Virtual visits and robotics to improve greatly the recovery of stroke patients. Chrissy Glover and her startup, Imago Rehab, are taking to market technology from Harvard's Biodesign Lab informed by deep experience in how stroke rehabilitation is done now.
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Highlights:
Sal Daher Introduces Chrissy Glover, Co-Founder of Imago Rehab
“...they've had a stroke maybe a year ago, and their hand is just stuck in this fist position.”
“It's well understood that what is required for successful recovery is high-intensity rehabilitation.”
300 Repetitions of Hand Movements per Day Is What’s Needed; Stroke Patients Now Get 30 Reps Twice a Week - If They Can Get to the Clinic
The Brain Is a Lot More Plastic Than We Thought, Even the Brain of the Elderly
“...we see people who are five years post-stroke and able to really drastically improve their hand function, which is really exciting.”
With The Robotic Glove in Their Home, Some Patients Go Way Beyond 300 Reps per Day and Have Great Outcomes
Chrissy and Imago Have been Through Mass Challenge
FDA Regulatory Path Is Relatively Simple; Imago Rehab Is Getting Reimbursed for the Virtual Visits Even Before Approval
“We actually just entered the market, which is exciting news for us.”
With Imago Rehab, Sal Daher Has Dèjá Vu from His First Startup Investment, EXOS, Which Involved a Force-Feedback Glove
Co-founder Kristin Nuckols Brings 15 Years of Experience in Occupational Therapy
Technology Developed at the Harvard Biodesign Lab under Professor Conor Walsh Who Is Also a Co-founder
Sal Daher on the Connection Between Creative People and Startups
How Chrissy Glover Decided to Become an Entrepreneur
Chrissy Glover Takes Notes and, More Significantly, Can Read Them!
“You talked about could there be a multiplier effect for therapists where we're taking out some of the mundane tasks so they can really be more efficient with their time.”
Imago Rehab Has the Potential to Build Strong Value for Individual Therapists and Thus Attract Large Numbers of these Sought-after Specialists
Basecamp and Summit Thoughts on Imago Rehab
“We're hyper-focused on stroke in the hand, but then we do have larger aspirations.”
“Actually, in the Biodesign Lab, there is a shoulder and elbow device also in development.”
“It could be learning algorithms, making their work more efficient, making their lives more manageable...Because the limiting factor in therapy is the availability of therapists.”
“This is entrepreneurship. It's Stone Soup.”
“...Imago Rehab, a startup that is getting ready to revolutionize the space of physical rehabilitation remotely...”
ANGEL INVEST BOSTON IS SPONSORED BY:
Purdue University entrepreneurship
Peter Fasse, patent attorney at Fish & Richardson
Robots in Rehab
Guest: Chrissy Glover
Sal Daher Introduces Chrissy Glover, Co-Founder of Imago Rehab
Sal Daher: This podcast is brought to you by Purdue University Entrepreneurship, and by Peter Fasse, Patent Attorney at Fish & Richardson.
Welcome to Angel Invest Boston, conversations with Boston's most interesting founders and angels. Today, we are privileged to have a young founder, Chrissy Glover. Welcome, Chrissy.
Chrissy Glover: So nice to be speaking with you.
Sal Daher: Great. Chrissy Glover is the founder of Imago Rehab. She studied design at Harvard, and she is commercializing technology that was developed at Harvard Engineering School. Harvard does have an engineering school, and like everything else, they do, they're very serious and very top. Let's jump right into it. For your information, I have listeners who grumble if I take too long before I jump into what the startup does. They want to know what the startup does. Chrissy, what problem are you solving with Imago Rehab? Hint, hint.
“...they've had a stroke maybe a year ago, and their hand is just stuck in this fist position.”
Chrissy Glover: There's definitely a hint there in the name. Perfect question. The problem that we're solving is for stroke survivors. There's really no clear path for them to recover hand function. A lot of times, we see patients and they've had a stroke maybe a year ago, and their hand is just stuck in this fist position. They have what's called spasticity, which is muscle tightness. Now, you can imagine, if you have impairment to a full half of your body and you can't even move your hand, you can't open your fingers, how much that drastically would affect your quality of life if you can't even cook, you can't drive for yourself or even pick up your children or your grandchildren.
“It's well understood that what is required for successful recovery is high-intensity rehabilitation.”
