← Becker Private Equity & Business Podcast
Becker Private Equity & Business Podcast
Founders, Leaders, and Investors on AI, Business Growth, and the Future of Healthcare 8-19-25
00:58:58
In this webinar turned podcast, Venkat Mocherla, Dr. Stephen Klasko, Manav Sevak, and Dr. Andrew Gostine join Scott Becker to explore the realities of building in healthcare, the transformative potential of AI, lessons for entrepreneurs,
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- [00:00]
A
This is Scott Becker with a combined program from Becker's Healthcare and Becker Business podcast and Becker Private Equity podcast. Today's discussion is part of what we call our Founders, Leaders and Investors series. Here we're joined by four tremendous leaders to talk about sort of business, AI and a lot more in healthcare and in business generally. The program that you're about to hear featured Steven Klaskow, brilliant physician, but also executive in residence at venture capital fund General Catalyst. It featured Venkat Mercola and Venkit is the founder of Midstream. He was also an operating partner before that at Andreessen Horowitz and has also been a seed investor in a lot of different businesses. Third, we've got Manav Sivak. Manav literally founded a company that grew into the tens of millions of dollars and more, Memorial Health. And he started when he was still in college at Georgia Tech. A brilliant, brilliant person. And finally forward is Dr. Andrew Gostein, who's the second doctor in the program. And he's the founder of a company called Artisight, which also has been incredibly successful. So again, this program will feature those four and discuss business growth, AI growth, what founders should know, what they wish people told them, and a lot more. Thank you for listening. Let me ask each of you for a minute or so to introduce yourself and tell us a bit in your own words about your background, what you and your firm do. And then we'll talk a lot about the biggest problems in health care and in business, about growth, advice for founders, and a lot more. Dr. Gostein will go on the same one I just started and the next question will reverse the order like the NFL draft and start the other way. Andrew, let me ask you to kick off.
- [01:46]
B
Perfect. So thanks for having me and thanks everyone who joined. I know a lot of our customers and prospects are on, so thank you for being here. So I'm Andrew. I originally am a physician by training, still practicing about one or two times a month as an anesthesiologist and ICU physician, but always was in and out of medicine. I left medical school for a while to go to business school, left residency to go to venture, and through that got really just a different perspective on the problems we were trying to solve in healthcare. And after coming back from seeing a lot of what I would consider very high performing industries like industries like high frequency trading where they were looking to shave microseconds literally on communication, I came back to practice medicine, got my pager and a fax machine number back, and realized that there was 18 generations of technology between where some of the highest performing industries were functioning and what we were using in the hospital. And it was just one fateful night in the hospital where I got very frustrated with a six hour process that shouldn't have even existed, which ultimately led me to the idea that we need smart hospitals. We need hospitals that can see like a doctor or a nurse, hear like a doctor or a nurse, propriocept, read a patient's vital signs. We need to get the hospitals to the point where I don't have to do all of the data generation. And that's what really sparked the idea for artistsite. Talk more about that in a little.
- [03:25]
A
Bit and take one moment. Andrew, Dr. Gosling, give me the gist of what artistsite does. I saw recently Northwestern great elite academic system here in Chicago invested with artistsite and I know another system did too. And you've got other rounds before that, but give us in 30 seconds what artisight exactly does.
- [03:48]
B
Yeah, so we've been fortunate to have a lot of great investors with 15 different health systems that are now investors. And all of our rounds have been led by Nvidia. So it's one of the few health care investments they've ever made. So really what Artisight specializes in is in giving the hospitals eyes, ears and a sense of touch. We do that in the form of deploying cameras, microphones, an asset tracking system, radar sensors, sensors, accelerometers that derive data. So we use a lot of computer vision algorithms to determine what's happening in the hospital. And then we start automating operations by automating the electronic medical record. So rather than having a nurse document that she just delivered to patients to the operating room, our cameras detect that, automatically document it, automatically send out notifications to the people that need to know about it.
- [04:43]
A
Amazing. And so it must be fascinating to have Nvidia, which has become the most successful company in the world, quite frankly, to be an investor and to be one of the partners in your company. That's a fascinating pedigree as well. Manav, talk a little bit about your growing a company, the origin story, and introduce yourself, if you don't mind.
- [05:04]
C
Absolutely. Thanks for having me, Scott. My name is Manav. I am a scientist by training, so studied computer science and biochemistry, did cancer research for a couple of years, and then started a company called Memora Health in 2016. A big picture of what we do is we build workflow automation software for hospitals. So we go into health systems, integrate with medical record tools, extract data from charts to Find patterns in how doctors are practicing and help them automate a lot of things that they may be doing repetitively. So things like medication management, appointment management, reminders for patients, things like that. Scaled the company and then last year the company was acquired by another company in our space called Commier, which we have had a relationship with for a handful of years now. So I'm excited about that. And since then I've started kind of ideating and I'm starting something new that's in stealth right now. And then also on the side running a fund that invests in everything from seed stage all the way to kind of pre ipo. And my journey as a result has been kind of all over the place in healthcare. Right. Like I've spent time on the research side, I've spent time on like the healthcare technology side. I'm kind of very, very slowly, I will say learning investing right now. And I'm fortunate to have had a lot of different perspectives on the industry.
- [06:33]
A
And take a second because in some ways you've lived everybody's dream. It's sort of starting the company out of the garage. In this case, starting the company out of your, out of literally in college. Talk a little bit about that and the origin story of Memora and how you did it and your co founder. Tell us a little bit about, about that journey.
- [06:52]
C
Yeah, absolutely. So we started the company technically when we were still in school. Um, and a lot of the kind of inspiration for it was actually.
- [07:03]
A
We.
