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 how health innovators maximize their success. I'm your host, Dr Roxy, founder of Legacy DNA and international bestselling author of how health innovators maximize market success. Through handed conversations with health innovators, earlier, doctors and influencers, you'll learn how to bring your innovation from idea to start ups to market domination. And now let's jump into the latest episode of Coiq. Welcome back to the show coiq listeners. On today's episode I have Iran Caba cough with me, who is the CEO and founder of Doc Cola. Welcome to the show, iron. Thank you very much. Thanks for having me. Appreciate it. So tell our audience a little bit about your background and what you've been innovating. Sure, I'm a clemission. I'm a healthcare provider, being in healthcare or patient care for over thirty years, the majority of it, is a physical therapist and I've been working on improving the conversation and communication between healthcare providers and patients, between or before after and between medical encounters, where there's the vacuum of communication that happens. Okay, so when did you get started and where you in innovation process now. So the first it first idea or the first drawing for the idea happened back in two thousand and one. For the listeners, it's two thousand and twenty, going going on twenty years from the Napkin drawing. Now I was working in the clinic and I had four patients that were so similar it was since then, in all my career, it never happened again. So it was it was something that meant to happen to push me into this crazy ride that I've been on. But the patients were young high school athletes with left medial me pain and I remember it today because it was so unique. And when I came out from the evaluation of the last one, I told my colleague, I said I just spent at least twenty minutes with each one of these athletes saying exactly the same thing. We have to make this better. It's twenty 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 was was starting. I'm a GIG so I was I I was playing with Internet. I said we had we can do this on the Internet. So I went home and I drew the idea and I started and I started researching, started looking around to see what was out there and how we can do it better. And Really, physical therapy is my love. I love doing it, I love the patient interaction and I love helping people and getting them feeling better. ...

It's the you always smile when you're talking about it. The amount of satisfaction I get isn't it's like nothing else. So so it is. It is a wonderful thing. But I found out that I have the same passion for getting the communication right in Indian counter because I've seen, I've seen the patients that I've had the opportunity to really interact with and communicate with and I've seen the patients that I haven't and the results. So I don't have empirical data. He reviewed evidence base data, but but I know, but I do have the clinical experience to be able to say those patients are doing better. So that was that was the nudge and I wish I could say that it was a notch downhill and it was like just spitting down and who it's like that roller coaster eye. That is awesome. It was actually a not to we all who heard the wish. That was the journey of entrepreneurship. It was it was it was an uphill and and it really went from there. So that that was the that was the impetus of what what it is that I'm doing today. So what have been some of the milestones that you have achieved or reached in this twenty year journey? I can write a book about that. The milestones. So so. First of all, I had to learn to I had to learn entrepreneurship, I had to learn technology. I went to say I never seen a piece of code before I started this. So I had to learn how to how to understand the technology and code and everything a about it. I had to really understand business management from a completely different perspective. As a physical therapist, I've run large clinics, I've been I've been on teams, but there's a different it is it is a complete it's a completely different place to be when you're working in a company and you're an administrator and you have even even if you're in a really large company and you're in, you're in minister and you have a huge budget, it's still you don't realize that way. Well, so even if you're a big working in a big company, when you when you live that nest and you go into entrepreneurship, really you find yourself on a boat in the middle of the ocean. Yeah, and then you have to work with a team and it's...

