Moving On

Over three years ago, a good friend of mine asked if I’d consider joining the board of a local startup. They were very early stage, in the healthcare space, they’d raised a bit of funding, and were looking to grow.

Great. I meet with a lot of startups, mainly trying to help and provide a sounding board. Many of the founders are inspiring, many have reasonable ideas, some of them will go on to be successful, but it’s really rare that I personally get excited about any particular company. Certainly not enough to join and invest time, money, and energy!

But I owed my buddy a favour, so we met at the closest pub to my flat, and I prepared my gracious-decline speech. Except something strange happened. As Chris talked about what they were building, I became increasingly interested.

Current Health (at the time named Snap40) had designed a clinical grade (requiring FDA approval) wearable intending to replace most of the normal monitoring equipment found within a hospital ICU. This device could then be linked to a phone or tablet, and could help identify patient deterioration, perhaps even before a human would notice. There were other applications too – for example, my mid-sixties father crashed his bike recently, blacked out, went to the hospital and got an MRI, then was held for a further 24 hours for “observation.” In this scenario, perhaps he could have been sent home earlier as long as he was monitored for deterioration. Plenty of conditions could benefit from proactive monitoring at the home linked to a healthcare provider, and even more mundane challenges like medication monitoring (ie, did they take their blood pressure medication? Lets see!) could be significantly improved.

A major challenge for sales within the healthcare industry is dealing with a sophisticated and opinionated Decision Making Unit. Doctors, nurses, pharmacists, administrators, and technical people all factor in, and in a new category educating this market can be really time consuming and expensive. Would healthcare professionals get this? I called a few physicians I knew and asked. They immediately got it, several of them referenced having this idea themselves, and one of them spent more than an hour telling me all the different ways it would save their hospital and health network money. So that seemed promising.

One of the key things that attracted me to this implementation is the wearable is a “dumb” device. Raw signal is sent to the cloud where it’s analysed and processed using a combination of machine learning (yes really) and other algorithms. This means a couple of things – the algorithms can be tuned using all data ever collected from every device out there, and new algorithms can be shipped without replacing the devices. In other words, the more data collected, the higher the accuracy.

This is a crucial distinction: Current Health isn’t a medical device company, it’s not a software company, it’s a platform company.

I joined the board in March of 2016, with one condition – I would resign every year in March. Chris could accept or reject my resignation. While I’ve been a member of the board at Administrate since I joined in 2011, I’d never held a board position on another company before. Maybe I’d suck at it. Maybe the company would outgrow my expertise. In any event, they wouldn’t have to wait too long to get rid of me if that became necessary.

“Is it going to work?”

For the first two years, this was the major question. Pilots at local hospitals were really promising, and we obtained a European CE mark which meant we could sell it within Europe, but we needed to get certified by the FDA to tackle the USA. This was tricky, because the FDA had never certified a hybrid device like this before.

The next three years (and three resignations) passed quickly, and I’m super proud of what we achieved. A CE mark, multiple pilots, FDA certification for use in both the hospital and home environments, recruitment of a fantastic team, an office move, a rebrand, and multiple funding rounds, including one of the largest seed rounds ever raised in Scotland.

But perhaps the achievement I’m most proud of happened recently during an extended pilot project in the United States – we identified a patient’s vitals slipping, and alerted staff to the issue. The traditional monitoring machines didn’t notice, and we saved a life. The first of many I’m sure.

The traditional monitoring machines didn’t notice, and we saved a life. The first of many I’m sure.

Current Health is going to fundamentally transform how we receive and provide healthcare. I’m super excited for the future, but I also realise that the time has come to step down from the board and make way for the next stage of growth. To the disappointment of most, there’s no drama here, it’s simply time to move on.

I remain deeply thankful to Chris (and my pal who introduced us!) and the team at Current Health for giving me this opportunity. I learned a ton, got to work alongside some incredible people, and I believe this experience made me a better CEO – sitting on the other side of the table can be really enlightening! I am extremely excited to watch how Current Health will grow and I couldn’t be more optimistic about their future.

Resignation

A few weeks ago I resigned. I drafted the email, proofread it, and sent it in. It was pretty standard – I thanked the company for the opportunity, mentioned I was proud of what we’d achieved together, and wished them well.

No, I didn’t resign from Administrate – I resigned from my post as a Non-Executive Director (sometimes abbreviated NED, sometimes NXD) on the board of Snap40, one of Scotland’s most promising startups.

I love helping out startups, mainly because I’ve received so much help myself over the years from others. I know first hand how hard it is growing a company, and some of the advice, time, and mentorship I’ve received has come at critical points along the journey.

Just over a year ago I was asked to join the board at Snap40, and while initially surprised that I was asked and skeptical of the company, I was ultimately impressed with the market, product, vision, and team. I thought I could learn a lot as well! But before I agreed to join, I made it clear that I would resign every year, and the company could either accept or reject my resignation.

Why?

In a fast growing startup, particularly when things are at an early stage, the type of advice and support a company and CEO requires changes quickly, just like everything else. I’ve seen other founders struggle with the awkwardness of how to ask board members and advisors to step aside when they no longer had anything to add, and it was important to me to demonstrate that I viewed my appointment to the board as a fixed term, renewable every year. If the resignation is accepted, no problem! If not, I’m here for at least another year (unless I need to be replaced before then).

I’d encourage other startup CEOs and board members to consider this model for board and advisor appointments. In my view, it’s important that the board members resign proactively as it demonstrates a willingness to step back and acknowledge that their time has potentially come to an end. Nobody likes to think that they’ve been outgrown, but it’s a fact of life, so lets not ignore it.

As for me? My resignation from Snap40 this year was rejected. I’m really excited about the company, the team, and the progress we’re making. I’ve learned a lot already and can’t wait to see what this coming year holds.

