“Don’t be afraid”, With Douglas Brown and Ting Shih

Don’t be afraid: Sometimes I think what I am doing may not be achievable — improving healthcare for over a billion people and trying to stand out as a health technology company amongst so many. But then I recall meeting these women, mothers and daughters in a remote village of Kenya. They built their own huts with […]

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Don’t be afraid: Sometimes I think what I am doing may not be achievable — improving healthcare for over a billion people and trying to stand out as a health technology company amongst so many. But then I recall meeting these women, mothers and daughters in a remote village of Kenya. They built their own huts with their bare hands, mixed with dirt and animal dung. On average they have 8 children and daily, they cook and care for them. They also work full time, usually making handicrafts that they carry and walk miles into town to sell. Any time they do travel out of their hut, to town or even to just get water, they risk their lives from attacks by men or accidents. Their lives are way harder, and they tough through it every day. In comparison, with access to so many more resources, we WILL accomplish our dream, our purpose in life. Don’t be afraid. You CAN do it!

As a part of my series about “Lessons From Inspirational Women Leaders in Tech”, I had the pleasure of interviewing Ting Shih, founder and CEO of ClickMedix, an award-winning healthcare technology enterprise born out of MIT Media Lab to enable health organizations to serve more patients through its telehealth and population health management platform. She spent the last ten years implementing mobile telehealth programs in more than 20 countries across North America, Latin America, Africa, and Asia to extend health services to over 1 million patients, enabling everyone to have access to healthcare, regardless of patients’ income level, race, age, or gender. The programs equipped patients, caregivers, health workers, nurses, and pharmacists with smartphones, tablets, and diagnostics devices to capture patient symptoms information, images, and other related health data to be reviewed by remote doctors and specialists who can provide diagnosis and treatment advice. With care being delivered to large populations worldwide, the system takes on an AI-driven population health management approach to reduce overall costs of care and address health issues pre-emptively where possible by displaying warning signs and preventative actions to care providers and patients. Ting is the 2015 Toyota Mother of Invention. She is also the 2012 Cartier Women’s Initiative Laureate for North America.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to learn a bit more about you. Can you tell us a story about what brought you to this specific career path?

I grew up in Taiwan and my family immigrated to the US when I was ten years old. I didn’t speak much English and struggled in school, except for in Math classes. I often turned in blank test papers because I didn’t understand the questions on the exam. After about three years, I finally caught up in English and worked really hard to graduate as valedictorian of my high school.

Since my best subject was Math, and I enjoyed my first programming classes in high school, I decided to pursue Computer Science at Carnegie Mellon University. After graduating college, I couldn’t decide what I wanted to do for my career and pursued a number of different jobs, from working at Morgan Stanley, NASA, Department of Defense, an online education startup, and to GSK pharmaceutical company. I think my calling came from working at GSK, where their mission was to “help people do more, feel better, live longer”. I thought to myself, that’s what I want to do! But as a project manager on IT continuity planning — which meant working at data centers and simulating disaster scenarios and making sure all IT services can withstand disasters — I was NOT directly helping people do more, feel better, or live longer.

I decided I needed a career switch and applied to MIT’s dual degree master’s program to obtain an MBA and MS in Systems Engineering. During the beginning of graduate school, in an MIT Media Lab course called Development Ventures, our assignment was simply stated as “Create a business that would impact over a billion people.” I thought this was my chance to help people live better by improving their health. And during that time, 2017, just before smartphones emerged, mobile phones have been used all over emerging markets, even before some people have electricity or clean water. I thought we can program mobile phones to enable treatment consultations anywhere.

After initial pilots in sub-Saharan Africa, in Botswana, we were able to successfully screen and treat women with cervical cancer, as well as start care for other cancers, and even HIV, using just a Nokia flip phone. The initial success fueled my passion to continue the mission of improving healthcare for billions with technology. I went on to commercialize the idea, founded my company, ClickMedix, to scale the service offering to really help more people live better and healthier lives.

Can you share the most interesting story that happened to you since you began at your company?

Early in the ClickMedix journey, I was trying to fundraise for the company. Many US-based investors asked the same question “are you working with insurance companies”? At that time, I was working with an internationally based insurance company, but none in the US yet.

I think many of us have similar experiences — trying to raise funding to engage larger clients, but the funding seems to be dependent on having the clients already. Long story short, through various networks and introductions, I engaged my first US-based Medicare insurance client, Brand New Day, based in California and started providing ClickMedix platform for insurance member case management, telehealth, and population health management. It’s a dream collaboration where we work to provide the ideal healthcare delivery — equipping home-visit nurses all the relevant information about the patient, and patients’ doctors with more information beyond just their clinic visits, so they can provide effective care and prevent any potential issues and hospitalizations. With another partner MedisoftRX, we bring together data from over 40 million people around the world to predict disease progressions and be able to intervene even before health conditions worsen (i.e. heart attack or shortness of breath).

