Lessons from Ellen Dasilva and Matthew Woo, Co-Founders of Summer Health, on building the front door for pediatric care
Ellen DaSilva (CEO) and Matthew Woo (CPO) from Summer Health, a pediatric telehealth company focused on radically simplifying access to care.
Subscribe to our substack for updates and listen on Apple Podcasts or Spotify. Connect with Andrew or Lipsa if you find this post insightful and want to learn more.
Welcome back to the Pear Healthcare Playbook! Every week, we’ll be getting to know trailblazing healthcare leaders and dive into building a digital health business from 0 to 1.
Today, we’re excited to get to know Ellen Dasilva and Matthew Woo, Co-Founders at Summer Health, the company bringing real-time pediatric care to your phone.
Summer Health is a pediatric tele-health company focused on radically simplifying access in pediatrics. With Summer Health, you can text a pediatrician (just as you might a friend) for any concern you have about a child, whether urgent or innocuous. Founded in 2022, Summer Health has raised a total of $7.5M in seed funding co-led by Sequoia Capital and Lux Capital. The round also included participants such as Box Group, Chelsea Clinton’s Metrodora Ventures, and many others.
Ellen began her career in investment banking at Barclays Capital before moving into tech at X (formerly known as Twitter). After graduating from business school, she joined as the 8th employee of the consumer telemedicine business hims&hers. Matthew started his career in consulting at Simon-Kucher & Partners. He then spent 9+ years in tech where he held various product roles at Meetup, Yo, Intercom, UJET and Meta/Whatsapp.
Ellen holds a BA from Brown University and an MBA from Harvard Business School. Matthew holds a BA in Business from Ivey Business School at Western University.
In this episode, Ellen and Matthew chat with us about building a delightful consumer experience in healthcare, their co-founding journey, and developing a stellar team.
If you prefer listening, here’s the link to the podcast!
Ellen's brief stint on Wall Street
Ellen began her career in investment banking but soon realized it wasn't her calling. She was more interested in the ambiguous, fast-paced start-up environment where individuals could have greater impact and forge a legacy.
“I learned that I like being in environments where individuals can create something out of nothing, where people are prized for their level of ingenuity and entrepreneurial spirit rather than for just being a cog in a wheel.” - Ellen on why she didn’t align with the culture of banking
Her journey led her to Twitter, where she played a crucial role in initiating the business operations function. During this high-growth period for the business, she learned how to make delightful consumer internet products.
After business school, she joined hims&hers (a brand new startup at the time) and became very taken with the healthcare landscape, realizing the need for a consumerized future for healthcare. It was a compelling opportunity to grow and scale a business from the ground up.
“Healthcare had mostly been gated by health insurance companies and large health systems, but consumers were trying to take healthcare into their own hands via the internet.”
Matthew's past in Silicon Valley Tech
Matthew, influenced by his father’s entrepreneurial background, started his first company, a mobile app, Shore Up, while in school. He described the experience as exhilarating to build something from scratch.
“It was really exciting to build a product. We launched it, did everything wrong, didn't do any user research, didn't even do any user testing, just launched it. Surprisingly, it got about 30,000 downloads.”
After working in management consulting for about a year, Matthew felt that it was not the right role for him. Consulting felt like applying set playbooks to new companies rather than learning new things. Instead, he took his pricing experience to move into product management at Meetup.com.
Since then, he worked in many product roles across different messaging companies eventually moving to bigger roles at Facebook and Whatsapp. Across these roles, he has had exposure to both small companies and large ones.
"One of the things that [working at Facebook or Meta] really taught me that I've always appreciated is how to really think big and work backwards. One of the things they teach you early on is if you can’t get to a $2bn business within two years, why bother doing it?"
Ellen’s love of healthcare came from her time at hims&hers
Up until 2015, Ellen notes that most people did not think about healthcare outside the context of their health insurance (brokered by their employer and providers). Ellen believes that the passage of the ACA resulted in a decoupling of healthcare from those artifices and opened up the possibilities for consumer healthcare products.
hims was able to find a condition that many people didn’t really like to talk about but were silently experiencing, like hair loss, and capitalize on how underserved it was. Launching hers (the women’s counterpart to hims) helped them realize just how marginalized women and other groups were from the health system and provide value to these groups.
After having three kids, Ellen notes that it is currently not possible for her children to have a great relationship with the healthcare system owing to legacy players and incumbents.
