Health Innovators
Health Innovators

Episode · 2 years ago

Dr. Grace Terrell On Implementing Commercialization Strategies & Tactics

ABOUT THIS EPISODE

When it comes to healthcare and innovation, the dysfunction of the system can seem hard to overcome without the right strategies. Why is it hard for some innovations to succeed? What are the key things you need to do in order to ensure your success? What are some of the biggest shifts in care delivery and benefits redesign?

On this episode, primary care physician and Envision Genomics CEO, Dr. Grace Terrell shares on her perspective on innovation as an early adopter of value-based care.


3 Things We Learned 

Innovators face a commercialization dilemma 

Many innovators find themselves at a crossroads as they try to commercialize. First, they can circumvent the current system and go direct-to-consumer, which means coming up with creative cash and subscription models, while handling the costs of educating the consumer market. On the other hand, they can go into the healthcare system, which means dealing with longer budget cycles and outdated payment models. This is a critical choice any healthcare innovator must make, and the decision affects every element of the business.


Why many innovations fail 

It’s tempting to focus on one part of the commercialization process - the product itself. Other key details must be considered; whether the product really meets the needs of the target market, how the product scales and who pays for it. 


The importance of being agile in innovation

Don’t become too fixated on one market segment or approach, be flexible enough to pivot when shifts are necessary. Many things in healthcare can change, especially in terms of policy and all healthcare innovators need to be in a position to move quickly. 

 

One of the biggest barriers to commercialization is how innovations are created. Healthcare innovators leave the industry to escape the dysfunction of the market, but end up creating products to sell back into that dysfunctional system. The problem is, it’s difficult to change healthcare outside of the system, or without involving many different people in the process. It takes a village to build a successful innovation and business, from investors, partners, willing payers and patients.

 

 

Welcome to Coyq and first of its kindvideo program about health, innovators earlier doctors and influencers, andthey are stories about writing the roller poster of Health Care andovation. I'm your host Dotor Roxy, founder of Legacy, DNA marketing groupand it's time to raise our COIQ welcome back to the show coiq listenerson today's episode. I have with me Dr Grace Tarrol. She is a primary carepractis inner she's, also the president and CEO of envision genomics welcome tothe show, make you very much happy to be here so for our listeners, who don'tknow who you are just yet and just take a few minutes to. Let us know a littlebit about your background and what you do sure so is you mentioned on the Primaritanphysician, I'm a general internist by training and still see patients in thatvenue and back in the late Tomi I founded with a group of other people,an organization coldfoistal healthcare that o a multispecialty group that go toabout about three hundred an seventy fivedocks in sint from North Carolina bit became one of the very firstorganizations nown tha. What's now called the moves to value movement, sowe were able to lower the costo fear and prove the Quality Tho, some of thevery first medical home things. After that I foundet a population El Fo, theinstrment company Culhes, which is now helping other organizations actually dosome pretty innovative things within the Germadal medesign space and for thelast two years, I'v Theen. We see oer envision genomics which is tha wholegenom, sequencing, startup, analytics company focused on really Changein theway we take care of people with Wer and dinote Ta misdiagnose diseases. So sowhat you're trying to say is that you're really bored and you havenothing to do littl it ofin Washington as well withPT putistic position, Foncus techniccal, byt, commission that looks atredesigning payment models for physician care and so yeah. I think life is an adventureand the an just need to make it something totally fun: Bu Justi, YeasYeah. Absolutely. I think your story is so particularly interesting because ofthe different lins of healthcare innovation that I think that you've hadthe opportunity to put on both being in early a doctor of Value Base Care, alsobeing an entrepreneur being in nonprofit and for profit. So you know what it what advantages anddisadvantages? Do you think you have comingto the innovation process as a physicianbeing an insider into the healthcare ecosystem? So I guess an advantage Iwould have is that I practice regular old in toutal medicine, an a clinic and advention cross,multiple venue since itwase, first atof Trainin, one thousand nine hundred andninety three. So I've been in everything from a reperson medical practice that includedme and my motherinlaw and Fatherinlaw to a multispecially group to noi alarge youp system. That's an immigrated health system and within that context,I've seen the good load in the ugly ind the way health care is and has beenpracticed and Hame always been somebody who that they can say. Well, you knowthere are things that we can do from this place in space. That can just beso much better, and so it's really from that land that Ithink I'm able to think through. You know what's out there in terms oftechnologies and the restence people...

