Health Innovators
Health Innovators

Episode · 2 years ago

Physician Co-Creation, Multi-Sided Markets & Planning Early for Commercialization w/Robbie Cape and Brad Younggren

ABOUT THIS EPISODE

Many innovators lead with their technology in their creation process, and in the process they leave behind the other important building blocks of a strong business. How do we avoid building a business with a singular muscle? How can we deal with the biggest barrier to successful commercialization? How can we get physicians involved in the ideation process, and what difference can that make? 

On this episode, we’re joined by the CEO and Chief Medical Officer of 98point6, Robbie Cape and Brad Younggren, who share their journey to commercialization and lessons learned.

 

3 Things We Learned 

The biggest mistake innovators make 

Many innovators lead with a technology and end up with that as the singular muscle behind the business. One of the things 98point6 got right is that they developed 4 core muscles in the business: the medical, technology, regulatory & compliance, and commercial muscle.  


How to build relationships with physicians 

When it comes to building strong relationships with physicians, we must look at doctors as a separate audience segment, understanding the problems they have and delivering a strong value prop to them as we would with any customer. 


How to get into healthcare and win the favor of stakeholders 

There’s a huge difference between coming into the healthcare industry as a competitor, and coming into the industry with the intention to find the right stakeholders and people and support their vision and goal. It’s more powerful to sit alongside the primary care community so that you’re not treated as a competitor. 


Innovators often focus mostly on raising money and building the technology. They think the vision, mission, values, culture and employee engagement are things that can be built-in down the road. The problem is, they miss the benefits of building these things into the system early on. In order to successfully commercialize, it helps to be deeply integrated with the people who will eventually become your customers and pay for your service. You do that by thinking beyond the technology and considering the greater ecosystem and stakeholders who are critical to your business. 

Welcome to Coiq and first of itskind video program about health innovators, earlier doctors and influencers and their stories aboutwriting the roller coaster of healthcare innovation. I'm your host, Dr Roxy,founder of Legacy DNA marketing group, and it's time to raise our COIQ.Welcome back coiq listeners. On today's show we have Robbie Cape with US andbeat Bradyngren the too, two of the minds behind ninety eight point six,and I am really excited about this episode. They are doing some incredible things andI will let them tell you a little bit more about it, butwelcome to the show. Thank you so much. It's so it's wonderful tobe here with you. Thank you. I think that you guys are doingsomething really amazing because you have instead of leading with a technology, you areleading with a problem that you were solving that's just being enabled by technology,and I think that that's just brilliant and you're addressing a big challenge that wehave in the market place of primary care access. So I can't wait tohave this conversation with you today. So, just to get US started, justin case our listeners don't know who you are, Robbie, tell usa little bit about you and your background. So I'm originally Canadian. As itturns out. I grew up in a single pair system and I endedup going to school in the United States. I went to school in New Jersey. Right after graduation I came out here at Pacific northwest to work forMicrosoft. I thought I'd work for Microsoft for three years and then start myown business, but my three year plan turned into twelve years at Microsoft andjust amazing learning and a lot of fun. Finally, in two thousand and fiveI left Microsoft and found it a company called cozy that's in the businessof helping families manage the day to day chaos at family life. Sold thatto Time Warner in two thousand and fourteen and then in two thousand and fifteengot together with my cofounder here at ninety point six and began this new adventure, and the rest is the history of ninety point six, which I'm surewe'll get into. Yeah, absolutely great. And what about you, Brad?Tell us a little bit about your background as well. So I'm anemergency position by background. I went to the military medical school primarily interested indisaster and he manitran medicine, found myself deeply involved in evaluating how medical devicescould scale on the battlefield. Became very interesting in the field of digital healthcare and how that could impact saving lives. After getting out of the army,after a number of involunteary vacation opportunities, sort of moved into the digital healthcare space and have been never really look back, but involved in anumber of device companies as chief medical officer and most recently company called Q healthdown in La Joya. My first company was a one called mobisante, whichwas the first FDA approved medical device in the country. Was An older soundpro plugged into a windows phone and we built the CREDET systems for medical deviceswith smartphone technology. And so I've been with ninety point six since the beginningof January two thousand and seventeen, help build the clinic and get us readyto see our first patient and February of that same year, and have beenever since. I'm excited to be on the show. That's great. Thankyou. So so let's just kind of level set here. Where are youin the commercialization process? Do you have paying customers now or are you stillin the launch process. Well, we're very much in the commercialization, likedeep, deep into the process. We launched commercially in January of two thousandand seventeen. Okay, you know, when we came into two thousand andseventeen we didn't have a single paying corporation on the platform. We now haveover seventy paying corporations on the platform. As it turns out, close totwenty five percent of those very large companies are. These are companies with typicallyover twozo employees. Over twenty five percent of them are actually in the healthcarebusiness, which is something we're super proud of. So it's been it's beenwonderful to see healthcare companies be very, very early movers in offering ninety eightpoint six to bear employees. Hmmm, yeah, absolutely. So what wasit like getting your first customers? You know, it's it's always hard towin your first customer when you're a startup. You know, we have this sayinghere which is that everyone wants to be first to be second, andit's just it is just a fact of...

