Outcomes Rocket Podcast_Sandeep Akkaraju: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey, everybody! Saul Marquez with the Outcomes Rocket. I want to welcome you to another episode of our podcast. Today, I have the privilege of hosting Sandeep Akkaraju. He’s Exo’s Co-Founder and Chief Executive Officer, and he’s a proven entrepreneur with hands-on managerial background in leading interdisciplinary technology and business teams and a track record of bringing to market complex hardware and software products. Exo is his fourth start-up organization. Prior to that, Sandeep was founder and president of Jyve, acquired by a major semiconductor corporation at an exit valuation of more than 60 million. And previously, he was CEO of IntelliSense, a leading provider of Micromechanical integrated circuits, mems, and nanotechnology-based software solutions. He’s done incredible work and helped the company grow to a valuation of $750 million. Just an incredible entrepreneur, and I’m excited to have him here to talk about the work that they’re up to at Exo. So Sandeep, welcome, and thanks for being with us.
Sandeep Akkaraju:
Hey, thanks, Saul. Thanks for having me on your podcast.
Saul Marquez:
It’s a pleasure. And so before we dive into Exo and the awesome work you guys are up to there, Sandeep, tell us a little bit about you. What is it that motivates your work in the healthcare space?
Sandeep Akkaraju:
You know, I have really no background in healthcare, but I have a lot of background in taking incredibly complex systems and really changing the economic value paradigm behind them, and by really shrinking a lot of that, using combination of nanotechnologies, a lot of software, and clearly, the new element here at Exo is AI, to change that economic value paradigm. My previous company, Jyve, we did a lot of the motion sensing that’s kind of going into watches, phones, AR/VR, everywhere. And if you looked at the hardware for that, you know, early 2000s, it was about … big and $80,000, and now it’s under a dollar on your wristwatch.
Saul Marquez:
It’s amazing, amazing, yeah.
Sandeep Akkaraju:
Exo started as really a blue-sky project in terms of, Hey, how could we really affect change in healthcare by taking something that’s expensive, complex, really hard to use and completely change that economic value paradigm by shifting it from shipping big boxes to making it really accessible to people around the world? So, in about 2015, ’16 timeframe, there was a World Health Organization report that came out that said that 75% to 80% of the world had really no access to any medical imaging, and so we really set out to change that. So, I think what drives me is big goals, and what drives me is taking something that’s incredibly complex, like delivering healthcare and trying to kind of streamline that and trying to kind of make that more accessible to people around the world. So we started Exo to build an ecosystem around medical imaging to really take it to places, to take it everywhere. I mean, as somebody once said, the future is already here, but it’s not evenly distributed.
Saul Marquez:
Yes, okay.
Sandeep Akkaraju:
And we’re trying to make medical imaging evenly distributed. You know, I grew up in India, I spent a lot of, I used to be an avid backpacker; I’ve seen the impact this lack of access can have. I mean, even the US, there’s care deserts everywhere, and I really set out to give people a view into the inside of the human body, okay, to be able to deliver proper diagnosis and proper care. So I think that’s kind of been what drives me. Yeah, I love it, though. I’ll leave it to that.
Saul Marquez:
Now, that’s fantastic. You know, and I think a combination of those two things, Sandeep, it’s dealing with super complex things, finding ways to simplify them, and then changing the value paradigm. That is literally the thing that healthcare needs. So you’re in the right spot, my friend, and we’re glad that a brain such as yours is dedicated to some of the challenges, in particular imaging. So talk to us about Exo, and it’s spelled E X O. It’s Exo with a high in the middle. How are you and the business adding value to the healthcare ecosystem?
