Transcript

Joella  00:00

When a patient asks you, hey, I read this thing on Google that said that I can't take this with this, or if I take this with this, something will happen to me, and they come to you and ask you that question, that is a sign of trust. They're asking you to validate a myth or something that they've read on the internet and help guide them through something very personal—their own health. Yeah. And when I thought about that in the context of what we're building for the company, it just clicked for me. I realized instantly, this is what we're doing. It's meaningful.

Leah  00:37

Hello and welcome to Season Three of The Founder Mindset, brought to you by ATB. I'm your host, Leah Sarich, and I'm delighted to be back for another season of talking to Founders about what it's really like to build a company from that first big idea. If you've listened to previous episodes, you know, I was a journalist for over 20 years, so I'm more curious about why anyone would ever want to become an entrepreneur, not so much about the business model, product, market fit and so on. I want to understand why entrepreneurs keep going, why they think they're the ones to solve a massive problem, why they want to make a real impact in the world. And if you're here, I bet you want to know why too. Let's find out.

Joining me in studio today is Joella Almeida, Co-Founder and CEO of MedEssist, a company transforming community pharmacies into pharmacist-led health clinics with technology and AI. Joe, thank you so much for being here.

Joella  01:31

Thank you for having me.

Leah 01:33

This is so great. If we had a video component to this, you would see listeners that we are matching today. We are matching and as our, Alex, the podcast producer, said, it's a happy accident. That's true. It's so fun to have you in studio.

Joella  01:46

Thank you very much.

Leah 01:47

I start all of these conversations by going back in time, using the time machine to go, how did you actually decide to become an entrepreneur? Or did you?

Joella  01:57

I did not decide.

Leah  01:59

That happens often.

Joella  02:00

Not really. I think I had this vision in my head that an entrepreneur was this person in a suit with an MBA and like had all of these steps figured out before, and so I didn't really think of myself as an entrepreneur at all.

Leah  02:11

Wow. So then, how did we get to MedEssist? Because I know it's not your first venture, so why don't you walk me through? I know it's a bit of a long story, but that's what we're here for. So if you can get us there, that would be great.

Joella  02:21

Well, I had a merchandising business for a little bit, which kind of got me dabbling in a little bit of web development and learning Shopify for the first time. But every time it was a late night and I was, you know, deep, dark, fixing something really boring, like aspect ratio or like HTML code or something, I couldn't help but wonder how cool it was that this, this software, this program that I was using was enabling people all over the world. It was so independent of bias. It didn't like… It can't tell who you are. It can't tell if you're young, if you're old, if you're a man, if you're a woman… It was just like, here's you… Here you go. You know, plug in your products here and sell them all over the world. And I can never get rid of that feeling of awe, like, how cool is this? I just, I couldn't get over it. I know that there were so many users, I know, like, everyone's probably bored of talking about Shopify. But when you look at the tech, and you look at the code, and you look at how it's built, it's like someone was behind this. Someone was very intentionally saying, I want to open up this capacity for everyone. And that was really cool. So I was doing that for a little bit, and I was very much doing it with the intention of all of my clients at the time, I was teaching them how to use Shopify as well. So I would like I'd run the company. I'd run whatever they wanted me to run, but I'd say, “Okay, once a week, you need to sit down with me and you need to allow me to teach you this. Because I'm not going to be doing this for too long, right?” I'm, frankly, I was getting bored because I needed to. I wanted to take it one more step. And the clients were never going to be able to, A) afford that, or B) even want that. They just wanted to sell their products, which is totally fair, right? And so that's kind of step one, and I was looking at a couple of different things. Like I was sort of consulting on my own. I did a whole gamut of stuff. Like one of my clients works with Barbie and launched a collection, like a makeup collection, with Mattel, it was fantastic. Another client was in Montreal selling chocolate, and had this just phenomenal reviews that he wanted to blow up all over and share with people, because people were reacting to this fresh cacao that he had brought from Brazil. He was an immigrant entrepreneur. And there were all of these really cool stories, and I was still trying to find my own cool story in the middle of that, not realizing, I guess that enabling them, I guess I am part of their story. But again, this was like, you know, hindsight is 20/20, so you realize all of this later. And a really good friend of mine, her name is Sarah, actually one of my closest friends from high school. She used to come stay with me in Toronto. I think she was living two hours out of the city, and she used to come live with me back then for her pharmacy rotations. And one summer, she stayed with me the entire summer because her rotation was literally across the street, or diagonally across the street from me on Bay Street, and she ended up introducing me to my Co-Founder, Michael. But she did it in a very… she was quite bored with the introduction, in a way, like she just said, Hey, I have this friend who's interested in starting something, and that's it, and that's it, like no other context. So it didn't sound very enticing. I didn't know. Do anything with it for a very long time, and he emailed me, and even he didn't sound very enticing, it was very vague, but then a big part of me really liked that, because I feel like I had spent, being on Bay Street, I had spent over a year going to sessions at Mars back when they had something called Mars 101, where they would try to teach entrepreneurship. And my favorite part from those sessions was every, I think, three classes, they would do a panel, and they would bring in entrepreneurs. And the entrepreneurs were, they were not like your Google CEO, your Facebook CEO, or someone trendy like that. They were just people in ordinary clothes, no business suits, no like fancy, you know, flair of okay, I'm doing this, I'm doing that. They would literally just talk about the problems they were solving right then, right there. Whether it was a laundromat or a key card service or a banking card that they were trying to start. And it almost gave you courage to think, hey, I can do that right. Like it doesn't have to be complicated. I don't need to have 10 things ready. I don't need to have the business plan. I can actually just go and start, and nothing's stopping me. Yeah. And that felt also really cool, because at that point in my life, I was working at a payments company, and the payments company moved amazingly fast, 75 people. It was beautiful, moving fast, and I learned a lot of things that I didn't learn before. So couple that with the timing of meeting Michael and and, you know, Michael just also being a very much, very much a “do” person—like do, do, do, do—very action oriented. It felt really nice to kind of be in control. A little bit of okay, if I need something to happen, I can make it happen by doing it, by working on it, by being persuasive or being persistent or trying to figure out how to unlock this or unblock this. And then over time, it sort of just teaches you this concept that you can do anything.

