How Innovation is Shaping the Future of Teletherapy

Russ Greenspan
CTO at PresenceLearning
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Joe Toste (00:15):

You're listening to the TechTables Podcast, a weekly Q&A podcast dedicated to interviewing industry leaders from across the world, ranging from startups to Fortune 500 companies, mixing it up each week with topics ranging from design and product innovation to IoT and Industry 4.0. Let's do this.

Joe Toste (00:33):

Hey guys. Welcome back to another week in the world of TechTables with me, Joe Toste. I'd love to connect with you behind the scenes on LinkedIn, Twitter, and Instagram. There you can even message me questions for future guests coming on the show.

Joe Toste (00:42):

But today I'm super excited. We're going to shift our focus to teletherapy and the innovation and insight of Russ Greenspan, CTO at PresenceLearning, a company that provides teletherapy tools for our friends with disabilities K-12. Huge thank you to Russ for taking the time to come on from New York to meet with me today.

Joe Toste (00:59):

But that's quite enough for me. Without further ado, I'm thrilled to welcome Russ Greenspan, CTO at PresenceLearning. Thanks, Russ. Really appreciate you coming on the show today.

Russ Greenspan (01:08):

Yeah. Happy to be here and thanks for having me.

Joe Toste (01:10):

Awesome. Let's kick off today a little bit about yourself and your tech background starting in 1999 with tutor.com and wanting to work in the web, rolling into PresenceLearning today.

Russ Greenspan (01:22):

Yeah, sure. It sounds ridiculous wanting to work in the web, but that was the case. tutor.com's original vision was to build a service where you could teach what you know and learn what you didn't. So it was going to be an online collaborative learning, everyone had something to teach and everyone had something to learn.

Russ Greenspan (01:44):

So it was a consumer-focused service. Knowledge providers would come on, set a rate. In one of thousands of subjects, you could find someone to teach you about something.

Russ Greenspan (01:55):

When you describe that now, it's kind of like, "Oh, yeah. That makes sense." But 20 years ago, a little ahead of its time. What happened was as the dot com bubble kind of collapsed, we regrouped, and out of the ashes, we formed a homework help service.

Russ Greenspan (02:12):

So we took the network of tutors that we had built, we found libraries, hired institutions, and actually the military looking for a homework help service. So a way to connect students to online tutors to get help with their homework and built a service out of that.

Russ Greenspan (02:32):

So it really transitioned the company, and then grew that from the ground up. So when I left, we had done over 15 million of these live online homework help sessions. We had a million different tutor applicants, thousands of customers to really figured out how to scale an online service.

Russ Greenspan (02:53):

Me personally at that time, I was not formally taught because I skipped the undergraduate phase of computer science. Got my first job because of aptitude in music actually. The company that I worked for is looking for people who didn't know how to code, but who had a math or music background.

Russ Greenspan (03:15):

During this time, I learned about all this stuff I didn't know and I ended up going back to school, doing the pre-reqs and then getting a master's eventually.

Russ Greenspan (03:26):

So I came back to tutor.com after that, grew the company. We had a lot of really interesting tech. We were doing socket-based communication in the browser in a pre-web RTC world. So really early stages of what browsers were capable of.

Russ Greenspan (03:45):

We used a variety of technologies. From the beginning, our online learning tool was written in Shockwave. That then became like a Flash HTML hybrid. Then we had a Silverlight client and then eventually back to full HTML, once browsers were capable of that.

Russ Greenspan (04:03):

Let's see. Meanwhile, 2012, 2013, ISC acquired tutor.com with the idea of taking the business back to a direct-to-consumer market, but still with this homework help model. But instead of institutions buying the service and then offering it to their patrons, parents would buy the service for students.

Russ Greenspan (04:25):

ISC brought in leadership from match.com, a consumer marketing muscle, but then shifted courses a little bit and decided to have a broader offering that would encompass test prep as well. Princeton Review is acquired. Most of the team, at least on the tech side, computer.com then became the Princeton Review tech team. Princeton Review had a large footprint in terms of offices and infrastructure, but no internal software development. Everything was outsourced.

