Building in Healthtech: Product Strategies for Innovators

[00:00:00] Brendan Iglehart: Welcome to Hard Problems, Smart Solutions, The Newfire Podcast, where we explore the toughest challenges and the smartest solutions with industry leaders. I’m Brendan Iglehart, Staff Healthcare Architect at Newfire Global Partners, and your host for this episode. In each episode, we bring you conversations with top innovators and decision-makers tackling the biggest issues across industries.

[00:00:28] Brendan Iglehart: Whether you’re looking for insights to drive your own strategies or learn from the best, you’re in the right place. Let’s get started.

[00:00:38] Brendan Iglehart: Hi everyone. Welcome to another episode of Hard Problems, Smart Solutions, The Newfire Podcast. In today’s episode, I’m thrilled to speak with Omar Mousa, who most recently served as VP of Product and Engineering at Ventricle Health, and then recently left to start a fractional CPO services firm and continue to do startup advisory.

[00:00:55] Brendan Iglehart: He’s a seasoned technologist with extensive experience in product management, go-to-market strategies and operations, particularly in the healthcare sector. He has successfully scaled technology teams and platforms, notably launching a zero-to-one heart failure care platform at Ventricle Health, which significantly drove growth and improved patient care efficiencies.

[00:01:15] Brendan Iglehart: He also co-hosts a popular and excellent health tech podcast, Concept to Care, and actively advises startups on product and market strategies. Omar, thanks for joining us today on the podcast.

[00:01:28] Omar Mousa: Thank you, Brendan. Glad to be here. And man, excellent. That…

[00:01:32] Brendan Iglehart: Impressive intro.

[00:01:34] Omar Mousa: It’s cool to be on the other side.

[00:01:36] Brendan Iglehart: Yeah. Alright, so to kick things off, I wanna ask you about your journey in your career ’cause you’ve moved from working between D2C initiatives, Propeller Health, to focusing on RCM at Adonis and then, uh, most recently doing VBC delivery at Ventricle. So, tell me about what motivated these transitions, and how did each role enrich your understanding of healthcare technology?

[00:01:58] Omar Mousa: Yeah. Uh, Propeller Health was a late-stage, already acquired health tech company. They were acquired by ResMed. I was coming out of consulting, so I broke into product management through consulting, was doing serving government clients, like agencies on their not-so-interesting custom software, and I wasn’t developing the scar tissue that

[00:02:20] Omar Mousa: one would develop when living with a problem. And so I wanted to break into product. I thought that’d be a great place to live, with a problem or solve hard problems in that role made the most sense. And then the other thing was I had gotten a healthcare sort of flavor of a technical degree. I was like, healthcare IT.

[00:02:40] Omar Mousa: And so I knew I wanted to spend my startup career in healthcare, and so I found Propeller. I grew up with asthma as a young age. I kind of grew out of it, but Propeller Health was solving for asthma and then trying to break into the COPD space, I joined as a product manager to help them figure out like what does the application experience for the patient need to be like for, for the COPD population?

[00:03:04] Omar Mousa: And so the takeaways. We’re like researching. I spent a lot of time researching the disease set. Right. So, understanding COPD, I might have read over 50 research papers and truly became an expert on the disease, and honestly learned a lot about not only the clinical aspects, but the nonclinical aspects of having the disease.

[00:03:26] Omar Mousa: And I think that was the thing that resonated most when building the product was the end user is receiving all sorts of care, and it doesn’t necessarily like, the, the main problems they face in their life are things like loneliness or being tethered to their device, or not being able to go to the grocery store or see their granddaughter get married.

[00:03:49] Omar Mousa: And so that was a major revelation for me. ’cause it was like, okay, I. The care industry or healthcare does an okay job of like the clinical piece, but the, but it’s good that these digital therapeutics are out here solving for things like adherence to medication, but also like how do I build a really robust app experience for patients so that they can do those things?

[00:04:12] Omar Mousa: I think, transitioning to Cerebral, I, I went to Cerebral after that, I kind of saw the writing on the wall with the direct-to-consumer services. It was like as the pandemic went blowing into full swing, um, so a mental healthcare company made sense. Hims & Hers was coming up. RO was coming up. I had even in 2019 written an article about, Hey, consumers want to

[00:04:33] Omar Mousa: take ownership of their own healthcare, and so was just super eager to get involved into a D2C business. Found Cerebral pretty early as they were, you know, in the series A, closing their B. Um, they had two product managers, but they weren’t folks who were just really scrappy and solving for the product manager role.

