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Vic Gundotra

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2016-12-05
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2016-12-05
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  1. So, Kara, this is an entirely new field. It's been only half decade since machines have gotten so good that we've had the software that with enough data, they can pull out things that we can't see. And so the field of medicine moves very slowly. Half decade is very short period of time. And so, yes, you're right, there is some resistance on the part of physicians that machines will be able to do diagnosis. But frankly, I've also seen incredible enthusiasm.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  2. You don't know, do you? And they're like, Yes, we do. I'm like, no, you actually don't. Like, just tell me, and that's fine. I noticed it was a lack of data. I kept thinking they didn't. It felt like they were guessing and they didn't need to because there was so much data.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  3. Think in the next half decade, no physician will practice without deep learning, machine learning systems by his side or her side. Is there a resistance?

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  4. Know maybe some far distant in the future beyond my lifetime that may happen. But I think like today, you would never drive a car Without airbags and anti-lock brakes. You just wouldn't buy one.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  5. So I probably have a radically different view. I think we're always going to need doctors because people want another human to tell them What's going on? And I think in the future Vinod Kosla has said this many times bedside matter. A degree in the arts is really going to

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  6. To do so. Well, there's two things that come off from this one is that do we really need doctors? Like our machines, will machines be our doctors? I just had a talk with Anne Wadiski about the lack of need for radiologists going forward, or you just need them to look like a machine can tell you what to look at once it reviews millions of...

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  7. Even if they're not taking them every day, once we have a signature of what you are. Then, based on millions of other samples, the machines are likely to be able to see things that humans can. No human doctor can look at an EKG and tell you with a high degree of accuracy what your potassium level is. But the machines might be able to do so

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  8. Absolutely, absolutely. I know I'm convinced we've already seen early indications that hidden in your EKG are other vital markers, maybe for potassium. But there's likely other things there as well that humans can

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  9. The morphology of your T wave is indicative of potassium levels. But what mayo clinic did was they started running studies and were able to pinpoint with a high degree of accuracy what your potassium level was. And they compared it with people who were taking simultaneous blood tests. And it was shocking to see the correlation. They used our device. In those studies. And so we were naturally the right fit for them to go partner, and we have a much bigger machine learning team.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  10. For some people it is, but if it's a life threatening condition, you do it. Imagine you don't have to take a blood test. In what researchers at the Mayo Clinic discovered, and it was, by the way, was well known before. They knew that your EKG

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  11. Or renal, a heart failure patients. Lots of conditions can cause this. The only way to check your potassium levels today is to get a blood test.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  12. Yeah, they've invested in our company in a pretty significant way. And that deal is incredible. I mean, the story of what's going on there. So let me tell you the story. People's electrical current can be interrupted, including in their heart. If their potassium levels get out of whack, either too high or too low, they call that hyper or hypocalemia. It's a life-threatening condition. And today, people who are on dialysis often will have this happen to them and they'll die.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  13. Absolutely. And we are absolutely going to get there. Let me just ask you a question. What do you think is going to be more accurate? Getting an EKG at your doctor's office once or twice a year. Or having an electrocardiogram of your heart every day

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  14. It also doesn't tell you anything. It doesn't say, ah, you ate this donut this morning, this is why your blood sugar isn't. By the way, you need to get up and do this. It should be more prescriptive, I guess. Absolutely.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  15. And to a large extent, that's where we are with wearables. The form factor is right, but we haven't hit the software experience that makes it something you have to have. Right. Fitness products are nice. We're not a fitness product. We're an FDA cleared clinical grade product. That's very different than a Fitbit. I think the issue with some of these fitness products is that once you use them and you know what 10,000 steps are, you know what that feels like, it's over. It

