many ways accelerated what we already planned to do. The thing that we did not plan to do, however, our core assets of the company happen to be really well suited and now has become a much bigger part of what we do is participation with cities and states, as well as our partners in COVID 19 testing. Right. And so if you think about our footprint, right, we primarily have had Urgent Cares running our software across the country to the tune of, you know, 200 million people across this country can book a same day, next day appointment on SOLVE within five miles of their home. Right. And that's a lot of how we thought about our growth is how do we increase access by ensuring that we have a broad footprint so everyone can get the care that they need. It just so happens that 80% of those are running COVID testing today. What happened was within the solvehealth.com and Solve App, searches for COVID testing started to really grow within the provider side and particularly within this urgent care category. We were seeing more and more capacity of testing. We started talking to cities and states around how do we improve access and use our core technology to enable testing across those organizations? And that is very new. The city of Seattle as an example, we're working with the University of Washington labs, the city of Seattle, the fire department. And the core SOLVE software enables the identification of the booking. So the online booking, core high throughput workflow, as well as data fidelity and connectivity to labs for the testing. And so they're doing, I think, 2,500 tests per day through SOLVE. It's something like 75 patients per hour. It's not just the core booking, but our software, which we were already using across providers across the country, we realized was incredibly relevant for this high throughput testing use case. That's been an incredible opportunity for us to really be part of the public health solution and also scale the business that we're growing. To date, we facilitated roughly 700,000 COVID19 tests on the platform. And we're just at the beginning of that, potentially, if you look at the CDC guidance in terms of what is required for us to open up as a country, this looks like something that we can do that is a very clear public health initiative and then a clear growth initiative for the organization.

Wow, 700,000. That's from finding where you can get a test, to booking it, to going to get it, to accessing results, to paying for it if you're paying for it or having the insurance deal with it.

Different partners are using different components of the software. But think of it as I'm going in through an entry point. So whether that's through Solve, I'm going to go through Google where there's a Solve partner. Think of all of those as entry points and then the core access to the capacity as well as the workflow, the software that manages the workflow. Right. And then the connection to the lab is all Solve and that's our core software that we've been building and you know, really iterating on since 2016 and happens to be a really good fit for this use case.

That's great. I do want to talk about when you were first pitching investors, when you decided to do Solve. And something that I found really interesting when I first heard about the company was you had some non traditional healthcare investors involved, but those who have been known for spotting real big enterprise consumer beds like Benchmark and Greylock. But I'd love to hear about what the experience was like pitching in those early days.

I didn't start out meeting investors with a pitch when Trulia was bought by Zillow Daniele and I effectively started meeting with whoever would meet with us, including investors, as we were refining our hypothesis for what we could build and we were working with the investors and identifying who is interested in the space that we're interested in and who can be additive to us. I mean, it was an incredible opportunity for us to work with incredibly smart people like James Slavitt and Sarah Tavel, who's now a benchmark, and Bill Gurley as they were thinking about these problems in healthcare. And so by the time we were actually fundraising, there was no one that we talked to who we didn't already know. And so, you know, I sometimes get asked to give advice to entrepreneurs. This is a hard one. However, if you can ensure that the first time you're meeting with an investor is not asking for money. Right. You should figure out all of the ways to do that. And so when we were first raising money, I would say there were certain types of investors who really leaned in. Those that had been longer term healthcare investors had a lot of skepticism around our approach. And that's okay because they gave me great advice and then now are great supporters of what we do and continue to give me great advice. But it was very clear to me that coming from a non traditional background, we effectively had to prove it right before the more traditional healthcare investor is going to take a look at us and say actually you can improve access and outcomes right within this healthcare ecosystem. And now we can see it.

That's Great advice too for entrepreneurs. Thank you so much. Has anything about those conversations changed now with investors? If you're in a position where you're thinking of taking on more capital or even figuring out if you should be thinking about it, like what are the conversations like today?

