Afsaneh Naimollah, Executive In Residence – Healthcare at Plug & Play Tech Center

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Saul Marquez:
Welcome back to the Outcomes Rocket. Saul Marquez is here, and today I have the privilege of hosting Afsaneh Naimollah. She’s an accomplished health care executive, an investment banker. She is currently an executive in residence at Plug and Play, the world’s largest early-stage VC fund and corporate accelerator. She’s also the managing partner of Xen Partners, an investment banking firm based in Palo Alto and New York covering the next generation of health tech companies. We’re going to be diving into innovation and healthcare investments, venture capital. And I’m so privileged to have Afsaneh here with us. Afsaneh, thanks so much for joining us.

Afsaneh Naimollah:
Pleasure.

Saul Marquez:
So Afsaneh. You do some fascinating work in health care and we’ll dive into that on the venture front. But before we do, we’d love to hear more about what inspires your work and health care.

Afsaneh Naimollah:
You know, I’ve been an investment banker and a strategy advisor for over 30 years, and I started my career in technology. So I come to health care with a fairly deep knowledge of what I call horizontal technologies on about 20 years ago. Honestly, I fell into health care just doing couple of deals. And then once I got to know the dynamics of the industry, it was, you know, now looking back and I got heavily involved and really started focusing on the industry and really for three, three main reasons. One is, you know, it is the largest industry in our economy. It’s 18 percent of our economy.

Afsaneh Naimollah:
It’s the only industry that directly impacts every human being in our country. And probably most importantly, it’s an industry that, despite its size, is social impact. It is probably still to this day way behind. For example, fintech and some other technology. So it’s an industry that really needed in my opinion, innovation. And it was really two technologies that we can bend the cost curve. So I said, well, I have some good tech background. I love the industry. And it was almost like a calling. I said that’s how I’m going to get involved with this health technology and make sure that I focus on sectors of the industry that could bend the cost curve.

Saul Marquez:
I love it. I love it. Yes. You sort of just accidentally threw a couple of deals, got involved, then strategically you said. This is a good fit and the impact is big. So, yeah, let’s roll up our sleeves.

Afsaneh Naimollah:
Yes, exactly.

Saul Marquez:
I love it. And so and so now, you know, you’re your role as managing partner of Xen Partners, an executive in residence at Plug and Play. You’re seeing a lot of mainstage work happening. And so companies coming up with new ideas and businesses succeeding, businesses failing. You know, what would you say you guys are up to? And really, I guess, where should we focus? You know, should we focus on fly and play or Zen partners or more?

Afsaneh Naimollah:
I can touch base on both, really. They are somewhat intangible. So, you know, as an investment bank banker. I’ve done about 150 mergers and acquisitions transactions. I raised over to a billion dollars of capital to IPOs, private placement, debt offering, equity offering. You know, when you do so many deals. You know, I’ve met so many thousands of CEOs and thousands of companies over my 30 some year career. You develop what I call an experiential intuition. You know, a pattern recognition. So what the reason when I moved to Silicon Valley three years ago from New York, Plug and play invited me to become an EIR.. And I was like, OK, I don’t have a lot of early-stage experience, but I know a lot about healthcare and I know a lot about next-generation technologies. And the opportunity afforded me listening to pitches like 20, 30 pitches a month of different companies addressing different parts of health care. And then, you know, it’s been three and a half years now. And what EIRs do at plug and play we do really two things. One is we help the five different venture funds that we have pick investments and more importantly, we take some of those mid stage. For me, it’s mostly early to mid stage companies. We’ve taken under our wings as EIRs. We work with the founding teams on everything from product strategy, go to market strategy, channel strategy and help them really articulate their value proposition, because especially the first time founders, they are sitting on a great technology.

Afsaneh Naimollah:
But I would say a good eighty percent of them do not know how to articulate the value proposition. And when, you know, as investment bankers, we have done a ton of pitches. Right. We our job is to package companies and tell the story to investors. And so we help them articulate their value proposition and really sharpen their skills in like… OK. Now that I can articulate my value proposition. Where is the best? Which markets are the best fit for market for my company? So, you know, having been an investment banker is helping me quite a bit with being in the EIR and really helping to great early stage new stage companies go to the next level, if you will.

Saul Marquez:
No, no, that’s that’s fascinating. And so, you know, it’s interesting that you feel a lot of these companies that are really like, you know, knee deep, neck deep in their technologies, They struggle with the story. Why? Why do you think that is?

