May 4, 2023 • 25 mins
Today we are speaking with Jamey Edwards, an entrepreneur in the digital healthcare space. Jamey was the CEO and Co-Founder of Cloudbreak Health, a language access and telehealth company providing interpretation services. In 2019 Cloudbreak Health merged with UpHealth via a SPAC. Jamey is now the Chief Platform Officer at StartUp Health, a venture capital firm, focused on investing in health transformers to achieve audacious health moonshots. Enjoy the show!
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Episode Transcript
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(00:09):
Thank you for visiting the Medi Apps show brought to you by the Medical Logistics and Transportation Organization,
Medi Apps.
I'm your host,
Ryland Stone.
Today we are speaking with Jamie Edwards,
an entrepreneur in the digital health care space.
Jamie was the CEO and co-founder of Cloud Break Health,
a language access and telehealth company providing interpretation services in 2019 Cloud Break Health merged with Up Health via a Jamie is now the chief platform officer at startup Health,
(00:39):
a venture capital firm focused on investing in health transformers to achieve audacious health moonshots.
I hope you enjoy the show.
Thank you,
Jamie for being with us today.
I really appreciate your time.
Uh Great to be here.
Thanks.
So just to kind of jump right into it.
Give me a little bit of background on yourself as a kid.
Family,
hobbies.
Kind of from the beginning.
(00:59):
We'll back it up and start there.
I mean,
how deep down the rabbit hole do you want to go,
Ryland?
Well,
do you have any uh like as a kid?
Where did you see that entrepreneurial bug in your childhood?
Anything like that?
Well,
you know what I grew up?
In Buffalo,
New York,
um,
which is like a super blue collar town and very early on.
(01:19):
Um,
you know,
prior to the rest of my friends,
I was the first one to have a job.
Um,
and my first job was like washing dishes and,
um,
I kind of feel like everything I needed to learn in life.
Um,
I learned washing dishes,
you know,
no job was below me.
Got to work with all sorts of different types of people.
But even at that age,
I was kind of driven to improve the process.
And I was working at this restaurant in Buffalo called Rick Lets.
(01:42):
And I worked my way up from dishwasher to head of the dish room.
Who knew that there was such a thing where I'd actually like trained to do the schedules for the rest of the dishwashers and all that stuff.
And then work my way up to become um the youngest uh saute cook that the restaurant had had.
And um really learned a lot from the restaurant business in terms of like customer service.
(02:03):
Um and what it meant to work hard and the joy of plating a great meal and giving someone a good experience.
Um And then throughout college waited tables to pay my way through school.
Um And then senior year took a class in entrepreneurship and personal enterprise at Cornell by this professor,
Professor David Ben Daniel.
(02:24):
And he taught me what entrepreneurship was in a very simple definition.
It was take an idea in your head and make it real and make it positively impact the people at scale.
And the second I wrote my first business plan Ryland,
like I was hooked.
Like I was like,
this is amazing.
I can take this concept in my head and turn it into something,
you know,
real in the world and then have people enjoy that experience or have it provide value to them?
(02:48):
And it was just hugely hugely impactful.
Uh Do you remember the,
do you remember your first business plan of what it was?
I do,
it was for a micro brewery,
right?
So taking that restaurant background,
I wanted to create something.
I teamed up with a group of friends from Port,
we wrote a business plan for something called the University Brewing Company.
And the idea was it was gonna be the local favorite everywhere,
(03:10):
right?
So you'd be able to open them up in college towns across the United States and this is before a concept like this kind of existed.
And um you'd be able to have,
you know,
in Ithaca as an example,
you know,
Ithaca is gorgeous ale or big red,
you know,
uh lager or whatever it might be.
Got you the same thing in different universities across uh across the uh the country.
(03:32):
And we just thought it was,
you know,
best thing since sliced bread.
Very cool.
Did you ever do anything with that?
Or just make the plan and go from there.
You know,
we didn't,
we,
we made the plan and then everyone,
um,
you know,
at that point went on their separate ways,
post graduation because it was like,
literally second semester,
senior year when we wrote the business plan and everyone already had jobs lined up and we toyed with the idea of potentially doing it and sticking around in Ithaca and then,
(03:57):
you know,
just made the decision that,
you know,
our educations weren't finished yet and we wanted to go off and get educated by the world.
Fair enough.
Well,
then I guess kind of just moving and transitioning from that into the rest of your career.
Where did you go from there?
Uh Just kind of looking over your linkedin,
it looks like you have a background in investment banking.
Yeah.
So um I learned in the class that and by the way,
(04:20):
I like grew up in the time of Enron,
right?
So I never wanted a CFO to be able to pull the wool over my eyes.
I wanted to build a financial skill set and candidly,
that was a challenge for me.
I was always really like the English and history kid,
not the math and science kid.
So when um I figured out that I really wanted to be an entrepreneur and I needed to learn about how to raise capital and how boardrooms were managed and you know how um thought leaders really analyzed their own businesses and thought about how to manage them.
(04:49):
Um Investment banking proved to be that great kind of testing ground where I could learn those things.
And um despite having no accounting,
finance,
economics background really to speak of,
um jumped in with both feet um became an analyst at an investment bank.
My first job was actually as a valuation consultant for KPMG P back in the day,
(05:09):
but I was there for six months before I transferred over to investment banking.
And um,
it was just an awesome learning ground learning from really smart people,
drinking from a fire hose.
I gotta tell you there were times where I was probably pretty close to mental breakdown that first year because I was trying to figure out how to build a financial model and have all my numbers tied and all those different types of things.
(05:30):
But I was almost like exposure therapy.
Eventually I became really good at that stuff and learned how to raise capital and learn that when you walk into a boardroom,
no one in there is necessarily any smarter than you are.
Um,
there might be more experience but you run into people and companies where there might be a really large company that's run by someone and you're like,
oh,
that person's,
how did they get to this position?
