Industry Expert Series: Sam Jactel

Industry Expert Series: Sam Jactel
A little bit about Sam:


Sam Jactel is the CEO and Founder of Ayble Health, a precision health platform empowering GI patients with chronic conditions such as irritable bowel syndrome (IBS) and inflammatory bowel disease (IBD) to manage their care beyond the pill. As someone who has been a GI patient for almost a decade, Sam has firsthand experience with the limitations of the current standard of GI care — the lack of accessibility, affordability and availability of physicians to build customized, comprehensive plans to address all patient needs — which is why he has dedicated his career to building a tool he wished had existed when he was diagnosed.

This interview has been edited for brevity and clarity.


Sid: Hey Sam, how are you?


Sam: Hey Sid.


Sid: Thanks for taking the time to sit with us today and share a little bit about your story and specifically about what you were up to at Able Health. So thank you for taking the time to meet with us.


Sam: Thanks for the invitation. Yeah, excited to get this show on the road.


Sid: Awesome. Why don’t we start by if you could share a little bit about yourself and kind of what you do?


Sam: Yeah, absolutely. I’m Sam, CEO and founder at Able Health. We are a precision health platform that helps patients with chronic GI conditions, including IBS and IBD, better manage their care beyond the pill. I come at the problem from a couple different angles. I started my career in clinical research and then I moved into the business world, doing everything from investing to startup business operations and consulting for large pharma and healthcare companies.


Sid: Amazing. Sounds like you get a pretty broad background in all sorts of different areas, which is amazing.


Sam: Yeah.


Sid: We see a lot of new brands that are solving a wide range of health problems. Was it a personal experience or did you notice a gap in the market that made you decide to move forward with gut health specifically?


Sam: Yeah. It’s a good question because I think this idea of founder market fit is just as important as product market fit. Perhaps one predates the other, but I think they both help. So, my experience, I’m a GI patient. I’ve lived with inflammatory bowel disease for about 10 years, and it has been a very up and down journey. I never really wanted to be an entrepreneur. I think a lot of people have their eyes set on that as a goal. For me, I’ve lived the last 10 years up and down in terms of symptoms, and I was solving a problem for myself, namely that I wanted to use diet as an adjuvant therapy essentially in addition to drugs. This has 20, 30 years of evidence that managing your gut health through your diet can be done. I just found it incredibly challenging to do by myself. So I built a tool to help me go through that process of experimentation.

As I was going through it, I realized I am not alone, maybe other people could use it. So we took that, expanded it out, did clinical research on it, published it, and then built that into a company. So that is my reason to go after it. It’s something that is very personal to myself, but also to our family as we have a history of GI conditions throughout the whole, my mother’s side in particular, of the family.


Sid: Amazing. You had somebody who’s had a similar story, I’m super excited that you’re solving this problem. I went through something similar, and for me, it was all about tracking my diet. I had all sorts of notebooks trying to keep track of it, trying to understand what is the cause of my migraines or what is the cause of me not having enough energy. And it’s almost impossible to figure out unless you limit yourself to one thing that you’re going to eat all day and then see what the impact is. So I think it really is a challenge that a lot of people experience, and I’m super excited because, again, I could definitely be one of your first customers because it is something that I had to do by trial and error. It took a lot of errors before I somewhat figured it out, and I’m still not sure that’s the right answer.


Sam: Well, you’re also not alone. I think this is one of the things that I realized. When you’re a patient solving for your own problem or a user solving for your own problem outside of healthcare, it’s very easy to say, “Oh, I’m solving for myself, and so I’m building a thing that I would use.” There’s a double-edged sword. Right? You either have a really deep understanding of the problem, which is great, but you also have really deep biases because you see the world from a very particular way.

So a lot of the work that we’ve had to do is also kind of expand beyond that, and you have to be kind of humble in that approach, but also realize that, I mean, there’s 70 million Americans that have a GI condition diagnosed and probably beyond that of people who have GI distress of some type. That’s twice as many people as have diabetes. So it’s an incredibly common thing that we just don’t like to talk a lot about because it’s poop and it’s kind of taboo, but it’s something that really does need to be solved for the many, not for the few.


Sid: Yeah, it’s really amazing. Right? If you look at gut health as a topic, it’s super trending. When you look at all the very social platforms like TikTok, we see a lot of young consumers getting a lot more educated about this particular kind of topic.

From your perspective, why is gut health so important and why do you think it’s also popular amongst the younger consumers? Given the fact that the majority of the people in my age bracket figure it out over time, but we see there’s a lot of interest amongst young consumers, and there’s all sorts of supplements and beverages that are being launched to kind of help tackle that challenge.


Sam: Yeah. This one’s kind of a nuanced question. I like it and I don’t like it from different perspectives. As a patient, as a clinical researcher, that’s my bias, to answer this question.

