Health Innovators
Health Innovators

Episode · 3 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 its kind video program about health innovators, earlier doctors and influencers, and their stories about 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 with me. He is the founder of the healthcare blog, cofounder of Health to point conferences, and you might know him even more by his twitter handle at Bolti boy. Welcome to the show, Matthew Ross. She's real pleasure to be here. Great jet to know you a little bit. I'm looking forward to Jayant. Yeah, I'm looking forward to having a very candid conversation with you about writing the roller coaster of healthcare innovation. Today, as an up face, was a downface. Will See. Yeah, let's shoot it straight today. So, you know, there's a lot of people out there that already 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 about your background and what you do. Well, so what I do now mostly is I'm I don't know what to say. I say I do health technology and early stage innovation stuff, because what I ask you do that. Dionms are based in that Milia. Way Back when I was a sup poor indisgruduate student hang out a stand for trying to figure out what to do in my life and I ended up stumbling into the politics and policy of Japanese and American healthcare, if you believe that. I ended up in a big funding project looking at those two things and I was thinking like a health policy health business guy 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 the UM at US half of the Lubum Japan, the panoff. Funny Enough, I've been back in Joban the last few years, but there was a long period ride in touch Japan for the reason okay, and I ended up getting my first insulting job out of Stanford. was in a place called the Institute for 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 the venture 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 about healthcare and they got some a bunch of health plans that would have project about technology, and no one was no one did it, and I watched the door and they went hey, you, you're doing this project. So I spend the s learning about healthcare, you about healthcare and learning my technology goes two together, and a project about that. And what eventually happened was that that was the same time as the web was taking off and the Internet was taking off and you know, everyone's joining the dotcom e health crazy and even I, 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 then the next decade, which was of the early teen thousands, some a bit of time on the beach postcom. But after that I did a lot of consulting 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 healthcare blog, because that was, you know, the teching news he started the blog back thanks pay three, right when there was instant pundit, daily coast and about ten other blogs. And actually probably what made that the career was was that in two thousand and four or five, the wall Schreol Journal wrote an article about, you know, the top blogs by industry, and the healthcare blog was the healthcarectersties, you know blog record, the one that for it was like a year and a half old or whatever that stage and maybe at twenty seven readers of a day. Anyway, that helped it take off because it was have got a bit of no variety. The other thing that was going on at the time so that the blog and still goes on the healthcare board. Please go there. Do It is it's all about healthcare business, healthcare policy, healthcare tech. Has a lot of video me and others and great articles. Needs in my inn...

...back absolutely at that time I was also kind of following up on that stuff. I looked about, looked at in the nineties like the the little companies that were still doing healthcare and technology on the Internet, and there weren't many of them around because the whole thing had imploded with the dogcom bust. But there were enough. It's just getting interesting. And then Google went public and its put more money around and buy two thousand and seven around somebody called two thousand and six and in the somebody from 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 enough to stuff to be interesting. When she was doing a bit of a searching trip as well and I said, you know, one of the a bunch of these people I've been talking to have this little company, said why don't you do a conference? I went, well, that'd be fine, I don't nothing about do the conference, and she went, yeah, you should do a conference. So we did it and that became health to point O and by, you know, the mid teens, we had a couple of thousand 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 we are compences in Europe. We had spin off one in South America and Japan and you know, we had a lot of activity go on. Eventually that conference business started the world others consulting and technology innovation work. And then two thousand and seventy is just two years ago, hymns purchased a conference side of it in you and I still run the bit called catalyst which does the which does kind of challenge competition management in technology. Right now we're running something the Rod with Johnson Foundation and you rous who want to have an application in the social determinus of health or in community at home based care should be entering that competition. That has prize money free to winters and just one of the many things we're doing them at the moment. There and then I also created a business school, smack health, which basically does early stage start up advisory up early to mid stage startup advisory, helping CEOS figure out, you know, how they should be resenting themselves to the outside world, helping throughout their business models, 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 me sensible and figure out who you joking about, bag a cap, all that kind of stuff. Much of different things. You know and still write and talk and a peal of stuff like this. So, yeah, but about me, my fresh life. Awesome. So, you know, as you just 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 two things, right. So there is the up and the down, and we're still in a an upfhase. But I think people are looking at the right top of this and going what happens now? So one is that it's connecting to to tech business as a whole, which, of course, is being a massive search up a cential. I mean there was a bit of a hiccup. You know, the other ten thousands and there was a bit of a hiccup, you know, ao nine and funding. But in general, the the transformation society by the people who sell us, you know, these que devices and by the people you are on the box that comes, you know, on to your front porch and the the the the ad that comes in 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 health technology is kind of attached yourself to that, especially the funding part. So there wasn'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 other thousands, by the late two thousands of starting to happen and starting that got interrupted by the depression of nine and then since two thousand and ten we've really had an uninterrupted amount of funding going to you know, what are your call it. Some of them are digital health. So we've got to postage your health like call a smack health doesn't doesn't matter what you call it. And the sector of technology that have health technology...