It turned out, I did not need the funding to get the customer. What worked was understanding the customer’s pain point, being able to deliver in record time, and continually collaborate on improving healthcare together. And eventually, I did also secure funding and now onto expanding ClickMedix even more with like-minded partners and customers who truly want to provide better care to people with help of technology to scale their impact.

Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

As an early entrepreneur, and exploring the market in sub-Saharan Africa first, I lived on a shoe-string budget and often stayed at hostels. One time, before my meeting with potential clients in South Africa, I took a short daytrip to visit the Safaris, and upon my return, I realized my shoes were stolen. All I had for shoes were the dirt-covered trekking shoes I was wearing. I thought to myself, “let’s hope no one looks down at shoes” — and I was wrong.

When I arrived in South Africa, Johannesburg airport, and met with my client right after I landed (giving me no time to buy shoes) in my business attire and the trekker shoes, my client took notice of my shoes, and I had to explain my mishap — could have probably blamed the wild animals for taking my shoes. Since the incident, I always pack extra set of business attire, including shoes, and allocate enough time between travels just in case. Also I would make sure valuables are locked away and kept off limits from wild animals or pesky humans.

Can you tell us a story about the hard times that you faced when you first started your journey? Did you ever consider giving up? Where did you get the drive to continue even though things were so hard?

During our research and development phase, even before founding ClickMedix, we did a number of pilots in tele-consultation starting with tele-dermatology across 10 countries. But we didn’t have a robust technology team, particularly in supporting ongoing feature requests and bug fixes, and we couldn’t support our client fast enough and eventually lost the client. That was a traumatic first experience.

I had thought about giving up and took a break to reflect upon what could I have done differently. Turns out, I would’ve done everything differently — new team, new technology, and new clients. The concept was still good and still proven — patients can get effective care through telehealth, and I am still stopping at nothing to help at least a billion people.

I then launched my new company, ClickMedix, rebuilt the technology from the ground up, designed it to be easy to change and support, and it also empowers customers to make their own changes without programmers. The new technology is also the new selling point — being able to deploy telehealth programs in less than 5 days.

None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are? Can you share a story about that?

Along the way, there are countless number of people that I am grateful for — my mentors, my team, and my customers — who are the real heroes in innovating and believing in my technology to help them serve more people. And I am most grateful to my mom who has encouraged me throughout my journey, despite my non-traditional career path. She also helped support me financially when my bank account went nearly negative. Most importantly, she never portrayed doubt that I can actually improve the lives of billions of people with just mobile phones, even more than 10 years ago, when that seemed to be impossible.

Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?

“The people who are crazy enough to think they can change the world are the ones who do.” — Steve Jobs

As ClickMedix continues to grow and innovate our offering and approach to improving health of billions of people worldwide, there is nothing that doesn’t sound “crazy” when we first start an idea within ClickMedix. First it was the age before smartphones and thinking we can program Nokia phones to deliver treatment. Now, we deploy all our services on smartphones and tablets and are onto integrating with portable mobile diagnostics devices. Along with partnerships with insurance companies, we are aggregating years of medical history in combination with real-time health data, to predict potential health risks or adverse events (e.g. heart attack, falls, pneumonia, etc.).The nay-sayers have endless list of challenges, such as regulatory constraints, patients won’t use it, no one will pay enough for it, and on and on. But each time, we prove the crazy idea is not so crazy — it’s the new way healthcare should be delivered.

Ok super. Thank you for all that. Let’s now shift to the main focus of our interview. We’d love to learn a bit about your company. What is the pain point that your company is helping to address?

Healthcare is a human right. However, due to constraints in cost (patient cannot afford care) and access (patient cannot get to clinics), in order to serve more patients, health organizations would need to hire more doctors, lower their costs, or build more clinics closer to the patients. None of these would be scalable without the use of technology, which enables doctors to provide care virtually. With the help of diagnostics devices, a virtual visit can be just as effective as a physical visit; the doctor can remotely see vital health information (heart rate, blood pressure, glucose, etc.), the patient’s physical appearance, and their mental condition.

Despite the realization to digitize and provide care virtually, especially during the current pandemic, many health organizations still need to determine how to put all the components together and create a new service offering. ClickMedix’s telehealth and population health management platform enables health organizations to implement digital programs in disease management, treatment, post-hospital/home care from concept to deployment in less than 5 days. It provides comprehensive suite of modules including risk assessments, video/chat, patient app, diagnostics device integration, and machine learning with care plan recommendations.

