On Launching A Successful Telehealth Platform And Going Through YC

Alison Greenberg
Founder, Ruth Health
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Ruth Health
from Los Angeles, CA, USA
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On Launching A Successful Telehealth Platform And Going Through YC

Hi, I’m Alison Greenberg. CEO of Ruth Health, a company I co-founded with Audrey Wu.

Ruth Health is a telehealth clinic and care hub for prenatal and postpartum people. We provide one-on-one telehealth services and resources to support them in their journey from pregnancy to several years post-partum. These include pelvic training and recovery, lactation support, and c-section recovery—as well as a hub full of supporting resources.

We serve patients across the country by offering 30-minute sessions that are as easy to schedule as a work meeting. Think of it as adding a meeting to someone’s calendar at a time that best works for them.

Busy working parents make up the majority of our patients, and they need the flexibility that Ruth Health offers. Our goal is to increase the accessibility and affordability of care that makes pregnancy a little easier.

We work together with our patients through two phases in the pregnancy journey: helping them prepare for birth as well as the healing process after birth.

We’ve raised $3.1 million in venture capital to date, been selected for Y Combinator (S’21 batch), and we’re finalizing an affiliate partnership with one of the largest health insurance companies in America.

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What's your backstory and how did you come up with the idea?

I always say my backstory starts with talking about vaginas at the dinner table growing up. I was raised by an OBGYN who, it turns out, is now our chief medical officer at Ruth Health—Dr. Vivian Greenberg. Growing up with a women's health provider as a mother, I was always interested in women's health matters. So, I know more than I probably should have. After college, I made my way into brand and health care strategy. There I worked more on the business side of things than the clinical side.

When I started my first business, it was in a separate field. I love learning, and I love new challenges, and that's how I found myself in Conversational AI. So, my first business was designing and building conversational experiences for chatbots for conversation assistants, like Alexa and Google Assistant. That's where I met my co-founder, Audrey Wu.

She had built a software company in the same space. We got to work together and became colleagues and because we stayed in touch, we realized that we wanted to make a more meaningful impact on humanity for the rest of our lives (chatbots were not how we would do it).

That's how we put our heads together and began an earlier venture in rethinking and redesigning women's health for us, by us. This initial research and development process turned into Ruth Health. We decided on the areas of pregnancy and postpartum because they’re the highest "volume of care" moments in a woman's life. It's when you are going to the doctor the most and when you receive the most testing and imaging, yet women still felt underserved.

We realized that there was this problematic hole in a woman's care journey during postpartum. Although birthing people have several visits prenatally, these turn into just one visit at the six-week postpartum mark, presenting a lot of opportunities to support birthing people in and around those doctor's appointments with what we call "interstitial care."

Here, we could focus on listening to the patient and working with them to build care plans and support their journey from the perspective of pelvic health, core recovery, and breastfeeding support. As we did this, we could continue to provide them with more evidence-based resources to give them everything they need beyond the doctor.

Take us through the process of designing your services

I think like most businesses that started around the beginning of the pandemic, there are going to be phased into the telehealth platform. There is an MVP (Minimum Viable Product) and rounds of feedback from patients and reviews on its usability.

Building the MVP meant creating an off-the-shelf composite. This was important for two reasons:

  1. To minimize risk, start with vetted platforms that were well documented in healthcare already and/or HIPAA compliant.
  2. To increase speed to market. So many players in virtual care have tried to reinvent the wheel, but we wanted to stitch together existing tools with minimal custom code to maximize features others have built.

While this MVP wasn’t perfect and even caused our team some frustrations, it allowed us to launch faster than we ever expected, while still keeping patient data secure

As we went through the process, we heard one thing loud and clear about what stuck out to our patients and that was our methodology of care.

We are excited to be approaching our next chapter beyond this phase concerning our platform, although, I think the goal when we designed the platform was to make it as simple as possible for the patient to sign up and self-schedule. That's a big part of it. It's about eliminating the frustration of calling a doctor's office and all the back and forth.

Most important for us, was that it would be easy for a patient to onboard. The plan was that they’d only spend about 10 minutes on health record questionnaires, and then self-schedule to have us pop onto their calendar or item with a Zoom link. As we approach the release of our new care hub, (coming out this summer), the goal is then, again, even more, ease and simplicity.

