Health Innovators
Health Innovators

Episode · 2 years ago

How Innovators Can Increase Their Chances of Market Success w/Matthew Holt


Healthcare innovators have to make a lot decisions in the commercialization process and each choice can determine the success or failure of the innovation. What are some of the pitfalls of bringing an innovation to market? What needs to change in healthcare to make innovation easier? Why is proof of efficacy and value so important to gain adoption?

On this episode, I’m joined by the founder of The Health Care Blog and, Matthew Holt, who shares his point of view on why some innovations succeed, why some fail, and where the market is going.


3 Things We Learned

  • The two main types of innovation
  • One of the biggest issues in healthcare
  • Why healthcare innovations get stuck before implementation


One of the main reasons why healthcare innovations fail to reach any level of customer acceptance and profitability is because the industry is a very unique beast to deal with. Healthcare innovators must consider the experience of the clinicians who will use the new solution. It’s also important for innovators and investors to expect and plan for the long sales cycles in healthcare. You also must know how your solution fits into the larger healthcare ecosystem. Ultimately, there are a lot of things that have to go right to reach commercial success and there are no short cuts to developing a winning commercialization strategy.

Welcome to Coiq and first of itskind video program about health innovators, earlier doctors and influencers, and their storiesabout writing the roller coaster of healthcare innovation. I'm your host, Dr Roxy,founder of Legacy DNA marketing group, and it's time to raise our COIQ. Welcome back to IQ listeners. On today's show I have matthew hold withme. He is the founder of the healthcare blog, cofounder of Health topoint conferences, and you might know him even more by his twitter handle atBolti boy. Welcome to the show, Matthew Ross. She's real pleasure tobe here. Great jet to know you a little bit. I'm looking forwardto Jayant. Yeah, I'm looking forward to having a very candid conversation withyou about writing the roller coaster of healthcare innovation. Today, as an upface, was a downface. Will See. Yeah, let's shoot it straight today. So, you know, there's a lot of people out there thatalready know who you are, but just in case some of our listeners don't, took just a couple of minutes and share with us a little bit aboutyour background and what you do. Well, so what I do now mostly isI'm I don't know what to say. I say I do health technology andearly stage innovation stuff, because what I ask you do that. Dionmsare based in that Milia. Way Back when I was a sup poor indisgruduatestudent hang out a stand for trying to figure out what to do in mylife and I ended up stumbling into the politics and policy of Japanese and Americanhealthcare, if you believe that. I ended up in a big funding projectlooking at those two things and I was thinking like a health policy health businessguy and I did a lot of work back in the early s looking at, you know, the evolution of the US healthcare system. I basically theUM at US half of the Lubum Japan, the panoff. Funny Enough, I'vebeen back in Joban the last few years, but there was a longperiod ride in touch Japan for the reason okay, and I ended up gettingmy first insulting job out of Stanford. was in a place called the Institutefor the future, and he's it was the future. Was this crazy?He's a research same tank sitting on Sanduel road, right next door to theventure capitalist kind of Perkins and had research and consulting into areas as health technology. Healthcare and one most technology, and really the two of them didn't mix. And somebody somewhere had sold a project to a bunch of tech companies abouthealthcare and they got some a bunch of health plans that would have project abouttechnology, and no one was no one did it, and I watched thedoor and they went hey, you, you're doing this project. So Ispend the s learning about healthcare, you about healthcare and learning my technology goestwo together, and a project about that. And what eventually happened was that thatwas the same time as the web was taking off and the Internet wastaking off and you know, everyone's joining the dotcom e health crazy and evenI, the end of the s joined the start up doingcom health stuff,and so I had a decade like getting mersed into into that. And thenthe next decade, which was of the early teen thousands, some a bitof time on the beach postcom. But after that I did a lot ofconsulting work for only for most of a tech companies about the healthcare system,but, as you pointed out, I also started this blog called the healthcareblog, because that was, you know, the teching news he started the blogback thanks pay three, right when there was instant pundit, daily coastand about ten other blogs. And actually probably what made that the career waswas that in two thousand and four or five, the wall Schreol Journal wrotean article about, you know, the top blogs by industry, and thehealthcare blog was the healthcarectersties, you know blog record, the one that forit was like a year and a half old or whatever that stage and maybeat twenty seven readers of a day. Anyway, that helped it take offbecause it was have got a bit of no variety. The other thing thatwas going on at the time so that the blog and still goes on thehealthcare board. Please go there. Do It is it's all about healthcare business, healthcare policy, healthcare tech. Has a lot of video me and othersand great articles. Needs in my inn...

