Turning Passion into Action: How Jill Michal Is Reinventing Caregiving with Kith & Kin

<p>hello everyone this is Cole from the American Journal of healthcare strategy and I'm joined today by Jill Michael Jill please introduce yourself hi thanks so much for having me uh yes so I'm jel Michael I'm the co-founder and CEO of a company called K and Kim K and Kim's an old fashioned term for friends and family because we know that there's no one single way that people care for the people they care about [Music] we're so happy to have you on we have so many questions to ask you about this amazing organization you know I've seen it on LinkedIn a few of my colleagues have been liking the posts when I saw your uh profile pop up I thought you'd be excellent to share with our audience um you got your start quite a few years ago at Penn State University with the bachelor's in accounting I want to ask when you got that degree did you want to be an accountant so ironically I did right and people used to say to me you don't seem like an accountant and I'd be like thanks I feel like that's maybe a compliment but actually no I loved it it was such an you know I strangely right so I I did take that to heart that people didn't feel like it wasn't you know I was an accountant but there was just something about really kind of understanding the financial nature of a business and how that actually drives how a business thrives or how it doesn't often times how it can get into trouble um and a lot of those pieces it just became a really interesting Foundation I would say I you know I didn't know how to do a journal entry from day one I didn't spend most of my time in that space But I did spend a solid seven eight years in public accounting and honestly I loved it it was kind of like an MBA for life and then after you did so you got your degree and then seven about seven years later it looks like you became the CFO yeah yes yes so I spent most of my time when I was at Anderson in the social service and in the healthc care space and in that one of my favorite clients at the time was United Way and I at a certain point in time they were looking for a CFO so I had you know had been debating back and forth whether I was kind of staying in public accounting for life or whether I was going to kind of do whatever was next and that turned out to be what was next so I was CFO there uh for a couple of years then a COO then the CEO from 2008 to 2014 I always kind of say that was a little bit of karma coming back to bite me I left Arthur Anderson about a month before Enron collapsed but they also took on the CEO role of United Way about a month before Leman Brothers collapsed so my timing was was always a little bit interesting from that standpoint it's interesting a lot of the some a lot of the Coos and especially CFOs IAL to they don't want that CEO rule they say that I've seen how they work it's crazy and I so you're saying you like reached out for it or it seems like you kind of maybe had to take on the role well you know it's such a great question because I remember I actually helped interview f for this PE other people for the CEO role at United Way for like six months and you know people kept saying you know you should really throw your hat in the ring for this role and I'm like yeah you know what I said I'm a fantastic number two like that is so like this is my skill set this is my sweet spot I've never been happier and then somebody one day said to me and I was like and I'd worked for amazing people like I loved my you know my my at that time predecessor in the role and the CEOs that I had worked for and they're like yeah but you don't know that you're going to love the next person and what if you know what if they try to take this organization in another Direction and we've worked so hard to get this far and do so many amazing things you know think about it and you know I thought about it for a while my kids were one and three at the time and and after a lot of kind of soul searching I you know I threw my hat in the ring and you know interestingly you know just a couple weeks later they stopped the interviewing process and then it was me and I never looked back I loved it I thought what I thought was going to drain my bucket actually filled it in a way that I never saw coming that is really good advice because one of the things I've been told is to always say yes and I think that does change a bit as you start having children as you get more experienced in your career but it's nice to see that it does work out and it can still benefit you in ways you didn't expect absolutely that's really great so then after that of course you went and worked at Independence Blue Cross for quite a few years and what I'm interested in is so now you have a lot of experience you worked in some of these really large firms and then you choose to work for a startup I've heard a few people do this why do you why did you choose to go and work for a startup specifically salera I think is the first startup you started working for yeah so you know it was interesting you know like I've always said to people I was like I'm entrepreneurial but I'm not an entrepreneur turns out I was again totally wrong about myself but it was actually so I was at Independence lacrosse and there was a guy from a blues plan actually out on the west west coast one of my mentors and Friends Ian Gordon called me and was like so I'm leaving the blues to go into an early stage startup it's out in Phoenix you know you would be great for this role I have I said Ian I'm not going to work in Phoenix I'm in Philadelphia you know my kids are still little all the things so one Friday night he's like just talk to me just spend you know just spend a couple hours time so we talk on Friday night we have a conversation and I'm like you I'm not going to work in Phoenix and so I come sit next to my husband on the sofa and I turn to him and I'm like so I'm going to go work in Phoenix you know he's always been incredibly supportive and he looked at me and he's like okay you know whatever you want to do it'll be fine you know we'll we've always figured it out we'll always figure it out and we did and you know it was the start of a really just kind of an interesting journey in my life and I you know while I've had many varied experiences in that space I will say it's where I you know I got the buff right it's that ability to kind of ideate iterate and execute all in the same business cycle without a PowerPoint that I loved and so being able to really do that just