#46 - High-Tech, High-Touch: How Salvo Health is Transforming Chronic Care

What if you had your own team of the leading medical experts in the country in the palm of your hand? Let's find out.

That's what we do, and we, we avoid a lot of expense in healthcare because we're managing these chronic conditions proactively. We can, we can both improve outcomes for patients, save time for doctors.

And there is still huge psychology, and humans like being with other humans, and they like talking to other humans. And so it's one of, I think, one of the challenges always with Healthcare.

And the doctor just looked at me and said, I wish that was true, but that's not how healthcare works.

Hello everyone. Welcome back to this episode of The Tech Optimist. Today we have a Meet the Startup episode planned for you, and the startup in question is Salvo Health. They're doing some really great things, but let's get into the voices of the show first. Our guide is going to be Mike Collins, founder and CEO at Illuminate Ventures, And then our guest entrepreneur today is CEO and co-founder of Salvo Health, Jeff Glick. And then of course, you know my voice, you recognize it. My name is Sam. I'm the guide and editor for this podcast. So a little bit more into Salvo Health. Salvo Health is a digital healthcare solution enabling local doctors and nurses to better treat the 60 million Americans who suffer from gut, GI, and metabolic chronic conditions, including IBS, metabolic liver disease, and obesity. Salvo Health partners with local private practices and hospitals to give each patient a team including a registered dietitian, a GI-trained nurse, and behavioral health specialist, along with an app for 7-day-a-week support. Now you'll see some footage of that app later in the episode today, um, but all of Salvo's multidisciplinary interventions are based on published clinical evidence honed by Salvo's renowned clinical advisory board. Including physician researchers from Cedars-Sinai, UCLA, Harvard, Columbia, and so many more. Salvo's wraparound care provides continuous care between in-person appointments, including whole health that encompasses diet and nutrition, microbiome restoration, mind-gut programs, reducing toxic exposures, and dealing with sleep, stress, movement, and lifestyle. So we've got a lot to cover today, so sit back, turn those listening ears on, and let's dive in. As a reminder, the Tech Optimist podcast is for informational purposes only. It is not personalized advice, and it is not an offer to buy or sell securities. For additional important details, please see the text description accompanying this episode.

I'm Mike Collins. I'm the founder and CEO of Alumni Ventures. It's my privilege today to be talking to Jeff Glick, the CEO and co-founder of one of our portfolio companies, Salvo Health. And Jeff, welcome to our show.

Thanks for having me, Mike.

So elevator pitch for Salvo Health. Tell me, what, what do you guys do and why does the world need it?

So Salvo Health addresses a problem in healthcare. We work with specialty medicine, and frequently patients wait a long time to see specialty doctors who are in shortage. But more importantly, after they see the physician, they might get a diagnosis and be told to come back in 6 months. Here's a brochure, good luck. And we believe that people with chronic conditions need a team. And so, we solve this gap in the healthcare system about augmenting the team of your primary physician, your local brick-and-mortar doctor, with a team that might include a nurse, a registered dietitian, and a therapist to work through an interdisciplinary program continuously. So, every day you have access to support over the months it can take to get a chronic condition under control. And, that's what we do. Yeah. We avoid a lot of expense in healthcare because we're managing these chronic conditions proactively. We can both improve outcomes for patients, save time for doctors, and it can be billed profitably to insurance. So, you know, it meets those 3 tests of it helps patients, it helps the physicians, and ultimately it's making the healthcare system more cost efficient.

