Lessons Learned: From a Health Tech Startup So Early Stage It's Still Got a Vestigal Tail

**Note to fellow early stage founders - when you can't sleep, spooling up a new Posterous is a great cathartic way to slow the mental gyroscope. I wrote this post pre-counting sheep last night.**

1am and all is well. And quiet. 

This isn't insomnia. My eyes feel like they have hidden fishing weights rooted to the sockets. I could probably start drooling and twitching upright in my chair. 

Now I see why programmers really get rolling between 11pm and 4 or 5am, despite the never-quite-conquered desire to snooze. There's no one around. It's like the external world is giving you a pillow of silence and stillness, gently, like a doting parent tucking you in tight. Anyone who wants to be up and moving at this time *really* wants to be doing, well, whatever it is they're doing. 

And so do I. And so I'm awake.

It's day 5 post-launch of Contagion Health's first web app,
 Get Up and Move (#getupandmove). 

Andrey and I decided to go out on a limb and show you a snapshot of our admin stats panel so you can see *exactly* how we're doing.

After all, this is your community of micromovement. You generated this data - you own it. 

As my Get Up and Move co-creator Andrey said when he read the draft of this post: "Feel free to put up a screenshot of the admin panel, if you're alright with the tongue-in-cheek Funding. I always wished more companies put up a glimpse of their "secret" admin stuff."

Two things to note as you view the panel...

1. "Completed Challenges (far right)" = challenges where BOTH the initiator (user 1, or U1) and the responder (user 2, or U2) have done their part. We don't count a challenge as finished until it's a 2-for-1 done deal.

2. Yes, we are looking for funding. Our B2C biz model for the web app = who the hell cares. Our B2B model = enterprise/white labeling for inclusion in employee wellness programs we think are so cool we'd actually use them (and of these we've only found 1 so far). We're using the DM model AmericanWell employees ($ per user/year). But more about that fun stuff later.

Back to the #getupandmove narrative. I have a feeling it's going to be an epic...

I'm going to tell you about this journey in occasional, lengthy posts framed in typical blunt-force-trauma style. I'll use the collegial tone, even though it's a risk, because most of the assumptions 'pre-founders' have about launch are complete horsesh&t. 

This whole startup tech blog world talks a lot of smack about what works and what doesn't, but the big secret is that we're all just sitting scared sh*&tless and tharn in front of our screens before we pull the trigger. 

One founder friend who is very successful told me he used to hide in the closet with a sleeping bag and flashlight for launches. 

This is orifice-clenching, teeth-grinding stuff. And that's CODERS talking about the feeling of launching - these are the folks who actually build and test the stuff in the wee hours obsessively, and thus have some significant control over it's developmental stages. 

It is, unfortunately, not a very different experience for someone who has no coding control, for someone who has gone from patient, to patient advocate, to nonprofit healthcare administrator, to healthcare tech startup analyst, to Health 2.0 blogger, to health+social media consultant, to hax0r wannabe, to health tech startup founder bootstrappin' it for all I'm worth - and then some. 

I certainly don't recommend a similar trajectory, unless you've got balls of steel and brains of Jello. Or probably both. 

Unless, of course, you are seeing something, or things, burnt onto the insides of your retinas before you sleep. Unless there's something, or things, you want and need to see built so badly that you would sacrifice anything to try and birth them. 

Then, by all means, go forth and build, young Jedi. 

I want to share some of the stuff we've learned thanks to your open and honest feedback (via 
our UserVoice forum
). And I want this sort of embarrassing gutcheck postmortem to become part of other early stage tech startups' journeys. 

Disclaimer: If you don't know what the hell I'm talking about, you probably haven't tried Get Up and Move
 yet. If not, follow @contagionhealth
 on Twitter, then mosey on over to getupandmove.me. The app uses your Twitter login information (it's built using Twitter's API) so there's no signup or profile creation. You'll notice it's free, and there's no ad-assault going on. 

So give it a try, and come on back and tell me what you think. Honestly. Like I'm going to share some lessons learned with you. 

Andrey and I have discovered some really amazing things in the past 120 hours. About ourselves, about Twitter, about each other, about you. 

Yes you, dear reader, dear alpha and beta users, dear masters of the microfitness universe who dared to try out being 'guammies' at this early, squalling infant stage. 

Without further ado...

Lesson 1: You've got a teensy weensy little SM streak in ya! 

Supporting Evidence: You *love* issuing challenges. My arms feel like wet spaghetti noodles. I'm doing between 2 and 5 minutes of pushups per day. I've had to start doing 'girl' pushups again, along with interesting versions of wall pushups (for triceps) and finally dips on the counter edge. 

And I'm loving every elbow-wobbling moment. This is *exactly* what I wanted. Exactly what I needed. Someone, well, several someone's actually, to push me further than I'd otherwise permit myself to go. 

Lesson 2: Some of you really, really like to be told what to do. 

