Mirah - Client Success Stories Gesmer Updegrove LLP

Mark Potter – CEO, Mirah

Tell Us About Your Journey

I’m an economist by training, but an entrepreneur at heart, and I have been attracted to the start from the very beginning. My first entrepreneurial experience was a driveway sealing business I formed in high school, and I’ve always been attracted to the idea of taking the risk and jumping out and doing something on my own.

Shortly after undergrad, I got exposure to a startup, again, this was right before business school, that really helped me see how fun it could be to really jump out there and do something that’s never done before. I pursued that with vigor coming out of business school in an energy technology startup called EnerNoc where I joined the two cofounders as the first employee in 2003.

We got to take that company public in 2007 so I basically saw the entire journey from nothing to IPO, and it was fantastic. While there, I saw through my wife’s eyes that behavioral health needed a lot of the same tools that we were building in energy technology. So we basically copy-pasted that approach, high resolution, low latency data, bringing it to behavioral health and saw the power, the transformative power of data in a healthcare environment.

What Is the History of Mirah?

I was working for the energy technology company and had just seen the transformative power of data to really move how an industry works. All the while, however, I had been seeing through my wife’s eyes how healthcare lacked a lot of the same tools and techniques.

So I met my wife, Mona, a Child & Adolescent Psychiatrist, just about the time I had started my work at EnerNoc. And what I saw through her eyes was that behavioral health lacked high resolution, low latency data, the same kind we were delivering in energy. So she was leading child outpatient services for McLean Hospital. And even at McLean, ostensibly the number one psych hospital on Earth, they lacked a way to track progress on a routine basis. So thus the idea for Mirah was born to do measurement-based care, which is high resolution, low latency data in a behavioral health setting.

Now, the problem with measurement-based care is it lacks reimbursement as a tool to support it. So even though it’s good, you really only get the forgotten country folks trying to do this on an everyday basis.

Thus comes collaborative care, which was born slightly after we had founded Mirah, so better be lucky than good sometimes. Collaborative care was the model that brought the power of measurement into behavioral health and the power of behavioral health into primary care but brought a financial mechanism along with it as well, a very robust financial mechanism. We’ve taken the power of collaborative care to bring measurement to behavioral health in a primary care setting, and we’re seeing its power to transform how care is delivered.

What Motivates You?

That is an interesting question because I think it depends a lot on the day. On some days, it is rainbows and unicorns and making the world a better place and thinking about the great outcomes we deliver in behavioral health. On other days, and this is what I tell my kids often, I picture Adam Sandler’s character in the Waterboy, and I just want to mash something and drive it into oblivion. So I’m very competitive, too. So what motivates me on any given day depends a lot on that particular day, whether it’s a competitive instinct or desire to be the best I can be, or to see the change in the world that we imagine through our mission and vision as company.

What Challenges Have You Faced?

A lot of what we face are the challenges that any entrepreneur would face. I would say that on top of that, I’ve experienced some of the challenges of industry switching from energy to health care. Health care is a whole new animal. It took me a while to understand it. I think it was some combination of hubris and naiveté that I thought I could just jump in and do things in this entirely new industry without stumbling a bit. We’ve definitely struggled with that.

I would say other challenges are the same ones that most entrepreneurs face, which are balancing growth, cash management, delivering greatness for your customers, all while building a team culture that is sustainable and a great place to work.

What Advice Can You Offer to Other Entrepreneurs?

If I could give advice to entrepreneurs, it would be these two things. Have the talk. So with your co-founder or co-founders, that early stage team, really get on the same page, get agreement about what it is that you’re in for, what is the covenant or pact between you as founders.

Another thing would be know your biggest problem. You should always know what your biggest problem is and how you’re going to solve that. For a lot of early stage companies, that’s cash management, so you got to know what your cash situation is at any given point in time. Just be really honest and transparent about it, including with yourself. I think that’s maybe the hardest thing to do is when you’re trying to tell yourself that this is going to work and maybe it isn’t, you also need to have that little dose of reality to know what you need to do to make it all work before you run out of money or before your biggest problem meets you.

Where Do You See Mirah in 3-5 Years?

Where I see Mirah in 3-5 years: World domination. We want to be the player for enterprise collaborative care, hands down. Now, what does that mean exactly? Let me start at the beginning. Our mission is to prove and improve behavioral health outcomes. Our vision is to make behavioral health a gold standard in medicine from a metrics and accountability standpoint. You don’t start with world domination there. You start with something small and the something small is that individual customer success. The delight we see at a practice level, when we hear our customers say, “This is magical”, we know that that is one of the critical ingredients to what could eventually be world domination. It has to work first on an individual basis before it can work at a macro basis. We’re seeing all those steps.

If you think about necessary but not sufficient things, there’s five things that need to work, and we’re about three down that list. But all three are check, check, and check thus far. We’re seeing customer delight. We’re seeing clinical outcomes. We’re seeing a financial model that makes sense top to bottom. Now, what we need to see is that we can do this at bigger scale without breaking. There’s a few if-thens between here and world domination, but I think we’ve got a line of sight on that, which is all you could ask for as an entrepreneur.

What Value Has Gesmer Updegrove Provided to Mirah?

Gesmer is a fantastic partner to have. As I think about what we’re trying to do at Mirah, or any startup, is that balance of minimum viable product for the market now versus the more robust solution that you’re going to need as volume grows. Where I think Gesmer is great is helping to right-size the solution for the task at hand. So it could be an MVP solution for a quick and dirty answer that just needs to get out the door. It could be a more gold-plated answer or steel-girded structure for something that needs to stand the test of time. Gesmer is a great partner in helping to right-size exactly what it is you need for the exact problem that you’re facing right now.

Why Go With Gesmer?

I go with Gesmer because they’re a part of the team. This isn’t a vendor that we have hired at the X, Y, and Z cost. This is a core part of the team. Gesmer helps me come up with the right answers. Gesmer helps me think about business problems. Gesmer is there when I need a shoulder to cry on or somebody to inspire us to be better. They are a fantastic partner top to bottom. I really couldn’t ask for anything better.

Client Success Stories – Mirah