[00:00:00]

[00:00:15]

[00:02:59] Rick: Lisa, it's been a while since I saw you in person, although we've spoken on the phone. Great to have you on the podcast.

[00:03:05] Lisa Suennen: Thank you. So good to see you.

[00:03:08] Rick: I've got so many questions for you. One thing Joe and I were talking about is just the fact that The response, the feedback we've gotten from a lot of our listeners is that we're taking a turn, really going much more into tech, innovation, disruption, and it always comes down to invest, investments, investors, and what's happening in the market.

[00:03:28] And there's no one better to have on than Lisa, the venture Valkyrie. So let me just jump in Lisa. I mean, there's so much that I want to talk to you about your, I think your intro kind of. Kind of spelled out your background, but let me just jump in on when you look back on your career It's been impressive obviously health care tech coming together.

[00:03:50] What got you started? What drew you to that space in particular?

[00:03:56] Lisa Suennen: Well, what drew me to, let's just say, tech, although it wasn't really intentional, was some really cool formative internships in college. Especially one at Regis McKenna that Regis himself was the, one of the forefathers of Silicon Valley. Helped start Apple and Intel and many other companies. And I worked at his professional services firm.

[00:04:18] I stayed in tech, general tech, for, you know, maybe five years before I realized I was kind of bored, to be honest, and in speaking to, to some folks, including my dad, who'd been a healthcare entrepreneur he suggested healthcare, because it had the potential to do something good while making well, you know, making money while doing good, kind of thing, so I ended up joining a healthcare startup pretty early on in my career that was extremely formative for me, and, Saw that all the way from its earliest stage to its ultimate exit and kind of stuck with it ever since, you know?

[00:04:51] Rick: Yeah being good and doing good I've always loved that and and from that kind of a start and that kind of a an introduction with the folks that you were You know, hanging with and part of your professional start to your career. You've seen a lot. I wanted to say this to the end, but let me just jump right in.

[00:05:10] What do you think about the current state of health care, health care technology? And really, where do you see it heading now? I always go five to 10 years. I think that's way too far. Let's just say three to five years.

[00:05:22] Lisa Suennen: Mm hmm. Well, I think healthcare is unfortunately you know, sicker than it's ever been in some ways. Just the complexities of the systems, how difficult it is for people to get good care and, and affordable care and equitable care and all of the things, you know, is, is becoming more and more difficult, I think.

[00:05:43] And I think the, you know, between the complexities and the consolidations and the economic world that we live in at the moment, I also think it's very hard for innovation to flourish. So it's a, it's a tough time, I think. I think technology, to focus on that specifically, is a tool in the toolkit to make things better if the incentives are more aligned.

[00:06:07] I think when the incentives are misaligned, technology has a hard time landing. And I don't believe personally that technology in the absence of services is that effective in most cases. So I think the trick is to Optimized services in a more thoughtful way for people, a more personalized way. I mean, with data the way it is now, we can be much more personalized and expand the definition of personalized medicine far beyond the drug world.

[00:06:34] And so I'm hopeful that's where we're headed.

[00:06:38] Rick: Yeah. And let me follow up with that. And I think the, you know, the sources of innovation, I would look historically at academic institutions, even government institutions. I have, I would say over the last three to five years, really look more to the private sector as the source of that innovative mindset and what's happening.

[00:07:02] Why don't you share your perspective with me and the listeners on your thoughts on how private equity and venture capital, the role they play in driving innovation in healthcare and medtech specifically.

[00:07:16] Lisa Suennen: Yeah, it's really interesting, Rick. I mean, I think a lot of innovative science and technology does come out of academics and government. But it's rare that it makes the leap over to the commercial side because there's the sort of skill set required to commercialize things from research to reality is often absent in those worlds.

[00:07:36] And so there have been a lot of collaborations to help, you know, people cross that chasm, if you will. Some of which work and some of which don't. People who come, you know, to the world with entrepreneurial and innovative ideas. That can make it, you know, tend to be more in the private sector. That is true.