Unfortunately, this picture is quite the norm. In the US alone, there are 7 million chronic stroke survivors. Out of those, around 5 million of them end up having this lasting hand impairment. It's quite a big problem and growing too with the aging population, and more people surviving from stroke. Part of the reason why it is a problem is, just the standard of care, it doesn't really address this issue properly. It's well understood that what is required for successful recovery is high-intensity rehabilitation.
What this essentially means would be many repetitions of moving the affected limb, in this case, the hand. Moving it on an order of at least 300 times per day, and then doing this daily. It's really retraining the brain. The more you move your hand, you can either strengthen damaged neural connections between the brain and the hand, or remap new connections. The picture of basically the standard of care, a patient, they'll go to outpatient occupational therapy sessions maybe once or twice a week, but we're dealing with people who they can't even drive, so how are they supposed to get to therapy?
300 Repetitions of Hand Movements per Day Is What’s Needed; Stroke Patients Now Get 30 Reps Twice a Week - If They Can Get to the Clinic
There's travel burdens that prevent access to therapy, but then even when they are there, they still don't receive nearly enough repetitions, moving their hand an average of 30 times per session. Then they're often sent home with a printed-out sheet of paper with exercises they're supposed to do. Still, if you can't move your hand, how the heck are you supposed to do these exercises? That leaves us with this picture of all these individuals who really have not a lot of hand function.
The Brain Is a Lot More Plastic Than We Thought, Even the Brain of the Elderly
Sal Daher: Now, you touched on something really important, and it should be very heartening to people who are getting older, such as I am. It has been discovered that the brain is a lot more plastic, even the brain of older people, and it is capable to rewire, to remap functions to different areas. I just recently read a couple of books. One of them is the Thousand Brains by Jeff Hawkins, and I'm reading now this book called Peak about the ability of the brain to retrain in particular areas. It's about expertise. Still, there's some things in there that talk about the physical reorganization of the brain.
That was a cool study. I don't know if you're familiar with this, done on London cabbies, the people who drive cabs in London. They found that the anterior hippocampus, hippocampus is this area of the brain that helps you find where you are, the anterior hippocampus actually is visibly larger in the people who pass the exam, called it The Knowledge. The longer they drive cabs in London, the bigger the hippocampus gets. After they retire, their hippocampus begins to shrink because they're not using it for navigation.
It is a really glaring example of how the brain, the brain of an adult, rewires, physically rewires. It's astonishing. What that means is that there's a lot of hope for your stroke patients who are needing to get new circuits, old circuits reused so that they can resume function.
“...we see people who are five years post-stroke and able to really drastically improve their hand function, which is really exciting.”
Chrissy Glover: Yes, and thank you for bringing that up, because it's true, there is hope. The old thinking was actually that there's no hope. Once you reach the six months post-stroke time frame, the thinking was, "The recovery that you've made, you're just going to be stuck with it." Now, we know, thanks to newer research, that that's not the case, and you could really keep making gains. In the studies that we've been doing with chronic stroke survivors, we see people who are five years post-stroke and able to really drastically improve their hand function, which is really exciting.
Sal Daher: Even five years though?
Chrissy Glover: Yes, even five years. We've even had one participant who was, I think, 32 years post-stroke. She had quite a young stroke. It's really heartbreaking. Even she was able to increase a little bit of strength too.
Sal Daher: Great. Chrissy, describe the technology for us.
Chrissy Glover: Our solution is two-pronged. In that picture, I described where a patient goes to therapy, and then they also have their home exercises. That's where we have our parallel. First, we meet patients where they are, which is in their home, do telehealth sessions with top stroke therapists. From the patient's perspective, they can't drive, that's fine, we meet them in their living room. Then, of course, if you can't move your hand, talking to someone over zoom isn't going to magically move your hand for you.
The other part is that home program, that printed out sheets of exercises. It's ineffective and we replaced that with wearable robotic devices. What we have developed in the Harvard Biodesign Lab is a soft robotic glove that enables high-intensity limb manipulation. In a single hour-long session of using this device, which also includes a custom app that goes with it, so it facilitates therapy gaming, for example, patient will move their hand 300 times, so 10 times more than what they do in the clinic. Then they have it at home so they can use it daily.
Sal Daher: Typically, over what time span of the day?
With The Robotic Glove in Their Home, Some Patients Go Way Beyond 300 Reps per Day and Have Great Outcomes
Chrissy Glover: That would be about an hour session. Then it's really up to the patient. In our studies, we've actually had some patients who use it twice a day, and then they're getting 600 reps in, and that's great for their recovery. Part of the beauty of it is they have it in their home, and it's really up to them when they want to do the sessions, and they can make it fit their schedule.
