Health Innovators
Health Innovators

Episode 102 · 3 months ago

Commercializing Med Devices in a Prehospital Setting w/ John Keane

ABOUT THIS EPISODE

John Keane considers himself a commercial strategy kind of guy - and with 35 product launches under his belt, we’re inclined to agree.

To reach that level of commercialization success, it takes a lot of expertise and an enviable ability to listen to stakeholders at every stage.

But he did it - and when he agreed to come on our show and talk to us about his experiences and insights around the med-tech and healthcare market, we were nothing short of thrilled.

Want to know why ego has no place in commercialization? Or how to avoid being the HIPPO in the room? Or why it’s never a failure if you’re learning something?

Pull up a seat and join us for John’s story!

Here are the show highlights: 

  • Talking to your customers makes the conversation easier (3:07)
  • Beware the HIPPO in the room (4:21)
  • Seek some input from outside the “box” (6:07)
  • It’s not failure, it’s learning (11:40)
  • How to navigate the tangled web of the healthcare market (30:05)
  • Why you need to leave your ego at the door when decision-making (39:58) 

Guest Bio 

John Keane is the Co-Founder, President and CEO of MindRhythm, a med-tech company focused on reducing stroke treatment times in the prehospital setting.

A medical device executive with three decades of experience developing and commercializing emerging medical technologies, John has been involved in more than 30 product launches.

His position in the healthcare community as a strategic leader and advisor to multiple companies helps drive his success in defining visions and positioning companies for dynamic gains.

If you’d like to reach John directly, you can find him on LinkedIn at John Keane, or you can email him at john.keane@mindrhythm.com.

You're listening to health innovators, apodcast and video show about the leaders, influencers and early adopters who are shapingthe future of healthcare. I'm your host, Dr Roxy Movie. Welcome bow healthinnovators. On today's episode I'm sitting down with John Keene, who isthe CO founder, president and CEO of mine, rhythm. Welcome to theshow, John. Thanks, Dr Roxey, have to be here. Thanks forhaving me. Yeah, good to have you. So let's start offby jelling our audience a little bit about your background and what you've been innovatingthese days. Sure, I like to think of myself primarily as a commercialstrategy person. I started out in pharmaceuticals, like many of us in Medtech did, a long time ago, and I found that I gravitated towards thenewer products, new product launches, injectables and you know, once daily's andthose types of things, and then I went from there into Medtech and overthe past thirty years or so I've been involved in about thirty five product launchiousevery at every level, so at the sales rep level, the junior level, management, middle managements to your management. So I've sort of been exposed towhat's needed, what works and what doesn't work. kind of an everyat every and with the still believe that the most important part is the peoplein the field. HMM, okay, this is me more about that.Sorry. So I just with any company, whether it's a medical company or manufacturingcompany or consumer electronics, it doesn't it doesn't matter if somebody's not interactingwith the customer in hearing what they want, what their needs are, what theirwork environment is like, it's really difficult to know what they need andto know what's right for them. And the moment that you get out ofthe field, and which is typically what happens when people go into management,I remember someone saying to me very early on what my managers said, theminute you leave the field you're no longer current. And he I learned fromhim. He was very good about listening to what his salespeople told him,what his clinical people told him, and and so he made better decisions andthen it was something that I adopted the course of my career. That's greatand that is it's so true that the closer we stay to the company,to the customer. I think that, you know, the more successful have, the more will be able to pivot and adapt and continue to deliver valueon an ongoing basis when we stay close to the customer, not just thisone time of launching something into the market. That's so true. And there arethings that you you don't think of, that you wouldn't necessarily think about unlessyou're talking to customer. Just a simple example. You know, we'reworking with my current company. We're doing stroke triage and they don't the MSTprofessionals don't have to any technology availables and they're only doing stroke assessments for patients. And I had someone say to me that the end of a long shiftthey're tired and they don't perform the assessment that with the same rigor at theend of the shift that they do at the beginning of the shift, whichis something I wouldn't have thought of. Yeah, and it's just it cameup in conversation yesterday. So it just made me think something I learned fromtalking to a customer twenty four hours ago. Yeah, and you know, beingable to we talked. We talked about it as different topics but reallyall the same thing of like creating learning organizations where there's this cute continue aslearning this continuous feedback loop that's in place to be able to pick up onthose little nuances that could make a big difference. You're absolutely right, andthe continuous nature of it is a very good point that you make in thatif if someone were to visit an account, they get a snapshot of what's goingon that particular day, at that particular moment in time. And theworld is very dynamic, particularly in healthcare. These things change on a regular basisand it requires just constant interaction.

