How Software Can Fuel Connection

Interviewer: I’m here with Matt Stevens and Steve McCall. Thank you so much guys for taking the time to join us today.

Steve McCall: Thanks so much for having us.

Matt Stevens: Yes, thanks.

Steve: We’re excited.

Interviewer: Absolutely. Let’s start by having you guys telling us a bit about your personal stories and how you got started in this whole world.

Matt: Steve and I met in college, and we got to know each other there and soon after college helped to start a software in the home healthcare space. Went on that journey together trying to figure out, right out of college not really ever working a real job [laughs].

Interviewer: Was that something you studied in college, the software angle?

Matt: No. We studied-

Steve: Not at all.

Matt: -communications. We didn’t really know anything.

Interviewer: What made you decide software was the thing?

Matt: We had a mentor that we had gotten to know as we were ending school. He had the idea and decided to go on that journey together the three of us and build that company and had some great experiences learning about software and operational efficiencies in technology and how it can help the healthcare space providing care, in that case the elderly people for the most part. We sold that business after running it for about five years to a larger tech company. Then we’re starting to work for the man, [laughs] and we didn’t like that. It was more like a real job at that point.

We started looking for what our next project might be, and one of Steve and my best friend’s son overdosed about three days after he had been out treatment. Steve and I were at the hospital with the family trying to help them learn what the different options are, helping them make decisions. That’s when we were really introduced for the first time to the space and saw the good that could happen, the bad with sometimes going into this blackhole after treatment. We thought, “Hey, maybe we could do some good here with some of the experience and learnings that we have gone through”. That’s what brought us here.

Really, we’re outsiders from the space. We didn’t know anyone in the space, didn’t know any treatment centers or any people that had worked in the space. We knew technology. We knew healthcare, and we knew that people needed help and that it had touched our lives in a pretty significant way. That’s what brought us here.

Steve: I think one of the other big things too that we looked at in getting into this space is we’re pretty passionate just about people in general. Matt touched on the healthcare aspect, but I think both of us recognize that trying to provide a difference in people’s lives is something that brings us a lot of satisfaction and makes us excited about going to work. I think that was another reason we got in and tried to get in the space is because we’re passionate about helping people, and this look like a place where people really needed help.

I think the other thing that we learned from our friend’s overdose is so many people come out of treatment and then they lose that connection to the treatment center. How can we help keep people connected, how can we help change what’s going on in the addiction recovery space with relapse rates that are so high, that was something else that really got us excited about what we could do here.

Interviewer: You guys said you met in college. Right? That was in Utah?

Matt: Yes, BYU.

Steve: BYU.

Interviewer: Nice. You said you came out, and you started this software company. Could you tell us a little bit more about what that did, what that first software company did?

Matt: Yes. We did operational software, basically very similar to what in this space we call an EHR for homecare companies. What homecare companies do is they provide caregivers to elderly people that would like to stay in their home instead of going to a nursing home and the operations involved with that, the charts they need to keep, the scheduling. They have a remote workforce. We built GPS technology. We’re first in the space to do GPS clocking in and clocking out these homes for the caregivers to supply the care and report what they’re doing.

We met some amazing people and created some life-long friendships helping this elderly population and really enjoyed that. What we found was that eventually that space was really becoming very synonymous with the home healthcare space that was more nursing based care, so we felt like it might be a really good opportunity for us to merge with this company we were very familiar with in the home healthcare space to help service both lines of those business. Actually, we really felt like it wasn’t the best decision.

We thought at the time that it was going to be really great for our customers to have more options to service more lines of their businesses as they’re evolving. What we found was that when we sold that business, Steve and I and our other business partner lost control. When that happened, they turned what our old approach was was one person working with one center through training, and all the way through you had this one contact that you’re talking to, turned it into a call center, let go a lot of our staff. That was hard on us. They pretty much stopped development and started turning it into trying to do all these process things internally to make it more scalable and things like that, but what that did was it hurt our customers.

A year and half after we were completely out of that business and not working for that company, we were still getting calls from some of our early customers saying, “Hey, we can’t get help. Can you help us?” We were going to some of our customers, spending all day there even though we had nothing to do with the business, just trying to help them. I think that’s really colored the way we’re approaching this space. Steve and I don’t look at this as a quick exit type of a thing. We’re looking at this as something that we are committed to for the long-term and wanting to keep control and being able to have the power to do what’s right because it’s so–
Power is such a big thing in recovery, feeling powerless, and we felt powerless in that situation after we did that. I think it was a great learning experience for us to know that having the ability to have the power to do the right thing is just so important in life and in business.

