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How to Pinpoint the Clinical Problem and Leverage the Unmet Need for Your New Tech w/ Kimon Angelides

 

A core foundation for market success is making sure that you’re laser-focused on the needs of your customers. Does your solution truly solve the clinical problem? Do you have validation to prove that it does, and it’s not just an assumption you’re making?

In this episode, Dr. Kimon Angelides, CEO and Founder of Vivante Health, shares insights into how he’s been able to continuously beat the odds and find huge success with several businesses he’s built. We talk about:

  • The critical need to solve a clinical problem that the “traditional” healthcare system recognizes and appreciates
  • How passion can look a lot being crazy — and how that craziness is a backbone of the most successful innovators
  • How to design a strategy that caters to your market, and how to pivot that strategy in the face of market changes like a big competitor
  • Mistakes he’s made, like treating all customer accounts as equal (spoiler alert: they’re not, and it almost sank them)

 



Guest Bio

Dr. Kimon Angelides is the CEO and Founder of Vivante Health, a pioneer in using digital medicine to manage digestive health. Prior to Vivante, he founded EosHealth (which became Livongo), a consumer digital health company with a focus on diabetes management.

 

But he wasn’t always in the business of improving population health through technology. He started his career as a biophysicist, spending more than two decades in academia. Later, he and his wife, a pediatric endocrinologist, launched Diabetes America, a network that eventually grew to nearly 50 centers in the southwest US.

 

To learn more, visit https://vivantehealth.com/. You can also connect with Dr. Angelides on LinkedIn or email him at kangelides@vivantehealth.com.

 

Episode Transcript

 

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Speaker 1: Welcome back to the show COIQ listeners on today's episode we have kimono and delete us with us. He is the CEO and founder of Avanti health and you may know him more by his, um, work with Lovango. Welcome to the show.

 

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Speaker 2: Well, thank you very much actually Dr. Roxy. It's fun. I like, uh, enjoy being here. Thanks very much.

 

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Speaker 1: So I am really excited to have this conversation with you and dig into your story. Um, before we get started though, uh, just for those folks that maybe don't know who you are, start off by telling our listeners a little bit about your background and what it is that you do.

 

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Speaker 2: Okay, thanks. Well, uh, that's always the hard part. Yeah. W what do you say about yourself? But, um, actually I'm originally trained as a scientist and so, um, and in many of the things that I have done, uh, to date, I think like a scientist. And so, um, I really am a biophysicist, uh, so I have a PhD in organic chemistry and biophysics. Um, I was an academician for, I was on faculties for a long time. Uh, my career probably 20, 25 years before I even went into business. And so I was a professor. Um, and so, uh, it was probably in 2000 and 2004 when I guess I got the bug essentially to, uh, to start thinking about, uh, building something or creating something outside of academics. And so, um, my first, uh, first business was obviously something that I was familiar with. It was biotech, um, and it was a collaboration between MD Anderson and, uh, GlaxoSmithKline and Valeant pharmaceuticals.

 

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And the objective there was to, uh, uh, to, uh, make a drug that actually was, uh, helping people with malignant melanoma, which is a big issue here in Texas where I'm at. The second one. Um, the second one is, uh, my wife who's a pediatric endocrinologist, we thought that there was a real unmet need and, and, and people who had diabetes. Um, so we set up a network called diabetes in America, which was a one stop shop for folks who had diabetes. And we had, uh, Oh, I think I all the way up to 40 or 50 centers, um, throughout the Southwest. And then, um, uh, in terms of what I did afterwards, and this was in 2008, 2009, I formed this company, which was EOS health, which really became Lovango was renamed with Mongo. Um, and that was really to be able to use technology to, to provide a service and diabetes for people who, uh, were geographically distributed, that they were all over the country instead of having committed to our clinics.

 

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And so, um, that's kinda the honest thing. And so I was an academician for a long time doing bio biophysics, looking through a microscope most of the day, which I liked. And then, uh, it morphed into, uh, trying to do what you would call population health and using technology to, uh, uh, to expand. And then Vivante health is, is, is a company that is really on, uh, the unmet needs of people who fall between the cracks, uh, who have diseases that no one really believes that they have. They don't look sick. Um, yeah, yeah. Cried. They're crazy, but they're, they're, they're crazy to find something that will help them actually. And so, uh, we started with digestive conditions cause that's a big, big deal and no one really wants to talk about their digestive problems. So that's why that's kind of the Odyssey.

 

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Speaker 1: Yeah. Yeah. So describe what it is like for someone who has founded several companies. You know, there are many several serial entrepreneurs out there, but I think what makes your story unique is that you, um, have been a pioneer in digital health and then successfully commercialize an innovation in healthcare. Really. You've beaten the odds.

 

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Speaker 2: Well, well, well thanks actually. I appreciate that. And so pioneer is not something that I like to think about. Uh, sometimes, you know, um, you know, I mean, being an entrepreneur is a, there's a lot of risk. Uh, although I don't actually look at it as a, as a risk profile, but I look at it as a challenge. I think, you know, I'm, I'm generally pretty optimistic. And so if you, if you actually start with the right problem and the right approach, and I'll tell you about why I think, uh, you know, in terms of digital health, if you, if you start from the right, from the right grounding, um, then, um, then then really you, you actually have a story and you can build a, the technology around the solution. And so, you know, really the, the long and short of it is, is that, uh, we knew the clinical problem, right?

