Tech Optimist Episode #46: High-Tech, High-Touch: How Salvo Health is Transforming Chronic Care

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  Speaker 1:
  What if you had your own team of the leading medical experts in the country in the palm of your hand? Let’s find out.

  Jeff Glueck:
  That’s what we do. And we avoid a lot of expense in healthcare because we’re managing these chronic conditions proactively. We can both improve outcomes for patients and save time for doctors.

  Mike Collins:
  And there is still huge psychology, and humans like being with other humans, and they like talking to other humans. It’s, I think, one of the challenges always with healthcare.

  Jeff Glueck:
  And the doctors just looked at me and said, “I wish that was true, but that’s not how healthcare works.”

  Speaker 1:
  Hello everyone. Welcome back to this episode of the Tech Optimist. Today we have a Meet the Startup episode planned for you, and the startup in question is Salvo Health. They’re doing some really great things, but let’s get into the voices of the show first. Our guide is going to be Mike Collins, founder and CEO at Alumni Ventures. And then our guest entrepreneur today is Jeff Glueck. He’s the founder and CEO of Salvo Health. And, of course, you’ll hear my voice—you recognize it, you know who I am. But anyway, my name is Sam and I’m the guide and editor for the Tech Optimist, this wonderful podcast.

  And a little bit into the episode content and the narrative that’s going to unfold today in the episode: Jeff and Mike really put the healthcare system in this country on its head. They talk about some of the pros and cons of the system and some of the flaws of the system, especially when it comes to gut health and resources around the gut health system, and how the system needs to be more in depth. There needs to be more people on your team that can help you get through these issues that you’re dealing with. That seems to be a new science within the healthcare industry.

  So Salvo Health does a fantastic job of providing this team for you and for anyone who’s suffering from these gut health issues. They’re really just trying to pave a way in the healthcare industry and make it cheaper, more affordable, and more coverable in all the insurances within this country. So they’re doing some great things. We’ll get into the nuance and the details here in a few seconds, but I’ll stop yapping and hand it over to Jeff and Mike. Sit back and enjoy the rest of the show.

  As a reminder, the Tech Optimist Podcast is for informational purposes only. It’s not personalized advice, and it’s not an offer to buy or sell securities. For additional important details, please see the text description accompanying this episode.

  Mike Collins:
  I’m Mike Collins, founder and CEO of Alumni Ventures. It’s my privilege today to be talking to Jeff Glueck, the CEO and co-founder of one of our portfolio companies, Salvo Health. And Jeff, welcome to our show.

  Jeff Glueck:
  Thanks for having me, Mike.

  Mike Collins:
  So elevator pitch for Salvo Health. Tell me what you guys do and why the world needs it.

  Jeff Glueck:
  Salvo Health addresses a problem in healthcare. We work with specialty medicine. Frequently, patients wait a long time to see specialty doctors who are in shortage, but more importantly, after they see the physician, they might get a diagnosis and be told to come back in six months—here’s a brochure, good luck. We believe that people with chronic conditions need a team.

  So we solve this gap in the healthcare system by augmenting the team of your primary physician, your local brick-and-mortar doctor, with a team that might include a nurse, a registered dietitian, and a therapist to work through an interdisciplinary program continuously. Every day you have access to support over the months it can take to get a chronic condition under control.

  That’s what we do. And we avoid a lot of expense in healthcare because we’re managing these chronic conditions proactively. We can both improve outcomes for patients, save time for doctors, and it can be billed profitably to insurance. So it meets those three tests: it helps patients, it helps physicians, and ultimately it’s making the healthcare system more cost-efficient.

  Speaker 1:
  Again, I want to boost and boast a little bit about Salvo Health. I want to put them on a pedestal for a second and give them props for their mission as a company. This is my MO. I’m on their website, salvohealth.com/science, which helps explain their process and their technology, I guess you could say. And I found really cool phrases on this page that I wanted to share that make you think about how you understand your body.