...that is sort of on the cloud and is aimed actor in users like consumers and colitions, right. And that has gone from some of the number suggesting one to two billion in the two thousand and ten, thousand and eleven and then estimates range between eight billion and fifteen billion in funding last year. That's still going going along. So one area, you know, it's all of our coasters, is the funding cycle and how much there is available. And we're seeing just a day pen dress goes public, last week Google going publicly we see all of interesting modern still lost making businesses going public on the stock market. There's a lot of money around 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 I think this is really interesting because you've got kind of too approaches. One is we're going to sell tools to the health system incumbents to make them more efficient and more effective, and most health technology companies view that as the way forward and 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 in the incumbents with the whole of the made me do better. There was a small slice out there, but some of the very highly funded the people saying this is not like, you know, selling barns and noble or borders a better online experience for their bookstore. This is about putting those guys out of business. We want to be Amazon and that there are al ways to a place to current incumbents by figuring out better ways to deliver a health planer or better ways to create a primary care group or have you and you and that Sectu 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 effective over the last two decades and more expensive and put its prices up. And if you look at the satisfaction with it to end consumers, patients, speed rough 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 solution that you know, the could have been, which is why, on the one hand, you've got a lot of grumpy people to on the right and the left talking about free market stuff and on the least you have the Medicare for all campaign. So I think it's really interesting to see if it's there's an opportunity to kind of really replace the way we do healthcare now or whether we're just going to sort of keep down the path of growing the U selfcare system, 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're a futurist and you know you kind of observe these patterns and trends right and you 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 hold for 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 to say in Europe in a conference health to go know him to Europe and next month 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 based systems and they've got actually things like doctor booking mechanisms and ai tools to help support the front end of reaching, reaching of consumers, reaching doctors actually growing quite fast over then. We well funded over there in Europe and to some extent that's been going for entrepreneur that's been going quite fast. Here we seemed quite 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 care and 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 different center 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 younger people like you, Roxie, who are less attached to an individual doctor or system. And I'm looking for more convenience and which is why you seem to go for the Virgin Care and the sort of demographic change there around the age of fifty roughly. So that's I think. One thing is, what can you do off to sell doct to a consumer, and there's a lot of opportunities 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 first few thousand dollars out a pocket system. Yep. The problem or the issue or the the underlying start things as system for the system is that that's all one and great. Most people use the system like that. Most people have modest health issues. Most people have you know this, kids get sick or whatever. They want to. They want to see urgent care, they want to see health. You can see a bunch of stuff around that, but most of the money and must have problems attached to a few, number of few people were sick. Right, yeah, those people that want us to who the current system makes all its money off and gives a pretty bad experience to. Because what we do in the current systems we do a lot of procedures 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 you know, one of the interneting is is to look at how can can what is the right unit for which to approach a better system for managing those those correctly your people and essentially stopping them going into the merchants room, stopping them going to the hospital, stopping them having come unnecessary doctors. It's but monitoring manner and managing them while they're in their home or while they are where they as 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 going that you can can impact them, and you're saying some very interesting companies to trying to you know, put sensors in the home persons is on people and building system where they can track and manage a monitor them and then start figuring out what they can do to intervene with services like nurses calling in or doctors going to the house or what have you. And I think that the key entrepursed