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Sandeep Akkaraju: “There are no substitutions for hard work”

Our technology has the opportunity to directly impact how millions of people are diagnosed and treated for medical issues, bringing equality, access and innovation to a medical system that could do so much more for millions of people around the world. Our lower-cost, higher-performance technology plans to intervene in this challenging space, not only making ultrasound […]

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Our technology has the opportunity to directly impact how millions of people are diagnosed and treated for medical issues, bringing equality, access and innovation to a medical system that could do so much more for millions of people around the world.

Our lower-cost, higher-performance technology plans to intervene in this challenging space, not only making ultrasound more accessible to markets that cannot afford traditional ultrasound machines that range from 40,000 dollars to 200,000 dollars, but also by providing a product that can service every body, every time, with a single device at the price of a modern laptop. This directly impacts physicians and their ability to improve patient care, as they will feel confident in their ability to image a patient — regardless of size or abnormalities — prior to entering the room.


As a part of my series about “Big Ideas That Might Change The World In The Next Few Years”, I had the pleasure of interviewing Sandeep Akkaraju.

Exo (pronounced “Echo”) Co-Founder and CEO Sandeep Akkaraju is a proven entrepreneur with a background in leading interdisciplinary technology and business teams. He has a diverse track record of bringing to market complex hardware and software products. Exo is his fourth startup.

Prior to founding Exo, Sandeep was Founder and President of Jyve Inc. (acquired by a major semiconductor corporation at an exit valuation of more than 60M dollars). Previously, he was CEO of IntelliSense, a leading provider of micro-mechanical integrated circuits (MEMS) and nanotechnology-based software and solutions. Under his guidance, IntelliSense expanded its physical presence into China and India and its sales presence into 30+ countries. Sandeep helped the company rapidly grow from a startup to its eventual acquisition at a valuation of 750 million dollars. In 2003, he led the re-acquisition of IntelliSense from Corning.

Sandeep holds a B.Tech from the Indian Institute of Technology, an M.S. from LSU and an M.B.A. from INSEAD, France.

When he’s not working, Sandeep enjoys spending time at the beach in Cape Cod with his family. When he first moved the U.S., he wanted to be a musician, but quickly realized his talents lied elsewhere.


Thank you so much for doing this with us! Before we dig in, our readers would like to get to know you a bit. Can you please tell us a story about what brought you to this specific career path?

My interest in the intersection of medicine and technology began at a very early age. My grandfather was a doctor and my grandmother was a nurse, and they established a hospital in Hyderabad, India in an effort to rebuild the Indian health system in the post-colonial era. They really opened my eyes to the underserved. My father was a space engineer and an entrepreneur who showed me the way technology can transform society. My own passion as a child was music. I dreamed of becoming a musician, exploring the creativity of making something unique and powerful. My career path has really been a culmination of all of these influences.

After pursuing an education in technology and business, I helped bootstrap a DARPA-funded garage startup into a MEMS technology company. However, my vision for Exo began on a year-long backpacking trip through Africa. When I returned to the U.S. I was determined to build a company that would impact the lives of people around the world in indelible ways.

Can you please share with us the most interesting story that happened to you since you began your career?

When I began my career, everyone was carrying around a digital camera, a flip phone, a calculator, etc. and over time we witnessed the digital convergence of these items into a single device, with the companies who invented some of them now non-existent. It has been interesting to watch technology disruption happen in real-time and at warp-speed in Silicon Valley, but it is not evenly distributed throughout the world. I realized this while backpacking in West Africa and thought about how technology could truly transform the health and wellbeing of people around the world.

Which principles or philosophies have guided your life? Your career?

For the greater good: I am inspired by the bold and those who break the mold like Mahatma Gandhi, Martin Luther King Jr, John Lennon and John Stuart Mill. Taking risks and standing up for the greater good are a big part of my philosophy.

Accessibility: This principle ties into my belief that it’s our responsibility to make imaging technology to accessible and affordable to every hospital around the globe. What I love about ultrasound is that it, when properly operated, it is safe to use and an extremely powerful tool. Through education and implementation of AI, we see our devices in the pocket of every health care practitioner.

Education at all times: I am the first to admit that I am constantly learning. When I started Exo, I was not aware of all the modern challenges medical care providers face in the U.S. By bringing on the best leaders in the ultrasound industry and listening to their insights, I’ve learned so much and it has influenced every aspect of our products.

