20VC VC Founder Fit with 3 Things Founders & VCs Must Agree PreInvestment & Why Having No Company Budgets Creates Internal Entrepreneurs with Jay Desai, Founder & CEO @ PatientPing

In this episode of the 20 Minute VC, host Harry Stebings interviews Jay Desai, co-founder and CEO of PatientPing, a healthcare technology firm that connects providers for better patient care coordination. Desai discusses his transition from finance to healthcare policy, leading to the creation of PatientPing to address the inefficiencies in patient care communication. He emphasizes the importance of CEO-VC fit, focusing on a single company objective, and fostering an entrepreneurial culture within an organization. Desai also shares insights on strategic decision-making between immediate revenue generation and long-term growth, and the value of aligning internal company goals with market demands. The conversation also touches on the utility of productivity tools like Slack and Evernote, and the significance of internal entrepreneurialism and not setting rigid budgets to encourage creativity and ownership among team members.

• Jay Desai is the co-founder and CEO of PatientPing.
• PatientPing connects healthcare providers across the country with real-time notifications for patient care coordination.
• The company has received funding from notable investors including Google Ventures, First Round Capital, and SV Angel.
• Jay's background includes work at the Centre for Medicare and Medicaid Innovation and experience in finance and healthcare industries.
• Finn Barnes of First Round provided the introduction to Jay Desai for the podcast.

I'm so excited to welcome Jay Desai. Now, Jay is cofounder and CEO of Patient Ping, a company that connects healthcare providers across the country with realtime notifications to seamlessly coordinate patient care.

This quote introduces Jay Desai and provides a brief overview of PatientPing's service, emphasizing its role in healthcare coordination.

• Jay Desai worked at the Centre for Medicare and Medicaid Innovation.
• His work involved designing and implementing ACO, bundled payment, and other innovative payment models.
• These models were funded by the Affordable Care Act with the aim of increasing healthcare delivery efficiency.

And prior to co founding Patient Ping, Jay worked at the Centre for Medicare and Medicaid Innovation, where he helped design and implement ACO, bundled payment and other innovative payment models funded by the Affordable Care Act.

This quote explains Jay Desai's role at the Centre for Medicare and Medicaid Innovation and highlights his involvement in creating payment models that were part of the Affordable Care Act.

• PatientPing notifies healthcare providers when their patients are admitted or discharged in real-time.
• The service aims to improve care coordination, which is crucial for patient care, especially for the elderly who see multiple doctors annually.
• Poor care coordination is identified as a significant and costly issue in healthcare.

What patient ping does is really straightforward. We notify healthcare providers in real time when their patients get admitted or discharged anywhere.

This quote succinctly describes the primary function of PatientPing and underscores the simplicity and directness of the solution it provides for healthcare coordination.

• The U.S. healthcare payment system is transitioning from volume-based to value-based models.
• In value-based models, providers are incentivized to keep patients healthy and out of the hospital.
• Jay Desai's experience at Medicare involved designing these new payment models.
• PatientPing supports this transition by enabling providers to track patient care in real-time, which is essential for effective care coordination.

We used to pay providers for volume, meaning do more procedures get paid for money, and we're shifting that to pay for value, which basically means if you keep patients healthy and out of the hospital, you get paid more money.

This quote explains the shift in the healthcare payment system from volume-based to value-based models, highlighting the change in incentives for healthcare providers.

• Healthcare providers historically lacked real-time information on patient care events, making coordination difficult.
• PatientPing addresses this gap by providing immediate updates on patient care events to relevant providers.
• The need for such a service was recognized by Jay Desai during his tenure at the government, leading to the founding of PatientPing.

We found that there was a very basic need that was left unfulfilled, which was just being able to track where your patients are receiving care in real time, because it's very hard to coordinate it and prevent it from happening if you don't even know that it's happening.