And you know from people have askedme over the years. You know, how have you come up with yoursales strategies, your marketing strategies? Like well, it's not that hard.You talk to your customers, telling you what they want. They'll tell youwhat they like, tell you what they don't like and having worked with,you know, surgeons for years and years, they're not shy about offering their opinions. So it's a pretty easy place to start. Well, I thinkit's brilliant. It's brilliant to go. You know what, I really cometo the conclusion that I don't have to have the answers. Makes it easier, doesn't it? Like why are all so many people fighting to have theanswers when they could just let that go and ask the customer. You know, it's funny because we're joking about this, but on a serious note, I'venoticed that over the year sitting in and management meetings, mmm to meone of the biggest barriers to coming up with a good product design or agood study designer or whatever is somebody wanting their own voice heard. And Look, we all have of opinions, we all have ideas and we want toshare them. We want to be treated with respect and when people to listen, sure, but it really should start with what is the right thing toto what is the customer want? What is Proper Study Group interactions in ainput from the team, and too often when I see decisions made that aren'tright, it's made by somebody who wanted a decision that was theirs, thatdidn't have enough specific knowledge to been able to make the right decisions just becausethey don't have the information. So it's something I try to avoid. Youknow, we call that. I say we, I didn't make this up, but they the term is hippo, the highest paid a part highest paidperson's opinion. And what is it? I mean don't. I've never heardthat, but boy is that true. There's so many teams, so manycompanies that companies that have a hippo in the room, and I'm and Ialways say like and if you don't know who the hippo is, look inthe mirror, because it might be you. That's so true. You know,especially, as you know, as consultants, as visors, as CEOSand Co founders, you know lot, very often people won't contest our pointof view and just kind of acquiesce to whatever it is our vision, ourstrategies and tactics are, and so you know that's never going to be asuccessful bath. That's a good point. I try to and it's hard sometimesbecause when people report to you, they feel that chain of command and thatthere. It's not okay, and I'll I'll tell people it's okay to tellme you disagree with me, just I mean, you could be nice aboutit, to tell me I'm dog. Yeah, but you know, ifyou have enough, if you have another idea, if you got an ideathat's better than what's there, you're improving the situation, you're making the companybetter. In making the product that are you're helping patients. So that shouldbe expressed and I do think that in many companies there's a culture where peoplefeel afraid to share their opinions because it's their livelihood, that dont want tolose their job. So, but that's it's counterproductition. Yeah, I reallylike what you're saying, is that you know we can have this expertise internally, but you know we're going to maybe be more successful when we are seekinginput from outside of the company, outside of the four walls, on aregular basis. Yeah, it's it's such an important thing to do and I'veworked with companies where they don't seek input. They design a medical product without seekinginput from medical people, which just seems to me as fundamentally not smart. And so I can recall a conversation and requirements discussion. For those inthe call it don't know what this is. When you're designing a device, ithas requirements that have to be in it, and one of the thingsthat we had for this particular monitor that's going to be used in an operatingroom was that the cord would have to withstand five hundred pounds weight being rolledover it, and the team was like, how oft it is five hundred poundsof way can to get rolled over this chord and I'm like in anoperating room in a hospital. I don't...

...at least once a day, andthey couldn't believe it, you know. But you know, you have tobe again, you have to be in the environment to know. Yeah,yeah, absolutely, that type of shadowing to is even different than, youknow, just asking people what they think about something. We have some conversationshere on the show about the difference between, you know, seeking input from customersand really gathering these new insights about, well, what are they trying toaccomplish, versus asking them, well, what do you want, because theycan't like you know, we often use the steve jobs example. Ifyou to ask customers what do they want, not very many people would have said, well, you know what I want, I want to ipod,I want a thousand songs in my pocket. We're thinking that revolutionary, but thereare still ways to be able to facilitate that conversation with the customers,to be able to figure out what they're trying to accomplish, what job arethey trying to do, and still be able to come up with revolutionary waysto be able to address that. That's very well said and I don't thinkthought about it in that fashion before we had a call today. Internally we'rewe're making a product design decision and essentially one of the components of it wasshould this be disposable a reusable? And my experience with disposables and reusables ismost customers say they want reusables but they don't like them when they get them. And so you have it available and then nobody ends up using and andthey throw them out. They get upset at they're spending more money. AndSee, phrasing the conversation, how you put it, what are you tryingto accomplish versus? What do you want? If you say what do you wantor going to say we want to use reusable do you really in anambulance at two o'clock in the morning a newer when it's raining? And Ithink so. And that's that's probably a better way to have the conversation whereyou can guide them down the pathway of what you're trying to do, gettingthat input, but making sure that the input is is qualified in some manner. Yeah, yeah, you know, it's usually to your point is thatthere's a big difference when we're asking someone would you, would you buy?Would you like this, you know, is this something that you would use? And then in okay, like how much would you pay for it?And Oh, no, I won't pay for it. Right, I woulduse it, but I don't want to buy it. I'm not going togive you my money for it. Interesting thing with respect money found in fundraising. All of our investors thought that we didn't have a product price high enough. All of our customers that we had our prices product price too high.So I notice that the people who think that the pricing on things is toolower the people who stand to make money off of a higher price. Thepeople think it's too higher the ones up to pay for it. So funnyhow that goes and and that, to me, is a great use casefor this type of qualitative market research that we are doing with customers to beable to create a business case. So you know, if you're talking withinvestors and you're saying, well, we disagree, or you know, thisis the price where we think it should be, in your kind of comingup with a different scenario to kind of back up that decision, that's verydifferent than actually, if you've got like interviews, videos of customers saying whatthey will pay. Right that's going to be so much more powerful feedback thatpeople can't contest. It's a lot more difficult to robut both for ourselves aswhether those advisors or investors are having that conversation, like when you're hearing directlyfrom the customers. Now it's really easy to adjust pricing in the board room. You just change it on a spreadsheet. You see your margins gool up,you see her revenue school like this is the direction we should be going. If they don't buy it, your revenues in zero, and so it. Yeah, totally so. Yeah. I had this, you know,experience personally where I was pricing something really...