I’m sure a lot of other people have other opinions. I love that having a conversation around these conditions and these problems is more and more common because these conditions are taboo and difficult to talk about in the same way that mental health was five, six, seven years ago. Because we’re talking about it, there is a much better understanding of the burden of these conditions, how much it sucks living with it, and that we’re willing to address and smash that taboo. That’s one of the things that we really are excited about at Ayble, is to set the way that we talk about these conditions and make it a more normal part of our conversation.

On TikTok and Instagram and stuff like that, you see trending hot girl IBS and all these kinds of things, that’s awesome. Right? We should be talking about these conditions. The caveat that I have to this, and this happens in all places, is that with a proliferation of voices, not all voices are created equal and not all solutions are created equal. One of the things that we are monitoring very closely and makes me a little bit weary of this space is that there’s a lot of stuff out there that is not evidence-based and that is not scientifically rigorous in its development and in the promises that some companies in some supplements and some just that even people talking about this stuff are making claims on.

So one of the things that we’re going to have to do over time is make sure that the voices that are heard the most are the ones that are based in fact, and that we’re not getting misinformation in this space because it’s such a complex thing. So it is a bit of a nuanced answer, and again, I’m biased in how I’m approaching it, but that’s kind of my perspective.


Sid: No, it makes complete sense. If you think about it, if you have a lot of large voices that are talking about something and people go about and they try whatever it is that we’re talking about and they don’t see the impact of it, now you’ve lost the impact of the movement. Right? So I think it’s a very super important point that you bring in, that if you don’t go with an evidence-based approach, if you don’t have a platform or methodology where you can feel comfortable that when people are going and experiencing it, that they’re actually going to get the result that they intended to do. And it’s not just some cool trend that fizzles away because it didn’t live up to the hype of the promise.


Sam: Yeah. But I think when you talk about gut health and gastroenterology, there’s also that nuance. On gut health, I think we know we are learning more and more about the gut microbiome and how it’s impacting all aspects of health, but we also have to understand that we still know very little about it. We understand what bacteria are in the gut and all that kind of stuff, we know how some of those are connected, but we are still working on finding the “so what?” to that and the “what do you do about it?” Right? So the intervention and the causal link is still something that is really not well understood. And it’s also a very kind of broad range, the impact on a bunch of different things. Our focus is on gastroenterology, addressing the specific symptoms related to inflammatory bowel disease, the specific symptoms related to IBS and other GI conditions. So it’s almost a different thing that we’re optimizing for, but we have a very clear target that we’re trying to address. So that’s another element that’s important to emphasize.


Sid: Amazing. Yeah, I think that’s a good call out between the two different things. I think a lot of people kind of blend everything together and just put everything on their gut, that it really is kind of similar, but it has two different approaches. Awesome. Well, maybe let’s talk through a little bit about the Able Health app and maybe just provide an overview of the technology and how it works for people that are joining for the first time.


Sam: Yeah, absolutely. So the flagship product that we’ve developed is essentially a precision nutrition program. We have a kind of multi-step process. So a user comes onto the platform, we are available online, direct-to-consumer. You can also find us through your insurer, your employer, even your provider. And we take in about 40 different variables to essentially personalize a pathway through an experiment you run on your diet with us that is most likely to be optimized for your health at the end of the day.

So it’s a program that is a 12- to 16-week experience. You get guided every step of the way through AI and machine learning to make sure that you’re going through the pathway at an N of 1, you. This is not a one-size-fits-all; this is a one-size-fits-none approach. So you have access to our app that guides you through this program. You also have access on demand, 24/7, to a health coach or a nutritionist, and that person is going to hold your hand through that process, plug in some of those gaps. At the end of the program, we will have co-designed that you created the least restrictive diet possible so that you have as much food freedom as you can, that has a measurable impact on your specific GI symptoms. We have done peer-reviewed publications and research on this that has shown that we can improve symptoms for about 81% of both IBS and IBD patients.

The last element to this is, throughout this whole process, it’s one thing to recommend that someone avoid one food or another, it’s very much another way to actually build those habits. The digestive relief needs to be maintained and applied to your life. So we have built out a database of grocery store items that covers around 95% of items on shelves across the United States and about two and a half million recipes that are categorized at the ingredient level. What we’re able to do is then filter all of those foods so that we are suggesting those that are compatible with your diet, and all a bunch of other important information around you, your allergies, your religious beliefs, to the extent that changes how you eat, your preferences, if you’re vegan, if you’re vegetarian, all of these things integrated. So it is the most comprehensive approach to identifying the foods that are causing your symptoms, eating that way, and holding your hand throughout that process end-to-end.


