This week, Stephen Ibaraki has an exclusive interview with Raghu Rai.
Interview Time Index (MM:SS) and Topic
|:00:23:|| ||What areas interested you before college?|
"....I've always been interested entrepreneurship and healthcare. It started when I was a young kid and my dad would always make me watch the 60 Minutes specials on Sundays and you'd see these great profiles of entrepreneurs like Steve Jobs, so it was really exciting to see how they built these companies over time. From the healthcare angle, I was always the one who would accompany my grandparents or my parents to their doctor's appointments and it was fascinating to see all of the inefficiencies within the system, whether it was the lack of records or lack of information. When I entered college it seemed like the two coincided very nicely and that led me into where I am today...."
|:01:22:|| ||Describe your college experience and milestones?|
"....I studied biomedical engineering at the University of California Irvine and got thrust into entrepreneurship during my first quarter of my freshman year. We were working on a project at the time where we were given an insulin pump and tasked with innovating on top of it in some way. The first idea that popped into our heads was to connect the insulin pump to the iPhone and that would allow patients to control their insulin delivery, monitor their blood glucose level and share that information with their care providers, all through mobiles. The professor encouraged us to enter into the campus-wide Business Plan Competition at that point, so really naively I submitted an executive summary and it ended up making it to the second round, at which time we got paired with a local business coach who ended up becoming our first angel investor and helped us craft a more formal business plan that took second place in the competition. One of the great opportunities was him seeing the potential in the concept at the time and to start assembling an advisory board of healthcare contacts and really moving the idea forward. I spent the next 2 to 3 years exploring that idea and transitioning in my senior year more towards what Jio Health is today. My entire college experience was defined by building the company and exploring all the possibilities behind it...."
|:03:20:|| ||You have expertise in the healthcare industry, can you talk about the research you have done and advisors you work with?|
"....After we had graduated in about 2010 one of our advisors at the time was a gentleman who had come from the electronic medical record and connectivity field. He had just come off selling his company to a very large technology firm and one of the opportunities he saw was focusing on patient engagement....One of the first research projects that we worked on was with a large hospital in Southern California and we focused on working with hypertensive and type 2 Diabetic employees as part of a court wellness program. The result of that study worked out really well in that it received the 98% of engagement with the prescribed wellness activities, and the real carrot that we provided these patients was a gamified wellness regimen....More recently we started focusing on a more acute healthcare problem which is congestive heart failure. In the United States with the Affordable Care Act one of the most pressing pain points for hospitals is to prevent 30-day emergency room readmission specifically for the diagnosis for congestive heart failure. We had worked with a very large insurance company nationally and a very large IPA (Independent Physicians Association) or physician group here in Southern California to address that problem...."
|:06:24:|| ||What are some useful facts or major trends about the healthcare marketplace in North America and globally?|
"....There's really three key trends that dominate the healthcare landscape. The first is accountable care. The industry is more focused on demonstrating meaningful outcomes from each of their care interactions so every healthcare system is now tasked with demonstrating that they have actually improved the health of their patients....The second is that consumerization is a great trend. If you ask any average American they are probably not aware of what their healthcare costs are or that they even have a choice in selecting their health plan....The third is the delivery of healthcare is changing. Very much like Uber disrupted the transportation model or AirBnB disrupted the real estate and accommodation model, I think there is a ripe opportunity for start-ups to disrupt the delivery stage of healthcare by focusing on digital consultations, at home visits, e-prescriptions; everything is going to be digitized in the delivery of healthcare...."
|:08:55:|| ||What are the pain points in the industry and for enterprises in the space?|
"....One of the age-old problems for the enterprise has always been connectivity. They don't like sharing data between one another....Another challenge that we've observed is that you have to scale your care resources to cover a larger population....Last, an interesting stat with regards to consumer brand engagement in healthcare. Healthcare companies are actually performing very poorly in this category. I think the NPS scores for most healthcare systems are in the low teens and when you look at some of their consumer counterparts like Amazon or Google, each of those brands is well above the 70s and 80s so I think there's a huge opportunity to enhance patient experience especially as we are preparing for this consumer trend in healthcare...."
|:11:07:|| ||Can you explain the meaning of the scoring system NPS?|
"....The NPS is a Net Promoter Score and it's used by marketers to determine the stickiness of a brand within the consumer's mindset...."
|:11:45:|| ||Can you go further into the solutions to the pain points?|
"....What we are focused on here at Jio at the very least is taking some of those persuasive elements of consumer technologies: elegant design, intuitive interfaces, the ability to integrate with wearables, sensors, to poll data ambiently, the ability to share that data securely through your mobile interface - I think all of those digital touch points deliver healthcare in a context that is familiar to the patient....I think that with the advent of product diseases you really have to focus on giving your patient tools that focus on prevention or management of day-to-day chronic ailments. Those things though very small steps, add up to a large component of the behavioral healthcare costs that impact the system...."
|:13:38:|| ||What will healthcare look like in 2 years, 5 years, 10 years?|
"....I know that you are a big fan of Big Data and machine learning and I think it's going to completely transform all aspects of healthcare, everything from diagnostics to the delivery of healthcare....Second, I think that primary care is going to completely drift into the cloud so once where patients used to go in to see their General Practitioner that entire interaction is going to happen through digital....Last, I think that the consumer trend is going to cause a greater degree of competition within the space which will allow a patient to access health plans that have greater benefits and different benefit styles...."
