S7E2: Kelsey Mellard is Easing Access to Specialists in Health, Tech, Policy, and Product with Her Company, Sitka

Go-to-market strategies in healthcare when you're practicing medicine are not easy, and having a really experienced team around you who's done this before is the most important thing you can do. We actually see it working. We see the impact that it's having on people's lives, and that's why most people enter healthcare, is they want to make people's lives better, and it is very much a belief-driven career.

Welcome back to the 7th season of The Room Podcast. If you've been here for a while, you might remember Claudia and me have been on a journey to navigate our early 20s careers in Silicon Valley. We started this podcast about 2 years ago now, which is pretty wild, in the middle of a pandemic, recording from our bedrooms. Since then, a lot has changed, both in the macro economy as well as in our own jobs and careers. So let's get you up to date on what's going on with us. Since 2020, Claudia has left Uber and become a full-time co-CEO and founder of Priv, a startup unlocking and disrupting recurring revenue for e-commerce brands.

And Madison is now a partner over seed investments at Defy VC, an early-stage venture firm in the Bay Area. Totally crushing it, and I'm so lucky to have her as an investor in Priv. We're two women navigating our careers and asking the people who inspire us to shed light on their stories. Unlocking Access starts with a conversation and context. We open the door to moments in technology history that traditionally happen behind closed doors. Mads, can you tell us what to look forward to this season?

Absolutely. This season, you can expect a really exciting 8-person roster of founders that you've definitely heard of. First up is Spencer Raskoff and his journey to building Zillow. Second, we have Kelsey Millard and her vision for the future of primary care, which is being empowered by the Sitka platform. We also have a look into the future of the modern data stack with Kashish Gupta, the founder of Highspot, where he's going to share his belief in the need for reverse ETL. And amidst a backdrop of a lot of macroeconomic turmoil, our guests are going to bring you into the room where they're making important decisions on navigating a downturn. In real time. Claudia, where can people find more about our key themes and guests each week?

Great question, Mads. Every week we launch a newsletter and related resources alongside the episode that helps our listeners get tactical. If you're local to SF, hit us up. We have an exciting schedule of in-person events, fireside chats, and pop-ups where we would love to meet you. Well, sounds like we're ready to open the door to this week's room.

In today's episode of The Room Podcast, we open the door to the rapidly evolving digital health landscape with founder founder and CEO of Sitka, Kelsey Millard. Kelsey took an untraditional path into being a venture-backed founder. She started her career in the public sector working for the U.S. Department of Health and Human Services. This was the year 2010, and she firsthand saw the implementation of what today we all know as Obamacare. After a stint in the private sector insurance space with UnitedHealth, she went on to lead partnerships at Honor, a software and network which provides non-medical home care services to families in more than 800 cities and towns across the United States. This is where she saw the need for a more efficient and effective primary care provider network, which can help you get a specialist's opinion on things like a knee tear or throat strain in days rather than weeks or even months. Enter Sitka, a telemedicine platform which works directly with your primary care doctor and specialists across the country to accelerate your time to diagnosis. Since launching in 2017, Kelsey has raised from hallmark venture firms like First Round Capital, Venrock, and Homebrew. In today's episode, we discuss insights and themes such as applying private sector innovation to the public sector, how to unlock your go-to-market within heavily regulated industries, and navigating personal health milestones. Such as pregnancy while being an entrepreneur. Let's open the door.

Kelsey, thank you so much for joining us on The Room today.

Thanks so much for having me. Looking forward to the discussion.

So are we. We like to start at the beginning with all of our guests to share a bit more about your own founding journey. You went to University of Kansas to study public policy at the beginning of your career and then spent 10 years in Washington, D.C., where you worked at the Kaiser Family Foundation and the advisory board company And from there, you decided to join the federal government after the passage of the Affordable Care Act as an early team member on the Center for Medicare and Medicaid Innovation. Couple different worlds there. Just curious about how starting off in the public sector informed your view of the world.

