Tag Archives: management

  • 0

Not It!

Tags : 

(Or the difficult case of monetizing mobile Mental Health Care Solutions)

Get a crowd of people together and ask who should pay for mental health treatment, and the likely result is a race to see who can shout out “Not It!” the fastest.

With the stigma that still exists around mental health some individuals can be embarrassed or uncomfortable to even seek treatment, let alone contemplate spending their money on it. When they do think about spending their money, they end up with bumper stickers saying “Gone Fishin’! ‘Cause it’s cheaper than therapy!” There’s also the large population that needs help but simply can’t afford it.

Outside of individuals, you certainly cannot go asking the trained professionals to stop making a living by demanding they give away their expertise for free. Prior to the Affordable Care Act here in the U.S., some of the insurance people would be the first to flee, and depending on your country, your government organization may have just ran out of the room pretending they didn’t hear the question at all, while others flat out say: “What? Health care? Wait! Not even health care, you mean mental health care? We’re not paying for that!”

Sure that’s a broad generalization, somewhat exaggerated for effect, but I bet you know exactly what I mean. And that’s for mental health care as a whole.

What happens when you start to throw technology into the mix? Who pays for that? 

At the beginning of our journey here at WeFeel, we had to figure out that exact question. Something that is often forgotten is that technology costs money to develop, and companies must have a revenue stream to exist. The ridiculous amount of “free” apps have conditioned people to think that if it is on your mobile device it shouldn’t cost anything, while they having given in to being inundated with ads. We knew from the beginning the monetizing a mental health care service via advertising was fundamentally a horrible idea. I’m sure you can imagine some of the damaging scenarios that could occur when the two are mixed.

We decided to go out and talk to experts to see what had been figured out so far, but what we found was disappointing in the lack of quality and quantity of information. The vast majority of our research and advice showed that no one really knew. We were told people won’t pay for anything considered an “App.” We found that people had tried with mental health care apps before and failed because they couldn’t crack this one issue. We spoke with local practitioners, and the overwhelming feedback was they couldn’t see adopting technology if it meant they had to purchase something for their clients to use. So we sat down and decided we’d have to figure it out ourselves.

When data is lacking, logic and experimentation come to the rescue

Here is our thinking about different models:

Advertising revenue: As mentioned above this was simply a “No.” If it was the only way, then we’d simply rather not create the company.

Free: From the beginning, we knew that WeFeel had to have a plan to make money. That’s not why WeFeel exists, but we knew that we wanted features that no one was doing yet, like the ability to share data between individuals. That meant servers and technology running in “the cloud” (specifically Microsoft’s Azure in our case). That costs money, as does continuously improving the service and providing tech support. While we looked into creating the company as a 503c nonprofit, from a practicality side it just couldn’t work that way. So free was out.

One-time fee: Many apps are sold by paying a fee to an app store and then you get the app. The problem with this model is it generally only works if the data is stored locally on the device, because you don’t have the overhead of the cloud and often you don’t provide technical support (or if you do you charge a lot more). Storing data locally doesn’t allow for sharing between people, syncing between multiple devices, or restoring data if you loose your phone. Those were all key features we wanted in WeFeel, and so this model simply couldn’t work, unless we started releasing new versions and requiring people to purchase them each time one was released, and that gets old…fast.

Provider-based subscriptions: In this model, each mental health care provider pays a monthly subscription, and in return gets a number of licenses that they can give to their clients. The overwhelming feedback we found here in Utah is that many of them simply couldn’t afford it, or couldn’t be bothered with that. We talked to some people who had attempted that model before and couldn’t gain traction. Another drawback we found is that if a person switched therapists they would loose access to WeFeel unless the new provider also had a subscription. This made no sense to us. A person’s mental health is theirs to own, and if WeFeel can help the individual we don’t want access to be controlled by someone else. In fact a core tenant of WeFeel is that the individual owns and controls their data. A provider-based subscription simply won’t allow us to meet that objective.

Individual-based subscriptions: Thanks to companies like Netflix, Microsoft, Amazon, Spotify, and Pandora consumers are becoming more and more used to buying technology as a service. And yes, while we also sometimes think “not another subscription to pay!” in this case we think it makes sense. Our costs are tied to the usage of the service. More importantly it gives us some unique benefits. First,it also allows us to have a base, free-version of the app for people to try that limits access to the things that cost us the most to deliver: sharing, journaling, and hosting large amounts of data. Then because we can sell the subscription via app stores directly in the WeFeel app, it means we don’t have to store any identifiable information from the customer on our end. No credit cards, no email addresses, or phone numbers. We simply get paid a percentage from the app store.

