For a startup, having a personal connection to a specific industry, especially one as complex as behavioral health, often helps entrepreneurs to sustain long term motivation to create a positive disruption. This is exactly the case for the founding team of Eleos Health, CEO Alon Joffe, CTO Alon Rabinovich, and COO Dror Zaide. All three founders had friends or family dealing with different mental health conditions, and regardless of receiving treatment over a period of years, they were not improving. For Joffe, it was military comrades who dealt with Post Traumatic Stress Disorder. “The sad truth is that although most people dealing with behavioral health conditions receive treatment, most people do not improve in treatment,” Joffe said. This is the underlying issue motivatingEleos Health to create an impact in the behavioral health space.
The founders set out first and foremost to understand the structure of the behavioral health system. During their initial market research, they uncovered that a large portion of the treatment in behavioral health is the conversation between a clinical therapist and a patient. The founders asked themselves, why isn't the industry currently leveraging these conversations to make an impact, understand what’s working, and improve the outcomes? This was their ‘aha’ moment. They understood that behavioral health was still a traditional industry that is vastly understaffed. , and uncovered through their initial research that there was a need for approximately four times the number of clinicians than there currently were, because of the tsunami of demand for these services.
Following the initial market research, the founders interviewed hundreds of clinicians in the United States to understand their daily schedule and major pain points. It was at this point that Dr. Shiri Sharvit joined the team as the Chief Clinical Officer to assist on the clinical front. Two main gaps emerged from their collective interviews. The first was that clinicians in behavioral health do not have any feedback on the work that they do, making it difficult for them to understand whether or not their patients are improving. During their studies clinicians receive supervision and feedback concerning their work, but once they are established in the field that stops. The second challenge that repeatedly surfaced was how burdensome documentation is, so much so that clinicians claimed it was the bane of their profession.
Clinicians spend an average of one day a week just on documenting their meetings, meaning for every 45 minute session there would be 15 minutes of documentation required. On top of the time suckage, clinicians don’t have much in the way of tools to help make this process more efficient, aside from their notebooks. This was the basis for the founders initial idea, to help improve the clinician’s productivity and quality of life by leveraging the unstructured data from their conversations.
The Eleos team began with a simple MVP that revolved around the clinician sending a session recording with the client’s consent on a secure portal. They would then send back the documentation and an analysis of the context of the conversation during the session. From the get-go they assumed =t no patient would give their consent to send Eleos their recorded sessions. Given privacy issues, they believed this would pose the biggest barrier and was likely a reason this problem had not been solved in the past. To their pleasant surprise, they discovered that a large portion of clinicians record their sessions, and in fact, according to their research, approximately 80% of consumers were willing to consent that their sessions be sent to Eleos Health for analysis.
With that barrier out of the picture, the Eleos team set out to build their initial MVP. They discovered early on that an MVP in the healthcare industry was expected to be slightly more robust than a standard MVP, that included more validation and testing. “That’s the challenge when you’re dealing with health care, your MVP is slightly more than an MVP,” Joffe said. What was most important during this phase was the exchange of value between the clinicians, consumers, and Eleos. They were dealing with personal health information and needed to ensure they abided by the industry compliance and security standards. Overall, the team was able to gain valuable insights from their MVP process, which ultimately helped them achieve product-market fit.
Gathering feedback and actively implementing it during the MVP process is a key method which entrepreneurs use to get closer to product market fit. During their MVP stage, the Eleos team received specific feedback from the clinicians they worked with that the turnaround time for receiving the analyzed meeting summary was too long. It was clear to the founders that the deliverable needed to be as near real-time as possible.
They also received additional feedback concerning workflow integration. Clinicians shared their thoughts from, ‘Hey, it’s great that you can send this to me but I need to copy paste it into the electronic medical records’ to ‘I need to log in to the secured system and I don’t remember the password’, which led them to understand the importance of a seamless workflow for clinicians - the report would need to be integrated directly into their workflow.