...high and not selling it very oftenand then changed it to where I actually went much lower than what I hadwanted and was kind of so, instead of going high and going no sales, no sales, no sales, need to drop it, no sales,going low and going sales, but they said yes, too quick. Okay, now I'm going to increase it a little bit. Okay, so I'mstill getting sales, but they still said yes, too quick, and thenall of a sudden you get to that point where you're like no, theythey're taking a little bit longer time and you kind of figure out where yoursweet spot is on pricing, but you're still building sales along the way,as opposed to going so high it's like, okay, no sales for months becauseI'm too high. Well, that's, you know, that's market research withouta nets. Right, right, exactly. But that's also you know, that willingness to adapt is a really, really important skill in really in life, but in business in particular. Your willingness to say, okay,Oh, I'm not selling anything in the price is probably too high and thenlet's just take do a radical reset. Oh maybe the price is too low, and then eventually found where you needed to be. Yep, for thethrough the willingness to change, and your point about the hippo another characteristic.There's, you know, our ignorance brings us to a mistake and our arrogancekeeps us in that mistake. That's good. Not My original line. It's beenapplied to be quite a bit, but it's just for our viewers andlisteners to chime into. It is the type of thing where, I think, because how we're brought up in our education system. It's we reward beingcorrect and we punish being incorrect. When you're doing something new, you're notincorrect, you're learning. And so if you do something and it's not workingout right and you adapt and you have a little bit of success, that'sa that's an evolutionary pathway and to me I view that is a very positivedevelopment. So I don't ever feel like, Oh, cheezs we did something andit was wrong and now we got to fix it. I feel like, okay, we learned what not to do, now we'll try something newand and I think the entrance parent about that. It can be so powerfulbecause it really demonstrates that there is no ego and that you are really opento learning and that you are adaptive. And so often I see innovators,especially startups, you know, one to present themselves to investors or potential customersas they've got it all figured out. You know, they kind of mappedpoint a to point B with three steps in between, and they've just beenplugging their way and without being really candid about what's going on and in reallythinking that that's actually going to lead to more success. But it's not true. It's not reality. And so if we were more vulnerable and more transparentabout those learning opportunities, I think we'd have more trust and more credibility andend up being more on a path of success instead of trying to fake likeeverything's just been perfect. I completely agree with that. In the beginning itcould be very difficult because the answer to virtually everything is, I don't knowright. Right. It's so because it's you know, it's you start outwith an idea on a cocktail mapped in, and it's you need to prove anumber of things. But I do think this is this was my firstforay into fund raising and you know product launches, design, what needs tohappen the FDA and all of the strategy and all that. I've done thatfor a long time, but fundraising was very new and you like it,you want to just keep doing it. Well, now that it's done,I like it. A couple months ago and maybe not so much, buttoday's a good day. I started out not liking it and I ended upliking it quite a bit, and I not liking it for the obvious reasons. Right. I moved to I moved into the uncomfortable. I moved intoan area where I didn't have expertise and...