Afsaneh Naimollah:
I think it’s just a matter of you know, it just takes a source on the founder to be both in the, you know, see the panoramic view as well as being in the weeds and really being able to see the ground level story, as well as stepping back and saying, OK, in the grand scheme of things, where does the rest of my company fit? And where should I sell? Where should I just give up and forget about it? Because of competition, et cetera, et cetera. So I think a lot of it is just being first time founders or being really married them in love with their technology but not knowing, you know, how to package them. You know, raising money, selling a company. It’s all about how you tell the story.

Saul Marquez:
Now, that’s great. I appreciate that. And you were about to mention something else and then just had a question, I guess,

Afsaneh Naimollah:
As a banker. I think, you know, investment banking, especially on the West Coast. I have to say, you know, I worked in Europe and I worked in on the East Coast, but investment bankers are not we’re not well understood on the West Coast because West Coast, you know, you have to be an engineer to really matter. And, you know, the job of investment banker, I think is a really important job. For one, helping the founders articulate their story, putting a good presentation together to be able to raise money.

Afsaneh Naimollah:
And if you’re selling your company, who is the best company for you to go? We shouldn’t go to to sell. Who really needs this technology and just give you an idea. You know, I was working with a great example of what embodies what I’m about to say. So there was a company that was in the, you know, medical display for minimally invasive surgery. And, you know, they came to us. They have had worked really, really hard. It was an amazing company, 90 percent market share. And the company said, oh, yeah, you know, we just hired an investment banker on this. Investment banker thinks that we should be sold for X because that’s comparable companies in the display industry are sold for Exxon. I said, wait a minute, you’re not a display company.

Afsaneh Naimollah:
Your product manifests as a display company, but you’re really an embedded software. It is your embedded software that allows you to do what you do with minimally invasive surgery. And I think you should be sold for y because those are not the comparable companies we should look at in better software companies. And long behold, he said, OK, I’m going to, you know, let go of my current bank or your higher none. We sold the company at 70 percent more than what he was told. He could sell it because we when we didn’t go to display company to sell it, we were doing better software company to. And this is one of many, many examples of the value of an investment banker can bring to the table.

Saul Marquez:
Yeah, that’s fascinating. It’s that ability to see across sectors, but also just, you know, across different companies, not necessarily what it seemed. You said it manifested as such, but, you know, they are actually something else. And so how would you say maybe that’s one example. Do you have any others?Where? Where?

Afsaneh Naimollah:
Oh, yeah, I have many. I have actually one very current example. OK. So, you know, a remote patient monitoring is now especially in the virtual care post covered big. Yeah. Unfortunately, remote patient monitoring companies are a dime a dozen. Everybody is getting into a more efficient monitoring. And, you know, most of the companies are getting into remote patient monitoring, have their own hardware. You know, they bring this blood pressure and wireless scales on oximeter to be able to let the doctors know how their patients are doing remotely. But most of them have proprietary devices on proprietary software. So I met this amazing what we call R.P.M. Demonstration Monitoring Company last year.

Afsaneh Naimollah:
And, you know, the founder presently at the time was selling the service to rural areas that didn’t know people who didn’t have Wi-Fi and patients who didn’t have a smartphone because a lot of this tech R.P.M. companies, you need to have an R.P.M. You need to have a smartphone. You have to like take a picture of the numbers on a group of monitoring device or blood pressure devices, sensors. This is like this. The patient has to do a lot of the work. And this company, the founder, builds a system that automatically first of all, it shoots harder. The founders build a system that is hardware agnostic. So any hardware can connect to the system to API.

Saul Marquez:
That’s big.

Afsaneh Naimollah:
And they build a system that automatically without patient, doesn’t have to do anything, just measure automatically this data is sent to the cloud of this company. And the doctor within three seconds can look at the results. And, you know, they were in the market trying to see, you know, seek advisors, try to see who they should work with to raise money. And yeah, there were some pushback, like, oh, you’re like another R.P.M. company. And then I got involved. And then, you know, the more we dug in, we realized this is our RPM as a service company. What they have build is a fire in a cloud. It is the most incredible, powerful cloud that any device you could just plug it in through API, which takes less than two weeks for any not only device. So, you know, they were selling it to doctors for their patients.

Afsaneh Naimollah:
The doctors post COVID said, well, you know, I really would like to do a virtual visit on on the same platform with my patients. And so the virtual visit that build it in two weeks. And because it’s a fire enabled platform. And so the doctor doesn’t have to get out of the system to go into a virtual visit dashboard and then come back. Everything is up. Then doctor said, well, what I want we’d like to have my billing done on this. They built a billing. And I have not seen anything like this. And so I said, you know, after weeks of working, this is really exciting because, you know, all of a sudden I said, you know what? You’re not an R.P.M. company. You’re R.P.M. as service. Yeah. And you are a mass customization. Anything you know, providers can pick and choose. Device companies can come to you and get connected to it. So that’s another great example of digging deep. This company didn’t know what a treasure they had built, if you will. So that’s how. That’s another great example of crystallizing the value proposition and articulating what the company was all about.

