Virtual Specialty Care with Julian Flannery of Summus

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Julian Flannery 0:00
The hospital of the future is not just the bricks and mortar hospital, and then you know in the middle of Manhattan or whatever city wherever city you live, now they have to build digital front doors into the world.

Alexander Ferguson 0:16
Welcome to UpTech Report. This is our applied tech series UpTech Report is sponsored by terylene. Learn how to leverage the power of video at teraleap.io. Today, I’m excited to be joined by my guest, Julian Flannery, he’s is based in New York. He’s the founder and CEO at Summus. Welcome, Julian could have you on.

Julian Flannery 0:34
Thank you, Alexander. Good to be here.

Alexander Ferguson 0:36
Now Summus is a virtual specialist platform. And you’re providing personalized expert advice to every medical decision that’s pulled from your website. And and in our prep chatting, I’m fascinated with you said it was kind of born out of this focus on specialty care creating this marketplace aspect building a network of doctors across any health question. And definitely virtual cares become huge during COVID. And you’re trying to like connect these and you put a lot into your recommendation algorithm. We’ll talk more about the technology in a little bit. But I’m curious. Jalen, can you take me back to the beginning? What What did you first see how did this begin for you?

Julian Flannery 1:14
It’s a great, it’s a great question. Well, thanks for having me, it’s nice to be here. You know, that, look, I tell a lot of people who want to found companies or want to be entrepreneurs, that you never want to build a company just to build a company, you have to you have to have a couple things, you have to have an idea that you passionately believe in. And you have to have a willingness to spend three to five years being highly resilient. You know, driving,

Alexander Ferguson 1:38
driving a company, if people try to like push you down and problems, you’re like, you have to be ready to bounce back.

Julian Flannery 1:43
No, no question. And I think where it came together for me, I’ve always in my, in my life, thought about the adventure of being an entrepreneur, I’ve had, you know, diverse kind of professional experiences in my life, everything from finance, to government, big institutions to kind of, you know, middle market sort of growth companies. And we’ll work on that you’ve

Alexander Ferguson 2:05
led founded, that’s right,

Julian Flannery 2:07
this is my first founding journey, which you you always learn along the way, but you know, that it really came together. So my family, I come from a family of doctors, and so I, you know, when I was a when I was a young man, my uncle sat me down, he’s one of these sort of World Class surgeons, and he said, Did you really want to do this, it’s, it’s really hard. And ultimately, I was pre med, I decided not to do it, right, because the journey of becoming a physician is arduous, you have to have a, you know, a deep appetite and passion for for medicine and for patients. So anyway, I went a different route. But what, what I, what I took from from my family is really I understand the physician psyche, I understand how they work. And I also understand specialists, right, there’s sort of, when you think about the world of medicine, there’s primary care doctors, and they’re specialists and they have different personalities, and even a specialist that different personalities, you have surgeons you have, you know, surgeons are also different. So, I, I understood the world of medicine, I understood the physician, view of the world. And then at the time, I was working at a company called GLG, which is the largest marketplace for expertise and in the world. And, and the premise there was, you know, sort of the foundation of primary research where people who are making decisions with capital or or nonprofits or lawyers or any anybody making decisions, you know, they want to get it you can inform those decisions, who access to a curated network of people who are, you know, perfect for that particular question, right? So

Alexander Ferguson 3:48
you have this background in in it with your family in medical, you don’t want to go into it yourself, but you know about it, because all your families, but then you’re you’re active working in a marketplace environment, connecting to people, so then you just naturally start to realize a connection between

Julian Flannery 4:03
Yeah, well, you know, my co founder and I sat down and he was a you know, he’s a former surgeon and, you know, turn Life Sciences investor. He said, Well, what if, what if we did the GLG for healthcare? You know, what if we, what if we, what if we built a marketplace for expertise in healthcare, and

Alexander Ferguson 4:16
what what year did this happen that you guys sat down, it was was

