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Why Great Healthcare Startups Still Fail | Health 2047 E202 · The Advancing Healthcare Innovation Show

0:11
Hello and welcome back to the Advancing
0:13
Healthcare Innovation Show. I am your
0:15
host, Michael Saminos, and if you are
0:18
new to us, welcome. Super pumped to have
0:20
you here. We're having some incredible
0:22
conversations with real leaders that are
0:23
painstakingly reshaping the future of
0:27
healthcare. We're pretty passionate
0:28
about a few different areas. We're very
0:30
passionate about access, about
0:31
leadership, about innovation, and
0:33
innovation adoption. And if you haven't
0:34
had an opportunity to check us out, let
0:36
me just sort of take a quick step back
0:38
and uh tell you a little bit more about
0:40
what we're trying to get done here. So,
0:41
the the ethos and the focus of the show
0:44
are bringing real stories of innovation
0:46
to life. not just stuff that you're
0:48
reading in headlines, but like real
0:49
people that are in the trenches, have
0:52
experiences, that have a willingness to
0:53
want to share some of their stories,
0:55
their their little wins and some of the
0:58
learnings. Um because when you're
0:59
innovating, you're not always winning
1:01
all the time. So, we want to explore
1:03
that. We want to go deeper. And if you
1:05
haven't had an opportunity to check out
1:06
any of our historical interviews,
1:08
wherever you are, if you're watching
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this, if you're listening to this,
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please hit the subscribe button now so
1:12
that any of the new episodes come
1:15
directly to you. Pretty pumped up about
1:19
today's uh conversation. We had a really
1:21
fun pre-show chat. Um, and I just want
1:24
to lead with this. So, in back in 2016,
1:26
the American Medical Association did
1:29
something that most people
1:32
never heard about and they made a bet
1:35
and it was a pretty bold bet. And the
1:39
oldest and most powerful physician
1:42
organization in this country decided
1:45
that the future of medicine was not
1:49
going to come from inside of medicine.
1:51
In fact, it was going to come from sort
1:53
of the intersection between clinical
1:55
truth and entrepreneurship.
1:58
And I am bringing today two fellow
2:01
entrepreneurs that are now embedded
2:04
inside of the venture studio called
2:07
Health 2047.
2:10
So the idea was was that this health
2:12
studio would transform American
2:14
healthcare by 2047, which is the AMA's
2:17
200th birthday, by the way. So, two
2:20
people that are doing the work. I've got
2:21
Warren Templeton, who's the managing
2:23
director at Health 2047.
2:26
Super interesting background. Came up
2:28
through investment banking. Then through
2:30
Fitbit during one of the most sort of
2:31
iconic uh moments in consumer tech,
2:34
co-founded a company of his own. So, he
2:37
knows a lot. Big big corpse, you know,
2:40
small corpse running scaling. And then
2:42
he found his way here to health 2047. So
2:46
um his job basically from our
2:49
conversations has been to find the
2:51
founders that are seeing things inside
2:54
the industry that the industry in and of
2:57
itself cannot yet see and then do
2:59
whatever it takes to help them build it.
3:02
And then we've got Jill Miranda who is a
3:04
strategic consultant at health 2047.
3:07
quite frankly probably one of the most
3:10
connected people I've ever met in the
3:13
digital health ecosystem. She is a
3:16
three-time exited founder. Uh she's
3:19
built companies from nothing. She has
3:21
scaled them. She understand what it
3:23
takes to scale in this. So she's worked
3:26
across chronic care, maternal health,
3:29
reproductive health, behavioral health.
3:31
Um, honestly, she spent a lot of time in
3:34
places that most in the industry just
3:36
sort of walk right pass by. And what she
3:40
and Warren and the rest of the team at
3:42
24/7, what they're doing is in my mind,
3:44
they are building this bridge between
3:47
what sort of physicians know uh, and
3:50
what technology can actually do. And
3:53
it's pretty fascinating. So, we're going
3:54
to kind of go into a lot of hopefully a
3:56
few different areas and we'll try to
3:58
have fun along the way. And hopefully
3:59
this will be really entertaining for
4:01
you. So Warren Jill, great to see you.
4:04
Welcome to the show.
4:06
>> Super happy to be here. Thanks for that
4:08
wonderful introduction, Michael.
4:09
>> Yeah, Michael. Seriously, like can you
4:11
do all my intros? That's great.
4:13
>> Yeah.
4:13
>> You know, we are recording this so you
4:16
can you can have this. You can you can
4:18
use it. It's uh it's all good. Um I want
4:23
to open up. Maybe Warren will kind of
4:24
start with you. Walk me back, you know,
4:26
maybe before health 2047. Um, you'd been
4:30
in banking, as I mentioned. You were at
4:32
Fitbit through the IPO. You co-founded
4:35
something of your own. What What was it
4:37
about this opportunity that made you say
4:40
yes?