Again, I want to sort of boost and boast a little bit about Salva Health. I want to put them on a pedestal for a second. And kind of give them props for you know their mission as a company. I you know this is my MO. I'm on their website salvohealth.com/science, which kind of helps sort of explain their process and you know their sort of technology. I guess you could say, and they have like really cool sort of like phrases on this page that I wanted to share that you know really make you think about. How you, you know, understand your body. So respect the complex. Conventional healthcare oversimplifies the way we think about our bodies, and we are here to change that. Awesome, amazing. Understand your body like never before with Whole Self Science. Whole Self Science is their model of care, and it's a trademarked thing. So in collaboration with world-renowned experts on our clinical advisory board. Whole Self Science combines diverse strategies from conventional and functional medicine to deliver results through a holistic, evidence-based approach. I'm going to throw up the diagram here just to get a visual on, you know, what exactly I'm talking about here. And it's very clear, very concise. It's designed really, really well. And in the center is mind, body, and gut. And then what's surrounding this is the environment that you find yourself in, the relationships in your life, your sleep habits, how much you move throughout the day, your microbiome, the food that you digest every day, any stresses that are around you, and so on and so on. They also talk about how your gut is a gateway. We believe your gut's health is connected to the brain, your behaviors, and more. To restore balance and improve chronic symptoms, we've developed a framework to address each part of the whole. Together, these add up to a more equipped and powerful you. They have some really great blog articles on here as well. But I wanted to sort of end this off with once you scroll all the way down to the end of the page, they have a really sort of like emotional way to sort of end your scroll through this page. And it ends with like love and, you know, taking care of yourself. And it says, love your gut with 24/7 care. And I just thought that was cool and wanted to share. So, all right, I will stop babbling. Let's get back into the rest of the show. And then hang tight, we're going to do an ad and then we'll be right back.

Hi, just a brief interruption to introduce you to the HealthTech Fund from Alumni Ventures. Alumni Ventures is one of the most active and best-performing VCs in the US, and we have raised over $1 billion from more than 10,000 individual investors. With our HealthTech Fund, you'll have the opportunity to invest in a portfolio of around 20 health tech startups. From transformative healthcare services to groundbreaking diagnostics, our founders are paving the way for a healthier future. To learn more, visit us at av.vc/funds/healthtech.

And where are you in your journey? Did you— have you picked this approach for a specific chronic condition? And I guess, where are you in kind of the development of the company? It's a pretty early stage, right?

We're a seed-stage company, and we're early in our evolution. We work with gastroenterologists today. Mm-hmm. So, we work with people who face chronic conditions like IBS or IBD, conditions of liver disease that gastroenterologists and hepatologists treat like NASH or MASH, what used to be called non-alcoholic fatty liver disease, which affects over 40 million people. GI conditions affect over 60 million people. And, we also help these physicians with weight management, whether it's GLP-1, medication or the like, so that we provide the follow-on care. So it's private practices for the most part that don't have these rich interdisciplinary services that, that we're, we're partnering and we're delivering the technology, the staffing, and the, the kind of medical content and protocols to, to do all the follow-on care with them.

Yeah. One of the areas I've just personally, you know, side hustle within running this venture capital firm, I, there are certain technologies that just capture my imagination. GLP-1 is one of them. And, you know, there's been some pretty good indications for some of these conditions, but GLP-1 medications really require this kind of regular monitoring and feedback that really the traditional healthcare system isn't very good at managing. Like, what are you, you know, side effects, what are you doing? Should I up my dosage? You know, those kinds of things. It's much better to have a team that you can be working with regularly. Are you, Are you finding that?

That's exactly our approach to this, Mike, is that what we're seeing is the physicians are prescribing GLP-1s and what's happening all too often is they don't have a comprehensive strategy and support services for the patient. Many patients face side effects and also insurance companies are loath to cover it. So, a lot of times they're facing supply or price challenges to stay on the medication. So, studies have shown that have tracked GLP-1 patients that 65% or more of patients don't stay on the medications for every year for all those reasons. Yeah,

it's not because it's not working, it's because the system just does such a poor job helping them managing through it.

Exactly. And so, as a GI specialist company, the side effects are generally GI-related nausea and the like. And so, Our nurses and dietitians are trained in how to help people. The other, the other thing, these are powerful medications and they're showing incredible 20-plus percent weight loss with, you know, um, some of the like Mounjaro and the like kinds of, uh, medications. And, and they have CVD, uh, benefits and lots of other chronic conditions. But one of the other issues that everyone is addressing is the loss of lean muscle mass with these. So if you approach them strategically and you're maintaining resistance training and protein, protein,

yep.

