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Get an inside look at the patients team at Alto Pharmacy to learn what it's like to work on Alto's customer-facing apps, which projects are on the horizon, and who makes the best barbecue short ribs.

Get to Know the Team That Builds Alto's Customer-Facing Apps

Imagine an app that allows you to buy things and have them delivered to you the same day, for free. Now take that app and put it in a highly regulated space like pharmacy. You face the challenge not only of building an e-commerce platform from scratch, but also of navigating medication pricing, federal and state regulations, and patient safety—and that's just the way the Patients Team likes it.

"It's a really exciting and fun problem to solve," says Mike Riess, the team's Engineering Manager. Software Engineer Angelique Nehmzow agrees: "There's a really strong product and design aspect, like more traditional startups, but then everything gets a little bit more interesting because it's healthcare."

Below, we chat with the team to learn what it's like to work on Alto's customer-facing apps, which projects are on the horizon, and who makes the best barbecue short ribs.

What does the Patients Team do at Alto? 

Ask anyone on the team why they joined, and chances are, they'll tell you they wanted to be on the product team closest to Alto's customers: "We really try to own the customer experience," says Peter Zeng, the latest Software Engineer to join the team. "If a customer is coming to the web app, or they're coming to our mobile app, we want to make sure that they're able to onboard with us as easily and conveniently as possible."

The team is also responsible for the customer experience beyond onboarding, from the moment a customer schedules a medication for delivery to the time that it shows up on their doorstep. "We already offer great services like free, same-day delivery and cost savings. The Patients Team empowers customers to make the most of our offering," Nehmzow explains. "You can see what prescriptions you have, check on the status of your order, and schedule automatic refills. In a more traditional pharmacy, you don't get that kind of visibility. You have to call them up or even wait in line in person. At Alto, it's a different experience."

What was it like in the team's early days?

Today, there are eleven engineers on the team working to build that better end-to-end experience—but it wasn't always that way. When the team first formed in 2019, it consisted of just three members: Riess, Brian McRae, and Andy Lau, all of whom are still on the team.

"The first priority for us was just stabilizing the foundations," Riess says of the team's early days. Every other week, the three team members, along with Alto co-founders Matt Gamache-Asselin and Jamie Karraker, would meet to audit the app's core flows. "For the first three months we probably didn't make it through some flow at least 50% of the time," Riess recalls. "There would be a ton of bugs in the onboarding experience, things that weren't working with the flows or navigation or deep linking."

Among the team's first projects was a redesign of the checkout flow. "There was a lot of work to be done to streamline the checkout flow, which is pretty much the main function of the app," says McRae, who initially joined the team as a software engineer and later transitioned into product management. "We had to make it easier to add a payment, add your addresses, everything you need to do to schedule your prescription for delivery."

"The growth of the team, in terms of both size and stability of the platform, has allowed us to swing at more interesting bets for the company," Riess says. In particular, the Patients Team has turned their attention toward experiences personalized for specific medical conditions.

"Different customers have different needs. A customer who wishes to start a family will have a different experience than a customer who needs to order their routine heart medications that they've been taking for the last eight years,” McRae says. “The challenge for us is how we serve all these customers well through the app."

"I think that's where Alto can be such a differentiator," Riess adds. "A world-class pharmacy experience is about so much more than just dispensing medications. We want to build tools for customers that help them get the most out of their medications—everything from simple videos teaching them how to perform injections safely at home to the ability to synchronize deliveries for multiple prescriptions for managing complex health conditions."

With these new projects on the horizon, engineers have ample opportunity to focus on the areas that excite them most. "We're full-stack and mobile and web," Nehmzow says. "Part of the team focuses more on experimentation, iterating quickly, and using data to make decisions. Part of the team focuses more on platform work, tooling, and improving the developer experience. There are a lot of areas to explore and contribute to."

One spring night, the Patients Team gathered in a back yard in San Francisco’s Mission District for short ribs and an impressive spread of side dishes. "Kudos to Robbi, who's the grill master. I just provide the grill!" Nehmzow says, laughing. While the team barbecue was the first time some members had met in person, Zeng notes that the team has been supportive of one another even while working remotely during the pandemic.

"The first real project that I was assigned to was working with the communications system. Before writing my first piece of code, I spent two weeks exploring what already exists and understanding the different parts of the system," Zeng says. "I've been really impressed with how understanding my teammates have been. They make the space for you to learn all the different pieces of code we own."

That culture of support is by design, reflected in the six principles—complete with matching emojis—at the top of the #patients-team Slack channel: "Empower each other," "be an owner," "find the path," "learn by doing," "embrace complexity," and "foster trust." 

While these principles echo Alto's company-wide values, they are unique to the Patients Team. "For a long time, we were the only external-facing product team at Alto," Riess says. "These principles were intended to be this motivation around how we win. It's a combination of how we treat each other, how we reason about decision making, and how we approach solving a problem that's never existed before."

As the team looks toward the future, those principles have never been more relevant: "We have a goal and an area we want to focus on, but in terms of which projects we're going to do, it's not a top-down thing," Nehmzow says. "It's very much, 'We're going to figure out how to solve this problem together, even when it's difficult.' That's my favorite part about the team."

The Patients Team is hiring! Learn more about open positions here.

In recognition of Women’s History Month, we highlight four women at Alto shaping the future of pharmacy. These leaders share their advice for women in the workplace, their unique super powers, and what they appreciate most about Alto's culture.

