Lessons from Tara Viswanathan, Rupa Health, enabling root cause medicine with specialty lab infrastructure
Subscribe to our substack for weekly updates and listen on Apple Podcasts or Spotify.
Welcome back to the Pear Healthcare Playbook! Every week, we’ll be getting to know trailblazing healthcare leaders and dive into building a digital health business from 0 to 1.
This week, we’re super excited to have Tara Viswanathan, CEO and Co-founder of Rupa Health, a healthcare company building the digital platform for the next evolution of medicine: root cause medicine.
Founded in 2020, Rupa is revolutionizing medicine by enabling access to root cause medicine, where practitioners aim to identify and solve the true underlying causes of an illness. A root cause approach looks at a person’s health holistically and employs advanced comprehensive diagnostics to understand everything from genetics to diet, stress, cortisol levels, the microbiome, and more. Rupa solves the most difficult part of practicing root cause medicine: lab work.
Prior to founding Rupa, Tara was on the early team at Parsley Health working on product and operations after earning her bachelor’s degree from the Wharton School and master’s in management science at Stanford University. On top of this, she’s also a certified nutrition and wellness consultant! In March this year, Rupa announced a $20 million Series A round led by Bessemer with participation from First Round Capital, Lachy Groom, and more.
Or you can listen on your preferred platform!
Tara’s fortuitous path to building holistic care for every person on the planet:
- Growing up in a small town in Texas, Tara always knew she wanted to create products and build companies. She was always highly creative, making collages and glass jar creations for Mother’s Day, clothes for all her dolls. Tara shares that her first business was making and selling duct tape purses at the mall at the age of 12 or 13, and she continued this path to Wharton for undergrad to study business.
“Growing up in a small town in Texas, I only knew how to eat steak and potatoes. I had never had a salad until my junior year of college.
It was only when I got to college where I faced a culture of intensity. Binge everything: binge studying, binge eating, binge drinking, binge exercising, binge partying. I experienced burnout, and my health got really bad — That was the first time I started thinking about my health.”
- Tara’s passion for health and nutrition started her freshman year of college and only compounded over the next decade. Still curious to learn more, she became certified as a nutrition and wellness consultant before going to grad school.
- In 2012, the term health tech wasn’t popular yet, but it’s what Tara came to Stanford to do, creating her own major, Product Design for Better Health. After graduating, Tara went to work at a food tech company but after six months, realized she wasn’t following her passion to build in the health field. She left the job and embarked on what she calls her “Healthcare MBA”: reaching out to companies she thought were making a difference and convincing them to let her work for them.
- Tara then joined Parsley Health during their seed stage and affirmed her belief in a holistic healthcare approach. Parsley was showing outcomes from helping people track their lifestyle changes and symptoms in multiple dimensions of health.
- During this period, Tara shares that she ended up flying home to help her mom when she got sick and her dad, who’s a physician, wasn’t able to help her. She realized she wanted to build infrastructure that made holistic healthcare available beyond certain pockets of the US, but accessible to every person on the planet.
“I believe the most important problem to solve around humanity is health. When we are healthy, when we’re happy, when we’re fully alive, we as humans are capable of solving any other problem.
That became my mission: How do I create a company that will improve the standard of living? What does it mean for every person on the planet to be fully alive? I wrote that down my freshman or sophomore year, and that’s still my north star.”
- Tara shares that she started Rupa because she saw the movement towards more holistic, whole-person health that wasn’t quite alternative medicine or conventional medicine, but somewhere in between. After reaching out to an old Stanford professor, Tara was invited to B speak to one of the healthcare classes she’d taken before. Rosa Hamalanein reached out after the talk and became Rupa’s first employee and eventual co-founder, inspired by Rupa’s mission even though it had barely begun.
Defining what is root cause medicine
- Simply put, it’s using data to get to the root cause of a person’s illness in a more personalized approach to healthcare. Tara believes that root cause medicine is the next evolution of healthcare and is a category that’s still being created, also referred to as integrative medicine, functional medicine, and precision medicine.
- If you go to a dermatologist with a skin rash, they’ll ask you a few questions and you’ll walk out with a steroid cream. On the other hand, a root cause practitioner will ask you about your sleep habits, your stress levels, your microbiome, your hormone levels, etc.
- Rather than using a treatment to suppress the symptoms, root cause medicine aims to find the derivation of the symptoms, and the insights of modern data allows for that.
- Historically, a lot of ancient medicines have been more holistic in nature, and Tara’s observed a large percentage of hospitals adding integrative clinics to their departments. In earlier centuries, the biggest threat to human life was infectious bacterial disease. For the chronic, complex illnesses that pose the biggest threat to humans today, the root cause isn’t as simple as bacteria, and that’s what root cause medicine is working towards.
Enter Rupa: A three-sided B2B2C marketplace between lab companies, practitioners, and patients.
- Rupa makes it easier to practice root cause medicine by modernizing the process of ordering specialty labs. It’s difficult for doctors to access and understand every new type of specialized testing like epigenetic testing, environmental toxins, advanced hormone panels, etc. Part of a root cause practitioner’s goal is to understand how to utilize more data around a patient, and that comes with understanding this testing. Rupa’s first product (which is still their core product today) is a marketplace for specialty labs, which now brings together 30 different lab companies and over 3000 different tests from microbiome analyses to food sensitivity tests.