- [07:04]
C
Had a, a very close friend of both of ours that we lived with in college who went through a pretty severe chronic episode and was diagnosed with colitis and just kind of going through the process of, of living with someone and seeing someone who is probably like the ideal Persona of someone who could be well equipped to navigate the healthcare system. Young health literate, tech savvy, has great access to medical care. Navigate a lot of the basics around just like understanding what medications to take at the right time, how to prepare for things like colonoscopies, was very telling. How you could spend a lot of time improving all the research that you do or improving a lot of operations inside of kind of clinical centers. But the last mile of how people actually experience the healthcare system is where a lot of it really falls flat. And it, it was basically the driving force for us wanting to start the company is seeing those experiences kind of first and secondhand.
- [08:07]
A
So I'll ask you one follow up question that any sort of surprise at the ability to gain traction and grow this out of your college Sort of being in college, was that, was that sort of shocking that you're able to build, gain traction and really get it going? I think you spent some time at Y Combinator too.
- [08:24]
C
Yes. So we started in 2016 and then we went through Y Combinator in 2018, which is a startup accelerator in the Bay Area. And the, the short answer is like, we, we didn't get traction for a very long time. Like the first, basically two and a half years of the company, we had, we had zero traction. And it's because healthcare has a very steep learning curve. It's a very complex system and it's such a big part of our economy for a reason. And that compounded with the fact that even in 2016, technology adoption in the industry was a lot lower than it even is today. And even today, you could argue it lags behind a lot of other industries. So frankly, the number one thing that we learned is having a lot of persistence and working through, having to iterate over and over and over again until you find a problem that that's worth solving.
- [09:19]
A
Thank you very, very much. Venkat, take a moment to introduce yourself and tell us what Midstream is doing. I know you're working with some of the largest, I think one of the largest health systems in the country, very closely, having an incredible journey. Venkit, tell us a bit about your background and what you're doing.
- [09:36]
D
Yeah, yeah, absolutely. Thank you, Scott. And it's so fun to see fellow panelists here that are close friends, et cetera. Me, I started in my time in healthcare right after the recession in 08, where I got to join one of the largest healthcare providers in the country, DaVita and CKD. And at the time we had the most fun job, which was, hey, can you go diversify this business? And so I grew up at a time when we went and purchased Healthcare Partners for four and a half billion dollars. We started a new company called Paladina in the direct primary care space. I cut my teeth into the healthcare world, really in care delivery. I then moved on, worked globally for a consulting firm, worked in the Middle east, in Europe and Canada. I'll get back to why I think that matters in the age of AI. Then about 10 years ago, got really fascinated about the intersection of AI applications in clinical operations. And there were not many people, frankly thinking about machine learning and AI 10 years ago. And there's always a three person team at OIC working on something in Stanford. And I found three amazing people at a company called Qventus joined them and Was able to see firsthand how hard is to like what Manav said is to just because you have a great idea, a new piece of technology doesn't mean people are going to willingly accept it. And got to see something go from just an idea in a hospital to hundreds of hospitals using it around the country and then join Andreessen Horowitz, like you mentioned, Scott, as an operating partner. It was the most fun job in the world at one of the greatest firms in the world of how do you help entrepreneurs scale their dreams? And it was really awesome to see something that I'd seen really in practice at one or two companies at scale at 70 + companies across the portfolio and then left and started midstream. Midstream, Scott, just sort of the 30 seconds. Our mission is entirely focused on advancing financial sustainability for the largest healthcare providers in the country. It is incredibly complex if you look at some of the financial decisions that are made in the myriad of stakeholders involved. For us, the way we help make those financial decisions a little more straightforward is by deploying these army of agents backed by world class infrastructure and a forward deployed organization to ensure success. And you know, I think when we go into some of the learnings for entrepreneurs, I want to sort of talk about how sometimes it's not just technology, it's a lot of people, a lot of process. You got to move to ensure outcomes in the last mile. So happy to get into that for our conversation.
- [12:19]
A
Thank you. I'm going to ask you one follow up question before we get to Dr. Klaskow and have his introduction and then we'll come back around the turn, around the curve. But yes, a founder as a leader, building an AI business or business generally. And this is a Dr. Klaskow concept. What's the one brutal truth that you wish somebody had told you? What do you wish somebody told you? I mean monitor he said, you know, got traction early and he said no, no, no, took a couple years. And anybody who's a founder entrepreneur probably knows that that's the case. And it's two, three years till you really get traction in most things that you do. But talk about what's the one brutal truth you wish somebody had told you?
- [12:59]
D
Yeah, there is no easy button. I think what happens in this more of a Valley perspective it used to be and I think this is already changing, which is fantastic. That really fundraising is a badge of honor and fundraising doesn't mean anything, to be honest. Don't get me wrong, it's really hard to raise money anywhere, let alone if you're outside the valley or inside the valley. But I think oftentimes when I talk to entrepreneurs about this, I think the most important thing is the customer. The customer, the customer. Like, are you delivering something of value that really matters to someone who's incredibly busy and probably is the hundredth person you're meeting that day? And then more importantly after that is do you have the people around you that can deliver on that promise you made to that customer? And what happens if you have, you know, if you focus on the customer and you focus on the team is. It's the opposite. You don't have to chase capital, Capital will chase you. And it's an amazing feeling when that happens, by the way. But that's the secret is if you stop sort of optimizing the fundraising game and think about building a great thing for customers and with a great team, I promise you, people will come and find you. Because that's what a lot of people are focused on doing. That's one. And then second, Scott, I'll just sort of say is that in the age of AI, I think we used to think a long time. Last 15 years I've been involved in startups like what's your moat? What's your defensibility? And my provocative, not so provocative statement that I think has now become mainstream, which is that I think there is no mode in 2025, apart from execution and distribution. I think that if you can execute the heck out of it, given that software no longer takes months, no longer takes months, no longer takes weeks, it could take hours to go produce a new application. In that era, it's all about the speed of execution and distribution. And that is. It's a hard lesson to learn.