I said things and, you know, got schooled quite a bit because I didn't know certain terminology. I hadto learn them. So that's that's uncomfortable. I also didn't like it because Ilove strategy. I love but you know, coming up with the commercialstrategy and the design. It's what I've done for so long. It's fun. Yeah, and you know, I was told in knowing certain terms bymy colleagues. You know, your jobs to keep the gas in the gastank and you really are going to spend a lot of your time raising money. And of course, during Covid it was more challenging and at first Iwas like I's taken me away for something I really like doing and I hadto get used to trusting the people around me take on some of those things. And so there was like an inflection point where I sort of developed acertain level of knowledge and skills with the fund raising and got used to handingoff some of these things to other really qualified people that have worked with overthe years and I've seen them growing their careers and now it's like, Oh, I've got good people that can do this. It doesn't have to bebig, good, I can sleep tonight. It's you know, it's ended upworking out quite a bit and now that the rays is over I getto go back to some of that stuff. But or yeah, it's really theprimary role and just, you know, how do we get comfortable with it? Is just do it right and do what you're doing it. Yeah, wait, yeah, the first time you run a fifty yards or throwa football or pick up the guitar, you're not going to be good atit. So let's play the drums. or you see the drums behind me? So, but I can't remember picking up a drumstick because I was soyoung the first time I did that. All drummers show like this. Yaskany drummer. We why did you start playing the drums? I don't know. I just thought it's going to play the drums. Every drummer as apicture of themselves with with wooden spoons hitting the pots and pans and okay,mom my dad's kitchen. So make well. It's just more than just doing itfor a long, long time. HMM. But drums you never getgood. So tell us a little bit more about mine. Rhythm and whatyou're innovating there and kind of where you are in this innovation or commercial process. So mind rhythm is a company. Right now we're focused specifically on stroketriosh and I'll cover a little bit about that, because there isn't even inthe medical world, even in neuro there's not really a lot of knowledge withrespect what goes on prehospital. So there you can basically have three types ofstrokes. You can have a hemorrhagic stroke, which is bleed. Nothing they rightnow. There's nothing they can really do for that other than lower yourblood pressure and evacuate in certain situations. If you're having in a schemic stroke, that's a that's a clock and it's if you have a part attack,you're having a clock heart. That clock goes to your brain. If yougoes to a small blood vessel, you have a small vessel inclusion stroke.If you have a large vessel seclusion stroke, it's a big clock in a bigvessel. For small vessels, they treat them with a drug. Withlarge vessels, there's only three hundred places in the country that can treat thatand you have to go to one of those hospitals in order to have themgo in and take the clot out of your head. Yep, and it'ssuch a it's such an important technology that it's a difference between getting treated inwalking out of the hospital two days later or being potentially in a nursing homefor thirty years permanently disabled, like not move it half your body. Soit's a it's really a binary situation. And so right now in the USthere's no way to tell what type of strokes somebody's having. So they're goingto the hospital, they scan them, they determine the stroke and then theytransfer them. So takes hours to get treat and then it causes permanent disability. So we've developed a device that can identify that for the paramedics in ninetyseconds in a Amulans, so they can say large vessel pluition stroke, theyneed to go those. I'm in Boston, so they need to go to massgeneral, bringing women's Beth Israel, one of those hospitals. In SanFrancisco you'd go to UCSF. And the more rural you get in your communities, the longer the transport times, and in outside the US it's significantly worse. It could be four or five hours...

