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We are here with Dan Weinstein. Health Transformer extraordinaire. I like saying that. COO, cofounder
of Cohero Health. Great to be here with you. Thanks Unity, great to be here. So, let's
start the convo by learning about Cohero Health, your moonshot. What's your mission and what
are you guys doing ? Cohero Health is disrupting respiratory care with smart connected devices.
So respiratory care. Asthma and COPD. Chronic diseases that affect millions of people. 50
million And that's just in the US. Yeah, about 300 million globally. They're chronic, there's
no real cure, but we have fantastic treatments that, when taken appropriately, do work really
well. And so, patients can really manage their disease. The problem is, people are people.
And, they don't take their medication the way they're supposed to. So there's less than
50% adherence to what's called a controller medication. So, often a patient is prescribed
a controller inhaler, so you've probably seen asthma inhalers, usually think of them as
rescue, when somebody can't breathe, they take a rescue puff. But often, patients are
prescribed a controller medication. So they take it every day, they're supposed to take
it every day. No matter how they're feeling. And that prevents exacerbations. The problem
is people are not adherent to their controller med. So we are solving that problem in two
ways. One, we have a smart device that attaches to an inhaler and it's like a Fitbit. It tracks
if you took it or not. It pairs with our software platform called BreatheSmart. Which has an
engagement platform, a mobile app that reminds you to take your medication, provides you
educational content, helps you engage and better manage your disease. We also have a
device that's called a mobile spirometer. So, we're not only getting people to do what
they're supposed to be doing better, we are doing things outside of the clinic that have
not ever been available before. So, usually you go in once a year to do a lung function
test. And you use a spirometer. It's generally this big, scary device. We have, we offer
a portable, mobile spirometer. Unity, So, you're in the real world when you're using
it. Exactly. And so, instead of getting one data point per year, you get one data point
per day, per week, per month. And then we enter the thing, that you at StartUp Health
love so much, is the whole big data play. Now for the first time ever we are, we know
a patient's demographic, how and when they're taking their medication, how and when they're
responding to their medication. And that has never before been done. And so now doctors
are empowered to make decisions based on real world clinical data, real world data driven
decisions. Patients better understand their disease, they do what they're supposed to
do. They stay out of the hospital. There's, $80 billion is spent on respiratory patients
in the United States. Half of that, 40 billion, is wasted and is a direct result of lack of
medication adherence. So, part of it's the adherence challenge. So keeping patients compliant
with their regimen, their treatment plan. The other part, it seems like, there's a lot
of learning that can happen about, maybe, what the triggers are for certain issues.
Certain blocks that might have, I don't know, certain dust or pollen issues, or whatever
the case may be. Are you starting to learn those types of things based off the data?
Yeah. Exactly. So, that is a perfect point. If something that is never really truly understood,
but that can now be understood with the advent of mobile devices and people living with computers
in their pocket. So, we just released a feature where patients can record symptoms and triggers.
So, many asthmatic patients have different types of triggers. It's weird. Some of them
are, like, laughing. Pollen. Dust. Animals. Weird stuff that triggers people's exacerbations.
So, now we can collect these things via the app. Patients can better understand their
own triggers, so they can be prepared, like when they go to moms house that has all the
cats, like, I really need to make sure I have my medication. Things like that. Their doctors
now start better understanding what's going on with the patients. But then, ultimately,
we know via the big data play, and you can understand, all right, if a patient who is
25 years old. Female from this region, if they, their biggest triggers are cat pollen
and cockroaches, they seem to do the best on X medication and X treatment regimen. So
taking this medication at this certain time. These are the things we are learning with
the BreatheSmart platform, and can then personalize. It's all about personalization. So in the
future, when somebody is newly diagnosed, we look at the Cohero dashboard and we say,
alright, you fit this demographic. People like you have done best on treatment therapy
therapy X. This is what we are going to prescribe. And so, ultimately, it's all about better
care at a reduced cost. So, it sounds like a very important component is the individualized
understanding of what this can do. But, is there also a population component to this
where you can start to learn across, maybe, a zip code, or a city block or a region, or
other types of demographic information, where you can start to use that data in a way that
becomes meaningful to the patients or providers that are working with them? Yeah. I mean,
the beauty of it is, it gets down to an individual level but also up at a population level. And
so, people who are responsible for populations, this is now a tool to better manage those
populations. So, if you think about a large health system that has thousands of respiratory
patients, we have tools and dashboards to very quickly look and see who in my population
is doing OK, who in my population needs intervention. And it's really key with platforms like this,
to make it easy to digest so that providers, their flow isn't super disrupted. So they
can very quickly look and say, all right, who do I need to respond to, we offer tools
to respond and to intervene in mass. So, you can look and say, all right, of my 10,000
patients, these 30 overused their rescue medication yesterday. That's something I want to remind
them, with a certain message. You can have automated messages that look for those criteria
and can message those patients, or you can show on a dashboard to a provider or to somebody
who would want to intervene, and they can then intervene. And then, the data also plays
at a population level. That's really interesting for payors to understand, kind of, the best
way to care for a different populations. It's also interesting, we also sell to pharmaceutical
companies. I was going to ask. Who are your main customers so people understand that?
