On the Health Record: Conversation with DrChrono’s VP of Product, Sean Ahrens

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Recently DrChrono’s Vice President of Product, Sean Ahrens, joined us on the On the Health Record podcast to discuss his work experience, history with startups, chronic illness and his unique experience with remote work. You can find the entire conversation here. However, if you do not have time to listen to the whole episode today, you can catch the highlights from that conversation in this blog!

How was your first experience at Y Combinator with your startup MessageParty?

Well I’ve seen Y Combinator in the summer of 2010 and the summer of 2012, and in the summer of 2010, I think we had roughly 80 other founders in the Y Combinator program. For those who don’t know, Y Combinator is a seed stage investment firm, and at the time, they specialized in giving funding to founders that had no funding at that point. Then they build a pipeline of investors for those founders to raise a much larger seed round. There’s been some big companies like Dropbox and Airbnb who have gone through Y Combinator.

I found the Y Combinator experience to be very exciting because when I walked in the door, we were suddenly spending time with a number of partners that were like superstars of Silicon Valley. We were all surrounded by a highly selected group of founders and really talented technical people, and it felt really powerful to be in that room. Though, at the same time, it felt like there was so much pressure on us.

I had spent high school and college getting close to straight A’s and being at the top of my class, so then suddenly being in this room full of people that I was pretty sure were smarter than me, maybe had better startup ideas and maybe more traction in their startup was really intimidating. I was sure that these were people that were going to be millionaires or billionaires someday, but I wasn’t totally sure if I had what it took. It definitely gave me a sense of imposter syndrome.

What was your main takeaway as a first time founder with MessageParty?

One takeaway is that in some ways, getting money from Silicon Valley can be rather easy. I remember us talking to some investor, and I thought at the time that we didn’t have our stuff together. Still, someone decided to just give us $100k. Even just getting into Y Combinator is like a magic touch, and I think only about 3% of applicants get in each year. But at the same time, how much can they really know about you from the 20 minute interview they do with you? I feel like there’s a lot of arbitrariness to who gets money in the Valley. Optics play a large role in getting your startup funded, and that does not seem like an entirely fair game.

Once I realized that, I understood that funding is not inherently validation of an idea. Getting funding does give you a better chance to have success, but people with bad ideas can get funded because there’s plenty of money out there to be spread all around. I eventually became much more focused on building things myself, and knowing that at the end of the day, my users were my guide, not my funding.

You realized that you want to build something for you and your users, right? That leads nicely into your next startup, Crohnology which was a platform for people with Crohn’s disease to connect and exchange information. Can you talk about that experience?

I had this idea for Crohnology since my junior or senior year of college, and I felt like it was about time that I came back to it. It was 2011, and the idea was that suddenly, every person living with a medical condition around the globe has the computing power and interface in their pocket to enable their personal experience living with their condition to be a part of medical research. Up until that point, medical research was almost exclusively done through clinical trials. These observational studies required participants to explicitly enroll in them and take time out of their daily lives to go into medical research facilities and take medications that weren’t the medications that they would necessarily need.

Those studies were usually very small and expensive. Meanwhile, I had been living for about 10 years with Crohn’s disease, and Crohn’s disease is something that affects you daily. There’s a condition called ulcerative colitis, and together Crohn’s and colitis make up inflammatory bowel disease which affects about one out of every 150 individuals. That means that around 3 million people in the US are living with this condition that is poorly understood.

In my process of thinking through this idea for Crohnology, I also understood there’s a whole host of other medical conditions that aren’t well understood yet either. Many of these have no cure. The treatment options that are provided currently by medical science are far from sure shots; at least in Crohn’s there’s a 30% chance that a given medication is actually going to work for you.

I thought, what if I made a tool that sits in each patient’s pocket that allows them to report how they’re feeling every day or whenever their symptoms change. They can tell us what pharmaceuticals they’re taking, and what experiments they’re doing to improve this condition for themselves. This could be through diet, different vitamins or supplements, different wellness exercises like meditation, yoga or acupuncture. I find that you have a lot of people in this world talking about how certain modalities of healing medicines can be beneficial for certain conditions, but there’s not a lot of evidence to back that up.