...a different experience. So everything about it, building something from nothing versus working in an existing, established infrastructure is it's like night and day. Right. Nine, yeah, so you embarked on building something from nothing. Yeah, and really, I'll be completely honest, it was truly an ignorant decision. Okay, I mean it was. I'm like, yeah, we can do this, not knowing anything. It was just it was let's let's roll the dice, not knowing that I'm rolling the dice right, right, right, right, right, and I do. I have a lot of friends now along the journey of I'm gathered a lot of friends who are entrepreneurs and I know now that I'm not the only fool. Yeah, yeah, to jump, but it was an ignorant decision. Yeah, yeah, Yep, completely. So part ignorance, part crazy and passion and absolutely you know, and I think for you know most of us, it's almost like you're it's a calling you. You almost you can't do anything else and it's just nothing else fits. You just feel like this is what you were created for. Yes, and and that's that's the only, the only thing that can get you started and really keep you, keep you going. Yeah, and a lot of times it's also for me. I have to check that feeling and I have to check it on a regular basis to ask myself, am I holding on through that feeling without having the right product or the right offering? Because just because I have a drive doesn't mean it's the correct drive. So I keep checking myself. So so, so we run. Let's kind of talk about that a little bit, because I think that that is a dilemma that most, if not all, innovators face between I have a I have a dream, I have a vision and I'm staying so determined and stubborn and making that come to fruition, but having to be agile and the method or approach that I take to get there. So this kind of this balance of being fixed and focused but also being agile and flexible and in the balance of those two things, in actually getting to product market fit, which is exactly what you described. So you can have a dream and not have market, product market fit, not have paying customers, not have a sustainable business, and... can be confusing because I think that in culturally, in this ecosystem, we continue to be told that you've got to be persistent in determined and focused and stay the course. So at what point do you know? Where again, you know, staying focused on the dream, in the vision, but not staying tied to your commercialization strategy, because there's something that needs to change to actually achieve product market fit and 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, if I can, if I share my rit respect and I hope somebody catches on to it and and does something better than I have. It has to start. It has to start early on, and you'll hear you'll hear people tell you that, oh, you have to, you know, create a minimally viable product and test it and and then you know we fit. Is Right. Well, it's only right at the time that you're testing it. So saying, you know, I have a drive, I have a market fit is correct, but then corona comes along and the market fits on any changes or forget coronas any any any number of things can happen. So my example, yeah, we ended up. So I ended up sitting on that idea in the drawer for about three years. I wanted to be a physical therapist. I was busy learning and becoming moving up the profession. When I finally decided to to create my first product. I search and I found this third party product and I basically took it and I modified it for myself and started working with it. Now, at that point I was checking fit for me. It was working for me. So my patient was working. That was wonderful. Right, about a year later I was sitting at the dinner with the surgeon that I knew. He asked me what I was doing. I told him and I mentioned that product me. So, oh my gosh, that sounds amazing. I can use it. Can I hate it? I'm like yeah, absolutely here. So he started using it and six weeks later he came back to me and he's he's saying this is amazing, you have to do something with this. So this is a second time where I get now now I have an objective view, not me thinking my baby works, but right, right, somebody else saying there's a market fit and that gave me really a bigger knowledge. So so then I then I drag my brother, into it, who my brother? He's my business partner. I dragged my brother into it and I said I think I have something here. So we bootstrap a minimally, minimally viable product. Where actually we I I design and with a team on creating the product and...

...we start testing. So the response from the market that I get is, yeah, it's working, but I'm not able to make money with it. So so now I have drive, I have product feed and I'm not making money. So that's the the really a crucial part of the equation of like, okay, how do I how do I make money off of it? And so I, when I recognize that I needed those, those three things in check at any given moment, I basically said my tests will be can I can I get the feedback from the client base saying yeah, this is really great and I'm I cannot live without it, and being and ask being able to make the money that that's what those are the those are the those are the feed. That's the feedback I'm looking for to know that I'm not just driving a runaway train. Without without going there. I will say this, though, that I've been doing this for nineteen years from the idea, but there are sweats of lend that I've readden this train of mind into like without control. Yeah, there are. There are times where I wake up in the morning and I do ask myself, what the heck am I doing? This is the no way, this is right, and people around me say the same thing. So people, the people that are close to you, when you're own this on this train, people will tell you, what are you doing? This is you could be doing something else and it's no stress and it's but pays the bills right, money coming in. Serious story and and that's when I have to look at those at those markers and say, yeah, I I do still believe in this. Hey, it's Dr Roxy here with a quick break from the conversation. Are you trying to figure out what moves you need to make to survive and thrive in the new covid economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why I created the covid proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a three hundred and sixty degree view of your business. I call them the six critical pivot lenses. As you make your way through this comprehensive kit, you'll be armed with the tools, tips and strategies you need to make sure you can pivot with speed without missing out on critical details and opportunities. Learn more at legacy type and DNACOM backslash kit. So I think what you're describing is again something that a lot of entrepreneurs face. Is, you know, in the beginning, when we create something, it's I think it's really common for... to have people having an objective point of view, even giving us positive feedback about whatever we created and say, yes, this is needed, this is awesome. We don't really get to product market fit, though, until we have piles of money pouring in from paying customers, and until then we can have a you know, I talked to entrepreneurs and innovators all day long and and I work with them and you can have I mean, I've seen people. They're they're winning awards, they're winning HACKATHONS, they're getting there getting funding and they you know, and this can happen for years, and so it. You know, all of that stuff is great stuff and it's all kind of giving you some momentum and some energy that says, yes, you're on the right track. Keep going. And they can do that for years and still never reach product market fit where they you know, they can look at their bank account and go, yeah, this is this is, this is product market fit, and I think most of us really struggle with trying to get from I have a few paying customers to I actually have like that first sixteen percent of the market, and word of mouth is happening where I'm not just having to tell people about my product, but people are using it, they're loving it and they're telling everyone else about it and people are buying it. It's that thing that people say about moving up to the next phase or jumping the the stage between entrepreneurship and company running. Hmmm, right. I think that when the time comes and the CALLA which, by the way, my company I didn't mention before, but but when we get to that point, I think that I would be more comfortable to give the steering well to a professional CEO who does that for a living, because at that point that's what you got, that that is what you need, and that's one of my personal milestones along the way was the realization, the humbling realization, that I don't know everything, I cannot do everything. I have to you have to come to to realization. These on my strength leaves, on my weaknesses. Yeah, and in my team members. When I when I started picking my team members, I basically wanted to find the team members that are filling up my weaknesses. So and that's why I think it works. So, yeah, that's it's important. It's an important part of the of the journey. Yeah, so you've been you've been, you know, doing this...

