From Idea to Product in Months: The Alluceo Story

Episode 188 · Fri, 21 Aug 2020 20:00:00 +0200 · 39:01 · SRT · archive.org · all Tanzu Talk

Welcome, listeners, to the first episode of our new podcast called Cloud and Culture. I'm Derek Harris of VMware. And I'm Danielle Burrow of VMware. This podcast is focused on VMware Pivotal Labs and the work it does to help organizations ranging from startups to Fortune 500 enterprises shift their software development into high gear. As the show's title suggests, that means addressing the technical aspects of building new applications and modernizing legacy ones, that's the cloud part, as well as the softer aspects that allow clients to continue thriving after our team of practitioners leaves, that's the culture part. So we'll do this by interviewing the people who know this process best, clients both past and present, and the VMware Pivotal Labs folks who specialize in helping those clients become proficient in modern software development. And for our first episode, we're speaking with a startup in the healthcare space, Mental Health, to be specific, called Alucio, about how Pivotal Labs helped it kickstart building out its first product and grow its engineering team. Our guest is Lori Gomer, who talks in detail about the nuances of building a healthcare startup with just a really good idea and a small team of subject matter experts. For Alucio, Pivotal Labs was a critical link between those two strengths and an actual functional product, as well as for establishing an engineering team confident in its ability to deliver high quality software fast. When we recorded this episode, Lori was the VP of business operations and strategy at Alucio, although she has since left the company for a new role. However, the relationship between VMware and Alucio carries on, and the results Lori discusses are just as real. We hope you enjoy listening to this interview as much as we enjoyed doing it. To learn more about Alucio, you can visit alluceo.com, and to learn more about VMware Pivotal Labs, you can visit tonsu.vmware.com slash labs. All right, Lori, so just to kick things off, can you briefly explain to our audience what Alucio does, what space you guys operate in, and kind of your role at the company?

Sure, happy to. So Alucio is a digital health platform that helps patients with mental health issues get those treated right inside primary care. And the reason that that's important is, as you can imagine, there's a lot of stigma often with getting help with mental health. And I think especially during these COVID times, anything that we can do to help improve the access and affordability for patients who need to get help with a mental health concern, all the better. In my role, Alucio, I'm actually the vice president of business operations and strategy, which at an early stage startup can mean that you do lots of different things, but really focused on running the internal operations, the recruiting efforts, building out the team that we have at Alucio. All right. And can you talk briefly just about what was the, I guess, the business problem or maybe the business at the right term or healthcare problem, whatever it is that Alucio was trying to solve when you engage with pivot? Like what was the existing process that, that now we, you know, you've built an application around and digitized? Absolutely. So the concept behind Alucio was actually born at Intermountain Healthcare, where one of the nurse practitioners there, Dr. Brenda Reese Brennan, had been practicing for a number of years and developed a methodology, just as I described, to help treat mental health inside of primary care. The reason, other, other reasons that's important that I haven't already named is there's a severe shortage of specialists to treat mental health. And so if you think about it from a supply perspective, just being able to offer the majority of patients. And of course there will be those patients that maybe have some high risk needs that need to be referred out. But for the majority of the population, if you can offer them treatment inside primary care, where perhaps they have an existing relationship with their primary care doctor, the data shows that, that you can, you can improve mental health quite a bit. And Brenda actually published a study in JAMA, which was really exciting.

And really, I think the foundation of the company when Intermountain decided to spin this out, which showed not only did patients, their mental health improve, more patients were getting screened for depression and their mental health risk improved over time, but also that it saved the health system money, which is always exciting if you can tackle both of those as a company. Right. Okay. And then, and then what was the actual, the process though? So, I mean, so obviously, Ellucian engaged with Pivotal Labs, but before we get into that, I just wanted to get into the, the actual process that needed modernizing or updating. Oh, sure. Yes. So if you think about, you know, how was this done? Brenda started working on this about 20 years ago. And so, as you can imagine, a lot of it was done with paper processes, probably lots of faxing and such. And what we really wanted to do was take the paper-based assessment that Brenda had created, which score, essentially helps someone score their mental health risk and modernize that by allowing people to take it on the web, on their phone. And that's, you know, that's really the first step. We're also working on some things that will automate the care plan for the physician, such that after the patient has taken that assessment, which again, in the past would have been done on paper and would have required a lot of manual scoring in the clinic. So a lot of time when you'd rather your providers be spending time with patients as opposed to scoring a paper packet, of course, that gave, that gives them back some time. And then also being able to serve up the most relevant parts that a physician might need to make a decision on what the next step is for that patient. Being able to just serve all that up in an easier, digestible, a better manner for them to make those decisions more quickly. That's really our goal. And so we've started with the assessment and giving those results to the clinician and their staff. And then of course, you know, we have a lot of, a lot of other ambitious plans on our roadmap to just make things easier for both the patient, providing them with resources.

