YouSaid · the spoken record

Josh Stein

lines on the record: 63
first: 2019-04-25
most recent: 2019-04-25
sittings or episodes: 1
sources: podcast

Every line below is reproduced as it was said and linked to the record it came from. Nothing here is summarised or generated. Directory · Search · Corrections

“One is build the multidisciplinary team early. Two is understanding if the person that suffers from the pain point can actually pay for your solution because there's a lot of misenlicened incentives in the healthcare system. And three, with the right technology, you can have massive impact on patient lives and the experience that we have with the healthcare system, which we will all touch in our lifetime. And if there's anything you can do to make it better, as an entrepreneur, I would say that is extraordinarily satisfying.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, because that, you know, you're creating the next thing and the next thing and the next thing, and you build out from there, and eventually you cover so much surface area that you become very sticky solution and you hopefully become a complete solution sort of closer to the A to”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“You've got the right solution, you can get very creative in how you get paid. So figuring out different pricing structures or value capture mechanisms, I think, is something that you can do pretty organically because if you are making a difference in the system, system has so much cost built into it and so much revenue flowing through it that there are ways to be very imaginative there. So that's the first thing I would say. The second thing I would say is thinking about adjacencies. going from one your core function to the next adjacent use case case not all adjacencies are created equal. One might be easier than the other. It's almost like jumping on stones across a pond or something, right? What's the next stone I can jump on that's least likely to make me fall into the water. Even if it doesn't get me as far as another one.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, no, I mean, absolutely. There's tons of things you can be doing on a daily basis with end users and just feedback mechanisms on how people are, are they actually able to do their jobs, for instance, and making minor tweaks to the workflows and whatnot. So that was always a component of a more organic and dynamic aspect of how we did things. The other thing that you need to kind of think about doing in parallel is so much of success of technology and healthcare is predicated on integrating into other ecosystem players. And so this is actually probably one industry where you definitely can't just build in a vacuum. You actually should understand even if it's not for another few years that you're really going to have to do this, like who are the players? We just need to get to know so that we're on their radar when time comes for us to take the hammer and like try to break down the wall of integration with that vendor that we are on their good side and that they know who we are so we can kind of make that happen faster. So things like that, I think you can be doing in parallel to the kind of formula.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“I mean, is there anything that you can figure out as you go? It sounds like you need to know so much before you begin and be so self-aware and so kind of like have the end game insight. Like, are there things that you can leave sort of more organic and like feel out as you go?”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“That and then have the conversation like, okay, if we were able to accomplish what we just described, is it worth it? Is the juice worth the squeeze? Because it's so expensive to distribute product in this market because of the sales cycles and the nature of the enterprise sales motion and whatnot that if you're not able to envision a path towards being like at least a half a million dollar kind of a year type solution in this space is actually not financially worth it to build a business in that area.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“It's almost like a necessary evil where you have to say in some way, shape, or form, you are going to reduce costs, but that can't be your primary value proposition. Because at the end of the day, it's a line in the cost structure that can get wiped out over time and potentially get commoditized.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Julie and I have had this debate before, which is a lot of the software platforms that go into healthcare have been sort of predicated on we're going to cut costs. And I don't know of any sort of solution out there that is meaningfully been able to make a very, very strong case that they can cut costs. And by the way, part of it, I think, is because it's really hard to measure costs.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“The only North Star you can have, and this is going to sound cliche, but really understanding your value proposition truly from the customer standpoint, it becomes a critical, critical sort of guide for what you do. And this is a debate that healthcare companies have all the time, which is, should your value proposition be I'm going to save the system money because the healthcare system is very inefficient and it runs on very low margins generally. Should it be that I am going to result in better outcomes for patients? Is it going to be I'm going to create some sort of a lift in terms of return on investment? There's a bunch of different ways you can think about value proposition. If you don't have that crystal clear from the outset, the amount of obstacles that you are going to hit along the way are going to make it such that it's going to be very difficult to get to the other side. If you don't really understand the workflow and the culture and the regulation and the governance and the politics and all of the other things, you can have a theory on what the value proposition is, but you need your customer to confirm that early on. And sadly, the best way to confirm that is to have them buy something, obviously.