Health Innovators
Health Innovators

Episode 109 · 2 weeks ago

Don’t boil the ocean: How to launch with success w/ Patrick Tarnowski

ABOUT THIS EPISODE

Over the years, we’ve had leaders, consultants, advisors - just about every manner of representation in the healthcare leadership ecosystem - but never one that had them all covered!

And then there was Patrick Tarnowski, founder of PTx2 Healthcare Consulting - a healthcare ecosystem veteran with over 30 years exposure to healthcare and innovation.

With more than half our listeners and viewers trying to sell to a provider market, hospital system, or a health plan, there’s been many challenges we’ve faced and opportunities missed.

Patrick sits down with us this week to share his insights and experiences in bringing successful healthcare solutions to market - from every side of the coin, and without trying to boil the ocean.

It doesn’t matter who your target market is for this one, because there’s something for everyone.

Here are the show highlights: 

  • This is how to successfully navigate long sales cycles (8:10)
  • Understanding your solution is as important as understanding your technology (15:13)
  • Is it a sale or is it a discovery? (20:55)
  • Why you shouldn’t try to boil the ocean (27:30)
  • Seek market understanding over product validation (30:06)
  • Don’t bypass the healthcare ecosystem hooplah! (38:03) 

Guest Bio 

Patrick is the founder of PTx2 Healthcare Consulting – a firm that specializes in helping small/early-stage companies understand and successfully navigate the healthcare ecosystem.

Over 30 years in healthcare leadership roles has culminated in a passion for helping innovators and founders navigate the complexities of the healthcare ecosystem.

Pat has successfully launched and scaled care delivery companies, digital solutions that included health and wellbeing, disease management and virtual care and worked with providers to achieve success in value-based payment models.

If you’d like more information about PTx2 Healthcare Consulting, you can contact Pat directly on LinkedIn at Patrick Tarnowski.

You're listening to health innovators, apodcast and video show about the leaders, influencers and earlier doctors who are shapingthe future of healthcare. I'm your host, Dr Roxy Movie. Welcome back tothe show health innovators. On today's episode I'm sitting down with Patrick Tanowski, who is the founder of ptx to healthcare consulting. Welcome to the show, Pat. Thanks, Dr Roxy's pleasure to be here. I'm looking forwardto this conversation. I'm so glad to have you here. You bring avery unique experience to this conversation. You know, we have healthcare leaders thathave been on the show and we have advisors and consultants, but not,I think, no one that as well versed in the healthcare leadership ecosystem thatis now become a consultant and so then to be able to bridge those insights. I think it is just going to make for a very powerful conversation today. Yeah, I think so as well. I've been so fortunate to be ableto really live and work for thirty years and every part of the healthcare ECO system, like you mentioned. So I'm looking forward a conversation.So let's go there. Tell her audience a little bit about your background andexperience and then you know what you're working on these days. Yeah, fantastic. So, yeah, I started off in the provider space. I'm aphysical therapist and really love what we're doing with our patients. Did that forabout ten years and did a lot of teaching, both continuing at and academicappointments at a few universities. Absolutely loved it, but just got a bitpooped with the day to day patient care and really realize that I still wantto stay involved and found a bit of a pension for the business of ourbusiness. So I took a bit of a left turn at that time andin the healthcare care and in an MBA and spent moved into medical devices andspent seven years there working with a one of the largest medical device companies atthat time. Then it was pretty exclusive to Orthopedic Surgery and rehabilitation and youngercompany. We were private. We were taken a republic, were taking privateby a large private equity firm. So I got as my first exposure intowhat private equity looks like. You know the good, the bad and theugly with it, but mostly mostly good. And you know in that experience gotto touch an awful lot of parts of the organization, whether it wasfrom quality to sales, to marketing, to product development and research, workingwith our national accounts payers, doing advocacy work in in in Washington DC andat a state level and absolutely loved it. Couldn't been a better learning lab forthe time. And doing an MBA as well, right, you know. But I was traveling a bunch of my kids were young and it justdidn't make sense to see on the road. So I was fortunate enough to bea CO founder of of a occupational medicine practice here in the twin citiesand we had great success. We scaled quickly and exited from there and andcan was invited to join the one of the largest health systems here in Minnesotato lead. This is really the early days of the development of clinical servicelines. So the Diet leadership model with physicians and we was fortunate enough tobe able to work with an incredible team of leaders, physicians administrators that werereally dedicated to this concept of how do we create an exceptional experience that isconsistent, that is affordable, evidence based across multiple providers and multiple geographies,and we had really, really good success with that. So it was justan amazing opportunity early stages of centers of excellence on. Yeah, yeah,conceptually like that. And then how do we how do we take what's what's, you know, at the core of a center of excellence and scale atinto multiple geographies and some of the really, I think, kind of unique challengesto that. There's certainly the administrative side that says, let's we canget system advantages and, you know, some of the the economies of scale. But but what became really interesting and informed enough a lot of the workI'm doing today, was branching into the more rural communities and understanding the uniqueand important position that rural providers and rural hospitals have in their communities. Youknow, unlike what we see in some of the more urban environments in wherethere may be multiple systems, multiple hospitals, when you get into a more ruralcommunity, that hospital and that Nick and that small nursing home are reallythe fabric of that community. And so we realize that we could bring outa you know, here's sort of the package for clinical consistency and such ana clinical service line. But I didn't always fit, you know, maybeeighty percent of that would fit, but twenty percent we need to respect that, which makes you know that that clinect that hospital unique to that community,and that was a great learning and great opportunity. So after, after that, I spent a few years with a with a venture group created a spendingup one of their portfolio companies dedicated to Musculo skeletal care, which is certainlycertainly a very hot segment and expensive segment,...