Starting off at the Center for Medicare and Medicaid Innovation was an incredibly unique experience because it was a startup within the federal government. So it really was, I was employee number 5 at the Center for Medicare and Medicaid Innovation. And so while it was the federal government and had strong elements of that, we had pressure from Congress, we had pressure from the White House, it was very politically driven. But with that, it was still a startup. And so we were hiring people, we were figuring out what our North Star was and how to engage stakeholders across the country. And that has really informed, I think, a lot of my own entrepreneurial spirits to say, let's start something, let's do something different. We can do something different. It was a great catalyst to also have many experienced professionals around me, many folks who had left massive careers inside the private sector to come join this movement of what we know now as kind of Obamacare at the time. And so the government had this level of energy that I don't think has ever existed before as a catalyst to drive all of the change that we see taking hold today across our healthcare industry. Of course there's room for more improvement, but it has served as a massive pulling mechanism for the entire industry to think differently about how we pay for services based on quality.

You're working within a startup within the government, which is a really fun opportunity and quite a unique one in and of itself. What was a key lesson that you learned in that time about just how complicated the healthcare system is and can be?

It's incredibly complicated. We really went back to the fundamentals and the government at that point in time was historically thought of really as a regulator. They were the payer, they were enforcing laws, they were finding fraudulent providers across the country. And while they still do all of that today, from a regulatory standpoint and a reimbursement, they're the largest payer. They're still combating inappropriate reimbursement strategies that people have, unfortunately. We really had to shift to be a partner. That fundamental shift actually took hold with some very basic lessons of how do we treat our taxpayers? When you're working in the federal government, you are working on behalf of taxpayer dollars. And that was something that we took very seriously and resonated a lot with me. And so we instituted several rules. We were going to respond to emails within 24 hours because we really did need to shift this perception from the big bad brother to, no, we want to partner with you to develop these payment models. There were some basic fundamental things that we could differently to have a drastic impact on the way we were perceived as the government, which I think still holds true to this day.

That's an incredible insight around where there needed to be some core, almost go-to-market unlocks for how the government thinks about interacting with its constituents or customers, as we'd use in the startup world, customers being the taxpayers. So you did stay in the public sector for some time, but ultimately made the switch back into the private side of things with UnitedHealth Group and then a senior care network, Honor. Both of those experiences, really helped to inform what now is Sitka. But could you unlock some of those insights that you observed during that experience, combining with your previous in the public sector, that really propelled you into the Sitka journey?

Going to UnitedHealth Group after the government was a total shift. I went from having incredible access across the entire government, to the White House, to Congress, to then being a publicly traded company where it was very tucked in and we needed to follow the course and the strategy, and there was no going rogue, and you were part of massive machine, a beautiful one, and one that serves millions of people, but it was still publicly traded and therefore there was different disciplines from a business perspective that we had to follow. So that was a point in my time where I was really tidying up my business etiquette, right? As a publicly traded company, quarterly earnings calls, how we presented ourselves. And I was still relatively young in my career. I was in my mid to late 20s at that point. And everything from dressing up in a suit every day and living in Washington, DC to really embody that, like, you know, businesswoman power. It was really funny in hindsight to me, but then moving west out here to the Bay Area to join Honor, that took me back to some early days that I had actually at Navi Health, which I went to Navi Health right after UnitedHealth Group. And Navi Health was an early-stage company as well. They were private equity-backed, so a little different capital structure, but still early in our journey there. And then of course, coming out here really reinstilled what it meant to be part of an early-stage company as they were closing their Series A from Andreessen Horowitz. And being on the ground floor of yet another startup, my third one, right, at that point, CMMI and then Navi Health and then Honor, really helped show me what the kind of cycle is of developing companies. And then of course, being in the Bay Area, it's normal to start companies here, maybe like an unspoken expectation almost. And maybe that's not always healthy, but it is, oh yeah, I started this company and I got funding from this person. And that's just general chatter here and social currency. And so I think coming out here to the Bay Area and having that experience at Honor really allowed me to feel like I had some solid footing to start Sitka and evolve it to where it is today.

