By Nash Roberts
The road to starting a company often takes many turns. It took Coletta Dorado, founder of AZZLY, Inc., an addiction treatment and behavioral healthcare software company, two careers, the loss of one relative, and the persistence of Job to settle on her mission. Here is the story of a founder, mother, employer, and pioneer.
But, first, some background on the world of behavioral healthcare.
Medically Assisted Treatment and the rise of EHRs
Over one hundred thousand Americans dead from drug overdoses.
That grim statistic was reported by the CDC as they reviewed the 12 months prior to April 2021. As our society faces a world of global disease transmission and tries to cope too frequently with isolation and alienation, some issues remain the same or are, tragically, escalating. How do we help one of our most vulnerable populations — those battling drug addiction and mental illness? As we expand our capacity to create ever more powerful controlled substances such as Fentanyl1, some practitioners have advanced their approaches to assisting people in breaking the deadly cycle of drug addiction. Enter Medically Assisted Treatment, or MAT.
MAT is the prescribed use of medications, in combination with counseling and behavioral therapies, to provide a comprehensive approach to the treatment of substance abuse disorders. While still a divisive issue amongst practitioners, many members of the behavioral health community are embracing MAT as one component for driving effective patient change in a multi-faceted treatment plan. However, to deliver MAT, clinics need medical staff to prescribe (and keep careful records of) craving-curbing substances.2 In addition, clinics must carefully document their patients’ treatment and prescription of these therapies for a variety of reasons, such as compliance with health regulators and reimbursement from insurance agencies.
Healthcare providers must distill the soft skills of individualized patient care into a digital world of electronic health records in short order. This is where electronic health record (EHR) companies are driving innovation by building record-keeping systems that behavioral health providers use to stay compliant amidst the swelling patient need.
MAT’s Growing Acceptance in Addiction Treatment
Founded in 2009 in Orlando, FL by Coletta Dorado, AZZLY Inc. is one such EHR company that has witnessed the marked, changing perception of MAT over the past decade in Substance Use Disorder (SUD) Treatment Programs. “Years ago, I shared at conferences (in which abstinence-based programs and services were predominantly represented) that offering a MAT option to individuals in need should be best practice … and was seen as the devil,” said Dorado. “Many thought medication was substituting one drug for another.”
However, Dr. Andrea Barthwell, former Drug Czar to the Bush Administration and AZZLY Senior Advisor and Strategist, clearly refutes those who oppose this path of treatment.
“Addiction withdrawal from alcohol, prescription drugs, or illicit drugs like heroin or cocaine is very painful. Many individuals fail during withdrawal. The prescribed medication works to ‘normalize’ brain chemistry, blocking the highs of a drug or alcohol and reducing cravings without going through the physical pain of withdrawal. The chances of a successful outcome are greater. Patient survival rates are higher, and patients’ ability to gain and maintain employment and function in society increases.”
AZZLY is an all-in-one addiction-treatment and behavioral healthcare-specific EHR and RCM3 system for substance use disorder and mental healthcare clinics with best practices established by medical directors. As such, the company clearly understood the benefits that MAT delivered to patients. With AZZLY’s help, clinics found a straightforward way to document and maintain records with standardized protocols. Without it, clinics could not effectively measure patient progress. “In the past, paper and pads sufficed,” says Barthwell, “But that’s no longer acceptable.” Thanks to the efforts of SAMHSA4, The Joint Commission (TJC) and The Kennedy Forum, providers began introducing best practice standards into behavioral healthcare programs that included SUD and mental healthcare services. As with most industries, standards of care in healthcare are essential.
Over time, MAT has gained a seat at the behavioral healthcare table.
The First Career – Financial Services
So how does one commit to creating a digital health solution? Coletta’s path to founding AZZLY is unique because she took a set of skills honed in one industry and used it to become an expert in another, unrelated field.
Being a female stock broker and trader in the 1970’s was unique. While working at Dominick and Dominick (a wealth management firm) she was recruited to join a startup broker-dealer which had a vision of a nationwide footprint of investment advisors and trading operations. “As a start-up entrepreneur, you wear many hats. My most fulfilling was transitioning the fast growing company from being paper-based to paperless.” Vetting the right modern technology to be the foundation of growth. This would become a recurring theme in her career.
Imagine this – maintaining physical records of trades performed on behalf of thousands of clients of 600 Investment Advisers5 and acting as a clearinghouse 6 for 70 regional bank brokerage departments. That small startup evolved, and became JW Genesis Financial Services, Inc. Its manual paper processes were limiting the company’s growth. As a Board Member and Executive Committee Member, Dorado realized that they had to find the right technology to automate their trading operations and order entry. “After researching the options, I made the right decision on beta technology that was Wall Street’s answer to trading automation,” related Coletta.
