Menagerie’s Final Update

We created Menagerie to make it easy for modern couples to confidently choose their wedding vendors. We envisioned a future where every couple would be able to receive personalized virtual wedding assistance and was equipped to seamlessly discover high quality vendors that fit their budget, style and vision.

Along the way, we grew our team, launched a MVP, joined an accelerator and received funding, pitched at Demo Day on both coasts, and worked very hard to deliver our vision to our couples. While there was much success to be celebrated along the way and our second launch in November showed promising initial traction, we eventually discovered that we were struggling with product-market fit.

In this reflection, I summarize and share our biggest learnings, and express gratitude to all those who inspired and supported us along the way. I hope this can not only become a valuable read for existing and future founders, but also motivation knowing that regardless of the outcome, you will have helped people and/or businesses along the way and that this startup journey will forever be one of the most rewarding experiences and greatest learning opportunities of your life.

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Problem Solving for the People by the People

Following an unprecedented election that left Americans divided and displaced, the media in battle over facts with the Trump administration, and the security of every individual uncertain and threatened, we are now witnessing an explosion of organizations and startups focused on uniting people and leveraging the power of collaboration to collect data and build technology to secure our freedom and future.

Fears of government defunding data collection, manipulating data sets and mis-communicating politically inconvenient research have inspired the founding of organizations like Data Refuge, a distributed, grassroots effort around the United States in which scientists, researchers, hackers, students, librarians and other volunteers are collecting government data to preserve it and keep it publicly accessible. Their focus on climate and environmental data is in defense of the White House removing climate data from the EPA website and screening scientific research. Others, like Open Context are helping preserve, annotate and share archeology data.

Find out what other government data is being removed from the Internet at Sunlight Foundation, where they are actively tracking the removal or changes to data sets.

Collaborative research platforms will emerge in every industry to not only aggregate and maintain integrity of data sets but also enable individuals to accelerate the development of solutions independent of government funding and policies.

This is Wikipedia on steroids and much more. Data.world is a social network exclusively for people who want to find and collaborate on building data sets. Similarly, ResearchGate provides a professional network for the scientific community to connect, collaborate, share results and drive progress. Already, more than 11 million scientists and researchers use it and are uploading more than 2.5 million publications each month.

Beyond the civic tech and education categories, this same model of empowering individuals to organize and work together to problem solve has also been successful in transportation with Waze, financial investing with Numerai, app development with GitHub, data science with Dataiku, startup solutions with ProductHunt, and many more.

Success of these platforms have initially been driven by users who are mission-driven, motivated by gamification/monetary rewards, or seeking to build an online portfolio. These platforms crossed over the chasm from passing curiosity to active and productive engagement, enabling them to truly provide more value with each user and establish a sustainable data network to help them accelerate solutions. And as these platforms grow, they will become future leaders in their industries and many will redefine our workforce.

 

Telehealth and the Future of Healthcare

As Washington continues to war over “Repeal and Replace” of the Affordable Care Act, one thing is certain: the need for affordable and accessible healthcare that is patient-centered and personalized. Millions of women, senior citizens, employees and independent business professionals will be affected by the expected changes to Obamacare, including, but not limited to, reduced health benefits and preventative services, discontinued subsidies, and rollback of Medicaid.

Waiting for sweeping government changes is not the solution, and development of innovative health solutions have already been underway. There’s no question that the future of healthcare is digital, where individuals are equipped to self diagnose, doctor communication is remote and timely, medication is on-demand, and data is empowering prevention, drug discovery and development. Concern and curiosity motivated me to explore our current healthcare progress and available solutions.

Remote care delivery will evolve to become the first point of contact for everything healthcare

 

There have been a number of telehealth startups that have entered the space in the last ten years, spanning doctor discovery and scheduling, remote care delivery, prescription management, patient monitoring and education, and more. However, remote care delivery proves to be a unique entry point with strong network effects that will enable it to quickly scale and evolve to offer services and products across the healthcare space.

