Episode #106. Scaling Healthcare: The Importance of Culture and Understanding in Innovation, with Dan Nardi, CEO of Reimagine Care

Summary

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Risk Never Sleeps Podcast – Episode #106

Scaling Healthcare: The Importance of Culture and Understanding in Innovation

Host: Ed Gaudet
Guest: Dan Nardi, CEO of Reimagine Care
Date: November 14, 2024

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Episode Overview

In this engaging conversation, Ed Gaudet sits down with Dan Nardi, CEO of Reimagine Care, live from the Health conference in Las Vegas. The episode explores how Reimagine Care is scaling cancer care beyond traditional clinical settings, the critical role of culture in fast-growing healthcare startups, and key advice for current and aspiring healthcare innovators. Dan shares stories from his career, insights about building resilient teams, and actionable wisdom for leaders navigating the risks and complexities of healthcare innovation.

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Key Discussion Points & Insights

1. Reimagine Care and the Cancer Journey

[01:40 – 02:32]

• Dan introduces Reimagine Care as “the industry's first on-demand cancer care platform,” combining technology-enabled services and oncology-trained professionals to extend cancer care outside the clinic.
• Core Problem: Oncologists are highly effective in-person, but most of the patient journey (97-98%) happens outside the clinic, leading to gaps in care.
• Solution: Reimagine Care bridges these gaps, functioning as an extension of the oncology team to deliver support and continuity at home.

“We have built this suite of services that really help deliver the highest possible support for those patients and be an extension of that care outside of the clinic.”
— Dan Nardi [02:23]

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2. Career Path & Early Days in Healthcare

[02:35 – 03:39]

• Dan “lucked into” healthcare—originally a math and computer science student, he transitioned from defense contracting to healthcare IT via startups like Channel Health, Allscripts, and Livongo.
• Highlights the benefit of learning by doing and the deep relationships formed in the industry.

“I was learning…more there than in any class. And I said, you know, I like what we're doing. Like, let's just do this.”
— Dan Nardi [03:22]

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3. Current Growth & Announcements at Health Conference

[04:07 – 04:57]

• Reimagine Care is expanding rapidly:
  • Memorial Hermann Health System: From successful pilot to system-wide rollout; Memorial Hermann is now also an investor.
  • Moffitt Cancer Center in Tampa: Recently partnered through the Cancer X Initiative.
  • Reimagine Care is experiencing 10x year-over-year growth and is in “rapid scale mode.”

“They loved it so much they came on as an investor…We just announced…full system wide. So we’re really excited about that.”
— Dan Nardi [04:19]

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4. Looking Forward: Value-Based Cancer Care

[05:14 – 06:40]

• With solid product-market fit, Dan’s focus is now on delivering services that enable the adoption of value-based cancer care.
• Cancer has lagged behind other specialties in value-based care due to its complexity.
• Reimagine Care aims to help organizations make the transition with the right risk arrangements and contracting.

“With the right combination of services, we're going to be able to help these systems as we work towards the right risk arrangements, the right value-based contracting. And we're going to be the leader in making that transition…”
— Dan Nardi [06:21]

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5. Scaling Culture in a Growing Organization

[06:40 – 08:23]

• Culture is always top-of-mind for Dan, especially in times of ambiguity and rapid growth.
• Startups require adaptable people; the “right people, right role, right time” is critical.
• Success is about building a learning environment where mistakes are part of the process, not failures.
• Example from Livongo: Revamping core company values to make them meaningful and memorable.

“There are people that are really amazing for early stage companies…But…in startups sometimes it’s 50/50, you get as much information as you can and then just like, let’s go make a decision.”
— Dan Nardi [07:42]
“It’s not just the culture…but it’s like a focus on a learning environment. Let’s always be learning. Right. It’s okay to make a mistake.”
— Dan Nardi [07:56]

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6. Career Reflections and Life Advice

[08:34 – 09:18]

• What would Dan tell his 20-year-old self? “Just say yes.”
  • Emphasizes the power of embracing opportunities and being open to risk.
  • It's important to remember that few decisions are truly irreversible.

“Just say yes. Right. Say yes. And take those opportunities to learn, meet new people, try it out, take a risk.”
— Dan Nardi [08:43]

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7. If Not Healthcare...Passions Outside the Office

[09:27 – 09:54]

• Dan’s dream job: Outdoor adventure guide—loves skiing, the outdoors, and the idea of making the world his office.
• Recently relocated to Boulder, CO, to enjoy the mountains.

