Everyone Said "It's unsexy". Now We're Serving 30M Patients | MedMe Health, Purya Sarmadi

Intro

00:00I went through many pivots. We had four different pivots of MedMDM me. But all throughout all those pivots, my conviction [music] for the market only grew and grew and grew. If you have conviction around the market, don't give up on the market.

00:07for example, healthcare or like vertical SAS on the outside looking in might be like unsexy but I was very fixated on building in healthcare because my mom she had a heart valve failure when I was around 6 7 years old at the time many surgeons were hesitant to operate on her it was very risky it's kind of a core tenant of our mission which is to change healthcare access for over 100 million people [music] every single one of those pivots, I started to get more and more information about pharmacies, about pharmacists, about their patients.

00:48[music] And in fact, that also helped narrow down which wedge was the most important wedge. Like, if you're a first-time founder, don't mistake being in the wrong wedge as being in the wrong market. So, you might be in the right market, you might have conviction about that market, you might just be on [music] the wrong wedge.

01:05My name is Pria Sarmati. I'm the CEO and co-founder of MedMDMI Health. MedMi is serving over 4,500ies across North America today. We power [music] the operations, integrations, and automations to transform drug dispensaries to community [music] healthcare hubs.

You Can Be Right But Still Fail - Don't Give Up

01:32I was born in Cologne, Germany. My family and I moved from Germany to Canada when I was around 6, 7 years old. Not so long after we moved to Canada, my mom, she had a heart valve failure. That was a very complicated period both for her and and by extension our family.

01:49At the time, many surgeons were hesitant to operate on her. It was very risky. They always present things in an optimistic light, but in a realistic light as well. And one thing that really does stick with me is at that time there [music] was fear.

02:01Fear in my dad's eyes. fear that he might have to raise two kids on his own if things didn't go well. And there was a lot of uncertainty there. And I just remember observing that interaction between my parents and the surgeon as a child. I think when you're around that age, like eight, you know enough to feel things, but you can't do enough to change change things.

02:28You can't really enact change. And there's a feeling of helplessness. But one surgeon was very confident amongst others in his ability [music] to try his very best to help my mom and his name was Dr. Tyrone David. [music] He's a legendary surgeon.

02:41Afterwards, I had the opportunity to meet Dr. David and I remember shaking his hand as a as a young kid and having this [music] really vivid memory of this feeling I had in that moment where that realization that [music] he with this impact not only saved my mom's life directly but had this rippling effect on the folks that relied on my mom [music] whether it be myself, my dad, uh my sister and all of my mom's even younger siblings cuz she's [music] the oldest of five.

03:05And that feeling was something that really stuck with me. this feeling that through healthcare you can have this large impact on people. Growing up I wanted to be a cardiovascular surgeon because of [music] that. Fast forward later I realized you know I have a not the steadiest hand and also some trouble with uh sleep.

03:28The combination of those two things didn't really make for a great surgeon. But one thing I was always passionate about was technology. And so the way to make a really scalable impact maybe is to double down on my passion for technology and and data science and try to see how I could really make that impact through another channel at a larger scale.

03:44Combining that with my passion for healthcare was sort of really what drove me through my career and eventually to starting MedMDME. When my mom had the heart valve surgery, she put in a mechanical valve and folks who live with mechanical valves, they have to check their INR broadly.

04:00It's a measure of their blood viscosity and they have to do that through diagnostic testing. So they have to check their blood very weekly or bi-weekly. Growing up after the surgery,

Why couldn't a pharmacy do this?

04:16[music] one thing that was very big memory for me uh throughout my life is my mom always saying to me, she would always see new specialists, [music] but she would always say it was the pharmacist that knew the most about her holistic treatment.

04:25[music] What didn't make sense to me was that why couldn't she just get that diagnostic service at the pharmacy? [music] I had this very strong conviction that pharmacies were were underutilized and [music] there was an underserved need of what pharmacies could do for the public because at that point they were just drug dispensaries and I really believed that they could be far more than just drug dispensaries because 95% of North Americans live within 5 milesi of a pharmacy.