Use of the platform enables health organizations to serve 10x more patients, while lowering costs and building capacity. It has been used in more than 20 countries, with over 1 million patients, and more than 3,000 health workers trained to screen for health issues, tele-consult with doctors and specialists, and task-shift to health workers for follow-up care.

What do you think makes your company stand out? Can you share a story?

Since the pandemic began early in 2020, treatment adoption has gained significant momentum in the US and worldwide. How we stand out is with our experience having worked all over the world, with all kinds of people, some live in rural areas without consistent Internet access, even in the US, some are seniors who cannot use technology easily, and some don’t speak or understand English. Our technology not only enables telemetreatmentdicine / video calls between doctors and patients, it provides the entire service flow that enables the patient to connect into a treatment call, to take their blood pressure, heart rate, etc. and communicate those important data to their doctors, and enable doctors to get compensated and patients to be able to afford the service (through their insurance or other installeent methods).

At the same time, we enable doctors to see all prior history about the patient and be able to quickly and productively determine the best treatment plan while getting better compensation for their services. During the process, we educate the patient and their caregivers on how to manage their health, as well as risk signs to look for to prevent their health from worsening.

In the US, we work with Brand New Day Medicare insurer, and we equipped their home-visit nurses with a health screening app and mobile devices to screen for health risks as well as connect virtually to their doctors. We also aggregate data for at least the past 5 years and show on-screen information about the patient’s health status to improve care provide and ensure preventative healthcare are followed. Through this system, we have seen that patients have improved health outcomes and the insurer gained significant cost-savings.

Our system is also quick to adapt to new diseases. Since the start of the pandemic, we also work with a mining company with 100,000+ employees and we were able to develop a COVID-19 screening app, with contact tracing and follow-up of COVID-19 cases within 3 days, including training all the healthcare screeners.

Our solution is easy and fast to setup for exactly the needs of health organizations needing to deliver better, faster healthcare services, whether it’s COVID-19 disease management, or other chronic diseases including diabetes, heart disease, and cancer.

Are you working on any exciting new projects now? How do you think that will help people?

One exciting project we are expanding on is equipping seniors with their own easy-to-use treatment kits consisting of smart devices such as a blood pressure monitor, pulse oxygen monitor, etc. and an app so they can easily connect to their doctors with a click of a button or an easy Alexa or Google Home command. The kit will help remind the patient to look out for any risk signs daily, tailored to their health condition and needs (e.g. are you experiencing any pain? Do you feel any trouble breathing? Any other discomfort?). It will empower patients to manage and improve their own health, have easy one-click access to their doctors, while lowering costs of care overall.

Let’s zoom out a bit and talk in more broad terms. Are you currently satisfied with the status quo regarding women in Tech? What specific changes do you think are needed to change the status quo?

I am not satisfied with the status quo regarding women in Tech at all. Only 26% of professional computing occupations in the 2019 US workforce are held by women (according to Department of Labor Bureau of Labor Statistics). If we look at the pipeline of those who would be in a tech role: only 21% of 2019 Computer and Information Sciences bachelor’s degree recipients were women (according to Integrated Postsecondary Education System (IPEDS) at National Center for Education Statistics (NCES)). So, the numbers are not promising for equity in tech roles between males and females.

In order to change the status quo, it is important to help women realize their potential impact they can have through tech. I remember my decision to pursue a degree in computer science was mainly due to my preference for math topics and I enjoyed the programming classes I took. But it actually wasn’t until I founded ClickMedix did I realize the power of understanding technology and being able to build and use it to improve our world. Now with many more tools to help learn technology, learn to program, and so many more opportunities for young girls to build something useful with technology (e.g. robots that help with cleaning or cameras that can recognize movements). I think the earlier we can tie the use of technology to impact it can have on people, the stronger the interest women may develop in technology and become involved in tech.

In your opinion, what are the biggest challenges faced by women in Tech that aren’t typically faced by their male counterparts? What would you suggest to address this?

Women in Tech usually have to try harder to highlight their credibility in developing and/or using technology, whereas with male counterparts, the credibility can seem to be assumed. There are countless number of times where I would be at meetings with my male colleagues, product managers and engineers, and clients would automatically point the tech questions towards one of them — even though I am the one answering their questions.

I believe it’s an unconscious bias, which is difficult to change. What has worked is to have a male colleague also support and direct tech questions to me, to help steer the credibility. Another method to overcome this is to establish credibility up front and talk to the tech content. And lastly, don’t worry too much about what other people think and focus on building the customer relationship, and winning the sales.