[00:04:51] Omar Mousa: And so I joined, um, as like the first formal product manager hire, um, and after that, and then they blew out the team a lot ’cause they just raised a ton of money and the team grew super fast. But I learned how to work at a super-hyper-growth company. That company hit a $5 billion valuation in two years. It felt like

[00:05:07] Omar Mousa: Uber, it felt like my shoes were growing or I was growing outta my shoes every couple of months. Experimentation is was super key in business performance, right? So different than Propeller. Propeller was selling to pharma, selling to uh, benefit pharmacy benefit managers, even health systems. Because Cerebral was a direct-to-consumer business, like funnel performance experimentation, AB testing, like a lot of the traditional product management skillset was very applicable here.

[00:05:37] Omar Mousa: And I, it was just really fun. And then also just learning about the like, required capabilities to play in a telehealth space. You, you go to one telehealth business, you go to another, you, you notice a lot of the components are the same. And then lastly, like how to organize like teams and projects, et cetera, and that, that sort of thing around outcomes.

[00:05:56] Omar Mousa: And that was like really important for my senior leadership growth. I grew into a senior product leader there. By the time I left, I had a couple of teams reporting into my portfolio, which was cool. Early, I built insurance at Cerebral and so, uh, from zero to one their insurance product. And I knew a lot and I was talking to the Adonis founders before they had started the business and, uh, you know, really jazzed about the, how broken our CM was.

[00:06:23] Omar Mousa: And so I joined Adonis as employee six, another zero-to-one situation. Major takeaways from that business was like I didn’t join in a product capacity. I joined as head of growth and I learned go-to-market through just like doing and just being scrappy and figuring it out. So like how, what to helping them determine what to build that resonated with their vision, how to message the product, how to sell it.

[00:06:48] Omar Mousa: Built a CRM like workflow and go-to-market motion around their products. And then really like getting in front of customers, just doing all sorts of scrappy things, like going to conferences, um, flying out to their, their office and saying, we were in the neighborhood and, uh, just doing all sorts of things to drive demand generation and, and you know, so I spent like a year with that business and they matured to a point where

[00:07:14] Omar Mousa: um, they have a real sales team. They don’t need, you know, Omar trying to figure it out. They had real salespeople, they had real go-to-market motions, they had product, and so I kind of, it kind of made sense as like, Hey guys, like I think you guys have grown and I would like to go do product again. Again, another like writing on the wall situation.

[00:07:32] Omar Mousa: We know a lot of care is moving towards value and so I wanted to participate in a value-based care business and so about 19 months ago I joined Ventricle Health as their head of product, helped build out the team and learned how to innovate on a payment model or alternative payment model. I never really touched alternative payment models before.

[00:07:50] Omar Mousa: It was always like direct cash subscription-based or fee-for-service. And then, uh, really like care management, care program, like selling a service was like a very different thing. And then the RPM, like how to integrate RPM into a platform. And then I’ve touched a lot of, you know, in your world, you know a lot about the interoperability on RAMP APIs.

[00:08:12] Omar Mousa: Like I got to touch a lot of those APIs to populate data at various points of care and build out like really robust enrollment workflows. So I, I think, long-winded answer to this I have had a bunch of different little career changes and all within the health tech healthcare space, and I, I think it’s formed a really decent worldview of how care looks like in in the startup environment.

[00:08:37] Brendan Iglehart: Yeah. That’s really interesting. Appreciate you sharing that journey with us. So I guess throughout that journey, I’m always curious to hear from people what’s been the biggest surprise that you’ve encountered and was there kind of a moment or, or an obstacle or something you faced that really shifted your perspective on how tech fits into healthcare?

[00:08:54] Omar Mousa: Yeah, I think three things. Technology and healthcare is like pretty bad. So the infrastructure in place is like behind, um, systems are disparate. It’s not like other industry verticals like FinTech, had their time in the sun. You know, there are other, you know, retail, they’re just really cool technology servicing other industry verticals and because

[00:09:21] Omar Mousa: healthcare hasn’t received that love quite yet. It’s starting to, but it, you know, it’s still has to pass a lot of hurdles. The second thing is that most of healthcare is supported by IT teams, not by product development teams. So the mentality is really different. I’ve been at organizations where I’ve been called like the IT team, and it’s like we are product managers and engineers and product designers, and

[00:09:46] Omar Mousa: we think differently. Like, IT teams that manage a queue of technology implementations and aren’t necessarily so entrenched in what the user needs are. But product teams generally are like, Hey, I’m, I’m building for an end user. I’m building for a problem. I I’m KPId even differently. Right? There’s still that tight or like there’s that balance to strike.

