Ellen Su, Wellinks, on remote patient monitoring, connected medical devices and relating to stakeholders
In this episode of “Spotlight on Women in Health Ventures,” we interview Ellen Su, a co-founder of Cinch, a connected medical device technology company that focuses on building software and hardware to improve treatment and outcomes for patients with musculoskeletal conditions. The company’s main product, the Cinch Strap, monitors patient adherence to their brace and communicates these results to physicians. In late 2019, Cinch was acquired by Convexity Scientific, Inc, which aims to deliver digital health solutions that transform respiratory disease management. They have rebranded as Wellinks.
Have a seat at every table
Ellen realized that she needed to empathize with the interests of all stakeholders in the industry. So she sat down with and learned from as many people as she could.
Wellinks stemmed from one of Ellen’s co-founders’ personal struggles with scoliosis. After wearing braces up to 24 hours a day for multiple years, he underwent a spinal fusion. Realizing that young patients are often disconnected from their care and that no feedback is involved in scoliosis management, Ellen and her team turned to children to better understand why they weren’t wearing their braces.
Although physical discomfort was part of the issue, an arguably more important aspect was the social stigma associated with braces. Most of these patients were young girls between the ages of 10 and 15 — a time when being perceived as different from peers is especially harmful for self-esteem.
Based on these lessons, Ellen wanted to incorporate peer support in Cinch’s devices. She sought to connect patients to a community that is able to lend support through tips and tricks for managing life with scoliosis. For example, girls would post clothing items that did a good job of hiding the brace. The connection piece was vital to Cinch. Ellen and her team wanted to inspire confidence in discouraged patients, but knew that a credible product needed to be backed by physician support and data.
Seeking partnerships with physicians and researchers became a priority for Ellen; but at first, she did not introduce herself as a student, when going through an industry list cold calling orthopedic surgeons. After multiple rejections with “I am not interested in buying anything,” the Cinch team soon realized they needed to explain they were not telemarketing. “We noticed that when we mentioned that we were students and cited their work, they were more responsive,” Ellen now acknowledges. Researchers were excited with the possibility of their findings being put into practice, which enabled Cinch to get vast support from providers and scholars.
They partnered with a scholar involved in the largest NIH funded study in orthopedics, which confirmed that braces were effective in managing scoliosis, and that lack of compliance was the real issue. In addition, they had published about a 40% increase in adherence when patients knew that they were being monitored and clinicians were able to follow-up and discuss data between visits.
“I think people appreciate when you do the work to understand them and their world.” By taking the time to learn about the problem and the people affected by it, the team became experts in the field. This in turn made them competitive as a business.
Bring everyone to the same table
After you’ve taken the time to get to know the industry, it is time to bring together all the relevant voices at one table, in one conversation. And as an entrepreneur, it is your job to lead this conversation so that it is beneficial not only to your company, but also to everyone at the table.
Cater to each stakeholder’s need
Ellen was often told that scoliosis as a market was too small, and that she should consider applications of brace technology to other musculoskeletal conditions, as this was a $4–6 billion industry. Ellen and her team needed to communicate Cinch’s huge market potential to investors.
Scoliosis is the second greatest healthcare expenditure for children in the United States. The condition is linked to over $1 billion in healthcare costs annually, and each corrective surgery costs approximately $200,000. This does not include long-term maintenance care (physical therapy), follow-up visits, and braces (1% of the cost). Ellen insisted that even if Cinch could prevent one surgery, it could erase the need for hundreds of other interventions.
Physicians and researchers understood the importance of preventing one surgery. But Ellen knew that the big data Cinch generated was not a draw to doctors.
“It’s what you do with the data to improve care and outcomes. You have to figure out what is making a difference,” Ellen advises. So, she focused on translating big data into useful insights for patients and physicians.
Once you have ensured that everyone is speaking the same language, it is important to guarantee that everyone’s needs are being considered.
One of the players in the conversation who Ellen knew she needed to reach a common ground with was manufacturing companies. They were focused only on manual production, and Cinch could contribute technological innovation. After much consideration, it became clear that Cinch’s goal was to develop a new code for brace monitoring and have this reimbursed by insurance companies.
On the other hand, insurance companies are looking for clinical evidence and patient demand. They ask questions like: Do people want to use this? Will this save us money? Another example is collaborating with pharmaceutical companies. They are willing to subsidize the costs of devices for patients in order to receive de-identified patient feedback and data.
In all of these conversations, potential collaborators and investors will ask valid questions, many of which may not be what was in the entrepreneur’s original vision. You have to not only consider your vision, but have to ask:
What is important to the people you are talking to?
When you consider everyone’s input, you are better able to match your product and your company to the key players.
But don’t go down a rabbit hole
Almost every time Ellen spoke to an advisor, she would be asked, “Have you thought of [blank]?” One person suggested repurposing the device to measure how heavy a backpack is. Another suggested her company design a smart dog-leash to help train dogs.
With only a five-person team, Ellen was aware of her limited resources, and therefore considered exploring other areas with an opportunity-cost perspective. She wanted to focus on scoliosis, and in order to help the most people, she needed to convince investors of the market opportunity and make a sufficient return.
Ellen reflects, “We had to be selective in the advice that we took from our mentors. Oftentimes, we would receive conflicting ideas.This was similar for investor conversations.”
However, in times of difficulty, it may be necessary to consider ideas that may at first seem a bit unusual. These creative solutions to problems can be lifesavers.
There came a time when Cinch was running out of money and needed bridge funding — Ellen remembers having to stop taking salary and doing side gigs for a year to pay bills. She put spending in hibernation mode and focused on strategic partnerships, manufacturing, and clinical studies — all in the hopes of finding a tactical next step for the company.
In the fall of 2019, Ellen began a conversation with Convexity through a mutual mentor. Convexity had just raised a $3.5 million Series B round and was focused on the respiratory disease space. They had one product, a nebulizer, for asthma and chronic obstructive pulmonary disease (COPD) patients. They were interested in building out a digital health platform and connected devices, and did not have the technical expertise to do so. Cinch, on the other hand, had the expertise but not enough funding. Soon after, both companies merged.
Final Advice
Ellen certainly dealt with her share of rejection. She advises young entrepreneurs to not take it personally — “No one says no to you directly.”
It is more about finding those who will guide and support your vision. Cinch thrived with mission-based and female-focused venture firms, like Refinery, 37 Angels, and Golden Seeds.
Surround yourself with mentors who are cheering for you, not just for your business but also for you personally — Ellen has found this in her female mentors. She also found support in looking up to founders that are 2–5 years ahead of her, many of whom have overcome similar challenges.
Finally, she urges us to ask ourselves if we are genuinely happy in our current roles. “You can’t set yourself on fire to keep other people warm.”
In healthcare, we can get caught up in a service mindset, but for the wellbeing of both yourself and your company, you need to come in with a good headspace.
Note: Convexity acquired Cinch and they rebranded as Wellinks.
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Story written by Luiza Perez and Priya Kumar.