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“But also, like, know where you're going and do that kind of like deep, I want to say, like soul searching, you know, on a company level and like build out accordingly. So how do you get that big center of gravity of really knowing yourself, knowing where you're going, but like be able to be flexible with that distortion along the way?”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“How would you both embrace that distortion early on and not get completely sort of knocked off your path by it? Because it strikes me that a lot of what you're describing is kind of like know thyself, like know yourself very deeply. Unless the tagline is known, by the way. Oh, was it really? Oh, that's really funny. I did not work that in for you.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Know the definition of product market fit is when the right product meets a good market creates such distortions in the marketplace that by the time you actually get through all the hoops, you have such a sort of skewed product. It's not really product market fit. It's almost like accepted product capture here. You have regulatory issues. You have pricing concerns. You have incumbents. You have so many aspects that sort of distort the market that I would argue that you don't have a normally functioning market for software in healthcare.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Have to have the full solution. And the related point I would make to that is it's really hard to have a point solution, even if that point solution is very, very good. I think people in general in the healthcare system are looking to buy a complete solution. So if you take the problem from A to B to C to D, that's great, but they need A to Z. And they can't get A to Z from you, it's very hard to get them to buy A to C from you. I'll go even further than Julia. I will say not”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“If a transaction falls through the cracks while you're doing some kind of revenue cycle type encounter, you might not get paid for a procedure that could have a severe impact on your bottom line. You need more funding. You need to think differently about your strategy for product and what that footprint looks like”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“I think in other industries, you can sort of quote unquote get away with having a product that does one thing really, really well, right? And then start there and, yes, expand over time, but at least you can get buy-in to prove your value with that initial use case. I think going back to a lot of the points you made earlier in healthcare, when you're in the flow of impacting a patient encounter and saying like you're going to rip something out or change the way that you're doing something or what have you, you have to make sure that it's going to give you the right answer, so to speak. And so even if it's just one feature, it might mean, okay, yes, it could be one feature, but you have to be integrated into seven different systems to make sure that the data flowing into that one feature is enough to inform the right outcome or decision-making.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, I mean, certainly at Cairo is the way we mitigated it was we thought about what our fundraising strategy would be to give ourselves enough runway to have that model play out. We needed to fund the sales cycles and the adoption cycles to create a new category of solution that didn't exist.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Totally, yeah. It's like once you do make it, it's totally sticky, right? The LTV essentially of tech companies that actually, you know, make it and get to a certain level of scale is through the roof. There's no incentive to rip them out, right? Because if they work, they work. The switching cost, because of all the human and cultural elements that we described is huge. Yeah.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely. Those are like the tangible examples, but the same applies to software and technology, and that's a lot of the reason why you see the market leading companies that own the EHR space today are literally 45 years old. And by the way, those companies also didn't hit their stride until like 20 years into their journeys, right?”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“The facts machine are not yet mass market adopted. And it's the same. Over the last 17 years, there's been like a bajillion better versions of this stethoscope that we are just not seeing. The wheel could have been reinvented, but better. Absolutely.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“You can think about it, all the things that I've tried to replace the fax machine are not yet mass market adopted. And it's the same. You could see it in, I think the study actually focused primarily on stethoscopes and thermometers and things that literally have not been redesigned for hundreds of years because it's been so hard to disrupt them.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“I mean, that's a clear future. And so the question is when is the system ready for your particular solution to a problem that everyone agrees exists, right? Everyone agrees that we have to do a better job at being able to diagnose folks with genetic disease. And I think everyone would agree that using genomics, the ability to do this at large scale, to query multiple times, to use software, to make intelligent queries would be a very powerful tool, a very powerful solution for that. But the reality was, continues to be, that just the structures of the industry are such, even though that's where I think we will end up, it's just not ready for it now. And I think this is true for any entrepreneur, right? Timing is a big part of anything you do. I think timelines are especially warped in healthcare because it just takes a long time to adopt new technologies.