  So, respect the complex: conventional healthcare oversimplifies the way we think about our bodies, and we are here to change that. Awesome, amazing. Understand your body like never before with whole self science. Whole self science is their model of care, and it’s a trademarked thing. In collaboration with world-renowned experts on our clinical advisory board, whole self science combines diverse strategies from conventional and functional medicine to deliver results through a holistic, evidence-based approach.

  I’m going to throw up the diagram here just to get a visual on what exactly I’m talking about. It’s very clear, very concise, and designed really well. In the center is mind, body, and gut. Surrounding this is the environment that you find yourself in, the relationships in your life, your sleep habits, how much you move throughout the day, your microbiome, the food you digest every day, any stresses around you, and so on.

  They also talk about how your gut is a gateway. “We believe your gut’s health is connected to the brain, your behaviors, and more. To restore balance and improve chronic symptoms, we developed a framework to address each part of the whole. Together, these add up to a more equipped and powerful you.”

  They have some great blog articles on here as well, but I wanted to end this with: once you scroll all the way down, they have an emotional way to end your scroll through the page. It ends with love and taking care of yourself: “Love your gut with 24/7 care.” I thought that was cool and wanted to share.

  All right, I’ll stop babbling. Let’s get back into the rest of the show. Hang tight—we’re going to do an ad, and then we’ll be right back.

  Speaker 4:
  Hi, just a brief interruption to introduce you to the HealthTech Fund from Alumni Ventures. Alumni Ventures is one of the most active and best-performing VCs in the U.S., and we have raised over a billion dollars from more than 10,000 individual investors. With our HealthTech Fund, you’ll have the opportunity to invest in a portfolio of around 20 HealthTech startups—from transformative healthcare services to groundbreaking diagnostics. Our founders are paving the way for a healthier future. To learn more, visit us at av.vc/funds/healthtech.

  Mike Collins:
  Where are you on your journey? Have you picked this approach for a specific chronic condition? Where are you in the development of the company? It’s a pretty early stage, right?

  Jeff Glueck:
  We’re a seed-stage company, and we’re early in our evolution. We work with gastroenterologists today. We work with people facing chronic conditions like IBS or IBD, and conditions of liver disease that gastroenterologists and hepatologists treat, like MASH or MASLD (what used to be called non-alcoholic fatty liver disease), which affects over 40 million people. GI conditions affect over 60 million people.

  We also help these physicians with weight management—whether it’s GLP-1 medication or the like—so we provide the follow-on care. These are private practices for the most part that don’t have rich interdisciplinary services. We’re partnering with them and delivering the technology, staffing, medical content, and protocols to do all the follow-on care.

  Mike Collins:
  One of the areas I’ve just personally side hustled within running this venture capital firm—there are certain technologies that just capture my imagination. GLP-1 is one of them, and there’s been some pretty good indications for some of these conditions. But GLP-1 medications really require regular monitoring and feedback, which the traditional healthcare system isn’t very good at managing—like side effects, what are you doing, should I up my dosage—those kinds of things. It’s much better to have a team that you can be working with regularly. Are you finding that?

  Jeff Glueck:
  That’s exactly our approach to this, Mike. What we’re seeing is physicians are prescribing GLP-1s, and what’s happening all too often is they don’t have a comprehensive strategy and support services for the patient. Many patients face side effects, and insurance companies are loath to cover it. A lot of times they’re facing supply or price challenges to stay on the medications. Studies that have tracked GLP-1 patients show that 65% or more don’t stay on the medications every year for all those reasons.

  Mike Collins:
  It’s not because it’s not working; it’s because the system does such a poor job helping them manage through it.

  Jeff Glueck:
  Exactly. And as a GI specialist company, the side effects are generally GI-related. Our nurses and dietitians are trained to help people. The other thing is these are powerful medications—they’re showing incredible 20% weight loss. Mounjaro and similar medications also have cardiovascular benefits and lots of other chronic condition benefits. But one issue that everyone is addressing is the loss of lean muscle mass with these.

  If you approach them strategically—maintaining resistance training and protein—

  Mike Collins:
  Protein, yep.

  Jeff Glueck:
  …you can successfully approach GLP-1s in a way that allows you to titrate off them over time for money, side effects, or whatever reason, and retain the weight loss and feel healthier. Unfortunately, people come off the medications without a plan, and 75% or more of the weight comes back on within months. So very low close relative to the condition.

