Health Innovators
Health Innovators

Episode · 1 year ago

The emotional roller coaster of building a digital health company w/ Eran Kabakov


When building a digital health company from the ground up, the road will, at times, arduous and challenging. 

Entrepreneurs have to constantly examine their goals, their approaches, and - perhaps most importantly, their failures in order to stay on task and motivated.

Not an easy task, but when you’re passionate about your solution, it’s a path you’re willing to take and a process you’re willing to submit to.

In this episode, Eran Kabakov speaks candidly about his company’s nearly two-decade evolution, some mistakes he’s made along the way, and how the COVID-19 crisis helped open doors.

Eran gives our listeners an honest look at the often unglamorous - but most often rewarding - rollercoaster ride of building a digital health company.   

Here are the show highlights:

  • How building something from nothing versus working in an existing, established infrastructure is like night and day (3:46)
  • Product market fit and how it can evolve and change over time(7:34)
  • Recognizing when you’ve reached product-market fit and how that can be different for every entrepreneur (13:44)
  • How a crisis can reveal opportunities, even if doors closed in the past (17:01)
  • Sometimes the market has to catch up to the entrepreneur’s vision (22:57)
  • Why keeping your eye on your end goals can help you stay on track and inspired (28:42)

Guest Bio

Eran Kabakov is CEO and Founder of Docola, a digital health tool that enables providers to quickly share information with patients, tracks progress, assesses comprehension, and provides utilization reports, all on a HIPAA/GDPR compliant platform.

Eran has been a clinician for over 30 years, has earned his BS in Physical Therapy from the University of Buffalo, and is a volunteer at the Aurora Project and the Society for Participatory Medicine.

If you’d like to reach out to Eran, or are looking for additional information on Docola, you can find him on  LinkedIn at Eran Kabakov or visit their website at .

Welcome to Coiq, where you learn howhealth innovators maximize their success. I'm your host, Dr Roxy,founder of Legacy, DNA and international befth selling author ofhow health innovators maximize market success through handed conversationswith health innovators earlier doctors and influencers you'll learn how tobring your innovation, fom idea to start up to market domination, and now,let's jump into the latest episode of Coiq. Welcome back to the show coiqlisteners on today's episode. I have the wrong Kabakov with me, who is theCEO and founder of Dacola, welcome to the show iron? Thank you ver muchthanks war. Evir me for Su. So tell our audience a little bit about yourbackground and what you've been innovating sure I aclamation I'm ahealthcoire provider Bein in healthcare or patient careful over thirty years.The majority of it is a physical therapist and I've been working onimproving the conversation and communication between healthcareproviders and patients between or before after, in between medicalencounters, where there's the vacuum of communication. That happens. Okay. So when did you get started andwhere are you in the innovation process now so the first ethe first idea of thefirst drawing for the idea, happened back in two thousand and one for thelisteners. It's two thousand and twenty going on twenty years from the napkingdrawing I was working in the clinic, and I hadfour patients that were so similar. It was since then, in all my career. Itnever happened again, so it was. It was something that meant to happen to pushme into this crazy ride that I've been on, but the patients were young high schoolathletes with left media neeping, and I remember it today because it was sounique and when I came out from the evaluation of the last one I told myColeague, I said I just spent at least twenty minuteswith each one of these athletes saying exactly the same thing. We have to make this better. It'stwenty minutes! It's eighty minutes total that we could have seen more.Patients have done more things. We have to improve this, and the Internet waswas starting, I'm a Gig, so I was I was playing with Agen and I said we awe can do this on Natenet, so I went home and I drew the idea and I started and I started researchingstarted looking around to see what was out there and how we can do it better and really physical therapy is my love. I loavedoing it. I love the patient interaction. I love helping people andgetting them feeling better. It's the... always smile when you're talkingabout it. The amount of satisfaction I get isit's like nothing else. So so, if it is, it is a wonderful thing, but I foundout that I have the same passion for getting the communication right inIndien counter, because I've seen I've seen the patients that I've hadthe opportunity to really interact with and communicate with and IU' intivationthat I haven't and the result. So I don't have enpirical data, the reviewedevidence based data, but but I, but I do have the crinical experience to beable to say those patients are doing better, so that was that was the Nutch, and I wish I could say that it was a nudgedown hill and it was like just spitting down and who it's like that roller coster ride. That isawesome. It was actually a not e all to wish that was the journey ofentrepreneurship. It was it was. It was a not uphill D and itreally went from there, so that was the that was the impetence of what what it is that I'm doing today. Sowhat Hav been some of the mile stones that you have achieved or reached inthis twenty year journey wel? I can write a book above that the milestones so first of all I had to learn to I hadto learn under a preneership I had to learn technology. I went to Inever seen a piece of code before I startedthis, so I had to learn how to how to understand the technology andcode and everything about it. I had to really understand business management from a completelydifferent perspective as a physical therapist, that I've run large clinics,Aenin or being on teams, but there's a different. It is. It is a compit's, acompletely different place to be when you' working in acompany and Yeurope an administrator, and youhave, even even if you're, in a really largecompany and you're in you in mistery, and you have a huge budget. It's still you you don't realize thet way. Well, I tin,so even if you're a big working in a big company when you, when you leavethat nest and you go into entrepreneurship, really you find yourself on a boat inthe middle of the ocean yeah and then you have to work with a team...