And then you go in a really small company and there's someone who's like a true genius running it and everyone's got their own challenges and crosses to bear from that perspective.
(05:57):
But I really learned that everyone,
you know,
that I,
I always walked in the room assuming I was the dumbest person because I just feel like that's the right attitude when you,
you know,
walk into a setting where you don't know people,
like just assume you're the dumbest person in the room.
But then I started to realize like,
you know,
you're not and you have something to contribute and I just sat there listening and taking it all in until I was able to kind of step up and contribute in my own life.
(06:20):
Very interesting insights there.
Thank you for sharing that.
Yeah,
no problem.
So,
so then from investment banking,
where did you go from there?
Yeah.
So I grew up in a family of doctors.
You know,
my mom wasn't a doctor and my dad wasn't,
but my sister is a doctor.
Uh,
she married a doctor,
aunts and uncles on both sides are doctors.
And I have one of my favorite uncles,
(06:40):
um,
who is a physician.
And I remember um,
junior year when I was at Cornell flying out to spring break,
he lived in Los Angeles,
he was a young er,
doctor,
he picked me up at the airport and drove me down and then had the beach pier.
Um,
and I was like,
oh,
you know,
one day I want to live in Los Angeles.
So that's what I ended up doing post graduation,
(07:01):
but having seen his practice when I was doing uh my investment banking work,
I ended up working on some consulting assignments for him.
And by the way,
very easy to impress,
impress your physician uncle um uh with concepts like revenue and cash flow and I and powerpoint and Excel and they don't teach those things in medical school.
Um But saw firsthand and doing the consulting work,
(07:22):
how I could have an impact on this industry,
right,
$4.3 trillion industry because it just didn't have the level of sophistication that I was expecting.
It was risk averse.
Um They didn't like implementing new technology,
it was lagging other industries like finance,
um e-commerce and retail in terms of digital transformation.
(07:44):
And I just realized there was a huge opportunity to lean in.
Um So I moved him out of his home office to real office,
built one of the first physician productivity systems in the country uh for value based care and Excel.
And um he eventually asked me to come run the business full time.
And so,
yeah,
a little bit of nepotism,
right?
For giving me my first CEO but we ended up growing that company from 12 million of revenue to 100 and 75 million of revenue over the next nine years.
(08:10):
Uh so growing pretty extensively.
And I feel like personally,
for you just kind of growing a company from that size to a much larger size.
Yeah.
You know,
it's,
it's interesting when you're in the mix,
it's kind of like boiling a lobster.
Right?
You don't realize how hot the fire is getting while you're sitting in the water as the temperature is rising.
(08:30):
That's what I would equate it to.
Um,
every day I just kept my head down and tried to lead by example,
I learned what servant leadership was all about.
That was like the leadership style that I wanted to ascribe to.
Um And I realized if I was gonna scale a big company,
like I couldn't have my hands in all the pieces that I wanted to have,
I needed to team up with great people.
(08:51):
I needed to delegate.
I needed to let the person closest to the problem solved the issue.
Um And then make sure that I supported them with proper coaching,
proper mentoring,
great strategy building,
the right culture,
making sure the firm had enough capital to operate like it was my job to make sure that people could do their jobs and I existed to serve them,
not the other way around.
(09:12):
And so those were great learnings for me.
Um As I ended up skilling that business with the rest of the team,
got you.
And then during that experience is that really where you saw the need for?
I know you went on to found Cloud Break Health.
Uh It looks like you had a couple other companies in between there that might have morphed into cloud break.
Health is that kind of where you kind of saw that need for tele medicine?
(09:34):
Yeah.
So I really cut my teeth on the provider side of health care.
And um you know,
in health care you hear people talk about all the time trial in like patient center,
patient center,
patient centric.
What I really saw the need was for a more provider centric industry.
I felt like,
you know,
the burnout issue is a real problem.
I saw my doctors um always being asked to do more with less,
(09:57):
don't see two patients c three,
don't see three patients C four.
Um and do that for less money than you were making before.
And um you know,
I saw this burnout was like a real problem because the number one symptom of this burnout is you treat a patient more like an object instead of like a person.
And you know,
who in the audience would rather be treated like an object instead of like a person.
(10:18):
And you learn very quickly that if you can restore the joy of calling back to these doctors and put them in a healthy working environment and give them the opportunity to spend more time by the bedside and put tools and fingertips,
uh put tools at their fingertips that help facilitate care instead of getting in the way of providing care,
like you could take a look at the E M R and say it's really got in the way of care to a large degree because it's really hard to use.
(10:42):
But people are now focused on creating a better user experience,
right?
Um With the E M R which I think is gonna be a huge market.
Um And I saw just firsthand that better technology could,
could do exactly,
you know what the mission was supposed to do,
which is let the doctor connect with the patient,
right?
Instead of typing into the screen,
(11:03):
there's now new ways to input patient data.
So you can,
you know,
talk to the patient,
spend more time with them and really diagnose them better.
Um And you know,
show them that you actually care.
Um And so what that led to was,
could I create a solution that actually did that at the point of care?
And for us,
it was the language services use case,
(11:24):
which proved to be um the one that after our research,
we really keyed in on and I met the founder of a company called the Language Access Network,
this gentleman Andy Panos.
And he had founded a company that brought language interpreters to the point of care for limited English and proficient patients over telemedicine,
first person in the country to do it.
And the company was struggling.
(11:44):
Um But I love the idea.
I saw the chance as a social impact entrepreneur to increase my impact at scale.
And I ended up acquiring that business.
Um and then that business ended up becoming cloud break.
Um And you know,
cloud break started off as a language services business,
but really redefined itself as a health equity solutions company which broaden our mandate and we were talking about health equity before anyone else in the industry was talking about it.