Celebrating Women at Alto Pharmacy

Liz Kelly, Sr. Director Sales, Fertility 

I'm responsible for hiring, coaching and supporting the needs of the national fertility sales team. I also work closely with fertility business and operations teams to deliver on our clinic and customer promises.

Before joining Alto, I was finishing up a sabbatical where I spent my time volunteering on the board of a non-profit called ServeHAITI. Prior to that, I was the West Coast Area Business Director at EMD Serono and worked with Matt and Jaime [Alto’s co-founders] to secure a contract to distribute fertility meds when they were still working out of AG Pharmacy!

What do you appreciate the most about Alto's culture? 

Hands down my favorite part of being on the Alto team is that the patient is truly at the center of every decision we make. I value that we make business decisions with our mission in mind.

What do you like doing outside of work?  

Of late, my favorite pastime is heading to the dog beach with my rescue, Bodhi, who has been the best medicine to ease some of the COVID-19 isolation I experienced over the past year. Before the pandemic, I made sure to travel to at least one new international spot a year. I love the experience of getting exposed to all things about another culture: cuisine, culture, belief systems, language.

I like to think that my super power is seeing the greatness in others, sometimes before they see it in themselves.

I aspire to live by the motto "be the change you wish to see in the world." I encourage women to speak up for what they believe is right, even if nobody else agrees. That includes planning for your own career path and making it a priority to develop your skill sets so that you are prepared to climb the ladder that serves your own greatness.

I graduated from pharmacy school in May of 1979 and started working at AG Pharmacy after passing my boards later that year. I bought AG in 1998 when the previous owner wanted to retire - he had been with AG since it first opened in the early 60's.

My family moved to San Francisco from Hong Kong when I was five years old. Our story is one similar to those of many immigrant families who came to America looking for a better life in search of the American dream: own a home, have a car, raise children safely and give them the opportunity of a good education and a chance to have a better life. My parents raised their children here, emphasizing family, hard work and education. They lived their American dream, and I have them to thank for all that I am today.

What’s your favorite thing to do outside of work? 

I love to travel. There are so many unique places to visit in this world. With the different cultures, the food, and the amazing sceneries/landscapes, there are endless things to see and experience! 

The thing I appreciate most about Alto's culture is that everyone works so hard together to bring about the best pharmacy experience for all our customers. You can feel the energy and the motivation of all the Altoids. I cannot emphasize how amazing it is to be a part of this team and to watch Alto grow and evolve into the pharmacy of the future and the pharmacy of our dreams!

What’s your favorite memory thus far at Alto? 

In the very early days, when Alto was still Scriptdash Pharmacy, a customer needed to get her trigger shot [as part of a fertility protocol] within the next few hours. It was close to rush hour, and we had no couriers available to deliver to the South Bay. Our CEO Matt came to the rescue on his motorcycle, and off he went to make the delivery. It was such a wonderful and warm feeling to watch and cheer him on together. That is truly what Alto love is all about!

I manage our amazing IT Support team, helping all Altoids get the technology support they need, when they need it. 

For the better part of the last decade I have been managing IT Support teams. From Facebook and Twitter to Lyft and Uber, I’ve seen it all (or at least most of it!).

Our incredible dedication to our mission. In my short time here, I truly see us putting patients first, and it’s moving to see. 

What do you like doing outside of work? 

I’m a big traveler, but since COVID-19 has put a damper on that, I enjoy flying around Colorado with my partner in our vintage Beechcraft Bonanza. I also love hopping on my motorcycle and just exploring! 

I’m in love with Central and Eastern Europe. Some of my favorite places are Prague, Vienna and Budapest. 

I’m originally from Iran but moved a lot growing up, including Oklahoma, Australia, Qatar, Kuwait, and Chicago. I have been in San Francisco for the last six years. I stumbled across software engineering in college and found a passion for building products and teams. I joined Alto as the third engineer and this is now the largest company I’ve ever worked at. 

I lead a group of 20 engineers across three teams. Two teams are focused on getting prescriptions ready to schedule quickly and accurately, and one is focused on enabling faster, higher quality, and more enjoyable product development across the broader product and technology organization. My work involves a lot of collaboration, creativity, transparency, and flexibility. 

I was an early software engineer at a small startup; before that I was a hybrid software engineer and product manager at a design and development studio. 

I like how passionate everyone is about what they do. 

I’m at my best managing a crisis or finding a path through conflicting strong opinions. 

I want to start with some advice for our allies: get more curious about the experience of the women you work with and learn about ways you can support and amplify the work of the women around you. Diversity, equality and inclusion is a team sport and, even if we win a game or two, it’s about the continuous pursuit of excellence. 

For my fellow women at Alto, I wish I knew earlier to focus more on improving my craft and impact so I can get a seat at the table, rather than trying to juggle advocacy and my own work. Once you’re at the table, you can really advocate for hiring, growing, and retaining women. 

To learn more about the work of our six employee resource groups (ERG’s) focused on building community - including Umoja (Black), Auténtico (LatinX/Hispanic), Women (WOAA), Proud (LGBTQIA+), Asian/Pacific Islander, and Working Parents - read our 2020 Diversity, Equality and Inclusion Report. 

Are you passionate about shaping the future of pharmacy? Join us as we deliver our industry-leading pharmacy care to millions of Americans. 