Simplicity: I have been inspired by Dieter Ram’s principle that truly elegant design is the least amount of design possible. Design should be beautiful, but it should also be extremely elegant and functional. I am passionate about Swiss minimalist design, and I believe this principle applies to all areas of life. I always ask my team, “Is there a simpler way to solve a complex problem?” We applied this process to the design of Exo’s software product as well as the handheld ultrasound device. The user should not need an instruction manual to operate either one, it should be second nature and intuitive.

Ok thank you for that. Let’s now move to the main focus of our interview. Can you tell us about your “Big Idea That Might Change The World”?

Medical imaging has lagged far behind the needs of today’s physicians and their patients. Affordability, lack of access, low image quality and the inability to image denser body compositions is holding more widespread adoption of handheld imaging back. Exo’s goal is to remove those barriers. Our team is building a handheld ultrasound device that has been developed, and is being refined and tested for use in the most demanding and urgent medical settings in the world. We believe it is stethoscope of the future. In twenty years from now, physicians won’t be trying to listen to your heart or lungs to determine if something is wrong with a patient, they’ll be able to look inside the body.

Our technology has the opportunity to directly impact how millions of people are diagnosed and treated for medical issues, bringing equality, access and innovation to a medical system that could do so much more for millions of people around the world.

How do you think this will change the world?

Much of the world doesn’t have access to any form of medical imaging. Even for those who do, patients are often challenged by multiple access issues in the healthcare setting. This holds true for ultrasound as well, where higher costs and limited imaging depth penetration associated with conventional ultrasound technologies are a real barrier for patients in rural areas. Certain body types, such as those with denser body compositions, also present unique imaging challenges, as it can be difficult for ultrasound signals to penetrate body fat in order to image organs underneath.

Our lower-cost, higher-performance technology plans to intervenes in this challenging space, not only making ultrasound more accessible to markets that cannot afford traditional ultrasound machines that range from 40,000 dollars to 200,000 dollars, but also by providing a product that can service every body, every time, with a single device at the price of a modern laptop.

This directly impacts physicians and their ability to improve patient care, as they will feel confident in their ability to image a patient — regardless of size or abnormalities — prior to entering the room.

Keeping “Black Mirror” and the “Law of Unintended Consequences” in mind, can you see any potential drawbacks about this idea that people should think more deeply about?

Exo is creating technology that has the potential to revolutionize the healthcare industry, and with that technology comes information, power and a great responsibility. It is a responsibility that we take very seriously. Being socially responsible and ethical with information collection and management is built into the fabric of our company.

Was there a “tipping point” that led you to this idea? Can you tell us that story?

I spent a year traveling through Saharan and sub-Saharan Africa and it was a world away from the often-insular technology hubs like Silicon Valley. The contrast could not have been starker. While Silicon Valley started with ambitions to change the world, it began to feel like it was descending into incremental and less ambitious goals — like selling consumer data for the digital advertising boom. Meanwhile, these villagers had little access to the basics of everyday life — things like clean water and simple medical care.

When I returned and re-immersed myself in the technology world, I had a different perspective. I was determined to build a company that would impact the lives of people around the world in indelible ways.

I felt that the drive to create foundational tools for mankind that Silicon Valley was missing. There was a gradual incrementalism creeping in, which opened my eyes to the fact that the Valley was no longer solving real issues for the population at large.

What bugged me on my travels truly crystallized in my mind. While Silicon Valley was pumping billions of dollars into apps, the monetization of users through advertising and small improvements to mobile devices, there were still large, transformational problems to be solved.

Through it all, one quote, originally attributed to author William Ford Gibson, kept sticking in my mind. “The future is here, it is just not evenly distributed.”

Exo is the culmination of my childhood influences and the product of these life of experiences — seeing the larger world and thinking about ways that technology can transform the health and wellbeing of people around the globe.

What do you need to lead this idea to widespread adoption?

In order for Exo’s technology to become widely used across the globe, it’s critical for our products to be simple and easily accessible. We know this won’t happen overnight, but we plan to stair-step our way to widespread adoption. We have a lot of amazing partners that are helping us get there like Bold Capital and Rising Tide Fund, who took the first risk in the company when it was just a garage startup. We also have some amazing corporate venture partners like Applied Ventures, Action Potential Venture Capital — a GlaxoSmithKline venture fund, Intel Capital, and TDK Ventures.