Interviewer: That’s cool that you had that experience and showed you how fleeting a good thing can be. You had this, and you built this thing up, and you had these customers who you’re really meeting their needs. Then if leadership changes and all that, it can go away pretty quick. Why did you decide to start helping the world of electronic medical records? You said your mentor helped you figure out to go into software. Did he also help with specifically going into electronic medical records, or how did that come about?

Steve: The first software we built was that operational side. It wasn’t technically an EMR, but what we were doing was really similar. We understood that the operational side of how people run businesses. As we were looking out at the different opportunities, we went through actually a lot of different spaces. We looked at in terms of, “Hey, we could build in janitorial, or we could build in construction management”. We could build in all these things, but we just kept getting drawn back to healthcare and the whole operational side of things.

As we went out and started looking at the different softwares in the space, we noticed that, one, there wasn’t that many softwares there. Two, the ones that were there, they did a good job at what they were doing, but we felt like we could provide a lot more technology advances that weren’t being utilized at all. That really helped us hone in on, “Hey, we can build something operationally in the space”, EHR, EMR, whatever you want to call, and we understand how operations work. We’d done that before. Start going out talking to different people in the space, made a lot of great contacts and got their feedback. Everyone we talked to was like, “It’d be so great if you could build an EHR that did this”.
We just kept getting this snowball of ideas of people of things they really wanted that they couldn’t get at the time, so we’re like, “Hey, there’s a great opportunity here. We feel like we’ve got a good foundation. Let’s go after it”. And just started designing and building and putting together those prototypes, taking them to people and getting feedback until we had something that they felt was like, “Hey, this would be something that would solve a lot of the problems we have”.

Interviewer: As you said, you have experience in the home healthcare and now doing this behavioral health recovery, what are some similarities and differences you would say between working in those two fields?

Matt: It’s very similar from a business perspective. In home healthcare, a lot of times there are large players just like in the space, but the majority it’s a very fragmented market meaning a husband wife team might have a treatment center that they run that’s six guests. That’s really all they have. There could be other family or friends relationships where they’re starting businesses. We see a lot of startups coming into the space. There’s a lot of startups coming in that space. Almost sometimes in other industries, having a big corporation can sometimes be a huge advantage. In this space, I don’t necessarily feel that’s the case, just like in home healthcare where when you’re trusting your elderly loved one, your mom or your dad or you’re trusting your son or your daughter or your brother or sister to a treatment center, being able to talk to the owner and talk to the person that runs the center that this is their livelihood and their business and this is what they’re passionate about now, sometimes has a much bigger effect on my choice of going with them than a Walmart.

From a competition standpoint, now the Walmarts of our industry have some great advantages too that counteract. I feel like there’s a good balance where the larger organizations can’t stomp out the little guys, but the little guys aren’t just killing the larger. I feel like there’s a really great balance. It’s very similar to home health care, so it creates a really wonderful space where there’s all sorts of different businesses that have all ranging ways of being successful. With that, as we know in this industry that can- and in the home health industry as well can have ranging effects on ethics and how those businesses are run and the regulation. There’s a lot of similarities I feel like.
Steve: For me, in the home health space, you’ve got a similar kind of workforce to what you have here in recovery as well where you’ve got a variety of different skill sets. You’ve got caregivers that are like techs, and you’ve got nurses that are like the clinicians and the nurses frankly in recovery too. Being able to help manage both of those I think was one of the great advantages we took from the last software we built was, “We understand how to manage a workforce of people from a variety of spectrums”.

In recovery, you’ve got so many techs that are working in the house. How can we give them all the tools they need? Looking at all the different roles and providing them tools is really similar I feel between both of the healthcare side and the recovery side.

Interviewer: As you were hearing all that feedback and how there was a need for this in the recovery side, how did you go about developing Alleva and then launching it I guess a couple years ago?