Reverend Stacey, who is also the Executive Minister at Trinity United Church of Christ in Chicago, sat down with us to share more about the challenges of fertility in the Black community, what fertility care providers can do to create more inclusive experiences, and some of her favorite memories in the history of FFCG. 

Rev. Dr. Stacey L. Edwards-Dunn on Her Mission To Improve Black Fertility Care

When it comes to fertility, there is a lot to navigate—from deciding which treatment option is right for you to figuring out how to afford the costs. In the U.S., about 11% of women experience infertility, and studies suggest that Black women are twice as likely to face infertility as white women. 

Rev. Dr. Stacey L. Edwards-Dunn is trying to change this. After working as a health educator in Chicago and an education director at Planned Parenthood, she founded Fertility for Colored Girls (FFCG) in 2013. As a 501c3, FFCG’s mission is to provide education, awareness, and support to Black women/couples and other women of color who struggle with infertility—something Stacey wished she’d had when she was on her own infertility journey. 

With 14 chapters across the country spanning urban and suburban communities, and with more opening each year, FFCG provides services including educational programs, grant opportunities, counseling, and monthly support groups where women can share their experiences and receive support.

What are the reasons Black women are almost twice as likely to experience infertility as white women?

There are a few factors behind this. The first is that in the Black community, infertility is a taboo topic. And it’s not something we expect to experience. In our communities, we have believed the hype that Black women are hyper-fertile. Much of this comes from breeding myths during slavery around our ability to be able to give birth. But the reality is, these myths are incorrect. So it begins with how we have been socialized and educated around our own reproductive health and our Black bodies. 

A second reason is that there are many Black women and couples who don’t trust the medical system. And because of this distrust, we’re not accessing health care. We think doctors don’t take us seriously and impose their biases on us. And even today, we still hear stories of Black women and couples having surgeries done on them and being sterilized without permission.

A third reason has to do with research. Most of the research around reproductive health and treatment has primarily been done on white women. So when research shows that in vitro fertilization (IVF) is not as successful with Black women, it’s because the trials haven’t included Black women. Once we start seeing more research done that includes black and brown women and other ethnicities then we’ll be able to tailor treatments better. 

A final reason has to do with marketing. We still have a number of fertility clinics that aren’t including women and babies of color and other ethnicities in their marketing. So Black women and couples don’t see themselves in the marketing and if you can’t see yourself, it makes it harder to feel welcome and to trust that you’ll get quality care. 

In addition to marketing and staffing, what other recommendations do you have for clinicians and fertility care providers to create a more accessible and equitable experience? 

I would say education. The staff working with women of color need to be educated. They need to be equipped with tools on how to be culturally sensitive to the Black women and couples that are coming into their spaces. Something I hear from Black women and couples is they want the doctor and team to partner up with them in their treatment—not to look down on them or talk at them. They want someone to walk with them on their journeys. 

Education can also help staff understand their own biases which, a lot of the time, they’re unaware of. It’s important they know what to say and what not to say to make sure they aren’t deterring Black couples. In addition, Black and other ethnicities need to be represented in executive roles and throughout the organization —from doctors to nurses to lab technicians. Making sure staff is inclusive, diverse, and culturally-educated.

Finally, they need to work with organizations like FFCG, who have their pulse on the community and can help them create relationships with the Black community. And they should be open to having these conversations not just during Black History Month, but all the time.

For the communities you work with and those who might not understand their family building options and the resources available to them, what do you want them to know? 

I want them to know there are multiple paths to parenthood. And though they are all different, they are not deficient. When I educate the women and couples I coach and that come to me, I help them focus on the goal, which is to be parents and to build a family. When you know the goal, then you can understand that you have other natural options, like IVF, intrauterine insemination, donor eggs or donor sperm, domestic adoption, et cetera. 

There is an option and a path that has been designed for everyone and I help them see that. Because when you have options, there are possibilities. I am very intentional about helping to open up the minds of the women and couples that I work with to help them see the goal. Because when you reach the goal of becoming a parent to a child, the reality is that you’re not going to love them any less because it is the child that God has sent you.

Is there a particular memory or moment that stands out for you since you founded Fertility for Colored Girls?

A powerful moment for me was when we gave away our first free IVF [cycle] to a couple. After experiencing a few unsuccessful IVF [rounds], they didn't have any money left and their state of Mississippi doesn’t have insurance toward infertility treatments. So they put their name into our raffle and won. They took the Megabus from Mississippi up to Chicago, Illinois to meet everybody that they had been talking to on the phone during prayer time. 

At this time, I was also one month away from giving birth to my daughter after seven in vitro cycles, so I really felt for them. Now they have five-year-old twins. This was significant because it was the first time we were able to provide physical resources to a couple in need. 

In addition to this, I am always so honored when women and couples call me and tell me they got a positive pregnancy test after IVF, or that their surrogate is pregnant, or their adoption just got approved. Often, I end up finding out before anyone else in their family does. I’m so honored that these women and couples trust me to share their journeys and their hearts. And most of them have never met me in person, they’ve just talked to me on the phone. 

These are women who have cried so many tears in silence and lived so long in shame, and they’ve found a successful path to starting a family. That is what gives me joy and fuels me to keep doing the FFCG work. It reminds me there’s still hope and the work that we are doing is not in vain. 