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  16. Smartphones were out there, but they only represented one or two percent of the usage until the iPhone happened. It wasn't that smartphones had the form factor wrong. It's just the software experience wasn't right.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  17. Every day. Right, right. So the concept is not sort of a lot of this stuff been wearables, has not really hit very big. There's a lot of them. Most people find them useless. Why do you think that is and where does it go? Because it seems like finding your steps or calling an Uber just seems kind of pointless. It doesn't even work in the Uber part, but where does this go with these wearables? Because wearables is an important part of your business.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  18. Got an email, I could read it to you, but the email basically from last night says a 69 year old man from a small coastal town in California says he bought the device because his wife is a cardiologist. Wife's cardiologist told him to get it. It helped her. She went into AFib and was in the hospital for two days. But two days ago, he was feeling sick. He thought it was indigestion. He pulls out the AliveCore device. It says his heart rhythm is not normal. He calls 911. They rush him to the hospital where he has a massive heart attack, 90% blockage. And he writes us a note that says, thank you for saving my wife's life and my life.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  19. So it communicates to you, the user will give you what diagnosis, whether your heart's a normal sinus rhythm or possible atrial fibrillation on the phone. In addition, we provide an option on the phone, two options. One option is to have a physician that you pay for do an overread of the rhythm strip. And you can pay $19 and have a doctor review this immediately. Another option is for you to email that, your rhythm strip, to your physician. And we see many patients do that. I mean, I get emails every day from people who've been affected by this device. I got one last night.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  20. Yeah. In fact, we just launched a band, the Apple Watch in Europe. We do not have regulatory clearance by wearing it right now. Yeah, we can't sell it in this country, but we're working very closely with the FDA. The moment they give us regulatory approval, we'll make it available for sale in the U.S. But this is on my Apple watch. I just touch it.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  21. They can put you on an anticoagulant that could save you from a stroke. And so it's largely an awareness problem. People don't know they can carry a stick in their purse.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  22. Is exactly right. And so women feel shortness of breath. It's the number one symptom of heart disease. And instead of checking their heart or feeling competitions, they say, Honey, I need to sit down and have a cup of tea. And they're not even aware You can have a device in your purse that can check your heart. And by the way, if you have AFib, doctors know how to treat it.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  23. It's also invasive. I mean, if you're a woman, you have to go in, take off your shirt, put on all these electrodes on you. It takes almost half an hour. You might get one or two done a year. And here's a device you can do every morning. You can just hold it for 30 seconds and do a check on your heart. Did you know on average it takes 1.7 years before they diagnose you as having atrial fibrillation? And by the way, in many cases, the first time you're diagnosed

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  24. So, the point is to do this every day because, why? Because people, this is not something people do. And listen, I've had a lot of EKGs. I had a stroke, as you know. It's expensive. It's a pain. It's something you don't do a lot at all.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  25. It records your voice. It'll record activity. If you have an Omron blood pressure cuff, it'll record hypertension. There's lots of ways you can use it. But I have this basic simplest level. It was originally a device that DigiRoe Electrocardi.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  26. Your phone. It's like the size of a stick of gum. And it's got electrodes on both sides. You just hold it. You hold it in front of your iPhone or your Android device. We'll do an electrocardiogram, an EKG of your heart. And most people can't read those squiggly lines, so our software will interpret it and tell you whether you're a normal sinus rhythm or you have possible atrial fibrillation.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  27. He was relentless until he made me look at this company. I met the people. I met the co founder, Dr. Dave Albert, who's a charming doctor. Once you meet Dave, you'll fall in love. And they need some leadership.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  28. We would be in crisis And yet heart disease is happening, and this company, Alivecor, has a product that allows you to detect a critical arrhythmia at home.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  29. He was actually having an episode of superventricular tachycardia minutes away from death. I rushed him to Good Samaritan in Los Gados where they saved his life. And the doctors told me that if I had been a minute or two minutes late, I would have lost my dad. Wow. And so, when you see someone you love having a heart issue, it's worse than a horror movie. You're looking at them and you're thinking, is this the last comment I'm ever going to hear from my dad? So it's horrifying. And then when you find out that it's the number one killer of women. One out of four women will die of heart disease. That's one out of 30 is breast cancer. Last year, 8.6 million women died of heart disease. That's more than 25,000.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  30. My brother came up to visit from Southern California with his wife and his kids, so my dad came over. We're all having a wonderful evening, and my dad had two glasses of red wine. He's about to go home. And I say, Dad, don't go home. You've had two glasses of wine. It's 11 o'clock. Stay here. And he says, where am I going to stay? The house is filled with guests. I said, stay upstairs in the den. No one slept up there before, but he says, All right, all right, all right, I'll stay. And a few hours later, about 4 a.m. in the morning, he bangs on my door, which happens to be right next to the den. And he's grabbing his chest and he says, you need to rush me to the emergency room. Something's really wrong.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  31. Yeah, you know, heart disease is a really big deal. Yeah. You know, more people die. Do you have family members? I do. My father had two heart attacks in front of me. It's one of the reasons why I'm doing this. One evening after I left Google,

