Commercializing a Disruptive Technology in a Hospital with Multiple Decision Makers and Influencers

Written By Patrick Kothe
 
 
 
 

Joe Steele is Head of Commercialization at Hemosonics, where they are providing point-of-care solutions to help clinicians make more informed decisions on blood product usage.   In this episode Joe shares  why moving up the ladder too fast may not be the best way to go, why experiencing failure will help in the long-run, how to use wisdom from past experiences and apply it to new situations, the challenges of hiring, training and managing a group of hard-charging people, getting into the C suite, and how Hemosonics is helping doctors make blood product usage decisions quicker and better.

Links from this episode:

Connect with Mastering Medical Device:

Support the show for as little as $3/month: https://www.buzzsprout.com/1286645/support

Thanks for listening!

 

Episode Transcript

This transcript was generated using an automated transcription service and is minimally edited. Please forgive the mistakes contained within it.

[00:00:00] Patrick Kothe: Welcome! Launching an innovative product in today's matrix medical system is more complex than it's ever been. We all think we have wonderful technology, and if people would just listen, they would see how wonderful we truly are. One of the problems is that so many people are impacted by any technology change in health care and we don't always do a good enough job of understanding how what we're proposing impacts each one of them.

My guest today is Joe Steele, Head of Commercialization at Hemosonics, where they're providing point of care solutions to help clinicians make more informed decisions on blood product usage.

Joe is an experienced, successful commercialization expert who will help unravel some of these complexities and provide insights into how you can be more successful selling in today's environment. In our conversation, we discuss why moving up the ladder too fast may not be the best way to go;

why experiencing failure will help in the long run; how to use wisdom from past experiences and apply it to new situations; the challenges of hiring, training, and managing a group of hard charging people; getting into the C suite, and how Hemosonics is helping doctors make blood product usage decisions quicker and better. Here's our conversation.

Joe, you've had quite an interesting career being with some of the top medical device companies in the world. And can you give us a little bit of a background on where you've been and what areas that you've been involved in?

[00:02:27] Joe Steele: So I've spent nearly my entire, adult career, honestly, after graduation was in short stint in finance, but really has been at the major, strategic organizations and med tech. So for the last 25 years, since 98, I've really been doing this and loving it. I was incredibly fortunate.

I started off at J&J. Um, within a kind of a startup incubator environment. So we were the first women's health focused medical device company working on quality of life issues that are standard of care solutions today. I stayed in a women's health care with Smith and Nephew and Bayer, launching some of their products.

Then I transitioned over to a more disruptive solution sell, with a small company called RF Surgical that was acquired by, Medtronic. I stayed on at Medtronic and I really enjoyed my time there. Got a chance to lead a national team. We were the fastest growing, medical device unit within their patient safety group.

And then I've transitioned over to a, an executive leadership position. as head of commercial with Hemosonics and we're in the diagnostics and acute, hemostasis business.

[00:03:30] Patrick Kothe: A couple of things there. Women's health has been more of a forgotten specialty for a lot of years and it seems like it is really moved up in the last several years, but you were there 25 years ago. So tell me a little bit about the evolution of women's health products within our industry.

[00:03:55] Joe Steele: For sure. So yeah, 25 years ago, we were really doing some groundbreaking work in not only bringing devices to market as a minimally invasive alternatives to larger procedures like hysterectomies. We brought devices to market, not just in terms of surgery, but actual, class three, medical devices through the FDA process.

More importantly, what J and J did, and it was part of Ethicon's Gynacare company at the time, they spent millions and millions of dollars on physician education in disease state management. and also we were the first really to do direct to consumer marketing and awareness campaigns, you know, stress urinary incontinence, menorrhagia.

These were all very taboo 25 years ago. One of the saddest things is the second that you take your foot off the gas on women's health, they're, it just, the volume, is lost. And as J& J transitioned out of that women's health business, You know, very successfully, but about a decade later, it's, I'm glad to see some new, bright, amazing companies come to the space with incredible solutions.

But it is also saddening at some time to think 25 years of investment, and we're still talking about some of the taboo things that we should be, that we would never hesitate. We talk about prostate cancer and prostate solutions and erectile dysfunction every single day in every room in America, but it's, it's harder to talk about women's health issues.

And I'm just. So glad that we've got some amazing, women, young, incredibly talented women leading the charge with incredible startups in the space, not only from diagnostics to, minimally invasive devices to, endometriosis research, just things that are affecting, all the women in all of our lives every day.

[00:05:48] Patrick Kothe: And investment seems to be flowing in that direction investment had been very difficult to get in that area and it seems like that's opening up as well.

[00:05:56] Joe Steele: Yeah, for sure. We've seen a floodgate in the last few years, and I just hope that continues because that's what it takes, right? it takes millions and millions of dollars and thousands of people working every day to bring something to fruition.

[00:06:07] Patrick Kothe: So you have been in large companies and been in startup divisions in in large companies. And you're with a smaller company now. So tell me a little bit about large company, small company differences that, that you've seen throughout your career and, and, and those small divisions within large companies.

[00:06:28] Joe Steele: I think if there ever could have been a better place to be, I can't imagine it than when I was at Ethicon Gynacare. I just have to say that. Shout out. We were brought in, given unlimited funding and unlimited,ability to advance women's healthcare. When we had great ideas, and great research. we were funded. We launched 15 products in 10 years. I talked to other small companies about that and they'll say,how were you able to do that? When I was at Smith and Nephew or some of the other large strategic that wanted to make investments in, adjacent markets, um, Joe, how did you guys do that?

I'm like, well, we were committed to it, right? There was a, there's a huge financial and,and pathwise legacy commitment that those large companies made to some of those markets, right. Um, You know, it isn't like we didn't make mistakes as well. I mean, we had early mistakes and Intuitive. We had early mistakes and some of the other markets and Ethicon just passed on them.

So I was very fortunate to work with a group of leaders who had vision, and were radical, a little bit out there on, on the edge, you know, in the early days at J& J to make those big investments. When I think about some of the large strategics and the differences. I've worked at Medtronic.