This quote identifies the core problem that PatientPing addresses: the lack of real-time tracking of patient care, which is essential for effective coordination and prevention of unnecessary procedures.## CEO-VC Fit

• CEO-VC fit is crucial for a startup's success and can be considered an unfair advantage when the relationship works well.
• The relationship between a CEO and their VC is not just about financial investment; it also involves fiduciary responsibilities and personal interactions.
• Aligning on the scope of ambition, monetization strategy, and the time commitment expected from both parties is essential to establishing a good CEO-VC fit.
• Being honest about these aspects can prevent frustration and cognitive overhead that comes from misalignment.

"I think that both vcs and ceos should explicitly be willing to call out what I'm calling CEO VC fit or founder VC Fit, because when that's right, it really does add to the company's unfair advantage."

This quote emphasizes the importance of openly acknowledging and striving for a good fit between the CEO and the VC, as it can significantly contribute to the startup's competitive edge.

• Founders should be transparent about their long-term goals and test if VCs are aligned with the scope of their ambition.
• Some VCs may prefer startups that aim for modest exits, while others are interested in supporting companies with the potential to become industry giants.
• Honest communication about ambitions can help find a VC that matches the founder's vision and risk appetite, avoiding future conflicts.

"I think it's important for founders to be really honest with the scope of their ambition, test it with the VC and see how it lands."

This quote highlights the necessity for founders to be upfront about their ambitions to ensure they partner with VCs who support and are excited about their vision.

• The monetization strategy is a key aspect of CEO-VC fit, with different approaches to balancing customer traction and revenue.
• Debating whether to prioritize short-term revenue or customer growth for future upselling is revealing of a VC's risk tolerance.
• Founders need to discuss with VCs whether they are comfortable with strategies that might depend more on VC funding and carry higher risks.

"Most businesses have the opportunity to trade customer traction for revenues."

This quote reflects the strategic choice startups face between focusing on growing their customer base potentially at the expense of immediate revenue or prioritizing short-term monetization.

• The amount of time and the nature of interactions between CEOs and VCs should be discussed and agreed upon.
• Some founders might value frequent and in-depth engagement with VCs for advice and hard questions, while others may prefer more independence.
• It's important to set clear expectations about the level of involvement and support from VCs.

"For me, as a first time founder, I found that my ceos have been an invaluable source of wisdom, and I've been very clear about wanting them to be very accessible."

This quote illustrates the speaker's personal preference for close and accessible relationships with VCs, valuing their wisdom and involvement in the business.

• After meetings with VCs, founders should feel energized and have gained new insights or knowledge.
• The ability of VCs to stimulate new ideas and draw on their experiences is a good indicator of a productive relationship.
• Paying attention to how VCs contribute to the conversation can gauge the quality of the relationship.

"But an important question to ask yourself is, are you more energized after spending time with your vcs?"

This quote suggests that the way founders feel after interacting with their VCs can be a measure of the relationship's health and the value VCs bring to the table.## Evolution of Company Focus

• The company's focus evolved from establishing product-market fit in 2014 to network expansion in 2015.
• In 2016, the emphasis shifted towards revenue and monetization due to changes in the fundraising market.
• The company has been concentrating on monetization while maintaining network effects.

In 2014, it was all about product market fit. So is this even something that the world wants and that they need and that we have an opportunity to build?

This quote highlights the initial stage of the company's development, where the main goal was to determine if there was a demand for their product.

In 2015, once we established product market fit, it really became all about network expansion.

After establishing product-market fit, the company's focus shifted to growing their network, which was critical for their business model.

When it hit 2016...we made a hard turn towards revenue, towards monetization.

In 2016, the company pivoted towards generating revenue, influenced by the fundraising market and the need to monetize their services.

• CEOs receive a multitude of advice from various sources, including VCs, advisors, and board members.
• It is important to discern whether the advice is relevant or outdated and to educate the advisor if necessary.
• Balancing the reception of advice without appearing defensive is a key part of a CEO's role.