...life. I don't think it onlygoes to you know, commercial endeavors. I think there's a lot of peopleout there in life in general, who like to be first to be second. It takes a certain amount of of sort of adventure seeking to want tobe one of the first adopters of a new platform. As it turns out, our first customer, we are very fortunate, and this is typically whathappens when you're when you're getting out the gate. Our first customer was actuallyone of our investors. It was an investor who had a company with afew hundred employees and he was kind enough and, you know, I thinkI'd even go so far as to say that, you know, he mightnot have been a customer of ours if not for the fact that he asan investor. But it gave us the ability to develop the experience a deployment, and you know, you need a first deployment because you need an opportunityto relentlessly improve and get the you know, get the experience right for both ofthem, both the employer and for the patients who are ultimately going tobe taking advantage of the service. It was a great, great experience and, you know, just less than a year and a half later, youknow, we've got over seventy of them. That's great. Yeah, that's thatis such a huge hurtle just getting that first paying customer. A lotof the innovators that I talked to, you know, talk about it withchicken or the egg. Right now it's really hard to find the people thatwant to be the first, especially in healthcare and a very risk averse industry. Yeah, we we actually implemented a pretty cool concept. Verierl on so, a commercial leader, was one of our first employees on our seven fulltime employee was a commercial leader for the organization, and this is a goodsolid two and a half years before we were even ready to commercialize. Sothis is back in in two thousand and fifteen. You know, we broughtthis individual on board. His name was Stephen Hurwitz, and he put togetherthis early development partner program where we had about fifteen employer in the Seattle areawho all helped us build the product and gave us feedback very early on onthe features that we were building and the types of deployments that we would do. Now, there was no commitment, they were just sitting around the tableand giving us feedback and in fact, if you look at the first yearof deployments, almost eighty percent of those early development partners ended up deciding todeploy the product to bear employees. So, you know, I'd say that thatprogram was very effective in helping us getting many of those early deployments.So I just I think that that is just brilliant and it's so contradictory towhat I hear in the market place. So I do a lot of educatingaround the fact that launching an innovation and commercializing and innovation is two very differentprocesses and that launch is part of commercialization, but commercialization starts way earlier than launchand it continues way after launch, and not a lot of innovators getthat. So what motivated you to invest in someone that was a commercial leaderso early in the process? How did you identify that need? That's youknow, that's a really good question. And it turns out that that there'sa lot of things that we're doing here at any point six that are veryunconventional and, you know, unusual. And I think that it's largely dueto the fact, and you know Brad can can talk about this from hisexperience, that we've put together an executive team that is literally every simple oneof the executives on this team is is covered with scar tissue. You knowthey've they you know, in the case of Brad, you know, Bradactually has some war wounds. For the rest of US literally sore, area little bit more virtual. Yeah, you know, but it's incredible whattwenty years of experience will bring to the methodologies that you employ to launch abusiness. You know, one of the very early things that we decided todo, and I'd say that this was a result of of my cofounder andI and the first few executiives who we hire, really having been through thisexperience of working at companies that had singular...

