Max Parmentier

Max Parmentier talks about how he and his team are building Birdie, a device platform that allows carers to provide better and more tailored care for the elderly.

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[0:21] Maiko: In today's episode, I'm joined by Max Parmentier, the co-founder and CEO of elderly care startup Birdie. Birdie has built what it calls a care companion, a platform that helps relatives monitor the safety and health of those that they are taking care of due to sickness, age or disability. Their sensors track behavior in the home and notify relatives once unusual behaviors are detected. The Birdie app helps families and relatives to constantly know what is happening with their loved ones and makes giving care an easier process for them. Founded only last year in 2017, the company is now 18 people strong, and has been backed by insurance giant AXA, and is now on a mission to disrupt the elderly care space. Welcome to Impact Hustlers Max, thanks for joining me. 

[01:02] Max: Thanks for inviting me. 

[01:04] Maiko: What's the story behind Birdie? Is there a personal story behind it as well? And what is the big problem that you're trying to solve?

[1:10] Max: Yeah, so clearly, there's a personal story and it is, kind of, the typical kind of founder story but it's a true one in this case, and really quite a moving one. When my grandmother passed away, about 10 years ago, my grandfather was left alone, and we decided, with my family to actually move him to a care home. And we thought it was the right decision for him he had Parkinson, but in a matter of months, he rapidly declined. He was not feeling well, he was very depressed, he wouldn't recognize his environment, and so on. And after seven months, he actually passed away, the experience for us was really bad, we realized he was unhappy, we didn't want to go it with it and I myself realize I wasn't good at going there very often, because it was just, you know, facing aging, facing people who are just aging and depressed and unhappy. And so, I would just not accept that and didn't go there to all. And the day he passed away, I thought to myself, we society really struggle with aging overall, we families, we, care professionals, we authorities. 

[02:14] Max: So, I kept that idea in my mind and I've been always involved in social innovation, from climate change to global health, throughout my different experiences in my career. And about a year and a half ago, we decided with some friends that it was time to do something next in your career with a very strong social impact and with a startup mindset to really bring some disruptive change. And so, elderly care came right into our mind, because we could think, we could see the social crisis that was brewing everywhere in Western Europe, but also in other countries like Japan, China or the US. And the problem we're trying to solve to your question is really the following, we see a massive amount of older adults coming, you know, coming up in the next 10 to 15 years, just by the sake of demography. We see that these people actually falling sick at the same age, but they die later. So, that's even a larger volume of what we call, dependent elderly, we see that governments today struggle to support these people just in the current state. 

[03:18] Max: And in the UK, we call it, you know, the social crisis, defending gaps, but you know, half a million people who don't have the right support. We see families who are more and more, you know, involved in work, live further and further from their parents, and so cannot take care of their parents as before. And we see care professionals in the UK, it's quite a staggering number, who also struggle to deal with the care. So, in the UK, because the margins are so small for the care agencies, one out of four home care agency is at the brink of bankruptcy. So, families can't cope, care professionals cannot support, the government cannot pay, we're only worse and because we had three times more people, in this case, coming up. So that was a very strong case for us to say we got this do something here. 

[04:01] Max: And so, we looked into it, and we heard plenty of stories from families and older adults and care professionals. And we realized there were a lot of inefficiencies in the process, we had to bring a solution, which is really helping the whole care community, professionals, families, older adults to deliver better care and to make sure that the older elders are safer. And we decided to do that at home because care homes are not the right solution. First, older adults don't want to be there, second, it's too expensive and third, there is not enough space, even if you're trying to find one, there's not enough space. So, the future is at home. And so, we've been working on building a holistic care platform to keep all the adults as long as possible and as happy as possible at home.

[4:43] Maiko: I think if you're looking at digital technology, and how much it's being used in the space for elderly people, it looks like there's very little technology actually being used right now. Do you have any reasons why that is? And why aren't there more companies like yours that are actually trying to tackle problems that are faced by elderly people and their relatives?