4:42
>> Uh, great question. So, you know, when I
4:45
was in uh finance, I was on the trading
4:47
side and of uh finance and um I took a I
4:51
was doing that in in London. and I had a
4:53
very different career path and I had
4:55
this moment of epiphany that hang on, is
4:56
this what I want really want to be doing
4:58
for the rest of my life. Did my MBA
5:00
which is wonderful time to kind of take
5:02
a step back and reconsider. Um and so by
5:05
the time I hit Fitbit, it was really,
5:07
you know, I was like, "Hey, M&A sounds
5:09
fantastically fun." Um learned a lot. Um
5:12
but then frankly, um found out that uh
5:16
consumer side was so much and what we
5:18
were doing was so strategic. Um, but it
5:20
felt like we were still dealing with
5:21
some pretty significant issues in uh the
5:24
health system and you know Fitbit was
5:26
kind of like on the bleeding edge but on
5:28
the consumer side but I was exposed to
5:30
all this friction and so um I bumped
5:32
into the health 247 team during you know
5:35
founding and they said you know uh we
5:37
need somebody to come help us run
5:39
products because we're a a venture
5:40
studio at the time and I said well I
5:43
don't know anything about healthcare I'm
5:44
willing to learn but I can tell you you
5:46
know done a lot of product and and build
5:48
work and they said all right well come
5:49
Come on, let's figure it out. And so,
5:52
you know, for 4 years, we were venture
5:54
studio in the kind of purest sense,
5:56
right? So, everything was internally uh
5:58
generated. Um, but we we pivoted
6:00
eventually when we, you know, figured
6:02
out that this stuff's hard, right? And I
6:05
think one of the things that you know
6:06
healthcare maybe gets a bad rap at times
6:09
is that not only do you have the um
6:11
commercial and build risk that everybody
6:13
every other uh organization has in
6:15
trying to build you know enterprise
6:17
businesses but then you add in
6:19
regulatory and um and science-based risk
6:22
um that just adds extra uh challenges in
6:25
building you healthcare startups. I
6:27
guess from the outside you can kind of
6:28
appreciate that, but only when you're in
6:30
the middle of building it do you start
6:32
to say actually this is material and
6:34
people are making big decisions off the
6:36
back of this. It's not kind of a I'll
6:38
I'll make sure I've got a slide on my
6:40
slide deck and that was the kind of
6:42
that's where my role is kind of been
6:44
born from which is recognizing those
6:46
four risk categories and helping
6:48
founders lead through that. Um, but it
6:49
started, you know, really with uh this
6:51
aha moment of, you know, I'm not really
6:54
um I I really enjoy my the trading time.
6:57
Um, it just wasn't where I felt like my
6:59
career wanted to or wanted it to go. And
7:02
so, um, you know, Fitbit gave me this
7:04
kind of exposure across healthcare and,
7:07
uh, consumer tech and I chose, you know,
7:09
the the healthcare path.
7:12
>> Pretty amazing. You know, Jill, um, on
7:15
your side, three companies, three exits.
7:19
Dip my cap to you. One exit. Sorry. But
7:24
>> why health 2047? You know, why why why
7:26
now?
7:27
>> Yeah, of course. So, um, I've been in
7:29
digital health my whole career. I'm one
7:30
of those very lucky people where my very
7:32
first role was operations in a a digital
7:34
health startup. Um, and I fell in love
7:36
and haven't left since. So I've been
7:38
able and very lucky to have uh different
7:41
perspectives on the ecosystem. I've I've
7:43
been internal in startups. I've been
7:45
working for service providers um where
7:48
our clients were, you know, venture and
7:50
PE, been a consultant um an adviser and
7:53
then also a recovering digital health
7:55
founder myself. So um the venture
7:58
perspective has always been incredibly
8:00
interesting to me. I was a founder that
8:02
had to fund raise as a female founder.
8:04
Um, and I have continued to advise uh
8:08
here and there on the BC side. Met the
8:11
health 2047 team maybe like 2 years ago
8:14
now, I don't even know, and have never
8:17
had a bad or even um slightly boring
8:19
experience with them. Uh, and over the
8:22
course of time, we just kind of started
8:24
talking about the health care world that
8:25
we wanted to see, the companies that we
8:27
wanted to succeed and and grow. Um, and
8:30
it just kind of worked out that they
8:32
were really focused on kind of becoming
8:35
um, even more of a thought leader in the
8:37
space and really put putting forth
8:39
thesis um, and supporting founders um,
8:42
and trying to figure out how to use
8:44
their incredible brilliance and power
8:46
for good to really support the early
8:48
stage ecosystem. And so was really
8:50
excited to come on board and help them
8:52
do that wherever and however I could.
8:55
Warren, you touched on something earlier
8:56
and I just want to tap it because it's
8:58
been kind of my mind. I want to make
9:00
sure that the folks that are listening
9:03
actually understand what this is because
9:06
it when when someone hears Venture
9:07
Studio,
9:09
>> um it's it it can mean a lot of
9:11
different things to to different people
9:13
depending on who you ask.
9:14
>> So, let me just ask it plainly. a
9:17
founder walks in the door with an idea,
9:22
but what actually happens next?
9:24
>> Yeah, good question. So, um uh so there
9:29
venture studio is kind of the catchall
9:30
for either you're an incubator or you're
9:33
um an investor on the kind of like
9:36
extreme ends and then everybody kind of
9:38
who does stuff that's a little different
9:40
sits in the middle, right? accelerators
9:41
kind of usually end up be re rebranded
9:44
as u uh venture studios as well. And so
9:47
we started out on the extreme end which
9:48
was we build this stuff all internally.
9:51
Um we pivoted to supporting founders
9:54
recognizing that um not only do founders
9:56
bring a passion and a and a substance to
9:59
their understanding of of a space but
10:01
they often are uh needing help to build
10:04
that business. And you know, I think the
10:06
first thing about, you know, health 247
10:08
is that that introspection, that, um,
10:11
humility is really important when we're
10:13
talking to founders. Um,
10:15
>> I'm not, you know, this is not who's
10:16
right, who's wrong. It's somebody often
10:19
times saying, "Look, these are risks
10:21
that either I'm not, uh, comfortable,
10:23
uh, addressing or it's outside of my
10:25
wheelhouse. Do you, Hell 247, have
10:28
people you would trust to help me build
10:30
this business um, and address some of
10:32
these things?" And so, you know, health
10:34
247 really works on this idea that
10:36
you're a founder, science-based almost
10:38
exclusively, right? So, um, and that can
10:41
be original research, that can be you've
10:43
assembled PubMed articles, like there's
10:44
a whole bunch of different pathways to
10:46
get to to that answer. Um, and you've
10:49
got some commercial incu uh, acumen or,
10:53
uh, inkling about where you can build
10:54
that a product that leverages that
10:56
science to improve somebody's life. Um,
10:59
a process in a healthcare organization.
11:02
Uh there's a v variety of different
11:03
categories which we can talk about
11:04
later. Um and then what we're doing is
11:07
we say right let's let's have that pitch
11:08
like how would you pitch this if you had
11:10
a fullyfledged company and then you know
11:13
if there's a interest then we'll say
11:15
right we're going to uh decompose this
11:16
and do a risk assessment and both
11:18
parties will come to the table and say
11:20
here's the category of risks um you know
11:23
commercial strategy risk uh technology
11:25
risk etc. And then we say, okay, well,
11:27
how not just, hey, these are risks. Go
11:29
solve them. It's how do we partner with
11:31
you to go build that solution, right?