Sandeep Akkaraju:
For us, what this is about is about accelerating diagnosis at the point of care. We truly believe that bringing imaging away from kind of the radiology departments and to more ad hoc settings around the world can really improve care. So that’s kind of the thesis that we’ve started off here. And to be able to do that, you can’t simply attack this from a hardware standpoint and say, Hey, we’re going to give you cheaper hardware to solve this problem. Because turns out a lot of caregivers don’t have a good sense of underlying, and again, and what pathology could potentially look like. I mean, I could, you know, the human body is incredibly complex, and just getting a view into the body and not understanding anatomy or pathology can lead to poor outcomes. So we’ve got to kind of attack it from a number of different angles simultaneously, and for us, that means delivering really high-quality imaging that’s cost-effective, and it can fit into your pocket. So, as someone once said, the best camera in the world is the one you have with you. You could have a super-duper camera there, but the number of pictures that get taken on your mobile phone versus your DSLR, right? And so, we really kind of believe in that, Saul. It has to be, and I think, so we’re going to be launching a handheld ultrasound device later this year that’s going to be portable, that’s going to be affordable, that’s going to be easy to use. Okay, we’re making it as simple as taking a picture on your smartphone. But that’s a starting point for us, okay, and we quickly realized that we’ve got to build an entire ecosystem around that. And to me, ultimately, to be able to shift healthcare in a major way, you’ve got to change workflow, okay? So we’re making it easy for physicians to be able to document, review, build, manage quality assurance and ultrasound exams, to be able to do that on your fingertips in seconds as opposed to logging into complex systems to be able to do that. We’re building AI that actually makes it really simple to be able to capture and interpret medical images. So today, being a sonographer takes a lot of skill. How do we kind of, I mean, we’ve built AI that really simplifies the acquisition of images. We feel that’s absolutely important, that’s step number one. I can give you easy-to-use imaging, but as you look into the human body, to be able to get to the right view and pick that out and show it to you is absolutely critical. Otherwise, you get lost with a new tool like this, so we’re really building that AI to make just that image capture super simple to do. We’re building educational tools, and because we believe to pick up a new tool like this, you’ve got to kind of mean, build-in moments of microlearning, I mean those little pieces of learning that kind of mean allow you to get to be better at imaging. There is something complex, these smartphones made everybody photographers, so our challenge out here is how do we kind of make more people sonographers? So we’re starting off with that as a central thesis to what we’re doing here. Because if you look at the imaging companies today, let me give you an example. Today in the United States, there’s about 20,000 cardiac sonographers. So, all of the major companies, years of work on this, they have 20,000 people who know how to use these systems, and you expect 20,000 people to serve 320 million Americans. Something’s seriously screwed up out there, right? I mean, you ask these folks, and they’ll tell you, oh, no, our systems are super user-friendly. It turns out they don’t make friends very easily. It’s a shame, right? I mean, you got to kind of attack it from that standpoint with a thesis of how do we kind of get more people to be doing imaging.
Saul Marquez:
So is the idea, and thank you for that, Sandeep. I appreciate the thesis around how this is going to solve for the problems of not enough people understanding of the anatomy, utilizing health information and devices in order to bridge that gap. So is the idea to enable other providers, aside from people doing imaging, to actually also be able to augment the workforce? Is that what we’re talking about here?
Sandeep Akkaraju:
Absolutely, absolutely. And again, sometimes people are looking for certain answers in certain care settings, and we want to focus on those jobs to be done as opposed to providing general-purpose tools, right? I mean, if you’re coming in, as an example, you’re an EMT, and you want to kind of typically the answer is an EMT may be looking for are very different than what a radiologist may look for, and, because it needs to be actionable in that situation. For instance, an EMT may say, hey, I want to know if this person has a puncture in the lung. Yeah, right? So, you know, you’re looking for a condition called pneumothorax. How about we make it simple rather than kind of providing you a general-purpose tool? How about we provided you software that made it really simple to get to that one answer very quickly? Or you have somebody who is a recovering heart failure patient at home, you know, just being discharged. How about we give you tools that make it simple to see how that person is recovering as opposed to a general-purpose tool that can, quote-unquote, do everything right? So that targeted care becomes really, really important. I hope that I’m making sense out there.