...and it's a different experience. Soeverything about it, building something from nothing versus working in anexisting established infrastructure. It's like night and day right, B, YeahLo, so you embarked on building something from nothing, yeah and really I'll. Be completelyhonest. It was truly an ignorant decision. Okay, I mean it was I'm like yeah. We can do this, notknowing anything. It was just. It was let's, let's roll the dice, not knowingthat I'm rowing the liys right right righttand. I do have a lot of friends now along thejourney. I'm gethered a lot of friends who are antrepreneurs, and I know nowthat I'm not the only fool yeh yeah to jump, but it was an ignorant decision. Yeah,yeah, Yep completely so part ignorance, part, crazy andUSSHIP and absolutely you know- and I think for you know most of US- it'salmost like it's a calling, you alo, you can't do anything else, and it'sjust nothing else fits you just feel like this is what you were created for. Yes, A and that's that's the only the only thing that can get you started and really keep youkeep you going yeah and a lot of times. It's also for me. I have to check that feelingand I have to check it on a regular basis to ask myself: am I holding ontothat feeling without having the right product or the right offering? Because just because I have a drive doesn'tmean it's to correct drive. I keep checking myself so Y, so so ron,let's kind of talk about that a little bit, because I think that that is adilemma that most, if not all innovators face between. I have a Ihave a dream. I have a vision and I'm staying so determined and stubborn andmaking that come to fuition but having to be agile and the method or approach that Itake to get there. So there's kind of this balance of being fixed and focused,but also being agile and flexible in in the balance of those two things in actually getting to product marketfit, which is exactly what you described. So you can have a dream andnot have market product market fit not have paying customers not have asustainable business, and it can be...

...confusing, because I think that inculturally in this ecosystem we continue to be told that you've gotto be persistent and determined and focused and stayed the course. So atwhat point do you know where again, you know stayin focused on the dream in thevision, but not staying tied to your commercialization strategy, becausethere's something that needs to change to actually achieve product market fitand have a scalable business? I think that it's part it's part of the process,but if I had to do things over again right, I if I CAV, if I share my ritprospect- and I hope somebody catches onto it and does something better thanI have it has to start. It has to start earlyon and you'll, hear you'll hear people tell you that, oh you have to. You know, create a minimally viable product andtestit, and then you know if it is right. Well, it's only right at the time that you'retesting it so saying you know I have a drive, I have a market fit is correct, but then coronacomes along and the market fit suddenly changes or forget Coronas Anany. Anynumber of things can happen. So my example Yan we ended up. So I ended upsitting on that idea in the drawer. For about three years I wanted to be a physical therapist. Iwas busy learning and becoming moving up the profession when I finally decided to to create myfirst product. I I search and I found this third party product and Ibasically took it and I modified it for myself and started working with it now. At that point I was checking fitfor me. It was working for me, so my patient was working. That was wonderfulright about a year later, I was sitting at the dinner with the surgeon that Iknew he asked me what I was doing. I toldhim- and I mentioned that Product Hing- oh my gosh, that sounds amazing. I canuse it. Can I ham it? I'm like yeah absolutely here, so he started using itand six weeks later he came back to me and he's he' saying this is amazing. You have to dosomething with this, so this is a second time where I get now. I now Ihave an objective view. Not Me thinking my baby works but right. Somebody elsesaying thirs a market seat and that gave me really a bigger nodge. So so then, then I drag my brother into it, who mybrother is my business partner. I drang my brother Ain Dude and I say I think Ihave something here, so we bootstrap a minimal V minimamly vibale productwhere actually weii design and work with a team on creating the product andwe start testing. So...