[00:07:52] And because in health care, it costs so much to get a lot of these companies really to scale venture capital and private equity are essential tools for them. You know, it's hard to, it's hard to bootstrap a health care company. It is done and it's better when done that way frankly, but, you know, the creation of most of the companies you'd be able to reel off by name these days in healthcare that are considered leaders in innovative things, whatever they may be, outside of the hospital systems, really come from the, you know, venture backed world and then ultimately sustained in many cases by the P.

[00:08:29] E. backed world, although that is a very different kind of financing, I think, than venture.

[00:08:35] Rick: Yeah. And one, one piece to that, that I've, I've thought is that although there's so many good ideas out there. Particularly in the startup healthcare space.

[00:08:45] But what there is, is a lack of real world understanding of how healthcare and healthcare economics and the delivery side of the sector works. And I know with what you do at Venture Valkyrie, you know, not unlike what I do my, and my side hustle for lack of a better term is working with those folks.

[00:09:03] Tell me about the key messages and insights. That you bring to some of your clients who are really trying to take that great idea and commercialize it in the delivery space

[00:09:16] Lisa Suennen: It's interesting. I spent last week. I think it was last week. Yeah. No, it was earlier this week. My God. Time. Time compression. It was earlier this week. I was at a, a very well known very well funded, you know, extremely high quality, academically generated healthcare innovation very much embedded in an academic setting.

[00:09:41] And they asked me to come in and help them look at their five or six primary projects because they, they're very well suited for the academic medical center worlds they sort of live in, but they don't know how to bring them to the marketplace. And I think the thing that was so obvious to me, and that is often not obvious to folks on the, in the innovation world, whether it's from the scientific academic side or from even the private sector side, is...

[00:10:08] How money flows in the system, understanding that how incentives are misaligned or aligned in the system, what it takes to get people motivated and incentivized to bring on new ideas, you know, and how complicated the cultural issues are, both the financial and cultural issues are and how essential it is not just nice, but you know, like you got to understand how to work in that in that milieu in order to bring your people together.

[00:10:38] Program to life. You know, I was one in particular I thought was a brilliant idea, but constructed in a way where my first question was, well, that's all well and good. But who pays for that? You know, and why? And they really didn't answer that question. And I think I'm often the person, you know, nobody loves it.

[00:10:54] But I I'm often the person trying to inject the reality of the of the system into the into the discussion, even if it's a device or drug or whatever it may be service innovation, because I think Oftentimes, people get enamored of their technology or idea and they have this sort of, if we build it, they will come mentality.

[00:11:13] And guess what? If you build it, they won't come. Unless you really serve their interest.

[00:11:22] Rick: And they won't pay for it either. That's the other,

[00:11:24] Lisa Suennen: They won't come, they won't pay for it, they won't take your phone call, they won't answer your email, they want nothing.

[00:11:31] Rick: So let me, let me go down a little bit of a rabbit hole with that. I have been very, you know. Bullish on the consumer side of things. What's happening and evolving. I think it's generational and with respect to many aspects and positive features of it. How does that fit into that equation? It's almost like short circuiting the health care economic, you know, structure to go into this consumer structure, but still deliver health care services.

[00:12:03] Is that something you see sticking growing? You know, top of mind for me or our companies like Roman hymns, what, what what's happening now, I think with one medical and Amazon, where that could lead. Give us your insights on that.

[00:12:18] Lisa Suennen: So I think that consumers, patients, humans mostly don't give a damn and don't want to be associated with the healthcare system in any way. They don't want to be thought of as sick or think of themselves as ill. They don't want to think about it until they're in desperate straits and need to think about it.

[00:12:36] And the only exception to that, I would say, comes in maybe three areas. One is pediatrics. People will do almost anything for their kids, even if it costs them a lot of money out of pocket. Number two is cancer. People try anything to survive when they have cancer, you know, including pay for things out of pocket that are not in the medical system.

[00:12:57] And number three beauty and sexual aids, which are the, the realms of, you know, Hims and Ronan and Roman and many of these other companies because beauty and some of those other things don't get covered by insurance typically. Outside of that, I think consumers aren't paying for anything and won't pay for anything, and it's getting worse, not better.

[00:13:18] And I think companies that rely on consumer pay are usually doomed, frankly, unless they're in one of the things I just said. Because even one medical doesn't make any material money from consumers. They make it from insurance and from, you know, deals they do with provider organizations. And they found that out the hard way.