(12:11):
And then you run into COVID and now every major health system in payer has a health equity initiative and it's really gratifying to see and who have been early on the curve in a market that was really about increasing access to care for underserved people for sure.
When you acquired the language access network organization,
what did that first iteration look like?
Were you guys doing dial up for language interpretation?
(12:34):
What that look like?
Yeah,
the cars were really expensive.
I remember the cards cost up to like 30 or $40,000 to put together.
Um we hacked together and,
and by the way,
those cards normally had to be plugged into like an Ethernet cable.
So we were the first really people in the country to take a wireless access point and strap it to one of those carts and have it,
you know,
move from,
(12:54):
you know,
access point to access point in the hospital,
which was its own unique challenge.
Back then,
hospitals didn't have great internet.
So we actually connected to our hospitals over our own private broadband network because we built one of the largest private broadband networks in health care in the country.
And that was an effort to make sure that when you hit the button,
what you expected to happen would happen and that you didn't and then you had really high quality video and that you were able to connect to an interpreter within the appropriate amount of time.
(13:22):
Um So yeah,
it was way different now,
you know,
the go to market is an ipad on a cart.
Um hospitals now have all all have ample internet access because a lot of the infrastructure um runs on,
you know,
making sure that it has that type of access,
wifi networks and hospitals are a lot better.
Don't get me wrong.
There's still challenges.
There's still a lot of hospitals across the United States that are operating on old architecture.
(13:47):
Um But it's a much different market now than it was back then,
for sure.
Very interesting.
It's,
it's super complex looking back at the history of health care going.
Wow,
how did we actually get to kind of where we are now?
Um Especially just with the technology that we take for granted,
iphones,
ipads for all the hardware that you were building.
(14:09):
Were you guys manufacturing the hardware or just kind of throwing some stuff together?
No,
we were not,
we were,
we were kind of taking best of breed products off shelf and amalgamating them into one solution,
you know,
so it might be like interesting Cisco access point Cisco screen Cisco router um attached to um you know,
a cart made by X Y Z manufacturer,
right?
Um There wasn't like a holistic solution at that time.
(14:31):
And so we definitely were piecing,
piecing it together.
OK?
And you guys were selling directly into the health systems directly or the hospital.
What was that?
What did that process look like for you all from smaller organization growing?
How did you break down those walls to get into these health systems?
You know,
it's a great question.
It was,
it was a ton of missionary selling,
(14:52):
right?
Going in finding your champion,
finding someone who um was impact aligned with you on um what they were trying to achieve,
who was focused on the right things focused on quality,
focused on care outcomes.
One of the ways um that we helped revolutionize the industry was before people were talking about language services and hospitals.
(15:15):
Um like it was well,
look,
there's we have to have it regulator,
but it wasn't really a performance improvement type of function.
And we really showed how having great language services could drive a big R O I.
We were the first people in the industry to launch an R O I model in the market.
And um it was amazing to see how that resonated.
The other thing that we did is we always approached hospitals from a cross functional standpoint and we never just approached the champion,
(15:41):
got the champion to sign a contract and then moved on to the rest of the hospital.
Um In terms of functional departments,
we would say,
look for us to be successful.
What we're really doing at the point of care is change management.
We're teaching someone a new behavior that they need to bring this interpreter to the point of care.
Um We need to have administration,
clinical and I T all in the same room making this decision together because more often than not a champion would make a decision and we would see good I T and be like,
(16:09):
hey,
so and so said they want to implement the system.
They're like,
hey,
that's great.
I can't do it for a year,
right?
Because I'm working on E M R implementation X or roll out of wifi network wide.
And we,
you know,
we just simply don't have the time to do it.
So we very early on espoused cross functional teams,
we made it a group effort.
Um We made it a consensus decision and I think getting everybody on board in a line was a key part of our success.
(16:35):
Any tips or tricks on how you kind of brought your team together to do that,
making sure that you're all on the same wavelength,
so to speak.
Yeah,
I mean,
Ryan,
you've probably heard this before.
I think building a great business is about great storytelling.
Um And I,
I don't mean,
you know,
fictional storytelling.
I'm talking about more nonfiction,
right?
This is a,
(16:56):
it's about creating a,
a mission and a vision that people can really rally around.
It's about having clarity around what your goals are for that month,
that quarter.
Um,
and it's about always coming back to your core values as an organization.
Um,
so we could always use those as kind of our true north.
Oh,
so,
and so client wants this,
well,
does that fit with our values?
(17:16):
That was kind of the,
the question we would ask ourselves.
And I have to tell you,
it's like,
it's fun paving new ground,
but it's also like painful.
Um There are a lot of times these hospital sale cycles are like really,
really long,
they range how long on average,
three months to three years,
right?
And I would say the weighted average is probably a year to make a sale.
(17:36):
Um And so you're just constantly cultivating relationships and these relationships become very important to you.
Um So,
you know,
I,
I would say the key thing is getting everybody aligned,
keeping the mission at the core.
Um And then making sure that if someone had the ability to contribute and raise their hand,
you were listening.
Um Again,
you know,
that servant oriented style of leadership,
(17:58):
I think served as well as we were trying to innovate because what we ended up building was a really flat organization where the person again,
closest to the problem was there to solve it.
Um,
and we were there to support them in that,
I think,
I think that allowed us to be really nimble.
And by the way,
I think the other thing that helped us is any time that we,
as an organization made a mistake,
like we owned it.
Right.
We never tried to blame the client or do anything like that.
(18:21):
It was like,
how can we help you solve the problem?
We're gonna own this and we're gonna navigate it.
And I've always said,
you know,
it's really easy to run a great company when everything's going well,
but really great companies are defined by when they face challenging times and how they navigate them.
And then I think that's something I'm really proud that Fabre did well,
very cool.
So everything you're talking about,
I'm assuming,
took a good amount of cash to make happen.
(18:42):
Uh Did your investment bank background play a role here?
Absolutely.
