https://simplecast.com Ops I did it again by Out of Pocket A limited series podcast by Out-of-Pocket, hosted by Alex Dou. Each episode is a post-mortem on a product or feature that didn't work the way it was supposed to. The goal: an encyclopedia of known failures so the next generation of builders can skip the mistakes we've already made and fail at something new. 2026 Out-of-Pocket Health, LLC en Fri, 15 May 2026 16:47:05 +0000 Tue, 19 May 2026 01:23:55 +0000 https://ops-i-did-it-again.simplecast.com Ops I did it again by Out of Pocket https://image.simplecastcdn.com/images/60e2b59f-ca09-4dc7-8d7c-c565a7f46186/58fb86a7-9a6f-49d8-89bc-e7587de1e493/3000x3000/ops_season_image.jpg?aid=rss_feed https://ops-i-did-it-again.simplecast.com episodic A limited series podcast by Out-of-Pocket, hosted by Alex Dou. Each episode is a post-mortem on a product or feature that didn't work the way it was supposed to. The goal: an encyclopedia of known failures so the next generation of builders can skip the mistakes we've already made and fail at something new. Alex Dou false https://feeds.simplecast.com/LlqXEJ6l operations, startup, digital health, healthcare, healthcare operations Alex Dou alex@outofpocket.health b313cf8d-37d2-4b60-88e8-07686d660689 Provider Directory: I will destroy your roadmap with Misha Nasrollahzadeh + Grant Veldhuis Grant Veldhuis (software engineer at Thatch, former Ribbon Health) and Misha Nasrollahzadeh (co-founder and CEO of Joyce Health, formerly Castlight Health and Ribbon Health) have both spent significant stretches of their careers trying to solve this. They walk through what they've learned, where they've hit walls, and what they'd do differently.

What we cover

- A working definition of Provider Directory: provider identity, location, specialty, phone number, and network status. Everything else: subspecialty inference, cost data, scheduling, is a layer on top. Don’t get it twisted

- Then you layer things on top of that working definition: NPPES (National Plan and Provider Enumeration System) gives you specialty. Claims data lets you infer subspecialty. CPT codes have to be translated into human language before care navigation is actually possible. Scheduling (Zocdoc's territory) is hideously complex and you don’t want that smoke

- Ways to constrain the problem (and *maybe* justify building in-house): Castlight maintained separate employer-by-employer directories built from claims data. Grant built a localized directory for the University of Michigan's 60,000-person campus. Both found success through scope restriction. Nationwide coverage is usually the enemy of accuracy.

- Be suspicious: Someone is going to tell you their data is 99% accurate. Maybe a vendor. Maybe an internal team lead. You need to dig into what that number actually means. One payer's head of provider directory once defended that figure but his definition was *whether or not the fields were populated*. Not whether the phone number actually worked or whether the address was still a functioning practice (The address turned out to be a car wash)

- Sharing is NOT caring: why CAQH (Council for Affordable Quality Healthcare) exists but payers don't have a great incentive to improve the underlying data, even when it benefits everyone.

- Oblique, non-obvious signals for keeping data fresh: referral coordinators at a value-based primary care group were the best signal Ribbon ever found, because they were calling offices every day and had direct incentive to log corrections. Published research papers are another: "they just published with this institution, so they must still be affiliated."

- Network effects and why they're hard: small care navigation companies can be required to contribute edits in exchange for data access. National payers paying orders of magnitude more cannot be asked the same thing.

- Build vs. buy, the age-old question: default to buying unless your use case is genuinely outside what vendors have mapped. ACA (Affordable Care Act) individual market plans are one example where standard data quality may not hold. University of Michigan campus resources are another.

Brought to you by

Basata AI - Basata builds AI agents for specialty practices. They answer phones 24/7, schedule appointments, process referrals and faxes, and take repetitive work off healthcare teams so they can focus on patients.

For inquiries about sponsoring the podcast, email sales@outofpocket.health

]]> Fri, 15 May 2026 16:47:05 +0000 alex@outofpocket.health (Misha Nasrollahzadeh, Grant Veldhuis, Alex Dou) https://ops-i-did-it-again.simplecast.com/episodes/provider-directory-G_tWUUnh Grant Veldhuis (software engineer at Thatch, former Ribbon Health) and Misha Nasrollahzadeh (co-founder and CEO of Joyce Health, formerly Castlight Health and Ribbon Health) have both spent significant stretches of their careers trying to solve this. They walk through what they've learned, where they've hit walls, and what they'd do differently.

What we cover

- A working definition of Provider Directory: provider identity, location, specialty, phone number, and network status. Everything else: subspecialty inference, cost data, scheduling, is a layer on top. Don’t get it twisted

- Then you layer things on top of that working definition: NPPES (National Plan and Provider Enumeration System) gives you specialty. Claims data lets you infer subspecialty. CPT codes have to be translated into human language before care navigation is actually possible. Scheduling (Zocdoc's territory) is hideously complex and you don’t want that smoke

- Ways to constrain the problem (and *maybe* justify building in-house): Castlight maintained separate employer-by-employer directories built from claims data. Grant built a localized directory for the University of Michigan's 60,000-person campus. Both found success through scope restriction. Nationwide coverage is usually the enemy of accuracy.

- Be suspicious: Someone is going to tell you their data is 99% accurate. Maybe a vendor. Maybe an internal team lead. You need to dig into what that number actually means. One payer's head of provider directory once defended that figure but his definition was *whether or not the fields were populated*. Not whether the phone number actually worked or whether the address was still a functioning practice (The address turned out to be a car wash)

- Sharing is NOT caring: why CAQH (Council for Affordable Quality Healthcare) exists but payers don't have a great incentive to improve the underlying data, even when it benefits everyone.

- Oblique, non-obvious signals for keeping data fresh: referral coordinators at a value-based primary care group were the best signal Ribbon ever found, because they were calling offices every day and had direct incentive to log corrections. Published research papers are another: "they just published with this institution, so they must still be affiliated."

- Network effects and why they're hard: small care navigation companies can be required to contribute edits in exchange for data access. National payers paying orders of magnitude more cannot be asked the same thing.

- Build vs. buy, the age-old question: default to buying unless your use case is genuinely outside what vendors have mapped. ACA (Affordable Care Act) individual market plans are one example where standard data quality may not hold. University of Michigan campus resources are another.

Brought to you by

Basata AI - Basata builds AI agents for specialty practices. They answer phones 24/7, schedule appointments, process referrals and faxes, and take repetitive work off healthcare teams so they can focus on patients.

For inquiries about sponsoring the podcast, email sales@outofpocket.health

]]> Provider Directory: I will destroy your roadmap with Misha Nasrollahzadeh + Grant Veldhuis Misha Nasrollahzadeh, Grant Veldhuis, Alex Dou 01:09:25 Strap in, young product manager or engineer (or vibe coder!). You have been tasked with the provider directory project. You have scoped it with your engineers, and you think you can get this done in a quarter. And so dutifully you make it your OKR. I'm here to tell you that this is going to be your next year. Certainly not your next quarter. And you should probably listen to this episode so that you know all the things that we have learned the hard way and can sidestep it. Provider directory is a bunch of data and feature and product raccoons all in a trench coat. What makes building one so hard is that you get trapped trying to build each raccoon. The way out is to be clear-eyed about all the different components that get lumped under the provider directory umbrella, be specific and choosy about which ones you actually need to serve your members, and be ruthless about not building any of the others. Strap in, young product manager or engineer (or vibe coder!). You have been tasked with the provider directory project. You have scoped it with your engineers, and you think you can get this done in a quarter. And so dutifully you make it your OKR. I'm here to tell you that this is going to be your next year. Certainly not your next quarter. And you should probably listen to this episode so that you know all the things that we have learned the hard way and can sidestep it. Provider directory is a bunch of data and feature and product raccoons all in a trench coat. What makes building one so hard is that you get trapped trying to build each raccoon. The way out is to be clear-eyed about all the different components that get lumped under the provider directory umbrella, be specific and choosy about which ones you actually need to serve your members, and be ruthless about not building any of the others. cost data, care management, nppes, provider directory, scheduling false full 5 2 b9139e31-14f2-40db-a534-6f975c9660e2 Predicting the Future (risk stratification) with Shay Sayed What we cover

Risk stratification is ranking patients by probability of an adverse outcome. Traditional indices like the Charlson Comorbidity Index use clinician-designed scoring systems; ML-based approaches automate feature generation and let the model surface correlations that a heuristic would miss. The tradeoff is interpretability: with tens of thousands of computations per prediction, explaining a ranking to a clinician of why it ranked Patient A ahead of Patient B is ... surprisingly hard to do. It's kind of like asking a human being "why did you do this thing X weeks ago"... memory fades, and us humans have this "delightful" post-hoc rationalization feature

Actually getting the data in a good shape is harder than training the model. Schema differences between organizations are structural: different table names, different column types, different ways of representing the same event. ML tolerates directional imperfection in a way that population analytics does not, but the cleanup is still slow and dependent on tribal knowledge that data owners often can't fully explain.

"Feature engineering" in this context means building hypotheses the model can test. An example we discussed was “if I’m trying to risk stratify kidney stones, what hypotheses might I try? Maybe soda intake. Maybe dehydration. Maybe SDOH." Those three things are all “features” in this context. The platform ClosedLoop built could generate complex clinical features in about ten minutes, which was most of the competitive advantage.

