The Connected Care Team

Virtual Care for Menopausal Support

• TigerConnect • Season 2 • Episode 20

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In this episode of The Connected Care Team, Jill Angelo, founder and CEO of Gennev, discusses the importance of education around menopause, integrated care models, and virtual care opportunities. Jill explains how technology provides value when addressing the gaps in resources and support for menopausal women. 

Gennev's mission 

Menopause is a hormonal shift every woman goes through, starting in her forties. Although it is a condition that affects all women, there is little education and support available. Jill Angelo created Gennev to address this gap in women’s healthcare. The clinic's mission is to improve the standard of care for women experiencing menopause by increasing access to support and quality care. 

“We surveyed 1,500 women to really understand where did you go for your menopause education? You know, how'd you learn about it? And the overriding insight in that research was ‘I was unprepared.’” - Jill Angelo, CEO of Gennev 

Integrated care in menopause 

Gennev’s purpose is deeply rooted in integrated care with dedicated healthcare experts on staff. OBGYNs provide medical guidance, diagnosis, and even prescription support. A team of health coaches and registered dieticians address nutrition, fitness, sleep, and mindfulness. With Gennev’s model, women can see a doctor and a health coach and continue to work with that coach monthly on a unique plan created just for them.

Additionally, Gennev has used innovation to set up an online menopause assessment. The data collected provides valuable information about women, solving the current industry gap of lack of sufficient intelligence to help support women better.  

“When you think about ‘how do you bring women relief from their experience in menopause?’ You've got to think about the whole person in whole-person care. And so our model is all about integrated care. " - Jill Angelo 

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[00:00:00] Will O'Connor: Today we have with us, Jill Angelo, Jill is the co-founder and CEO of Gennev which is an online clinic for menopause. Prior to running Gennev, Jill had a 20-year career in technology, 15 of those years at Microsoft in various executive roles. And she recently joined the board of directors for the Special Olympics of the state of Washington.

[00:00:26] So Jill, great to have you here. Welcome to the show.

[00:00:29] Thanks for having me.

[00:00:30] So tell me a little bit about your background.

[00:00:31] Jlll Angelo: You know, really, just kind of, like you said, in the intro, I have really grown up in the technology space. I've seen the value of what technology can bring to, the world in terms of, you know, efficiency in terms of, you know, empowering people to do new things and a big part of what, I intended to do when I left my career at Microsoft to start, Gennev was to really, fill and address a gap in women's healthcare, where there's just been very little innovation. And I saw technology as a means to bringing and giving more women access to quality care providers for post-reproductive care, starting with menopause.

[00:01:14] Will O'Connor: So, is that why you started the company, you recognized there was a gap there?

[00:01:19] Jlll Angelo: Yeah, I did, you know, I, I not only saw women in the workplace leaving or talking about, some of the symptoms that they were really struggling with at this time of life, but I was on the cusp of it myself. And I'm, I'm certainly a patient of what we do. And so when you're going through an experience yourself, it certainly brings it home and it makes a personal, and it's just been really a mission to improve the standard of care for women and menopause from the, from the day we started.

[00:01:48] Will O'Connor: That's a, that's a big career switch for you, you know, someone working in technology and then, and then going to become a CEO. Tell me about how you, how you did that. And some of the challenges you faced.

[00:02:00] Jlll Angelo: Yeah. You know, I think, some of it, it's kind of a gift. I'm naively, optimistic, and, in a way I didn't know what being a CEO was all about. You know, I've been in executive roles, but in a big company, when you have big teams and budgets and you know, you're working collaboratively across a lot of different people.

[00:02:23] And this was a whole new world where when I launched out, I was pretty much on my own. You fight for every meeting, you can. You figure everything out, you do every job. And so it's been, I'd say a humbling job. Sometimes CEO sounds like a flashy title but at the end of the day, it means you get to - you're responsible for everything until you are able to bring somebody into take that function and, and take it forward and even do it better most often do it better than you've ever done. So it's, it's been an incredible and humbling transition, and I've, I've loved it, but, very hard work.

[00:02:59] Will O'Connor: Let me just pause for a second. That was a perfect answer. That was really good. Next question, I'm going to ask you a little bit more about Gennev. Jill, tell me a little bit about the company and you're helping women with menopause. You know, I would just think on the surface that, you know, this is something that would be addressed by, you know, someone's family physician, but it seems there's a big enough gap here for you to start a whole company. Can you comment on that a little bit?

[00:03:29] Jlll Angelo: Yeah. First I'll start with what we actually do and then, and then explain why we do it that way. So we are an online clinic, we're a virtual clinic. We provide an integrated care model, which means we bring multi-disciplinary, experts together to bring and help women find the treatment that they need for the myriad of symptoms.

[00:03:50] So menopause, is a hormonal shift that every single woman goes through, starting in her forties. And it can last for 20 years between perimenopause and post-menopause. And those there's kind of two phases because perimenopause is leading up to one day, which is menopause, which has been 12 months consecutively of no menstrual cycle.