 

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That, you know, and, and so, so, so the clinical problem actually affected people or affects people, diabetes or whether it's digestive conditions. And so, you know, technology is kind of a tool really, um, to be able to, to bring all those resources that people need together. Right? And if, you know, they need to have some nutrition, they need to actually have some other coaching technology is, allows it to be a, to be brought together. And so I think in terms of where we may have been successful or been successful is to really focus first on the clinical problem and then to bring as many sort of techniques like technology together to be able to address it. And so we've always been clinically focused, um, you know, oftentimes, and last thing I'll say on this oftentimes is that digital health, um, you know, uh, people start from the tech, the tech, the tech space, right? And they, and they think that healthcare is like any other type of consumer business. And, and to a certain degree it is. But, um, you know, you're, you're talking about, uh, just a vast variety of personalities and conditions and things like that. And so healthcare has really been different. So that, that's really, I think that the key is, is focusing on the clinical problem.

 

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Speaker 1: So I, you're probably one of those guys that just had, you know, born with all the knowledge and resources that you needed to just through entrepreneurship, you know, with these four companies. Right.

 

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Speaker 2: And that was easy. That was, you know, it's sort of like the Royal family has been, you know, being, being held something right there and having a trust fund and all that type of, yeah.

 

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Speaker 1: Right, right, right. Exactly. Um, so I kind of want to go back in time a little bit. So think back to the real early days of one of your first companies. Um, you know, what was it like building that first company?

 

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Speaker 2: Uh, well, I mean, I think there's just one word. It was, it was crazy. Totally, totally crazy. Um, but we were crazy enough actually when we started with MD Anderson. Um, and then I'll talk about the digital health, but enough to be able to somehow convince MD Anderson that it was good. And I think in large part, I think a large part is because it was a good, it was a good clinical problem, right? I mean, um, and, and just as her in a sidetrack, I think you'd find this interesting is that, you know, um, people who have cancer, for example, um, they, they, they do make antibodies that are immune system actually starts to react to this, this bad stuff in their body. So we pose the question, well, if they're doing that early enough, right? Um, you know, they're trying to kill this cancer cells off. Why can't we actually isolate? Those are the really good antibodies that ultimately get overwhelmed by the, you know, the cancer cells. Why can't we just try to see if we can harvest those and bulk them up and grow them up and use them as, as a therapy? And so, uh, you know, the first question and the first answer that even in digital health, well, that can't be done. Um, that's kind of a fun thing to say, well, let's try. Right?

 

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Speaker 1: I'm crazy enough to try it. Yeah.

 

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Speaker 2: Yeah. It's crazy enough to try it. And it's my time. And not necessarily yours. And then the same thing with the digital health. I remember when we first used mobile phones in our diabetes clinics, um, the, they were these and I've kept them all. They were these bar phones. Motorola came out with a bar phone with a little tiny screen. There wasn't any AppSource, it was in 2005, 2006. And we said, well, let's, you know, maybe we'll use mobile phones actually to be able to do sort of healthcare, you know, diabetes, look at numbers and all that and say, Oh, that won't work. Um, so let me show you, it'll work. And at the end it did. And so, uh, um, I think the first word there is crazy. And then Kenny is, let me show you. And um, you know, there's, uh, it goes on and then you get, and then you get trapped in you're, you're doing it

 

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Speaker 1: right, right. And then you're addicted to it. And then you're like four companies in

 

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Speaker 2: or companies and you've got followers, right? You're leading and you've got followers. And, and, and actually, uh, you know, they start to get engaged. And so they're, you there, you find yourself with a. And the thing on that it'd be, to be quite Frank with you is, is that if it really was purely a technology, then basically your followers are only as good as this sort of technology. But if you have a really good clinical problem, there are lots of ways to sort of get around that clinical problem. And so, um, I've been lucky in that respect. You get these followers and they got good brains and they, and we eventually solve it.

 

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Speaker 1: And so are your followers meaning like the team that you work?

 

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Speaker 2: Yeah. And you know, followers. I mean, you know, you're, you're, you're the first crazy one and then you have the second person who comes on and then the third and then it actually becomes a group.

 

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Speaker 1: Right, right, right, right. Okay. So for all of our listeners, the prerequisite for market success is a dash of crazy, maybe even a little more than a dash with a lot of passion, right? Yeah, yeah, yeah, definitely.

 

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Speaker 2: Basha crazy with, with a lot of passion and it goes a long way. It's, you know, there are a lot of smart people out there, by the way, but if they don't have fire in their belly, by the way and things like that, um, it doesn't go that way.

 

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Speaker 1: Right, right. Yeah, absolutely. And, and you know, to your point, it's that crazy that allows you to think about, believe that you can do the what, what people are saying can't be done. Right. And, and the passion to be the fuel to, you know, stand back up again when you've been knocked down a hundred times.

 

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Speaker 2: Totally, totally. Right. Absolutely. Totally. Right. And it's, um, you know, um, yeah, it, that's actually totally right. It's, uh, you know, the, the passion gets you because you're, you, you need to do it. You, you feel an inside the in to do it and that you can do it. So, um, yeah, I mean, it's, uh, those are the two essential things.