11:33
So, if it's technology risk, we've got
11:35
some amazing builders in our network
11:36
that we will bring to the table and
11:38
partner with a founder um to get rapidly
11:41
to a prototype that then, you know,
11:42
there's then responsible to go sell to
11:44
health system, payer, whomever. Um, and
11:47
then, you know, once we hit some of
11:49
those milestones criteria, then it
11:51
unlocks an investment from us. Um our
11:53
check sizes range from half a million to
11:56
two million. Um and there's a lot of
11:58
kind of uh kind of components to that,
11:59
but um the goal ultimately is that we're
12:02
part of somebody's seed uh round and
12:05
then we reserve follow on capital uh to
12:07
you know do our investing side of you
12:09
know what we have to do. Um but um we we
12:12
really try to put the founder in the
12:14
center of our uh ecosystem. Um it it's
12:17
more around high conviction and so for
12:20
us high conviction means no more than
12:22
kind of two or three checks a year uh
12:24
into denovo uh businesses.
12:26
>> Um I mean I would love
12:28
>> you're getting a lot of looks. You're
12:29
getting
12:30
>> we're getting a lot of looks. Um
12:33
but you know at the end of the day we're
12:34
looking for things that are
12:35
transformational. Um and those
12:37
transformational concepts and ideas come
12:39
from uh you know not only just a variety
12:42
of backgrounds but then you know they're
12:44
they often have to be kind of centered
12:46
on one of our three pillar areas um
12:48
around chronic disease management data
12:50
which is encompassing of AI you know
12:52
transfer etc and then physician
12:54
productivity. Hm.
12:57
Jill, you've you've looked at this from
13:00
a founder working inside of the digital
13:02
health ecosystem for, you know, a couple
13:04
of almost a couple decades now. Um,
13:07
would there be anything that you would
13:08
add to that?
13:10
>> Um, first of all, a couple decades is
13:13
aggressively aging me, so let's chill
13:14
with that.
13:16
A decade plus,
13:18
>> more than a decade. A decade plus couple
13:20
decades is a lot. Um, thank you.
13:22
>> I got it.
13:22
>> Um, what was the question? Sorry. I was
13:25
>> Would there be anything else you would
13:26
add sort of to, you know, Warren's kind
13:28
of illustration? Anything anything that
13:30
was missed?
13:31
>> Yeah, I mean, I think he he got
13:33
everything. I will say uh venture studio
13:36
model kind of falls in and out of vogue
13:38
pretty quickly, right? Like every few
13:39
years it's like this is a sexy thing and
13:42
then it stops being sexy. And the
13:44
reality is building in healthcare is
13:45
hard in general. Building from that
13:47
early early stage is really hard.
13:49
There's so many pivots that a business
13:50
goes through throughout the course of
13:52
time, right?
13:53
And the reality is most people are not
13:55
able to actually act both at that
13:57
investor and that founder. I think one
13:59
of the really things about health 2047
14:02
when they say that the founder is
14:03
central, they're really not they're not
14:05
screwing around. They really truly mean
14:07
it.
14:07
>> Um and they kind of just envelop them in
14:11
this like buoy of support throughout
14:13
every course as they grow. They are
14:16
consistently there for every pivot, for
14:19
every rethink, for every reframe. Um,
14:22
and that makes a world of difference.
14:25
That is also more slightly in line with
14:27
the studio model than it is generally
14:29
with a a VC fund, which a lot of the
14:31
time are kind of like we get in, we
14:33
write the check, we're like there for a
14:34
few board meetings around, then we kind
14:35
of like off, right? And we're not
14:37
really involved in the day-to-day. Um,
14:39
so I think they take kind of what's best
14:41
out of the venture model, which is that
14:43
genuine support and commitment to a
14:46
founder. um and and take that and kind
14:49
of mix in some of the more uh normal
14:52
venture kind of things as well, which is
14:54
what I've always loved about the firm
14:55
and and the fund.
14:57
>> I I think to to echo one of the things
14:59
that Jill was saying and she's spot on,
15:01
you know, there there's a a mission
15:03
story to our business, right, with the
15:05
AMA backing our our journey. Um, we have
15:09
made investments in companies like
15:11
Scholar RX that on the face of it look
15:13
more like a uh a pure play mission
15:16
story, right? This is a an education
15:18
platform
15:20
uh for healthcare workers. Um, not only
15:22
has that turned into a wonderful
15:25
opportunity to scale medical education,
15:28
you know, na internationally, right?
15:30
They've been picked up by the WHO to
15:32
help in some of their goals in Africa.
15:34
Um but this has turned from not just a
15:36
mission story but there's an IR story
15:38
alongside that and you know we get to do
15:41
this from a point of view of um we
15:44
mission first and then you know margin
15:46
returns come after that. Um but you know
15:50
part of that often for our founders they
15:52
get the benefit of us being on their
15:54
board and some of those IRR founders uh
15:56
sorry um u board members from you know
15:59
other investors and what we see from
16:01
that relationship is you get folks who
16:03
are really you know focused on okay
16:05
financials hit those milestones etc. Um
16:08
whereas you know we're investing on well
16:10
how are you going to get to that impact
16:11
story? How are you going to get to the
16:14
mission that we originally invested in?
16:16
um and and are you on track to go do
16:19
those things? And so I think often times
16:21
at a board level you're getting this um
16:24
healthy tension between short-term and
16:26
long-term um which you know is I I mean
16:29
think we can all agree that um you need
16:31
both to be successful. You do.
16:34
>> You do.
16:35
>> And trust in the founder, right? That's
16:37
not easy for investors to do. Often they
16:40
kind of want to come in and say, "Nope,
16:41
this is what we see as the best scalable
16:43
opportunity." And kind of the founder
16:46
being a founder is that internal move
16:48
between you obviously need to be
16:49
coachable and take the advice of your
16:51
board, but you also you know your
16:53
product, you know your mission, you know
16:55
what you're building, and you know what
16:56
you need to do to get there. And so, and
16:58
I I consult with so many companies. I've
17:00
seen this happen so many different ways.