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8. Personal Risks & Memorable Moves

[10:21 – 10:57]

• Riskiest decision: Moving solo from Vermont to San Diego for a job that ultimately didn’t materialize.
• The move turned out to be pivotal—leading to lifelong friends and meeting his wife.

“Packed up my car, drove out by myself for four days and got to see some of the country on the way and…ended up making some great friends and I met my now wife…”
— Dan Nardi [10:57]

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9. Desert Island Albums

[11:31 – 13:04]

• Dan’s picks:
  • Pearl Jam – Ten
  • Van Morrison (any album)
  • Tom Petty and the Heartbreakers (any)
  • Led Zeppelin IV
  • Cody Johnson (influenced by attending his live show with his son)

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10. Advice for Aspiring Healthcare Innovators & Entrepreneurs

[13:39 – 14:51]

• Dan’s essential tip: “Read the manual.”
  • Deeply understand the segment of healthcare you wish to impact.
  • Know the current players, payment models, and the implications of your innovations.
  • Many startups fail not because of an idea, but because they don’t know how to navigate entrenched interests or operationalize their solutions.

“To be really successful in building companies, you have to really, deeply understand what you’re affecting, because there are entrenched players in all of healthcare…if you want to go shake up the world, you have to understand whose cheese you're…moving.”
— Dan Nardi [13:47 & 14:18]

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Notable Quotes

• On innovation in healthcare:
  “You can have a great idea, but so many startups won’t end up being successful because they can't figure out how to, like, actually monetize it…or they can't figure out, like, how can I take this great idea and turn it into something that isn't going to piss off a whole bunch of other people and they'll basically squash us.”
  — Dan Nardi [14:32]

• On the shared mission of healthcare:
  “That's what we're here to deliver all about. That's right. Better patient experiences.”
  — Dan Nardi [04:53]

• On scaling startups:
  “The ambiguity sometimes can crush people, the pace can crush people, the ability to make decisions. Like, I'm a big fan of right people, right role, right time.”
  — Dan Nardi [07:08]

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Memorable Moments

• Dan recounts seeing U2 at The Sphere in Las Vegas for his anniversary, highlighting the camaraderie and serendipity that happen at industry conferences. [01:02]
• Personal side: His love for the mountains, adventure, and spending time with family—especially skiing and attending concerts with his son. [09:27, 12:48]

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Timestamps for Major Segments

• Reimagine Care Overview & Mission – [01:40 – 02:32]
• Dan’s Career Start in Healthcare – [02:35 – 03:39]
• Company Announcements and Growth Updates – [04:07 – 04:57]
• Transitioning to Value-Based Cancer Care – [05:19 – 06:40]
• Maintaining and Scaling Culture – [06:40 – 08:23]
• Career Advice for Younger Self – [08:34 – 09:18]
• Dream Jobs & Passions – [09:27 – 09:54]
• Riskiest Decision in Life – [10:21 – 10:57]
• Desert Island Albums – [11:31 – 13:04]
• Advice for Healthcare Entrepreneurs – [13:39 – 14:51]

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For more risk leadership insights and strategies, visit:
www.censinet.com

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Transcript

[A]

Foreign. Welcome to Risk Never Sleeps where we meet and get to know the people delivering patient care and protecting patient safety. I'm your host, Ed Gaudet. Welcome to the Risk Never Sleeps podcast in which we talk to the people that are on the front lines delivering and protecting patient safety. I'm Ed Gaudette, the host of the program and I am live at Health in beautiful Las Vegas and I'm with Dan Nardi, CEO of Reimagine Care. Dan, welcome to the show.

[B]

Thank you for having me. We're excited to be here for another round of health.

[A]

Is this your fourth year or third? Third year. Wow. Okay, okay. You like Vegas?

[B]

Not really. I like health. I like being able to come here and see people that we worked with 20 some odd years ago or even last year. Just the opportunity to connect as far as where it is, you know, it's all good.

[A]

Been to the Sphere yet?

[B]

We were very lucky. So last year's Health was right around my anniversary, so my wife actually came out and we got to see you two at the Sphere. It was nice, an amazing experience. Love music and that was our first time, both of us, actually. I saw him years ago, but it's my wife's first time.

[A]

Nice.

[B]

And so we had a great experience and just a fun extra couple of days at the end.

[A]

I did three dead shows in June at the Sphere. Yeah.

[B]

How was that?

[A]

It was amazing. Yeah.

[B]

And the Eagles are there right now?