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“That's a good question. So, look, the way I would think about it, I described what was for us at the company a very obvious evolution of where genetic testing would go. You would sequence everything first and you would test multiple times in silicone.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“One of the big challenges in healthcare is this idea that you can be too early. You can be too early for a couple of reasons. One is you need a lot of changes to workflows for the entire system to become much more modern.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah. I mean, my philosophy was to throw them in the deep end as part of the onboarding experience at Kairos, you had to visit a hospital call center. And they actually let you listen in on calls. It was like a religious transformation for these team members who went. Some came back and said, I cannot believe that this is how these organizations operate, right? Because like everyone thinks of healthcare is this very pristine. Like I'm going to trust you with my life and they'll come back and be horrified because they see that things are being run on paper and just how much burden they put on the customer, right? Because part of what you hear when you're listening in on these calls is like asking the patient, what do you want to do? And the patient's like, well, why would I have understand? I'm calling you guys a hospital. You're supposed to tell me what to do. So that was one reaction. The other reaction was completely emotional, right? Because a lot of these patients who were calling in had just been diagnosed with cancer and they have no idea what they're doing and they're calling because they need help. And then the call center agents sometimes felt helpless because they didn't have the tools or the work.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Totally. I'm going to be biased because I was the chief product officer of my company. And that's where I would say it would split, where I do think it's important for the leader of that organization to have a pretty deep understanding of the market. And so I happen to have had healthcare experience, not specifically in this particular segment per se, but I understood some of those cultural nuances and just dynamics of how the market worked to be able to set strategy. Below me, however, some of my best product managers were not healthcare people at all. And in fact, we had three products, one that was the call center product that I mentioned earlier, where the end users themselves were not healthcare people, right? And so these guys, you know, some of them were like high school graduates who go home and they use their iPhone and they're used to all these modern technologies and the rest of their lives and then they come to work and they're faced with these totally esoteric crappy hard to use systems and so I wanted someone who actually had kind of a consumer mindset”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“You need both in the get-go. Industry specific on the customer spacing side and domain expert from the engineering side. And then let's talk a little bit about the middle, the product, right? That's where the sausage gets made.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Making sure that the engineering team is as modern as possible is the most valuable thing you can do for your company. Because I think what's generally true and probably definitely true across the board is that healthcare, the data sets are so complex, right? They're complex in terms of their variety. They're complex in terms of their volume. They're unstructured. There's regulatory requirements. There's so many things that are challenging from a Whoever's customer facing I think has to be from that game, has to understand the space, has to understand who the customer is, has to understand the cultural norms and all of those things. Those things are both important.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Not a bad thing per se, but you wanted people who could really think out of the box and not be married to the way it's done today, because actually that's exactly the point of building companies in this space is to not do it the way it's been done. And so most of the technology systems that are in place are written on super legacy technologies and don't have things like APIs and whatnot. You need to be super creative about how to get into these systems and get data out because they were fundamentally not designed to have liquidity around the data that's stored in them. And so it was helpful to have people from the financial services industry, for instance, who had figured those things out with similar banking systems and whatnot and could kind of bring some of that creativity to the healthcare space. So engineering is definitely a space where I felt there was a positive to not having that healthcare domain knowledge, but certainly on the commercial side of the business, I think it's critically important.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah. So my thing from a team building experience, one of the biggest lessons that we certainly learned was valuing healthcare domain expertise earlier in the evolution of a company relative to other sectors. And then also thinking about where that makes sense, like what functions that makes sense, because it's not 100% universal statement across the board. I would say our engineering team, it was actually better that they came from outside of healthcare.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“But can help us understand the culture and the politics and what it means to even like talk to a physician. You know, we had a bunch of folks who had never been in healthcare who walked into meetings and called doctors by their first names. And that was a complete taboo in certain cultures where you have to call them Dr. Jones or Dr. Smith.