Failure modes tend to be around operations, not accuracy of the algorithm. Buyers without a clear care management strategy can't actually impact patients on the list. ROI attribution takes years, by the which case people might revert to the mean. And without tracking what the clinical program is actually doing, you can't separate a model problem from a workflow problem

ETHOS is Epic's transformer trained on serialized clinical event histories from 300 million patients. The way I think about this is if LLMs “predict the next word most likely to occur”, then ostensibly you could get a training set of healthcare events and “predict the next {event} most likely to occur” where {event} is NICU stay

Brought to you by

Toboggan Labs: A consultancy for healthcare builders. If you have a health product that needs engineers, product people, or experienced operators to help you build or fix something, go talk to them at https://bit.ly/oop-readmission

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Find Shay

  • https://www.linkedin.com/in/shaayaan-sayed-8097b1100/

Timestamps

[02:07] Shay's background: training models from scratch at Closed Loop

[04:22] How Shay got into ML in high school by cold-emailing every professor in Houston. By contrast, Alex really got into Dynasty Warriors in high school

[10:43] The CMS (Centers for Medicare & Medicaid Services) AI Health Outcomes Challenge. ClosedLoop won $1 million against some big names: Mayo Clinic, Geisinger, and Mathematica. The two components: predictive performance across 13 to 15 adverse outcomes, and interpretability for clinical teams

[16:00] A layperson’s definition of risk stratification: a ranked patient list by probability of an adverse outcome. The Charlson Comorbidity Index as a standard example, and why ML outperforms it once you need more than one outcome.

[29:27] The data layer you need. Claims, EHR (Electronic Health Record) dumps, SDOH (Social Determinants of Health) feeds, ADT (Admission, Discharge, Transfer) data. This is hard because everybody has different schema: payer one's data looks nothing like payer two's, and the data “owner” often can't explain their own tables.

[41:50] Feature engineering: building hypotheses the model can test. The difference between "feature" as a PM uses the word and "feature" as a data scientist uses it.

[47:52] Interpretability: being able to tell a human being why a patient ranked where they did. Two structural issues: incomplete data and unknown causal frameworks

[54:14] Failure modes: Buyers without a care management strategy. Reversion to the mean within two years and you don’t know whether you made a difference. Not knowing where to cut the list (Patient number 50 vs 51?). And a related issue: missing data on what the clinical program is actually doing, which makes it impossible to separate a bad model from a bad workflow

[01:09:39] Whether anyone should still learn traditional ML, or just LLMs. Shay's answer: gradient boosted trees and transformers are on a spectrum so it’s kind of a false dichotomy. Then: the ETHOS paper from Epic, a transformer trained on 300 million patient records that enables one model for many outcomes and counterfactual inference. And what Shay is watching next: robotics and the last-mile problem. AI can identify a list of people with fall risk but something or someone still has to act on it

]]> Wed, 29 Apr 2026 16:00:00 +0000 alex@outofpocket.health (Shay Sayed, Alex Dou) https://ops-i-did-it-again.simplecast.com/episodes/predicting-the-future-risk-stratification-with-shay-sayed-o3pHbD7h What we cover

Risk stratification is ranking patients by probability of an adverse outcome. Traditional indices like the Charlson Comorbidity Index use clinician-designed scoring systems; ML-based approaches automate feature generation and let the model surface correlations that a heuristic would miss. The tradeoff is interpretability: with tens of thousands of computations per prediction, explaining a ranking to a clinician of why it ranked Patient A ahead of Patient B is ... surprisingly hard to do. It's kind of like asking a human being "why did you do this thing X weeks ago"... memory fades, and us humans have this "delightful" post-hoc rationalization feature

Actually getting the data in a good shape is harder than training the model. Schema differences between organizations are structural: different table names, different column types, different ways of representing the same event. ML tolerates directional imperfection in a way that population analytics does not, but the cleanup is still slow and dependent on tribal knowledge that data owners often can't fully explain.

"Feature engineering" in this context means building hypotheses the model can test. An example we discussed was “if I’m trying to risk stratify kidney stones, what hypotheses might I try? Maybe soda intake. Maybe dehydration. Maybe SDOH." Those three things are all “features” in this context. The platform ClosedLoop built could generate complex clinical features in about ten minutes, which was most of the competitive advantage.

Failure modes tend to be around operations, not accuracy of the algorithm. Buyers without a clear care management strategy can't actually impact patients on the list. ROI attribution takes years, by the which case people might revert to the mean. And without tracking what the clinical program is actually doing, you can't separate a model problem from a workflow problem

ETHOS is Epic's transformer trained on serialized clinical event histories from 300 million patients. The way I think about this is if LLMs “predict the next word most likely to occur”, then ostensibly you could get a training set of healthcare events and “predict the next {event} most likely to occur” where {event} is NICU stay

Brought to you by

Toboggan Labs: A consultancy for healthcare builders. If you have a health product that needs engineers, product people, or experienced operators to help you build or fix something, go talk to them at https://bit.ly/oop-readmission

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Find Shay

  • https://www.linkedin.com/in/shaayaan-sayed-8097b1100/

Timestamps

[02:07] Shay's background: training models from scratch at Closed Loop

[04:22] How Shay got into ML in high school by cold-emailing every professor in Houston. By contrast, Alex really got into Dynasty Warriors in high school

[10:43] The CMS (Centers for Medicare & Medicaid Services) AI Health Outcomes Challenge. ClosedLoop won $1 million against some big names: Mayo Clinic, Geisinger, and Mathematica. The two components: predictive performance across 13 to 15 adverse outcomes, and interpretability for clinical teams

[16:00] A layperson’s definition of risk stratification: a ranked patient list by probability of an adverse outcome. The Charlson Comorbidity Index as a standard example, and why ML outperforms it once you need more than one outcome.

[29:27] The data layer you need. Claims, EHR (Electronic Health Record) dumps, SDOH (Social Determinants of Health) feeds, ADT (Admission, Discharge, Transfer) data. This is hard because everybody has different schema: payer one's data looks nothing like payer two's, and the data “owner” often can't explain their own tables.

[41:50] Feature engineering: building hypotheses the model can test. The difference between "feature" as a PM uses the word and "feature" as a data scientist uses it.

[47:52] Interpretability: being able to tell a human being why a patient ranked where they did. Two structural issues: incomplete data and unknown causal frameworks

[54:14] Failure modes: Buyers without a care management strategy. Reversion to the mean within two years and you don’t know whether you made a difference. Not knowing where to cut the list (Patient number 50 vs 51?). And a related issue: missing data on what the clinical program is actually doing, which makes it impossible to separate a bad model from a bad workflow

[01:09:39] Whether anyone should still learn traditional ML, or just LLMs. Shay's answer: gradient boosted trees and transformers are on a spectrum so it’s kind of a false dichotomy. Then: the ETHOS paper from Epic, a transformer trained on 300 million patient records that enables one model for many outcomes and counterfactual inference. And what Shay is watching next: robotics and the last-mile problem. AI can identify a list of people with fall risk but something or someone still has to act on it

]]> Predicting the Future (risk stratification) with Shay Sayed Shay Sayed, Alex Dou 01:28:17 Shay has been working in healthcare AI since high school, when a cold-email to a Houston lab professor accidentally landed him in an ML research group in 2016. He went on to ClosedLoop, a seed-stage healthcare ML platform out of Austin, where he spent years training models from scratch on claims and EHR (Electronic Health Record) data, embedding them into clinical workflows, and training nurses to use the outputs. More recently, he works in AI governance: advising health systems on which tools to deploy, how to evaluate vendors, and what due diligence on healthcare AI actually looks like. This episode covers risk stratification end to end: what it is, how it gets built, where it tends to fall apart, and what transformer-based clinical event models might mean for the whole field. Shay has been working in healthcare AI since high school, when a cold-email to a Houston lab professor accidentally landed him in an ML research group in 2016. He went on to ClosedLoop, a seed-stage healthcare ML platform out of Austin, where he spent years training models from scratch on claims and EHR (Electronic Health Record) data, embedding them into clinical workflows, and training nurses to use the outputs. More recently, he works in AI governance: advising health systems on which tools to deploy, how to evaluate vendors, and what due diligence on healthcare AI actually looks like. This episode covers risk stratification end to end: what it is, how it gets built, where it tends to fall apart, and what transformer-based clinical event models might mean for the whole field. charlson comorbidity index, risk stratification, dynasty warriors, ml, ethos, gradient boosted trees false full 4 2 4fe95508-3264-4227-a66c-9b1278bf6c1c $400 CAC, $100 MSRP: why it’s so hard to build hardware, with Erynn Petersen What we cover

Your hardware margin is grocery-store thin. Founders coming from software expect 80% margins. Hardware is more like 5%. Grocery stores run at 3%. Getting to even nominally profitable meant Emme flipping its model entirely: give the case as a loss leader, sell the app. CAC went from ~$400 to ~$25

Civil engineers take an oath, why not software engineers? Civil engineers are personally liable if a bridge falls. In healthcare/healthtech, we often make ethical choices without even realizing it. There are actually a lot of duties that we have to our patients, our local community, our world, that aren’t always obvious. Selling data is a tantalizing revenue driver to boost your razor-thin margins: how do you tie yourself to the mast to avoid that call? How are we thinking about LLMs and the non-zero resources that each prompt takes? 