Matt: Yes. We launched in June of 2017, so we’re nine months in. We have about 40 treatment centers that use us today. We really developed it with a few partners: people that had worked in the recovery space that weren’t necessarily tied to any specific company. Then we had some companies that opened their doors to us and said, “Hey, this is what we’re doing. This is how our process is. This is what we wish would be better”, so we worked with those companies and basically took their feedback.

Sometimes we like to think we’re pretty smart, but really when it comes down to it, we just try to be good listeners. We don’t come up with very many ideas ourselves. It’s more we have the skill set of listening and understanding how to prioritize what’s most important and what’s most valuable and especially now it’s great with our customer base we have now, being able to just listen to their needs and what they want and being able to put the time and effort into building what they need.

Steve: So much of it is just sitting down in their office and watching process and understanding, “Why do you do it like that?” We ask why. We totally listen. We ask lots of questions. “Why do you do it that way? Why don’t you do this?” Most of the time, it’s like, “I do it this way because this is the only way I know how to do it”, and looking at that and saying, “This is how you do that specific task. If we did this way, we could save you this amount of time. Do you think that that makes sense?” Them coming back and saying, “Yes, that’s awesome”, or no, that doesn’t make sense. A lot of it, it was just sit down, watch, listen, provide alternatives, get feedback, and then apply that in the application and see how it worked for them.

Interviewer: That’s cool because at the company where I work, we have the web team. Obviously, we’re creating web applications and websites, and it feels like it’s a similar thing because they’re so deep in the weeds, and they’re such experts at what they’re doing. They have a vision of, “People will do this and then this and this, and this is kind of the journey. This is the user experience”. Sometimes before they launch them, they’ll open it up to the rest of us and be like, “Hey, can you guys test this out?” Because you really don’t know how people are going to actually use it until you ask them, until you see.

Steve: Totally. I think one of the biggest things- Matt really hit on it -is we don’t really try to come out with too many of our own ideas. Especially in building software, you want to make sure it’s stuff that’s validated by the industry first. Anytime we come up with an idea, we’ll go turn to somebody and be like, “Hey, does this really make sense?” Most of the time they’re like, “That’s okay, but this I think would provide a lot of value”. Try not to just go build off on our own because we think we’re smarter than everyone else. That’s not how we do it. We realized that in this space we know how to deliver software. You know how to take care of people. Let’s utilize your knowledge base to make the best software possible.

Interviewer: For people who aren’t familiar with Alleva, how would you introduce an overview of what it does, what it offers and maybe how it’s different than other EMRs that they’re used to?

Matt: I think many of the electronic medical records that have come out over the last 20 years- because it’s been an iterative process as people have come off paper and gone electronic.

Interviewer: People are still coming off paper.

Matt: Yes, people are still coming off paper. I feel like those softwares have done similar processes to what we’re doing. The difference was they were coming off paper, so most of the software out there runs very similar to a paper process when you need to do certain actions for a client. If I’m doing paper, I open the filing cabinet. I take out a folder, and I put something in or take something out or fill something out and put it in, then I closed the filing cabinet. I open a new filing cabinet.
I’m a nerd. I like Harry Potter I think. I look at us as, “Hey, take one piece of paper, write down all the things you need for all these different clients. Then it’s going to magically cut and to all these different flying pieces of paper and fly to these different cabinets”. We’ve tried to re-imagine the way that we can do our clinical work in a clinical setting to the way that is most beneficial to the clinicians and to the staff so that they can be focusing on what they do best, which is the patient care.
I look at it as when people transition to our software off other softwares or even off paper, it’s actually quite a different way of doing their same processes then they have–
Interviewer: The workflow, the user experience.

Matt: Yes, the workflow it’s different. We spend a lot of time and energy training and helping them to do it in this way that is different than they’re used to, which can be scary sometimes, but in the end, it always seems to be a huge value and benefit.

Interviewer: That’s a interesting point because 20 years ago, if you were introducing an EMR, you would’ve been making basically a digital version of the paper, and now you’re beyond that is what you’re saying.

Matt: Yes. It’s like the next iteration of a digital version of previous digital versions. We’ve seen a ton of success in time savings and efficiency and compliance and not missing things that were being missed before and in the way that we can communicate today. What wasn’t being utilized before a huge part of that is the patient interaction. For millennials, which is a big population that’s being serviced in our industry, they’re used to being connected and to have a more free flow of information. The way the EMRs of the past and the systems of the past were built and designed was for the doctors to have the information and then provide care, and then that’s it.
We built tools with technology they have today with apps and video and different technology available to the patients and to the staff to create a new way to care and to communicate back and forth with patients during care and after care. We’re, as far as I know, the first EMR to really bring the patients in to a collaborative process during the actual care that’s being given, not just maybe after care.