You can successfully approach GLP-1s in a way that you have the option to titrate off them over time and for money or side effects or whatever reason and retain the weight loss and feel healthier. Unfortunately, people who come off the medications without a plan, 75% or more of the weight comes back on within months. So, we really— very low cost relative to—

Yeah, it's a super application for that. And again, just You know, I know in our office of, you know, 100 people, we probably have 10 on them. So these, these issues are definitely— you're right, you're speaking, you're speaking to people who can definitely relate and hear water cooler conversations that are exactly on trend here. So talk to me, just— we always try to take a step back and beyond the particular company. You have a great perspective as an entrepreneur coming into this space. What do you think are kind of tailwinds, big trends that Salvo Health is kind of riding the wave of?

Well, I think for people who know my career as CEO of Foursquare, CMO of Travelocity, I'm a very data-driven entrepreneur. And what people don't often understand about machine learning is that you have to build really high-quality structured datasets to serve as training sets. And when I was CEO of Foursquare, we had 13 billion check-ins where people would say, I'm at this place or I'm at that place to try to be the mayor. But that was really profound because it allowed us to do ML models to sort of detect where a phone passively entered at 100 million places. And so to build those structured datasets takes years. And the AI approaches, LLMs, and yet I think that that has all kinds of limitations in that you're reading an enormous amount of papers that are mostly about drug discovery. And so, they don't tend to capture kind of interdisciplinary programs that include psychology and diet and movement and lifestyle change and stress and sleep. And we're very interested in the interplay in a personalized precision medicine sense of how all these things work for different patients. And if you think about drug discovery, it tends to be how do we find a medication that can pass a controlled RCT? And then, we're going to give it to everyone whether or not they have the right genetics or the right case history because that's lucrative. And so, I'm very interested in precision medicine. So, I think the trend that we're playing on ultimately is this is a data company about building machine learning to improve personalized medicine. But, you can't start there. Yeah. You have to build these rich datasets and And by partnering with local brick-and-mortar gastroenterologists and hepatologists, and hopefully soon weight loss clinics and primary care doctors, we are both solving their short-term problem, but we're improving medicine over time with those datasets.

I think, you know, in looking at this company too, I always, you know, I'm a tech venture capitalist, but there is human beings in this equation and there is still huge psychology and humans like being with other humans and they like talking to other humans. And so it's one of, I think, one of the challenges always with healthcare, which is how do we use technology more, better, more precisely, more personalized, but then at the end of the day, free up humans to interact with other humans in the way we all want to be interacted with.

Well, I think that's so spot on. In fact, the first question in the app when you get assigned your nurse and your dietitian, the patients ask almost always is, are you real people or am I talking to a bot? And, they're so happy that they're talking to real people with expertise in their condition. And yet, we've invested a lot. I mean, we've raised $15 million in automation. Yeah. And so, literally, the average patient spends about 3 hours a month with our services and 2/3 of them are entirely software-mediated.

Yep.

Um, one-third is human, but we want that human therapy.

Yeah, one-third is so important, right?

I think this aspect of, you know, the digital atmosphere that Salvo Health creates within their app and within their sort of staffing, um, is really important and really cool. So I found an interview, um, that Jeff gave with Logan Plaster of Startup Health TV, and they talk about Salvo's health digital-first care drives strong outcomes for chronic GI issues. Now there's a span of about 4 minutes in this interview that I think is really insightful and will add some context to the narrative that we have going here. He talks about staffing issues throughout the country, and he also talks about, you know, how The digital infrastructure really helps provide these connections between, you know, the dietitians, the therapists, and the nurses that Salvo helps provide to the patients that, you know, utilize their technology. So really quick, we're going to do one last ad and then we'll hop into that segment of the interview. And then after that, we're going to hop into, you know, Salvo's Ask for everyone here at the Element Adventures community. And then we will just round off the interview right there. So hang tight. Let's get back into it.

Do you have a venture capital portfolio of cutting-edge startups? Without one, you could be missing out on enormous value creation and a more diversified personal portfolio. Alumni Ventures, ranked a top 20 VC firm by CB Insights, is the leading VC firm for individual investors. Believe in investing in innovation? Visit av.vc

Welcome to StartUp Health TV, where we celebrate the entrepreneurs and innovators who are transforming health. I'm your host, Logan Plaster. It's my privilege to be here with Jeff Glick, CEO and co-founder of Salvo Health. Jeff, thanks for joining me today.