They've got some amazingly talented people there as well. But when we talk about, the difference between highly matricid environments and, cutting edge, startup, eat what you kill and you better be amazing from day one, and we're not going to train you, we expect you to have that when you get here.

Those are just very different things. And I think they attract different people, with different skill sets and different wants and desires. So. I've been fortunate enough to seen all of it. I would love to be who wouldn't want to be at like a Medtronic or a J and J or an Intuitive and be given the keys to the kingdom in an unlimited budget, and really no one saying you can't do that. That'd be great. But that just doesn't really happen. It certainly doesn't happen anymore. At the large strategics, that's why they're acquiring, right? It's very hard to develop anything from within. We were very fortunate to have some amazing engineers and some really good insight from physicians, Everything we built at Ethicon Gyna Care. We had a couple acquisitions, but a lot of that came from, in a lot of the material science stuff came from within house, came from core competencies and then development outwards, I think now. You just see a lot of the strategics that are, they're acquiring what they don't have, right?

If it's Boston Scientific acquiring Exonix, it's, hey, neuromodulation maybe even better than we do. And this is amazing. And you've already got it up and off on the ground and got momentum. We're just going to do that. So I think acquisitions have played, are the way they're making that happen.

And some of them do it really well. I don't know if anybody does it better than Smith and Nephew, our Stryker, I should say, in terms of just bolt on acquisitions that just tend to bring value, they do a really great job with stuff like that. So yeah, you're either, you need to be at a strategic that is, that has that kind of Stryker mentality of finding the great things to bolt on and then a really good team to let them do it.

or, you go create your own path at a startup, which is, what I've chosen to do as well.

[00:09:26] Patrick Kothe: So today's discussion, we're going to be focusing more on the commercialization side, not on the product development side, because you have built a very successful career on the commercialization of new technologies. Tell me how you do that.

What is the pathway? We got sales, we got marketing, business development. Tell me your journey. in getting, your expertise built in, commercialization.

[00:09:53] Joe Steele: I've been fortunate enough to have started in sales and get my footing in sales. So being in front of the end user, the customer, in the trenches, so to speak, carrying a bag and then move into sales training from sales training lead, go into sales leadership, very, regimented matrix, environment that I was in at j and j, in terms of training.

And then I've had an opportunity to also do upstream and downstream marketing. And then finally in this last position, a taste of kind of like, how do we put it all together? To create a commercial launch organization that can be successful on the timeline that we're all demanded to be on these days.

The success you'll find in commercialization comes from having a toolbox that is deep enough and broad enough and diverse enoughyou can draw from it because when you move to that early commercial company, that startup company, besides your board, you don't have anyone going like, hey, you know what it really be a good idea? You should try this Joe. Like that just isn't there, right? You're expected to be that person. And that is, that's challenging for anyone who hasn't led. It is never about, Pat, it's never about tenure really. It's about how many experiences have you been able to get under your belt?

I'm rewatching band of brothers. And in two years, like those guys went through so many experiences. that they became hardcore, just experts. And they looked at the new guys like, yeah, you, you got to do this, but it wasn't about being 50 years old or going to West Point, it was about living long enough and acquiring the knowledge necessary, to move on to the next stage.

And I think that's been part of my success. I've just. I've lived long enough, I guess, so you know, and I had like nothing's killed me yet. So I guess that's a good thing.

[00:11:38] Patrick Kothe: Yeah, I just wrote a post on LinkedIn, as a matter of fact, talking about experience and experience is not your resume, where you've been. Experience is all of the things that you've picked up along the way, all of the skills that you've picked up. Because as we build those skills, now we can look for patterns within different things.

Because every I've launched, 50 plus devices in my career. Every device is different. Every situation is different. Every customer is different. And if you apply the exact same cookbook for the 50th device as you did for the 30th, it's not going to work because you've got to, you've got to put your new situation in, but you draw on all of these other experiences that you had in order to have a good solution to the problem and not just saying, well, I did this last time, this is going to work this time.

[00:12:33] Joe Steele: Oh my gosh, there's there's probably no sooner rate of failure in the dynamic environment that we're in right now than to think that what worked before will work again. If you that does you're probably lucky or you haven't strayed very far, or you're not in something disruptive, you're just applying.

But I gotta tell you, I I, it's you in your career, if you're not striving to learn something new every day, to never be the smartest person in the room to surround yourself by, by people who can bring you to the next level, will give you those experiences, then you're shortchanging your career,

[00:13:04] Patrick Kothe: And I'll speak from my own personal experience. When I was younger and early in my career, boy, I thought I knew everything. And it took some humbling to understand that I don't. And as you described your career growing up on the sales side and then moving to sales training and management, I have got a similar background. Started carrying a bag and then moved up, moved over into marketing and then took over other leadership positions as you move on. And every time that I moved up, you start realizing, boy, I don't know as much as I thought I knew. Boy, I wish I would have gotten more information before that.

So, I've become more humble over the years.

[00:13:48] Joe Steele: It's not only what you don't know. It's what you don't know. You don't know, right? It's, it is. And the breadth of the experiences that you can bring in are really what help would help. And I think one of the actual, biggest derailers you can have if you want longevity and you want to increase responsibility of roles over your career is that you have to be enrolled long enough to actually have those experiences.

if your goal is I'm going to move, I'm going to move, I'm going to move, I'm going to move. I can guarantee you this. There's like one in a thousand people that can move out of a role within a year, and have actually gained the experience from that role to go to the next level. And then there just becomes this self limiting ceiling where you're like, you just get to problems you can't solve.

if you're that one kid from Boston that, solves the problems on the wall of Harvard. You might be able to get through, but if you're like the rest of us, you have to acquire, you know, uh, course one before course two before course three before you start going into, algebra, trigonometry, and the rest.

Like, you have to have that base. You can't just start at trigonometry and start doing advanced mathematics day one. You have to have exposure to those things, for most of us, 99 percent of us.