Russ Greenspan (04:58):

So we all went and took over the Princeton Review's roadmap and started to build out a new offering for the Princeton Review, consolidating a whole lot of different technologies and stuff that various vendors have built over the years.

Russ Greenspan (05:14):

Eventually, ISC sold Princeton Review, the combined company of Princeton Review and tutor.com, to ST Unitas, a Korean test prep company. That's about when I was starting to think about doing something else. Kind of interested in learning some new technologies and different ways of doing things, and PresenceLearning has got a really amazing mission.

Russ Greenspan (05:37):

So PresenceLearning does online special ed, mostly speech therapy, but a lot of behavioral and mental health and psych stuff as well from the services sold right now into K-12 districts where there aren't a lot of speech therapists or mental health providers locally, and schools are looking for a way to get these kids help. PresenceLearning has, similar to tutor.com in some ways, a network of therapists that the schools are then taking advantage of to service their kids. Yeah, so I think that gets us up to date.

Joe Toste (06:14):

No, that's really great. We compacted 20 years into five minutes, which is excellent, which is great. We've got a little intro into PresenceLearning. I think in a post COVID-19 world, as we're shooting this right now ... And I'm actually in my closet right now because we're still in the lockdown. I think it's a big winner, especially just because it's a niche platform, serving our friends with disabilities in that K-12 segment. Where do you see innovation taking place in the teletherapy world, specifically on the IT side?

Russ Greenspan (06:45):

Yeah. I think what everyone's realizing, as good as Zoom is, and as much as we're struggling now and Zoom is filling a void for people to communicate, it's just not going to cut it for all use cases. I think therapy is a great example of something that ... Video is an important component of, no doubt, but there's a lot more to it. That's where I think ...

Russ Greenspan (07:10):

We talk about teletherapy. Teletherapy is not Zoom. There's a lot of tooling that goes into what makes a really good experience when you're talking about a therapist connecting to someone needing help.

Russ Greenspan (07:24):

So a lot of this stuff is around control. So it's about giving the therapist control of the workspace. It's also about a collaborative workspace. In Zoom, you can share your screen, for example, but you can't play a game together. You can't watch a video together. It's not quite that collaborative experience that I think you need when you talk about therapy.

Russ Greenspan (07:49):

Yeah, I think those are the things that I think people are becoming aware of as they experience a lot more Zooming and thinking about what's lacking from a teletherapy perspective.

Joe Toste (08:02):

Yeah, I really liked that. I know in our internal Slack channel, one of the next big things is like, well, there's Zoom, but what's after Zoom. Zoom is not going to fill every use case out there. So I really like where PresenceLearning fits into the ecosystem.

Russ Greenspan (08:21):

Yeah. The other thing we do on the mental health side, we've taken a lot of the assessments, print-based assessments and digitized them. We work with various publishers. That's something that ... Most people are doing paper and pencil. When you move into Zoom, you continue doing paper and pencil. It's just not very efficient.

Russ Greenspan (08:43):

But if that stuff is part of the experience, if there's a way for students to be using a digital version of some of these assessment tests, then it's a whole new world of assessment.

Joe Toste (08:58):

Yeah, that's really great. That's actually a really great bridge into the next question, as far as the underlying tech. Let's talk about that. Tell us a little bit more about the underlying tech at PresenceLearning.

Russ Greenspan (09:11):

Yeah. From the end user perspective, we've basically built an application around various third-party texts. So we use Topbox, for example, for audio and video. We use Firebase as a real-time database. So making use of a bunch of really, really good and robust, and also stuff that's easy to build around tools, so that we can construct and spend our time on the experience.

Russ Greenspan (09:39):

So we use that on the therapy room side. On the backend, everything is cloud native. So AWS start to finish. And really every single tool we talk about is cloud native.