 

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Speaker 1: So what, from your perspective, what makes commercializing and innovation in healthcare so difficult?

 

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Speaker 2: Yeah. You know, um, uh, and I appreciate that question. And, and, and, and, you know, um, so, so, so healthcare is, is obviously unusual in the, and when we're talking about digital healthcare, it's unusual in the fact that, um, it's, it's easy or easier to see how you can commercialize digitized banking, right? Because, because you don't have to essentially when healthcare, you don't really have to essentially undress, right. And tell your story. You're, you know, so you're at a disadvantage when he go into healthcare because there you are in one of these floppy gowns, right? And you're telling your story and you're really, you know, it's not your natural environment, right? Yeah. You're, you're vulnerable. So, so I think the key right here is, is really to take out that vulnerability, if you will, right. Is, is to make it as personal as you can or personalized as you can, right?

 

00:11:47:16 --> 00:12:50:10

So that you can address that healthcare problem, right? And get rid of that vulnerability so that you're, you're really on equal footing with the people. So that as we find out, actually interesting, and I'll get to the commercialization, is that people are willing to tell you a lot more about themselves. Just like on social media, um, when, when you, when you level the playing field. So, so given that, that's one aspect, the second aspect is, and I'll go back to the clinical problem in terms of commercialization. You know, again, there's lots of technology out there. Roxy, there's just lots of technology out there. But if you don't have a, if you don't really have a, a problem that's a, that's of sufficient magnitude, um, and, and passion essentially, um, then it's just going to sort of sit there as a, as a technology and you know, it might be acquired, but it doesn't really do anybody good. So, um, you know, the commercialization, it always comes with a good, with a, with a good product and a, and a and a and a and a good clinical, a good clinical solution. So, so that's for a foremost in my opinion.

 

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Speaker 1: So I'm going to just jump right in. Um, and, and you can kind of envision yourself, um, naked and afraid with your hospital gown because I'm going to get vulnerable really quick. What are some of the mistakes, you know, if we're just being really honest here, just mean are you in a few thousand listeners, what are some of the mistakes that you can look back and see that you made along the way that you would want to share with others so that they can kind of be on the lookout for them or make sure that they don't make those same mistakes?

 

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Speaker 2: Yeah, that's an easy one. And that's an easy one. Uh, because I made plenty of them and I, I won't go down the list, but it, you know, for, for a lot of the lot of the folks out there actually in a lot of the, uh, I would say younger people who are starting in the, in the area. Um, so you have a great, you have a great solution, you have a great program, you have a product for example. It's gotten some exposure and all of that. So that's, that's all right. You feel really good. I've got some traction. So then a big, uh, a big dog comes up like a big health plan for example. And they say, I really like what you're doing and we would really like to, to begin, uh, distributing your solution. Okay. So you're a little itty bitty sort of startup. You might have 10 to 15 or 20 people, right? There are these go really big and you say, that's so cool. We're, we're so recognized. And then what happened? You know,

 

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Speaker 1: crazies, go see, see, we weren't crazy.

 

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Speaker 2: Yeah. So, so, so what happens is, is, is that now you're on, you have quite of a tailwind. It's like a tornado. You can't keep up with what they do. You know, you're, you're sucked into the vortex of a large company that incredibly slowly, that has a totally different culture than you do. And now you're going from one of the customer to the other customer, the other customer, and you're building up. Um, in some cases they use it as a sales mechanism, right? So it, it, it benefits them, but really it doesn't benefit you in terms of developing a product and, or, or, or your revenue line. So I've done that. I won't tell you who the health plans are. And so we said, this is super cool and we almost died. Actually, I'm trying to service those accounts. So I would tell everybody out there is that it really looks good, but you've gotta be very careful on the accounts that you do because you take all of them, right? You're, you're starting, you take all of them

 

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Speaker 1: well, and especially if it's a big reputable company, you know, you kind of get woo, like, Oh my gosh, this is, this is it, this is the only deal we need. And now like successes, they're right around the corner

 

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Speaker 2: and you're, and you're totally, you're toast at that point. It really is because you can't keep up with it. Um, they're not looking out for you in terms of developing your product. Your revenue line doesn't increase the way that you think it is. Uh, your expense line goes way up. Alert your people are frazzle and they say, well, crazy was one thing, but crazy is, is really not. So.

 

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Speaker 1: Yeah. Yeah, absolutely. I've heard many stories about that being a death trap.

 

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Speaker 2: It is. Totally. Yeah, totally. So that's, I think the, probably the biggest mistake in, in, in the area. Um, and you know, and I think the second thing is, um, everybody thinks that, uh, uh, that they have the most beautiful product and stuff and sometimes you just gotta step back and you gotta say, is it really good looking or good? Is it ugly? Or, you know, when you say, you know, if it's ugly then let's pivot. But you sometimes you've just got to say, this just is not going to go.

 

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Speaker 1: Right. Right. Yup. Absolutely. Those biases that I think we all have as entrepreneurs and innovators, um, you know, to create something and Hmm. Be really more inclined to find people to agree and validate what we've created and instead of give us the truth that we really need to hear in order to be successful. Right.

 

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Speaker 2: You hit it exactly correct. It's actually trying to get the truth out of your quote followers and your team that you have a realistic approach and you're not doing a nosedive when you think that you're climbing. So, yeah, you're correct.