[00:14:56] Patrick Kothe: and I think the other interesting thing is, when we promote people, we're going to pro, if that's a top performer, he's had success, we're going to promote that person. Now they got success. Okay. And they're going to promote that person. The valued learning comes from failure. that's where the real value of learning comes in.

So if you are not in a position long enough to experience failure, okay. As I said, I've launched over 50 products. Not all of them have been great. Some have been dogs and some of them, some of them were my fault. And when you have to look back and say, what did I contribute to that? Well, I don't want to go through that again.

Let's let's feed that learning back in. But as if we just promote the person who's never had that at some point, they're going to run into it.

[00:15:44] Joe Steele: Yeah, a hundred percent. embracing the never wanting to be the smartest person in the room, embracing looking for the diversity of opportunity and experience and always being on the edge. If you're uncomfortable, you're probably learning. You know, my grandfather said, you know, you know, we don't learn something when we do it right.

We learn something when we do it wrong. And there's been a number of like alpha chargers that have gone from. Every facet of their life to not really ever doing it wrong. Like we all know the person that could do the backflip day one, right? They can just do it. Can they teach it to someone else?

Can they scale that? That's the big thing, right? When you bring your leaders in, they have to be able to help you scale an organization. So they have to be able to teach or be able to scale the teaching through others to lead through others. You know, that becomes the largest skill set you have to learn and that's really hard to do when you haven't failed.

[00:16:35] Patrick Kothe: So looking at the beginning of your career and where you're at right now, did you realize that at the beginning of your career? Did you say, I need to have these experiences. I need to stay in for a period of time. I need to move from this discipline to that discipline in order to get to the level that I want to want to go to.

[00:16:51] Joe Steele: Oh my god, no, I was that kid that like, you know, that stove is hot. Let me just try it, you know, I was You know, I had to test it out. No,I was immature. I, I came from, I worked on Wall Street a little bit. I had been a finance guy, had, some swagger and I got brought into this, crazy world of med tech and, I was really just thought I had to be promoted every two years and the faster I moved up, the better I moved up.

You know, I moved myself and my family three, four times in those years. A lot of sacrifices. And ultimately, looking back on my career and I see some of the people. that have done it really well and super efficiently. It's more about the thoughtfulness of their choices, their willingness to take non linear roles that brought additional perspective.

I think one of the biggest things I've seen that helps create success for the individual, success for the organization is those folks that, say I'm going to go take a country manager position at XUS. I'm gonna go see the rest of the world, right? I think that's probably one of the biggest missteps I made early on is I didn't view the ex US as having the value that the US had.

It's super, super, you know, immature, just thinking, right? Very fatalistic. US is the best kind of thing. And,what you learn is there's something you can learn from everywhere. and there's perspectives that we have to bring in to create that diversity of. Of thought. but yeah, it's, I look back on it.

No, I wasn't that person. I, I was, I thought I was a failure when I wasn't promoted. And you know, I became a regional manager at Ethicon in two and a half, three years. It was almost unheard of, but very, very rare. And then it's like, all right, what do I do from here and what do I do from there? And ultimately, hopefully you find a mentor and they will take you to say, listen, if you're not acquiring this, and this, in this timeframe, I'll give you a great example. we built such amazingly great teams, mostly because we had amazing products. We never actually got to test those folks in really challenging positions.

Because the technology was so amazing. So guess what? I didn't have to learn how to hire unbelievable talent because the product was amazing. That's good. It's not a bad thing. It's just good. And I didn't have to, I didn't have HR issues. I didn't have a lot of those things that many first, second year managers deal with.

I didn't deal with that till 15, 20 years into my career because I'd always been in a position of rising, sometimes of my own doing, but a lot of times carried by product and team and company. And yeah, that was just the perfect example for me. I don't. I didn't have many people I fired. I actually promoted nearly all of my people.

That's the, that coaching and growing and skill sets. I didn't acquire those too much later in my career as opposed to some of my peers. Oh, like on day one may have had just a crazy HR issue. Like it's just a skill set you work through. They got in day three. I did not have that until day, year five.

That's different.

[00:19:38] Patrick Kothe: As the saying goes, success is a great deodorant. We live through a lot of things that, um, problems that are under the surface because we're being so successful and only when the worm turns do we start, start understanding, I guess I wasn't as good as I thought I was.

[00:19:58] Joe Steele: If you're not questioning your success every day, you're just waiting for failure to happen. I mean, in the good times, when you are rising, that's the best opportunity to take a break, understand your success, and understand your frailties and the weak spots, and you address them then, right?

You don't want to address them as the bullets are flying. You address them in the down moments between the battles.

[00:20:19] Patrick Kothe: So we hear a lot about, current generation, younger people coming in, coming into the workforce and having that, um, thought that, I want to get, I want to learn more. I want to get promoted every year or two years. Is that new or did we do the same thing?

[00:20:36] Joe Steele: I think the percentage of people that are doing it now is just different. We certainly had hard chargers, right? As when we were going through the system 25, 30 years ago, and we were both one of those, I mean, I just wanted it, you wanted it more, put my hand up, I'll move, I'll do those things.

I see incredible greatness and intelligence, and creativity from this next generation. And I think that also has to be, put in the capsule of you're not going to have everything on day one. Um, you're not with a terrible company if they can't promote you in day one. Part of the hard part it's going to be for the startups is attracting that talent and getting them to stay right.

If you're not growing a thousand percent and you're not getting promoted six times, are they leaving? Also, if you're with a company with an unbelievable mission, you will retain your people. I was underpaid at J and J. I'll just say that out loud. I was completely grossly underpaid.

We were a startup growing at 50 percent per year. We went from zero to 500 million in eight years. And I don't think any of us ever made more than 200 grand. Like, I mean, it just, like, just, we weren't paid that way. We're that generation before the, and the Ethicon guys and gals before us were paid even less.

