September 27 2018
Eden Health

Words by Rachel Sugar

Eden Health is a subscription service for employers. A company signs up with Eden, and Eden, in turn, provides access to a cozy healthcare cocoon. Think of them like the company doctor, if the company doctor was also available by app round the clock.

Company Breakdown

Location: Eden Health

Employees: 20

Founded: 2016

Funding to date: $4 million

“We’re the first point of access for employees when encountering the healthcare system,” explains co-founder and CEO Matt McCambridge. In practical terms, that means that Eden has its own staff of salaried medical providers — a mix of Physician Assistants and supervising MDs — who manage patient care 24/7. They provide round-the-clock telemedicine through the company’s online platform and offer same-day appointments in two different Manhattan locations (a third is forthcoming). If a patient still needs to see a specialist, the clinical staff will refer them to someone pre-vetted who actually takes their specific insurance; if a patient has questions about billing, they help sort it out. “From the very basic to the very complicated” — dermatitis to cancer — “having somebody who understands the healthcare system and understands your financial situation is really, really important,” McCambridge says.

He’s all too familiar with the alternative. As a kid, McCambridge watched his older sister navigate the healthcare system. She was sick, but no one was sure what was wrong. It took four years and more than 70 specialists to get a real diagnosis. “It was a dehumanizing experience,” he says. “They tell you they need to take a new image every single time you come through — even though you’ve done the same one the week before, your tests don’t go with you. It’s totally uncoordinated as a system.”

It shouldn’t be all that radical to combine telehealth (that is, care-via-app, phone, and so on), in-person primary care, and insurance navigation, McCambridge points out. The problem, he says, is that the current incentive structure of healthcare doesn’t support efficient, patient-centric care. But comprehensive care is in the interest of employers. Since they’re the ones footing the bulk of the bill, it makes sense they’d want their employees to avoid duplicate procedures and unnecessary ER visits.

Employees want good, approachable, effective care that’s easy to access. Employers want to save money, without sacrificing healthy, happy employees. (Happy, healthy employees also save money.) Eden works by bringing those goals into alignment.

“The simplest way to think about it is that insurance companies have effectively inserted themselves into the medical office,” says Eden co-founder and Chief Product Officer Scott Sansovich. They determine what’s covered and what isn’t and how much it’s going to cost. “It’s this added layer of complexity between the patient and the provider.” It’s a design problem, he argues. And Eden is designed to insulate providers from those types of complexities, while also arming them with technology that allows them “to actually operate in a way that’s convenient for them and for the patient.”

Like its founders, Eden Health is young, having launched in 2016. (In March of this year, the company announced $4 million in seed funding.) Right now, the company is headquartered at Grand Central Tech. As of this writing, the staff currently numbers twenty, including McCambridge and Sansovich, though, by the time you’re reading this, the number will almost certainly be higher. “As we expand as a company, it will be about really deepening what we can do for employees,” McCambridge says. “We want to continue to grow independently for as long as we can.”

Annelie Roding always knew she was going to do something in medicine. “I was that kind of...strange person in the neighborhood,” she laughs. “When there was roadkill, I’d look at the insides.” Now, she’s the clinical quality manager at Eden, in addition to being one of the clinicians herself. And while her background is in medicine, she’s quickly come to embrace the technology side of the business, becoming a critical liaison between the clinical and technology teams. “I take a lot of pride in finding bugs,” says Roding. “If they need someone to test a new feature or something, they come to me. I'm like, YES I LOVE TESTING!”

On Pets

This is my dog, Marley. He’s not currently living with me, but he's the love of my life. He went to live with my parents for a while, when I was in grad school, and then my dad and Marley fell hopelessly in love. They’re best buddies. Marley doesn’t leave his side. When my dad sits in his study, Marley will be under the desk, sitting on his feet. My mom calls herself a grand dogmother. At this point, I would feel bad taking him away from my parents. They feed him kangaroo from Australia — I can’t compete with that!

A quirk of Eden’s corporate culture is an unlikely devotion to squash, and Roding has become a court regular. “It just started happening!” she recalls. Brian Lee, Eden’s director of engineering, introduced the idea. “He said, ‘oh, we’re going to play squash today,’ and everyone went.” These days, she says, it’s gotten pretty competitive, though not so competitive they can’t reunite for dinner after.

