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“Get An Amazing Designer On Your Team. Great Design Is Critical” 5 Startup Strategies With Sebastian Seiguer

I had the pleasure to interview Sebastian Seiguer, CEO of emocha Mobile Health, a company that uses mobile technology to secure medication adherence through Directly Observed Therapy — the practice of watching patients take every dose. They have been recognized by the National Institutes of Health, U.S. Centers for Disease Control and Prevention, and Patient-Centered Outcomes Research Institute to secure medication adherence rates of 90–95%. Recently, emocha was listed among the Top 10 Most Innovative Companies in Health by Fast Company.

What is your backstory? How did you get involved in your industry?

I started my career as an attorney based in London. One of my major clients was in Munich, Germany and there just wasn’t a place to get a good cup of coffee there. I created the San Francisco Coffee Company from scratch and expanded to 25 locations. But after a decade in the business, I realized that I wanted to do something more fulfilling. My parents, my wife, and my sister are all doctors, and I saw how rewarding it could be to work every day to make people’s lives better. I sold my ownership in the coffee business and moved back to my hometown of Baltimore to pursue an MBA at the Johns Hopkins Carey School of Business.

Well-known researchers at Hopkins had developed one of the world’s first mobile health platforms for collecting research data related to infectious disease, which they had named “emocha.” In exploring potential commercial opportunities, I found out that public health departments — such as the one in Baltimore — were going to extreme lengths to make sure patients took their medication. Like all other health departments in the United States, they were watching every dose of medication in-person, a technique known as Directly Observed Therapy (DOT). I was amazed to learn that DOT is the only proven means of securing high rates of medication adherence, and set out on a mission to fulfill DOT using technology. I licensed the Hopkins software and launched emocha Mobile Health with the Baltimore City Health Department as our pilot customer.

Can you share the funniest or most interesting story that happened to you since you started your company?

The craziest thing ever — the technology actually worked! I honestly thought it was a longshot, and it was lonely being the only believer for so long.

What do you think makes your company stand out? Can you share a story?

Healthcare is a seeing a technological revolution, but few concepts take the time to validate their technology in a serious, independent manner. Clinical validation is critical in this industry, and we have multiple publications, including those published by the CDC, Johns Hopkins, and our customers, proving the efficacy of emocha’s platform. One of the most meaningful and gratifying examples of this was our work in Puerto Rico to help stop a tuberculosis (TB) outbreak at a remote mental health facility. The CDC published their case study this past December.

Between the years 2010–2017, Puerto Rico was in the midst of a recurrent TB outbreak that could not be contained at a home for men with mental illness, resulting in the deaths of six residents. DOT is considered the gold standard of care for TB treatment and requires that each dose be taken under observation, but can be logistically challenging and burdensome for healthcare providers and patients. Due to the remote location of the facility and staffing shortages faced by the PRDOH, daily in-person DOT was not feasible and previous attempts to use livestream video options had failed to improve medication adherence.

With conditions worsening for many of the patients, we implemented our video DOT platform at the facility one week prior to Christmas 2016. By May 19, 2017, all active TB (11 patients) and latent TB (six patients) patients using our video DOT solution demonstrated clinical improvements in health over the six-month treatment program and the outbreak was declared contained by the PRDOH.

The results of this work was published in a report by the CDC and include:

· Active TB patients achieved a 92 percent medication adherence

· All patients successfully completed treatment

· PRDOH saved 360 staff hours, allowing time to be reallocated to other needs

What are your “5 things I wish someone told me before I launched my Start-Up” and why. Please share a story or example for each.

· Be a reasoned and objective contrarian. Every time you are told that something cannot possibly succeed, listen carefully to the reasons, but attack the opportunity even harder. The fact that something sounds impossible means that either you are completely wrong, or that you have identified a massive opportunity. An entrepreneur exists to discover novelty, which is by nature non-obvious. Videoing yourself taking your medication is a ridiculous concept on its face — but it works and can help save lives.

· Get an amazing designer on your team. Great design is critical. To be honest I already knew this, and we have the best designers!

· Keep things simple. Our job is complex, but software must remove complexity.

· Build a well-rounded, incredible team. Make sure everyone understands exactly what your product does, meets customers, and has insights into company financials. Transparency across a company puts everyone in the same boat. We sent our engineers and designers to Puerto Rico once the outbreak was contained to meet public health officials and the patients they helped.

· Drink a lot of coffee. I drink at least six cups of day and recommend starting as early in the day as possible (I also knew this one before starting emocha, full disclosure).

Is there an entrepreneur or business leader you look up to? Why?

Judith Faulkner, CEO of the electronic health records company Epic Systems, is a healthcare leader who is a great inspiration for building a massively successful health IT enterprise that has helped to revolutionize healthcare — without outside capital.

Perhaps less well-known is Frank Bond, who started the world’s first commercial gym that became Bally Fitness and made him a millionaire in the 1970’s. He has since established multiple award-winning communities as a real estate developer. Frank leads a reserved and private life in Maryland horse country, but is a force of nature. His son is the smartest person I know aside from my wife.