...for a long time and, like you said, you know you can imagine over actually you don't even have to imagine. You know firsthand that market trends change all the time, even when you don't have a pandemic happening, right, and we're consistent having new entrance and mergers and acquisitions, and you know just the evolution of the mobile phone and you know consumer behavior and all kinds of different you know market changes that happen. Then you have the pandemic. So how has that affected your innovation journey and in kind of what are you doing differently going forward to adapt in this new normal? The pandemic, while a negative effect on the world, for me personally, was a huge vindicating moment. HMM, because when we went out to raise money initially and we didn't know exactly what we were doing and we were going after VC money, I did the VC tour and the and the feedback that I got was, you're in Tampa Bay, you know, you far away from us, your team is all over the world, you are one person office, so you're not a real company and it's it just we, you know, we don't invest in this. It's like you you have to have a team, you have to be local, you have to be New York or or Silicon Valley, and a lot of times that we got pushed out of the room because of that. MMM. We've been virtual from the beginning. It was something that I was passionate about it because it enabled me to get amazing talent, amazing team that we will meet like this, we've been using zooms the beginning. Yeah, yeah, and so the pandemic hits and suddenly everybody runs to zoom and everybody is talking aboutt working remotely. I wanted to. I wanted to find my email list from back then and you know the those investor and say how do you like me now? Right, all right, guess what, I already know how to run a virtual company and I also know how to run a global company exactly. It's like this is this is what we do and we can write, we can write a handbook on how to do it. Yeah, so, so it was. It was a big it was a big winning in a way. Now, we didn't make my bank account bigger, but it made me feel a little better and and about what we're doing and how we're doing. 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 a form a company perspective, we are Digital Health Company. We Are we are the best platform to to to have a synchronious communication with...