|:15:45:|| ||There is so much attention globally towards many areas including healthcare. Can you share your views on the United Nations and the ITU and their efforts?|
"....One of the sustainable development goals for the UN is good health and wellbeing and obviously the ITU is focused on connecting the world through the web, so I think those two go hand-in-hand. Our vision is really to be the best way to access healthcare and we've even started exploring some opportunities in Southeast Asia with a few hospital systems....I think the great thing about digital healthcare technologies and the UN Sustainable development goals is that those digital technologies facilitate the reach and access of healthcare. I don't think that there's been an opportunity like that in the past where you could be in a rural village and be able to access healthcare without having to go through the tremendous pressure and strain to travel or visit more urban areas...."
|:17:29:|| ||What prompted you to found a start-up?|
"....I don't think there really is one reason behind it. I think it was embracing the right opportunity and feeling passionate about the vision that we developed...."
|:18:20:|| ||You started very early (essentially out of college), in fact beginning within college itself, what mistakes did you make?|
"....Lots of mistakes. You really can't have a successful start-up without mistakes. Initially we began building our product without reaching out to any users or customers. We didn't really clearly understand our users and we felt that we could anticipate their needs - that's a big mistake....I think focus is one of the most critical aspects of a start-up. We thought that we could tackle anything and everything under the sun, but you have to sacrifice many good ideas for that one great idea - that's a consistent challenge that we faced...."
|:20:00:|| ||What are your successes and milestones currently and into the future?|
"....I'm very happy to see the performance we've had in our healthcare pilots. 98% engagement in our early corporate wellness pilot was extraordinary. The cost savings that we accomplished at the congestive heart failure pilot were great, saving $100,000 in three months is a great feat. Now we have shifted our focus towards more of a consumer healthcare model and I'm excited by the reception that we've gotten with our early glimpse for the mobile app and specifically how versatile it is in terms of being embraced by everything from wellness, to improving discharge at the hospital setting, to a population management tool at the insurance companies...."
|:21:44:|| ||What lessons can you give to enterprises who are using the start-up mentality to drive innovation and agility?|
"....I think internal teams need complete autonomy from other business units. They need to have the ability to gain an outsider's perspective on the business problems that you are trying to tackle....You need to encourage customer engagement from day one....There also needs to be a strong definition of the business objectives that you are trying to accomplish with these internal projects so that you can constantly measure whether you are actually achieving the ends that you wanted to accomplish....Fail fast and fail often and have a culture where it is not frowned upon to make mistakes or not quite hitting the mark every single time....Before a single line of code is even written you should focus on just mocking out the front end UI and sharing it with as many focus groups or people as you possibly can to determine if what you are endeavoring to build is valuable in the first place...."
|:25:07:|| ||How does your start-up integrate with the United Nations Sustainable Development Goals and the ITU World Summit on the Information Society Action Lines?|
"....I had mentioned that we were working with a few hospitals in Southeast Asia and those markets are developing markets so they don't have as mature of a healthcare system in place at the current moment. The challenge that they have is delivering healthcare to a population that may not all be centralized in urban areas and they need to deliver care to people in remote provinces....By introducing technologies like Jio or digital health to these new and developing populations you could educate those folks on accessing healthcare more remotely, understanding what the conditions and symptoms are that they are currently experiencing, and maybe prescribing alternative routes of accessing healthcare and making sure that if there is an acute need for healthcare, that you can reach a patient hundreds of miles away in a remote village and guide them through some remedial steps before they are able to come into the care facility...."
|:28:47:|| ||What are the key attributes in individuals and teams that produce winning products and services?|
"....I think it all comes down to conviction in a vision and communication....Our team is unique, it is a distributed team in that it's global and we have to interface with not only the folks here in the States but also a large part of our technology team in Southeast Asia. That involves commitment – late night talks, going through business requirements, technology requirements and keeping that communication flowing and smooth. Our team is motivated by the vision and the conviction that what they are working on is truly going to make an impact and it keeps everybody on the same page...."
|:30:42:|| ||Can you comment on open networks where you have a team and ensuring that you have quite a bit of diversity in that team environment but where the team is able to work well together? That can be difficult at times but it can lead to success.|
"....We have a very diverse team and it lends to a broader understanding of healthcare....The more open your networks the more relevant your solution...."
|:34:05:|| ||How do you know you have a winning product or service?|
"....I think it comes down to just putting it in front of as many people as possible. We've displayed our product to quite a few diverse audiences....We are constantly measuring the response to our features, functionality and that gives a good degree of confidence in moving forward....Keeping a very close pulse on your target customer and constantly looking to them as the source of truth as you are building your product and your platform...."
|:38:58:|| ||As a successful executive and head of an enterprising healthcare company do you have any leadership lessons that you found successful for you?|
"....Being open to learning every single day....Opening up your networks, being a little more diverse in the people that you access, working with folks that are a lot more senior and have the experience and being receptive of the feedback and wisdom....Being a great listener....Continuing to direct the team towards the vision....Constantly refining the vision...."
|:40:54:|| ||There are now over 133 “unicorns” (a start-up that has a valuation of over a billion dollars), why do you think this is happening?|
"....I think it's because a lot of those companies are targeting the consumer so your market is enormous. Also it's about bringing those traditionally offline businesses online....It's going to be a challenge to keep pace with this rapidly evolving business model and when start-ups anticipate them and embrace them early on, they'll leave the traditional industries far, far behind in the dust...."
|:42:35:|| ||Do you have any closing comments that you'd like to share?|
"....I'm really focused on seeing the changes of healthcare, specifically bringing more of a consumerization to healthcare and I am very excited about a lot of the work being done with the digital health start-up community. I think the opportunity is amazing to also implement a lot of the lean start-up principles to healthcare which typically has been a very costly space to operate in...."
|:43:51:|| ||Raghu with your demanding schedule, we are indeed fortunate to have you come in to do this interview. Thank you for sharing your deep experiences with our audience.|