...and then multiple years with another healthplan where I was fortunate enough to lead a digital health portfolio. Allof the products that we we would choose to bring in that we would thenbring to our self insured and sometimes a fully insured and sometimes the government markets, and it was just an amazing time at the explosion of all of thisdigital care, to be on the buy or side of that and understand thethings that are really important not only to the to the health plan, butalso to the to the employer partners that we have and ultimately to our members. What years of that that would have been started about two thousand and seventeenup until about a year ago. Yeah, and so really is, I said, the explosion of the digital health and then layering on a pandemic wherewe're not only did to than the number of technologies coming to market increase,but so to did the adoption and and so from the health plan we therewas really some unique opportunities and unique challenges there as well. You know,how do we how do we vet these for safety and security? How arethey going to fit into a provider provider community? How will they fly withour members? How and how, now that our most of the employers areremote? You know, there's both opportunity and challenges there. So all youknow, all of those things were very formative and left there about a yearago and began getting calls from founders saying what you've been in these different theholy ecosystem. Most recently union, as I mentioned, you were buy ora health plan and we would love to work into a health plan. Wewould love to work with employers. Can you help us understand how they howthis works, how they think? And what I have so enjoyed is workingwith founders, whether they're they're early in their career or, you know,this is their second or third founding, who who see the opportunity for disruptionin healthcare and the opportunity for improving care delivery, but they just might notunderstand the the sort of underbelly of how healthcare works or doesn't works, withthe complexities of it. So being able to help advise, informed, guideand do an awful lot of customer discovery has just been a has been sucha pleasure. That is remarkable. So is there anything that you haven't doneand how many yers that you had in one lifetime? Yeah, let's sayall of them. Yeah, and you're not just nationally based, you're doingsome work globally as well. Correct. Yeah, I have been fortunate enoughto work with clients from the Middle East, from the UK, from Canada,who have in unique needs, exceptionally smart people, great technologies, whoare what I have appreciated about all of them is they're willing to say Idon't quite understand the the US market and I'm not so enamored with my technologythat I'm forgetting about the workflow with providers or the the experience of the ofthe end user, the member. Where are those probable those people? Yeah, we have to remember them. So I've really appreciated, appreciated working withfolks who are open to those kinds of conversations and realize that they did.They they don't know when. They need some help understanding it, sure.Yeah. So then let's go back to the the the Lens of you beingon the other side. You know, it's really not that long ago thatyou were on the buyer side and at least I think half of our audiencehere is is trying to sell into a provider market or a hospital system ora health plan. So what are some of the challenges or opportunity these thatyou would want to share with the community today? Yeah, that's that's suchan important question. The opportunities are great in that we when we just whenwe look at the spend and health care, it continues to go up. Youknow, we have we have pockets of whether it's disease management or experiences, pockets in the in the and different geographies where there's been good success.But in aggregate we still see that there's great opportunity to change the way careis delibered, to reduce cost and improve quality. So so while there's greatopportunity and a lot of lives that we just we simply can't touch today.I mentioned the rural health markets. Before we look at just whether it's sociallyor economically disadvantaged communities who we're just not serving. Well. There's amazing opportunitythere. The I think the pandemic, and I've heard so many times otherexperts on this, on your on your show, talk about how the pandemicsort of pulled back the curtain and said boy, there's opportunity here for it, for digital care. So we see all of these these, I think, avenues for growth and avenue for accessing...