This is huge for us in maintaining things like HIPAA compliance, and more importantly for us to help people feel comfortable logging their deepest emotions, since we physically can’t know who they are. The individual also gets to not only own their data, but to control who has access to it, including the ability to stop sharing with their therapist. By doing it this way we’ve created the concept of a mental health record that transfers from therapist to therapist at the control of the patient. We think that’s pretty cool.

But there are some downsides. What happens if a large organization wants to buy subscriptions for people? We solved that by creating a licensing portal that maintains anonymity, and when an organization buys a license they are purchasing it on behalf of the individual. Once a patient is licensed that subscription is tied to the patient, and not the organization. This is pretty much a hybrid of the individual-based and provider-based models.

The final hurdle is what is the right price? And to be honest we’re still working that out. Typically you price this things based on the utility they provide, but how do you value the ability to improve one’s mental health? We could compare it to medication and say many people spend upwards of $30 a month on pills, and so we could randomly state “we’re easily worth half that so $15 a month sounds right!” We could argue one’s mental health is worth more than watching TV, and Netflix is around $10 a month, so $10-$15 a month is still about right.

The problem is when comparing to those kinds of things, people simply do not want to pay for mental health services.  Showing the value of the service doesn’t necessarily work, and we don’t have enough data yet to make definitive statements like “WeFeel reduces the need for the number of sessions per patient by 10%”

So here’s where we are right now, we spent some time looking at subscription prices that we felt in general most people could afford. Then we did some experimentation. We initially tried $60 a year, which was seen as a bit high but doable by most of the people we spoke with. We didn’t randomly pull that number out of a hat, it was based on cost projections and helping to grow the company rapidly.

And it seemed OK, until we had couples come into the mix. In couples therapy you really need two subscriptions, and $120 a year per family was higher than some of our early adopters could afford.

We changed our growth model and dropped the price to $40 a year, and for many that was OK, even couples. But we were finding that the therapists in our test program were reluctant to ask a patient to go out and spend $40. So to alleviate that concern we put WeFeel on sale at $20 a year. Now the therapist could say that its roughly the same price you would spend on pens and notepads for a year, which you’d be buying anyway to do your “homework.”

For the sake of transparency, I don’t know that as a company we can sustain that $20 sale price for the long term (though I’d like to be able to). That low of a rate means we have to have 3 times as many subscribers to break even. But in the early stages of a company, especially when you are trying to create a market, sometimes a “low low price of just $19.99!” is what you have to do.

If you’ve made it this far, I’d love to get your feedback as to what you think is not only fair, but practical for your patients.

Finally, for those in the industry, we’ve also heard your concerns regarding people who can’t afford WeFeel at any price. How do we get WeFeel into their hands? I’ve been thinking a lot about that lately. And I’d like to run something by you all.

What if we instituted a pay it forward program?

Essentially it would work like this, each paid subscription would include the one for the individual who paid for it, and one to be donated to someone in need. To do this it would have to be all or nothing. Remember we don’t have a way to track who paid for what. That’s on purpose, but means we can’t allow a person to buy two subscriptions at a discount and then choose to donate one. It also means we’d have to at least bring subscription prices up to a point that we could cover the operating costs of a second subscription. So what are your thoughts? Would your patients be encouraged by the fact that in getting a subscription they are also helping someone in need? Would they see it as an added burden?

I look forward to hearing responses. Feel free to comment here on this post, or to email me directly at jeff@wefeel.us


  • 0

Borrowed Trust: who’s your lender?

Tags : 

 (or When did I lose my ability to decide where to eat without the whole planet’s input?)

As you navigate through this age of overloaded information, you’ll find that, by necessity, you will have to take shortcuts when it comes time to making decisions.  If you use Yelp, Amazon, EBay, or any other service that features reviews given by people “just like you” then you probably have taken one of those shortcuts.  You know what I’m talking about, ’cause just like me you’ve thought:

“I’ve never heard of The Steaming Burrito, but 92% of the reviewers say it’s the best, and so I shall dine there tonight!”*

For me, and maybe some of you, it’s become an addiction. Maybe addiction isn’t the right word.  More like it has become so deeply integrated into my process that I won’t eat it, buy it, watch it, or hire it unless I can find something online that tells me it’s OK.  Anonymous validation that if I want a steaming burrito, it’s gonna be good (and not overstuffed).

Crowd sourced information can help us make better decisions

If you are from the “When I was young our video games had 8-bits, one d-pad, and two buttons and we grateful to have it because our parents’ video games were rocks!” generation you’ll remember a time when you talked to actual people to get an opinion on a purchase, new restaurant,  or movie.  Well some of us did that, some of us who aren’t so good with the talking just found one thing we liked and stuck with it.