Thanks in part to her efforts, the leadership team grew it over 15 years to a $100 million+ valuation, selling it successfully to a regional brokerage firm after taking it from private to public.
From Financial Services to Behavioral Health – Dorado’s motivations
It turns out, in the black and white world of compliance, there are visible correlations between financial services and healthcare. The digital trade order execution platform Dorado helped build turned out to be a valuable experience for her.
In her words, Dorado “retired too early at 48,” an experience which gave her the chance to evaluate the effects of paper-based processes in another industry. As she brought her aging mother to her doctors’ appointments, the degree to which paper-based healthcare so limited primary care providers shocked Dorado. As her interest grew, she attended a Healthcare Information Management Systems Society (HIMSS) conference. There, Dorado and Microsoft Health executives discussed the applicability of digitalized healthcare records, drawing on her previous experiences. She says, “They loved my passion, and I was hooked. I believed that I could make a difference in healthcare.”
“AZZLY’s core functionality started within the Microsoft BizSpark program. The program’s purpose was to launch small businesses and support entrepreneurs during the early startup phase, streamlining the clinical and business processes of a healthcare practice into an all-in-one solution,” remembered Dorado. Providers, feeling they needed a better solution, fortunately shared their knowledge, needs and pain points with AZZLY. Dorado designed the Company from the ground up as a seamless solution, unique in the behavioral health space.
When her son, Derek, graduated from Stetson University, Coletta hired him to assist with sales development. Quickly realizing that there was an underserved niche within the behavioral health community, “I joined AZZLY in 2012 just prior to launching the first version of its product into the healthcare market,” says Derek. “I was part of the team that evaluated the behavioral health space when we decided to transition, dedicating our resources and talents to behavioral healthcare.”
So, Dorado had the skills and experience to apply lessons learned in financial services to healthcare. Moreover, when Coletta and Derek lost a family member to alcoholism, she became personally motivated. Like many in the behavioral health field, the experience of losing a loved one to a preventable fate led Dorado to pivot AZZLY towards the addiction treatment community.
In addition to growing a valuable enterprise, Dorado’s optimism for AZZLY’s impact on care providers remains.
“The mission is to help treatment centers streamline their clinical and business needs for better outcomes so they can serve more individuals in need,” says Dorado. “It always was. If we save one provider from burn out or prevent a patient from quitting treatment because they are engaged and are provided the right individualized treatment plan, we are winners. Rarely has any person not been touched by a SUD disease by a family member, a friend, a co-worker, an employee, or a loved one. “
Listening to your Customers – Applying Automation to Billing
Many behavioral health providers rely upon Medicaid and Medicare reimbursement, but they struggled to stay on top of their billing. To meet this growing need, AZZLY expanded its product suite. Helping process these reimbursements quickly and efficiently was crucial to keeping practitioners in business. It was then that Dorado realized it was worth getting “some of the band back together” from her brokerage days. She asked her former colleague, Joyce Wagner, Executive Committee Member and head of Compliance and Operations at the brokerage firm, to join the team.
The notion of following the money was a path Wagner and Dorado followed during their career transitions from financial services to behavioral health.
“AZZLY was designed to be an all-in-one platform inclusive of Revenue Cycle Management (RCM) tools,” says Wagner. “The system has evolved over time, and today we have automated claims submission. Previously it was a labor intensive, manual process, replete with rejected or denied claims due to human error. We realized early on that automation was key to increasing the number of approved claims. Our success would hinge upon reducing RCM employee costs as our clients grew their businesses. They often say ‘be a reviewer not a doer’.”
Dorado’s determination to grow AZZLY drew interest from outside capital sources. She won various competitions in the State of Florida and was the first female entrepreneur in 2013 to win Venture Florida’s First place prize.
Shortly afterwards, she met Bruce Bedford, former Chairman of Flagship Financial, a financial services firm, before it sold to NUVEEN. Bedford liked backing angel-stage companies, many with female founders and CEOs, through his family office, Paddington Investments, where he participated in AZZLY’s early financing rounds. When Bruce passed away suddenly in 2021, his daughters, Julie and Susan, remained active shareholders and advocates of AZZLY and are represented on AZZLY’s Board.
“Dad had a genuine desire to see female entrepreneurs succeed,” says Susan. “After a lengthy career in financial services and as a father of two girls, I think he appreciated their struggles. He understood that women in business must over-prove themselves. For decades, he invested in several women-run businesses and liked to see entrepreneurs who broke the mold of a traditional risk-taking A-type. Coletta’s background and dedication impressed him.”
There were additional factors that drew her father to invest in AZZLY at an early stage. Susan cites a struggle even wealthy families wrestle with.