Sal Daher: Excellent. Let's talk about how you are hoping to make a profitable business. Would you care to get into, that your business model?
Chrissy Glover: Sure, yes.
Sal Daher: Okay. I understand there's some good news. You have just been accepted to a program.
Chrissy and Imago Have been Through Mass Challenge
Chrissy Glover: Yes. We were just accepted into the AI Labs, Launch Lab X GEO program which we're quite excited about. In this early stage, and I'm a first-time founder, so we need all the help we could get. We are also a Mass Challenge finalist, so currently wrapping up that program. It's been super great too for helping us out.
Sal Daher: Awesome.
Chrissy Glover: Your question on business model. Really, the way that we see it with this two-pronged approach therapy plus device is monthly rehab subscription. The patient will get full use of the glove as a monthly rental. They will also get weekly telehealth calls. Then all of the progress reports and data analytics, that's wrapped up into it too. We measure basically, range of motion, strength to open and close your hand remotely through the glove. Then we could show how the patient progresses over time.
All of that is based around 600 a month in revenue, where it's around 50 to 160 out-of-pocket for the patient, depending on their insurance. With the business model, a big part of the thought process behind it was trying to fit into the current reimbursement landscape, because reimbursement is quite important for stroke survivors if we actually want them to use this, and it to be accessible for them. With that, COVID changed a lot of stuff with telehealth. We're fortunate in that we get to capitalize that on a bit.
FDA Regulatory Path Is Relatively Simple; Imago Rehab Is Getting Reimbursed for the Virtual Visits Even Before Approval
We have the therapy sessions, which are covered through insurance. Then the device itself are immediate, or once we do launch the device, our first reimbursement strategy there is using an existing HCPCS Level II code for a capped monthly rental so that we can cover actually part of the device, even before we do our full clinical trial, and then petition CMS for a custom reimbursement code.
Sal Daher: Interesting. What is the half-year? You mentioned a clinical trial. You're hoping to have reimbursed revenue from the device before you go through clinical trials?
Chrissy Glover: Yes. With our device, it'll be Class I exempt which is good news for us because we actually don't have to do a clinical trial first. We don't have to do 510(k) or any of that. It is a bit of a faster path to market on the regulatory side with actually getting revenue and entering the market. We actually just entered the market, which is exciting news for us.
“We actually just entered the market, which is exciting news for us.”
We're doing what we call our telerehab beta. In this, we are able to treat clients over telehealth sessions or telerehab sessions that are available, while the clients also use a prototype device for free as a loan. We just launched that. We're now treating clients cash pay. We don't have insurance coverage for the therapy sessions yet, but we do have our applications in so that we can be in-network with five payers in Massachusetts.
Sal Daher: Do you expect that by the end of the year, it'll be a reimbursed expense?
Chrissy Glover: Yes. For the therapy sessions. The timeline is a bit uncertain for when those contracts will come in, they say 60 to 90 days for Medicare, and then up to four months for the private payer. We're in the waiting game now, but we do hope Medicare by the end of the year.
With Imago Rehab, Sal Daher Has Dèjá Vu from His First Startup Investment, EXOS, Which Involved a Force-Feedback Glove
Sal Daher: Excellent. This is really interesting for me, fascinating, because I remember that we had a conversation online and I told you that really the first startup that I invested in was a glove that was helping people who had impaired function in their hands, this is circa 1992. It was a force-feedback glove. It measured how much strength the person had in their hand. It was intended for people who were going to get hand surgery. It would help a hand surgeon quantify that. It managed to sell 35 units. The problem was that the technology wasn't there at the time. The computers kept crashing. They didn't have enough computing power on the desktop.
It was a little bit hard to use. They didn't have reimbursement and all of that. The founder decided that she was going to give money back to the investors and by an accident, she ended up pivoting to create a video feedback game controller, and ended up selling the company to Microsoft. [chuckles] It was a very nice exit. It was my first investment as an angel. The founder is Beth Marcus, who is at Amazon now. There is an interview in which I interview Beth and talk about this. For me, it's a little bit like having this feeling of dèjá vu. Oh, a glove for someone with an impaired hand, but it's not 1992. It's almost 2022. It's like, this is extremely interesting.
Chrissy Glover: Thank you. It's exciting for us.
Sal Daher: What are the things that would help you most to get Imago Rehab to the next step?
