Blake Marggraff is a name you probably already know. He launched his first company in just his second year in college, later receiving an Arch Grant for it, and has now shifted his focus to Epharmix: a company that, as long as patients have a phone or know someone with a phone, helps them stay connected to their doctors and care givers to help treat and monitor the toughest chronic illness.

A Bay Area native who reverse migrated to St. Louis for Washington University’s strong academic offerings, we sat down with Marggraff at CIC@CET where Epharmix offices to get to know him, his company and his aspirations a little better.

Your first company, Betaversity, received an Arch Grant, talk to me about that first company.

Betaversity, which I founded during my sophomore year at WUSTL, was a totally bootstrapped small business in the education technology space that, aside from being a great experience, to date is in several universities and Fortune 500s. The founding team met out at a conference at Stanford and we’d all experience the same pains at our own universities.

That pain being, how to do you take an idea, especially for a physical product, and get it out there? And universities were struggling with that as well, retaining engineering talent, providing the necessary resources for prototyping—it was kind of the beginning of the maker movement wave.

So that’s the problem we solved. We started a consultancy and then we launched the core product that we have today, Betabox, which is a mobile prototyping lab, literally a makerspace in a shipping container.

So how did you go from Betabox to Epharmix?

I’d been saying since 2012 or so that I wanted to found a digital health company within the next 10 years, which means that I was keeping an eye out for it.

I’d been chatting with my co-founder and chief medical officer Avik Som, who is an MD/PhD student at WUSTL and he mentioned that physicians will take out a pad and prescribe, “go to gym 3x per week” and patients actually do it.

My first knee-jerk reaction was, “Cool, how can they prescribe technology?” So we started to list off what would need to happen to prescribe technology: It would have to be proven to work and have research behind it, it would have to work for every patient, not just patients with smartphones.

And then rather than a wellness program, it would have to apply to something specific, like a chronic illness.

Then you get into the business side. It would have to be economically viable. It’d help patients, make doctors money, save time in the average workflow and save insurance companies money; that’s a tall order.

Then you have the perfect list: Create almost impossible sets of limitations and then build to those. If you can hit every single goal, then maybe you have something viable. You also have to work very close with the customer.

Before Epharmix was a tech company, it was a research project at WUSTL with a simple premise: Create disease-specific tools that allow generally the most medically underserved patients to stay in touch with their doctors, nurses and care teams and prove that the technology works.

So we run randomized trials within Epharmix, which is weird—technology companies aren’t supposed to do research. They are supposed to build something and sell it. But we hold ourselves to a higher standard.

Is there a reason that heath was the specific avenue that you wanted to go down?

You can start a company doing anything, a company with disappearing photos that makes a whole lot of money for example. So not to trivialize it, right, but if I am going to spend my time doing something at the highest level, then I want to spend that time doing something that’s going to help people in the most meaningful way possible.

And the two best ways I’ve been able to find so far are education and health. You help people live better lives, you help people live longer lives—and ideally both.

So that’s why. Digital health I think is a cool space because like any other, the phrase digital health is going to mean something totally different five years from now, and five years from then.

So where is Epharmix now?

Epharmix is almost exactly 11 months old. We launched the product on time two months after closing our round.

We added paying customers about 71/2 months ahead of schedule which is great validation that the product is really working, and since the beginning of the year, we’ve been scaling in our sales and account management teams and also scaling the research side. We now have five large randomized controls underway—all based in St. Louis.

At what moment did you feel that Epharmix was a viable company, the moment when you felt, “Okay, this is working.”

So you never fall into that trap of comfort saying, “Yes, this is totally good!” but back before Epharmix was even a company, one physician had heard about the early, early Epharmix product which was for end-stage renal disease patients and actually pitched my co-founder Avik to develop a product for his patients. An actual elevator pitch, but the other way around.

That also speaks to word of mouth communication in healthcare. It’s a very tight industry. So if you create something that fits the mental schema of care provision, as Epx prescriptions do, then maybe those are going to be spread in more traditional paths than most technology.

What’s your vision long-term for Epharmix and your career?

So every hour, every day goes to Epharmix. In medicine, there’s the concept of standard of care. It’s what doctors, nurses and everyone has to do to provide the best care to their patients.

That’s how new drugs are adopted. That’s how new devices are adopted. I believe if the right research is done, that is how technology can be adopted.

That is the vision for Epharmix. It’s to not only support the health of hundreds, thousands, millions of underserved patients in the country, but to also align with and become the standard of medical care for those patients.

Talk about a moment of doubt, how did you overcome it?

I think that it’s first, recognizing that you’re having a moment of doubt and then deciding what your reaction is. For a lot of folks, and maybe they’re more risk-averse, or they’re more sane, but their reaction is, “Oh, better not go down that path—stay away,” versus embracing, “there’s this potential for failure.” 

Generally, it’s minor. Most days you don’t wake up and feel like your world is on fire.

But rather, embrace it and jump instantly to the question, “What are the different solutions?” And it sounds like a cliché, but more often than not, when the Epharmix team or Betabox team hit a roadblock, it was the people on the team that meant we could walk away even stronger.

What’s the best advice you’ve received so far?

One right off the top of my head is: Don’t work with people where you walk away saying, “Geeze, good thing they’re on my side and not against me.”

Those kinds of folks who you’d be scared to have on the other side of the table: don’t work with them. It almost always comes back to bite you.

The second one, which is totally different, is to continually task yourself, “If you weren’t doing something already, would you start now?”

“I think a lot of teams get trapped in this. Everyone doing something because, “It’s the way it is,” which can be dangerous.”

“Something that I’ve realized is, startups tend to mirror the industries that they are in with speed, operations and risk. So for us being in healthcare, it’s not acceptable for us to move at the speed of healthcare so we actively fight that and try to improve it as a whole.

Then the simplest one, “Make everyone around you look good.” Be cognizant about how you are making the people around you look and feel whether that’s the investors, partners, employees—everybody.

Who is another founder local or not that you admire?

Gabe Lozano at Lockerdome. I have a huge admiration and respect for what he is doing and the way that he approaches work.

How do you wind down on your off time?

I go on really long walks; I still don’t have a car. And listen to podcasts. Radiolab: that’s the bedrock of podcasts. That and about 13 others I try to keep up with.

If you weren’t working within Epharmix or in digital health at all, what would you be doing?

I would probably be building houses. I loved building stuff when I was growing up. I love that the hours fly by when you’re working with your hands.