...the response from the market that I getis yeah it's working, but I'm not able to make money with it. So so now I have drive, I have productfit and I'm not making money. So that's the the really crucial heartof the the equation of like okay. How do how do I make money off of it? Andso when I recognize that I needed thosethose three things in check at any given moment, I basically said my tests will be. Can I can I get the feitback from the clientbase saying yeah? This is really great and I cannot live without it and beingin us being able to make the money tthat's why those are th. Those are thethose are the fit. That's the fit that I'm looking for to know that I'm notjust driving arunaway train without without going ther. I will say this loop that I've beendoing this for for nineteen years from the idea, but there are swats of land that I'vewridden this train of mine into like without control yeah. There are. There are times where I wakeup in the morning, and I do ask myself what the EC am I doing. This is there'sno way. This is right and people around me say the same thing, so people thepeople that are close to you when you're on this on this train peoplewill tell you what are you doing this is you could be doing something elseand it's you kno stress and it's but pays the ills, wriht money coming inseriously story, and and that's when I have to look at those at those markers and say yeah. I do still believe in this hey it's DrRoxy, here with a quick break from the conversation. Are you trying to figureout what moves you need to make to survive and thrive in the new covideconomy? I want every health innovator to find their most viable andprofitable timit strategy, which is why I created the covid proof. YourBusiness Tythekid, the PIPOCIT, is a step by step framework that helps youfind your best tivid strategy. It walks you through six categories. You need toexamine for a three hundred and sixty degree view of your business. I callthem the six critical pivot lenses, as you make your way through thiscomprehensive kid, you'll be armed with the tools, chips and strategies youneed to make sure you can piv it with speed without missing out on criticaldetails and opportunities, learn more at legacy. Tythan DNACOM BACKSLA Kit.So I think what you're describing is again something that a lot ofentrepreneurs face. Is You know in the beginning, when we create something?...

It's, I think it's really common for usto have people havein an objective point of view, even giving us positivefeedback about whatever we created and saying. Yes, this is needed. This isawesome. We don't really get to product marketfit, though, until we have piles of money pouring in from payingcustomers anduntil, then we can have a you know. I talk to entrepreneurs andinnovators all day long and and I work with them- and you can have- I meanI've seen people there they're winning awards, they're winning hacathonsthey're, getting theyre getting funding, and these you know- and this can happenfor years- and so you know all of that. Stuff is great stuff and it's all kindof giving you some momentum and some energy that says yes, you're on theright track, keep going and they can do that for years and still never reachproduct market fit where they. You know they can look at their bank account andgo yeah. This is this is this: Is Product MarketFit and I think most of us really struggle with trying to get from?I have a few payin customers to. I actually have like that. First, sixteenpercent of the market and word of mouth is happening whereI'm not just having to tell people about my product, but people are usingit they're, loving it and they're telling everyone else about it andpeople are buying it. It's the thing that people say about moving up to thenext phase or jumping th the stage between entrepreneurship, a and companyrunning right. I think that when the time comes and LOALLA WIS by the way mycompany I didn't enten before but but when we get to that point, I think that I would be more comfortable to give the steering will to aprofessional co who does that for living, because at that point that's what youthat. That is what you need and that's one of my personal milestones along the way was therealization, the humbling realization that I don't know everything I cannot doeverything I have to you have to come to to realization, Tis, 't, my strengthto live on my witnesses, yeah and in my team members when I, when I startedpicking my team members, I basically wanted to find the TA members that are filling up my weaknesses so and that'swhy I think it works so yeah. That's it's important. It's an important partof the of the journey yeah. So so you've beenyou've been. You know doing this for a...