Ooo: more pink taxes. Women's health is a restricted category on most major ad platforms. Reproductive health is doubly so. Shadow bans are common, policies change without notice, and the cost of reaching your customer is structurally higher. It is unfair, yes, but if you are building in this space, you should know it exists

If you get software investors for your hardware company, you're gonna have a bad time. Look for experienced hardware investors. They understand the margin profile and the multi-year payback curve. They're also one of the better early validators for whether an idea is worth building at all. Taking checks from people expecting software returns, then managing that conversation at year three, is an all-too-common failure mode

Firmware versioning was a decade-long problem. Now it isn't. Managing versions across device serial numbers, OS versions, and phone generations used to require a support matrix that could kill a small team. AI has quietly made this tractable: feed your codebase and version history to your AI engine of choice, and it maps the dependencies

Brought to you by

Toboggan Labs A consultancy for healthcare builders. If you have a health product that needs engineers, product people, or experienced operators to help you build or fix something, go talk to them at https://bit.ly/oop-readmission

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Find Erynn

Timestamps

  • 0:00 – Intro
  • 1:20 – Pleasantries (Friday the 13th, alligator moons, and a rectangular February)
  • 6:04 – Resilience and ethics in healthtech: the biggest system failures come from within, civil engineers take an oath, and Emme's answer to the data-selling temptation
  • 15:08 – The economics of healthcare hardware: 5% margins if you're lucky, the path through payers is getting harder, and why consumer-grade industrial design is creeping into med tech
  • 18:20 – Why Rhode Island is an underrated place to build: defense, healthcare, research, and a manufacturing base small enough to navigate quickly. Also: return to office (said it)
  • 25:05 – The hard economics and margins of hardware: 5% if you're lucky, before marketing. Grocery stores run at 3%.
  • 29:04 – Ad: Toboggan Labs – if you're selling a physical health product DTC and a third of your kits never come back completed, go find them at tobogganlabs.com
  • 31:34 – Advertising in women's reproductive health is hard on hard mode: shadow bans, shifting platform policies, and the SEO-to-GEO transition hitting just as Emme had figured out content strategy. Find hardware-aligned investors before you take a check from someone who expects software returns.
  • 39:34 – Ad: Data Camp – June 25-26 in Boston. Tactical sessions, hands-on practitioners, great swag, and a secret plan for a data wreck room involving a paper-mache EDI file
  • 41:39 – Firmware versioning: a decade-long nightmare, why AI has made it tractable, and whether it’s worth draining a lake in South America faster to answer which states had the most sex during the Super Bowl
]]> Wed, 15 Apr 2026 16:00:00 +0000 alex@outofpocket.health (Alex Dou, Erynn Petersen) https://ops-i-did-it-again.simplecast.com/episodes/400-cac-100-msrp-t1BBaAUO What we cover

Your hardware margin is grocery-store thin. Founders coming from software expect 80% margins. Hardware is more like 5%. Grocery stores run at 3%. Getting to even nominally profitable meant Emme flipping its model entirely: give the case as a loss leader, sell the app. CAC went from ~$400 to ~$25

Civil engineers take an oath, why not software engineers? Civil engineers are personally liable if a bridge falls. In healthcare/healthtech, we often make ethical choices without even realizing it. There are actually a lot of duties that we have to our patients, our local community, our world, that aren’t always obvious. Selling data is a tantalizing revenue driver to boost your razor-thin margins: how do you tie yourself to the mast to avoid that call? How are we thinking about LLMs and the non-zero resources that each prompt takes? 

Ooo: more pink taxes. Women's health is a restricted category on most major ad platforms. Reproductive health is doubly so. Shadow bans are common, policies change without notice, and the cost of reaching your customer is structurally higher. It is unfair, yes, but if you are building in this space, you should know it exists

If you get software investors for your hardware company, you're gonna have a bad time. Look for experienced hardware investors. They understand the margin profile and the multi-year payback curve. They're also one of the better early validators for whether an idea is worth building at all. Taking checks from people expecting software returns, then managing that conversation at year three, is an all-too-common failure mode

Firmware versioning was a decade-long problem. Now it isn't. Managing versions across device serial numbers, OS versions, and phone generations used to require a support matrix that could kill a small team. AI has quietly made this tractable: feed your codebase and version history to your AI engine of choice, and it maps the dependencies

Brought to you by

Toboggan Labs A consultancy for healthcare builders. If you have a health product that needs engineers, product people, or experienced operators to help you build or fix something, go talk to them at https://bit.ly/oop-readmission

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Find Erynn

Timestamps

  • 0:00 – Intro
  • 1:20 – Pleasantries (Friday the 13th, alligator moons, and a rectangular February)
  • 6:04 – Resilience and ethics in healthtech: the biggest system failures come from within, civil engineers take an oath, and Emme's answer to the data-selling temptation
  • 15:08 – The economics of healthcare hardware: 5% margins if you're lucky, the path through payers is getting harder, and why consumer-grade industrial design is creeping into med tech
  • 18:20 – Why Rhode Island is an underrated place to build: defense, healthcare, research, and a manufacturing base small enough to navigate quickly. Also: return to office (said it)
  • 25:05 – The hard economics and margins of hardware: 5% if you're lucky, before marketing. Grocery stores run at 3%.
  • 29:04 – Ad: Toboggan Labs – if you're selling a physical health product DTC and a third of your kits never come back completed, go find them at tobogganlabs.com
  • 31:34 – Advertising in women's reproductive health is hard on hard mode: shadow bans, shifting platform policies, and the SEO-to-GEO transition hitting just as Emme had figured out content strategy. Find hardware-aligned investors before you take a check from someone who expects software returns.
  • 39:34 – Ad: Data Camp – June 25-26 in Boston. Tactical sessions, hands-on practitioners, great swag, and a secret plan for a data wreck room involving a paper-mache EDI file
  • 41:39 – Firmware versioning: a decade-long nightmare, why AI has made it tractable, and whether it’s worth draining a lake in South America faster to answer which states had the most sex during the Super Bowl
]]> $400 CAC, $100 MSRP: why it’s so hard to build hardware, with Erynn Petersen Alex Dou, Erynn Petersen 01:03:54 Emme started as (and still is!) a smart pill case. Beautiful, award-winning, Apple-level-designed, beloved. It was so well-designed that nobody needed to buy a second one and they’ve only had 5 returns in 3 years The CAC (Customer Acquisition Cost) was $400 and the case retailed for $100. I think you can see where I’m going with this Erynn Peterson, CEO of Emme, walks through what it took to flip those economics and what every hardware founder learns too late: your margin isn't 80%. It's 5%, if you're lucky, and that's before you've spent a dollar on marketing. Also you should know that it’s really expensive and fraught to market in women’s health, much less women’s reproductive health The conversation covers the full stack of hardware reality: minimum order quantities before any supplier will take your call, ad channels that shadow ban women's reproductive health products, the shift from SEO to GEO that reshuffled the deck just as Emme had figured out content strategy, and the firmware versioning nightmare that AI has (only recently) made tractable. Emme started as (and still is!) a smart pill case. Beautiful, award-winning, Apple-level-designed, beloved. It was so well-designed that nobody needed to buy a second one and they’ve only had 5 returns in 3 years The CAC (Customer Acquisition Cost) was $400 and the case retailed for $100. I think you can see where I’m going with this Erynn Peterson, CEO of Emme, walks through what it took to flip those economics and what every hardware founder learns too late: your margin isn't 80%. It's 5%, if you're lucky, and that's before you've spent a dollar on marketing. Also you should know that it’s really expensive and fraught to market in women’s health, much less women’s reproductive health The conversation covers the full stack of hardware reality: minimum order quantities before any supplier will take your call, ad channels that shadow ban women's reproductive health products, the shift from SEO to GEO that reshuffled the deck just as Emme had figured out content strategy, and the firmware versioning nightmare that AI has (only recently) made tractable. cogs, cac, bom, hardware, ltv false full 3 2 751aabaf-0019-4b1e-bd52-2107bc584881 Ignore brokers at your own risk. Antagonize them at your ruin. Build a health plan with Nick Soman What we cover

Start with brokers, not against them. The typical "tech disruption" approach frames brokers as rent-seeking middlemen. 

Nick's counterargument: 

  • Brokers fill a trust role that no website can replicate
  • They touch roughly 70% of small-to-mid-size business health plan sales
  • They will pick up the phone (how many millennials and Gen Zers can say that? Certainly not I)
  • Brokers will also tell your product team what's missing. All of those "oH, MemBeRS woN’T bOOk USer IntErvIeWs wITh mE" Product Managers should probably be talking to brokers

If you don't have rate relief, you have nothing. Rate relief is the one question brokers are being asked by their clients, day in and day out. If you can't show that your plan is cheaper for at least 40% of groups, the conversation doesn't start. Nick's heuristic: if the broker doesn't have price, they have nothing to sell, no matter how elegant the technology.

Therefore: focus on steerage. The difference between the cheapest and most expensive MRI in Austin, TX is roughly 8x. If you can build a plan that guides people to the lower-cost option for non-emergency shoppable services, you've found the actual lever. Nick's starter heuristic: for all non-emergency hospital claims, do you have an alternative good spot to send members to next time? 

Then simplify until it hurts. Decent spent four years before it could credibly sell the Zero Plan: “if you do what the plan wants you to do, it costs you $0 outside your monthly contribution.” That is the level of simplicity you need to actually break through to the decision maker at your prospects. The HR person who has to make this decision once a year and really doesn't want to be in this conversation needs a message that lands in one sentence. This also helps brokers sell (remember rule number one).

Brought to you by

Stedi - Stedi is the modern healthcare clearinghouse. They’re the new way to verify insurance, submit claims, and track claim payments. http://stedi.com/demo

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Find Nick

Exciting upcoming events in the OOP world

  • We have a Hackathon in SF from Apr 17-19. We’re full on Hackers, but you should definitely come to Demo Day and see what people built. I built an app for people to lend Oura Sleep/Readiness Points to each other… at 10% Daily Compounding. I’m calling it “Oura Farming”. I guarantee you there will be 10x better ideas than that at Demo Day

Timestamps

00:00 Intro: Why Tech People Fail in Healthcare (With Nick Soman, Former CEO of Decent)

09:47 Tip #1 — If You Can't Sell to Brokers, You Have Nothing

19:17 Reframe Brokers as Channel Partners, Not Middlemen

29:06 Make It Simpler. Then Simpler Again. (The Story of the Zero Plan)

34:53 The Secret Weapon: Steerage (And Why an 8x Price Spread Changes Everything)

43:56 Narrow Networks, Broker Trust, and Building Something You'd Put Your Own Family On

]]> Wed, 1 Apr 2026 16:00:00 +0000 alex@outofpocket.health (Nick Soman, Alex Dou) https://ops-i-did-it-again.simplecast.com/episodes/ignore-brokers-at-your-own-risk-antagonize-them-at-your-ruin-build-a-health-plan-with-nick-soman-IolTc0VX What we cover

Start with brokers, not against them. The typical "tech disruption" approach frames brokers as rent-seeking middlemen. 

