Today’s guest is Nick Desai, who is the founder and CEO of Rene. Rene is a developer of patient-centric software designed to improve healthcare services for elderly and underserved patients. The company’s application helps schedule appointments, request in-home services, fulfill medication prescriptions, as well as share vital signs remotely. Rene recently raised $4.4 million in a second seed round led by Quiet Capital, and the other investors include Mucker Capital, Vika Ventures, Tao Ventures, Global Founders Capital, SaaS Ventures, Cetalight Capital, and the AARP. During this interview, I sat down with Nick to discuss several items, including his journey as a serial entrepreneur, why he decided to start Rene and what it’s contributing to the healthcare space, some of the lessons that he’s learned along his journey, as well as his advice to individuals who are also interested in starting their own companies. Hi Nick, we’re so excited to have you on the podcast today. Thank you so much for joining us. Great to be here. Glad to be able to talk with you and your listeners. Absolutely. So Nick, before we jump into some of the questions today about Rene specifically, it’s part of our tradition here at The Pulse Podcast to ask all of our guest speakers to discuss what did you want to be when you grow up? You know what? I am one of those people, I think a pretty minority that will say, this is all I’ve ever wanted to do is do my own startup. I remember startups, which is I remember being five years old and thinking one day I’m going to be the boss of my own company, right? I didn’t know how much work that entailed when I was five, but this is what I’ve always ever wanted to do. That’s amazing. And obviously that has worked out well. And so let’s go ahead and jump right in. And so we’ll be spending most of the time talking about Rene, but before we go into Rene, I know this is not your first venture within the healthcare space in general. You obviously co-founded before the company Heal. We’d love to learn a little bit more about your background from a work perspective leading up to the finding of Heal or the founding rather of Heal, and then why and how you ended up going to Rene after that. Yeah. So even Heal was not my first venture funded startup. In fact, Rene is my fifth. So Heal was my fourth venture funded startup. This is, as I said, all I’ve ever wanted to do. So I went to undergrad and grad school in electric engineering, and I worked while I was in grad school. And then for maybe a year after that in actual semiconductor physics, which is what my, you know, graduate degree was in from UCLA. And since then, I have done startups, right? And eight years ago, I founded with my wife, Rene. I founded, my wife’s a physician, and I’m an engineer and serial entrepreneur, and we founded Heal. And it was a very, very, very simple idea. We had very young kids at the time, and it was very hard to get our young kids, you know, we’re talking about infants, and they were, you know, underweight infants, so you’re putting a five, six pound kid in a car seat, and for anyone that’s ever done it, most of your students may be listening to this, so you’re still younger than that, but for anyone that’s ever done it, it is, it’s nerve wracking when you have your first kid, and we just thought there’s got to be an easier way to see a doctor. And so we built an app that let you book a doctor to come to your house, a doctor house call. And at first it was cash pay, and then very soon after, we were accepted by 25 major insurance companies, and then we were offered by about 70 major corporations. We operated in 11 states around the country, we were accepted by Medicare, and we became one of, we really created the space of home-centric primary care and doctor house calls, which, you know, at the time was, it went from no, this will never work, to no one’s going to use it, to well, people use it, but it’ll be too expensive, to okay, we’re going to cover it, to it’s a good alternative, to it’s the best way to get care is in the privacy of your own home. So that was HEAL, and I ran it as, so I was CEO from the day we founded the company, which was literally, I built a demo version of the app and showed Renee, and she joined as chief medical officer from there, to $200 million in venture funding, 100 million of that from Humana and our Series D, and we were a Deloitte Fast 500, CNBC Disruptor, Consumer Electronics Show, Small Business of the Year, we just, Fierce 15, Rock Health, Innovation Winner, and most importantly, we served 300,000 patients with primary care in the comfort of their own home. That’s amazing. It’s, I did not know about the status before that, so that’s cool to know that there were kind of potentially multiple iterations or trials before you got to HEAL, but obviously HEAL ended up working out very well, which is very exciting. And so I suppose coming away from HEAL and now into Renee, I’m interested in first learning and potentially sharing with our audience, what is Renee and how is it different or similar to what you’ve done at HEAL? What is the product or the business model and how it differentiates itself as your next venture now? Yeah. So the answer to your question is, Renee is a personal health assistant. HEAL was an actual provider of care. We were a doctor’s office, except without the office, right? We basically did to doctor’s offices what Amazon did to retail stores, which is we brought it to your house, right? And that was great. And it is great. And HEAL continues to do that and thrive and basically something we