[00:13:39] You know, trying to get, create a business around just the, You know, the membership fees. It's it's it's immaterial compared to the insurance payments they gather. So I think while I hear you on the consumer front, and I do think consumers in some segments of society are more self aware and more engaged than previously.

[00:14:01] I would say it's a small minority and it's it's not a way to target a business except in the areas I mentioned

[00:14:07] Rick: great points. So when you're, when you're advising, you know, the, the investment firms, the cat that, that, that you're, that you're obviously. Putting your key insights to what kind of influence does that mindset, that thought process have when you're telling them about certain considerations for a given opportunity?

[00:14:31] Lisa Suennen: Yeah,

[00:14:32] Rick: in heavily? Are they surprised? I'm just, I'm just trying to gauge what,

[00:14:35] Lisa Suennen: it varies. I mean,

[00:14:36] Rick: that's an aha moment.

[00:14:38] Lisa Suennen: You know, they're often surprised, but they're, and they often will listen and sometimes they won't, you know, and you know, the nature of consulting and advisory work is, you know they want your opinion, but they don't always want to hear your opinion and listen to your opinion. And, it's probably the main reason why I actually don't intend to stay in this role.

[00:14:59] I'm actually looking for a CEO role right now headed back to the operating side because I think, you know, it's hard to influence companies. Either as an investor or as a consultant to really make big change in their objective because they've, you know, sort of set their strategy and they're willing to do some incremental stuff sometimes, but it's really hard to get them to make fundamental business model changes unless they've already experienced misery and doom, you know?

[00:15:25] I spent actually a lot of time counseling companies coming from overseas. And so many of them just do not understand the fundamental differences in our healthcare system from a, you know, a single payer, state sponsored healthcare system type model. And, you know, they are blown away, I think, sometimes by how illogical our system is designed to be.

[00:15:46] Maybe not designed to be, but turns out to be. And how different that is from, you know, their models in Europe and Australia and other places. How that makes the leap overseas almost impossible in some cases. I think digital health has suffered from this in the U. S. quite a bit, is that it really fundamentally is mostly designed, the products and services in the clinical side of digital health, for value based, you know, single payer type worlds, which we are not.

[00:16:13] And while we talk about it a lot, you know, if I had a, you know, if I had a dime for every time somebody said value based to me, I'd, you know, be rich and not on this podcast because I'd be in Hawaii somewhere. But I don't know. It's It's a complicated endeavor to try to get companies to and, and change their stripes, you know,

[00:16:32] Rick: Yeah. I think two big points in that one, you know clearly I, I'm in, I'm in total agreement with you on the, on the, on the overseas, non U. S. healthcare perspective. It is just apples and oranges. It's beyond there's, there's just no comparison. I mean, here in the U. S. that's right. Right. Phyla. Yeah. I mean, I think that's why we've got, we've got academics And masters and health administration and our policy and our economics.

[00:17:05] They're all within this structure of health care, which I think other, you know, fairly highly evolved systems with respect to health care delivery. They don't have any idea of some of the challenge. It is not only from a financial perspective, but just the regulatory hurdles and the delivery side here in the U.

[00:17:26] S. Which brings me to another point. When I look at investment right now, it seems to me that, you know, certainly on the on the health side, the tech folks who are trying to keep the faith for the future and what I think is kind of, you know, shaky times they're really looking at a handful of things.

[00:17:47] Maybe it's telehealth, AI, wearable techs. What do you think they're betting on for for 2024 and beyond that, is it just more of the same building on that or is it the tactical and practical? Is it models of care?

[00:18:05] Lisa Suennen: you mean for investors, I, you know, I think the big, the biggest sort of hot trend, if you will, is moving care to the home. Everything from basic, you know, to diagnostics, to care delivery, to even ICU at home. I mean, that is a massive trend. I do think AI is, well, certainly the buzzword of the year. I maybe the only words said more than value based in my day to day life, but I think there's still a lot of hype more than there is action in most of the segments of A.

[00:18:45] I. And the practical use of it is not yet there. That will be there and it is coming, no doubt about it. But the business models and the material applications are not well understood. And there's real distrust, I think, in a lot of the data and the outputs as there should be in a world where data is not, you know, It's not easily integrated.