Copyright© 2014 Motivation Science Inc.
Copyright© 2014 Motivation Science Inc.

While the barriers to entry are low, new entrants’ will face a difficult and costly uphill battle as they attempt to bring on high quality providers onto their platforms, and compete to secure employers and health plan contracts in advance of leaders like Teladoc, MDLive, American Well and Doctor on Demand, who are already expending significant costs to capture market share of these customers. A robust salesforce and brand awareness are key to penetration, but also not effective without offering ease of product implementation & interoperability, billing & claim filing, and regulatory compliance (HIPAA, NCQA). The strategy to secure employers and health plan contracts is an attempt to capture mass membership quickly and establish high switching costs as many self-insured employers (ASO) and insurers may only adopt one telehealth platform; according to a 2016 analysis released by the Congressional Budget Office, ~155 million Americans have employer-based health insurance coverage.

However, there is room for certain specialist-focused telehealth startups, such as Spruce, who is primarily focused on the dermatology market, which remains untapped by incumbents and accounts for >5% of annual visits, or 56 million visits. This type of specialist visit is recurring and typically costs higher (up to 3x – 4x the cost of a primary care visit).

The existing focus among players remains client growth, but the future indicator of market dominance will be member conversion and [recurring] utilization to drive PMPM, visit fees and secure client relationships. Achieving these future indicators will rely on management, business models, consumer-centered & mobile-optimized products, and seamless integration of concentric mergers.

Why now? – Political

This future of healthcare has been accelerated because of easing regulation on telemedicine definition, reimbursements and coverage. Already in 32 states and the District of Columbia there are parity laws that require private insurers to cover telemedicine visits the same way they cover in-person encounters, and in 49 states and District of Columbia reimbursements are now provided for video visits in Medicaid fee-for-service programs.

Additionally, more states have removed the requirement for a tele-presenter to be present during a virtual consultation. Finally, 18 states have enacted laws to join the Interstate Medical Licensure Compact, which will begin to grant crossborder licenses.

Why now? – Social

Easing regulation complements today’s consumer needs. Consumers no longer want to pay high costs for healthcare and are looking for more personalized care at a time when many of the other decisions they make on a daily basis have been empowered with technology and made more affordable, accessible and personalized (i.e. food, wealth management, online streaming, transportation, travel, shopping). Early direct-to-consumer fitness trackers and health apps invited consumers to increasingly value and invest in their health, and track their own progress and symptoms.

Telehealth will continue to gain traction especially at a time when Repeal and Replace Obamacare risks exacerbating lack of access and rising costs. Approximately 1/3 of all ambulatory care visits, or 417M, are treatable via telehealth, which would result in an annual saving of $6 billion in U.S. healthcare costs. Cost saving opportunities via telehealth are also true for other specialist services.

Big 4 Telehealth

The four largest telehealth players are Teladoc (NYSE: TDOC), MDLive, American Well, and Doctor on Demand. Despite Teadoc’s current leading market position with ~17M members, it still represents only a minority of the whole market.

Teladoc Investor Presentation

Of these four, Doctor on Demand (DoD) is unique as it does not charge a “Per Member, Per Month” (PMPM) subscription fee, which typically costs $1 PMPM. Unlike the other three, DoD only charges visit fees, which they keep ~25%:

Medical Doctor:
$49 for a 15 min consultation

Psychology:
$79 for a 25 min consultation
$119 for a 50 min consultation

Lactation Consultant:
$99 for a 25 min consultation
$229 for a 45 min consultation

As telehealth platforms compete for employers, DoD offers an affordable option without the PMPM fee. While DoD’s model lacks the initial recurring revenue from PMPM fees, it is able to more easily align with the cost savings and ROI incentives of employers, drawing evidence that utilization rates are below 5% with other major players; Compared to Teladoc’s 5%< utilization rate, DoD boasts a much higher utilization rate of 25%-30%.