Well, you know, they're a lot easier. The good news is, like I said, We've seen 14 million consumers in front of a provider in some way. We've had incredible growth. The telemedicine. One data point that we collect is where would you have gone if you did not book through Solve? This is direct through Solve, roughly 15 to 20% would have gone to an emergency room. So putting on your cost savings hat right. We've been impactful in directing consumers to the appropriate side of care where they can get quality care but at a lower cost and to the tunes of multiple hundreds of millions of dollars of spend saved. Right. That makes our conversations with health care investors, payers and other sort of larger entities who previously wouldn't have paid attention to what we're doing that makes them all pay attention. We're now at 6 million web visits. So not doctor visits, but 6 million web visits to solve per month. Once you have proven that there is a real customer side value proposition and that's the SOLVE operating system enabling the online booking, the workflow, the telemedicine, digital payments, digitizing, the intake, all of those components and you've monetized it and you've proven it. And you also have a big and growing consumer audience. We're actually connecting them to care. More people start paying attention.

And at the same time there are several other telemedicine platforms out there, not just the big ones like Teladoc or American well, but a lot of other little startup solutions and point solutions. What's the most defensible aspect of Solve?

We don't pay $1 for our consumer acquisition. There are incredible startups that are working in telemedicine against very specific use cases that have gotten a ton of traction. So obviously looking at a lot of the direct to consumer drug space has been really interesting. Another area is working specifically with payers against a specific population where that's going to drive demand to you. And then there's a whole other group that are just sort of broad telemedicine. I think that's a hard category to win in because you're now competing for patients with traditional providers. One thing that happened the shift with COVID is it's not a third party physician who I've never had a relationship With I'm now going to the same primary care physician or urgent care doctor, but now I'm just visiting them through a different modality. So we're actually enabling that. Right. And though. And as you think about the consumer sort of demand generation, we've been building that over the past for years. Right. And so we've built a audience that is looking for access to care without paying a dollar to do it. This is again one of the Trulia learnings. Right. If we build a website and mobile app that's going to help consumers answer some questions which happen to be really hard to answer in healthcare, we're going to be able to build a significant organic audience who's going to come to us seeking that career. That's something that we started doing from the very beginning. One other key difference actually that might be interesting to highlight is at Trulia, we built that audience, but of course you're not going to transact. Right. There are lots of people who look at houses all day long. Thank you all very much. Because that was a great business. We were able to build from all the people who are looking all the time at the really cool new kitchen or what their neighbor's house was worth or their boss. It was great. Like that was basically, it was a top of the funnel search where ultimately the unit of value was the lead that was sent to the agent, but that real estate agent would then make 3% on a transaction. So they could be fairly infrequent. It made sense to build this big audience. In healthcare, many people take the same approach, but the equivalent is like symptom search. When you hear that 1 in 18 searches on Google are healthcare related, that's really attractive from a consumer technology standpoint. However, the way we approached building a consumer audience was not let me acquire all these people at the top of the funnel who want to know like what the green bruise versus the black bruise means. There are lots of people who do that very well. Ours is people who want care now. So conversion to actual appointment on Solve is incredibly high. Right. Because we're not again looking at the symptom level. We're looking to fill the need when they have it.

Let's talk about a little bit more. What's the same and different from working at Trulia and working at Solve. They're both big companies and really interesting times.

They're categories with very large players, similarities, heavily regulated, quite opaque for the consumer in all scenarios. Tons of online traffic associated with each category. You know, in terms of our approach, what was the same At Trulia was work with the innovators who are really trying to deliver a better consumer experience, power them with software, which ultimately will lead to higher roi, them making more revenue. So we brought that mental model to solve. And then I think a really interesting thing is the fact that we had these economic crises with both companies in the categories that we were operating in. Right. So the 2008 crisis in real estate, in the economy, specifically with real estate. And then of course in 2020, this healthcare crisis with the pandemic. You know, when I think back to Trulia, then I can't recall how much traffic we had at the time. You know, but clearly our paying customers were going to make far less revenue. Right. People were unable to buy houses. However, we were still growing. And what we realized was in that moment, again, on both sides of the marketplace, there became a trend really focused on deals, frankly. Right. Price cuts, what's happening across the country, where can you have more value? We started surfacing foreclosures as part of our core search experience because what we realized is people would continue to look, but what they were looking for and how they engaged was changing. And we were really able to take advantage of that to scale our consumer audience and then continue to build our customer audience, which again were the brokers and real estate agents. And that really took us through that period. Fast forward to today. We're now in a much worse in many ways, but now we're in healthcare. And so similarly, the trend that became very obvious to us, again starting with the consumer side, was I need to get care and telemedicine is how I'm going to do it. And so identifying the provider side who wanted to deliver that to them. And then the second element is what I just talked about with COVID testing. So in many ways, in both scenarios, we were able to identify how does what we have service the new needs on both sides of our market today. And how is that different than it was two months ago. And so it's just been, you know, it's been a really interesting experience. I hope that it's not, you know, causation, correlation. It's a joke. Obviously.