Saul Marquez:
Yeah, and it’s and it’s oftentimes just, I guess, lack as you don’t know what you don’t know. Right. And when you see so many of these and you’re familiar with different models, then you could really begin to appreciate what it is that you’ve built. Or maybe you don’t even realize that that’s what you’ve built. And you need the right framework.

Afsaneh Naimollah:
Yes. Yes. Yes. Exactly. Exactly. And that’s really, you know, banking, investment banking. And, you know, to some extent also venture capital and private equity. You know, we see so many deals. We see so many failures and successes that, as I said, I loved the phrase experiential intuition. You develop this intuition through the pattern recognition. Then you say, OK, you know, this company, in my opinion, in my humble opinion, is going to fail. Forget it. Or this company is amazing. And they know what they’re doing. So they really don’t need me. But, oh, this company. He’s amazing, but they don’t really know what they have built. Let me help them articulate what they have done.

Saul Marquez:
So what’s this R.P.M. as a service company called?

Afsaneh Naimollah:
It’s called Lucid Act. L U C I D A C T. Lucidact.com,

Saul Marquez:
I’m sure you know, you know that was a total hook.

Afsaneh Naimollah:
Yeah. I mean, it was amazing. I’m you know, it’s a great female founder and, you know, it’s cool and pleasure to work with with a woman founder and a first-time founder.

Saul Marquez:
I love it. I love it. Lucid Act, one of many. And yeah, you know, it’s knowing what it is, how to frame it. What would you say other than the story right and articulation of the value, which is huge when you and you think about product market fit. What’s one of the biggest mistakes that that founders make? And it could be at any stage of the process where they’d be raising money or selling or IPO-ing, you know, what’s the best the biggest mistake that you see made?

Afsaneh Naimollah:
Let me tell you what I think a successful founder embodies and then I’ll tell you the opposite, right. I think a successful founder should embody two important characteristics, humility and confidence. So being humble and confident is a very potent, in my opinion, secrets to success. But it is not easily doable. So I have seen founders that saying that their product is the best. But nobody else is better than them. And they are not listening. You know, there are all these other competitors you cannot say are the best or you’re certain that, you know, just be a little bit more humble and acknowledge that, OK, there are competitors. But the market is big enough that hopefully if I execute right, I can succeed. So there are I think there are founders are way overconfident. And then the other side, those that are founders that are way too humble and they don’t project confidence.

And, you know, you cannot raise money or sell your company if you’re not projecting the right confidence. So is this the ability to mesh humility, empathy? You know, humility itself is an umbrella for a lot of other things, the humility, the umbrella or humbleness or empathy. So to be able to mesh that humility with grounded confidence is really what I think every founder should aspire for.

Saul Marquez:
I think those are two too great ones. And really, I guess it’s the opposite. Being don’t too humble. Don’t be too confident.

Afsaneh Naimollah:
Yeah, exactly.

Good. You got to have a good mix of both. And so, you know, there’s tons of stories of you know, deals gone wrong or opportunities that have opened up because of critical investor. And any thoughts there as as as listeners think about, you know, pitfalls in the investing process.

Afsaneh Naimollah:
Mean founders that are trying to raise money and raise money for you. Right. I think a couple of words of advice I have is investors don’t like to invest in a person. So make sure you have a founding team. That’s number one. Nobody would like to invest in one person. Yeah. Very few companies have been able to pull it off, like Travis said, over a few others. But, you know, even Microsoft, Google, you know, all of these guys have founders right. More than one person. So make sure you have a two or three group of people that bring a variety of backgrounds together to be able to execute on the plan. So that’s the first thing that I. So if you are a single guy and you think, oh, I see the technology and therefore I’m going to be everything, I’m gonna be CEO, President, CFO, chief fund raiser, chief sales officer, it’s not going to go. So make sure you recruit co-founders. I think the other thing is having, you know, have an open mind to bring my here early in the process. Again, people who especially first on founders, people who have been there, done that again, pattern recognition. You know, they’ve gone through the offering and they have been tried. They have had successes. They have had failures.