Julian Flannery 4:19
2015, we really didn’t get going until 2016. But that’s when the idea was sort of hatched and whatnot. And that’s where I think it’s, it’s really, you know, we’ll talk about this, how COVID accelerated virtual care and all that kind of stuff. But you know, that that’s the, that’s where it really came together. I’d had my second daughter at the time and I said, Well, gosh, I really need to be able to, you know, I need to think about what I want to do this. I did about three, four months of research, looked at all the players out there I thought it you know, got smarter about the tech and what we needed to build, and ultimately decided to do it. And it was, I would say, you know, the the founding journey for me has been the most challenging professional experience I’ve ever had and I’ve had some pretty challenging ones but also the most rewarding and the most amazing you know journey build the building something from nothing is is a powerful powerful feeling when you when you get it off the ground What if

Alexander Ferguson 5:15
you had to pick one of the more challenging challenges that are a good way to say that of founding a company compared to all your previous challenges? What What comes to your mind immediately

Julian Flannery 5:28
you know at the end of the day yeah what comes to my mind is it is really 100% on your shoulders in the early days nobody’s going to help you and you know they might everybody everybody applauds you you know people talk to you about you know, Capital Partners, all that kind of stuff, but at the end of the day, you’ve got to get up and put 100% into trying to build a company every single day. And if you don’t do that, it’s really you can’t you’re sitting inside of a bigger company like wow, you know, sort of hang around a little bit today I’m a little tired but if you do that you just nothing happens for you. And so

Alexander Ferguson 6:04
did you get a VC funding in the beginning do you have that base to when you got started?

Julian Flannery 6:09
So I made the decision not to take VC funding. In the early days we put together a great group of investors which were more individuals with sort of specialized you know, you know, talents and views which has been tremendous You know, there’s there’s arguments for VC for we do have VC funding now. But we you know, we decided to build a company using a different investor base than the traditional sort of traditional sort of venture seed model.

Alexander Ferguson 6:39
So you start with a specific group of investors angel investors wherever you want to call them that that saw your mission you start off the first few years was the problem that you were solving what you were expecting, you know what you expected that it has to be changed over time. What was that first few years ago?

Julian Flannery 6:57
Yeah, I mean we started as a consumer business and and you know, it’s and what you realize in healthcare is that people are reactive to healthcare you can’t be proactive with with healthcare you know, you can talk about preventative care and wellness and all that kind of stuff but at the end of the day you know, building a business you have to you have to think about the the reactive nature of people in healthcare something happens to me therefore I’m going to engage the healthcare system right so the consumer business I mean there’s lots of great you know, virtual companies or you know, consumer focused companies in healthcare that have been built using the learnings of that but I very quickly realized that we had to sell to employers and large groups so you know, that was we made the transition to you know, from b2c to b2b and and

Alexander Ferguson 7:44
and now with that, that that shift happened that was

Julian Flannery 7:47
right around too late 2016 early 2017 Okay, and then you realize you’re like wow, this sales cycle thing like whoa, whoa that’s a little little different, right? It’s 12

Alexander Ferguson 8:03
boom, and then businesses are like yeah, I will talk to you in three 612 months

Julian Flannery 8:08
Exactly. I know you’re sitting there looking at your cash flow like what would you mind like two months?

Alexander Ferguson 8:14
Let’s move up the timetable. So especially come up with the idea in 2015 really kick it off 2016 that first year year and a half you’re like boom, consumers maybe not switch to business for 2017 focused on them. And from our prep that we you’re now focused employers have 1000 or more is that right? mid market enterprise? Exactly. Okay. And cashflow fun for the first year or so.

Julian Flannery 8:40
Yeah, I mean that’s my biggest advice to people is just be ruthlessly focused on your cash flow and have a plan to get to break even I mean look there’s there’s lots of venture models out there that that’s not the that’s not the model and I totally understand that but you know, in in this type of thing where you have to think about sales cycles 24 months out you know, 1224 months and just planning for that funding environment making sure you’re making the right investments you know, it’s it’s a journey and you have to do so you have to raise enough capital to do that right.