We ended up raising around 35 or $40 million for um cloud break and that money really helped us scale and also navigate some tough times.
So when we raised our series a round,
um we raised $15 million and the company was 12 million in revenue at that time.
(19:03):
And then on that $15 million we tripled the company in three years because we have growth capital,
we can invest in sales.
Um And then,
you know,
we ended up going through COVID and during COVID our investors again stepped up for us as a business to help us manage,
navigate uh what were challenging times,
as you can imagine.
In the initial part of COVID,
we don't,
we were hospital based telemedicine for all intents and purposes and when people were going to hospitals um that presented a real challenge.
(19:29):
Um But what we saw was financial partners who stepped up for us every step of the way and uh helped us navigate to our eventual exit.
Very cool.
Well,
kind of congrats on building that company.
I it looks like you guys actually merged with Up Health.
Is that correct?
That is correct.
We merged with Up Health,
which was a spa transaction that closed in June of 21.
(19:50):
How was that from a founder perspective?
Kind of going through that?
Yeah.
Um That is a super interesting question.
Um You know,
migrate is selling your company is one thing merging into a public company is like a whole another beast.
And there are a lot of really fun things that we got to do as a part of that process.
(20:10):
We got to go out,
raise money,
take the company public,
you know,
ring the bell at the New York Stock Exchange,
a bunch of fun kind of rites of passage there.
But,
you know,
Candidly was difficult to go and we were part of a six way company merger.
Um And so the complexity there was pretty high.
Um And you know,
(20:31):
I eventually realized that being the lead of a public company wasn't um where I wanted to be and that,
you know,
the opportunity to go back and help founders.
And to me the,
the fun part of running companies is that beginning stage,
it's product market,
fit and growing and doing the missionary selling everything that we had done with cloud break early on.
(20:52):
And so that ended up leading a post by transition period at up health.
Whereas the president of the public company for around six months,
um to me joining startup Health is an entrepreneur in residence and really uh you know what they call the Chief Health Transformer.
Um And my role of really helping our companies at startup health coaching,
all those founders helping them navigate their challenges.
(21:14):
You know,
we talk about all the time that like,
you know,
the growth of your company is in a hockey stick.
I know that's what the projections say,
but it's really more like a roller coaster and you spend far more times in the dips than you do at the peaks.
And we like to talk about the fact that we build startup health to help navigate those dips.
So now at startup Health,
are you the chief platform officer?
Yes.
So my role is really to make sure that the 300 plus companies that we have in the portfolio have a great experience.
(21:41):
And what we really feel like we've created is a value creation platform.
It's startup health and a community driven learning experience.
And our theory on it is the more a company leans in on the value creation platform,
the more value they'll create.
So the more they take advantage of the education and peer support.
Um our ability,
there's really three legs of the stool at startup health.
(22:04):
So one of the legs is our coaching platform.
Um and that is where people get to spend time in office hours doing quarterly what we call recalibration.
So their ability to come in and actually take a pause on their quarter and like take a step back work on their business instead of in their business,
which frequently founders don't get to do because we're constantly heads down,
(22:24):
grinding,
grinding,
grinding.
Um So that's a key part of it.
Um We have our community,
which is that peer support understanding that you're not going through it alone and that ability to rely on other founders as well for advice.
So not only are they relying on coaches like me who have,
you know,
built multiple companies and have a lot of experience to share,
(22:45):
but they're also relying on each other because they have this shared lived experience of going through this at the same time.
So being able to workshop that we have something we call circles,
which is a peer support group.
Um That's part of that community where they meet on a monthly basis.
It's modeled after Y P O for um and then the third leg of the stool is brand amplification.
So our ability over time,
(23:07):
startup health is 15 years old and built this curated audience of people who are interested in solving the world's greatest health challenges,
which is startup health's mission.
And it's a group of investors,
innovation officers from health systems and payers,
you know,
people from industry and Pharma.
Um and you mix that with the founders and you've created uh a network of effects that's really hard to ignore.
(23:30):
So for us,
you mix the community with the coaching and then the ability to tell the stories of our founders broader to this curated audience of people um in the investment and innovation world in health care.
And it's really just a,
a 123 punch if you will of uh of a value that,
that the founders get to experience.
(23:52):
Yeah,
I think Startup Health is a,
a great organization and a great vessel for all of that stuff.
If anyone wants to learn more about startup health,
where would they find that?
W w w dot startup health dot com?
Uh You can also follow us on Twitter or Instagram and linkedin.
Um Just put startup health into the search box,
all the handles will come up for each one of those.
Um And if you wanna,
(24:12):
you know,
get in touch with me,
I'm at Jamie Edwards on Twitter.
It's J AM E Y and um I'm happy to sync up with people on linkedin.
Continue the dialogue online.
Uh The social media aspect of things is really important.
It's important that we,
you know,
engage in a dialogue about how to make health care better and environment.
And this podcast is a part of that.
So super grateful to you for uh for being able to host this dialogue,
(24:34):
of course.
And then just to kind of wrap up,
looking back on your life,
what would be a piece of advice that you would give your 21 year old self?
Oh,
a piece of advice,
I'd give my 21 year old self.
Um You know,
I would kind of say that being vulnerable is a key part of.
(24:54):
I think what's made me successful.
Um I've never been afraid to kind of share what I'm going through with people um and never been afraid when I've experiencing a challenge.
Like I've never really put on a brief face if that makes sense,
like I've never tried to cover up whatever situation is or whatever challenge I'm trying to face is.
And I think that vulnerability is a strength,
I think as a leader.
Um If we can show that we um are trying to navigate challenges just like,
(25:19):
you know,
our team is and you can really become relatable,
then I think you,
you're just,
you're a better leader.
Um You know,
when you can relate to your team and people don't look at you as being some,
you know,
superhero,
um,
if you will.