invented and created that continues to change the world. What we realized in creating Renee is that after we left HEAL, Renee, herself, Renee the person, my wife, Dr. Renee Dua, became a caregiver for her own aging loved ones as 53 million Americans are now, which are adults who are busy and trying to be adults in their own life who are now taking care of parents and grandparents in their 70s and 80s and 90s. And those 53 million people are spending an average of four and a half hours a week doing things like scheduling doctor’s appointments and picking up medications and texting your dad to make sure he takes his medications and then getting that information to the doctor. And then the doctor prescribes that you need to go get an MRI and then you have to schedule the MRI and you have to wait on hold and nobody wants to spend their best years waiting on hold and nobody has time to wait on hold, right? And so we built Renee as a healthcare assistant. And what Renee does is we take care of and handle the most cumbersome, most routine healthcare tasks for people. And that is we schedule all of your healthcare appointments. We deliver all your medications right to your front door, all your prescriptions. We remind you to take your medications. We enable you to easily share data with your doctor. We track your vital signs. We do all of this stuff in an extremely simple, intuitive, easy to use app. It’s not even an app. It’s just a web browser-based experience, so you don’t even have to download anything that any person can use of any age, but it’s specifically designed for usability and ease of use by aging and polychronic Americans. So the 100 million Americans over 50 that have two plus chronic conditions, we are designed to help those people complete their healthcare tasks. And the result of that, completing those healthcare tasks for those people is that they get better health, right? So if you make all your doctor’s appointments, if you follow through on the labs, if you follow through on the imaging, if you take all your medications, then you will get better, right? That’s the only way to help people. And that is what we are doing for people. That’s what Rene is. That makes a lot of sense. And that’s a very exciting venture to head into. I’m sure many of our listeners will understand what it’s like to help some of their chronically ill relatives as well as friends take care of all the different tasks, as you mentioned, that they need to complete just to receive care. And so that’s exciting in terms of how you can kind of build a centralized force around that. To dive a bit deeper there, I guess, in the sense of saying a personal assistant, you mentioned multiple things. And in reading about Rene, it looks like there are multiple components. The scheduling component makes a lot of sense. You also mentioned tracking vitals, looking at prescriptions or helping them monitor or rather organize all of those different pieces. How do you move beyond, as you think about it as a web browser, from the scheduling component, which potentially is more easily done in a remote setting with the potential or needed integration into the scheduling systems for providers, into things like vitals, as well as moderating prescriptions or ensuring that there’s potential adherence there? How much of it is virtual and how much of it needs to be incorporated in person or rather with the patient? Yeah. So the answer to that question is, the first thing to say is, Rene is designed for patients to easily manage their health care and handle their health care tasks. And it helps people who are caregivers and it helps people who are patients. But the most important thing to note is a lot of people don’t have a caregiver or a helper. So we’re helping them themselves and we’re helping them accomplish things that they simply could not otherwise, right, by schedule. It’s not just that it’s time consuming to do some of these things. One in three seniors don’t have reliable transportation to get to a pharmacy, right? Many of them don’t have the health literacy to wait on hold. It’s not just waiting on hold, but then your doctor tells you, sorry, you need this imaging and it’s a nuclear medicine imaging. You call the imaging facility and they’re like, press one for nuclear medicine and press two for an MRI. The average person doesn’t know the difference between those things and they don’t know. So demystifying that in a way that we are able to help real people with their health care needs is for the caregiver or for the patient themselves or for both, right? That’s an important point to emphasize. The second thing to mention to answer your question specifically is the unfortunate reality of health care in a world where basically we can truly live a ponderance of our life online, right? We can order our groceries. We can order our food. We can date. We can get our movies. We can get any service, contractor, party, throw whatever I need to come to my house. I can do everything. Health care remains ridiculously manual, right? The most obvious example is scheduling doctor’s appointments and to schedule doctor’s appointments, you pretty much have to call and wait on hold. 70% of doctor’s appointments in America are still taken that way. So what we do on the back end of Rene is that we have an actual team of care concierges, human beings, plus a lot of AI and software. So if you need a doctor’s appointment and that doctor allows online scheduling, great. We would schedule your appointment for you online, but chances are they don’t. We’re going to call and wait