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Lessons from Erica Jain, Healthie, building and scaling no-code healthcare infrastructure for virtual-first care
Erica Jain, CEO and Founder of Healthie, infrastructure for next generation digital health organizations that offer virtual-first care.
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.
This week, we’re super excited to get to know Erica Jain, CEO and Founder of Healthie, infrastructure for next generation digital health organizations that offer virtual-first care.
Healthie’s API-first and fully brandable suite of solutions - EMR, coaching platform, scheduling software, and patient engagement - enable healthcare builders to launch and scale best-in-class experiences for their members and quickly scale a provider network. Currently, more than 2,000 organizations use Healthie’s services and organizations that use Healthie work with more than 2 million patients on the platform.
After operating profitably for the past 5 years, Healthie announced a $16M Series A raise in July 2022, with participation of over 60+ healthcare and SaaS builders, angels, and some Healthie customers as well.
Prior to founding Healthie in 2016, Erica worked in the healthcare practice of the Boston Consulting Group and on the nutrition team of the Clinton Health Access Initiative in East Africa. Erica completed her undergraduate degree with honors in Health Disparities at Duke University and completed her first year at the Wharton School in Healthcare Management at the University of Pennsylvania (more HCM and BCG representation!)
In this episode, Erica shares about Healthie’s early founding days in a business school classroom (staying focused on the prize, skipping a Brazil trip to pursue Healthie 24/7), building customer love and scaling to thousands of providers, valuing a pathway to profitability (before it was cool in 2022), and the power of collaboration with other tech players in the quickly-evolving healthcare infrastructure industry.
Erica’s journey to founding Healthie:
Some of the best founding journeys are serendipitous. Erica initially had zero intention of starting a company out of school. Healthie began in 2015 as a school project in a Wharton entrepreneurship class. During this time, Erica had watched her parents go through the process of losing 35 pounds with the help of their corporate benefits. “I saw that experience and said: how can we make that available to every American in this country?”
Throughout her career prior to business school, Erica had realized how imbalanced the trillion-dollar healthcare system is. It was designed for physician-only, episodic care and as a result, ignored 95% of the healthcare experience for the everyday person: day to day decisions that would have more of an impact on overall health and wellbeing.
When prioritizing the founding focus, Erica shares one of the greatest pieces of advice she received from a Wharton alum with a background in telehealth (who’s now an investor in Healthie):
“You can be a tech company or you can be a services company. If you try to do both, you’re going to constantly have this tension between investing in care delivery/care quality and building out the tech. You’ll struggle, and you have to prioritize your resources even at those earliest stages of a company.”
Ultimately, Erica’s team decided on the technology, because technology was where their core team's strengths lied and was what they loved building.
Launching Healthie’s MVP in the first semester of business school:
Erica met her co-founder Cavan Klinsky, an undergrad at Penn, during Thanksgiving of her first semester. Over Christmas break, Cavan built the first version of Healthie and they launched with a barebones MVP in January of 2016. Their first few sales were to dieticians and coaches who were using Healthie in their own practices.
“I had never sold anything before. We put a number on the board and said, ‘What would you pay for this?’, and people started paying for our product. It was just a really interesting testament to see that people were really excited about what we were building on a small scale, and that gave us the conviction that there was something really powerful and exciting here.”
They started laying the groundwork for an EMR platform and a client engagement software that would work to facilitate long-term relationships between care providers and patients— focused on nutritional care and behavioral health from the outset.
“Enabling providers and care teams to build long-term relationships with their clients is the central underpinning to Healthie’s product philosophy. ”
Hitting the acceleration pedal as Healthie’s product received pull from the market
Erica’s second semester of business school was all about company building. The team spent the summer at an accelerator and didn’t go back to school the next year as the momentum kept up— Healthie’s numbers were going up, people kept buying the product, and they continued rolling out new features.
Erica believes that an accelerator environment was invaluable to Healthie’s foundation, especially when it came to strategy and metrics that contributed to both short-term and long-term success. “I learned more in one summer than I did during my first year of business school in terms of how to actually build and run and operate and scale out a company. It’s a concentrated environment where you’re surrounded by people and mentors who have done it before.”
When it comes to the grit of founding a startup, Erica shares that you have to be so excited about the idea that you’re spending all your time thinking about wanting to work on it.
“If it’s something that you’re so passionate about and you can’t imagine the world without, you’ve got to go for it. I don’t think that business plans are helpful. In particular, I think you have to talk to customers, really hear about their pain points, and then start building and getting the product out there.”
The product: Healthie offers API-first and white-labeled infrastructure including scheduling, EMR, and client engagement.
What this means is that healthcare builders don’t need to recreate the wheel when it comes to core undifferentiated infrastructure, allowing them to focus on their unique value propositions.
Erica believes that COVID really accelerated the way that virtual-first companies can launch and scale. Without Healthie, customers would need to build in-house, spending millions of dollars and investing a ton of time each year.
“There is an unprecedented need for innovation in healthcare.
It’s not going to come from hospitals, it’s not going to come from health systems, it’s going to come from new companies that value the consumer experience and value people not as patients, but as individuals that deserve access to better healthcare - that’s what Healthie powers.”
Erica shares that Healthie’s foundation has always been to support longitudinal relationships between providers and receivers of care. Because Healthie is API-first, customers can leverage Healthie’s products to build out their own experiences and scale to huge degrees. Companies have gone on to be unicorns on the Healthie platform, and Erica believes that’s a testament to the fact that Healthie customers are able to focus on what’s differentiating clinical care and outcomes rather than their backend infrastructure.