So I think the vulnerability side of it,
I say don't be afraid to be vulnerable.
Awesome.
Well,
I'll definitely try to take that to heart and really appreciate your time today,
Jamie.
(25:39):
I appreciate you Ryland.
Thanks so much,
man.
Have a great rest of the week.
Thank you for visiting the Medi Apps show brought to you by the Medical Logistics and Transportation Organization,
Medi Apps.
I'm your host,
Ryland Stone.
Today we are speaking with Jamie Edwards,
an entrepreneur in the digital health care space.
Jamie was the CEO and co-founder of Cloud Break Health,
a language access and telehealth company providing interpretation services in 2019 Cloud Break Health merged with Up Health via a Jamie is now the chief platform officer at startup Health,
(00:39):
a venture capital firm focused on investing in health transformers to achieve audacious health moonshots.
I hope you enjoy the show.
Thank you,
Jamie for being with us today.
I really appreciate your time.
Uh Great to be here.
Thanks.
So just to kind of jump right into it.
Give me a little bit of background on yourself as a kid.
Family,
hobbies.
Kind of from the beginning.
(00:59):
We'll back it up and start there.
I mean,
how deep down the rabbit hole do you want to go,
Ryland?
Well,
do you have any uh like as a kid?
Where did you see that entrepreneurial bug in your childhood?
Anything like that?
Well,
you know what I grew up?
In Buffalo,
New York,
um,
which is like a super blue collar town and very early on.
(01:19):
Um,
you know,
prior to the rest of my friends,
I was the first one to have a job.
Um,
and my first job was like washing dishes and,
um,
I kind of feel like everything I needed to learn in life.
Um,
I learned washing dishes,
you know,
no job was below me.
Got to work with all sorts of different types of people.
But even at that age,
I was kind of driven to improve the process.
And I was working at this restaurant in Buffalo called Rick Lets.
(01:42):
And I worked my way up from dishwasher to head of the dish room.
Who knew that there was such a thing where I'd actually like trained to do the schedules for the rest of the dishwashers and all that stuff.
And then work my way up to become um the youngest uh saute cook that the restaurant had had.
And um really learned a lot from the restaurant business in terms of like customer service.
(02:03):
Um and what it meant to work hard and the joy of plating a great meal and giving someone a good experience.
Um And then throughout college waited tables to pay my way through school.
Um And then senior year took a class in entrepreneurship and personal enterprise at Cornell by this professor,
Professor David Ben Daniel.
(02:24):
And he taught me what entrepreneurship was in a very simple definition.
It was take an idea in your head and make it real and make it positively impact the people at scale.
And the second I wrote my first business plan Ryland,
like I was hooked.
Like I was like,
this is amazing.
I can take this concept in my head and turn it into something,
you know,
real in the world and then have people enjoy that experience or have it provide value to them?
(02:48):
And it was just hugely hugely impactful.
Uh Do you remember the,
do you remember your first business plan of what it was?
I do,
it was for a micro brewery,
right?
So taking that restaurant background,
I wanted to create something.
I teamed up with a group of friends from Port,
we wrote a business plan for something called the University Brewing Company.
And the idea was it was gonna be the local favorite everywhere,
(03:10):
right?
So you'd be able to open them up in college towns across the United States and this is before a concept like this kind of existed.
And um you'd be able to have,
you know,
in Ithaca as an example,
you know,
Ithaca is gorgeous ale or big red,
you know,
uh lager or whatever it might be.
Got you the same thing in different universities across uh across the uh the country.
(03:32):
And we just thought it was,
you know,
best thing since sliced bread.
Very cool.
Did you ever do anything with that?
Or just make the plan and go from there.
You know,
we didn't,
we,
we made the plan and then everyone,
um,
you know,
at that point went on their separate ways,
post graduation because it was like,
literally second semester,
senior year when we wrote the business plan and everyone already had jobs lined up and we toyed with the idea of potentially doing it and sticking around in Ithaca and then,
(03:57):
you know,
just made the decision that,
you know,
our educations weren't finished yet and we wanted to go off and get educated by the world.
Fair enough.
Well,
then I guess kind of just moving and transitioning from that into the rest of your career.
Where did you go from there?
Uh Just kind of looking over your linkedin,
it looks like you have a background in investment banking.
Yeah.
So um I learned in the class that and by the way,
(04:20):
I like grew up in the time of Enron,
right?
So I never wanted a CFO to be able to pull the wool over my eyes.
I wanted to build a financial skill set and candidly,
that was a challenge for me.
I was always really like the English and history kid,
not the math and science kid.
So when um I figured out that I really wanted to be an entrepreneur and I needed to learn about how to raise capital and how boardrooms were managed and you know how um thought leaders really analyzed their own businesses and thought about how to manage them.
(04:49):
Um Investment banking proved to be that great kind of testing ground where I could learn those things.
And um despite having no accounting,
finance,
economics background really to speak of,
um jumped in with both feet um became an analyst at an investment bank.
My first job was actually as a valuation consultant for KPMG P back in the day,
(05:09):
but I was there for six months before I transferred over to investment banking.
And um,
it was just an awesome learning ground learning from really smart people,
drinking from a fire hose.
I gotta tell you there were times where I was probably pretty close to mental breakdown that first year because I was trying to figure out how to build a financial model and have all my numbers tied and all those different types of things.
(05:30):
But I was almost like exposure therapy.
Eventually I became really good at that stuff and learned how to raise capital and learn that when you walk into a boardroom,
no one in there is necessarily any smarter than you are.
Um,
there might be more experience but you run into people and companies where there might be a really large company that's run by someone and you're like,
oh,
that person's,
how did they get to this position?
And then you go in a really small company and there's someone who's like a true genius running it and everyone's got their own challenges and crosses to bear from that perspective.