Co-founder Kristin Nuckols Brings 15 Years of Experience in Occupational Therapy
Chrissy Glover: Yes, that's a great question. Our team-- I don't think I mentioned this, but I'm joined by my co-founder Kristin Nuckols. She's our clinical programming lead. She's been an OT working with stroke survivors for about 15 years now, so she really understands the space and the problem quite well. We have other team members in robotics and hardware. We're all new to this.
We're entering into the telehealth and the digital health space watching other players and watching how the field evolves. Again, it's all new to us. Really, anyone who understands this space better than we do or who has been in this space before in telehealth or digital health more broadly, any connections are super helpful for us. Otherwise, for growing our business, it's a combination of where we're working to create more devices so that we can support more patients.
Then also we're also working to get more patients. We have a wait list now for our patients who are ready to go once we have the devices to support them and the insurance coverage. We're building up our clinician referral network. We love speaking with therapists and clinicians just to hear their feedback on our approach so that we can constantly refine it, and make sure it's the best one out there for the patients to drive the best outcomes. Also, there could be partnerships there or avenues to get more referrals,
Sal Daher: Call to action. People who are familiar with the problem, people who are familiar with medical devices, people who are familiar with rehabilitation, people who invest in these spaces, people who advice company in these spaces, this is a company that you should think about helping for variety of reasons, in addition to just making money, which is a great thing but also serving a tremendous social purpose, which is helping people regain the use of their limbs.
It's an increasing problem. If you are a 40-year-old and you are full of vim and vigor, some day you may have a stroke. Some day you might be 80 and you might have a stroke. There might be this glove out there that is going to help you regain your function so you can get back into the squash court or whatever else you're doing. Tell me a little bit about the founding story. Also include in that how you connected with your co-founder.
Chrissy Glover: Sure. Our founding story, I guess on a personal level first, I guess for me-- I'm a designer by training so in the apparel area and textiles. When I was in high school, I liked sewing, I liked volunteering and helping people. I decided when I grew up, I wanted to make clothes and help people and start a company to do so. Didn't know how, but something that would bring all those pieces together. That led me to study textile and apparel design at SCAD first. Then I got really interested in wearable technology and making textile-based sensors which then eventually led me to do my master's at Harvard and their graduate school of design.
Technology Developed at the Harvard Biodesign Lab under Professor Conor Walsh Who Is Also a Co-founder
While I was there, I started working in Harvard Biodesign Lab with Professor Conor Walsh. When I graduated, I stayed on working in the lab where I joined this project, which was the soft robotic glove for post-stroke hand rehab. I guess I joined the project in, I think 2019. We were getting a team together and really refining the stroke use case for the technology. It was quite clear that the technology was impactful for patients.
Clinicians saw that it met, or they told us it met, an unmet need. Back to my personal passion of starting a company that involves clothing and involves helping people, I ticked the boxes. We were motivated to spin it out. I took the lead on that. Kristin, my co-founder or one of my co-founders, was also a team member on that project, and quite excited about spinning it out, as was our professor, Connor Walsh, who was really supportive of all the efforts.
Sal Daher: He's also co-founder?
Chrissy Glover: Yes. He's also a co-founder. Then our other team member, Diogo, who's our systems engineer in the lab with a lot of past experience in stroke rehabilitation research, he was also really excited about spinning it out. That was the impetus.
Sal Daher: Diogo sounds Portuguese.
Chrissy Glover: Diogo, yes, he's from Brazil.
Sal Daher: He's from Brazil. Yes, Diogo is--
Chrissy Glover: You pronounced it better than I did.
Sal Daher: Diogo is the Portuguese version of Diego, although there are Diego's in Brazil too, and Diogo's in Portugal, I'm sure, but Diogo is the Portuguese version. Anyway, this is really interesting.
Sal Daher on the Connection Between Creative People and Startups
This sets off another connection in my head, which is you fall into the category, you come from a design background, creative, but functional person. This intersection of creativity with functionality, which I see with architects, and I see also with my sound engineer Raul Rosa, who's going to be editing this. He is a guy who's an extremely creative guy, but he's very practical because when you're a sound engineer-- He's also a musician. He's a composer, and so forth.
When you're a sound engineer, you're always working deadlines, and you have the artistic side which pushes you to, really, the idea of perfecting something, which is very close iteration, and so forth, is creating a product, design a product, and perfecting a product, finding product-market fit, getting something to work. Artistic people who are very high-functioning have that ability to keep doing this boring really difficult thing over and over and over until they get it right. Which I see in Raul. For example, he's not a photographer, but he takes great pictures because he sweats the details. He's also a founder.
