Eliot Brooks – Healthcare On Demand
An ounce of prevention is better than a pound of cure… Often it is only when the symptoms of a disease/ problem become unbearable that we seek medical advice rather than dealing with symptoms when they initially became pronounced. Eliot Brooks, Hamish Grierson, and Tom Livesey co-founded Thirva to address this and offer people a proactive way to manage their health. Eliot talks about the evolution of the business, and shares his thoughts from fundraising advice to the future of healthcare.
From Left: Hamish, Tom, Eliot
Favourite Book/ Blog
I’m a big fan of ‘Wait but why’. My co-founder, Tom, recently sent a fascinating article on AI to the team. It’s Artificial Intelligence for dummies – having read that I feel like I can now talk about it with some minute understanding. I’d really recommend that particular article and the blog more generally, for its ability to distill things down into it’s nuts and bolts.
Slightly nerdy, and it may become the app that I hate the most, but I’m really enjoying intercom. We’ve just added their CRM/Chat solution to our website, and it is a great tool for any business. The app lets you handle all of the chat support that comes in remotely. I’ve found myself waking up in the middle of the night to a random chat question, and I can’t help but open it to reply. It’s pissing off my girlfriend a little bit, but it’s such a powerful solution for a business at our stage.
Hottest UK Tech Company
There’s one company I have in mind – the founder’s a friend who I met through Seedcamp. It’s called CharlieHR and is a free HR tool for start-ups. It may not sound like the sexiest business, but the product itself is great. Very slick and loads of great features, plus it removes a lot of admin from daily operations.
Inspiration in Business
Elon Musk. He looks at things with an almost childlike naivety, pursuing innovative solutions to big problems. Tesla just turned its first profit for this quarter. What he’s done there is amazing. What he is doing at SpaceX is also impressive; completely different industries, completely different knowledge required for all of them, but he simply has the sheer brain power and drive to tackle them.
What does disruption mean to you?
I think that it is definitely an over used word. You get a lot of businesses who slightly improve things or undercut competitors and talk about being disruptive. There’s nothing disruptive in that. Disruption is when you introduce a game changing solution, one that turns an industry on its head.
Tell me about Thriva, the evolution of, and what you are currently working on?
Thriva empowers people to engage with, understand and manage their health, by making important data more readily available through finger-prick, home blood tests.
The evolution has been a while coming. Hamish and I first started batting around the idea early 2015 – both still in full time employment at that stage. It was very much ideation for 6-9 months. We then brought on my co-founder Tom, and helped get a MVP live. Off the back of that we raised an Angel round of funding, and got onto Seedcamp. We then re-launched the business in late June, and have been growing well since.
We’re currently doing a lot of product improvement – the actual presentation of the information that you get back – and that has been a big focus in the last couple of weeks. You can’t just give people data, you have to educate them as to what it means, why it is important, and what can they do about it.
Also, we’re fundraising at the moment – that’s taking up a lot of our time!
What skills from your previous business ventures or corporate roles tenure have you found most relevant appreciated since founding Thriva. What are greatest skills you have developed?
It’s hard to say – you learn a lot of skills without realising the skills that you are learning – it comes from experience. One thing I learnt at Travelex was around the Lifetime Value (LTV), Customer Acquisition Cost (CAC ), and balancing those two numbers to make sure that ultimately you end up with a profitable business. The good thing about Travelex is it is a big company, with big data sets. That means you can do some really interesting stuff around understanding those two numbers and ultimately how to balance them.
Tandem was also great for so many things. It’s very hard to pinpoint a particular skill, but seeing a start-up go from 10 to 100 people is an invaluable experience. You see so many challenges, how they’re managed well, and how they could be managed better. I learnt so much, and it has really helped with all things thriva to date.
Greatest skills developed? Multi-tasking & prioritisation probably. There’s lots of spinning plates. It’s about making sure you keep the right ones going. I have a few hacks that really help me stay organised and working on top priorities, from how I organise my to-do list, to little chrome plugins.
What do you wish you had known before setting up Thriva?
I wish I’d been a doctor! I wish I’d had the foresight I was going to be involved in Thriva and done a degree in Medicine. Actually, maybe not, I’m actually not the right type of person to be a doctor. A better understanding of the fundraising process would have definitely helped. I had seen it at Tandem, but not been that close to it.
What were the largest obstacles faced when launching and what is the biggest challenge today?
Finding a lab, and then getting set up with them. For awhile, we were doing this outside of our day jobs, so it was quite hard to get a relationship set up, and the technology in place.
I think the biggest challenge any start-up has -unless they have something truly amazing – is convincing people why they should part with their money. It takes time to really understand your customers, why they want to buy from you and how your product really solves a problem for them. We did a lot of work on that just after launch and we’re now starting to see the fruition of it; we’ve massively ramped customer numbers in the last month.