On transitioning from tech to healthcare
Matthew highlights the critical importance of consumer experience and simplicity in healthcare. Drawing from his background in both consumer and SaaS (Software as a Service), he points out that reducing friction in user onboarding is vital to improving product engagement. However, he notes that in healthcare, the heavy regulations often hinder innovation.
"One of the first things that Ellen and I started to work together on was to answer the question: How do we radically simplify access to care?"
Drawing from the culture at Meta, where the mantra is to move fast, Matthew and Ellen initially ran Summer Health off an off-the-shelf SMS platform to test the market rapidly. This approach allowed them to quickly gather data and understand user preferences and engagement levels with SMS-based care.
They asked questions like “Do people want access to care via SMS? How engaged would they be? Is there scale or efficiency you can gain because providers can have multiple conversations?”
“Within the first two months of working together we could answer those questions which led to our ability to raise a seed round.”
Matthew underscores the significance of being deliberate about choices and values, noting that successful startups are much more deliberate than unsuccessful ones. In fact, one of the key practices he and Ellen adopted from the outset was spending time defining the company’s mission, vision, and the types of people they wanted to hire.
"It sounds kind of cheesy, but we literally spent the first week together just thinking about what's the mission? What's the vision?... What values do we have to cultivate to achieve our vision?"
On challenging tropes in healthcare
"Why is it that message-based care hasn't proliferated? ... The more you poke and prod a little bit, the more I think you find that assumptions can and should be challenged."
Ellen emphasizes the importance of challenging established norms in healthcare. She questions why certain practices, like the necessity of in-person visits, are so ingrained, suggesting that alternative methods like message-based care could be equally effective.
Her goal is to achieve the highest standard of care but to come at it from a first principles approach and build great products that just happen to be solving healthcare problems.
“There’s a quote from Charles Munger: ‘Show me the incentive and I’ll show you the outcome.’ The incentive in healthcare is driven by insurance. Messaging hasn’t been built because you can’t bill for it.”
Matthew highlights their deliberate focus on building products tailored to the needs of patients, in this case, the parents, rather than insurance-driven incentives.
Both Ellen and Matthew also stress the importance of simplifying healthcare access. We discuss the barriers present in traditional telemedicine, such as the formalities and scheduling akin to in-person visits. They advocate for a more accessible, informal and direct approach to healthcare queries, akin to how people seek answers in other areas of life, like household errands.
Ellen's search for a co-founder
Ellen's drive to address pediatric care problems led her to leave her job at hims&hers and start a new venture. She was determined not to go it alone, believing strongly in the adage, "If you want to go fast, go alone; if you want to go far, go together."
She turned to her network to find a co-founder, a decision influenced by advice on the impact of a great partner on a business's trajectory. A friend from high school introduced her to Matthew, suggesting a conversation even though he seemed unlikely to leave his job at WhatsApp.
The initial meetings between Ellen and Matthew were insightful and productive. Ellen recalls their first major discussion fondly saying, "this is the best 90 minutes I've spent in a month... this has elevated the stature of this idea and this business tremendously." Despite Matthew's plans to travel to Europe, their conversation continued, deepening their mutual understanding and commitment.
Matthew’s decision to join forces
Matthew notes that finding a co-founder is always part luck. As it happened, at the time of their meeting, Matthew was already planning to leave WhatsApp and was exploring different ventures.
Matthew highlights the importance of working with a potential co-founder before making a long-term commitment. This trial period helps in understanding each other's work styles, strengths, and weaknesses.
“I was asking a few other people: How do I evaluate co-founders? … If there are red flags in the beginning, there’s no point in moving forward. It only gets more challenging as time moves on. ... Second, see what people are like under some level of discomfort.”
One significant part of their decision-making process was a multi-hour hike, which Matthew used to understand Ellen's character under a bit of discomfort. He emphasizes the importance of seeing how potential partners react in different situations.
The deciding factor for Matthew was the shared vision with Ellen and the positive feedback from early users. Their fast-paced testing and direct communication with users validated the importance of their vision, convincing Matthew to join Ellen in this endeavor.
They both note the importance of getting alignment in transparency, candor and communication styles. Ellen and Matthew spent months working together to understand each other’s communication styles and being explicit about it.
“How do you resolve conflict? How do you deal with situations where you don’t know something? How would you let somebody go? We’ve had a lot of those conversations already, so we feel very comfortable and trust one another.”