Is there anything else you’d like to highlight about your work with FFCG and your mission?

I will add that I think you are able to have peace on your [infertility] journey when the mind, body and spirit are aligned. Because if any of those aspects are not aligned everything can really fall apart. Therefore, my approach, and the mission of FFCG, is to minister to each aspect of a person’s life as they are all equally important. 

In addition, it’s important for people to know the resources that are available to them through FFCG—from grants they can apply for to education to support in our prayer circles. Many Black women and couples struggle with having the resources and support to move forward, so I want to make sure they know this.

To support or donate to Fertility for Colored Girls visit the FFCG site. You can also learn more about the Black Reproductive Endocrinologist and Infertility Specialists making history and bringing hope to their families on 2/25 at 6 pm CT. Register here.

At Alto, we know fertility treatment can be an emotionally, financially, and physically challenging experience. That’s why we believe choosing the right pharmacy can help you avoid additional stress caused by waiting for hours on hold, tracking down your medication delivery, and navigating insurance benefits.

The health of your gut can impact everything from your mood to your immunity. Here’s what you need to know and how you can keep your gut healthy.

Why Gut Health Is Key (and How To Improve Yours)

You may have noticed in recent years that the topic of gut health seems to come up a lot more in conversation and health news. Why is that? Over the past decade, scientists have been learning that your gastrointestinal (GI) system—of which your gut is a key part—does a lot more than just move food through your body. And that the health of your gut can impact everything from your mood to your immunity. Here’s what you need to know and how you can keep your gut healthy.

Gut Health 101: What It Is and Why It’s Important

Your body is full of trillions of microorganisms that make up your microbiome. Many of these microorganisms are bacteria. Some are harmful and associated with disease, while others are beneficial and key to your health. The ‘gut microbiome’ refers to the bacteria that live in the part of your GI tract where digestion happens—your large and small intestines—where, at any given time, we have between  300 and 500 different species of bacteria living. 

While everyone’s microbiome is unique, a general indicator of a healthy one is having a diversity of bacteria. In unhealthy people, scientists have observed much less diversity although they don’t know for certain which comes first—the bacteria or the disease. 

Inflammation, which studies point to as the root of many diseases, is kept in check in the gut. When the balance of your microbiome gets out of whack, inflammatory bacteria can take charge and, via metabolites, spread inflammation throughout your body. This can affect your brain, heart, and immune system function as well as your skin, weight, and ability to absorb nutrients. 

Having a healthy gut, on the other hand, has been linked to a stronger immune system, reduced symptoms of depression, lower risks of heart disease and certain cancers, as well as reduced symptoms of arthritis. 

So how do we keep our gut healthy? As with many other aspects of health, it largely boils down to the foods we eat and the lifestyle choices we make. Other factors like medication and emotional stress could also play a role. 

To start improving your gut health, it’s helpful to first look at what might be wreaking havoc on your microbiome. While there are many different symptoms that could point to an unhealthy gut, here are the most common.

Upset stomach
Signs of an upset stomach can include gas, bloating, constipation, diarrhea, and heartburn. When your gut is in balance, these symptoms should reduce, since your gut will have an easier time digesting and eliminating your food.

Poor sleep (or constant fatigue)
Serotonin, the sleep and mood hormone, is mainly produced in the gut. An imbalance in your gut can impair serotonin production and affect the quality of your sleep. 

Weight changes
Poor gut health can affect your body’s ability to absorb nutrients, regulate blood sugar, and store fat. Decreased nutrient absorption can result in the urge to overeat and unintentional weight gain. On the other hand, a bacterial overgrowth in the small intestine could cause weight loss.

Skin irritation
When your gut is inflamed, certain bacteria and toxins can leak out into the body, which could irritate your skin.

Autoimmune conditions
As mentioned earlier, research suggests that an unhealthy gut can lead to an inflammatory response in the body and affect your immune function. This could make you more susceptible to autoimmune diseases like Type 1 diabetes and celiac disease where the body attacks itself rather than harmful invaders. 

Food intolerances
It’s theorized that food intolerances can result from an imbalance in the gut. When you’re intolerant to a certain food, you may experience symptoms like bloating, gas, abdominal pain, and nausea.

A high-sugar diet
Sugar, often linked to inflammation in the body, can decrease the amount of good bacteria in the gut. This can cause more sugar cravings, making the situation worse.

You don’t necessarily have to keep your gut under a daily microscope, but following some general health practices—from keeping a balanced diet to getting a good night’s sleep—can go a long way. Your healthcare practitioner can also give gut health recommendations. Here are some common lifestyle choices that research shows can improve gut health. 

Chronic stress can wreak havoc on your whole body, including your gut. Some ways to reduce stress can include exercise, meditation, yoga, connecting with friends or family, and decreasing caffeine consumption.

Having a good pre-bed routine can be as important as the sleep itself. Your pre-bed routine could include minimizing screen time and exercise. In terms of the ideal amount of sleep to log, the National Sleep Foundation has recommendations based on your age. 

3. Avoid smoking
Studies have found that smoking can increase the amount of potentially harmful bacteria in your gut, while decreasing the amount of good bacteria. It’s also been shown to affect heart and lung health, as well as increase your risk of cancer. 

Water helps everything from digestion to carrying nutrients to your cells. And it can help maintain the balance of good bacteria in your gut. Drinking at least four to six cups a day is recommended. 