He's founded a company called PodSpot. I've recorded first podcast there, and I'm going to record more podcasts there. It's a super, removing friction from podcast recording. Raul has this entrepreneurial bent because he's supported himself with his business for decades now. He's been an entrepreneur. Now he's creating this startup, which is pretty cool. I find this connection of creative and functional talent coming together. I see it in architects, I see it in you, I see it in Raul. I just find that fascinating. The idea of starting a company, do you have an example of that in your family or is that something you picked up along the way? How did that come to you?
How Chrissy Glover Decided to Become an Entrepreneur
Chrissy Glover: Good question. I actually don't really know. I guess it's just something that I've wanted to do, but I don't actually know where the impetus came from. I suppose my dad, he worked for himself and worked from home growing up. That's a bit of an example, but no one has done startup or anything like that. I don't know, I don't have a specific example that I could point to other than it's just always-- Like the idea of starting something and figuring things out as you go, and tackling challenges that you have no idea how to tackle them until you get into--
Sal Daher: That's not normal. That's highly unusual. Most people like to do things that are structured, but there's a little bit of challenge inside that structure. When they're given an unstructured situation where they have to create the structure, very few people can do it. I suspect creative people probably can handle that better because creating stuff is highly unstructured. You're creating stuff like that.
Chrissy Glover: Yes. I didn't think about it that way. That's an interesting observation.
Chrissy Glover Takes Notes and, More Significantly, Can Read Them!
Sal Daher: Yes. That's pretty cool. Chrissy, we talked about your business model, and we talked about what you need to go the next step. I had a suggestion for you when we spoke, taking the company in a different direction. I don't recall exactly what it was but I thought it was something that made a lot of sense to me at the time. Do you remember what it was?
Chrissy Glover: I can look back at my notes because I wrote everything down.
Sal Daher: [laughs] She’s so thorough! This is amazing.
Chrissy Glover: [chuckles] I could actually probably find it if I remember the date that we talked. It would probably take a few minutes.
Sal Daher: I'm so flattered. We spoke on August 19th last.
“You talked about could there be a multiplier effect for therapists where we're taking out some of the mundane tasks so they can really be more efficient with their time.”
Chrissy Glover: Okay. I'm looking for-- Oh yes, here it is. You talked about could there be a multiplier effect for therapists where we're taking out some of the mundane tasks so they can really be more efficient with their time. You shared the example of test prep companies where they can help get students to spend more time on studying. Pilot.com was an example you shared too. We have a solution for OTs doing therapy online, making their time more effective. With our solution or a company, we were essentially a virtual clinic. The idea is therapists will work for us. They can work in a contract capacity, some will be full-time.
They're working from home and they're treating patients who are in their home too, so it's all virtual. In that sense, it actually is quite attractive for the therapist. It's pretty normal for OTs, so this industry that we're in, for them to do per diem jobs, or basically hourly jobs. They might do some home health work while also working in a clinic like Spalding, and picking up sessions. If they can also work from home that works well for their lifestyle. We also work with-- This field is primarily female. They're starting families, so that's attractive for them. Also, with the use of the device and this whole system, one thing that makes it all more efficient is we're actually measuring improvement remotely through the device so you don't actually need to be necessarily hands-on with the patient and taking up a full 45-minute session just to do assessments.
Sal Daher: That's the potential that I saw there. I'm thinking pilot.com is a model. Another model that I had in mind, I'm an investor in a company called Finetune Learning. They have a platform that is used by the college board to help human graders grade the AP essays. Basically, they increase the efficiency of a human grader. The last time I saw it, I guess there were 50% improvement in the efficiency. I can see the potential for this becoming greater and greater. The idea of this interaction between algorithms and software, making humans superhumans, I see the potential for that here, not just in terms of using the glove.
Imago Rehab Has the Potential to Build Strong Value for Individual Therapists and Thus Attract Large Numbers of these Sought-after Specialists
That's an important, thing that the devices are important. If this business is pursued the right way, it could be an enormous business that can really scale. You're just going to be more valuable to the members that you have. Another comparison that you could look at is also the people who are doing online therapy behavioral health. There's explosion of that, I've seen, I don't know, three, four companies. One of the things it's doing is alleviating shortages, local shortages. If you need to talk to a psychologist or someone like that, you can sometimes go across state lines.