...muscles. You know, you know, you look at companies and typically, you know, a company will havea technology muscle and that will be very clear that that's their main muscle.Sometimes you'll meet companies, and I'm sure you know, Brad has seen companiesthat really had a really strong medical muscle and that was at therefore, youknow, medical or research. But you know, this is very common tocreate businesses with singular muscles. You know, you want to be focused and youwant to be strong and you want to be good, and we recognizedin the business that we were entering that we were going to have to builda company that had, for muscles and then we were going to have todevelop those muscles from the very, very beginning. One of the muscles istechnology, it's true, but one of the muscles is also medical. Youknow, it's a major muscle for our company. One of the muscles thatwe developed very early on, like literally our fourth or fifth full time higher, was on the regulatory and compliance br we hired a full time attorney whohad a specialty in healthcare related law to build our our regulatory and compliance muscle. And then, lastly, we made the decision that for us to builda successful, scalable business that we needed to have a commercial muscle. Weneed it to be deeply integrated with the people who would eventually be our customers, who would eventually be the people who would pay for the service, andthat turned out to be self insured employers. And so our seventh full time higherwas someone who would focus all of their time developing those relationship. Hmmm. So that is so true and it's so challenging. I just it's sochallenging for health innovators because, as you know, in the beginning, resourcesare our slim and and so that is it's not expensive, I mean it'snot cheap to hire for those for those muscles. Right, it costs somemoney. It's basically, you know, a big bet and a big investmentthat you're making into the future of the company. There's one of the layerto it which is probably worth highlighting is early on, when I started talkingto Robbie about coming on a nine point six the chief medical officer, seeingthe conversations around the development of the four muscles and, additionally, this notionthat over half of the technologists in the company we're going to be focused onthe physician facing side of the technology. That investment in the physician technology wassomething I not s team the market and really helpful in terms of hiring andbuilding our physician medical culture. Having a deep interwoven relationship between the software engineers, product development team and the medical team has been incredibly valuable for us toscale as fast we've been able to. HMM, yeah, absolutely, it'sso let's talk a little bit about that. We're kind of on the fringes aboutproduct co creation and it sounds like that's really fundamental to part of YourBusiness, and so let's just talk about, you know, that co creation processfor you. How did you include them and who did you include?You want to talk about them? Sure, I can talk about the physician side, for sure. I think that what we're doing with our physician groupthat we call the core clinicians, is unique at the market and sort ofanswers at least part of your question perfectly. So our physicians to really deliver thehigh quality care that we wanted to at ninety point six across the country, across fifty one license boundaries, we decided that we were going to takea very different approach to delivering physician care on the platform. So, asopposed to most technology platforms that higher locom Tenems or part time physicians to operateon the platform almost independent of the rest of the organization, we took acompletely different approach. We hired our clinicians full time at ninety eight point sixso that they would be deeply invested in the corporate culture that we are building, with our core values and to make sure they're fundamentally aligned with us inour mission. And then, on top of that, all of our physicianshave a percentage of time, about twenty percent, dedicated for nonclinical activities,so that freeze them up to impact on multiple dimensions across the entire company,which our position side is a big pleaser. They like to feel like they canbe part of the product development, recruiting, UX research and design,really any domain you could think of within the context of the company, andthat helps also the technologist get perspective, a physician perspective, very fast.When we have a question about what would physicians think about something, we askour own internal physicians, which now is over north of twenty five in housephysicians. You are full time that help us develop the product every day andand and that that same sort of integration.

That happens across all of the muscles. So whenever we're building a new capability in the product. I thinkour launch of pediatrics earlier this year is a great, great testimony to thissort of interweaving of the muscles across the company. We literally had to haveevery, you know, senior people from every single muscle in the room aswe were defining our roll out of pediatrics. Like obviously there were deep, deepconsiderations on the medical front, but there were also incredibly complex issues tobe grappled with on the regulatory and compliance front. The way you treat pediatricsand the way you flow information related to pediatric visits is different in every oneof the fifty one jurisdictions that we're in and every fifty state and DC therules are different, and so those considerations had to get woven in. Therewere different considerations for each of our commercial customers related to how they considered pediatricsas part of their membership and how they define those people. And obviously itwas deep, deep consideration on the technology front around how we were going tobuild this motion and build out the capabilities that we're going to make the experiencecomfortable for, you know, a a two year old or a five yearold or even a fifteen or sixteen year old, all of whom are ourpediatric patients and yet clearly all of whom had very, very different capabilities whenit comes to interacting with technology. Yeah, I remember when my three year oldniece was showing me how to use the IPAD. They're pretty darn advanced, aren't they? So you know, how impactful would you say that gettingphysician input early in that ideation process? How do you think that that's beenimpactful or how do you think that shaped who ninety eight point six is today? I think it's poortant part of the core of what makes us different thananyone else you could find in the market. Just fundamentally it. It is reallya created a culture where physicians are very excited to come work for us. We have a very large pipeline. Our fortunate and that in that regard, and so that's great to see where that the company is really on amission to really deliver primary care to the no one has to make a financialtrade off to get primary care. And I state actually globally. But there'salso another mission which is sort of saving primary care. It's in a crisis. Yeah, position community is feeling as deeply and as physicians come across ourcompany and discover the focus and intention we have around physician quality of life,physician culture. It just believes across the entire company. HMM, yeah,it mean it just it seems like that would trickle down to like employee satisfactionand customer satisfaction, you know, with the experience and employee satisfaction both withthe culture and their ability to have impact as well as just their experience comingto work every day or stay in where they are at work today every day. It absolutely does. You know, we have a saying. Actually itwas lent to us by one of our board members, which is that cultureis not the most important thing, it's the only thing, and our missionthat that Brad articulated is absolutely central to that culture that we've created. Wereor a mission driven company like yes, we are, you know, buildinga profitable, commercially exciting corporation. Yes, that is important and we happen toalso believe that, by virtue of the work that we're doing, wecan make the world a better place and ensure that every human on this earthhas access to high quality primary care without ever needing to make a financial tradeoff to get it. Yeah, yeah, absolutely, and I'm starting to so. There's a conversation that I have on a regular basis and it's thisidea of why some innovations fail and why do some succeed. So, beforeI kind of go there, would what's your perspective on why some succeed inwhy some fail? You know it,...