[00:10:06] Omar Mousa: I, I think healthcare has not. I think sometimes it makes sense to have a healthcare like a IT team, and sometimes it makes sense to have product development teams. And then the third and last thing, it’s like, you know, the mantra of moving fast and breaking things, or the lean startup like that. Makes sense in some businesses, but in healthcare it does not apply.

[00:10:27] Omar Mousa: There is a lot of risk associated with that.

[00:10:29] Brendan Iglehart: The, the thing you’re breaking is often you and me, so that’s a little scary.

[00:10:34] Omar Mousa: Yes, yes. It’s people’s lives. People’s lives are at stake, people’s licenses, right? Like the individuals who are practicing care, there’s insurance against them, right? Like they are taking oaths to provide high-quality care.

[00:10:47] Omar Mousa: And so it, it’s really, you know, like a frame-perfect thing that needs to happen. And. Yeah, not a lot of room for error and so the “move fast break things” mantra like grandiose and great sounding like does not really make sense here.

[00:11:04] Brendan Iglehart: Yeah, I definitely agree with that. So you’ve noted in some of your kind of past discussions are writing around how health tech infrastructure isn’t really equipped to handle the volume of, of data or unstructured data specifically that’s being generated.

[00:11:18] Brendan Iglehart: In my world, interoperability that obviously presents a big challenge. Can you elaborate on that issue and, and talk about how you see that problem coming to light here?

[00:11:27] Omar Mousa: Yeah, that issue’s pretty exacerbated by like a lot of things. I’ll try to describe a few, but I, I think like healthcare, as I said, is it’s been around forever, right?

[00:11:38] Omar Mousa: Yeah. Back to the days when we were bleeding people out to cure them of diseases, and it’s evolved and know technology has supported various businesses or industries. FinTech, like I said, has had the love. Healthcare has a lot of legacy system architecture, so most healthcare IT systems were built on like very basic relational databases or models optimized for structure like tabular data.

[00:12:06] Omar Mousa: We have things like diagnosis codes, billing codes like most IT or healthcare IT systems were built for the purpose of billing, and that was like the whole 2009 American Reinvestment Act investment, like everyone was building an EHR, but really they were building a billing tool, right? Medication lists, lab values, like.

[00:12:27] Omar Mousa: But we all know that like when you go to a doctor, you are interacting with a physician who’s like typing the conversation that’s happening. Hey, I checked this, I did this. I talked to the patient about this. This was the response. So there’s a lot of free text notes, images, unstructured data that doesn’t necessarily fit within that system architecture.

[00:12:45] Omar Mousa: And that’s just like where all the goodness is, where all the good stuff and the the value is. The other thing is a disparate system. So there’s just multiple systems in the value chain, right? There’s the front office, there’s the actual clinical notes or the EHR. There’s practice management systems, there’s platforms that are doing, hey texting.

[00:13:06] Omar Mousa: There’s the lab system. Like all of this stuff has very valuable data that should be talking and it doesn’t, and it’s siloed, right? And so the data, we’re just unable to make sense of the full picture. Like I can tell you where the patient had an appointment. I don’t. It was six. There’s a six-month gap. I can’t tell you what’s happened in between that.

[00:13:25] Omar Mousa: Right. Data standards are getting better, but they’re still inconsistent and they’re old, right? Like if you think about X-12, which is used for claims, it’s like that’s XML. I don’t know how many systems you want to touch these days that have XML. I know finance has like some, some like archaic data standards too, but do a good job of like leveling it up and kind of modernizing it a bit.

[00:13:49] Omar Mousa: Um, we don’t. Healthcare struggles, I think, and, and again, with that unstructured data that’s like living in clinical notes and it just doesn’t fit really well and we can’t do a lot of processing with that. Another thing’s like what I call vendor lock-in, it’s like there are proprietary data formats, um, associated with

[00:14:11] Omar Mousa: various systems, and then some like EHRs, like closed APIs, or they’re just like not published tools, right? So it’s just like, I don’t know how to work with this unless I am a customer. And then also the tool doesn’t really support a lot, right? ETL process limitations. So just legacy ETL tools. If you go like look at like some of the more modern stuff, like I like how many ETL tools have built connectors for Stripe.