...back absolutely at that time I wasalso kind of following up on that stuff. I looked about, looked at inthe nineties like the the little companies that were still doing healthcare and technologyon the Internet, and there weren't many of them around because the whole thinghad imploded with the dogcom bust. But there were enough. It's just gettinginteresting. And then Google went public and its put more money around and buytwo thousand and seven around somebody called two thousand and six and in the somebodyfrom the Indian to buy an indus a doctor who had a clinical background.But when it's a business, and I said, you know, there's enoughto stuff to be interesting. When she was doing a bit of a searchingtrip as well and I said, you know, one of the a bunchof these people I've been talking to have this little company, said why don'tyou do a conference? I went, well, that'd be fine, Idon't nothing about do the conference, and she went, yeah, you shoulddo a conference. So we did it and that became health to point Oand by, you know, the mid teens, we had a couple ofthousand people come to our big conference in Santa Clara, California. We had, you know, maybe three or one representers. We had dozens and dozens, at hund more than a hundred live demos. That every conference in weare compences in Europe. We had spin off one in South America and Japanand you know, we had a lot of activity go on. Eventually thatconference business started the world others consulting and technology innovation work. And then twothousand and seventy is just two years ago, hymns purchased a conference side of itin you and I still run the bit called catalyst which does the whichdoes kind of challenge competition management in technology. Right now we're running something the Rodwith Johnson Foundation and you rous who want to have an application in thesocial determinus of health or in community at home based care should be entering thatcompetition. That has prize money free to winters and just one of the manythings we're doing them at the moment. There and then I also created abusiness school, smack health, which basically does early stage start up advisory upearly to mid stage startup advisory, helping CEOS figure out, you know,how they should be resenting themselves to the outside world, helping throughout their businessmodels, some of the stuff that's a pretty precursor to the what you do. We don't really get into the fast commercialization stuff, but we do it. We do can to help around making sure that your deck looks so mesensible and figure out who you joking about, bag a cap, all that kindof stuff. Much of different things. You know and still write and talkand a peal of stuff like this. So, yeah, but about me, my fresh life. Awesome. So, you know, as youjust described, you've been around healthcare innovation for, you know, decades now. Your take on what it's like riding the roller coaster of healthcare innovation today? Well, I think the roller coaster part is is highly depending on twothings, right. So there is the up and the down, and we'restill in a an upfhase. But I think people are looking at the righttop of this and going what happens now? So one is that it's connecting toto tech business as a whole, which, of course, is beinga massive search up a cential. I mean there was a bit of ahiccup. You know, the other ten thousands and there was a bit ofa hiccup, you know, ao nine and funding. But in general,the the transformation society by the people who sell us, you know, theseque devices and by the people you are on the box that comes, youknow, on to your front porch and the the the the ad that comesin when you type something into the certain engine. You know who I'm meant, right. Yep, the transformation of society that has been dramatic and healthtechnology is kind of attached yourself to that, especially the funding part. So therewasn't there was a decent amount of activity in the in the S,but that really was too early. There wasn't much. I do the otherthousands, by the late two thousands of starting to happen and starting that gotinterrupted by the depression of nine and then since two thousand and ten we've reallyhad an uninterrupted amount of funding going to you know, what are your callit. Some of them are digital health. So we've got to postage your healthlike call a smack health doesn't doesn't matter what you call it. Andthe sector of technology that have health technology...