I say every single situation is isdifferent. I think that likely most entrepreneurs feel, at least the stories thatI hear as I talk to entrepreneurs in the market, is that is thatmost opportunities failed because they they don't end up with enough capital. HMM,you know, capital is this. For most CEOS, capital is the thethe the resource that constrains them most dramatically and out ultimately the thing that theyrun out of. So I think that's most most clear, it's most salient, although I don't actually think that money is the issue. I think moneyends up being a proxy for time. I think time is the scarceest resourcethat that startups have. I think it's not only the amount of time thatit takes to build something and prove that it can be successful, but it'salso the amount of time that you spend building something to prove it it can'tbe successful. You know, it shows out fast, right, that's exactlyright. You know. You know they they don't teach you. If ifthere was, you know, start up entrepreneurs school, like if such aschool existed, and it doesn't exist and there's no great signal book to youknow that. On the topic, my bet is that there would be abunch of talk about tenacity and continuing to push hard and push through object youknow, objections, and keep trying and pivot and try again, and thenpivot and try again, and and so there's a lot of talk about that, but it turns out that there's not nearly as much talk about how tofail right, and in fact, failing is way more important in some waysthan succeeding. I mean, failing happens. You know, people say it's ninetynine percent. I think that that number is way, way too low. I think it's more like ninety nine point nine or ninety point nine ninepercent of a time. You know, people fail, and yet there's nolearning about how to fail. And I so, you know, I thinkone of the most important things that that entrepreneurs can do is even in thosefirst six, twelve, eighteen, twenty four months, independent of whether ornot they have access to a lot of money. Like, in some ways, access to a lot of money can be the worst thing that happened tothem, because it enables them to take too much time right. Yeah,what really need to do is, and some investors are really good at puttingthese these milestones in place and if you don't meet that six month milestone andyou don't meet or you don't meet the twelve month milestone, you know,know that it's done. Right now, the way you define those milestones isincredibly important, right that your milestone around consumer adoption and you're in a consumerspace and you know that it takes a year or a year and a halfto start getting consumer adoption. That's probably an unrealistic milestone to set. Sure, Yep, absolutely. So I think that that is just incredible wisdom forour audience to listen to, heed majority of our listeners or innovators that arein the trenches today and and there is a big fear of failure and rightsociety does not embrace that enough, especially in the entrepreneur market, and Icome across people that get access to millions of dollars and they pour it allinto the product. They don't always do what you did, which they're notalways including stakeholders in the product development, the CO creation process. And I'vetalked to someone not that long ago. They were three years in, likefive million into the product, and they hadn't even gone to market yet.They were because it wasn't ready yet and it's so somebody needed to take thatmoney from them away. Take that away a long time ago. Yeah,it's true. So there's there's another thing that really stands out to me thatI think that you guys do extremely well and it's storytelling. So let's shiftgears a little bit and talk about storytelling in how how do you feel,how do you think that storytelling fits into...