Nick's counterargument: 

  • Brokers fill a trust role that no website can replicate
  • They touch roughly 70% of small-to-mid-size business health plan sales
  • They will pick up the phone (how many millennials and Gen Zers can say that? Certainly not I)
  • Brokers will also tell your product team what's missing. All of those "oH, MemBeRS woN’T bOOk USer IntErvIeWs wITh mE" Product Managers should probably be talking to brokers

If you don't have rate relief, you have nothing. Rate relief is the one question brokers are being asked by their clients, day in and day out. If you can't show that your plan is cheaper for at least 40% of groups, the conversation doesn't start. Nick's heuristic: if the broker doesn't have price, they have nothing to sell, no matter how elegant the technology.

Therefore: focus on steerage. The difference between the cheapest and most expensive MRI in Austin, TX is roughly 8x. If you can build a plan that guides people to the lower-cost option for non-emergency shoppable services, you've found the actual lever. Nick's starter heuristic: for all non-emergency hospital claims, do you have an alternative good spot to send members to next time? 

Then simplify until it hurts. Decent spent four years before it could credibly sell the Zero Plan: “if you do what the plan wants you to do, it costs you $0 outside your monthly contribution.” That is the level of simplicity you need to actually break through to the decision maker at your prospects. The HR person who has to make this decision once a year and really doesn't want to be in this conversation needs a message that lands in one sentence. This also helps brokers sell (remember rule number one).

Brought to you by

Stedi - Stedi is the modern healthcare clearinghouse. They’re the new way to verify insurance, submit claims, and track claim payments. http://stedi.com/demo

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Find Nick

Exciting upcoming events in the OOP world

  • We have a Hackathon in SF from Apr 17-19. We’re full on Hackers, but you should definitely come to Demo Day and see what people built. I built an app for people to lend Oura Sleep/Readiness Points to each other… at 10% Daily Compounding. I’m calling it “Oura Farming”. I guarantee you there will be 10x better ideas than that at Demo Day

Timestamps

00:00 Intro: Why Tech People Fail in Healthcare (With Nick Soman, Former CEO of Decent)

09:47 Tip #1 — If You Can't Sell to Brokers, You Have Nothing

19:17 Reframe Brokers as Channel Partners, Not Middlemen

29:06 Make It Simpler. Then Simpler Again. (The Story of the Zero Plan)

34:53 The Secret Weapon: Steerage (And Why an 8x Price Spread Changes Everything)

43:56 Narrow Networks, Broker Trust, and Building Something You'd Put Your Own Family On

]]> Ignore brokers at your own risk. Antagonize them at your ruin. Build a health plan with Nick Soman Nick Soman, Alex Dou 00:54:00 There's a specific flavor of hubris that shows up when a tech founder enters healthcare. It sounds like: "Brokers are just middlemen getting rich off of a broken system. We'll go direct to the employer." Nick Soman spent years building Decent, a health plan designed around direct primary care, and he watched a lot of smart people make this exact mistake. He also made some of them himself. This episode is the map of those wrong turns. Nick is the former founder and CEO of Decent, now Chief Commercial Officer at Nice Healthcare (Decent and Nice, Nice and Decent). I can happily say that Nick lives up to his two companies' names. There's a specific flavor of hubris that shows up when a tech founder enters healthcare. It sounds like: "Brokers are just middlemen getting rich off of a broken system. We'll go direct to the employer." Nick Soman spent years building Decent, a health plan designed around direct primary care, and he watched a lot of smart people make this exact mistake. He also made some of them himself. This episode is the map of those wrong turns. Nick is the former founder and CEO of Decent, now Chief Commercial Officer at Nice Healthcare (Decent and Nice, Nice and Decent). I can happily say that Nick lives up to his two companies' names. brokers, steerage, insurance false full 2 2 dd6ec4f1-918c-45c0-9964-f028f4bcdd9c PROs, UX/UI Design for trials, and the nocebo effect | Paul Wicks, PhD The episode moves through three connected ideas.

First: clinical trials have a UX problem.

One in five trials recruits zero patients. Half under-recruit. Paul's early work was understanding why – and fixing it. The answer was almost never the science. It was that patients had no parking, caregivers had no wifi (or babysitting!), and the protocol assumed everyone could get to Mass General by 9 AM on a Friday via public transit. Solving that required showing trial designs to actual patients before locking them, and listening to their recorded reactions rather than just summarizing their survey scores.

Second: measuring patient experience is genuinely hard.

There are no inches of insomnia. No pounds of pain. Patient Reported Outcomes – PROs – exist because the most burdensome chronic conditions don't have actual units that can be measured. There are thousands of PROs, many are outdated (the fibromyalgia questionnaire from the early 2000s asks how well you can vacuum and cook for your family), and most were designed for clinical trials, not for weekly check-ins on a mobile screen. So for you, Product Manager/Engineer/Builder: how are you going to measure whether your Care Model actually improves patient health?

Third: building PROs into a product creates specific traps.

Paul runs through the ones he has seen firsthand: copyright violations (most scales are licensed and litigation can cost millions), engagement drop-off (5–10% of users is a good day for consistent tracking), incentive fraud (cash rewards attract bot farms), the nocebo effect (asking about pain can worsen it: hey, 1-10 scale, how itchy are you right now?), and the regulatory ceiling – go too far with your tracker and you've crossed into medical device territory, with all the compliance that comes with it.

The Five Things to Know Before You Build

1. You probably don't have permission to use that questionnaire. Most validated scales are owned by universities and licensed for a fee. Saying you found it published online doesn't mean it's free. The database PROQOLID lists rights holders, and some of them are quite litigious 

2. Only about 5–10% of patients will track at the cadence you're planning. The ones who do are not representative of your broader user base. Obsessive trackers skew your data. Users with executive dysfunction may not be able to log in, let alone complete a questionnaire.

3. Cash incentives destroy your data. If you offer a financial reward for completion, expect an avalanche of bots and fraudulent responses. Survey researchers report 80–90% fraud rates in incentivized studies. Things that seem to work better: setting group goals, an AMA with the scientists behind the study, and giving users a summary of what their data revealed.

4. Asking about symptoms can worsen them. The nocebo effect is real (for example: scale of 1-10, how itchy do you feel right now?). Paul's team designed positively-framed questions ("how well are you sleeping?") rather than deficit-focused ones ("how bad is your insomnia?") specifically to reduce iatrogenic harm.

5. Interpreting a score triggers regulation. Tracking is fine. Saying that a score of 5/5 means "severe" COULD make your app a medical device and suddenly make you beholden to a lot more regulation

Brought to you by

Nirvana - Nirvana delivers real-time eligibility checks and cost estimates and plugs right into your existing workflows

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Resources

Timestamps

  • 00:00 — Paul's origin story: ALS research, patient communities, and clinical trial ethics
  • 03:00 — PatientsLikeMe and showing trial protocols to patients before locking them can actually INCREASE recruitment
  • 11:00 — What PROs (Patient Reported Outcomes) are, why there are so many, and why none of them agree
  • 18:00 — Pharma, payers, providers, patients – and who actually cares about PRO data
  • 26:00 — The fifth stakeholder: scale developers. Beware for license fees and lawsuit risk
  • 30:00 — Which patients actually track data, and what to do about everyone else
  • 33:00 — False starts: psoriasis body maps, crab-to-clam scales, and positive framing
  • 38:00 — The regulatory ceiling and pharmacovigilance
]]> Wed, 18 Mar 2026 19:00:00 +0000 alex@outofpocket.health (Paul Wicks, Alex Dou) https://ops-i-did-it-again.simplecast.com/episodes/pros-ux-ui-design-for-trials-and-the-nocebo-effect-paul-wicks-phd-2nzdmtuG The episode moves through three connected ideas.

First: clinical trials have a UX problem.

One in five trials recruits zero patients. Half under-recruit. Paul's early work was understanding why – and fixing it. The answer was almost never the science. It was that patients had no parking, caregivers had no wifi (or babysitting!), and the protocol assumed everyone could get to Mass General by 9 AM on a Friday via public transit. Solving that required showing trial designs to actual patients before locking them, and listening to their recorded reactions rather than just summarizing their survey scores.

Second: measuring patient experience is genuinely hard.

There are no inches of insomnia. No pounds of pain. Patient Reported Outcomes – PROs – exist because the most burdensome chronic conditions don't have actual units that can be measured. There are thousands of PROs, many are outdated (the fibromyalgia questionnaire from the early 2000s asks how well you can vacuum and cook for your family), and most were designed for clinical trials, not for weekly check-ins on a mobile screen. So for you, Product Manager/Engineer/Builder: how are you going to measure whether your Care Model actually improves patient health?

Third: building PROs into a product creates specific traps.

Paul runs through the ones he has seen firsthand: copyright violations (most scales are licensed and litigation can cost millions), engagement drop-off (5–10% of users is a good day for consistent tracking), incentive fraud (cash rewards attract bot farms), the nocebo effect (asking about pain can worsen it: hey, 1-10 scale, how itchy are you right now?), and the regulatory ceiling – go too far with your tracker and you've crossed into medical device territory, with all the compliance that comes with it.

The Five Things to Know Before You Build

1. You probably don't have permission to use that questionnaire. Most validated scales are owned by universities and licensed for a fee. Saying you found it published online doesn't mean it's free. The database PROQOLID lists rights holders, and some of them are quite litigious 

2. Only about 5–10% of patients will track at the cadence you're planning. The ones who do are not representative of your broader user base. Obsessive trackers skew your data. Users with executive dysfunction may not be able to log in, let alone complete a questionnaire.

3. Cash incentives destroy your data. If you offer a financial reward for completion, expect an avalanche of bots and fraudulent responses. Survey researchers report 80–90% fraud rates in incentivized studies. Things that seem to work better: setting group goals, an AMA with the scientists behind the study, and giving users a summary of what their data revealed.