What I really wanted to do was actually to create a tool that would validate or invalidate a lot of these modalities, so that patients would have a really clear guide for what they should try. By trying these things and recording them in real time, they could be contributing back to the world’s knowledge on their condition to help other patients.

Can you talk about how big Crohnology grew from start to finish?

I’m a little bit sad about Crohnology because I built a thing that from a product standpoint, and just judging from the reactions and growth of the network, was a really well designed product that scratched an itch that was completely unaddressed by other products. We had testimonials from patients all around the world of how this thing was blowing their mind that this existed.

The challenge was that we were so underfunded. I brought Crohnology through Y Combinator in summer 2012. I convinced an old college buddy to join me as my co-founder, and he convinced a college friend of his to come join us as a software engineer. We got about $150k going into Y Combinator from Y Combinator and associated funders of Y Combinator. Then when we launched, we only reeled in about another $200k, and at the time, I didn’t realize how measly of a funding round that was.

Then at some point we came to a juncture where we needed more funding if we were going to make anything of this. The problem that I ran into when I was raising the funding of our initial round was that a lot of the vision I had for our product was so geared towards altruistic purposes. When I tried to pitch this product to venture capitalists, the framing of this through altruism of improving medical research didn’t really land with a lot of them.

When I did attempt to do those pitches, I found myself really outside of my comfort zone talking about business models that related to using the user data to help pharma companies. It’s a narrative that doesn’t inspire all of the patients that are contributing to this research and actually felt like a bit of a betrayal to them.

Ultimately I became a bit distraught about how I would marry those two worlds to the point where I realized I couldn’t raise the funding and feel true to what I actually wanted to do. So I laid down the computer and decided I needed more time to think about next steps forward.

Over the course of its existence, it grew to 30,000 patients with Crohn’s and colitis throughout the world, and that was all organic. We didn’t spend a dollar on marketing, and we did a horrible job of SEO. We just had an invite feature inside the app that allowed patients to invite their friends that also had the condition. I really think that’s a testament to the product we built.

One thing I understand is that you have about five years on the rest of us when it comes to working with remote teams. What are some of the opportunities and challenges that come with remote work?

I wish I had a good answer for you because even though I spent this amount of time working remotely, I’m still a student of it. Now my role at DrChrono is actually the first time where I’m working with an entire team that is also all working remotely. When I was working with the University of North Carolina, I was one of maybe 30% of our team that was working remotely.

The challenges that I experienced then have largely been alleviated by the fact that now the world understands that remote work is a really big thing and that we need certain services to make that work well for remote workers. Back in the day when I was doing this in 2014 through 2019, social isolation was a big problem that I realized that I was suffering from.

I didn’t have coworkers to see each day, so I had to get my socialization and ongoing education in my trade from outside of work. For socialization, I found that I really loved living in intentional community houses, so I’ve lived in a number of them around the Bay Area. Basically home was a place where socialization and chosen family existed for me. Then for ongoing education, I would do just a lot of Udemy courses and YouTube videos on learning new programming languages in user interface and user experience strategies.

Still, it was really isolating initially, but now it doesn’t feel that way because so many of my friends also work remotely. I’ve partaken in a couple different kinds of digital nomadic tribes, basically, that all work remotely, but we realized that we want to do that from beautiful, fun places around the world. Then outside of working hours, we can really enjoy ourselves together.

I did this in Panama in May of last year; there’s about 20 people and some people working on some well known startups that I won’t name. We’re all co-working from a beach in Panama and enjoying the beach life during the nights and the weekends, and that was something that didn’t exist in the early days of remote working for sure.

Conclusion

This covered some interesting portions of the full podcast episode, but there was much more to learn in the complete conversation. Make sure to check out the full episode here, and if you like what you hear, hit that subscribe button.