Absolutely. Moving out here, even myself having grown up in Seattle, which is home to a lot of great startups, there's just something in the water in the Bay Area. It's in a good and a bad way what most people talk about every day. And it sounds like that alongside your incredible wealth of knowledge really launched you into becoming co-founder founder and CEO of Sitka, which you are today. But taking a step back, having grown up in the Midwest, gone to college there, and then found yourself in this bicoastal nature post-grad, did you ever think you're going to become a founder?

No, it wasn't really on my radar. I grew up in a very academic household. I wasn't really exposed to the founder space. My parents were professors. In hindsight though, my dad's work was primarily funded through grants at the University of Kansas. And there's a lot of similarities. I remember my dad running to FedEx to submit their grant proposals at midnight to get funding from the Department of Labor, Department of Education. And so this like, hey, I have an idea, let's go get funding for it. There's a lot of similarities, but the word founder and that persona was not on my radar at all. It was more like my brother has a PhD, follow the family roots of some educational journey, and as long as you stay the track, you'll be fine. And so this has been a total delight and really feeds my need to do something different than what we currently have in our world. And how to bring the value of that to people who can benefit greatly from it.

It seems certainly like entrepreneurial spirit has always been in your background, but really coming to the Bay Area, leading partnerships at Honor, you really got a taste for the startup ecosystem more deeply. At what point did you take a step back and say, "Hey, we're going to start Sitka. There needs to be a value-based primary network." And talk a little bit more to us about the problem that you saw and how you thought you could go ahead and solve it with Sitka.

It's quite audacious to think that I'm gonna go solve this problem and I'm gonna convince a team of people to join me on this and investors to put capital forth. And if you really think about what you're doing, it's pretty daunting as opposed to just doing it. And so I started doing it and I was advising a company that was really focused on specialty care and specialty surgeries. So in an ambulatory surgery center, outpatient surgery center setting, and the providers kept saying, hey, Kelsey, how do we solve our clinic? And I'm like, I don't know, what's wrong with your clinic problem? And they're like, we're seeing the wrong patients at the wrong time. And so as a multi-practice orthopedic spine surgeon, my co-founder, I started spending a lot of time with him in clinic to figure out how do we get him to see the right patients at the right time? How do we go further upstream before the patient presents at his clinic? To actually route patients appropriately. Like, how are we going to solve accessing specialist care at the right time, as opposed to 8— waiting 8 weeks to 12 weeks like we see today? And that was really the starting point of Sitka.

What were some of those early days like after you and your co-founder decided to take the plunge? You're spending a lot of time in clinics. Tell us a little bit more about those early few months of company building.

It was a lot of product building, finding our lead engineer as well to help us on this journey to actually build the software. And then it was a lot of kind of experiential learning, spending time in clinic, which was our modern-day, like, garage in startups. That's where we could see all of the action occur and figure out what could we do differently here. There was also a ton of talking to customers. And so I was flying around trying to sell our idea to potential customers, and that was a very lonely job. You're flying around by yourself. Trying to convince these other CEOs of large self-insured employers, and eventually primary care groups that we have a solution that's not like totally defined either. So it's a pretty opaque sales process to help get some traction on this. We luckily found some traction with one of our great partners, ChenMed, and that came through my work at the federal government. So the early days were not glamorous. There was red-eye flights to the East Coast, waiting for that one meeting, and then immediately flying home 2 hours after the discussion. Similar to many other founders' experiences, you're just trying to go as fast as you possibly can to figure out what is the true value proposition that people will buy. And then once you have indication that someone's going to buy this, you have to actually go build whatever you sold at the onset.

What was that product that you ended up building, taking to market, and really having customers enjoy and see value from?