What would you advise to another tech leader who initially went through years of successive growth, but has now reached a standstill. From your experience do you have any general advice about how to boost growth or sales and “restart their engines”?

Sometimes in tech, initial successive growth may be from early adopters who are curious and interested enough to pay for your products/services. However, if it reaches a standstill, it’s best to examine what worked well in the past, and what might be reasons for stifled growth. It’s also important to examine externally for any market changes, particularly any competing or substitute solutions that you may learn from and pivot into new offerings. Equally important is to examine inwardly as to what part of the business was most exciting and fueled you and your team’s energy — and are you doing enough of that?

Do you have any advice about how companies can create very high performing sales teams?

I would separate sales teams by products/services that are B2B or B2C. For B2B sales, what I found to be successful is to first determine who and how are the highest performing sales conducted and systematize the sales process. Then to encourage all sales team members to follow the sales process, set up metrics to show results and sales performance. At the same time, also encourage new ideas for improving sales and include those tips or learning into the improved process. Also important is to build sales morale and passion for the product. At ClickMedix, everyone is committed to improving the health of people worldwide, and to that end, we all help identify potential opportunities and then activate the sales process to engage customers.

For B2C sales, for our product suite of treatment kits, we found channel partners being very effective in introducing the products to consumers. Channel partners can be engaged by sales teams in similar ways but are incentivized by revenue shares or other financial agreements. Evaluating channel partnerships are also very important — to anticipate potential scaling needed and ensure the consumer experience is streamlined from learning about the product to purchasing, and to using the products continually.

In your specific industry what methods have you found to be most effective in order to find and attract the right customers? Can you share any stories or examples?

In healthcare, credibility is key, and what has been most effective in attracting the right customers is referrals from existing customers, respected publications, or other organizations that publicizes your work. Starting out in global healthcare, my company was selected to join Innovations in Healthcare (IIH), a program hosted by Duke University and founded in 2011 by Duke Health, McKinsey & Company, and the World Economic Forum.

The program aims to improve healthcare worldwide by supporting the scale and impact of promising innovations. The program brings together both large corporations and foundations that are committed to increasing the scale of healthcare innovations and help facilitate collaborations, and publications around innovative models.Through IIH, I met one of my first large customers, Medtronic, and provided the teleconsultation platform for tele-ear infection program named “Shruti” in India. From that point on, more publications and referrals led to additional customers.

We’ve been involved in similar efforts within other networks. One of them is Springboard Enterprises, which is focused on women entrepreneurs. The network helps train women founders to scale their business, introduce them to potential customers, partners, and investors. One more that has been transformative for my business is GSBI — Miller Center for Social Entrepreneurship, hosted by Santa Clara University in California. It’s a one-year mentorship program with 2-week onsite intensive bootcamp that helped transform my business altogether. Mentors are all experienced and successful entrepreneurs themselves and many of them based in Silicon Valley and well networked in the venture world.

Based on your experience, can you share 3 or 4 strategies to give your customers the best possible user experience and customer service?

Work with customers to co-create the user experience: Healthcare is not all the same. My customers are healthcare service providers, and each delivers unique end-patient experiences. We work with each of our customers as innovators and help them enhance the patient journey through technology in order to deliver the best care possible. If you work collaboratively with the customer, and co-create a service model with them, you can create lasting impact together.

Anticipate customers’ needs: “Change” is the only constant in building a business. The more you can anticipate your customer’s needs and how they might change, the more you can prepare for the change and turn it into ongoing sales and customer engagement.

Give every customer your 100%: technologies always need support due to feature updates, or code fixes, especially when the technology is instrumental to health service delivery. Always be responsive, listen to your customers’ issues and resolve them with clear communications and expectations throughout. Staff your team around your customers’ needs so they always get a timely response and resolution to their issues. And to supplement support needs, we built our own chatbots to address frequently asked issues, and to collect information to speedup troubleshooting, while providing timely updates throughout.

As you likely know, this HBR article demonstrates that studies have shown that retaining customers can be far more lucrative than finding new ones. Do you use any specific initiatives to limit customer attrition or customer churn? Can you share some of your advice from your experience about how to limit customer churn?

It may take months to years to engage a healthcare organization as a client, and therefore keeping them is going to be much easier than engaging a new client. We use a few methods to retain our customers:

Bring them continual benefits: we perform ongoing metrics and analysis of healthcare data and showcase them to our clients, particularly any new insights they may have missed. We also run machine learning algorithms on data to look for patterns and predictions to share with our customers.