Leah  07:15

Yeah. Wow. Okay, so then how did that meeting with Michael lead to what we know as MedEssist?

Joella  07:23

That's a good question. So at this point, Michael had been a pharmacist for, I think six or seven years. He was a pharmacy manager, and I had met him at his pharmacy in West Queen Street—Barkdale. And we literally worked in the back of his pharmacy, because there was no place. I mean, every pharmacy has a counseling room or two, and then there's the manager's office, and there was this back room with literally a table and a bunch of garbage bags all over because they were being prepped to take out. It wasn't like an unhealthy, unsafe environment or anything like that. It was just like shredded paper and things like that. Yeah. And I think what was most remarkable about Michael, and what is most remarkable about Michael, is he has this deep, deep humility, and he's definitely a first principles kind of person, like always trying to solve things, always trying to make up his own mind. And honestly, it felt very inspiring, but at the same time, I could easily see what was missing, which is like talking to people and convincing people of your why and really getting to the root of that why. And the beautiful thing about Michael is, at this point, he had gotten some provincial funding. We had a patient-facing app, and he was in the middle of a patent process. And I was like, “This is crazy. Like you're doing all of this and running the pharmacy and living your life. This is very strange.” And so we spent about a year, I always tell the story of us walking north east, west of Toronto, like 14-hour days. You know, we'd start at seven in the morning. He'd pick me up. We'd drive out to some random town, we'd park it at Tim Hortons, and then we’d just walk. And we do like, 14,000 to 21,000 steps in a day, visiting about 14 to 16 pharmacies a day, and just talking to them and telling them, “Hey, we have this app. We know how hard it is for your patients to manage their medication.” Nobody knows the spelling of medications on a good day. Like, I don't think anyone does that, and then we expect all of these senior patients to remember their medication. It's ridiculous. And so he had built this beautiful app that could pass medical data via computer vision, NLP. It was just available on anyone's cell phone—anyone—so it suddenly democratized access to the way that you were storing and managing your patient information and also helping with your daily life. And Michael's story is more impressive. He's so cool. He is an award-winning pharmacist, but you know, he came to the same realization that even if he was an award-winning pharmacist, you have patients. And I think most healthcare practitioners come from the same background. They want to solve the problem at hand. But sometimes the problem at hand is much bigger than you are. And so he had patients passing away from something so simple, like forgetting a medication for three, four days. It's a massive problem. It's a $600 billion problem that people have been trying to solve for years and years and years. Now, the nuance in that is, after doing that for a year, you know, the pandemic was starting to happen, right? And the pandemic was very polarizing in some ways, but at the same time, if you talk to healthcare practitioners, pandemics are not new. They've happened before. So you can learn from your mistakes in the past, so you can learn and you can anticipate what's coming. And the biggest challenge of what was coming was this unequal balance of demand and supply. Everyone's going to want, there's going to be demand for a solution or a cure or a vaccine, but the supply was not going to be able to ramp up in time, because we've never had that kind of volume that we've had to manage, to produce, distribute, triage, all of that stuff, right? And pharmacies have this beautiful, beautiful consistency all over the world. I always talk about how pharmacies can transcend geography and language. It doesn't matter where you're traveling. You can go to Spain and not speak Spanish, but if you see the pharmacy sign, you know you can walk in, there's a very high chance you can figure out a way to mish-mash some version of what you need, and the pharmacist will get it. But you don't go into another country and go to the hospital or go to another country and go to the doctor. That never happens unless, like, you are really in a dire situation where you're using your insurance, right? But a pharmacy is super accessible. And so it was very obvious when we started designing a solution, well, Mike started designing a solution, that we could do this really well. And in our first iteration, we were doing it for flu season because we thought, okay, the vaccine's not going to come till December, which was true. So in the meantime, let's get a test bed out of what we've built, and let's see if we can match this right now, because we have something we can emulate. We have high dose flu shots, which you can emulate. Technically, the flu shots the way they're given out, you're supposed to protect the most at risk, the seniors, because people do still pass away from the flu. It still happens. And so there is a triage process that we could use to mimic what's going to happen with the COVID vaccines. And we did that really well. We scaled across every province in Canada. We had a very small cohort of 30,000 patients. But what was most impressive was that 10,000 of those patients were matched before doses even arrived. Like properly matched. You knew who they were going to, it had your name on it, they were taken care of, and you could move on to the next thing. And that was the thing that we wanted to share with other people. And so really, that was like the culmination of everything. It was the culmination of starting the company. It was the culmination of realizing pharmacies can play a bigger role in not just COVID, like even think, fast-forward to today. It's 2025, and you know, here, it's very sad to see this, but Albertan pharmacists have the widest prescribing scope in the whole world, which I think a lot of people don’t…

Leah  12:34

People don't appreciate that.