In other words, the cost per visit with Teladoc is significantly higher than $49 when factoring in PMPM. This strategy has had promising evidence as DoD now has about 400 employers (200% increase YoY) including Comcast and Union Bank & Trust, covers more than 45 million Americans and has secured relationships with UnitedHealth, Highmark*, Humana, and a number of Blue Cross Blue Shields.

*Highmark ended $1.5M contract last year with Teladoc to switch over to DoD and American Well. Most Teladoc contracts are only 1-year old…

Adoption goes both ways.

Slack, Dropbox, LinkedIn and many others have demonstrated that adoption goes both ways. And similarly, monetizing the B2B becomes much easier to achieve if you’re able to demonstrate success with B2C. DoD has since introduced a Per Provider Subscription Fee…(I don’t have numbers around this).

This is a defining time for healthcare – the winners have yet to take all and new entrants will need to be thoughtful about their unique entry point and resourceful with acquisition.

Tiffany’s Birthday Fundraiser for BrightEyes

Please help me celebrate my 25th birthday by joining me in contributing to BrightEyes, a mentorship program dedicated to providing college students a unique opportunity to explore different career paths.

Four years ago, I started BrightEyes in hopes to make mentorship and career opportunities more accessible to students. With your help and generosity, we will be able to send a class of students to San Francisco, where they will be able to meet with their role models and future mentors as well as tour leading companies in startup, tech and venture capital.

I’ve also decided that I would be matching the total donations made on my campaign page, up to $1,000, so please consider giving!

To be successful, we all require someone willing to invest in our potential and vision. We’ve all had someone invest in us along the way. Join me in investing in these students’ vision and potential.

Contribute to BrightEyes: http://brighteyes-students.org/donations/

If you are not in a position to donate monetarily, please like BrightEyes on Facebook and share the program with friends & family, on Facebook, Twitter, and anywhere else you’d like!

Thank you for helping me celebrate my birthday this year.

The Right Voice is Your Voice

social_media

These days, if your company doesn’t have a voice online, it doesn’t exist to people. Online presence is necessary, but even more important than being online is having the right voice and content.

Many startups outsource their social media management, and while it may work initially with creating an online presence, it is not recommended when building an online brand. A company’s online voice needs to be consistent with the overall company’s mission, vision and current initiatives. An individual outside of the company does not have that transparency into the company and especially with early stage companies, initiatives are constantly changing and emerging and direction is constantly adapting to market responses. This brings me to another point, that social media is one of the most effective ways to gage market response to your product without spending lots of money testing and collecting consumer feedback. Eventually, your social media channels will also become a form of customer service, where you will be able to respond directly and in real-time to customer concerns or feedback. You definitely need someone who understands the product and process and is up to date with the company to fulfill this role.

Not every channel is right for every business.

This is important to understand because pushing content out where your target audience isn’t will waste time, resources and content. And more importantly, the goal to increase brand awareness and engagement will not be achieved. Identifying the right social media channels requires a strong understanding of the business, vision and short-term and long-term initiatives and goals. As the company grows, channels may also be added.

While an external agency or individual may be able to provide the right type of content, it won’t be able to create personal interactions with potential users and provide transparency into the company and product, a necessary function of social media. To be clear, this is more true for twitter and instagram than for blogs. Unlike blogs, twitter and instagram are more interactive and the content shared on those channels are more frequent and require more effort to be consistent.

Each channel has its own voice and strategy.

This pretty much says everything. To build a truly strong brand on a channel and engage your audience, you must customize your voice and content to that platform to reach the right audience. On twitter you may want to reach a broader audience (across your industry) but on instagram, where the demographic and type of engagement is different than that of twitter’s, you will want to be more focused on a specific audience, which will determine the type of content shared.

Here are a few examples of social media frameworks for different types of businesses:
– Showcase Fans and Customers (e.g. Lyft shares customers’ experiences with drivers)
– Motivational/Inspirational (e.g. Nike, Gatorade, Lululemon)
– Umbrella Theme (e.g. Shapeways & 3D Hubs share all things 3D printing related)

On instagram, we are seeing many companies showcase their communities rather than share their own content (SoulCycle, Flat Tummy Tea, Lole Women, 3D Hubs).