...in Ireland to a hospital can treatyou by then you know you're dead. Yeah, so that's what that's whatwe're aiming to solve. We are the device works. We have to publishpapers, but we're most companies would take those papers and get FDA clearance.Now, YEP, we chose not to do that. This is based myown experience. I find that nobody will use medical technology, new medical technology, unless you prove beyond a shadow of doubt that it works, and thenyou have to prove it's better than what they have. In our case,they don't have anythings. Also, so we what happens is comple pause therefor a second. In your case, what they don't have an option.So we're feeling something that doesn't exist right now. Yeah, so if it'sa brain tumor and you have a new way of removing brain tumors, whilethey have open resection, they have radiation therapy, they have laser treatments,chemo, all different things you can use. With us, nothing exists. Sothat part of the pathway is actually easier for us, because the paramedicswant what we have. But in general there's resistance to using new things.It's very difficult, as you know, to get new medical technology adopted AAY. So, in as in a startup situation without this proof, we're doingan ambulance based trial right now to show that it works in the environment whereit will be used. We're doing it in Metro Detroit through way in state. And short of that, I don't believe we will have the support tochange state policies because most of these practices of where to take patients are determinedby state protocol. They're not going to change state protocols without evidence based medicine. Yep. So that's what we're doing. A typical scenario and network for companiesthat have done this. They try to get the product to move foras little money as possible, which means no FDA trial or limited trial getout. Then they hire sales force, which is very expensive, and thenthey go across the country. They don't sell anything and then you can overthe head and say why aren't you selling? So we're not. I think thereason I'm so sensitive to that is I was in that role so often. I was the VP of sales, which is, you know, it'sthe bulls eye position. You get blamed for everybody else's mistakes. It's soI just I was like, we're not going to do that, and it'shelpful because I work with people who are very experienced, so they've seen thesame thing. And then one of my colleagues is a neurologist, so he'sfocused on stroke as a position. He doesn't want to put something onto themarket that isn't fully bettered in the environment just because it's his reputation. Sowe're all in alignment on that. And so we are pre FDA. Wejust submitted our FDA presub about an hour ago. I don't suppress people.Yeah, so, like we, we spend a lot of time on itbecause they're we didn't even understand the prehospital situation. And defining the problem isvery important, because we don't define the problem correctly, the solution isn't goingto be viewed as valuable as it actually is. I mean, there's aliterally a lifesaving, in life altering product, and so we don't define that.You know, that's on us. Hey, it's Dr Roxy here witha quick break from the conversation. Are you trying to figure out what movesyou need to make to survive and thrive in new covid economy? I wantevery health innovator to find their most viable and profitable pivot strategy, which iswhy I created the covid proof your business pivot kit. The pivot kit isa step by step framework that helps you find your best pivot strategy. Itwalks you through six categories you need to examine for a three hundred and sixtydegree view of your business. I call them the six critical pivot lenses.As you make your way through this comprehensive kit, you'll be armed with thetools, tips and strategies you need to make sure you can pivot with speedwithout missing out on critical details and opportunities. Learn more at legacy and DNACOM backslashkit. So one of the things...

...that I see often, and I'mnot saying that this is the case with you, I just kind of wantto explore this, is that I'll see innovators come up with solutions to problemsthat their target audience doesn't know exists or is not looking to solve. Andthat doesn't necessarily mean that that's a dead end business or a dead in innovation. It just means that there is a very different strategy to commercialize something likethat when you're in a very mature problem market or the how do we saythat? The the problem is very mature. Right the market all is very familiarwith the problem. They just trying to choose between a and the newthing or versus. When there's IT's a very immature problem. Market like wedon't even there's a population that doesn't even know they have this problem. Soas you think through that, you know kind of tell us what you've encounteredor how what's the strategy for being able to educate the market about this particularproblem and kind of elevating it as a priority for them to seek to solveit. So what you just asked a question that I'm going to answer thisin a different way than you phrase the question because you're the first person who'sever brought this topic up and it's such an important topic to me. Itell everybody the single biggest thing that you can have with the new medical technologyis to have a technology that has a known problem and they don't have asolution for that. They actually want Yep, and you almost never have those thingsright you you either have something that they have a they have another solutionfor, and now you're what was the old thing? Who moved my cheese? You know, you're changing. You're changing what they have to be exactly. They don't. They don't want it. They have something new, they haveto learn something. They don't think it's problem. You know, Iwork with transfusions, which is a huge problem. Nobody thought it was aproblem. Yep, and I've actually tried to convey this to our investors becausewe actually have this situation. We have a product that's a huge problem.The situation's huge problem is really well known and everybody wants it, and soI probably should be careful, since you're according this, because my investors willread this or they'll they'll watch this the we like, John, you're notselling much. You said that everybody wanted this, but in I've never experiencedthis with anything I've worked with before. I've had people tried to buy thisfrom us in prototype for and I'm like, I don't look good owner of it. Can we just do it right? And I'm not saying this to likepush this, you know on the podcast I'm saying this is literally Iwas shocked when I encountered this. I was expecting. You know, Ihave this joke. A friend of mine sent me a picture of the world'sfirst anisthesia machine which is in the medical museum in Paris and it was myclinical person. She sent me a picture and she said look, the world'sfirst Anisthesian machine, and I said in ten minutes later the world's first antithesiologist said, what do I need a machine for? That's the resistance tonew technology. So I was my expectation, as always, to have that resistance. In our case. We don't have that. We have the exactopposite. We've got a problem that we benefit everybody because the places that aredoing these surgeries, you know, the hospital makes a lot of money,the patients benefit, the patients that can't the hospitals that can't treat they don'twant those patients coming to their hospital right and the amulance crews don't like droppingoff people at the wrong hospital where they know that they're not going to getgood care. So everybody benefits. where I think we're going to have ourchallenges is actually a unique situation for us, which is at the state level.HMM, because these are all policy driven practices. State of Massachusetts,where I live, they they designated that all strokes go to the closest strokecenter. There are two types of stroke centers, primary stroke centers, comprehensivestroke centers. Only the comprehensives can treat these big, big strokes. Somost patients end up going to a primary stroke center. They get scanned,if they have a small stroke, they...