- [14:56]
A
No. So I love that one is solve a problem, really provide value to a customer that they really need. Second is execution in distribution, in this entire intersection of actually making it work for somebody is so critical and with urgency is what I hear. Dr. Glasgow, let me turn to you and start with the introduction. You give us a little bit of your background. I'm going to ask you one of the first questions to get started on here too. Sure.
- [15:21]
E
Well, Scott, this is a big moment for me because I think I like the grand slam of tennis. This is my fourth. I've done Becker's Healthcare, Becker's it, Becker's private equity, and now this. So I feel really honored to be here. I actually, I was a broadcast journalism major, started my career as a DJ and somebody reminded me here in Napa, 25 year old. That was when DJs made less than than doctors. Became a private practice obstetrician, delivered about 1500 babies. And I have this disease where I just can't handle mediocrity. So back when I was practicing 97% of OBGYN for male the number one performed procedure in the country was hysterectomy followed closely by C section. Happened to be at a Penn State lecture listening to, as I remember him, an old male obstetrician, actually probably my age now, which is a little depressing, but he was talking about hysterectomy and said if somebody has a small fibroid, just take out the uterus. Woman doesn't need that after a childbearing age. For the top 10 nonfiction bestsellers when I got to Barnes and Noble were what My Hysterectomy did to Me. The Hysterectomy Hoax. How Hysterectomy Ruined My Life. So I ended up leaving my private practice, taking about an 80% pay cut, starting a company called Spirit Women. And that was my first foray into how you can take risk, make no money and hopefully be successful, but actually do well and do good. Went to Wharton, got involved in a major grant around what makes stocks different than normal people or other people, depending on the audience and how we handle change. And through a very, very, very opportunistic, lucky and different series of events, became the dean of two different medical schools. Drexel University College of Medicine, Philadelphia after Al Gheny went bankrupt and University of South Florida, which interestingly, if you want to know everything about academics in Florida, University of South Florida is in Northwest Florida, Tampa. Then became the CEO of USF Health. Then finally, as you know, when we met, I was the first single campus leader for Thomas Jefferson University and Jefferson Health, which was a 200-year-old one hospital, one campus university. In nine years we became an 18 hospital, two campus university. We merged the number three design university in the US with a health science university, created an MD master's in design Design of the human experience. Starting from home, we acquired an insurance company and through that our mission became we want to be a 200-year-old academic medical center thinking like a startup company. So I met that that really attracted people like some of Venkat's former bosses in Hemant in Asia. Hemant had just written a book called Unscaled about their investments in Airbnb, Warby, Parker and Stripe. We became friends, wrote a book called unhealthcare, a Manifesto for health Assurance, which has now been translated into a few languages. And then in 2022, I became an executive residency, general catalyst. I'm also board chair of a company called Dot Go, which does everything between the hospital and home. And it's a NASDAQ company. I'm board chair of a medical device company called Teleflex, which is trying to move things out of the hospital. And I work with several GC companies, including being on the board of a company called Paradigm, which is using AI to revolutionize clinical trials.
- [19:00]
A
Dr. Glasgow, let me start here with you and the next question for our panelists and I'll ask each of you to give us a minute or so on this question. Dr. Klass, I'll start with you. I start with the concept of, and I'll put it in two different ways, the biggest impact that AI will have in business and in healthcare. But more specifically stated, if you had to bet your entire portfolio on one area, will AI will create trillion dollar value or will create huge value, what would that one area be? And are people looking in the right or wrong place? What's the one area you think this is where we should be all in on in terms of AI and impact?
- [19:50]
E
I think it's going to be in the whole issue of infinite staffing and all of a sudden staffing being abundant and it'll bring in a bunch of different things, some of which Venkat and Andrew are working on. But I think the whole issue, like one of the companies that I was initially involved in investing is called Hippocratic AI, which is really creating Rachel the AI nurse. And the one thing for people that are listening is, I mean, and I think Andrew, you brought this up, but you know, it used to be that that kind of thing would get better every six months or a year. It's getting better every week to the point where in some of our pilots, you know, that have Rachel the AI nurse talk to them post op, they'll come to the office and say, hey, could I see Rachel? She's so much nicer than the nurses in your office. And I think so. The ability to literally have somebody following your career, the ability for, whether it's ChatGPT or OpenAI to have all your My health records literally be able to be your guide and then have a conversational AI like Hippocratic. There's another one that I work with called Ellipsis Health, which is using voice biomarker technologies to basically say, hey Steve, you know, on this webinar you sounded a little bit more depressed and anxious. You know, could we talk about it? Because they've basically looked at my voice and know that the last time I talked to you, I was more upbeat. So I think that combination of things where you have your own personal coach and then combined with I'm on the board with the chair of the board of Oura Ring and I think that whole 247 seamless, continuous. My car, I'll just end with this. My car right now gets better care than I do because when I get back to Florida, my car is going to say, hey Steve, while you were away in Napa, my right front passenger tire got a little low. Could you fill it up? Because it sends continuous data. I had a Mayo executive wellness visit, you know, about three weeks ago and you know, this is what you should do. Come back in 18 months. Well, it has no idea what's happening between then and now. Once we have that continuous data, I think that that combined with everything else I talked about will be a revolution and a several trillion dollar business.