But even the most outgoing, know-everyone individual still had a limited pool of knowledge to draw from.  We made lots of bad purchasing decisions.  Case in point:

While people have been pondering the concept of the “Wisdom of the Crowd” for a long time (we’re talking more than 2000 years ago when Aristotle wrote about it), there hasn’t been a way for an individual to have near instantaneous access to the thoughts and opinions of huge amounts of people until fairly recently in human history.

Lior Zoref, showed us what can happen if we take the idea of crowd sourced thinking to the extreme back in 2012 when he gave the first ever crowdsourced TED talk. He recreated a classic example of guessing the weight of an OX by bringing a live ox on stage, the results are impressive.

So that settles it right?  Evidence says turning to the crowd to make decisions is a good idea. I like good ideas. I like not having to expend mental energy on figuring out if I should spend my money on the latest mediocre remake of a mediocre movie from a time when I thought giant, sarcastic turtles that know karate were a good idea.

But…(and this time I’m not gonna flip it)

When we use online opinions we are borrowing anonymous trust

One of the benefits of the good ol’ days…or maybe just ol’ days, is that when we went and asked for an opinion from someone, we also had an existing relationship of trust with that individual.  We wouldn’t have asked them in the first place if we didn’t put some weight into the validity of their response.  That’s not to say, we don’t still ask our friends for advice, but that in many cases we have taken something that used to have an initial barrier of “Do I trust what this person will tell me?” and turned it into “Since lots of people have an opinion on this, it is equally (or more) valid than that of someone I know.”

We choose to seek out someone (anyone!) who already has built a trust with whomever we want to deal with so that we can minimize our risk. Once we find them, we can borrow their trust until we have some of our own.  The more people we borrow from, the more confident we are that we have made a correct decision. And thanks to group feedback systems, there are now efficient means of borrowing huge amounts of trust:

5247 people gave it 5 stars, it must be good!

It’s crazy if you think about it, in less than a generation we went from depending on the voice of a trusted few, to the voice of thousands of random people to help us with our decision making process. There’s just a slight problem with that:

Anonymous trust can be purchased, faked and manipulated

In our efforts to make efficient decisions, we’ve inadvertently made the online review such a valuable commodity that it’s now become subject to Campbell’s law/Goodhart’s law.  The gist of these laws/rules say that the more important a measure becomes, the more susceptible to corruption it becomes and that once a measure of something becomes a target/goal, it no longer is a good measure.

For example, on Yelp you have a restaurant and you know that 5 star restaurants get way more business than three star ones.  You need to boost that rating and so you “bribe” your patrons by giving a 10% off coupon when they post a 5 star review.  You took what was a good idea, providing people with a means of judging quality, and corrupted it by buying good reviews in order to draw in even more customers. As an aside I need to mention that, Yelp is doing all they can to fight these purchased and faked reviews.

And that brings me to what prompted this post.  Back when we were working on our (unfortunately failed) Kickstarter campaign, we were contacted by people offering to sell us likes on Twitter and Facebook.  There were places that would take our money to pledge it right back to our campaign in order to make it look like we had more real supporters.

We could buy fake trust and lend it out to all those people who needed to borrow some in order to trust what we were doing.  Being the naive not-so-little Aspie that I am, it made no sense to me until I started looking into the value of borrowed trust.  It turns out cheating the system is a huge thing.

You can go to fiverr.com and find thousands of people willing to sell you a review, but if you are thinking you could make a quick buck this way, you might get sued. And if you are a merchant buying fake reviews- Amazon’s already sued thousands of its own vendors so you could be next.

So what are we as intelligent (you are still reading this post that has gone waaaaay long, so you clearly are smart) individuals supposed to do? I did the search for you and found a piece of advice that I really liked on a page from some attorneysthat will get fake bad reviews removed for you:

Trust the 3 star review

That’s something I never thought about. I normally jump to the 5 stars and then the 1 stars and ignore pretty much everything else.  Logical to me- see what the best and worst of something is.  But something in that article stuck with me:“Nobody leaves a fake three star review.”

So for me, I’m going to change how I borrow trust.  I will start by looking at the 3s; taking the time to read the comments.   People who post 3 star reviews seem to point out both the good and the bad of whatever it is they are reviewing. There’s no rabid fan loyalty and no agenda. I’m certainly not saying don’t trust places with 5 star reviews, and definitely not saying choose the mediocre 3 star somethings.

Give loyalty to the services that are the best out there.  Just be smart about the unknown.  The trust you are borrowing may not be real.  If honesty is what you value you most in your trust lender, then right there in the middle with the 3s are a great place to start.