Concept and Execution of Summer Health
“$350 bn is spent every year in pediatrics. There are 123 visits to the emergency room for every 100 kids. Kids get sick 8-12 times per year and there are virtually no tools right now that help parents beyond the seven minutes per year that you get on average with your pediatrician.”
Summer Health was born out of a vision to simplify access to pediatric care. At its core, Summer Health is a text-based platform that provides immediate access to pediatricians. In the past year, it’s grown to be more than that.
Ellen emphasizes the uniqueness of their approach noting that it’s purely text-message based. After texting the phone number, a parent can get connected with a pediatrician in under 15 minutes, 24/7 in all 50 states for any question that they have. This innovative approach addresses urgent care needs and expands into behavioral and developmental inquiries.
[Source]
They started with urgent care but now also treat behavioral issues and have pediatric specialists such as sleep, lactation, nutrition and behavioral child development.
Matthew notes that at Facebook there were so many users that you could start to see emergent behaviors. Since the Summer Health team radically simplified access to care, it allowed them to see many more users which helped them develop the concept of every day care.
Everyday care for Summer Health users and reasons to use it
“We started from the caregivers, the parents of our patients, to understand what their biggest pain points were.”
In addition to wanting round-the-clock urgent care style triage for their children, Summer Health users wanted a credible source of information for their children’s wellness broadly for questions beyond urgent care.
Upon surveying other telehealth companies, Ellen and Matthew found that most of them specialize in urgent care which is what you can typically get through insurance. There is little optionality for longitudinal care in the market.
“I don’t think anyone’s really thought of virtual primary care in the way that we have. I think everyone has assumed that telemedicine can only be very transactional, as opposed to longitudinal and relationship driven.”
Pre-everyday care, most Summer Health users were interested in rash, pink eye and typical urgent care issues. Post-launch, Matthew and Ellen see questions about behavior, sleeping plans, feeding. Specialty care usage went from 10% to 40%.
[Source]
On innovation and experimentation
An innovative solution they adopted was assigning physicians to patients rather than patients to physicians (like most telemedicine platforms). Caregivers are not assigned to providers they don’t know – instead the provider is trying to build a relationship with the caregiver so that they can be present for urgent needs and all the time in between.
Matthew notes that Summer Health was one of the first healthcare startups to work with OpenAI and sign a BAA with them. They moved quickly to find a variety of use cases to leverage LLMs to improve clinical workflow satisfaction, monitor conversational quality and empathy and even personalize care plans and content.
“This [OpenAI BAA & subsequent product development] improved the leverage of pediatricians on staff, giving them superpowers, effectively. We believe, and want to believe in a world where there is an abundance of care and not a scarcity of it.”
Another innovation they’ve introduced is enabling providers to deliver care on the go. Most telehealth doctors are in front of their computers when giving care (especially since it’s often video-based). At Summer Health, doctors text, which mimics the relationship one has with a close friend. In this way, doctors are not blocked from doing other things.
Ellen and Matthew stress the need for a culture of experimentation in healthcare startups. They advocate for a data-driven approach, where each experiment is designed to inform and direct future strategies.
Building a stellar team
“Matthew and I set forth to build core values that we thought should underlie the kind of business we’re running and also our own personal values.”
Ellen remarks that the foundation of their stellar team is based on their seven core values, reciting them by heart: mission-driven empathy, humble expertise, independent collaboration, integrity, simplicity, radical transparency, candor and accountability.
Ellen and Matthew started with values and role descriptions to help them interview and vet candidates. She points out that the team has to work well together but they don’t always need to be similar, and that, in fact, the best teams are diverse.
Scoring candidates on their core values, they found a team of independent experts that gel well together but also embody their culture.
Designing and materializing a healthy culture
Ellen and Matthew use a values shout-out weekly to help them materialize the culture they wanted. At first it seemed “cheesy and silly”, but now the team has bought into it. Every week, their small team makes at least 5-6 shoutouts. A core measure of their success became whether their team could name their seven values.
“A founder once told me that most problems are people problems.”
One book that has deeply influenced their culture is “No Rules, Rules” about Reed Hastings and Netflix. Their main takeaway is that building trust can get you very far as a team. Building a team of trust and autonomy by focusing on high talent density will empower people to do what they excel at.