The product is a specialty physician network. That's 100% virtual, and we collaborate with primary care providers so that primary care providers can do a peer-to-peer consult. The patient example would be you're at your doctor's office with your primary care provider, and instead of having that primary care provider refer you out to go see an orthopedic surgeon or a dermatologist or a urologist or an ENT doc, they would request a consult with one of our specialists. Asynchronously via video and text, get that answer within about 5 or 6 hours, and then be able to actually take care of you as opposed to referring out. Over 85% of the time when a primary care provider uses Sitka and our specialty physician network, we're able to answer their question. So we completely avoid a referral. I know that all of us have had experiences and we've all delayed care because we're like, we don't want to start down the rabbit hole of going to see the dermatologist and waiting and then for them to tell us that, oh, they can't treat us or you have to come back in 8 weeks. So this avoids the entire muck of that transition and handoffs that currently exist in our—

A very clear value prop, but you mentioned an opaque sales process, early days, founder-led sales. And as a founder who's figuring out my go-to-market motion and sales strategy, I'm always super curious to learn a little bit more about other founders' transition from them selling this early product that might not be fully defined to actually building a repeatable sales motion. Could you speak a little bit more to that process and some of the learnings you had along the way?

This is where your team becomes essential, right? Because they're going to push you to create processes and have visibility where if you're a one-man or one-woman show, you just don't need to have. Our leadership team at Sitka has done an incredible job shaping and informing the way that we provide our business development cycle, our contracting cycle, and ultimately our implementation process. And without other perspectives around the table, you're never going to be able to create the scalable process. And so that's been actually one of the really delightful aspects of team building and also company building. Sometimes people struggle with this because they're like, well, I can do this. This is what I've done. I did this before everyone else was here. Why do I have to change it now? That's where the scaling aspect and unlocking that becomes crucial so that that if you're out for a period of time, that the machines keep running and everyone knows what to do. So it also creates a different level of trust and reliance across the team that is incredibly healthy for not only the founder, but more importantly, the entire team that you've assimilated and that you've convinced to join you on this journey is really important.

Definitely words of wisdom. I think very early on I realized We probably shouldn't be in a position where if I'm out for a few days for a medical reason, for vacation, whatever, the whole company doesn't come crashing down. And so building out those systems and building that team that you can rely on seems like a no-brainer. We chatted a little bit about your early sales process. I'd love to spend a little bit more time on a slightly different sale, that is to venture capitalists and investors. Last year you raised your Series A from BenRock, investment from First Round, Homebrew, and others, some really iconic and incredible investors. Who was the first person to say yes to Sitka, and what was your fundraising journey like?

Takes me back to a totally different time in Sitka, right? So the first person to say yes was Finn Barnes at First Round Capital. However, I had no idea based on how the meeting went if that was going to be a yes or a no. I remember leaving that meeting and having literally zero inclination if there was going to be a potential partnership between Sitka and First Round Capital at that point in time. Finn and the team at First Round Capital, he's no longer there, but we still work very closely with First Round Capital. They've been incredible partners from day one, and they're incredibly transparent, and they really think about the entrepreneur and the business as their client. Everything is phrased as that, like, you are our customer, Kelsey, what do you want to see? And being that explicit about it, I do think changes the entire relationship between investor and entrepreneur. And I think this is a continuing evolution within the venture and entrepreneurial ecosystem. I think the dynamics of the, of the partnerships are becoming healthier and almost a little bit more equal in some ways, right? I have a product that's valuable, and as things continue to be more competitive in the venture space, finding that right partner and shopping your deal appropriately is really imperative to make sure that you're choosing the right partner. It's a two-way street. And I think sometimes entrepreneurs forget you get to choose them too. And that choice has to be deliberate. You shouldn't just take money from anyone because they're willing to give you money. That's probably a terrible idea if someone's willing to give you money and you don't really know them and haven't done the diligence on them. And so I do think these types of dynamics are shifting and getting smart capital and helpful capital around the table has been one of the biggest lessons for me and has surrounded me with a group of people that think differently, see the world differently, and really helps us create a better product and team and business.

