Episode 40

Improving Diabetes Care from Austria to America

with Frank Westermann

August 16, 2022

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Frank Westermann
Co-Founder and Co-CEO, 9am.health

Frank Westermann is a multi-time founder. He is the co-founder and co-CEO of 9am.heatlh and the founder and CEO of Whitewater Ventures LLC. Previously, he was also the co-founder and CEO of mySugr, which was acquired by Roche. Frank earned a diploma in Business Administration from the Otto Friedrich University of Bamberg as well as from the Düsseldorf University of Applied Sciences. He also completed an Erasmus Year in Business Management at the University of Angers.

“Great experience must be consumer style experiences.”



[00:00:28] Lynne Chou O’Keefe: Well, thank you for joining us for an episode of Day Zero. I am joined here by Frank Westerman, who is a serial founder, and who I’ve known for a long, long time, even in his first company. And so thank you, Frank so much for being and joining with us

[00:00:47] Frank Westerman: Lynne, thank you so much for inviting me. Right to be here with you.

[00:00:51] Lynne Chou O’Keefe: Appreciate. Well, let’s first talk about the beginning of your journey, Frank, and just tell us, why you’ve become an entrepreneur. What has inspired you to, a multi-time entrepreneurial journey here? Tell us about the beginning of how you think about

[00:01:09] Frank Westerman: Yeah. I think, for me, it’s probably a bit of a unique story and also a very personal story, because I think what brought me to being an entrepreneur, and especially being an entrepreneur in healthcare diabetes, is that I got diagnosed with Type 1 diabetes around 20 20, 20, 20. Oh my gosh. Long time ago, 25 years ago now. And whereas the first 10 years of my life with diabetes, I was not even thinking about going into the diabetes direction. I was rather avoiding to meet people with diabetes because I had the impress that they were rather kind of bringing me down than kind of giving me more optimism to live with the disease. After a while, I realized that probably that I live with diabetes is not just a curse, but also blessing because as a patient myself, I really better understand what annoys you about using certain devices or medications, how it is to talk to a doctor, what you appreciate, what you don’t appreciate. And that was the reason why I started my first company which was called MySugr, and which was basically an application, a digital tool that helped you to better understand your diabetes data. We use gamification elements to help people to be better motivated to take care about their diabetes. And it, yeah, was a lot of fun. And yeah, that’s how I got into the whole thing, basically.

[00:02:27] Lynne Chou O’Keefe: Yeah. And I mean, honestly, that’s how we started our journey, just knowing each other through MySugr. And what’s unique about MySugr is that you started that in Europe. And so tell us a little bit. Just with love, you’ve now founded a company in Europe and one in US, you’re in the, I’ll call it San Diego, Southern California region, now with 9am. Just to, curious, because we haven’t had a founder in Day Zero that’s founded a company in Europe. Any differences you see, any similarities in those founding countries?

[00:02:57] Frank Westerman: Yeah. I mean, there are a lot of differences. Of course, some good, some bad. And when I think about, as for MySugr founders now 10, 11 years ago, we just didn’t know what to do. We got lucky. We got a few grants from the State of Austria, and non-dilutive though, no equity just, just gave us money to do something basically. I think it’s hard to get that in the U.S.. And also back then, and it’s not that long ago, but it seems like forever in 10, 12, 13 years ago, basically, there was just one VC company in Austria, really, I mean, and one business angel. And we got lucky. We had that business angel investing. It was Hanzi Huntsman. So a great guy. My first mentor, amazing person and, yeah. That was, and if I look at Vienna today– and of course, I have a lot of relations still to Vienna– that the ecosystem just evolved a lot. But the U.S. Ecosystem of course also developed during that time. So it’s even bigger and bigger as it is here. But yeah, a lot of things developed since then for sure.

[00:03:59] Lynne Chou O’Keefe: Yeah, absolutely. So, Frank, you had a successful run with MySugr, actually exited to Roche with that company. And a lot of the same team members from MySugr started 9am with you. What was that like in terms of having kind of almost another built-in team? That is also different than some of the journeys of our other founders. We’d love to hear what were those conversations like?

[00:04:26] Frank Westerman: That is, I think one of the really great thing about also being an entrepreneur, that you can really choose who to work with, and my co-founders and a lot of my 9am team members, they are my friends. And so what we did after, we decided to leave MySugr, we just, basically, as a team made a list what do we want to do. And on one of the top positions was we want to continue to work together, because we just enjoy being around each other. We enjoyed doing stuff. A lot of things we think alike. There’s also always healthy friction. But yeah, so it was never a question that we, we never thought about stopping to work together. So, yeah. And I totally do not regret, you know being around these guys and girls for the last few years,

[00:05:16] Lynne Chou O’Keefe: Yeah. So let’s talk about now your next venture, which is 9am and this team that came together from MySugr. What does 9am do? And how did that differentiate from MySugr? What were some of those lessons learned from MySugr that helped inform 9am?