But I had this unbelievably well articulated vision, that I was able to enroll myself in, the better good of what we were doing in that belief, and that's what held me in that position probably to my own career detriment. And I think with today's teams and today's, folks, you're either going to have to pay them, you're going to have to unbelievably challenge them, or you're going to, they're going to have to be enrolled in a vision. So I just, I just think there's a greater number of those people that are now like, I don't have to be with one company 20 years, Joe, and I can go to seven companies in eight years and I can give them a solid year at each.

and I think that's probably true for the top 0. 01 percent of the talent that's out there and the rest of the town. I, it's a little bit of, you're kidding yourself if you, if you're thinking that's the reality of the world, cause it certainly isn't anymore in terms of company's ability to move people that quickly.

And we face that in our business today. I've had, had some, positive, negative attrition where people just don't feel like they're moving as fast as they can move. And I'm like, I've promoted you twice in two and a half years and you have double the responsibility you had and the company's growing at a hundred percent.

What, what, what is your definition of fast?

[00:22:56] Patrick Kothe: And that's, that's a great challenge because you, you could put the artificial things out there. Well, I'm going to go from product manager one to product manager two to senior product manager, and you're doing the same thing, but you're getting a bump in salary and a bump in title, but are you really learning anything?

I mean, that's one way to artificially do that. But if you're truly promoting somebody, but you're doing it at a rate that's, An artificial rate, you're not allowing them to learn. And as we talked about to really get those positives and negative experiences through there,you're holding onto those people.

But are you really developing those people?

[00:23:36] Joe Steele: Let's be honest. I mean, the development is a luxury, that is held by the medium to strategics because they have the time, energy, money, and resources to develop people, right? It's much, much harder to be in an early commercial or startup experience where you have the time, energy, you always have the want and willingness to develop people and bring in great talent.

But when you're moving from. surviving to, to thriving in that adoption curve. it's really hard to say, Hey, you know what, let me give you a couple hours of my time to give you my experience and let's walk through that. that is, I feel like that's one of my largest challenges in early commercial is, if you're bringing in people that want development, I don't know that that's the right place.

I'd love to say we live in a, Panacea, perfect world of, Hey man, we're growing a hundred percent per year. And I'm so amazing at my job as a leader. I have time to give to you that apparently no one else gave you in your career, but really early commercial startup. I should be bringing in people that are better at the job than I can be.

I should be a net importer of talent and they should already know how to do that job and the job above them when they come in, because that's what the. That is what I'm offering them. I'm offering the opportunity to cut the line. You can stay at Medtronic. You can stay at J& J. You can stay, you know, at Striker and they're amazing companies for great people.

And that'll take you this long. Um, if you have that same success here, you can probably do it in a third of the time, or through equity or some kind of other reward. Or I honestly, I think the biggest reward Pat today is to be part of something that truly moves the needle on patient care or patient outcomes.

Not all of us in med tech have had that ability, right? If you're in durable medical, maybe you haven't had that ability, but if you have launched a product that becomes standard of care and impacted million of people to, even if you're the janitor in that company, you got to be a part of something great.

And I think that's why many of us stay in, in med tech,is to be a part of something great once in your life in terms of giving back and doing something positive.

[00:25:38] Patrick Kothe: I completely agree. One of the, one of the things as we're talking about this and we're talking about building skills and how the industry is changing, how our companies are changing, how our management has to change. One of the skills that we really need to also develop is training because we know that If this is the case, we're going to have greater turnover.

You still need to have competency in your organization. So how do you bring somebody in and get them competent as quickly as possible, knowing that they may be gone in two years, but your mission is still there. You still need to need to move that forward.

The odds of me having turnover are higher than what they were 10 years ago, and how am I going to address that? What systems am I going to put in place to make sure that I've got continuity when somebody does leave?

[00:26:33] Joe Steele: Yeah, 100%. And here's the other thing. if you are not large enough to put those systems in place, then outsource them. Don't give up on something that is an absolute must. You have to be able to train your people. The training can be a little different, right? It's, I'm not, we're not going to train selling.

I'm going to train you on how to sell our product. I think that gets lost in the mix sometimes. Like I'm going to, I'm going to train you on our specific value proposition to each of the five stakeholders in this ecosystem that we're trying to disrupt. Training is absolute. It never stops. We struggle a little bit with it just because of our size, and not having a dedicated function.

Um, and that's when we're going to be able to do it. You are also hoping that you've brought other people into your organization. And we have recently that have training background that are going to, they're going to be, you have to, if you're hopefully bringing in some profiles that are like, listen, I want to see this thing win and I'm going to do whatever you need.

You made you some training today and I have the background to do it. Great. And we have to rely on our people, to be, utility players at times, like you're going to do your day job and I need you to do this. Is that this environment you think you can thrive in? Yeah, man. I'd love to do that when I'm not doing this I can do that. But like I said, if you don't have those resources outsourcing them. is a great solution as well. There's plenty of companies out there that will get you will provide you that, that resource.

[00:27:50] Patrick Kothe: So I want to talk a little bit about Hemosonics, kind of what you're doing right now, and then I want to go back to the commercialization process and where we are today. Because it's, it's really morphed in the 25 years that you've been in it. But, and part of it has to do with how we Look at marketplaces today versus, even, five years ago.

What's changed? But let's let's kind of lay down what Hemosonics is and the challenge that you've gotten the opportunity that you've got to help patients

[00:28:25] Joe Steele: Yeah, absolutely. So Hemosonics is a innovative technology company. We play in the whole blood diagnostics arena. And within that we are in the acute bleeding management part of it. So we are in the OR at point of care, helping physicians make optimized decisions on transfusion therapy. We help them, we give them a huge piece of information and a very accessible and easy to interpret diagnostic, uh, parameter, and we do it in near real time. So you're in the CVOR. You've got a patient that's oozing or bleeding. We can run it. We can run basically with 2 or 3ml of blood. We can run a whole blood sample in the OR with a system the size of a small printer, sitting off in the corner and in 12 minutes we've got all of the parameters that really help to define, do we have a coagulopathic bleed?

Or hey doc, did you nick something that we didn't see? And having that information at your fingertips. creates efficiency, reduces cost. Obviously it drives optimal patient, therapy. and let's not forget we were in, uh, you know, post COVID, we were in critical blood and blood product shortages. We will be for the next decade.