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“And you're like, who there is no general reader? There's like. Or whatever. Like, these are different people. Yeah, there you go. So, yeah. So basically, we had folks in our company who had quote unquote healthcare experience, but maybe it was from the pharma industry or from payer or even like a different segment of the provider market, but not the specific market that we were going after, which was like a very esoteric, we were going after the biggest health systems, like the top-down approach in the enterprise space. And there's very specific characteristics of those organizations that are very different than even smaller hospital networks. The areas of the team building exercise that I wish we had been more thoughtful about were in terms of customer-facing roles where it was the team responsible for managing the customer relationship longer term, just how important it is for those people to have some kind of understanding and empathy and ideally experience with the kind of people that we were servicing. There is total merit to saying actually we need some insiders who might not have any technical skills whatsoever.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“What does that actually mean? 20 billion. Yeah. I used to work in publishing, and it reminds me of people who would pitch their books to us and be like, it's for the general reader. And you're like, who? There is no general reader. There's like somebody who likes to read Amy Tan. There's somebody who likes to read like, you know, or whatever. Like, these are different people. Yeah.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“So, my co founder is a physician by training. So we had sort of a deep clinical knowledge. But I would say actually we didn't have that many people who knew the specific market that we were going after. And that's another characteristic of healthcare startups is healthcare is so massive that when you talk about market segment, you have to be very specific about what you're talking about. So like when people come and say like, oh, I have a company that sells to providers. I'm like, that's great. That's like, you know, 20 billion. Like there's 20 billion ways that you could just describe providers. Like are you selling to hospitals? Are you selling to health systems? Are you selling to individual practices? And each of those can be multi-billion dollar markets in and of themselves.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“My prior experience was not in healthcare. And so a lot of my views on how to do these kind of things were informed by a company that was just a pure enterprise software company. And one of the mantras was you want to, in the early stages of a company, hire for all around athletes and just people who are utility players who can like roll with the punches and figure it out. It doesn't matter what kind of experience they had, as long as they're scrappy, intellectually motivated people, they're going to figure it out. So certainly took that approach when we started Kairos and hired folks, not necessarily from healthcare who maybe had some engineering experience or sales experience from elsewhere in the world and said, we're just going to go in there and figure it out.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Okay, so we've talked about kind of knowing the workflow and the complexity of the system, running the numbers and specking it out as concretely as possible. How about in terms of team building? Are there ways that you knowing what you knew down the road that you would have changed how you thought about building the team from the very beginning?”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“And I think we see that same trend actually happening in the consumer world where you used to have a bunch of services like the marketplaces that were purely tech and were just matching supply and demand and then getting out of the way. Whereas now you see a lot more services like in the real estate market where they're actually managing properties or we're actually going to clean the place and make sure it has good furniture and all that kind of stuff. My thing's the same premise holds true in healthcare where you realize that in order to truly make an impact, you kind of have to own certain parts of the full stack. And that's what you see playing out in the rest of the world as well.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Too unstructured. So that historically been the case. So if you have ways to ingest data and clean it and make it meaningful, then I think that is valued. Probably the most public one is what Flatiron was able to do and ultimately getting acquired by Roche for $2 billion. That's viewed as using an electronic medical record to capture patient experiences, take that information, and give researchers the ability to drive valuable insights from that. That's a relatively new thing. So I think there is the ability to create value there. So I think that's one axis. I think there's a general shift in the model that having a tech enabled service can be a valuable thing. And if done well can be a scalable business. In other words, if you know what you're trying to build and if the software layer reduces sufficient friction in the system and allows you to add people, not linearly as you scale, right, but in a leverageable way, then all of a sudden you can have technabled services that can grow.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Look, I would argue it's shifting on a couple of axes. The first one is data is becoming more and more valuable. Historically, data was viewed as being either too small in terms of its impact, too narrow, too dirty, et cetera, et cetera.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“A pure software company in healthcare is a really hard thing to do. Because on the one side, you have this challenge that it's hard to create a sort of a solution that's going to fit everyone. And therefore, you need to have some level of services around that software. That's on one extreme. So you need to have humans in the process or in the loop. And then the other extreme, if it is pure software, then it's considered that it should be free. So it's very hard to abstract value.