4. Asking about symptoms can worsen them. The nocebo effect is real (for example: scale of 1-10, how itchy do you feel right now?). Paul's team designed positively-framed questions ("how well are you sleeping?") rather than deficit-focused ones ("how bad is your insomnia?") specifically to reduce iatrogenic harm.

5. Interpreting a score triggers regulation. Tracking is fine. Saying that a score of 5/5 means "severe" COULD make your app a medical device and suddenly make you beholden to a lot more regulation

Brought to you by

Nirvana - Nirvana delivers real-time eligibility checks and cost estimates and plugs right into your existing workflows

For inquiries about sponsoring the podcast, email sales@outofpocket.health

Resources

Timestamps

  • 00:00 — Paul's origin story: ALS research, patient communities, and clinical trial ethics
  • 03:00 — PatientsLikeMe and showing trial protocols to patients before locking them can actually INCREASE recruitment
  • 11:00 — What PROs (Patient Reported Outcomes) are, why there are so many, and why none of them agree
  • 18:00 — Pharma, payers, providers, patients – and who actually cares about PRO data
  • 26:00 — The fifth stakeholder: scale developers. Beware for license fees and lawsuit risk
  • 30:00 — Which patients actually track data, and what to do about everyone else
  • 33:00 — False starts: psoriasis body maps, crab-to-clam scales, and positive framing
  • 38:00 — The regulatory ceiling and pharmacovigilance
]]> PROs, UX/UI Design for trials, and the nocebo effect | Paul Wicks, PhD Paul Wicks, Alex Dou 00:45:11 Your executive just asked your team to build a symptom tracker. It seems straightforward. Ask patients how they feel, collect the data, show a graph. Then in six months, pull the numbers: patients came in at a 9/10 on your Symptom Tracker, and after six months of weekly use, they're at a 3. Company gets a CPT code. You get promoted to Senior Product Manager. Everybody goes home happy. Paul Wicks has spent 25 years watching that plan run into walls. In this episode, neuropsychologist and digital health consultant Paul Wicks walks Alex through everything product teams don't know when they start building Patient Reported Outcomes into their apps – from why researchers should physically walk through hospitals as patients before locking trial protocols, to why your scale might use a crab instead of a number Your executive just asked your team to build a symptom tracker. It seems straightforward. Ask patients how they feel, collect the data, show a graph. Then in six months, pull the numbers: patients came in at a 9/10 on your Symptom Tracker, and after six months of weekly use, they're at a 3. Company gets a CPT code. You get promoted to Senior Product Manager. Everybody goes home happy. Paul Wicks has spent 25 years watching that plan run into walls. In this episode, neuropsychologist and digital health consultant Paul Wicks walks Alex through everything product teams don't know when they start building Patient Reported Outcomes into their apps – from why researchers should physically walk through hospitals as patients before locking trial protocols, to why your scale might use a crab instead of a number digital health, patient reported outcomes, clinical trials false full 1 2 c7c88caf-82c3-4513-a961-84b38115e59e How Photon Used Automations to Change E-Prescriptions | Michael Rado, CPO, Co-Founder, Photon Health In this episode of Ops I Did It Again, Michael Rado (aka Rado), Co-Founder and CPO at Photon Health joins the thinksquad aka Danielle and Nikhil to break down how they built and scaled products to support over 20,000 e-prescriptions a month. Rado shows a live demo of their build (on YouTube version) and candidly shares his learnings on how to scale with optimization and automation in mind. 

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center; Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9

Hosts:

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Nikhil Krishnan (https://twitter.com/nikillinit)

Guests:

Michael Rado (https://www.linkedin.com/in/michaelrado) 

 

Timestamps:

(00:00) Intro

(01:45) Michael Rado and his journey to Photon

(03:14) How Photon Health works

(07:36) Courses by Out Of Pocket!

(16:49) What photon automates and measures

(24:23) The approach towards product development at Photon Health 

(29:25) Practical experiments for orgs to try 

]]> Thu, 28 Mar 2024 17:00:25 +0000 alex@outofpocket.health (Nikhil Krishnan, Michelle Poreh, Danielle Poreh) https://ops-i-did-it-again.simplecast.com/episodes/how-photon-used-automations-to-change-e-prescriptions-michael-rado-cpo-co-founder-photon-health-4hjOZCWh In this episode of Ops I Did It Again, Michael Rado (aka Rado), Co-Founder and CPO at Photon Health joins the thinksquad aka Danielle and Nikhil to break down how they built and scaled products to support over 20,000 e-prescriptions a month. Rado shows a live demo of their build (on YouTube version) and candidly shares his learnings on how to scale with optimization and automation in mind. 

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center; Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9

Hosts:

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Nikhil Krishnan (https://twitter.com/nikillinit)

Guests:

Michael Rado (https://www.linkedin.com/in/michaelrado) 

 

Timestamps:

(00:00) Intro

(01:45) Michael Rado and his journey to Photon

(03:14) How Photon Health works

(07:36) Courses by Out Of Pocket!

(16:49) What photon automates and measures

(24:23) The approach towards product development at Photon Health 

(29:25) Practical experiments for orgs to try 

]]> How Photon Used Automations to Change E-Prescriptions | Michael Rado, CPO, Co-Founder, Photon Health Nikhil Krishnan, Michelle Poreh, Danielle Poreh 00:34:06 In this episode of Ops I Did It Again, Michael Rado (aka Rado), Co-Founder and CPO at Photon Health joins the thinksquad aka Danielle and Nikhil to break down how they built and scaled products to support over 20,000 e-prescriptions a month. Rado shows a live demo of their build (on YouTube version) and candidly shares his learnings on how to scale with optimization and automation in mind. In this episode of Ops I Did It Again, Michael Rado (aka Rado), Co-Founder and CPO at Photon Health joins the thinksquad aka Danielle and Nikhil to break down how they built and scaled products to support over 20,000 e-prescriptions a month. Rado shows a live demo of their build (on YouTube version) and candidly shares his learnings on how to scale with optimization and automation in mind. digital health, healthcare operations, healthcare startups, healthcare, healthcare product design, e-prescribing false full 8 1 ef2d8df9-bad8-4713-a442-09911321bd2d Digital Health Ops: A Playbook for Every Growth Stage | Rahul Agarwal, COO Medplum On this episode of Ops I Did it Again, Rahul Agarwal (COO of Medplum) joins Danielle to share his digital health operations playbook. The “hero’s journey” playbook breaks down pro tips and gotchas throughout every stage of scale: from pre-seed all the way to scaling to 50 states.

If you are building a clinical workforce, scaling your digital health operations or looking into the future on how you should be building, this episode will give you several tactical tips to implement.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center; Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9

Hosts:

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Guests:

Rahul Agarwal (https://www.linkedin.com/in/rahul-agarwal-330a979/) 

Timestamps:

(00:00) Intro

(02:23) Rahul explains his playbook

(02:58)Tips for early stage operators

(06:32) Leaving the jungle: finding product-market fit

(08:55) Operational playbook for scaling digital health services

(13:45)  Courses by Out Of Pocket!

(15:20) How to define  encounters

(24:10) How to develop care plans/clinical pathways

(30:59) Optimizing provider recruiting and workload with EHR design

(33:30) Standardize your metrics and avoid metric soup

(35:50) Dos and don’ts when scaling to 50 states

(39:43) Practical experiments for orgs to try 

]]> Mon, 18 Mar 2024 16:50:03 +0000 alex@outofpocket.health (Michelle Poreh, Nikhil Krishnan, Danielle Poreh) https://ops-i-did-it-again.simplecast.com/episodes/how-to-scale-your-digital-health-operations-ysAfDijh On this episode of Ops I Did it Again, Rahul Agarwal (COO of Medplum) joins Danielle to share his digital health operations playbook. The “hero’s journey” playbook breaks down pro tips and gotchas throughout every stage of scale: from pre-seed all the way to scaling to 50 states.

If you are building a clinical workforce, scaling your digital health operations or looking into the future on how you should be building, this episode will give you several tactical tips to implement.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center; Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9

Hosts:

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Guests:

Rahul Agarwal (https://www.linkedin.com/in/rahul-agarwal-330a979/) 

Timestamps:

(00:00) Intro

(02:23) Rahul explains his playbook

(02:58)Tips for early stage operators

(06:32) Leaving the jungle: finding product-market fit

(08:55) Operational playbook for scaling digital health services

(13:45)  Courses by Out Of Pocket!

(15:20) How to define  encounters

(24:10) How to develop care plans/clinical pathways

(30:59) Optimizing provider recruiting and workload with EHR design

(33:30) Standardize your metrics and avoid metric soup

(35:50) Dos and don’ts when scaling to 50 states

(39:43) Practical experiments for orgs to try 

]]> Digital Health Ops: A Playbook for Every Growth Stage | Rahul Agarwal, COO Medplum Michelle Poreh, Nikhil Krishnan, Danielle Poreh 00:43:04 On this episode of Ops I Did it Again, Rahul Agarwal (COO of Medplum) joins Danielle to share his digital health operations playbook. The “hero’s journey” playbook breaks down pro tips and gotchas throughout every stage of scale: from pre-seed all the way to scaling to 50 states. On this episode of Ops I Did it Again, Rahul Agarwal (COO of Medplum) joins Danielle to share his digital health operations playbook. The “hero’s journey” playbook breaks down pro tips and gotchas throughout every stage of scale: from pre-seed all the way to scaling to 50 states. digital health, clinical operations, scaling, healthcare operations, healthcare startups, healthcare, ehr false full 7 1 4f80ce79-f84b-41dc-b221-3ffe40bfa868 Building Differentiated Patient Experiences | Kerem Ozkay, COO and Ayo Omojola CPO, Carbon Health In this episode of Ops I Did It Again, Kerem Ozkay (Chief Operating Officer) and Ayo Omojola (Chief Product Officer) from Carbon Health join the thinksquad aka Danielle and Nikhil, to discuss how they designed and deployed product solutions. They breakdown real examples of AI tools to enhance operations, strategies for patient care, and unique top of funnel marketing approaches. 