I don't know Breathe new life into me in a in a whole different way and yeah I've loved it I never turned back although I will say I talked to serial entrepreneurs you know now that I have my own startup and I look at people who are serial entrepreneurs and I'm like why the hell would anybody ever do this more than once some people the way their brain is structured it's like a addiction almost when they just keep you know the sleeping on the factory room floor and they just keep like doing there's got to be some like Adrenaline Rush that you get out of it that's not what fuels me that craziness but but no I do I mean I I truly love it and for me it's just it's been a way to bring all of my experience to a single place and be able to use all my skills at once because I'm really you know but one thing I do know about myself is I'm way better at doing a lot of things than I am at doing one thing know I don't check a box I realized somebody and I were talking about this not that long ago and I've almost never had a role that wasn't created for me that it like existed before because even you know even United Way didn't have a CFO role when I came but you know all the roles the VP of Business transformation and like head of networks and community- based organ I had all kinds of weird titles and it was because I was almost always in charge of you know what one place referred to as the Island of Misfit Toys it's like if it doesn't work give it to Jill she'll just go fix it she'll figure it out she'll fix it but it was weird because that was just kind of a spin my thing that is not that is not a job out there so when you kind of go and look at well what am I qualified for I'm like I don't know I'm only good at a lot of stuff all at the same time that's kind of what my skill set is when you kind of go with those narrow and deep verticals I'm like that's not my thing and running things that that work is also not my thing because once things work I kind of get I wander away like that's not super helpful if you're trying to run a team of things that work incredibly well I'm just way better at you know figuring things out and doing a lot of things at once so this was kind of that's I think ultimately how I figured out that this was my space interesting so maybe like a fractional CEO in the future where you turn around these there you go you know who knows who knows what it is it's just I yes that's you know that is what I love and so it's been a great you know this has been this has been a labor of love for me but it's also you know it's taught me a lot about myself it's you know I will say hands down hardest job I've ever done because of the people that are relying on you when you take other people's money that that sense of obligation gets heightened a thousand times from any other job I've ever had I raised a friends and family round at the very beginning from my friend and family and so it's you know you you don't want to disappoint them you don't want to lose their money you don't want to lose their confidence or their trust and you know it just adds something to to the top of any other job I've ever held it's interesting on that too because we you know we don't we didn't do friends and family we put in a little bit of our money and then we were very lucky to have some investors but we are low cap you know we're low Capital we don't need we're not actually building like an app but even though the money is like less than I would make in a month from my day job this the pressure of making sure that money actually works Y is a lot more like I get you know it's crazy but you do feel like this huge obligation to make sure these people who are putting faith in you you know and of course for you too I think it's great that youve you you've had over 20 years of experience and different roles that you're able to to bring to this which I think really AIDS you a lot where it's tough for for some younger Founders I was talking to someone he was like a second or third hire and he was saying it's good if you work a normal job for a couple years so that you can see what industry is like before you just go and start a found you know found a company yeah no it's absolutely true that was huge for me because like I said what I was good at was lots small parts of lots of different things so for me having had all of those different experiences and being able to kind of bring them to Bear into one's face was really valuable and and don't know that I would have been able to right in my 20s I you know look in my 20s I would have certainly thought I could do it right because in your 20s you think you could do anything despite you know I always used to say you know well you know what she lacks in skills she makes up for and confidence so but you today I know what I don't know right but I also have a way to figure it out that I don't think I had at that time right I didn't have a network I didn't have resources I didn't have you know necessarily always the confidence to kind of pick up the phone or drop a note to somebody and and ask for help either and today I will do all of that all day every day I mean I'm not shy about asking for help I'm not shy about asking for advice and I'm you know I don't Kid myself about the things that I don't know I simply don't know them doesn't mean I can't figure it out but it does mean I need some resources I need somebody who's been there and now I kind of you know as you get further along in your career to your point about kind of getting a job and the you know in a more traditional space you do form a fantastic Network there you do form a group of resources and people who are content experts and things you can only ever hope to know 2% of and then to have them in your corner is just you know that's that's so so incredibly invaluable you know a lot of our fellows help you some of the younger individuals learn how to cultivate these networks learn how to step out of you know their comfort zone but one of the questions I want to ask you because of your excellent Network and experience how do you delineate and how do you tell good advice from bad advice especially in a field you know nothing about yeah it's such a good question because we you know in there's like one very specific example in this that you know in our space because you know our our our product model right is around the this kind of family care man management family and friends right the K and kin model you know is really about that collaborative Health Management so when you're kind of in that caregiver