Passion Behind the Hustle

Ravi Sharma, CEO of OOTify, joins us this week. Ravi has had two successful exits in healthcare and clean technology and has incubated and invested in numerous technology startups through his family office, iBOS Ventures. Ravi was one of the youngest portfolio managers at Western Asset Management Co. and was personally responsible for approximately $1.3 billion in assets on behalf of sovereign wealth and institutional clients.

OOTify (Hindi meaning - "lift-up") is a clinically data-driven mental health services ecosystem that uses educational content, predictive triage analytics, and enhanced telemental health services to empower clients to find the right approach to improve their mental wellness and easily get high-quality therapy. The company is founded by serial healthcare entrepreneurs with successful past exits and who have experienced the personal impact of the mental health epidemic.

Having lost two family members and a dear friend to suicide and after navigating the fragmented healthcare system for years, Ravi decided to build a platform that could solve the structural and systemic problems in our mental healthcare system. We dig into the challenges he and his founding team have faced along the way.

You come from a finance background but have built products in the health-tech space (EMR) before. What makes working in health-tech so challenging?

Challenges in digital health are multi-faceted, but here are the top two:

• Sales Cycle - My first healthcare startup sold electronic record medical solutions into large hospital systems (e.g. Scripps). The sales cycle was very long but each contract value was six figures. If you are able to find champions within these enterprises and deliver a solution that customers love and that has a clear positive ROI impact, you can build a scalable and sustainable business. It also creates the opportunity for a successful liquidity event as I exited this company in 2010.
• Competing Stakeholders - In health-tech, you need to solve for the three P’s: Patient, Provider, and Payer. Your technology, content and resource support, and customer service have to bring value to each stakeholder, which is complex. The formula that has worked for us is a strong focus on customer happiness, engagement, uptake (e.g. continued utilization), and improved health outcomes.

What type of compliance or regulatory overhead do you deal with at Ootify? How have you navigated these in the early days (knowledge, cost constraints, talent, etc.)?

Privacy and security are paramount. When you’re building a digital health-tech startup, you need to ensure that the electronic health information you receive is protected, not just for compliance and regulatory needs, but for trust and to respect your user’s privacy. OOTify takes our users' data security and privacy very seriously as a core value of our company.

Health data is sensitive information so ensuring our platform is HIPAA compliant is crucial. Ten years ago this was a manual and cumbersome process. Today, it is much easier to ensure the highest quality of compliance and privacy through third-party providers and auditing capabilities with services, like AWS and GCP. All of our data is encrypted at rest and in transit, which meets or exceeds current compliance and regulatory requirements.

At OOTify, we took it a step further because we do not collect or store any therapy session information. We are always looking for ways to go beyond current data security standards, which are already pretty robust, including decentralized ledgers where only the client and provider have token access to their data. This is just one of many ways that we’re trying to find cutting edge solutions to continue to create trust and bring value to users on our platform.

With OOTify, you are working on a clinical trial to prove out your thesis around the benefits of subclinical treatment. As a startup with a finite amount of cash, how did you make this happen?

It started with a simple introduction from someone I played ping pong with at our WeWork office in Playa Vista. He had a background in psychology and knew the professor at Loyola Marymount who had interest in the field we were working on. I asked for an email intro and pitched OOTify to the professor and he literally was shocked by what we were building. The professor stood up half way through the pitch, went to his book shelf and grabbed a book that he had published in the 80’s, and flipped to a chapter that captured the essence of what we had built. He had thought technology would get to a point where a matching algorithm could help improve health outcomes with therapies and beyond.

After a few conversations, we decided that we could conduct a clinical trial with LMU students to test our thesis around the efficacy of short duration telehealth and sub-clinical interventions along with digital phenotyping. We reviewed over 1,000 existing publications to ensure our clinical trial was well researched.

During preparation, we had to ensure we were bringing a new hypothesis, a quality study design, willing psychographic participants, an independent principal investigator, regulatory approval with an Institutional Review Board (IRB), therapists, marketing, technology, thoughtful subject exclusion criteria and safety protocols, and much more. This work had to demonstrate to universities that our solution was clinically-sound and rooted in proven data metrics.

We were able to accomplish our successful clinical trial with a team of in-house clinical expertise and external partnerships. The passion internally and externally allowed us to do what other technology platforms are spending millions of dollars to do.