on hold for you. So you press a button, say you need an appointment with Dr. Smith. You want it on Tuesday. We schedule the appointment on Tuesday with Dr. Smith and then we text you and let you know when you have that appointment and then we remind you to go to the appointment and all of that stuff, right? So it is really, really very, the way we built this is thoughtful in the sense that we are giving people the help they need with the tasks that they have to do, but sometimes can’t do or won’t do. And we’re combining the AI with the human touch. That makes sense. One thing I guess that I’m thinking about as you’re talking through this, especially with this emphasis or focus rather on elderly or senior patients, specifically those with comorbidities or multiple chronic conditions. I can’t help but think tech is potentially a difficult skill set, if you want to call it that, to overcome for some of our senior patients. I know in my previous experience working with Medicare Advantage populations, even the idea of launching telemedicine in which some of the patients would have to tap into an application to see their provider created some complexity or some complications that we had to work with them to overcome. How is Rene and how are you thinking about overcoming some of those technical difficulties or rather obstacles that some of the senior patients could run into in order to truly make it seamless and help alleviate some of those manual components? Yeah. So there are a couple of different factors here. The first important thing to know, Zaid, is that the notion that seniors are not tech savvy is really folly, right? In the following sense, especially post pandemic, yes, there are some people, seniors in particular, but people of all ages that really can’t use tech, right? But 89% of seniors use text messaging on a regular basis, right? 75% have done video calls with their relatives over the holidays, not in the 80 plus audience, but in the 55 to 80 aging American population. They’ve done video call, they do FaceTime, they don’t want to hit the button. Is that using tech, right? If you can send a text message and if you can click a link, if you can send a text message and you can do a FaceTime call, you can use Rene. That is how easy we have made the product. But the other point is that the reason seniors often don’t want to sign up for telehealth, yes, sometimes they don’t know how, but again, the pandemic has accelerated adoption of some of these services because seniors didn’t want to leave their house, nobody did. And so they had to figure out stuff. But the problem is not the senior. The problem is health tech, right? There’s a standard that we look for in any tech solution. We call it, it’s as easy as doing it on the internet, easiest tech, right? Amazon, Uber, Grubhub, Netflix, any of these, Instacart, these are instantly super easy things that anyone who can click or send a text message or can figure out how to do, right? But health tech never seems to rise to the ease of tech. Never it falls to the complexity and quagmire that is healthcare. And so what do you end up with? You end up with an app for telehealth and an app for mental health and an app for prescription delivery and an app for tracking your diabetes and an app to track this and an app to do that. And a real 70-year-old person has obesity and diabetes and hypertension and needs all of those services. And what are they supposed to do? Sign up for eight different services that don’t talk to each other, right? No one wants to do that. I don’t want to do that. And I’m as tech savvy and health literate as they come. No one wants to do that, right? So what Rene does is specifically solve that problem by unifying and simplifying all our healthcare all in one place. We put it all together. We booked the doctor’s appointment, understand what the doctor prescribed, deliver the medication, remind you to take the medication, share the data, track your vitals, all easily, all in one place, all in a way that a regular person can use, again, as easily as sending a text message, as easily as using FaceTime, as easily as any of those things. So if you make health tech as easy as tech, and if you make health tech solve the problem of ridiculously disconnected, disjointed, absurdly hard to use experiences, you can build a truly differentiated product. And that’s what we’ve set out to do. And that’s what I think we have done. That makes sense. And I appreciate, one, the stats around text messaging as well as FaceTiming. I think that’s a great point. I think of my own parents, and they’re both great with FaceTiming whenever they need anything. And so that totally makes sense. And I appreciate that perspective. Yeah, exactly. My parents were like, ah, we’re not going to do that stuff. And then we, my wife and I had kids, and then all of a sudden, hey, why don’t you, you didn’t FaceTime us in the last three hours with the grandkids. You know what I mean? Like, somehow everything becomes easy when they want to do it. But the point of that is that tech has to be that easy. I don’t think it’s at all unreasonable for any person to expect that the technology is designed, they don’t have to learn the tech, the tech should learn them. Absolutely. That’s a great way to put it. With that said, just going through, you kind of went through what I could only describe as an end-to-end patient experience with our healthcare system, from scheduling to see their provider, to actually seeing their provider, to filling their medication, to actually any additional follow-ups, that