How Experienced Founders Think Differently [Podcast #96]

Ozan Dağdeviren

Hello, and welcome to the startups of London podcast. I’m your host O and the founder of startups of London. Today, I’m joined by Kelly Klifa, co-founder of Ally Health. Welcome, K to our chat.

Kelly Klifa

Hi, O. Thank you for having me. It’s great pleasure to be with you today.

So, let’s jump straight in from the deep end. What it is like to work as a co-founder of a startup founder in London? What is it that you had not expected before you started all of this?

That’s a good question. And I liked it. What I hadn’t expected? I think is the strengths of the ecosystem that you have in London. I think it’s just an amazing sort of community of founders that really are out there. You know, we’re all trying to solve different problems, we’re all working on different aspects, especially in health tech as I am. But there is this sort of, community feeling where you’re really able to support each other; sharing insights, and it’s just really, really helps you push ahead as a founder. And I think that’s so valuable when you have, as you always do in this startup journey, when you have moments of doubts or moments where you’re you’re seeking additional support, that ecosystem is very strong. I think what I like about London as well as there is very many facets to that community. So, in health tech, you know, we can we can spend days talking to scientists and researchers who are working on sort of the most cutting-edge technology and research. And then you can also the next day be really getting to know investors, getting to know what excites them. And I think it’s just the intersection of all these conversations that keeps it so dynamic and such a great place to start a business.

How long has it been, since you started ally health? And was this your first startup?

Yes. So, we started ally in May of this year. And we’ve been on quite the journey since then. But before Ally, I had co-founded another startup called testing for all. And testing for all, I co-founded with James Monaco back in April 2020. It’s not for profits COVID testing business. And so that was my first taste of entrepreneurship. And I loved it, we had a roller coaster for two years, we did large-scale COVID testing over a million tests in 2021. So it prepared me in a way over the course of two years, I probably experienced what most entrepreneurs would experience over maybe five or 10 years of crazy scale-up and then all the ups and downs that come with it. So, LA is now back to kind of, the drawing board in a way with the challenges and the excitement of a pre-revenue startup. So, it’s been fascinating to go through that transition.

Few founders, I had a chat with a couple of last year. It shows if they have built a startup, and then there’s starting their second project or if it’s their first time around. I think there’s a real sense of appreciation about how difficult it can be at the same time that there is there’s more experience. So how do you think you’re different from starting your new business compared to the first time you started a startup?

That’s a good question. I think I am acutely aware of the need for focus. I think that’s really what I’ve learned and grown so much. And, when you start, it’s very tempting to try and be everything to everyone because you know, you’re out there trying to get them narrowed down on your hypothesis, you’re testing out your idea. And naturally, you will come across very many different opinions and many different opportunities. And there is almost I guess, for me, what I experienced initially, was this sort of like FOMO, I guess of okay, gosh, if I can’t address this problem, then, you know, I may be missing out on this amazing opportunity to just scale further, but I think it’s holding really strong convictions and picking a focus as early as possible. And we had almost with testing for all the luxury of being given a focus if you want because COVID testing was such a pressing need at the start of the pandemic and it was so well defined in the UK with very much sort of marketplace system of you recall all have like travelled testing and these things. So, in a way, I often say that I didn’t have to look for a product market fit, I could focus. And Jameson I could focus on really being great at executing and being amazing on the tech side and the operation side. And I didn’t have all the uncertainty of finding a product market fit in a way. And now going into Ally, I’m really encountering that challenge in a completely different light, which I love. Because I think it’s adding to my kind of tunnel of experiences. And it’s adding as well for us as a team to go through that process. But yes, it definitely needs focus.

One of the most difficult things is fixing the demand problem next to impossible. Unless you’re creating a market. I remember… I don’t know if you’ve encountered this… There was something called Airbnb experience. Perhaps there still is. And this was before COVID. And I was trying to explore the landscape for startups and entrepreneurs. And I went to one of these Airbnb experience events for startups. And there, I met a guy called Anthony and he was kind of a mentor. He was showing us a tour of the different places and so on. And we had this conversation about what a market is. And I remember having a really interesting perspective from him, where he said, basically, in 99% of the startups, you do not create a market. Because I think there’s kind of like a misconception for first-time founders. If you compare yourself to the Amazons and the Googles, and the Facebook, and so on, or Airbnb, for example, for that matter. In some cases, we can make the case that they’ve created a certain market for them, or a certain niche, completely changing how people use something, essentially creating new demand in a place where demand was not. For example, smartphones. But I think people misunderstand and think that it is quite achievable to create a market, whereas 99% of the cases, in my experience, are as a startup, on this, you have billions and billions of dollars or pounds and a couple of years to spend, at least. It is difficult to create a market. It’s difficult to create a demand. But you create a supply for the existing demand. So it’s very demand driven. And this is something that I like and that I also dislike about the startup ecosystem. But I don’t know if you agree with that. What are your thoughts on this specific issue? Do you think? First of all, do you agree that it is as demand-driven as I make it to be? And secondly, do you think, is it bad in a way that it is so demand-driven? Because it leaves less room for innovation?