Roding is Swedish, and while she was born in the States, she credits her interest in healthcare systems to her childhood in Sundsvall, a small town four hours from Stockholm. “That’s where I became obsessed with the idea of universal healthcare, that everyone should get healthcare at an affordable price. It’s something that just seemed like what should be normal: the same way you pay taxes to go to public school, you should pay taxes to get healthcare." These days, she lives in Astoria, Queens, but while she is enthusiastic about the neighborhood (she is enthusiastic about most things), she’s preparing to make the move to Manhattan. “I feel like it’s a rite of passage,” she says. “Everyone has to pay super-expensive rent for a shoebox to live in.”

On early morning hours

So I wake up, I check my phone, I start answering questions from patients. If it’s an acute medical complaint, we start with asking them if there's any sort of emergent symptoms that would warrant them a trip to the emergency room. So, a sore throat is a good example: there are few things that could cause emergencies if you have them as a result of a sore throat. So we'll ask them, ‘Okay, are you having any shortness of breath? Any difficulties or pain swallowing? Do you have any other associated symptoms? If they answer no to those emergent things, then we go through other questions that would point us to the correct diagnosis — it’s a decision tree. Eighty percent of the time, the correct diagnosis can be found just by taking a medical history, so we do that right over the app. We ask them questions just like we would in-person, and if there's something that we’d like to see in a physical exam, we just have them take a picture. With phone cameras these days, I can see just as well as I could in-person.

The clinicians all have our on-call days — days when we’re supposed to be available for telemedicine and in-person appointments —  and then we each have an off day, where you can literally throw your phone in your laundry basket and forget it. Technically my clinical off day is Tuesday. I tend to still be on, though. I do like providing care. It doesn't really seem like a job to me.

Annelie Roding, Clinical Quality Manager at Eden Health

A good book

This is going to sound so geeky, but I’ve been leisurely reading Lange Family Medicine, which is just like, a medical textbook. This is my first time practicing exclusively family medicine — previously I was working on ear, nose, and throat — so I’m reading up on all the things I don’t want to miss out on when I see it in person.

On true crime

I watched this crazy Netflix series yesterday, Evil Genius. It’s about the pizza bomber. I don’t want to say it’s my favorite, but I definitely recommend watching it.

Annelie’s Top Three True Netflix Crime Docs

The patient room of Eden Health's Financial District location in Manhattan

An early hire even for a company as young as Eden, Brian Lee is mainly responsible for two things: he’s the company’s director of engineering, and he’s the guy who got everyone into playing squash.

Lee is no stranger to early stage startups. Before Eden, he was an early hire at TripleLift, which he joined “nine months after they incorporated, but before they had a real product.” After five years there, he decided it was time to move on. “I always feel like five years is the max you should be someplace,” he says. But initially, he had some reservations about joining another company that was just getting off the ground.

On ending up at Eden

I'd just done a super early stage startup, so I was looking at places that were a little further along. There are a few downsides with super early startups. Obviously it's a lot more risky. You don't have the support of an actual team, so you're doing everything yourself. You have to go through those challenges of growing a company, growing a team — it’s hard. After TripleLift, I thought, do I want to do this again?

Scott and Matt are both first-time founders, and they’re pretty young. But the more I talked to them, and talked to the investors, the more I felt like, well, guys with years of experience in the industry find what they’re saying credible, I think what they’re saying is credible, and then I talked to my dad, who does a lot of VC work, and he was like, “sounds credible.” Eden is the kind of business model that's really attractive, I think — especially if you're an investor — because it’s a membership. If a company gets rid of it, it’s noticeable — something goes missing from their employees lives. In ad-tech, sometimes we’d get a million or two million dollar sale, but then that’s it. You have to go back out and keep selling in order to get revenue. But here, once you've made a sale, it'll keep coming back. Right now, Eden has a 100 percent renewal rate.

Before I accepted, these guys took me out to dinner, and after dinner, took me out to drinks, and after drinks, took me out to more drinks. But even when they're just hanging out, just chilling, they talk about solving hard problems. I specifically remember Jonathan [Eden’s chief of staff] talking about how he would fix the MTA and I remember thinking, this is the most insane thing to be talking about. I liked these guys. They don't run away from hard things, you know?