  Mike Collins:
  It’s a super application for that. And again, I know in our office of a hundred people, we probably have 10 of them. These issues are definitely—you’re right—you’re speaking to people who can relate and hear water cooler conversations that are exactly on trend here.

  So talk to me: we always try to take a step back and, beyond the particular company, you have a great perspective as an entrepreneur coming into this space. What do you think are tailwinds—big trends—that Salvo Health is riding the wave of?

  Jeff Glueck:
  I think for people who know my career—as CEO of Foursquare, CMO of Travelocity—I’m a very data-driven entrepreneur. What people don’t often understand about machine learning is you have to build really high-quality structured data sets to serve as training sets.

  When I was CEO of Foursquare, we had 13 billion check-ins where people would say, “I’m at this place” or “I’m at that place,” trying to be the mayor. But that was really profound because it allowed us to do ML models to detect where a phone passively entered at a hundred million places. Building those structured data sets takes years.

  AI approaches like LLMs have all kinds of limitations—you’re reading an enormous amount of papers that are mostly about drug discovery. They don’t tend to capture interdisciplinary programs that include psychology, diet, movement, lifestyle change, stress, and sleep.

  We’re very interested in the interplay, in a personalized precision medicine sense, of how all these factors work for different patients. Drug discovery tends to be: how do we find a medication that can pass a controlled RCT? Then we’re going to give it to everyone, regardless of whether they have the right genetics or case history, because that’s lucrative.

  I’m very interested in precision medicine. So I think the trend we’re playing on ultimately is: this is a data company about building machine learning to improve personalized medicine. But you can’t start there—you have to build these rich data sets.

  By partnering with local brick-and-mortar gastroenterologists, hepatologists, and hopefully soon weight loss clinics and primary care doctors, we are solving their short-term problem while improving medicine over time with those data sets.

  Mike Collins:
  I think in looking at this company too—I’m a tech venture capitalist, but there are human beings in this equation. There’s still huge psychology, and humans like being with other humans and talking to other humans. It’s one of the challenges with healthcare: how do we use technology better, more precisely, more personally, but at the end of the day free up humans to interact with other humans the way we all want to be interacted with?

  Jeff Glueck:
  I think that’s so spot on. In fact, the first question in the app, when you get assigned your nurse and your dietitian, the patients almost always ask: “Are you real people, or am I talking to a bot?” They’re so happy they’re talking to real people with expertise in their condition.

  And yet we’ve invested a lot—we’ve raised $15 million—in automation. The average patient spends about three hours a month with our services, and two-thirds of that is entirely software-mediated. One-third is human, but we want that human therapy.

  Mike Collins:
  One-third is so important, right?

  Speaker 1:
  I think this aspect of the digital atmosphere that Salvo Health creates within their app and staffing is really important and cool. I found an interview that Jeff gave with Logan Plaster of Startup Health TV, where they talk about Salvo Health’s digital-first care driving strong outcomes for chronic GI issues.

  In this interview, there’s a four-minute segment that’s really insightful and adds context to the narrative we have here. Jeff talks about staffing issues throughout the country and how the digital infrastructure helps connect dietitians, therapists, and nurses for the patients using their technology.

  We’ll do one last ad, hop into that interview segment, then move into Salvo’s Ask for Everyone in the Alumni Ventures community, and finally round off the interview. Hang tight—let’s get back into it.

  Speaker 5:
  Do you have a venture capital portfolio of cutting-edge startups? Without one, you could be missing out on enormous value creation and a more diversified personal portfolio. Alumni Ventures, ranked a top 20 VC firm by CB Insights, is the leading VC firm for individual investors. Believe in investing in innovation? Visit av.vc/foundation to get started.

  Speaker 6:
  Welcome to Startup Health TV, where we celebrate the entrepreneurs and innovators who are transforming health. I’m your host, Logan Plaster. It’s my privilege to be here with Jeff Glueck, CEO and co-founder of Salvo Health. Jeff, thanks for joining me today.

