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Patient Acquisition When Building from Scratch


You order your food on an app, you order your furniture on an app, you plan your travel on an app… So why shouldn’t there be something similar for your healthcare? Jenny welcomes Sal Braico, CEO and Co-Founder of Pivotal Health, to the show to explain how he has pulled it off. Sal has worked in healthcare for 20 years, and still realizes just how difficult it can be to navigate the confusing and changing world of health insurance and care. On top of that, realizing the barriers to access for many people to even get the care they need. He discovered some organizations doing clinician house calls, which was great, but Sal knew that this could be something much more by leveraging tech and automation. So he and his friend, who happens to be a tech entrepreneur, started their own company and did just that. With their combined experience, they were able to choose the right tools, and the right designs to streamline processes in a remarkable way. 

They began marketing and outreach, and they’ve expanded to other cities around Wisconsin. The response has been overwhelming and in fact, many people think it’s too good to be true. Using methods from online shopping and bringing it into the healthcare realm is reshaping the way that people can control their medical needs with more ease and convenience.

Watch their discussion below or listen to the podcast, We Are Marketing Happy – A Healthcare Marketing Podcast.

Other Links and Resources

Learn more about Pivotal Health:

Connect with Sal on LinkedIn:

Connect with Jenny on LinkedIn:


Full Transcript:

Jenny: [00:00:00] Hi, I’m Jenny Bristow and I’m the CEO and founder of Hedy & Hopp, a healthcare marketing agency based in the Midwest. We started the We Are, Marketing Happy podcast because of our passion for improving patients’ access to care. And understanding the innovations and shifts in the healthcare industry are key to making that happen.

Please follow, share, and let us know what topics you’d like for us to cover next. Enjoy.

Hi friends. Welcome to today’s episode of We Are, Marketing Happy. Today, I am super excited to have Sal Braico on. He is the CEO and co-founder of Pivotal Health, which is a company located in Wisconsin. They’re in three metro regions right now, and they’re really changing the way that consumers have the ability to access health care.

So Sal, I’d love to start off with you just telling us a little bit about your organization, the timeline, when it started, and what you’re doing to be able to provide patients this [00:01:00] improved access to care. 

SAL: Yeah. Jenny, thank you so much for having me on. So, you know, I’ve been in healthcare for about 20 years now. I’ve started, run, and scaled multiple healthcare companies, so I’ve seen healthcare from many different angles. Over the years, I’ve just become more frustrated myself with having to try to navigate it. You know, even as someone that understands how health insurance works and kind of what’s, going on in a provider organization.

It’s still difficult for someone like me to even make appointments and get prescriptions filled and to try to get help from my family. And it’s, it seems like it’s almost purposely designed to be confusing and you know, that’s not the case, but, that’s what it seems like.

And, again, that’s coming from someone who really understands healthcare. So, someone who doesn’t really understand healthcare, someone who hasn’t been in this industry for [00:02:00] so long. I mean, I can’t imagine what it seems like for them. So back in early 2020, I ran across a couple of companies across the country that were doing these clinician house calls, and I thought, Oh, that’s pretty cool.

I really like that. I really like that it brings the healthcare to the patient right off the bat. That should be a better way so, I recruited a friend of mine, Pete Johnson, who is a tech entrepreneur. He’s started run, scaled, multiple tech companies. And so he and I started to dig into this.

You know, there are these other companies that are doing these house calls. Most of them are not really leveraging tech in smart ways. They’re basically recreating traditional healthcare organizations with the big billing teams and the big reception teams and all this kind of stuff. And you know, if you try to use their app, it’s not a true app.

It’s just like a web form kind of thing. And it doesn’t really seem like it’s integrated with their electronic medical record. I mean, it just triggers them [00:03:00] to call. So we said, okay. We can leverage tech in a smarter way to really automate everything around the visit. Because the value in healthcare happens when the provider is with the patient, right?

That’s when the value happens. Everything else is a drain. And so we’ve automated the scheduling, the triage, the payments, the charting. All these things we’ve automated so that the provider can very cost effectively go to you at a time that you pick. 