...that is sort of on the cloudand is aimed actor in users like consumers and colitions, right. And thathas gone from some of the number suggesting one to two billion in the twothousand and ten, thousand and eleven and then estimates range between eight billion andfifteen billion in funding last year. That's still going going along. So onearea, you know, it's all of our coasters, is the funding cycleand how much there is available. And we're seeing just a day pen dressgoes public, last week Google going publicly we see all of interesting modern stilllost making businesses going public on the stock market. There's a lot of moneyaround for for that. We'll see how along that last Yep, Yep.The second and equal important part is how's the health system reacting, and Ithink this is really interesting because you've got kind of too approaches. One iswe're going to sell tools to the health system incumbents to make them more efficientand more effective, and most health technology companies view that as the way forwardand they're looking at either selling the drug companies, hospital systems, device companies, selling into provide Lens, a big vite organizations or health plans or,you know, government ages. And what happen? Then they're selling stuff inthe incumbents with the whole of the made me do better. There was asmall slice out there, but some of the very highly funded the people sayingthis is not like, you know, selling barns and noble or borders abetter online experience for their bookstore. This is about putting those guys out ofbusiness. We want to be Amazon and that there are al ways to aplace to current incumbents by figuring out better ways to deliver a health planer orbetter ways to create a primary care group or have you and you and thatSectu of me is very interesting because if you look at healthcare across the board, it's only your bigger, more bloated than more in efficient to more effectiveover the last two decades and more expensive and put its prices up. Andif you look at the satisfaction with it to end consumers, patients, speedrough to use the system, it's going down and access to it is well, that improved side of the ACA still going out and that wasn't the solutionthat you know, the could have been, which is why, on the onehand, you've got a lot of grumpy people to on the right andthe left talking about free market stuff and on the least you have the Medicarefor all campaign. So I think it's really interesting to see if it's there'san opportunity to kind of really replace the way we do healthcare now or whetherwe're just going to sort of keep down the path of growing the U selfcaresystem, adding new technology but not really changing what it does fundamentally. Hmmm, uh, Huh, Yep. So you just kind of building on that. You know, everything that I know about you is that you know you'rea futurist and you know you kind of observe these patterns and trends right andyou kind of just touched on some of that and kind of forecasting what's next. So where are we going in you know, what does the future holdfor entrepreneurs who are bringing innovations to market? Well, I say this is interesting. I'm actually literally just got off a call about what I'm going tosay in Europe in a conference health to go know him to Europe and nextmonth and it's a you know, we've been talking a lot about activities.So there to sort of unleashed the consumer side from their more standardized state basedsystems and they've got actually things like doctor booking mechanisms and ai tools to helpsupport the front end of reaching, reaching of consumers, reaching doctors actually growingquite fast over then. We well funded over there in Europe and to someextent that's been going for entrepreneur that's been going quite fast. Here we seemedquite a lot of activity towards consumers. I'm thinking about the tele medicine companies. I'm also thinking about the bricks and water companies, I urge and careand what have you, who been who been getting out their own change.They consumer experience a little bit and we...

...there's some suby there. They differentcenter suggesting that there's a significant difference between sort of old fasts like me,who care about their okay, who care about the doctor relationship, and youngerpeople like you, Roxie, who are less attached to an individual doctor orsystem. And I'm looking for more convenience and which is why you seem togo for the Virgin Care and the sort of demographic change there around the ageof fifty roughly. So that's I think. One thing is, what can youdo off to sell doct to a consumer, and there's a lot ofopportunities in that area, especially as probably it's going to stay this way,that the US is staying in a higher deductable more consumers pay in the firstfew thousand dollars out a pocket system. Yep. The problem or the issueor the the underlying start things as system for the system is that that's allone and great. Most people use the system like that. Most people havemodest health issues. Most people have you know this, kids get sick orwhatever. They want to. They want to see urgent care, they wantto see health. You can see a bunch of stuff around that, butmost of the money and must have problems attached to a few, number offew people were sick. Right, yeah, those people that want us to whothe current system makes all its money off and gives a pretty bad experienceto. Because what we do in the current systems we do a lot ofprocedures to people. We don't do very good management of people a chronic illness. Who are the people who gost all the money? And I think youknow, one of the interneting is is to look at how can can whatis the right unit for which to approach a better system for managing those thosecorrectly your people and essentially stopping them going into the merchants room, stopping themgoing to the hospital, stopping them having come unnecessary doctors. It's but monitoringmanner and managing them while they're in their home or while they are where theyas my friend James, as some carrents sort of boo called health consuming,says, where they where they were, they live, live, work,play and pray. Right, yeah, where the place to people are goingthat you can can impact them, and you're saying some very interesting companies totrying to you know, put sensors in the home persons is on people andbuilding system where they can track and manage a monitor them and then start figuringout what they can do to intervene with services like nurses calling in or doctorsgoing to the house or what have you. And I think that the key entrepursedto throughout. What's the unit where they're selling to in that? Arethey selling to health and churance plan like America, a manage plan they signed, to a hospital system that's now taking some risk? Are they staying directto consumers? We know they sent to employers a lot of sort of questionsabout where. Who is the answer? Who? Who is responsible for thosepensions? Are they selling debasions to? They selling a service to people myage for their parents who are serving alone in their ads of what had you? So I think that that's a big question, is that you know ifyou're going direct to con some something's cheap and easy, or if you somethingsomething complex but it's going to reduce healthcare costs and improves the care of peoplewith Modivele chronic illnesses? What's the right unit your where do you how doyou prove that out? And then the next point is what I said,prove it out. How do you get clinical data the validate what you're doing? HMMMM, Yep, what when I say Colt will day or how theydo it means, you know, yeah, yeah, you proved that this thingactually works. There's a lot of controversy about that as well, bythe way. Everything so you know the law. People say you that someof these plan wells friends wanted are not a fakive and don't don't work.A lot of companies have kind of got in there, done the sort ofmove fast and break things and get in there and start running the programs withoutreally proving that out. So controversy about that as well. Yep, absolutelythe efficacy of those things. So have you come across any pretty unique businessmodels that you think maybe either become a challenge for that innovator or become aopportunity for them? Well, are a lot of challenges because the main peoplewho hold the money now have are either...