...get treated there. If they're havinga large stroke, they get transferred. In Massachusetts, they the community hospitalsgot upset when they designated primary stroke centers. Is the places that all stroke patientswould go to. So the response by the state was to designate everyhospital as a primary stroke center. So it's not a good response. It'sso the we're work it. We're doing a pilot project with one of theMS companies to change state practice. That's where I think we're going to runinto our challenge and that is unique. I've never work with anything as before. What about being the term that you use as prehospital? So that's somethingthat I don't come across very often as well. Is is is that consideredkind of a prevention solution, you know, in are there any things that weneed to be a that you need to be aware of or we needto be aware of when we're thinking about prehospital solutions? So it's a goodquestion and I've spent my entire career working in the hospital and Free Hospital isthe term that they use. The hospital people use as the care that takesplace before the patient gets to the hospital. You'll hear like in cardiac arrest,that's a neurological injury, but the the the lifesaving behavior, takes placebefore they get to the hospital. So they'll always say we need to affectprehospital care. So that's a commonly used term in the EMS world. Okay, so to your point, there there isn't a lot that goes on prehospitalbecause there isn't a lot of technology that the paramedics and emts, they livein the special world by themselves, right. So they they have defibrillators, they'vegot EKG, they have entitled Celt and I pull sex SVENTRY. Thatis their entire technological armamentarium. Yeah, everything else is a one call,unknown situation. Assess this in a chaotic environment is not an easy job.Yeah, so you can see why they have embraced technology like ours, becausethey're like okay, they go, we have something, you know, andso they there isn't a lot of technology. Since there's not a lot of technologythere are a lot of companies making things and there aren't a lot ofin therefore, the there's not a lot of fdiregulatory stuff. There's not reimbursementassociated with it. It's it's all its own world. And then the emsworld is also very different because you have public companies, private companies, hospitalo companies and then fire departments, and they all did all in then midflightand they're all taking care of the same patient group but in a different way. So it's it's I've never worked with it before, but I was fortunateenough I worked for Resolt for a while. I'm soul was. There's also amajor manufacturer of defibrillator so a big portion of their sales for spends timestrictly any UMASS infect some of the people on the soul team have helped mewith me, helped our company, but with specific introductions and with gaining anunderstanding of what's really essentially a very different environment than the hospital in Romor.Sure, yeah, I can see that. And we might actually be a hybridbecause we might actually be purchased by the hospital then given to the amulancecompanies. There's a business model for that. There are specific medicare rules pertaining toit. You know, you kit, it's not a kick back. Youcan't give it to him in exchange for patients, but it's true.Yeah, so you know, you got to be careful of doing something likethat in there. So there are guidelines associated with it. But it makessense. The hospitals making the money off the patient. The ambulance company isit's costing them money to buy this technology to rout them to the correct hospital. They're willing to do it, but the real financial beneficiary is the hospitalin the insurance company. Yes, just another example the complexities of commercializing andin a nation and healthcare, with all...

...these multisided markets and the tangled webwe weave. One of the guys who's on our board is a longtime friendof mine actually through music, Kyle York, and he he specializes in tech.He sold his company to Oracle a few years back and he's running atech fun and he's always like your world is so difficult. Your product actuallyhas to work before you get it onto the market, and not just work, but work better than anything else. That's our market exactly. He's like. He's like, you know, with with software, you can just makesomething, put it up and then work on it while it's out there.And it's just healthcurse. Health is challenging, but it's it's rewarding, it's worthit, it's a nice place to be. So so you've got apretty interesting lineup of investors, sorry, not investors, advisors that are partof your advisory team or Advisory Council. Some pretty big hitters. They justkind of share with our audience. You know how that came about? Imean most people are trying to figure out how do they get the best advisorsthat put them in the right position, whether it's going to be introductions,funding, strategic guidance, whatever that's going to, you know, be.But how did you get access to these folks? And, you know,is that making a difference for you and your company? So I would saythe unique situation that I had, MMM is probably was really instrumental for mebeing able to complete the race as a first time doing this with not alot of contacts. So some of this won't really be transferable because it's kindof luck. My colleague, way a Dr Smith, is that he's avery wellknown neurologist at a very it's the UCSF is the top rank, thetop neurology department in the United States and he's a director at the department.He was instrumental in the original thrown back to me trials, the ones thatthe technology for treating these large strokes. So he's very well known and he'sin San Francisco. So he so he's helped a lot of people. He'staken tore of family members who are grateful, and there's he does a lot ofresearch. So he is a number of contacts. My other colleague,Paul is, he's been an entrepreneur for a number of years. So hehas his level of contacts of people that we could talk to. And thenI had my own, you know, much pewer contact, but I hadmy own group of people that I that were in my network. And sowhat I found is, I mean that's a really eat that's a really goodhead start to have if you if you're if you've never done fund racing andit's like Oh, John, you know, let me introduce you to the inventorof robotic surgery and sure, okay, I'll talk to him and you know, let me, let me introduce you to the inventor of view too, but it's a lot easier to talk to those people when you get personalintroductions to the so a lot of it was that, and so that's justlucky. I just kind of lucky because I had known Dr Smith from myprevious companies and we have a good relationship. So, you know, the careerdoes feed into it, but that accesses I wouldn't have had on myown. The pause for there for a second because you said kind of lucky, but you know, kind of I had this prior relationship that led tothese other things. I think what's important, like a good takeaway for our audiencehere, is that, you know, those relationships that were cultivating early inour career are usually like lifetime customers or life time there's a lifetime ofvalue associated with that relationship. So it's not going to be just that onecompany that we worked with them and then kind of we moved on. AndI mean they'll be those people that they will be the other people where youdeliver incredible value and you really cultivate a strong relationship and those people will beeither your customers in the future for your next five or ten businesses, orthey'll be part of your network that can...