Sid: Amazing. Is this a one-time thing? Or do you go through the program for the number of weeks you stated then you kind of go off, do what the program tells you to do, and then you come back to it? Or is this like, you set it up once and then you should be good for a while?


Sam: Yeah. So the challenge with GI conditions is that they will fluctuate a lot. So one of the things that we are really excited about is that the program is the first start. It is a really good first step in your journey to manage your gut health, but after the program, there’s a long kind of tail of maintenance application and iteration of your diet, which you can do with your coach, utilizing our grocery and recipe tools on a continuous basis over the course of several months to years.


Sid: Amazing. So it kind of almost just becomes part of your lifestyle.


Sam: Exactly.


Sid: As your gut evolves and as your GI evolves, you kind of evolve with it.


Sam: Yeah. And we give you back all your data, and I think that’s really important, in a way that you can interpret and that you can learn from throughout that program. So it was really you and your coach, our partners in this environment, but you get to use our fancy ML and AI tools to help.


Sid: Amazing. One of the things that I think you had mentioned to me when we had initially chatted was the fact that rather than just throwing something in the market, one of the things that you did was to put clinical validation behind the Able Health program, before building the platform itself. How do you think that sets that apart in the digital health world, given the fact that there’s other people that are trying to do similar things as well?


Sam: Yeah, it’s a really good question. It’s something that we are very passionate about, my background in clinical research and as a patient there. We published a peer-reviewed clinical journal, our research, before we took a dollar from anyone. And that was an important kind of ethical thing, but it’s also something that we see in the space. So there’s a couple elements that guide this pathway. One is, there’s been a proliferation of digital health tools that are out there. And the question then becomes, how do you differentiate or choose one from the other? Ultimately, I think at the end of the day, patients and consumers are educated, enterprise customers are very sophisticated. And at the end of the day, to make a difference, you need to prove that your thing does what you say it does. So that’s a major differentiator. It’s something that we have seen as a big difference.

I think the other element is that there’s an element of trust. With the proliferation of a lot of companies and there’s the bell curve of companies that have a bunch of evidence, companies that don’t have a lot of evidence, what you’re seeing is that there, unfortunately, has been a history of erosion of trust with the person, the patient at the end of the day. So what we do with our research is, it’s not just to differentiate from other competitors, it’s also just to meet that patient where he or she is and say, “This is validated. We’re showing you the research, and so you can make an educated decision. We’re not talking down to you, we’re meeting you where you are. We are here and we have made the investment to earn and keep your trust over time.” And that’s really important because I’ve been predated upon by a bunch of companies making a lot of statements and claims that aren’t always backed up.


Sid: Yeah, that’s super important. I think if you look at adoption of any sort of technology, the fact that you have a lot of people that have built it out and throw it out there, see if it sticks. Right? 

There’s like a whole school of thought around that. I think when it comes to health specific things, I’m not sure that’s the right formula, I think what you’re doing kind of makes a lot more sense.

It’s like, let’s validate, let’s build trust, let’s make sure that we have something in place that has been validated, that when we go to market that we feel confident. Because the thing is, if we don’t feel confident, then at the end of the day how do we expect our customers to feel confident?

So I’m super pumped that you’re going with the more traditional longer approach, which again, when it comes to health care, it’s probably a little bit more in line with what you need to be doing.


Sam: Yeah, I mean it’s hard. That’s the other thing. It’s hard and science is unpredictable, but it’s really important for us to iterate and develop new science and contribute to the research and be part of that ecosystem. And as you’re talking, I think the thing that came up was this idiom, move fast, break things. Right?

I think that works when you’re in consumer SaaS or B2B SaaS or whatever. But when you’re talking about a patient’s health and people who need this support, I don’t think you should be that. You shouldn’t move that quickly or break that many things. So I think that’s it. It’s just important to keep in mind.


Sid: It’s important. Right.


Sam: It’s a different industry. Yeah.


Sid: Yeah, and that kind of leads me to my next question. You mentioned that your software uses AI. AI’s been around for a while, it’s finally becoming mainstream. A lot of brands are incorporating it into their product, but there’s still a lot of skepticism about blindly trusting AI over human interaction. How do you see that transpiring into confidence and trust over the years? And does Ayble Health have a human touch at any stage of the user journey? I know you mentioned that there’s some coaches and stuff along the way, but it’d be good to get an idea of how you manage that.


Sam: Yeah, I think there’s a couple elements. If you ever use an AI chatbot, I think most people really don’t enjoy that experience. It helps for very surface things. When you’re talking about changing behavior, we see AI as a tool to make the process faster and more effective and more personalized. But it’s not perfect, so we do two things. One is, we keep everything as an open loop. We do 95% of the work, and then we take input from the patient every step of the way through to make sure that what we’re co-developing with that user and what that patient is doing is theirs. And that we’re learning from the feedback, from that patient on a regular basis to make that AI more effective.