[00:14:39] Omar Mousa: Like, Stripe is a beautiful API or a beautiful platform. There are ETL products for that. But for healthcare, you know, you have connectors like MuleSoft and things like that, that are pulling HL7 data out. But even there, it’s just like lackluster, not so perfect. And then the last thing is just like there’s no APIs, like even companies, even products with APIs,

[00:15:00] Omar Mousa: the APIs are just, they have a couple of requests, right? They’re not robust enough to really achieve the thing that you want to do. Um, API documentation’s pretty weak. Um, and then know, I just, I engage with EMRs, I’m not gonna say names of EMRs, but they might have eight endpoints and the endpoints are just like not that valuable.

[00:15:19] Omar Mousa: So they check the box off of like, yeah, I have APIs. And it’s like, cool, but can I actually do the thing I wanna do with your APIs? And that’s, you don’t really figure that out until I have a two to three year software deal and I’m kinda locked in and my clinicians know how to use it. And so I just think like,

[00:15:36] Omar Mousa: all these things I’ve mentioned really exacerbate. It’s just like a tech debt, right? It’s just, it’s, it’s hard to come from that. And so we need to really be innovative and think creatively around how to get around some of these things and modernize ourselves.

[00:15:51] Brendan Iglehart: Not to introduce buzzword bingo too much, but I’m, I’m curious to get your perspective.

[00:15:56] Brendan Iglehart: The thing that was coming to mind as you were talking about that was AI and how that might help with some of those problems you mentioned. Do you have any perspective that you wanna share on that?

[00:16:03] Omar Mousa: I think unstructured data and like large language models are really good at reading text, right? Lots of unstructured data lives within EMRs, uh, coming from various notes and labs and et cetera.

[00:16:18] Omar Mousa: And I think, you know, these foundational models are gonna be better than any of us at reading through an entire patient’s life history of clinical notes and then coming to some sort of assessment like it also read all the research papers and understands the literature and understands like healthcare in general.

[00:16:37] Omar Mousa: And so I think like LLMs are gonna help us save a lot of time in going through this text. It’s gonna help us summarize all this information. It’s gonna help us extract the things that matter. It’s gonna help us identify like if A happens and B happens and like, then C should probably happen, right? So just like the things like find correlation within that unstructured data and it’ll help us scale the clinical workforce, uh, those who are looking at that information and making assessment on it, right?

[00:17:10] Omar Mousa: So I think it’s gonna empower clinicians. Um, I also think it’s gonna help us take all that unstructured data and get value out of it. ’cause there’s so much nugget, like great goodness in there. And none of us, or I wouldn’t say none of us, but I, you know, we still have barely breached the surface of like capturing that value and taking advantage of it.

[00:17:33] Omar Mousa: So I think LLMs are amazing. I think AI is really gonna make some big changes in healthcare. That’s why the venture community is investing so heavily into it. And, you know, I’m really excited to see what it’s still like, we’re still at the first frontier and I’m really excited to see what some of these startups do.

[00:17:51] Brendan Iglehart: So pivoting back to kind of more looking through things from a product lens, I’m curious if you could tell us a little bit about the challenges that come along with in the know the circumstances where an end user is not the one who’s making purchasing decisions. How do you navigate a situation like that?

[00:18:07] Brendan Iglehart: ’cause it seems like you’ve had some experience there.

[00:18:11] Omar Mousa: Yeah, so healthcare in America is pretty weird ’cause it’s like sometimes you don’t even know why you are required to use a specific service or your affiliation with X, Y, Z organization. Payers have members. We are effectively members if you belong to an insurance plan and bucketed into various plans, which dictate what sort of care you have.

[00:18:33] Omar Mousa: And then we go through a kind of adjudication process to figure out like what is the cost share between the patient and the insurance company. And I think that is unusual, like most services that you participate in, like I want to get my lawn mowed, I go out to a lawn mowing company. I ask how much it’s gonna cost to do X, Y, Z service.