...do it that's leading you to futurecustomers, and so I think, you know, that's one of the threadsthat I think that I pick up on that maybe most innovators don't even articulate, is that as you're moving through your career, you know, those formidablerelationships just continue to pay off because you're delivering value. You doin the rightthing, even maybe when it's not always the best financial thing, but you'redoing the right thing and delivering value and they just become incredible for our careers. It's very well said. I think I hesitated there when I said itwas it was lucky, and I my hesitation was exactly what you referring to, because right I would you know I wanted to acknowledge the fact that itwasn't. I am grateful to be in this environment where I was able tobe introduced to those people, but at the same time, I think forfor all of us where we're at in life, a lot of times canbe attributed to what we've done previously, and so it's not just the thingsthat worked out that contribute. The things that don't work out also learned too, and so you know, and so I went from various VPS of salesroles. So I have a whole network of people that I know when Ineed a sales team I'll have a good group of people. Yeah, Ihave the strategy and everything else, but I also had roles where I wasspeaking to investors before I was doing this. So each one of these things preparesus for our next role. Yeah, and I think to your point,if if you engage with people and in genuine and authentic way treat peoplewith respect, you do cultivate relationships over the years and eventually the combination ofdifferent skills and hard work and things that worked and things that didn't work canlead to something that these last few years of my life have been. They'vetaken a lot of commitment on my part because when you start a company ornot taking a salary of any type, and you know, we had nomoney and my previous company went out of business and there was a lot ofturmoil and I involved in the drum company as well, and so I hada lot of cash outflows and a lot of risk that I was taking on. Yeah, and you know, nobody sees that part of it right.They say seem like about it either, but act like that doesn't exist.So it was just like a strategically made this decision and everything was great.I had this big payout of my last GIG. That's, you know,funded me for now. But you know, I mean just fake it until youbecome it and without being real about what what this life is really like. Absolutely. I said to my cousin, who's a good friend and he's aninvestor in the company. He's a actually lawyer for a MEDTECH firm.When we're not talking about music and cars, we talked about talk about Medtech andhe said, you know, I don't. It takes a lot ofcourage to doing to do what you're doing and, you know, not takinga salary, starting a company from scratch, not knowing where it's going to go. And I said, you know, I've reached a I've always wanted todo this and I've wanted to have a team in place of people witha similar philosophy and a similar life you that I have. I will eitherall get along really well or we'll be at each other stroll. It's butwe'll find out. And but I've always wanted to do it. If Idon't take this chance at this point in my life, you know, withwhat I'm able to do, then I just I don't I think I'm notliving courageously. And so I'm saying that because for the last few years,I'm on a personal I will have been like, is it really so smartto live so gurrageously? Right, things are starting to come together now.Write. The companies starting to have some success and we're moving forward and likeI wake up in the morning and I have to be awake for a fewminutes to be like, oh no, no, there's no major crisis ofdealing with today. Things are things are going well, it's smooth, andwhich is not to say they won't be, you know, after you coming ontomorrow or something else, but it...