We never have enough blood. When products are used more of in a shotgun approach, like I don't really know what the patient needs. I'm not going to wait for that test to come back from the lab, right? Lab does an amazing job. There's some of our best partners. They are the backbone of the diagnostics and they really impact patient care. But if I've got a patient bleeding in the OR, sending to the lab, down the street, just, logistically doesn't work. We,

[00:30:03] Patrick Kothe: So prior to your technology, prior to this 12 minutes, give me the, give me the scenario, patients on the table, bleed happens, what happens prior to your technology?

[00:30:15] Joe Steele: prior to my technology, they would take a sample, they would run it to the lab. the lab would put it in the queue with everything else they have. If it's marked stat, it's marked stat, but you've got travel time right to the lab. Oh, maybe it's not, it's never, the lab's never on the same floor as the OR

you might have a stat lab, but you probably don't. It's probably down in the basement. If you're at some of the major academics, it's down the street. And they would run that test, and maybe at the best, it might be 45 minutes, could be an hour, could be an hour and a half. But

[00:30:45] Patrick Kothe: What's going on in, and what's going on in the OR when that's, when that 45 minutes an hour is happening?

[00:30:51] Joe Steele: Exactly. That's what I asked the physicians. I'm like, so what's happening while you're waiting for that? Well, it's a hemodynamically that patient's a completely different patient. That patient's a different patient minute to minute, let alone, looking at the clinical presentation of what's going on in the OR, waiting an hour and a half, the results come back.

You're like, Hey, that's great. I look at it and I look at it like I'm on the highway and I'm using Waze. But the latency on Waze is an hour. That doesn't really help me navigate traffic, right? Like, oh, I should have taken the left at Albuquerque an hour ago. Okay. Thanks. Thanks. I can't do that now.

You know what I mean? Like, you know, it's a bug's bunny. ah, thanks. I should have taken a left. Like I, I can't do that now. Um, you know, and, and also, you know, we help navigate the siloed nature of the lab doing everything they can do to be the backbone of diagnostics. And then the clinician is patient facing.

Those are silos. the lab doesn't see the patient, they don't actually have that and they don't always understand the need for the immediacy and urgency of the results, especially in cardiac.

[00:31:57] Patrick Kothe: 10 years ago, if you were introducing this product into the system, how would you have introduced it?

[00:32:07] Joe Steele: Well, 10 years ago, uh, would have been much easier. Uh, but how would I have introduced it? I think we would have had to do a lot of education. We would have built as we would today, not much different. We would build out value propositions for each of the stakeholders.

Knowing what we know now, we would look back and understand the importance of the decision maker in the lab, right? So when you've got siloed decision makers, that don't actually talk and yet alone, the other complexities, they don't actually hold the budget for the other one. I need to use something clinically, but over here, I'm going to pay for it.

And I don't have any benefit in my department from the great outcome over here. That's been our law. That's the, that's a large challenge for many organizations is. At the enterprise level, it is absolutely the right thing to do. At the patient level, it's absolutely the right thing to do. I use this in the best way possible. The dysfunction in the box in the middle is how do we get everyone aligned to the same page that don't have the same incentives or don't have the same alignment to the outcome. but I, if you were hard pressed me, I'd say, yeah, 10 years ago, we start with a lot of education, around connecting the dots between the diagnostic and the lab team and the stakeholders, the clinicians that actually have to administer that, and the anesthesiologist that have to act in the blood bank that actually has to give that product out.

Having a better education and awareness on that. It would start with open conversations and webinars around that. This is the problem. This is the impact to the patient first, always. This is what you're doing and you don't know, and this is what you're doing. And you do know, and cross tracking that, you know, across those silos to give them, To, to diffuse the animosity of you're not giving me what I need. That's not my job to how do we put the patient in the middle of that? And then also I probably would start very high level with, the C suite, which is what we're doing building now, which is that value proposition around the enterprise value of bringing technology and it's not just about cost.

It's it, but it has to be profitable. Let's just face it. If it's not really profitable or at least net neutral. It's not that hospitals aren't willing or wanting. It's that there's so many things in front of you,that they can, that they're looking at today. And today's even harder.

[00:34:32] Patrick Kothe: So 10 15 years ago, um, the decision maker is probably different than it is today. Who was the decision maker 10 15 years ago?

[00:34:44] Joe Steele: 15 years ago, I can bring this to one cardiothoracic surgeon. They'd be like, yep, we need that Joe. And it's in, go get a PO. Like that just was the way it worked. Probably up until a decade ago. and I don't know that's right. I don't know that it's wrong. It certainly worked for us. and, but I've also been on the right side of amazing technologies.

So was it easier? Yeah, but it was also better because patients got access. I think the best systems, I'm talking to people would probably be a value analysis committee that has a heavy influence or, has a partnership with lead clinic that there's a clinician involved in the value analysis committee, right?

When we were in patient safety, we'd have people literally going Hey, your gauze is this, and that gauze is that, and like, this is just gauze. I'm like, wow, you missed the whole solution part of it. The technology in the gauze to prevent the retained surgical item, and that isn't on your line.

This isn't mesh to mesh. It's not, stapler to stapler. This is solution. It's much harder than solution, disruptive technology, because you're not replacing something. You are creating a new operating system, that should yield better results. So in my mind, the optimal system is having your, having a key financial, key, operational and key clinical,delegates on your value analysis committee to do true value analysis and to let the vendor have and the industry have a voice in there that way.

[00:36:08] Patrick Kothe: I wanted to start back 10, 15 years ago, because I think it's important for us to realize that, the world has changed, but we also, those of us that have been in the industry for a while, we've got stuff that's embedded in us. And, we look at it from that way. Somebody coming in new to the industry would say, well, you guys are nuts.

You know, that, that's, as you said, you didn't know if it was right for that CT surgeon 10 years ago to say, I want that, bring it in. Yeah. and it shows up. I think what we had at that point, we had a lot of stuff that came into the hospital and a lot of money that was spent and that wasn't used, for a variety of reasons.