Bring them potential partners or new revenues: we continually engage partners, whether they are specialists in various diseases areas or new diagnostics devices and try to build new partnerships and services that can be delivered on our technology platform. For example, we brought a tele-wound care consultant group to our Medicare insurance client and now they can provide better wound care services to end-patients.

Check-in and provide updates to your customers: particularly customers that might be consider other alternatives, they would likely fall silent or become less responsive. Continue to check-in with them and explore how you can continue to help improve their service.

Here is the main question of our discussion. Based on your experience and success, what are the five most important things one should know in order to create a very successful tech company? Please share a story or an example for each.

  1. Vision without action is a daydream. Action without vision is a nightmare. It is a Japanese proverb that reminds me of the balance needed to achieve my vision of improving healthcare for over a billion people through technology. As we bury ourselves in work, it’s important to come up for air and check if our actions are still helping us achieve the vision. Or are we just spinning our wheels doing busy work or running around in circles and not getting to our milestones towards the vision? This may mean re-evaluating your business strategy, are you targeting the right customers, the right markets? Do you have the right product that will more customers will pay for, in multiples over time? During my 10+ year building ClickMedix, I can recount many of those years spinning around applying for funding, grants, and business plan competitions, while trying to grow the business. While those tasks are necessary, it’s important to not be caught up in it and shift towards building towards your vision.
  2. Find a key metric you care about and try to double it every month. One of my good friends, Komal Ahmad, CEO of Copia, shared one of the best learnings she got from Y-Combinator — that was to pick a measure, and try to double it every month. That tip was transformational for me — I knew exactly what metric to pick — the number of lives we are improving. And I can do that by continually engaging current and new clients, and help empower their teams of health workers, nurses and doctors to serve more patients, at least 10 times more at that. That tip also came as a relief — that it doesn’t have to be revenue since B2B sales tend to have longer sales cycles. After focusing on doubling patients served monthly rather than stressing out about revenue numbers, I was able to pinpoint customer segments and how to appeal to their needs and help increase their reach and impact, while reducing their costs. And by doing so, revenues also increased, and my business actually scaled faster than it did before when I was just focused on revenues.
  3. Follow your cash flow: when I first started ClickMedix, most of the projects were paid through grants from medical research institutions interested in using our technology as part of their research budget to better collect data and test tele-consultations in rural areas. However, by watching my cashflow carefully, I realized many of those funding is capped or limited time and not likely to continue ongoing. But it was also those those early projects that helped establish the credibility of the system and the teleconsultation method as clinically effective ways of providing remote diagnosis and treatment recommendations.
  4. One step at a time: in the midst of scaling and working with a growing customer base, I started writing a long list of features and sharing them with my team. I may not have realized it myself then, but I was feeling overwhelmed. Then one of my lead developers said, “Sounds good, we will get them done one by one.” Those were the most comforting words. I remind myself every day that one step at a time, we will get things done.
  5. Don’t be afraid: Sometimes I think what I am doing may not be achievable — improving healthcare for over a billion people and trying to stand out as a health technology company amongst so many. But then I recall meeting these women, mothers and daughters in a remote village of Kenya. They built their own huts with their bare hands, mixed with dirt and animal dung. On average they have 8 children and daily, they cook and care for them. They also work full time, usually making handicrafts that they carry and walk miles into town to sell. Any time they do travel out of their hut, to town or even to just get water, they risk their lives from attacks by men or accidents. Their lives are way harder, and they tough through it every day. In comparison, with access to so many more resources, we WILL accomplish our dream, our purpose in life. Don’t be afraid. You CAN do it!

Wonderful. We are nearly done. Here are the final “meaty” questions of our discussion. You are a person of enormous influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. 🙂

My favorite part about ClickMedix is inspiring other people to build solutions to solve our world’s problems, and I am especially passionate about empowering females to do just that. I have met many men and women along my journey and have found most females tend to be naturally empathetic and understanding of the problems but may not realize they can also act on building solutions to address those pain points.

If I could inspire a movement, it would be “Women Who Build”.

The movement would help women maximize their strengths and abilities, make best use of available resources, and ultimately build solutions and build networks of other women who are empowered to the same.

Together, we have the potential to solve all the problems in the world! And of course, bring along the men too. #womenwhobuild

We are very blessed that very prominent leaders read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch with, and why? He or she might just see this if we tag them 🙂

I would love to explore how best to improve the lives of billions of people with Bill Gates. Has he always wanted to help people and Microsoft was a means towards it, or because of his journey at Microsoft, he now works on solving the worlds’ most difficult challenges through Bill & Melinda Gates Foundation?

Thank you so much for this. This was very inspirational, and we wish you only continued success!

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