...and bringing more care, different care, virtual care, to two different lives. Some of the challenges, though,that I think I have, I've been able to share with with manyof the the clients that I'm working with, and you know these founders. IsOne. Let's just understand it's a long sales cycle and and I thinkfolks here that. But we'd say, I know I can save money,I've done my pilot work and I've got I've got a few clinical studies toshow that it has an impact. And while someone comes into the to apayer with that data, we'd say, well, that that's great, butwe need to validate that with our own data. So that's those things down. We need to understand. How does it fit, because I, asI mentioned, I had a full portfolio of products and bringing something new intothat. I need to understand how, how would it complement or potentially collidewith something that I currently have? And for me, if there's, ifthere's a opportunity for it to be additive, I still need to be thinking,you know, the sales cyclist. So long. I need to bethinking for the next two and a half years, you know. So bythe time I've made my decision, I'm selling for probably two years ahead.So those are some of the things that I think have been interesting for thesefounders. When you say selling two years ahead, you're not talking about asthe founder, you're talking about as the buyer. So as the buyer,you made the decision that you're going guy and and it's still going to takeyou two and a half years, two to two and a half years,to sell. So do you mean like selling the other leaders within the company, the other department? No, yeah, that's important, important distinction. Soyes, there's, as with any as with any enterprise, sale,it's how do we align and create find the resources internally and get those levelsof approval. But when we look at, if so much of the market thatwere bringing these solutions to is the self insured employee. You know,it's say, because the health fans in that case are acting essentially as areseller, even though there may be provider contracts or however. We're does.However, the reimbursement is working my so we're right. We're recording this inNovember. So all of all of two thousand and twenty one is sold.It's in the CAN, it's in the books and for many of the thelarge employers, the National Accounts Jumbos, whatever terminology we want to use,those decisions are typically made in February or March, right for then for thenext calendar year, and that means I, as a buyer, need to havehad contracting done and filings into state plans by probably August of the previousyear, which means I probably started this URFP and and review and negotiations eventhe year before that. So that's some of the complexity and I think whenwe start talking about that with founders would say, you know, I've gotI've got my seed money, I I've maybe you know I've raised some dollarsand we say white it's going to it's going to take you a couple ofyears to probably get a first client. Now there are some some health fansthat will say, Yep, I need it, I wanted you're you're fillinga huge need and let's go fast. But for the majority it's a slowerprocess and I think some of the founders are thinking, I didn't know that. So I need to better understand that and maybe there are some other avenuesthat we can take along the way to show show adoption. That would makethe investors happy. And I think just even the term fast is really relative. It's very sec very subjective right right there. Their perception of fast,I need this fast, I need this now, is very different, Ithink probably you know, than a lot of these startup inventors and entrepreneurs.Yeah, so, so what? So some of the challenge is the fundingright. So is it a different conversation with those investors? Is it adifferent type of pitch debt to set the expectations of the amount of resources thatare really needed to, you know, be able to build a company aroundthis? I knew idea it because you're going to need resources for so long. How how were they getting investors to support that? Oh, Yep,you're not going to have cash flow for three years. Yeah, I II believe what I'm seeing. What I advise is just that let's let's bevery upfront with the investors. Yeah, and I know for and I'm notthat's not an area of great expertise for me. So there may be someothers that would that will counter this and say no, here's here's the betterpath. But I've always been a believer in saying in just being very,very transparent with whomever is investing that we've got an idea, we've validated it, it, we're working through these processes. If our channel is with an employer, I'm sorry, with a health plan and then ultimately to the employer, it's going to take us time to get there. So I think beingupfront with that seem it seems to me,...