If you start another company next, I wonder what sector will cause another huge economic upheaval.

Definitely us.

That's really interesting. Now, are you hiring locally or are you doing remote?

We are certainly open, looking at a more distributed team. Like many organizations, we're trying to figure out what does remote work and flexible work look like at solve in the new world. The one thing that's very clear is we don't go back to what we were doing before. And so yes, now we're actually hiring basically for every role. And so anyone who's interested, please reach out. But sales, engineering, customer success, product marketing, we're effectively hiring across the organization, bd, you know, it's a whole new challenge trying to recruit in a much more distributed way and then onboard, that's the new challenge for all of us for sure.

What do you hope the rest of 2020 is going to look like? Or getting into 2021? Do you have a roadmap?

I mean certainly for the company, we have a roadmap. Is this a company question or is it a Heather personal question?

Oh man, that one's too hard. I don't know who has one of those. I guess how do you create a roadmap knowing that you have to have a lot more flexibility in it now because anything could change again or.

Yeah, I mean like I said, Heather, we're not doing anything that is outside of the vision of the company and where we want it to go. So whether that's accelerating the shift to digital. So like I said, not just telemedicine, but really digitizing all of the upfront experience as well as post experience. Right. Like that was already in. Roadmap continues to happen. Telemedicine clearly. COVID 19 testing is a new dimension. Think of it as a new service and we're also working with new partners. But ultimately, like we started this call, right? Where should I go for the problem I have? When can I be seen? How much does it cost to enable the consumer to have access to high quality same day, next day care? Right. It is all consistent with our core mission of what we're doing. So that's probably the element that has least certainty. But what is very clear is continued work with state and local governments to enable access will continue to be a priority. Right. As the testing landscape shifts, you think about antibody testing and vaccine distribution and frankly all the stuff that happens. And then as we enter flu season, right. This is all consistent with our core plan. It's just the unexpected element. Flu season is right around the corner, right. These are seasonal businesses in a non pandemic world. And so, you know, thinking about the scenario where we don't have it under control and we're launching into flu season, we may see telemedicine go back up to 50% depending on what's happening in the country. I like to remain optimistic. I think that there is going to be more testing, there's going to be different types of testing that become more available because I'm an optimist at heart. But, you know, ultimately, I think we're equipped, were equipped effectively, no matter what happens.

Before you were working in startups, you worked in communications, including working as a deputy press secretary for Senator John McCain during his presidential run in the year 2000. And you've mentioned in the past how this experience really helped you learn some of the key lessons that would shape how you thought about approaching entrepreneurship. Can you share a little bit more about that?

Absolutely. First, let me Clarify is John McCain's 2000 presidential, which you said, which is the straight Talk Express John McCain, not the 2008 campaign, which I was not involved in. That was an incredible, incredible training ground to be an entrepreneur. And every time I talk to someone who comes from politics and then specifically from campaigns in my startup life, I'm immediately attracted to. I certainly didn't know it at the time, but I think fundamentally, so much of what I learned sort of came from that experience. You know, first he assembled basically a band of misfits. You know, John McCain in 2000 was not beloved by most Republicans, so it was not conventional wisdom that he was going to come anywhere close to winning. So he sort of brought together this band of misfits who really didn't give a shit about what other people thought, but they believed like, in the candidate and in the mission. Right? And so that was sort of lesson one. When you are the underdog, finding the organization, the team that's going to stand with you against conventional wisdom is sort of the most critical component. Second is, I just remember, you know, Forbes was also running in that primary. Our headquarters was a little shack of holes in the walls in Northern Virginia, in our. In Old Town, was not anything to look at. I don't recall there being many windows, you know, but we were there 16 to 18 hours per day, seven days a week. And I remember to get to the office, I used to have to walk by the Forbes campaign headquarters, which was like brick and beautiful glass. And I. I have a recollection of there being like workout machines in the windows. I just remember thinking, like, wow, like, they're spending so much money. So that was sort of the second thing. It's like, more money doesn't mean you win. Right. And so especially at a startup, recognizing that, like, the scrappiness that comes from not being overfunded is actually a great thing. And then I think the third main lesson was around when the Bush campaign, who. That's who we're running against, in the primary, started spreading the rumor that, you know, McCain's POW years, which in many ways were so much of the narrative that made him great and made people love him. But what they did is they took that and they turned it and said, actually being a POW for that long, of course, would make you crazy. And so this became this narrative in the media that he was not stable to be president. And we did the coolest thing. And I take zero credit because I was a deputy press secretary, very junior person looking at all these senior people. And what they did was they basically released all of his medical records. So they were like a dozen giant binders of medical records. And they just made them entirely open to the media to pour through them. And so that was sort of my lesson on radical transparency. Right. There's an element of taking the narrative and then just being really, just really transparent about who you are. You, of course, are going to still. There's a lot of stuff in those medical records, but that really shut down that story and then really helped us in that race.