Russ Greenspan (09:54):

Then as far as the team goes, we have a really remote-first team, I would say. We have people in a variety of locations. So we spent a lot of time figuring out how to effectively communicate and work together.

Joe Toste (10:10):

Oh, I love that. There was a piece in the episode I shot with Erin and Jeff on the whole product creation framework side. We talked about remote and distributed teams. I love that you guys are all remote. Actually, I think I tweeted about it, or was it a LinkedIn post? That post started trending on LinkedIn for remote work, which is pretty funny. I was like, "Oh, I'm trending for remote work on LinkedIn right now," or Twitter, which is pretty funny.

Joe Toste (10:38):

So how are you thinking about the roadmap in this kind of post-COVID world? I know we came into 2020, everyone had high hopes, CTOs had high hopes, and then COVID-19 smacked everyone across the face. What are some of the biggest priorities right now, new features, existing code, reducing operations overhead, new products? How are you thinking about that?

Russ Greenspan (11:02):

I think for the most part that stuff is where it was in terms of maintenance and the never-ending quest for improved reliability and scalability. But for us, from a product perspective, we've now started offering our service directly to schools for use with their own therapists.

Russ Greenspan (11:24):

So as we were talking about, the platform we have, there's a better way to do online therapy. Now there's no choice but to do online therapy. And so, schools can now take advantage of our service and use it with their own therapist.

Russ Greenspan (11:40):

And so, that's opened up a whole new bucket of things we need to do to best support schools working with their own therapist and not [inaudible 00:11:49] therapist. So that's something brand new for us.

Joe Toste (11:53):

I love that. Then as far as taking that roadmap, let's talk about the culture of being agile and iterative, especially in software development. You guys obviously have an online digital learning platform today. Can you talk about that culture that you instill as far as shipping quickly and shipping fast?

Russ Greenspan (12:13):

Yeah. I think a lot of it has to do with where your innovation is coming from. What we're trying to do is get ideas in front of therapists and find out if we're on the right track, find out if this is something that's worthwhile, and really work with our therapists to fine-tune the experience to offer the best service that we can.

Russ Greenspan (12:41):

And so, the faster we can iterate and the more we can explore, generally the more and the better our product for it. So we try to make a lot of room for that bottom-up innovation, in addition to doing the more traditional top-down, design-heavy approach. We try to hit it from both sides.

Joe Toste (13:05):

Yeah, that's great. As far as some of the tools that you guys use to collaborate internally, we got the Slack, Zoom piece there. Or are you guys using Slack, Zoom, Teams? What's you guys' [crosstalk 00:13:18]?

Russ Greenspan (13:19):

Slack. Yeah, I had previously used Teams. There's something about Slack. They've really just nailed the experience. You just feel good using Slack for some reason, I don't know what it is, compared to teams. I know it's a very nuanced thing, but there's something about it that just feels really good.

Russ Greenspan (13:36):

So, yeah, I'm a huge fan of Slack. We use Slack to communicate predominantly. But we do a lot of stuff in Confluence Docs. We do a lot of stuff in Figma, so comments and Figma mocks. We do a lot of stuff in Google Docs as well. So as we're coming up with ideas, we'll have a really comment-heavy document.

Russ Greenspan (14:01):

We have a variety of ways to get that kind of asynchronous communication going. Then we use Slack or Zoom for synchronous meetings as well.

Joe Toste (14:12):

Nice. Yeah, definitely, something about Slack. They really nailed it. Sometimes I have to hop on Teams, and it's a little painful. So I definitely try to pull as many people as I can into Slack, whether they're clients or whatever. I just try and pull them in there because I'm like, "No, I don't want to do Teams. I want to work in here."

Joe Toste (14:32):

So new normal, it's not going anywhere, work from home. I'm in my closet shooting this. What are some of your tips for running an engineering and product team remotely? I know we started with some of the tools, but I'd love to hear any additional tips that you have.