I agree with you. I think, for me, there is so much difficulty in really creating new markets, and I see a lot more potential in improving the way that existing demand and supply, for example, dynamics work. I think, there is a way to kind of impact more when you focus on the existing interactions of certain markets and look at their dynamics. And you start to see that there are… if I take our examples with health tech and healthcare, we’re seeing this very real problem within a market of accessing basically mobile nursing capacity. And we’ve seen that there’s a real issue in how supply and demand come to meet together. And we’re not reinventing by any means the activities of that industry. We’re taking what’s there, but we’re really enabling it to be more efficient through that tech overlay. And I think for me, that is applicable across many different industries. And I like to look across to other verticals. If you look at, for example, fintech. I think they haven’t created a market there. They’ve just really taken a pre-existing,

Indeed, taken over the market.

Yes, exactly.

Thanks to perhaps…

Absolutely and completely redefined the way that people access these services. So, I think it’s very rare to be able to create markets from scratch. I think it can be done if you have very, very strong innovation. And I know healthcare, so I’m going to speak about healthcare. But if you look at the diagnostics side, I think there is a market that is trying to come to life now post COVID, around accessing diagnostics at home. And there’s a lot of hope and a lot of hype as well around the point of care, and diagnostics. And the power that’s, we’ve discovered through these lateral flows, how much more uncontrolled people can be of their health. But realistically, it’s gonna take so many trials and errors before we get to meaningful innovation, in accessing care in your home and accessing having a device that allows you to test for a gamut of different diseases or infections on one device. It will be fundamentally game-changing when it comes up, but that will be a new market, right? There will be a new way of accessing healthcare and a completely new set of behaviours from people. I think it’s important just to keep these sorts of breeding grounds for innovation alive. Because they do move the needle, but at the same time, you cannot. Put all your hopes and beds into these baskets. And we’re much more about fixing what’s here and what’s now and future-proofing it.

So, can you tell us how Ally Health’s idea came to be? Was it a demand-driven idea, as we just mentioned, that come from a personal anecdote? And with that, perhaps a brief overview of what the businesses and the way it solves the problem would be much appreciated.

Yes, absolutely O. So, it is a demand-driven problem. It’s looking at the existing way that people current way that people access healthcare. So, coming out of the pandemic, I like many other patients out there have gone to experience what it is like to access health care remotely and access a virtual GP on your phone. And I think that pandemic really got a lot of us used to that mode of accessing healthcare. Now, as a patient, what I experienced was a very disjointed pathway, where I had the convenience of being able to speak to someone via my phone in literally 15 minutes. But where it fell apart, and as a patient I grew very frustrated was, as soon as I was told, Well, you’re going to need a blood test, I don’t really know how to help you here, we’ll need to do a blood test. And once we have the results of that blood test, we’ll be able to put a diagnosis. When that was basically as soon as that came up. I was then told well, actually, we as virtual GPS. We’re not quite equipped to help you take that blood test. So, why don’t you go and see your NHS GP, they will refer you to their local clinic, where you’re going to be able to have that sample taken.

It’s almost like a break in the supply chain. It’s an…

Exactly, absolute break. And you know, it’s almost you’re disillusioned as a patient, because you’re kind of given this hope that your problem would be solved, and you’d have the answers and you’d have control all throughout that pathway. And suddenly it all falls apart. So, I ended up calling my NHS surgery waiting for a week for an appointment. Then you add another week before you can take that sample. And you’d have to go to a clinic that’s out of your way during, working hours, and completely lose that convenience. So, that was the problem that I experienced alongside many other people out there. And I started to dig into it. And the statistics kind of speak for themselves, what we find that actually 70% of all medical decisions are rooted in lab examinations. And so, you can imagine that’s just blood tests, right? You can imagine how many more in-person care interventions are required beyond blood tests for any patient journey. So that was the problem we experienced is a disjointed patient pathway that almost prevented the full potential of digital health solutions from coming to life. And we started to initially think, gosh, there must be a way to access mobile nursing, like what does it look like today? If I want to have a nurse come to my home to take a blood sample? And that was an eye-opening question.