- [22:09]
A
No, I think that's a fascinating perspective. We're already seeing different pieces of that play out. I think that's a fascinating perspective in this concept, this change in staffing and where that goes is just a fascinating issue. Thank you. Let me ask you the same question. You know, where is the one place people ought to bet everything in? And then before I ask you that question, you know, where's the biggest impact going to be? A reminder audience, I've got one great question. The audience so far. We'll get to that with our, our four panelists. We'd have to get through this one round. Venkat, where's the biggest area of impact?
- [22:43]
D
Yeah, you know, I'm listening to kind of Steve and obviously like, you know, Steve's has always been ahead of, of his peers and, and I completely agree. I think the one caveat I'll sort of say and where I sit and obviously I've put my money where my mouth is and building company like midstream. But I do think where in the world you sit matters and I'll tell you why I think that, you know, having grown up in India, my grandfather was, it was a primary care doctor in rural India. You know, I worked in Europe, the Middle East, Canada. I do think that, you know, one observation I've always had is that the ability to sort of innovate on consumer or direct to consumer businesses is just much faster in the, in outside the US and so I genuinely believe the pace of innovation for the consumer that frankly has graduated from Dr. Google to Dr. Chatgpt or anthropic or the N number of applications built on top of these foundation models. I think it'll just fundamentally change the way you navigate your healthcare from being reactive to proactive obviously using the devices that Steve mentioned but coordinating and connecting what's from X Dr. Minto Specialist Y I think all of that will happen and I think it'll be absolutely revolutionary enterprises big I think the U.S. i think the sort of us has, it's the minute you come to the U.S. you've lived here, you worked here, you realize how complicated the financial flows are and the number of stakeholders, all the three letter words you can think of from payers to PBMs to whatever you want to have. And so for me I think from what's really exciting from a trillion dollar if not more opportunity opportunity is just the administrative augmentation of these decisions. There's a massive if then equation like it or not in every dollar of care that goes on in this country and there's a lot of stakeholders that frankly don't want you to know the equation. And I think what's going to happen in this sort of Google Maps and Waze moment for us is those decisions now have an agent or an assistant that are going to create transparency in that equation and also help you augment that equation depending on your perspective. Right. We help provide financial sustainability for providers and that's our perspective but everybody has their, has their angle and I think, I think there's going to be a massive opportunity to sort of think about.
- [25:02]
A
Compute there and Venkat, will there be enough human support behind these things so that people don't feel sort of left in the, in the sort of, I don't know what the right phrase is. If they're not getting the help they want from the agent is there you know because people love the human touch. I've been in so many hospitals, you always feel better when there's enough staff there versus not is there going to be enough human touch behind these? And even if you improve all the navigation tools, all the, the, the, the discussion tools, what if we don't enough doctors? I mean how do we deal with some of these things if we don't have enough specialists, will this help fill the gap or we still going to have to solve that problem too?
- [25:39]
D
Yeah, I mean you know I'm, I'm going to be shortly marrying a physician. My brother in law is a physician and you know if you, if you think about what they want to get, what they got into medicine to do and I, you know I'm sure Andrew and Steve have perspectives on this to what they actually do. I am actually so optimistic of like, you know, getting this joy back into their lives of actually talking to the patient and figuring out the actual medicine versus, you know, spending n number of hours in their pajamas, you know, charting. I do, I do think back to your question, Scott, of like humans and not humans. I just find it so fascinating. You know, I was reading something the other day which is like, you know, when you go and get coffee, you know, the experience is so bizarre. Somebody, there's a big menu of things you got to look at. Somebody tilts a big blue screen and says, 20% tip, 25% tip, 30% tip. And. And you're waiting there and what you just want is like frictionless experience. Like if you ever get into a waymo, it's a completely frictional experience. Leave me alone. I want to just get my coffee or get to point B. If you're on vacation and you know, the highest paid experiences are super personalized. Right. There's a concierge, there's a, you know, person who's carrying you and navigating you every, every step of the way. And I do think in healthcare it's always going to need the human touch. There's no way around it. I just think we deploy humans to do the worst jobs today.
- [27:09]
E
I think we've. Yeah, the issue is we still accept medical students and nurses based on science, gpa, med cats and organic chemistry grades, and memorizing the Krebs cycle, which is what the robots are going to do. And we're amazed doctors aren't more empathetic, communicative and creative. So I think, Scott, you brought up an incredibly important point. We spent way too much time talking about the technology, way too little time talking about how the humans have to change.
- [27:33]
D
Well, I think even if you're passionate about helping, and I feel like, again, I take people in my own family who are very passionate about taking care of people. It's just we've assigned them the wrong jobs to be done to these people and we've frankly taken the human spirit out of them and we've made them into robots, which is like the wrong place. And so, Scott, I just don't see that argument of taking the humans out. I just think I'm actually super optimistic. We actually want to introduce the humans back into the system.
- [28:02]
A
No, And I think you do see this to the point of a lot of these discussions. I see, for example, in the oncology world, so many oncologists that are so narrowly siloed that they're, that they have a very hard time seeing the entire picture of the patient, even the best and best and brightest amongst us and how do we get them tools and help to be able to do that. And you see some of that in companies that are evolving and doing those kinds of things modif. Let me ask you the single biggest impact that you would see and the one sort of truth, the brutal truth about building an AI business that you.