[00:18:54] Omar Mousa: They give me a quote, I say, okay, and then I pay for the service once complete. Like this is unusual for any industry. And then talk about healthcare just has such a complicated stakeholder mix like no other business. Or industry has, like, you have the doctors, you have the nurses, you have the admin staff, the clinical coordinators, the lab techs, you have the patients themselves, the caregivers, the payers, the pharmaceutical companies, the, the brokers, the like, there’s just so many people involved and have like interest in the value that’s being generated from a product or service.

[00:19:30] Omar Mousa: And so, that dilutes the mission or like the focus. So I think that’s how the end-user is often missed. Right. So you just have all these stakeholders, let’s say, let’s talk about a service, right? Like a, a healthcare service or a tech-enabled service, you’re. The people within the company aren’t the people using the product, and then you often don’t really have access to the patient.

[00:19:54] Omar Mousa: And then like compliance and HIPAA rules kind of make it hard to engage those individuals anyways, right? So I think that’s one factor. The other factor is like market and funding constraints are a factor here, right? So if you’re a startup and you just raise seed funding and we think about like go-to-market timelines for some of these companies, they’re long, they’re 18 months sometimes, right?

[00:20:18] Omar Mousa: So it’s just, I have X amount of dollars to contribute towards building a product or a service. I only have so much time. I need to do the bare minimum from the patient side, but I need to get distribution and I need to lock down deals with payer or health system so that you know, it’s in that situation

[00:20:34] Omar Mousa: it’s like I need to live. Or survive for the next fundraising round. And so this is another way, like the kind of the end-user, the patient is missed ’cause it’s, I need to do X, Y, Z, C tomorrow. The other thing is like decision-maker are not the provider sometimes or the end-user, right? So if the end-user is a provider, they’re not making purchasing decisions or if the end-user is a patient, they’re also not, they don’t have any say over the technology that’s being used.

[00:21:01] Omar Mousa: If you’re a patient, you get a portal, sometimes you’re like, okay, I had like nine of these portals at the different little pri primary care doctors I’ve seen. I guess I have to sign up for another one and remember that password or like you’re a provider and you’re like, this is the lab that you’re supposed to prescribe, or this is the me, this is the EHR that you’re supposed to use, and you just don’t have much say over that.

[00:21:22] Omar Mousa: And so ultimately what I think ends up happening is like you have this complicated stakeholder mix you have to build to survive, right? You have to build certain things or certain features or solve certain things on a go-to-market perspective or distribution. And what you end up with, it’s like

[00:21:38] Omar Mousa: something that provides some clinical value, something that provides some financial value, some operational value, and then, but ultimately from an experience perspective, like no one’s really happy, right? Like you’ve made no one ultimately like super, okay, you’ve truly listened to me and you’ve solved my problem.

[00:21:55] Omar Mousa: So I think from like a, if I were to do like the ideal situation, I think from like an order of operations perspective is like deliver value to patients. Health tech solution must deliver meaningful benefit directly to patients, whether you’ve improved health outcomes, convenience, or just a better experience, right?

[00:22:14] Omar Mousa: The second thing is once you have that go for ROI for payers, so like this is insurers. This includes employers. Like you need to see measurable cost savings or efficiency to justify like this investment that you’ve made when you’re building this sort of things. And then the third and last thing is like

[00:22:32] Omar Mousa: invest in a sustainable business model. So like a scalable health tech business must balance patient outcomes and payer value with like ops efficiency, right? And so that’s just like if I were to go start a company tomorrow, like that’s the agenda.

[00:22:47] Brendan Iglehart: So looking forward to feedback loops here, and these are critical in every industry, I would say, but particularly so in healthcare.

[00:22:55] Brendan Iglehart: And so kind of leading from the, the previous question where you have different stakeholder groups involved in this whole equation, how do you make sure that feedback from actual users influences the products you’re developing and how do you balance that with potentially some conflicting goals, um, such as from parties like payers?

[00:23:14] Omar Mousa: Yeah, the reality is you get it where you get it. Like you just hope it comes to you, and if you don’t, you need to do a lot of work to find it. But qualitative user feedback is the predominant one. So, sending out surveys to either the clinicians that are deploying your service or using the technology that you build or surveys to the patients that are using it at Propeller, we did an advisory board.

[00:23:38] Omar Mousa: We like helped pay for patient medication or gave them discounts on things, even like Amazon gift cards, like, you know, very general stuff. But they were very empowered and excited to help provide information. ’cause they’re like, Hey, I, I’m a super user of your platform. I want this to get better for my own sake.