That's an incredible reminder just to think through also on the investor side, how these relationships really are 10+ year relationships in the best case scenario, which we're always all hoping for. And we often say that actually what we do from a capital perspective is a commodity. You can get capital from anyone or anything these days. And if we're selling you capital, we should hopefully be offering a lot more than just cash. I love the way that you frame that as a true partnership and the discernment that goes into actually aligning on who is going to come and be a part of the cap table and ultimately the team. It sounds like you had an incredible opportunity to have some great players join you with Sitka on these earliest stages of growth.

It's been such a ride, and obviously in healthcare things move slower, the sales cycle is slower, and so having a group of people who have have the patience but also the foresight on— you can't just be like patient and say, oh, it's going to work out, it's going to work out. You have to see incremental progress towards your goals. And the group that we have sitting around our table are very experienced in B2B healthcare, which creates, I think, a healthier conversation for the business and like healthier tension in the conversations about the decisions that we're making about the business.

Absolutely. And building trust as well, because as we're feeling a little bit more right now than maybe we have over the past 2 years, there are hard conversations that need to be happening about what is What does the long-term look like? Are we in a sustainable path to profitability? What might that be? And having investors around the table who you trust to have those conversations well is really vital.

You have to think about your investors and put yourself in the worst-case professional scenario that you've been in and ask yourself, do I want to call this person if this is going to happen? Because that's ultimately what is going to happen. And having the relationship established so that you can pick up the phone at any point in time to deliver good news, bad news, ask a question, seek advice, that's really where the value of these relationships come in. And it's a really gratifying one as well. I've really enjoyed building the relationship across our investment community and with all of our individual investors and also their firms that obviously they work at and they all have incredible resources that we try to take advantage of, but that can be a full-time job too, to figure out who has what resources and how to bring them to bear.

Totally. Well, taking a step back, we're talking about one specific stakeholder within this ecosystem, which is your investors. But on the other side of the ecosystem is your customers and the base of really what is Sitka's core product. And that's both end users, so patients like you and I, but also doctors and healthcare providers. We've talked a bit about go-to-market strategy as it relates to how you've been developing it, but the healthcare ecosystem is such a complicated one. And frankly, for me, me not coming from that world, I even hesitate to ask a question here because I'm probably going to put my foot in my mouth. But, you know, as we think about the providers, we think about the payers, the patients, there's this kind of government approach as well where regulation is actually a huge challenge for why technology has not been able to intercept in a meaningful way on digital health. And curious, just your learnings that maybe any other digital health founder could take from what you've done over the past few years on expanding state by state and some of the aha moments you've had in that part of the go-to-market strategy.

Go-to-market strategies in healthcare when you're practicing medicine are not easy. And having a really experienced team around you who's done this before is the most important thing you can do, especially when you're early on and trying to test a new model that's not widely adopted or widely understood or widely acknowledged. But Madison, you hit a really good point on this state-by-state because so many digital health companies are hindered by the state-by-state regulatory environment. And I think obviously this is becoming a potent point of discussion as we think about Roe versus Wade and state-by-state ruling and choice. In our case, we get to practice medicine across state lines because we're not creating a doctor-patient relationship. And so it's actually been a massive scaling opportunity for us in the way that we fundamentally started our model. Which no other company at that point had. And this really goes back to— I get to understand legislation really well because I was there writing some of the rules that came out of CMMI. And CMS, the Center for Medicare and Medicaid Services, did change their policy on what a peer-to-peer consult could be. And we were able to jump on that based on where we were in the development of our business and actually bring that to life with all of our partners. And so scaling in a B2B manner has been really delightful with all of our partners and being able to travel into the clinics that we serve and sitting side by side with our frontline primary care providers who use our specialist network is one of the most gratifying things that I get to do along, alongside our team. And we all get sheer delight out of that because we actually see it working. We see the impact that it's having on people's lives. And that's why most people enter healthcare is they want to make people's lives better. And it is very much a kind of belief-driven career pattern of people believe in making someone else's life better. And if you talk to frontline clinicians, that's oftentimes a massive draw.