Alexander Ferguson 9:12
Did you raise at that point some more capital

Julian Flannery 9:15
yeah we so we I mean, you know, we had raised at that time about two and a half million that was called sort of our series A and then you know, recently we we sort of accelerated that with our Series B and you know, because there’s sort of a clear breakout you know, once you get traction and you’ve got a bunch of customers you know, we were actually breakeven and profitable so it gives you a lot more leverage to go out there and say look, we’ve got this incredible model big market you know, we’re profitable right now I don’t need your money but here’s the opportunity it’s a much better position to be in

Alexander Ferguson 9:49
you plan that like perfectly alright, we’re gonna wait till we get profitable and we have the right margins and then I’m gonna go out and raise more capital was that like a step by step plan?

Julian Flannery 9:57
No. Well, I mean, look, I mean, you you, I think very,

very quickly you become very focused on the cash flow profile your business and you know, the the time of the sales cycle, the average contract values, you know what you need to make in the investments you need to make to try to drive those opportunities. But the goal is always always breakeven because again, as as a, as an entrepreneur, if you raise more capital, you’re giving away more of your company. So you know, every entrepreneur has to, you know, make decisions on Capital Partners, who they partner with how much and there’s, there is a dangerous game, I’m sure you talk to lots of tech entrepreneurs, there’s a dangerous game where if you get a little overextended on, on on valuation, or even, you know, the capital you bring on, and then you start to lose control of your company. And that’s just a it’s a decision that every entrepreneur needs to needs to make. So

Alexander Ferguson 10:55
marketing to businesses in the health care, because you switch from consumer marketing and health care to now, businesses, and this is like, where you’re those who have a lot of employees, what was that? Like? What was that mind shift? And your messaging? how did how did that change? And how are you focused right now?

Julian Flannery 11:14
Yeah, I mean, that you know, selling, selling, uh, you know, the b2b sales cycle, you know, thinking about marketing, you have to sort of combine, how are we different in the market, you know, our buyers are inundated with lots of different types of solutions, you’re our buyers are the HR teams, you know, at employers, and they get, they get hit up on a lot of things. And so, you know, you want to make sure that you understand how to engage them in the right way. You know, how to expose them to your value proposition, why you’re different. And, you know, ultimately, as I’m sure you have this conversation with many entrepreneurs, you know, you just have to get a couple companies to bet on you. And then you have to deliver on that value prop, right. And so, you know, what I like about our journey is, you know, some, some companies that the marketing get ahead of the actual delivery of what they’re saying, you know, what they say they’re doing, we actually developed a product that it was driving was aligned with our marketing, right? So it was, you know, we could go the next sales cycle and say, Look, here’s why we’re so unique. And here’s the, here’s the data to prove it. Here’s the feedback from our customers. And so you, you start to build credibility in the market, and that sort of a snowball, and then you’d kind of drive that, you know, drive that marketing engine,

Alexander Ferguson 12:31
recipe for success, get a few be able to use those as case studies, in your marketing say, we’ve done it, this is how we can do it. Exactly, exactly. You What are the alternatives to your platform that you like, when you’re selling to them? What are these HR managers what, what I would be using?

Julian Flannery 12:48
Yeah, we have to think about this. I mean, it’s something like 14 billion was invested in in the first half of this year in digital health companies, right. And so there are lots of companies, an HR managers and benefits managers are inundated. And so I like to, I like to call it a tapestry problem where, you know, they’ve brought a bunch of stuff on board, but they have too many solutions, their employees don’t really know what to do. And so, you know, I think you you know, in terms of marketing, you really have to think about differentiation, you know, where you fit in the market. So we, you know, will compete in the second opinion category will compete in the navigator category. These are just categories of virtual care and digital health. We also compete with the specialized solution. So you know, for those, you know, whether it’s a women’s clinic, fertility concept and Ms K, musculoskeletal concept, there’s narrow solutions, there’s broad solutions, there’s primary care solutions, they’re specialized care solutions. And so you really have to find your niche. And you have to really highlight your differentiating points, be able to back it up, be able to prove the ROI. And that’s how you kind of get, you know, get in the game, so to speak.