Thirva is certainly making it much easier to conveniently and accurately find out what’s going on inside your body. How often do you encourage follow up’s and who is your target consumer in terms of demographic? is this a fad or something that will have staying power?
In terms of the follow up’s, we took a deliberate view early on to take that out of our hands – it’s not credible for a business to stand there and tell you that you should be doing it every month, particularly when it comes to health. The way our product is designed means that any follow up and recommendations are all handled by the GP’s on our platform. We’ve separated ourselves from that to provide a trustworthy, credible product and hopefully a reason for people to purchase or not purchase in the future.
Staying power? We’ve only been for live three months – normally the recommended re-test date is a minimum of three months – and therefore we’re about to find that out. The early signs look good. We had a lot of feedback from customers saying I just want to do this on a regular basis, I don’t know what that looks like, you tell me.
We have two very distinctive target customers. Segment one is people who are managing existing conditions that require regular blood tests, and we are a more convenient way that puts information in their hands, rather than what currently exists through the NHS. I actually have a genetic condition which means I have regular blood tests for my cholesterol. The idea for the business came from my own bad experiences. For us, it’s about putting information in people’s hands rather than relying on appointments to extract it out of their GP.
Segment two is the quantified-self, bio hacker types who just love information and data on their body – we offer another broad piece of data which they can use in their evaluation of their general health, alongside their Fitbit or their Jawbone.
With the growing interest in health worldwide, what factors do you think will have the greatest influence on your business model going forward and of these what do you see as the most important?
There are some really exciting mega trends in health at the moment. Ernst & Young published a health paper called the ‘Changing Paradigm of Health’ – it talks about a shift in the patient/doctor dynamic. We increasingly expect to be serviced on demand, whether it be getting an Uber in minutes, or paying at a restaurant in seconds. Healthcare is about to be transformed as businesses figure out how to bring this level of experience to our lives. As a result, we should see a shift from reactive healthcare systems to proactive healthcare products.
Can you share fundraising history and advice? What do entrepreneurs want in an investor? When is the right time to raise money in terms of the life of the business? How do you retain a meaningful enough stake?
The main lesson learnt was the validation stamp getting onto the Seedcamp programme gave us. We found out that we were on the programme on Friday, and had our angel round of funding pretty much committed by Monday. We were quite lucky we already had a lead investor in place, who was super helpful too.
What are we looking for in an investor? You ultimately want someone who loves the vision of the company, recognises the value of the team, and believes that the team is the right fit/
You also want to see what value they can add beyond money. Do they have the right network, experience, can they draw parallels from previous experience themselves? I think that London should soon start seeing second generation entrepreneurs who are also angel investing; they can bring so much value to the table, particularly for early stage companies. Having that person who has been there and done that is invaluable.
In terms of raising money, you just raise it when you need to and when you’ve proven what you set out to prove. Maintaining a meaningful enough stake can be hard. We’re a business of three co-founders, all equal stake, but the average size is probably two. The answer to retaining a stake is what do you deem a meaningful stake? That’s reflective of your vision; if you’re going to build a billion-pound business, you care less about your stake being lower. Ultimately we all believe thriva will be a big business, and you’d rather have a smaller piece of a massive pie, than a big piece of a pie that ends up on the floor!
What are some of the KPI’s that you measure success by for both you and your team? What are the unit economics of the Thriva model?
I’m the COO: I do finance, performance, and the more analytical side of marketing and operational aspects. We’ve started ramping up of performance marketing spend and therefore I’m focused on CPA, highly concentrated from an operational perspective on our turnaround times. One of the things customers love about us is convenience – part of that is speed of results into hand. That transpires into me chasing doctors, making sure they’re writing reports for all results that come in to keep that window down as low as possible. We try to process in under three days.
Company wide, we look at the above in addition to month on month growth, NPS – making sure you have a positively high NPS is crucial because if you don’t it suggests you’re not ever going to grow organically, which is key. We also look at referrals – what the repeat purchase is per customer. We use Gecko which is a dashboard tool for your business. We have eight metrics on there. We also look at failure rates and results – you don’t want to ship a product that doesn’t work.
In terms of Unit Economics, we are relatively small. We are a small fish to the labs we work with who are handling big NHS contracts – therefore we’re not on the best pricing currently, but we have to keep in mind what it could come down to. We’re not rigorously focused on them at the moment, but we just need to make sure we can eventually get them to where they need to be.
My own KPI’s? I work heavily on visualising – what am I visualising five years’ time. That might be a headline about how Thriva is being used in the NHS and used as a preventative medicine to reduce the cost of the NHS, and ultimately save it. More of a vision than a KPI!