And so we started the company in late 2020. We started seeing patients in the Madison, Wisconsin area, spring of 2021. And it was like a friends and family kind of thing, just kind of letting people know. Before that we actually recruited a Chief medical Officer, Dr. Andrew Culp. So he actually started the company with us, and he’s a [00:04:00] very entrepreneurial clinician.

You know, like I said, we would let people know, Hey, we’re just kind of doing this. We were starting to get our contracts with insurance companies and so, you know, over time now we’re in network with all major payers and so then fall of 2021, it really started to take off. And then we opened up a second metro office in the Milwaukee area, and we have kept on growing.

And then in August we opened up in Lacrosse, Wisconsin. So now we’re seeing patients in three metro areas. Like I said, we’re in network with all major payers. We’ve got full-time providers out there seeing patients. We have a very small back office because like I said, we’re automating almost everything and people love it.

Jenny: I completely understand why they love it. I’m in St. Louis, so I cannot use your services yet. I hope you come south soon. I have three young boys and I can only imagine the ease and amazingness of having somebody come to my home for them [00:05:00] whenever illness strikes. 

So let’s talk about your app a little bit more because I think we’ve worked with really large hospital systems in the process of watching them try to integrate their existing systems into an app is always a huge headache. And they always say at some point during the process, Oh, I wish we could just throw everything away and start over from scratch. And you had the beautiful ability to actually start from scratch with no preconceived notions about what what it had to look like.

So talk to me a little bit about that process and then also from the patient’s perspective, the ease of scheduling an appointment. 

SAL: Sure. So I mean, you’re right. I mean, when you have these huge legacy systems and processes, it is incredibly difficult to try to build new solutions around those. And I ran a healthcare IT company before this, so I mean, I’ve seen it firsthand.

So with this opportunity, we were able to really look for best of breed tools, you know, the best tools out there that would [00:06:00] serve this mission, right? And so we chose. Athena Electronic Medical Record. That’s our backend. And the reason why that we picked that was because it had the most robust APIs out, by far.

So we knew that we can build our own mobile app and do other things that would fully integrate with that. So we’ve saved a tremendous amount of cost too, because we didn’t have to have like a big database. We didn’t have to implement Oracle or, you know, SQL Server or Snowflake or anything because we’re using the electronic medical record as the backend. 

You know, the cost to develop apps has come down tremendously. I mean, you know, years ago what we did would’ve cost millions. Right? We did this for a couple hundred thousand. I mean, that’s amazing. Really. And you know, with my background, with Pete’s background, we were able to really kind of, again, follow best practices, what is the best design, you know, get a really good [00:07:00] specification for the app so that again, it’s super, super easy. 

Jenny: So you have this app, you have the entire system set up ready to serve patients. What was your go to market strategy? How did you actually raise awareness within the patient populations of the metro areas? 

I mean, it was a lot of, um, social media just trying to get the, you know, um, get the word out there.

SAL: You know, This is, this is not a solution that’s for everyone. There are a lot of people that really like going to the doctor and they like to sit in the waiting room. I don’t know why, but there are people that actually like that. And so, but there are populations that this is perfect for who immediately see the value.

And that tends to skew a little bit younger. You know, people are so used to ordering food with their phone to ordering mattresses with their phone. I mean, years ago to buy a a mattress, you had to go to the store. You go and you lay down on the mattress and, Oh yeah, I think this is okay, And then you would like buy it. Now you just go to, um, Casper or to [00:08:00] whatever, and you just place the order and the thing shows up at your outdoor. People are used to that. And during Covid that accelerated, Right. Even more so, you know, it’s reaching those target populations, um, getting the word out there, like I said, via social media.

We do some Google AdWords. We’ve started to reach out to employers that have the health plans that we’re contracted with, and that’s been really successful because it’s not a sale. I’m not going to them with some new digital health tool that’s like, Oh, we’re gonna save you money, right? I mean everyone says that, right?

It’s like, No, this is in network. This is super convenient, and people immediately see the value. Actually, the most common response that I get, Oh, I don’t believe you. I don’t believe that you guys are doing this. No. I’m like, No, no, no. I’m serious. You, you picked the time. You tell us how we show up at your house.