This is a really interesting insight around how you can work within the boundaries that the healthcare system has around state regulation. And given the constraints on specialists of, hey, I am the best knee doctor for X type of meniscus tear, but I live in Kansas and I'm the who lives here in California, it's so awesome that you're able to say, hey, it's just doctor to doctor, so we can get that information, not have to have doctor in California, a registered in Kansas, and then vice versa, which is an incredible unlock for scale. And having this depth of knowledge on your end for what's actually in the policy is an awesome example of how founders can really come from everywhere. Just because you don't have that, quote, traditional tech background doesn't mean you don't have a superpower in building what is a service that relies on both technology and deep understanding of the digital health space. This leads into a bit more of a forward-facing perspective that we wanted to talk about, which is there's so much happening and changing under our feet as we speak around healthcare. And in some of it, maybe good, some of it maybe not so good. But nonetheless, 5 years from now, we're optimistic that the acceleration that COVID has brought will continue to reform and create better access to healthcare for a lot of people. What, with your deep expertise, do you think is going to become status quo 5 years from today that perhaps right now maybe would sound implausible or very unlikely?

For all of the tragedy that COVID has brought forth in the world, there have been some silver linings as it's accelerated some of the healthcare delivery mechanisms and the reimbursement mechanisms that you alluded to, Madison. Madison. In 5 years from now, I think aging in America will look very different. I think the senior housing community will look very different because we have this massive influx of population. And regardless of age, the way that we access care will absolutely look different and when we access it. So today we all have WebMD access, which is dangerously fun and anxiety-producing at times. But in the future, remote patient monitoring wearables will help inform when something is actually really wrong, and it's going to have more of a smart system to help us triage ourselves. Right now, the triage that we all do on ourselves is WebMD and call a nurse or a family member that we may know. And instead, it'll be much more data-driven. That's going to create a totally different pathway to really think about how do you stratify a population based on their needs. That's going to be the biggest game changer here that people are more comfortable with sharing things over the internet, with having visits via telehealth, texting, chatbot triage systems. People are fed up with this whole notion that you have to take a half day off work to go see a doctor. And being able to have text conversations with my primary care provider has become an expectation of mine. And that's only going to be accelerated when I can then take a picture of a rash and send it and they can tell me what to do and can prescribe without seeing me in person. So these types of access points are going to be just common ground. The part though, that I think we're still confronting and are conflicted with as a healthcare system is the difference of access based on our payer. So if I'm a commercial patient versus a Medicaid patient versus a Medicare patient, those experiences are drastically different. And this unfortunately comes down to zip codes, socioeconomic status, race. And so over the next 5 years, these newly created access points as a result of COVID will help help bring these drastic ends of the spectrum more middle ground is the hope and intent that I think there's a lot of good investment in creation and innovation happening around. But that's the part that still really hurts my soul is to think of the population that may not have a smartphone. And so how do they talk to their provider? And closing that gap of disparity will be hopefully one of the things that is drastically different in 5 years.

Thank you so much for sharing that perspective. There is always no shortage of opportunity to innovate, and technology is really a tool that helps to do so in a meaningful, scalable way. I love that you touched on this word access. It is definitely a central point of our podcast and how we think about opening both the door to the room where it happens, but also opening experiences and opportunities. And so just what you're doing with Sitka today and where the digital health ecosystem is going, it's just super aligned with how we think about hopefully having increased access for all. Taking it down a level though, just to your own lived experience, which you've really generously shared about in the public eye on being a founder who is a woman and decided to go through her own fertility journey as she's building a company, your other baby, so to speak. You recently shared about this experience in TechCrunch, and one of the parts that really stuck out to me in that conversation that you shared was around having to go to your investors, just given this was going to take you out of the day-to-day work for a bit, and that you chose to tell some of your investors before even your own family that you were entering into this moment of being pregnant. Could you share a bit with how some of those conversations went?

