Jain’s Innovators: Bringing Transformative Health Care Ideas to Life at Google Ventures

        by Sachin Jain, MD

Almost every physician has had an idea for how to improve care through innovation in technology and service delivery. Only a select few test those ideas secure funding and bring them to reality.

Krishna Yeshwant, MD, a physician partner at Google Ventures, the venture capital arm of internet giant Google, spends his days making bets on the ideas and individuals that will transform healthcare. With hundreds of millions of dollars at their disposal, Dr. Yeshwant and his colleagues have quickly established a reputation for making astute healthcare investments that have real-world impact.
I spoke recently with Dr. Yeshwant to better understand his pathway towards a career in clinical medicine and healthcare investing, hear his thoughts on the future of healthcare entrepreneurship, and solicit his advice for would-be physician entrepreneurs.

You are a physician and a venture capitalist. What was your path to joining “Google Ventures” and what do you there?

I started out as a programmer when I was very young. Both of my parents are physicians so I ended up working on some projects for them and realized that I could do really useful things for their practice even as a kid. I ended up majoring in Computer Science at Stanford University and helped start two software companies in California, one of which was acquired by Hewlett-Packard, and the other was acquired by Symantec. As I thought about what to do next I felt there were huge opportunities in healthcare, which is when I decided to move to Boston to explore biology and medicine.

When I first came to Boston, I worked on software to enable image-guided surgery. I spent a lot of time with several surgeons at Massachusetts General Hospital who welcomed me into the operating room and the clinic. The experience of working with patients was what I fell in love with and propelled me to apply to medical school. Harvard Medical School and Harvard Business School gave me a great opportunity to do both an MD and an MBA in a new joint degree program that helped me both become a physician and gave me a broader exposure to the business world.

While I was completing my MBA, I did an internship at Google and started working with Google Ventures, which was in the early stages of being created. It was clearly a rocket ship getting ready to take off and it was very refreshing to see how rapidly people at Google could make good decisions. I also decided to complete my internal medicine residency at Brigham and Women’s Hospital at that time. Although my schedule is sometimes very busy, I feel very lucky to be part of two tremendous organizations that are so people-focused and so successful at creating the future.

Since joining Google Ventures, I have had the chance to help build and invest in several companies. My job at Google Ventures is to identify interesting companies and find ways for Google Ventures to help scale them from being a tiny company into a larger business. I am particularly interested in the intersection between medicine, biology, and information technology. I think there are some truly tremendous opportunities that lie ahead. Having a firm footing in both computer science and medicine has been critical in understanding where the transformational opportunities are hidden.

How will Google Ventures participate in the transformation of American healthcare?

Transforming American healthcare is such a big problem that it’s probably the wrong way to formulate the issue. Certainly information technology, including large-scale computation, machine learning, mobile technologies, and social networks, will play some role in the “fixed” version of our healthcare system. Though major technology players will have a large role in transforming healthcare, it will be less likely that anyone comes up with a magic bullet to fix everything that is broken in our healthcare system.

With that said, I think Google Ventures is in a great position to approach problems in this space. We know how powerful technology can be in solving large problems and we have a pretty nuanced view of healthcare. We have a team of physicians on board who spend their time every day thinking about these issues. Google Ventures is constantly looking for ways that consumers and technology can change the world. I think that’s a valuable point of view since much of the innovation from healthcare comes from inside the industry right now, but the truly disruptive ideas will likely come from outside the field.

As a venture capitalist at a place like Google, you surely see some cutting-edge ideas. Of the ideas you’ve seen lately, what are you most optimistic about?

I think broadly that there are a number of areas where bringing modern information technology approaches to healthcare and life sciences can be transformative. These fields seem to be about 10 years behind in the adoption of new technologies. We are looking at many companies working on approaches to do this. We are particularly excited by the promise of genomics. Many people look at the fact that the human genome was sequenced more than 10 years ago and feel that there have not been any interesting innovations in that space. I disagree. I think we are just at the cusp of starting to see insights derived from genetics beginning to affect the clinical world. This opens up clinical, as well as IT, opportunities. We tend not to do as many investments in traditional diagnostics, devices, and therapeutics, though we have seen a handful of extremely interesting technologies in these areas and are excited by them.

What are some of types of ideas that have promise on the surface, but don’t hold up to closer scrutiny?

We have found that most ideas in the health IT space seem like great ideas initially, but tend to have a difficult time finding a viable business model. These are such important areas for development, but the business models rarely seem to pan out because they are part of a broader system that is largely nonsensical and broken. Many of the medication adherence solutions we have seen also seem interesting initially, but patients are real people and almost never do what your applications or device expects them to do. I do think this will evolve with time.

Many physicians have entrepreneurial ideas that they’d like to grow as new businesses. What kind of advice can you give physicians with ideas for devices, therapeutics, or new care delivery models that can improve care?

I think the key question in entrepreneurship is usually how you can get the most amount of information for the least amount of time and money. Physicians actually already know how to think in this manner when discussing patient management. For example, many physicians will think about whether a given radiologic study will or will not change their management before subjecting a patient to the time and expense involved in getting the study. I think it’s worth bringing that sort of thought process to starting companies. Before blindly moving forward hiring developers, building expensive prototypes, and renting physical space, I believe physicians should ask whether there are less expensive and more valuable ways to ask their questions to get the information they need faster and more cost effectively.

I also think that physicians should spend more time outside of the hospital. The rest of the world is innovating rapidly in new ways to offer services and products. Just because patients currently have to visit the hospital to receive care doesn’t mean that’s the right way for care to be delivered. This is a market that could change in the future.

Sachin H. Jain, MD, MBA, is a physician at Brigham
and Women’s Hospital and Harvard Medical School and
Senior Institute Associate at Harvard Business School’s
Institute for Strategy and Competitiveness. He was previously
a key official in the Obama Administration, where
he helped launch the Center for Medicare and Medicaid
Innovation and the HITECH Act’s Meaningful Use provisions.
He is a leading national authority on healthcare
delivery reform.

Clinical Topics: Arrhythmias and Clinical EP, Genetic Arrhythmic Conditions

Keywords: Health Care Reform, Medicaid, Meaningful Use, Software, Biological Science Disciplines, Genomics, Internship and Residency, Medication Adherence, Social Support, Surgery, Computer-Assisted, American Recovery and Reinvestment Act, Delivery of Health Care, Genome, Human, Medicare, Internal Medicine, Internet, United States

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