...and culture, to sort of redesign the way you think about bt,taking careo people, so so just kind of paint a picture for usfrom your point of view. What is it like? Writing the roller coaster ofhealth careenovation, but I'm one of those people that sortof tends to be on the bleeding edge. So was one of the very first to be ableelectroni health record back the early twosand wore the first to be oncepatient sin, medical home. So a lot of times when you're early and onlyadoptor in the innovation space, there's a lotof uncertainty, and when I look back now, I sort ofsmile because people oncasional ne that teach me alacturally about things thatI was actually you know in the early process of helping the todesign and Bild about fifteen years ago, when we didn't really know what we weredoing a get it up. You know we make a lot ofmistakes, you have to be willing to accept that and learn from them, and and just continue to think about thefact that there's a lot of ability, I think from most people in that are educated people to criticize but Tho create thecreative process, which is so much more. Fun is harder for people ore just notused to doing it, and so what I have found in my career, that's been mosthelpful, is to take all those cuiticisms. They just keep makingthings and building things, and that's really what I think innovation is allabout. How have you seen us be able to move the needle? I think you touched onsomething you there's a lot of criticism about. You know the oldtradition, you know kind of a broken model, but at the same time, there'sthere's a lot of people out there that are doing really phenomenal things. So how have you seen the needle move? So I will go back way back when I was a kid ro grown up in rual NorthCarolina and watching my Franddad essentially have a terrible last couple,O years of his life because of terrible conary argury disease, where you knowYeu, could hardly get from the house to the born without stopping to take aNitrogristerin and bypast graft was something that hadjust happened for part Turdery, but he he didn't get it intime. He died wentto visit one of the first hardcases in the in the county, which was a friend ofhis who did get that shortly before he died and sent something along the linesof it. Ut they just could hit mov en, like a chicken brash ti, but now it'sall better SOML. Anyway, we went from that to the. By the time I was inmedical school at Duke in the lifeess operations were being done atbeing health centers and were O ow. This big fancy deal, but peoplewere getting better and then, by the time I you know, training Haas an enteror medicineresident makes Moris. It was stance that were out there, and you know,after that we got steps and bypass, went to the community hospitals andstants, were you know, going all over the place and fixing things and my myCousi, my dad had a bipass operation in s in the community. Hospital was homein two days he's and then I've Ben, a cosint who recently had cornery disease and he he was Om in a day. Okay Soif youcheck thelong Vou, either like incluningl arder Disneams, where youlook at the w. What happened within the HIVspace, where, when I was in medic, one thousand nine hundred and eighty fiveever oting dad to YSCROIC disease, you...