...long time and like you said you knowyou can imagine over. Actually, you don't even have to imagine you know,first hand that market trendschange all the time, even when you don't have apandemic happening right and we're consistent having newentrance and mergers and acquisitions, and you know just the evolution of themobile phone and you know consumer behavior and all kinds of different.You know market changes that happen. Then you have the pandemic. So how hasthat affected your innovation journey and and kind of?What are you doing differently, going forward to adapt in this new normal thepandemic, while a negative effect on the world? For me personally was a huge vindicating moment, because when wewent out to raise money initially- and we didn't know exactly what we weredoing and we were going after VC money, I did the VC to her and the and the fetbackthat I got was you'rein Tempa Bay. You know you faraway from us. Your team is all over the world. Youare one person office, so you're, not a real company and it jus. We, you knowwe don't invest in this. It's like you, you have to have a team. You have to belocal, you have to be New York or or Silicon Valley, and a lot of times wegot pushed out of the room because of that M we've been virtual from thebeginning. It was something that I was passionate about it because it enabledme to get amazing talent, amazing team that will mit like this queve en usinsOomsin, the beginning, yeah yeah, and so the pademic hits, and suddenlyeverybody runs to zoom and everybody is talking about working remotely and Iwanted to. I wanted to find my email least from back then, and you know thethose investor and SA. How do you like me now right right, guess what Ialready know how to run a virtual company, and I also know how to run aglobal company exactly it's like this is this is what we doan and we canwrite. We can write a handbook on how to do it, yeah so it so it was. It wasa big. It was a big win. I, in a way now e didn't make my bank accountbigger lute made me feel a little better and and about what we're doing and how we'redoing. It definitely gives me a better story.Moving on when I do talk to other investors, but that's that's. On the personal level,from fom a company perspective, we are a digital health company. We are. Weare the best platform to to have a syncronius communication withpatients. So that means that if you, if...

...youare seeing a patient on utill amedicine call when you hang up the call it's the same as the patient living theoffice and at that point, thepetation is alone. Patient Needs Information andwith do Cola, the information the patient gets is from Mein declanationof r their oteclanations and that it's available o twenty four seven. It'sbasically a clone of me available to my patiente at any given time an givenmoment, so the definitely increased the interest inwhat it is that we're doing it also, finally, making our salves processeasier, because when we get to a when we get to a client, they understand why.Now I will tell you- and I haven't- talkedabout Dokolo much, but our product is free, so we, through the journey we've tried all the we have tried all of thes salesprocesses we can find and we read the books and we look isten to blogs and-and it was how do we get this? How do we? How do we fund this? How do we makemoney and we realized that we were really having a too prong approach? Wehave the passion project. We know the Cola Kin, make healthcare better, can increaseaccess to healthcare and help people who are the best, the worst part of t theirtime where they're not feeling well when they're dealing with with thephysical difficulties. So anyhow, we decided to give that forfree, but in order to give that for free we have to make some moneysomewhere, and that was, and that was Ur crew. We realized where the money inhealthcare sits and we we license with technology to othercompanies for a profit and again, that wit the pandemic. It'senabling us to have a better conversation with ourpain clients, as well as the ones who are getting noas yeah. So would you saythat your value proposition is resonating more now with covid? Yes, absolutelyabsolutely it's before we had to yell it really loudand we would get I I don't get it. I don't Wa. Why do I need it now? The declinations were talking to arebasically telling us. I have to have something. What do you? How can youhelp so it becomes a much more collaborativeprocess. Then I than a push ova, Sall, yeah yeah. You know- and I think that'sreally interesting to because a lot of the health innovators that I talk tothat are clonitions that are...