We are seeing more and more companies become more successful as a result of their online presence (Warby Parker, Bevel, Well+Good, Peek, Wealthfront). And in some cases, companies are being formed as a result of a community that has formed online first (Product Hunt, Startup{ery). Social media can be one of the most valuable intangible assets to a company so treat it as your own and expect to create value from within not from without.

The Lesson: Don’t Oursource Social Media Management

Travel the World with Cultr.Club

I am excited to share this guest post from Evans, founder of Cultr.Club – congrats on the recent launch!  Cultr.Club is a subscription service for cultural explorers.  Each culture kit* (subscription box) includes a culture guide, specialty magazine, digital mixtape, edible treat, and artisan gift.

As a frequent and passionate traveler, I am very excited about this travel service and believe it will help invite the curiosity to travel to each of its members.  Unlike many other subscription services, Cultr.Club is educating individuals with each product and helping them discover a new part of the world.

Cultr.Club is currently offering a 20% discount on their first culture kit with the code ‘BrightEyes’ to show its support for BrightEyes – a program dedicated to helping students develop their careers and professional network!

*Each culture kit is $45.  Cultr.Club ships worldwide and offers free shipping in the U.S.  The inaugural Panama release is limited to 250 members only.

CultrClub_LaunchPage

Culture Kit Items_CultrClub

 Guest post from Evans, founder of Cultr.Club.

Anyone can be an entrepreneur nowadays. Advancements in technology have enabled everyone from the corner barber to your very own grandmother to launch a product. With the explosion of the Lean Startup movement, publicized by Eric Ries, all it takes is a dollar and a dream, sometimes literally, to launch a company. This has both helped and hindered the movement.

On one hand it levels the playing field. Visionaries can exploit missed opportunities in the marketplace that established companies leave on the table – either because they have no incentive to change or simply do not know how. On the other hand, because barriers to entry have decreased while access to capital has increased, they fall victim to larger than life ambitions. This “Blurred Lines Effect” is when startups try to cater to every vertical and horizontal market that remotely relates to their product. Just because you can build anything you can imagine doesn’t mean you should. Sadly, I learned this lesson firsthand.

The tourism industry is ripe for innovation in all areas from housing (Airbnb) to tour operation (Vayable) to culinary curation (FindEatDrink). I had ambitions to transform the industry with an app focused on curated culture and meaningful sharing. Problem is, my team and I could not get the project off the ground for a variety of reasons. What started out as a travel concierge club turned into a hybrid travel guide, social network, and customer service center. I was getting no where and fast.

I spent many nights with my head stuck in a Starbucks’ cup trying to assure myself that my passion for the project remained. To prove it I flipped through my thick leather notebook of great ideas dating back to 2007. They all had some element of cultural exploration. Convinced that my heart was still in the game I went back to the drawing board and rethought my company agenda.

My solution is a leaner startup approach where I focus on different ideas, in the simplest form, and let them grow organically and individually. This “conscious uncoupling” allows the products to best serve their individual purpose. Trust me, it is not a loss of faith in my grande vision but a realistic assessment of my available resources and capabilities. Look around you, even established companies are taking note and exploring singular focused agendas slightly outside of their core competencies. Instagram did it with the Bolt app and Facebook did it with its Paper app. Niche just became super niche.

I am proud to say that I am staying the course by focusing on the one thing of value I can offer the industry – cultural context, which distinguishes me from other ventures. I am a culturist who has studied and traveled abroad for extended periods of time studying economic, regulatory, and culturally landscapes. I bring that experience to the newly relaunched Cultr.Club (“Culture Club”), a subscription service for cultural explorers. We travel the world exploring different cultures and send members a box of artifacts to experience it for themselves.

I intend to share the beauty of the world one member at a time.  Wish me luck. See you on the other side.