role just for you're a parent you're the you know oldest child of an aging parent that kind of model so that's one piece of it and being able to organize health information for yourself and your family to kind of manage all of that stuff that happens outside of medical records but there's there's this whole world in kind of the medical record space where over the last two years it has not been an area where certainly I know it from being in the healthcare field being in the insur space all of those things but being in the pure like data interoperability space was not my sweet spot and I could not you know I I was like I got to just learn so for me it was about talking to as many people as I could and getting various kind of points of view but then still forming my own opinion right because if I had listened to all of those people independently and just you know and listen to all of those people and I would have probably jumped in a certain direction that now knowing what I know today would have been would have probably not been the best use of resources over the last year or two given kind of where that space is from a patient access standpoint but I took all of that information and for me it was really about trusting my gut and also forming relationships with people that I felt were sincere relationships you try to figure out kind of who you can trust in the space and then it's it's about finding those people and then kind of going back to them and continuing to gut check other things you hear and eventually for me in those spaces it really helped me form a much more intelligent opinion than I certainly could have come up with on my own um but it's about trying not to be kind of sold on the flash and the pump and Circumstance that's that's just been really important to me it's just you know finding those handful of people that I trust to to do those gut checks do you think it's easier to to I guess trust your own gut in a way or to at least formulate your own opinions because you've had 20 years of experience I mean sometimes it's hard when you're you know you're in your 20s because you don't even know who you are yet a lot of times so it almost seems like for me like when somebody tells you something it's it's almost impossible for me to always not be pulled in different directions yeah it is really hard because you're you don't have that lightning rod yet you don't have that defining Rod you haven't kind of figured out exactly to your point who you are you don't know enough of about it you feel like you kind of trust the experts and then you figure out that a lot of the experts you're talking to are not experts at all they just have opinions like everybody else and they're not oftentimes not worth you know as much as they perceive that they're worth right so that's where kind of being able not to the point where you're kind of making yourself crazy right because I also know people who go and try to find 72 different opinions but if you really go out and the pursuit of information for information's sake as opposed to trying to validate a preconceived point of view I find it's a thousand times easier because sometimes people go and seek advice in validation of their their their belief coming into the conversation if you do that you it's going to be very hard for you to discern the crap from the real like real nuggets of information that will be incredibly valuable to you and it allows you to have a more real conversation with folks the other thing I would say is just never be afraid to ask a thousand questions like I mean you'll you know if you've ever been in a meeting with me you hear me start with okay I got a remedial question here right like is I just want to know I I just feel like I have to ask all the questions in the room I don't I and still like you know after 20 years in the space I still a remedial question almost every day because there's no possible way I could know you know even a fraction of what's out there so for me it's been about kind of allowing yourself to be vulnerable in those spaces allowing yourself to be a learner as opposed to a validator and I think that is really makes a huge difference because people don't even often realize that they're trying to validate their own beliefs when and so they shape a convers in a certain way or they only ask questions that help get to the answer they think they're looking for as opposed to just trying to understand the the ecosystem the nature of the work like a lot of the things because oftentimes if you leave room for that that's when people give you the information that you weren't smart enough to ask right like I was like oh I didn't ever even think about that I didn't even know that was a thing now I know it's a thing but I wouldn't have asked right because I didn't know because I was over here trying to get an answer to a very specific question so you know to me that's what you know even today I still you know still tell my kids look people will teach you as long as you continue to be teachable and the minute you aren't people aren't going to spend any more time and they're not going to invest any of their any more of their time with you and so that's you know I think still being teachable in my 50s has been really important to me because I'm still learning I if I wasn't I would be bored as hell and so you know I that's that's honestly that's what I would that's what I would say that's a it's a good advice and it it'll be something that I think we'll we'll have to you know somebody in my 20s have to work on because it's that mix of having that confidence but also being okay with being wrong and like I said being teachable but also knowing who you are so that that's a tough mix it is a tough I appreciate that advice it's a tough mix and you know I still remember going in there was one job where they asked you know why should we hire you right because you don't have this background and the skill set and you know for this particular job and I was like well the biggest thing I can tell you is I'm not afraid to be wrong and you guys have a lot of things you got to figure out and they're not all going to be right you know to spend a lot of time being safe and then you know hoping you're right and then being wrong and you spend a lot of time and money Mone if I'm going to fail I'm going to fail fast and I'm going to but I'm going to figure it out but but that's I that doesn't bother me right I care more about getting it right than I do about being right and that's that's got to matter and I think at