Russ Greenspan (14:46):

That's funny. Number one is don't work out of your closet. No. Actually, I think that that's part of the way I would answer that, which is what we're doing now, making quick decisions about how we want to work, finding ways to communicate. Everybody's thrust into this environment of being at home with their kids, with all of the difficulties that go with this time.

Russ Greenspan (15:13):

This is not really what I would describe as remote working. For people who are doing it for the first time, it's in the vein of what remote working is like, but it's not exactly the same thing. Obviously, our stress levels are super high, and I think people might come away from this experience mixing those two things up a little bit and ... I don't know. So it'll be interesting to see where we go from here.

Russ Greenspan (15:39):

But as far as remote work, I think we talked about some of the asynchronous communication. That's obviously super important. I think along with that is recognizing when asynchronous communication is not the right way to be having a conversation.

Russ Greenspan (15:55):

So when there's a lot of back and forth and there's no consensus, I think a lot of the time people like to express themselves in writing, but that can often be inefficient. Also, it's just so hard to understand tone in writing. So it's really important to say, "Okay, we've reached this point in the conversation. It's time for us to now get into a synchronous conversation and continue to have this discussion."

Russ Greenspan (16:26):

So, yeah, we really try to make sure, in addition to that, that we're having regularly scheduled meetings to keep everyone on the same page professionally, definitely, talking shop, but also interpersonally. So recognizing that this isn't Twitter and there's the human on the other side of the conversation that you're having.

Joe Toste (16:51):

Yeah. I really like when you first mentioned this isn't actually remote work to some degree. I mean I love going to coworking spots. I love that side interaction, being locked in your house. I have a toddler and then we have another daughter. They're just running around, you're on calls. They're jumping on my back and throwing stuff at my face. It's not exactly the remote work definition. So curious, any career advice for aspiring tech folks who want to become CTOs one day?

Russ Greenspan (17:32):

Yeah. I would say what's worked for me, I guess, is that staying really hand-on in the tech. It's very important that you understand the tools that the people that you work with are using. You have to really understand of the challenges. At least for me, experiencing that firsthand is really what has worked so that I can understand what the experience is like for everyone that I work with. That'd be one thing.

Russ Greenspan (18:03):

The other thing is engineering is really a team effort and I think it's important to understand that everybody does well or no one does well. So you have to put yourself in a position to make the people around you do as good as they possibly can. You'll benefit from that as well.

Russ Greenspan (18:21):

Then where technology fits into an organization is ... It's important to understand what the role of technology is in an organization, depending on what else the company is doing. So understanding how you can best be of service to the company is another thing that I think ... Spending some time thinking about that. It'd benefit you as a CTO, or to one day become a CTO.

Joe Toste (18:47):

That's great, that blend between business and technology. Love it. Then I'm just curious, are you still hands-on in the code or-

Russ Greenspan (18:58):


Joe Toste (18:58):

You are? Okay, nice.

Russ Greenspan (19:00):

I don't know. I still just get excited about making a computer do what I ask it to. I don't know why. It's like even just really dumb, simple things, adding a filter to a GraphQL query, which sounds mundane, but there's just still something very exciting about it when you press the button and it works. So yeah.

Russ Greenspan (19:23):

For me, coming to PresenceLearning was also about learning new technologies. So it's all new stuff for me. I had come from a dot net background, React on the front end. At Presence, we're doing Python, Django on the backend, Angular on the front end. So it's just a completely different ecosystem. And so, it's been really exciting to learn new technologies.

Joe Toste (19:47):

Love it. Okay, so I call this kind of the 60-second TechTables' three quick questions. They're pretty easy. Question number one: where's your favorite place to go learn about new technologies you might go use?

Russ Greenspan (20:00):

Yeah. It's probably the same answer everyone gives, but blogs and podcasts for the most part. A lot of good blogs like Basecamp, Airbnb, Spotify. I think the ones that probably everyone reads, I think that those are really inspiring podcasts.