...do see remarkable progress on thescience side or the medical side. But what what we haven't realizedis that we're neal doing the same thing on the care, O liverby side, and so there's a lot of remarkable things outthere. If you were in the middle of having a bypass operation in o nineteen, one thousand nine hundred and eightysomething when it was still sortof early on, you wouldn't have imagined what itwould be like. You know twenty years later, so I ther were drugs that wouldproduce the incident. An forn areas, an es, an much bette care, but it was. Itwas a process that was going on. That's what's happening right now with Caruliy,and it's because we're starting to think about things outside of Jusantechnologies that used to be in the big hospital buildings. But what can bedone in the rigital world? What can be done with you know, artitatialintelligence. What can be done with genomics with innigration ofinformation, Acrosse, multiple SOURCIS, and when you take that and you movel itwithin the context of care, delivery and payment, modelre design, benefitirydesign, then then we are making Fogis, and I think that what well say over thenext twenty years would just be some significant improvement more than youcan actually see from Rintemmin of the battles on the day, dayvention YeahYeah. Absolutely so I think it's really good for us just topause, periodically and kind of go down memory at lame. Like that and really kind of, I guess I would say, celebrate some ofthe Innovation and progress that we've made. You know not ignoring the factthat there's still a lot of progress that needs to be made, but so it can bediscouraging, and so we need to encourage ourselves that, yes, we aredoing it, we can do it. Can we do more, yes and we're all working towards that? So a lot of the conversations that Ihave with innovators, like yourself, is just you know how difficult and complexit is to commercialize an innovation and health care. So from yourperspective, why do you think that some health carnovation succeed and somefail on commercialization is all about theapplication of capital into a system that will allow something toscale and meet People's needs? A lot of innovation. People have a on offsolution and APP. If you will t a they're trying to super impros on topof a very complex sealthcare liveri system that doesn't isn't able to sortof accommodate that within the payment thelivery model. So I think the bestway to think about any type of innomation is how does it meet somebody's needs? Howare you going to scale it and WHO's going to pay for it and so much ofhealthcare, the person who's paying for it? Is it necessarily the one who itmeets their needs, and so a lot of people come up with solutions to fix aparticular problem bit we're not looking at it within the complexity ofof the system. Those that are successful either have created a bypassaround Thad as you're now getting with the directorconsumer movebunt in ways for theyre working to to come up with a way of intogratinginto a system that actually makes it easier rather than farder, and that'snot always easy in the Innovation Space Yeah. I think that's a crossroad thatis that innovators always face do I do I try to circumvent the current healthcaresystem. That is going to be a really long, artorous road for mefor me...

...and go directo consumer and kind oflook at more creative PA cash models subscription models all of thedifferent innovative business model options that we have today, but thenthere's there's a there's: a cost associated a much larger cost witheducating and promoting to the consumer market. And then, if you go into the healthcare system, it's how do you navigate that right? How do you navigate that tomake sure that you don't just get bogged down with something? That'sreally innovative, but because of that payment mechanism that payment models that are still somewhatoutdated? How do I not just kind of find myself really right back where wewere here's Agob, you know if you're doing witheal systems and you'reselling to a OL system, they've got about an eighteen month, budget cycle,and so just the process of doing with large healthcare systems, for what youneed to do is a difficulty for many startups. TAThave just lower amounts of cash and and realy can't sustain that,particularly because most of the official capitalists are looking at apretty quick internal investment, so part about capital markets really justnot set up for that Yep. If you're, if you're talking about the payor market,know you're, basically trying to get someone to pay for your our thing. You've enomated B, they have a very different set of wayof thinking about things t at have to do with clinical utility and evidence.That's a little bit behind the way, most innovators think about solutions,and so you describe that a little bit moreokay, Sureso within my space holding on sequency, we know the if you do holdonon seqens an on Pacingt, good weare and diagnose misdiagnosed diseases on acertain criteria: children, Wil Developmento, the laingseizures that are and determined calls hepeople that have certain things thatyou just can't figure out. If you get that, if you get holding on SEQUENCIG,you can sometimes say hundreds of thousands of dollars, bail market withrespect to the cost of care, but they ten to dotheir analysis at the level of it being ohere's on there. Five thousand dollarchast, if you will, as a pase O Sayn this five thousand dollar Chancees,going to say two hundredhsand dollars andgetting them to actually see that clinical utility is just aslow process. Ta. That's part of that really what example about yeah. So whatphase of the commercialization process are you in now? Do you have paying customers? Are youstill in kind of the prelaunch help us understand that Ye'r right at the level where we've gota process I, with with a product that is ready to go to market,which is codacum, which is a dadianalytic tool that to make adiagnosis from the genetics information in about an hour for the things thatused to take days, and so it requires certain licensingwhich we have, and we were. This is just for the nature ofstartups. We were ready to launch last year, had capital lined up in the in the capital source was being led by someone who wdied unexpectedly, at age, sixty three of an unlikely Aman. Sothis is the type of thing that happens in the store op world wev bout, thewild ride of Ante ewership. Right I...

