Too often, people are asked to give away their insights and time for free. Jen Horonjeff, founder and CEO of healthcare startup Savvy, knows this first hand and is trying to change that by applying a cooperative model to her business.
As an infant, Horonjeff was diagnosed with juvenile idiopathic arthritis. Since then, she has been diagnosed with a number of autoimmune conditions. Seven years ago this month, she had a brain tumor removed.
“I’ve just always been somebody who’s been a patient,” Horonjeff tells TechCrunch.
Horonjeff’s experience in the health system led her to become a human factors engineer focused on human-centered design, she says. In that area, work centers on trying to fit the world to people with different abilities, rather than the other way around. From there, Horonjeff, who has her doctorate in environmental medicine, has been most interested in patient-centered outcomes.
“So what matters to patients and what affects their health and health behaviors outside of just the traditional things [are what] we’ve been looking at,” she says. “It was being on that side of the professional equation that I heard my colleagues and partners talking about wanting to help patients, but they were never talking with them. And what they were talking about were not the same priorities as the patient communities that I was part of. And because I’m very open about my condition, they kept coming to me to ask me to be that sole patient representative. When they kept coming back to me, that was really a signal of a diversity issue, since I am white with a Ph.D. in New York City.”
Horonjeff’s discomfort with the lack of diversity led her to become a matchmaker between healthcare innovators and patient communities. This is where the idea for Savvy was born.
“That was really the moment where I realized this needed to be operationalized,” she says. “We need a better way for companies and innovators to connect directly with diverse patients. Otherwise, they keep going to the same low-hanging fruit and creating products or services that only serve a subset of the population.”
Established as a cooperative that shares profits with its users, Savvy connects patients with healthcare companies and other providers looking to better serve people through products and services. Patients can take paid gigs that include tasks like interviews, focus groups and user testing.
“I wanted to make sure that we were not going to create a company that was perpetuating the inequalities and inequities of healthcare by being extractive for patients,” says Horonjeff. “I landed on the idea that this would be a cooperative, that we can give patients ownership so that they can have a voice in what we’re doing and they can share the upside, rather than just taking from them. That works so well with Savvy because the co-op model matches exactly what we do as a business. As a business, we are trying to elevate the patients’ voice and make sure they’re fairly valued.”
Savvy’s clients include digital health companies, pharmacy companies, market research companies and more. Abridge, a startup that helps patients record and document their health-related conversations with doctors and specialists, is one of those clients.
Through Savvy, Abridge has been able to reach about a dozen people with chronic diseases. For Abridge, it’s helpful to be able to reach not just relatively healthy people, but people throughout all parts of the health spectrum, Abridge founder Shivdev Rao tells TechCrunch.
“There is a spectrum of human out there,” he says. “On one end there are very healthy young people and on the other end there are people with multiple chronic diseases. We want to be relevant to the entire spectrum.”
Abridge, which wants to be a people-centered service, is able to access the very people it wants to help through Savvy’s marketplace.
“I think that’s where the puck is going and needs to go in order to create the change the U.S. healthcare system needs to see,” he says.
Tina Aswani Omprakash, who refers to herself as “basically a full-time patient,” got involved with Savvy about a year ago after she had already been doing some patient-advocacy workaround Crohn’s disease. At the time, she was not familiar with the co-op model but it was appealing, she tells TechCrunch, because of the flexible advocacy possibilities.
“With my hectic schedule of maintaining myself and my health and wanting to give back to the community, it seemed like an optimal route to go,” she says. “It allows me to do something for the larger community based on my experience with my sickness. Some people want nothing to do with their sickness when they go into remission. But for me, it’s more about if I can give back to the community or provide my expertise as a patient.”
On top of being able to give back to the community, Omprakash says she feels empowered because she has a stake in Savvy. Patient-members like Omprakash each get one vote at the board level and receive dividends based on participation in the co-op. Omprakesh’s vote is just as valuable as the vote of Horonjeff and other Savvy employees.
Savvy is not yet in a position to pay out any dividends, but when it is, they will be distributed based upon contributions. Additionally, Savvy is legally required to share at least 51 percent of dividends with patron members.
Unlike traditional companies where certain board members may have more votes than other members, each member gets one vote in a co-op.
“But if over the course of the year, you participate a more, use a bunch of apps and recruit a bunch of members to the co-op, you would get a larger percentage of our profits through dividends,” Horonjeff says. “Even though our votes count the same, you would get rewarded for helping the co-op more.”
Savvy is set up as a multi-stakeholder cooperative. Those stakeholders are divided into four classes: patients, Savvy employees, founders and investors. Savvy currently doesn’t have any investors, but if they do take them on, investors can never control more than 50 percent of the company. Savvy is in discussions with investors but Horonjeff says she recognizes that funding co-ops is not easy.
“It’s just because it’s a different structure,” she says. “I have to say a lot of investors are, first of all, not curious. And those that are curious — and we’ve gone down the path with people like that — think we’re this cool new thing, but just don’t understand how it’s going to jive with the rest of their fund. So there aren’t great mechanisms in place to kind of bridge the gap between what people know and what the new economy could look like.”
Despite having no outside funding, Savvy has figured out how to exist on revenue to fully sustain operations. Still, Horonjeff says she wants to connect with funders who are interested in taking the cooperative model and applying it to a large, scalable tech platform.
“We want people that are curious and that are thinking about what is next in this sort of new economy and in the tech platform,” she says. “The way we look at it is co-ops are like network effects taken to the next level. They help make you sticky and really enhance your business.”