5. Take a probiotic or prebiotic
Probiotics are live, good bacteria that can come in pill form or from foods like yogurt. Though the science is still out on the extent of the pills efficacy, there seems to be a general consensus that adding a probiotic can be a good idea to help restore your gut’s balance. Prebiotics are the food that probiotics can eat and are usually fiber-rich. Having prebiotics in your gut can help promote the growth of the good bacteria. 

6. Exercise regularly 
Working out may help increase gut health by growing the diversity of good bacteria in your gut. How much should you exercise? For general adults, the recommendation is at least 150 minutes a week or 20 minutes per day. 

Minimize the amount of foods in your diet that are processed or high in sugar or fat—all of which can lead to increased inflammation in the body. When it comes to gut-healthy foods, diversity is key. Here’s what studies show are best for your gut:

Fiber-rich foods like legumes, beans, peas, oats, bananas, asparagus, and berries

Fermented foods like kimchi, sauerkraut, yogurt, kombucha, tempeh, miso, and kefir

Garlic and onion which may also help minimize the risks of certain cancers as well as boost the immune system

Collagen-rich or collagen-boosting foods like salmon, bone broth, mushrooms, egg whites, and cashews

Gut health can be key to helping everything from your brain to your immune system function properly. To keep your gut microbiome healthy, a key place to start is with a balanced diet as well as healthy lifestyle practices. Even though we can’t see our gut, there are many symptoms that can help let us know when ours is out of balance and needs some attention. 

If you are concerned about the potential effects of your medications on your gut health, talk to an Alto pharmacist. Our team of patient care pharmacists are ready to help whenever health questions come up. Reach out any time phone call (1-800-874-5881) or in-app secure messaging.

This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or another qualified health provider with any questions you may have regarding a medical condition.

Why Gut Health Is Key (and How To Improve Yours) 

For Black History Month, we’re recognizing pivotal Black leaders in healthcare who’ve paved the way forward for our country and the Black community.

5 Black Healthcare Leaders to Know

At Alto, part of our work is to redefine the modern pharmacy to make sure patients from all backgrounds have reliable, affordable access to the medications they need. This extends to fostering a culture of inclusion in healthcare and honoring the Black leaders who have transformed the medical field. For Black History Month, we’re recognizing pivotal Black leaders in healthcare who’ve paved the way forward for our country and the Black community.

Black Healthcare Leaders Who’ve Paved The Way 

Dating back to the 19th century, there have been many Black individuals who, despite discrimination and prejudice, have made a profound impact in healthcare. From hospital bedsides to the front lines of the abolitionist and suffragist movements, here are five Black pioneers in healthcare you should know.

James McCune Smith: The first Black doctor in the U.S. 

When James McCune Smith showed potential and promise at a young age, his parish collectively raised funds so he could afford to attend university. Because of his race, he wasn’t allowed to attend school in the U.S., so he earned his baccalaureate, master’s, and medical degrees from the University of Glasgow in Scotland. 

Not only did Smith become the first Black doctor to practice medicine in the U.S., but he was also the first Black physician to publish articles in U.S. medical journals. In addition, he penned and edited articles for abolitionist newspapers including “A Lecture on the Haitian Revolution” (1841) and “The Destiny of the People of Color” (1843). He worked closely with Frederick Douglass and the two founded the National Council of Colored People. As a highly-educated Black physician and scholar, Smith was a key figure in not only abolishing slavery, but also in helping make its success credible.

Mary Eliza Mahoney: The first Black licensed nurse in the US

Mary Mahoney, born to freed slaves in 1845, learned the importance of racial equality at a young age. This became her reason for pursuing nursing school: to fight for and serve women and the Black community.

After years as a janitor, cook, and washer woman at the New England Hospital for Women and Children, she was accepted into their nursing program. The program was so demanding that only four of 42 students finished—Mahoney was one of them. And with that she made history as the first Black woman to become a licensed nurse. 

She earned many accolades in healthcare, became a member of the American Nurses Association (ANA), and co-founded the National Association of Colored Graduate Nurses (NACGN), where she was an elected leader. The NACGN was later absorbed into the ANA in 1951. Mahoney spent her days caring for those in need at the hospital and her nights campaigning for women’s suffrage. Her efforts were so influential that after her death, she was inducted into the National Women’s Hall of Fame alongside her fellow suffragists in Seneca Falls, NY. 

Dr. James Hildreth: President & CEO of Meharry Medical College 

A leader in immunology, Dr. James Hildreth leads Meharry Medical College in Nashville, Tennessee — one of only four Black medical schools in the country. Their mission is to create more opportunities in medicine for the Black community. Hildreth is renowned around the globe for his decades of influential HIV research as well as his work to fight the global COVID-19 pandemic. He was recently appointed to the FDA’s COVID-19 Vaccine Review Committee.

Hildreth earned his Bachelor’s at Harvard, his Ph.D. in immunology from Oxford and became the first Rhodes scholar from Arkansas who was Black. He joined the Advisory Board at Alto in August to help reimagine the pharmacy experience as one of its two anchor members. 

Phill Wilson has lived with HIV for over 30 years and lost his partner, Chris Brownlie, to the virus in 1989. Ten years later, he founded the Black Aids Institute (BAI) to ensure Black communities receive the information they need for prevention and treatment. The BAI has been leading the fight to end HIV in Black communities for over two decades and is the only national HIV/AIDS think tank focused exclusively on Black people. 