...large and somewhere sclerotic insurance companies whodon't really want it. There are some experimentation or there, but don't reallywant to jump in and do something great new and have very established relationship withprovider organizations or are provider organizations who are thinking about getting this new world oftaking risk and doing value based care, but in general make all their moneydoing seem the service and, you know, want to make sure their beds arefilled. So I've I mean, I'll give you one example. Ihave a company I work with that which has an interesting produbt program for reducingreadmissions Post Hospital. This charge. So as you know now, hospitals getdon't get paid if they're really made a patient off the thirty day, withinthirty days, and there's a lot of Congress about that. What you're sayingis that a lot of argue about whether that's effective or and a lot ofreadmissions on day thirty one thirty two. So this company is struggling to findpeople, you know, because they believe they can rease remissions, probably bydoing stuff and that. So they're kind of struggling to prove that out becausethey you know, the biggest because they can't find the people who are stillgo for the system. And then not only is the issue of well,how do I prove something out that, you know, just going to stopthe remission on day thirty one with also gets paid again, but also they'rehaving the really basics where they'll sell this to the sort of finance person orthe marketing person, some of you want to say administration will buy this,but then they have to go and have a conversation with somebody who's running abunch and nurses calling on the phone and change their workflow and that's really hardand mentally a lot of the times to get stuck there. You know,you have the medium and at the third meeting the person running that group,as I'm too em busy what I want to change this. You know,we're we're doing's okay, Yep, yeah, and stuff get stuck in the kindof implementation phase or even before the implementation phase, right the sign offfrom from those people on the front lines. And you know there's this is thingthat's such in Jane a care or he says there's like a delivery layerinnovation layer, and these two things don't talk very well, and that's abig problem because you have millions of millions people that delivery layer, a bunchof US running on this innovation layer and there are people, as organizations thatare innovation groups and are funding groups trying to cross that bridge, but rollingout these new systems, within these within these organizations, of is very hot. Yeah, yeah, Yep, absolutely. So I talked about this stat often. You know that research indicates that ninety five percent of innovations that arebrought to market fail to reach any adequate level of cup, customer acceptance orprofitability. And so the question that I have for you is, you know, as someone that's had your ear to the ground for so long, whydo you think some healthcare innovators fail and some succeed? Who I mean?So I think a lot of it. You can't you as a way backin my career, before he got to the US, I spend time astime as the future strader and used to joke that it's good to be goodand it's good to be lucky. Is Better to be lucky than good.Right, so lucky, right, are you in the right place at righttime? Right time especially, so I see stuff that looks super cool now, is it is don't succeed now. That is exactly the same the stuffthat was done ten years ago and that didn't succeed because it's time. Itwas wrong. They can give the right people there. A lot of itis can you get the right time can you get the right champion that organization? You know, the right did you do you fit a payment stream thatwas coming online now that wasn't online five years ago, even though there's theresult would pretty much with the same. So one of these, like luckand timing, m you can do something to kind of figure out if youare at the right time as the right luck and if the regulations or thepayment stream is going the right way. The second is is, I hatesays, relationships. The right relationship driven business and it takes a while tomake those and you know, sometimes you can go around those relationships. Youcan do the Ouver, the taxis or the Amazon to the boards and bounceand noble, but a lot of it, if you're having to go with theyou you have to figure out the right relationship with those organizations and thosecan be very tricky because there's a very...