Later in the episode, Ayo shares a behind the scenes view at Carbon’s home grown EHR - it’s best viewed on YouTube so you can all the magic.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center; Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Guests:

Kerem Ozkay (https://www.linkedin.com/in/keremozkay/)

Ayo Omojola (https://www.linkedin.com/in/omojola/)

 

TIMESTAMPS

(00:00) Introduction

(01:43) 4 levers for tech-enabled healthcare

(03:03) Running patient acquisition, operations, and marketing

(09:34) SEO strategy and AI integration

(15:36) Courses by Out Of Pocket!

(17:11) The experience of scheduling

(28:04) Performance metrics and feedback loops

(29:54) Being 2x better at one thing vs 10x better at everything

(33:53) Understanding patient acquisition and call content

(36:04) The best tech for clinic reports

(37:49) Convincing doctors to adopt new tools

(41:02) Importance of localized patient acquisition

(41:31) Moving off of slack for field based team

(43:32) Automating Revenue Cycle Management (RCM)

(50:44) Charting and patient care with AI (live demo)

(55:05) Future of AI in healthcare

(01:03:26) Kerem and Ayo’s team dynamics

(01:05:38) Closing thoughts

]]> Thu, 29 Feb 2024 17:00:00 +0000 alex@outofpocket.health (Danielle Poreh, Michelle Poreh, Nikhil Krishnan) https://ops-i-did-it-again.simplecast.com/episodes/building-differentiated-patient-experiences-carbon-health-kerem-ozkay-chief-operating-officer-and-ayo-omojola-chief-product-officer-kIDq_kqK In this episode of Ops I Did It Again, Kerem Ozkay (Chief Operating Officer) and Ayo Omojola (Chief Product Officer) from Carbon Health join the thinksquad aka Danielle and Nikhil, to discuss how they designed and deployed product solutions. They breakdown real examples of AI tools to enhance operations, strategies for patient care, and unique top of funnel marketing approaches. 

Later in the episode, Ayo shares a behind the scenes view at Carbon’s home grown EHR - it’s best viewed on YouTube so you can all the magic.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center; Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Guests:

Kerem Ozkay (https://www.linkedin.com/in/keremozkay/)

Ayo Omojola (https://www.linkedin.com/in/omojola/)

 

TIMESTAMPS

(00:00) Introduction

(01:43) 4 levers for tech-enabled healthcare

(03:03) Running patient acquisition, operations, and marketing

(09:34) SEO strategy and AI integration

(15:36) Courses by Out Of Pocket!

(17:11) The experience of scheduling

(28:04) Performance metrics and feedback loops

(29:54) Being 2x better at one thing vs 10x better at everything

(33:53) Understanding patient acquisition and call content

(36:04) The best tech for clinic reports

(37:49) Convincing doctors to adopt new tools

(41:02) Importance of localized patient acquisition

(41:31) Moving off of slack for field based team

(43:32) Automating Revenue Cycle Management (RCM)

(50:44) Charting and patient care with AI (live demo)

(55:05) Future of AI in healthcare

(01:03:26) Kerem and Ayo’s team dynamics

(01:05:38) Closing thoughts

]]> Building Differentiated Patient Experiences | Kerem Ozkay, COO and Ayo Omojola CPO, Carbon Health Danielle Poreh, Michelle Poreh, Nikhil Krishnan 01:06:37 In this episode of Ops I Did It Again, Kerem Ozkay (Chief Operating Officer) and Ayo Omojola (Chief Product Officer) from Carbon Health join the thinksquad aka Danielle and Nikhil, to discuss how they design and deploy product solutions at scale. They breakdown real examples of AI tools to enhance operations, strategies for patient care, and unique top of funnel marketing approaches. In this episode of Ops I Did It Again, Kerem Ozkay (Chief Operating Officer) and Ayo Omojola (Chief Product Officer) from Carbon Health join the thinksquad aka Danielle and Nikhil, to discuss how they design and deploy product solutions at scale. They breakdown real examples of AI tools to enhance operations, strategies for patient care, and unique top of funnel marketing approaches. digital health, scaling, startups, healthcare operations, healthcare startups, healthcare, healthcare product design, product, healthcare marketing, carbon health false full 6 1 c6a40417-b6c9-49bb-b024-13e309595e29 How Thyme Care Scales Care Teams | Nate Brown, VP Market Operations Nate Brown  joins the Thinksquad, aka Danielle and Nikhil, to share lessons learned from scaling a 90 person care team in 3 years at Thyme Care.

We break down their organizational design, recruiting best practices (which includes lots of role play) and how to generally think through building alignment at different levels and stages of a start-ups evolution.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

--- 

Hosts:

Nikhil Krishnan (Twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Guest:

Nate Brown (https://www.linkedin.com/in/nate-brown-50a4a625/)

--

TIMESTAMPS

(00:00) Introduction

(01:48) What is Thyme Care & their mission

(03:53) Nate's journey & role

(06:22) Measuring qualitative data

(08:25) The hiring process

(14:38) Role play in interviews

(23:17) ‘Pods' in organizational design

(25:33) Measuring success and adjusting for patient needs

(26:56) Company planning and aligning goals

(35:17) Conclusions

]]> Tue, 6 Feb 2024 16:30:00 +0000 alex@outofpocket.health (Danielle Poreh, Michelle Poreh, Nikhil Krishnan) https://ops-i-did-it-again.simplecast.com/episodes/how-thyme-care-scales-care-teams-nate-brown-vp-market-operations-hquo8GnC Nate Brown  joins the Thinksquad, aka Danielle and Nikhil, to share lessons learned from scaling a 90 person care team in 3 years at Thyme Care.

We break down their organizational design, recruiting best practices (which includes lots of role play) and how to generally think through building alignment at different levels and stages of a start-ups evolution.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

--- 

Hosts:

Nikhil Krishnan (Twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Guest:

Nate Brown (https://www.linkedin.com/in/nate-brown-50a4a625/)

--

TIMESTAMPS

(00:00) Introduction

(01:48) What is Thyme Care & their mission

(03:53) Nate's journey & role

(06:22) Measuring qualitative data

(08:25) The hiring process

(14:38) Role play in interviews

(23:17) ‘Pods' in organizational design

(25:33) Measuring success and adjusting for patient needs

(26:56) Company planning and aligning goals

(35:17) Conclusions

]]> How Thyme Care Scales Care Teams | Nate Brown, VP Market Operations Danielle Poreh, Michelle Poreh, Nikhil Krishnan 00:35:09 Nate Brown  joins the Thinksquad, aka Danielle and Nikhil, to share lessons learned from scaling a 90 person care team in 3 years at Thyme Care. We break down their organizational design, recruiting best practices (which includes lots of role play) and how to generally think through building alignment at different levels and stages of a start-ups evolution. Nate Brown  joins the Thinksquad, aka Danielle and Nikhil, to share lessons learned from scaling a 90 person care team in 3 years at Thyme Care. We break down their organizational design, recruiting best practices (which includes lots of role play) and how to generally think through building alignment at different levels and stages of a start-ups evolution. primary care, startups, operations, healthcare operations, healthcare startups, healthcare, start-up, patient care false full 5 1 0a81d716-dee8-418b-8934-0cf4c656e55d Aledade’s Patient Engagement Playbook | Douglas Streat, COO Aledade Care Solutions In this episode of Ops I Did It Again, Douglas Streat, COO of Aledade Care Solutions, joins the thinksquad, Danielle and Nikhil to unpack how they built patient engagement strategies to support over 2M patients alongside primary care practices. Doug shares his tactical advice and learnings on how to create behavior change - we also get to play a fun game during it. It’s our most tactical episode yet.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center) at https://www.outofpocket.health/course-library

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Guest:

Douglas Streat (https://twitter.com/dougstreat)

 

TIMESTAMPS

(00:00) Intro

(01:31) Introducing Patient Engagement

(04:29) Doug’s Career Insights

(06:19) The Role of Aledade Plus

(08:39) Redefining Call Centers as Patient Engagement

(12:56) Key Performance Indicators in Patient Engagement

(14:57) The Importance of Evidence and Experimentation

(17:05) Patient Engagement Game!! 

(20:12) Challenges of Patient Scheduling

(21:33) Role of Direct Mail in Patient Engagement

(27:57) Staffing Strategies for Rapid Scaling

(32:23) Importance of Characteristics when Hiring

(33:56) Practical Tips for Effective Patient Engagement

(37:45) Conclusions

]]> Thu, 11 Jan 2024 15:45:00 +0000 alex@outofpocket.health (Michelle Poreh, Nikhil Krishnan, Danielle Poreh) https://ops-i-did-it-again.simplecast.com/episodes/aledades-patient-engagement-playbook-atCLVYyq In this episode of Ops I Did It Again, Douglas Streat, COO of Aledade Care Solutions, joins the thinksquad, Danielle and Nikhil to unpack how they built patient engagement strategies to support over 2M patients alongside primary care practices. Doug shares his tactical advice and learnings on how to create behavior change - we also get to play a fun game during it. It’s our most tactical episode yet.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course; Use code: IBELIEVEINME for $100 off

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center) at https://www.outofpocket.health/course-library

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Guest:

Douglas Streat (https://twitter.com/dougstreat)

 

TIMESTAMPS

(00:00) Intro

(01:31) Introducing Patient Engagement

(04:29) Doug’s Career Insights

(06:19) The Role of Aledade Plus

(08:39) Redefining Call Centers as Patient Engagement

(12:56) Key Performance Indicators in Patient Engagement

(14:57) The Importance of Evidence and Experimentation

(17:05) Patient Engagement Game!! 