[00:19:11] It is not often correct, and it is filled with bias that's a problem for the outcome of what it says. So, while there's some really interesting and promising uses and I think there's a lot of investment going there I think there's a lot of reckoning to be had as well before it, you know, before the Gartner hype cycle starts back up, you know?

[00:19:34] Rick: right. And you know, I think about when I get to the investment side, the silver lining, you know, higher returns from lower valuations, you know, the long game to a certain extent. Is there a shift now towards more early stage investments? Because of the kind of cycle of where we're at with AI and ML versus the later stage.

[00:20:01] Lisa Suennen: No, actually, what there is is a bifurcated world right now. If you look at the numbers around investment in healthcare venture, especially the numbers are down by, I don't know, 50 60% over prior couple of years. The cycle is not done. I mean, we are nowhere near the bottom. I don't think, personally.

[00:20:20] I think we got at least another year of pain here. So what's happened on two investors is they're investing in basically three things. One in, mostly, is the companies they already invested in to try to save them during this difficult time. And actually in that, in that regard, they're starting to get to what I like to call the Sophie's Choice part of the program, which is picking which ones of their investments they're going to save because a lot of them, it's too late or can't be done.

[00:20:45] Number two, they're investing heavily in late stage assets that are now available to them at earlier stage prices. So basically investing in growth with venture money because you can get a late stage company that's valuation is dropping because of the market. And, you know, much more de risked, much earlier exit timelines.

[00:21:07] So, great, you know, bet if you do it well. And then the third thing they are investing in is the very, very early stage. Seed stage. Pre A, if you will. Because it's inexpensive comparatively. And the problem with all of that is when you get to needing the A round or the B round when you're one of those young companies, you better hope the market's coming back.

[00:21:31] Because that is, you know, the so called valley of death. Always, but it's a, it's a particularly deep valley right now.

[00:21:40] Rick: Yeah, no, that's it. That was a great lesson. I think with the bifurcation in that of what's happening in the market right now, particularly, I don't know if I could characterize it as such, but the slippage of these later stage from a valuation perspective into something that's more probably not the right term to use.

[00:22:01] For an investor and, you know, when you do risk and,

[00:22:05] Lisa Suennen: it's more like avalanche.

[00:22:06] Rick: yeah, yeah, avalanche on that, but with everything that's hitting, it probably is. That's, that's a good, that's a good point. Let me shift a little bit and get, get a little you know, inside your head. Yeah, your focus on, you know, coloring outside the lines, challenging old ways of thinking.

[00:22:24] I think some of what, what you believe in a lot philosophically just came through in what we're just talking about. Share some of of this approach in action with me and with the audience.

[00:22:37] Lisa Suennen: it looks mostly like just being brutally honest, right? And, and, and not engaging in conventional wisdom, not engaging in buzzwordy, you know, orientation stuff. But... In being super granularly practical about opportunities and that shouldn't be coloring outside the lines. That should be the lines.

[00:23:01] But unfortunately, I think it is, you know, and calling it out as it really is is something I guess I'm kind of known for and people either love it or hate it, you know, I also feel like we spend way too much time thinking about how things have always been done. And incrementing from the side of that.

[00:23:22] And while it's much harder to blow something up and start over, and this is particularly true, I think, in running businesses, not so much in creating new startups, but in businesses where they've kind of always done something a certain way and they're wanting to change it from, you know, like, red to orange.

[00:23:38] I'm like, why not green, you know? I think getting people to think outside their usual parameters, you know, of what their conventional wisdom is, is, is so important because, you know, I seem to be the one that was always in the room going like, well, why do we have to do it that way? And I'm amazed how often that not just surprises people to think something that way, but also that how much, well, I'm not surprised how resonant it is because nobody wants to be locked in their box, right?

[00:24:11] If they can get out. But it's not always easy for people to do.

[00:24:15] Rick: Yeah. So tell me, how does that mindset and I love that, by the way, it's not, it's not green. It's not red. Maybe it's yellow. I love that. When you think about what you're doing. You've been working with the NAS with NASA, the Translational Research Institute for a while. Government entity. How do they respond when you get into a bureaucratic kind of an organization?