...you know, just always deferred tothe let's let's be realistic and honest about it. So yeah, youknow, otherwise I think we have investors coming back to founders and just beingvery upset and, you know, dissatisfied and that leads to more tension withinthe organization and perhaps we know those organizations are making poor decisions as a result. Yeah, and great ideas in the Zombie graveyard, not because it wasterrible technology. Yeah, yeah, so, so, you know, as youare working with innovators who are figuring out their business model, is therea particular payer, and I don't mean it like a managed care organization,but is there a particular payer where you're saying that if you can figure outa business model for this target market, you're going to be better suited thentrying to sell into this because you know you've just saved yourself eighteen months ofsales cycle here. You know. Is there any learnings around that that mightbe useful for the community? Yeah, I think there are, and there'sthere's probably a few different ways to look at that. Yes, understanding theunique needs of a payer, because once you've, once you've sort of madein roads or made connections, are unders and one payer, you have understoodone payer. Everybody has their unique needs, and so understanding what their drivers are, what are they're key initiatives? How are you fitting into DEI initiativesor whatever, you know, whatever those those are, and what needs dothey have? So that that's one piece of it. The other piece thatI think has to happen before that is for these founders to really understand theirproduct and what, not only from a tech perspective and care delivery perspective,but what problem are you solving? Because what, in sorte of my mantrahas always been I'll take the call if someone wants to talk to me,you know, when I was either the buyer or today. I'll always talkwith him and let's just see and being very honest and hey, this makessense, or you're not ready yet because of this. Yeah, and oftentimeswhat I what I discovered, was that they weren't ready because they didn't quiteunderstand the problem. They hadn't done the homework, they hadn't done the discoverywork to talk to to the potential buyers, the customers, and not even selltheir product. Don't go into sell, go into say I have a hypothesis. Help me understand if I got it right or wrong. Tell meabout your day to day. In fact, it was just doing that this morningwith a with a client. It's got a really, really, reallyimpressive idea around senior preventive care. Fascinating eating and and if, if theycould, I believe that they can, find the right clients or the rightbuyer, they will have great success in reducing hospitalizations. But the yesterday wewere we were talking with a with a buyer and administrator in a certain segmentwho said, I'm not sure you're going to like what I'm going to tellyou. And you know we say in Minnesota, sort of Minnesota Nice thing, right, and we said no, you know, feel free to tellus that the the baby is not the best looking one here. Tell usso we can avoid mistakes. And then today we spoke with a with aphysician in a different part of the country who said, I think I thinkpeople like me would be all over this, we would love this. So it'sthat sort of thing. But we what we're learning in this discovery isnot just walking in with a I can fix at all. But here's Iunderstand you. I understand you, understand your problem, I understand where Ican fit and I understand the the the real challenges that that you have.So that's I think, I think that's an important piece to be more successfulin targeting the the health plans is coming in with a really focused and youunderstand not only your business model or finances, your technology, but you understand thesolution. And what's what solution? I'm sorry, what problem? Thatsolution is solving. Yeah, and obviously that's very critical really, no matterwhat market segment. Funny to yeah, that's not a new concept, butit's, I think, to me how how we tend to forget that toooften. Yeah, I think there ends up being a lot of ego anda lot of biases that are woven in to the fabric of this initiative thatbecome really just difficult, just a lot of emotional investment in the idea,in the technology, in the pathway. That gets really difficult to kind ofunravel in yeah, and I also find that founders really want to move fastand and so there's this perception and and the reality that customer discoveries, youknow, slows things down. Yeah, and it could, but it doesn'thave to. You can do a very...

...rapid customer discovery and the process thatthat that I use is really based on. I was was fortunate enough a fewyears ago to be part of the National Science Foundation in their eyecorp programand I know many of the folks on that listen to your show have referencedthat. And you know, the old adage there is get out of thebuilding, go talk to people, and it is it is so much funto talk with folks from all over the country and we're not, you knowthe we'd say, we're not here to sell anything, we're just here topick your brain. Yeah, talk about talk about you, talk about youryour your environment, talk about what keeps you up at night and and youknow, if you are on the other side of this conversation, what doyou think would be really important for us to know? Yeah, so,so that can move really quickly versus some of the more it's a more traditional, expensive twelvemonth let's go explore a market. I think you can do those thingsvery quickly and and with a with a get meaningful information from relatively smallsamples. Eye. Hey, it's Dr Roxy here with a quick break fromthe conversation. Are you trying to figure out what moves you need to maketo survive and thrive in the new covid economy? I want every health innovatorto find their most viable and profitable pivot strategy, which is why I createdthe covid proof your business pivot kit. The pivot kit is a step bystep framework that helps you find your best pivot strategy. It walks you throughsix categories you need to examine for a three hundred and sixty degree view ofyour business. I call them the six critical pivot lenses. As you makeyour way through this comprehensive kit, you'll be armed with the tools, tipsand strategies you need to make sure you can pivot with speed without missing outon critical details and opportunities. Learn more at Legacy Dacom backslash kit. Solet's let's talk about that. I want to dig in the weeds a littlebit because I think that such a valuable conversation. So we let's say we'veconvinced folks that you need to do customer discovery. So some of the theroadblocks that I have witnessed and have heard about is recruiting, you know,depending on who they're trying to get to sit down and give them twenty minutesof their time. A lot of times it's more of these svps or thesea suite that they're selling to maybe, or physician providers that are going tobe the users in this, and so getting access or recruiting them for thoseoneonone conversations or, you know, those facetoface encounters is is really a challenge. So what are some of your recommendations for being able to overcome some ofthat. Well, I would I would challenge the assumption that the that theright the right level of discovery is the sea. Sweet okay, Yep,because let's let's let's envision that we're found while we are founders. But let'svisue we've got a product today and and we it will solve this particular problemin healthcare. If we go to the sea suite that that population has,you know, eight thousand things on their plate right now that they're they're thinkingabout, worrying about, future state, current state, all of those allof those areas that are inherent to that position. Are they going to bethe users of the product? Will they be able to really help you solveand understand the the the daytoday ecosystem? And oftentimes not. I mean they'rejust they just might not be connected to that frontline work that needs to bedone. So going, yeah, going to that level. To me thatalmost feels more like a sale then it does a discovery. So if wecan get to a to a front frontline in this part of the discovery is, you know what, who is the buyer? We start with, wethink it's we think it's this and another adage from the from the Natural ScienceFoundation is, you know, buildings don't buy, boat don't buy products.Right, people who goes don't either. Right, yeah, right. It'snice to put a logo on your site, you know, your website, andsay that there are a customer, but the logo isn't buying, it'sa it's a it's a person. So who is that person? What istheir title? And then understand what's important to to them. If you figurethat out, often times in part of that discovery they will say, Ohyeah, if you're on and someone says they are, you know, theireyes light up and say I'm buying today. Good. Who Do I need totalk to now? Right, well, let me walk this down the hallto so and so. So, you know, I think that,you know, just challenge the assumption that we need to start it to seesweet or with the key opinion leaders, because they get the pitches all thetime and and I'm not sure that you're the founders would necessarily learn what theyneed to at that level. Yeah, yeah, I think that's a reallyvalid point. The other one that I...