That's something that we're currently offering as well, a resource library that the physicians and their staff can send to the patients based on how they score on the assessment. So. Sounds really interesting, Lori. I mean, so it sounds like you're both doing this assessment, but then you're also helping connect the patient to all of their care providers and anyone who needs to be, you know, helping them through the diagnosis and the treatment process. Absolutely. Yeah. Sounds really interesting. And that's, you know, in addition to just moving the treatment for mental health inside of primary care, one of the key things that was central to Brenda's methodology was really this notion of team-based care. And so you're spot on in that it's not just the provider and physician, you know, it's the front desk, it's the medical assistant. Everyone has a role to play in helping deliver whole person care, if you will, not just physical care, but also mental health to patients in primary care. Right. And digitizing all of that makes it so much more efficient, I would imagine. So yeah, that's really, that's really interesting. I would love to know kind of how you came across VMware Pivotal Labs as an option to help you get started with this. Sure. So I joined the company in February 2019 and about a month and a half before I joined, the CEO had been hired and we were looking at a pretty aggressive timeline. Our investors and board wanted us to get to pilot, I think, you know, Q4 2019 or Q1 2020. And having come from a number of startups, you know, it takes a while, especially in a regulated space to, to build a HIPAA compliant platform, you know, and you have to do a lot of user research to figure out exactly what you need to be building, of course. And so when I looked at the timeline and knew that, you know, also investors are going to want to see that we have our own team built out that can obviously sustain whatever software it is that we ended up building to support mental health integration and primary care.

I had actually moved from the Bay Area previously after working at a number of digital health startups. And actually a couple of my startups had had engagements with Pivotal Labs in the past. And so when I looked at the tight timeline and I looked at, I had just myself moved to Utah and our CEO was actually not located in Utah, you know, we didn't have as robust a network there as perhaps I might have in the Bay Area to recruit some of that initial technology talent. And so I naturally thought after, you know, spending a few weeks getting up to speed on the problem and what we, you know, what we wanted to try and do with the company, Pivotal Labs came to mind and then we reached out. So that's, that's how we got to you guys. All right. And I mean, what type of skills did you have internally or I'm just curious about the scope of the engagement. Was this like a, we have nothing and we need to, we need to start to ground up or was this a, we have some competent people and we need to, I'm just curious what, you know, how, what the scope was. Yeah. So the CEO and I were both, you know, business operators, you know, both of us had a lot of business development, marketing, you know, operational life roles. So not, not your software engineers, your designers, your product team. And so those were, those were a number of the roles that we were going to both need to hire for as well as need to get help with initially. And so, you know, in my mind, having worked with Pivotal in the past, that was kind of the perfect marriage for us is because I knew that if we waited to essentially hire out enough of a team to get started, it was probably going to be very difficult for us to hit those timelines that our investors and board wanted us to hit. So having worked with Pivotal in the past, I knew that we could kind of approach them in tandem such that we could get started with a lot of that initial discovery and start working to hire out our team in the same process. So that's exactly what we did.