Interesting question…

Yes, this industry is stuck. 20 years ago, I mentioned FinTech earlier, but it felt like we were looking at banking 20 years ago. And it was all analogue you had to get a phone call to be able to book a nurse, then someone would call you back, and that nurse would call you back, but you didn’t know when. And you had no transparency in that process at all and no control as a patient. So long story short, we got to that point where we found that there was almost a lack in the value of a big gaping hole in the value proposition of digital health. And if it was to really take hold, we needed to kind of fill that gap, which we call the last mile delivery of digital health care. Getting to the patient in their communities, rather than having them pile up back on the NHS waitlists. And so that’s where we started off really. And then from there on, we went into problem-solving mode. And we started to look at what were the solutions that we could bring to life there. And the short of it all is effectively what if we could create the equivalent of Uber? But for mobile nursing? What would it be like if we can make community nursing available on demand to patients? So that they keep control of their pathway, it integrates into their digital GP flows. And on the other side, on flip side, for the nurses that would work with us. It would mean that they can be flexible in the hours that they work with us for that we can optimise their task allocation as well. So that’s also a big gain from their perspective. And the result from a provider point of view from a digital GP point of view, for example, is a closed loop. You do not lose your patient as soon as they need an in-person care intervention. You take care of them in their communities. And then you bring them back to you for that follow-up appointment which in blunt terms. Because people don’t really like to talk about money when it comes to healthcare. But in blunt terms, it has additional revenue opportunities for them as well. And of course, at the end of the day, it’s better to access for patients and better experience throughout. So that’s what we’re really out there building with Ally.

Indeed, a big part of the building is how you partner up. I love this saying. A startup is one deal away from either making it or failing sometimes. So, looking back historically, perhaps over the last six months. What were the big wins for you? What were the big partnerships? What were the biggest milestones that you overcame so far?

Yes, that’s a great thing, I can really relate to it. So, for us, we found a lot of strength in the partnerships we had established whilst building testing for all. So, what we were looking for in the early days of Ally was a way to just very simply test our hypothesis. And say, Okay, we’re going to put a v1 of this product into the world. And we need a partner that’s going to help us check whether our product improves the patient experience, and really brings convenience, through that sort of on-demand digital booking. And we can actually improve also, how the nurse are interacting in their day today-to-day how much as sort of freelancers, mobile nurses. Can you do in your day of work out there? So, we turned to one of our best partners from the testing for all days, and their lab is based up north. And they agreed to kind of give us a shot at this. And they were looking at the time, as a lab, they needed to validate more tests as they were coming out of COVID. And they were really keen to expand their test portfolio. So, they need to validate any new tests that come on board. And to do that requires a lot of sampling venous sampling to be done. So that was a simple way for us to say, Okay, let’s go we have a common goal here. We have a solution that can help you do this. We think very seamlessly, and very efficiently. And we can hopefully prove a few basic assumptions. So, it’s very much a testament to what you’re saying, Ozan. Because we could have been building kind of in the unknown for many, many months without really confronting our product to the reality of the market. And actually, that partnership helped us come to conclusions much, much faster on assumptions that we had been making that kind of disconnected from the real world, the really big one on there. And I think yeah, that’s probably in the past few months been really defining in the choices we’ve made.

Looking at the future, what do you think are the big milestones for you to achieve? What is critical for this business to be successful in your opinion?

Absolutely. Scale is absolutely critical for us, both on the demand and on the supply side. We know a lot, we read a lot about network effects and startups that have failed at landing any type of network effects. So, the scale is going to be key. And I think…

The platform type businesses…

Exactly, exactly. And we have to be quiet, I would say, methodical about how we approach to scale. And what I’m keen to do is the first milestone and we’re working towards it now is establishing this micro-network, and the platform, balancing the platform dynamics on a micro scale, which for us is London. So, we have the closest milestone for us is the launch of two key partnerships in January for us in London, where we’re really going out there and we’re testing whether there is enough supply and enough demand to keep both our nurses engaged, but also end users, ie your patients satisfied with the access to the care that they can get. So that’s the short term. And then looking beyond that the longer term will be the challenge will be replicating what we found on that micro network across a nationwide scale. So, having access to also the nursing capacity and being able to keep our pipeline of really great nurses engaged and coming through to us.

It’s about finding a critical mass, which is key, this… And also for other entrepreneurs and potential entrepreneurs. A key point you made that I just would like to underline is… Because you’ve achieved certain network assets in some way of saying it’s via testing for all you’re able to leverage that in this new business. And I think that’s kind of a key component of the growth of a company, growth of a successful startup is that you need to have a different volume and class of assets. And one of them is the network asset. One of them is the relationships you have with people, time and money and energy and motivation, and meaning, of course, they are there as well. But we almost never start from scratch, there is always an asset that we rely on, which is okay, and which is good, in a way. So, I would urge new founders to take that perspective if they’re building a startup from scratch. So, the right question to ask is, what are the assets? What are the competitive advantages that I already have? And that usually ties back to either? Which industry do you know, well? Which people do you know well? And which problems do you know Well?