[5:03] Max: Yeah, I think we need three elements. The first element is that you're talking about a highly fragmented market with many different stakeholders. So, it's really hard to address a problem in a piecemeal fashion, there are people doing just technology like hardware, just people doing digital software's, people talking to care professionals only to families. Because there are so many stakeholders involved, it only works if you have a holistic solution for everyone to be connected and to deal with the care. And this is the approach we're taking. So, it's really hard because it requires really an ambitious road map in terms of technology. The second thing is, and everybody's struggling with that; older adults are very tech resistant. And so, you have to find a way to deal with their care and make sure that they're fine at home as long as possible, but it doesn't mean specifically that we have to bring them on the technology. And so, people have been battling with that. But thinking that an older adult will use eco right away is a bit a thing of wishful thinking. 

[06:04] Max: The third reason is that funding is very hard to find in this industry, if you look at the number of elderly care startups, whereas their a, you know, crying need for this kind of services, there's only a few startups which have raised, not usually by from VC, but from other kind of investors. Reason is, nobody has done a proper exit, or there's no like, fund return metrics that VCs are looking at. So, finding the money to actually support this kind of technology is really hard and that's why, you know, I think we have seen only a few players on the market

[6:33] Maiko: In your case, you have raised your funding from AXA, and it's been backed by them and by their company builder, how was the process of getting that funding in place? And why would somebody like AXA actually back this?

[6:45] Max: Yeah, absolutely. And I think that's where we're quite well positioned to, you know, I'd say, to support the ambition that we got. And we'll talk about social entrepreneurship, assuming that our ambition is within five years, to have radically improved the life of 1 million older adults and have the financial means to sustain our growth. So really, the purpose here is not money, the purpose here is impacting the lives of people, but having sufficient leeway, financially speaking to accelerate that impact. And, that is something that AXA dear to quite a lot. Because they're moving with a call from a strategy of peer to partner, they just don't want to be a claim manager anymore, they want to become the daily partner of their customers. And among the different initiatives they're looking at, elderly care is a very important one. But they didn't know how to take it, they don't have a lot of expertise in that field. 

[07:38] Max: And so, we came up with a model that they found very interesting, from a strategic standpoint, to say, well, we'll fund you, do you think, sure that it works, sure that you can impact substantially life of these people and then we will deploy with you. And we are very privileged to have a long-term relationship with them, which means that we can invest in the future as well, we don't need to generate revenue tomorrow, of course, we do that we're also investing in the future with things like what we call the health and narcotics. So, we're using all the data we got from the sensors, from the digital products that the carers hold, the families are using it to actually anticipate issues in the house that are happening, such as infections, or decline mobility or depression. These are long term research things to do and it requires some funding to push it. But if we crack it, it's a massive change in industry. And that's where a partner like AXA, is very powerful, because they believe in us in the long term as well

[8:27] Maiko: Walk us through the customer journey, if I'm a relative, and I have to take care of my mom, which might need take care of my grandma, what do I do? Well, how do I use your solution?

[8:39] Max: So, we have two waves in terms of the way we distribute our product, the wave one, which we were doing right now, is we work with home care agencies, which are using our solution to record all their notes, instead of doing that on paper. So, imagine today, your mother is living at home alone, she has Parkinson and there's a carer passing by three times a day, to take care of her, to prepare a meal, to live to help her bathe and to make sure she's fine. After each visit, the carer would actually write on a piece of paper how your mother was doing when she came in and came out; that's very backwards. And it's a lot of waste of time for these carers. The first thing we did is to say, well, let's actually build an app, a web app for the care agency, to freely file all that information, have it in real time to make sure that we flag an issue on time and also that we save a lot of time for the carers. And we give that for free or nearly for free for the agencies. 