...patients. So that means that if you, if you are seeing a patient on a tele medicine call, when when you hang up the the call, it's the same as the patient leaving the office and at that point the patient is alone. Patient needs information and with the Calla, the information the patient gets is from me the clination of from their other clinations and the it's available twenty four seven. It's basically a clone of me available to my patients at any given time and a given moment. So the definitely increase the interest in what it is that we're doing. It also finally making our sales process easier because when we get to when we get to a client, they understand why. Now I will tell you, and I haven't talked about the column much, but our product is free. So we through the journey. We've tried all the we have tried all of the cells processes we can find and we read the books and we look into blogs and and it was how do we get this? How do we how do we fund this? How do we make money? And we realize that we were really having a two prong approach. We have the patient project. We know the call I can make healthcare better, can increase access to healthcare and help people who are at the best, at the worst part of their time where they're not feeling well, when they're dealing with with the physical difficulties. So anyhow, we decided to give that for free. But in order to give that for free, we have to make some money somewhere, and that was and that was our crew. We realize where the money in health consids and we re license the technology to other companies for a profit. And again that we dependemic. It's enabling us to have a better conversation with our paying clients as well as the ones who are getting course. Yeah, so would you say that your value proposition is resonating more now with covid? Yes, absolutely, absolutely. It's before we had to yell it really loud and we would get us. I don't get it, I don't know. Why do I need it? Now the the clinicians were talking to are basically telling us I have to have something. What you how can you help? So it becomes a much more collaborative process. HMM. Then then a push of a sale. Yeah, you know, and I think that's really interesting too, because a lot of the health innovators that I talked to that are clinicians, that are physicians, that they come... this whole journey really very differently than just serial entrepreneurs or even technologists. And you know, you very often you see a problem, you're extremely passionate about solving that problem, but there isn't necessarily an obvious customer who is experiencing that pain like you see it, and is a prior high enough priority, that they're looking to solve it and pay to solve it. In so I can envision, with these market changes that we're experiencing, that I'm hearing that there's a pattern of clinician, clinician and physician lad innovation is starting to take off in a little 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 obviously critical to getting the product market fit right. You know, we can't beat people over the head and go this is a problem. Don't you see it? Don't you want to solve this problem? I mean we do, because there's so passionate about it, you know. So sometimes we find ourselves in situations where we're trying to convince the market that there is a problem and that there's a problem worth them solving. And so, you know, maybe now the markets catching up. I think so, and I find the healthcare in generalism market is is well, I'll use the word horrific to sell him to it's risk averse, it's very conservative, it's very regulated. The High Regulation Yep. And and so it's very difficult to innovate in an environment like it's a counter innovative environment and you're trying to bring in a solution. So the if some days I wish I just created a widget that I could sell on Amazon for kids to play with, because the direct to consumer route seems so wonderful to me, but I'm not there. So one of the biggest problems that that we have today, I don't like the word problem, I'll say challenge, opportunities we have today to be positive with my language, Yep, is the fact that when we meet with clinicians and we say this is a free product, they the pushback is, Nah, what do you mean free? Like, Hey, it's free, we are giving it free, and and we are. We actually are working now on doing a better job at communicating why is it free and that it is really free. But clinicians and healthcare are used to something that would cost in a supermarket two dollars,...

...when when you sell it into healthcare, suddenly it's twelve dollars. Yeah, it's healthcare, so it's more expensive. I always say that if it's if it's for a baby, a wedding or healthcare. It's three times the price it should be. So the that's just an example of when you talk about market fit, we have a perfect market fit. We but but what's what's giving us issues is the messaging. And the message is good. We are. We are a social good start up. I would call us right. We are trying to really change the world. We have a passion for that. And and when you go to the market, the market looks at you and says no, you're trying to sell me something, because I've been burned before, many, many times and I think that you're trying to, you know, do something like trick me into yeah, yeah, yeah, it's that perceived value of free to so the freemium model absolutely is a successful business model. You know, we see it time and time again. Typically it's when it's a utility. Yeah, Yep, mm, yeah, up and we again. We we tried many things. Strongly believe in the free model of what it is that we are even for free. Yeah, and we do. And we think that there's going to be opportunities to not US monetizing it, but but the community that is using the product will figure out ways to monetize it for themselves. There's definitely value build into it, because we know that today a clinician that's using the collar they save about twenty percent of the time with the patient in the in the room on a Tele Medicine appointment. Twenty percent per patient is enormous number in healthcare. Yeah, so for then that's the monetization. You know, they cannot build, they cannot charge the insurance company for it, but there's waste for them. But anyhow there's we for now we're riding to train on the free and that's that and way and were worth. We're feeling good about that. That's great. That's really wonderful. So so, as we kind of wrap up here, what are some lessons learned or advice that you would share with our viewers and listeners today? For somebody WHO's, you know, been in this company and growing and building it for nearly two decades, I'm sure that when you look back in hindsight that like who, I could have done this, should have done this, and then you know and how you're you know, implementing that in...