17:02
And I've been the founder that this has
17:04
also happened to, right? Like you have
17:05
your board meeting and you're like, "All
17:06
right, gearing up for a fight. Like we
17:08
have to go in um everything has to look
17:10
perfect and we have to really sell what
17:13
we're doing." It's um there's not always
17:16
the trust in the founder to really lead
17:18
their own business and and define what
17:20
success looks like and how they're going
17:21
to get there. Um and when you don't
17:23
trust the founder, what's the point of
17:25
writing a check if you're not going to
17:26
trust the founder to really push their
17:28
vision forward? Um yeah. So, what do
17:31
what do some founders maybe
17:33
misunderstand about what health 2047 is
17:36
is actually offering them?
17:41
>> Uh, probably the most common misbeh mis
17:43
mis misunderstood belief. There we go.
17:46
>> Um, is that um miraculously they're
17:49
going to get access to all AMA members.
17:52
That is we are not we are in no sense
17:55
the marketing agency or trying to sell
17:57
AMA members, right? that is that is uh
17:59
the Chinese wall, right? Church and
18:02
state, whatever you want to use as the
18:04
proxy for division. Um in fact, um you
18:06
know, we don't even really show up at
18:08
the AMA member meetings that, you know,
18:11
happen, you know, in earnest twice a
18:13
year at a national level. Then there's a
18:15
variety of structured events that
18:16
happen, you know, within state, but we
18:18
don't do any of that, right? And so I
18:20
think that's probably the u most common
18:22
uh mish um uh belief around what we are
18:26
doing. Look, you know, at the end of the
18:28
day, the AMA brings some amazing um uh
18:32
guidance and governance to what we're
18:35
doing. Um and they're they're an amazing
18:37
partner from a research um and insights
18:40
point of view. Um but you know, we're
18:42
here to amplify the AMA's mission um on
18:44
the commercial side, right? We have a a
18:46
really wonderful policy organization in
18:49
uh Washington DC um who work at the kind
18:51
of government level, that's federal and
18:53
state u from the AMA. our role is on the
18:56
commercial side, right? And so, you
18:57
know, somebody writes dollars, somebody
18:59
says, "We got to solve a problem
19:00
somewhere in the country." Um, usually
19:02
it's the commercial, you know, side of
19:04
of health care or, you know, vendors who
19:06
pick up that, you know, uh, that mantle
19:09
and run with it. And so, you know, we've
19:11
we believe that one of the things we
19:13
should be doing is helping, um, founders
19:15
build in that, you know, context. And so
19:17
um you know we've got experts from
19:19
clinical research um AI uh commercial uh
19:23
financing funding etc all on the team to
19:27
underscore not just um where those
19:30
businesses need to find um tools you
19:33
know see earlier comments about risk
19:35
management but then how are we helping
19:37
those who are established you know I
19:39
probably take uh a third of my calls are
19:41
from established founders just like hey
19:43
we're trying to navigate some some you
19:45
know pretty meaty challenges is, you
19:47
know, what's your how do you approach
19:48
that or what's your thoughts on this?
19:50
Um, so, you know, it's a joy of my job.
19:52
I mean, this is the best job I ever had.
19:55
>> It doesn't feel like a job. You're just
19:57
enjoying it too much.
20:01
>> And Jill, I want to touch base on
20:02
something because you in my mind are an
20:05
expert when it comes to ecosystem
20:07
building.
20:08
And when you think about a vibrant
20:11
ecosystem, what are some of the things
20:14
that need to happen in order for that
20:16
ecosystem to be sustainable? Because I
20:18
can imagine there's probably elements
20:21
that the AMA has and health 2047 has.
20:24
And I just want to know other things I
20:26
think we haven't considered
20:28
>> um for building a healthy ecosystem.
20:31
>> Yeah. Yeah.
20:32
>> Takes a lot of work, right? It's like
20:34
any type of community building, like you
20:36
need to be ever present, right? Like
20:39
you're always trying to create more
20:41
connections, more touch points, more
20:43
opportunities. Um that kind of being a
20:46
master connector and being able to see
20:48
different people from different parts of
20:50
the ecosystem and be like, "Wait a
20:51
second, if they got together, they could
20:53
do X." Right? trying to kind of make
20:55
those uh those connections and utilize
20:58
your network in a way that doesn't just
21:00
uplift your goals, but uplifts
21:02
everyone's. Um I'm obviously extremely
21:05
biased here, but the one the most
21:07
incredible ecosystem I've ever been a
21:08
part of is the women's health ecosystem.
21:11
Um unlike other areas, there is kind of
21:14
more of an abundance mindset of a rising
21:16
tide lifts all ships, right? there's
21:18
something to said for when um
21:21
>> you're kind of spending a lot of your
21:22
time fighting, right? It's it's tough to
21:24
be in women's health. It's tough to be a
21:26
founder in the space. Um it's tough to
21:28
get money. It's tough to fund raise.
21:30
It's tough to like actually sell that
21:31
this isn't like just some niche market
21:33
and all of the things, right?
21:35
>> Um and part of that like daily fight
21:37
creates a solidarity and also just a an
21:42
ethos of showing up for each other,
21:45
right? um you don't genuinely and truly
21:48
if you're like if you need something
21:51
you're going to this ecosystem and
21:52
somebody's going to be there to be like
21:53
absolutely I can chat you through this I
21:55
can make this introduction I can I can
21:57
help right so the fact that everybody in
22:00
the ecosystem first of all is like
22:02
pretty active right and genu
22:05
>> um the opportunities to come together
22:07
we're starting to get more of them but
22:10
there aren't uh a ton we're scattered
22:12
all across the country right so that
22:14
that willingness to help and show up for
22:16
each other, to support each other, to
22:18
celebrate each other's wins, to like be
22:20
there to hold hands for each other's
22:22
losses um is really really important for
22:25
any ecosystem and I think healthcare,
22:28
digital health, every ecosystem can
22:30
really learn from the way women's health
22:32
has done that um and the ways in which
22:34
we've created such a a tightlyknit group
22:37
that is not exclusive, right? like we're
22:40
we're always willing to bring new people
22:42
in and to to accept people into the fold
22:46
and slowly but surely it's growing. Um
22:48
but the willingness to like really show
22:50
up for each other is I think probably
22:52
the most important part of any strong
22:55
ecosystem.