Interviewer: Cool. You brought up training is big. It seems like that maybe not an obstacle but a challenge as you’re bringing people on. What are some of the challenges or the barriers you see during that phase?

Steve: The biggest thing with training is just making sure that everyone gets the information they need. What I mean by that, again you’ve got so many different roles, people with different responsibilities within the facilities. Are we spending enough time teaching them about their specific roles and what needs to be accomplished? I think that’s a big thing in training is understanding you’re a clinician. What do you do on a daily basis making sure we solve that?

We put together a pretty good program for training, but every facility still operates a little bit differently. Making sure you tailor your training to how they run their facility to what the different roles are, is something that will constantly be adjusting and updating to make sure people have the best training experience possible.

Matt: We’ve learned from early on when we’re bringing on our first handful of clients to today, we’ve gone through a lot of learnings and roadblocks and stumbling blocks as we’ve learned how to best communicate because when we were building this, we didn’t look at any other EHRs. We knew that we were building some new technology that wasn’t out there, but we didn’t really realize that the process we were building was going to be so different from what had already been out there because we didn’t really think about it. Earlier on, it was definitely like, “Wow, we didn’t know this was going to be a different way than- this different than what you’ve been doing before”.
It took us a little bit to figure out how best to bring people through in an easy way. I really feel like we definitely aren’t perfect yet, but man, we have really cut down on the time and energy that transitions and switch overs take and the amount of impact it has on the business. I feel like we’re on a really good path in our own learning. We’re just always trying to figure it out and stumble along and get better and learn from our mistakes. I always tell everybody on our staff, I want everybody to fail and tell me about how you’re failing, but once you fail, just don’t ever fail at that thing again.

Interviewer: What you were just saying gets back into the outsider element that you were talking about earlier. Could you say a little bit about what it was like coming into this space as an outsider, maybe some things that surprised you about the recovery world?

Matt: A lot of things. We came in right at the very tail end of all the lab upheaval that happened. We didn’t even know that labs were really a big part of treatment when we were initially building our system. That was something that was very shocking so try and navigate, “I didn’t know there was bad players or unethical players”.

Interviewer: People taking advantage.

Matt: Yes. How do we navigate that? Same thing with even patient brokering and things like that, we didn’t know any of that existed. We didn’t know that there was problems with that and even some of the marketing things that the way that you can’t pay commission to your business development people. There’s lots of things there that were just, at least to me, I don’t know about you Steve, was just shocking. You went like, “Whoa, okay. Wow. I didn’t know any of that stuff existed”, so just learning. I feel like we’re actually still pretty naive a lot of the times. We usually just assume everybody is awesome and trying to do their best.

Interviewer: That’s not a bad way to go through life.

Steve: It’s how we go through life in general.

Matt: We’ve definitely learned from the small runway we’ve had thus far. We’re still learning how to best help people to force compliance and just do it the right way and to try and to be bright and do what’s the right thing.

Steve: I think another thing that was at least interesting for me was breaking into the space. You’re in the recovery space, so you’re not. Trying to break down those barriers at the first couple of conferences was something I wasn’t expecting and pretty challenging.

Interviewer: It’s like it was hard for people to recognize that you were a part of this?

Steve: Yes, it’s a super tight knit community, so if you haven’t been in the community before, it’s really hard to become a part of that community. I think the first couple of conferences we’re trying to get our name out there. We’ve got people who have gone through recovery who were on our team too, but Matt and myself haven’t gone through recovery in specific. We’ve worked in healthcare. We’ve had a lot of that experience, but trying to break down that barrier initially was really tough.

As we got to get to know people and people saw that we’re really trying to do business on the up and up, we run a pretty squeaky clean ship, more and more people were becoming excited about what we can offer. Being able to connect with people and have them help us feel included in their community and start to connect with different softwares or partners in the space, building companies and building softwares really helped us to break that barrier where now I feel like people look at us as Alleva we’re part of the community whereas before we were trying to get in that community.

Interviewer: You’re in the club?

