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Sebastian Seiguer of emocha Health: “Hustle ”

Hustle — early on, we instilled a culture of hustle. We do not shy away from the fact that our work is hard and approach challenges with grit and determination. We are fast, nimble, and strive to complete work with both excellence and rigor. As part of my series called “Five Strategies I Used To Grow My Business […]

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Hustle — early on, we instilled a culture of hustle. We do not shy away from the fact that our work is hard and approach challenges with grit and determination. We are fast, nimble, and strive to complete work with both excellence and rigor.


As part of my series called “Five Strategies I Used To Grow My Business To Reach Seven Figures In Revenue”, I had the pleasure of interviewing Sebastian Seiguer, is the CEO and co-founder of emocha Health where he is responsible for overall company strategy and management. Prior to emocha, he was CEO and co-founder of a German retail chain that scaled nationally to over 25 locations and more than 200 employees. He is fluent in German, Spanish and English, and holds a JD from Columbia Law School and an MBA from the Carey Business School at Johns Hopkins.


Thank you so much for joining us in this interview series! Before we dive in, our readers would love to learn a bit more about you. Can you tell us a story about what brought you to this specific career path?

I’m from Baltimore and went to college and law school in New York. My first job out of law school was working as a junior attorney in London. I became an entrepreneur in 2000 when I started a coffee chain from scratch in Munich, which grew to 25 locations, and €12M in annual revenues. In 2010 I sold the business — I still loved coffee, but I wanted to start a healthcare technology venture, and enrolled in a healthcare-focused MBA program at Johns Hopkins. My parents were doctors, my sister and wife are infectious disease doctors, and I have always been inspired by their dedication and passion to such a noble profession. During my MBA I was looking for the biggest problem that I could solve, and it was obviously medication non-adherence — more than 50% of medication is not taken or not taken as prescribed. I met Dr. Bob Bollinger and his team in 2013, who introduced me to the public health experts at the Baltimore City Health Department. There I discovered Directly Observed Therapy (DOT), a true solution to medication non-adherence — effective but seemingly impossible to scale. I licensed emocha’s technology, one of the first mobile health platforms, from Johns Hopkins in 2014 and built a team of developers, designers, and public health experts to build a digital medication adherence platform. Dr. Bob Bollinger from Johns Hopkins transitioned to our Board of Directors, and Dr. Bollinger now serves as our Medical Director.

Can you share the most interesting story that happened to you since you began at your company?

The most interesting and fascinating thing that happened is that emocha actually worked on the first try. DOT is a daily medication management appointment with a patient, and we believed it could be performed asynchronously, using video recordings. The patient uses an app to video record themselves, talking about how they feel and taking all their medication. The provider reviews and responds back to complete the appointment. People thought we were lunatics. Even I was highly skeptical and nervous launching in Baltimore City and then Harris County, TX in 2014. It worked and I was shocked. We have now evolved the product, layering in some AI to speed up the process. It’s now a life-saver for patients in more than 400 health departments, HIV, asthma, and transplant programs and we’re not the crazy people anymore.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

There are many people and many stories. I am deeply indebted to the NIH and to our investors who have believed in emocha and invested their time. Standing out is Dr. Bob Bollinger, a world-renowned infectious disease doctor at Johns Hopkins. He is also a highly-respected scientist. He named the original platform emocha back in 2008 while drinking with colleagues around a campfire somewhere in rural Uganda. Bob and other clinician scientists have suspended their doubts to try a novel approach to supporting patients remotely.

We’d love to learn a bit about emocha. What is the pain point that emocha company is helping to address?

emocha is a digital platform that solves the decades-old problem of medication non-adherence. At least 50% of patients with chronic diseases don’t take their medication properly, which leads to approximately 300B dollars in avoidable costs — not to mention avoidable pain and suffering. These medications are incredible, but as our Surgeon General Koop stated in the 1980’s “drugs don’t work in people who don’t take them”. emocha supports proper ingestion, inhalation, or injection of medications through a Digital Adherence Program, using a validated, CDC-endorsed public health solution: Directly Observed Therapy (DOT). DOT includes a daily medication appointment, confirmation of adherence at every dose, and most importantly compassionate and frequent human engagement. We make DOT scalable, delivering high adherence and improved clinical outcomes at a fraction of the cost.

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

We leverage a validated public health practice that has proven effective for decades, but which has previously been impossible to scale. Since our inception, we’ve become the standard of care in tuberculosis treatment; thousands of patients across the country use emocha every day to take over 90% of their medication, successfully curing their disease. We’re extremely motivated to apply this same adherence solution to chronic diseases that affect millions of Americans, including asthma, diabetes, hypertension.