...physicians, that they come to this whole journey reallyvery differently than just cereal entrepreneurs or even technologists,and you know you very often you see a problem you'reextremely passionate about solving that problem, but there isn't necessarily an obvious customer who is experiencingthat pain. Like you see it and I's a PRI high enough priority that they'relooking to solve it and paid us Olv it, and so I can anvision with these market changesthat we're experiencing, that. I'm hearing that there's a pattern ofClenihian, clonision and physician led innovation is starting to take off in alittle bit of a different way than it was previously because, there's more,like you said, there's more awareness in the market need which is obviouslycritical to Gettin the product market fit right. You know we can't beatpeople over the head and go. This is a problem. Don't you see it? Don't youwant to solve this problem? I mean in we do because we're sopassionate about it y. You know so sometimes we findourselves in situations where we're trying to convince the market thatthere is a problem and that it's a problem worth them solving, and so youknow maybe now the market's catching up. I think so, and I find that health carein general is a market. He's is use the word forrific to sell into it's risk, onverse, it's veryconservative, it's very regulated, whish, high regulationand, and so it's very difficult to innovate in an environment like it's acounter innovated environment and you'r trying to bring in a solution so the some days. I wish I just created awidget that I could Sett on Amazon for kids to play with, because the directorconsumer of route seems so wonderful to me, but it I'm not there. So one of the biggest problems that thatwe have today, I don't like the word problem, I'll,say challenge or opportunities we have today to be positive with my language.Yep is the fact that when we meet with clanitions- and we say this is a freeproduct- the the pushback is now. What do youfree? Like? Hey? It's free? We are giving it free and- and we are- weactually are working now on doing a better job at communicating. Why is itfree and that it is really free, but cleanations and healthcare...

...are used to something that would cost in asupermarket two dollars en when you sell it into healthcare? Suddenly, it'stwelve dolrs yeah it' tere. So it's more expensive. I always say that if it's, if it's fora baby, a wedding or healthcare, it's three times the price it should be. So that's just an example of when you talkabout market fit. We have a perfect market, fit we, but but what's what'sgiving us issues is the messaging and the message is good. We are. We are asocial good startup. I would call us right. We aretrying to really change the world. We have a fashion for that and and when you go to the market, themarket looks at you and says no you're trying to sell me something becauseI've been burned before many many times, and I think that you'r trying to do something like trick me: Yeah Yeah Yeah. It's that perceived value offree too so the Freemim model absolutely is asuccessful business model. You know we see it time and time again. Typically it's when it's a utility,Yeah Yep Yep. We again, we tried many things, Eyostrongly believe in the fre model of what it is that we are giving for freeyeah and we do and we think that there's going to be opportunities to not asmonotizing it, but but thecommunity that is using the product will figure out ways to monetize it forthemselves. There's definitely valuebuilding to it, because we knowthat today, accleanation that's using thecola. They save about twenty percent of thetime with the patient in the in the room, Orotella, medicine appointment.Twenty percent for patient is a enormous number in healthcare yeah. So for them, that's the monitization.You know they cannot build. They cannot charge the insurance company for it,but there's ways for them, but anyhow there's we for now we're writing train on thefree and that's that and were and r we'e feeling good about that. That'sgreat! That's! Really! Wonderful! So so, as we kind of wrap up here, what aresome lessons learned or advice that you would share with our viewers andlisteners today for somebody who's? You know been in this company and growingand building it for nearly two decades. I'm sure that when you look back inhindsight that you're like O, I could have donethis should have done this and then you...