Now it’s back to work!

The Problem of Homelessness

Like most people, I used to have very little interaction with the homeless.  I’d see them every now and then on a street corner, or sometimes sleeping sheltered against a doorway if I was out early in the morning or late at night, but that was about it.

A couple years ago I started helping out with an operation that provides a meal for the homeless once a week, run by a local church here in Edinburgh.  They do a fantastic job of providing a really good meal in a nice, warm, safe setting, and the thing I like most about it is they encourage their members to bring their families and attend and eat alongside the guests.  It leads to some really interesting situations where you’re never really sure who is homeless and who isn’t, and it’s a dynamic that I really enjoy.  It’s non threatening and they don’t evangelize, they’re just providing a community and a meal.

One of the things I learned through this experience is that the edge is often very fine – many of us are just a lost job, divorce, or mistake away from being out on the streets, and once that happens, it can be very difficult to get back into normal life.  Another thing I learned is that most of these people are invisible.  I see them a lot on the streets of Edinburgh, and they look like you or me.  It’s quite nice seeing a guest and stopping for a quick chat, even if sometimes it takes a few tries calling their name because they’re not used to being spoken to while walking around.  While the safety net in Scotland is fantastic, particularly when compared to America, there are still people who fall through and there are an estimated 35,000 homeless here.  Often they’re afraid of something, running from something, or have mental health issues.  Providing these people a way out is difficult, and that’s why we’ve been proud to support SocialBite for several years at Administrate – they often provide our weekly team lunch, lunch for our board meetings, and have catered various events for us, and they do so staffed mostly by the formerly homeless.

This year, I’m choosing to join a couple hundred other business leaders to sleep outside for one night in December in support of those of us who often have no choice.  Money raised will go towards the construction of homes for those who have none.  If you’d like to donate to this effort you can do so here, and you can read a bit more about this over on the blog at Administrate.

Thanks!

 

 

How to Ask for Advice / Feedback About Your Startup

One of the things I’m passionate about is helping other startups and the community of entrepreneurs we have here in Edinburgh (and in Scotland).  Since becoming more intentional about “taking the pledge“, I’ve been meeting with lots of folks locally, and been surprised by the amount of requests!

So much so that other team members here at Administrate are helping me shoulder the load, according to areas of expertise (thanks Mike and Patrick!) and time constraints, and I know of many others in the community who are donating their time and expertise.  Helpfulness and support has always been a hallmark of the Scottish startup scene, so this isn’t anything new, but there’s so much more activity now, so many more companies, and so many more entrepreneurs now!  It’s great to see!

I’ve found that sometimes people don’t know what to expect, so I thought I’d lay out a brief framework to help everyone get the most out of the time.

  1. Remember that most advice is delivered within a context vacuum.  Don’t take my advice (or anyone else’s) without fully thinking things through and satisfying yourself.  Bad advice can come from really great people.
  2. In order to be at all helpful, I need context.  Things I usually ask about are: the problem you’re trying to solve (as a company), your business model (SaaS, etc), your market, some metrics around revenue, customers (people paying you money), team size, how long you’ve been going, growth, and churn.  It’s ok if you don’t have all of this information, but the quicker we can rattle through these items, the faster we can get up to speed.
  3. It’s totally cool if you just want to chat, but I’ll usually ask you what you’re biggest challenges are – we have these at Administrate and sometimes they feel cyclical (first we’re worried about sales, then tech, then support, then sales again, etc.).  Even if everything is going well, the question will often be “ok, how do we double down and make it even better?”
  4. I probably can’t help you too much with hiring (particularly “line” staff) – my network is mainly in the USA (so not local), and we’re in high growth mode here at Administrate, so if I know of any devs or whatever we’re probably going to hire them!
  5. Expect me to be very, very blunt.  If you’re British it may come across as almost hostile sometimes.  Sorry.  When I get into problem solving mode or analysis mode, I tend to interrupt, ask lots of questions, and don’t filter much.
  6. Expect me to play devil’s advocate.  Expect me to really push you on a few things.  Expect to be challenged.  The best advice I’ve ever received was from someone telling me they thought I could be a lot more ambitious, which annoyed me at the time, but really made a difference.
  7. One thing you won’t get from me is griping about raising money in the UK, finding a team, or complaining about Scottish Enterprise or Scottish Development International.  If you’re annoyed about these things, fine, but expect an argument from me!
  8. I’m not going to be very helpful to you with introductions to angels, VCs or syndicates.  These people all make their own decisions and won’t look at you in any different light if I make an intro for you.
  9. I won’t share anything about our conversation unless you specifically tell me you don’t mind.  I also expect the same in return.  This means I don’t mind if you want to ask me about challenges I’m facing now, etc.  We like to be transparent, and often it can be comforting to hear that someone else is going through something you’re struggling with.
  10. The majority of my experience and expertise is in high growth Business-to-Business Software-as-a-Service.  So be aware I’ll bias towards that style of company.  I don’t like most B2C ideas because they are riskier, require more funding earlier, require a lot of traction to be successful and are often harder to build and/or monetise.
  11. A couple of times things have gotten emotional (really!).  That’s OK! Building a business can be really hard.  Relationships are involved. It can feel overwhelming.  That’s normal.  Don’t be embarrassed.  It’s not the first time.
  12. Unfortunately, you may have your appointment changed around a few times.  Sorry, but Administrate comes first!  Also, it may be awhile before we can meet, and depending on what you’re looking to talk about, we may provide someone else from our team to give you a better perspective.

Hopefully that helps you get an idea of what to expect and makes everything run just a bit smoother!  I’ve enjoyed all of the conversations I’ve had and am always encouraged by the amazing people we have in Edinburgh working away on building things and solving problems.