...hear a lot about is compensation.So Am I, you know, expecting folks to be able to have theseconversations were free to do. What kind of budget do I need to haveallocated for this sample size? How many people do I need to have theseconversations with until I get some kind of statistical, significant learnings that I cankind of make informed of decisions on? Yeah, sample size. Generally,the more of the better, right, because if you talk with ten people, you're probably going to get, unless you are so totally dialed in,you're going to get eight different responses which at that point you may have justfigured out the the discovery process, you might have figured out, oh,we're asking their own question. So more is better, but not everybody canafford more. In in my experience in this discovery process we're asking people forfifteen minutes. This isn't a sit down, give me two hours. So itand and I think we're in as we become a much more virtual society. It's okay in back and you know, pre pandemic, pre virtual, ideallywas great to sit down facetoface with you, and so there's travel expensesand all of those sorts of things. But now we can do it here. We can do it when someone sitting in their car. It's good tohave some to have a face, facetoface, at least virtually, because then wecan we can watch your pupils. Let's say, wow, you're onto something, or we see the nonverbals that give you the I don't knowwhere you're going with this, but we can say just that. Yeah,I see that this, you know, this doesn't seem to resonate. SoI think from from a budget perspective it's more about it's the time to doit, but to find fifteen minutes with folks. I've just found people tobe very, very willing to talk for fifteen minutes. Yeah, and youcan learn a lot in fifteen minutes of somebody if you're if you're targeted inin the questions, and you know it's not rambling, rambling, just bevery respectful of their time. Yeah, I completely agree. I think thatit's worth it. It's the their entire business is really reliant upon the foundationright, the these decisions that are being made based upon so many different assumptions, and so if it takes you an extra tenzero dollars, if it takesyou an extra sixty days to actually have some validated assumptions or validated hypotheses thatthen you're building all of your other resources around. I mean that's just ano brainer. Yeah, that seems like it's the ounce of prevention, youknow, concept and and it was just even this morning I was talking withwith a founder and his cofounder. Potential, potential, we could do some worktogether. But we spoke three weeks ago, just an intro call,and as they were explaining what they were trying to do, they could seemy nonverbals because I did give them the you know, the eyebrow one upright. I started to sit back from the screen and and we at itagain today and they said, here's what we've learned, because I've given arejust a couple of suggestions, and they said today, here's what we've learned. We've gone from a boil the ocean strategy to this and it is,at least on the surface, looks to be elegant and in solving a bigproblem. Yeah, so it was just so exciting to see folks take thaton. And what did it cost them? Three weeks and twenty phone calls andprobably fifty hours of reading. Yeah, you know, and I want tolike have a conversation around that. Boil the ocean. You know,I think that's another challenge that so many founders are facing when they really areonto something like it's very common that there is a problem that's pervasive and andmaybe it's other markets besides healthcare, or maybe it's just many mini sectors withinhealthcare that they could sell to or many variations of that product and in sometimes, you know, I think they're just thinking that bigger is better. Andso if I'm, you know, Oh, I've got ten markets and three products, like that's so much better than one market and one product. Andyou know, it's not to say that you can't have that big grand vision, but you got to start somewhere, right and I think it's always,it's very often alarming when someone's trying to boil the ocean. Yeah, it, and it's really it's really attractive. When you mean, how many timeshave you heard from people, you know, the the the Tam the total arrestaddress? The market is, you know, billions of dollars and ifwe can just get two percent of that, we're going to be great, exactly. And it's like, and you're right, your math is right,but let's talk about what it what would...