...know and how you're you knowimplementing that in the next season or stage of the business, but my first, ifsomebody's thinking of doing it or somebody's only starting the process. Iwould say beware of the Sharks Kay it is. It is a it's definitely. Startup is an ocean voyage for surethere's a lot of sharks in the water. You are passionate, you you, you areignorant, I was. I am ignorant still you don't know what you don't know andthere's people who want to take advantage of you because of what it isthat you're doing so when, when you get te email about thatgreat hakathon or the great start up program or incubator, you haveto be really really good about vering. These things out do not do notget fished, and there is the fishing in Othe prenorship thee, there's a wholeside. That is negative, so be careful of that that my I've failed. I've feltfor it and I've experienced that's the first thing yeah. The second thing that worked for me specifically isstarting from the end and what I mean by that was initially when I just wasgoing. I was so passionate and so driving. I was just doing it for thesake of doing it, but I never really stopped and said. Why am I doing this for what am Ilooking for me as a person? What is the end goal? Whether I want to be do Iwant to be an egg, but it like to have the exit? Do I want to be on forbs onthe cover? What is it at I'm looking for? Do I want to have matching bowingthree seven N, seven Thry, seven in my parking lat, and so for me once I realized that mywhat I rea when I realize what my goal is from a family from where I'm livingfrom what it is that I'm was doing. It really clarified what it is that I need to do with thecompany in order together and and those days when I wake up and I'm like whatam I doing, the answer becomes really clear. When I look at the end, like NoiSickin, doesn't matter what's happening right now with the boat, the that's thelighthouse over there, that's what I'm going for just you know correct the course, and you know, focuson the on the personal goal. What it is that I want and the driver and that'swhat helped me through all these years, that was really still stillyis every morning is, is thedriving force yeah, and you know that makes a lot of sense, because havingthat vision in missing to guide you and your decision making, helps youdetermine who you're hiring what customers you dobusiness with right. You know all it really becomes the linsthat you can use in your decision...

...making to make sure that you don't endup either chasing the shiny new object or you'rebeing so influenced byoutsiders that you might reach some form of someone else's version ofsuccess, but not true to what your in game was all long correct and you knowwhat the best example I see and that's that's a very tangible. I don't watch TV much,but when I do travel I am in a hotel. Sometimes I get I end up watchingsomething so I shark Sharktink, the show I sit there and I see the sharks offer.You know I'll, give you w two million dollars for this and thatand and the undepreneur saying no and I'm like. Oh my gosh, take it tak that money and an innovate againuse that money like so stories. The stories we hear is: Oh, Iexited, and I made eight hundred million dollars. He made three hundredmillion dollars. Who Cares about the three hundred million dollars? You haveto look at's like what I, what if somebody comes and says, here's tenmillion dollars and- and you can take that ten million dollars and turn itaround and do something else, but just leave on the beach somewhere forever. That's fine! You! But if you don't knowwhat it is you want. You know you're not going to know that the offer on thetable is right or the opportunity on the table is right, regardless of whatit is, because you don't know what it is you're trying to do with thatopportunity, right, right, yeah, no guiding star correct, and I thinkthat that would be. That would be my starting point nexttime, Yeah Yep! So what's next for Dacola as we youknow we're in June now and we're halfway through twothousand and twenty. What's next for you, what are you most excited aboutbeing on the horizon? For you, I think we have some really exciting relationships withorganizations that are seeing the power of the technology and understand it andkane open doors for us to larger groups ofusers. So traction is a thing and we want to get hattraction. I'm really excited about some researchthat we're doing some. Some research do to show from Aan embiricle standpointthat what we do is the right it is right and that we are on the right path, and I think that I'm excited about somerelationships in the forma world we are. The farmer world is a big, is our biggest line of revenue and athere are things that are happening. I'v really seen the farmer industrychange over the last ten fifteen years,...

...and I'm really excited about how openthey are to positive collaboration for help helping healthter, yes, youthat's, exciting,yes, exciting, well Ron. Thank you so muchfor sharing your wisdom with our listeners and always being sotransparent and so candid about what this journey is really like. I knowthat it becomes very inspiring and very encouraging for all of our viewers andlisteners, and so I appreciate that. Thank you. I appreciate it, I'MINLINKTAN! So if anybody San it, then they have a question find me there yeah,so is that the best way to get a hold of you if anybody likes to absolutelyabsolutely all right sounds great. Thank you. Thank you so much forlistening. I know you're busy working to bring your life changing innovationto market, and I value your time and your attention to save kind and get thelatest episodes on your mobile device automatically subscribe to the show onyour favorite podcast APP like apple podcast, spotify and stitcher. Thankyou for listening and I appreciate everyone. WHO's been sharing. The showwith friends and colleagues, see you on the next episode of coiq.

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