...insuluent standaris organization has been around fora hundreds of years. So everyone reason some case. And then I thinkthe the the typical one, which I think is true. It is kindof ignorant of the healthcare system. People take people of this your coming fromthe outside, not understanding what's the frontline experience the clinician is etc. Etc. And finally just dies there. So, yeah, there's a bunch of reasonswhy you don't you don't get it right, and I think allied toall of that is all for the say of this is that you need alot more time and money. You think you do. is by nature problemwhen you're on only stay start up because you don't have much time and muchmoney in your investors could be putting money in instagram or whatever. The thingis going to flip to facebook in twelve months and make a lot of money. And why do they want to see you out of several years? Ithink invest is getting wiser a lot and you know it's it's not. It'sthose pressures on startups in those stage. Venture backs, whatever she's, arealways going to be around. Yeah, you know, I have a lotof conversations around. You know, folks that think that just because they've identifieda problem and they have a product that they think is superior to anything elsein the market, that it's going to be the shoe in, that it'sgoing to automatically equal success. And you know, to some degree there's alot of Zombie graveyards out there with these these innovative products just kind of sittingin there. Some were eating to be resurrected and some will never come backout to play. Absolutely and look how I look at the world of soo Apple Health records, for example, which is based on a company whichstarted the health supernocle glimpse. worshiped them, still out to launched the the healthto pre conference. Yeah, and that's super cool. I was ina company. Cool I be can in two thousand and two thousand and one, which I basically exacting the same thing and went to try and set thewhole bunch of people and you re sure we'd have and that's a I'm surethat software sitting in box somewhere. I could be restaurant where it is bought. That was timing, but it was money. Probably was lack of alwaysdifferent things, but again it's it was you know, they're underline stand aswork. There bunch of of reasons why it didn't work, but really wasthe market wasn't ready for it and you know, a big player like applein the side, they have time to take it into forcing. The marketwas so now done. So a lot of who knows. Not that pity. I'm like, I like to solids. To apple me a lot of money, but it those examples it was too port to buy it back.Right, right, right, yeah, you know. So. So whatdo you think the biggest pit falls are to commercialize in an innovation? ISIT product market fit? Is it problems solution fit? Is it being ableto get in front of the right people, Latin surviving the long sale cycle,developing the clear business model? You know which thing is the last twomore than me, also think it's like the cell cycle just takes forever.HMM, doesn't matter. You know you're going to take several months and thenyou're going to lose people, your invest is going to lose interest, whatever. It's just going to take long and you think right, so I think. I think the the cell cycle. The the other problem, and Irun this all the time with my stuffside work, with it's it's really hard, and this is not just in health, this is in any new startup field. It's very hard to clearly explain succinctly and effectively what is that youdo. Yep, and therefore you end up getting bucketed as being something likeyou're you're like this beer a bit different than whatever, and I don't getit. And then we have seventeen those. It doesn't rise to the top.I'm I right now either. Super Clover, company I'm working with that'sin the medication sort of Management for consumer..., doesn't dozens of medication coopreminder APPs out there and we're it's really not easy trying to figure out howis it that you are different, better? What's the thing that you've got theday and getting over that hurdle with the first conversation of the first commonconversations with investors, clients, customers, employe whoever, it is right andtwo minutes. Yeah, even doing fifteen, this is super hard and getting theshop to make that makes sense is hard. And, by the way, you may not be different to Theo's other seventeen. To figure out whatdo you have to go where and build it is different, or rap andfind something that will all maybe your choices. You go and sell one of thoseseventeen or one of their customers and be a plug into something they're notdoing or whatever. Right, right it. But yeah, you're right, we'vegot back to ninety five percent. Don't make it think a lot.You're the uds of stacked against you in this business. Yeah, yeah,so what needs to change in healthcare to make innovation easier? Oh, wasit? Some of these changing rights in the FTA, Scott Goalie, whorecently resigned as commissioner, really got behind. But Cooper tell and his work inthe FTA. So creating a sort of framework work for for allowing digitalhealth technologies to be approved along the they come for the right process rather thanevery time it's like changing the device happens or the tech happens, to haveto put it back through the FDA approval process. So that, I think, is a good help. Is Very funny to see when Scott Calling leftround. There's a far right libertarian, all these liberals, I know ontwitter a crying tears of the saddest dual saunders, because they've already done sucha great job to help. There's the field wrong. Not many trump administration, you know, the heads the departments who've got lefted. People are mourning, you know, anyway, the so there's one thing that that. That'sthat's a help. But I think the biggest thing is how we think aboutpaying the healthcare. And really, if you look at it, we arein a world where still hostage spite all the talk about value care, value, you know, value based care. Hospitals and doctors get paid for doingstuff. Yeah, don't get paid for the outcome of maintaining health, andso this means that you have to do work around. You have to goto as you have an innovation that's the service or a tech that's going tokeep people healthy for long, you have to go and transfer of the endpayers and maybe the impairs an employer. But you know, they're not reallythe right people to be buying you types of Health Cavalry Service. They reallyshould be buying it from a party. But they pay insurance, coming insurance, going to some care because they used make money on the on the markup. The hospitals don't care because they maye from doing more stuff. Untilwe change the way fundament and you think about payment stuff, we are goingto be kind of be slicing around the edges. Now I'm optimistic that's gonnahappen here or a rhetoric about it. medicares talking about changing the way itdoes plays primary care. You know, it's more and more people in Medicarebondage planers and we could change every pay medical vantage so that it's really rewardingbetter outcomes and there's less risk adjustment around the the risk assessment or cheating andlying around the risk assessment scores. That the change. How there's Medicare ofwonder for I just get paid. However, you know, I'm not intruding optimistic. So changing the next couple of years, but I think we're headingin the right direction. But that's the biggest thing. If you know,if you did can change that. The on, the on. That's thefor the sick people, for the healthy people are paying out a pocket.I think we just need better communication that there are these other things out there. I mean, I'm stunned when I go to a crowd. I've beenin two crowds recently where the audience was pulled about had they ever used totell a health is it, and these were people at a health technology conference, and their word operational, being maybe early adopters. You know, thenumber is about thirty percent of the the ever had one and it's not thegeneral population numbers are a lot better. You're going, why the hell not? It's already covered on your plan.