If you live, I don't know, in Arkansas, in the rural Arkansas, you may not have a psychologist nearby that you need to talk to. That might be someone in Tennessee that they can provide you with help. That's also maybe a model you could be thinking about. This company gets me very excited because of this potential of you taking it the next step. The fact that you took notes of my idle speculations tells me that you do your homework, which is really important.
Chrissy Glover: I remember it was a good idea.
[laughter]
Sal Daher: You don't take notes the way a typical-- My daughter's a physician. Physicians, if they took notes their handwriting, wouldn't be able to read it. Only pharmacists-- This is in the old days, they would scribble something, and only pharmacists could decipher what the doctors had written.
Chrissy Glover: That's funny. My handwriting's not that great, but I suppose it's legible enough.
Basecamp and Summit Thoughts on Imago Rehab
Sal Daher: The base camp goal that you have is to get this device in the homes of patients together with your app, and having these therapists who are mostly women, mostly work part-time, corresponding or interacting with them. Sometimes they'll come to the home. Sometimes they'll just follow up and keep track of how people are doing. Do not underestimate the importance on the therapist's side of being a little bit-- You may have noticed that I've lost some weight since you last saw me. I'm going through a weight loss program, a very structured weight loss program.
I'm very much helped by using Plenity, which is a product of a company that I invested in about 12 years ago called Gelesis. Between Plenity and the HMR Program, I've lost about 40 pounds. One of the important things that they do in this weight loss program is to check in twice a week. There's accountability. If you don't check in, somebody's going to call you. I suppose a therapist should have that kind of accountability and also be able to monitor how the patient is using the device to see if the patient's not using the device. They might give them a little bit more support.
Chrissy Glover: Yes, exactly. We are able to monitor usage and compliance in addition to all the progress reports that we can measure with the glove. It is great. As you're saying, if we see somebody who's not been using it, with the population we're working with, a lot of times the stroke survivor, they might also have depression or just be really lonely because of all the effects of their condition. Having that ability to have a face-to-face interaction, even over zoom, or just a phone call, we've seen and we've heard from the participants in our studies and others who we just interview or do focus groups with that's super meaningful for them.
We've had really high compliance in our study, partly because, or we believe partly because we do have these check-ins. We're talking with them and troubleshooting, is there anything that we can change that will help you be more compliant? Are you facing any issues? We're able to, yes, we're able to see their compliance and then tackle it head-on, figure out what the issue is if compliance drops for any reason.
Sal Daher: This is a silly example, but I just read Why Startups Fail by Tom Eisenmann in preparation for the interview, it'll launch before your interview. Tom Eisenmann is a Professor of Business at Harvard Business School, and he is a specialist in Why Startups Fail. It is a great book. By the way, every single new founder should read Why Startups Fail. As an angel investor, I particularly urge-- I had a conversation about this week, a founder of a company which failed, hey, two-thirds of angel investments fail. Angels are expecting companies to fail, but when you fail, you should make sure that you fail gracefully, as Tom Eisenmann puts it.
One-third of his book is explaining how to fail gracefully, what you do. You don't just go silent and disappear on people, and then they look up your LinkedIn profile and you've taken a job somewhere. What happened to my company? What happened to the money I put in? It's like the next time you're hear from the founder is when you look up-- The founder pops up on LinkedIn having accepted a job in the industry. It's going to happen. Of course, the founder needs to go on if the company isn't working, but there's stuff to be done. There are things to be done so that the investors can take a loss, a tax loss. There are all kinds of things. I highly recommend that book.
Chrissy Glover: Yeah, I just wrote it down.
Sal Daher: One of the companies in there is a company called Baroo, which was a dog-walking service, not the same as important as a physical therapist, but dog-walkers are people who work for themselves. This is one of the problems they had, was that they had their own corporate dog-walkers, it was really hard for them to break in. I always thought that Baroo probably would've been a lot better if it was a Boston company.
I wonder if they had just been a platform to make the life of a dog-walker easier, to supercharge dog-walkers, to make them super dog-walkers. That could have been so much easier to do, acquire customers much faster, probably not as profitable initially, probably not as appealing to VCs initially, but in the long, long run, it could have been a really sustainable business. I think I see that possibility here. There's another company that I'm invested in, it's called Alice's Table. Alice, who was on Shark Tank, she went to Techstars. It's teaching people how to arrange flowers, teaching people how to have nice spreads, and so forth.