...it actually take to get there.and well, what if it's half of that? And and how do we? How do I think there's great value in narrowing it down. Let's let'sprove our concept, let's prove our technology, let's prove the value. However,we define value, you know, whether it's a improvement in cost orsafety or or security or engagement, whatever it would be. Let's demonstrate thatthere's value and that becomes a much I think that's a story that would resonatewith me as a buyer, much more than I can fix all of yourproblems, you know. So let's come in with with a target and andthat actually lends itself to and you know, there's the only eddage, you know, the death by a death by pilot and the number of pilots thatwe do. But but I believe they are willing providers are willing, healthplans are willing health systems to pilot something. And it's a lot easier when it'svery targeted, because then we can identify the patient population, of themember population, or the employer employee population whatever. However, we're segmenting thosegroups and not only I done by them, but start to see did we makea difference pre in post. Yeah, and if there's a difference, oddsare that's going to lead to something, something bigger and better. Definitely.And I think the the positioning in the messaging is so much easier whenyou're very narrowly focused, right, you can really have a much stronger valueproposition and positioning strategy than if you're trying to, you know, maybe beall things to all people. Right. Yeah, we I recently worked witha with a client that when we started some of this discovery and some otheractivity, we kind of heard. So I don't really get what it isthat you do. And and then that has changed over the course of acouple of weeks to Oh yeah, that makes a lot of sense. Soit's just it's the refining. And again I think that's that's the it's theslowdown to go fast anything. Let's let's learn quickly, but from there it'snot just not just learning, but now it's the application. You know,we talked about that with with with patient care all of the time. Wedon't necessarily need more information. As healthcare consumers, we have all sorts ofability to gain information. It's now how do I how do I activate?How do I use that information in a meaningful way, and that's the foundersneed to apply that to their own businesses. They need to apply that as welook at well, this is information that's going to be meaningful to theproviders. This will really really change the providers world. And when we actuallysit with leaders or frontline providers, I say I'm so overwhelmed, I don'tknow how this information, how to use it. It's not necessarily actionable,it doesn't fit into my workflow and I'm so busy today I don't quite knowhow to apply those. So, I mean those are just the things thatI think are so important for the founders to just spend a bit of timelearning and understanding. Yeah, yeah, in going into it with the mindsetto seek understanding as opposed to validate what they already believe, right, hmm. You know, like I'm on a mission to learn something new instead ofI'm on a mission to confirm that all my ideas are correct, right,and and and so, you know, we seeing over the years those kindsof those kinds of discovery sessions where when when a customer is saying now it'sthis and this, and you see a founder say, yeah, but no, but I think you've got it now. I don't think you're getting it.I don't think you know. And so they're really trying to sell andand you know you just want to do that hate time out. Listen,this is what they're telling it's okay, this is this is what you needto hear. Yeah, but that's hard. It's really hard when you've, whenyou have put so much of yourself, you know, physically, emotionally,spiritually, financially, into this, and then someone says you don't havea quite right. That's really, really hard to hear. And it unlessyou're unless to take a very you know, the approach. He dispension. I'mhere to I'm here to learn. Yeah, yeah, and you know, I don't think that we can talk about that enough. When it comesto entrepreneurs is is just shouting this from the rooftops, because the sooner theylike, acquiesce to this strategy in this process, the sooner that they willbe on their path to profit. Versus I'm going to ignore that. I'mgoing to, you know, launch into the market place. I've got tohave a million or a million dollars invested, or maybe even more, and I'mtwo or three years in I kind of had some false positives with afew customers that bought. So it felt like I'm on the right track andnow all of a sudden I can't. I lost all my traction. I'mstuck and I can't really grow. What's happening here? And it's just becausethe whole house is built on the wrong foundation. I think there's a lotof truth in that. And it might not even be the wrong foundation.It just might be that that it's the...