...mean you, laugh Fortai, can't pedictthatfrdwonderful mentrities, it's very hard for me to Yono, have a prittyparty from for myself, an EOI tes. You lost his one, an I his family, you know,is very much suffered from that far more than I have, but te nomtherless.That was just one of those things and that Tis the world te Stot. Starting upso had you talk to me, you know a year ago I would have saidMa thispoint we would have had a expectation wi be about three threemillion dollars in the positive wit, respect to Revedu. So in the startingworld things happen, these are black swanes, and this like that happened. Sowe are in the Middle Right now of n, designing things around a merger process with another companythat has complementary business model and n. That en that happens, I think Yowill be seeing some interesting things in the next few months of the year, sosta tune all right, that's great, so I think you kind of touched on this.You know I was going to ask you or I am askingyou what at some of the biggest challenges that you faced as anentrepreneur. Certainly having something like you just describe happenis a huge challenge. You know I like to have really candidconversations about what it's like to be a health care entrepreneur, becauseif we share those realities, I think it's just very encouraging, like hey,I'm not in this alone, right man, it's happening to you too. I don't take itso personal and then, if we share strategies of howwe overcome that you know, then together we can kind of move the needlea little bit so just kind of speak to maybe some of the other challenges thatyou faced and what have you in you know ways that you've overcome them I'll, give it seflis one outson Motpuent company, but you jolked about the Tesu for capital,so my multispecially medical goup, Co, stone very early own, saw that therewas going to be a move to value and came up with a strategy to to do that that we knew it wouldrequire capital and partners, as well as willing players, and we went downthat path and had some of the some results in terms ofoin the cost of Care Abou. Twenty percent in he very vulnerable highcouse population of patients, that's been published by the way in thegeneral population Helt, but the payents were slow and the Poiticschangedwhat look like what's going to happen after medicat ispentionlegislation that sort of confounded by e SupremeCourt decisions, it really changed the treatory of themarket, so we continue to have results, but we lab with respect to our abilityto to to move as fast as we thought themarket was going to fast. So we ended up seking out partners for what we weredoing. EAN those partners, an Fu id lab cool and wait Fori Babness, which thetime was an independent econemic medical center in our community andultimately, we spon Ou, O company called chess and additional capital,and the ability of that thost resources has allowed chuse to besuccessful. Is Now managing, I believe, Thaut a hundred thousand lives. IndValue based contracts has been successful in multiple Medicareadvantage and next Jin acons, and when wait, forst just announcedthat it was...