[09:37] Max: And then on the back of that we say, we also have a range of sensors we can install in the house, of the families, of the older adults, if they want, to actually make sure that 24\7, we know what's going on, not only want the care is them. And then we are now, we launched it about a couple of months ago, deploying an app for the families, which is a free version, basic free version and then they can actually upgrade with sensors to actually gather all that information that care companion. And so, agencies will go to these families and say, hey, we got this great app, which not only allows you to know when the carer came in and came out, which you don't know about today, and you're very much worried about that, which enables you to communicate with a carers, which is today done on post-it and lots of post-its and so on, which allows you also to see how your mother was doing during the visit. And you can track how she has been doing over the last days and you can really see plenty of different things in there. 

[10:30] Max: But also, thanks to the sensors, let you know if there's anything wrong, she's full and she's outside of the house at three o'clock in the morning if she has Alzheimer's and she's not in the bedroom right now, things like that. And you can tailor these alerts based on your specific needs as a family member. So, that 24\7, you got that peace of mind. And then we bring a range of services for these families as well to actually treat every issue, every case. So, we have a GP on call, we have our in-house care manager, we have specialized transportation services, everything, one app. So, the families are being warned or being notified by the agencies that this product exists and that it will help them deal with the care so much better. And then we deploy this care app, this care companion with these families to make sure that they can deal with the care better and that they're really reassured 24\7 and everything is fine. And if not they'll be notified about it and that we have them in treatment. 

[11:25] Max: So, that's step one. Step two is to say once we have a large network of care agencies working with us, we are actually able to go directly to the families, whenever they need. And that's, I think what you were saying is, you know, your mother is a bit wobbly these days, call us and we'll help you find the right solution for this specific case, whether it's technology in the house, to make sure that if anything happens, we'll know about it and act upon it or whether it's a carer that you need to come once or twice a day. Good news, we have a network of care agencies fully integrated with us who can provide that service. So, that's holistic solution to help families deal with the care, is clearly what we want to launch in the next six month.

[12:05] Maiko: Isn't then a real issue of trust as well, in terms of if I install these sensors, and my mom's home, how do you face or do customers and those people that re actually being monitored, do they trust you, in terms of monitoring them 24\7? And have you encountered any issues with that?

[12:24] Max: So, it's a question that arises very often from people who are not so much involved in the industry and there are really two answers here. Number one is we always ask for the consent of the older adult before installing any kind of equipment in the house. So clearly, no, she or he knows that we'll be installing these sensors. And number two is that the sensors themselves are not so intrusive, whether are we talking about, motion sensors, like alarm sensors, which are in any case, usually in the house. So, it's not very intrusive. Clearly, yes, we know where they are, in which room at all times, it depends on the needs of the older adults, but for, you know, Parkinson patients or Alzheimer patients, we are the stage where it's about their safety first. And if they provide consent, usually they say, well, it's true that sometimes something might have happened, a fall is a very good example, I can guarantee you that one out of two falls today, we could avoid it or if not avoid it, we could actually react upon it faster. We've had, yesterday, in the case of an older lady, telling us she's not using our service, telling us that she had to wait two days lying on the floor, because nobody came to rescue her after a fall. These kinds of people, they're actually fine to be monitored passively because the knowledge for the safety and the just don't want to experience this again,

[13:47] Maiko: How big can this be? Is there's a problem that you mainly see across Europe and the US or is this something that could be applied even in developing economies or maybe for families that might not be able to afford all the sensors? How big do you see the spread? And how big of an impact can this potentially have?

[14:05] Max: So, it's a very good question and talking about social entrepreneurship, the point eventually is to have a systemic change, right? I firmly believe that you need to start with a private approach, so that you can sustain your growth while you're actually experiencing, you know, all the devices, all the technology that you're trying to deploy. And so yes, clearly, we are addressing the market right now with, no, these are families that will have to pay for the sensors. And the price tag is frankly not very high compared to what they pay already for care packages, it's about, you know, a few percentages of what they pay. So, the willingness to pay is very high in any case. The pain point is massive, one out of two families I was talking to during our interviews, in the early stage of this company, was crying in front of me, saying it's such, you know, such a burden to deal with my mom, and I love her but it's really hard, I got three kids, I have a job to do and yet I have to take care of my mom. 