  Jeff Glueck:
  Great to be here. Eighty-six percent of patients we survey with chronic gut problems say they’ve been to doctors, but they’re not better. They’re not resolved. These are things that doctors, for the most part, don’t have a lot of time to treat. Doctors usually aren’t trained in nutrition, cognitive behavioral therapy, or microbiome rebalancing. They also don’t usually have the staff or the time to do the follow-on care in a very personalized journey. People don’t feel heard.

  One of the nice things for us is that each patient, through our Salvo Health app, in addition to their main doctor, gets a nurse, a dietitian, and a therapist, plus digital programs every day. They feel heard for the first time.

  IBS is one of the most common ailments in America, and it used to be called “Hysterical Housewife Syndrome” by men because it’s two-thirds women—mostly younger women. They’re gaslit, ignored, and stigmatized by the system. It’s embarrassing to talk about this stuff. We’re really giving the privacy of your own team over a four- to six-month treatment period where you really get to know your team and they get to know you. It’s very software-enabled, so it’s very affordable.

  Speaker 6:
  Interesting.

  Jeff Glueck:
  We can talk about our new research on the cost of these underserved patients in the system, which is really hot.

  Speaker 6:
  Yeah, tell me about that. How did you conduct the research?

  Jeff Glueck:
  We contracted with the leading actuarial firm in healthcare. They ran a study for us looking at nine and a half million covered lives. We asked them to compare IBS sufferers and IBD sufferers’ total medical expenses—all medical expenses—to the average American, both commercial and Medicare.

  The results that came back—everyone knows Crohn’s and colitis patients (IBD patients) are very expensive, six times the average. But what people don’t talk about enough is that there are 15 times more mid-acuity patients like IBS and similar conditions. Those patients cost double the average patient. Instead of $7,000 a year in total medical expense, the cost to the system is over $14,000. These are the mid-acuity patients.

  You know what happens? They don’t get good care. They usually get a colonoscopy or an endoscopy and are told, “You don’t have colorectal cancer. Good news, 28-year-old sufferer, you don’t have cancer. Come back in nine months. Here’s a pamphlet.” That’s the usual care today.

  Those people then end up in the ER. They go back to PCPs. They see different GIs seeking different answers. They get new imaging, new studies. They’re very expensive. They also have anxiety and depression, miss work, and they’re costly to care for. If we could address the problems, we could cut huge amounts of waste and reduce human suffering. That’s what we do. It’s an absolute myth that these mid-acuity patients are not high utilization. Sixty million people are frustrated, they’re suffering, and they’re expensive. They deserve solutions.

  Speaker 6:
  It’s a whole philosophical switch to really focus on the needs and costs of mid-acuity patients. We’re talking about gut health, but I see that as a trend across the landscape—to say there are these needs just under the surface, maybe that haven’t reached urgent care or emergency level yet, and yet they’re potentially breaking the back of the system. They’re also stopping people from living full lives.

  Jeff Glueck:
  That’s right. This is where the intersection of the gut health crisis and staffing shortages in America hits. Everyone here at HLTH is talking about the shortage of physicians, but there’s also a shortage of nurses and psychotherapists. There are only about a hundred gut-focused psychotherapists in the entire country, and there are 60 million sufferers.

  So what we’re trying to do is take the very best experts in the field, digitize a lot of what they do, enable it through software, and keep the human touch of a dedicated support team. The average patient in Salvo Health treatment gets three hours of care a month in the app. They’re opening it nine times a week on average.

  Speaker 6:
  Wow.

  Jeff Glueck:
  But because of all the software and technology—I’m a former CMO of Travelocity and CEO of Foursquare, as you know—the ratio is 3x. It takes less than an hour of nurse, therapist, and dietitian time to provide three hours of care.

  Mike Collins:
  To make it as productive and as efficient as possible. So what are your asks, Jeff? How can our community of other entrepreneurs and investors help your company?

  Jeff Glueck:
  The best thing is going to sound simple: if you’re a fan of how we’re trying to change medicine and you have a gastroenterologist—particularly in a private practice—introductions are how we’ve grown. Introductions to your local gastroenterologist lead us to talk to their firm.