One of the most important pieces of feedback Eleos founders received was that they were supplying clinicians with irrelevant information. For example, the team provided a sentiment analysis on the documentation to show how positively or negatively someone was speaking, but the clinicians did not care for this information. The reality is, people can be angry in sessions, and in fact, in some cases releasing anger is the very purpose of the session. The question is not whether the patient is angry, rather from a clinical perspective which interventions are being used on the patient. When a clinician is seeing 40-50 consumers a week, the next time they see any one of their consumers they won’t necessarily remember what was spoken about in the previous session. Not to mention a clinician has 30 seconds to two minutes to prepare between appointments, and there are three main things they need to understand in that time span:
Armed with invaluable feedback and capacity for quick implementation, the team set off to better understand all the relevant stakeholders in the space, of which there were many. The initial MVP focused on mom-and-pop type clinics, but the team had realized early on that this was more of a B2B play than a B2C. For that reason, they wanted to understand what it would take to sell to a large health system. To do this, the team divided and conquered.
Zaide took on the clinicians, he oversaw speaking with them, understanding their pain points and what they require to improve their work, with the ultimate goal of winning over the end user. Rabinovich was in charge of understanding workflows, security, compliance, and technology. Lastly, Joffe was set to the task of understanding how money flows in the space. What does the payer want? What are the desires of the health system? The healthcare system in the U.S. is extremely complex and very different from the one in Israel, so Joffe’s job was essentially to follow the dollars.
The main goal for the team was understanding the interplaying dynamics between the different stakeholders, because a lot of the time their needs and wants conflicted with each other. It took the team a few months to feel confident in their understanding of the market. At that point the team had built an MVP for the purpose of enabling stakeholders to visualize what the final product would look like, and what the Eleos team sold as their first pilot. The team ended up approaching a senior person in a large healthcare organization over Linkedin, with the purpose of getting her thoughts on their idea and product. Although it was, as Joffe’s put it “held together with glue on the backend,” the senior official was extremely impressed, and essentially the team started working on their first contract while they were still forming the company. By then, the team had successfully done a cross validation of the stakeholders in the space. They began seeing commercial traction with their system within the segment they planned to sell to.
They now had a good grasp of the technology they needed to build the product, what the product would look like, and a solid understanding of the dynamics of the market and where they could fit. They packaged everything together and in February 2020 started fundraising… then COVID-19 hit.
When the team started fundraising and told investors they were in behavioral health, the common response was “what, is that an industry?” It was considered something “hippie dippie” and the team had to explain repeatedly that it was the stepchild of traditional medicine and traditional healthcare. They were walking into an unfunded, non-budget industry.
When COVID-19 peaked, Joffe remembers it quite vividly, “there were a few ripple effects,” he said, “one was the increase in demand for mental health services, second, telehealth usage spiked from single digits to approximately 80%, and third, behavioral health became a mainstream topic at the forefront of healthcare.” Suddenly, the team found themselves in one of the hottest industries. They had the benefit of such a foresight and understood that the telehealth and behavioral health wave was going to strike the United States in full force. he country, although unprepared, had the will to change its healthcare processes. One of the major transitions was the industries switch to telehealth.
Originally, the Eleos Health product was built for face-to-face meetings. In the wake of the COVID-19 crisis, the team decided to scratch that, change the entire product, and focus solely on telehealth. In hindsight, Joffe admits that the team was agile enough to change quickly and efficiently, they were still quite small, and the change came easily. The sudden shift in the market in terms of the necessity and acceptance of telehealth, and the team's swift ability to take advantage of the changing market, was what enabled Eleos Health to grow as quickly as it did.
In the final analysis, the Eleos Health team’s ability to bring an MVP to market as quickly as possible, gain and implement the invaluable feedback they originally received from clinicians, their in-depth understanding of the stakeholders and complex dynamics in the space, and their agile approach to the changing market was what enabled the team to discover and reach product-market fit. The team was successfully able to understand the value they needed to deliver, and make good on their goal to deliver it, and today, the product is working and their business is growing. In 2021 the Eleos Health team was able to retain 100% of its customers and signed collaborative deals with 20 leading behavioral health providers. “Retaining customers stems first and foremost from a product that delivers value,” Joffe said. “We have a lot of room to grow, but for now we will stay in the realms of behavioral health to continue our mission to help the people in this huge market.”
Forbes Israel. (2022, March 21). אלון יופה ואלון רבינוביץ’. https://forbes.co.il/rankings/2022under30/alon-joffe-alon-rabinovich/