to throughout. What's the unit where they're selling to in that? Are they 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 direct to consumers? We know they sent to employers a lot of sort of questions about where. Who is the answer? Who? Who is responsible for those pensions? Are they selling debasions to? They selling a service to people my age 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 if you're going direct to con some something's cheap and easy, or if you something something complex but it's going to reduce healthcare costs and improves the care of people with Modivele chronic illnesses? What's the right unit your where do you how do you 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 they do it means, you know, yeah, yeah, you proved that this thing actually works. There's a lot of controversy about that as well, by the way. Everything so you know the law. People say you that some of 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 of move fast and break things and get in there and start running the programs without really proving that out. So controversy about that as well. Yep, absolutely the efficacy of those things. So have you come across any pretty unique business models that you think maybe either become a challenge for that innovator or become a opportunity for them? Well, are a lot of challenges because the main people who hold the money now have are either...

...large and somewhere sclerotic insurance companies who don't really want it. There are some experimentation or there, but don't really want to jump in and do something great new and have very established relationship with provider organizations or are provider organizations who are thinking about getting this new world of taking risk and doing value based care, but in general make all their money doing seem the service and, you know, want to make sure their beds are filled. So I've I mean, I'll give you one example. I have a company I work with that which has an interesting produbt program for reducing readmissions Post Hospital. This charge. So as you know now, hospitals get don't get paid if they're really made a patient off the thirty day, within thirty days, and there's a lot of Congress about that. What you're saying is that a lot of argue about whether that's effective or and a lot of readmissions on day thirty one thirty two. So this company is struggling to find people, you know, because they believe they can rease remissions, probably by doing stuff and that. So they're kind of struggling to prove that out because they you know, the biggest because they can't find the people who are still go for the system. And then not only is the issue of well, how do I prove something out that, you know, just going to stop the remission on day thirty one with also gets paid again, but also they're having the really basics where they'll sell this to the sort of finance person or the 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 a bunch and nurses calling on the phone and change their workflow and that's really hard and 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 kind of implementation phase or even before the implementation phase, right the sign off from from those people on the front lines. And you know there's this is thing that's such in Jane a care or he says there's like a delivery layer innovation layer, and these two things don't talk very well, and that's a big problem because you have millions of millions people that delivery layer, a bunch of US running on this innovation layer and there are people, as organizations that are innovation groups and are funding groups trying to cross that bridge, but rolling out 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 are brought to market fail to reach any adequate level of cup, customer acceptance or profitability. 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, why do 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 back in my career, before he got to the US, I spend time as time as the future strader and used to joke that it's good to be good and it's good to be lucky. Is Better to be lucky than good. Right, so lucky, right, are you in the right place at right time? 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 stuff that was done ten years ago and that didn't succeed because it's time. It was wrong. They can give the right people there. A lot of it is 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 that was coming online now that wasn't online five years ago, even though there's the result would pretty much with the same. So one of these, like luck and timing, m you can do something to kind of figure out if you are at the right time as the right luck and if the regulations or the payment stream is going the right way. The second is is, I hate says, relationships. The right relationship driven business and it takes a while to make those and you know, sometimes you can go around those relationships. You can do the Ouver, the taxis or the Amazon to the boards and bounce and noble, but a lot of it, if you're having to go with the you you have to figure out the right relationship with those organizations and those can be very tricky because there's a very...