 

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Speaker 1: So, so what we're again, kind of doing this look back, um, you know, what were some of those game changing decisions for you? Maybe something that was a surprise or wasn't, but something where, you know, maybe you made this one decision and you, you know, you thought it was a good decision, but you didn't realize that it was going to be such a game changer. And so maybe it was a, a customer, maybe it was a message, maybe it was a team member. Um, you know, there's a whole host of examples that you could share with us. Um, but maybe one or two of your, uh, changing stories.

 

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Speaker 2: Um,

 

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Speaker 1: you know, um, I think after, you know, I think after trying to, to realize that not all customers are equal, that's, that's one thing that's good, big realization, I think. I think the other thing too, uh, is, um, if you're in a decent area and you're good area right and it's a good problem, you're going to have competition, right? So, so, and that's good, by the way. Um, if, if you have competition, sometimes people's like, Oh gosh, I've got competition and we're better than these folks, or we don't have competition. It's a wide open field. So we're really good. We got a Greenfield type of thing. Um, I remember when, um, I remember early on when Qualcomm put $90 million into a competitor. Oh, that's a scary moment.

 

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Speaker 2: Yeah, we were, we were taking a nose dive then. I was, you know, I was dipping into every personal thing that I, that we had actually to, to, to sell basically. So I said, you know, um, you know, here's a competitor, has $90 million and, you know, this is, this is, uh, this is a tough one. Um, but that was actually a good thing in the end. It really was because we, we, I sat back a little bit and I said, you know, what are they putting $90 million into and do they understand it? And, and we sort of reevaluate it at that point. And so that really was a pivotal point where, uh, you know, although we were kind of second, if you will, um, you know, uh, that gave us an opportunity to sort of redesign some things and it just like skyrocketed after that. So the $90 million really didn't make a difference at all. I think we did much more and you know, I don't know, 400,000. And so I think, I think that was a game changer is that sort of, um, you know, think about competition, but, but that's not, that's not where it ends really.

 

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Speaker 1: So let's kinda dive into that a little bit, cause I think that's a really powerful story. I want to understand the situation. So was it that you hadn't gone to market and you saw this investment and you saw what they were doing and you were able to make your Mark with the gaps that they weren't filling? Or were you already in the market and it helped you pivot?

 

00:20:04:08 --> 00:20:45:06

Speaker 2: Yeah. Mean in essence, it was really kind of the second one. So, so, so here's, here's really the story. Um, one of the things that Lumon go has, it has a cellular meter essentially. And then I'll tell you, um, at that, at that particular point had a cellular meter that we put, uh, a SIM card and just like a phone we had already, we had already really developed it, um, and it prototyped it and we knew it was going to work. I went from the Bluetooth devices and things like that because people could measure their blood glucose on their meter and it would go over to their phone and then it would go up to him. You know, I'd go to a server and all that. And so we, we said we wanted to make that experience a little bit easier. So I started building a cellular acellular meter.

 

00:20:45:24 --> 00:21:55:21

Well, because Qualcomm in the phone business and the radio type of business, they said, Oh, and Paul Jacobs, actually, his family had had diabetes. So he says, I'll throw my $90 million, um, to do something very similar. And I'm not sure whether he, they did it actually to quash us cause they had seen us, it doesn't matter. So, um, we, uh, we were kind of already in the market. We had already had some customers. Uh, we were, we were reeling from the customers. We had, we had this great piece of technology that we were going to roll out. We were down to our last pennies and then go $90 million. He said, well, what the heck are we going to do here? And so we, yeah, we, we took a step back and we said, okay, this is what we need to think about and how we need to think about it. It's not technology. We're trying to address a clinical problem and a consumer ease problem. And that made, that made all the difference. We redesigned it, we made it touchscreen, we made it colorful. Um, uh, we, we did a variety of different things. And so it was, it was a good moment. Um, I look back on it as kind of a, a pivot

 

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Speaker 1: okay. Um, is there, so when you think about the, the companies that you built before Lovango, were there like some specific strategies or tactics that you implemented at Lovango, um, that you had learned from the past? Yeah,

 

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Speaker 2: yeah, yeah, we did, you know, when, when the, the diabetes company in the way that I think about the Vontay health now too is, um, because we, we'd been in the clinical business, we had clinics, so people would actually come in and it was a full service. They would be able to, they would be able to get everything they needed for diabetes and stuff. So I insisted on no white coats, first of all. And we had a large room there so doctors could mingle and talk with the, with, with, uh, patients or people. We never called them really patients. So, and so. So, um, we wanted to sort of buck the traditional hierarchical mode where the doctor's here and a patient is here and an MD, you know, um, you know, sort of, uh, uh, you know, all of these, these, uh, uh, these services where you can get, you know, education and do dumps for, for information that tries to get you up here.

 

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But, but so, so what we wanted to do is put, you know, physicians, for example, other people on the same, on the same, on the same level. And so that was a diabetes reg. And that's when I really wanted to do actually in Longo. And that's what I want to do at Vontay and Avanti. Getting back to that is, is even a, a bigger difference right here is that people who've got digestive conditions, whether it's your trouble bowel syndrome, you know, which is really prevalent in females, you know, they'll go to the doctor and they'll say, you know, I'm, I'm, I'm, I have diarrhea all the time. I have bloating all the time. And, and, and, and so then they'll get scoped, right? And the doctor will say, I see nothing wrong. Um, and they say, well, it's in your head. So immediately there's an asymmetry there.

