Justin Kahn was struck in the head with a baseball bat when he was 14 years old. In his teens and twenties, he would suffer from anxiety and panic attacks. When Justin was 27, he had a panic attack that scared him into seeking out the help of a neurologist. After working with her for almost a year, she discovered that he did not have PTSD. Instead, what he had been experiencing for 13 years, were seizures that were caused by the traumatic brain injury. She put him on an anti-seizure medication that alleviated what he had been experiencing.

In 2009, he read an article that was in the speech that Robert Gates, the former Secretary of Defense, gave to the graduating class of West Point. He said that the Department of Defense was going to begin investing billions of dollars each year to address the PTSD epidemic plaguing all branches of the military.

Justin grew up around the VA. His stepfather was an administrator for the VA. He thought that the way to address this problem would be to establish a relationship at the beginning of the service member’s career with their home state VA and have it continue into the rest of their lives. He knew from his own experience that the most effective mechanism for him to deal with his seizures, which can be similar to the symptoms of PTSD, was having someone to talk to.

A lot has been done to address mental health in the military, but there are some service members that do not proactively address the issues they are dealing with. The reason is there can be a stigma attached with having mental health issues, as well as real world implications because they can be pulled away from their unit, possibly lose rank or pay, get passed over for advancement, or even be discharged. The result is, as troops transition to veteran status, some come back suffering from traumatic experiences that are having a dramatic effect on their transition back to civilian life.

Justin approached the Salt Lake VA with the idea of having active duty troops being able to meet with VA practitioners from their home state while deployed, and have it be done through secure video conferencing. The VA agreed to test the concept of online care by teaching relaxation exercises to a small group veterans to see if they would have the same retention rate or better as doing in-person.

When Justin received pre-seed capital in 2012 to start TruClinic, he approached his friend and software engineer, Trevor Wilkin. Justin Kahn/CEO and Trevor Wilkin/CTO have known each other since 2007, and have worked on multiple creative projects together. Brian Russon was originally introduced to TruClinic while he was with Microsoft and looking for Surface use cases in healthcare, of which we were utilizing with the University of Utah’s NICU unit. Brian joined the company initially in an advisory role for over three years before joining the company as Chief Revenue Officer. Lori Douglas joined the company as a result of her excellent work in the physician staffing industry with one of our investor/board members when we identified the need for someone to manage and grow our existing clients to ensure client success with our early adopters. Alex Zoller & Vitaly Leokumovich, co-Founders of joined the company in 2017 with the TruClinic acquisition of Alex has over 10 years in the EHR industry and is now TruClinic's Head of Product. Vitaly is the co-Founder of IDEOM and Ego7 and is now TruClinic's VP of Engineering.

What it does

TruClinic connects the clinical applications and services healthcare organizations need to fit their unique workflows and patient population by streamlining communication between multiple clinical systems and services to eliminate repetitive tasks and data entry. Fast access to information when providers need it leaves them with the time they need to focus on patient care by staying connected with patients through telehealth technologies.

TruClinic gives the caregivers the tools they need to provide the right types of healthcare services and information at the right time to best serve the patient's individual needs. TruClinic is used as an extensibility of the systems the providers and staff use on a daily basis. TruClinic solves the problem of patient management, patient engagement and patient adherence by giving the providers the ability to customize the telehealth experience based on their different subsets of patients.

How we built it

Trevor Wilkin and Jon Fuller/Director of Customer Support were the driving force of the first two iterations of the TruClinic platform. The first version was built on a LAMP stack using Javascript. Version 1.0 used a Flash based video codec. TruClinic was an early adopter of WebRTC for the video codec which was rolled out in Version 2, along with moving away from Javascript and into Node.js and Angular. Version 3 (code name: Olympus) is built on Node.js, Angular, React and Typescript.

Challenges we ran into

We believed that TruClinic would be the solution that providers would flock to. The thought at first was to get customers, regardless of size of practice or length of sales cycle. We were not charging enough either. The positive side of the challenge was that we got a birds eye view into all different types of healthcare providers. The negative side was that we did not have a cohesive sales strategy and it was very hard to predict revenue. Small practices were easy to sell to, but they had high attrition rates because they did not have the infrastructure or budget to implement a successful and scalable telemedicine strategy. Enterprise customers have the infrastructure and budgets, but the sales cycles can be anywhere between 6 months to 2 years. This experience helped to shape the customer acquisition strategy and that helped us focus on hone in on our sales process.

Fundraising was also a major challenge. As a small company where everyone is wearing multiple hats, the time and resources needed to fundraise were taking away from other tasks that needed to be completed. The executive team decided to raise the least amount of funds possible and to bootstrap for as long as possible. The whole team learned to operate using lean methodology and kept the growth in line with revenue. The company was not able to grow as fast as it had projected, but it gave us time to work out all the bugs before it was ready to scale.

Accomplishments that we're proud of

TruClinic was a winner of the Village Capital/VentureWell/SOURCE/Hitachi Foundation accelerator in 2014. The company is also an alumni of the Startup Bootcamp Miami accelerator in 2016. TruClinic currently has 11 employees and 7 independent contractors. The technology has been featured in trade organizations and publications such as The Advisory Board, AGC Partners, IDC Global Insights, the Journal of mHealth & Healthcare IT News. The company has two issued patents which outline the process for browser based online healthcare consultations (US Patent 8,718,245 and US Patent 9,374,394) with a third in review. TruClinic currently has 25 customers spanning 4 continents, in 7 countries and in all 50 states.

What we learned

The use cases for telehealth are as broad as the providers and the patients they care for. We have learned that our customers want a flexible technology with a modular feature set that they can scale throughout their entire organization. We have also learned that healthcare moves at different paces, depending on the priorities, budget, internal teams, etc. We learned to work with our customers to develop the strategies and deployment plans that will lead to a successful rollout. We treat our customers like partners and learn as much from them as they do from us.

What's next for TruClinic

We will be doing a fundraise at the end of Q1/2017 for sales and marketing scale. On the technology front, we will be integrating biometric, biofeedback and wearable feeds intro TruClinic sessions, and will continue with additional EHR integrations. The future is bright and we're all wearing shades.

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