It's raging quicker than going to aregular doctor. I've done a bunch of them. Yeah, and somehow yetconsumers haven't gone and made the lead to go. I can use these newtools for stuff that I'm going to be paid for anyway. You know,I'm going to be paying being at least my copay and pretty more likely myentire cost up until like my two thousand and off fie. That's not thedoctable right. So you know, I think there's an awareness factor on thesort of easy, cheap stuff. But what I think will help there's thetechnology coming into the home. You know, we out weight the scales. Ihave a blood pressure cuff sitting in front of me that, you know, I bought for thirty bucks at the drug store. And that stuff studyall getting online and they'll be more and more of that stuff in the bathroomand more and more I see at home testing companies being funded. In facttwo of them really well and cool. You check. I come me theother one. Just call you a big rounds the three thousand and fifty millionto that home diagnostic testings. I mean a lot of this stuff is goingto going to come into that pan of ply of what we do, andthere's a lot of that going on. The Apple Watch and what have you. So I think for the for the sort of cheaper end, for theincremental occasional accute stuff, and we're basically healthy, we are going to bedoing more and more at home and people can are more and more aware ofthe type of a lottions available to them. But there is still awareness thing because, you know, the healthcare system is healthcare system and people don't reallythink it changes. So so when I hear you speaking, you know there'sthere's a lot of decisions, a lot of commercialization decisions that are health innovatorhas to make and a lot of these are in a related like. So, for example, as you were talking about, you know, depends onwho is the buyer in who I'm identify is my target market. Is thenhow I'm going to structure my value proposition, it's how I'm going to align mybusiness model. In really, in order for me to have kind ofthis recipe for success, I've got to be able to have some type ofdecisionmaking framework and really way to be able to identify how all of these arein a related how, when you're working with clients, you know, howdo you help them ask the right questions and kind of test and push andplay devil's advocate on some of these assumptions that they're making. Maybe I don'tdo nothing asking the way is that? What can I identify as the piecethat they going after? Right, I've got one plot. I work withinthe's got like AP since your personal health record thing, I'm going that's tooborders to general. You know you don't be able to sell that. Whereyou who do you think? My buy this and we worked it out andwe believe there's a space for them in clinical trial management and people will pullback issues around if they got their data and make it a pull back what'sgoing with their issues in the tical trial. That there is a definite target marketthere. So that's one way to say. How do you narrow downthe focus? You're small. Some of the makes and trashedron again the fightpeople all call off. So you're all like trying to pull the ocean.Yeah, I think not, that I'm deeply involved that you've seen some successof this kind of on the one in the prescribing direct to consumer space.So come with successful companies. I mean, so some of my good x anda WHO's identified that you can present at the time and decision out thecounter in the pharmacy a bunch of options to absolow your cost right and thentell people exactly how that works by spending money on ads. Similarly, allthe people doing now sort of telements and to get very specific drugs, usuallyfor boardness or exild is function or birth control. So new Rx, hymns, Roman, few others in that in that space right penalty health in thebay area, you know very much saying, you know, we're not going totry and do everything for you, but that one specific thing, wecan help you with that one issue and we can take away barriers to goin new your doctrine, being embarrassed by the fact that you have, youknow, edy or whatever the issue is,...

