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

“Well, so, in our experience at NOMA, it was interesting because here, this is a company, the sole purpose of the company was to provide software capability to analyze genomic information. And so when you launch that, your assumption is, well, this could be used to power all kinds of applications. It could be used for research, either in academia industry. It can be used for clinical diagnostics.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Absolutely, because there is so much variability, because there is so much localization, the notion of the pure SaaS model, where you're just throwing technology over the fence and assuming that it will fit into whatever environment you're deploying it into, that is a moot point in healthcare. You actually do need to think about the services component of things. There was a whole generation of companies that got started like a decade ago that took these sort of tech-only approaches and failed to get scale or had to fundamentally pivot their models to actually take into account more of the human element of the service delivery model. I mean, even there's a term for it now, right? Tech enabled services is a way of doing things now in digital health that I think is well recognized that it's necessary to wrap the technology with a human component to essentially address and be able to accommodate all of the variation that you see across different customer bases. And it changes your cost structure fundamentally, the nature of how we talked about the business and how it scales.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, it probably had an impact on like go to market product design and product strategy, most importantly, the service model of you could either say we're going to design our software to be so flexible that it could work in any environment, or you could say we're going to provide services to come train your people to behave in a more standardized way relative to the rest of our book of business. And so we ultimately ended up taking a hybrid approach to both. But the latter, you know, that services approach is something that we hadn't thought about that allowed us to sort of abstract out the variation to some degree, but also provide value back to the customers in a pretty unique way because then we had the best practices for how it should work.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Correct. Yeah. When you boil that down to like, I'm a call center agent. And how do you define my job so that when I give you another piece of software to use to do that job, it's going to be seamless. And when you have that kind of heterogeneity around even the sheer definition of what the job is, it makes it very hard to design a scalable solution that can kind of fit into all those different environments. So day one, we actually were fortunate to get a customer that did have a pretty robust centralized call center group that was hundreds of people who literally.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Like on day one. First of all, there's heterogeneity and the actual scope of services of pretty much every call center that we encountered. Some call centers might be fully centralized and there are like a central 800 number that receives every call that comes into the hospital versus others that are decentralized that only serve the primary care line versus the cardiology line versus the dermatology line. And because of that, they will have just fundamentally different starting points of where they have to be in the workflow for the thing to work. The other aspect is the scope of functions that the call center plays. It could be everything from just a general marketing service where a customer might call in and say, do you provide these kinds of services? Can you give me directions to the clinic all the way to I need a prescription refill? I've been diagnosed with this thing. I need to figure out what kind of surgery I need. So again, much.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, and then you pull up the wool and it's like, oh, something else completely opposite cost centers. I mean, that's definitely an industry that if you look at retail or even all the airline companies and how they operate their customer service operations tend to be pretty standardized and pretty sophisticated in a lot of cases.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, the lay of the land. Yeah, and especially, I think it's very easy to get fooled in healthcare by looking at other industries and seeing how it works in the rest of the world. Because certainly the...”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“With Kairos. One of the products that we had was a product that was used by call center agents in hospitals. And our thesis when we first launched the product was, oh, well, we're just going to go after every hospital that has a call center. And they probably all operate similarly. And what constitutes the job of a call center agent is probably relatively homogenous. And so we can make all sorts of assumptions about how it's built, how it's deployed, and how it's managed over time.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“So, what does that mean? So, we have kind of knowledge of workflow, the knowledge of variety and spectrum, and that you are ultimately working in weirdly an n equals one scenario. I want to bring it back to like actual practicalities of this sort of company building in your experiences. You both founded companies. What do you wish you had known or done differently from the very beginning, given the complexity of that space and the unique challenges that building a company in healthcare presents?”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Healthcare, it's like politics, it's very local. Thinking that you're going to have an out of the box one and done solution, even in systems that look similar from either a side standpoint or reach standpoint or even a geographic standpoint, these are all kind of N of ones.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“It could be variation in terms of actually literally the decision that if you have 10 doctors who are all presented with the same patient, you might see 10 different decisions about how to treat that patient. Some physicians might be more aggressive about using invasive surgical techniques versus others who are more holistic, even just how I was brought up religiously or culturally might impact the way I think about that problem from a product perspective, you could have multiple drugs that all treat the same condition, that all have different implications and whatnot. So even there, even though you have a patient population that is characterized by the same diagnosis, you could have dozens of different ways that those patients play out. And so it makes it very hard for a technology company to come in and sort of generalize and say, you know, there is one single method for manufacturing this thing or for making this decision and managing this patient population. Ultimately, that reflects as differences in the financial profile of different patients.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Yeah, and some of that is actually lack of standardization. You would think that medicine is an industry that has a tremendous amount of standardization and protocols around how people make decisions and do things. But it actually turns out that healthcare is an industry that actually is characterized by a tremendous amount of variation.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source
“Well, first of all, I think you're touching on a very important thing, which is in the space, and I'm going to specifically focus on sort of the healthcare system. So let's call it provider systems payers and the like. You have to really understand what the workflows are, what the problem space is, you know, and how to actually address any of those things. And so one of the biggest challenges I think that companies have when they want to build software products here is to really understand what problem they're going to solve. Because I think you have this weird sort of intersection between it's very non-intuitive, it's still very human driven and centric. There are regulatory barriers. You don't want to get in between, say, a provider and a patient. You know, most people aren't born with the ability to say, like, I know I can insert a piece of software into this part of the workflow and I will solve an acute pain point for the system. That's not obvious.”
2019-04-25 · a16z Podcast · a16z Podcast: So You Wanna Build a Software Company in Healthcare? · IDENTIFIED FROM THE TRANSCRIPT · source