On hiring

There are four people involved in the interviewing process for engineers, and none of us have ever all enthusiastically liked a single candidate—which is good, I think. It shows that we look for different things, and someone has to have most of those things.

I always look for people who are a little more curious, more willing to try out new things. People who are capable of thinking outside the box, but who also are very realistic about how to apply it. I care about someone's potential. What do they want to do? Do they have a clear vision of where they want to be? Because as a manager, it's my job to help people get to that point. If they have an idea of where they want to go, and if they have an idea of how they're going to get there, that already shows me that this is someone with some sort of ambition.

On food & wine

A few years back, I took the first Court of Master Sommeliers exam. I don’t actually want to work as a sommelier, but I want to know what I’m talking about. So I sat down with two of my friends and multiple times every week, we’d be drinking wine, we’d be blind tasting, quizzing each other: where is this grape grown? What type of soil? I like Barolos. They’re made from the Nebbiolo grape, grown in Italy. It has a thin skin, but it’s a highly acidic, highly tannic grape, so it feels like it has a lot of weight to it, but because it's thin skinned, you can [almost] see right through it. It's much more light bodied than say, a Cabernet or a Merlot.

Brian's Monday Morning

Monday, 9:30 AM: We have our morning stand-up. After that, I’ll sync with our head of product, and we’ll plan out what we need to get done from a product and engineering perspective, just get aligned for the week ahead.

Lunch: Today I had sweetgreen. That’s healthier than my usual options. My go-to is this place called Kiosku. It’s basically the takeout portion of SAKAGURA — literally, it's like a kiosk.

Sprint Planning Session: My philosophy is you always want to make your sprint planning meetings as efficient as possible, ideally 10 to 15 minutes. It’s just prioritizing the tasks for the week. Usually, we have a pretty good sense already, because we’ll have talked about it the previous Friday — right now, we’re doing one-week sprints.

Matt McCambridge and Scott Sansovich have been friends since freshman year of college, and colleagues since they became mutually obsessed with the state of American healthcare. Both are keenly aware that what happens now, while the company is still in early stages, sets the culture to come. “To be very candid, once you hit 25 people, it’s very, very hard to start to change a lot of internal dynamics,” McCambridge says. Right now, they’re at twenty.

Matt, on cooking

I'm on the board of a school in the Bronx. A friend and I used to teach Saturday cooking classes there. The first class, we thought green eggs and ham would be fun — it was just blended cilantro — but people were, like, not so sure about the green eggs.

I like to cook for dinner parties. My crowdpleaser is a fennel au gratin, with potatoes and gruyere. It’s really good. Barefoot Contessa action.

On office culture

MM: We're not overly focused on everybody being in the office. We are focused on everybody getting the work done, and we track that on a weekly basis basically. I typically work from the office. I just like it.

SS: We’re not philosophically opposed to remote work. I think just given how small we are, we're trying to move fast and given the domain complexity, we really just try to often get in the same room and hash things out.

MM: And people like it. People like being here. People hang out a lot, whether it's impromptu squash nights, or whatever. We have one guy who's all about squash. And so he started saying ‘let's play.’ And then the courts are close… I just think that people like working here. You know, there are other people on this floor that aren't our team members, and on a Friday, we are the last people here. This last Friday, everybody was still hanging out at 7:30, which is late for Friday. And nobody is saying, you have to stay.

On interviewing

SS: When you think, ‘I want to build great products!’ you often don't think of healthcare, because your experience with healthcare technology is crusty web portals and weird check-in kiosks, 1995-style websites, things like that. Not beautiful, intuitive, simple interfaces. So the interview is a bit of an education process, where we’re explaining, ‘here’s why [healthcare] is broken, here’s how we’re fixing it.’

MM: Anytime we have an opportunity to go work on an idea together with a person, we do that: Here's something we're thinking about rolling out clinically, what's your view on this? What's your input? At this stage of a company, you're looking for everybody to be contributing and excited and thinking about this stuff when they're going home. You don't want somebody to end up here and be like, ‘oh, I thought we were doing this thing, but it turns out we’re doing this other thing.’ Working with somebody through that process is just a cool way to get alignment.

The view outside from the floor of Eden Health's office situated in the Financial District

"The interview is a bit of an education process, where we’re explaining, ‘here’s why [healthcare] is broken, here’s how we’re fixing it."