Erica shares that Healthie is also building out a marketplace that’s integrated with over 35 partners from e-lab companies to messaging platforms to CRMs— she believes that the new generation of care delivery requires a new infrastructure and health tech stack.
They chose to find partners rather than building everything in-house as to focus on what they do best, which is creating the overall seamless data experience.
“We would rather partner with RCM vendors in the space that are so good at what they do— I don’t think it’s important for us to own that, and we never will.”
Things to keep in mind when building compliant healthcare software:
Make sure you’re going to deliver a secure and private experience that healthcare mandates and deserves.
Keep timelines in mind. Many of Healthie’s customers are building partnerships with payers, employers, and health systems. Erica shares that there’s a time cycle to all of that coming into play: contracts, negotiations, procurements, and relationships that can take years as opposed to other sectors like FinTech.
Scaling Healthie to millions of patient lives
As you scale, you have to continue focusing on delivering value to maintain strong customer retention.
Erica shares that SaaS and tech companies like Healthie need to continue evolving their products.
“If a customer who has raised $800 million in venture is using our scheduling software, we have to earn the right to make sure that our scheduling software continues to be the absolute best. It’s a genuine and deliberate focus on delivering value and building and shipping the best product.”
Healthie focused on what they did best (technology) in order to keep up with a changing industry.
Erica shares that Healthie stays focused on their tech because that’s where they provide the most value to their customers who can then focus on clinical care and outcomes. This includes keeping up to date with the major and minor advances in healthcare and technology - whether that be Apple updating it’s screen sizes or an update to healthcare regulations. As Healthie customers sell to health systems and payers, Healthie is there to help with security assessments, vendor reviews, and backend support.
As you scale, make sure to be conscious of accumulating tech debt.
Healthie was growing incredibly fast in the beginning— a storybook performance The team was shipping features over the weekend, launching them on Monday, and giving them out to customers. Erica shares that this works for a V1 MVP, but you’ll invariably hit a ceiling whereby you’ve accumulated tech debt and it’s really hard to fix. “You’re effectively putting bandaids on a system, and that’s not scalable.”
In 2017, they made the tough decision to rebuild their platform from scratch so that it could sustainably scale. Now, Erica shares they’ll never have to do that again due to smart engineering decisions.
“We’ve made so many mistakes, and we will continue to make mistakes as we scale. What’s really important to our company philosophically is that we learn from our mistakes and hopefully don’t make the same mistakes twice.”
Keep the pathway to profitability in mind.
Healthie raised a seed round, then operated profitably for close to 5 years before raising their Series A. Erica believes that having a pathway to financial independence even if you’re able to raise that money is extremely important, because it gives you the ultimate ability to make the best long-term decisions for your company.
Erica believes that a surefire way to ensure that your product is providing value to your customers is if they pay. When customers are keeping the lights on, you’re motivated to make sure that you’re delivering value and build out processes for customer success.
“We turned down so many interesting distractions and opportunities. We sat down and said, ‘How are we going to focus on building the best product for our customers?’ I think it’s set us up for a fantastic future, because we have those cultural underpinnings in our DNA.”
Pushing your company vision through from seed to Series A
Focus on creating the best product you can to solve the cold start problem— word of mouth will do the rest of the work.
Since Healthie was first started in 2016, the landscape of health tech has evolved tremendously
“During our first pitch, we literally had to define what telehealth was in a footnote, because no one was talking about it and no one knew what it was.”
A question to readers/listeners: What will be the new footnote concept that no one was talking about, but will be universal? Would love your input!
Healthie initially started with dieticians, therapists, health coaches, personal trainers, digital healthcare startups, etc., many of whom came to Healthie looking for API’s to support their own frontend. Erica shares that their path really began with listening to what customers wanted and delivering on that. Even today, their go-to-market is 85% referral and inbound, something Erica shares is a testament to the power of word of mouth when you deliver a genuinely great experience.
Fundraising for Series A after seed:
Through Erica’s personal experience, she believes investors are looking for similar qualities. It’s about showing people what you’ve done, how you’re going to make things happen, and why you’re unstoppable.
“In 2022, the burden is higher than we’ve seen in awhile in terms of proving “Why YOU”: do you have 1) Passion, 2) Traction, and 3) a Vision for the Future?”
Investors have been most impressed with Healthie’s resilience. It’s not that there haven’t been ups and downs, but the team’s ability to keep going is indicative of success in the long haul.
The future of healthcare is collaborative, driven by essential infrastructure as a service building blocks
“It’s on all of us to build bridges, and that is how we’ll push this movement forward that is bigger than any individual company.”
When it comes to innovation within the healthcare industry, Erica believes that old and new companies must work together to move the paradigm forward. The previous generation of health tech companies built walls around their technology on purpose as part of their competitive advantage. Erica believes that change requires collaboration— innovations may begin outside of the hospital systems initially, but partnerships will evolve in the future. There isn’t a need to build products that already exist; it’s much better to use all these products in various capacities, which pushes the needle forward.
Erica advises prospective founders to not over prepare or overplan, just go for it!
“Go for it. Don’t overprepare and don’t overplan. From a timing perspective, you’re never going to feel ready and the timing is never going to feel right…
Becoming a mother has really shifted my perspective because you realize that you’re out to build a career and create a meaningful impact in society that’s going to outlast you and be better for the next generation. I think it’s really important to follow what you’re interested in and then work as hard as possible to make your vision come to life.”