...the next season or stage of the business. My first if somebody's thinking of doing it or somebody's only starting the process, I would say, beware of the sharks. HMM, okay, it is. It is a it's definitely a startup. is an ocean voyage. For sure, there's a lot of sharks in the water. You, you are passionate, you, you, you are ignorant. I was. I am ignorant still. You don't know what you don't know, and there's people who want to take advantage of you because of what it is that you're doing. So when when you get the email about that great hackathon or the great startup program or incubator, you have to be really, really good about vetting these things out. Do not, do not get fished, and there is the fishing in an entrepreneurship. There's a there's a whole side that is negative. So be careful of that. That I've failed, I've felt for it and I've experienced that's the first thing. Yeah, the second thing that worked for me specifically is starting from the end, and what I mean by that was initially, when I just was going, I was so passionate and so driven, I was just doing it for the sake of doing it, but I never really stopped and said why am I doing this for? What am I looking for? Me As a person. What is the end goal? What do I want to be? Do I want to be an egg, but it like to have the exit? Do I want to be on Forbes, on the cover? Do what is it? And I'm looking for you, I want to have matching bowing three seven thirty seven in my parking lot. And so for me, once I realize that, my what I read, when I realize what my goal is from a family, from where I'm leaving, from what it is that I'm was doing, it really clarified what it is that I need to do with the company in order to get there. And in those days when I wake up and I'm like what am I doing, the answer becomes really clear when I look at the end like yes, I can, doesn't matter what's happening right now with the boat. That's the lighthouse over there. That's what I'm going for. Just, you know, correct the course and you know, focus on the on the personal goal, what it is that I want and the drive, and that's what helped me through all these years. That was really still still is every morning. Is is the driving force. Yeah, and you know, that makes a lot of sense, because having that vision and mission to guide you and your decision making helps you determine who you're hiring, what customers you do business with. Right, you know, all it really becomes the lens that you can use and your decisionmaking to make sure...

...that you don't end up either chasing the shiny new object or you're being so influenced by outsiders that you might reach some form of someone else's version of success but not true to what your in game was all long correct. And you know what? The best example I see and that's that's a very tangible I don't watch dv much, but when I do travel, I mean the hotel, sometimes I'd get I end up watching something. So I shark, Shark, think the show M I sit there and I see the sharks offer, you know, I'll give you, you know, two million dollars for this and that, and in the entrepreneur saying no, and I'm like, oh my gosh, take it, take that money and innovate again. Use that money. Like stories, the stories we hear is, Oh, I exited and I made eight hundred million dollars. He made three hundred million dollars. Who Cares about the three hundred million dollars? You have to look it's like what if? What if somebody comes and says here's ten million dollars and you can take that ten million dollars and turn it around and do something else. Will just leave on the beach somewhere forever. That's fine, but if you don't know what it is you want, you know you're not going to know that the offer on the table is right or the opportunity on the table is right, regardless of what it is, because you don't know what it is you're trying to do with that opportunity. Right, right, yeah, no, guiding star correct, and I think that that would be that would be my starting point next time. HMM, yeah, Yep. So what's next for that Cola? As we you know, we're in June now and we're halfway through two thousand and twenty. What's next for you? What are you most excited about being on the horizon for you? I think we have some really exciting relationships with organizations that are seeing the power of the technology and understand it and can open doors for us two larger groups of users. So traction is a thing and we want to get the traction. I'm really excited about some research that we're doing some some research to show from an an empirical standpoint that what we do is the right is right and that we are in the right path, and I think that I'm excited about some relationships in the farmer world. We are. The farmer world is a big is our biggest line of revenue and as the are things that are happening. I said, I've really seen the farm industry change over the last ten, fifteen years and I'm...

...really excited about how open they are too, positive collaboration for helping healthcare. Yeah, huge, that's exciting. Yes, very exciting. Well, Ron, thank you so much for sharing your wisdom with our listeners and always being so transparent and so candid about what this journey is really like. I know that it becomes very inspiring and very encouraging for all of our viewers and listeners, and so I appreciate that. Thank you, I appreciate it. I'm on Linkedin, so if anybody's seen it and they have a question, find me there. Yeah, so is that the best way to get a hold of you if anybody want to? Absolutely absolutely, all right, sounds great. Thank you. Thank you so much for listening. I know you're busy working to bring your life changing innovation to market and I value your time and your attention. To save time and get the latest episodes on your mobile device, automatically subscribe to the show on your favorite podcast APP like apple podcast, spotify and stitcher. Thank you for listening and I appreciate everyone who's been sharing the show with friends and colleagues. See You on the next episode of Coiq.

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