22:56
>> Yeah, you you said it. It takes time
22:59
too.
22:59
>> So much time.
23:00
>> Sometimes people are just like they want
23:02
the end product. It's like wait a second
23:03
that like nothing awesome that was built
23:07
uh was ever built in a short amount of
23:08
time. It took took a little bit.
23:11
>> And I think the other part of um and
23:13
this is something that has been kind of
23:15
defined the way I go about my
23:16
professional life is like the there is
23:18
definitely um there's the ability to be
23:22
transactional particularly with what we
23:24
do, right? Seeing people being like,
23:26
"Okay, what value can they bring to me?"
23:28
And that's the way that you're defining
23:29
a person in that relationship.
23:31
>> Um and there's nothing worse you can do
23:33
for yourself over time than be a
23:35
transactional person, right? like you're
23:37
not going to be able to build the
23:39
relationships that really are
23:41
sustainable and stand the test of time
23:42
if you are going about it in that way.
23:45
So the and it's tempting because it's
23:47
easier, right? And it kind of gets you
23:50
to your ends faster, but viewing each
23:52
and every relationship as an opportunity
23:54
to help someone else and to really show
23:56
up and have that be the reframe in the
23:59
mind that you're looking in. Um, and
24:01
also taking the time to maintain it,
24:04
right? Like I'll see some post on
24:07
LinkedIn makes me think and I I'm like,
24:09
"Oh, let me text this person, see how
24:10
they're doing, right?" Like this is
24:12
actually really relevant for
24:13
>> no agenda. Just reach out. Hey, how are
24:15
you?
24:15
>> Yeah. Yeah. The connectivity. Um and
24:18
again, it's time consuming, but also
24:20
when you when I need help, when I'm like
24:23
I don't really know what to do
24:24
right now. I always know the people that
24:26
I can call and text and I know they're
24:28
always going to answer my call because I
24:30
help because I've helped them before,
24:31
right? you build reciprocity in a really
24:34
beautiful supportive way um when you go
24:37
at community and and your professional
24:40
networking at that in that way.
24:43
>> Totally couldn't agree with you more.
24:44
It's a living breathing ecosystem. You
24:46
got to constantly feed it. If you're
24:48
going to eat from it, you got to feed it
24:49
way more than what you take from it.
24:51
>> Exactly.
24:51
>> Um I want to go in on maybe maybe one of
24:54
the ports if possible. Um maybe take us
24:58
inside of one of them. You mentioned
24:59
Scholar RX. So, it'll have to be that
25:00
one, but there's a few other ones. I'
25:03
love to just kind of talk about, we know
25:05
that this journey is not one that's sort
25:08
of a straight road. There's a lot of
25:10
detours along the way. Maybe talk a
25:13
little bit about to the degree that
25:14
you're able to talk to when things kind
25:16
of detourred. Um maybe you were
25:18
generally concerned things weren't going
25:19
to work out like and and what you did.
25:23
>> Yeah. Um so, I'm going to use a couple
25:26
of vignettes from different ones. Um and
25:29
so uh you know Zing Health is the first
25:33
big one that we did once we kind of
25:34
graduated from our pure uh venture
25:36
studio model. Um you know this was a
25:38
team that was uh uh founded by um a
25:43
wonderful uh cardiologist uh Dr. Eric
25:45
Whitaker um and he kind of came to us
25:48
and said look the managed Medicare plans
25:50
are not serving you know
25:51
African-Americans Latinx populations
25:53
southside of Chicago. Um this is 20 uh
25:57
late 2020 or sorry early 2020. Uh in
26:00
fact it was the last trip I had to as
26:02
part of the founding and getting
26:03
gathering the team together before co um
26:06
was getting you know team around the
26:07
table. Okay how are we going to tackle
26:09
this problem etc. We'd already kind of
26:11
committed to what we're going to try to
26:12
do collectively but then it was okay now
26:14
we're going to need to start executing
26:16
and um he said look we don't have
26:18
anybody to you know lead our digital
26:20
marketing strategy. Uh you know Warren
26:22
are you are you up for it? And I said, I
26:24
I've I've never done a anything like
26:27
this. And so that summer I started, you
26:29
know, figuring this out, like learning,
26:31
you know, obviously I knew I knew a bit
26:33
about marketing, but not at the kind of
26:34
structural level. And obviously the um
26:37
uh all the regulations that exist around
26:39
it, by the way. Um and very quickly, not
26:41
only did we have an amazing team, we
26:43
executed really well that year and set
26:45
us up, you know, for a successful 2021,
26:48
but you know, from from the start, you
26:50
know, working with Dr. Whitaker all the
26:52
way through to you know the end of that
26:54
a cycle. It was a sprint and a well
26:56
sorry it's a marathon but a series of
26:58
sprints to not only redefine how um you
27:02
identify the target audiences how you
27:04
then go after them and how you serve
27:06
them in a way that um makes most
27:09
scalable sense. And so for Zing you know
27:12
that's that's part of their ethos.
27:13
That's their that's their structure. Um
27:15
and they've kind of carried that
27:17
through. who they're now, you know, uh
27:18
serving dual eligible um uh members
27:21
throughout the largely the Midwest um
27:23
with this focused on um underserved
27:26
populations. Um and they, you know,
27:27
their major city or urban environments
27:29
that they're uh serving, you know, our
27:32
predominantly, you know, underserved
27:33
communities. And so, you know, we're
27:35
super excited about what they're doing.
27:37
Um and then you uh kind of roll forward,
27:40
we we backed another business, um a
27:42
company called
27:43
>> Wait a second. So, so they brought you
27:45
in. You know what it reminds me of? Like
27:46
as you were mentioning that unpacking,
27:48
I'm like you're like a Navy Seal. You're
27:51
like, "All right, we have this mission.