Matthew explains that the best and smartest people don’t want to be told what to do and they are also difficult to manage. You need to have extremely high value guidelines to empower them to make their own decisions.
He also explains that you need to have extremely high talent density to be successful in a startup. When you add someone to the team, the teammate is either multiplicative or subtractive. The bar for hiring someone should be, “are they multiplying the overall impact of the team?”
Improving engagement with a healthcare product
Summer Health has very detailed instrumentation (fancy tech word for activity tracking) which helps them understand everything a user does on their website. Using this data, they have been meticulous about understanding what drives engagement.
“It should not take you more than just sending a message to get a session started.”
In terms of engagement drivers, Matthew notes that simplicity is key. He also notes that keeping an SLA is important; you should keep your promise that you will deliver care in under 15 minutes. Finally, follow-ups are a big driver of positive experiences with the Summer Health product. Pediatricians (under the everyday care model) are trying to develop a relationship with the caregiver and reach out often to deliver value to them.
As of the recording, Summer Health’s average wait time is 2.87 minutes with 100% follow up rate.
On the provider shortage in healthcare
There is a provider shortage in healthcare right now. “It’s estimated that more than 83 million people in the U.S. currently live in areas without sufficient access to a primary care physician.” We asked Ellen and Matthew how they plan to work around this problem if Summer Health is supposed to increase access to a pediatrician.
Summer Health sees technology as the layer that can help solve the provider shortage. Allowing providers to be more efficient with their time to practice medicine is what they try to optimize for. They believe that creating a tool that physicians will be delighted in using will improve their relationship with them as well.
The integration of AI and data-driven approaches is a cornerstone of their strategy. Matthew highlights how technology has been a game-changer, especially in enhancing the efficiency of their services.
“It used to be that it would take our providers 30 minutes to basically write their SOAP note because they would have to review the conversation. Frankly, (no offense to doctors) doctors don’t like writing. So there would only be like 3-4 sentences in their note, with mostly technical or medical jargon. With LLMs, we’re able to reduce that to literally one and a half minutes and the note is much more robust and comprehensive.”
Through note summarization, they have drastically reduced the amount of time needed to document the clinical encounter for the provider. The doctor still needs to review the automatically generated note before signing and sharing with the patients but the patients love it too because the notes are much more comprehensive.
Improving the quality of care is another top concern for Summer Health. They use OpenAI to help improve the empathy of conversations between the pediatrician and the caregiver.
In the future, Matthew looks forward to using MedPalm from Google to start to incorporate some of their multi-modal models to help with early diagnosis.
The fetal and maternal health crisis in America
“Summer Health can give the parent access to a pediatrician all the time. This helps with maternal mental health. Much of the maternal health crisis is mental… A huge number of deaths related to postpartum have to do with depression and anxiety. A service like Summer Health .. [can help provide] a big support system and somebody who is there to help you think through the health and wellness of your child.”
Ellen sees Summer Health is improving long term health outcomes for children coming from preventative medicine and an abundance of care. Using Summer Health should help parents feel like they have always-on care for their kids, leaving their children healthier. This will lead to a flywheel of healthier adult caregivers as well.
Summer Health in five years
Looking ahead, Ellen and Matthew aspire to make Summer Health a comprehensive care platform. Ellen envisions a future where their service is the first point of contact for any medical query.
Ellen mentions starting in pediatrics because there are so many questions that parents tend to have and they tend to be more careful about the health and wellbeing of their children. Matthew is excited about the next generation of kids that will grow up with Summer Health and have a single healthcare company with which they spend their lives.
Advice for founders
Ellen’s advice is to leave fear behind, use a thoughtful framework around testing and experimentation and be data driven.
“Prioritization is not prioritization unless it hurts and it should be therefore aligned with the long term goals that you have.”
Matthew recommends thinking through prioritization for experiments and hypothesis testing. It’s easy to run a bunch of incoherent experiments that don’t actually move you in one direction and that can be very confusing for the team. It’s important to move with conviction and all your experiments should help you prove a particular, higher level hypothesis.
Interested in Summer Health? Learn more on their website and LinkedIn.
A note from our sponsor: PacWest
Looking for guidance, connections, resources, opportunity? Pacific Western Bank’s banking products and services are built to support your evolving needs as you navigate the challenges of growing a successful business. As you continue to scale, our team will be with you every step of the way. Ready to take your business to the next level? Learn more at pacwest.com!