[00:23:58] Omar Mousa: Now I have asthma or COPD and therefore I’m willing to help. The boots on the ground people provide a lot of good feedback. I can’t tell you how many times, like I got a Slack message from a nurse about something very like seemingly micro, but actually super impactful, uh, just about the experience that they’re delivering, and that’s really good.

[00:24:19] Omar Mousa: I think the second thing is like instrumentation. So like building user feedback loops into your product, there are platforms that help you do this, like CDP platforms, customer data. That’s what it’s called. CDP, customer data platforms, and then building out your data infrastructure and like instrumenting various funnel experiences, right?

[00:24:38] Omar Mousa: So, like if you have an enrollment workflow, understanding the various points of failure or drop off if you are measuring adherence or you’re measuring engagement in your app, right? Like figuring out how to do that and leveraging that to help inform decisions. And then the third thing is like patient-reported outcome measures.

[00:24:56] Omar Mousa: These are defined by the clinical community called proms. In mental health, we had PHQ-9s. In cardiac care, we have KCCQ-12, right? And so like, this is another just indicator of like, is what we’re doing working from a clinical perspective, right? So ultimately, you know, just qualitative feedback, getting your quantitative feedback from like instrumentation within the product and then like other spreadsheets of your, how your model’s performing.

[00:25:24] Omar Mousa: And um, and then patient reported outcomes is how I would, it’s how we, how I’ve gone about these things.

[00:25:32] Brendan Iglehart: I came across an article that you wrote or you were quoted in on, uh, making build versus buy decisions and product development. As you know, here at Newfire, this kind of assessment is one of the services that we offer to our clients and help them out with.

[00:25:45] Brendan Iglehart: So curious if you could share some of what you’ve learned about making that evaluation, and specifically, what are some of the key considerations that often are overlooked by perhaps executive teams when assessing? How to, how to go about that.

[00:25:59] Omar Mousa: Yeah. It’s a hard one, Brendan, and to your point, like a lot of people want to know like, are my, am I doing the right thing?

[00:26:06] Omar Mousa: Because it could be detrimental or very costly to the business. Unfortunately, I, I don’t think it’s a one-size-fits-all approach. It’s not a build and it’s not a buy only, it’s, it’s usually a mix of it. It depends, and it’s like probably a hybrid approach. But I’ve thought about it in a way of like, what happens if you buy your, all your solutions or if you build, and then what does the hybrid approach look like and like what stage of businesses should be doing what?

[00:26:32] Omar Mousa: And so I, I can kinda walk us through that. Ultimately, I think the questions you need to ask yourself is like, what does core to your business, like what am I offering right? Is my EMR or like my ability to do revenue cycle, the most important thing about my business or if it’s not like, should I be investing so much effort or engineering knowledge into that. Second thing, stage a company, which I talked about, and I’ll get into more detail.

[00:26:57] Omar Mousa: Um, and the third thing is like, how quickly do I need to go to market? And if we’re talking about a healthcare service, it’s very important. If you buy all your solutions, what ends up happening is you’re, you’re kind of unable to compete with incumbents in new entrants, right? You’re like not flexible enough

[00:27:12] Omar Mousa: to adapt or you can’t do anything new or novel, like you’re kind of restricted within the technology that you’ve bought and you’re beheld to the product roadmap of the vendor, right? Which, who knows what that looks like. Um, you also, when you buy all your solutions, you can’t really develop any like IP.

[00:27:31] Omar Mousa: You can’t really say that your service is delivered by any sort of like intellectual property. It’s like your core experiences are really the product or the byproduct of something else that you’ve integrated or pulled into the fold of your service. And then I think the most important thing, if you buy all your solutions, you’re gonna hit a ceiling on impact on your metrics.

[00:27:52] Omar Mousa: Right? Um, hopefully most businesses know what metrics are most important to them, your ability to. But when you buy something, like you’ll hit a certain, let’s say you’re optimizing or you’re using it to the best of that product’s ability, getting every ounce of value out of it. You hit a, you hit the metrics, or you kind of measure your progress against those metrics.

[00:28:15] Omar Mousa: They won’t improve unless you start adding any sort of like investing in, hey first appointment is really important and the scheduling experience within my product kind of sucks. And so like I need to maybe deviate out of my existing scheduling solution and figure out a way to get the first appointment on the books faster, right?