[00:24:41] That's that's what comes to mind. When I think about that organization, how do you make them think innovatively out of the box outside the lines, particularly when you're in a high reliability process like they're working on day in and day out. Yeah.

[00:25:00] Lisa Suennen: Well, it's interesting. So the institute that I'm involved with, which is the Translational Research Institute for Space Health, is an institute funded by NASA that is exactly designed for what I do, which is figure out completely out of left field, different approaches to supporting the health of the astronauts on the mission to Mars and deep space, because everything we do in conventional medicine ain't gonna work.

[00:25:21] So you imagine, if you will, You're on a three year journey in a small capsule with no place to stop. You know, there's no one medical on the way to Mars and Now you're this the the flight Surgeon who's on the trip the one flight surgeon who's likely to be on the trip and you've got an emergency Situation where that person is incapacitated For whatever reason let's call it a kidney stone, you know What are the odds are gonna be middle aged men mostly that odds are high, right? So How do you prepare,

[00:25:56] Rick: is working against you.

[00:25:57] Lisa Suennen: right? You can't put a giant lithotripsy machine on the space capsule. You have to think about how do you miniaturize, how do you do this differently, who can, what non surgeon might be able to perform a procedure, how do you get them ready to do that, you know, what, so it's a huge exercise in not in the box thinking.

[00:26:17] And it crosses, it's so interesting because if you look at the issues that come. That affect people in space. They're almost exactly like the issues that affect people as they age. So, it's cognitive issues. It's eyesight issues. You know, pressure on the ocular lens. It's bones deteriorating, you know, because of the anti gravity thing.

[00:26:41] It's access to good food that's not processed. It's access to pharmaceuticals in real time because they expire, you know. While you're in space and like what do you do? So how do you make real time medicines all sorts of things and very little space to work in because it's a small, you know thingy, so how do you just completely think differently about science and medicine and marry both government and Entrepreneurial thinking to the to this use and that Institute is specifically about that so it's not a bureaucratic enterprise at all they have a lot of authority to do kind of weird stuff and The people that run that, I mean, I'm on, I, I chair the scientific advisory board, which is an absolute blast.

[00:27:26] And the people you're dealing with are just amazing, smart people, both the people that work at the Institute and, and the companies and entrepreneurs and scientists and researchers they interact with.

[00:27:39] Rick: Anything that you've seen that you think are insights that we should be applying in the healthcare delivery system or that a young entrepreneur might say, Hey, this should be

[00:27:53] Lisa Suennen: Yeah,

[00:27:53] Rick: into, you know, care at home. Not unlike

[00:27:56] Lisa Suennen: 100%.

[00:27:57] Rick: space.

[00:27:58] Lisa Suennen: That is actually kind of the counterpart mission there, which is if we can do something that will benefit. And address these issues in space. They should work in the real, you know, earth world too. And so that's why there's so much collaboration with entrepreneurs. But yeah, sure, miniaturizing things, making it minimally invasive, making it possible to do procedures with non, you know, surgeons for instance, or in the, in the home , you know creating pharmaceuticals in real time, creating you know, healthy foods in a weird environment in real time.

[00:28:36] In keeping the environment of the capsule healthy, so it doesn't fill with chemicals or, you know, gases or things that are harmful to the health of the astronauts. All of those things have to happen, and every one of those things is applicable on Earth as well.

[00:28:54] Rick: Yeah, switching to things that are applicable on earth. Something that's happening on earth. Sea sweetener. Fantastic initiative. Tell us a little bit about that your role and that and what's happening with it with with what's new and exciting. I think with some partnerships with it.

[00:29:15] Lisa Suennen: Yeah. Well, actually, it's a company I founded some years ago, 2015 or 16, something like that, I think. And it was a, it was and is a matching kind of a matching, you know, dating software, if you will. But instead of dating, it's for matching women rising in health care with executives and experts. in healthcare who are interested in giving back and mentoring women on the rise.