...going to going to Lerge with Achem and Charlotte,which is one of the largest health systems. In the southeast, in theirprincs release, they mentioned chances beeing one of the resources and assetsthat they were bring in to the Tanble for what they were planning. So if youlooke back in two thousand and thirteen when we're making these merry harddecisions about we'r going to do this rine, we don'thave enough money, who's going to be our partners where we are now and the fact that you know it's. Just like that. Bypaststory we couldn't Hav Couldt, have seen the we would b right. It was a very,very hard Ro. The value that the Shergon grow, SOMPoston will have en in chance over the next ten years should be multiphone relative to the lunch wetand ters and Horn werethat o get into it in the UO late, twohuzand, tente, two thousandand thirteen, but it's taken longer than withab get it to partners. So so,what's that conversation like with the board with the shareholders, with theinvestors of we're, going we're goingno get there, but not yet we're going toget there, but not yet. Sometimes it's a very hard conversation. You know people are impatient. Peoplewere scared, they don't see the future and sometimes ou're wrong about youknow, were the markets cool in Owr howlt fans, it's going to go, but we thought all long that it was goingto beabout some very basic truths, which was therewas a lot of exess experense in health care that could be improved by redesigning models, appearethat were much more patient centry that took car of the Nage, where there wasin a waitof information and inpositions that were managing this with a team ofpeople that could greatly benefit from intewated information on everything,from pharmacy to a Curwanto Redesign, and we were very convincd. That was thecase in the market was going to need that, because of all the trends thatwe're al aware of and tre to health car calls, and so that was a truth that you know we had some ieproof pointsthat ended up being good evidence of that and so ass. Therest of the morket came along with the way we were thinking about it. Then we continue to have on Thoese,esess and there's payers now, who will not do certain types of contracts? Indis in this way, without our are being involved in u marketbesomething that that we know what we're doing so. That's experiences, Maye difference, podosright, yeah, it's kind of win yeah. So, as you kind of went to market, you know both in your previousexperieence. In your current experience. Are you you know having any type of liketargeting or segmentation strategy, where you're really separating theinnovators in the earliadoptors and identifying and finding those andpresenting your offering to them versus presenting that to the mainstreammarket? That's not ready yet that deeds a different, absolutely so Wev in thecontext of hoding on sequencing and rare disease. One day you and I and our children areeventual. We wilall have Veri an Expensif holging on sequentin at somepoint in our lives to be in a secure, safe stored environment and it can beaccessed by any type of position or patient when it's needed to basicallyinform about medical risk. Impossible disease possible sideeffects, fom drugs, but that's not where we are right now.So where we are right now, is that this technology is out therere its gettingcheaper and the people who needed the most or those...

...are not very well serve by ou currenthealthcare market wi or those with mosty children with Rarizingis therehavbeen misdiagnosing on the Dner, so they end Uf the children's hospitals, the people that will benefit from thisnow ar Antoe hospitals. And so we, the Dialogu, is with those thatunderstand this. The children's hospitl market T- and they don't have theresources to do this, we're making it less expensive for them, so that Tay anorder is testing and we're serving as a source of expertise so that they canactually get it to the people that that needit the most. Ultimately, thewhole system will have this as AF technology, but right now, there's a probably five percent of the populationis, is extremely porly served our coul help folivery system, which is focusedon planet diseases, and those with rare desseases need a verydifferent strategic approach, so the places that they go er the places thatwe need to be marketing and pargeting right now M so is, as we think, aboutthe commercialization process and all of the decisions that are made when you're developing that earlyadoption strategy targeting communication branding messagingbusiness model development. What are what are some of the strategies thatyou've deployed? That would be valuable to share with our audience. So I think one strategy that you haveto teploy that we've done is to not beeverything. Anybody but Soin, Oen, that there you've gotlimited resources, limited hapabilities and so going towards thosethat meed the most an maken as easy as possible for them to provide thatservice. Sometimes you have to choose not to have somebody beaccustomer, because it's going to look ot too much resource and it's notreally where you're moaning in lipset of Ar. Sometimes you have to Piv it. Soyou may think thate's that a product that's going to serve one the segment and in that Semmeta athing, O Wole. Whenthat happens, you have to you have to move, and you have to do itha way. That makes sense. So when example of this would be when we were developing ches, mypopulation, helth management company and two thousand and twel thirteen. This isbefore sprinfoldecision in medicaideExperiencen, so we had developed the model for the duing eligibles, becausewhen selved in this being somebody that nheinfordable careactis medicadeexpansion, happend would be high cost and that you can put some realnovationaround giving them tatter care and away. It would be better for them an a flowof calse t. What expansion didn't happen. We just had to do something very different with thatand really y know win in another direction, fo which medicar expansionand medicar search savings. Nixton Andcos,not because we didn't laserve that market, but because there was no no wayO pay for it. If you look at some of the facies coming out in Washingtonright now, particularly with some of the focus on the waivers there, will that marketwill open uption, but it wasn't there in two thousand and twelve just becauseof some Yu policy changes yeah yeah. Absolutely so I talk to some innovators, who are either physicians that are first timeturned entrepreneur or maybe an executive or a leader within abig healthcare organization that have left because they'v I identified aproblem that they want to solve on their own and one of the things that'sreally intarresting is for the innovators that are doing it. For thefirst time there seems to be a lot more.