[A]

Yeah, they're here till I think probably the end of the year. January. Yeah, February maybe. And I think the dead are coming back. But let's get into reimagine care. Tell us a little bit about your role and your organization.

[B]

All right, so I am CEO and I've been with the company for about a year and a half and Reimagine care, we have develop the industry's first on demand cancer care platform. And so we have a technology enabled services combined with our team of oncology trained RNs, MAS apps and we partner with health systems AMCS community practices to really extend the cancer care outside of the four walls. And so we know that oncologists are really amazing when the patients are there with them in the clinic, but tend to lose touch with them and lose the ability to support them at the highest possible levels when they're on the 97, 98% of their cancer journey that happens outside of the four walls. And so we have built this suite of services that really help deliver the highest possible support for those patients and be an extension of that care outside.

[A]

Of the clinic got it. Interesting. How did you get into healthcare?

[B]

Oh, I completely lucked into it, totally honest. I was math undergrad, computer science masters. I was going to go conquer the world of coding. I actually, I had a. A contingent job offer with a defense contractor to apply my pattern matching algorithm was the thesis I did with IBM and uvm. And so it was all contingent and I moved to San Diego for it and was just waiting for it to come through, and it unfortunately didn't. But I had interned for a small company called Channel Health, which was owned by idx, which was bought by All Scripts. And so early days, you know, and Mark and I were just talking with Lori McGraw, so early days, I got in on the All Scripts ride. And so when the Defense contract fell through, I just said, you know what? I really. I was learning. Had learned more there than in any class. And I said, you know, I like what we're doing. Like, let's just do this. And so kind of lucked into it and, you know, 13 years later, we had a great run at Allstrips and, you know, led to another run at Livongo. Joined early. So I've. I've worked with and for Glenn and Lee and Joe and Laurie and that team for quite a long time and had the opportunity to learn a lot along the way, which has been great.

[A]

And we both worked with John Halleck.

[B]

That's right.

[A]

One point. Yeah. John's a good man.

[B]

Fellow Boston sports fan. So shout out to the Red Sox and Pats. Not doing too great, but.

[A]

No, no. Yeah. John introduced me to Jonathan Bush. Oh, very good. Yeah. Have you met him, Jonathan?

[B]

I have not, actually.

[A]

You won't forget it.

[B]

That is what I've heard.

[A]

All right, so let's talk about why you're here at Health. Have any announcements or.

[B]

We actually. We couldn't hide some of our announcements, so we actually put a couple out just recently. So we have an expansion. Memorial Herman, which is one of our earlier clients, had a very successful phase one. They loved it so much they came on as an investor.

[A]

Okay.

[B]

In the company. And then we just announced a little bit ago the expansion, full system wide. So we're really excited about that. And then Moffitt, one of our newest partners.

[A]

Yeah.

[B]

Moffitt Cancer center in. In Tampa. So we're really excited about the continued growth, you know, across our health systems and AMCs, and so really being able to launch with them. They've been a really great partner right out of the gate. We got to know them really closely during The Cancer X Initiative. We were one of the accelerator cohorts, we were one of the initial companies accepted into that. So really just excited to continue to, you know, partner with the best in class organizations and really support the patient care journey. I mean that's what we're here to deliver all about. That's right. Better patient experiences.

[A]

That mutual shared mission that we have in healthcare, it's like nothing else. It's amazing to be able to partner with so many great individuals where we're all really on this journey together to make care better for everybody. Because we're all patients, we all know patients. Right?

[B]

Yeah.

[A]

So if you look out over the next couple years, what are some of the key initiatives on your list?

[B]

Yeah, I would say that we have found a product market fit with what we have right now, which is great. And that's where we're, you know, the new clients that we've been bringing on, new partnerships and the growth, you know, we're going to 10x our ARR last year to this year. So we're in that like scale, scale. We're in that rapid scale baby, which, which we, we love. I love, I love the stage of business and it's why I was brought in. Super excited about obviously the mission, but this stage of business is a lot of fun for me. So we've got that as our foundation. And now what has me really excited for the next couple of years is being able to add on to our services and really help drive the adoption of value based cancer care. So helping to support all of these systems as they are making the slow trudge to value based care. We know the health care system in general has been on a very slow kind of march towards this cancer care due to its variability and so many a combination of so many different diseases. Cancer is not just one. Cancer care has been even further behind the rest of health care. But now is the time. And so with the right combination of services, we're going to be able to help these systems as we work towards the right risk arrangements, the right value based contracting. And we're going to be the leader in making that transition in helping all organizations which would be better for patients and it's going to be better for the overall kind of spiraling cost of cancer care in general.