requires, at least when I’m thinking about it, an impressive amount of care coordination across the board when some of those steps or stops along the way of the patient journey don’t necessarily communicate with each other. How did Rene, or how does Rene continue to think about coordinating that care for the patient when those elements, unfortunately, within our current healthcare system, tend to sometimes not communicate, if not for a centralized solution that needs to reach out to every single one of them? Yeah. And the answer to that question is we become the hub. We become the exchange for that data. We become the hub. So we start, we don’t just start by saying, oh, we want to get your health records, or we want you to fill out some long, complex form. The Rene experience starts with a one-to-one human personal care activation call, in which a real human care concierge takes about 45 minutes to get to know a patient, their health issues, their doctors, their medications, their insurance, their labs, their needs, their goals, their preferences. And then the patient has a lived-in experience, and then the more they use it, we prescribe, the doctor prescribes the medication, we get it delivered, we track the usage. We know when your refill’s up, we can deliver the next month’s medication. We can do the this, we can do the that, right? Because we do everything, we will eventually get all the data. The problem with the gaps in data in healthcare are that people don’t have all the data because they only do part of the service, right? The doctor prescribes the medication, but it has nothing to do with you getting the medication. The pharmacy lets you get the medication, but it has nothing to do with you taking the medication, right? As we get involved in every single step, we’re able to add value and close the loop on all that data working together to enable more proactive, more data-driven, more effective, more cost-effective, more clinically effective healthcare. So to me, there’s a micro element there of working with each patient, and that makes sense from a care coordinator perspective in the back end. But I would assume there’s also a macro element in terms of having to potentially partner with providers and or even payers. For Renee, has that been the case in terms of partnering with certain healthcare systems on a broader scale in order to acquire or work with some of those patients, or is it still in the sense of finding those buckets of patients and then working with whatever system that they currently are in? Yeah. The answer to that question is we want to work with the patient in whatever system they are in, right? We want to make it super easy for the patient at the individual level and at the macro level. We want to check their insurance so that we get their insurance information, so we know their eligibility, so that we are recommending to them if they need telehealth, we’re not just saying, oh, here, go use this telehealth, right? And we don’t know if it’s covered by insurance. We’re actually signing them up for the telehealth service that is covered by their insurance and sending them a link and saying, click this link for your telehealth call, right? Click this link for this. Click this, right? So that everything we give them is in the context of their insurance. And what that does is it allows us to showcase insurance benefits and plan benefits in a way that patients can truly appreciate and enjoy. And insurance companies, more importantly, equally importantly, will also appreciate because we’re delivering serious value to them in identifying the benefits that their patients are actually using. That makes sense. And I agree, or not rather agree, but commend the effort of reaching out to the individual patient and then going through those different pieces for them. Because even at the macro level, based on my experience in talking to several folks, if you were to go with a specific insurance plan or a specific provider group, every patient still has a very different experience. They might be seeing in-network, out-of-network. They might be getting their medication from pharmacy A versus pharmacy B. And so hitting each of those elements at the individual level, to me, feels like it could potentially overcome many of those issues in that disparate connection or lack of connection rather between all those different pieces. So that’s very exciting. And that’s the exact point here, right? Which is that no two people are alike. Person A uses doctor A and pharmacy A. And especially when people become over 65, they want and they like that choice and they want their lifestyle driven choices that they’ve made to be the ones that they get to use. And we work with any doctor and with any insurance and with any pharmacy, and we still enable delivery and we still do this and we still do, you know what I’m saying? So that is why the solution is uniquely effective. Absolutely. And so as you’re thinking about growing Rene further or scaling or potentially the future of Rene, what’s the vision there? You know, to start working with those individual patients or to start building out a solution for each of them. But I’m interested in hearing of where would you like to take it? Where do you envision Rene going? Look, our vision is, you know, our vision when we built Heal was that in 10 years, no one would go to a doctor’s office. And we still think that a decade or, you know, for now, health care is a little bit slower to change. But a decade from now, just like I don’t think my kids will ever actually learn how to drive a car