...and take away some of the cost. Now, don't forget they've all had to say, well, we'regoing to direct to consumer for the stuff that's based in cash pay, whenwe're going to have to market it like a very consumer product, which isvery expressive. It means TV ADS and by Google ads and facebook games andreally, you know, make trying to build a brand, which is nota cheap thing. But if they can do that then they can slice offwhat should be very profitable piece of the describing the debscribing market. And youknow, and you probably will end not seeing some of the big players inin the drug story distreet buying all of those guys up, I would think, if they're successful, already coming after them with their own version of it. HMM. So. But I think in all those cases they've taken somerelatively small and gone after it, you know. And then, yeah,try to identify clearly to both their investors and to the buying public or theirpurchases, in this case they consumes. One of these they're doing. Youknow, here's the three things that we thinks for you come see us andI think a lot of the problems of I see you've contact coming, especiallyBEDBTA companies, is that they'll go to a they'll go to a big clientlike a health plan or vite organization, and they can, you know,they have their platform and the clients it's great, can you do this,this, this, and then they will build that up and they built they'vekind of become a quaity technology consulting companies to that client roll. That's somethingthey can just stand and repeat across many customers. But at least they're inthere in the door there and they've got a customer they're getting going. It'shard for them to get out of that, out of that manager. It's alimit what they're pro writing. Right, right. It's a difficult decision setfor a for an only stage company to wrestle with. Yeah, yeah, absolutely. Are you customizing your solution for one customer or you making surethat you have something viable across the board? Right? Yeah, they can bothbe right solutions, but you'll probably if you go too far down onepath, you're probably going to find it difficult put on the other hand.You know, you may, you may, you may launch this platform and makeit available to lots of people, but no one might buy it becausethey were wants to be customized and getting your kind of stock. That right. So yeah, I think you know, when you and I were talking severalweeks ago, we were talking about that example full of someone that Ihave, you know, spoken to that you know, they built a platformthat they thought was going to be across the board for everyone, kind ofa a certain configuration for everyone. They landed a big account. They wereso excited. It had a three year engagement and over those three years thatclient demanded so much from them and so much customization that they didn't have anytime or attention or resources and actually building their company. And then they didn'trenew the contract and they were kind of scrambling going, oh my gosh,we only have a run rate for another three months. What? What?What happened? It's a it's very it's a very tricky business. Or youwant multiple students were carrying revenue and bought yours and yours, any customers,because that makes you look good at front of the best is and it's,it's it can likes it. The ninety five percent for anyway is not ajoke. Yeah, absolutely. So, you know, a lot of ourlisteners are health innovators that are in the trenches. So what advice do youhave for them? We're just some of the lessons that you've learned along theway that you would suggest for our listeners? Well, I'm saying the cold things. Are wanted to be and crwy honest about where you are. Iwas actually a meeting talking about the ethics of leadership last night. Comes onand it was one of US start up saying, you know, I haveto pretend, I have to pretend that I'm doing better than I am,because otherwise, you know, investors will say, well, you're on,you that and you have to stretch the limits of what's acceptable and then youget people who go con put your bill on those bounds and start doing reallyleft and stuff. We see those examples in healthcare enough, and we seein our side of health care right. So I think one of the oneis to be honest about where you are and I think probably about who youare as well. So not every company...