Saul Marquez:
You are! Yeah, yeah, and then it becomes modules, right? Like software modules or options for particular points of care that help expedite the care that’s delivered in different specialties. I love it. I think it’s a really great concept and something needed, and you focus the discussion on workflow, like, you know, the importance of aiding people in the workflow that they’re dealing with. That’s one of the biggest problems in healthcare. So, is that one of the differentiating points of Exo?
Sandeep Akkaraju:
Absolutely. I mean, one of the theses at Exo is that, hey, an 80% solution or a 90% solution that serves 5 to 10% of the population is way better than a general-purpose tool that does 10% of that solution. And to be able to do that, you’ve got to really understand how this fits into the care workflow. And sometimes, you have to look at that across the continuum as well. And so we really bet, in the company, that if you can really move workflow around, there is a lot of arbitrage value to be derived from there in terms of where, how value is getting generated. So, our focus out here is delivering very easy-to-use, compact, simple workflows around imaging as opposed to delivering general-purpose tools that claim to do everything.
Saul Marquez:
Love that. One of the favorite things we say in business, the riches are in the niches, and the more niche down you get, the better differentiation, the more focused, the more nuance, and the higher the value, so I love it. I think it’s a great point, and I appreciate you bringing that one up. And for any entrepreneurs out there, take a note of what Sandeep just said. You know, it’s the opportunity to focus so hard on a particular area that you become so valuable in that particular area. And for the providers and payers listening to this, there’s options with the work that Sandeep and his team are up to at Exo. When does all this become available, or are you guys doing pilots right now? Tell us a little bit more about the go-to-market and where you guys are at there. It’d be interesting to know.
Sandeep Akkaraju:
Yeah, absolutely. I mean, we really were supposed to launch our device last year, to be, in all honesty, and the supply chain issues hit us like a ton of bricks, right?
Saul Marquez:
The whole industry, I mean, the whole world, right? Every industry.
Sandeep Akkaraju:
Exactly, and for a technology-heavy product that depends on silicon from Taiwan, you can imagine how that went, right?
Saul Marquez:
Yeah.
Sandeep Akkaraju:
But we saw that as an opportunity to really kind of push some of the workflow solutions that we were doing. So the IT solutions, we believe were kind of been really important in kind of … hooking up various endpoints within the hospital system. So we actually launched our Exo Works product last year, which is our workflow solution, and that product has actually done incredibly well. I mean, we’re now finishing up major installations. We kind of went through a pilot phase, but we’re doing major installations at IDNs at scale, so we’re working up in multiple departments, multiple specialties across entire systems right now. So that’s kind of been gone incredibly well.
Saul Marquez:
And what’s the, can you give us the skinny on Exo Works? Like, what is it?
Sandeep Akkaraju:
Sure! So, what we focus on today is enabling exams at the point of care. Today, a lot of imaging gets done as a scheduled visit. I mean, you can schedule an imaging, and you go and show up. If you wanted to do imaging on an ad hoc basis, say in an emergency department where, unfortunately, you cannot schedule emergencies, right? And patient just shows up, and hey, you’ve got this incredibly valuable tool in terms of point-of-care ultrasound, and you want to be able to document it, you want to be able to bill it, you want to be able to do that in a compliant manner, and that turns out to be very, very inefficient and time-consuming and cumbersome. So we focused on kind of taking an entire encounter-based workflow and simplifying it and putting it into your smartphones and putting it into ways that work with any ultrasound systems out there. So all of a sudden, we’re enabling departments, whether it’s kind of labor and delivery, whether it’s emergency, whether it’s acute care, to be able to image at the point-of-care to get to the answers at that point-of-care and to be able to review, document, bill, manage the quality of those ultrasound exams. So this is about kind of making it very simple because, ultimately, all of this overhead takes caregivers away from patients, contributes to burnout. So we said, Hey, we’ve got incredible amount of technology on your phones to kind of simplify all of that. And then that’s where we’ve kind of been focused on with Exo Works, and it’s interesting to see people kind of adopt it and use it in their point-of-care ultrasound programs today.