And it worked fantastic for us because again, if we had waited to get enough of those core team members, design, product, you know, at least a few engineers on board, that would have taken several months before we could have actually gotten started on that, on developing the platform. So that was, that was really key for us to be able to hit those timelines that our board had asked of us. Right. That makes sense. And it sounds like maybe there wasn't a CTO or someone more technical on the ground already. So, and, and so in terms of, you know, kind of just getting started, how, how did, how did things kick off? Yeah. Yeah. It was, so we, we were based in Utah and so the closest Pivotal office was in Denver. So myself, the CEO and Dr. Brenda Reese Brennan, and actually another physician from Intermountain healthcare and a project manager from Intermountain healthcare all headed out to Denver and we got to meet our team. The team was pretty lean, our pivotal team, because we didn't have, of course, our Lucio product delivery team yet. And so it was a pretty lean team. And we spent a lot of time, you know, of course, unpacking the 20 years of research that Brenda had been working on, combining that with the healthcare, digital health industry knowledge that the CEO and myself brought to the company, as well as some of the experience that the physician had had who had been practicing this in sort of the manual paper-based world of having patients fill out the paper assessment and scoring it and practicing with those methodologies. And so trying to pull out, you know, what's happening now, what are the areas for improvement? You know, Pivotal really helped us focus on, I think, our North Star and, you know, trying not to get too sidetracked because there's always a million things that you want to do and lots of aspirations. And you have to really be able to narrow those down so that you can figure out what can make impact quickly and what can drive value for your end users.

And I think they were really instrumental in helping us figure out what made sense to tackle first and what was for later. But, you know, we're not losing the idea, but we will hold that for later because it probably makes more sense to do perhaps a little bit more research or just from a time perspective, perhaps on how long it would take to build that concept. So I think that's so interesting, especially from the startup perspective of getting the stakeholders, the executives, the business leaders in the room at the same time, even before anything is built. Because I think sometimes, right, like if you have a team in place, they're kind of caught in their own momentum of how things have been going. Yes. And the business has its own ideas of what it wants. But to come in with a neutral third party and just the business team and talk through like, what do we want and how can we get started getting there in a reasonable way? That seems like, I think it's a luxury that might frankly be for startups, you know, a lot easier than getting the, obviously the seed team from a large enterprise. Absolutely. Yeah. Just, you know, that kind of takes me back because it's been several months, of course, now since we, you know, started our engagement. But, you know, we all came from very different perspectives. You know, I had been the only person that had come from, you know, I'll say a traditional startup background. You know, the clinical nurse practitioner, she had been, you know, within Intermountain for a number of years, but really came from an academic clinical research kind of mindset. The clinician had been practicing in clinic for a long time using this methodology. And our CEO came from, you know, much larger companies still in the digital health or health technology space, but much larger scale companies. So we all brought, you know, different opinions and different thoughts on where we might need to go. But I think the process really helped us as a group determine what was truly the most important and help us, you know, kind of forge a path on, on what we were going to tackle first.

And everybody kind of leave the room and agree that that was, that was a path forward. Not that we couldn't change our minds, but, you know, at least we had initially started to kind of chip off on what we were going to tackle first. Right. That makes a lot of sense. It's really interesting. And then, you know, you mentioned not really having a team, you know, starting out with this very lean group. How did, how did labs kind of help Elucio, you know, build up a software capability? Yeah. Since, since I was the one in charge of recruiting and I had perhaps never formally had that role at a company. Sure. I had, you know, recruited people to work on, on my teams in the past, but I had never run a recruiting role at a company. So I was learning in the process of doing this and, and hadn't specifically, you know, even, even diving into it more, hadn't specifically recruited for product management design or software engineers, had been around it, had some friends that I could, could run to and ask a few questions, but really hadn't had to dive into that before. And so Pivotal was very helpful to me in helping me understand, you know, I spent a lot of time with, with all of the people in those various functions, as well as some of the leaders in the Denver office who really helped me understand how they go about recruiting and what their process was. And so then I kind of went back and created what I thought made sense for, for us, for a company of our size. And Pivotal also helped us screen some of the applicants that ended up joining our team. Again, because, you know, I, I should not be the one, you know, deciding whether someone is a good engineer or not. You know, a lot of ones and zeros, it probably doesn't mean as much to me as it does to them. And so you wouldn't want me deciding if you were a good candidate or not. So for some of the technical screening for each of those roles, Pivotal was really helpful in helping us kind of get through that technical hurdle.