(20:12) Challenges of Patient Scheduling

(21:33) Role of Direct Mail in Patient Engagement

(27:57) Staffing Strategies for Rapid Scaling

(32:23) Importance of Characteristics when Hiring

(33:56) Practical Tips for Effective Patient Engagement

(37:45) Conclusions

]]> Aledade’s Patient Engagement Playbook | Douglas Streat, COO Aledade Care Solutions Michelle Poreh, Nikhil Krishnan, Danielle Poreh 00:39:03 In this episode of Ops I Did It Again, Douglas Streat, COO of Aledade Care Solutions, joins the thinksquad, Danielle and Nikhil to unpack how they built patient engagement strategies to support over 2M patients alongside primary care practices. Doug shares his tactical advice and learnings on how to create behavior change - we also get to play a fun game during it. It’s our most tactical episode yet. In this episode of Ops I Did It Again, Douglas Streat, COO of Aledade Care Solutions, joins the thinksquad, Danielle and Nikhil to unpack how they built patient engagement strategies to support over 2M patients alongside primary care practices. Doug shares his tactical advice and learnings on how to create behavior change - we also get to play a fun game during it. It’s our most tactical episode yet. digital health, primary care, call center, contact center, healthcare operations, patient engagement, healthcare false full 4 1 68a40688-a770-4ade-ac3d-45dec38dae61 Holiday Special: 12 Tactical Healthcare Ops Tips This episode is sponsored by Out of Pocket, because no one is prouder of us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

--- 

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (linkedin: https://www.linkedin.com/in/danielleporeh/ twitter: https://twitter.com/danielleporeh )

Guest:

Sandy Varatharajah (twitter: https://twitter.com/sanvrajah?lang=en)

TIMESTAMPS 

(00:00) Introduction to the 12 Gifts of Ops Christmas 

(01:30) Gift #1: Think like a product person 

(02:49) Gift #2: Run a drip campaign 

(04:12) Gift #3: Give people sight into the problems 

(06:01) Gift #4: Face your hidden factories, make swim lane maps 

(08:50) Gift #5: Start an offboarding doc 

(10:42) Gift #6: Prove something can be done before hiring a team 

(12:58) Gift #7: When in doubt, fly out 

(15:20) Gift #8: Build an ops roadmap 

(18:05) Gift #9: Before effort comes focus 

(22:43) Gift #10: Upgrade your software to AI features 

(26:33) Gift #11: Contracts create choke points 

(30:53) Gift #12: The power of schedule sending

]]> Thu, 28 Dec 2023 18:05:00 +0000 alex@outofpocket.health (Nikhil Krishnan) https://ops-i-did-it-again.simplecast.com/episodes/12-tactical-healthcare-operations-tips-Vw3D5xdL This episode is sponsored by Out of Pocket, because no one is prouder of us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

--- 

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (linkedin: https://www.linkedin.com/in/danielleporeh/ twitter: https://twitter.com/danielleporeh )

Guest:

Sandy Varatharajah (twitter: https://twitter.com/sanvrajah?lang=en)

TIMESTAMPS 

(00:00) Introduction to the 12 Gifts of Ops Christmas 

(01:30) Gift #1: Think like a product person 

(02:49) Gift #2: Run a drip campaign 

(04:12) Gift #3: Give people sight into the problems 

(06:01) Gift #4: Face your hidden factories, make swim lane maps 

(08:50) Gift #5: Start an offboarding doc 

(10:42) Gift #6: Prove something can be done before hiring a team 

(12:58) Gift #7: When in doubt, fly out 

(15:20) Gift #8: Build an ops roadmap 

(18:05) Gift #9: Before effort comes focus 

(22:43) Gift #10: Upgrade your software to AI features 

(26:33) Gift #11: Contracts create choke points 

(30:53) Gift #12: The power of schedule sending

]]> Holiday Special: 12 Tactical Healthcare Ops Tips Nikhil Krishnan 00:39:23 Sandy Varatharajah joins the solo thinksquad, aka just Danielle, to share their 12 gifts of Ops Christmas. Together, they share 12 tactical gifts they’ve learned through growing and scaling operations teams at digital health start-ups. The gifts range from practical tips to manage your day to day, how to work better cross-functionally and hacks for leveling up your own operations skills. Sandy Varatharajah joins the solo thinksquad, aka just Danielle, to share their 12 gifts of Ops Christmas. Together, they share 12 tactical gifts they’ve learned through growing and scaling operations teams at digital health start-ups. The gifts range from practical tips to manage your day to day, how to work better cross-functionally and hacks for leveling up your own operations skills. digital health, scaling, healthcare operations, entrepreunership, value based care, product false bonus 1 4e563ee2-3c4e-486c-826f-e9551b16110a Real Gen AI Use Cases in Healthcare | Matthew Woo, Co-Founder & Product at Summer Health Matthew Woo, Co Founder and Head of Product at Summer Health joins the thinksquad, aka Danielle and Nikhil to unpack how Summer Health builds an AI first company. He breaks down how they think through operationalizing AI, instilling an AI first culture throughout their team and how you can start applying it now.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us.

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101).

Referenced websites:

OpenAI Customer Story: 

https://openai.com/customer-stories/summer-health

---

Hosts:

Nikhil Krishnan (twitter)

Danielle Poreh (linkedin)

Guest: 

Matthew Woo (LinkedIn)

--

Timestamps 

(00:00) Intro to Matthew 

(02:10) About Summer Health 

(03:04) Achieving SLA for SMS Response Time 

(04:28) Evolution of SLA and Scaling 

(05:55) Improving SLA through Staffing and Routing 

(08:42) Managing On-Call Operations 

(09:36) AI Integration in Healthcare 

(16:19) Adopting GPT Models in Summer Health 

(19:44) Process of Obtaining a BAA with OpenAI 

(21:29) Availability and Cost of BAAs 

(23:49) Exploring Other Large Language Models 

(26:34) Designing Effective Prompts for AI 

(29:53) Embedding AI in Company Operations 

(32:43) AI Tools and Workflow Optimization 

(36:51) Expanding to Multimodal AI 

(43:02) Scoring Empathy in Conversations 

(44:44) Choosing the Right Problems for AI 

(46:09) Bringing AI into an Organization 

(47:07) Starting Small and Proving Use Cases 

(48:05) Implementing AI into Clinical Workflow 

(49:03) Monitoring and Reviewing AI Output 

(50:01) Doctor's Excitement and Adoption of AI 

(51:27) Takeaways

]]> Tue, 19 Dec 2023 17:25:00 +0000 alex@outofpocket.health (Nikhil Krishnan, Danielle Poreh) https://ops-i-did-it-again.simplecast.com/episodes/real-gen-ai-use-cases-in-healthcare-matthew-woo-co-founder-product-at-summer-health-vsEk74En Matthew Woo, Co Founder and Head of Product at Summer Health joins the thinksquad, aka Danielle and Nikhil to unpack how Summer Health builds an AI first company. He breaks down how they think through operationalizing AI, instilling an AI first culture throughout their team and how you can start applying it now.

This episode is sponsored by Out of Pocket, because no one is prouder than us than us.

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101).

Referenced websites:

OpenAI Customer Story: 

https://openai.com/customer-stories/summer-health

---

Hosts:

Nikhil Krishnan (twitter)

Danielle Poreh (linkedin)

Guest: 

Matthew Woo (LinkedIn)

--

Timestamps 

(00:00) Intro to Matthew 

(02:10) About Summer Health 

(03:04) Achieving SLA for SMS Response Time 

(04:28) Evolution of SLA and Scaling 

(05:55) Improving SLA through Staffing and Routing 

(08:42) Managing On-Call Operations 

(09:36) AI Integration in Healthcare 

(16:19) Adopting GPT Models in Summer Health 

(19:44) Process of Obtaining a BAA with OpenAI 

(21:29) Availability and Cost of BAAs 

(23:49) Exploring Other Large Language Models 

(26:34) Designing Effective Prompts for AI 

(29:53) Embedding AI in Company Operations 

(32:43) AI Tools and Workflow Optimization 

(36:51) Expanding to Multimodal AI 

(43:02) Scoring Empathy in Conversations 

(44:44) Choosing the Right Problems for AI 

(46:09) Bringing AI into an Organization 

(47:07) Starting Small and Proving Use Cases 

(48:05) Implementing AI into Clinical Workflow 

(49:03) Monitoring and Reviewing AI Output 

(50:01) Doctor's Excitement and Adoption of AI 

(51:27) Takeaways

]]> Real Gen AI Use Cases in Healthcare | Matthew Woo, Co-Founder & Product at Summer Health Nikhil Krishnan, Danielle Poreh 00:52:25 Matthew Woo, Co Founder and Head of Product at Summer Health joins the thinksquad, aka Danielle and Nikhil to unpack how Summer Health builds an AI first company. He breaks down how they think through operationalizing AI, instilling an AI first culture throughout their team and how you can start applying it now. Matthew Woo, Co Founder and Head of Product at Summer Health joins the thinksquad, aka Danielle and Nikhil to unpack how Summer Health builds an AI first company. He breaks down how they think through operationalizing AI, instilling an AI first culture throughout their team and how you can start applying it now. sms, digital health, primary care, generative ai, technology startup, gpt3, ai, chatbot, gpt4 false full 3 1 1553df98-6676-49e8-a277-c204007ef947 How House Rx Builds Product | Denali Cahoon & Mina Iskarous They share their lessons learned and core principles that made the build happen so quickly. We go deeper into interview tips, building flexibility in product and frameworks to ensure alignment along the way. 

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

Nouns and Verbs Framework Example: https://www.figma.com/file/12KN4gcVbGMRZ8rPAkia47/Nouns-and-Subnouns-(Ops-I-did-it-again)?type=whiteboard&node-id=0%3A1&t=91gvKyCbIfPcwnNg-1

--- 

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Summary

In this episode, HouseRx discusses how they built their product and created a flexible and massive software from scratch. They emphasize the importance of taking the time to learn and build relationships within the team. They also highlight the value of recruiting product-minded individuals and empowering them to provide feedback and contribute to the product development process. The team shares their experiences in building the MVP and the investments they made early on. They discuss the importance of flexibility in the product and the metrics they used to measure success. Overall, their approach focused on collaboration, continuous improvement, and delivering a better experience for pharmacists and patients.