Saul Marquez:
Want to give you a lot of kudos, Sandeep, because it’s what you do with what you get. And you, along with many other entrepreneurs out there, dealt with the challenge of supply chain, especially the chips and other problems, right? But you guys said, all right, there’s a bigger picture here, this gives us time to work on the intelligence and the workflow. And fast forward, now you have that ecosystem where IDNs are signing up for this, and now comes the device. I feel like that order is probably even better. So I think it worked out in your favor thanks for you and the team’s kind of thoughtful approach.
Sandeep Akkaraju:
Think of it as our iTunes before the iPod, right? I mean, one couldn’t have existed without the other.
Saul Marquez:
Amen, that’s a great comparison. Look, super fascinating, and folks, it’s E X O . I N C. We’ll leave links in the show notes for you all to check out some of these really insights-based workflows, management, and what’s to come. When you think about what you’re most excited about today, Sandeep, what would you say that is?
Sandeep Akkaraju:
Really, I think it’s, the new element out here is AI and how quickly it’s maturing. And I think one of the realizations, I mean, when we first started dabbling with AI, like many people kind of looked at it and said, Yeah, this is just data science, or this is just software, right? But AI is truly science, and to be able to do science, you’ve got to have collaborators across the industry. You’ve got to kind of, I mean you can’t be doing AI in an open-loop manner, you’ve got to be able to collaborate with medical practitioners in the field, with caregivers. And once we kind of figured that out, and we’ve kind of made, you know, it’s incredible what our teams are doing here. And as we pilot our AIs out, I’ve had physicians kind of … starting to play with these AIs, kind of … react like little kids getting a new toy.
Saul Marquez:
That’s awesome.
Sandeep Akkaraju:
I mean, to me, that’s kind of like absolutely wonderful to see.
Saul Marquez:
Yeah, yeah.
Sandeep Akkaraju:
Then all of a sudden, you know, and I get calls from physicians saying, Hey, so-and-so sent me this video clip. How are you doing this, right? I want it now. So, I mean, once you kind of, you know, really combine all of these into one roof, I mean, it’s just kind of an absolutely exciting.
Saul Marquez:
That is exciting, to get that type of feedback, and then probably also along with the excitement, the nuances of feedback that help get the product even to the next level. I think it’s super exciting. Look, love the work that you guys are up to. Sandeep, I think when you guys launch the actual handheld, we’d love to get you back on to hear about what’s been happening, but until then, you know, let’s leave the listeners with a key takeaway and the best place they could reach you and the team.
Sandeep Akkaraju:
Sure! One takeaway for me is we think that point-of-care ultrasound is going to be transformational in healthcare. This gives you an ability to look inside the human body and get immediate answers to support faster diagnosis and treatment. You know, when most people think of ultrasound, they think about baby pictures. So this is now about looking at every part of the body, from looking at your lungs to figure out if there’s a lung puncture or if there’s consolidation from pneumonia, looking at your heart and getting ejection fraction and cardiac output and various quantifications of the heart, or, hey, you know, going into an urgent care with a stomach pain and figuring out immediately that it’s probably a kidney stone or a gallstone. These are all going to be kind of life-changing, or those with kids kind of figuring out if it’s a fracture or if it’s a tear or if it’s just kind of a sprain. These are all ways that this technology is going to contribute to better, better care everywhere. And you can learn more about us at visiting Exo.inc or following us on Twitter or Insta.
Sandeep Akkaraju:
Love that. Sandeep, thank you for that. And on that closing note, it is those technologies and teams that allow healthcare to be more integrated that will be successful in the future, and I look at Exo as one of those. So, Sandeep, really appreciate you being with us today and looking forward to staying in touch.
Sandeep Akkaraju:
Hey, look forward as well, Saul, and appreciate having us on your podcast.
Saul Marquez:
It’s a pleasure. Talk to you soon.
Sandeep Akkaraju:
All right. Cheers then.
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