So was it a good, was it a good system 10, 15 years ago? Well, if you're selling a product, a one time product, yeah, it was pretty good for you, but was it good for the system? Well, if it's not going to be utilized and you're just spending money in there and it's, taking up room in the corner of the OR. Not so good. So let's talk about today's environment. And I think as you described the VAC committee and having multiple stakeholders in this matrix sales process, what is the best way today to introduce a technology like yours in this changed environment?

[00:37:28] Joe Steele: So we are like three levels of complexity from where we were, 10, 15 years ago. So in a nutshell, like I said, like you were mentioning, Pat, that chief surgeon could bring something in right, wrong and different. It happened, five or 10 years ago, value analysis really started to take over the process, um, you know, in the last few years we have had the ability to have clinical operational input to that. I think today to be successful in your commercial launch, you have to develop value propositions for each of those stakeholders in their own native language. What is important for each of those stakeholders? To understand how does that ladder up to the benefit of them, their patient, their department, how does that ladder up to the greater good of the organization, tying it into the enterprise goals of the organization.

So we're working more of a top down, bottom up approach, right? Where I want to meet with the C suite. I want them to understand our mission of an org, as an organization. And why should this be on? Why should this be in the top five of your war room? So this year, my goal, right? Or our goal, right? Is how do we get to be that top 10?

Nothing else is going to get done besides those. You're going to have contract switch outs, suture for suture, mesh for mesh, this, for that, stapler for stapler, ENT for ENT, that all gets done with contracts, everything else that's new and it's bigger and better, or as disruptive is going to be put on a board and it, and you're going to be competing with other enterprise initiatives.

So we look at it from the perspective of I have to have an enterprise value proposition. Okay, you are spending 30 million a year on blood acquisition. That's the hard cost. Hey, Joe, why isn't my team bringing this to me? then I have to be able to explain why is this not organically coming up to the C suite internally, right?

So I have to find a nice way to not call their baby ugly, but say, Hey, there's just organizational dysfunction. there is everywhere for us it's hey, the lab does this amazing job. They're not tied into the cardiac surgery OR. They don't see the need. The cardiac surgeon just believes something should show up tomorrow, doesn't understand the complexity of bringing a point of care device in, and they're siloed.

So no one is going to bring that to you because of the siloed nature of the organization, right? It's why amazing ideas don't go from the janitor to Jeff Martha at, at, you know, at Medtronic, right? Because there's too much In the middle. We have to have a really good way we explain that to the C suite.

And then for every other stakeholder, like you have to look at it. What problem does this solve for them? We all talk about how we're going to save OR minutes. We're going to save dollars. That's level one. You need level two, level three insight. How are you saving those dollars?

Where do those dollars actually map to within the organization, right? If, and here's the hard part, if no one's actually accounting for those dollars, they don't really know they're lost and you're in trouble because it's no one actually cares in the middle. because they're not being held accountable for it.

In patient safety, we had amazing hospitals, where the OR was not held accountable for certain outcomes, and they weren't measured against it, but the budget to supply our product came from them. So they're like, Joe, why would I spend $300,000 more on this when I'm not even held accountable to that? And that's when I have to go to the C suite and go, you have a disconnect.

You have amazing people down here doing amazing work, but they're never going to bring you this because they're not aligned to the outcome that you, is actually on your dashboard. So you have to find out what does the dashboard look like for the people you're working with and that are integral to the decision process.

Because if you can impact their dashboard, that's a really good thing. And then fine tuning and refining that message so that it lands and resonates and it's so compelling that they are moved to action, easier said than done for sure. But that's the template that we're using.

[00:41:36] Patrick Kothe: What's challenging is that you talk about the different stakeholders in there and finding value props for each of the stakeholders. Sometimes there's a negative value prop for somebody. Where you say, we're going to do this work and it's going to be moved into the OR. And now we don't need as much, as many people, so we're going to, we're going to downsize your department in the lab because you're not going to be doing that. Well, they're not going to be too happy about, embracing this new technology, that stakeholder, but it's better for the patient. The, the, the, the OR team is going to be much happier. It's going to be better at the, at the C suite level. So managing this process is sometimes complex. And the other thing is, I want to ask you about face time in the C suite, because we keep hearing that, people are, establishing relationships at the C suite. Everyone seems to be wanting to get in the C suite, and there's only a few C level people in there.

So getting that relationship established, How has that been for a new technology?

[00:42:45] Joe Steele: Oh, it's incredibly difficult, depending on the size of the hospital, 15 years ago, you were at a small community hospital. It was not uncommon that I could get that in that audience. I think there's also people who say they call them the C suite. And then there's actually the people who call them the C suite.

Um, you know, I mean, how are we defining the C suite? You know, the VP of peri op is not, it's not really C suite, right? If you're talking to the chief operating officer, the chief medical officer of Novant or whatever, you're talking to the C suite. You're talking to someone who has enterprise responsibility.

There has to be a compelling narrative for why they're going to give you any amount of their time.We use a process, that we've cultivated over the years. It's nothing new. Anyone who's worked in challenger sales or any of the more disruptive sales models knows that we have to open up for impact.

We have to give a reason for that executive to want to listen to us, and it has to be relevant and important to them. but yeah, that may start with, me connecting with someone on LinkedIn, and then I try to bring them value in some way, maybe adjacent to my product, but just to show them that I am someone that they should want to talk to and then, yeah, then the process, I have to pre sell before I sell.

And then ultimately you have to remember your product won't be right for everyone at that moment. And that, that is, you have to embrace that. And I've, the second, it's a great day of freedom when you literally can say to people, I don't think this is actually the right technology for you at this moment.

We're pioneering, this area, this is a pioneering, technology. If you're not willing to accept. XYZ as part of that pioneering process, then yeah. And then I've had these hard conversations. I'm like, you just can't say you're a pioneer then, you know, it's, it's a tough, it's a, maybe that's just a Northeast conversation.

I don't know, Pat, but there's tough conversations we have. And the second that you create that equal business stature where you can have an honest conversation with someone, it's like, listen, you can say you're the best. My job is if you're going to say you're the best and you need to be the best at this metric and you're not.