I think that when I get feedback that is either outdated or not relevant or not helpful, I think you need to calibrate whether or not you need to use that moment to educate the person and react...

This quote reflects the CEO's approach to handling advice that may not be applicable to the current situation, emphasizing the importance of calibration and education.

• The company uses OKRs (Objectives and Key Results) to drive internal alignment.
• Initially, they had three OKRs: grow revenues, deliver more value to customers, and build a great team.
• They later realized the need for a single, focused OKR to rally the company around the most important goal at the time.

So we decided to shift to just one company, OKR, which we found that there's something very powerful about organizing the company around the thing that's most important right now.

This quote explains the strategic decision to focus on a single OKR, which helps in aligning the entire company towards a central, critical goal.

• Promoting an ownership culture and internal entrepreneurialism is crucial for the company.
• The company does not allocate budgets, as it is believed that budgets can lead to inefficient spending.

I think internal entrepreneurialism and an ownership culture is incredibly important.

This quote underscores the significance of fostering a culture where team members feel a sense of ownership and are encouraged to be entrepreneurial within the company.## Company Resource Management

• The team is encouraged to treat company resources as if they were their own, ensuring thoughtful expenditure.
• Decisions to spend are made with consideration of defending the choice to anyone who asks.
• This approach promotes entrepreneurial thinking and accountability.
• Employees are expected to consider the return on investment and the overall financial health of the company.

"Our team understands that any decision to spend the company resources should be one that they would be comfortable defending with anybody that asks."

This quote emphasizes the culture of accountability and responsible decision-making regarding the use of company resources.

• Constraints can enforce creativity by limiting resources, which encourages innovative thinking.
• The lack of budgets in the company has resulted in more thoughtful spending rather than superfluous expenses.
• Employees are more careful with decisions as they must justify their choices.

"Constraint enforces creativity. So it forces you to reimagine and think of ways to do things that otherwise you would have just sort of hired somebody to figure out or hired somebody to think about."

Jay Desai agrees with the idea that constraints can lead to greater creativity within an organization by forcing individuals to find alternative solutions.

• Jay Desai's favorite book is "Pastoralia" by George Saunders, which impacted his thinking.
• For productivity, he uses tools like Slack, Evernote, Google Calendar, and Todoist.
• He maintains a daily productivity inventory to track accomplishments and ensure meaningful work.

"It contorted my mind in ways that I just hadn't experienced before then."

Jay Desai credits "Pastoralia" for significantly influencing his thinking, indicating the impact of literature on personal development.

"I keep a daily productivity inventory that I fill out at the end of each day as I think it's important."

This quote reveals Jay Desai's method for maintaining productivity and ensuring that his time is spent effectively on valuable tasks.

• Jay Desai regularly reads "Consult" by Michael Ramlett and "First Round Review."
• If given the chance, he would choose to be Donald Trump for a day to withdraw from the election.
• Jay Desai looks forward to connecting 5000 hospitals through PatientPing and enjoys the challenges of his job.

"Consult by Michael Ramlett. He does a daily healthcare news vlog, which I love."

Jay Desai highlights his preference for a healthcare news vlog, indicating his interest in staying informed about industry news.

"For patient ping, there's 5000 hospitals in this country, and we're going to connect them all."

This quote outlines Jay Desai's ambitious goal for PatientPing, demonstrating a clear vision for the company's growth and impact.

• The Headspace app is recommended for its guided meditations to address various life challenges.
• Luma provides a surround Wi-Fi system that enhances internet speed, security, and control within the home.
• Both Headspace and Luma are presented as solutions for improving quality of life and productivity.

"Headspace is meditation made simple."

The quote highlights the Headspace app's purpose of simplifying meditation for users, promoting mental well-being.

"Luma is the world's first ever surround wifi system that brings speed, security and control to the home network."

This quote introduces Luma as an innovative solution for home Wi-Fi needs, emphasizing its unique features and benefits.