[A]

Yeah. One of the challenges with scaling an organization is the effect it has on the culture. Does that keep you up at night?

[B]

So there are some founders that love diving into the culture and really think about that all day long and there's some that don't and they surround themselves with people that do. I do. I always think about it. You know, from our early days, I felt like that was a big differentiator for us at Livongo was we hired a bunch of really great people and we had a really great mission and we pointed everyone in the same direction and we got some shit done and same thing. So I brought that and applied that at Carom. So I joined Caram as employee 16 and really helped build that for four years as COO and now being able to do the same thing here, reimagine care. It is extremely important at these early stages of a company and especially going through the growth stages, because the ambiguity sometimes can crush people, the pace can crush people, the ability to make decisions. Like, I'm a big fan of right people, right role, right time.

[A]

Yes.

[B]

And so there are people that are really amazing for early stage companies that can handle all that. Love wearing multiple hats and making decisions. And you know, people talk about the 8020 rule. Well, in startups sometimes it's 50, 50, you know, you get as much information as you can and then just like.

[A]

Let'S go make a decision.

[B]

That's right. And let's learn. And so really building, it's not just the culture, but it's like a focus on a learning environment. Let's always be learning. Right. It's okay to make a mistake.

[A]

Yeah. Take the risk.

[B]

Yeah, yeah.

[A]

Adjust accordingly.

[B]

Absolutely. So it's a big part of what we're doing at Livongo. And I'll give you one example. Right when I joined, we had some values and they were great, but I felt like they were, they could have been applied to any company. And so we spent six months and really as a team, revamped our values, narrowed it into three. So they're very memorable and they're very specific to us. And so I think that is just an important part of a culture.

[A]

Yeah. Excellent. All right, so we're going to get into you a little bit about you, your background, Dan. So you go back in time. What would you tell your 20 year old self?

[B]

That is a good question, I would say. And I've tried to live this, but I think sometimes I get caught up in it is like, just say yes. I think it's very easy as you're going through your career or growth and just everything on your plate, personal life, work, life, all that stuff. You know, it's very easy to say no and then I think doors close. So I think it's really important. Just say yes. Right. Say yes. And take those opportunities to learn, meet new people, try it out, take a risk. That's right. And here's the other thing. Like I tell people, whether it's moving, you know, moving cities or changing careers or whatever it is, like, can always go back. So go do it. Say yes, try something new. I would say that's something I generally good at, but I think my 20 year old self probably would have helped me learn some lessons. Maybe a little faster.

[A]

Yeah. Excellent. And if you weren't doing this job, what are you most passionate about? What would you be doing if you weren't in, in health care or in tech?

[B]

Well, I think we joked about being a baseball player. That was my dream as a kid. But realistically, I would probably be an outdoor like adventure guide. Like I would love to be. Like, I love skiing.

[A]

Yeah.

[B]

I grew up skiing in Vermont, so I would.

[A]

Helicopter skiing. You're doing.

[B]

I would do that. I would be the first one to jump out. I would. My brother in law is like, that's his job. And so I'm like secretly jealous of like, I think he's in Antarctica right now. So I like, I would, I would love to go do that. To get paid to see the world.

[A]

Yeah.

[B]

Just be outdoors, like have the great outdoors. Be your office. So yeah, that'd probably be it.

[A]

You ever ski Snowbird or Ulta? I have. Aren't those amazing?

[B]

They're both amazing. Yes.

[A]

It's nothing like it.

[B]

And we're super excited. So we just, the family just moved to Boulder and so we're excited to. Okay.

[A]

Yeah, yeah.

[B]

Try out all the mountains in Colorado.

[A]

So yeah, it's. Oh, beautiful. That's great. This is the Risk Never Sleeps podcast. So I gotta ask you, we'll tee this one up. What's the riskiest thing you've ever done?

[B]

Oh, that's a good question. Riskiest thing, probably moving to San Diego.

[A]

Really?

[B]

Well, in from Vermont, from Vermont. So I mean, I think it's almost the furthest in the contiguous 48 states.

[A]

You could get from Vermont, Tucson, Arizona, maybe.

[B]

Yeah, it was, I mean it was way out there, but it was for me. You know, I had grown up in New England. We traveled all up and down the east coast, the Midwest, but like had never really been further than Colorado before. And so just the opportunity to say, you know what? For that contract that hadn't come through yet, I just said I'm gonna, I'm sick of waiting.