Alexander Ferguson 14:01
If finding those areas that you compete on those that narrow the wide it was that fairly quick, were you able to identify those? Or what was that process? I think it

Julian Flannery 14:16
has to be it has to be an ever evolving process. And it has to be tied to your product, right? So we, we started in the second opinion category, and we said, well, we’re just better or video based, the quality of our network is better. But then, you know, then we realized that we could go to market with a radically different model, which is we expanded our networks and we created this really broad funnel inside of an employer where we can legitimately say to people, hey, 90% of your health questions, just type it in the box inside of the CMS platform, and we’ll connect you within hours to a really high quality doctor who can help you understand what to do in healthcare, right? And so you’re always you know, you always need to watch your competitors. You need to watch your buyers you need to watch, see where the markets going. And then really, really work on those those differentiators because they are, you know, HR buyers, at least in our industry, they they want to put in good solutions that are going to deliver for them, they don’t want to look bad. So they want sort of proof of the, you know, of the solution.

Alexander Ferguson 15:21
You had mentioned to me, on our previous chat call about, you’re also helping small business, but through the connections of other platforms, like HR solutions, or like an API connection. Can you speak to that? Yeah, I

Julian Flannery 15:36
mean, we so we can be a differentiator for lots of different platforms that that sell to companies, right? Whether it’s a, you know, HR platforms, or benefit administration’s platforms, or tpas, third party administrators, we can affect lives to those platforms. So they have their value prop, they go in there, the bed admin industry, for example, is very competitive, right. So it’s, and so, you know, they’re looking for differentiated products that are going to help them, you know, deepen their hooks into their clients, and also fight off competitors. And so you, you don’t always need to think just, hey, we’re selling directly to employers, you could you could sell through other platforms, and reach employees and employers in the same way. And in some, in some cases, what’s wonderful about that is some of these platforms are aggregating small businesses, right? So it doesn’t make economic sense for us to go sell the small businesses below 1000. But we can sell to the platform that has 250,000 of those small businesses, you know, and provide that across the board. So you get that sort of scale, if you will.

Alexander Ferguson 16:48
Yeah. It works business wise, and business model wise for you to be able to offer many, as you realize was consumers, it just didn’t work now. A marketplace? Yeah, that’s what you’re based on that that is what you’re offering connections, and you invest a lot in your recommendation algorithm of connecting the two, building a marketplace. Can you speak to that? It was an easy finding all the doctors and tabulating that,

Julian Flannery 17:14
yeah, well, marketplaces are hard, right? Because you have to, you have to manage supply and demand, right? So you kind of have to build supply before you create demand, but then you have to create demand so that the supply stays interested. So is this kind of delicate balance, if you will? And I think in in medicine, it’s tricky, right? Because you don’t it’s not like, it’s not like Uber, where you have endless drivers, right? And you can just go, you know, just go get anybody and whatnot. And you Yeah, yeah. Well, but in so in our, in our world, it’s, it’s what’s called a managed marketplace, because it’s a finite, highly valuable supply side, right. So we focus a specialized care if, you know, specialists, they don’t, they don’t waste their time. They don’t, they don’t work with anybody, they have a clear view on the value of their time and who they work with. And so you have to create a really interesting value proposition for them. But the cool part of that is, once you do build that, that sort of critical mass, you have this incredible ability to just deploy high quality doctors on health questions. And, and there’s, there’s a clear line between better outcomes, better cost efficient outcomes, and the quality of the physician, sort of, you know, engaging with that, you know, with that patient,

Alexander Ferguson 18:36
if you had to think of one takeaway for someone else was trying to build a marketplace, and you’re building the supply first, what would be a lesson learned a tactic that worked? Well, when building up that supply?