 

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The doctor says, you know, I, you know, there's nothing wrong with you, right? It's in your head, but the user or the person essentially says, I feel terrible. Well and I feel terrible all the time and I know it's not in my head. So what we tried to do here is, is actually raise it such that, you know, that those two individuals are going to be the same. In other words, let's give credibility to the user or to the patient. Their issues are, you know, are truly real. Um, and then make sure we take that sort of realness and give it to the doctors to show how real it is essentially. So that, you know, they get engaged in that too. So the one that's short of it is, is that I think we're able to do that is to sort of level set even using technology and, and in our approach. So that's kind of kind of, sort of the, the, the theory behind it.

 

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Speaker 1: okay. So, so that's really good. So let's talk about the strategies that you use for either Lovango or the ones that you've already, you know, implemented for Avanti health. Um, you know, some of the basics of your commercialization plan. How did you define what was going to be your beachhead market? So I know that you saying that you started with a problem, um, but you know, as I've worked with innovators, sometimes their problem, the problem that they're solving, um, there could be several markets or um, customer groups that are experiencing that problem. How did you narrow down what was going to be your beachhead market?

 

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Speaker 2: Well, so, so, so that's probably an easier one. Um, in the sense that even with diabetes America, Lovango um, w with diabetes America, we did something very special there. Um, we, we thought we were really pretty good. Um, and so we had all the care that, you know, that people could use and it contained it and all the data so that we wouldn't do duplications and things. So that allowed us an opportunity to go to health plans and it allowed us to go to large employers because they pay the cell phone and to do carve out so that we say, okay, we're going to take some risk here. Right? We think we're that good. And so, you know, your cost might be 7,000, um, for each person who has diabetes and we're going to do it and we're going to cap it at 35, 3,500.

 

00:26:10:15 --> 00:26:57:23

Okay. They like that because they're self funded and they're public entities and so they where they're going to be. Yeah, I did that with Lovango as well. I, I used a method whereby actually, you know, I'm getting strips in the meter and all that was bundled in one in one in one area so that it was a single price and that single price for all those services was the same price as you would buy for testing strips. So it was a, you get all this other stuff essentially and you bundle it. Um, so the cost, uh, uh, would be equivalent to just buying the supply. So, so the self funded market, the guys, the guys who actually pay for the health care, like that model because either we took risks, um, or we took, uh, or we made it sort of equivalent and we added a lot more value.

 

00:26:58:10 --> 00:28:00:07

And the same thing with Avanti though here too, uh, uh, as it turns out is that we're going to sell funded employers. Now the difference is cell phone, an employers and health plans. But the difference is here with Avanti and digestive is that while employers have wellness programs and they have diabetes programs and they have musculoskeletal program behavioral health, they had nothing for digestive health programs. Okay. Yeah, there's nothing that existed there. So, um, we, we were able to, to go to cell phone and employers, but as it turns out, um, for digestive conditions, there's a huge pharma component as well. In other words, you can just turn on the TV right now and see advertisements for Humira, uh, Stelara, you know, all sort of Vidas, all of that. So the, the other market that allowed us to look at was pharma and, and so our thesis, and I'll finish here on this, the thesis was, you know, these are really expensive drugs right there.

 

00:28:00:07 --> 00:28:51:07

They cost about 50 or $60,000 a year with the employer. Is, is paying for those, right? For someone who's on it, the person who's getting these drugs is getting no extra value except a drug, right? Yeah. So we said, let's just do a wrap around these things. Why not? Why not, you know, go beyond what the molecule is. Let's have a service that accompanies it so that you have actually the full spectrum. Some people are gonna need more of the drugs. Some people are going to be less of the drugs, some people are not going to be on the drug, but they're going to have a program that's going to be sort of goes along with it that's going to educate them and going to help them like an adjutant therapy. Does that make sense? So we have a whole pharma, we have a whole pharma place right here where we can actually add value to beyond the molecule. So that's something that's very different. Those are the channels that we're looking at.

 

00:28:51:15 --> 00:28:59:14

Speaker 1: So did you have you or are you in the process of doing like a strategic partnership with a pharma company and that'd be part of your go to market strategy?

 

00:28:59:23 --> 00:29:58:12

Speaker 2: Yes, we just finished a strategic partnership with a very, very large pharma. It will be announced in the next couple of weeks. Um, and uh, it's exceedingly exciting, um, for us. Um, as it turns out, um, people who are on these, uh, these expensive drugs, um, actually the only work in one in four, one in five people. And so, um, there is the opportunity to be able to, um, to match the right people from the very beginning. And then those people who are on them where they've lost their response, to be able to change them onto another therapy therapy like nutrition part our program and actually start to heal their gut, um, and uh, and, and get them off of the drugs for a little bit of time. So, um, it's a, a new direction for pharma, um, and it's, uh, it's a great direction for us too, so I'm excited as super excited about that.