[00:04:09] And on the other side of that is post-menopause. Throughout that 20 year journey symptoms will shift and change based upon the fluctuations in hormones that are just, again, part of this natural evolution that women go through. And, when you think about the symptoms that are associated, there's 34 of them to be precise, and it's things beyond what we typically think about with just hot flashes or moodiness.

[00:04:35] It's also, you know, very irregular periods. It is a depression. It is weight gain. It is insomnia, heart palpitations, in some cases. Women really struggle with brain fog and forgetfulness, and then painful sex. There's a lot of sexual dysfunction during this time and every woman goes through this transition differently. There's no one size fits all. And so when you think about how do you bring women relief from their experience in menopause? You've got to think about the whole person in whole-person care. And so our model is all about integrated care. We have both clinicians that are OBGYNs, that are providing the medical guidance and, diagnosis and even prescription support.

[00:05:18] And then we also have a team of health coaches. Who are registered dieticians that really address nutrition and fitness and sleep and mindfulness. And in that model, women come to Gennev.com and they can book an appointment with a doctor to start with. And then oftentimes that doctor will recommend they also work with a health coach and they can continue to work with that coach on a monthly basis on a unique plan that is created just for them.

[00:05:45] And how women traditionally have done this in the past is by going to a family practitioner or primary care GP. And interestingly, the healthcare profession doesn't have any formal education for family care providers for GPS around this part of women's health. They're flying blind if you will. Gynecologists, one in five of them take the elective course on menopause. So there's even very little formal education for gynecologists. 

[00:06:16] And so as we think about women and when they go to their primary care physician, oftentimes, that physician, again, needing to know a lot of things about a lot of things, if your patient is complaining of not being able to sleep and gaining weight, even though she hasn't changed anything and moodiness, more than often, women are prescribed a sleep medication or an antidepressant, and they're told to go lose weight. Versus really understanding and looking at the underlying issues of hormonal change that are really creating these symptoms that are in front of them as well as potential ones down the road. 

[00:6:50] And so when you think about the quality of care and treating what's happening at that root cause versus just the band-aiding kind of the symptoms, that's the big difference between what has been status quo versus where we're trying to take the standard of care for women moving forward.

[00:07:06] Will O'Connor: Yeah, it's funny, you said band-aiding the symptoms when you were describing it. That's what I was thinking. This is the traditional treatment for this has been like a band-aid on a bullet hole.

[00:07:16] Jlll Angelo: Yeah, very much so.

[00:07:17] Will O'Connor: They're not getting at the root cause. You know, I, it, it seems that there is a, a massive opportunity then here to improve and it, and it also seems to me like since this has through sort of a lack of knowledge and training, as well as what others might deem to be lower priority compared to some other more emergent conditions. I was thinking, you know, as you were talking about what this must've been like, during the pandemic and are you seeing that driving some engagement for you? It's hard enough to get in, to see a physician it's probably really hard to get in to see a physician because you might be having some menopausal symptoms.

[00:08:03] Jlll Angelo: Yeah. You know, I think, we saw obviously incredible growth, really coming out of the pandemic, I think at the heart of the pandemic a lot of women were focused on caring for their families and caring for everything, everyone in every everything around them, because their world was kind of flipped on its head.

[00:08:21] But really in early 2021, as we started to. Uh, emerge from the pandemic or some of the worst of it. Women got back to caring for themselves and we've really seen, you know, over the last 12 months, over 200% growth in patients, coming to book appointments, not only because telemedicine is just the new norm, but then also they're caring for themselves again. They're getting back to really addressing, wanting to feel better so that they can do their jobs well and care for others in their family and their kids and their parents. So, we've seen just incredible growth, really spurred, I think by the pandemic.

[00:08:56] Will O'Connor: Yeah, it seems to me that this would lend itself very well to telemedicine. A lot of this is talking about your symptoms versus probably minimal physical exam. So I would think telemedicine is perfectly appropriate for this, what kinds of other technology have you been leveraging to deliver care here?

[00:09:18] Jlll Angelo: You know, I think in addition to, obviously the, the core telemedicine infrastructure that we built, there's the industry and the healthcare industry knows very little about women, longitudinally from a data perspective in terms of how they progress through this 20 year, you know, shift in their health and then how it will potentially impact, or even could be a predictor of long-term chronic issues, heart disease, dementia and Alzheimer's and osteoporosis. Those are the big three that are very much linked to how a woman manages her menopausal symptoms. And so one additional aspect to our platform is what we call our menopause assessment. And we've had over 200,000 women take this assessment and it helps them.

[00:10:02] It gives them information. It tells them, are you in, you know, if they're in menopause and if so, where in that 20-year journey. But we're using that data to longitudinally track. symptom fluctuations and changes how that impacts quality of life and how over time, the outcomes, the health outcomes of our treatment, can change that for women. And the future of our vision and the future where we want to take that is to be a predictive data set around how we look at potential heart disease, avoidance, or, osteoporosis.

[00:10:37] Avoidance or minimizing dementia based upon the treatments that were we're giving a woman in her fifties. So there's a huge opportunity here to use data, to the benefit of the broader healthcare industry, let alone to this, this particular community of people.