Steve: Yes, we’re in the club. Exactly. Totally how I felt for us at the beginning.

Interviewer: I understand. We’re sitting here at this conference. It can be intimidating. It’s like 100 plus exhibitors, 1,000 plus people. It’s tough to come in and say, “Hey, I’m new here”.

Steve: Let me in. I’m the new kid in school.

Interviewer: Interesting.

Matt: It did take a while. I do feel in the last three months, we’ve really feel like there’s been a little bit of a shift in some of that feeling like, “You guys can hang out here”.

[laughter]

Interviewer: I know another thing that can be tricky in this space is HIPAA. This is off the record. Do you guys want to talk about that? Is that something that you deal with in your–?

Matt: We dealt with it in our last softwares. It’s across all healthcare, HIPAA. It just is what it is. You either do it or not.

Interviewer: I’ll ask the questions see if we go somewhere. You’re just not going to want to use it. I know that another thing in the space that can be tricky is HIPAA, and that can restrict a lot of the ways that you can communicate and all that. How do you ensure with your software that you meet those privacy needs while also offering users the best possible experience and taking that information wherever they are?

Steve: I think building software I guess since we got out of college at this point, the entire time has been in the HIPAA environment, so we understand and know it really well.

Interviewer: That was one thing that would be similar between your last-[crosstalk]

Matt: Exactly.

Steve: It’s exactly the same. We understood all the nuances, what are the requirements. I think the biggest thing with HIPAA is you want to provide as much information as you can because taking care of clients is all about getting them whatever they need, and getting that information disseminated across your organization can be really difficult. One of the things we really focus on is making sure that we do everything– We want everyone to be HIPAA compliant because we don’t want anything to happen to any business where they have to shut down, where they get fined. Our whole focus anytime we’re building stuff is that the very first thing from a software perspective is, how do we make this aspect HIPAA compliant?

One of the things that we build into the application is what we call Alleva Presence, and it’s HIPAA compliant video conferencing. One of the things in the space- I’m saying this aloud so you can cut that out -one of the things in the space is people will use FaceTime, they’ll use Skype and they’ll do these different video calls with people, and they’re not HIPAA compliant. We realize that’s a challenge because they need to do that, and sometimes your very first interaction with a potential client or family member is via that FaceTime or that Skype. We said, “How can we solve this within HIPAA?” And went and built that application.

Interviewer: That’s a way for people to interact with potential patients even?

Steve: Totally. They can come. They can do admission screenings. They can do any screenings they want to face-to-face. If they’re doing therapy sessions with family members, they can actually use our app, and it’s got the HIPAA complaint video conferencing. Everything falls in line with those requirements, and they can now take family members, take other people and make them a part of the treatment that we’re doing.

Interviewer: How did you make the video HIPAA compliant? That may be a stupid question.

Steve: It’s just how you house the data. We went and worked with software that’s done it in the past and built that solution and integrated it into our software platform, where now it’s not like Skype. It’s not like FaceTime. Everything conforms to the rules, and we’re not saving it in some server somewhere else. It’s all saved within the application.

Interviewer: Cool. I know we’re starting to talk about technology a little bit more, and that’s something that’s always changing. The way people are using it is always changing. How do you stay on top of that in your business and make sure that your software gives users the experience that they’ve come to expect from technology?

Steve: A quote that we learned a long time ago when we were building the last business is from Wayne Gretzky. They asked him how come you always know, how come you’re always in the right place. He essentially said I’m always going where the puck is going to be. Rather than looking at where people are or trying to worry about any of the other softwares, we say where is this space going? What do these people need? We’re constantly in communication and contact.

Here at conferences, we talk to people all the time, and we find out what they need or what they want. We work with our clients, and we really try to focus on putting out technology that’s going to help further what they’re doing. They may be two years behind what we’re thinking about building, but we validate that as, “In the future, this is going to be a great opportunity”. We put together our prototypes. We design and we review them with people, and then we deliver them and just watch as people start to gravitate towards it. Sometimes we build things that are really- they’re a couple of years early.

Interviewer: It can be a little bit of a risk.