And then after that, of course, you know, it was a lot of the more personality type questions that you would typically have, but they had some really, I think, great tips on how to make sure we were hiring people that could work in a highly collaborative environment, because that's, you know, one of the distinguishing features of extreme programming and, and agile that, that Pivotal teaches its customers and practices is it's collaborative. And so, you know, I think, I think we all learned you can be, you know, perhaps the most brilliant software engineer, the most brilliant designer, so on. But if you're not collaborative, you may not be a good fit for, for that type of environment. So helping get even more granular on the types of questions or activities to draw out those behaviors. So we could really see if we thought someone would be a good fit was, was really, really helpful. I know you hadn't been in that role before, but what was your sense of what it was like hiring in Utah, where I, where there is some tech talent, obviously, and some pretty successful tech companies that have, have been based compared with maybe hiring, you know, your impression, at least if hiring in the Bay Area, where maybe you get like these, my impression is that you're not going to get these superstars with these resumes that you might look at and go, I don't know what that means. You worked at Netflix, I guess. So you're a good candidate. You know, I, I was pleasantly surprised with, you know, I, I will, you know, very much admit that, you know, I spent the majority of my career and in total about 13 years in San Francisco, both before and after I went to business school, like did so much I came back, I suppose, but then I left. So anyway, I, you know, I think I was surprised at how competitive it was to recruit, not just the engineers, but also design and product in Salt Lake. And maybe you don't have quite the density of technology companies. All I think a lot, a lot of the Bay Area companies are, you know, I probably pre COVID when people

were still going into the office a lot, we're actually setting up some satellite offices here in Salt Lake. So I think I was starting to see some of that talent shift, shift here, as well as just was pleasantly surprised of, you know, how competitive it still was. I wasn't sure because again, I was new to Utah as well, how competitive it would be to, to hire an engineer or designer or product here in Salt Lake. And again, maybe, maybe not the same volume to choose from, but I think we were, we were happy with the quality of folks that we, that we got on our team. And, and I, I honestly think part of that was a number of them had either heard of Pivotal Labs or in fact worked with Pivotal Labs at some of their previous companies and really had a great experience in that. And so when we were able to tell them as part of the recruiting process that we were working with Pivotal Labs, I think that was a real bonus for, you know, a small startup that, you know, presumably that I, I'm sure they would think wouldn't have much structure. I think that gave them a lot of confidence that we were serious about developing a well-functioning, well-oiled product delivery team. All right. And that's interesting too, because I think, I mean, not to go too off topic, but I do think there's a, there's maybe a, a misconception among companies and markets that haven't traditionally been tech, you know, what you might call tech markets, but like the, the, the skills are democratizing companies are setting up, setting up offices in various cities and it is a more competitive landscape. I mean, if Facebook has an office in your city, right. You, you don't get to dictate the terms necessarily anymore. Yes. It doesn't, it doesn't hurt that in Utah you're, you can, you know, if you're in Salt Lake or myself, I live in Park City, you can get to the ski slopes a lot easier than you can when you live in the Bay area. Yeah. That's a nice quality of life bonus. And Laura, I guess I'm curious now kind of what stage are you all at with the product

development? You know, you explained kind of that early discovery kind of scoping phase where you really figured out what you wanted to hone in on and focus on first. And then you've built out this team. Yeah. Where, where are things now? Sure. So we, so we had sort of multiple versions of our MVP. I think we finished our first, first, you know, 1A MVP, if you will, in December. And then we continued to iterate on that. And we, we kind of had our, you know, as much as you can say final MVP, the features that we wanted to have in there, we had all of those done in March. And so since then we did get a little bit delayed starting our pilots as probably a lot of companies did with COVID because we were going to be starting our pilots right as, right as COVID hit toward the end of March. So we got a little bit delayed. Luckily we'd become very, very much experts I'll say in, in doing a lot of user research. So we use that time while we were delayed to start our pilots and really digging into some other areas that we, we knew we need to build anyway. So we did a lot of user research and we actually started up our pilot at the end of June, beginning of July, our first pilot. And so really what we've been doing is getting that pilot feedback and starting to iterate on that, which is exactly what you want to do. Making sure that we're listening to the users, understanding their pain points, you know, when they grunt, when they sigh, figuring out what we can do to make that better. That's what we've really been focused on. And of course we have, you know, our longer term roadmap and some items that we know we'll need to tackle. And so chipping away at those. But right now, I think the most important thing is that we figure out and make sure that our, we can get our core product to, to really deliver the value that we want for both the patient and the clinic end users. All right. So, I mean, that sounds like a, frankly, a pretty impressive timeline, all considering the delay that COVID had caused on everything that you would be from, it sounds like maybe