...insuluent standaris organization has been around for a hundreds of years. So everyone reason some case. And then I think the the the typical one, which I think is true. It is kind of ignorant of the healthcare system. People take people of this your coming from the 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 reasons why you don't you don't get it right, and I think allied to all of that is all for the say of this is that you need a lot more time and money. You think you do. is by nature problem when you're on only stay start up because you don't have much time and much money in your investors could be putting money in instagram or whatever. The thing is 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? I think invest is getting wiser a lot and you know it's it's not. It's those pressures on startups in those stage. Venture backs, whatever she's, are always going to be around. Yeah, you know, I have a lot of conversations around. You know, folks that think that just because they've identified a problem and they have a product that they think is superior to anything else in the market, that it's going to be the shoe in, that it's going to automatically equal success. And you know, to some degree there's a lot of Zombie graveyards out there with these these innovative products just kind of sitting in there. Some were eating to be resurrected and some will never come back out to play. Absolutely and look how I look at the world of so o Apple Health records, for example, which is based on a company which started the health supernocle glimpse. worshiped them, still out to launched the the health to pre conference. Yeah, and that's super cool. I was in a 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 the whole bunch of people and you re sure we'd have and that's a I'm sure that software sitting in box somewhere. I could be restaurant where it is bought. That was timing, but it was money. Probably was lack of always different things, but again it's it was you know, they're underline stand as work. There bunch of of reasons why it didn't work, but really was the market wasn't ready for it and you know, a big player like apple in the side, they have time to take it into forcing. The market was 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 what do you think the biggest pit falls are to commercialize in an innovation? IS IT product market fit? Is it problems solution fit? Is it being able to 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 two more 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 then you'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 I run 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 you do. Yep, and therefore you end up getting bucketed as being something like you're you're like this beer a bit different than whatever, and I don't get it. 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's in the medication sort of Management for consumer..., doesn't dozens of medication coop reminder APPs out there and we're it's really not easy trying to figure out how is it that you are different, better? What's the thing that you've got the day and getting over that hurdle with the first conversation of the first common conversations with investors, clients, customers, employe whoever, it is right and two minutes. Yeah, even doing fifteen, this is super hard and getting the shop to make that makes sense is hard. And, by the way, you may not be different to Theo's other seventeen. To figure out what do you have to go where and build it is different, or rap and find something that will all maybe your choices. You go and sell one of those seventeen or one of their customers and be a plug into something they're not doing or whatever. Right, right it. But yeah, you're right, we've got 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, was it? Some of these changing rights in the FTA, Scott Goalie, who recently resigned as commissioner, really got behind. But Cooper tell and his work in the FTA. So creating a sort of framework work for for allowing digital health technologies to be approved along the they come for the right process rather than every time it's like changing the device happens or the tech happens, to have to put it back through the FDA approval process. So that, I think, is a good help. Is Very funny to see when Scott Calling left round. There's a far right libertarian, all these liberals, I know on twitter a crying tears of the saddest dual saunders, because they've already done such a 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's that's a help. But I think the biggest thing is how we think about paying the healthcare. And really, if you look at it, we are in a world where still hostage spite all the talk about value care, value, you know, value based care. Hospitals and doctors get paid for doing stuff. Yeah, don't get paid for the outcome of maintaining health, and so this means that you have to do work around. You have to go to as you have an innovation that's the service or a tech that's going to keep people healthy for long, you have to go and transfer of the end payers and maybe the impairs an employer. But you know, they're not really the right people to be buying you types of Health Cavalry Service. They really should 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 mark up. The hospitals don't care because they maye from doing more stuff. Until we change the way fundament and you think about payment stuff, we are going to be kind of be slicing around the edges. Now I'm optimistic that's gonna happen here or a rhetoric about it. medicares talking about changing the way it does plays primary care. You know, it's more and more people in Medicare bondage planers and we could change every pay medical vantage so that it's really rewarding better outcomes and there's less risk adjustment around the the risk