Annual Report: One year of Pictal Health

One year ago, on my 40th birthday, I fired up the Vermont Secretary of State website and filed a new business, Pictal Health. I bought a PO Box, got a business bank account, and started working on the brand and logo. From then until now, I’ve gone through periods of accomplishment and stagnation, emotional highs and lows, and varying degrees of chocolate consumption. Allow me to break some of this down, in the name of personal reflection and organizational transparency.

Accomplishments

• I put together a website, brand, and business that enables me to work 1-on-1 with people to visualize their health history. This involved putting together legal agreements, figuring out how to take payments, developing templates, and making the process clear on the website.
• I’ve had 7 paying customers so far and have worked with almost 30 people total. (I’ve clearly done a lot of pro bono work.) I have a paid pilot starting with the VA right now as well, and I’ll be working with 10 additional veterans. Working with people 1-on-1 has helped me refine my designs, understand the needs of diverse patients, and really understand who this process benefits most — people with complicated, mysterious, unsolved health issues who are prepping for a future doctor appointment.
• Spreading the word about this work and its impact is central to my mission. I’ve written many articles here on Medium, and I’ve had a chance to share my work at both local and national events — most recently Health Datapalooza in Washington, D.C., and I’ll also be speaking this fall at my favorite healthcare event, Medicine X. I’m also going to be presenting at a local pitch competition, LaunchVT, in a couple of weeks.
• My background is in design, so learning and strategizing about business models has been a good ‘growth’ process for me. I have had a lot of help on this from business-minded people, especially locally here in Burlington, VT. By my count I’ve had at least 68 meetings in the last year with informal business advisors, healthcare organizations, other healthcare startups, and potential organizational partners. How wonderful to meet so many smart, interesting people who have given me so much of their time and encouragement. I am extremely grateful.
• I’ve learned a ton from talking with the patients and healthcare providers who have been so generous with their time. I’ve spoken with 22 alternative or holistic practitioners, 8 specialists, 6 nurses, 45 patients, and I’ve surveyed about 150 additional patients. User-centered / human-centered design is in my blood, so it feels good to know I am grounded in real insights. And, through these meetings I’ve been able to test and validate (or disprove) multiple business model hypotheses.
• As a designer, I have had to hold myself back from getting too wrapped up in detailed design — my specialty — but I do have a pretty good prototype of a more scalable software product.
• Personally this has been an interesting journey. I’ve learned how to work alone and stay motivated; my girl Jocelyn K. Glei and her Hurry Slowly podcast and RESET course have been a big help. I’ve also learned that working alone doesn’t really work for me, and I’m currently trying to fix that. I’ve had a chance to ponder what I want from my life, what a sustainable business looks like for me, and what ‘enough’ means for me. (On that topic, check out Paul Jarvis’s book Company of One — a great read.)

Challenges

• In the past, I’ve felt most alive and happy when I am collaborating with a good team and doing work at which I excel. This past year I have had to work mostly alone, and I’ve found myself doing new, slightly uncomfortable types of work. Being isolated from other people and from the work of being a designer has been my biggest personal challenge and has resulted in extreme emotional lows at certain points. I’m currently working on ways to remediate this.
• It’s hard to build a business without a lot of revenue or seed money. I have opinions about venture capital money, and how I want to avoid it — here’s a related article from Jeffrey Zeldman on that topic. I don’t want external pressure to grow, grow, grow; sell, sell, sell; ‘exit’; so I’m trying to figure out alternative routes.
• And hey, it’s not very fun not having low-to-no income.
• The business model is a big challenge; in healthcare, the people who get the most value (patients and doctors) often aren’t the ones paying. It’s tricky. Ask anyone with a small healthcare startup that is still figuring out its business model; it’s a slog.
• I’m sure there are a lot more challenges. Every day is a challenge and an opportunity. I’m trying to stay focused on the good stuff and keep in mind the bigger mission and impact this work could make.

Things I am grateful for

• All of the people who have contributed their time and expertise to me, and encouraged me to keep going — it’s fuel for me.
• The chances I have had to actually collaborate with others: on branding and design with Alli Berry, on strategy with Jackson Latka and Tad Cooke, and on accountability with Anna de Paula Hanika.
• My coach for the upcoming LaunchVT pitch competition, Anne Miller, who knows her stuff and is helping me understand and plan for the business commercialization aspect of this work.
• My friends, family, therapist and husband who have provided a lot of emotional support in the last year. The people at VCET for being nice humans who I can go be amongst.
• My IVIG nurses, who administer my strength-inducing go-go vein juice and talk to me about true crime.
• Also: dark chocolate, being in nature, having a flexible schedule for when I have insomnia, costume parties, our cool classic Toyota space van, etc.

Anyway. Is this TMI? Thank you for reading.