seven months-ish. Yeah, it went pretty fast. I mean, you know, I, I'm sure there were days if I look back that, you know, it seemed like it was, it was long because we were trying to make some, some really crucial decisions. I, you know, it makes me laugh. I'm thinking back to when, when it was just, you know, the CEO of myself going there on a regular basis before we had hired the rest of the team. And we had to kind of, along with the Pivotal team who was helping us, of course, you know, decide what, what tech stack we were going to go with. And I, boy, I'd never had to, you know, make those decisions. Of course, I, I had some friends to, to call, thankfully in the Bay area and Pivotal was wonderful at kind of giving us the pros and cons. But, but yeah, it was a fast process. And, but I think, I think they were also good and kind of pushing us through, they being Pivotal, pushing us through some of those areas where given, I might not think I have enough expertise pushing us along because, you know, we did need to move fast. There were timelines and expectations. And so I appreciated, we weren't moving fast carelessly. It was pretty thoughtful, but I think I appreciated having someone move us along and say, okay, we need a decision by this date because if we don't, it's going to delay this, this, and this. So. Yeah. And I'll assume just knowing the Pivotal Lab scene that, I mean, the, the, you, even if it's a, even if it's a fast decision on the tech front that it's designed with modularity for lack of a better term, right? So if something needs to change. So I'm curious too, what, like how big is the team now? So what, what kind of a tech team do you have in place at this point? Yeah. So we've got, we've got three developers. We have, as far as our product delivery team, we've got three developers, we've got a product designer and a product manager, all whom were vetted and worked very closely with their Pivotal Labs counterpart. And, you know, depending on, depending on when someone joined, you know, one of our engineers

joined in August of last year. So he probably got the most exposure to working with Pivotal. So they all got, you know, some exposure, but it varied depending on the length of their, you know, when their start date was. But I know that I think each of them really, again, going back to, I think, I think having, having the knowledge that we were working with Pivotal and letting that be part of the recruiting process. And we, we followed one of the, the, well, several of the Pivotal sort of interview steps and that we, we wanted people to come onsite and spend, depending on the role, half day to a full day working with our team. And so for the engineers, that meant coming to Denver at the time, which it sounds like, Derek, you have been around some of the engineering recruiting in the Bay Area or, or know of it much like I do, you know, that's, that's a bit abnormal to ask someone to come in for a day and spend their day pair programming. But I think that really helped us determine, again, going back to that collaborative piece, really helped us determine who was going to be a good fit. So all of that to say, you know, I guess we're still a pretty lean and mean team because we're at our seed stage. And so, you know, we'll be continuing to pursue fundraising next year. But, you know, I, I, I think they're a, they're a pretty mighty team because they've learned some good practices and I've really been amazed at the speed that they've been able to, to crank out good software, even after we had finished our engagement. So that's awesome. And I was in the Bay Area, it would have been a whole day of flying out and being put through mental gymnastics that no one could reasonably expect, be expected to answer and solving the most complex algorithmic problems. So, yeah, that's probably a better approach. Yeah, that, that, that's really true. And Lori, I was going to ask, you know, you talk about the lean and mean team that you've got and, and kind of getting started with these pivotal labs methodologies that we often help