When you first started the business, what drove you, what was your primary motivation?

It seemed obvious to me that if we could help patients take their medication consistently and properly, we could directly tie our efforts to their health outcome. I am in healthcare to make it my daily business to help other people who are in difficult circumstances. emocha is a quick, targeted solution that generates an immediate and positive effect.

What drives you now? Is it the same? Did it change? Can you explain what you mean?

Chronic diseases must be managed and often last a lifetime. We had to recreate and evolve emocha to be helpful and achieve an outcome, without requiring lifetime participation by the patients. Our thinking had to change as well as our expectations. We developed a program to get the patient on track fast — and to develop a relationship that allows the patient to access our experts once the intensive program successfully ends.

Are you working on any exciting new projects now? How do you think that will help people?

Our program for asthma is unique in that inhaler technique correction is critical, and so our support of the patient includes a lot of mechanical training and support with breathing technique. Our approach here has evolved and in 2021 we will release some unexpected and surprising modules that will help us set the standard of care for asthma medication adherence.

Seven figures is really a huge milestone. In your experience what was the most difficult part of being able to hit your first million-dollars in sales revenue?

It was not difficult to hit seven figures of revenue. We did that relatively quickly. The challenge is to make revenue repeatable, scalable, with a high gross margin. The hardest part was transitioning to a technology-enabled model for providers who do not have the time to engage with their patients in between visits. Making that model easy to understand and packaging that into a subscription model was a challenge.

Could you share the number one sales strategy that you found helpful to help you reach this milestone? 
Passion and conviction for a goal shared by the customer. When we are aligned on the outcome we are trying to achieve, the customer is energized and inspired by a positive, competent, and aggressive determination to help them help their patients.

Presuming emocha has a sales team, do you have any advice about how companies can create very high performing sales teams?
One element we’ve continuously emphasized for our sales teams, particularly in the past year, is the ability to attach results to metrics and goals. We’ve put a company-wide emphasis on actually tracking our objectives, which lets us know when we are (or aren’t) meeting them, and what we need to do differently. Every single team member at emocha has the ability to pivot rapidly, and under pressure, which has undoubtedly helped spur our sales successes.

What are your “Five Strategies I Used To Grow My Business To Reach Seven Figures In Revenue.” Please share a short story or an example for each.

1. Optimism & Inspiration — To make something happen which has not been done requires the ability to inspire yourself and others. Change is difficult, as is generating the momentum to try something new.

2. Think Big, Creatively — while we started as a technology software, we’ve since created a full service Digital Adherence Program that addresses every facet of medication non-adherence: powered by people.

3. Listen — no CEO or person in leadership has all the answers. Creating an interdisciplinary culture in which teams can not only work together, but listen to each other’s feedback, is always a net positive. We learn continuously from other members of our team, experts in our fields, and continuing education opportunities.

4. Hustle — early on, we instilled a culture of hustle. We do not shy away from the fact that our work is hard and approach challenges with grit and determination. We are fast, nimble, and strive to complete work with both excellence and rigor.

5. Value Design — a large part of our success is attributable to design, particularly in selling the dream before it’s fully baked. We firmly believe that beautifully designed experiences, which are often undervalued in healthcare, will always win.

What would you advise to another business leader who initially went through years of successive growth, but has now reached a standstill. From your experience do you have any general advice about how to boost growth or sales and “restart their engines”?

Sell now, or reinvent your product and services to reach other markets or customers.

In your specific industry what methods have you found to be most effective in order to find and attract the right customers?

The network effect is real and fruitful. Establishing a base network of customers not only helps you solidify what you are doing, but it also leads to newer customers and referrals. These are inbound strategies, however, there is no substitute for heavy outbound outreach. In the end, outbound outreach is critical in a competitive marketplace or where you are trying to make the market, as we are.

This HBR article demonstrates that studies have shown that retaining customers can be far more lucrative than finding new ones. Do you use any specific initiatives to limit customer attrition or customer churn? Can you share some of your advice from your experience about how to limit customer churn?

We experience extremely low churn rates, which is largely attributable to the support we deliver our customers, and the fact that we have developed very rewarding relationships with customers over time. We try to make sure our customers know that there are people behind the product.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be?

If all medications were taken as prescribed by all patients, we would have far fewer avoidable deaths and the promise of these wonder drugs would be realized. Novel medications changed human history and life expectancy in the 20th century — for those who took them properly. In the 21st century we will create a culture where taking all medication properly is the norm. Like wearing your seatbelt.

Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why?

I will take lunch with almost anyone, in a packed, noisy restaurant, with little space on either side of you. The pandemic makes you miss the strangest things.

Thank you so much for this. This was very inspirational, and we wish you only continued success!

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