Transparency is also really important to us. We want a patient to be able to access their health records and be able to see what the provider says about them along with the notes they've taken along their journey. This is something that most people are not used to having access to. However, these things are important. It helps put things into context and it's helpful to see that information in different ways.

Moreover, we want to keep a patient’s record of care, billing, scheduling, and health so it can be in line with our resources. That way we make sure that there are written and video resources and all kinds of helpful content available to our patient community when they need it so we can be there for them even when not one-on-one.

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Describe the process of launching the business.

We officially launched patient services with Ruth Health while we were in Y Combinator, a fast-paced Silicon Valley accelerator program. It was us, only a few others in health, and a bunch of software companies. So, it was a pressure cooker experience.

There was zero expectation that our application to Y Combinator would be accepted. Audrey and I labored over the many questions and simply used it as an exercise to nail down our vision and narrative in even deeper detail. Ultimately, I think one key to acceptance was identifying the customer, the market size, and how we were different from incumbents.

We also defined a collaborative care methodology that would truly solve the pervasive problem of patients’ being and feeling underserved. And finally, we identified potential partners in the payer space that made it clear we knew how deep the complexities of healthcare run.

While inside YC, we were being pushed to launch as fast as possible and start seeing patients and generating revenue. When you are a software company, you can just go out into the world and see what happens, but when you are in healthcare, you have to take precautions.

You have to make sure that things comply. It was a real push-pull between wanting to launch as fast as possible and also do it in a safe and compliant way. We were finally able to do that in July of 2021.

We launched with just one product, our flagship Pelvic Training, and Recovery service. It was so exciting and nerve-wracking at the same time. Throughout that first month, we continued to fine-tune the experience, trying to make it easier for patients to access the platform.

As we went through the process, we heard one thing loud and clear about what stuck out to our patients and that was our methodology of care. They were just amazed at the difference they could feel after a couple of sessions.

Many were surprised that they could even work on the pelvic floor remotely from home. Hearing those initial positive signals gave us the impetus to keep going. Since then, we have continued building and providing those same positive, surprising, and delightful experiences from home.

Since launch, what has worked to attract and retain customers?

Quality of service

In April 2022, we had our highest patient retention yet and hit over 90% retention. It’s been amazing to see the journey there.

I think it’s all due to the quality of our providers, the positive experiences, and the listening ear behind it all. We have worked on providing that human side to Telehealth care, and we think that’s what keeps patients coming back.

TikTok

Getting the word out in a couple of different ways and different channels have been extremely helpful. One of these avenues is through growing our TikTok presence. I never thought TikTok would be a place to talk about perinatal care, but these are new times and we’ve had incredible growth after launching an account just a couple of months ago.

We use it to tackle myths and fight hearsay and the old wives' tales of pregnancy with evidence-based information, and our audiences are responding positively.

Referrals

The other channel through which we are trying to build the business is physicians. Although we are direct-to-consumer telehealth, we are building out a referral partnership network of physicians across the country. We were just recently at ACOG, the biggest conference in women’s and maternal health.

All the physicians we met who are used to hearing the problems we are solving told us they would recommend pelvic floor work to a patient. However, they were aware of the supply problem: the wait time was sometimes up to six months. Or they wanted the patient to seek a lactation consultant, but maybe they lived in a rural area, and it was hard to get out and see somebody.

All in all, there has been a need for more accessible options. Thus, we've established relationships with those doctors to be our referral partners. We truly see them as the key because when a physician recommends us, people are hearing that from somebody they trust.

Find your champions, and work within organizations to get to know people. Ask for advice, and then you might get that support.

We are proud to have built this network of close to 200 physician referral partners who believe in Ruth Health and who want their patients to have an option like us.

How are you doing today and what does the future look like?

We are growing today and are excited to launch our new patient portal! We’re also excited to bring new interstitial care to patients beyond what we are doing today. Moreover, I look forward to new use cases that I can't talk about just yet. We are bringing other types of birth workers like Doulas into the equation within our telehealth care.

Looking ahead, we will continue to meet patients where they are whenever they need us. That means, not just one-on-one care, but asynchronous care. It means the ability to call and text a provider throughout the week, through and out the month, whether during the pregnancy or postpartum period. It means more evidence-based resources. It also means expanding our services so you can do group experiences or watch a video or follow along on your own time.