I fully agree, it comes back down to what, as a founder, what is your unfair advantage? And it could be like you say, be an industry that really well, where you have a unique insight on things that haven’t worked out quite well there, where you can solve a really very, very sort of acute pain point. And I’ve seen it a lot. And again, I go back to health tech. But you see, that’s also why you see a lot of clinicians becoming founders of health tech companies. Because they’ve experienced it firsthand. And they are also in the process of defining the problem, they probably have also their first customer. Because they’ll be working with hospitals, or they’ll be working with trusts where they know that this problem is acute. And if they can come up with a solution, they’ll probably have their first customer and they’re there for sort of proof of concept in that journey,

Indeed. And a big part of the founder’s job is to be able to direct resources. So, as we’re approaching the end of our time, let’s touch on that a bit. And when I say resources, basically I’m referring to the team, you have, investment. If you have any investment or partners or any accelerators, or co-working organizations that you’ve been part of. So essentially, the people and the money side of things. Tell us about that a bit.

Sure. Yeah. So, our team has been through a lot together, I’ve been really fortunate to continue working on Ally with the team that is behind the success of testing for all, which means that we know each other so well, we can trust each other. And we know we’ve overcome a lot of challenges over the past two and a half years or so. So that’s really a massive advantage at this stage of our journey, where there is a high degree of uncertainty, and you need to have a very sort of agile team. From testing for all. We also keep our tech-first approach to solving problems. And naturally, the core of our team is engineering. They’re really working under the guidance of James, my co-founder on testing for all, now chairman of Ally, who’s got that sort of product owner hat on and is really helping us prioritize the features we choose to focus on in the early days. Most recently, I’ve also shifted from a b2c business with testing for oil and to the world of b2b enterprise sales. I needed the expertise of someone who had done that successfully before. And I was lucky enough to cross paths with Sasha Torre, who was previously at cured, where she was head of business development. And she had exactly that experience of scaling the business up and doing it in the Health Tech digital health sector as well. So super relevant to us. And she initially joined ally as the chief growth officer. And more recently, as we’ve gotten to know each other and started to trust each other a lot. We, you know, we took the move to, for her to become my co-founder, our ally, you also asked me about funding. So today it’s we have not had to seek external funding, we self-funded and we’re in a lucky position where we’re not rushing to the table for VC money. Rather, what we’ve done is we’ve engaged with them early doors to get feedback and kind of test whether or not or vision had legs. And I think I would really recommend that to anyone starting out there. As soon as you feel like your ideas taking shape, and you know, You’ve obviously done your homework and everything. Put yourself out there Go to VCs, go to angel investors and get their views and get their opinions because They have a very critical lens on the industry that you’re working in. And so whatever challenge is going to be thrown your way you’re going to learn from and it might save you some headaches down the path as well. So we really valued these early discussions and the plus size for us as we got some VCs very excited about what we’re doing. So we’re confident that when we decide to go back out when we have solid traction and Product Market Fit to show for ourselves, we’ll be able to have really meaningful conversations with VCs we know can really support us on that growth path.

Are you hiring new team members?

So, for now, we’re really hiring on the tech side, on the tech and product side. It’s Mission Impossible, trying to find like talent these days. So, you’re really as many out of startups out there. We’re hunting for the best talent. And yes, hopefully, if anyone from Twitter or any other tech startups out there is listening to this. Give us…

Are you looking for software developers or product managers?

We are looking. Yes, we’re looking for software developers, and we’re looking for product owners as well.

Got it. So, people, if they’re listening to this, you can reach out to K and introduce yourselves. But yes… Amazing chat. Thank you for sharing your insights, and your experience. I think it was not only insightful but also sincere. It can get a bit difficult building a startup in London, one of the issues perhaps for most people, as they’re starting out, as a lot of the content out there on the internet is geared towards perhaps the US. And it’s different to build a startup in the UK. It’s different because especially the health, we’ve interviewed some of the health tech companies before, and the NHS structure also makes it different in its own regard. But I feel you have a lot to give. And I also think allied health is really sophisticated in the way that it’s structured and in the way that it’s trying to solve the problem. So, I not only wish you good luck, I hope it becomes successful. So, we can depend on it as users because it solves a real problem as well. Thank you for your time.

Thank you, O. Thank you for having me is really a pleasure chatting with you and yeah, thanks. Thanks for your time.