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  32. The three things I told him was wearables. I believe computing since my earliest days has gone from PCs to tablets to phones. And I think wearables are going to, in the future, we will have computing on our bodies. Number two, machine learning. When I started the machine learning efforts to do voice recognition on the phone in 2007, people laughed. They said, no one's going to speak to their phone. And yet we trained Mandarin. We cut voice recognition working in Mandrid in six weeks. Because we took Chinese newscasts that had closed captioning and we fed that into our systems. And then the work we did with Google Photos, with machine learning, I had a deep understanding of the impact it could have.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  33. And he said, I'll stop calling. If you tell me what it would take to get you to go lead a company. And I said, I'll call you later next week and I'll tell you. And I told him three things. And he said, I got a company that has those three things. And you need to go visit this call.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  34. Never before you want something. Oh my God. I can't even tell you how many times he called. He called over the course of the year so many times that the phone would ring, my wife would see it. Friday night, 7 p.m. is when he would call when we were at a dinner. And she would say, don't pick it up. It's Vinote.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  35. Oh, my friends told me they said Vic, you're gonna be bored. You can't just take photographs and travel. You're going to want to do something. And I was convinced they were wrong. I didn't realize I was burnt out. I didn't realize it took about a year until those feelings of leading software teams, building software really came back. And they came back in a big way. And I thought about what do I want to build? And as I was thinking about that, Vinod Kosla, who's relentless, never give him your phone number.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  36. And I took photographs. It turns out it took me more than a year to recover from Google. I didn't realize how burnt out I was. And it turns out building Google in particular. Was extremely stressful. And getting a year to be with my kids and taking that opportunity was a wonderful thing.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  37. Well, I left because it was approaching eight years and I had teenage children, and for me it had been twenty four years of sixty to eighty hour work weeks, and I didn't want to miss my kids growing up. And I thought I had accomplished everything I wanted to accomplish. I wanted to shift the focus of my life, and it was time for me to move. And I did that. I left. I thought, honestly, I thought I was going to be retired in the sense of the word of not working professionally for a living forever.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  38. Yeah, I mean, he's also a very technical guy. So, like Satya, these are technical CEOs that really understand what they're doing. And so I couldn't be happier for both of us.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  39. And he's really pivoted the company, got everyone to rally towards a common cause, a common architectural framework, and he's made it available for even my small company. We're building on TensorFlow. And so that's fantastic. If you win developers, you win the platform, you're going to be protected in the future. And Sundar deeply gets it.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  40. He had to keep it going. And he's At least Satya had a ship that had kind of stalled, you had to get him going. In many respects, Sundar's job was even harder. Expectations to keep Google going. And I think his shift to really focusing on the next big platform.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  41. Another level of tremendous product visionary guy. I mean, think about what he led with Chrome How is Google going to produce a browser that beat a browser that shipped in the operating system, yet he was able to accomplish that? So I worked with Sundar for many, many years. He is brilliant at bringing people together. Without the confrontation. In fact, I think he's much better at leading without confrontation than probably anyone I know. And so he has got a big challenge now. How does he keep Google continuing to move? He inherited a ship that was already on fire. Right.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  42. And Twitter, a little bit of Twitter, but mostly Facebook. And my kids are on Snapchat incessantly. So what does Google do like?

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  43. So, what do you assess? When you look back, and then we're going to get into what you're doing now because it's a total shift. It's a complete shift. It's sort of. It's a platform. You're in a platform.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  44. You can't force social. You can't force it. There's subtleties to human behavior and connection that you got to have social people working on social progress. Right, right. And if you don't have that, then

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  45. I think you hit on it. I think you actually hit on it. You can't build a product that everyone doesn't use. You don't have all the engineers using social. Then you're going to miss some of the nuances. And it turns out building social is very difficult.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  46. Yeah, you know, social is important because people will give you their personal information. Their name, where they live, their relationship status, if you provide value. What is the value that Facebook provides in logic to connect and share photos with your friends? It allows you to stay connected. And in exchange for that. You're willing to trade off some information. And that information is extremely valuable. And so I think that's at its very core level. That's why we were trying to do that.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  47. Why create a social network? Because I have to tell you, Google are the least, they didn't use social media, they aren't on it still. They are not social people. I mean, it's a joke that they're robotic, but they're robots.

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  48. Do you want to advertise you're a wedding photographer? You want to advertise to people within 50 miles of Palo Alto who have just changed the relationship status into engaged. Facebook absolutely nails that scenario, where Google at the time couldn't even tell you if you were a male or a female. And so you could see the threat to the core revenue. And so, yeah, there was no

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  49. There was a period of time when Google's all about And when you see very talented people leave for something else, that's cause for concern. And at that time we were losing a number of our people to Facebook. Facebook had tremendous momentum. And frankly, some of us, including me could see the threat that Facebook

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT

  50. And Larry kind of laughed. He goes, Oh, I forgot I was supposed to tell you. You're writing our social efforts now. And so that's how I found out

    2016-12-05 · Decoder with Nilay Patel · Recode Decode: Vic Gundotra, CEO, AliveCor · IDENTIFIED FROM THE TRANSCRIPT