Julian Flannery 18:49
Yeah, I mean, you have to build a critical mass of like, net promoters, right. So in in and it depends, though, right? Because if it’s a human driven marketplace, you you have to have net promoters, people who like your platform, people who believe in your mission, if it’s a hierarchical structure, like medicine, you know, people who sit on top of the hierarchy, whereby people look up at them and say, oh, wow, if that person is doing it, I should do this. Right? So it just, it’s an understanding the dynamics of what’s valuable for the supply you’re looking for. And then thinking about, you know, how do you how do you build, you know, what is the value proposition for them, first of all, because if you don’t have a sustainable value proposition for them, then you might as well just not build the marketplace, right?

Alexander Ferguson 19:33
So if you have nothing to actually sell them on, That actually sounds great, then don’t bother. Yeah. And

Julian Flannery 19:38
is it sustainable and defensible right. Now,

Alexander Ferguson 19:43
so building this recommendation algorithm, recommendation algorithms are are they the key to the success of a lot of sass companies these days? Netflix is like the consumer model everyone thinks of but was that simple, easy? What do you just find the right tech person, the CTO

Julian Flannery 20:00
Yeah, no, I think look, I think algorithms are, are very good. But we’ve chosen also to inject a level of human sort of clinical interpretation on top of the algorithms to, right, because, you know, sometimes you go on Netflix, you know, like, Well, why the heck they recommending them over for me, right? You can’t afford to make those mistakes in specialty care, right? So it’s not a you you can the algorithm is really supporting our ability to, you know, take a network or curated network, and very quickly tie it to a particular case. And then and then, but there is a clinical layer, because there’s so much judgment around it, you know, where is this person in their care journey, what is their, their, their history of present illness, you know, all those different types of things. And so there’s a couple chip, clinical checkboxes that we want to do. And then, you know, you continue to optimize your recommendation engine over time. And look, I think, look, you know, in technology and healthcare is vitally important, everything from AI, machine learning, all this kind of stuff. But healthcare is also very human, you have to keep the human in healthcare, otherwise you otherwise you’re not going to succeed.

Alexander Ferguson 21:13
If it’s soundbite right there should be human in the healthcare because otherwise she don’t succeed. Where do you see healthcare going? If you were to to imagine with me and and predict, with technology innovations in the next five years, what do you think we’re gonna see?

Julian Flannery 21:31
Well, I mean, look, it’s there’s been a huge push on the consumerization of healthcare, right? And, and I would say, you know, my company, we’re in virtual care. So I deeply understand the world of virtual care, I sort of understand the concept, you know, the data and whatnot, but there are so many solutions out there that are improving the world of healthcare, I think, I think ultimately, you, you’re going to see a vastly improved consumer experience, you’re going to see an EHR, hopefully, which is, you know, just sitting on your, on your phone, where you can access all your medical records and that kind of stuff. And then you can tie into, you know, different platforms, you’ll see a lot of interoperability. So you know, whereas right now you have a bunch of different systems trying to talk to it or not not talking to each other that that’ll change over time, you’ll see the cleaning. And I would say that, you know, that data as data is choosing important today, but it will become much cleaner over the next three to five years, and really informed decision making and whatnot. And then I could just speak to virtual care, you know, it’s just going to be a huge piece to the care continuum, everything from diagnostics, to outpatient care, to monitoring all that kind of thing. You can take a lot of costs out of healthcare, you can drive a ton of improvements in how patients are engaged, you can meet the patient where they are, you can design whole person care, which is a combination of in person and virtual. So I think I think you’ll see you’ll see a lot of that, you know, the hospital of the future is not just the bricks and mortar hospital on you know, in the middle of Manhattan or whatever city wherever city you live, they have to build digital front doors into the world. And so I think it’s, it’s interesting.