Joella  12:35

People don't know that. They don't. They're not aware of it. Most Albertans don't know about it, like nobody knows this. And pharmacies had a branding problem for decades, centuries, really. But the recent situation with, you know, the way at our healthcare system is distributed, and I always say, like, healthcare or like, yeah, procurement is generally federally procured, but provincially distributed. And so there can be gaps in how you're distributing to which community where, what are the nuances of that community? Do we share our information? Everyone's talking about how Nova Scotia got this right, or Alberta got that right, but then how you share that information so that we can actually work together and learn from that right? So it's a very sad situation today, because the pharmacy ecosystem has just faced some massive cuts where they've taken away the ability for pharmacists to get reimbursed for their work and their time. But on the other end of the spectrum, pharmacists are being asked to do more than ever before, like they are leaving the profession in droves, in hundreds. And they are leaving to other things. They're retiring. They're moving away from their practice. They can't take it anymore. Yeah, right, and that's not independent of just pharmacists. The entire healthcare system is facing that. So it's not independent, but yeah, that's that's where we are.

Leah  13:50

That's really exciting. So tell me where MedEssist is at right now. So for example, how many employees do you have?

Joella  13:55

I have about 20.

Leah  13:56

Okay, that's exciting. Very small team. Very small team. And then how many pharmacies are you in right now?

Joella  13:56

About 650 across Canada and the US. A big bulk of that is in Canada, of course, of course. But we've got quite a few customers in states like Pennsylvania, Washington, Florida, and two more that I'm forgetting at the moment.

Leah  14:20

That's okay, that's what we have computers for. That's incredible. So you're in North America. So let's just take a second there to pause, because I know entrepreneurs are not good at this, at taking a moment to reflect, yeah, on how incredible that is.

Joella  14:34

It is pretty cool.

Leah 14:35

How do you feel about that? 650 pharmacies? Very cool.

Joella  14:39

And yet my entrepreneur mindset is like, it's not enough. Like, what's the next goal? Is it 700 is it 750 is it 800 is it 850 like… That's just where you go. But I look at it from a very different mindset. Now as well, every pharmacy serves between 3000 to 20,000 patients, depending on if they're a small, independent or if they're a big banner or a big enterprise store. And so when I look at the beautiful thing about the way we've built MedEssist is… it's a true platform approach, like I've started to share with people, that we're actually 10 different product lines in one platform, and some of them you can buy independently, but most of them work really well together. And so if I think about that, the average user of ours has about 14 to 15 staff, and every single one of those staff is using the platform. And we can see that, and that feels really cool, because it's like, okay, you've not just bought something, and you're sitting on it and it's on your shelf, you're actually using this, and you're talking to patients. And one of the cool parts about MedEssist is we do a monthly town hall. That's not cool, but what we share on the town hall is data we share. How are we doing, like, how are we tracking? How are we measuring ourselves? Because we're very proactive around patient care and patient interactions. And we just had a monthly Town Hall last week, and we had some phenomenal data about how over 50% of our patients are actually over the age of 65, which feels so cool in 2025 I know that's so boring, but it feels so cool because it's like when you think tech, and when you think cool tech, you think young people, you think people with the latest phones. You think like social media apps. You don't think my father in law, who's 60 years old, ordering his medication and booking a service and like doing a full patient intake form in 45 seconds. And you don't think about, wait, how cool is that? Because you're bringing them into this ecosystem that's traditionally only for kids or like, young people. So called…

Leah  16:33

So called, right? That is incredible. So I'm going to ask you again, because you switched right to the data.

Joella  16:40

Tell me. Tell me.

Leah  16:41

What does it feel like to know that what you've built is having a direct impact on patients and the pharmacists too, making their lives easier.

Joella  16:50

I think it feels very cool. It really does, because there are tough days in startups where someone's got more funding than you, someone's got a big hire, someone's got connections to something, and their story gets told in a very provocative way that, you know, rallies the masses, and you can feel dejected very easily. But looking at how we solve solve actual problems, I think it inspires the whole team, actually, if I'm being honest. Because it's very hard. It's very hard to be in a startup. It's not normal. It's not a nine to five job for anyone. And we're definitely at a place in the company where people have started, you know, having their first and second kids, they've got their houses, they've got more responsibility and to see people show up and do their best effort. We have a wins channel, and everyone contributes to the wins channel. When a customer says something amazing, or when a customer points out something, or when we hear about something, like, we share it in that wins channel for everyone, because we're also a remote company. So it's really hard to manage culture and like, see people. There were some people that, you know, I would hire and I wouldn't meet them in person for eight months or 12 months. So that feels really, really cool. It's the thing that keeps us going. It's the thing that gives us the ability to wake up every morning and not feel dejected. It's like, Wait a minute. Go look at what we're doing. And everyone on our team has access to this. Everyone has access to, you know, seeing how a pharmacy is performing and feeling like, Oh, I didn't just convince this pharmacy to join us. Like, look at what they're doing. They've done this, and they've done that, and they've got all of these proof points, and it just feels so cool. It feels… it feels very cool. It feels very meaningful.