You know, naivete, I'm going to do thison my own. I've got all the answers. I understand the problem. I understandthe solution. I understand my commercialization strategy and so forthand whereas you know other folks, like yourself, who've, like I've done this,I've done this. You know there's lessons that you seem to take with youof like we tried this and it didn't work or you know all of the differentthings. So what advice do you have for those listeners? Those healthinnovators who are, you know, may have a health chair background may not buttheyre they're doing this for the first time and they're really reallypassionate about the problems that they're solving and the technology thatthey're innovating. What advice do you have for them? Wo'll be arrogant, let's Tay Fassionate and listen, listen,listen to to people about what their real concerns are, because sometimes youhave a your shoving, the problem that they don't think that they have, andsometimes there is a nusonspite Ta war and at other people involved I meanmost solutions: ware, not one person's work, although that's sortof the way you we tend to think about things in our comfort, ourindividualist culture, bugits, a focus, a team bay, so many physicians, MeneAnfo Premiers- may not have the text of business skills that are needed to basically manage a larger team tobasically understand everything from businessdevelopment, a marketing and sales. Some of them don't seem to know.There's a weete superet things right right right, just that fundamental Tlat.Those are three deferete things. Thei'mlike founders are not always thebest ones to to lead businesses to me next planes inspace, and sometimes passion can get in the way ofexecution. I am very forrtunate that I've been in a Mosi different types ofsituations where have been in medical practice that I'm S. no I'm fornow, twenty years that we grew from four or five people around the table toorganization it had. You know, twoousand four years and had lots of people helping me, butthat's a very verydifferent place in space in terms of managing someting ofthaut size and complexity and building it and growing it ban in the situation.Onin right now, wr start up and chance to complete. That was in between whichesince hey had was spint off out of the big company. AWE CO DI works, initially Ta Ecam Separate Company was sort of eenbetween that. So I am not a I'm a dog right, so I have alot of skills because I've been these other things,but it's always within the context orealizing that I'm a generalist and that they're that requires a tam ofpeople just like it does in the O ar just like. I is everywhere else forbasically Bild building like the Wil Businesses Im for something that can beimportant in meaning for so a lot of folks that are at star up me and theydon't get that perspective, because they'e beenfrustrated with the system that they find. This function then work and thenthey leave the solve a problem and they want to sell it back to thatdisfunctional system, so othave your hand around being part of something and understandyour place, Itho system of thing, ten thousand of those stories, if not ahundred thousand of those stories right...

ISO, you touched on something you knowevolving different people in the process. So I love what you justdescribe, because you're talking about building Bu Business, building right RG in that it it takes a village right. It all starts with the people, even when you're building a product,you know we're evolving other stakeholders in that productdevelopment process. What are some of the strategies and tactics that you'vedeployed at possibly involving patients and providers in the development of thesolution, or even the development of the go to market strategy? So I will give MOU an example right nowwin the place in space. I am with you knowmits, but I'll go back to what wewere doing when we were building it out. Some of the things that she has in I mean this thisis, the type of thingit doesn't sound like an innimation. It didn't sound like a you know: Gan afoty or black turtle neck or something an IC stage, but we what we're thinking about. We designingmoder Secar around patients. We dewelpd the committing of patiencs that we werefrom our walks and life that Wer port of Ur Tatjust, like one of the othercommittees, an Coli Toms, an we had finance Committi and operations andAlwasan. We had a onventon committee and they told us what their actualexperience was. Ander very as opposed to you know what we thought we wereproviding and from that we learned a lot and weunderstood what some of them difficultis were. One thing that I'm doing right now thatI am finding just so much fun is I'm working doing some independent work for the primary care, Jo medicineprovider and I'm learning so much from these patients that have zero access,the primary care or desperate pefund solutions. FROR problems that thetechnology can easily provide outside of the troditional healtare system,sometimes don't know the limits of that, but IAM learning more about thehealthcare market. Ways that I didn't know when I hadnintwenty years sitting in my practice, orboing some of our tings that we do inour extensive this transition care, planet, forebact, Por on SOM patioushose these are the people that there were came NTO my office and they're,using he technology now, ibsouty about twenty five hundred Pantiens, anipanjust like this since Februnar, sometimes they're in their corn,sometimes they're at work, sometimes yeah home and comes there in the bed.Si Theyre upplanin loading, pictures of ther, poits and Iving for me to tellmiss plase an amy and it's eamiant, Pang Tom giing patient satisfactionnate back, but these were pracers. Did they call him because theyre they can'tget a refill? The doctors offiser she clas, where they can't afford to buiandto see their doctor, but they can afford a he codpay for this type ofthing, so sometimes just getting outside of what you usually do and getanother perspective Ouknowi think can make a breat willdifference. It's just fascinating for someone that's been so entrenched in somany different fassets. That really can be that honest of I'm still learningright, because we are no matter wha. How much we know we're always learningsomething new. It's just so much tof, I'm just sort ofThi is Wa. I could never specialize and it as quit, essential general liss. Ilike, I can't imagine just thow when one thing really really well, I'm justgoingto know a lot of things, not so well, but a lot of right right, yeah. So some of the challenges with likepatient and provider, Co creation, some of the conversations that I've hadaround this, especially for a startup, is that you know I completely by intoinvolving them in the process. It's not something t I'm opposed to. I'm eagerto do that,...