- [28:34]
C
Wish somebody told you, yeah, single was biggest impact. I would double down on what Venkat and Dr. Klasko just said. Like I think that there's kind of when you enter US Healthcare, you realize how much administrative overhead and complexity there is and how healthcare is delivered here. So you're kind of seeing this like massive wave of companies being built optimizing for solving or applying AI to a lot of these tasks which frankly, if agents and models become good enough in the next 10 years, probably shouldn't exist. If the world actually worked the way that it was supposed to, things like prior auth and revenue cycle management probably should not exist as categories. And the goal is if technology becomes good enough then we should eliminate them. And I think that there's a lot of companies thinking about that as kind of the N plus one of where AI is going to take us. And instead we should probably think about N2. If all the administrative stuff is something that you can have agent to agent interactions become really good at, if there's a lot of, call it non catastrophic clinical care that the actual science models can become really, really good at and can become extremely strong clinical decision support tools. The, the area that I find most interesting and that I think is maybe like a trillion dollar opportunity is twofold. The first is raising the ceiling on what is actually clinically possible. And then the second is how do all these people that are delivering care that is actually very like pathway based or very repetitive to some degree and in many cases things like primary care or some types of specialty care. How do those people essentially focus on a lot of the intangibles of actually delivering healthcare so they can optimize kind of like the human experience beyond just the science. So that would be the thing that's kind of the most interesting for me and frankly what I've spent a lot of time looking at as far as top advice that I got and top advice that I'd maybe give to other people that are building AI businesses is that you know, startup costs have come down so significantly that one, the amount of risk that someone needs to take in starting something is a lot lower than it's ever been before. And it means that people can spend or kind of have a lot more liberty in tapping into their creative energy. Right. I think that we've consistently been in this world that's been a lot more constrained around, well, if I want to start a company, here's the financial trade offs I have to make, here's how much money I have to invest up front to actually start something. And a lot of those just kind of equations are changing pretty rapidly. And the thing that I would say is that people should tap into their creative energy. They should have a lot of very, very high conviction. And because products are a lot cheaper to build now, they can have that high conviction. But keep it very, very loosely held because your ability to iterate is a lot greater than it was maybe two years ago. Your ability to actually get something to market and be able to get customer feedback is a lot lower than it was a few years ago. So that would be the biggest thing. I think one thing that I severely underestimated about the early stages of the company and even with the second company now, is how many times you have to be comfortable changing your idea or iterating on it. Even if no matter how well you understand an industry or how well you understand a consumer or someone who's paying for whatever you're building, the devil's always in the details and you have to be very, very comfortable consistently kind of like updating your thinking or iterating on it. And that's frankly, it's easier than it's ever been before to be able to do that.
- [32:29]
A
But I think that's fantastic. It's that constant pivot, that relentless improvement, that relentless trying to find the exact customer pain point in product market fit, such a relevant need. And then talk about as a startup again, like Venka talks about execution and distribution, talk about that getting going on execution, distribution again, harder, easier, need the right partners. How do you think about that in terms of execution and distribution?
- [32:56]
C
Yeah, sure. Two things. One I'll just kind of add to other advice that I'd maybe may note is like it's a lot easier to build bigger, better solutions than it's ever been. And I think what that means is we should also really, really push people to be very bold in what they want to try to build. There's a lot of things that touch the consumer experience in healthcare in some capacity and a lot of companies building in that space en masse. If you were to go to the large majority of Americans or even the large majority of people probably internationally in most countries and ask them just what their basic experience of navigating the healthcare system is. It's still not that great, right? Like, and there's not a lot of people, I would say, making extremely bold bets on rebuilding that entire interface or that entire experience of how someone interacts with healthcare. So I think being very bold is also important compared to like incremental point solutions, which, which I'm going to come.
- [33:53]
A
Back to you on the point solutions in a moment because we have a question in the audience on that as well. But I want to get to Dr. Gostine first. Let me you were going to do one follow up on the execution distribution question because we've got to talk about the point solution versus the broader solutions in a second too.
- [34:06]
C
Yeah, frankly, I mean I think a lot of like the secret sauce and how healthcare companies is built, especially enterprise healthcare companies, has always been in go to market. It's how good are you with your relationships with potential customers, how much trust are you able to build with people? How, you know, good are you at being able to actually listen to your customers and iterate on things that they're telling you and incorporate their feedback. And I would say that that's probably doubly triply more important now than it was maybe five years ago because the cost of technology is coming down and products are becoming more and more commoditized. So the thing that I would kind of really, really push is, or at least give advice to people on is to spend a lot of time, like more time than you traditionally maybe would have listening to your customers and actually in the field, like go visit them, get on a plane and go visit them and you'll learn a lot more for building your company than than you would from actually just spending a lot of time on the product side is what I would say.
- [35:08]
A
No 100%. So I absolutely love that. I mean you have to be so all the technology out there had to be so integrated and so close with your customers who you're actually doing business with that they actually see that connection between your technology and them. And I love that. Dr. Gostine, let me turn to you with two questions. First, the biggest impact that you see on AI in healthcare. What's the, what's the biggest place, the trillion dollar place in AI and healthcare? And then second, Dr. Gostein, what's the brutal truth? One brutal truth you wish somebody had told you as a founder in building a business that that nobody told you or that you wish somebody had told.