[00:05:34] Frank Westerman: Yeah. I think in to a certain extent, probably 9am is a result of all the things we learned at MySugr. And also a bit of the result of the pandemic, which we went through the last few years and maybe still are. So many things changed. So when you look back at the time when we were starting MySugr, there were no connected devices. Nobody would have ever thought that we would have virtual care doctors who prescribe medications online. And so that was very different time. And we progress and now find all these wonderful opportunities we have, and quite frankly, also society who is much more receptive to doing everything virtually. It just was about time to take these learnings and basically where we had to stop at MySugr, and build now layer on top of just looking at data, better interpreting data, really, layers the care level on top of that. And that’s what we do at 9am.health. So at 9am.health, you really get everything that you need as a person who lives with diabetes, basically 24/7 support of a care team. You get your prescriptions. We deliver everything to doorstep that you need be. For example, your medication or an A1C test kit, or we even send kind of at home phlebotomist to your house, if you rather have someone drawing your blood instead of kind of pricking your finger to do an A1C test, for example. So it’s a very convenient, easy and affordable way to treat your diabetes.

[00:07:01] Lynne Chou O’Keefe: Yeah. Well so, how has it been building this company now also in contrast to MySugr, you’ve really built 9am during COVID. And you had a distributed team, both here in the U.S. and some team members in Europe. What are some of the lessons learned as a CEO and a founder around that?

[00:07:21] Frank Westerman: That is a difficult question because to be honest, Lynn, you know, sometimes I really hate this virtual thing. I love to have people around me and work with people. So that is really hard. I would have never imagined that you can basically raise two rounds of financing purely virtual. And that is clearly very different. But the good thing is of course, it speeds up a lot of things. You can save so much time with not traveling but doing things remotely. So that is for sure very different. Regarding you our collaboration, or working together with our team in Vienna, that is something we have been used to. So because the core of our team members here in the U.S., there are old MySugr colleagues, and we always worked with our colleagues in Vienna. So for us, nothing really changed, pre-COVID post-COVID. So in that regard, we are probably a bit of a, yeah, unique animal, but also kind of the people that we hired now. So for them, it’s also, I think they even enjoy to work with people in Vienna because it’s an interesting aspect that we can add to what we are and who we are. And people of course like to visit the team in Vienna. So I was just in Vienna, two of our team members have been there working with the product team. So It’s very interesting kind of note, I think.

[00:08:39] Lynne Chou O’Keefe: Yeah. As you’ve built 9am, what are some of the lessons from building MySugr, things that you said, I definitely want to do that again, or areas where you’re like I want to do it a bit differently this time. What would be some of those?

[00:08:55] Frank Westerman: I think one thing that I clearly learned at MySugr was that I had to realize that coming from Europe things can be very challenging, especially when it comes to having the financial resources that, allow you to grow fast. And we had that case, MySugr versus Livongo, where, we at MySugr, we were rating in $7 million, which was amazing for healthcare company back in the days in Europe. But at the same time, Livongo was rating I think $350 million. And so you have to realize that that is disproportional, and you can’t really compete globally with the companies that can out race you so massively. And that’s a learning I clearly take from that journey with MySugr, that you need to be in the U.S. to build faster, bigger businesses. Maybe it works in Asia as well. I don’t know. It probably does, but in Europe it’s really hard. It’s such a fragmented market, access to capital is very different. And also valuations are very different in the U.S. versus Europe. Income are also very different. It’s also kind of a bit of a sad thing, I think that, for us Europe becomes a bit like an offshore location where we have access to really great talent for a lot lower price. And yeah, these are just a few of the learnings we made.

[00:10:13] Lynne Chou O’Keefe: How do you build culture too? And what I’m interested into is, you have such a tight senior team that you brought over from MySugr to 9am and obviously though you’ve hired new team members. How do you think about culture building when there’s been a team that’s worked together so long, but then now you have new elements coming into?

[00:10:35] Frank Westerman: So first of all, I think, it’s really tough to build culture remotely with Zoom. All these companies who are purely remotely, it must be horrible. I always prefer to have people somewhere around here, not that everybody needs to be in the office every day. But I think to really build culture, to get to know each other, you need to see each other, work with each other in person. It is so hard to do it over Zoom. So, that’s one thing. The other thing is, it’s not only the senior team, that, came over from MySugr, but I also a lot of people we worked with joined us. And of course there is that bond. But on the other hand, I think we have a very strong mission. And a lot of people that join us at 9am.health, they join us on that mission. And so, and then it, its just, yeah. One mission that drives everyone to work on the same goal. And it doesn’t really matter if you work together at MySugr before or not.