...your commercialization process, and what wasyour purpose and intention behind building out such an incredible story? I think ourstorytelling is likely more related to the brand and the trust and our position inthe market then. I mean, obviously all of that is incredible is directlyrelated and feeds into commercialization, but it really started with the the need tomake decisions around what we were going to stand for as a product. Like, like, yeah, it's true, we're delivering primary care and people getsick and they come to us and we dignose and treat them, and yes, we can look at it at that level. But what we wanted todo is really stand back and and think about our role in this incredibly interesting, this complicated and and sort of rich with history ecosystem. You know,it's easy to stand and throw darts the you know, at the healthcare ecosystemin the United States, and I know there's a lot of people who liketo spend most of their past time throwing those darts. But we wanted totake a position in that ecosystem, which meant that we were going to becomepart of that problem, you could say, and we wanted to define what ourrole would be within that ecosystem, an ecosystem that I happen to believeis actually pretty incredible. I mean, you look at the work that Bradhas done, you know, in his time before he came to nineteen pointsix. You know, you look at the innovation, whether it's innovation thathappened on the battlefield or the innovation that that he was a part of aroundmicro fluidics or any of the other amazing innovations that are happening. Some ofthem are happening at health systems and it you know, in in laboratories.I mean it's an amazing ecosystem. Yes, there are problems, but our narrative, our story, was about beginning to lay out how we wanted totake some degree of responsibility in this incredible ecosystem and the impact that we wantedto have. That's that. That was really the purpose for the storytelling.Yeah, yeah, well, I think sometimes health innovators really with struggle withtrying to figure out what's their clear and distinct value proposition. Right. Ihear from investors quite often of them being pitched by innovators to raise that capitalthat you were talking about. And in and I set them, set withthese folks for forty five minutes or an hour and I still don't really knowwhat they do. And and and and I think it's even more complicated whenyou're talking about a breakthrough innovation because it's radically different. No one's really setthe ground work right. So what does on demand primary care mean? Youknow, and you've got to kind of create a story to communicate that andwhat it means. And so I think that you guys have done a reallygood job and in a real good example for our listeners to kind of heedsome of that storytelling that you've done. It takes a lot of work,you know. When you see that single value proposition, you think that it'sOh, it's just one sentence. You just, you know, take afew minutes, twenty minutes and just knock that out and it's it's not right, right, right, it's so you know, when it came to themessaging, you know tied to the storytelling, you know what was some of thethings that you struggled with because, again, our audience is is kindof doing this right now, trying to figure out what their value proposition.So how did you go through that process to in where you are today?Good, thanks. Yes, just the on the physician side. I thinkwe've done a lot of work around understanding how to exist within the ecosystem andthere's tons of very passionate people in healthcare who are trying to do the rightthing. Some of the infrastructures and place for them to make the impact theywould like. Our approach is to come into that space and find those advocates, find how it can align and support their visions, look at as partnersand solving problems, not necessarily even as disruptors to the existing ecosystem. Thatallows us to sit alongside the existing primary...

...care community instead of looking as likea threat to the primary care community. And and Brad is raising the theelement that was by far and away the most complicated part of building our narrative. It was thinking about all of our constituents. It turns out we havea lot of constituents. We have some of these constituents, well, actuallyall of them are people who we want to ultimately serve. You know,in fact, here at ninety point six we we try to avoid using theword customer because I never want us to be sitting around the table and debatingabout who our customer is. It turns out they're all our customers, right. The patients are our customers, the self insured employers are our customers,the health plans are absolutely our customers. We are hopeful that the health systems, with the physicians who ultimately carry those health systems day in and day out, are our customers. You know, we're learning that there are other elementsof the ecosystem the people often don't even talk about, you know, likethe pharmacy, you know, like all of these people are our our constituents, who we believe that we can serve. You know, we didn't think aboutthe physicians who we were hiring as people who we serve, but thatthat was actually that was a mistake we should have now it turns out ournarrative work really well in that context. But the truth of the matter isour constituents include every single person who we hire. It includes every physician whowere trying to recruit. So the hardest thing for us was building a narrativethat would be compelling to every single one of these constituents. That's really,really hard in this industry, you know, and unfortunately, if you're if you'rebuilding a narrative that is compelling, the chances are that it's going toupset someone right, that someone is going to be turned off by that narrativeor think that you have Hubris, you know, representing the narrative in thatvoice. And so we were really careful and ultimately had to come come throughwith something that we not only believed in deeply, you know, in oursoul, but also was a narrative that we felt would be embracing of allof these different constituents. HMM. Well, I think that's so right, becausea lot of people ask me, you know, why is it socomplex? Why is it so difficult to commercialize and innovation and healthcare compared toother industries, and being a multisided market that you just described absolutely aids inthat complexity and that difficulty because, like you just described, the the theuser, is not necessarily the by are right, it's not necessarily the prescriber. I mean it's just it's health care is just such a complicated ecosystem inbuying process in and I find that sometimes stayholder groups or constituents can be eliminate, it forgotten when we're going that messaging process, or they can be justmuddled and tangled and in we or we're just we're always like we're really excitedabout the patients and how we're going to change their lives and make their makethis world a better place. That we forget, you know, a lotof the value proposition to the V to be stakeholder. So that's just so, so true. So you kind of touched on this a little bit.So want to talk now about like what are some of the things, thedecisions, and we touched on it, but what are some of the decisionsthat you think that the I didn't know it then, but when I madethis decision it was really, really influential and the success that we're experiencing today. So I'm going to sort of set brad up here a little bit becauseI'd like him to answer this question with a little bit of back drop.Yep, when when we hired Brad, it's fair to say that, well, I certainly had no I had no more than a year of experience withhealthcare and I certainly personally, you know,...