 

00:29:58:24 --> 00:30:47:15

Speaker 1: So how much of this do you think plays a part in, in your success with both Lovango and you know, already with Avanti? Because what I hear from you is that self insured employer groups were part of that beach head market for both companies. And you know, I think that that is, um, it's not necessarily unique, but it's very powerful because there are so many other companies that are going the traditional healthcare route that seemed to be just kind of pounding the pavement, knocking on doors and banging their head up against the wall because of all the bureaucracy, because of the time that it takes for that sales cycle. And you know, going to the self insured employers certainly has a lot of advantages, um, to be, to overcome some of those obstacles of the traditional path.

 

00:30:47:24 --> 00:32:12:23

Speaker 2: Right. Well, you know, um, when we first started with a cell phone and employers, it was as early as 2004 I went to them in 2008 again for Lovango, um, uh, and, and, and that was new. Um, I, I was at a recent meeting, um, at a, a, at a recent meeting with a 50, 60 employers. And someone commented at that the, a fleet to dog ratio is pretty high, um, these days, but the fleet of dog ratio was not so high. So, you know, if you have, and that gets back to one of your original questions, if it, if, if you have a solution or you think you have something that's technology based, there's a lot of out of them. And there are a lot of vendors, uh, circling these, these employers. But if there's really a void and a need and you can actually show that it's a big ticket expense item, like, you know, like digestive conditions, um, it's actually within, you know, they never realize this when we started looking at their claims, it's within the top five of all of their, their uh, their expenses. And so once you point out that promo essentially, and, and you have a solution that doesn't cost them any extra money and can save them some money, um, then then, then you're, then you're in, now if you have a diabetes program or you have a pre diabetes program or an exercise program, it's a little tougher. Yeah. You don't really know where the ROI is there. Right.

 

00:32:14:09 --> 00:33:00:01

Speaker 1: the other thing that sounds really different is, you know, like the business model component of, of bundling. Yeah. You know, so was so as you, when you talk about the fleet of dog ratio, right? There's this explosion of innovation. And so, you know, there's innovation in all industries, but it just feels like it's a lot more concentrated in healthcare. And you know, if you're trying to sell your to someone, you know, instead of maybe someone else this month pinching a competing or substitute solution, they might have had three just in the last hour. Right. So it's so, so saturated with innovation. So I wonder, um, you know, were you with this bundled approach, was that part of how you arrived, able to rise above the noise,

 

00:33:01:03 --> 00:33:47:04

Speaker 2: um, in part, in part by the way. So, so, so the bundled approach or any approach, you know, if you think that you're, if you think you have a good solution, you shouldn't be afraid to take some risks. Right? And there are some successful companies out there that are beginning to take risks. So, you know, you've got to put your money where your mouth is in that respect, I think. Yeah. So, um, and, and then you brought up an interesting point. You say there's an explosion of innovation. Um, it might look like an on the surface. As it turns out, there's a lot of variation of the same theme. It's hard. I wouldn't necessarily call it innovation. Um, and, and, and so, you know, bringing another disease management program, whether it's digestive disease, uh, you know, um, I wouldn't call it an innovation in itself at all.

 

00:33:47:04 --> 00:34:28:08

I really wouldn't just, you know, that's even our program. I wouldn't call it innovative in that respect, but I would say that the components that it brings essentially, and the things that we'll reveal are things, uh, and information that we would never learn, not only about digestive conditions, but about all sorts of chronic conditions that haven't been addressed and about pharma. So there's components of this essentially, which, um, you know, are our new learning experiences. And so, um, you know, um, a lot of them right now are just throwing, you know, throwing sort of a solutions they're calling innovative. Um, but they're not that well thought out. I, I don't mean to be, you know, throw water on it under cold water on it, but,

 

00:34:28:09 --> 00:34:50:09

Speaker 1: so what's missing? Cause I think that's, again, I think you, you know, you continue to hit on these golden nuggets that I think are going to be really, really valuable to our listeners. What, what, when, when you're kind of talking about people that are throwing stuff at the wall that's really not re innovative, what are they missing and, and what do they need to build into it in order to really have something of value?

 

00:34:50:22 --> 00:35:34:24

Speaker 2: Well, okay, so that's easy. I mean, to be honest with you, it's easy. It's the person and the outcome. I mean, look, if you, you know, you're, you're, you're, you're a person who has a particular illness, right? I mean, I Y Y Y through technology. I mean, you know, we're just, we're just so heavily Laden with technology, right? Yeah. I don't call that. And then they call it engagement. You know, these folks, folks who, uh, who have a chronic condition want to be less engaged with their, their, their, their illness, right? I mean, you don't want to, you don't want to be thinking about inner sick all the time. So it's a flip side of that, you know, what can you do to have them feel like they're less engaged? But having to think about, you know, being sick or doing this or having diabetes and all that type of stuff.

 

00:35:34:24 --> 00:36:21:05

So, um, that's, that's part of the problem is, is that if you throw some technology or you throw a solution that's, that's got a lot of technology and you don't think about how burden the individual is with technology. I mean, how do you expect them to be more engaged with an illness they don't want anyway? So I think that's, that's part of the issue, right? You know, I mean, there's companies that are measuring your feelings and they're doing this and they're, you know, they're after the feelings, they want you to go see a psychiatrist or a psychologist. I mean, you know, right. Create why create a problem when, you know, so I think that's the problem. You, you know, you can throw a lot of this stuff out. Hope something sticks. Hope somebody has a problem.