assessment or cheating and lying around the risk assessment scores. That the change. How there's Medicare of wonder 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 heading in the right direction. But that's the biggest thing. If you know, if you did can change that. The on, the on. That's the for 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 been in two crowds recently where the audience was pulled about had they ever used to tell a health is it, and these were people at a health technology conference, and their word operational, being maybe early adopters. You know, the number is about thirty percent of the the ever had one and it's not the general 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 a regular doctor. I've done a bunch of them. Yeah, and somehow yet consumers haven't gone and made the lead to go. I can use these new tools 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 my entire cost up until like my two thousand and off fie. That's not the doctable right. So you know, I think there's an awareness factor on the sort of easy, cheap stuff. But what I think will help there's the technology coming into the home. You know, we out weight the scales. I have a blood pressure cuff sitting in front of me that, you know, I bought for thirty bucks at the drug store. And that stuff study all getting online and they'll be more and more of that stuff in the bathroom and more and more I see at home testing companies being funded. In fact two of them really well and cool. You check. I come me the other one. Just call you a big rounds the three thousand and fifty million to that home diagnostic testings. I mean a lot of this stuff is going to going to come into that pan of ply of what we do, and there'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 the incremental occasional accute stuff, and we're basically healthy, we are going to be doing more and more at home and people can are more and more aware of the 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 really think it changes. So so when I hear you speaking, you know there's there's a lot of decisions, a lot of commercialization decisions that are health innovator has to make and a lot of these are in a related like. So, for example, as you were talking about, you know, depends on who is the buyer in who I'm identify is my target market. Is then how I'm going to structure my value proposition, it's how I'm going to align my business model. In really, in order for me to have kind of this recipe for success, I've got to be able to have some type of decisionmaking framework and really way to be able to identify how all of these are in a related how, when you're working with clients, you know, how do you help them ask the right questions and kind of test and push and play devil's advocate on some of these assumptions that they're making. Maybe I don't do nothing asking the way is that? What can I identify as the piece that they going after? Right, I've got one plot. I work within the's got like AP since your personal health record thing, I'm going that's too borders to general. You know you don't be able to sell that. Where you who do you think? My buy this and we worked it out and we believe there's a space for them in clinical trial management and people will pull back issues around if they got their data and make it a pull back what's going with their issues in the tical trial. That there is a definite target market there. So that's one way to say. How do you narrow down the focus? You're small. Some of the makes and trashedron again the fight people 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 success of 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 and a WHO's identified that you can present at the time and decision out the counter in the pharmacy a bunch of options to absolow your cost right and then tell people exactly how that works by spending money on ads. Similarly, all the people doing now sort of telements and to get very specific drugs, usually for boardness or exild is function or birth control. So new Rx, hymns, Roman, few others in that in that space right penalty health in the bay area, you know very much saying, you know, we're not going to try and do everything for you, but that one specific thing, we can help you with that one issue and we can take away barriers to go in new your doctrine, being embarrassed by the fact that you have, you know, 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're going to direct to consumer for the stuff that's based in cash pay, when we're going to have to market it like a very consumer product, which is very expressive. It means TV ADS and by Google ads and facebook games and really, you know, make trying to build a brand, which is not a cheap thing. But if they can do that then they can slice off what should be very profitable piece of the describing the debscribing market. And you know, and you probably will end not seeing some of the big players in in 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 some relatively small and gone after it, you know. And then, yeah, try to identify clearly to both their investors and to the buying public or their purchases, in this case they consumes. One of these they're doing. You know, here's the three things that we thinks for you come see us and I think a lot of the problems of I see you've contact coming, especially BEDBTA companies, is that they'll go to a they'll go to a big client like 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've kind of become a quaity technology consulting companies to that client roll. That's something they can just stand and repeat across many customers. But at least they're in there in the door there and they've got a customer they're getting going. It's hard for them to get out of that, out of that manager. It's a limit what they're pro writing. Right, right. It's