What values do you hold and what kind of company are you looking to build? How easy has it been to build the business in terms of finding people with the right skills and culture?
I want people to feel like they have autonomy. I feel like there’s a high level of autonomy in the best companies that are out there at the moment. Greater than that, is having people who come into work every day and really enjoy it – recognition that where possible a job is fun – it needs to be to get the best out of the team. Recognising work life balance is crucial and leading by example – everyone says it but I don’t think enough people actually go the extra mile. In summary: high autonomy, fun, and rigorous emphasis on doing what’s right for people.
We’re already thinking of hiring off the back of our next fundraise. I think that you find people go to the talent that they know from previous roles. As a start-up you can’t afford to pay expensive recruiter fees and do a broad search of people who might fit that role. You have to go in with a very clear idea of the job that needs doing and what those skills look like, and what kind of experience those people have. That’s how you get the right people with the least amount of effort, and money!
What is the long term vision as well as the more immediate imminent milestones?
To be a global pioneer for personal health by empowering people to take control. Ultimately something that might help existing healthcare systems like the NHS survive.
Immediate milestones feel very small in comparison to that big vision, but they are close our fundraising, boost out the team with 4 – 5 hires, and to keep growing!
What is the biggest competitive threat?
You don’t really know where it’s coming from. When I look at our current competitors out there I’m not worried. They are doing something similar – but we’re confident we have the team to do it better. I’m more worried about a company bringing to market a radical new way to test blood, and then building a direct to consumer business from it. Hopefully they would partner with us, but you never know. All you can do is work hard to keep you finger on the pulse.
Do you have a key business partner?
Our lab and our doctors on our platform. We’re grateful to have awesome GP’s who buy into the vision and work super hard. They all have day jobs and login outside of hours to help us. They work very hard to adhere to our KPI’s in terms of turnaround and do a fantastic job. Those two parties bring the medical expertise to our business. Hopefully one day we will be able to count the NHS a key partner.
How important is a good board or other advisers?
It’s imperative you surround yourself with people who can plug knowledge gaps, and also lend a helping hand. Neither myself, Tom or Hamish have come from a healthcare background, and so there was no way we would have got Thriva off the ground without solving that.
Burn the Boats
Burn the Boats moment – what enticed you to co-found Thirva? What advice would you offer anyone trying to conceptualise an idea/problem.
I am a big believer that founders should solve a problem they know. I had a problem because of my condition, and it was the pain in the arse process of blood tests. Most frustrating was the fact I never got my results and couldn’t keep track of them. Finding out that it might be possible to do a finger prick blood service was the very beginning of the idea.
I would say it’s about truly understanding the problem. If it’s not you who truly understand the problem you are addressing, you need to ask the right questions. ‘The Mom Test’ is a good start. You need to be asking the right questions in the right way.
How do you think founders can identify nascent and attractive markets that are ripe for disruption?
Technology allows for stuff to move out of the physical world. That’s a good starting point – we’ve seen it with retail, banks, anything that has a physical place which people go to is going to be under real threat. Look at Lloyds of London Insurance market for example – it is giant market place where people meet to talk about business and negotiate deals. I think that’s the biggest sign that perhaps there are some inefficiencies there to be disrupted…
What is your motivation/ what makes you tick?
I’m a big believer in visualisation. When times are tough you’ve got to pull that visual image in your head to keep you going. There’s also something about business that gets me excited. Any business. For me, its finding the pleasures in understanding different nuances and areas of a business. I also like numbers – if you can see that they’re not going the right way then you just need to understand what you can influence.
Who do you surround yourself with/ what business support networks do you value?
The NEF and Seedcamp and a few other networks I’m a part of have been hugely supportive – these communities are full of like-minded entrepreneurs always willing to help. I always rely heavily on Family and friends. These guys can act as great sounding boards and really help put things in perspective.
What keeps you awake at night?
Getting our fundraising closed! Hopefully that’s coming, and can stop keeping me awake. I can’t help but look at my phone, take an intercom customer support message, or take an email before work – that will often keep me up at night. I’m trying to stop doing that and give myself a solid hour before I go to sleep where I don’t look at anything. Start-up life involves billion dollar days and bankrupt days, as long as you’ve got more of the former than the latter, you’ll survive and stay motivated.
In ten years’ time how would you like people to talk about you and Thriva? What does success look like?
It would be great if we were known as the business that helped people make the right decision in life to stay healthy. If we were thought of, as the pioneers of modern healthcare. By that I mean, preventative and proactive.
For me, success looks like positively impacting the health of over a billion people by 2025. You have to set ambitious goals, otherwise you’re going to end up with something small.