Takeaways

Take the time to learn and build relationships within the team.

Recruit product-minded individuals and empower them to provide feedback and contribute to the product development process.

Invest in building a flexible product that can adapt to different use cases and workflows.

Measure success through metrics such as support tickets and time to fill.

Chapters

(00:00) Introduction to HouseRx and its departments

(01:57) Early activities and building a relationship

(03:23) Creating a better experience for pharmacists

(04:23) Learning from initial experiences

(06:19) Recruiting product-minded individuals

(07:44) Coaching and empowering the team

(09:40) Assessing product-mindedness in candidates

(10:36) Recruiting from large, structured organizations

(13:13) Encouraging feedback and collaboration

(14:12) Iterating on the product and gathering feedback

(15:37) Timeline for building the MVP

(17:30) Starting to see patients on day one

(19:52) Investments made early on

(21:21) Flexibility in the product

(23:37) Nouns and verbs framework

(25:03) Building flexibility into the product

(28:49) KPIs and metrics

(29:17) Improving support tickets

(33:31) Time to fill as a North Star metric

(36:20) Investing time and space for learning

(37:18) Being present and physically involved

]]> Thu, 7 Dec 2023 17:00:00 +0000 alex@outofpocket.health (Alex Dou) https://ops-i-did-it-again.simplecast.com/episodes/how-houserx-builds-product-denali-cahoon-mina-iskarous-bsO_sKUG They share their lessons learned and core principles that made the build happen so quickly. We go deeper into interview tips, building flexibility in product and frameworks to ensure alignment along the way. 

This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

Nouns and Verbs Framework Example: https://www.figma.com/file/12KN4gcVbGMRZ8rPAkia47/Nouns-and-Subnouns-(Ops-I-did-it-again)?type=whiteboard&node-id=0%3A1&t=91gvKyCbIfPcwnNg-1

--- 

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Summary

In this episode, HouseRx discusses how they built their product and created a flexible and massive software from scratch. They emphasize the importance of taking the time to learn and build relationships within the team. They also highlight the value of recruiting product-minded individuals and empowering them to provide feedback and contribute to the product development process. The team shares their experiences in building the MVP and the investments they made early on. They discuss the importance of flexibility in the product and the metrics they used to measure success. Overall, their approach focused on collaboration, continuous improvement, and delivering a better experience for pharmacists and patients.

Takeaways

Take the time to learn and build relationships within the team.

Recruit product-minded individuals and empower them to provide feedback and contribute to the product development process.

Invest in building a flexible product that can adapt to different use cases and workflows.

Measure success through metrics such as support tickets and time to fill.

Chapters

(00:00) Introduction to HouseRx and its departments

(01:57) Early activities and building a relationship

(03:23) Creating a better experience for pharmacists

(04:23) Learning from initial experiences

(06:19) Recruiting product-minded individuals

(07:44) Coaching and empowering the team

(09:40) Assessing product-mindedness in candidates

(10:36) Recruiting from large, structured organizations

(13:13) Encouraging feedback and collaboration

(14:12) Iterating on the product and gathering feedback

(15:37) Timeline for building the MVP

(17:30) Starting to see patients on day one

(19:52) Investments made early on

(21:21) Flexibility in the product

(23:37) Nouns and verbs framework

(25:03) Building flexibility into the product

(28:49) KPIs and metrics

(29:17) Improving support tickets

(33:31) Time to fill as a North Star metric

(36:20) Investing time and space for learning

(37:18) Being present and physically involved

]]> How House Rx Builds Product | Denali Cahoon & Mina Iskarous Alex Dou 00:42:15 Denali and Mina join the solo thinksquad, aka just Danielle to break down how they built a massive pharmacy management software from the ground up at HouseRx in just a year. Denali and Mina join the solo thinksquad, aka just Danielle to break down how they built a massive pharmacy management software from the ground up at HouseRx in just a year. digital health, startups, operations, healthcare, product, pharmacy software false full 2 1 9b29e3aa-38a9-4fe5-b24a-5ed574e2659a Text your patients | Ajay Haryani, MD In this episode, he shares his clinical and operational playbook for executing on the channel effectively and even laughs at Nikhil’s jokes. We go deeper into how they measure value, track SLAs and how the channel has evolved. 

For folks who are in the value based care world, looking to incorporate texting into their care model or curious about how Galileo tapped into the channel so effectively, this one is made for you.

--

This episode is sponsored by Out of Pocket, because no one is prouder of us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

--- 

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Timestamps:

(00:00) Intro to Ajay

(00:59 What Galieo does and Ajay’s role

(3:11) What field based teams do

(5:36) Lessons learned building a field based team

(09:10) How Galileo builds comradery to avoid burnout

(11:00) What Ajay does on roadtrips

(12:00) When to use and not use SMS

(13:56) Ajay’s take on what makes SMS so valuable

(17:57) Should we charge for texting?

(22:14) Triage protocols for SMS

(25:12) Bucketing SLAs for SMS

(27:48) QA on triaging and continuous improvement

(29:26) The flow of a single SMS 

(30:52) How to get started with SMS

(33:46) When it’s time to centralize the function

(34:34) The galileo care team

(36:56) Determining outbound SLAs

(39:17) Preferences in population 

(40:00) Groupchats

(42:22) How to sound like a human & 24/7 care

(43:31) Measuring value in SMS

(47:26) Speed matters

(49:01) Hot takes

(50:57) SMS in a virtual based care model

(52:56)  Making sure people have your number

(56:12)  Ajay’s Mike Jones moment

]]> Thu, 30 Nov 2023 15:00:00 +0000 alex@outofpocket.health (Alex Dou) https://ops-i-did-it-again.simplecast.com/episodes/you-should-text-your-patients-z5D4LMrq In this episode, he shares his clinical and operational playbook for executing on the channel effectively and even laughs at Nikhil’s jokes. We go deeper into how they measure value, track SLAs and how the channel has evolved. 

For folks who are in the value based care world, looking to incorporate texting into their care model or curious about how Galileo tapped into the channel so effectively, this one is made for you.

--

This episode is sponsored by Out of Pocket, because no one is prouder of us than us: https://www.outofpocket.health/

You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library

--- 

Hosts:

Nikhil Krishnan (twitter: https://twitter.com/nikillinit)

Danielle Poreh (https://www.linkedin.com/in/danielleporeh/)

Timestamps:

(00:00) Intro to Ajay

(00:59 What Galieo does and Ajay’s role

(3:11) What field based teams do

(5:36) Lessons learned building a field based team

(09:10) How Galileo builds comradery to avoid burnout

(11:00) What Ajay does on roadtrips

(12:00) When to use and not use SMS

(13:56) Ajay’s take on what makes SMS so valuable

(17:57) Should we charge for texting?

(22:14) Triage protocols for SMS

(25:12) Bucketing SLAs for SMS

(27:48) QA on triaging and continuous improvement

(29:26) The flow of a single SMS 

(30:52) How to get started with SMS

(33:46) When it’s time to centralize the function

(34:34) The galileo care team

(36:56) Determining outbound SLAs

(39:17) Preferences in population 

(40:00) Groupchats

(42:22) How to sound like a human & 24/7 care

(43:31) Measuring value in SMS

(47:26) Speed matters

(49:01) Hot takes

(50:57) SMS in a virtual based care model

(52:56)  Making sure people have your number

(56:12)  Ajay’s Mike Jones moment

]]> Text your patients | Ajay Haryani, MD Alex Dou 00:57:06 Ajay Haryani, MD joins the thinksquad Danielle and Nikhil to break down how SMS has been a major unlock in Galileo’s care delivery programs. Ajay Haryani, MD joins the thinksquad Danielle and Nikhil to break down how SMS has been a major unlock in Galileo’s care delivery programs. sms, mychart, operations, healthcare operations, patient care, value based care, texting false full 1 1 2d90f79f-02d0-42c6-8eee-1d4606e187fc Introducing Ops I did it again Introducing Ops I did it again, a limited series podcast by Out-of-Pocket, hosted by Danielle Poreh and Nikhil Krishnan. We interview builders in healthcare operators breaking the mold (aka solving problems all ops people are facing)

First episode dropping soon!

Links:

  • Out of Pocket: https://www.outofpocket.health/
  • How to Build a Healthcare Call Center Course: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center
  • Knowledgefest 2024 Waitlist: https://www.outofpocket.health/knowledgefest-lp
]]> Mon, 20 Nov 2023 16:35:00 +0000 alex@outofpocket.health (Alex Dou) https://ops-i-did-it-again.simplecast.com/episodes/introducing-ops-i-did-it-again-4VgaUO3o Introducing Ops I did it again, a limited series podcast by Out-of-Pocket, hosted by Danielle Poreh and Nikhil Krishnan. We interview builders in healthcare operators breaking the mold (aka solving problems all ops people are facing)

First episode dropping soon!

Links:

  • Out of Pocket: https://www.outofpocket.health/
  • How to Build a Healthcare Call Center Course: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center
  • Knowledgefest 2024 Waitlist: https://www.outofpocket.health/knowledgefest-lp
]]> Introducing Ops I did it again Alex Dou 00:01:20 Introducing Ops I did it again, a limited series podcast by Out-of-Pocket, hosted by Danielle Poreh and Nikhil Krishnan. We interview builders in healthcare operators breaking the mold (aka solving problems all ops people are facing). First episode dropping soon! Introducing Ops I did it again, a limited series podcast by Out-of-Pocket, hosted by Danielle Poreh and Nikhil Krishnan. We interview builders in healthcare operators breaking the mold (aka solving problems all ops people are facing). First episode dropping soon! digital health, healthcare operations, healthcare startups, healthcare false trailer 1