that space you can be confident without knowing all the answers to the questions you just have to be confident you can figure it out not that you have figured it out so that's one of the keys then that we should all take away is be confident that you can figure it out that's where you get your confidence from in your motivation to keep going but then be okay with being wrong or maybe even be happy to be wrong really because then you'll know that was not the right thing to do can find there so that's that's very very helpful I just and we can cut this out but I want to ask you this personal question here you left salera in 2019 in July and then you didn't found the company till January of 2020 what was going on between you know those six months there yeah so that was so that's actually when I had the idea for kiss and Kim so I was starting it was just that fall when I had left Sara I was in this space of I you know ear to our earlier conversation I'm like I don't know I'm entrepreneurial am I an entrepreneur do I want to start something do I want to go back and be part of somebody else's something right and I've done a little bit of both since then but it really became this kind of question right because you I mean look you can decide you want to be an entrepreneur but if you want to be an entrepreneur and you have no idea that's a little rough right if you don't have anything and so it was during that time frame that I was thinking through this and it was actually at one of you know the 10,000 healthc care conferences right so Health out in Vegas where all good highly risk averse individuals go to learn healthare information right and so I you know sitting in the audience and you know there session after session about patient adherance right getting people to do what they're supposed to do and you know they had automated pill boxes and you know Outreach tools and all the 50 million other things and then one morning there was a woman by the name of Helen lease from Oliver Wyman who was doing a keynote and she flashed a slide up on the screen that said women control roughly 70% of the healthc Care spend and utilization in the US and I'm sitting in the audience and I'm going let's see we've got doctors we've got pharmacists we've got therapists and the person in charge of patient adherence in my house is me I'm the one who makes sure everybody takes their medication and goes to the doctor and does the followup and does all the chronic Care Management all the things and I have better tools for travel volleyball like my tools to manage health information and so at that conference I walked out into the hallway and called my co-founder at the time and was like is this a thing she's like yeah because the same way you're taking care of your kids with all the stuff they're dealing with with we just had a close friend you know die of cancer and we're a group of single women in our 30s and we were carrying the binder you know and whoever had the binder with them and the binder was the Bible and then you then you take pictures of the things and then you had the WhatsApp and the text thread and the photos of everything from rashes to discharge procedures I was like yeah so it's not just me and that's actually how we started we you started the company formally technically kind of sitting around a kitchen table in January of 2020 but then spent the next thousand hours in user research before we wrote a single line of code just talking to humans which is not something we do a lot in healthcare you know we don't we don't actually talk to any of the people who use it very frequently when we're trying at least trying to design the technology side of it right and so you know we were just trying to listen to people about like how do you manage this information now what do you do with it when you get it who do you share it with and really that was the G Genesis of kith and kin now as the kin keeper app is just trying to help people manage Health the way they manage life and not try to force them into kind of the health care Paradigm but actually create a tool that mirrors their existing social support structure where it's truly portable it includes your voice your information you can share some information with some people and other information with other people right the way you do in real life and that's the you know that that honestly that was the Genesis of the tool that was the vision back in 2020 and it's what's finally kind of manifested itself in our you know full launch of now full mobile app to K and so it's on the Apple App Store and on Google Play and it looks like it's a really well-designed app a thank I have a couple questions the first one is how do you guys make money from that what's the income source so starting in April we gave everybody the first month or so for free on premium so there will always be a free-for lifee version of it which will be kind of the in case of emergency so things that you can manage on there obviously things like your profile Basics your conditions you know medication allergies practitioners you know some of your personal notes um and then a premium subscription which is $3.99 a month $3.99 or $30 a year really lets you unlock everything so then you can store photos like I mentioned before so one crazy thing you would not think right so I would never just a position between your my chart right and your life on your life you take pictures of 10,000 Things like documents and all the things and then you're scrolling through your like camera reel to try to and you're like okay hold on when did that thing happen I took a picture of the well it snowing so it must have been February let me go look in February right this is how people manage information right this is how so so being able to do things like that so you know for the obviously to cover the cost of storage being able to do some of the collaboration and sharing so custom sharing permissions being able to add everything then from you know medication management to the you know an upcoming feature that'll be launched in April is this to-do structure that'll be like hey I'm the kin Keeper in the family and so there's like five things that we need to do for my son or you know if I'm managing an aging parent there's like all these things that we need to do for dad let me make the list but normally the one who makes the list the one who has all the stuff and knows all the stuff is in charge of all the stuff and so that person is isolated frustrated and exhausted and that person wants to share