Wow.

Yeah. We ended up winning New Hampshire in that primary. It was incredible. Another fun story on that campaign was we had the Wall Street Journal editorial board on the Straight Talk Express one day and he kicked them off because there was this kind of punk reporter, that's how I remember him, named jake tapper@salon.com and he loved Jake. And he was like, we don't have space. You guys are off. Jake, you're on. And I just remember thinking there's something like that. Unconventional. Doing what he thought was the right thing versus the thing you're supposed to do. It was really an amazing experience.

That's the perfect segue for this next question about. We've had a lot of CEOs on gray matter lately who talked about how this moment in time is really changing the way that they're approaching their role. Like not only from basic things like how often they hold their all hands meetings, to what kind of mental health support they provide, or just getting better at making decisions very quickly so that the team can feel a little bit more peace of mind.

How has the role changed for you during this time?

It's an interesting question. I think the role of the CEO feels very different right now between the uncertainty of what's happening across the country with COVID 19 and then add to that the appropriate and righteous anger around racial injustice in the country and what feels like social injustice while we are all in our homes and unable to socialize with the people that we love and do Things to distract us. The moment is very intense and in some ways it feels like the role of the CEO is in part to acknowledge that. And where there are statements to be made where you decrease the uncertainty, the importance of us doing that is just so much higher. Even minor things. Like I mentioned to you, we decided fairly early on to continue the work from home, remote work through the end of 2020. It certainly wasn't clear that the world wouldn't be back. Right. That San Francisco wouldn't be back open and people would be back at the offices. But it was just so clear. People needed to have some certainty versus this. Every day, every week, every month update that was incremental. And so that's what I mean. Right. Areas where you can provide certainty. I've become much more biased to give it. Or areas where I may not have the final answer, but I can disclose the progress. I'm much more inclined to be proactive about that. I think to effectively try and add some normalcy or stability in like these pretty volatile times. There are also just a number of tactical things that we're doing differently. Proactively monitoring vacation time so we can reach out individual by individual to say, hey, you haven't taken a vacation, you should schedule the time off. There are little things, but thinking of that as the company as a whole, to make sure that self care is a priority. Things like enabling a wellness monthly benefit for the Meditation app. We're a startup of 55 people, but the things that signal like self care is critically important right now for us to continue doing the important work that we're doing. You've got to take care of yourself. And so I could give you a long list of the tactical things that we've done. Probably the other big difference is as a leadership team, we're talking about it probably every other week, sort of getting a sanity check on how is the team doing and what needs to happen in order to ensure that we can continue to perform because our team is healthy. Yeah.

And also for you, I mean, you're a parent, you have three kids.

I do.

And are you homeschooling all of them? I hope you have, I hope you have co teachers and teachers, aides.