Steve: It can be a little bit of a risk because we’ve just spent a lot of time doing this. In the last business, Matt was talking about GPS tracking for the staff as they’re going out into the field. When we first built it, about 10% of the staff going out had smart phones. Didn’t make a lot of sense at the time but if you look at it now, probably 95% of people have smart phones, so it’s out there, and they could use it. I think that’s a lot of what we’re trying to focus on here at Alleva is what can we do right now. If you look at today, you’re already behind the technology that’s coming from tomorrow.

Interviewer: Anything else to add? All right. Cool. Taking that conversation the next step, how do you see technology moving forward? How do you see it affecting specifically this industry recovery over the next couple of years in the future?

Matt: I know this has been a theme. I’m sure your listeners have learned a lot about home health than they wanted to, but it’s our experience. In that industry, they introduced a star rating system, and what that was is basically it was outcomes and based on your outcome results would dictate the reimbursement level that you would receive reimbursement for treatment. If you were getting good outcomes, you would receive higher reimbursement than someone who’s getting worse outcomes. What it did is it shut down a lot of poor outcome shops, and then a lot of consolidation happened.

Being able to track those outcomes, being able to provide the efficiency and reporting and data needed to make those business decisions to help you continue to drive towards better outcomes is something that we at Alleva are heavily investing in and planning on because we feel that this industry is very similar when we first entered the homecare industry. It’s like the wild west a little bit. That’s how this industry feels to us a little bit, and we see that this type of similar transition that happened in the home healthcare industry is going to happen in this industry.

Technology is going to be a huge driving factor in the ability to stay ahead and on top of those changing regulations and how it will affect reimbursement and how it will affect your business. We’re investing heavily in that knowing that that’s still probably three, maybe four years away. We’re investing heavily in that today to be able to be ready for that for our customers because that’s where we believe it’s going.

Steve: The thing that Matt alluded to too is data is going to be king. If you can extrapolate data and start to understand trends in how you’re providing your care, that’s what’s going to help you get to the next level of providing better outcomes for individuals because all of us are in this space to help people get better. We want to help people get better, and I think providing the tools and the data and the analytics to understand when people are getting better or when people are going to have a relapse episode is going to be incredibly valuable going forward.

Interviewer: I just have a couple lighter questions. Some of these Chip sent, so I may or may not use them. We’ll go through them anyway if you guys are good with that. The first thing I see that you’re CEO, Steve, and you’re president, Matt. What’s the difference between that? How did you guys divide that up in that way?

Steve: Sure, we can talk about that. We basically flipped a coin. Matt and I really run the business together, so president and CEO are essentially the same thing. Matt and I are collectively making decisions. We run things by each other. It’s a really good partnership. I don’t know how many other questions you have in terms of the light questions, but Matt and I essentially are step for step in everything. We went to school together. We’ve lived next door to each other our entire time since school which is kind of weird.

Interviewer: You still live next door to each other today?

Steve: I just moved-

Interviewer: You just moved.

Steve: -last month which is actually a problem.

Interviewer: You’re breaking the bond.

Steve: I did.

Matt: Our daughters are best friends. Our sons are very close in age. I have one on the way now, so I’ve been looking at Steve wondering what’s going on man.
Interviewer: He moved out of the neighborhood, so who knows?

Matt: Yes.

Steve: Matt’s looking at a place by me now. We just do everything. We’re in step in everything, and really we run this business together. It’s a partnership to manage everything.

Matt: The other side is Steve runs the product and the technology and the client experience once they’re in the Alleva fold, and I run more of the what you would call the outreach and business development and the marketing side of the business. That’s also a little bit of that division of responsibilities.

Interviewer: Another thing Chip asked me to ask is why does Matt always wearing orange polo, but I see you’re both wearing orange polos today. Is that a special thing for you, Matt?

Matt: I bought about 30 of these at an Under Armour outlet. I thought they popped, and then I had them embroider our name on them. Every conference I have three of these things, so I wear them. Steve wears them. We have some of our other team members that come and wear them.

Steve: We totally use this though. It’s branding ourselves too. You walk around the conference, and everyone now recognizes that the heather orange Under Armour shirts is Alleva.

Interviewer: You found your niche.

Steve: We did.

Interviewer: Looks like it makes a good team.

Steve: It’s pretty fun.

Matt: We try.

Interviewer: Steve, Matt, thank you so much for your time and for sharing all that with us.

Steve: Thank you so much.

Matt: Thanks.

Steve: We appreciate it.