Leah  18:32

That's amazing. I love that for you and your team. That's wonderful. So you're growing super fast. You've expanded to the US. What is the real difference between working with pharmacies in Canada and in the US?

Joella  18:57

Oh, good question. I would say pharmacies in the US, they're even more hopeless and dejected than here in Canada, really, in many ways. So for scale, there are 88,000 pharmacies in the US, and there's 12,000 pharmacies in Canada. Oh, wow. And that's just massive. Now, again, like I was saying, pharmacies have this ability to be very influential in the community, because there's one on every block. So if you think about driving from Canada to, I mean, driving across Canada like I did from Toronto to Calgary, you'll probably run into over, you know, 7000 pharmacies just along your drive, because there's technically a pharmacy in every strip mall, and that same concept in the US is massive. So our pharmacist scope in North America is very disjointed. Even here in Canada, it's very disjointed. So what I mean by that is, I can go to British Columbia tomorrow and I can get birth control from a pharmacist. I cannot do that in Ontario. I could probably get treated for a migraine with more complicated medication that actually works here in Alberta, can't do that in Ontario, can't do that in BC, can do it in Montreal. And so the regulation has not kept up with the scope of what they learn in school, which makes no sense. It's just some some group, or some amount of people who are sitting there saying, This is how it's always been done, and they're very happy with that answer. And they have not looked at population demographics that have changed over the years in Canada, population density in towns that had 2000 people and now have exploded to 7000. Our population in Canada—I did a session with ex-Minister of Health, Jason Copping recently, and he shared this phenomenal data about how. The time we reach 2036 I think in Alberta we're going to pass 7 million people. Like, where's the housing for those people? Where's the healthcare for these people? Yeah, so we have to think about that in terms of this discrepancy between the US and Canada. Now, in Canada, we have a lot more capacity. We can do things in different different ways, like I said, and all the provinces and a big part of MedEssist is unifying that now, when we have US customers, our US customers onboard to the same platform, and they see all these tools in there, and they start drooling, and they're literally asking questions like, Why can't I do that? Can I do that? Oh, we can't do that here. I wish I could do that here. That would help me a lot. Or, you know, I'm in a very low, low-income neighborhood, not everyone has Medicaid and they can't afford healthcare. I wish there was something I could do about that. So really, what we've tackled this year is filling that regulatory compliance and unifying the profession gap. And that is the thing that I'm most excited about right now with MedEssist, because it means all of this time, all of the change that I've talked to you right, all of what we've discussed so far, it's just between you and I, and it's me and the company. Now, we can take that out to the world and show the world, wait a minute, let me show you what we can do. Your pharmacist can't prescribe you contraception in Ontario, rural Ontario, where the nearest hospital is 100 miles away. I can unlock that for you, no problem. Pennsylvania, you've got pharmacist prescribing has, not prescribing, pharmacist recognition to be billed by insurance is finally, they've got prescriber status. But most of the insurance companies haven't even made billing codes for this yet. And like, we can't sit down and just wait for them to make the billing codes. It might take a year. It might take two years, I have no idea. In the meantime, patients need care. Patients are going to the hospital. Patients need someone to do something about it. And whose face are they in front of? The pharmacist. They don't show up at the hospital and sit in the ER room for forever like sometimes they do. They can show crazy stories of patients dying in the hallway and things like that, but that doesn't happen to your everyday person. So if we can arm pharmacists with something that finally unlocks the ability for them to do what they've been trained to do. They learn this in school. Yeah, they've done education for this. It's not like we're waving a wand and saying, Here you go. Now you can do this. They've been trained to do this their whole life. And if we can unlock that, that is the beauty of tech. Like that is the whole reason to have a tech company. Otherwise, what are you doing?

Leah  22:47

Right.

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Leah  23:12

I love how passionate you are. They're so great. It's so great. But you know, you sort of mentioned this when, when you suggested that being an entrepreneur is really hard. And you know, every entrepreneur that sits here, I always ask them, let's reflect on that do-or-die moment in the evolution of your company that that go or no-go, moment when you're like, I just don't know if this is gonna work. Let's, let's explore that with you. What comes to mind when you think of that moment?

Joella  23:36

It's really just back to that COVID moment. But the reason is not for what you think. The reason is because, while we were here, having this very small pilot, 30,000 patients, doesn't feel big. Doesn't feel massive in the scope of the life science framework. It doesn't feel very big. What was most impressive, we were a team of five serving 30,000 patients.

Leah  23:59

That's kind of extraordinary.