(05:57):
But I really learned that everyone,
you know,
that I,
I always walked in the room assuming I was the dumbest person because I just feel like that's the right attitude when you,
you know,
walk into a setting where you don't know people,
like just assume you're the dumbest person in the room.
But then I started to realize like,
you know,
you're not and you have something to contribute and I just sat there listening and taking it all in until I was able to kind of step up and contribute in my own life.
(06:20):
Very interesting insights there.
Thank you for sharing that.
Yeah,
no problem.
So,
so then from investment banking,
where did you go from there?
Yeah.
So I grew up in a family of doctors.
You know,
my mom wasn't a doctor and my dad wasn't,
but my sister is a doctor.
Uh,
she married a doctor,
aunts and uncles on both sides are doctors.
And I have one of my favorite uncles,
(06:40):
um,
who is a physician.
And I remember um,
junior year when I was at Cornell flying out to spring break,
he lived in Los Angeles,
he was a young er,
doctor,
he picked me up at the airport and drove me down and then had the beach pier.
Um,
and I was like,
oh,
you know,
one day I want to live in Los Angeles.
So that's what I ended up doing post graduation,
(07:01):
but having seen his practice when I was doing uh my investment banking work,
I ended up working on some consulting assignments for him.
And by the way,
very easy to impress,
impress your physician uncle um uh with concepts like revenue and cash flow and I and powerpoint and Excel and they don't teach those things in medical school.
Um But saw firsthand and doing the consulting work,
(07:22):
how I could have an impact on this industry,
right,
$4.3 trillion industry because it just didn't have the level of sophistication that I was expecting.
It was risk averse.
Um They didn't like implementing new technology,
it was lagging other industries like finance,
um e-commerce and retail in terms of digital transformation.
(07:44):
And I just realized there was a huge opportunity to lean in.
Um So I moved him out of his home office to real office,
built one of the first physician productivity systems in the country uh for value based care and Excel.
And um he eventually asked me to come run the business full time.
And so,
yeah,
a little bit of nepotism,
right?
For giving me my first CEO but we ended up growing that company from 12 million of revenue to 100 and 75 million of revenue over the next nine years.
(08:10):
Uh so growing pretty extensively.
And I feel like personally,
for you just kind of growing a company from that size to a much larger size.
Yeah.
You know,
it's,
it's interesting when you're in the mix,
it's kind of like boiling a lobster.
Right?
You don't realize how hot the fire is getting while you're sitting in the water as the temperature is rising.
(08:30):
That's what I would equate it to.
Um,
every day I just kept my head down and tried to lead by example,
I learned what servant leadership was all about.
That was like the leadership style that I wanted to ascribe to.
Um And I realized if I was gonna scale a big company,
like I couldn't have my hands in all the pieces that I wanted to have,
I needed to team up with great people.
(08:51):
I needed to delegate.
I needed to let the person closest to the problem solved the issue.
Um And then make sure that I supported them with proper coaching,
proper mentoring,
great strategy building,
the right culture,
making sure the firm had enough capital to operate like it was my job to make sure that people could do their jobs and I existed to serve them,
not the other way around.
(09:12):
And so those were great learnings for me.
Um As I ended up skilling that business with the rest of the team,
got you.
And then during that experience is that really where you saw the need for?
I know you went on to found Cloud Break Health.
Uh It looks like you had a couple other companies in between there that might have morphed into cloud break.
Health is that kind of where you kind of saw that need for tele medicine?
(09:34):
Yeah.
So I really cut my teeth on the provider side of health care.
And um you know,
in health care you hear people talk about all the time trial in like patient center,
patient center,
patient centric.
What I really saw the need was for a more provider centric industry.
I felt like,
you know,
the burnout issue is a real problem.
I saw my doctors um always being asked to do more with less,
(09:57):
don't see two patients c three,
don't see three patients C four.
Um and do that for less money than you were making before.
And um you know,
I saw this burnout was like a real problem because the number one symptom of this burnout is you treat a patient more like an object instead of like a person.
And you know,
who in the audience would rather be treated like an object instead of like a person.
(10:18):
And you learn very quickly that if you can restore the joy of calling back to these doctors and put them in a healthy working environment and give them the opportunity to spend more time by the bedside and put tools and fingertips,
uh put tools at their fingertips that help facilitate care instead of getting in the way of providing care,
like you could take a look at the E M R and say it's really got in the way of care to a large degree because it's really hard to use.
(10:42):
But people are now focused on creating a better user experience,
right?
Um With the E M R which I think is gonna be a huge market.
Um And I saw just firsthand that better technology could,
could do exactly,
you know what the mission was supposed to do,
which is let the doctor connect with the patient,
right?
Instead of typing into the screen,
(11:03):
there's now new ways to input patient data.
So you can,
you know,
talk to the patient,
spend more time with them and really diagnose them better.
Um And you know,
show them that you actually care.
Um And so what that led to was,
could I create a solution that actually did that at the point of care?
And for us,
it was the language services use case,
(11:24):
which proved to be um the one that after our research,
we really keyed in on and I met the founder of a company called the Language Access Network,
this gentleman Andy Panos.
And he had founded a company that brought language interpreters to the point of care for limited English and proficient patients over telemedicine,
first person in the country to do it.
And the company was struggling.
(11:44):
Um But I love the idea.
I saw the chance as a social impact entrepreneur to increase my impact at scale.
And I ended up acquiring that business.
Um and then that business ended up becoming cloud break.
Um And you know,
cloud break started off as a language services business,
but really redefined itself as a health equity solutions company which broaden our mandate and we were talking about health equity before anyone else in the industry was talking about it.
(12:11):
And then you run into COVID and now every major health system in payer has a health equity initiative and it's really gratifying to see and who have been early on the curve in a market that was really about increasing access to care for underserved people for sure.
When you acquired the language access network organization,
what did that first iteration look like?
Were you guys doing dial up for language interpretation?
(12:34):
What that look like?