our, our customers adopt, including pair programming. And, you know, it's not a fit for everyone, but a lot of our clients actually find it really effective. And I was also just curious to hear kind of how the team has adapted to working remotely with the pandemic. I mean, maybe they were a distributed team before, maybe not, but how's that gone? You know, that's a really great question. I think, you know, and I, I keep in touch, obviously, with a lot of my friends who are still in the Bay Area. And I know, you know, it seems like companies have had varying levels of success with that. I actually think that, you know, working with pivotal set us up really well to be able to work remotely effectively. Because essentially, we weren't, you know, we weren't necessarily spending, you know, our engineers, our designers, our product manager, wasn't spending necessarily every week in Denver. And so there might be a week where they were there. And then there might be a week where they were in Salt Lake. And if they were in Salt Lake, that probably meant that one of the, the Lucio engineers was pairing with a pivotal engineer in Denver. And so I think just naturally, the team had had to be able to cope with being in person, but also being remote. So, you know, I didn't, I, we haven't noticed a drop in productivity really since the pandemic, other than, you know, I think everyone, maybe across the world is a little burnout on video calls, perhaps, but, but I haven't really lost, we haven't really lost any productivity. And I think the work that they had to do with Pivotal being remote some weeks and in person some weeks really prepared them well to be able to do that. We needed to, so. All right. Cool. And Laurie, what, what step, I mean, so obviously you're in the pilot phase with, with this initial application, I mean, if you look at your overall roadmap, at least the existing roadmap, like

how far along would you say you are and when, what, and what role does Pivotal play or does LAPS play in going forward in, in that, in, in the, in that future? Yeah. I mean, I, you know, I've, I've never, at least I've never worked at a startup that had an end to their roadmap. So it's hard to perhaps put it into it, but I think, you know, we started with some of the, the things that we thought were basics. And I think, you know, one of the things we're really focused on now is how can we enhance the patient experience? And so bringing more value to patients, I've been sitting in on a number of, which when I have time, I, I still love to do a number of the user research interviews. And we've been doing those for patients recently. Before that, we were really doing some work on trying to enhance the experience for the care team and their staff, you know, the doctors, the nurses. Really, as anyone who's been in the clinic or perhaps, you know, on a telehealth visit more recently, you know, they don't have a whole lot of time to prepare for your visit because, you know, there's someone before you, there's someone after you. Like there's, there's just not a whole lot of time to do a lot of research before. And so the name of the game, at least in my experience is trying to make that as easy for them to digest and making that information that is going to be the most helpful in their decision-making, making sure that that's surfaced in an easy way. So making sure that we have a clear next step guidance based on how the patient scored, those things we want to continue to enhance for the providers as we build out. And then longer term, I think we see ourselves, we're, we're not a, you know, there's a lot of mobile apps in mental health, for example, not just telehealth mobile apps, but, you know, apps that might help you with meditation or, or things like that. And I think longer term, the vision is to be able to perhaps be part of, you know, enable an ecosystem where we can support all of those different, those therapies that might help

someone and recognizing that everyone's different, that, you know, some people may prefer some in-person activities while other people might prefer to use a mobile app. And we, we want to be the, you know, the enabler that helps people understand if there's a concern or a risk that they might need to address, that they have a comfortable place to do that, that we help them ask the right questions with their provider and that we can, even though it might not be our product, because there, there are plenty of, plenty of apps out there that had already do a number of great things that we could be sure to refer them to some that are known to be effective based on what their goals are. And what kind of a role, and maybe you alluded to this and I missed it, but what kind of a role do you see? Do you see labs helping out as you, as you've done that path? Yes. I left out that part. You know, you know, who, who knows down the road, I think while I've had some of my, my companies that, you know, I've seen start off with Pivotal Labs just as, just as we have, or known of companies that have done that. I've also been with startups who, you know, started with an engagement with Pivotal Labs and then found, you know, at some point later that, that they needed, you know, you know, two very different work streams perhaps. And they didn't have all the staff internally to execute on both. And so I think that's naturally a great place. If you've maintained a lot, I mean, probably, you know, even if you haven't maybe maintained the practices that, that Pivotal teaches perfectly. But I think if, you know, for us, we're, we're really trying to maintain our extreme program and agile practices. And so I think if we found ourself in a situation where we signed a big customer contract and there were a lot of deliverables that it was going to be hard to see how the team by itself was going to be able to execute on all of those, that that might be a natural place for us to,