because of automated vehicles. And my eldest is eight. So eight, 10 years from now, I think driving is going to be a thing of the past, like blockbusters a thing of the past and so on and so forth, right? I think the doctor’s offices are going to go away, too. With Rene, we want to become the unifying point, the national brand, the place that you think when you think I need health care, not just for seniors, the same caregiver who’s caring for their parents is often caring for their kids, is often caring for themselves, is often caring for a spouse or partner. And we want to simplify and unify health care for everybody and use that ultimately as a vehicle to drive health equity, because the bridge to get lower income and disadvantaged people the health care that they deserve is to use technology to make health care more cost effective and more data driven so that everyone gets the health care, the best of health care. And we think we can be an incredibly important enabling sort of hub of that, because anytime you need health care other than calling 911, if you come to Rene, we’re going to handle it for you. The more we handle, the more data we have, the more partners and services we have integrated, the more we can handle. And it’s a virtuous cycle. Absolutely. One interesting point that you made that I guess I’d like to ask an additional or follow up question to is this idea of ensuring health equity across all the different patient segments in terms of making it more cost effective as well as accessible for all. And over the last couple of years with the pandemic, I think we’ve seen a shift pre and post pandemic and what I can only describe as uncovering health inequities as opposed to finding out that they’re brand new. And so how does Rene, I’d love to kind of learn a bit more about how does Rene think about bridging that gap specifically now that we’ve seen not how broken, but rather how incomplete health care as exists today within the US is for everyone that needs it? Yeah. So, look, my view on health equity is this, right? The lack of health equity in the United States is tragic, is staggering when you think about it. The average person in the lowest 20% socioeconomically will live 12 years shorter, will die 12 years sooner than the average person in the top 20%, right? That’s a staggering difference, 20% life expectancy difference, right? It’s unacceptable. And the way to solve this problem is to use technology so that people in rural areas, people can’t leave their house, people are socioeconomically disadvantaged, can get treatment, can get diagnosed, can get medications, can get care. Anything that is not truly ambulatory, truly emergency, truly complex surgery can be done in the privacy and comfort of their own home, virtually or in person at a much, much lower cost. And Rene should enable that by bringing these choices to people and by letting a lower income person or socioeconomically disadvantaged person have access to the best care that their particular insurance, even if it is Medicaid or Medicare, whatever it is, give them the best options that are there for them and help bridge the divide between people and the technology that can help them. Absolutely. And I agree. I think tech is the solution there. On this podcast specifically, obviously we focus on bringing in a lot of digital health entrepreneurs as well as startups within the space. Every time I learn about another venture within the space and what they’re doing, it seems like we’re covering or rather trying to get to another element. And at least for me, and I’m pretty sure for our listeners as well, it’s pretty exciting to see all of these different startups within the space as well as entrepreneurs like yourself within healthcare in general that are trying to potentially overcome some of those obstacles in there. So that’s very exciting. Yeah. And I’ll tell you, you know, I’ll tell you that healthcare, you know, the American healthcare system is a disastrous quagmire, right? In which so many people have inserted themselves into the value chain, right? I talk about this on my own podcast, Nick’s notes on slice of healthcare so often, right? Between 1985 and 2015, in that 30-year period, average life expectancy hasn’t really increased in the United States. Yet the real adjusted purchasing power parity normalized cost of healthcare is quadrupled. That’s a lot of bureaucrats, insurance companies, brokers sticking their hands into a pie where it doesn’t belong. So the worst enemy of progress in American healthcare are the entrenched forces of American healthcare. And we have to overcome that. And that’s why we go direct to consumer. That’s why we have to engage the patient. That’s why the patient has to demand a change that, hey, I will pay this, but I will not pay that because I want what’s better. I want what’s easier. I think that makes sense. And I think that’s at least what a lot of not potentially startups, but companies are coming up with, and specifically within the digital component are trying to overcome or hoping to overcome. So taking a step away from Renee, I really appreciate all the context there, and I’m excited to see more of kind of what happens within or for Renee. Interested in learning more about your entrepreneurial experience, obviously we are an MBA podcast and we have a lot of potentially MBA graduates, but as well as MBA students listening in that are interested in starting their own companies within and outside of the healthcare space. Wondering what that experience has been like you and if there’s any certain wisdoms