Great to be here. 86% of patients we surveyed with chronic gut problems say they've been to doctors, but they're not better, they're not resolved. These are things that, that doctors, for the most part, don't have a lot of time to treat. So, doctors for the most part aren't trained in nutrition or cognitive behavioral therapy or microbiome rebalancing. Then, they don't have usually the staff or the time to do the follow-on care in a very personalized journey.

Yeah. And, people don't feel heard. I mean, one of the nice things for us is each patient gets through our Sava Health app in addition to their main doctor, They get a nurse, a dietitian, and a therapist in addition to digital programs every day, and they feel heard for the first time.

Yeah. And, you know, this is— IBS is one of the most common ailments in America, and it used to be called hysterical housewife syndrome by the male, you know, because it's 2/3 women, it's younger women, they're gaslit, they're ignored, and it's stigmatized by the system. It's embarrassing to talk about stuff. And so, we're really giving the privacy of your own team over the 4 to 6 month treatment period where you really get to know your team and they get to know you. And, it's done very software-enabled, so it's very affordable. Interesting. And, we can talk about our new research on the cost of these patients that are underserved on the system, which is really hot.

Yeah. Tell me about that. How did you conduct the research?

So we contracted with the leading actuarial firm in healthcare. They ran a study for us looking at 9.5 million

covered lives, and we asked them to compare IBS sufferers and IBD sufferers in total medical expense, all medical expense, to the, you know, to the average American, both commercial and Medicare. And the results that came back— obviously everyone knows Crohn's and colitis patients, IBD patients, are very expensive, 6 times on average.

But what people don't talk enough about is there are 15 times more mid-acuity patients like IBS and the like, and those patients cost double the average patient. So instead of $7,000 a year TME, The cost of the system is over $14,000, and these are the mid-acuity patients. Right. Because you know what happens? They don't get good care. They usually will get a colonoscopy or an endoscopy and told, you don't have colorectal cancer. Good news, 28-year-old sufferer, you don't have cancer. Come back in 9 months. Here's a pamphlet. That's the care, the usual care today. Those people then end up in the ER. They end up going back to PCPs. They go to different GIs. seeking a different answer, they get new imaging, new studies, they're very expensive. They also have anxiety and depression and work, they're missing work and they're expensive in care. If we could address the problems, we could cut huge amounts of waste and the human suffering associated to it. And that's what we do. So it's an absolute myth that these mid-acuity patients are not high utilization. Mm-hmm. These, you know, 60 million people are They're frustrated, they're suffering, and they're expensive, and they deserve solutions.

It's kind of a whole philosophical switch to really focus on the needs and costs of mid-acuity. We're talking about gut health, but I see that as a trend across the landscape, and to say there are these needs just under the surface, or maybe that just didn't reach the level of urgent care or emergency yet, and yet They are potentially breaking the back of the system. They are also stopping people from living full lives.

That's right. That's right. And, I think this is where the intersection of the gut health crisis and the staffing shortages in America hit because everyone here at HLTH is talking about the shortage of physicians, but also shortage of nurses, shortage of psychotherapists in this country, right? And, there's only about 100 gut-focused psychotherapists in the entire country, and there's 60 million sufferers. Yeah. So, what we're trying to do is we're taking the very best experts in the field, and we're digitizing a lot of what they do, and also enabling it through software, but then keeping that human touch of a dedicated team for support. And so, the average patient in Savo Health getting treatment is getting 3 hours of care a month in the app. They're opening it 9 times a week on average.

Wow.

But it only— because of all the software and technology, I mean, I'm a former CMO of Travelocity and CEO of Foursquare, as you know. Like, we're doing 3x is the ratio. So it takes less than an hour of nurse and therapist and dietitian time to provide 3 hours of care.

And they make it as productive and as efficient as possible. possible. So what are your asks, Jeff? How can our community of other entrepreneurs and investors, how can we help your company?