Afsaneh Naimollah:
So, you know, surround yourself with two or three co-founders and two or three early-stage when your early advisors that really understand your industry, because, you know, I start a lot of time founders say, oh, you know what? I only want advisors. I can open doors, I can sell my products. Well, that’s good. That’s honorable. But that’s not always, that shouldn’t always be the requirement. Go with people that really understand your technology and may be able to open some doors for you. So that’s the second thing. And the third, I would say is, again, remember, we were talking about being humble and confident. There is in a business model, there’s also two kind of a contrary phenomena. You have to as a founder, you have to have two vows in front of you. One vows is, you know, being steadfast to do what you think your company should do. And then the other vows is what I call the pivot vows. Right. And to be able to pivot when you think it’s best to pivot. And I have many examples. So it’s like, yes, I kind of know what my mission is. But then. I know what my technology can offer. But let me also pivot, have flexibility, too pivot. And I know, you know, there is this amazing company called Live, which is robotic process automation for revenue cycle management. We are in healthcare. Right. And I think they have raised like 50, 60, 80 million dollars, but they have pivoted so many times. Another one, Thiab an oncology, real-world data company. They have pivoted ten times a day. They never really took their eyes off of the excellence of their underlying technology is the business model. So as a founder, they have those two valves in mind, a – steadfast in your mission and b – a pivot valve around that. You have to fine tune your operating model.

Saul Marquez:
I think that’s great. And really, the pivoting has to do with product market fit. Right. just getting fine tuning, fine tuning in to you or even changing right to civilian channels.

Afsaneh Naimollah:
You may decide that indirect channels are better than direct channels. You may decide just the opposite. These indirect channel partners are not doing any good. I got to go direct to the customer. I know. I know. Cost of customer acquisition is more expensive. But that’s probably the best way. So you’re absolutely right. It’s the business model.

Saul Marquez:
Yeah. That’s really great. That’s really great Afsaneh. It’s super, super interesting.

Saul Marquez:
And, you know, as much as you think about how things are changing, right. Everybody’s saying pre COVID post COVID. I’m a firm believer in that. We do have a new way of doing things and it will continue to change toward digital. And so what would you say you’re most excited about today?

Afsaneh Naimollah:
Couple of things. And I kind of put them in two different buckets. One, I’m sort of in a scientific bucket and one I put it in IT bucket. So the IT bucket is clearly everything and anything that is remote should be remote. So I think some of we will have obviously the use of virtual carries up one of our 6000 percent or something. But some of it is, you know, it’s not going to stay that way. But I think the world has changed forever. And one of the reasons it has changed forever. Thank God for CMS. Thank God CMS has been so helpful. And so a last-second flexible in reimbursing things they didn’t used to reimburse virtually they For the first time now they are reimbursing remote patient monitoring. They never used to do that. The fact that you don’t have to be licensed in a state that you receive, you know, do a virtual call. I mean, there may be you know, there may be a prospect there in the long run. So anything and everything that is remote. So what does that mean for remote hospital at home? I think that’s a real possibility and it will be fueled by these different them on my patient monitoring devices. You know, people are talking about remote ICU. You know, there are some experiments that are being done there. So on the ICU side, I would say anything that is remote. Thank God for CMS that is fueling that industry because people want to get paid for it. If CMC wasn’t named versing, we won’t be here So CMS was reimbursing. Payers are reimbursing.

Afsaneh Naimollah:
On the IT side.The other thing that I’m really excited about is ambience voice. So we’re early stages of this. This is basically the ambience voice listening to the conversation between the doctor and the patient and, you know, populating the EMR automatically. And then it will be some, you know, editing that has to be done better than, you know, nowadays.

Saul Marquez:
From scratch.

Afsaneh Naimollah:
When we had in-person visits, my doctor never really looked at me. He or she would be looking at the EMR, talking to me so that that I am very excited about that. You know, and I think we are edging towards better and better intra operability. So, you know, we are seeing some good technologies there that are helping a physician that needs to pull data from three different EMR on the patient. You know, there are companies that can normalize the data and harmonize the data and render it to the physician in one language, if you are one terminology. So there is really exciting stuff there happening on the scientific side. In the scientific bucket. I am really super excited about these A.I. engines for drug discovery. So these are agents that have ingested thousands and thousands and thousands of peer-reviewed literature, you know, formulas. And so to be able to for the scientists to look at these A.I. engines and, you know, they’re not going to discover drugs, but they’re going to expedite drug discovery. I mean, some of these A.I. engines, for example, have been able to repurpose existing drugs or orphan drugs that, you know, have been written off. And all of a sudden these drugs are coming back for other purposes. So that’s really, really exciting to me. So this A.I. engine for drug and drug discovery, which is really a marriage between IT and Science. And then the other thing that is really exciting to me is we are just the beginning of gene editing with all its pitfalls of ethics and everything that any new technology of this magnitude would entail. You know, a company just got funded. Gene editing is mostly for healing, difficult orphan diseases.