Supporting Evidence: You *love* completing challenges. Quick, fast, and in a hurry. Sometimes I've just barely clicked "Done My Part" and then started the timer before you respond with - whabam! - a notification that you've completed the challenge. 

Lesson 3: If I have met you face to face (in addition to being buds on Twitter and/or Facebook), I'm more likely to finish your challenge (and immediately or near immediately after you issue it), unless you sh&^ talk me on Twitter and shame me a lil' bit in the public square. 

Supporting Evidence: Some of our guammie friends may not like the are-you-ready-to-rumble approach, which is why Andrey and I designed the app to deliver challenges via safe, dark-corner, agoraphobic-friendly direct message rather than via public tweet. 

Interesting point here...my mom @susanlindsey is now bugging my friend @ePatientDave and Los Altos startup pal @alexdmoore for challenges. She likes knowing the people I work with (and guys, if she starts asking questions about whether or not I'm eating well or brushing my teeth, the answers are always "yes" and "you betcha."). 

My dad @litomikey said flat out that he doesn't really need the motivation to work out. This is a guy who's a former Navy SEAL, taught my younger sister @kbluey and I to poke someone's eye out using a thumb and a dirty look, and just kicked my butt at the gym on Friday (and that of my younger, Jacob-buff cousin Jack). He is NOT going easy on me just because his semi-sweet daughter launched her first app. 

Instead, he pointed out that he's sending me challenges (and accepting mine) not because of the movement aspect, but because it's *me.* 

This is more than random acts of microfitness. This is more than 'instant' exercise. My dad feels closer when he thinks of me being happy and healthy, even for 2 minutes of pushups where he probably doesn't know I'm cursing his name (ahh, whoops, sorry about that Pop!:).  

This emotive connection is fascinating, and emergent in a ridiculously simple 1:1 Twitter app. That leads me to our next revelation - although we can't take credit for this one...

Lesson 4: Location, location, location. You want to share WHERE you're moving.

Supporting Evidence: An interesting number of GUAM users are already adding 'addendum' tweets with location-based data, which you are typing as free text and then sending as a SEPARATE and independent DM or public tweet or email or Skype chat or text or message in a bottle. Just kidding about that last one, although that'd be a damn awesome way to get user feedback. 

Anywho, you're telling us things like how you just closed the door to your office, squirreled out of your desk chair, and busted out 2 minutes of crunches on the floor. Or that your 5 minutes of running was to the 7-11. To get a Nutty Buddy ice cream cone. <crickets/> 

Point is, a certain subset of you seem to *want* to make the initiator of a challenge aware of your surroundings, so we can get a nice mental picture of where you were when you moved it for us. It's like returning a favor or something. 

But we didn't ask for that at all, and that's another nifty emerging norm that we'll do something about programmatically to easily allow you to 'check in' Foursquare style if you so choose. 

When Andrey and I talked about this, we went back and forth about the utility and privacy risks related to allowing personal geolocation (although I'd planned to do this from the beginning with the #getupandmove mobile applications). 

I explained that I like to get a smell of the Blacksburg VA air and see my sister Kate's thoughtful look over the horizon when I challenge her to 15 minutes of walking (with my niece or nephew onboard in utero). 

It's this personal and sensory connection that matters most to me with Get Up and Move, this weird and wacky deepening of ties enabled by something as stoopid simple as a Twitter-based challenge. 
For some reason, it just works to create a picture in my mind's eye that reminds me of the people I love most and miss most (and that I should probably return their phone calls more often). 

So we'll work on how best to allow you to set the scene for your Get Up and Move friends. If you've got druthers, send em this way. I give you permission to be harsh. And speaking of permission...

Lesson 5: You maybe want us, or the app Gods and Goddesses, to give you permission to RT the challenge, and maybe to add a little additional incriminating info. 

Supporting Evidence: Although tons of you asked for a public RT button, we expected that if you want to call someone out on Twitter - slash - motivate them to #getupandmove, you'd just take the initiative and copy/paste and RT that way. 

But almost no one's done that. It's like the community of Twitter users who are also using Get Up and Move are awaiting permission, aka us programming in the RT button on our app. 

Andrey disagrees with me here, as the best startup teams do...He doesn't imagine you're waiting for permission, but rather that the "culture of Twitter discourages blind copy/pasting, people feel as if they have to add a 'taste of themselves' into each message to justify sending it out." 

That's why plain RT turns him off. (Note to healthcare brands trying to negotiate the Twitter landscape - Andrey's just told you everything you need to know, and while responding to a message at 5am no less). 

Relax, my movement loving friends. We shall deliver. Andrey's got something really nifty up his sleeve.

Lesson 6: You want to be able to respond to a challenge later. Even if it's a tiny time commitment and easy to finish, you want control over *when* to respond.  