The people who are involved are mostly women, the clientele is mostly women, and so forth. I can see a business like this, which is helping women make their lives more productive, more manageable in a more rewarding, and less hectic. I find this, it’s really exciting potential for Imago Rehab, of it being not just rehab, but a big step towards just creating a platform. I'm very excited about this.
“We're hyper-focused on stroke in the hand, but then we do have larger aspirations.”
Chrissy Glover: Thank you. We're excited too. We certainly see where we're starting now as being our starting point. We're hyper-focused on stroke in the hand, but then we do have larger aspirations.
Sal Daher: That's your base camp. Then you got Everest to climb up to.
Chrissy Glover: Yes. We're going to hit Everest tomorrow.
[laughter]
Sal Daher: You're working on your base camp it’s hard enough to get to the base camp with all your equipment, and all your oxygen bottles, and everything else that you have to get ready. Then someday you're going to scale the Everest or K2 or whatever.
Chrissy Glover: I guess our Everest, or our medium Everest, I don't know if it's smaller, or maybe our Mount Washington.
[laughter]
Our medium-term goal is really to be this one-stop virtual clinic for comprehensive post-stroke care, adding other devices so that we're not only treating the hand, but now we can do shoulder, elbow, lower limb as well, even bringing in speech therapists.
Sal Daher: What could be the other devices that would be helpful here?
Chrissy Glover: Stroke, it impairs full half of your body, cognitive impairment, speech impairment. It's not only the hand, just the hand is really meaningful for patients, and it's actually the most difficult to recover. That's part of the reason why we're starting with it.
Sal Daher: Low-hanging fruit.
“Actually, in the Biodesign Lab, there is a shoulder and elbow device also in development.”
Chrissy Glover: Yes. You can imagine if you only have one functioning hand, how much that drastically impacts your quality of life. Actually, in the Biodesign Lab, there is a shoulder and elbow device also in development. There's a chance that we might commercialize it as well. That could be our second offering. Then we can also work on the ankles, so AFOs are commonly used post-stroke
Sal Daher: What are AFOs?
Chrissy Glover: Ankle foot orthoses. You wear it on, it goes up your calf, and it helps with foot drop. It helps to keep your foot in the correct position. It's a similar idea, a high-rep idea of doing lots of repetitions for the neuroplasticity and leading to recovery. It's not only for the hand, you would need to do this for your leg and ankle as well, shoulder, elbow. We really could have other devices to really target all of the limbs.
Then after that, and really being this comprehensive post-stroke solution, our Everest or our bigger vision is really to be a digital health solution for physical rehab more broadly, where we can now expand into other conditions beyond stroke as well. Other neurological conditions such as spinal cord injury, CP, and orthopedic recovery as well. Really, we see our niche as being this virtual clinic, having this telehealth solution, but being able to serve people who need something to facilitate that limb manipulation.
Sal Daher: I think the way that you can create a defensive moat in your business, is to create so much value for the therapist that therapists want to be on your platform and not elsewhere.
Chrissy Glover: Yes, that's a great point.
“It could be learning algorithms, making their work more efficient, making their lives more manageable...Because the limiting factor in therapy is the availability of therapists.”
Sal Daher: For example, it could be the devices that you provide, it could be the software that you have, other things. It could be learning algorithms, making their work more efficient, making their lives more manageable, and so forth. Because the limiting factor in therapy is the availability of therapists. It's only going to get worse, because people are getting old fast, and those professions are professions that are very, very taxing, very difficult. There's going to be massive demand. To the extent that you can make the life of the therapists better, and more productive and more rewarding, more manageable, it has a network effect.
If all the therapists are on your network, or 80% of the therapists are on your network, you're going to get the referrals, you're going to learn more. It's not an immediate network effect, like with Skype, somebody gets-- You want to talk to me, they get a link for you to start. It's not like that, but it's more similar to training, you're going to have a training set for your AI.
I'm really proud to say that the Angel Invest Boston podcast is sponsored by Purdue University Entrepreneurship and Peter Fasse, Patent Attorney at Fish & Richardson. Purdue is exceptional in its support of its faculty, faculty of its top-five engineering school, in helping them get their technology from the lab out to the market, out to industry, out to the clinic.
Peter Fasse is also a great support to entrepreneurs. He is a patent attorney specializing in microfluidics, and has been tremendously helpful to some of the startups which I'm involved, including a startup which came out of Purdue, sub-run technologies. I'm proud to have these two sponsors for my podcast.