 

00:36:25:13 --> 00:36:49:17

Speaker 1: so you know, you talked about leveling the playing field between, you know, the physicians or the clinicians and the patients are people that have, are users or have the condition. Have you Daptiv adopted any strategies into your product management or product development where you were involving them in the process of building out? So let's talk about that a little bit. Okay.

 

00:36:49:19 --> 00:37:33:04

Speaker 2: All the time, you know, um, and actually you bring up a good point because, um, you know, there, there's a, there's two schools of thoughts. I think even, even, uh, Apple do that, you know, consumers don't know what they want, right? So we're just going to build it. And in some cases we've done that in more recent with Vontay. Actually we have a, when we first went into it, I didn't know this area. We, uh, it, it was, it just, it was astounding. I didn't know much about social media, but we tested out with social media. Um, the pictures that we got back from people who've had a digestive conditions, whether it's IBS and they had that constant diarrhea or people who have constipation. It was an interesting outlet to see the pictures and the social media that we got back. It was, you know,

 

00:37:33:16 --> 00:37:37:08

Speaker 1: and you're like, surely they're not gonna want to publicize that, but they are, right.

 

00:37:37:12 --> 00:38:29:13

Speaker 2: Yeah. They are actually. And so, so, so that actually was a key is you know, you ask yourself, you know, um, for people who don't have sort of conditions like this, we're not leaving, you know, living like this all the time. Um, how willing are you to share actually, you know, your poop pictures or for the pictures, right? You're living with a condition essentially like this. This is just part of your, you know, your, your normal life. So, um, we have those user groups all the time. We test the products out there, they tell us, so this is useful, this is really garbage. Um, you know, this is, you know, how we feel, um, a lot of the people in our company actually, and I won't say I hire for it, that might actually have these chronic digestive conditions. And so that's also important components. So, so, so, so we do testing in there like us who got these conditions.

 

00:38:29:22 --> 00:39:32:24

Speaker 1: Yeah. Yeah. I think that's really important too because you know, I think traditionally lot of companies innovated internally and, and felt a sense of responsibility to come up with all of the innovative ideas within the company and have something kind of complete to bring to market. And that's when customers or prospects were involved in any process of like, Hey, here, is it here? Here it is. Do you want to use it or do you want to buy it? Whereas there's definitely over the last couple of decades in other industries, and I'm starting to see a little bit more of this in healthcare, we're just scratching the surface of, I don't have to be the expert internally. I just need to be able to ask the right questions and, and, and allow those prospective customers to be a part of that product innovation process and like, wow, I mean, you know, your R and D costs go down and your success rates go up. So it's a win win. But you kind of have to put your ego to the side that says, I don't have to have all the answers. No,

 

00:39:33:08 --> 00:40:12:21

Speaker 2: you're totally, you're totally, you're totally right. Um, you know, uh, you know, people don't all, I mean, if you crowd source it type of thing, they don't always know. Um, but, but you know, um, there's some commonality. You're, you're, you're 100%, you're 100% right. That's exactly correct. And so, luckily, actually, um, I'd say our product development is, um, and this is not meant to, is run by women. Um, and, um, and they get it. I, I, I have, they, they get it, you know, the ego aside, at least the, the folks we have, they're extremely good and they're open up. Um, and I mean, they just get it. The, there's a sensitivity there that I, we just don't have the team.

 

00:40:14:20 --> 00:40:51:07

Speaker 1: So obviously, you know, we, it doesn't take a rocket scientist to know that, you know, companies are comprised of people and, you know, strategies, products, every processes, everything kind of begins and ends with the team. If you don't have the right team, you know, you're not going to have a successful company. Um, one of the things that I noted that was really interesting about you and Vivante health is I would say that you are a younger company, right? Vivante has only been around for a couple of years and you already have a chief commercial officer.

 

00:40:51:12 --> 00:42:12:21

Speaker 2: We do. We've hired actually of our C a C suite. Um, so we'd have some really great new hires. Um, yeah, bill Snyder came from Virta health. He's absolutely spectacular. Um, he's a vigorous young guy who's got a great track record and, um, he's done. He's done marvelous. He's built a great team for us. I have Catherine Moore, who is the chief product officer. Um, she came from Zoc doc and then Guild education. She's got her so far together that, um, and uh, she's extremely good. We just hired two, uh, two new people in the C-Suite. Uh, and then there's Andy loving I should say, who came, who was in Nashville, who was with narrows health and aspire and Healthways, uh, really a seasoned veteran. And we just hired two new people. Our chief technology officer is a Deborah and Bron. Uh, she came from HP and United healthcare. She's absolutely terrific. Um, and our chief medical officer, uh, will be coming on in a couple of weeks is, uh, assignment Matthews. Um, he's a GI doctor from Hopkins. He was on the faculty of Hopkins and he decided to join us. So I've got a really a terrific young, a young team, um, that are passionate and uh, and uh, uh, have all those ingredients. So, um, I've been really lucky, um, with esteem. Super lucky.