[00:11:34] Lynne Chou O’Keefe: Yeah, no, that makes a lot of sense. The other thing that you’re really targeting with 9am as you’ve said, is a more direct to consumer approach, while having the depth of like an end-to-end solution around diabetes care. How have you thought about, as healthcare becomes more consumer, what are the opportunity sets you see are the challenges? How does it affect your team build and how you’ve thought about that, as example?

[00:12:01] Frank Westerman: Yeah, I think that great experience must be consumer style experiences. And telling something directly to a person and asking for their money directly and not through Yala healthcare control versus reimburses service is something very different because you get direct feedback. You are forced to build a great service, a great experience. You know, with something that is in nature not really something you would you like to do. So you’re forced to do your best very differently than otherwise. And, we rather take that route as something that shapes our product, shapes how we think about providing better care and sets up later on to maybe go to employers or other more traditional players in the healthcare space. But we really see the consumer as the most important, the consumer, the patient, and at the most important factor. And I think that direct relationship just helps you to build a better experience.

[00:12:57] Lynne Chou O’Keefe: Yeah. What are some examples, Frank, of where you maybe heard from a consumer, or just because of your knowledge of the diabetes journey like that insulins product or UI/UX in a way that you were saying that closeness with the consumer so important?

[00:13:12] Frank Westerman: There are so many example, and I think what really stands out about what we do is that we really wrap the whole diabetes care journey. And I hate this journey term, that we use so often, because it always sounds like a vacation trip, but the diabetes care journey is, it is so cumbersome, like always you need to go to your doctor, you need to pick up your medications. You need to not forget about so many things, and providing everything in one cohesive experience, having someone who really, talks your language, understands what you think– a lot of our diabetes care specialists, they live with diabetes themselves, or they have at least someone there where in the family that lives with diabetes– so really understand how you feel as a patient. And I think that is something that is super unique about what we do. That is something that our users absolutely appreciate. And that’s why they love us.

[00:14:05] Lynne Chou O’Keefe: Yeah, well that’s the new tagline, Frank, is that working with 9am, it’s not work you’re on a vacation. I think that’s what we should

[00:14:13] Frank Westerman: I like it.

[00:14:13] Lynne Chou O’Keefe: Because they are patients like they are on a vacation, which just raise the question. How did you come with 9am, the name?

[00:14:20] Frank Westerman: Yeah. We are a virtual diabetes clinic, but we also more broadly, we are for example, treat people if they have like hypertension, hyperlipidemia, so we are chronic care platform at the end of the day. And if you live with a chronic disease, you have it your life long, but you of course have good days and bad days. And especially diabetes is disease where individual decision can determine so much of if you have a good day or a bad day, and the good thing about that is that you always, even if you struggled one day and you had a bad day, you have a next day. And in our opinion, the tough day starts somewhere around 9am, when you dropped the kids at pool, you had your breakfast, when you are ready for the real day, and yeah. And you have always a chance to do better than before. And that’s why we named the company 9am.health.

[00:15:09] Lynne Chou O’Keefe: I love it. I love it. So, Frank, maybe just reflecting, we’ve talked so much about MySugr, 9am. What are just some pieces of advice you have for other entrepreneurs that undergirding their journey or their vacation? However we want to say what’s some advice you have for them?

[00:15:27] Frank Westerman: Um, I always give a very simple advice. I’m not a smart person, so as simple as it can get, these are things that I understand.

[00:15:36] Lynne Chou O’Keefe: I don’t know about that., but

[00:15:39] Frank Westerman: But I think you follow your gut. You need to be really passionate about what you do and then really follow your gut. I think your gut a lot of times really tells you if a decision is right or wrong. And if it doesn’t feel right, don’t do it. And I think the most important thing I had to learn it kind of the hard way, and it’s still sometimes really hard to follow your gut, because your brain tells you, it makes so much sense to do that. Frank, do it, but your gut tells you, it doesn’t feel right. And then really the gut is right. The gut is always right. That’s my first advice.

[00:16:13] Lynne Chou O’Keefe: No. Absolutely. Absolutely. Well, thank you, Frank so much. Appreciate this walkthrough, what’s inspired you, and being a multi-time founder in multiple countries, and what you’re doing today, and just like how the patient centers around everything you do, and ultimately to your point, follow your gut to like what makes impact for patients. I think, if I think of you as a founder, absolutely that’s something I think about all the time when I think about 9am and your team. So thank you again for joining us here at day zero and really appreciate your time.

[00:16:48] Frank Westerman: Thank you so much Lynne for inviting me. Thank you.

[00:16:51] Lynne Chou O’Keefe: Absolutely.

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