Joella  24:00

Yes, all working remotely, all not allowed to see each other, and actually not just serving. It's not vanity metrics. It's not 30,000 patients clicking a button and saying, like, it's not 30,000 patients registering for a dose and then just disappearing into there. It's actual matching. It's… your name is on this dose when you get to that pharmacy and it's given to you, and it's given to you in time, in like, the right framework, because you are ought to get it and vice versa.

Leah  24:29

Which is a life-changing…

Joella  24:30

It's very complicated too. Yeah, it's very complicated. And it is life changing. It's saving, it's literal saving lives. Yeah, so that was very if there was any a time for us to think of ourselves as a school project, which is mostly what we thought of ourselves for the first couple of years, like we looked like kids walking to these pharmacies, we had backpacks at one point. My friend had me dogsitting, so I had a dog with me. Like we looked ridiculous, like we couldn't even take ourselves seriously at some point. But then when we started to digest and understand we're actually doing this, and when patients started telling their pharmacists, and then pharmacists started telling us, that felt… okay, we can do something with this. And what was cool, though, was every company has a chat of some sort with their customers and their users, and with pharmacy and the pandemic, or in healthcare, when you have something like a pandemic, there are executive orders that get released at the touch of a moment. Like they get passed down from the federal government to the provincial government to the communications team, blah, blah, blah. Pharmacists would tell us the executive orders overnight. Like we'd get messages at 1am, 6am, 3am. Whenever they'd get that message, they would come into our chat and tell us about them. And that felt very cool because, and very important because it meant that someone was putting trust in you. Yeah, it meant they're saying, I have this confidential message. I'm not supposed to share anyone, but you're the system that I use to distribute this, and you could probably benefit from this, so I'm going to tell you what's coming. Can you please build some way for me to do this?

Leah  25:53

Right? Because, can you help me?

Joella  25:55

And we… Yeah, exactly. It's, can you help me? Yeah? Just such an enduring and powerful ask, because it's like, I don't have the means to help myself. That's right. Pharmacies don't have a bouncer at the door. They don't have a receptionist at the door. They don't have an HR person. Like, they are everything. Even the enterprise customers, they are everything. If there's a lineup outside your big box grocery store, they can't really do anything about it. There's only so many people and hands on deck at a time. So that trust… That was that moment where it felt suddenly, felt like we've got to take these people seriously. There's people actually willing to ask us for help in moments where no one else can help them. They're not going to public health, no, they're not going to their bosses. They're not going to their banners or buying groups or, you know, the Ministry of Health. There's no one they can go to. They're asking us because we are in their face. They are using us every single day, and we are their communication to patients.

Leah  26:55

And you've been talking to them every day. And you know it's entrepreneurs sit here and they're like, We’ve got to talk to your customer to find out what they need. Well, that's exactly what you did.

Joella  26:59

100%.

Leah  27:03

And you built that trust in that process where you were trying to figure out, what can we do to help you?

Joella  27:09

Yeah.

Leah  27:10

That's incredible.

Joella  27:11

Yeah, yeah.

Leah  27:12

Isn't it nice to think about that?

Joella  27:14

It's very cool. I just thinking about also, when I first moved to Calgary, one of the pharmacists here, I remember I was training her, and she's like, you know, I have my daughter's going to school at U of T. Any chance you can, like, say hi to her? She's gonna be alone on campus. And I thought, wow, okay, what do you need? But again, it's just not trust.

Leah  27:35

No kidding.

Joella  27:39

I learned that from my Co-Founder too, because my Co-Founder runs these beautiful sessions where we work with about 100 pharmacy students a year with every pharmacy school in Canada except for maybe two. And that means pharmacy students who are on their second degree are doing 4-week or 10-week or 4-month rotations with us. And often, my Co-Founder will run these community sessions where he'll walk them through getting out of the mundane. Okay, you're studying for this exam. Okay, you have to know these drug interactions. But wait a minute, when a patient asks you, hey, I read this thing on Google that said that I can't take this with this, or if I take this with this, something will happen to me. And they come to you and ask you that question, that is a sign of trust. They're asking you to validate a myth or something that they've read on the internet and help guide them through something very personal—their own health. Yeah, and when I thought about that in the context of what we're building for the company, it just clicked for me. I realized instantly, this is what we're doing. It's meaningful. It's not just some marketing gimmick. It's actually matching people and talking to customers and seeing real-life situations happen right in front of them. Feels very cool.

Leah  28:54

It's incredible. Yeah, it's incredible. Oh, I love this. That's wonderful. So now, of course, that doesn't happen without all kinds of impacts on your personal life and like, what does that mean for talking to friends, family, et cetera? So I always ask entrepreneurs, too, what does this look like for you in terms of just your day-to-day life and your personal life? What does it mean to be an entrepreneur, and do you even have a personal life?