So we're either going to have an honest conversation and we're going to talk about why you're not, and I'm going to tell you why it's still important to you, or we're not, and that's okay too. Of course, the nuance and the emotional intelligence of delivering that message in a way that they will listen to you is is a lot. that's the tough part of it.

[00:45:05] Patrick Kothe: The skills one needs to sell clinically is different than the skills one needs to sell at the C suite level. So the type of conversations, the type of training, the type of people in this complex sale becomes extremely important to understand how your sales process is going to work and then how do you get to those different people.

Tell me a little bit about that and the difference between Medtronic, where you've got a lot of people who, who can do a lot of things and a startup where you're a little bit more resource constrained, but still have to sell at these multi levels.

[00:45:48] Joe Steele: It's interesting, right? Because, some of the large strategics, I think they're actually handcuffed.I think they can actually struggle. That's why they're requiring smaller companies. I've loved my time at Medtronic. I love the people I worked with. Very bright, very brilliant people.

But I mean, there, there's also times where, I'm working on something incredibly innovative. not novels, probably other great companies working, but I'm working on something innovative and, um, you know, in, you know, a true value play and a hospital says, wow, that's amazing. We should do that, right?

Like true value based healthcare. and I remember this one example where, this one all the way to Omar's team at Medtronic, right? And now I've got like Omar's lawyer on the phone at a conference call with this great Pennsylvania healthcare system. And they're going like, Hey Joe, we thought we could just do this in the back of a napkin and make this happen.

I'm like, no man, that's not going to happen here. There's a lot that goes when we start talking about value based healthcare, there's a lot that goes into it. So sometimes it's really hard to work within the strategics because of the, legal ramifications of working with a, 40 billion company.

It's why they acquire small companies and hopefully let them run their own business for a few years before they Ethiconize them or Medtronicinize them. At a small company, yes, our resources are limited. but when I have an amazing idea, it goes from me to the CEO, potentially the board, and then that's it.

And I can go back to that CEO at the hospital or I can have that conversation and say, you want to create something amazing with us? We can do that. let's get down to the, the bolts and tacks and let's figure out how to make this work. You want to really do healthcare this way? We can do that.

And that has opened up some amazing conversations and here's the great thing, Pat, the conversations that opens up actually create a win because they may think they actually want value based,buying and purchasing. I'm like, we can do that. Of course, you're gonna have to open up all of your books and you're gonna have to understand your own metrics so I can create a baseline.

They're like, oh, that might be hard. We don't actually collect all that data. Right, exactly. But at the same time, It draws you down that road of being able to do it or not being able to do it. But it does create a nice bond and being in a small company. Yes, you are, you're constricted by financial resources.

But innovation comes from the most unlikely of places. It just comes from people with great ideas and I have absolutely no red tape. We have compliance and anything that is compliant, we, that we can envision, we can make happen. And that is what is amazing about working at a, a small company.

It's not that the J& Js and the Medtronics don't do amazing things. They do, we've seen how they have start and stopped with, the RAS space, and how long it has taken them to get to where they are. And that's a mindset issue. That is a mindset issue.

That's not a resource issue. I mean, these guys, these folks are spending 10, 15, 20 million a month, a quarter. To commercialize and five years later, we're still where we are. So resources do not equal results, right? That's the biggest thing. It's really, do you have an innovative idea?

Are you, are you unlimited? I'd rather be unlimited in creativity than unlimited in resources. Because with creativity, I can do a hell of a lot.

[00:49:11] Patrick Kothe: Where do you stand right now in terms of market, adoption, acceptance? Are you just at the front end? tell us a little bit about your commercialization, early commercialization.

[00:49:21] Joe Steele: Yeah, so we're standing on the shoulders of a couple legacy technology companies that have been around for 20, 30 years. They've done some great work. We looked at what they were doing and we said, how can we make this all better? And that's where we're at today. We are working through, lengthy, long term contracts with legacy technology companies and disrupting to say, this is a way you could do it. We're doubling in size every year from a revenue perspective. More importantly, from a base revenue perspective. So we're going on our third year of doubling revenue. small numbers begin with, but that's the geometric progression you need.

[00:49:56] Patrick Kothe: When did you launch?

[00:49:57] Joe Steele: We launched in the U. S. in 2018, 2019. I think the biggest thing I'm honestly proudest of is when you're trying to bring things through the FDA during COVID, like that's not easy.

It's not fun. probably the best gift that our competition ever got was COVID on some levels, because that really took the surprise advantage, right? Of the attack. Be like, we know they're stuck in the FDA because they're running a trauma study, and to run trauma study, you have to have the patient's family sign off on the, on that letter, and they're not allowed into the hospital at this point.

So, you know, we had a two year delay. in our trauma study. but, here we are today, we, I believe we are the most innovative, player in the space. Vizient and other organizations believe that we're innovative as well. We've brought four or five, clearances through the FDA in the last three years. I think that, for a small company to have a regulatory team and an R and D team that can do that is, that's what really attracted me. and yeah, the, the doubling size every year. I mean, yeah, it's, It's not much in the first two years yet in year three, four and five. It's, it becomes massive. And the goal is we're going to be the dominant player in the market over the next five years, for sure.

[00:51:14] Patrick Kothe: In my experience, as much, research that you do prior to launching the product and under, you're trying to understand the process, trying to understand everything that can go right and go wrong prior to launch. It helps, but when you hit the market, that's where real learning occurs.

[00:51:40] Joe Steele: What did Mike Tyson say? It's like everyone's got to plan until they get punched in the face.

[00:51:44] Patrick Kothe: Yeah.

[00:51:44] Joe Steele: Punch in the face for many companies and a terrible thing for all of us to go through, but certainly if you're leading innovation. COVID was very terrible.

[00:51:53] Patrick Kothe: So aside from what we all went through with COVID, what were some of the things that you learned early on that, that you hadn't anticipated? And this could be anything about the product or the sales process or the,the value prop that you got a little bit wrong. How did you,learn those things and what was it?