27:53
We need you to do this." And you're
27:55
like, "All right, let me let me figure
27:57
this out." Like at any given point in
28:00
time, did it seem like it was a lot for
28:04
you to manage, especially given
28:06
everything that's already on your plate?
28:08
Um you know so you know when when we do
28:12
have these deep dives with you know as
28:14
an you know executive in residence or
28:15
however you want to call it um we we
28:18
kind of throttle back some of
28:20
responsibilities at hell 2047 so it
28:22
never feels too ownorous frankly the
28:24
biggest one is like now I'm on the team
28:26
and trying to make sure that this is
28:27
going to be a successful business right
28:29
so no longer am I you know shouting from
28:31
the sidelines I'm I'm literally playing
28:32
the game
28:34
>> um and so and so I think that's been
28:36
that was a big you know aha moment for
28:38
that one. Um, you know, and we'll talk
28:40
about another one here coming up. But I
28:42
think, you know, it's it's one of those
28:44
things where I think as a builder um,
28:47
and you know, I I co-founded a marketing
28:50
company um, somewhere in the past 10
28:52
years and, you know, we had a sideways
28:54
exit, I guess, if you want to call it
28:56
that. But, you know, part of that
28:58
building was, okay, how do we all get
28:59
together in um, uh, around this problem
29:02
and then like just, you know, solve it,
29:04
right? you know this um uh wonderful
29:08
like evolution that every team has which
29:10
is okay we understand the problem but we
29:12
don't have a solution and eventually you
29:13
get to that solution um and that's all
29:16
you know that's what any of us would do
29:17
and I think you know you say Navy Seal I
29:19
I would probably say we're more like you
29:21
know just a friendly set of consultants
29:23
that can show up and help out um because
29:26
not and it doesn't mean that we're
29:28
always showing up you know uh as experts
29:30
day one right you can't tell me that
29:32
somebody from one of the big four
29:33
consulting shops is like the expert in
29:35
the thing the day be or uh on
29:37
everything. They're they're go doing
29:39
their own training and and learning the
29:41
day before, a couple days before. Um and
29:43
you know, we've we've luckily got a
29:45
great advisory network who, you know,
29:47
when I say, "Hey, I I got to do some
29:48
marketing stuff." Oh, we've got three
29:50
people who've literally run marketing
29:52
for Fortune 100 companies on our
29:54
advisory council. Um or, you know, we're
29:57
we're wrestling with a gnarly uh sales
30:00
process into a health system. We've got
30:01
three or four leaders who've run either
30:03
the health systems themselves or the um
30:06
the you know uh vendor management
30:09
procurement processes on our advisory
30:11
council. And so I get to call those
30:13
folks up and they're helping me get
30:15
smart really quick and then you know as
30:17
a a backs stop when we're trying to
30:19
execute. Um and so you know Zing will
30:21
cover over 40 I think 45,000 lives or so
30:25
this year um with the growth that
30:26
they've had. So we're excited about
30:28
where they're at.
30:29
>> That's amazing. Yeah,
30:31
>> that's really amazing. Are there any
30:33
ones that have come through
30:36
the early venture studio that you know
30:39
haven't made it? You know, any ones that
30:41
you're willing to to share and you know
30:43
what maybe some of the learnings were
30:44
from that?
30:46
>> Uh yeah, I mean we look you there's
30:48
always the anti-portfolio. There's
30:50
always the group that uh don't quite
30:52
make it. I I think the the biggest ahas
30:55
are you know and in fact it's born. It's
30:58
actually how our diligence works, right?
31:00
It's um you got to be able to articulate
31:02
the problem really succinctly and um you
31:05
know we can I can count you know on two
31:07
hands how many companies that we've
31:09
partnered with or been you know in the
31:11
midst of trying to you know uh back etc
31:15
where they just didn't understand the
31:16
problem as well as as they really I
31:19
think should have um because then
31:21
doesn't matter how great a solution is
31:23
if it's not a clear problem or something
31:24
that somebody's really aching over. Um,
31:27
you know, one of our one of my
31:28
colleagues, Carl, uses the framing of
31:30
um, is it a vitamin or a painkiller? Um,
31:33
and, um, you know, these the if the
31:36
problem looks like a vitamin, it's got
31:37
it's just weak weaker than, you know,
31:40
painkillers. And so, we're always
31:41
looking for painkillers. So, that kind
31:43
of part of our diligence process. The
31:46
other um, frankly is always on the
31:48
commercial side. Um, healthc care is
31:50
actually really, really hard from a
31:52
commercial point of view. And why is
31:55
that, right? So you raise funds. Let's
31:57
say you go raise, you know, nice seed
31:58
round, right? Maybe you get two years,
32:00
two and a half years out of that seed
32:02
round.
32:04
That is just the start of your journey.
32:06
It takes 18 to 24 months to close
32:08
contracts for most of healthcare. There
32:10
are short circuits and some people have
32:12
faster routes, etc. But by and large,
32:14
like the industry standard is 18 to 24
32:17
months. And guess what? The house always
32:19
wins. So, if you start doing that sale
32:22
on day one of when that money lands,
32:24
you're running out of money from that
32:26
seed raise right as you're getting your
32:28
first commercial, you know, uh, go live
32:30
probably running. And that's not good
32:32
for, you know, venture money, but it's
32:34
also frankly not good for the, uh,
32:35
founder um because now they're raising
32:37
on, oh, I just need like another six to
32:39
eight months to get to, um, to get to
32:42
that, you know, early revenue, you know,
32:43
signaling. What is re what is revenue to
32:47
an investor? Well, it's signal from the
32:50
customer that they like what you're
32:52
doing. It's not a pilot.