...has to be, you know,the next in certain name here, the next interest ie do their next google. Right. A lot of it is you build a cool product which isgoing to fit fine in a bigger portfernio of somebody else's products. And thereare plenty of players in healthcare by small companies and rebrandom and do stuff withthem. And you know we mentioned apple buying Gamester four, but you knowopten UN I did buys a tanner companies now has done. There are plentyof other tech companies are by the comings and that made a fine way toexit and get some scale. And it may not be you may not bethe next steam jobs or Mark Zuckerberg er, whomever, but that might be afine solution. So I think about where you are and what is yourexit and scaling strategy and it maybe it's not to be solo on your own. So we ask the first one here and and be realistic about that ninetyfive percent number that we the scals. So I mean that's the that's oneof my first and main piece of advice. I mean the second one, ormore practical level, is there are a lot of people. You know, this is sell something for you and me. Roxy let me looking help, right. Who are you know about healthcare and can you know, anddon't be afraid to talk to them, to be afraid to get involved inorganization Asians that are that are going to help sort of the OB ecosystem.And you got a confession. Don't get too wrapped up in your own yourown company, your own internal issues. Try and and get none of yourself, but your team members, such as you have out to sort of surveythe general, the general happen share because, yes, you got to be on, you going to be selling, go to mean whatever we've also don'tunderstand that there is a wider world out there which can help you and alsowe can learn a lot about you can bring back to your company, eventhough it may not be directly about the initial problem you have. It maybe more wider stuff about the whole healthcare ecosystem. So I think, youknow, be realistic about yourself and then look for external advice and feedback and, you know, general, be breathing in the general ecosystem are, asit were, of all the things that that are go on healthcare because oflots to learn. Yeah, absolutely. I mean I think it's so complexand so difficult and a lot of the innovators that I come across that maybehave never done it before, they think that they have all the answers andthey don't meet any outside expertise. It's the ones that have tried to doit before or the ones that have already done it that are like, Oh, this is not happening, like I thought it was going to happen.But at that point, you know, I mean you still welcome them rightwith open arms, but at that point they've burned through a lot of resources, a lot in and so yeah, tapping into someone like you know,myself's like you early and in that process is going to save them a lotof headaches and a lot of money. Yeah, thanks, I'm by theway, I think the other time noticed the all is that there's a lotof there's a lot of gender based traits in that. We ran through theManu went also directions, and it's true I have a lot of all thefemale see as my network. You want to be much more realistic about wherethey are, what they're doing, and interesting it has mentioned become more femalethan that. They're out look here. I think. Yeah, yeah,absolutely, that's that's really interesting. I'll have to marinate on that a bit. I've never caught that, but I bet you're right. You know,and here's the thing, you know, just like anything, when you're askingfor help or get outside expertise, it doesn't mean that you know that youdon't have that you're not smart, that you're not good at what you do. And I force from the joy. Yeah, out is that Roger Federabest par in history tennis as a coach? Yeah, right, feel good,and you just because he has one? Right, right. I mean,how many times have you worked with someone that they've might have spent,you know, six months or more mulling over their investor deck and you lookat it and within fifteen minutes. You're..., that's not clear, that'smissing. It mean, it's just it's when you're in it you can't seewhat you can see when you're on the outside, right. Yeah, well, thank you so much for sharing your wisdom with our audience today. Howcan folks get a hold of you if they want to connect with you further? That's I'm very easy to find im as you said, I'm at multipleon twitter, Massy a massing hold on that is when email and you canfind more about smackhealth. Thinkus only bought it smack, smask don't health onthe way. A bunch of other place you can find me. Google,Google, masthing hold, there's a male model in London. As media comesmountains. Awesome. Well, thank you so much. I appreciate your insightstoday. Ross he's been a real pleasure dooring men, until next time.Thank you. What's the difference between launching and commercializing a healthcare in avation?Many people will launch a new product, few will commercialize it. To learnthe difference between launch and commercialization and to watch past episodes of the show,head to our video show page at Dr Roxycom. Thanks so much for watchingand listening to the show. You can subscribe to the latest episodes on yourfavorite podcast APP like apple podcasts and spotify, or subscribe to the video episodes onour youtube channel. No matter the platform, just search coiq with DrRoxy. Until next time, LET'S RAISE OUR COIQ.

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