I would put a homeschool in air quotes. You know, I, I joke. It is really hard to be a parent of toddlers right now. I'm lucky in that my kids are 6, 9 and 12, so they're right in between where I don't need to manage every second of the day. During the school day. We create a calendar of what needs to happen. My six and nine year old boys are probably 70% compliant, which is good enough. We're all happy with that. And my 12 year old girl, you know, is in middle school and she's been a delight. And I think just as a team, as a family team, we've been very focused on supporting each other sort of through this and being very honest. It'd be much harder to do if I had a toddler right there that's sort of physically taxing in a different way. One other quick thing on that, a friend of mine made this comment to me a couple of months ago. I reflected on it because it's so true, which is the macro of this moment feels pretty stressful and pretty overwhelming based on all the stuff that we've discussed. But there is an element of the micro of the moment and for me, particularly with my family, which really is a silver lining. You know, in the past five months I've had dinner with my kids every single night except for one night which was my wedding anniversary to my husband of 16 years. And so there are silver linings in all of this.

That's great. What advice do you have for entrepreneurs today?

Interesting. So for health tech specifically, this moment in time is an incredible opportunity. When you think about one of the biggest impediments to progress, when you think about the consumerization wave is really around incentives. Who's going to get paid and where and how does the payer play into that and what happens to the fee schedule? All of that is so complex. This particular moment, especially the shift to digital, is going to enable new models to get traction. Sort of that combined with this other trend that's very population centric. And so I guess what I would say to the health tech entrepreneur is there are some incredible models that have worked historically and that's great. But like really press on the opportunity in this moment because I truly believe that a number of really compelling companies are going to come out of this that are just able to start on an entirely different playing field. Right. New models of primary care, new models of how you think about digitized health. I think my advice is do it, do it and think about how this particular unique moment is going to transform the next 20 years. And then sort of generally for entrepreneurs, I guess I would say don't believe the hype, you know, about how you're supposed to be or feel or you know, how successful you're supposed to be as an entrepreneur. I remember when I started, you know, so we raised the funds when I was 40 as a 40 year old mom with 3 kids and not conventional in my profile and people who care about me said I think it's going to be really hard for you and I'm worried. And they were right. They care about me. Right. But I think there's an element of we get to define what the next looks like. And so much of the, the narratives around entrepreneurism and who's successful are just not true. Right. Like the average age, especially in digital health is much older than that 22 year old in the hoodie. Right. Like that experience and your network and your maturity is going to enable you to succeed. So I guess that's it. Don't believe the hype. Right. Like if you have conviction and enough of the elements of magic and it really does take some magic and luck to get it all started, go for it.

That's great. And before we wrap up, we like to do little shout outs. Like if there's anybody on your team who's really stepped up in the last few months and really made it possible for, for you to really get through this. Good time for, for business, but challenging time nonetheless.

Gosh, I mean we have such an incredible team. I find it really hard to highlight just a few people.

That's a good problem to have.

I think about the early team who joined us sort of pre product and we're still there today ensuring not only that the product is successful but that sort of culturally as an organization we're true to who we say we want to be. I think about our customer success team who were overnight we all of a sudden were onboarding different types of providers within a telemedicine product which was getting so little traction and we're sort of creating as they went. I think about our product team and those that are focused on our COVID testing and the research and how much empathy they're building for that end user as we're building out the product. So I would love to name one person but I can't. I just feel very grateful for the organization I get to be a part of.

Thank you to the entire SOLVE team.

Yes, to all of them.

And then one more thing, just keeping your sanity. There's our being entertained or learning more through this. You have a book, movie, podcast, show activity, anything that you're doing during this time.

Dolly Parton's America is a 10 part podcast and it is fantastic. I highly recommend. I'm of the school of appreciating a good solid distraction which has nothing to do with my day to day. Whenever I can. And Dolly Parton's America is incredible. Everyone should listen to it. And given the age of my kids, you might imagine I have a lot of X Men and Avengers and various other movies in my life. But the part that's for me, you know.

No, that's great. I'm the same way, too. After work, it's like fiction cooking shows.

Exactly, Exactly. When you don't get to physically separate yourself between work and home, I think it is very useful to build in whatever sort of unnatural transition for you to move from one to the other. And that's been a strategy for me. Great.

Well, thank you so much for joining me today. This has been great. Really interesting.

Thank you, Heather. Thank you for all the time.

Okay, everyone, that concludes this episode of Gray Matter. You can subscribe to our podcast on soundcloud.com greylock partners or you can find new episodes and blogs on our website, greylock.com youm can also follow us on Twitter at greylockvc. I'm Heather Mack and thanks for listening.