...and and a bunch of people whoI had, you know, on the executive team, even at thatpoint had no experience actually building a clinic. And you know when, when,when Brad came on board and we were just incredibly fortunate to be introducedto him and you know, our conversations spend several months, you know,before Brad was ready to to join us. You know, I gave Brad andhis peers all gave Brad an enormous amount of room to to build theclinic of the future, you know, to build a clinical operation that likelyphysicians only dream about and and but unfortunately, you know, never really have achance to dream about. And there were a lot of decisions. Ilet and Brad will talk to you about a couple of them that Brad madeearly on that weren't they weren't part of they couldn't have been part of ourplan at the beginning because we had no business making a plan around those issuesbecause we not had no history. Yeah, but but what we knew was thatwe had to have incredible talent at the table to help us make somedecisions. So, Brad, maybe you can talk about some of those criticalfirst decisions you made around building the clinic that have ended up just being poreto to how we operate s thanks for having I think, to Robbie's credit, you gave me a lot of space the first few months to really diveinto one of our core values of critical and informed thinking and on constrained thinkingaround what could we do to really build this clinic of our dreams that heasked asked us to build. And there are a couple dimensions to that whichwere even new for me. I'd built clinics in the past, but obviouslynothing on this scale, nothing that demanded this sort of to build it ondemand primary care service that crossed the boundaries ultimately provided seven care to adults endkids, was a fairly heavy lift. When I looked at the market,I just felt with the most important thing to fall back on was quality,that if we could build a quality physician service, a medical service that wasconsistent with the brand, but that ultimately that that over time, would reallyallow us to come to the market and have hell systems and employers as wellreally appreciate the work we're doing, and so that we had to start fromthe beginning with that fundamental approach. So I went to Robbie and I said, after a few months of molling is over and saying, you know,I think we need to license our physicians across the country. I haven't seenany company that's done that yet. So, but we're gonna have to be thefirst. It's going to cost a fair amount of money. Doctor.Yeah, you know, I know, I just get a couple months ago, but I need a lot of money to do this. And and,but I think it ultimate give us way you want, which is instead ofbeing a company that it's out the market, saying we have five, three,four and four thousand doctors in the market that service our clients, thatwe have a smaller number of core clinicians who deliver the care every day.When you when you come in a ninety point six, you know exactly thekind of care getting because you can look on our website and see exactly whoour physicians are their work for ninety eight point six. So we started thatprocess and I had never worked in the company that had a core value setthat was so lived, believed and discussed on a daily basis. I'd neverexperienced that personally, and I think a lot of physicians health care. I'venever seen that. So to impart that kind of culture on to dephysician throughare coming on was incredibly exciting. Everyone was really on board of that andwe started licensing those clinicians across the country and we've continued with that strategy sincethe beginning to this day, and that's still how we're approaching our physician hiring. That, you know, as long as we continue to hire our physiciansas full time and so put them to the same rigorous tests that the othermembers of the company have. So one of the things that's probably worth highlightingis I didn't want the physicians to be looked at any differently here for thethe easy and for the heart. So they go to the same interview process. The soptware engineer goes through the same interview loop. They don't and there'sno shortcuts. And I think you know we only hire one out of everymaybe twenty applicants, but the ones we hire are of the quality that canreally represent the brand. Seven three hundred and sixty five. Are you guysvery intentional about the the training and development...