information and share the load so now in the the version that'll launch in April that person can then create a task list and assign tasks to you and I right or to other people who need to help them take care of this person or they can just ask for help if they don't know who kind of it should go to they can ask for help and it'll say Hey Jill you know you'll get a text they Jill ask for help with Dad you know volunteer to do one of these things right because we heard from so many people you know how that they wanted to do this they want to do it well they want to do it right but they fundamentally don't have a way to share information and they don't have a way to share the load it sounds like a lot of features somebody gets for $3 a month I mean that's that's excellent so I think the pricing is is really that's important for us too because at the same time we spend a thousand hours in user research I also spend a lot of time talking to companies who taken a run at this before us and failed and one of the things was pric that you know it's got to be it's got to be accessible financially and and from Tech technology standpoint I noticed and tell me if this number is inaccurate but I noticed that the funding the seed was just under a million dollars so we've to date we've raised I know it depends on where you have to go to update things right so to date we've raised $2.3 million since 2020 okay that's still a very low amount for what you've accomplished I appreciate that and trust me that I feel that that's what I was gonna say is it is it because you have this accounting CFO background that you're you know fiscally conservative because you know people spend 1020 million to do something I mean we were we've been looking at websites because we're designing a website that's like similar to MacKenzie's you know like a hundred pages and we're getting like quotes for like 10,000 a month for maintenance and it's like you know ludicrous so for two million I mean that is impressive yeah well there's a couple things that go into that yes you know certainly my Frugal nature is is one of those but really you be and being very deliberate about that but knowing that we had to build an affordable solution so we couldn't overbuild the technology such that a consumer subscription or even a b Tob to see sub subscription because we're also going to Market through Partners right and that needs so whether it's employer benefits or it's you know a partnership with a you know long-term living or you know skilled nursing or rare disease or you know children with disabilities kind of space any of those if they want to offer it to folks and if they want to offer it to their constituents or their patients you know that has to be on a population level that has to be well less than a dollar a person right so you have to be able to build such that that can be sustained from that standpoint I will also say look nothing helps you be more frugal than a recession and a banking crisis and a pandemic yeah I was waiting for the Locust because I was like really is there any worst time to start a company um but the last so the last couple of years I think it kind also forced you into a level of you know of frugality and management of resources that the likes of which we've haven't seen in 20 plus years and I'm hoping we never see again but we're not out of it yet so not quite ready to look that reiew mirror I just think you I've been reading through you know the marketing materials and things and I I you know you've avoided spending a lot on like AI advertising which is like where a lot of companies will just hire this like Chief AI officer kind of a black box and they'll just dump money into that and so I think you know it does seem I think another thing on like why it's important to either have experience yourself or have experienced advisors you know because you you a lot of the young companies where it's mostly young people the money just seems to kind of just fly away so see companies raise 2030 million doar and then end up in layoffs because you know because the world around them changed for whatever reason right sometimes it was something they should have foreseen sometimes it was something they couldn't have so but you know for us especially at an organization at this size and Stage having a highly variable cost structure right so talking to the accountant right so being able to dial things up and down as you're seeing progress in one area opportunities pull back in another area that's not bearing fruit like that's important and you've got to be able to turn on a dime to do that you can't be in a position where you're like oh i' you know I have to unwind I have 90 days to unwind that decision you can't do that you know when you get a couple million bucks you really have to make sure that you can make a decision with a week's notice and make the change and turn off the spigot because you can't keep spending right you just can't keep spending where it doesn't make sense to spend you try things and you're thoughtful about how long they should take and if they don't you also have to be disciplined enough to stop doing them which is the other thing right you know one of the most strategic words you can say in this space is no because there are just things you can't or shouldn't do that oftentimes you know people feel like they have to do and so you know you got to shed the shoulds like there's a lot of things people will tell you you should do but you just have to kind of know better in that space and be like yeah maybe but I also have to be you know be really thoughtful about my resources that's incredible incredible advice uh for me as well as I'm sure everyone watching thank you so much for coming on and and spending this time and giving us this free advice I couldn't be more appreciative for that we're going to link the app your LinkedIn as well as your company in this post so everyone please go and check it out you know download it take a look at at how amazing it is especially if you're a Founder I encourage you to look at how well the marketing materials are done that alone would probably cost people millions of dollars nowadays I I know our graphic designer he is you know none of us are are paying ourselves and he is working so hard and some of the quotes you've gotten are just outrageous so I I'm am just really impressed with it and I couldn't be more appreciative for you coming on and and talking with all of us well I deeply appreciate you taking the time and and giving me this opportunity</p>