[00:28:37] Omar Mousa: If you build all your solutions, you also run some challenges, right? So, if you build everything, you end up reinventing the wheel on things that like you probably just shouldn’t, right? They exist, they’re decent. Again, it’s not core to your business. You probably should be focusing a little bit more on your go-to market or innovating and learning on things that are core to your business.

[00:28:58] Omar Mousa: So every time you iterate on your product, you’re gonna get some learnings out of it. Um, you also create a ton of tech debt by making a ton of engineering investment before you truly understand your end-user population or your business. And so if you’re early on and you’re just building everything you, you’re gonna make costly assumptions that are gonna have to end up in refactoring of something or just redesigning an entire product.

[00:29:24] Omar Mousa: And then lastly, if you build all your solutions, like there’s a major upfront cost without promise of revenue, and honestly with the current venture landscape, you’ll be crushed ’cause it’s, I think in 2021, I knew a lot of startups that were building their EMRs from scratch. Now, if you come to me today and you tell me I’m gonna build my own custom, EMR, I tell you to get out of the room, like, I don’t know, maybe I’d say something nicer, but I don’t think that’s smart anymore.

[00:29:51] Omar Mousa: Those who did it and have it and have done successful in that, like great, they came in a different time, but now I just don’t think that’s really responsible or fiscally responsible. So, with a hybrid approach, I think it’s the only way to achieve the following, right? You drive down your costs, you increase margin, you ensure sustainable unit economics.

[00:30:12] Omar Mousa: You can also achieve clinical outcomes and compete in a very, what I think is like a saturated market, right? There’s just a lot of lookalikes of various services and then you probably, or hopefully don’t die before you achieve your goals. I’ve also like thought about it in stages, right? So an early-stage company should be optimizing on solving use cases to prove out their hypothesis.

[00:30:35] Omar Mousa: And like the best approach for that is like, hey, use some existing solutions off the wall, right? Or off the shelf. Key focus is gonna be on like cost effectiveness, speed to market, scalability and integral or like how like integratable that platform is. The second stage I would call like growth stage companies.

[00:30:53] Omar Mousa: They should be prioritizing revenue and you know, plan to be a bit more cash efficient, but not overly so, like the best approach there is that hybrid approach I talked about. So it’s like, you should be investing in customizing or building solutions that differentiate you in the market. You should think about a balanced investment in like build versus buy and like how thinking about flexible integration.

[00:31:15] Omar Mousa: And then the mature company moves from like cashing efficient to long-term sustainable unit economics. And I think the best approach for them is like, I understand my business and now I need to just build a lot of custom software to help make that business the most successful it possibly can be and bring shareholder value.

[00:31:31] Omar Mousa: And so like key focus is like tailored solutions, control and flexibility of the solution itself. And then long-term ROI and the ability to continuously innovate on that. It’s building a really robust architecture and uh, I’m able to iterate fast and do feature development quickly. And so, long-winded answer to say like it depends and it just, you know, it depends on where you are as a company, what’s core to your business, and like how quickly you wanna go to market.

[00:32:00] Omar Mousa: But I always think it’s the hybrid approach is probably the best.

[00:32:04] Brendan Iglehart: So Omar, I really appreciate your perspective and it seems like a lot of the things you’ve talked about have been influenced by the scaling efforts that you were involved within your roles at, at Cerebral and Propeller. So reflecting on those experiences, can you tell me about some of the lessons that you learned during those growth cycles and how does that shape your, your approach to build versus buy and kind of just general product development?

[00:32:26] Omar Mousa: Yeah, I think like, again, like I really like the hybrid approach and so for the buy decisions, there are a couple things I consider. I first consider capabilities and use cases like, does this tool or technology actually solve the use case I need solved though, for example, like I need to schedule patients with a provider.

[00:32:45] Omar Mousa: Providers have their own availabilities in these like friendly PC, MSO 10 99 bottles, and then patients have their own ability and like we need to service both. So does the technology allow me to understand a provider schedule and then allow a patient to schedule directly from a calendar or even like a clinical coordinator, do that, right?

[00:33:05] Omar Mousa: So that’s like, just like a very easy example. The next thing I consider, it’s like after it solves my use case, it’s like what does the user experience look like? So does it not only solve my use case, but does it solve my use case better than like the competition would, if that’s really important. And then do the users of the system enjoy using it?