...that goes along with them to beable to live out those values, you know, without being under your roof? Yeah, I mean the we're we the clinicians have their own private communicationchannels to discuss the core values and how how those are impacting the work they'redoing. They're discussed by everyone in the company on a day day basis orcalled out in meetings, in group meetings and one on ones on a dayto day basis, which it's really excited unique at. The physicians are engagedin that same type of behavior. So they're we have really spent a lotof time, as we fired some clinicians who are not in Seatt all forvariety of reasons, that they really have to be as deeply engaged in thecompany as everyone else. So they're in the office a lot because we wantthem interwoven the same way and sort of ultimate charge to the team was thatI want the clinician in Florida to feel as deeply connected to Robby Cape asthe physician who lives in Seattle, and I think we've accomplished that. Yes, it's great and I you know it is. It is so deeply impactfulwe are and it's one of the reasons why we've been so successful at recruitingsome of the best primary care physicians in the nation. To nineteen point six, you know this, this point that that Brad made around every one ofour employees being one of our physicians being one hundred percent dedicated to ninety pointsix and being being being a permanent employ the company. That is part ofit. The other part of it is everything he talked about around the waythat we treat them at the company. You know, a lot of alot of physicians. I hear this. I've I am not a physician,I've never been a physician, but I hear from physicians we hire that they'rethey're used to working in this environment where they're they're almost lone wolf's, evenif they're part of a huge system, still like they're alone in the room. Yes, they have a patient there, but the patient is the person they'reserving. They they operate very alone the vast majority of the time,whereas here, even when a patient is in that that chat with a singleposition, that physician feels like they are part of a very large team.I'm and it's not just because of the software that they're using. It's because, you know, when when they get off that shift, they're probably goingto be jumping into meetings with, you know, five or six or sevenpeople across the company talking about some future innovation that we're going to build intothe product that's going to make a difference for our patients or for them intheir physician experience. And that team dynamic is incredibly powerful and it ends uprecruting all these other values, you know, just just as a matter of nature. It's really just it's really magic. HMM, it sounds like it andyou know it. To me, it kind of goes back to lookingat the physicians as a separate audience segment, understanding the problems and needs that theyhave and then being able to deliver a strong value proposition to them,just like you would paying customers. That's right. Yeah, that's about it, just just like we do for the software engineers who you know, whowe're out there trying to recruit, and just like we do for the marketersor the communications people. I mean, you know we we have to buildsup as a company, as a growing company that's out there competing for talentin an aggressive market place. We we think very carefully about the value thatwe're delivering every single person who has a role to play on this team,and the physicians are no different. And it sounds like you had that mindsetearly on, which you know in the conversations that I have with a lotof health innovators, they think about vision, mission, values, culture, youknow, employee engagement down the road. Right now it's about raising money andbuilding the technology and I think that some of the some of them kindof miss out on the benefits of putting all of those other things in placeearlier on in that process. Yeah, that's that's really true. I Ihappen. You know, personally, I'm incredibly fortunate in that, you know, we have I have a CO founder...