Joella  29:15

I think it's really hard to have a personal life. I would say I probably have a personal life in waves. I think there are waves where you can text me or message me, and I probably won't respond to you for weeks at a time. And then I come up for air, and I just, I try to get back to people, but it's… it's deeply… it sucks, actually. There's no other way around, right? There's no time for anyone. I was talking about how I got married with you, in September, back in September, and we just, we had so many barriers to trying to get married, because there were family deaths, and then there were family that we couldn't figure out how to bring them over. And there was, there was just always something, especially with my life, and how, how chaotic it can be around a startup. You know, one week I just can barely get a meal in with my husband over lunch. And then other days, it's like, okay, maybe we can take a break and do a bike ride or something fun. And like, in those moments, it's really hard, especially during the pandemic, it was extremely hard because for any of the rollouts we knew where the doses were, and we had this abominable task of trying to match people and do right by all of the stakeholders that you've earned trust from. It's like, okay, you've got that one step where you've earned trust, the next step is, okay. What do you do with that trust? And how do you distribute that responsibility? Carefully so it definitely plays on you. I didn't think that anyone would come to my wedding. I didn't think any… I didn't think I had a right to ask anyone to my wedding. If I'm being honest, I just, I remember telling my husband I can't send an invite out like I haven't talked to this person in four years, or I haven't said something to this person in three years. I've barely been there for them when they need me, and now I have the audacity to be like, hey, come to my wedding and celebrate me. That feels just wrong, but I was very grateful. My husband planned our entire wedding, and he did such a good job, and I did have people show up, and it was beautiful. It went by really fast. But overall it is really, really, really hard. There's no two ways around it. I think both Michael and I have had moments where you can see it on our faces. You can see red in his eyes from lack of sleep. You can see black under mine from lack of sleep, like there's phases. And we just think about it as you… you've got to do what you've got to do. That's it. You have people relying on you. You have a team relying on you. You have customers relying on you. You can't let them down.

Leah  31:45

No, you can't let them down, but that doesn't mean it's hard, for you and your team, yeah, when you're trying to do this kind of work. So if that's the case, then let's transition to what do you love about being an entrepreneur? Like, what gets you excited to do this really important work?

Joella  32:03

Seeing the impact that it has. Having a customer call you and say, like I mentioned, we have this wins channel in our ecosystem, our virtual headquarters, and everyone posts wins. And there was a chat just a couple of days ago from a customer here in Alberta. Literally, the guys like writing out quick, short sentences, like, as if he's WhatsApping us. “We love you guys. Everything works so well. This new build is so cool.” Or, you know, an actual customer leaving a comment on a tech video randomly on social media, like, “This is the best feature ever. It saved so many hours of time, blah, blah, blah.” And it just maybe the story sounds really weird to other people listening on the podcast, because in the social media world, in other products, you just you do that. That's normal. You buy a great pair of shoes, you buy a couch, you write a review. It's normal. Pharmacists don't do that. Okay? They don't have time. They don't like… they just do not have time. And if someone is stepping out of their day to tell us that we built something well, it is an incredible feat. It just feels super cool. And you see it on demos, like, again, going back to our wins channel, we have this demo where this customer is raving like, she's heard about us for the first time, and she's like, I can't believe you guys, “How long have you been around? Why have you been hiding from me? Like, why didn't you make a better effort to reach me? This is so cool. I can't wait to use it. I need to talk to my partner. When can I call you back? Can I call you back in an hour?” And it's, it's wild. It's so cool seeing that. I wish… We're gonna figure out a way to share some of this, because it just feels so cool, and you can't help it. You can't you. You have impacted that there is no one in our company. I think that feels like if they asked Mike or I for something, that we would say no. We'd always, always let them, you know, if they can come up with a solution, if they can come up with something they want, and they can advocate for themselves, we let them do it, and that feels very cool for them, because our team looks good in front of their customers, and that also feels special. Last year I talked about how I have never had someone leave us at MedEssist, ever. We've like, let go of people, you know, in the national transition of things, or students that have ended rotations, but I'd never had anyone leave us, and last year I had someone leave us, and I was so sad. It's when you go through your first like, you know, quit, it's, it's always so… it's so sad. Especially when you're growing them. And Founders grow people. That's just what we do. We don't have a choice. Like we're growing people. But it also feels like, okay, they've grown up. They're going on to something good, good for them. But this team member came back within three months and left a higher paying job, not marginally, like a very high-paying job, and came back and said, I don't get it. I was working for a company where there were no developers. It was like they were not building their own tech. I was selling to customers, and customers were taking out loans to buy this product, and when they realized that they were trapped in this cycle, they were stuck, and they would come complaining to me, and I could do nothing, and it felt awful. And I've had experiences like that myself, where I've, you know, maybe been at a company where we've sold a product that felt very predatory in some ways, and then you'd see the customer success team or the support trying to handle that, but there's nothing you can do because you've trapped them in some kind of legal binding system. And it just makes you think like, why would you do that? Is your product not good enough that you have to trap people and be sly and do all sorts of very negative-feeling… Like that's the complete opposite of what you're supposed to do with earning people's trust and building a company and solving problems as an entrepreneur. So that was really cool. Like that was the first for me hearing validation that, oh my god, we're not crazy, like people actually want to work here. Okay, cool. We've figured something out. That's a huge win. It is a huge win. That is a huge win. I put that in my board meeting because I was so happy about it.