In 2010, President Barack Obama appointed Wilson to the President’s Advisory Council on HIV/AIDS. Over the last three decades Wilson has amassed countless national and international accolades, including the Ford Foundation’s award in Leadership for a Changing World.

Anna Louise James: One of the first Black female pharmacists

The daughter of a Virginia slave who escaped to Connecticut, Anna Louise James grew up in Old Saybrook, Connecticut, where she became the first Black woman in the state to earn a pharmacy license. She ran her own pharmacy and, when her brother-in-law—one of only two Black pharmacists in the state—was drafted in World War I, he asked her to run his pharmacy. 

She renamed it James Pharmacy and was known to everyone as “Miss James.” More than a place to pick up medicine, her pharmacy was a central gathering spot for the community. Miss James ran the pharmacy for 50 years and today, the building still stands and is listed on the National Register of Historic Places.

Our work to redefine the modern pharmacy begins with recognizing and honoring past and present Black leaders in healthcare. The leaders who’ve not only advanced the field of medicine, but who continue to break down barriers to help ensure equal access for all. Interested in making a difference at Alto? Follow us on LinkedIn to learn more or visit our Careers page for open roles.

At Alto, we’re obsessed with our mission to improve quality of life for everyone who needs the help of medicine. Our mission guides us in all we do and every decision we make. 

Our mission and diversity work are tied together with one word from our mission -- everyone. Too often, only those with significant resources access the best and benefit from innovation in healthcare. We see it everyday in the data. Too many among us continue to struggle with solvable challenges, in our own wellbeing and in the larger healthcare system. These statements and environments have existed in the workplace as well, influencing the products, services, and policies that steer how the organization works for all of us.  Our work is to make Alto different.  Our work is to build and sustain an inclusive culture.  Our work is to attract, develop, reward and retain talent from all the communities we serve as patients and build a product that supports everyone. 

Today marks another step in our diversity, equity, and inclusion journey as we release our first annual diversity report. We share it because this work is central to our mission and in doing so, we use transparency to hold ourselves accountable, as well as hopefully play a part in raising expectations and norms throughout the healthcare and technology industries.

In 2020, across the company we saw a 13ppt increase in women and 7ppt increase in underrepresented groups (Black, Hispanic/LatinX and Native professionals).

As for women in leadership, we saw increases of 3ppts in Women Managers and 1ppt in Product, Engineering and Design driven by both hiring and promotion. At the leadership level, 32% of leaders identify as women.

In 2020, we saw 10ppt increase across our underrepresented managers to 13% Black, 16% Hispanic/LatinX, 2% Native/Indigenious.  In the leadership group, we saw an 8ppt increase to 15% Black and 2% Hispanic/LatinX. 

In 2020, we also established our Alto Advisory Board and our first two anchor members, who will help guide Alto towards our mission, advise on key decisions, and support strategic initiatives. We’ve formed the Advisory Board to support our leadership as we navigate the regulatory landscape, launch new features to modernize the pharmacy experience, and adhere to the highest standards of operational excellence and patient care.  

Dr. Hildreth is the President and Chief Executive Officer of Meharry Medical College, one of the nation’s oldest and largest private historically Black academic health sciences centers. He received his Bachelor’s degree from Harvard University, his Ph.D. in immunology from Oxford University as a Rhodes Scholar, and his medical degree from Johns Hopkins School of Medicine. He was the first Black American in the 125-year history of Johns Hopkins School of Medicine to earn full professorship with tenure and is internationally known for his influential HIV research.

Jennifer Kent served as the Director for the California Department of Health Care Services, where she led the second largest public healthcare system in the nation, with an annual budget of over $100B and serving over 13 million Californians. She oversaw the administration of 24 managed care plans as well as 56 county behavioral health plans. She has also held leadership roles in the Health & Human Services Agency, Governor's Office and has experience in the private sector as a lobbyist, consultant, and association executive. She has more than 15 years of health administration and policy experience in California.

Alto created our DEI strategy with our team aligned to four pillars – Hire, Include, Develop, and Invest.  Each pillar's actions tie to our people and our business. This means the return on investment is clear and goals are aligned to business outcomes.

Medical Health Care Premiums and Part Time Health Care Benefits in SF: 

In order to increase access and affordability to critical health-care services, we asked our broker to offer a special mid-year open enrollment 2020, reducing premiums for most plans by 5%. We reduced out-of-pocket maximums and speciality office visits by an average of 37%. We reduced co-insurance as well as costs for labs, x-Rays, and emergency room visits for our Cigna plan by 50%. Finally, prescriptions copays were reduced by 25% for Brand medications and 75% for Generic prescriptions. This benefits the employee with direct access to care and a better employee experience as compared to direct contribution to the city fund.

We increased our paid parental leave across all US locations to 8 weeks (up from 6 in 2020) for all parents requesting leave as of January 1st.  Throughout 2020 parents and other caregivers were impacted significantly as schools, daycare, and caregivers were closed, isolated, or unable to rely on pre-covid support. We offered laptops to parents who couldn’t afford them for each child to participate in remote learning.  We offered expanded benefits above and beyond FFCRA. Finally, we offered paid sessions for remote learning, tutoring, and experiences for parents and caregivers.