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Because they didn't want the data to go outside. And it's for the reasons that we would expect. There's regulatory, there's risk associated with that today in 2019. In fact, the companies that have managed to use this technology have taken the sort of full stack service approach. So that sort of high low strategy became the approach is get folks to deploy into the cloud when they were willing to. And in the case where folks needed an appliance, we basically had to go to labs that had enough of sample volume that an appliance made sense for them and make basically the case there from an investment standpoint.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Had to do with plan A and a plan B. And so the plan A was we assumed that there would be a couple of. Forward-looking labs or forward thinking labs that would be willing to work in the cloud environment, much easier to deploy there. Plan B was we had to create a box. We had to create a box, and the box had to have essentially the computation of the ability. Yeah, we had a gnome appliance. Remember that.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Running the numbers for them. And by the way, we tried everything. I mean, we brought representatives from AWS that could show them that they had a HIPAA compliant cloud, that they had received all the certifications. And it came back to risk aversion. So the lab director saying, like, look, I'm sure all of that's true, but I'm not going to risk sending all of this data up into the cloud. So that was a big, big challenge for us. And it ended up being a major limitation for our ability to expand into the clinical setting because of all of those barriers.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Who's frankly, I think just defining the specs of what would be required to bring in our technology. Because I think people intuitively know that genomic data is massive, but I don't think they know sort of the level of computation required to run the interpretation.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“At that time, arguably even today, arguably even today in 2019, but definitely at that time, we probably should have known that earlier that would have changed how we thought about going into the clinical lab space.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Was a big roadblock. So, what that required us to do was to then focus on clinical labs that had the ability to make certain investments in upfront costs. And those tended to be very sophisticated labs that do a lot of research work in addition to patient care. And they tended to be on the sort of on the bleeding edge and they wanted to incorporate new technology and they were great partners and all of that. But then it goes back to your end of one problem. So you sell something into that lab and you go next door. And next door has a totally different set of capabilities, a totally different set of constraints, a totally different set of expectations. And so therefore all of a sudden the solution you created for lab A is not relevant or unattainable for lab B. Now to just add to the stepping in it, you know, when you're analyzing genomic data, there's a massive amount of computation required. And so we went in there assuming, well, this is easy. We're just going to shoot all of this up to the cloud. We'll run the analysis. We'll send the data back to the lab. The lab could verify it, generate a report, and off we go.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Too expensive. So, even though the theoretically, there's an ROI, a return on the investment of sequencing upfront, just the way the industry is structured, the way reimbursement flows, the way payments flow, it just didn't make sense for a lot of labs to do this.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“You can again... Assumption to make. And it turns out that there was a lot of challenges with that assumption. The first one is every lab is different. A lot of them didn't have the budget or the willingness to basically pay the upfront piece to buy the capability to use this technology. Or they didn't have the ability to sequence everything up front, even if all of the subsequent queries would be technically free later.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Get signed off by a lab director that goes back to a physician. Usually it's in the form of a diagnosis, right? And it gets signed off and it goes to the physician. The physician now takes that report and basically decides what to do based on that information. So our assumption was, well, if you have the ability to sequence DNA now in a way that you couldn't before, before you'd have to do all of these specific tests, you have to know what to test and then you'd test it and then you'd get a report. You have to know what street lamp the keys were under, right? Like there in that case. Whereas once you had the full genome, you could just sequence everything and just run a bunch of software queries. So our thought going into this was, well, that's an incredibly powerful tool for clinical labs because first of all, you can sequence just once and analyze over time.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Our initial hypothesis for an application in a clinical setting. You have technicians and docs that are inside of the laboratory setting receiving samples, running a test, analyzing the results of that test, generating a report,”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Thought was very flexible. And so challenge one is a solution looking for a problem is always a very, very dangerous thing. I think that's universally true. It's especially true in the healthcare space. And challenge two was understanding exactly where in the case of the clinical setting where this technology would be used in the workflow. So here we wanted to go after the clinical labs.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source