Leah  36:16

As you should. Those are the stories that people remember and connect with. So as you should. You briefly mentioned it, but I wanted to just dig into it a little bit more. But impact is really important to us at Thin Air Labs, and I know it is to you as well. So I just want to ask you a bit more about how you think about creating meaningful human impact, particularly at MedEssist?

Joella  36:35

So what we're doing right now, this whole concept of turning pharmacies to clinics, it can be provocative, depending on how you understand what's going on. Not just in healthcare. I think we just talked about how, you know, there's a bunch of people that want to do things the way it's always been done. And the world is evolving. Come on, you've got to grow with the world. It's just… things are changing. We've got population density that no one's been able to handle before. So when I think about that, what we're really doing is turning the healthcare hierarchy on its head. And right now, your entire life, you have been told when you're sick, go to the doctor. Your entire life. Everyone has. But no doctor has the capacity to see you. Yeah, I read somewhere recently that there is no walk in clinics. There are no walk-in clinics, I mean, in Calgary at all anymore. Like they all tell you, do you have an appointment? How can you have an appointment at a walk-in clinic? It's a walk in. Complete irony. What's going on here, right? And so instead of trying to do it alone, and this goes for any one of us in life, like we need to rely on our communities. We need to rely on the people around us. So there is, there are stories of pharmacists and nurses stepping up all around all around the country. There's even some recognition of that in the new draft, I think, that was put out by the last health minister, where he said, We need to start embracing collaborative care. We really do, because no one has capacity. These are all humans at the end of the day, right? Yes, we've got AI, but AI can only go so far. AI is not going to start assessing you and prescribing you, not just yet. It could. We could probably get to a place where, you know, on Star Trek, and we have the Tricorder assess you and do instant X-rays or instant MRIs, but I don't think we're there yet, and in the meantime, people still need care. They need care yesterday, they need care tomorrow, they need care today. We need to do something about that. So what we've done right now is we've enabled a model of care which is new. You can go to a pharmacy, and despite the regulatory barriers and the provincial clap downs and blah, blah, blah, you can still get care for any one of like 16 conditions that we've put out. And these are things like contraception, diabetes supplies. What does that mean? If you're a diabetic patient, you're going to your doctor for your diabetic medication, but you need certain supplies to keep monitoring your glucose levels, your insulin—you need supplies. You can't just go out and buy that because they are not available off the shelf. You need someone to prescribe you that. Isn't that wild?

Leah  39:12

It's wild.

Joella  39:16

And you can't do that right now. You have to go to your doctor to do that, which makes no sense. It's nuts. So we've got about 16 conditions that we've started with, but our goal is really way more. Our goal is 3050, the whole gamut. Because, again, it's not that we're trying to be… we're not trying to, like, force someone into this, but we're more trying to say there's a pharmacy on every block. It's recognized as a healthcare site. Just give them the ability to do the basic things. And guess what? It opens up your capacity as a physician, or, you know, a surgeon, or whatever it is, to do the harder things that they cannot do, they can't do. Exactly. So that is what we mean when we say we're taking pharmacies from pharmacy to clinics, really, and very provocatively, we're making pharmacies extinct. There's not going to be such a thing as a pharmacy in about three to five years when we're done with this, like, there's just not. Every pharmacy student that graduates is going to launch a pharmacy clinic. Wow, either a pharmacist-led clinic or a pharmacy care clinic or a pharmacy health clinic, or whatever you want to call them doesn't matter, but they're going to be launching these because it gives them the ability to do this. And it's working. It's working. In Ontario, we've got… where this is most meaningful… We've got about 40 pharmacies up that have converted into clinics overnight without the renovation cost, without having to hire extra staff, without having to put up more branding and do a fancy press release saying that they're converting their pharmacy into a clinic. They literally just put up one poster saying, Hey guys, now I can solve for these 16 things. By all means, if you want to still go to the ER room, go to the ER room. It's free. We get it. Some pharmacies are doing it completely free, which is also wild, because they are in regions where the population density is 3000 people, so small, but the nearest hospital is 100 or 200 miles away. 6pm at night, where are you gonna go? You're gonna go driving to us? Like it doesn't make any sense, and the practicing physicians in these towns are all starting to retire. We cannot graduate doctors fast enough. So in the meantime, again, it's really that demand and supply program, that principle. It's what we've based our entire company around, right? If you cannot solve that problem, can you go upmarket and solve the next problem before that? And in this situation, we can. We've had, like I said, over 40 pharmacies on this program right now. We've done over 500 prescriptions, which is so cool, because that is actual… Every one of those 500 is a visit that we have evaded from going to the ER,

Leah  41:45

That's incredible.

Joella  41:47

It feels really meaningful in, like, a big way. Yeah, and that feels really cool. So when I talk about…

Leah  41:55

When you talk about impact, that's what you're talking about.

Joella  41:56

That's what I'm talking about. I don't care about the 600 pharmacies I've got that's cool. They're growing. They're gonna keep growing. I've put a great team in place, but right now, this is what I care about, and we've got quotes you talk about, like, what helps me get up in the morning? Our team put together a couple of quotes where they just asked the pharmacies, you know, if you had to talk about this, how would you feel? And this one, there's several, but this one guy stood out and said, This is the only true pharmacy care clinic model, because I can actually do things for my patients that nobody around me can do. So then you've got patients who've got nowhere else to go, and they're coming to you, and you have solved that. And that feels, that feels like impact that's actually meaningful.