Finally, in December we launched Modern Health with 6 paid coach/therapy sessions and access to a digital wellbeing library and resources to all Altoids.

We launched six ERGs in 2020. Formalizing the work of our original Diversity Committee into six groups: Umoja (Black), Auténtico (LatinX/Hispanic), Women, Proud (LGBTQIA+), Asian/Pacific Islander, and Working Parents. These groups are focused on building community with both those who identify and allies. They support our education, development and investment in our communities. Each has been given a budget, an executive sponsor, and access to other company resources.

We recognized as a leadership team that we needed to educate ourselves. We were not going to rely on those from underrepresented communities to educate us. We embarked on four three-hour sessions focused on learning about diversity and inclusive language, naming our privilege, and starting the work each of us wanted to do. It was only after these sessions, with clear self-awareness and awakening; that began the work of empowering other leaders -- managers and other Altoids on this journey. There is more work to be done, as Neil Frye, Chief People Officer, mentioned in his blog post in late 2020 -- this is not a sprint, nor is it a marathon; it is life-long work.

Focus on Latinx Senior Manager to VP talent; with targeted outreach, activation and networking for opportunistic and open hiring

Expand employee resource group events throughout the year supporting inclusive environment, educating and investing in our communities

Get to full participation in DEI Workshops and launch additional sessions like What’s My Privilege and Moving to Action across the company

Explore new partnerships with Community & Higher Ed Institutions (i.e. Historically Black Colleges and Universities, Hispanic Serving Institutions, etc.)

2020 Diversity, Equity & Inclusion Report

The beginning of a new year is a perfect opportunity to refresh your routine and set health and wellness goals, but it can be difficult to follow through on these intentions in the long term: studies show that 80% of New Year’s resolutions fail by mid-February. If you entered January with big intentions only to find your new habits slipping, there’s no time like the present to recommit to your physical and mental well-being. Here are a few potential areas to focus on as you hit reset.

A Guide to Year-Round Wellness

Exercising more frequently is one of the most common New Year’s resolutions every year, and for good reason: regular physical activity can lower your risk for many chronic health conditions and improve your mood and sleep, among other benefits.

To make lasting, meaningful changes, set achievable goals. Many Americans exercise less during fall and winter in comparison to warmer months. If you don’t currently have a regular routine, aiming to work out for an hour each day may not be a practical starting point. Behavioral scientist Susan Weinschenk Ph.D., outlines three critical steps for building new habits that stick: start with a small and specific action, tie it to an existing habit, and make it easy to accomplish during the first week. 

Rather than trying to become a hardcore workout enthusiast overnight, resolve to enjoy your morning coffee while walking, then increase your daily walk by ten minutes the next week. When you anchor your intention to an existing action, you give your brain a natural cue to put it into practice. And since the key to solidifying your new habit is repetition, starting with an easy action will create self-trust and allow you to expand on your goal over time.

Mental health is an important aspect of your overall health, as mental health disorders such as depression can increase your risk for numerous physical conditions, from diabetes to heart disease. For many, this is a particularly challenging time from the standpoint of mental health. Approximately 5% of U.S. adults experience seasonal affective disorder (SAD), a type of depression triggered by changes in the weather and reduced exposure to sunlight, while 10-20% of Americans experience a milder form of the winter blues.

To combat the effects of winter depression, try to keep your home as bright as possible by keeping curtains and blinds open and sitting closer to well-lit windows when you can. Be sure to spend some time outside every day, even if the weather is cold or the sky is gray. The morning is an especially impactful time to get outside and walk around.

For many Americans, mental health challenges persist year round. Burnout, a form of chronic stress often linked to workplace demands, has grown increasingly common throughout the course of the Covid-19 pandemic. Of the 1,500 U.S. workers who participated in a 2021 survey about burnout, over half reported experiencing burnout related to their job responsibilities. The effects of burnout go beyond missed deadlines and a lack of motivation — chronic stress influences many aspects of your physical health, from your risk for heart disease to the brain-gut connection.

To maintain emotional balance, start by learning the signs of burnout. Look out for insomnia, exhaustion, changes in your appetite, headaches, and stomachaches. Opt for healthy stress management strategies, like meditation and exercise. In addition, try to stick to your usual sleep schedule. 

If you find that symptoms of burnout or other mental health disorders are interfering with your relationships or daily responsibilities, reach out to your doctor or a mental health professional. You may also benefit from free mental health apps like What’s Up?, which helps you manage stress and negative thoughts through a therapy approach called cognitive behavioral therapy (CBT), and Insight Timer, which has a diverse library of free guided meditations.

As you prioritize your overall mental health, focus on deepening social connections or creating new ones. Social isolation and loneliness have been growing issues in the U.S. even before the Covid-19 pandemic — a 2018 study from the Kaiser Family Foundation and the Economist found that one in five Americans often or always feel isolated — and the pandemic-related rise of remote work has only solidified the trend. In a recent public opinion poll from the American Psychiatric Association (APA), nearly two-thirds of the participants said that they felt isolated or lonely at least sometimes as a result of working from home.

Having a strong social network and regularly connecting with others can improve many areas of your health, including your cardiovascular and cognitive health. Whether volunteering, exploring new hobbies, or catching up with friends or family virtually or in person, small acts of connection go far.

It’s challenging to keep up with health goals if you’re sidelined by the cold, flu, or other illnesses. Fortunately, there are simple steps you can take to give your immunity a boost, even beyond getting your annual flu shot and staying current with vaccines. 