...right foundation but it's just not executedcorrectly. True, very true. Yeah, and I just I continue to beimpressed by how amazingly smart, passionate committed so many founders are and howhow frankly courageous they are to say we're going to go do this, I'mgoing to change the world. Yeah, yeah, that's a right. It'sa big leap and I so appreciate their energy along the way. So yeah, it and it might not be that the ideas completely wrong. It justmight be that it's not. It's not executed right, but it might bethat the idea is really wrong too, and let's learn that faster before there'sa catastrophic mistake. Well, and you know what I think sometimes the mindsetis is that I don't know if I want to say something's wrong with me, but you know, like something's wrong with me if I don't already havethe answers, something's wrong with me if I don't just know what path Ineed to go, or even thinking that this is like a startup issue.It mean, it really isn't. I mean no matter what size company youare, no matter where you are in the product life cycle or in thecompany life cycle. You know, there's a book I read called experimentation andit's just endless stories of even companies like Microsoft who experiment and experiment and theychange and they tweak and they conversate and all of these little things and theymean the change of one button, you know, was like ten million dollars, you know. So it's it's not something that just entrepreneurs have to do. It's just smart business for anyone today. Yeah, absolutely, and you youraised a point earlier on with it. It can be hard to do andI think especially in the founder space, and there was someone on your showrecently who was who was talking about you know, we see these companiesthat were founded today and then in three years, their valuation is a gazilliondollars and such. But but she made such an important point when she saidno, we started our company ten years ago, right, and it wasn'treally until we incorporated this way or became our escorporate, whatever it is.That's sort of like the official on paper date. But what we tend toforget is there's been a long, a long lead up to that point.And and so, yeah, I think the founders often times who just feelthat they feel a bit exhausted or they feel that there must be something thatthat I'm doing wrong or I'm not getting the traction that I want. It'sreal and and you know, I think they can get stuck sometimes by seeingthese sometimes rocket chips that are that that, you know, we may not hearthe whole story there, the full back story. You know, Ithink that's a big role that this show plays in the very is is,you know, for those folks that want to be honest and candid to comeon, you know, to come on here and really be transparent about therealities of it. You know, not because we want to be negative Nancyand doomsday here, but we just want to be real so that we otherfolks are encouraged and not thinking that, oh, I just need to goa BC and Eureka, because it's just not realistic. Right, right,and I think you know you you founded and done your own thing and youknow that it's never it's never linear. Right, it's not. It's notA to J it's a to wherever. It's a to Pluto and back.We're all over the place and the same boat here. You know, II'm learning every day, not only from my clients and from from customers,but I'm learning every day about how to, how to be a better founder,how to run a business differently. I've got such a amazingly supportive groupof peers that we can sit down and share stories with. You know,there's great learn great readings, podcasts like this that are just filled with informationabout, maybe not necessarily to how to, but here are, here are mistakes, here's learnings along the way, and let's share those. Yeah,let's just, you know, encourage each other. It's wisdom, but alsosome inspiration and some encouragement to yes, exactly, there's this invaluable yeah.So so let's, you know, talk about I want to kind of goback to, you know, this business model and kind of gleaning some ofthe insights that you have. So, knowing a lot of the complexities withinthe traditional healthcare ecosystem, I think you see a lot of innovators that godirect our going direct to consumer, that I'm going to circumvent all that healthcareecosystem, Hoopla and I'm just going to go direct against the POPLA, justgoing to go directly to the consumer and life is going to be so mucheasier. Are you know what kind of conversations are you having with founders likethat that are kind of at that cross road where they really could go directconsumer or going more of the Bab Route?...

Yeah, so, so my personalconversations with those folks is I'm not a direct a consumer expert, soI would be really cautious about taking advice for me on that strategy because thereare people much, much better prepared to have that. But but what someof the next part of the conversation needs to be. Well, let's understandwhy. What? What do you think that opportunity could be? Why?Why would you make that decision? Is it because you haven't gotten traction inthe more traditional Hookla model? That's a reference. Is it is because youyou can't get in the door? Is it that folks are just not understandingyour model or whatever it would be? So let's let's understand why you're makingthat decision. And have you have you? Have you been as efficient or effectiveas you could be on that, on the traditional model? If theanswer there is yes, where we've exhausted and we just aren't finding a wayin, then let's look at a little a little differently with well, now, how does your model need to change? Because on this side, the moretraditional, you probably have things like you could be a provider, youknow pay your contracts. That you might have to look at. You mayhave different billing models, you know, permember per month or based on asuccess speed or whatever it is. And now that models going to change ina direct consumer. Again, I can't speak to what it cost, youracquisition cost and a direct consumer could could be meaningfully different versus over here.So I think the conversation is really about, well, let's just understand the why. And they have previously worked with it with a client that was tryingto do both. We think we can do a medical a medical side,and we can do a direct consumer. That's you know, a click downin terms of cost and complexity and that sort of thing. And kind ofback to your point earlier, that's a really, really broad strategy and notnot unachievable, but it needs it needs resources, both, you know,people and connections and and financial to manage both of those. Yeah, yeah, and you know, I think you go back to we're talking about earlier. It doesn't have to be either or, but it really should be either orto start and gain some traction there and then we can add that otherlayer into it. Otherwise your resourced so thin a I think you, youknow, end up not being successful in any pl you know, really financialresources, but all we also just time and attention. Yeah, and Ithink we can get a mile wide and inch deep, but that's really challengingto run. Yeah. Yeah, so, what are some other things as wekind of just start to wrap up here, because I feel like wereally could talk for days. I could just you know, you're just soeasy to talk to and have such a wealth of knowledge. What are someother things that you want to make sure that you share with the community,both those, you know, innovators that are corporate innovators, as well asthose more are early stage startups. Yeah, I think a couple of things that. But some of my I think that my clients have maybe been alittle surprised about, especially those that are really early in or maybe are enteringhealthcare for the first time. Yeah, is, as you mentioned before,the just not understanding the complexity and the interconnectedness. And you know how manytimes we say well, because because this you know this one and this oneand this one, and you know, if you try to put it ona whiteboard somewhere, it just start to look like a mess. But butone of the other things is is being able to speak the language and spendingtime with people who know the language. You know, because the the healthplan is going to talk about members, they're going to talk about their clients, being the being the employers, they're going to talk about their their governmentline of business, and you know the different the different lines of business withinthe organization. If we're talking with providers, we're talking about patients and we're talkingabout workflow and we're talking about productivity and we're talking about moving into valuebased models and you know, I'm so overwhelmed with daytoday. If we talkwith health systems, it's a little different conversation. If we're talking about devices, it's a little different conversation. Or not made my conversation. The languageis a bit different. And and so I think for founders that are movingacross multiple parts of the of the healthcare ecosystem, spending a bit of timeto just understand the things that are unique to each of those and and again, eighty percent of your message might be just fine, but twenty percent probablyneeds to be unique to that individual market. And that's an area that, especiallyfor folks who are new to healthcare, is is a challenge that can makea difference. I don't think we realize how many acronyms we have because, my God, all customed to speaking.