[00:52:18] Joe Steele: Yeah, I think we had two things early on. Not to dig too deep into our own coffers here, but I think we had two things really early on that, that were really tough. One was the value proposition for the enterprise and the amount of ambient noise being created by our environment that no matter how good this looked and sounded, and I'm talking about multiple seven figure savings, why would you not want to talk to me?

And understanding where the buying, the economic buy Power was coming from and the clinical power and how they were misaligned on the outcome for the patient and just how heavy that lift would be to align them and to move them forward. So, you know, you've got a lab that owns the CLIA license, the ability to do the work, that and they are strapped and they're doing so much every day and then you're going to, you're going to say, hey, we're going to put this at the point of care, not in the lab where you can watch it every day.

We're going to give a Ferrari to your 17 year old child who just learned to drive. That's the cardiac surgeon. We love them too. But we're going to give that to them to drive, and they really haven't had any driving and they're like, Whoa, that's a problem. We didn't, I don't think as an organization, even prior to my time that we really realized how big that would be.

So we needed to solve that and that's really coming through the partnership we're doing with the lab to understand the world from their view, and the importance that they do and to align more closely with them and then get them to partner. Um, you know, and I think secondly, when you're struggling because of your environment to bring things through in rapid succession, But we had cardiac hands down I believe we're the best cardiac diagnostic in our marketplace. And I think some of the best institutions in the country who are using us would say the same. Okay, that's all we had. And we got stymied by COVID and the bringing it through. So I'm I, then I have the challenge of how do I hire a sales team that needs deep cardiac experience, cause that's all I have to sell right now, but then as we move to liver trauma OB pediatrics, I'm going to need enterprise sellers. And that is a different mindset. Sometimes you get incredibly lucky. We've had some incredibly talented cardiac people come in and out of the organization. because that's what we needed at the time., Um, but I think that's the one thing we just, um, That was something that just hits you. Like I, I have to actually field talent today, for something that will change radically. And I don't know when that's going to change. So how do I hire that? What does my go to market model look like? What does my deployment model look like?

Do I run with, 4, 8, 10, 12. How do I run it clinically versus capital? Um, and those are the things in that market that changed so quickly for us. But I think the most important thing you can do is you take every bit of information you have, you make your plan and you execute your plan. You play the cards you have to the best of your ability.

And then you take the time to reassess. When you get a breather and you're not always going to get it right from the start,

[00:55:22] Patrick Kothe: And that's where experience pays off. That's where all these past experiences, all these other launches, you know, again, kind of looking for patterns within there, looking for the puzzle, looking for the right piece to employ, to be able to make that, make that puzzle come to life.

[00:55:39] Joe Steele: For sure.

[00:55:41] Patrick Kothe: Thank you so much for a really interesting, conversation, Joe. Really appreciate it. As, um, You're talking with other peers, other people that are launching new technologies into our medical device ecosystem today. What are a couple of things from a, from an overall standpoint when you're looking to enter a new marketplace, what are some of the things that, that you like to talk about to, to people that are in this launch phase?

[00:56:12] Joe Steele: I think it's kind of a summary of what we've been talking about. It is what is the most important thing to rally around in that first initial stage. I think the caution, the cautionary tale is,understand your market down to its nuts and bolts. Don't build out too quickly, establish your initial team very carefully and build slowly, as revenue builds.

There's nothing harder than, building out too quickly, having to re entrench, explaining that to the board, or other teams. I think, other things that we talk about are the ability of a very solid tech stack to enable you to touch the customer earlier in the buying process without, without the sales team, right?

To be able to digitally touch that customer earlier in their buying process. So I talked to one of my mentors and that's really what they're relying on. It's like our reps can't get to these people fast enough. We want to interact with them sooner. So technology allows us a very well integrated tech stack will allow you to communicate with those buyers and then only put your best people in front of those physicians, those buyers, whoever it may be, those stakeholders when they're ready to be in front of so that the efficiency of your deployment is much greater.

Um, and I, I think those are the things that we really discussed and we're really trying to look at that tech stack and how we do that. Um, you know, our integration with Salesforce and HubSpot and,and LinkedIn and Sales Navigator and a few to empower our team to touch the customer, connect with the customer, hopefully get into that back channel where your product is talked about when you're not there. Those are the things that really, I think, matter at this point.

[00:58:03] Patrick Kothe: That was a fun discussion. Joe has so much experience in commercialization and how it's changed over the years. But he is laser focused on today. And how he and their team can operate in today's market. A few of my takeaways. First understand who you are and what resources you have. Joe spent a lot of time talking about big companies, small companies. And what resources he actually has to work with. So he's, he's come to terms with when you don't have resources, how do you view things? Um, bringing outside help in doing things different, asking people to do training. Uh, when it's outside of their jobs and when you do have resources, understand that those resources, sometimes they're, they're more of a crutch than they are really helpful to you.

The second thing that I really liked was being successful in a commercial launch today. And he talked about a lot of different things in this subject. But one of the things that, that kinda, he, he described it as you have to develop value propositions for each of the stakeholders in their own native language. And I think that's the key. Everybody talks about value props, but have you, have you translated into their native language? Once you do that, you understand how that ladders up uh, to the benefit of them, their patient and their department. And then once that's done, how does that ladder up to the greater good of the organization and tying it into the enterprise goals of the organization?

And obviously we, each one of these things you need to discover. You need to discover what those goals are and then how you fit. That's your value prop. The final thing was career advice. And he had so many great things that he shared, but kind of summing it up. He said, if you're not striving to learn something new every day, to never be the smartest person in the room, to surround yourself with people who can bring you to the next level who'll give you those experiences, then you're shortchanging your career.

Thank you for listening. Make sure you get episodes downloaded to your device automatically by liking or subscribing to the mastering medical device podcast, wherever you get your podcasts. Also, please spread the word and tell a friend or two to listen to the Mastering Medical Device podcast, as interviews like today's can help you become a more effective medical device leader. Work hard. Be kind.

 
Patrick Kothe
Previous

How to Build and Manage a Powerful Advisory Board
Next

Open or Closed Robotic Systems – Are We at a Crossroads?