Yeah,
the cars were really expensive.
I remember the cards cost up to like 30 or $40,000 to put together.
Um we hacked together and,
and by the way,
those cards normally had to be plugged into like an Ethernet cable.
So we were the first really people in the country to take a wireless access point and strap it to one of those carts and have it,
you know,
move from,
(12:54):
you know,
access point to access point in the hospital,
which was its own unique challenge.
Back then,
hospitals didn't have great internet.
So we actually connected to our hospitals over our own private broadband network because we built one of the largest private broadband networks in health care in the country.
And that was an effort to make sure that when you hit the button,
what you expected to happen would happen and that you didn't and then you had really high quality video and that you were able to connect to an interpreter within the appropriate amount of time.
(13:22):
Um So yeah,
it was way different now,
you know,
the go to market is an ipad on a cart.
Um hospitals now have all all have ample internet access because a lot of the infrastructure um runs on,
you know,
making sure that it has that type of access,
wifi networks and hospitals are a lot better.
Don't get me wrong.
There's still challenges.
There's still a lot of hospitals across the United States that are operating on old architecture.
(13:47):
Um But it's a much different market now than it was back then,
for sure.
Very interesting.
It's,
it's super complex looking back at the history of health care going.
Wow,
how did we actually get to kind of where we are now?
Um Especially just with the technology that we take for granted,
iphones,
ipads for all the hardware that you were building.
(14:09):
Were you guys manufacturing the hardware or just kind of throwing some stuff together?
No,
we were not,
we were,
we were kind of taking best of breed products off shelf and amalgamating them into one solution,
you know,
so it might be like interesting Cisco access point Cisco screen Cisco router um attached to um you know,
a cart made by X Y Z manufacturer,
right?
Um There wasn't like a holistic solution at that time.
(14:31):
And so we definitely were piecing,
piecing it together.
OK?
And you guys were selling directly into the health systems directly or the hospital.
What was that?
What did that process look like for you all from smaller organization growing?
How did you break down those walls to get into these health systems?
You know,
it's a great question.
It was,
it was a ton of missionary selling,
(14:52):
right?
Going in finding your champion,
finding someone who um was impact aligned with you on um what they were trying to achieve,
who was focused on the right things focused on quality,
focused on care outcomes.
One of the ways um that we helped revolutionize the industry was before people were talking about language services and hospitals.
(15:15):
Um like it was well,
look,
there's we have to have it regulator,
but it wasn't really a performance improvement type of function.
And we really showed how having great language services could drive a big R O I.
We were the first people in the industry to launch an R O I model in the market.
And um it was amazing to see how that resonated.
The other thing that we did is we always approached hospitals from a cross functional standpoint and we never just approached the champion,
(15:41):
got the champion to sign a contract and then moved on to the rest of the hospital.
Um In terms of functional departments,
we would say,
look for us to be successful.
What we're really doing at the point of care is change management.
We're teaching someone a new behavior that they need to bring this interpreter to the point of care.
Um We need to have administration,
clinical and I T all in the same room making this decision together because more often than not a champion would make a decision and we would see good I T and be like,
(16:09):
hey,
so and so said they want to implement the system.
They're like,
hey,
that's great.
I can't do it for a year,
right?
Because I'm working on E M R implementation X or roll out of wifi network wide.
And we,
you know,
we just simply don't have the time to do it.
So we very early on espoused cross functional teams,
we made it a group effort.
Um We made it a consensus decision and I think getting everybody on board in a line was a key part of our success.
(16:35):
Any tips or tricks on how you kind of brought your team together to do that,
making sure that you're all on the same wavelength,
so to speak.
Yeah,
I mean,
Ryan,
you've probably heard this before.
I think building a great business is about great storytelling.
Um And I,
I don't mean,
you know,
fictional storytelling.
I'm talking about more nonfiction,
right?
This is a,
(16:56):
it's about creating a,
a mission and a vision that people can really rally around.
It's about having clarity around what your goals are for that month,
that quarter.
Um,
and it's about always coming back to your core values as an organization.
Um,
so we could always use those as kind of our true north.
Oh,
so,
and so client wants this,
well,
does that fit with our values?
(17:16):
That was kind of the,
the question we would ask ourselves.
And I have to tell you,
it's like,
it's fun paving new ground,
but it's also like painful.
Um There are a lot of times these hospital sale cycles are like really,
really long,
they range how long on average,
three months to three years,
right?
And I would say the weighted average is probably a year to make a sale.
(17:36):
Um And so you're just constantly cultivating relationships and these relationships become very important to you.
Um So,
you know,
I,
I would say the key thing is getting everybody aligned,
keeping the mission at the core.
Um And then making sure that if someone had the ability to contribute and raise their hand,
you were listening.
Um Again,
you know,
that servant oriented style of leadership,
(17:58):
I think served as well as we were trying to innovate because what we ended up building was a really flat organization where the person again,
closest to the problem was there to solve it.
Um,
and we were there to support them in that,
I think,
I think that allowed us to be really nimble.
And by the way,
I think the other thing that helped us is any time that we,
as an organization made a mistake,
like we owned it.
Right.
We never tried to blame the client or do anything like that.
(18:21):
It was like,
how can we help you solve the problem?
We're gonna own this and we're gonna navigate it.
And I've always said,
you know,
it's really easy to run a great company when everything's going well,
but really great companies are defined by when they face challenging times and how they navigate them.
And then I think that's something I'm really proud that Fabre did well,
very cool.
So everything you're talking about,
I'm assuming,
took a good amount of cash to make happen.
(18:42):
Uh Did your investment bank background play a role here?
Absolutely.
We ended up raising around 35 or $40 million for um cloud break and that money really helped us scale and also navigate some tough times.
So when we raised our series a round,
um we raised $15 million and the company was 12 million in revenue at that time.
(19:03):
And then on that $15 million we tripled the company in three years because we have growth capital,
we can invest in sales.