Sure, yeah. So, we sell, the beauty of the platform is, everybody benefits. Patients
are healthier. People who care about those patients are better informed about what's
going on with them. Providers, for the first time ever, have data to drive their decisions.
Insurance companies gets better outcomes for the patients at a lower cost. And pharma companies
sell the appropriate amount of their product. Because when there's less adherence, they're
selling less than they should. So, we sell primarily to, through the channels, through
pharmaceutical companies, through healthcare providers with large integrated networks,
and then insurance So, would a patient ask their doctor about this? That's right. Yes.
So right now, it's a b2b model. Although we're toying with how best to go b2c, because we
just get so much tremendous interest from patients who see this and they want it. Those
are our core business channels. Talk about the journey to validate your solution, and
really prove the efficacy of what you're doing. What was that like? Yeah. So that's key. That's
like for any platform in digital health, especially specially disease management. In order to
sell it, you need to convince people that it works and you need to show real clinical
evidence. And that it's safe. And it's safe and effective. So, we were born, so my cofounder
and I both met at Mount Sinai where we have done clinical studies and we have ongoing
clinical studies to demonstrate that the platform does what we say it does. That it improves
adherence and reduces exacerbations. So That's really part of the DNA of how you were born.
That's right. Yeah that's right. That's a core strength of Melissa's, especially in
Cohero Health's, and it's key. So when, like other StartUp Health companies that are thinking
about how to succeed, this is a strength that you just need to have. You really need to
understand it, because it can be really expensive to do. So you want to make sure you're doing
it right, so that you have the endpoints that you need. Because when you want to sell to
like a health system. Because, especially, if your cost saving? So, a lot of our value
is cost savings, which is a harder sell than revenue generation. So, when you go to a health
system, and you are telling them you're going to save them costs, you have to prove it.
So the data is really important. And so, we continue to do it, so we have multiple studies
going on right now at Yale, at Northwell Health, a few other institutions, just to continue
to validate in different populations and different use cases, it's just key. What are your
biggest lessons learned as an entrepreneur? A few things. So one, healthcare is hard.
Right? The beauty of where we are right now, is there's a lot of things broken in healthcare,
but the challenge is healthcare is really slow. It's really challenging. So, lessons
learned? It's really weird being a tech company in healthcare, because you're really quick
and nimble on one hand, but your customers can take two years to make decisions. And
so, it's really challenging to balance those two things. It's also really important to
understand the customers and understand why they're slow and, kind of, what their reservations
are and to make sure you can address them. It's also, healthcare is regulated. And there's
a lot of, like, a lot of things you might not have expected to have to do. Especially
like for software, as regulations become more and more clear, and different apps become
medical devices, that's like a really interesting challenge to be considered. To again, stay,
how do you stay nimble? Lean startup, doing agile development, but yet documenting just
about every decision you make to make sure it's safe and it meets, kind of, your company
goals. One of the things we focus on is, with all of Startup Health's companies, is this
Health Transformer mindset, and the first mindset is about having a long-term commitment.
And, I think you hit the nail on the head. If you don't have that, sort of, long view
perspective, as well as the persistence to, sort of, navigate the long sales cycles, the
validation process, it becomes very hard to succeed, if not impossible, to be successful
in this sector. I totally agree. I think it plays in entrepreneurship in general. But
especially in healthcare. If you're getting into entrepreneurship, you need to believe
in your mission and if you treat it like it's a lottery ticket. I meet people who, when
their start ups seem to be successful, they're already envisioning cash and selling out and
all that stuff and I, whenever I meet those people, I am certain that they're going
to fail. Because that, like, that's not why you need to be in this. You have to have
the long view, you have to be dedicated. All you're doing when you sign up to be an entrepreneur
is sign up to work your ass off. Right. With zero guaranteed reward. Other than an awesome
experience. So, what does the future look like? Talk to us about your dream at Cohero,
and what the next few years look like when, hopefully, millions, maybe hundreds of millions
of people are using these smart devices? I mean, the long term goal, the long term dream
is just that. Every patient who is diagnosed with a respiratory disease gets a platform,
the Cohero Health platform, to help them have the best outcomes possible. So that will take
time. The near term is, we closed our series a a few months ago. We're now scaling commercially.
Congratulations to that. Thank you. Thanks. I met you, your team is growing, you have
a new CEO who is awesome. Agreed. Mel and I have been in in this for years, basically
first phase is build something, validate it, prove that this thing really could work. Next
phase is prove the business model, get a few deployments, show that people can, customers
like it, it gets them an ROI, that we can like, we're viable business models. We've
passed that. Now it's just go full guns blazing. And build, you know, a true infrastructure
to sell to large health systems, lots of different customers, and then support them. So, you
know, hundreds of thousands of patients, which we expect to have in the near future. That's
a real enterprise. And so that's, we just hired Joe Condurso as our CEO, and that's,
he has terrific experience scaling and building companies like this. So, the next, the next
two years, really, are going to be focused on scaling, selling a lot of these things,
getting health systems set up with them, and then continuing to build the case for it.
Collecting the data from these new deployments, and then starting with the big data. Starting
to understand what's going on with all these patients. And improving the way we treat respiratory
patients. Well, thank you for everything that you already do. It's a very important mission
and it's inspiring to get to collaborate and work with you. So, thank you. Agreed.
Thanks Unity.
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