“Our family, like many others, has faced addiction issues. Bruce liked that AZZLY focused on helping clinicians in that space. A well-thought-out, electronic medical records system like AZZLY allows clinicians to concentrate on patients and their treatments, knowing that AZZLY tracks and maintains their details and admin issues well. Bruce liked doing his part to help modernize treatment.”
Coletta has witnessed marked improvements in the number of women in healthcare. Many have been recognized for their skills; other entrepreneurs have secured funding, elusive heretofore. Speaking of her own experience, I broke into the stock brokerage industry when it was male dominated. Because I was ahead of the times as a woman in financial services, I always stood out. I was also early in healthcare, and, looking back, it is a good feeling that, just maybe, I paved the way a bit here for other female entrepreneurs in Florida.
When asked about her skills as a female executive, Coletta replied, “I have that innate skill to manage many moving parts at once and also to attract passionate staff based on the fair life/work balance that we offer.”
Calling on Carofin
There are many EHR/EMR systems in the general health tech SaaS space. However, according to Coletta, “ AZZLY is one of very few specializing in mental health and rehabilitation, so it is much beloved by our customer base who feel it’s ‘made for them.’ “ Susan Bedford concurs.
Through Bruce Bedford, Dorado and AZZLY connected with Carofin, an investment bank that specializes in raising capital for privately held companies. “AZZLY epitomizes a meaningful investment, one of the guiding principles of our firm,” says Bruce Roberts, Founder and CEO of Carofin. “Society needs more effective addiction treatment, and AZZLY plays a critical role ensuring that a patient’s progress and the therapy received are delivered effectively.”
Thanks to a combination of individual investors and family offices, Carofin raised over $3.5M for AZZLY from 2020-2022 using a combination of convertible debt and equity. Additionally, the investment bank attracted board members such as Dr. Barthwell and others with expertise in building valuable healthcare software enterprises. Proceeds helped build the SaaS Sales Team and Pipeline, enhance the technology platform and performance to scale, and to streamline operations, client services and support. Coletta reflects on the Carofin experience:
“Carofin recognized the multi-billion-dollar market that we could serve. Bruce Roberts, the CEO, influenced by his grandfather’s death by a drunk driver, was determined to raise the much-needed additional growth capital for AZZLY. It takes a team, and Carofin delivered that team by securing the funds.”
Medical Challenges and the Demand for AZZLY’s Services
Reported Increases In Overdose Deaths During The Pandemic
The U.S. (and other parts of the world) have faced many medical challenges. Prior to Covid, the Opioid Crises was everyday news. Joshua Greene, VP of Sales and Analytics at Carofin, comments, “Since Covid’s onslaught, Mental Health and Opioid Overdoses are featured in the news and documentary series all too frequently.” If you look at a map highlighting the states with the highest overdose deaths, AZZLY has a footprint in 30 of those 50 states already.
“Carofin believes that we have a great opportunity to make a difference in this battle,” Joshua said. And, not to be overlooked, due in part to the unfortunate demand for AZZLY’s product suite, we expect that AZZLY can hit a $100 million valuation within the next several years.”
In the world of EHR Behavioral Healthcare software, AZZLY competes with the likes of AdvancedMD®, KIPU® and Insync®, all three recent benefactors of VC and PE investments. Many, if not all AZZLY competitors, have been in the market longer, possess larger market caps and provide their record keeping systems to other types of healthcare providers in addition to behavioral health practices. Yet, Dorado and her dedicated team have aimed to create the premier clinical and business tool for residential and outpatient addiction treatment and mental healthcare providers.
The promise of helping someone cope with, and, in some cases, move beyond the throes of drug addiction and mental illness, remains alluring. It’s the goal of every behavioral health practitioner. Someone, who, likely, has been marginalized, is back with us — back in the community, with the family, maybe employed productively. AZZLY aims to help practitioners do that work more effectively through its software suite. The passion in this industry for helping others is like nothing I have ever been a part of,” says Wagner. “Members of this community “pay it forward” every day.”
For more information on AZZLY, please visit its website here.
1 Approximately 100 times more powerful than morphine
2 Such as Buprenorphine or Methadone for opioids or Acamprosate and Naltrexone for alcoholism.
3 RCM, or Revenue cycle management systems store and manage patients’ billing records.
4 SAMHSA – the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services
5 Investment Adviser – an individual or company who is paid for providing advice about securities to their clients.
6 A clearinghouse is an intermediary between financial buyers and sellers. It finalizes trades, settles trading accounts, collects margin payments, regulates delivery of the assets to their new owners, and reports trading data.
7 Registered Investment Advisor – A firm that advises clients on securities investments and may manage their investment portfolios. RIAs register with either the U.S. SEC or state securities administrators.