[A]

Wow.

[B]

Packed up my car, drove out by myself for four days and got to see some of the country on the way and, you know, ended up making some great friends and I met my now wife and so it all in San Diego. In San Diego. So it all worked out. But like, at the time, I mean, I think a lot of people were like, you're crazy.

[A]

I love that. I love that answer. Yeah. All right. Desert Island. You could take five records with your albums or whatever these kids are taking these days, streaming sites, whatever. Yeah. By the way, you know a con fan from Vermont, you know, Noah Khan. A little bit. Little whiny.

[B]

A little bit.

[A]

The kids love them. No. All right, five records, five albums. What would you bring?

[B]

I'm a big Pearl Jam fan.

[A]

Yeah.

[B]

So I would take 10. I think that is like an. Just an epic album start to finish. I try to see them every time they're on tour. So I would take 10. Growing up, I have a little bit of nostalgia for. We had a six CD changer and there were like three CDs that never changed. They were always in there. Van Morrison's Greatest Hits.

[A]

Oh, there's a rule. No greatest hits. That's okay. No, that's okay.

[B]

So, all right.

[A]

Van Morrison.

[B]

Any Van Morrison.

[A]

Okay.

[B]

Tom Petty. I would do the same thing. Tom Petty and the Heartbreakers.

[A]

Nice.

[B]

I also like Led Zeppelin.

[A]

Which one? I was a big Zep fan growing up.

[B]

I would go four.

[A]

That's four.

[B]

Yeah, I know.

[A]

Four is great though. Four is. Every album is great.

[B]

Yes.

[A]

Every album is different.

[B]

Every album's great for repeated listenability. That's probably why I would go for it. And then I got one left, right?

[A]

Yeah.

[B]

Oh, that's.

[A]

We could do five more too, if you want.

[B]

I mean, we could be. We did five movies.

[A]

Yeah, we do movies.

[B]

Let's see another one. Actually, you know, funny enough, my son and I just went to. We've over the years become country fans and so, you know, I listen to all music. I love all different types. Cody Johnson.

[A]

Oh, yeah.

[B]

We went to his show in Denver. My son and I, we got tickets last minute and our friends gifted them to us. And I don't think I really appreciated his music as much until I saw him live. And he's a wonderful musician, so I think we. That probably another one.

[A]

So do you like Zach Brian?

[B]

Yeah, we. I mean, I think country is funny. Like as a family is like the one we can all disagree on. Like just put that on and country. Mix country like Unplugged.

[A]

Zach Brian is interesting because he's like a modern day country version of Dylan. Like, he's that level Songwriter, that level of lyricist. Yeah. Really, really amazing. All right, last question. You could give advice to someone graduating from college that wants to break into high tech or healthcare wants to be an entrepreneur. What advice would you give them?

[B]

I would say just proverbially, I would say, like, read the manual. And what I mean by that is, like, really understand. Like, healthcare is so complex. Understand the part of healthcare you want to get into, understand how it works, understand the existing players, understand how it's paid for, how it's delivered. Like, to be really successful in building companies, you have to really, deeply understand what you're affecting, because there are entrenched players in all of healthcare. And so if you're going to come in and have this novel idea and you want to really go shake up the world, you have to understand whose cheese you're going to be moving.

[A]

Yes.

[B]

Right. I'm using all different analogies.

[A]

Start with Epic.

[B]

It's.

[A]

Well, I mean, find the white space.

[B]

So, you know, again, 13 years at all scripts, so, you know, special place in my heart for Epic. So I think it's really. That's my advice. Because you can have a great idea, but so many startups won't end up being successful because they can't figure out how to, like, actually monetize it, or they can't figure out, like, how can I take this great idea and turn it into something that isn't going to piss off a whole bunch of other people and they'll basically squash us. So again, I think it's. I'll use read the manual as that term, but that's what I mean by that.

[A]

Excellent. Thank you. Dan Nardi, CEO of Reimagine Care. This is Ed Gaudette from the Risk Never Sleeps podcast, live from Health in Las Vegas, Nevada. And if you're on the front lines delivering patient care or protecting patient safety, remember to stay vigilant because risk never sleeps. Thanks for listening to Risk Never Sleeps. For the show, notes, resources and more information and how to transform the protection of patient safety, Visit [e-mail] that's C-E N S I N E T.com I'm your host, Ed Gaudet. And until next time, stay vigilant because risk never sleeps.