What are your “5 Things I Wish Someone Told Me Before I Started” and why. (Please share a story or example for each.)

  1. Pursue huge ideas that can change the world. As Steve Jobs once said, “Those who are crazy enough to think they can change the world are ones who do.” Life is short and you have a limited number of hours on this planet, so I feel it’s important to make everyday count. And one way to do that is by taking big risks, which is the purpose of startups. I caught the startup bug early in life, so spent a lot of time around others in the industry. What really struck me is that it’s true what Bill Gates has once said, “Most people overestimate what they can do in one year and underestimate what they can do in ten years.” I’ve learned that if you set your sights on the horizon, you can do amazing things by continuing to take small steps forward.
  2. There are no substitutions for hard work. You must put in the hours to build your chops. And I have found that the harder I work, the luckier I get! Some of the best musicians and artists out there put in an incredible amount of work to produce something innovative, like the technical American composer Philip Glass, whom I admire. Ultimately, at Exo, our goal is to push the state of the art forward. It takes a significant amount of hard work, but it puts you in a position to push the envelope.
  3. Choose your team wisely. Startups are a difficult journey, and having a great team makes it easier. One of the incredible things I’ve learned about Exo actually happened serendipitously, which is that each co-founder has brought different perspectives and skillsets. Team building is really about being complementary and putting checks and balances in place — the ability to check the worst tendencies of other people. It’s a lot harder to hire people who are unlike you, because we gravitate toward like-minded people, but it is very important.
  4. Invest in personal outlets and hobbies to keep your creative juices flowing. Right now, I’m trying to get into bebop guitar. Part of learning this is really understanding the history and then there’s the fact that it’s basically a different language. How do you take music that was intended for a saxophone and convert it to a guitar? For me, it’s about connecting dots in a very different way and getting lost in the learning. Some of my best ideas come when I’m in that meditative state of mind. And if an idea strikes, I use my phone to record voice memos.
  5. Everyone has a unique voice; find yours and inspire others to join in the chorus. In general, this is the ideology behind startups. If you have an idea or think you want to start a business, and truly believe in your vision, don’t give up. Keep pushing until you find others that believe in you and your vision. They often say companies never fail because they run out of money, but rather because the founders gave up.

Can you share with our readers what you think are the most important “success habits” or “success mindsets”?

– Wake up early and hold creative calls at the beginning of the week.

– Set aside time to edit and provide thoughtful feedback (turn off alerts, ignore email and Slack and focus on the task at hand).

– Hire people whom you trust and delegate tasks to them with that trust in mind.

– Constantly read, listen, watch videos and engage with learning what you don’t already know.

Some very well known VCs read this column. If you had 60 seconds to make a pitch to a VC, what would you say? He or she might just see this if we tag them 🙂

Simple. We are re-imaging the stethoscope for the 21st century. Rather than hearing what’s happening in the body, how about just seeing what’s under the skin?75% of the world’s population doesn’t have access to medical imaging, and for many, cost is the main barrier. Exo intends to change that. We have developed a proprietary, mass-producible, ultrasound imaging device that costs about the same as a PC, works with your mobile device, fits in the palm of your hand, and delivers high-quality imaging on par with traditional ultrasound systems that are many times more expensive. Exo’s transducer technology was designed to be scalable in size and quantity, allowing for use in a multitude of form factors and applications. To ensure these systems can integrate into the hospital seamlessly, we’re building AI and workflow tools so people can not only get the data they need to make clinical decisions, but also safeguard that data so it is secure throughout the hospital’s IT environment.

Exo was built from the ground up by people with storied careers in startups and global conglomerates, with experience in mobile technology, software and service knowledge, a deep expertise of ultrasound and others with decades of semiconductor development under their belt. Exo’s paradigm-shifting vision is to bring the same convergence of consumer technologies to healthcare with devices that will forever alter how physicians use technology to diagnose, triage and treat patients forever.

How can our readers follow you on social media?

Instagram: https://www.instagram.com/theexoeffect/

Facebook: https://www.facebook.com/exoeffect

Twitter: https://twitter.com/theexoeffect

LinkedIn: https://www.linkedin.com/company/exo-imaging.com/about/

Spotify (Podcast): https://open.spotify.com/show/2vGxOyz1NSkuOyw5lW4iPi

Thank you so much for joining us. This was very inspirational.

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