There's the military and then there's healthcare. In terms of the ACRONYMS, right, and for those for thosewho have have kind of grown up in this and spent our whole our wholecareers here. Yeah, the acronyms are easy, you know, they justsort of they roll off our tongue and we and we get it and thereare times when we just say well, because of this, but for someonewho's new, that has an amazing idea and is passionate and could really disruptand eliminate waste or whatever the focus area is. A little time there,I think could just go a long way. Yeah, so I want to endon this question. What is your outlook for two thousand and twenty two? Rite we've had a really rough couple of years and some ways, becauseof all the challenges from the pandemic, we've also had a lot of disruptionand a lot of opportunity. So what do you most excited about in twothousand and twenty two when it comes to health care innovation? So I'll answerfirst I still think we're I still see that we've got we're not out ofa pandemic. We still have some meaningful things happening and the providers that Ithat I speak with, are exhausted, yeah, for all sorts of allsorts of reasons, and so we get that. So so I think someinnovation will still be tempered by the fact that we're not we're not done yet, know with the pandemic. So that that I would just cave out toeverything. There's still some work to go, especially for the providers that are listening. You know, we hear you and we thank you for all thework that you're doing or that weird. Have covid right now. You knowa man? Yeah, absolutely. Where where I'm very optimistic is that there'sstill amazing opportunity to disrupt, to change, and where I get excited is whenI talk with people that are seeing it's not just a technology but it'sa technology and service, and I hear more folks talking about the importance ofof be moving beyond engagement to activation into whatever it is. So I canget someone to download my APP and use it or to download and turn iton and register, but are they actually going to use it? So it'sthis activation and I see, I get excited when I feak see folks talkingmore and more or here folks talking more and more about the the activation andthe importance of behavior and behavior change in what we're doing. So that thatgets really, really gets me excited because I think there's amazing opportunity there.That's awesome. I mean, that's that's that's the ALO holy grail. Right, we're really going to only transform healthcare and until we have some behavioral changeas a whole. Yeah, the other the other piece that gets me veryexcited is to hear more and more people talking about. Let's remove the discconnections between whatever my technology is, the health plan, the employer and theand the provider. And you know, again, that's that's the other holyGrail, if there is one, if we can have two of them,that's the other one at the table. We can only dream, pad,we can only dream, but I but, but the conversation is is different,you know, it just seems as though we're recognizing that and and Ithink in the next couple of years more and more employers that have really embracedthe value of digital digital care will start to push and demand that that thesethese services start to connect even more, even better than they do today.So that's really exciting because that conversation is on its way. Yeah, Icompletely agree. I mean I think that organizations are going to figure out thatthey have to play ball and order to maintain their presence, may build asustainable business them that continuing in the silo ecosystem is will get will get rolledover by the Amazon care and the you know, the apple care and youknow, with and by the consumers. Mean that the consumers are yeah right, they're demanding and thinking different, which is which is great. That's justgreat and again. That's where I come back to with the founders looking atthis environment and saying we can help, we can do this differently, butbut we can't just come in without understanding how ecosystem sure. Yeah, exactly. Well, thank you so much for sharing your wisdom and your experience withus today. I really appreciate it. How can folks get Ahold of you? If anybody wants to connect with you after the show? Yeah, bestway to find me is on Linkedin and all my contact information is there.I said earlier, I will always take the call. I love talking withfolks. If someone just wants to pick up the phone, email me andsay can I bous an idea of off of you a hundred percent. Pleasefeel free to do that. Awesome. Thank you so much for joining metoday. Thank you so much, what a pleasure. Thank you so muchfor listening. I know you're busy working to bring your life changing innovation tomarket and I value your time and attention. To get the latest episodes on yourmobile device, automatically subscribe to the...

...show on your favorite podcast APP likeapple podcast, spotify and stitcher. Thank you for listening and I appreciate everyonewho shared the show with friends and colleague. See You on the next episode ofHealth Innovators.

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