[15:05] Max: So, this problem is across the board, in Western Europe, in Asia, in the US, any developed economy, developing economies less so as such, because you don't have all the infrastructure in place already, so, usually they stay at the home of their children. But the pain point in developed economies is massive and I think, I call it the next climate change, we are in a fast rain, going to hit a wall big time if you don't address the issue now. So, let's try to start to address it now. Our approach to say, let's do that with private pay first, honestly, the price tag is not very high. So, the change, the potential of impact is already very high. And let's depreciate our technology, if you wish, let's make sure that the marginal cost for us is getting lower and lower, so that we can actually deploy with different versions for the people who cannot afford it at the moment. And I think one way to do that also is to prove that for authorities, for the government, our solution will actually be only beneficial for them because it will be cheaper. If you can avoid, 16:04 [inaudible] is saying that we can avoid one out of five hospital admission for older adults if we use the data the right way. Everybody's winning, the old adult, the families, but also the NHS and the local authorities. And if you bring this kind of model in place, then it's actually the government which is going to pay for that, for the recipients of the care. And so, that's really the purpose, everybody's winning and then you have a scalable model.

[16:29] Maiko: In which direction do you see all this moving? I mean, there's a lot of new technologies and developments happening, there's robotics coming up and robots and taking care of the elderly, or at least that vision is out there right now. Do you think it will move more towards, okay, let's put a bunch of sensors and robots in the house and not worry about the elderly anymore? Or do you have rather vision where the robots and sensors and AI works together with humans to--?

[16:58] Max: So, our stronger bet is the second, is the latter. And if you look at recent reports on automation of jobs and so on, the need for carers, the need for professionals supporting our society and people in need, particularly elderly people, well on the rise. So, we are strong believers that it's a combination of both, it's truly a combination of enhancing the quality of care provided by the care professionals with technology. And that's what we're trying to do, we're trying to provide much more tailored, preventive care, combined with some kind of technology in the house, which will make the care much better. People are talking about robots; indeed, I think first that it's going to be in 20 years, not now. And people are starting to be piloting a few robots, but you know, just climbing stairs is really quite very hard and usually there's always stairs in house of the old age. So, there are plenty of frictions for these kinds of technologies to be scalable but yes, it will come. I think that the human touch will still be absolutely critical. And I think we have to look at technology and new organization models to actually make sure that these humans are actually empowered to deliver better care, supported by technology. And in our case, as I was saying, we're using the data provided by the carers, and the data provided by the sensors, not only to anticipate issues, but then to ask, to these carers and to these families to take the right action. So, it's kind of a virtuous circle and we're just here to support these guys to do a better job.

[18:29] Maiko: I'd like to go back a bit to your personal story, and also your personal views on social entrepreneurship, impact driven entrepreneurship as I love to call it. You actually work for big NGO previously, and you've been in that space and made an impact through that, what initially got you into social entrepreneurship, what got you to believe that this is a way to do it, or one of the ways to do it?

[18:54] Max: So, it's a-- And I think we were changing about that a second ago. I've been always into social innovation and I've been always convinced that technology and new organizational models can really drive a systemic change to improve how society works and deals with issues. So, you know, I worked at McKinsey for four years, and I was involved in climate change and fight against deforestation particularly, I could see how, kind of new government models could actually solve massive issues like, you know, deforestation, which is a big problem for climate change. But I was frustrated by the speed of things. And then I joined the Global Fund and in there, I think we really achieved a massive impact, was in charge of building the largest global health e-marketplace. And just in a nutshell, the basically, the Global Fund is one of the largest global health organizations, they give about $4 billion per year to 140 countries for these countries to purchase medicine, against malaria, aids and the likes. 