The philosophy that I was taking was that I had just committed to building this company with their money, and that was a commitment and an agreement that I took very seriously. Instantaneously. In the back of my mind, though, I, of course, knew that I was in the early phases of pregnancy, and that we were going to have to navigate this. My husband and I were very aligned on who we were telling when. And I said, I have to go tell Bob and Brian at Venrock immediately. Like, I just took nearly $14 million from them to invest in this business, and I'm committed to it. And there's going to be a new life joining this journey as well. And so it was awesome. And I think this really speaks to how you have to think about the relationship that you have with your investors. It's a two-way street. And I went to them and scheduled time with them. We had regular check-ins because we were a newer portfolio company at that point in time. I just said, look, I have news to share. George and I are pregnant and we're going to have a baby. And so we're going to build Sitka and we're going to figure this out. But I want you to know my commitment is deeply aligned with Sitka and building this company with you guys and I'm going to build a family alongside that. And they were awesome. They're dads, they're human beings too. And they were like, great. I was like, that's it? That's all you have to say is awesome, good job? No, I was like, anything else? And they're like, no, congratulations. Like, we're fully supportive. That totally shifted my ability to also discuss it with others because I was like, okay, they're aligned. Like, they don't think this is a big deal. We're just going to do this. I'm like, I can do this. So it gave me a different level of confidence in navigating the waters ahead. And of course they've been awesome and texting with the guys from Homebrew and sending baby pictures. Everyone is very much aligned with this journey. And I think Madison, the other thing is like when you're building a business, regardless of what's happening in your personal life, you know, how separate those things are, or frankly are not most of the time, timelines and objectives have to exist. And so in some ways saying, okay, I'm going to deliver this baby. Sometime in September. Let's put a timeline in place. Let's build out an executive team. Let's get the trains on the track and let's keep cruising. And those dynamics actually accelerated, I think, a lot of really wise business decisions that we were making about our partners and our product at that time that had it not been for kind of an accelerated trigger at some point, we may not have the business that we have today.

I love that last takeaway there for any founder who might also be thinking about their family and how they want to go about their fertility journey and the timing is is leveraging a timeline and a plan and deliverables just like you would any other thing that's gonna be going on in your life and move forward. Grateful to hear too that there is a bit of a shift, I would say, in how receptive people are being to the realities of this for founders who are women. We had someone on in our first season who had been a founder in the early 2000s, and she shared about somewhat snide comments that she got from her investors at the time about her pregnancy and what that meant for her ability to join the board meetings and And just to see in the past two decades how that's really evolved and there's just been more of an openness and willingness to entertain this is, of course, a given, but at the same time not. And so it's wonderful to hear that's been your journey and your experience.

Madison McIlwain, I think it's a really good point, and my heart goes out to fellow women who had not the level of support that I think exists today in our world. It's also on us as women to just own it, to be like, I'm having a baby. There's no headline here. The business is great. I will be back. Here's the plan. And we're going forth. I would love to see us own it differently too. Instead of— I get it. We are trained historically to have to like dance around it and to not like, you know, own it. But I think the times are changing. And I think this is a really potent point of time to be pretty bold and just be like, I'm doing this. Do you have anything to say about it? Great, awesome. I'll see you at the next board meeting, right? I will say I have been incredibly conscious of, okay, don't talk about my son too much. There are always those dynamics that I think all of us face about how much we show in our personal lives in the professional spaces. We're trying to make up for decades of inequality, but I think it is time to just own it. What would a male CEO do if his wife was pregnant? Pregnant? And how would that communication go? And if you put on that hat, it changes the dynamics a little bit. They probably tell him that their wife is having a baby. Do they leave? I don't know. And so these are all choices that trying on hats of different people in this space of creating families and building businesses is, I think, a healthy exercise to help navigate your own journey.

Thank you, first of all, for just like sharing that journey and your experience and just thoughts there. I think it gives a lot for female founders that are entering into that stage of life, but really like women in the technology industry and just in industry in general. And again, congratulations on becoming a mother. I'm sure there's a lot that is new every day during this journey of both raising a company as well as raising kids. To shift a little bit more personal, what's something that you're excited about up ahead over the course of the next couple of years.