Leah  42:36

Yeah, I love that. You get emotional, you know? I love it. It's my favorite thing in the world. Okay, so as we move to wrap this up, I ask everybody two final questions. You are the Co-Founder of MedEssist. You're writing the story for the company. How do you hope that story goes?

Joella  42:52

I want to do what I just said we're going to do. I think we're going to make pharmacies extinct. I think in the US there are, there are pharmacies closing every single week. I think it's in the hundreds. It's over 200 or something a year, which is a lot. But here in Canada, we have a new pharmacy school, the U of Ottawa. We have over 60 pharmacies that we have helped open at MedEssist, as in, they come to us before they've even made the decision. They tell us, hey, I'm leaving my job soon and I'm going to start a pharmacy. What can you guys help me with? And we can help them with a lot, which, again, feels so cool, like, what? How did you even hear about us? That's so wild, but they trust us. Okay, cool, very cool. But that's really where I wanted to go. I want students to be able to graduate and not feel like they're under the thumb of the ecosystem, or the physicians in their community, or the community capacity, or the health system… all of these redundant, bureaucratic red tape nonsense that doesn't help anyone, really. And I say this, you know, I'm speaking about physicians negatively here, and I want to make sure that I correct that, because this is not a solo problem made by us. I have physicians on my team. Yeah, my Director of Medical Affairs is literally an emergency physician who has worked in the ER room and understands this. So there are, there is a narrative of healthcare practitioners themselves wanting to help each other. They've hit their mark, you know? And recently, again, you talk about stories. I was watching the interviews done by my clinical team, and I caught my own team telling other healthcare practitioners, yes, I left the profession because of burnout, but I love it here because I'm actually making a difference. Like, I can see the difference that I'm making. That feels strange to me. How can you say that? Like, here you're working at a computer. There you were actually talking to a patient, and like doing physical things that you do with the patient. And here you feel more impactful. Isn't that strange?

Leah  44:53

But incredible.

Joella  44:54

It's wild, but like that is, that is where I want the company to go. I want our story to be defined by how many visits have we avoided from the ER? How many patients have you know, not seen their doctor in three years and finally, finally got access to something like a shingles vaccine? It just permeates every community. You can't stop it.

Leah  45:16

Yeah. We all need it.

Joella  45:18

We all need it. Something so simple, like this measles outbreak, yes, and, like, really, it comes down to that first, that first story, like I said, it's, it's. Demand and supply problem that we can solve. But then the other story is we've all forgotten, okay, cool, COVID happened, COVID is over. Everyone's got PTSD from it. We never want to talk to a pharmacist again. But like, the pharmacy is how we solved that problem. Yeah, the pharmacy in every country, the UK, Australia, Ireland, the US, every country stepped up in a way that nobody expected them to step up. So you've got to ask yourself the question, if they can do that for COVID, can't we do that for other population health activities? And the answer is yes.

Leah  45:58

Oh, that's amazing.

Joella  45:59

So yeah, that's where I want the impact to go.

Leah  46:02

I love it. I love it. Okay? And you're the Co-Founder. So this is you. This is on you. How do you hope your own personal story goes?

Joella  46:09

Ooh, I think being a Founder has a capacity for growth that I never knew I was missing. I always often tell my husband I don't recognize the person I was 10 years ago. I like, I see pictures of that person, and I do not associate with that person at all. Because I just… I can do so many more things now, and I have been forced to grow in a way that I never expected. When you let go of your first person, when you're trying to fire a customer, which is not something I think anyone does, but you know, realizing, hey, this customer is actually hurting the entire team's morale. When you're like, running on fumes and literally trying to figure out, like, should I even pay myself? Am I worth paying myself when other people need to get paid? It's really hard. There are decisions you make on a day-to-day basis that are really hard, and they don't get easier. They get more trying in their depth and how hard they are, and so the earlier ones do look easier, but really, the situations that you're going through now are just so much more complicated. But it's a capacity for growth that I don't think I would get anywhere else. So I'm very grateful for it. If I'm thinking about the impact for myself, what I would like to, what I would hope to achieve, is better, not balanced. There's no such thing as work-life balance for a Founder, it's not a thing, but better cognition and recognition of where I can help myself. I did my first ever CrossFit class, which feels super weird. But it's in an effort to, like, take care of myself and show up for my team and show up for the other people in my life that are not related to MedEssist, like my family, my friends, my acquaintances, etc. And to do that, you have to selfishly put yourself first, which is really, really, really not easy. I don't know if it's easy for other Founders, but it's definitely not easy for me. There are some days where I'll just skip lunch because I'm like, No, this person needs me more. I need to go solve that so I can unlock them and they can do the next thing. But I need to get past that. I need to get over that. So for myself, I hope that I can grow through that part of it. Not the business stuff, but, like the personal stuff.

Leah  48:18

Yeah, big area for growth. Yeah. For most Founders. Joe, thank you for this conversation.

Joella  48:21

No problem.

Leah  48:31

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