[00:29:37] And I founded it with a colleague and started it as a result of my fellowship at the Aspen Institute and the health innovation fellowship I had there, which was super fun. You know, it grew. There were hundreds and hundreds of people involved as mentors and as participants, and I was lucky enough to be able to sell it to the HLTH Foundation a few years back, and they've continued it on and grown it quite a bit, so my ownership of it is no longer a thing but my participation in it as a mentor is.

[00:30:06] It's really fun, you know, it's like you meet these amazing people who want to meet you and learn from you and where you learn back. I mean, it's really a lovely partnership, really. Experience to feel like you're helping someone, but also to feel like you're meeting people that are going to be important in your life along the way.

[00:30:22] So,

[00:30:24] Rick: Yeah, and changing lives and changing things like care delivery. And again I would say challenging the status quo, which is fantastic. Getting that diversity of ideas couldn't happen without it. Super let's let's tectonics. I think when we look at the book very intriguing. I know it's been out a few years.

[00:30:48] Tell us a little bit about the feedback you got. Well, first give us the, the, the quick pitch on the, on the book itself.

[00:30:57] Lisa Suennen: sure.

[00:30:58] Rick: is it still relevant? Which I think it is.

[00:31:01] Lisa Suennen: Thank you. Well, Tectonics was a book I wrote with David Shaywitz now a entrepreneur in residence at Takeda. Brilliant guy. He and I had started a podcast called Tech Tonics, which you can still found out, find out there on iTunes or Apple or whatever they call it now. About the intersection of health and technology and the sort of new thinkers in that space.

[00:31:29] We did that for six years and we were sort of, you know Actually, we were also writing, both of us blogs and things about the topics and we decided to collaborate and pull this book together thinking about how entrepreneurs and others are coming to the space to make a difference and the opportunities and challenges of doing so.

[00:31:53] Well, the book is a little out of date. It's in the specific in the general, I think it's very much still topical because it speaks to the issues around the complexities of this and also around the joy of making a difference in this space when you do and how, you know, great thinkers in health tech and health services and pharma and biotech and medtech are trying to do that.

[00:32:20] It's a lot of fun. It was a lot of fun to write together. I actually just wrote a chapter in another book. Called Artists Remaking Medicine, which is authored primarily by Emily Peters, but who's awesome. I'm sure you can find it on Amazon. And the book is about the intersection of art and healthcare, which is a weird combo when you first hear about it.

[00:32:41] But if you read the book, it's kind of amazing how many interesting things are there to think and learn about and to sort of look at the world differently through art its intersection with healthcare, which is quite profound, actually.

[00:32:55] Rick: Yeah, and I have been a big believer that the entrepreneur is artist is that the themes that carry across both those personas is very, very powerful. And, you know, if you think about drivers. And when you throw health care in that, I mean, you know, it's just a variable that has got such a particularly now for young people really could influence them.

[00:33:23] And I think the book and as you said that the chapter that you that you just wrote must reads for anyone that's out there thinking about what their next step is as an entrepreneur or if they have a startup in health care. And Lisa, with that, let me ask you this just to wrap things up is our final question.

[00:33:43] You've worked in tech and healthcare. You've been on, on boards. You advise on the venture side as well as really cool things like what you're doing with NASA. your advice for the young folks that are up and comers or entrepreneurs thinking to make a difference with something that to them is game changing?

[00:34:06] What would you say to them?

[00:34:10] Lisa Suennen: First of all, I'd say go for it, you know, because we need change and we need innovation and health care because it needs help to be better. But I'd also say surround yourself. If you aren't somebody who understands health care, how it actually works today, really at every granular level, like surround yourself with other people who are because it's very tough to, to, to blow it up and disrupt it and all those cute words.

[00:34:34] It's, you really have to figure out how to integrate into a. Kind of crazy system and change from within. That's my biggest piece of advice, I guess. And also just, you know, it takes a really long time for these companies and Ideas to be adopted and to scale. So, gird yourself for the long haul. It's a 10 to 15 year experience But don't give up.

[00:35:01] Like just, you know, lock in because it's Hard and it's long, but it's very rewarding when it when it happens. Yeah

[00:35:09] Rick: Don't give up. That's the key. And I'm glad you haven't given up. And with that, we want to have you back on the podcast, see what you're up to in

[00:35:17] Lisa Suennen: Thanks.

[00:35:18]