Experts at the Cleveland Clinic recommend incorporating immune-boosting foods into your winter menu to help your body dispatch any seasonal invaders. Fill your grocery cart with a wide range of colorful fruits and vegetables to ensure you consume a full arsenal of antioxidants. Be sure to stock up on raw garlic, which contains antiviral compounds, along with vitamin-C-rich foods like citrus fruits, peppers, broccoli, and kiwis.

According to the Mayo Clinic, people who don’t get enough sleep are more likely to succumb to sickness after being exposed to a virus. Aim for seven to eight hours of sleep per night to support healthy infection-fighting antibodies and cells. We’ve compiled these tips for getting the nightly rest you need when sleep is elusive.

At Alto, we believe that staying on top of your health should be as simple as possible, and we’re here to support you with exceptional pharmacy care all year long. We offer free, same-day delivery and medication management tools like reminders and auto refills in our mobile app.

Reach out any time through in-app secure messaging or by phone at 1-800-874-5881.

Editor’s Note: This post was originally published in January 2021 and has been updated for accuracy and completeness.

We were honored to sit down with Dr. Hildreth to discuss the challenges and opportunities we are facing at this pivotal moment in history. In addition to recounting his inspiring personal story, he shared many profound insights about the COVID-19 pandemic and the state of American healthcare. 

The COVID-19 Vaccine & Racial Disparities in Healthcare: A Q&A with Dr. James Hildreth

In August, we announced that Dr. James Hildreth had joined our newly formed Advisory Board as one of its first two anchor members. Dr. Hildreth’s extensive healthcare expertise has been invaluable as we’ve sought to guide Alto into the future and continue reimagining the pharmacy experience. 

A Fascinating Chat with Dr. James Hildreth

Dr. Hildreth is the President and Chief Executive Officer of Meharry Medical College—one of the nation’s oldest and largest historically Black academic health sciences centers. He is internationally renowned for his decades of influential HIV research and is deeply entrenched in our current global health challenge as a member of the FDA’s COVID-19 Vaccine Review Committee.

Can you tell us about your background and professional journey?

I grew up in a small town in Arkansas. It was one of those towns where if the two traffic signals were synchronized, you could drive right through and not even notice it. My father passed away when I was eleven years old. Quite honestly, because we were poor and Black, my father received very little medical attention. That was what prompted me to become interested in medicine.

I had no role models to look to, so I went to the library and read books about medicine. At age thirteen, I read a series of books that ranked your chances of getting into various medical schools. One of the universities was head and shoulders above all the rest, so my life’s work became getting into Harvard University.

To make a long story short, I got scholarships to Harvard, Princeton, Brown, Yale, Stanford, and many other places. But because my research had shown that Harvard was the place to go, that’s where I went. I got a job at the medical school, and the professor who ran the lab was also from Arkansas. He took me under his wing, and suddenly I wanted to be an immunologist. 

It was too late to change my major, but I was hooked. I applied for and was awarded a Rhodes scholarship in 1978, becoming the first Rhodes scholar from Arkansas who was Black. I got my Ph.D. in Immunology then went to Johns Hopkins School of Medicine. 

I planned to become a transplant surgeon until I met my very first patient. She was an African American woman with HIV who had just given birth to a baby who also tested positive. At the time, all we could do was watch them die, and that impacted me deeply enough to change my trajectory. I became an HIV researcher, and I have been studying HIV for the last thirty-eight years. 

I have been President of Meharry Medical College for five years. I feel that my life has come full circle because Meharry’s mission is to give opportunities to individuals who otherwise wouldn’t have them. 

Can you tell us more about Meharry’s mission?

Meharry was founded in 1876, but the story is that in 1826, a young, white teenage boy named Samuel Meharry was driving his salt wagon in the backwoods of Tennessee. His wagon got stuck in the mud, so he knocked on the door of a nearby cabin. An African American family greeted him, gave him a place to stay for the night, and helped him on his way. He promised them that if he ever had any resources, he would do something for Black people. 

Sure enough, fifty years later, he and his four brothers made a gift to a central Tennessee college to start a medical department for African Americans. That department evolved into Meharry Medical College.

To be leading an organization whose purpose is to give opportunities to people who look like me makes me feel that my life has come full circle. Meharry is one of four Black medical schools in the country, and without us, the face of medicine in this country would look very different. We are very proud of our mission and I’m so happy to be leading the organization at this time. 

Given that you’re on the FDA’s Vaccine Review Committee for COVID-19, what is your perspective on how we’ve handled the pandemic to date?

Blog

Get to Know the Team That Builds Alto's Customer-Facing Apps

Celebrating Women at Alto Pharmacy

Rev. Dr. Stacey L. Edwards-Dunn on Her Mission To Improve Black Fertility Care

Why Gut Health Is Key (and How To Improve Yours)

5 Black Healthcare Leaders to Know

2020 Diversity, Equity & Inclusion Report

A Guide to Year-Round Wellness

The COVID-19 Vaccine & Racial Disparities in Healthcare: A Q&A with Dr. James Hildreth

Supporting Working Parents at Alto

Diversity At Alto: Building an Inclusive Healthcare Company and Culture

Get to Know Alto’s VP of Engineering, Mike McClay

Coming Out with Pride: Nicholas Satow Shares His Story

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