*Ok, so I made up “The Steaming Burrito” but you know what I mean.


  • 0

Blurry Lines, Corporate Caste Systems, and the Emotionally Detached Leader

Tags : 

I love lines, and boxes, and points of demarcation.  Everything in its file drawer in my head.  This is mine, that is yours. Useful person, Useless person. Godlike senior executive, plebian workers to be expended at will.

Oh wait. I think that last one may be wrong. Or maybe it’s not. No. It’s gotta be wrong doesn’t it?

What I mean to say is, traditional management teaches us to not get too close to those who work for us.  I know this ’cause I was learned it in the University.  I been gived readin’ books on “how to be a great boss” that done did said it.  Some’un wrotes it.  Must be gospel.

Just because an expert said something doesn’t make it the right thing for you

Here’s the problem with lines: Different people (often “experts” in their field) draw the lines in different places. This causes me all kinds of trouble. I go through phases of voraciously reading everything I can about a topic, and often end up with very conflicting points of view on the same subject bouncing around in my  head.  I have to actually think and come up with my own conclusions.

 

Many of the places I’ve worked keep some separation between management and not-management. Often, they go so far as to draw another line between executive leadership and management. This is great for the people that draw the employee charts. It leads to nice triangley shapes.  And since I’m an “executive” I get to be the pointy part at the top.  I like pointy, it’s better than pointless.

Speaking of points, here are some of the reasons I’ve been given to avoid fraternizing with the help.

Don’t develop close relationships with people who work for you because:

  • You’ll likely end up friends with some and not others, which could be seen as unfair.
  • They might not respect you, or take you seriously.
  • Friendships are based on equality, and bosses aren’t equal. They have to do performance reviews, set salaries, give promotions.
  • They might take advantage of your kindness.
  • You might have to fire them in the future, which will be difficult if they are your friend.

Here’s the thing. Or at least a thing.  Look at that list.  What’s the driving factor between each item.  I’ll give you a hint…they all take about future possibilities. Things that might happen.

When you don’t do something because it “might happen” you are acting out of fear.

Fear is a powerful motivator. It can be a great thing in certain situations. It keeps us safe from danger. But it also causes us to miss out on having a deeper, more meaningful existence. And more importantly, fear can cause us to draw unnecessary lines. Lines that keep people out of our lives. Lines that lead to thinking some are better than others.  Lines that effectively place a caste society right in your office.

Right now, where you work, do you really feel that your leaders sincerely care about your life?  Do you really care about people who work beneath you?  Have you ever thought about the fact that we use phrases like “Bob works under me” or “the people below me on the org chart”  are like saying we’re above them… better than, even?

And you thought we were progressing towards equality.

Here’s what I think:  I’ve chosen to treat people who report to me (directly or indirectly) as someone I care about. Yes, in the end I have to make the final decisions, and I get to bear the responsibility of failure or success, but having more on my shoulders shouldn’t have to mean I have to be some unreachable island. When I care about others I can best serve them as a leader, mentor, and even as a friend.

I get that it’s a bit ironic for me to say that, because by nature I’m about the most emotionally detached person you’ll find. Despite that I’ve found that when you see each person on your team as someone who is trying to do their best in life,  and someone who is worth getting to know, you’ll find coming to work is a much better experience. You will all be more productive and happier, which rubs off on customer interactions, which equates to more customer loyalty, which in the end means a more successful company.

So even though I’m simply not good at being a friend, and as a result I’ve failed my fair share of times, I still think my life has been better for trying to cross the line between boss and employee, and the teams I have been a part of  have been more successful for my efforts.

Have some taken advantage of me?

You betcha! But there have been many more times where someone would go the extra mile to get a job done because they knew that it mattered to me, and you do things for people you care about.

Have I held on to an employee longer than I should while trying to help them get their life together?

Check! While I’m a big believer in parting ways with an employee who can’t fit in for whatever reason as early as possible, I’m also a big believer in trying to bring out untapped potential. While I haven’t always succeeded in my efforts, I’ve had some people turn around to become top performers. I wonder what their lives would be like today had I just tossed them to the wind? Overall the benefit to myself and the companies I’ve worked for has been greater than the bit of wasted money on holding on to a few of the wrong people for too long.

Have I had to fire a friend?

I’ve had to lay off a whole team of people I cared about. It sucked. But years after we shut the division down the team arranged a get together dinner to reminisce on old times. I temporarily wrecked all their lives…and yet I was still invited. That meant a great deal to me.  I’m still proud to see all that they’ve accomplished since then.