...who is able to spend the majorityof his time focused on fundraising, which has allowed me, you know,in my position as the CEO, with the executives on the team, tofocus almost all of our time on building the company. Now the the otherthing that was important to us from the very early days, and again I'dsay that this was related to advice that we got, odd not only frommy cofounder, but also from the other people who we were seeking advice from, who are some of the most phenomenal business leaders in the world. Wewe decided early on that we had to build the company for scale. FromDay One, we knew, or actually we couldn't have known. We imaginethat the value proposition that we were creating was going to be incredibly compelling andthe people were going to want to adopt it quickly. And then we wantedto be in a position to deliver. So we were going to have togrow the company quickly. In order to do so, we we needed tobuild a very solid foundation. You know, it's like you know you're building askyscraper and you want to be digging, you know, your foundation deep,deep in the ground because it's got to carry this incredible building that you'regoing to build up on top of it. And so we literally thought from dayone about building the infrastructure that would support a business that we imagined couldbe incredibly impactful in the industry. So things like the core values that weset, we set those very very early. The muscles that we set, weset them very very early. The executives who we hired, you know, we brought those people on very, very early, all to support thegrowth that we were hoping would happen. We couldn't know, but we knewthat if we executed, it would happen. Yeah. So so I think thatyou've, you know, as as we've had this conversation today, you'veshared a lot of your personal experience and that that's been really invaluable for thelisteners. The last question I have for you is there anything else, anyother advice that you would want to give to those other health innovators that areout there in the trenches right now? It's from my perspective I would justkeep keep motivated in on the task that you believe can actually change healthcare andkeep driving forward to that and don't be lulled by the traditional sale cycles thathospitals may have, because there's other many of the opportunities to drive your idea, Your Business, your company forward more than an annual sale cycle. Willhave to have a whole another episode to talk about that. Yes, sorry, what do you have to say? You know, it's it's almost it'salmost the same point the brad made and maybe just said slightly differently. Sureit's it's about fail fast, but even at the micro level, which meansyou need to take what you're building or what you're thinking you want to buildout there as quickly as possible. Certainly it shouldn't take you more than amonth or two months to go out there and begin gathering feedback from the marketthat you're ultimately going to want to sell to on whatever it is that you'replanning on building. You know, if it's consumer business, you should beable to stand it up in a month or a month and a half.Absolutely you should. It might not be everything that you wanted to be,but you need to start that cycle of failing and relentless improvement and failing andrelentless improvement. I mean that is you know, it's all about failure.You know, you said no one wants to fail. If you don't wantto fail, you shouldn't start a company. It's all right, okay, where'sthe wildom? You've heard it right here. Okay, if you gotto fail, you got to learn, you got to change, you gotto grow, and the sooner you can get that cycle going to better.If, if it is a a an enterprise sale that you need to doand you're thinking, oh my God, it's going to take me a yearand a half or two years to build out a product that I can actuallysell to the enterprise, I don't agree. Build a prototype, even if it'seven I if you build it with a sharpie and a piece of copypaper, Yep, build a prototype and...

...then go sit down in front ofthe people who you'll ultimately sell that product to and get their feedback. Letthem tell you that your baby is ugly and actually want to hear it,because that's what's going to get you to go back and relentlessly improve. That'swhat it's all about. Yeah, sometimes I think that innovators, they areafraid to ask those constituents what they think because they might not think like theythink and they really want to build what they want to build and they almostdon't care what the audience wants. I know what you need, let megive it to you. Well, we we, we all know how thatstory is, right, right, right. Yeah, those are the ones,just maybe that aren't failing fast. They're taking a whole lot of timeand people and money down with them in that failing process. That's right.But I mean I'll ultimately ultimately those people like yes, there might be aone in a million of them, and everyone likes to focus on the onein a million that ended up just building what they wanted and didn't ask anyoneand they ended up succeeding. It's very easy to focus on that one ina million. Yeah, yeah, what one in a million doesn't happen right? That's not how the vast majority of successes occur. Sure you know successis happening. Happen by building what the customer wants, and the only wayyou know what the customer wants is by sitting in front of them and asking. Now. Absolutely well, I think that that was a great way toin this episode. I have thoroughly enjoyed this conversation. I hope everybody that'slistening is taking notes, because there's just a wealth of wisdom that's peppered inthroughout this series, and so I'm just going to ask you as our closingquestion, how can people get Ahold of you if they want to find outmore about ninety eight point six and what you're doing? What's the best wayfor people to reach you? So there's there's two things that I'd love forfor every listener to do. First of all, go to the APP storeand download ninety point six and try the product and send US feedback. Imean it's twenty dollars for the first year for unlimited access to primary care.So even on your first visit the the APP will have paid for itself andyou can use it another ten times, you know, for the reminder ofthe ear, and it's not going to cost you a single penny. Themost of all, send US feedback. So that's the first thing that we'dlove for you to do. And the second thing you know, if youyou know, if you directly or indirectly know of people who lead benefits orgoing zations and who are delivering benefits to their employees, please have them goto ninety point sixcom and learn about our offering for employers, learn about ouroffering for health plans and then send us a contact us note, because we'dlove to talk to you about how we can bring the value of ninety pointsix to those people who depend on you. Well, that's awesome. I'm araving fan and I will help you promote this company as best as Ipossibly can. Okay, okay, what's the difference between launching and commercializing ahealthcare in avation? Many people will launch a new product, few will commercializeit. To learn the difference between latch and commercialization and to watch past episodesof the show, head to our video show page at Dr Roxycom. Thanksso much for watching and listening to the show. You can subscribe to thelatest episodes on your favorite podcast APP like apple podcasts and spotify, or subscribeto the video episodes on our youtube channel. No matter the platform, just searchcoiq with Dr Roxy. Until next time, LET'S RAISE OUR COIQ.

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