04:48the very first iteration of MedMe and the idea

The Pivots

04:56was hey you have a lot of prescriptions coming in wouldn't it be nice if you can just scan the prescriptions and automatically the data entry happens now mind you this was in 2018 so this was prel's the business problem we were solving was a real one but the technology wasn't there to make this viable that actually sent us to a pivot where was actually a physical product it was a product related to drug adherence but hardware is hard.

05:19There's a lot of starting capital cost to hardware. That's partially why we pivoted away from that kind of iteration. As we were talking to pharmacists and pharmacies, we realized there is a need for clinical care for the community and the panels of patients that pharmacies have, but they just don't have the time to do this clinical care.

05:35That actually led us to

Wrong wedge vs. wrong market

05:44the pivot [music] which is closest to what Medne is today to give software toarmacies to allow them the capacity and the tools to be able to provide consultative care to their patients. What what I was looking for was the one problem that could be served with one solution for one customer.

06:00If you were to say, "Hey, we won't exist tomorrow." And they would say, "Well, if you don't exist tomorrow, my life will be worse." Then you knew that you'll have the right wedge. We were in Ontario and we were introduced to someone in Alberta.

06:09There was literally a day that I remember very vividly where he's like, "Hey guys, I've canled all my subscriptions. These [music] four different subscriptions that I was using before, I've canled. I'm just using Medi." That's when we knew, okay, we've solved this underserved [music] problem with our solution for this one ICP.

06:31I [music] think one lesson I can share from that period is that every single one of those pivots I started to get more and more information about pharmacies about pharmacists about their patients and that was all part of the same data set. What was changing was the wedge [music] and in fact that also helped narrow down which wedge was the most important wedge.

06:47[music] Don't mistake being in the wrong wedge as being in the wrong market. So you might be in the right market, you might just be on the wrong wedge. [music] And then fast forward a few months later, COVID

From 100 to nearly 1,200 pharmacies in ten weeks

07:04happened. That really proved out our thesis. All of a sudden, this broad network ofies across the [music] continent had to become these sites for physical clinical services, whether that be vaccines, whether that be point of care testing to respond to the pandemic.

07:19Literally in a 2 and 1/2 [music] month period, we went from near 100ies to almost 1,200ies. [music] What was really important was building that conviction both personally but also functionally pivoting through which wedge made the most sense.

07:27As long as you find the [music] right wedge, then you have a avenue in order to kind of build on that wedge and capture a much larger market opportunity over time. Really spend the time to figure out you're building the right thing. That [music] same kind of rippling impact that I felt and I alluded to kind of revered from Dr.

07:53David and meeting him, that's [music] a really core part of what drives me and it's kind of a core tenant of our [music] mission, which is to systemically change healthcare access for over 100 million people.

Build on What Tech Can't Replace

08:09Every dot you see here represents a pharmacy that closed just last [music] year. I wouldn't say it's collapsing. I would say it's being disrupted and it's transforming. One big motivator around the timing of when MedMe started, you were seeing a lot of onlineies pop up.

08:25So these onlineies, they were direct to consumer. They had big marketing budgets [music] and they really had better unit economics and logistics. And so with drug margins shrinking, the increase and acceleration of onlineies, simultaneously, there's a shortage of primary care, there's an increase of chronic illness.

08:41Now more than ever, patients were looking for proactive, personalized, and consumer-driven health care products and services. Where I think you're going to see a resurgence is the pharmacies that are investing in the clinical side. Patients coming back to them, not only to pick up their drugs, but to get their flu shot, get their A1C levels checked, get consulted on a blood monitoring device or a glucose monitor or blood pressure monitor.

09:05Those types ofarmacies are the ones that are going to thrive because they have this enduring lifetime value and patient relationship. One thing that will never be replaced is that human element of patient care [music] and that that trusted healthcare practitioner is there to take care of you and knows your longitudinal care history and knows what your likes and dislikes are and knows your family.

09:29That is something that's very hard to replace. That is what makesies indispensable. And in Nova Scotia, patients like my mom who are on blood thinners are able to go to the pharmacy for INR monitoring. And they're doing that today as we speak using MedMi.