Russ Greenspan (20:21):

I think the AWS Tech Chat Podcast is really good. It's hard to keep up with all the innovation happening at AWS and the 150 services. So if you're using AWS, I'd definitely recommend that podcast.

Russ Greenspan (20:34):

There's another really good one called Software Engineering Daily that I'm sure plenty of people listen to also, which is a daily podcast, and it's always really ... It's like an hour every day, and it's always really good. So I would find lot of value in listening to that.

Russ Greenspan (20:49):

The problem I'm having right now is that without commuting, I'm not spending very much time on podcasts. I'm trying to figure out how to make time for that in the non-commute world.

Joe Toste (20:58):

Yeah. I think we talked about that pre-show, podcast volume being down. That'd be interesting to see the demographics. So your kids are a little bit older, right?

Russ Greenspan (21:06):


Joe Toste (21:07):

What are your kids' ages again?

Russ Greenspan (21:08):

Yeah, my oldest is 14, my youngest is 10.

Joe Toste (21:11):

Okay. We have an almost two-year old and we have a 10-year-old, and the 10-year-old doesn't want to walk and the two-year-old doesn't have a choice. So I throw him in the stroller. That's how I get my audio books and podcasting done. I try and get in X amount of steps a day to stay healthy.

Russ Greenspan (21:29):

Yeah, yeah. I have to try and ... I can make time for it. That's what I used to put on the calendar or something. It's like it happened by default when you're sitting on a train and now you're just going to have to make time for it.

Joe Toste (21:42):

Yeah, definitely. Okay. Missed all the time, blast from the past, favorite conference you used to go to before COVID?

Russ Greenspan (21:52):

The way out past. I haven't been to this conference, but I've been watching all of the videos that they're producing. It's the CTO Summit from CTO Connection is the one that I was most eager to attend. They do them throughout the year. They also have podcasts, but the videos are great. So I'd highly recommend that one.

Joe Toste (22:19):

Love it. Favorite next Netflix series?

Russ Greenspan (22:22):

Yeah. I haven't spent time with this one. I don't want to say Tiger King. I was like, "What have I watched recently?" Recently, I've just been catching up on Better Call Saul because I skipped that. But I think my favorite might be Maniac, actually. I was a big fan of that.

Joe Toste (22:40):

Okay. I'm only laughing really hard with Tiger King because my wife and I joke about it. Her sister watched it with her husband, and my wife's like, "We're not watching Tiger King." I'm like, "It looks so funny right now." She's like, "We're not watching it."

Russ Greenspan (22:56):

Wait, so did you not watch it?

Joe Toste (22:57):

No, we haven't seen Tiger King. No.

Russ Greenspan (22:59):


Joe Toste (22:59):

But on Netflix, it's like their banner every time we log in. It autoplays the trailer if you just leave it on for more than two seconds. [crosstalk 00:00:23:10].

Russ Greenspan (23:10):

You guys are probably the last two people in the world. Maybe that'll protect you from something. [inaudible 00:23:17] interesting apocalyptic book where the only two people who haven't seen that show somehow survived. No, I mean it's kind of like the best and worst of humanity. So to me that's fascinating. But, yeah, my wife wasn't into it either.

Joe Toste (23:33):

Yeah. I'm going to have to share this podcast episode with her and just say, "Hey, just skip to the end. I want to see what your reaction." That's great. And where can people find you? Where are you hanging out, LinkedIn, Twitter?

Russ Greenspan (23:44):

Best place to find me is LinkedIn. Yeah, I would say LinkedIn is probably the best place.

Joe Toste (23:48):

Okay. Awesome. Well, I love it. That's all for today's show. We're going to wrap it up. You can find Russ on LinkedIn. Russ, huge thanks for coming on. Really appreciate it.

Russ Greenspan (24:01):

Yeah, it was fun. Thanks for having me.

Speaker 3 (24:04):

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Joe Toste
Joe Toste
Host of TechTables Podcast

Host of TechTables 🎙- Conversations with Top Technology Leaders