Alexander Ferguson 23:21
There’s a lot that you just kind of put in there, I’m sure we get a lot of time on packing one being I agree getting more access as individuals to consumers to our health data. For those that remember you do have a past interview we did with a company called human API, Andre, and there’s just a lot being innovated that’s on that okay, how do we get that information and data transferring nicely between all these different health care providers, and new apps and solutions and individuals. But I appreciate your last piece there the digital front door is that the phrase you gave pops in my head is like you go to the local store that you go by then you’re going to see a little booth to get your doctor or we can all have tricorders that when we have our virtual care, we can scan ourselves what’s what’s what’s possible here,

Julian Flannery 24:09
this is this is what’s exciting for us is that we can we’re focusing in specialty care, which is a little bit more complicated in terms of the platform and how people engage versus you know, a zoom call or an urgent care call where you just kind of dial up some doctor and you’re you know, you’re talking to them about something right? It’s a little more robust and specialized care because you have imaging you have more complex issues, you have medical history you have you know, all those different types of things

Alexander Ferguson 24:35
in specialty care is just a lot more conversation and then when you need certain things done, you just go to go get an X ray or go and they’ll just send you somewhere is that I mean, how does specialty care usually looked at because I imagine like the the you said on a more normal primary care. There’s only there’s a few things that can talk to you about but sometimes they just need a I feel like a doctor just needs to look at you and like do tests and so to What virtual care can do right now? But is that different in in specialty care?

Julian Flannery 25:06
No, it’s not. I think there’s limits in in you know, every, like in person care doesn’t go away, you know, you sometimes you have to go get a an X ray or an MRI, like you just have to do that or you have to get bloodwork taken, you can’t, you couldn’t do that remotely, somebody you know, can show up at your door and do it. But, you know, you’d be amazed what you can accomplish with virtual care, everything from the beginning of the journey, what do I do, who do I go see, you know, talking to somebody, a navigator, or one of our doctors who’s helping them understand what they you know, what their options are, to, you know, right now, if you’re, if you’re looking at a telemedicine appointment, which is really the practice of medicine, the virtual medium, you know, that that’s happening today at a pretty high volume, you know, people are getting diagnosed and getting prescribed drugs virtually. And then in specialized care, you know, you’re, you have to be definitely careful, right? Because, you know, in a virtual environment, there’s licensing issues. So, you know, I wouldn’t be able to diagnose you on what you know, what’s happening with you, I mean, you would need to see you in person. But if you do have a diagnosis, or you do have, you’re struggling with something that’s been diagnosed, or you just trying to explore treatment paths, the virtual medium allows you to really, like do geography goes away, you can you can engage with, you know, with doctors really anywhere, via platforms like ours, to help you understand what, you know, the best path of care or treatment that that’s optimized for your diagnosis.

Alexander Ferguson 26:38
What do you see is the biggest barriers for continued growth in in virtual care, whether it’s specialty care or other?

Julian Flannery 26:47
I think, you know, we’ll see what happens in the in the post COVID era, you know, I think, you know, I think you’ve seen virtual volumes come down a little bit. But that’s okay. Because, you know, the COVID, it was artificial, right? Because nobody was going in person and doctors weren’t, you know, other than COVID patients, they weren’t seeing them. So, I would say, look, I mean, that there’s a ton of competition, but I think, you know, in terms of the future of virtual care is very bright. I mean, you look at the Mercer data, I think I put it on LinkedIn the other day. You know, 72% of employees. Believe employers believe that digital health will be a huge piece of their benefit offering over the next over the next few years. So employers are thinking about it differently. They see the cost efficiencies, they see the benefits of doing so. So the future’s bright and virtual cast.

Alexander Ferguson 27:43
I love it. Thank you so much really, for sharing the the journey that you have been on and learning through that as well as a little bit on the technology in the future of virtual care, specialty care and where it’s going for those that want to learn more, go to Summusglobal.com that’s s u m m u s global.com. And thanks again, Julian. Good to have your alright guys.

Julian Flannery 28:06
Thanks a lot.

Alexander Ferguson 28:07
We’ll see you all on the next episode of UpTech Report. Have you seen a company using AI machine learning or other technology to transform the way we live work and do business? Go to UpTech Report calm and let us know.