09:38So patients like my mom in growing jurisdictions all across North America are now able to rely on a pharmacy rather than going to an emergency room or an outpatient uh diagnostic center or an urgent care center for the care that they're relying on to stay healthy.

09:55And I think that's really really exciting to see that come full circle and and in practice in North America [music] in the AI era. A lot of very optimistic early stage founders.

What AI changes for founders, and what it doesn't

10:10They see big market opportunities. AI is changing the playbook. Like the old playbooks for different industries might not be relevant today. But for your customer, AI is not changing their jobs to be done. [music] Their jobs to be done are still the same.

10:17AI is just giving us the right to be able to solve a different class of problems or a broader class of problems.

Comfort Quietly Kills Your Best Partnership

10:37Most companies uh they end because of co-founder breakups and those happen in a couple of years. I did meet Nick via something called the NEX36. The next 36 is a startup accelerator in Canada. From the moment we met, I really felt we had a complimentary skill set.

10:53We had a mutual respect but also a mutual interest in this problem space. And in the first uh week of the program when we uh started full-time in the summer of 2019, [music] I kind of presented to him all the data that I had collected using that early data that I had collected through the pivots.

11:10I basically convinced him we should work on this together rather than what he was working on. And uh he agreed with me. Nick and I

The message that nearly broke his co-founder

11:17have been together for 7 years in counting. But there was a moment where I became overly critical of how something had gone under his purview. My frustration led me to almost frame it as you're not capable of doing this. You've shown that you're not capable of doing this.

11:31I don't believe that you're capable of doing this. That set of kind of messaging to your co-founder is really damaging. I think it's defeated. And you never want to defeat your co-founder. I I really learned that the hard way. Like I think that sort of messaging can be uh very [music] demotivating.

11:53I've seen others not be able to overcome this. There's a very big risk for you to [music] kind of default to blaming the other person that blame can be so [music] counterintuitive. It could actually work so much against you. It works against the organization.

12:06It also works against you because you are losing your number one ally. As a good co-founder, one of your main responsibilities is to make sure both yours and your co-founder's [music] candle stays a light. The ups and downs of a startup will sometimes make that candle become more fierce, the [music] flame will be more strong.

12:21And when you

The candle principle

12:30go through the the down parts of being a startup founder, that's [music] when the candle dwindles. And you have to do anything you can to keep those flames al light because if you don't, it's very hard to reignite the flame once the flame goes out.

12:39Sometimes when you go through the trials and tribulations, there's not many people that [music] understand you. It's hard to yes you know you have your family you have your friends [music] but they're not going to fully be able to empathize with what you're going through as a [music] seauite of a company or as a founder.

13:06The person that you can lean on the most through those ups and downs is your co-founder. [music] So that's one of the things that I think is a strength like having a co-founder and having someone to lean on in that way makes a huge difference.

13:17[music] I literally said this in my wedding speech at Nick's wedding a couple months ago when CO [music] happened. We obviously had had built this like early stage web app with independentarmacies. They [music] were using it and we actually had an enterprise come to us and say, "Oh, we need a solution for this.

13:28We need it at an enterprise scale." [music] Uh Nick and I, but a lot of it was Nick at the time. He [music] built a prototype. He pulled two allnighters with me. 72 hours of non-stop work, two allnighters of just being able to build a prototype.

13:44[music] We demoed it, we presented it to the leadership team, and they were like, "That's amazing. When can we go live?" And then we had to go back to our team and we're like, "All right, guys. We have like 6 to 8 weeks to make this real." That was our first enterprise customer.

13:59And since then, [music] that first enterprise customer was what built us the trust and credibility to win subsequent enterprise customers. [music] Having the pleasure to work with him side by side during that 72-hour period, that's how I really knew that he was kind of who I needed as a business partner.

14:14No matter what the constraints were, we would be able to take them on head on and [music] not only survive, but thrive. Don't contribute to your co-founder's candle dwindling, cuz [music] you're just working against yourself and your startup.