Oh, and by the way, it costs the same or less. People were like, No, I, No. Come on. I’m like, Yeah, no, I’m [00:09:00] serious. So that, that’s the biggest challenge that we have, is to convince people that we’re not full of it. Like this is real. We’re actually doing this today. I mean, all of the traditional hospital systems, there’s so much bureaucracy.

Jenny: The thought of somebody being able to just start from scratch and make it this easy does seem crazy. So it sounds like as you’re walking through your target audience, it sounds like you’ve done a lot of persona development work of really understanding who the buyer is what their pain points are. I mean, did you go through a formal process of defining that or is it something that you just kind of knew from the beginning and have kind of followed that path?

SAL: Yeah, I mean, we knew from the beginning because we are the perfect customer, right? We’re all busy professionals. I mean, so we built something that I want to use, you know, this is common sense. I mean, you know, people wanna save time, right? People want to get things on their schedule.

There’s processes, you know, that Amazon or these other companies have already created that we’re [00:10:00] copying. I mean, buying things from your app is, People have been doing that for, for years. It’s gotten better and better over time, but we’re just bringing those things into healthcare.

Healthcare still uses faxes. I still, I laugh whenever I hear someone say fax. I’m like, I can’t believe. I mean, but we’re still, that’s how healthcare is, right? It’s so far behind, right? Yeah. And then also, also what I’ve seen too is. A lot of traditional healthcare organizations, they look at these rules and they kind of take it to the extreme right?

Like, they’re like, Well, you can’t use, um, text message. I say, Well, wait, why? I said, Yes, you can. Sure you can. If the patient consents to it, you can, you can definitely text message. Now, you know, we’re not gonna text you a sensitive test result, right? We’re not gonna do that. Patients want to communicate in that way and as long as they consent to and all that kind of stuff, it’s totally fine. I mean, I could, if you consent to it, I could take your test results. I could put them [00:11:00] on a, on a billboard. If you consent to it. It’s all about consent for sure. That’s how it is, right? I’ve seen bigger organizations are like, Oh, we can’t use SMS text.

Jenny: Yes, absolutely. Everybody’s so afraid about HIPAA compliance that they just choose not to engage at all with smart technology.

SAL: Right, And you just have to do it smart. You have to, you know, But that’s what patients want. That’s how they’re communicating with their friends. That’s how I mean that when, when I’m talking with my kids, it’s through text message.

Right? That’s how, that’s what it is, right? I mean, you know, and, and that’s what people want. And so that’s what we’re doing is just kind of bringing it to what people want. 

Jenny: So where should we expect to see you in the next five years? What’s gonna happen with Pivotal? 

SAL: We’re growing, we’re looking to expand to more metro areas.

We’re trying to figure out what are the next metro areas. Having started in Wisconsin makes logical sense for us to expand [00:12:00] to other states in the middle of the country. But we’ll see. As entrepreneurs, we are very opportunistic. So maybe we’ll pop up in Charlotte or in Atlanta.

I can’t say for sure, but St. Louis. Maybe we’re, we’re definitely looking at it, it’s on our short list. I mean, what we know is that people love this, right? And so it’s, there really is no place in the country that we can’t go to. So it’s just a question of us trying to use our resources as smartly as we can to figure out what makes the most sense.

Jenny: Absolutely. Well, Sal, I wish you nothing but the best. I’m so excited to watch your trajectory over the next couple of years. Thank you for being on. 

For all listeners, I’m gonna put not only a link to Sal’s LinkedIn profile in the notes, but also we’ll link to their website. So if you wanna learn more about Pivotal Health, you can dig in.So thanks for tuning in folks before to seeing you on the next episode.[00:13:00]



About the Author

Jenny Bristow is the CEO and Founder of Hedy & Hopp. Prior to starting Hedy & Hopp, Jenny launched, grew and sold a digital agency in Seattle and worked at Amazon. She was named one of St. Louis Business Journal’s 30 under 30, won a Stevie Award for Female Entrepreneur of the Year in 2018 and speaks regularly at healthcare marketing industry events.

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