Afsaneh Naimollah:
But, you know, this company just got funded about 80 million or something. I don’t remember their name, but there are now doing gene editing for diabetes.

Saul Marquez:
Right. Right.

Afsaneh Naimollah:
Oh, my God. How cool is that? Those are some of the areas that truly just make me really excited. And this is why I got into health. It’s like you never stop learning because innovation never stops.

Saul Marquez:
Yeah, especially. Especially as it relates to health. And, you know, our body extending our life span, our health span is never dull. Appreciate you sharing that. Those insights of Sonny. And, you know, as we wind down the interview. Quick one for you. Do you have a book you’d recommend to us?

Afsaneh Naimollah:
You know, I don’t read books. I read about 20 newsletters a day to you.

Saul Marquez:
Oh do you?

Afsaneh Naimollah:
yeah, I. I really, you know, on a personal note, is the book that sits by my bed 24/7 all the time is the power of Now The Power Now, which is by Eckhart Tolle, which is so it’s more of a spiritual book. As a person, you know, I really believe I feel like I’m a Buddhist. More than anything else. So I really feel my participation in health care more of a spiritual journey. But, you know, I. Sorry, I don’t really have a, quote unquote health care book that I can come and only.

Saul Marquez:
It doesn’t have to be healthcare.

Afsaneh Naimollah:
I also should say that I, I do write monthly newsletter. If anybody wants to subscribe to it, I’m happy they can send me there. So this month my newsletter has ten thousand readers. It’s a one-page editorial that I write every month about what’s on my mind. And then the rest of it is all the important transactions that have done have been done for the month. And when I think of them, it’s a really good.

Saul Marquez:
Where can we find that, Afsane?

Afsaneh Naimollah:
Just e-mail me at afsaneh A F S A N E H then partners X E N then Partners dot com. I will make sure our administrator puts it puts you on the list distribution list.

Saul Marquez:
Love it. Well, please,

Afsaneh Naimollah:
It’s really next generation. It’s all of our next-generation health care and what’s around the corner. You know, I started talking about a lot of things that are now at the forefront two, three, four years ago, the only reading that I may recommend.

Saul Marquez:
Hey listen. That’s good. The power of now. And your newsletter.

Afsaneh Naimollah:
My newsletter is called H.I.T. Greatest Hits.

Saul Marquez:
I love it. I love it. HIT Greatest Hits, Power of Now and listeners send an email to Afsane. And it’s A F S A N E H. And is it Zen Health?

Afsaneh Naimollah:
X E N partners.

Saul Marquez:
X E N partners.com.

Saul Marquez:
Ok, X E N partners dot com. And, well, we’ll leave a link to Afsaneh’s email at the show notes so that you could email her if you want that email or that letter that she produces. I certainly will be signing up Afsaneh. Thank you for the invitation there. And what closing thought would you leave us with. This has been a lot of fun. I’ve enjoyed it. What should we be thinking about as we wrap this up with you?

Afsaneh Naimollah:
I know you have a very varied audience, so this may or may not resonate with everybody listening. You know, keep innovating. There is a lot of money. There is a lot of money out there. And make sure whatever you’re working on or innovating a story can be built around it, whether it’s your you know, a lot of people go on star companies because they have had such horrendous experience in the health care industry themselves. You know, Oscar, the insurance company, the and insurance companies started that way. For example, a lot of rebounded R.P.M. companies started that. So, you know, I think it’s like the curve because our industry is in such deep need of innovation, the curve of innovation. It hasn’t been done in this industry. You know, there’s only so much you can innovate, extracting oil from the ground. Right. But the curve of innovation in health care hasn’t bend. So there is a lot of money for a good idea. So if you have them, keep innovating. That’s my concluding thought.

Saul Marquez:
I love it Afsaneh. Very succinct and encouraging for all of us innovating in health care. Please continue innovating. There’s tons of cash out there for you. You just got to have the right story. The Right. founders. Yeah. And don’t be afraid to pivot.

Afsaneh Naimollah:
And be humble and confident and at the same time.

Afsaneh Naimollah:
There we go. There you go. That takes us home.

Saul Marquez:
Exactly. I love that. Afsaneh. Thank you so much. This has been a ton of fun.

Afsaneh Naimollah:
My pleasure. Thank you for giving me the opportunity. I really enjoyed it.Thank you, Saul.

Saul Marquez:
-Absolutely.

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