...but when I reach out to those folksthey're excited about what I'm doing, they're just really not excited aboutcontributing their time for free and and then the innovators you know, areser their boottrafp right and in their strop for cash and so as they're makingdecisions of what they're doing with the limited funds that they haveallocating funds to pay those patients sort of pay. Those providers for thatfeedback, so they can cocreate with them, becomes a real challenge. Howhave you address that? You know? Were you just finding people that you haverelationships with or people that were saying? You know I'm willing to giveyou some of my time for free? What did that? Look like in the Museumpol I game for thepatients a lot of terms since wher people withhad written complaints. They were passionate about a bad experience thatthey had. Ye Ha invited them to solve that. So we may not be the tephicalpeople. Wet E was like. I just had a really bad experience with oization andsort of like great when you become mverson, O plait committe, and you knowles get better and se that that ended up, because it was meeting a need thatthey had. It was an emotional need. They were unhappy people that wonorisnothing sotra in within the context of of other types of audienceeseverybody's got MOMS and DADS, and children and cousins twice removed, and you can reach out some times of friendsand family, not just for capital for just the way. A lot of people thinkight right rig in terms of prouct feedback. So havetobe you know. Sometimes your family s, the only one who's going to tell you something negative and critical aboutyou. So we can be that way from your friends and family. Let them invest in your company, NotJus, financially Wut Investin, your company win fe back, so that's just asomething that they go. Il innovator other realize his that the friends andfamily reund I's not just about money, an so a the village. It takes ontimesto bin Somther. Absolutely well, Dr Terrell. I thank you so much for yourtime in thes, just incredible wisdom that you shared with our audience.Today. It's been such a delightful conversation. How can our audience our listeners andviewers get a hold of you if they want to talk more about what you're doing orhave some questions with their own commercialization processs sure? So youcan reach me by email with g teral at envision genomiccom. We can find me on twiter. It grace ttwenty two and I'm Onlin in so I would be happy tohave conversations with people eanly, lhose meenins and if it would behelpful PASSOM. Thank you so much for your time today right. What's the difference between launchingand commercializing a health care, novation many people will watch a newproduct. Few will commercialize it to learn the difference between latchand commercialization and to watch past episodes of the show head to our videoshow page at Dr Roxycom thanks so much for watching and listening to the showyou can subscribe to the latest episodes on your favorite podcast APPlike apple podcasts and spotify, or subscribe to the video episodes on ourYoutube Channel, no matter the platform just search Coyq with Dr Roxy untilnext time. LET'S RAISE OUR COIQ.

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