32:54
>> It's not, you know, anything that's kind
32:55
of like transactional. It's a it's a a
32:58
relationship. You know, going back to,
33:00
you know, Jill's comments earlier, your
33:02
first customer is going to be your
33:04
reference customer. Your first customer
33:06
is going to be where you're going to
33:07
generate success metrics out of. So, you
33:09
got to land this right. And that's often
33:12
times I think not only a
33:13
misunderstanding about healthcare in
33:14
terms of the complexities of go to
33:16
market but then um where you know
33:18
founders often times struggle is
33:20
understanding that they have to be
33:22
science chief right usually because
33:24
we're backing science-based businesses
33:25
you got to be somehow technically
33:27
literate because you got to build
33:28
something usually that's technical in
33:29
this back this story and then lastly you
33:32
got to go sell it so now you got to be a
33:33
salesperson as well these are like
33:36
oftentimes desperate like uh you know
33:39
skill sets
33:41
Jill, I want to bring you in here
33:42
because you're really good, you know, at
33:45
this stage. Where what are some of the
33:47
skills that you see people are missing?
33:49
And then where what are some of those
33:51
gaps where you think health 2047 kind of
33:53
upskills some of the founders that
33:55
they're working with?
33:57
>> Skills founders are missing or just in
34:00
general or for
34:00
>> just in general. I mean I mean just even
34:02
for commercial work just because yeah
34:04
>> I feel like your area kind of intersects
34:07
between net marketing the go to market
34:10
and a lot of those other areas that that
34:11
require you know booking revenue
34:14
>> you've been in that space for a bit
34:17
>> yeah yeah um I think coachability is
34:19
like one of the most important things
34:20
right um you have to be able you as a
34:23
founder you need to believe without a
34:25
shadow of a doubt that you have the best
34:27
product that it's going to make it um
34:28
you have to have internal optimism right
34:31
But you also have to be able to listen
34:33
to others and be able to adjust and
34:36
change, right? Like adaptability is the
34:38
most important thing that you can
34:40
possibly have as a founder. And if
34:42
you're not able to take that, hey, this
34:44
actually might not be the best way we
34:46
need to take X and actually do Y, then
34:49
you're not going to make it. Um, I think
34:51
the other thing is, and this is
34:53
particularly with commercial, right?
34:55
like that having that high EQ again the
34:59
relational instead of transactional
35:02
qualities
35:03
>> approach relationship building um that
35:07
you that it's a marriage between you and
35:08
your first customer as Warren was saying
35:10
right like this is what's going to be
35:11
the proof point for everything you do
35:13
after that and so being able to maintain
35:17
that relationship and build trust um
35:20
even when things might not be going well
35:22
or right being able to Um, some
35:27
>> just showing people, you know, when
35:28
something goes Yeah. When something goes
35:29
off track, how do you respond? Do you
35:31
just
35:32
>> do you ghost? Do you go offline or do
35:34
you come back and you hit it head on and
35:35
say, "Here's what we're doing. Here's
35:37
what we're doing about it. Here's what
35:39
you know how we've approached it.
35:40
>> How can we think through it together,
35:42
right? Like this is a whether it's a
35:44
pilot or an early relationship, we're
35:46
still seeing how this is going to work.
35:47
Like let let's be partners in this." Um,
35:50
and that's also I think something
35:53
founders don't necessarily just like
35:55
that e piece right of like relationship
35:58
maintenance and growth is extremely
36:00
extremely important and that's how
36:02
you're going to be making sales, right?
36:04
It's going to be the relationships you
36:05
have. Most of your commercial deals,
36:07
particularly in the beginning, you're
36:09
not getting them from a cold call,
36:10
right? They're coming from your network
36:12
or they're coming from you. And these
36:13
are people that you've already been able
36:15
to build some trust with personally or
36:17
you're borrowing the trust that somebody
36:19
else has built whether it's a
36:20
co-founder, adviser, investor, whatever.
36:21
And whether it's your trust or trust
36:23
that's been borrowed, you need to
36:25
maintain that, right? Um, and that takes
36:28
a lot of energy and it takes a very
36:30
specific view on on how to grow and how
36:32
to work with others and support others.
36:37
I think it's important to recognize like
36:40
borrowing somebody else's network is
36:42
kind of like a common practice, right?
36:44
But it's actually a skill set from a
36:46
founders's point of view. So if you're
36:47
going to borrow somebody else's network,
36:49
it's about having respect for that.
36:51
>> Yeah.
36:52
>> Again, not transactional. And I think
36:53
one of the biggest challenges that, you
36:55
know, anybody is going to be facing in
36:57
this is um it's so easy to be, oh,
37:00
thanks for the intro. and then go run
37:01
off and man and and kind of like and
37:03
ghost the person who did the original
37:05
introductions. But like I I can't
37:07
underscore this enough. If if you don't
37:10
understand as a founder that borrowing
37:11
that network is about respect for that
37:14
that originator, then you're also
37:16
missing a key key element. We've we've
37:20
had we've been through that several
37:22
times and it's not a pleasant thing and
37:24
frankly it often comes back to bite both
37:26
parties in the proverbials.
37:29
Yeah. 100%.
37:31
>> Yeah. Extending credibility is um
37:35
extending credibility to the wrong
37:36
person is a really damaging thing.
37:39
>> Yeah.
37:39
>> And you obviously learn, you know,
37:42
you've got scars on your backs, you
37:44
know, from doing it. Everyone, even the
37:46
best connectors I know have done it. And
37:49
you just have to be really mindful. Uh
37:51
sometimes you make mistakes, right? And
37:54
you learn from them. That's just how
37:56
life works. you're either getting better
37:57
or you're just you're not.
38:00
>> And that's what separates a good an okay
38:03
founder from a phenomenal founder,
38:05
right? Is like learning from those
38:06
mistakes. I will always say like the
38:09
best experiences I've had that have
38:11
taught me the most were failures, not
38:12
successes. You learn so much more from
38:14
failures than us, right? Um, and so
38:16
being able to take those lessons learned
38:18
and those scars and reflect and then
38:21
have it change your behavior going
38:23
forward is really what separates
38:26
successful versus and unsuccessful
38:29
founders.
38:31
>> So let's just say you and the team,
38:33
you're continuing to crew it along.
38:35
You're doing your two to three
38:36
investments per year.
38:38
You're doing that for a few years. Then
38:40
what?