that you can share with our listeners on starting your own company and overcoming some of the obstacles obviously that come along with that. Yeah. So a couple of different things. First of all, love talking to people of an interest in being entrepreneurs. For me, it’s a calling and I absolutely love being an entrepreneur. As I said at the start, it’s the only thing I’ve really ever wanted to do. I truly love doing it. For me, it’s about a blank page, creating something out of nothing and changing the world for the better and seeing a world that I want to exist and being a part of making that happen. Right. I did not get an MBA. I had thought about it, but an MBA program typically requires five years of work experience. And so I went and what I did was I took a bunch of night classes in accounting and finance. So I understood how those aspects of business work because you don’t learn those in engineering grad school. And then I started my first company and five years later I had started and sold a company. So I was ready to start another one. Right. And, and, you know, my advice to an MBA student, my advice to any student is, first of all, a great education is always helpful no matter what you do, because a business may not always work out. Second of all, specifically for MBA students, and especially at a great place like Wharton, take all the finance and accounting classes you can, right? If you learn nothing, marketing changes and tracking changes and, you know, the, what, what they taught in organizational behavior class and MBA classes, you know, 20 years ago is totally inapplicable today in the post COVID hybrid work environment where people and our, you know, our team that has building and launching Rene is literally has programmers in Croatia, designers in Indonesia, support people in the Philippines, people in the U.S. People of all different ethnicities, backgrounds, ages, races, right? People working from home, people working from offices, people working from coworking spaces. So how does any of the old rules of organizational theory apply? They don’t apply, right? So, but here’s what we is not going to change. Language has a business. That business is called financial statements and financial projections. And those things are learned in accounting and finance classes and knowing how to do those is the language of business. And if you can’t communicate that language, you can’t start a business, right? And the other thing I would say is let your education be an enabler, but not a hindrance, right? All of you, all of the people who listen to your show that are MBA or grads or students that, that are coming out of Wharton, every single one of you is going to get a job offer. There’s no question, right? And that job offer is going to pay you money and it’s going to have benefits and it’s going to Procter and Gamble or this or that, whatever, right? Some big fancy company, some startup maybe, or, or whatever. But if you go take that gig, right, and you get comfortable and you start a, you have a car payment and a mortgage and a mortgage and whatever, it becomes harder and harder to start. Right? I started my first company when I was 23 years old, I had no kids. I had no wife. I had no expenses. I had worked a year after grad school. I had saved up some money. My fixed expenses were, I mean, yes, my parents had given me an old car, but my fixed expenses were a grand total of 400 bucks a month, right? So I could take the risk and I built and I built and I saved. And now I can continue to do startups and take the risks I need to take. But comfort is the harbinger of mediocrity, a harbinger of mediocrity, in my opinion, right? And of complacency. And you don’t want that. What you want, if you want to be an entrepreneur, is to be uncomfortable, to live lean and mean and to run your business lean and mean, so that you can truly build something and not be caught up in, you know, I got to make this much pay to make my, you know, monthly expenses are so high. Right? Absolutely. Thank you for sharing that advice. And I’m sure a lot of our listeners will appreciate that, especially in terms of the approach and what sounds like throwing yourself at starting something and whatever it may be and then seeing how it goes and going from there and iterating upon it. My final question for the day is potentially a bit more direct. Again, a lot of MBAs that are listening to this podcast, is Rene currently hiring or looking to expand when it comes to MBAs and non-MBAs as well as you grow further? We are not stuck on MBA or non-MBA. We’re in the midst of launching our working feverishly today and tomorrow and whatever in the next few days towards launching our product on October 4th. Once the launch is done and the product extraction, we would look to build out sales, marketing, business development, operations, product, engineering, all of those roles. And we look for smart, talented people. And we’re not specifically looking for MBAs or non-MBAs. We’re just looking for well-educated, highly qualified, motivated, you know, entrepreneurially minded people. Amazing. That’s exciting. Well, Nick, thank you so much for jumping on the podcast today, talking to us about Rene and the industry in general, as well as some of your personal advice as well. We’ve really enjoyed having you on board and we can’t wait to see what happens with Rene. Awesome. Thank you so much. And for your listeners, please check out Rene.com, R-E-N-E-E.com and try it for your parents, your grandparents, tell your friends about it, help us spread the word. Thank you.