[19:56] Max: And we build basically a central platform for these countries to procure the drugs via us. And we built this platform, from sourcing and dealing negotiating directly with manufacturers through supply chain and through, kind of a bid, Amazon.com, for Zimbabwe, to purchase medicine. And there, I was frustrated by the bureaucracy of such organizations, but we basically built a spin-off within the organization to deliver and that was very much thought of minded. And I got to really like how technology could substantially improve the way we deal with these issues and actually generate massive impact. In this case, you know, it's a billion-dollar transactions for years, about $20 million of savings realized so that means about 100,000 people under treatment, additional people into treatment, so that's a big impact. 

[20:43] Max: And I got excited about that. And so, in my mind, I've always said, there's four verticals, I want to work one, one is climate change, the second one is global health, the third one is elderly care and the fourth one is unemployment. And I'm on the third one and I thought that when looking at elderly care, all the models in place, were either not scalable or too slow. And that's where I think social entrepreneurship is an amazing vector because it brings together a range of different people, you know, it is kind of that multidisciplinary approach, which is very powerful. It brings in technology, which is really a disruptor in some instances, I mean, that's what we're doing now. And also, it brings these people together to actually deliver much faster. So, the model is really small, agile, highly, you know, highly efficient, super speed-oriented organizations, which can deliver at such a high speed. And so, that's what gets me gets me excited, because I think with that kind of model, we can actually change. And I've tried large NGOs, small NGOs, international organizations, government, and all of them are doing a great job so I have no criticism. But in my case, if you want to achieve fast, systemic change, I believe this model really works because we have, you know, the leeway, financial leeway, the skills, the organization model, to deliver quickly.

[21:58] Maiko: Do you feel this social entrepreneurship model is something that's really on the horizon, that more and more people realize? I think if I look at your sector, for example, the health sector, I think it's quite obvious if you look at the data that there's already a lot of money being spent. So, from my perspective, I think if you argue, okay, we're going to come up with innovation in that sector, it's very clear for somebody to understand, okay, there's some money to be made in that sector. Some other sectors where I solve social problems that might not be as clear, do you think healthcare might be, well not easier space but will, more logical space to start with or do you still see barriers and other sectors? What's your view on that?

[22:36] Max: No, I think it all, you know, goes back to the concept of what is social entrepreneurship? And the definition has been, really, you know, difficult to provide, but by all means, is it about making money while having an impact? Is it about, you know, privilege in the social impact before the money? Is it a bit of both? Is it a scalable model or not? So, we're all struggling with that definition. I think there are clearly industries and verticals where you can have a much better impact, indeed, or high impact, because it's kind of a more of a no brainer. In this case, yes, elderly care or health care, overall, it's easier, because there are so many inefficiencies and frictions that you can actually address it and there's a willingness to pay. So, there's a revenue model you can make. And I think in the end, it's about setting the rational, having a scalable model and having the culture to deliver and healthcare takes in all three of these criteria. Other industries, much harder; much harder, because fully subsidized, much harder, because too many stakeholders, much harder, because there's no money at all. And so, people try, and so it's going to be probably more niche but there are opportunities. But clearly, healthcare for me is one of the most interesting verticals. But climate change is very much another one, I think, where it is a virtuous circle of a revenue generating model, you know, improving how society can deal with climate change but there are a few only, I think.

[23:56] Maiko: You mentioned that you want to impact a million people over the next five years, I think, what's the real long-term goal? What's the big impact that you want to make here, in terms of like 10, 20 years horizon, what's the big impact you're trying to make?

[24:11] Max: Our vision is very clear, it's to help any older adult to envisage their future very serenely, and to be able to stay at home as long as they want and healthy and happy. So, that's the vision and so, for us, Birdie should be the solution for anyone who's looking at the few years coming, wants to stay at home to say, well, great with Birdies, I know that I'll be happy at home, healthy because I'll be coached, I'll be supported to get there. So, that's really the vision and it's about dealing with aging the right way as a society and taking care of elders the right way.

[24:47] Maiko: I wish you all the best on that journey. Thanks very much for joining me today and thanks for being part of the revolution in the healthcare space, thanks.

[24:54] Max: Thank you.

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