...takes a lot of effort and ittakes a lot of belief in yourself. I mean, I'm describing my rolein particular, but the people in my team, it's the same thing.They're taking a chance. They could be at you know, I have peoplewho are working that could be at these they've come from large mettech companies withbig salaries and yeah, for when keys and security and everything else, andthey're taking a chance on this. And that's our team, or the teamof people who believe in what they're doing, who want to contribute, make adifference on this planet and do well. And you know, sure we wantto grow the company and make lots of money or sell the company andprofit from now. Sure we all want to do that, but I thinkthe primary motivation for everybody is getting up in the morning and doing something thatthey think is worthwhile and working in an environment where we all we admire eachother and we work together as a team and we have fun. Yeah,definitely everybody's taken a risk right in looking out for the reward on the backend of that. So, as we kind of just start to wrap uphere, John, I want to give you just another opportunity to say,okay, if you kind of like think back to your experience with mine,rhythm and and maybe this most recent, you know, seed endeavor, ormaybe it's even going further back and some other commercialization experiences and product launches thatyou've had. Are there any other lessons learned that we haven't touched on thatyou just want to make sure that you share with our audience, who's alsosin the trenches doing different things at different stages. But any other wisdom yetyou want to share with them. So I think the lesson I story Itell all the time is I learned. I didn't know it. I learnedvirtually most of everything I learned about business I learned growing up because my dadowned his own business. So my whole life was kind of an involuntary NBA. Course he would ask me questions. I've learned. You know, Ican. I can recall one. I'm sitting at Massachusetts General Parking Lot inmy hockey equipment. You know, he stopped there on the way to agame and he's got this customer situation's running it by me. He's like now, how would you handle us? I'm like wait, how old are you? I was ten, ten years old. I've no idea. So he wouldgrill these things into me and so, I mean, it's it's just Iit's just a vivid memory, but my whole life was like that.And the thing he always said to me, which I think is we've covered partof this, but the first part of it was he said reserve yourjudgment. You should get all of the information you can possibly get before youmake a decision. Get get input from everybody that you work with, allof the different stakeholders, your customers, competitors, wherever you can get it, get information and and be neutral about it. Don't bring your own egoand emotion into your decision making. In question everything. Then when you makea decision, make it and if it doesn't work, adapt. Yeah,and I think if you apply that philosophy pretty much to anything, it's goingto work. By the way, he wasn't so open to when I saidquestioned him. Right, right, right, he's like a player question business things. He was, he's he's great with that. What did he doin his career? He actually he owned a medical company, but it wasn'tmettech like we think of it. He owned medical record company and so hishis business model was different because he was dealing with the people in medical records, in the hospital information chain, and he actually one of the things thathe did that I thought should have taken off that never did, Yep,was he tried to partner with all the electronic medical record companies when we weremoving over to the electronic medical record. He said physicians don't like looking atcomputer screens, they like holding these charts and if you design this without usingthe way these charts are, yeah,...

...you're going to design and nobody wouldbite on it. And look what we have now. We have things wegot to click back for things to find something and then they weren't designed withthe end user. Yeah, so we're all electronic at this point, but, and I thought it was a bit eavy about it, it's not anefficient workflow necessarily. Yeah. So, so I was always in hospitals,you know, I was always go with him to hospitals, but it youknow, the medical side of it. He was never into the medicine.He came up through the paper industry, right, right, the business partof it. Yeah, exactly. Yeah, okay, okay. So how tofolks get Ahold of you? If anybody wants to learn more about minerhythm or just connect with you after the show? Well, there's always theeasy ways, right Linkedin, and just check with me on Linkedin. I'mpretty open to whoever connect with me. There's contact at mind rhythm, whichwill eventually get to me, or you could just email me at mind rather. It's just John Dot keen at mind rhythmcom and and reach out. I'mI tend to be pretty responsive. My background and sales is just you know, I just say to people in the dumbest person in the room, butI'll return your phone call, and so I do get pulled in a lotof different directions. So if it takes me a bit to get back sometimes, I apologize. Bear with me. I tried to try to be responsive. If if I don't you and your picking me a second time, I'mnot going to be offended. So isn't that the world we live in today? Please don't anyone take it personal. You need to reach out at leastthree times exactly. Be Fair. Well, thank you so much. It wassuch a great conversation, so much wisdom that you shared with our audiencetoday. I know that they will find it very valuable. Oh thanks.There was a lot of fun. I appreciate you inviting me on it.Had A good time and hopefully people get something out of it. Thank youso much for listening. I know you're busy working to bring your life changinginnovation to market and I value your time and attention. To get the latestepisodes on your mobile device, automatically subscribe to the show on your favorite podcastAPP like apple podcast, spotify and stitcher. Thank you for listening and I appreciateeveryone who shared the show with friends and colleagues, see you on thenext episode of Health Innovators.

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