There’s no better way to build your product than getting started and your idea in front of customers
It doesn’t matter what you do, just get started and get in front of customers. If you listen to them, they’ll tell you how to move in the right direction.
- Tara was deciding between moving to New York with Parsley or taking a leap of faith to start a company. Recognizing the broader opportunity in the holistic healthcare space, she decided to take the leap. She left Parsley and went home to spend time with her family where she started to ideate Rupa’s first iteration.
- On a flight back from a holiday vacation, Tara set herself a deadline: by the time the plane landed, she would have mocks ready to show potential customers. The plane landed, she called her acupuncturist, started iterating and got to work.
“One of the things that I learned seeing startups succeed and startups fail is that one of the biggest traps you can get into as an early stage founder is analysis paralysis, where you’re just not sure what to do. You’re thinking about everything and you’re planning. The only thing to do when you’re at zero is to build and is to get in front of customers.”
The earliest days are the hardest.
“It’s counterintuitive — it’s not like you’re answering to anybody, it’s not like you have a team to manage. But it really is the hardest. It gets easier once you start to have momentum. The faster you can create momentum and cycles and structure, the more energy you’ll have every day.”
- As an early stage founder, you have to decide what to do — there is no momentum driving you and only after you’ve decided what to do is you know, then you do it. That distinction is what separates it from any other job.
- Tara shares that she and Rose set ridiculously aggressive deadlines for themselves. They committed to building a digital health clinic from scratch and launching with paying customers in a month. They figured it out, and they did it. Start with your goal and put it out there ASAP so you can actually get insights from your customers.
- When you hit product market fit, you will feel the market will pull. Tara realized they had gotten momentum when practitioners she reached out to responded with immediate enthusiasm, one even saying they couldn’t launch a new clinic without Rupa. In January 2020, they launched their portal to 2 practitioners in the Bay Area. Within 3 months and without any marketing spend, it had exploded to 47 states in the US through word of mouth.
Building Rupa’s B2B2C GTM strategy
Your go-to-market strategy depends on where the pain points are and finding the customers most willing to convert.
- Tara structured Rupa’s go-to-market strategy B2B2C because they’re serving a chronic illness population rather than one-time use patients. They initially built a consumer-facing marketplace for patients to discover practitioners, but quickly discovered that customers wouldn’t convert unless the need was severe enough.
- Rupa chose to sell to practitioners because if a patient has already sought out a practitioner, they are the highest need customer who have the highest willingness to convert. Furthermore, the primary pain point in the journey was ordering tests on the practitioner side. Before Rupa, practitioners didn’t have access to tests or didn’t know about certain tests, calling labs and stocking kits individually and manually.
Healthcare is expensive. Be transparent with your customers so they can make the most informed decisions.
“Even if we can’t bring the price down today, we’re going to tell you exactly what your commitment is upfront so you have the knowledge to pay for that and to make a good decision for yourself.”
- Medicine today can be prohibitively expensive, from appointments to testing to grappling with insurance. A common patient journey is getting expensive or even unnecessary treatments without having known the cost or consequences upfront. Tara shares that with Rupa’s mission to bring root cause medicine to every person on the planet, it needs to be accessible and affordable and the first step in that is price transparency.
Scaling with Rupa’s Series A
Work with an entrepreneurial growth person who specializes in scaling businesses. Even when your product isn’t 0 to 1, have a 0 to 1 mindset with growth.
- If you don’t know how to test different channels for channel product fit, partner with somebody who knows how. Tara shares that most growth people are people who know how to scale, rather than people who are zero to one on growth, and finding the right creative entrepreneurial person is incredibly important.
- At any time, different parts of the business are at different maturity levels. Even if your product’s evolved, still approach growth with a grassroots mindset.
“While we had hit product market fit, we had not hit channel product fit. We had no idea what channels were going to work for our product and so we had to operate in an entirely different way. We experimented with like 10 to 15 channels before we found the few that really worked for us.
Looking forward towards Rupa’s future
- Tara shares how the holistic healthcare space has highly evolved in the last 3 years and has a huge amount of opportunity — what’s next for Rupa is staying focused. Their priority in the short-term is growth, and in the long-term it’s to make root cause medicine more financially accessible. Tara believes that lab testing is the core of getting to the root cause, and there’s more to do with data, insights, education, etc. and eventually, bringing the cause of root cause medicine down. Rupa wants to be able to reduce the time physicians spend combing through data by providing them with the right insights off the bat, and that will contribute to reducing costs for patients.
Tara’s tips on highly effective motivational practices you can incorporate weekly
The people who succeed are the people who don’t give up — remind yourself of the progress you’ve made so you stay motivated to keep going.
“The reasons you don’t keep going are burnout, lack of motivation, lack of optimism… How do you manage that? How do you make sure as an early stage founder that you don’t burn out, that you don’t lose your excitement, that you’re showing up 1 year from now, 5 years from now, 10 years from now?”
One of Tara’s biggest lessons has been to try and compartmentalize her time. Every week, she writes down:
- Three Lessons from the previous week
- Three Goals for this week
- One thing to improve on
She also has an Apple note every month where she keeps a photo and a quick sentence every day. At the end of every month, she’s able to look back and see how far she’s come.
“If you are in the early stages, you only focus forward. It’s not until you actually look back that you feel really grateful and feel really proud and you remember all the small moments. Try to protect your mental health, because that’ll help you keep going, which will help you be successful.”