We would like to be more and more accessible with more variety of services. And there are so many places where we can expand, whether it's nutrition or early childhood support. There is a lot of care required for a healthy, happy pregnancy and supported postpartum. And I think we are just scratching the surface right now by focusing on pelvic, breast, and core health.

On a grander scale, we always had the mission of impacting the nation's mortality crisis. So, not just providing wellness care but starting to break into our ability to lower the severe mortality rate in America.

While Pelvic floor work and lactation support are likely not preventing any maternal deaths today, we are looking to build from these more accessible use cases so that we can get to more serious health care needs. We want to make pregnancy and healing after pregnancy not just easier, but safer.

Through starting the business, have you learned anything particularly helpful or advantageous?

I learn something every single day. You always hear when you are building a business to talk to your customer, patients, or users. From our experience, that has been invaluable, and the more often you can do it, the better. The more diverse conversations you can have, the more you can serve patients. That's why we've always had a beta group with every new service launched. Those conversations are some of the most incredible learning opportunities one could hope for.

The other important thing is to always ask: What more can we do? What frustrates you? Those conversations have shown us so much about how current care systems are inaccessible or clunky or hard to figure out. And when you approach the process from that inquiring standpoint, everything then becomes a problem that can be solved. We do believe that every problem is solvable. It makes it kind of joyful to go through the world and find these problems because you are approaching them with a solutions mindset.

It comes down to starting from a solutions-based mindset and not getting frustrated because right now women's health is a very frustrating topic. We are not even in control of our reproductive rights, and you have to look at these challenges and ask, "where can I have some control, where can I make a difference, where can I offer people a better option?" So, I'm learning to just try to keep that positivity, even when things feel very frustrating and dark.

What platform/tools do you use for your business?

Dozens! Our business would not run without Slack, Asana, and Jira.

Zoom is also crucial to us. It's how we go live with our patients. Google Docs and Google Drive are key platforms that allow us to collaborate in real time.

Our team of twelve people is spread across the country, and we have to be able to workshop things together. Canva is an amazing tool for design and social media assets. We've designed a huge chunk of the brand by using tools like Canva. It's a whole collage of different platforms which allow us to create quickly and collaborate at all times.

What have been the most influential books, podcasts, or other resources?

More than I can name! If there is one book I could recommend, it would be Invisible Women. It’s a really powerful, sort of creative non-fiction book about the bias in data. It goes into how much everything, from tech usability data to health care data, is biased against women, women of color, the LGBTQ population, plus other minorities.

Women are 51% of the population and account for 80% of health care decisions, yet we are under-sampled in peer-reviewed research. That book taught me to talk about stories and not just statistics. So much of women’s health has not been measured, and if it can’t be measured, it can’t be managed. That being said, we just try to listen to people and their stories because, more often than not, those stories become data.

In terms of podcasts, I love Master of Scales and How I Built This. I also love listening to the Huberman Lab Podcast for the latest research science on human health and behavior. Finally, we have a lot of industry-wide sub-stacks that have been of interest. I’m a big fan of Second Opinion by Chrissy Farr. She does a great job breaking down trends and topics in digital health.

Advice for other entrepreneurs who want to get started or are just starting out?

Find your champions. You are not an island. My co-founder Audrey and I have seen this time and time again. Whether in the Accelerator program or with the amazing managing director Matt Miller of the UnitedHealthcare Accelerator Powered by Techstars, or mentors like Nick Desai, co-founder of HeyRenee, and co-founders like Sarah Hollingsworth of Poppylist, having champions across the board is so important.

We've been so lucky to find people who are in the position to work with us or hire our business or help us generate leads. We could not do our work without those partners and affiliates and in many cases, our friends.

Find your champions, and work within organizations to get to know people. Ask for advice, and then you might get that support. But I think that's been pivotal for us. To have friends and people who promote us along the way whom we were not selling in many cases. In many cases, we just wanted to compare notes.

I think that's an earnest way to start a conversation and to build camaraderie that eventually can veer more into mentorship and partnership.

Where can we go to learn more?

If you have any questions or comments, drop a comment below!

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Alison Greenberg, Founder of Ruth Health
Pat Walls,  Founder of Starter Story
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