Um And then,
you know,
we ended up going through COVID and during COVID our investors again stepped up for us as a business to help us manage,
navigate uh what were challenging times,
as you can imagine.
In the initial part of COVID,
we don't,
we were hospital based telemedicine for all intents and purposes and when people were going to hospitals um that presented a real challenge.
(19:29):
Um But what we saw was financial partners who stepped up for us every step of the way and uh helped us navigate to our eventual exit.
Very cool.
Well,
kind of congrats on building that company.
I it looks like you guys actually merged with Up Health.
Is that correct?
That is correct.
We merged with Up Health,
which was a spa transaction that closed in June of 21.
(19:50):
How was that from a founder perspective?
Kind of going through that?
Yeah.
Um That is a super interesting question.
Um You know,
migrate is selling your company is one thing merging into a public company is like a whole another beast.
And there are a lot of really fun things that we got to do as a part of that process.
(20:10):
We got to go out,
raise money,
take the company public,
you know,
ring the bell at the New York Stock Exchange,
a bunch of fun kind of rites of passage there.
But,
you know,
Candidly was difficult to go and we were part of a six way company merger.
Um And so the complexity there was pretty high.
Um And you know,
(20:31):
I eventually realized that being the lead of a public company wasn't um where I wanted to be and that,
you know,
the opportunity to go back and help founders.
And to me the,
the fun part of running companies is that beginning stage,
it's product market,
fit and growing and doing the missionary selling everything that we had done with cloud break early on.
(20:52):
And so that ended up leading a post by transition period at up health.
Whereas the president of the public company for around six months,
um to me joining startup Health is an entrepreneur in residence and really uh you know what they call the Chief Health Transformer.
Um And my role of really helping our companies at startup health coaching,
all those founders helping them navigate their challenges.
(21:14):
You know,
we talk about all the time that like,
you know,
the growth of your company is in a hockey stick.
I know that's what the projections say,
but it's really more like a roller coaster and you spend far more times in the dips than you do at the peaks.
And we like to talk about the fact that we build startup health to help navigate those dips.
So now at startup Health,
are you the chief platform officer?
Yes.
So my role is really to make sure that the 300 plus companies that we have in the portfolio have a great experience.
(21:41):
And what we really feel like we've created is a value creation platform.
It's startup health and a community driven learning experience.
And our theory on it is the more a company leans in on the value creation platform,
the more value they'll create.
So the more they take advantage of the education and peer support.
Um our ability,
there's really three legs of the stool at startup health.
(22:04):
So one of the legs is our coaching platform.
Um and that is where people get to spend time in office hours doing quarterly what we call recalibration.
So their ability to come in and actually take a pause on their quarter and like take a step back work on their business instead of in their business,
which frequently founders don't get to do because we're constantly heads down,
(22:24):
grinding,
grinding,
grinding.
Um So that's a key part of it.
Um We have our community,
which is that peer support understanding that you're not going through it alone and that ability to rely on other founders as well for advice.
So not only are they relying on coaches like me who have,
you know,
built multiple companies and have a lot of experience to share,
(22:45):
but they're also relying on each other because they have this shared lived experience of going through this at the same time.
So being able to workshop that we have something we call circles,
which is a peer support group.
Um That's part of that community where they meet on a monthly basis.
It's modeled after Y P O for um and then the third leg of the stool is brand amplification.
So our ability over time,
(23:07):
startup health is 15 years old and built this curated audience of people who are interested in solving the world's greatest health challenges,
which is startup health's mission.
And it's a group of investors,
innovation officers from health systems and payers,
you know,
people from industry and Pharma.
Um and you mix that with the founders and you've created uh a network of effects that's really hard to ignore.
(23:30):
So for us,
you mix the community with the coaching and then the ability to tell the stories of our founders broader to this curated audience of people um in the investment and innovation world in health care.
And it's really just a,
a 123 punch if you will of uh of a value that,
that the founders get to experience.
(23:52):
Yeah,
I think Startup Health is a,
a great organization and a great vessel for all of that stuff.
If anyone wants to learn more about startup health,
where would they find that?
W w w dot startup health dot com?
Uh You can also follow us on Twitter or Instagram and linkedin.
Um Just put startup health into the search box,
all the handles will come up for each one of those.
Um And if you wanna,
(24:12):
you know,
get in touch with me,
I'm at Jamie Edwards on Twitter.
It's J AM E Y and um I'm happy to sync up with people on linkedin.
Continue the dialogue online.
Uh The social media aspect of things is really important.
It's important that we,
you know,
engage in a dialogue about how to make health care better and environment.
And this podcast is a part of that.
So super grateful to you for uh for being able to host this dialogue,
(24:34):
of course.
And then just to kind of wrap up,
looking back on your life,
what would be a piece of advice that you would give your 21 year old self?
Oh,
a piece of advice,
I'd give my 21 year old self.
Um You know,
I would kind of say that being vulnerable is a key part of.
(24:54):
I think what's made me successful.
Um I've never been afraid to kind of share what I'm going through with people um and never been afraid when I've experiencing a challenge.
Like I've never really put on a brief face if that makes sense,
like I've never tried to cover up whatever situation is or whatever challenge I'm trying to face is.
And I think that vulnerability is a strength,
I think as a leader.
Um If we can show that we um are trying to navigate challenges just like,
(25:19):
you know,
our team is and you can really become relatable,
then I think you,
you're just,
you're a better leader.
Um You know,
when you can relate to your team and people don't look at you as being some,
you know,
superhero,
um,
if you will.
So I think the vulnerability side of it,
I say don't be afraid to be vulnerable.
Awesome.
Well,
I'll definitely try to take that to heart and really appreciate your time today,
Jamie.
(25:39):
I appreciate you Ryland.
Thanks so much,
man.
Have a great rest of the week.
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Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.