It's estimated that 50 million, or 1 in 5, adults in the U.S. have chronic pain, and many of them struggle to find adequate care to manage their condition.
Jennie Shulkin, a Harvard-educated attorney, understands this experience at a personal level. Shulkin suffered two traumatic brain injuries in college that left her with a complex, full-body chronic pain syndrome.
For nine years, she traveled across the country and tried different doctors, medications, devices and treatments, but most failed. After graduating from Harvard Law School, Shulkin served as a law clerk to a New York federal judge, a Manhattan assistant district attorney and a white-collar criminal defense attorney. But while attending school and building a career, she struggled to find relief for her own complex chronic pain syndrome.
"What I came away with from that experience was that the chronic pain care industry is so fragmented and frustrating and that in many ways the chronic pain patient has been forgotten about," Shulkin said in an interview.
In her experience, providers of different disciplines would not speak with one another; the result was disjointed, and, often, care that resulted in treatment plans that were in contradiction to one another.
"There are countless providers and companies focusing on the low-hanging fruit: people with acute pain. That’s where traditional healthcare excels—injections, surgeries, painkillers. After traditional treatment fails, it’s chronic pain patients like me who are told they’re out of options, forgotten about, and thrown away as too complex," Shulkin said.
Shulkin teamed up with her father, David Shulkin, M.D., a former Department of Veterans Affairs (VA) secretary, to launch a new startup focused on providing a comprehensive virtual health solution that takes a team-based approach to care.
"We basically founded the company, Override, because of my own experience with chronic pain," Shulkin said. Override’s model is the type of care she felt she and others needed but didn’t exist.
Override raised a seed funding round of $3.5 million led by 7wireVentures and Martin Ventures, with SignalFire and Confluent Health also participating. The company used these funds in part to acquire a pain management coaching business called Take Courage Coaching.
Jennie Shulkin is the company's co-founder and CEO while her father, David Shulkin, also is a co-founder and serves as executive chairman.
Override uses a virtual, team-based approach to care that matches each patient with an interdisciplinary care team of a pain specialists, according to Shulkin. The company offers a non-opioid solution that bridges the gaps in traditionally fragmented, one-size-fits-none chronic pain treatment. With Override, patients are matched with a team of coaches and chronic pain specialists in pain medicine, physical therapy and behavioral health. These specialists treat Override patients individually and work together as a team.
The company also uses the latest in pain neuroscience research to help patients make functional, behavioral and movement-related changes needed to calm the nervous system and rewire pain neural pathways. The program strives to transform people dependent on opioids, chiropractors and repeat injections into self-managers of their own pain experience and broader health, according to Shulkin.
"Some of the best results for people with chronic pain come from interdisciplinary pain rehab centers. Those are generally brick-and-mortar programs that have a similar team structure with these types of providers who are working with the patient pretty intensively every day for anywhere from like four weeks to four months," she said. "But the problem is that there are fewer than 50 of these centers in the country."
Override aims to offer this team-based, holistic treatment virtually to reach more patients who need care.
David Shulkin spent most of his career leading major health systems like Beth Israel Medical Center in New York City. In 2014, President Barack Obama appointed him as the VA’s undersecretary of health, and, in 2017, President Donald Trump appointed him to his cabinet as the ninth VA cecretary. Under his leadership, the VA created programming, called Whole Health, that provided veterans with a team-based approach to care and peer support to help scores of veterans with chronic pain taper off opioids, according to David Shulkin. That program’s success informs much of Override’s approach.
"He was a natural partner. His experience in healthcare is pretty much unparalleled," Jennie Shulkin said. "He's always been attracted to tackling the most difficult problems in healthcare. I mean, he's done some things in his career that nobody before him was able to figure out or accomplish. And he approaches problems with imagination and innovation that is pretty much unmatched by most other leaders."
She added, "When I was a kid we called him Mary Poppins because it was like he would fly into a broken health system, clean it up and then fly out with his umbrella and do that somewhere else."
There is a growing crop of startups targeting chronic pain and musculoskeletal issues.
Digital health startup Clearing launched a new platform last year with $20 million in seed funding to provide opioid-free pain relief with the aim of reaching the 50 million Americans living with chronic pain. Clearing provides physician-prescribed, personalized pain management treatment plans.
Shulkin believes there are large gaps in the market to offer effective treatments to chronic pain patients.
"Most of the companies in the space are primarily targeting musculoskeletal pain but that's largely acute pain. A lot of these big physical therapy companies like Hinge Health and Sword Health, we've talked to some of them and they say, 'We really don't treat chronic pain patients.' That could be chronic musculoskeletal pain that's not responding to their type of physical therapy, but it could also be underlying conditions like fibromyalgia, rheumatoid arthritis and lupus. There's this broad spectrum of chronic pain that I think most people don't think of because when they think of pain they think of neck and back pain."
Many digital health startups also focus on physical therapy, and Override offers a differentiated approach with a comprehensive multispecialty care team, Shulkin said.
"At 7wireVentures we often support founders whose lived experiences fuel their passion to change how healthcare is delivered for the better. Jennie Shulkin, CEO and co-founder of Override, and her family have struggled for years to find the right treatment for her chronic pain. Her learnings, and those witnessed by her father, Dr. David Shulkin, during his tenure leading the VA, have informed Override’s integrated, interdisciplinary care model," said Lee Shapiro, 7wireVentures managing partner and Override board member, in a statement.
Override works directly with patients and also is piloting its model with employer and health system partners.