a difficult decision set for a for an only stage company to wrestle with. Yeah, yeah, absolutely. Are you customizing your solution for one customer or you making sure that you have something viable across the board? Right? Yeah, they can both be right solutions, but you'll probably if you go too far down one path, 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 make it available to lots of people, but no one might buy it because they 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 several weeks ago, we were talking about that example full of someone that I have, you know, spoken to that you know, they built a platform that they thought was going to be across the board for everyone, kind of a a certain configuration for everyone. They landed a big account. They were so excited. It had a three year engagement and over those three years that client demanded so much from them and so much customization that they didn't have any time or attention or resources and actually building their company. And then they didn't renew 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 you want 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 a joke. Yeah, absolutely. So, you know, a lot of our listeners are health innovators that are in the trenches. So what advice do you have for them? We're just some of the lessons that you've learned along the way 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. I was actually a meeting talking about the ethics of leadership last night. Comes on and it was one of US start up saying, you know, I have to 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 you get people who go con put your bill on those bounds and start doing really left and stuff. We see those examples in healthcare enough, and we see in our side of health care right. So I think one of the one is to be honest about where you are and I think probably about who you are 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 is going to fit fine in a bigger portfernio of somebody else's products. And there are plenty of players in healthcare by small companies and rebrandom and do stuff with them. And you know we mentioned apple buying Gamester four, but you know opten UN I did buys a tanner companies now has done. There are plenty of other tech companies are by the comings and that made a fine way to exit and get some scale. And it may not be you may not be the next steam jobs or Mark Zuckerberg er, whomever, but that might be a fine solution. So I think about where you are and what is your exit 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 ninety five percent number that we the scals. So I mean that's the that's one of my first and main piece of advice. I mean the second one, or more 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, and don't be afraid to talk to them, to be afraid to get involved in organization 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 your own company, your own internal issues. Try and and get none of yourself, but your team members, such as you have out to sort of survey the 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't understand that there is a wider world out there which can help you and also we can learn a lot about you can bring back to your company, even though it may not be directly about the initial problem you have. It may be more wider stuff about the whole healthcare ecosystem. So I think, you know, be realistic about yourself and then look for external advice and feedback and, you know, general, be breathing in the general ecosystem are, as it were, of all the things that that are go on healthcare because of lots to learn. Yeah, absolutely. I mean I think it's so complex and so difficult and a lot of the innovators that I come across that maybe have never done it before, they think that they have all the answers and they don't meet any outside expertise. It's the ones that have tried to do it 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 right with 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 lot of headaches and a lot of money. Yeah, thanks, I'm by the way, I think the other time noticed the all is that there's a lot of there's a lot of gender based traits in that. We ran through the Manu went also directions, and it's true I have a lot of all the female see as my network. You want to be much more realistic about where they are, what they're doing, and interesting it has mentioned become more female than 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 asking for help or get outside expertise, it doesn't mean that you know that you don'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 Federa best 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 look at it and within fifteen minutes. You're..., that's not clear, that's missing. It mean, it's just it's when you're in it you can't see what you can see when you're on the outside, right. Yeah, well, thank you so much for sharing your wisdom with our audience today. How can 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 multiple on twitter, Massy a massing hold on that is when email and you can find more about smackhealth. Thinkus only bought it smack, smask don't health on the way. A bunch of other place you can find me. Google, Google, masthing hold, there's a male model in London. As media comes mountains. Awesome. Well, thank you so much. I appreciate your insights today. 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 learn the 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 watching and listening to the show. You can subscribe to the latest episodes on your favorite podcast APP like apple podcasts and spotify, or subscribe to the video episodes on our youtube channel. No matter the platform, just search coiq with Dr Roxy. Until next time, LET'S RAISE OUR COIQ.

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