  We see much more success with private practices than giant healthcare systems because those don’t make decisions on a human timescale. That’s turned into a number of clients. So that’s the question: if you work in healthcare or know a gastroenterologist you admire and think is forward-thinking, please connect them to Salvo Health.

  Mike Collins:
  Excellent. We will do that. We have people in our network right down the middle of the fairway for this, so please reach out.

  Talk to me a little about your origin story. You have a really fascinating background. How did your career develop and how did that path lead to Salvo Health?

  Jeff Glueck:
  I spent my twenties on other mission-driven projects before I came into tech. I worked in the White House, did economic development around the world, worked on Middle East peace and climate change. Finally, with a friend, I started a travel e-commerce company back in 1999. The two of us built an amazing team and got to $100 million in sales in two years. That was incredible to do back before Google or Facebook existed.

  Mike Collins:
  That’s a ride.

  Jeff Glueck:
  It was a blast. I got hooked on startups. My career evolved. I ended up running product and marketing at Travelocity. I invented, with our team, the Travelocity Gnome. We launched him. The original Gnome is back there in my home office.

  Jeff Glueck:
  And then I ended up being CEO of Foursquare and growing that company—including a couple of acquisitions—about tenfold in a couple of years. We built a platform that was machine learning-based.

  But I went through a personal experience where my wife and I lost what would’ve been our first child at 23 weeks. In hindsight, it was a preventable loss. We had a clotting disorder, and we were able to have, thank goodness, healthy children afterwards—but only because we knew to take some anti-clotting medications throughout the pregnancy.

  I remember asking the OB/GYN, “How come you don’t test for this?” And they said, “Well, we don’t even bother because the insurance companies don’t pay for genetic tests until you’ve had three miscarriages,” which just seemed humanly tragic and also short-sighted.

  Mike Collins:
  Stupid.

  Jeff Glueck:
  These aren’t expensive tests. Losing a baby at 23 weeks is a really traumatic and frankly expensive hospital process. It’s just heartbreaking to go through that. I asked the OB/GYN at Mount Sinai, while we were in tears having lost this child, “Please tell me the next couple is going to somehow benefit—that what happened to us is less likely because all this data goes into really well-structured data sets, and the best physician researchers and the best machine learning and data scientists are in there improving healthcare each quarter.”

  And the doctor just looked at me and said, “I wish that was true, but that’s not how healthcare works.”

  I worked in ad tech and e-commerce, and none of that was ultimately as meaningful as healthcare, which is, in some sense, the most important industry because it’s life and death, and it’s our quality of life and that of the people we love. I just vowed that if I was ever in a position to start a company that would continually bring learning and data to improve healthcare, I would launch that company.

  During the pandemic, I finally found myself with the time to think about what kind of company I wanted to launch next—and we launched Salvo.

  Mike Collins:
  Well, thank you for sharing that very personal story. You have a lot of fans rooting for you, and the work is important. The journey is just starting. I tip my cap to you for jumping into the fight. Getting back in the arena, Jeff, is noble. We appreciate you and are really proud to be part of your company. Let’s have our community reach out and get the flywheel going. To the extent we can help, that would be great.

  I look forward to checking in six to twelve months from now and getting an update. Jeff, thank you. Keep up the good work—it’s been really nice meeting you.

  Jeff Glueck:
  Thanks, Mike. We’re really honored to have Alumni Ventures as a backer. We’re in the fight for all the right reasons and glad to have you as a partner.

  Mike Collins:
  Excellent. Okay, have a great rest of your week, Jeff. Nice meeting you.

  Jeff Glueck:
  Same, right back.

  Mike Collins:
  All right. Take care.

  Speaker 1:
  Thanks again for tuning into the Tech Optimist. If you enjoyed this episode, we’d really appreciate it if you’d give us a rating on whichever podcast app you’re using, and remember to subscribe to keep up with each episode.

  The Tech Optimist welcomes any questions, comments, or segment suggestions. Please email us at [email protected] with any of those. And be sure to visit our website at av.vc. As always, keep building.