If you are in a leadership position ask yourself:

“Do I keep an emotional distance between myself and those under my care because I am afraid of things that *might* be a problem later?”

If the answer is yes, maybe take some time to re-think what your team could be if they had a leader who they cared for as a friend. No one is saying you have to be BFFs, remember a friend is simply a “person whom one knows and with whom one has a bond of mutual affection.”  So the question is:
Would you have a more positive workplace if there were more bonds of mutual affection?

Yes! Though it will be hard on you.  You will have to have the willpower to not be biased, to not make poor decisions because you don’t want to mess up a friendship, and to treat everyone equally.  But you rose to a leadership position because of your abilities.  I’m sure you can handle it.

And if you work for an emotionally detached leader, it might be good to put yourself in their shoes. Maybe they aren’t very good at forming attachments to people, or perhaps they may have been taught their entire career that they can’t be close to anyone who works for them. Can you imagine what it would be like if you had to come to work each day knowing you weren’t supposed be friends with the people you interact with the most? It can be really hard, so why not do what you can to help them out?  Afterall, they are also just there trying to do the best they can.

A wise mentor once told me “no one comes to work hoping to fail.”  It’s much easier to see that when you care about each other’s success. The point of all this: Even in my black and white world, I can see that some lines aren’t so great.  Sometimes we should blurry them up a bit.

Don’t let fear prevent you from getting out your eraser.


  • 1

Awesome Buts (Or this complement will self-destruct in 5 seconds.)

Tags : 

Dude, that’s so cool that you climbed up there- let me get a picture. You are so awesome!

But, holy crap how did you manage to get your shirt so dirty???

See what I did there? Bet you’ve done it, or had it done to you. I just went and let my but get in the way of making someone feel good.

If you think about that from the physiological standpoint, what I did was even more cruel than it sounds.

A simplified explanation is that by giving some words of encouragement and approval his brain kicked up the levels of Dopamine, Oxytocin and Serotonin, making him feel good about himself, loved and successful. His reward system kicked in telling him everything is great. Shortly after, I knocked him down a few pegs causing those neurochemical levels to drop, inducing feelings of rejection and sadness, and since they were at a heightened state due to my previous statement, the difference felt is more drastic than if I’d not given the compliment at all. Not cool!

Flip your buts!

This isn’t my original idea, I first learned in from a leadership training session taught byKirk Weisler.  His suggestion is that if you’ve got a criticism to say, and you’ve got something positive as well, always give the negative first.

“Devin, your shirt’s really messy and you should take better care of it, but that’s a really awesome spot you climbed up to so let’s get a picture to remember it.”

Simple to do, and why wouldn’t you want to leave a person feeling good about themselves?  This isn’t just for with your kids or loved ones either.  At work we can change:

“Bob, you’ve done a great job with sales this quarter. You’ve blown away your overall target, but we need you to get more enterprise customers.”

to:

“Bob, focusing on getting more enterprise customers next quarter needs to be your priority, but I wanted to congratulate you on the awesome job you beating your overall sales target last quarter.”

Which is going to leave Bob feeling more motivated to go out and help the company with its goals?  The first scenario where we basically told him you did great but it’s not good enough, or the second where we gave him direction on where to focus his energy and then told him how how great he’s doing?

Follow This One Weird Trick to Make Your Buts Awesome

(Sorry, I just had to throw the click bait title in there, I couldn’t stop myself.)

I think Kirk’s advice is great, and I’ve tried to use it when I can.  Recently I’ve had more time to spend with my kids while Kim is out building support for our WeFeel Kickstarter campaign, and I’ve caught myself both remembering and forgetting to flip my buts.  And me being me, I got to thinking about how I could do even better.

Here’s what I’ve come up with. Whenever I feel the need to add a but to a statement, I want to try to figure out how to turn that into a learning opportunity.  Instead of “you did great, but here’s where you failed” or even the better form “here’s what you could of done better, but I’m proud of you” I think we have an opportunity for a real conversation.

Something along the lines of

“Hey let’s talk about <topic>. Here are some things you may not have considered that I think could help out…  What are some of the things you learned? If you were to do it again what would you change?   Cool, I think you’ve done an awesome job so far and it’s great that you are thinking about how you can do even better. I can’t wait to see how you do next time!”

See what I did there? I got rid of the buts. And despite Sir-Mix-A-Lot’s preferences, sometimes no buts are the most awesome buts.


Get the App

tablet-2sm

When you download the WeFeel App you start a journey. Where that journey takes you is up to you, but you can't get started without the app:

Get WeFeel for Windows

Get WeFeel for Android

Get WeFeel for Apple