Well, the best thing is going to sound simple, but if you happen to be a fan of how we're trying to change medicine and you have a gastroenterologist, and particularly if they're in a private practice, introductions are the way we've grown. So introductions to your local gastroenterologist We'll talk to their firm. We tend to see a lot more success with private practices than giant healthcare systems because those don't make decisions on a human timescale. And so that's, that's turned into a number of clients. And so that's the ask is if you work in healthcare or you have a gastroenterologist who you admire and you think they're forward-thinking, please connect them to Salvo Health.

Excellent. We will do that. We have people in our network that are You know, that's middle of the fairway for. So please reach out. So talk to me a little, you know, give me the origin story. You have a really fascinating background. How did, you know, how did this, how did your career develop and kind of how did it, the path lead to Salvo Health?

So I spent my 20s on other mission-driven projects before I came into tech. I worked in the White House. I worked in economic development around the world. I worked on Middle East peace. I worked on climate change. And when I finally, with a friend, started a travel e-commerce company back in 1999, and it just— the two of us, we built an amazing team of other folks, and we got to $100 million in sales in 2 years. And That was an incredible thing to do back before Google or Facebook existed.

That's a ride. Yeah.

And it was a blast. And I got hooked on startups. My career evolved. I ended up running product and marketing at Travelocity. I invented with our team the Travelocity gnome. We launched him. The original gnome is back there in my home office here. And then ended up being CEO of Foursquare and growing that company, including a couple acquisitions, about tenfold in a couple years. So we really had built a platform that was machine learning-based. But I went through a personal experience where my wife and I lost what would have been our first child at 23 weeks. And it was, in hindsight, a preventable loss in that—

Hmm.

We had a clotting disorder and We were able to have, thank goodness, healthy children afterwards, but only because we knew to take some anti-clotting medications throughout the pregnancy. And I remember asking the OB-GYN, you know, how come you don't test for this? And they said, well, we don't even bother because the insurance companies don't pay for genetic tests till you've had 3 miscarriages, which just seemed human tragic and also shortsighted.

Stupid.

It's just stupid. These aren't expensive tests. And, and losing a baby at 23 weeks is a really traumatic and, and frankly expensive hospital process. And it's, it's just, but it's just heartbreaking, um, to go through that. And, and I asked the, the OB-GYN at Mount Sinai, please tell me, we've, we're, you know, we're, we're in tears. We've lost this child. Yeah. And please tell me that the next couple is gonna somehow benefit. Like what happened to us is less likely because all this data goes into really well-structured datasets and the best physician researchers and the best machine learning and data scientists are in there improving healthcare each quarter. So this— and the doctor just looked at me and said, I wish that was true. But that's not how healthcare works. And I worked in ad tech and all of this in ecommerce. And none of it was ultimately as meaningful as healthcare, which is in some sense the most important industry because it's life and death. Yeah. It's our quality of life and for the people we love. And I just vowed that if I was ever in a position to start a company that would continually bring learning and data to improve healthcare, that I would launch that company. And what happened during the pandemic is I finally found myself with the time to think about what kind of company I wanted to launch next. And we launched Salvo.

Yeah, well, thank you for sharing that, you know, very personal story. And, you know, you have a lot of fans rooting for you and the work is important and the journey is just starting. So again, I tip my cap to kind of jumping into the fight, getting back in the arena, Jeff, is noble. Yeah. And, you know, We appreciate you and really proud to be part of your company. And let's have our community kind of reach out, help, you know, let's get the flywheel going to the extent we can help. That would be great. And I look forward to checking in 6, 12 months and getting an update. So, Jeff, thank you. Keep up the good work and really nice meeting you.

Thanks, Mike. And we're really honored to have Alumni Ventures as a backer. So, We're in the fight for all the right reasons and glad to have you as a partner.

Excellent. Okay, have a great rest of your week, Jeff. Nice meeting you.

Same, same right back.

All right, take care. Yeah.

Thanks again for tuning into The Tech Optimist. If you enjoyed this episode, we'd really appreciate it if you'd give us a rating on whichever podcast app you're using, and remember to subscribe to keep up with each episode. The Tech Optimist welcomes any questions We're always looking for questions, comments, or segment suggestions, so please email us at info@techoptimist.vc with any of those, and be sure to visit our website at av.vc. As always, keep building. Keep building.