Chrissy, we're getting towards the end of our podcast. What I thought I'd do is open up the forum to you to give you a chance to address our audience of people who invest in startups, people who are thinking of founding startups, people who have founded startups, or people who are just interested in startups. What would you like to communicate to them?
Chrissy Glover: I guess given where I am and where our team is, probably I can best communicate with either other early founders or people who are thinking about founding or co-founding a startup since I'm just starting now. I would say if there's something that is interesting to you, and there's a clear problem that you've identified, and now you have this idea maybe you'll start a startup, you might think you need to kind of figure everything out first, because there's a super long timeline of scaling the whole company, and even getting started. I would recommend just jumping into it. Not in a carefree way, still be logical about it.
Sal Daher: Jump into it by first reading Tom Eisenmann's book, in which he will advise you to really do your homework on figuring out if there's an opportunity, what the competition is, and so forth, because one of the causes that people fail most frequently is that they just fail to understand what's out there. They think there's a market opportunity, but there's not. It's like a false positive. That is entirely possible, and you also have to have with that in your minds.
At the same time, you cannot overanalyze because it's never going to be a perfect case study and then it's going to make sense. When you are going to found something, you have to bend reality a little bit, the reality distortion field of the late Steve Jobs, his capacity. Just to an extent, not to the extent of lying to people or doing crazy things, but you have to redefine expectations, redefine what's possible. I agree, get out and start something.
Chrissy Glover: Yes. It'll be a huge challenge, but if you like tackling challenges then you'll just figure out a way to figure out the solution to each little challenge that comes up along the way. A big part of that too is surrounding yourself with others, mentors, advisors who have done this before, can introduce you to other people, and help you, because it seems daunting if you're doing it alone, but you're really not doing it alone. You have a huge network, and really should take advantage of that to help.
Sal Daher: Yes. A word of networking, when you say networking, you're somebody who's used to networking. If you're not used to networking, networking doesn't mean spamming people you don't know. Networking means corresponding with people that you know. It's trying to find ways to have them connect you with the people that might help you. Read Keith Ferrazzi's Never Eat Alone if you want to learn about the networking. Chrissy's noting it down. I can see on the Zencastr video she's writing Ferrazzi's Never Eat Alone, which is true.
This is the idea, is the choice, having lunch with someone. The idea is not to use people in your network, but the idea is reciprocity. People who are helping people out all the time, people just can't wait to help them. It's contagious. They said this person is doing this doing that. She's been so helpful. What can I do for her? It's Stone Soup. Do you remember that story?
Chrissy Glover: I feel like we read that, yes, when I was little.
“This is entrepreneurship. It's Stone Soup.”
Sal Daher: Some people walk in, and there's no food. They're going to make stone soup, and they get everybody excited. The people all of a sudden start coming out with cabbages and onions to put in the stone soup because eventually all they have is water in a kettle, and it makes a fire. Then it turns out to be tremendously tasty. The baker who initially didn't want to have anything to do with these characters comes out and brings bread for everybody. This is entrepreneurship. It's Stone Soup. If you don't know about Stone Soup, look up Stone Soup. Part of the reading list for this podcast. [laughs]
Chrissy Glover: Go home, read a children's book. [laughs]
Sal Daher: I have grandkids. It's fresh in my mind. It's been a long time since you read it, but for me it's fresh.
Chrissy Glover: That's a great analogy, too. Early founders are really generous with helping other founders too. That's something that I've learned. Building a network of other founders is super helpful, too, just so you have others to commiserate with and share challenges with, and help each other out along the way.
“...Imago Rehab, a startup that is getting ready to revolutionize the space of physical rehabilitation remotely...”
Sal Daher: This is very true. Chrissy Glover, co-founder of Imago Rehab, a startup that is getting ready to revolutionize the space of physical rehabilitation remotely, in the home is a person who takes notes, does her homework, and has ahead of her a very challenging, but I think a very doable task of creating this tremendously valuable startup that's going to help a lot of people. Thanks for being on the podcast, Chrissy.
Chrissy Glover: Thanks so much for having me, Sal. It's been a joy.
Sal Daher: Great. This is Angel Invest Boston. I'm Sal Daher. Thanks for listening.
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I'm glad you were able to join us. Our engineer is Raul Rosa. Our theme was composed by John McKusick. Our graphic design is by Katharine Woodman-Maynard. Our host is coached by Grace Daher.
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