 

00:42:13:13 --> 00:43:00:15

Speaker 1: So what do you say to those health innovators that, you know, only obviously all of us only have a certain amount of resources to work with and you're making the decision of, you know, obviously the suite is, is expensive or more expensive than, you know, let's get some interns, right? So it's two completely different mindsets for a leader of a company. Um, and you've got a limited amount of money to work with and you need to invest in the product. You need to invest in your go to market, but you need to invest in the team that's going to help you with all of that. So what do you say to innovators that are, you know, kind of on the Teeter totter between human capital? Yeah. Technology go to market.

 

00:43:01:09 --> 00:43:48:00

Speaker 2: Yeah. Well, it, you know, I think, um, this, uh, I hope this will sound, I, I'm, I'm really lucky I have, I've, I've had a pretty broad background and I think being trained as a scientist has allowed me to, to do each and every one of these tasks. So first of all, I know what each and every one of them entails, right? You can't hire somebody and say and not have had that experience. And I never do that. So I always do things first and myself and so, so that's kind of number one. And so, um, when you hire people, then you have a better sort of, um, understanding of what you need in that individual. Right? And quite frankly, when, um, when, when, when you start talking with folks and you start to bring on, on these folks, there's two elements. I'm a little older and there's respect.

 

00:43:48:09 --> 00:44:34:14

One is trying to, to, to have the, their careers grow, right? I think the best accolade is to, I really do is to train them so well that they want to leave, but I'd have them leave. And so, um, I, I, we started out doing all of this stuff myself. And, um, as a team gets bigger, they say, why are you doing anything? We don't want you to do anything. You're just interfering. Um, that's how it grows. You know, you start to get those people and, and it comes down to a sort of a, what I would call a cultural thing. You know, you said they're expensive and the suite, well, um, people want to work primarily at places where they're valued and they can grow their careers. Right? And, and, and, and, and have that freedom and experiment. So, um, I don't really go for the highest dollar.

 

00:44:34:14 --> 00:45:24:09

I won't do that. I mean, but, um, and I want them all to be shareholders. So we're generous on that because, and we rolled the same direction. We all profit from that same direction. So, um, I've been really lucky in getting people who, they have the right chemistry, they have the right passion. Um, they have good experience. Um, and my job is simply to, um, to, to try to see if I can develop their careers. Um, you know, um, further, um, that's what I was supposed to be doing, uh, and enduring the vision of the company. But, um, so, um, for the other entrepreneurs, well do all the for yourself and then, you know, solely add, but you don't have to buy really expensive people cause you think they're quote experienced, right. It's a matter of people who've got fire in their belly and are willing to learn new things. Um, so that's how I look at it.

 

00:45:25:04 --> 00:45:45:23

Speaker 1: Well, and I couldn't agree with you more. The fire in the belly is just so important, right? Because again, as a startup company, there's just so many challenges and so you've gotta be able to be resilient, um, and, and keep that fire in the belly. Um, you know, not everybody is going to be so, uh, such high risk takers, but there's a big reward at the end of it, right?

 

00:45:46:03 --> 00:45:59:12

Speaker 2: Yeah. There, there is. Yeah, there is. And, and you actually can see your vision actually getting laid out on a daily basis. And that's kind of cool because you know, every little thing you do, you know, you've done it yourself. And so that's pretty cool. You can see the advancement.

 

00:46:00:14 --> 00:46:17:01

Speaker 1: So, um, as we wrap up here, is there anything else that you, um, you know, kind of think about it for just a second. Is there anything else that you would want to share with fellow health innovators that are in the trenches today that are listening to this episode?

 

00:46:17:20 --> 00:47:11:15

Speaker 2: Well, well thanks for that. You know, I think the biggest thing I would say is, and I'll go back to choose, uh, choose, uh, an important, uh, clinical problem that you can solve a clinical problem that you know, has an unmet need, um, that the quote traditional healthcare system can appreciate, right? Um, doctors, nurses, hospitals and all that. So, um, and, and, and think about flipping it such that it's not a technology that precedes it. It's really a clinical problem that is being supported by technology. And so that would be my mantra. Um, and, um, and that requires a, that requires some deep thought in terms of, uh, of the problem and the approach. So that's, that's kind of it. Hang in there. I mean, I, you know, I mean, things look grim sometimes actually on a daily basis, on a millisecond basis. Hang in there. It's always good.

 

00:47:11:23 --> 00:47:49:09

Speaker 1: Yes, absolutely. That's why we're here to share strategies, share tactics and, and encourage our listeners to hang in there, um, that, uh, you know, we need folks to hang in there because we need to change are a lot that happens in healthcare today, um, for, for everyone's benefit. Yeah. Yes. So thank you so much for sharing your wisdom with our listeners today. I have really enjoyed the conversation. What is the best way for folks to be able to get a hold of you in case they've got some questions or want to find more about what's going on with you?

 

00:47:50:05 --> 00:48:24:13

Speaker 2: Yeah, I mean certainly they go to our website, which is, you know, Vivante health.com and, and um, see what we do. Um, I have no issue with handing out my, uh, my, uh, email. It would be K, Angelina's, a N, G, E L, I D, E S at Vivanta health, V, I V a N T E H E a L T h.com. So just drop me a note, um, connect on LinkedIn if you'd like. Um, I'm always, I was willing and welcome and I love to hear from other folks who, uh, want to just talk about building a business.

 

00:48:24:23 --> 00:48:28:13

That's great. Thank you so much. Pleasure. It's my pleasure. Thanks, Roxy.