- [35:44]
B
You, you know, so I'm, I'm pretty Socratic, maybe too rational in my approach to these things. So I'm, I literally just. It's an equation. If you look at the US health expenditure, it's about $4.9 trillion. 50 to 55% of the cost in health care is staffing. That makes finding ways to make staff more productive a essentially $2.5 trillion opportunity every year. If you could, theoretically, and this is not our decide's mission, but if you could replace all of the doctors, nurses, clinicians, that's a $2.7 trillion opportunity every year. Now, Artisite is a little bit different in that space. Rather than replacing doctors and nurses, and there are AI companies and robot companies out there literally saying, like, we can replace your staff. What Artiside is trying to do is make the doctors and nurses so much more efficient that there is no economic incentive to replace the doctors and nurses. Because I 100 agree with you. Like everyone wants part of the experience to be human. Touch. I don't think anyone wants to go to a hospital and have a robot take you around the hospital, hold your hands, intubate you take out your gallbladder, and then deliver the food tray in your patient room. What we're trying to do is make doctors and nurses so efficient in an industry that has, and this is Bob Kocher's study in the New England Journal of medicine, got 1% less productive every year for the last 4, 40 years. It's not because the doctors and nurses are lazy or getting tired, although I will tell you, I am very tired all the time now. It's because there is so much clinical and administrative burden around us. And so the initial big opportunity, because the big opportunity is going to change by year. But the initial big opportunity for the funds that are investing right now with a 7 to 10 year horizon is in reducing the administrative burden around the delivery of care to make the doctors and nurses twice as efficient, to cut our staffing cost in half or to keep staffing cost constant, but to double the amount of care we can provide. It is a multi trillion dollar opportunity and doing it in a way that preserves the roles and responsibilities of the doctors and nurses. There are very few companies out there that are trying to do that. And we're happy that we've had physicians and nurses on the board of Artiside since we started the company. The thing I will tell you, to answer your other question, what is it that I wish someone had told me. I'm going to answer two questions. This is from my media training. Answer the question. I want to answer. There's something I'm glad nobody told me and that's a quote from Jensen Huang. I'm thrilled that nobody told me how hard it would be. I never like Jensen never would have started a company if someone had told me how hard it was going to be. You look at Europe, they have 15 startups per 100,000 people in health care. You look at the United states, we have 1.4. There's a reason for that. It is way harder to start a health care company, especially in the United States. So I'm glad nobody told me how hard it was. Otherwise we never would have started our decide. We never would have gone on to become this solution that's now improving the lives of doctors and nurses in about 450 hospitals across the country. So I'm glad nobody told me how hard it was.
- [39:19]
A
Dr. Andrew, let me ask you a question really quickly because we always think of the US is so entrepreneurial so people starting stuff but the stats that you just gave would, would, would say the the opposite. That Europe on average people are starting a lot more companies that than we are. Is that, is that correct?
- [39:38]
B
Yeah, you can go pull the data on that one so I can send you some references later for the.
- [39:42]
A
No, no, I trust you completely. Dr. Goss is one of the smartest people that I know. And so it is. And I've told other people how smart you are and you're proving it again. But, but I did not know that. I find that to be fascinating.
- [39:55]
B
You know, the opposite of what you would expect for sure. You know and kind of that old adage like America innovates, China replicates and then Europe regulates it would be the opposite of what you would expect but for a lot of reasons and market forces. There is not as much people starting healthcare companies because I think it is hard.
- [40:18]
A
You were going to say one more thing. Sorry about that.
- [40:20]
B
Things that I wish people had told me was that and this is not necessarily as applicable to artists because I do think in that we win 90 plus percent of the RFPs that we participate in. I do think we have the best technology for a lot of objective reasons. But it's not who has the best technology who owns distribution that wins in the United States and in healthcare the distribution is very much a relationship driven game. And I do love this quote from Mark Cuban that if no one is paying you for your solution, it is not a company. It's a hobby and so you need to be finding ways to get revenue very quickly. That is a relationship game in the United states. Like with Dr. Klasko. Had I known him when he was the CEO of Jefferson, it would have been way faster for me to get a contract with Jefferson. With not knowing the current CEO of Jefferson, it is going to take me a lot longer to get a contract with Jefferson. So it is very relationship driven. Who controls distribution and the relationships is the key to hardware sales.
- [41:24]
A
Thank you. I've got several audience questions. I'm going to work through some of those audience questions with the four of you and give each of you about 30 seconds to weigh in on the question. And because we've got so many audience questions coming in, I'll probably after we get a couple answers on a question, move to somebody else. Dr. Garcia, I'll start with you. In terms of point solutions versus enterprise solutions as a health system, at what point do you not keep on working with your enterprise or EMR solution who's not solving your problem and go to point solution when you're cautious about adding more point solutions on? Any quick thoughts there? And I'll ask you to address that, then I'll try and get the next question to somebody else.
- [42:11]
B
So I would say you should never pick a point solution. You should always pick platforms and you want to find the platform that has the point solution that you're looking for. So you know, artisight offers about 48 different use cases on our ambient intelligence platform for hospitals. We certainly have hospitals looking for point solutions and our job is to really convince them that you want that point solution to be solved by our platform because of all the other benefits. So I would say it's never the answer to find a point solution. You should go out there and find another platform that includes the solution to that problem because that will future proof you you'll be able to move far faster and at a far lower cost for the next hundred problems that you have.
- [43:01]
A
Venkat, let me ask you a follow up question, another question from from an audience member and anybody's free to weigh in on this first question as well. Somebody asked the question recommending or preparing your workforce for AI. Some one system ran a needs assessment and said 300 out of 600 people, you know, weren't comfortable using AI or have a very moderate understanding of AI. How do you get your people, your teams, your staff? And I'm approximately those numbers. How do you get people interested in working with AI and comfortable with it? Venkate you want to take a shot at that answer?
- [43:36]
D
Yeah. It's going to sound so simple but like, the amazing thing about this round of technology is like it's all natural language. In other words, you can literally use English in words to start interacting with it. And so my suggestion is quite literally, if you use anything from chatgpt to Anthropic, if you want to get a little fancier, there's things like Replit, figma, where you can actually start to like the most powerful thing that happens, Scott, is like not just your first query you put into ChatGPT or one of these Claude or one of these other models, but it's when you type something into one of these other companies. I'm talking about Figma or Replit, where you have an idea and it's like my mom wants to have a weather app that also is based on her favorite Korean food. Type that in and it mocks it up in 30 seconds in front of you. So if you just take the first five, six mostly used applications, these things are the easiest things to use and just the more you interact with it, honestly, they're phenomenal consumer applications and so it's maybe a little simple and my panelists might have better ideas, but that.