It's been so fun to navigate this space as a mom, as a partner, as a sister, as a daughter, as a CEO, as a dog mom, like all of the hats that we wear. And continuing to navigate that while seeing it through the lens of our 9-month-old son, and our dog and everything else has been just really fun. And so I'm really looking forward to literally just the journey of seeing the world through someone else's lens as he continues to grow up and blending all these worlds together. Frequently he'll join a Zoom call and say hi to our company. And the more that I can do that and help facilitate that across our entire organization, I think the healthier our culture is as an organization and also the healthier perspective people have on work and this concept of work-life balance, which I don't really always believe in, but navigating that on their own. Is I really want to continue to help be a catalyst to, to navigate those conversations and those journeys while people raise families and have very successful careers.

Absolutely. It's incredibly inspiring. We've chatted a little bit about your personal life, what's up ahead there. Switching gears a little bit to Sitka more specifically, what should users or potential Sitka users get excited for over the next year or two?

All of our primary care partners continue to have a better experience from a product perspective as we integrate into their workflows and integrate into their electronic health records. And so as we continue to figure out how best to tee up the access to our consults and to our specialty network at the point of care, that's what we're really excited about, is continuing to collaborate with our PCPs to figure that out. Concretely, our partners are gonna drive more savings, better patient experience, and we're gonna continue to decrease the amount of friction in the system to actually create a really robust consult so that they don't have to refer that patient out.

Awesome. After a ton of incredible insight into not only your business but the industry, yourself as a female founder that's a mom, just looking at myself personally, there's been so many women along the way that's really impacted my journey. And so I'm sure that is the same for yourself. So I'd love to end the podcast with our hero question, which is who's a woman in your life that has had a profound impact on yourself and your career?

I think you have models of women in your life, but they don't know that they're your model. And then you have people who are really in it for the journey. One of the people that's probably had a really profound impact is actually a woman that I grew up with. We met on the soccer field when we were 8 years old, and she too is a very successful businesswoman. She has 3 kids. She entered child rearing way earlier than I did, nearly a decade ago. And I would stay at their house and I would see her come downstairs in the morning, not look at her phone at all and be totally attentive to her kids. And I was like, "Sarah, don't you like check in on work?" And she's like, "No, I'm not at work right now. I am with my kids." And I was like, "Yeah, you are with your kids, right on. That's what you're doing. Like, you don't have to be on your cell phone all the time and checking your email and checking Slack." So, she probably doesn't know how much of an impact she's had in really being not only a model for me in motherhood, but being on for the journey and founding a company is not easy. It is really exhausting at times. And having someone that you can call to just be like, "I know this isn't going to go anywhere, but you won't believe what just happened." That support and friendship has been so incredibly informative and comforting and really empowering in a way that that I don't— we're the same age. And I think that's also like a unique aspect of it is like we're on this together. And she hasn't founded a company, but she's had this amazing career, amazing promotions along the way, and has done it with grace while navigating her own life and motherhood and relationships. And really having a friend along the way, I think, is one of the most important aspects of what you can do if you think about building a company. And while we all quote, role models we may not ever meet, I think that the value of having that friend that you can call anytime is really incredible. And yeah, I'm really grateful for it.

Cheers to friendship. I know Madison and myself being podcast co-hosts, investor, founder, just friends for life, definitely resonate with that. Kelsey, thank you so much for sharing your story of Sitka on this podcast today. We've loved having you.

Having you on. Thank you so much for having me, and thank you for doing this. This is so cool, and I think, yeah, we're so lucky to have you guys doing this. So thank you.

Thank you so much for joining us at The Room Podcast. If you want more from The Room every week, subscribe to our newsletter at theroompodcast.com/newsletter. We'll be back next week with a new episode, Tuesday, 10 AM Eastern, 7 AM Pacific. See you in the room.

All All opinions expressed by Claudia and Madison and podcast guests are solely their own opinions and do not reflect the opinion of the 5EC. This podcast is for informational purposes only and should not be relied upon as a basis for investment decisions.