And even with that, we know that there’s going to be a gap. And that’s why we have the coach. The coach is there to do a lot of the… When we talk about behavior change, behavior change is hard, takes a long time, it’s both psychological and habit driven, and so we need that person on the other side to hold your hand through the process, address the fears, address the concerns, address the technical, how do you move forward through the program. So we do both, but we see AI as a tool to accelerate and improve on the standard of care. It’s not the tool itself. Everything is together holistically.


Sid: Amazing. It’s kind of like a co-pilot as opposed to somebody flying the plane.


Sam: Yeah, I love that. Yeah, that’s a great analogy. Yeah.


Sid: Yeah, it’s amazing. This is why I’m super also excited about your approach along with the evidence-based approach, is having kind of a human along with you for the journey. Right? Because at the end of the day, there is this whole notion that the more coaching that you do and the more that you can humanize that process, it will ensure that you have somebody coming along the journey for a longer period of time.


Sam: Right.


Sid: So I think having that balance of the right amount of data with some decision-making capabilities and then a human guiding you along the way, hopefully leads to better outcomes over time.


Sam: Yeah, we certainly think so.


Sid: Amazing. So in terms of the future for what you’re building, where are you in the journey? Are you guys live? Are you going to be out there pretty soon? What’s the future? And how do you see that kind of transpiring over the next couple of months in terms of your launch?


Sam: Yeah. Well, so we should be live any day now. Perhaps when this comes out, we will be live. Our goal is to get it in the hands of as many people as possible who need this kind of support. We think of our evolution over time as kind of just deepening our support of patients in the GI space. We are actually currently doing research with and building a complimentary program that would sit side by side in parallel to our diet program all around psychology.

The gut and the brain are connected. It’s actually a bidirectional connection, and a lot of the evidence supports that if you can use elements like cognitive behavioral therapy and even elements of hypnotherapy can actually help manage symptoms for both IBS patients and IBD patients. So we’re developing very much in the same infrastructure, a personalized psychology program for patients to make sure that we are now comprehensively supporting that patient, everything beyond the pill. So that way we are going to be really rounding it out and making sure that patients have all of the tools at their disposal to help themselves over time. And then after that, we’ll see where it goes.

Sid: Amazing. That sounds super exciting. As I’m hearing you kind of talk through all of these different things that you have to put together, I’m sure over the course of this journey, going from idea to where you are today, I’m sure you’ve gained a lot of skills, a lot of painful lessons along the way.


Sam: A lot of gray hair.


Sid: Do you mind maybe sharing a little bit about what that journey felt like? Because it is, you’re tackling a super hard problem. You’ve got a lot of skill sets that you need. There’s a lot of first time things that you need to figure out. So I’d be curious just to find out what that felt like and some of the challenges you had and how things have transpired and your journey of actually getting from idea to launch.


Sam: It’s a tough journey. I mean, shout out to all the other entrepreneurs that are out there building and doing the hard thing and doing the hard thing the right way. That’s amazing. It’s sometimes a bit of a lonely journey, building that out. People will say no to you a lot. People will say it can’t be done or it shouldn’t be done. There’s a lot of no out there, but I think there’s also a lot of yes.

The thing that has been really propelling me forward is talking to patients, seeing the impact that we make on those patients, and that really motivates us. And the other element is that there’s quite a few people out there that are innovative and thinking about things in a way where they are not assuming that the way that it has been done is the way that it should be done in the future. And when you latch onto that and you partner with those folks and you try to make a rising tide float all boats, rather than competing against him or her and just saying like, “I’m better or worse,” we’re all in the same space, solving the same problems somewhat differently. And it’s really exciting to learn from each other too.

The community in the digital health space has been great. Community in gastroenterology is super complimentary. And I just think that it’s an exciting place. I think we as entrepreneurs need to hold each other accountable to doing things the right way, really investing in the evidence and all that kind of stuff, but also being there for each other because there is days that are tough, there are days that are easy, but it’s all worth in the end because it’s exciting to build things for people who need it.


Sid: Yeah, I’m super excited. Just talking about the healthcare community, we’ve spent our time talking to a lot of different founders in a lot of different industries, and I think the one thing that’s super special amongst folks that are finding or funding in these healthcare companies is the fact that they’re so purpose driven, that at the end of the day, it’s not about winning, but it’s all about how do we win together and bring about big change? So I’m super excited. I can’t wait to try out the product and go along and check out the journey for myself.


Sam: Yeah. Well, we would love to have you on board. Thank you so much for the time. I appreciate it. It was a great conversation.


Sid: Amazing. Looking forward to it. Thank you very much for your time as well.


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