- [44:53]
A
Really is the issue. Venkat, you have to work with them enough to really integrate them into what you're doing. If you use ChatGPT once, twice, it's cute, it's nice, etc. But if you start to use it every day, you really start to use the understand the use cases and you almost have to train your people to get into it deeply enough and use it enough that they start to use it regularly. Stephen, you were going to say something.
- [45:14]
E
Dr. Glasgow, just a couple of things. One is, but I think the next generation is very different and we got a little bit of a preview where it's going to follow what, what you're doing.
- [45:22]
B
And I think great point.
- [45:23]
E
One of the huge transformations will be, you know, it used to be, Scott, if I was as a high risk obstetrician telling somebody that lupus during pregnancy and they said, oh, I Googled it in St. John's Ward or something, is is better than what you've prescribed. I could just knee jerk and say, I don't even want to see it. Now if I do that and they've gone on ChatGPT 4.5 and I say, look, I don't want to see that. What I told you is the best, they'll go, oh, so you disagree with the chair of obstetrics at University of California, San Francisco that just wrote in the New England Journal of Medicine what I'm saying works. So we're going to have a whole different patient physician relationship. And just the second thing I want to say, because the first question you asked is the number one question. I talk to 50 or 60 health system CEOs and board chairs a year. The three things I hear are as relates to GC and other VCs. We're tired of putting all the Lego pieces together for all the point solutions that you guys create. And I go, yeah, but they're different founders. They don't care about that. Second thing is, you've lied to us for 40 years, Steve. The technology would make our life easier, starting with what one CEO called the epidemic. EMRs would make our life easier. That didn't quite quite work out. And the third is that literally when we talk about things that are getting us to a different future of value based care, as one CEO told me, like I'm having a heart attack. I lost $200 million last year. You're talking about value based care. You're like my, my dermatologist telling me, you can move my liposuction up till next week. I need a, I need an interventional cardiologist. So the concept of creating platforms that are going to help us today in total cost of care access, quality and user experience are really what, what clearly the founders like Andrew and Venkat have gotten. But, but not, not all founders have.
- [47:22]
A
Madhav, let me ask you a question from a founder's perspective. You have this very complicated issue that most founders develop really fantastic point solutions that are far better than what the platform often does, at least to start with. But at some point they realize there's not enough scale in that point solutions, they have to go differently. Any advice to founders and entrepreneurs about point solutions versus versus platforms in getting going? Because it's a very complicated thing as a founder. Love your thoughts there. Then I also have a question about sort of defining AI. You know, somebody talks about the distinction automation, machine learning, predictive text and AI. How do you differentiate AI versus some of these other things that are maybe pieces of the puzzle? So point solutions and then this question of how to define AI versus some of these other issues.
- [48:19]
C
Yeah, I'll actually, I'm just going to go back to the last question really quickly. One thing I would just say on preparing workforce as well is there's only two components. One is like, do they trust these tools? And then the second is how integrated are they into the workflow. And I think my bet is 15 years from now saying like, oh, is this AI enabled? Is going to be very similar to how today we think of something as being Internet enabled. Right. I think that that's the place that the world is headed. So you have to meet them where they are, you have to meet them in the workflows that they have today. You have to be very comfortable learning what they do today and you have to be very comfortable spending a lot of time building trust with them. And generally there's like hesitation around adoption of AI from a large set of people. There may be misconceptions on what they think the tooling is being brought in to actually do. And correcting that, understanding the problems that they actually have that they could use tools for, I think is really important. There's some matchmaking to be done.
- [49:20]
A
Yeah, but that's a time intensive process of getting people comfortable with it. Right. I mean it's sort of a time intensive process of getting people really comfortable. I mean even, you know, originally at a business, we're outsourcing stuff to India years and years ago, but it took a lot of management to start to get that right and somewhere started to use AI, ChatGPT, all these things. It's great, but it takes some time, it's but in real time to start to get it and get to use it well and right. Even though it is, it's easier and easier, but to really make it part of your workflow is a real thing. But the question was point solutions versus platforms. From a founder's perspective, how do you bridge that gap? Because everybody wants platforms today, but there's only so many platforms. And most of us are great at creating great point at point solutions, but less and less big systems want to buy another point solution. So point solutions, platforms.
- [50:07]
C
Yeah. When you're starting a company, it's very hard to try to go very broad because you're trying to figure out what is something that I can build that's small, that people are actually going to love, that I can get adoption with, start building user base and then start expanding outwards and go broader and broader. So there's kind of this like chicken neck problem of everyone wants to be platform, but it's very hard to start with platform without having a lot of access to a lot of capital or access to a lot of time. And the very simple kind of framework that at least we learned in yc, which I still think is true, is that the bar for someone to actually adopt a point Solution. Is it's 10x better than the alternative or it's 10x better than the status quo? If you can actually build a product experience that is truly 10x better than, let's say that you're evaluating a startup versus something that you can access through Cerner or through Epic. Is this actually 10x better? Where it can justify the lift of implementing something independent is one, and then the second is does this have potential to actually become more of a platform and service more and more and more of my needs over time. And frankly I think that that's, it's as simple as that. I think there's a lot of things.
- [51:19]
A
That are, I think that is a brilliant take on it. So if I'm going to use a point solution versus going back to my emr, my Oracle, my Cerner, whatever Epic, whatever it is or whatever platform you're working with, whatever one it is, that point solution versus the platform for whatever area it's in, it better be demonstrably better. You said 10x. You know, it's, it's a, it's a, it's an inexact stat, but it must be far better. It really must be worth doing. I think that is just great.
