Jake Sattelmair, Wellframe — Founder Q&A

My rowing coach told me something that’s served me well since: he said don’t let your highs get too high or your lows get too low.

The rapid rise of telehealth has called into question a number of long-held assumptions about people’s willingness to use technology to manage their healthcare needs. That might have surprised some, but not Jake Sattelmair, the founder and CEO of Wellframe, a digital health management startup based in Boston.

Jake always looked for ways to use technology to make an impact at scale. As Jake recalls, “when we first started Wellframe, people told us we were crazy because older, sicker, poorer people would never use smartphones to manage their health. It just wasn’t conceivable.” Fast-forward to today, and that claim has been debunked.

Wellframe reimagines healthcare relationships through a new approach to digital health management that uses high tech to deliver the high-touch support people need, when and where they need it. The company’s comprehensive suite of digital health management solutions for care management and advocacy help organizations forge more meaningful connections with members across their healthcare journey.

We spoke with Sattelmair about how he envisions the use of technology to bridge the gap between healthcare resources and people’s needs, not just when they’re in front of a physician or being cared for in a clinic or hospital, but also during all the moments in between.

Q: Tell me a little bit about where you grew up?

I was born in Ohio, but from the age of two, I lived in Massachusetts, down near Cape Cod. It was a really small town — more trees and cows and cranberry bogs than people probably realize.

Q: What did your parents do professionally?

My father worked in marketing for technology companies. My mother was in healthcare, working in sales and business development for biotech and pharmaceutical companies. She left that to start her own homeschool from our house — more of a nonprofit mission than anything else.

Q: Did you wind up being homeschooled?

No, but I did end up getting pulled in to teach some classes in math and science when I was in high school and college, and that was pretty fun. I guess it was my introduction to entrepreneurship.

Q: Were math and science your go-to subjects back then?

Probably, though I liked a lot of different subjects. I was really interested in moral reasoning and Greek philosophy.

Q: Where did your interest in health come from?

Back at a fairly young age, maybe I was 12 or 13, I realized that I just felt better on days when I exercised. I could focus on my homework better, I was nicer to my family — and it occurred to me that when I exercise, it affected me physically, mentally, and emotionally in a really positive way. And I was like, hey, that’s awesome. I started thinking about how I could help other people benefit in that same way. I wanted to help them be healthier but had no idea how to do that.

Q: I saw something interesting in your history: you did competitive rowing at Harvard University and then at the University of Oxford. You also took part in the 2000 World Rowing Junior Championships in Zagreb, Croatia, where your crew came in third place, I should mention. Why rowing?

Maybe it had something to do with me not being good enough at any ball sports to have a real future there and being sufficiently masochistic to be drawn to the sport. Rowing was one of those things where if you focused and worked really, really hard, you could get better. And if you worked harder than everybody else, you could get even better. I kept at it and so by the time I got to college, I was able to row competitively. It was a pretty big part of my educational experience.

Q: Was there anything you took away from that experience that helped later on in your work career?

My rowing coach told me something that’s served me well since: he said don’t let your highs get too high or your lows get too low. And I think that guidance has served me well from an entrepreneurial perspective, and it’s also advice that I’ve leaned on the last number of years while building Wellframe.

Q: So, now you’ve got a couple of Harvard degrees — including a doctorate in epidemiology — sandwiched around your time at Oxford. Did you ever consider teaching or working as a full-time medical practitioner?

Well, while my education gave me a fantastic grounding in public health and methods of evaluation, I knew pretty early on in that I probably wasn’t best suited to be an academic or focus on publishing papers as the primary way of making an impact on this area. I was always trying to figure out during that time, where can I have the most impact in terms of people’s day-to-day behaviors and improving their healthcare decisions and their health outcomes.

Q: What was the path you took to put those ideas into practice?

I tried a few different things. I spent a summer at the World Health Organization, and then I helped start a nonprofit to get kids moving in schools as a way to both improve their physical health and academic performance. Eventually, I ended up getting connected with a health tech company where I was asked to write a research report on a personal health record. Back then, I had no idea what a personal health record was, but I thought, `Yeah, sure, why not?’ Eventually, I became kind of a de facto product manager within the organization. It was through that process of working there that I fell in love with the idea that technology could be used to influence people’s health behaviors, their healthcare decision-making, and their health outcomes.

Q: Did it work out the way you hoped?

No, but while that particular effort wasn’t ultimately successful, I learned a ton and was still sold on the idea that we could use technology to make an impact at scale while also appreciating some of the reasons why it often fails to realize that promise.

Q: What did your folks think? Their son has all these medical degrees and now you’re chucking it all to pursue a business idea that was still pretty fuzzy?

Well, I suppose I was definitely the black sheep when you look at my classmates who were going into academia or to the CDC at the time. But it didn’t really look like a business at the time. In any case, I was fortunate that I never had a lot of career pressure coming from my family.

Q: When you were going for your degree, did Harvard put enough emphasis on students to apply what they learned in fields other than medicine?

If you look at Harvard Medical School and Harvard’s School of Public Health, in general, I think they’ve done a lot since then to foster entrepreneurship and create opportunities for students to identify different paths. At the time I was studying, it wasn’t that obvious. But it’s encouraging to see the school make investments since then. It’s much more at the forefront of people’s minds and there’s a lot more activity, which is encouraging.

Q: What was the general thinking about the connection between physical activity needed to lower the risk of heart attacks and stroke when you studied for your doctorate?