38:44
Hopefully there's an exit or
38:45
>> hopefully there's some exit. I mean, you
38:47
know, we're we're an evergreen fund. So,
38:49
you know, if you're a founder and you
38:51
don't understand the nature of funds,
38:53
right? Then there's kind of a short
38:54
circuit thing, right? So, first of all,
38:56
you always want to understand where you
38:57
are in somebody's in the target
38:59
investors like investing cycle, right?
39:01
So, healthcare most funds are probably
39:04
in the, you know, 10ish year duration,
39:06
right? So, they take capital in year one
39:09
and then trunch it over a period of
39:10
time. Um, but then they're having to do
39:12
that the returns by year 10 or at least
39:14
hopefully.
39:15
>> Yeah.
39:15
>> And if you're going to be in the uh
39:17
returns bucket, then you need to be able
39:19
to get out within the, you know, the
39:20
10-year cycle. Um, we are an evergreen
39:23
fund, so our capital, you know, we're
39:25
we're rolling that every year. And the
39:27
goal is not an immediate IRRa on like a
39:30
set time frame. It's really around um
39:33
reinvesting in our business model and
39:35
then um and then hopefully the AMA as
39:38
well. And so we don't have a that ever
39:41
sorry we don't have that time horizon.
39:43
So um the reality is that we would love
39:47
to have a a wide ranging portfolio of
39:50
companies that are you know consistently
39:52
you know bucketed in seed A B C exits
39:56
etc. Um because that's how not only I
40:00
can't spend all my time on boards um and
40:02
eventually our our role on an early
40:04
stage board becomes less relevant later
40:06
stage. we may sit as board observers
40:08
etc. but um the responsibility that you
40:10
know that being on a board has you want
40:14
somebody who's going to help you hit
40:16
your next milestones eventually um our
40:19
role is really early stage and that's um
40:21
and that's the joy of having a portfolio
40:23
of businesses that are across the
40:24
spectrum. So, uh, you know, if I had my
40:27
choice, we'd be doing this, uh, till,
40:29
you know, I couldn't understand what
40:31
technology was being developed any
40:32
longer. Um, because it really is, you
40:35
know, some of the most rewarding work I
40:37
get to do is working with, you know,
40:39
founders. Whether we've invested in you
40:41
or not, I love talking to founders. It's
40:43
actually the only way that, um, I get to
40:45
be better at my job is staying curious.
40:48
Um, it's talking and working with, you
40:49
know, amazing people like Jill, uh, who
40:52
bring a fresh perspective. um but
40:55
frankly have you know built and have
40:57
their own war stories that um are
41:00
important for not just you like oh how
41:03
do we build a better business right now
41:04
one of my favorite things to do is ask
41:05
founders how they're using AI in
41:08
building their business and contracting
41:10
costs because at the end of the day for
41:12
me right I would love to see businesses
41:14
that are getting built on lower total
41:16
money in for a variety of reasons least
41:18
of all because it's more efficient um
41:21
and uh um and that's a fun story and a
41:24
fun uncovering to do um because we're
41:26
really in this like intersection of you
41:28
know we're really reinventing the way
41:30
that capital is being deployed for the
41:32
many of these um these platforms some
41:35
you know we've we're doing experiments
41:36
on right transparency of data data
41:39
governance of what the AI models are
41:41
producing from a consumer point of view
41:43
but uh uh of of a product but then the
41:46
other side of it is that hey I can run
41:48
my business more efficiently because I
41:49
don't need a finance team right I can do
41:52
accounts receivable and all my
41:54
accounting automatically. My expenses
41:55
are now done automatically. Um, these
41:58
are people who, you know, I used to
41:59
employ early stage. I mean, you know,
42:02
seed financing might employ somebody
42:03
part-time from a third party. Um, that's
42:06
not no longer happening. And the list
42:08
continues like marketing's getting the
42:09
benefits of this, etc.
42:11
>> Yeah. Yeah. That's super interesting
42:13
that you mention that. Jill, I want to
42:15
go back to something because it's been
42:16
in my mind since you made a comment
42:18
around sort of the women's health
42:20
>> because it's it's it's gotten kind of
42:22
front and center now. I just I'd say
42:24
over the last five or so years and I
42:27
think you've been in the space long
42:28
enough to kind of know that you know
42:31
trendy isn't always the same as you know
42:35
funded um and take and taken seriously.
42:38
I'm just sort of curious like what like
42:40
what has actually changed and like what
42:44
hasn't changed at all, you know, as it
42:47
pertains to on the women's health side
42:49
of stuff.
42:50
>> Yeah. So, women's health is uh has been
42:53
an emerging market for like I don't know
42:54
a decade, right?
42:56
>> It's been a while. I feel like it's it's
42:57
been a while.
42:58
>> It's been a while that we've been
42:59
emerging and we'll see when uh and if we
43:02
actually emerge. Uh but um I think a lot
43:05
of things have changed in positive ways
43:07
and a lot of things have um stayed the
43:09
same or changed in negative ways, right?
43:11
So there's definitely more focus on
43:14
women's health. There's more media,
43:16
there's more education, there's more um
43:19
c like click appeal, right, than in
43:22
previous years. the biggest problems
43:24
women's health founders really had. Um,
43:26
you go in, you pitch your company, you
43:28
don't even get a chance to talk about
43:30
your business or your product because
43:31
the entire pitch is taken up explaining
43:34
the problem to people who have
43:35
absolutely no understanding of what the
43:37
problem is. Right? So like most founders
43:39
like problem is a slide and then you get
43:40
to move to all the cool fun things
43:42
you're doing and women's health people
43:43
were sitting in the room with men being
43:45
like menop like menopause is a disease
43:47
the same way all that right like just
43:49
genuinely no understanding. So that
43:52
education piece took so long and it was
43:54
so difficult to do. Um with just kind of
43:58
also the advent of uh social media AI
44:01
information being a bit more available
44:02
to us and it having been some time that
44:04
these companies and these founders have
44:06
been in in the game that part genuinely
44:09
and truly has gotten better, right? Like
44:12
you go into versus 5