Supporting Evidence: Maybe work isn't really the type of place where shaking your groove thang to 2 Taylor Swift songs is the type of thing management smiles upon - especially right before those holiday bonus checks are cut. 

Andrey and I talked about this for a bit pre-launch, but then decided that we wanted to keep the 'micro,' 'random acts of fitness' mantra intact. 

We firmly believed (and I still do, actually) that challenges should be able to be done just about anywhere by just about anyone, with no special equipment or training, and completed in less than the time it takes your barista to whip up that limited edition Peppermint Mocha (no whip). 

But here's the bottom line: Calendaring or 'snoozing' a challenge is better than you refusing because you can't do it instantaneously. Far be it from us to stand in the way of your progress. So look for something nifty in this area soon.

Lesson 7: You want control. I know. I should be ashamed of myself for getting this one wrong. So I'll issue an apology. We underestimated you.

Supporting Evidence: I thought that if we gave you the ability to create your own challenges with no constraints (just user/user, open A variable for activity and open T variable for time in the Get Up and Move equation) you'd mess something up and alienate people, or create something too complicated, or, even worse - not use the app at all.

Andrey maintains a healthy dose of skepticism about what will happen to the ecosystem if we let loose the constraints on activity and time. As he says: "I'm still suspicious about this but we're here to experiment, right?" 

How very paternalistic of us. Indeed we are here to experiment. But so are you. You are the early adopters, the innovators. The people who try the next big thing before it's the next big thing, when it still may *never make it* to the next big thing (although mentioning that to a startup founder is like naming The Scottish Play). 

Although our motives were noble - to launch with just 3 challenges just about anyone would look at and say "Oh yeah! That's so friggin easy! Of course I can do that..." - we may have messed up badly here. I'm not sure yet, but we'll see next week when we start building the big feature push for version 2. 

I hope you can wait that long for some new stuff....and that brings up...

Lesson 8: Founders - launching an app is like the end of year 1 in a marriage, where you can say objectively your spouse still looks pretty good first thing laying on that pillow next to you hogging the covers, but you're over the morning breath. 

You will have to harness both boredom (with yourself, with your app), a lack of confidence (will we make it through this together?), and prioritize in real time (LAN party or movie night with the significant other?). 

You have to fall in love with some small, newly unearthed or rediscovered part of your app EVERY. SINGLE. DAY. If you can't, it's only a matter of time til the divorce happens (and hopefully someone gets a fat successful-exit settlement before you look for spouse/startup #2). 

Everyone I've met in the Valley BS's about iteration, iteration, iteration. They say it's to keep the users from getting bored and searching out greener pastures. That's horsecrap.

So-fast-you-can-barely-code-it-and-debug iteration keeps BOTH sides from getting bored - programmers and participants using the app. With our always on, instant gratification world, it's iterate or seek amusement elsewhere. 

But, the good news is each one of us has control over our responses. No matter how cool Andrey and I make Get Up and Move, you'll always have millions of other options about what to do with your time. 

Speaking of responses, the cool thing about this early Get Up and Move community that both frightens and excites us is that we're trusting each other. There's no way to verify if I'm actually weeping on my stained concrete studio floor doing the 8th crunch challenge of the day. It's working on the honor system. 

For the mobile application, we'll use the accelerometer and some other nifty stuff including timestamping to VERIFY that you're at least moving when you're logged in, but for now, it's tell the truth.

And who'd try to scam a system like this? There's no gain for misdirection or untrustworthy behaviors. Ahem. I have to admit, since we created the app, I tried to cheat. I really did. 

I challenged my dad (sorry Pop, you're getting all the fallout today) and then lied. I said I'd danced for 2 songs when I hadn't done it yet.

You know what happened about 5 minutes later? I felt so damn guilty seeing my dad doing pushups on 2 repaired shoulders *for me* *because I'd asked him to and for NO other reason* that I got up and danced to 2 Beatles songs. 

I'm not encouraging cheating the app before we have a way to verify your movement and location. But you could do it if you really wanted to. 

Or, you could take the easier route and just move your a^% for a minute or so.  

We just hope you'll move it with us, and each other. 

Bottom line: No one controls your boredom, or decision paralysis (or lack thereof) or your 'adherence' to a healthier lifestyle but you. Lesson learned. 

We're looking at ways to let you create your own challenges and let loose the real exponential power of self motivation turned outwards and traded for the movement of others. 

And while we're talking about control, I'm going to exhibit some and get some shut eye. There are many more lessons swirling around in the brain pan, but frankly I'm worn out from a day of moving and shaking. 

Plus, I have a feeling I'll be moving a lot again tomorrow, thanks to all of you...

Jen S. McCabe

CEO/Founder: Contagion Health 

CoFounder: NextHealth (NL)

LinkedIn: Jen McCabe 
Skype: jenmccabe

iPhone: 301.904.5136 
Dutch Mobile:  +31655585351


Posted via email from Jen's Posterous

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