We are proud of the work we accomplished with our clinical trial and humbled by the support we have received from our partners: Loyola Marymount University, University of Southern California, Pacific MFT, and our team, including our ~50 current investors. We were able to complete the entire clinical trial with a few hundred dollars in marketing costs, absorbing the therapy costs internally with our clinical staff and relying heavily on the internal team and our partners.

Currently you are focusing on selling to large universities. Why did you choose this audience? What is the sales cycle like and what specific challenges have you faced?

We wanted to have the maximum impact with a demographic most in-need and at-risk with their mental wellness - college-aged students. 75% of mental illness onset happens by the age of 24. Our GTM strategy is college students because that’s where we believe the biggest need is and how we can quickly reach the largest number of people who could use support.

The sales cycle and internal review process for approvals is long, but the ROI of university systems is high. We’ve been able to get the appropriate support necessary at many universities to move the conversation forward with our evidence-based solution.

To learn more about the impacts and breadth of mental illness, head here.

How are you measuring success at OOTify? Who is responsible for these and how do you process these?

We measure our team’s success based on a combination of traditional OKRs and custom OOTify metrics. Sales success is based on revenue growth, and those metrics are driven by customer value-delivery and our expansion strategy into our 4 different customer bases. Because OOTify serves multiple user types, we have to ensure our technology and product, marketing and content, sales strategy, and customer success are effective and clear for each customer.

Those user types are:

• Mental health providers and coaches offering their expertise and professional services on OOTify’s application
• A non-student client user who is seeking mental wellness education and/or therapy or coaching resources from OOTify
• University leadership and staff who are partnering with OOTify to improve student mental wellness on campus
• A student client user type who has access to their campus and OOTify’s resources through the OOTify mobile app and our online content

In order to serve all of our audiences, we have two main approaches.

1. A targeted approach for providers and their clients so they can streamline and grow their mental health or coaching practices on our platform through our technology and better automated processes.
2. A targeted enterprise approach for universities and students where we can customize OOTify’s full array of assets for those school systems.

Our sales cycle to providers and mental health and coaching professionals is very short (anywhere from 2-8 weeks) and the internal sales process is straightforward. We deploy direct sales emails from tools like Apollo and run targeted marketing campaigns in our social media channels + partner content and thought leadership pieces, set demos & meetings through Salesforce Inbox and Calendly, track the providers in our Salesforce CRM, project manage our weekly tasks in Trello, prioritize customer issues/new features in JIRA with our development team, and leverage multiple communications channels to stay in sync with all OOTify departments (weekly check-ins, Slack, email, g-chat, text messaging, etc).

Our sales cycle to universities is long (anywhere from 6-12+ months), and the sales process is unique to each school.  There are variations in each schools' budget, available resources, and individual needs. We leverage all the same tools mentioned above for tracking and deployment of our sales strategy.

To evaluate the success of our offering, university leadership is provided a tailored, de-identified, HIPAA-compliant dashboard to track student engagement and overall mental wellness improvement on campus. University leadership can strategically deploy budget spend based on their students needs. They can track the overall success of the mental health and wellness initiatives by directly evaluating class attendance, better grades, or higher graduation rates, and job placements.

As a lean startup, the team wears many hats. We have a business development/customer success rep focused on our mental health and coaching providers. She is a licensed clinical social worker and has the appropriate training and expertise to connect with other mental health and coaching professionals on how they can maximize their utilization of OOTify.  Our CEO, Chief Medical Officer, and COO are responsible for enterprise sales. Our COO leads our enterprise sales strategy and customer success approach. She is the decision maker for our internal SaaS tools and processes, leveraging industry best practices, to keep the team optimized, focused, and organized so the team’s execution meets and exceeds our goals and deliverables. To learn more about the team, check out our site.

You have been in the startup world for some time; what is the best anti-advice you would provide startup operators and founders ?

Adjust to all the criticism. A well thought out critique is great if it’s something that can inform and challenge you. But that’s where it should stop. Use it as fuel for the fire, take any insight and execute.

What have you been reading lately?

Traction by Gino Wickman, The Lean Startup by Eric Ries, and Twitter. It’s amazing to see the content you can access from some of the most brilliant minds in the world in real-time from social media. You have to do it in doses, though, for your own mental wellness.

What startups are you paying close attention to at the moment?

Mindstrong Health and Field Trip - I think they are doing some phenomenal things in the mental health space.