you know, go back docking on Pivotal's door and say, okay, we want to tackle both of these things. We're thinking we can section this off. Like, can we define this as a project that we could work on with you? Something like that. All right. Yeah, that sounds fair. Teach a man to fish and whatnot, right? And I've heard that from other customers too. Like actually a big, the big, a big, a big point of pride was we built this on our own. Yeah. We got the skills to build this on our own. So that's a good thing. I know our developers were, I think, I think it was bittersweet. They were very sad. We really enjoyed every single person at the, at the Denver office that we worked with. They were just, just all fantastic. And, you know, we had a little farewell Zoom party because I guess that's the best you could do during COVID and had some, you know, accolade sharing and such. And so I know that everyone was sad to leave, but they were also really proud of, you know, the first feature or set of features that they delivered, you know, sort of without the training wheels, if you will, but we had, we had a fabulous experience. So I, I think it was bittersweet. That's probably the best way to describe it. I had kind of just a higher level question just about, you know, startups or, or maybe even this applies to larger companies too. Just in your experience, what do you think is, you know, the biggest disconnect there between really bridging that domain expertise, you know, like you came in with your business partner and, and all of this research around these psychological assessments, you came in with all this, all this really rich domain expertise, but then you needed to kind of bridge that with the technology. And just kind of wondering, like, where do you see the biggest disconnect there for folks being able to do that? Yeah, I think, I think, you know, and speaking from personal spirit, I think it's, it's, it's often very hard. And I think in healthcare, traditionally, a lot of the software has not

been perhaps as modern or modern built as, as, you know, I don't know, FinTech or the travel industry or some, you know, where a lot of interesting companies with modern software have, have come out of, and, and so I think, I think Pivotal's process and structure around, you know, it's, it's agnostic to industry, right? And I think that's why it's so great, because it really helps you focus on the most important things. And I think it challenges those of us who, and even though I've worked in, in healthcare startups, healthcare, as far as technology, has just always been a little bit behind a lot of other industries. And so you don't want to just bring, you know, I'll say, some of the bad habits, perhaps of technologies of the past, you want to make sure that you're challenging yourself and, and building your software such that that's going to be an advantage and an asset to you, so that you can pivot and, and, and move quicker than perhaps some of the larger, more established companies. I mean, in the end, that's usually the advantage for a startup, right? And so I think because the Pivotal process is agnostic, it sort of challenges even those industry experts. And again, we were not, those of us who started were not industry experts in building software, but we had been, you know, around a lot of these companies, it really challenges you to make sure that you're building the right thing. And you're really focused on the user. And then you're focused on what are the metrics that you're trying to move as opposed to, this is what we think we should build, because this is what every company always builds when they start. I think it was a healthy process of challenging us to make sure that we were, you know, again, staying true to that North Star. So I don't know if that answered your question exactly, but that's how I think about it, at least. Interesting. Yeah. I assume some of that too, is just a function of, and healthcare maybe is an industry where it's prevalent to buy off the shelf software versus building stuff, custom software,

which actually solves the exact problem you have versus kind of. That's true. Yeah. You see that in other industries too. And it's just like, yeah, at some point they, a lot of companies wake up and say, okay, we can't, we can't wait for the, our vendor to address this issue we need. Right. Or we can't be, or we just want something different. Right. Like it sounds like kind of what you're alluding to a little bit is, you know, changing your mindset to, instead of thinking about software is like, oh, we've, this is something we have to do. It's like thinking about it as how can you leverage your expertise to your competitive advantage using software as, you know, the medium for that. You know, the other, the other interesting thing that makes me think of is the, the, one of the product managers that we worked with in Denver was really good at reminding us. And I didn't, you know, I didn't pick up on the parallel myself at first. She was really good at reminding us that we were actually very similar to pivotal labs because we were building the software, but in the end, you know, this is behavior change that has to happen in primary care. We're, we're having to teach the team and the clinic how to operate a little bit different because traditionally mental health has not been a core part of, um, the healthcare delivery in primary care. And so I remember her telling me one day, you know, yes, we're building software and that's going to solve this problem, but there's also the services part. And so just as, you know, pivotal labs makes perhaps our software approach sticky, you know, it's because we've got this services model that really supports that. And that really clicked for me. And I think we were able to draw a lot of parallels as we were thinking about, and that is closer to my area of expertise is, is sort of the customer success realm, thinking about how we were learning things for the first time and how, you know, the pivotal model helped make some of the practices that we were trying to implement more sticky, um, because of the way they've married those two. So.

Right. I don't know, Danielle, that seems like a good place to end unless you have any other, other questions. So once we tie the learning culture and it feels like a complete story. Yeah, this has been really great. Thank you.

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