[00:10:50] Will O'Connor: Yeah, that's interesting. So, you know, what you're saying is properly managed menopause leads to not only a better quality of life, but potentially less chronic disease and chronic type conditions, which would of course result in significantly less, less spend, and less and less costs given that, have you been, talking to, or, working with any, any payers or employers yet on this? As you know, clearly there's there's some significant impact to what you're able to provide.

[00:11:31] Jlll Angelo: Yeah. You know, both. Um, in fact, there's been a lot of employer interest. Uh, we spend probably a lot of time just educating employers right now around, how this can not only you know, improve, productivity and quality of life and retention, of some of their most executive, you know, senior women leaders in the company, but I always remind them as well every man in the company that is married to, or partnered up with a woman, in this time of life is going through menopause and menopause, often impacts the family, you know, everybody around her, um, just because of the impacts that it has on her. So, this is not just a female benefit alone.

[00:12:14] Female workers. It is, it is for the men in the accompany to, but I think employers are getting there. Obviously cost avoidance is a huge component of what we have to prove. And I think that the biggest challenge is this particular community of people have the costs associated with their care and the mitigation of those costs has never been studied.

[00:12:34] And so we're having to kind of prove that math equation as we go. Same goes with payers, you know again, costs associated with women 40 plus haven't been singled out and tracked according to, you know, misdiagnosed, medications or treatments, or, you know, the range of ER visits that happen because women are having heart palpitations associated with a hot flash and they think it's a heart attack.

[00:12:58] And so, we've got to continually educate both payers, payers in this space to start to single out in steady those claims, and compare that from us an actuarial study perspective against the claims data on Gennev. So we're working obviously to get insurance coverage. It is a pay-out-of-pocket model.

[00:13:19] We provide a lot of receipts for our patients to get reimbursement and our services are a hundred percent reimbursable. But we are, we're working right now with payers to get that insurance coverage upfront.

[00:13:28] Will O'Connor: Yeah, I would think if you're able to secure that, that would lead potentially to a very large, increase in, in business. How, what kind of capacity are you built for today? How many patients are you seeing a month?

[00:13:43] Jlll Angelo: We're seeing about 500 patients a month. You know, we're, we're, licensed in operating in, 49 of the 50 states. So every state but Alaska, and so we're, we're really ready to scale. We also have a model in place where we not only. Our recruiting gynecologists and health coaches, that have a baseline expertise in menopause or have taken the North American Menopause Society certification.

[00:14:10] But then we have our own kind of protocols on top of that. So we are prepared and ready to staff up our medical team to continue to address the growing need and, and scale of this audience.

[00:14:23] Will O'Connor: You know, speaking of that audience, it's a big audience. I'm sure you've sized it. There's tens of millions of women that, that need these services. How are you, how are you finding and doing outreach and educating people about this, that these services are available?

[00:14:45] Jlll Angelo: You know, I think you hit on it. Education is the core thing. Early, when I started the company, we surveyed 1,500 women to really understand where did you go for your menopause education? You know, how'd you learn about it? And the overriding insight in that research was ‘I was unprepared.’ Start the conversation.

[00:15:05] And so we made an investment to start publishing, medically reviewed, evidence-based education, from the onset and that, we've optimized it for the high volumes. There's millions and millions of searches every month from women looking up symptoms and exploring, cause this is a little bit of an embarrassing, shameful aspect to our health.

[00:15:25] And so women go online. They're searching for symptoms and answers and solutions online. And so that's still today. We see about a hundred thousand women every month coming to Gennev.com. And they're finding us because of just looking up a symptom and landing on one of our education pieces. So we've taken an education-first approach, from the onset, not only in our practice, but in our growth strategy. And it continues to pay dividends today.

[00:15:50] Will O'Connor: That's a, that's a sizable number of visitors. A hundred thousand a month. So that your word for it is getting out there. That's fantastic. What's next for Jill? And what's next for Gennev?

[00:16:02] Jlll Angelo: You know, you know, I think first and foremost, you know, we're, we're obviously working, with plans to get coverage upfront. We want to unlock access. We have proven the model 94% of our patients, say that their symptoms have improved after working with our team. And so we know we're onto something and we've just got to open up access for more women.

[00:16:23] So, we're working to credential our providers, in specific states as a start to get the insurance coverage we want. We do intend to go into the employer space as well. That's near and dear to my heart, um, is really supporting working women. And then from there, you know, obviously we want to grow old with women and be her post-reproductive, you know, go to in the future around really understanding how her health and wellbeing now can impact long-term heart disease and, and brain health and bone health. And so our only intention will be to grow old with her in the services and the education and the offering that we provide.

[00:17:00] Will O'Connor: Well, Jill, I really enjoyed having you on the show today. Please promise to come back and see us, when you're at 500 employees and you're a household name, because I, I really think that, you're onto something here and the need is obviously tremendous. And, really, really sounds like you're going to have a lot of success. So, thank you again for coming on the show and, we will see you again in the future.

[00:17:30] Jlll Angelo: Thanks for having me, Will. It was great to be here.