There were hundreds of studies that connected physical activity to reducing the risk of cardiovascular disease, generally. I was focused on trying to characterize the dose-response relationship, that is, how much exercise is actually needed to bestow a benefit. That matters because if you tell people, well, you have to do a hundred minutes of exercise to get any benefit in a day, a lot of people won’t do it. But if you tell them to do two minutes of exercise when they actually need 10 minutes of exercise to get the benefit, you haven’t helped either. We were trying to figure out how to help policymakers decide the right amount of exercise and find the point where you’re going to get the most bang for your buck in terms of the widest adoption and the most impact. So, I was doing kind of a meta-analysis of a lot of different studies to try to figure that out.

Q: Do you think hospitals better understand the topic and this connection between behavior and chronic disease and management?

Hospitals haven’t needed to think a lot about that. That’s not what’s primarily motivating most hospitals. They’re trying to provide the most appropriate care to people when they need it. But health plans have strong motivations to invest in encouraging people to live more healthfully. That puts them on the path to get better outcomes and reduce the kind of overall cost for the care they need.

Q: How do you see that happening in the context of your idea about combining technology with your knowledge of epidemiology and disease prevalence among populations?

We can use technology to bridge the gap between healthcare resources and people’s needs, not just when they’re in front of a physician or in the hospital, but really during all the moments in between. And we have the financial motive that helps subsidize doing this at scale.

Q: What still needs to happen before digital models of care management fill the gap to help produce better outcomes in instances when there’s a need for ongoing guidance?

It’s an interesting time to be asking that question because as I’m sure you know, COVID has really accelerated a lot of trends on the digital engagement front. Telemedicine has been the most obvious and prominent example. People haven’t been able to see a provider in person, but we’re seeing regulators, payers, providers, and consumers motivated to leverage telemedicine to replace those in-person visits with virtual ones. It’s also teaching everybody the value of digital as a way to connect people in healthcare and to extend relationships of support.

Q: Has that been one of the very good things to come out of this experience?

Yes, telemedicine has played a big part in helping respond to COVID and ensure patients are getting the care they need, but it’s still episodic. Let’s say you saw your physician for 13 minutes. You’ve now got the next three months where you’re on your own. We need to make sure we’re using digital, mobile, and technology generally to extend therapeutic support and help to people, especially those with multiple chronic conditions and higher levels of need. In other words, how can we help those people feel connected, cared for, and supported by the healthcare that they have during all those moments in between their encounters with their physicians.

Q: How do you define that approach?

We begin with our mission, which is about reimagining what healthcare relationships can be, and how we can facilitate that change through technology. We use technology to deliver the high-touch support people need, when and where they need it, whether that’s to manage multiple chronic conditions, or to get the most out of the healthcare they have.

We use technology not as a way of replacing human care but as a way to strengthen those relationships and meet people’s emotional and relational needs — in addition to any clinical, informational, or logistical needs.

Q: Do you think that sort of healthcare delivery would be skewed according to generational cohort, that is, with younger people who are more likely to be digital natives?

We work with health plans that are commercial plans, Medicaid plans, Medicare plans, and exchange plans. And if you look at the adoption of mobile technology among every associate demographic, it’s up and to the right. So, while the pace, maturity, and timing may be different across demographic or age groups, it’s all moving in the direction of this being a primary channel for interaction, engagement, and communication as well as accessing information about health.

Q: How far along do you think we are as a society in relying on technology tools for our healthcare?

Obviously, there are populations that may not have access, the cognitive or physical ability, or the inclination to use the technology. But we already have partnerships where the majority of people, or their caregivers, are leveraging mobile to get support from their care managers relative to more traditional, or telephone-based models.

Q: Speaking of technology, where do you see the shortfalls in virtual or digital support?

If you look at telemedicine, there were a bunch of reasons why it hasn’t been adopted more widely. But I think all those things are changing. The pandemic and the response to it have opened up people’s eyes to what’s possible in ways that weren’t the case before. There’s a lot of activity right now in the digital health arena. And I think there’s a general sense that what’s happening is a relatively accelerated transformation of how care is provided and how people access care and the expectations of consumers in terms of how they’re able to get support relative to their health and relative to their care. You have both a lot of new entrants doing interesting things, and a lot of incumbents who are racing to adapt and to stay ahead of these trends. It’s a really dynamic time in the industry right now.

Q: Do you still have time to do any rowing?

Not much. Between a couple of young kids at home and building a business, it doesn’t leave for a whole lot of time for discretionary sports. Maybe at some point I’ll return to it. But not right now.

Q: So how do you burn off the stress?

That’s a good question. I try to keep moving and stay healthy, but that’s about the extent of it right now. I try to keep it pretty simple. Nothing too extravagant. I used to walk for my commute, but now that we’re working from home, I try to run a couple of times a week and otherwise aim to hit 10,000 steps a day.

Q: What’s your favorite book?

Choosing one favorite book of all time is way too hard. But a couple that have stuck with me recently are “Justice: What’s the Right Thing to Do” by Michael Sandel. It’s basically the book version of one of my favorite classes in college on moral reasoning. The other is “How Will You Measure Your Life” by Clay Christensen, which lent some timely and meaningful insight into how to think about what is important in life.

Q: What’s your favorite movie?

“What About Bob?” with Bill Murray.

Q: Last, but definitely not least, who’s the one person, personally or professionally, you most admire?

Again, choosing one person feels pretty impossible, but I have a lot of respect for Jason Jacobs. He founded, built, and sold his own company (RunKeeper), and with the freedom that came after, he dove 100% into tackling climate change. He is building an impressive movement that is poised to make a big impact. There’s a lot to admire there.