- [51:48]
D
The, one of the, one of the lessons Scott, if I can add to that is that I think the most successful company in the age of AI has been Palantir in the public markets. And the reason is, is they have, you know, this work of a forward deployed engineer, basically somebody who is like a consultant on site understanding your workflows and I think change management, understanding your workflows are the ball game. And so if you can not only deliver a 10x experience, but you have the understanding of what's the next 10 things you can do, then you have a piece of platform you can start to build. Otherwise it's.
- [52:24]
B
Yeah.
- [52:24]
E
And just to add really hard. The key and what Palantir is able to do and others is how you customize the experience to the individual health system. Right. Because here's my product that you can all use, you know, what Jefferson needs versus a rural health system. So the ability, and come yours doing some of this, of being able to say tell me what your problem is and I'll forward deploy my engineers to solve your problem.
- [52:49]
D
Bingo.
- [52:50]
E
Much different than here's my product off the shelf like you're getting it from Walmart and you know, use it, you know, use it the way we've told you to. No.
- [52:59]
A
Fantastic, Fantastic. I'm gonna ask each of you one final question. I'll start with you, Dr. Glasgow, and then I'll work back around the horn here. The, the question is, what are you most focused on and excited about right now? Like, give us 30 seconds of where you're most focused and excited. You touch so many different things. Your chairman of different companies, on the board of different companies. I had a chance to visit with Tom Hale recently of Aura Fasting, what they're doing. But what, what do you, how do you keep her so focused and what are you most focused, excited about?
- [53:25]
E
What I'm excited about is instead of starting with the technology, really starting with the problem. At age 71, I get to pick the things that I want to transform. The two that I'm very, very excited about. One, as I mentioned, is a GC company that's revolutionizing clinical research. We are stuck in the 90s in clinical research as far as how that gets done. Going to health system to health system, literally. We will now be able to have somebody in Ocala, Florida, not have to fly to New York or Houston to get a phase 1b clinical trial. The second is a board that I'm just joining, which, interestingly, one of the board members is the chair of the board of Oura Ring, but it's called Amplify md, which is literally creating a model where people can see some of those subspecialists are just impossible to get. Endocrinologists, rheumatologists, migraine specialists, and not have to leave their rural hospital to go to the other hospital because they've created a virtual care network of those very hard to see specialists. Both of those companies are things like solving a problem that I've known exists for 30 years. And the technology is almost secondary. It starts with the problem.
- [54:40]
A
No, no, absolutely. Dr. Gostine, what are you most focused on, excited about?
- [54:45]
B
I would say, you know, we started the company because we wanted to make lives better for doctors and nurses. We're now under contract and rolling out to 7% of the United States. Probably over the next 18 months, we'll be in 30% of all patient rooms and operating rooms across the country. And so it's seeing the results that validate that we set out with this thesis, which has not changed. We want to make it better through automation in the data collection. You know, how we got there. Like Manav said, tons of pivots all along the way. But that thesis and the vision has been the same. Now we're actually seeing the results from all of it, delivering as high as 15x ROI. But most importantly, we're seeing turnover Rates at all of our client sites plummet by 75%. And so it's just nice with a mom as a nurse and a dad as a doctor and all my friends who are still practicing, the nurses that I've been on call with in the middle of the night who quite honestly hate their jobs. It's awesome to see that we're getting all of the validation and people saying I no longer want to quit.
- [55:57]
A
Fantastic. In in Manav. Besides getting married and vet get the same thing and you that better be the number one thing you're focused on and excited about. What are you most focused on and excited about from a business and and world perspective and healthcare perspective?
- [56:13]
C
Yes, that is definitely number one. Very exciting. Thank you, Scott. Number one, I'll say, is in healthcare, my big bet is that the overall cost of delivering healthcare is going to come down dramatically over the next 10 years. Admin costs will significantly decrease. The cost of medical reasoning will significantly decrease. Labor will play a very different part in the equation of delivering care. And that's essentially kind of the wedge for actually disrupting how consumers interact with insurance and how large of a burden health insurance has or kind of places on the entire economy. So essentially changing the model of how health insurance is delivered is something that's really interesting. And then the second thing is just the kind of advanced and kind of faster consumerization of healthcare as a result of AI tools becoming a lot better and people generally as consumers becoming a lot more amenable to using AI tools.
- [57:17]
A
Fantastic. Thank you very, very much. InventKit, wrap us up. What are you most excited about currently and focused on?
- [57:25]
D
Yeah, beyond the big day, I would say. You know, for me, I think there's too many still hospital. This is a crazy stat. My. My co founder's father is a physician and every single hospital he's worked at in rural America is shut down. And to me, how do we take, you know, compute and AI and agent applications, all the latest work that's happening, and take away the pebbles and sand, not the big rocks, the pebbles and sand of daily decisions that actually add up to making sure the hospital stays open versus closed. That's what we think a lot about at midstream. And then for me, just a personal passion project is how do I help the founders coming into healthcare? How do we help to make sure they're also successful? Just like all of us have navigate and all of us got help for people like you and Dr. Klasko and others, how do we extend it to the next generation of incredible talent that's also something I think about.
- [58:21]
A
No? Absolutely fantastic. I want to thank the four of you. Dr. Gosting, Dr. Klasko, Monav, Venkate. Just for me. It's a great pleasure to learn from the four of you, to connect, to hear what's going on, what you're thinking. Just fantastic. We'll distribute this through Becker's Healthcare as well as Becker Private Equity, Becker Business. I can't tell you much. We appreciate all your time and all of your thoughts. Thank you very much. We'll wrap up at this point. Thank you all for listening in and joining. Thank you very, very much.
- [58:53]
C
Thanks, Scott.
- [58:55]
E
Thank you, Scott.