[00:33:23] Omar Mousa: So, for example, like for a CRM, you know, enrollment CRMs are very good at like sales motions and enrollment and funnels. Salesforce is super highly customizable and can help solve any healthcare use case. However, I’ve looked at like HubSpot and I thought, oh wow, HubSpot has like a really great user experience and it’s easier to understand for that kind of resource, right?

[00:33:48] Omar Mousa: And so like for the individual using that, who’s gonna have higher NPS? Will the enrollment specialist know how to use Salesforce or will they prefer to be in like HubSpot? The second thing is like scalability. So like, do you have a modular architecture? And can your platform perform at scale or like it should be adding new functionality or can I scale in components independently in my own architecture with this tool?

[00:34:17] Omar Mousa: And then, will this tool be able to handle scale? Like is it 10 patients it does really well. Is it a hundred patients it still does really well. A thousand patients. It does. Okay. And then like at 10,000, it’s just like awful. Like I need to know those numbers so that I can be responsible about bringing these things in.

[00:34:35] Omar Mousa: Is the off-the-shelf solution, flexible or customizable? Can I customize or configure the solution to basically serve my needs a little bit more? Like obviously I can’t make it do exactly what I need it to do, but is there custom dashboard reporting or does it have APIs that I can leverage to allow for custom development down the road?

[00:34:55] Omar Mousa: Or is the data model flexible and allows me to add metadata to various things or objects? Right. So this is like things that I would look for. Security and compliance has gotta be baked in, right? You just gotta make sure PHI is not overly permissive or, uh, it complies with all the HIPAA regulation and like, does the vendor sign PaaS?

[00:35:15] Omar Mousa: Um, and this is the most important one, probably it’s like cost and ROI, like, what is the total cost of ownership? How much do I spend to implement it? How much do I spend on the contract itself, the vendor value, and how much do I spend to like maintain it over time? Are engineers having to do things or IT specialists having to do things?

[00:35:34] Omar Mousa: Are Ops teams having to do things on a regular basis to like factor all that cost in? And then what does the expected return on investment? Sometimes the use case does not have an expected return on investment, but like you should have an assessment of what does my percentage of revenue should be for revenue cycle. Like it’s just a thing that we have to do. It is tied to revenue that I do collect, but is it a revenue driver? Like, sort of, not really. So what’s a responsible percentage of revenue that I’m allowed to spend on that? And how does the cost scale? Is it cheap at first? But as I get more users on the platform, it just gets really expensive and hard to manage.

[00:36:11] Omar Mousa: That’s something to consider. Um, for the build decision, I think a lot simpler. Is this use case core to my business? I said this already, or like a point of differentiation for me. Um, if it is, then I need to build that specific thing and I need to plan for my roadmap. Like maybe I solve for it with an off-the-shelf solution.

[00:36:31] Omar Mousa: At first, I. Um, that’s fine if you’re trying to get to market quickly, but if you’re really trying to kill it in that category, let’s say you’re like in the referrals business. I currently advise a company that’s, you know, helping connect primary care providers with high-quality specialty networks. And it’s like referral is like the main game for them.

[00:36:50] Omar Mousa: And so of course the referral experience needs to be built metic or meticulous and like they’ve thought through everything and that should be like a build thing that they work on. And they should be thinking about, can I build that better than any existing solution out there? And can I drive a metric better than any solution out there, right?

[00:37:11] Omar Mousa: Because the metric is probably one of the most important things. And then the last thing with that, like can I build it cheaper than the total cost of ownership of any given technology that’s off the shelf? So I think those are two things that, those are things that I think about when building and when I, and buying decisions.

[00:37:34] Brendan Iglehart: So, Omar, I’m curious, how do you, how do you navigate the differences between D2C or direct to consumer and then clinical product development in healthcare tech? And what are some of the unique challenges and opportunities in in each of those pathways?

[00:37:47] Omar Mousa: Yeah. I think direct-to-consumer is so fun. I think it’s the most fun thing that you can ever be a part of.

[00:37:53] Omar Mousa: It’s no nonsense. It’s like the best experience wins no matter what. It doesn’t lend itself to. Various factors that like a B2B environment would. So it’s like it’s very performance-driven. Pro product people thrive in it because it’s data-driven. And D2C lends itself to that. Opinions backed without data

[00:38:12] Omar Mousa: don’t really fare well in that environment. And that’s kind of why I like it. Um, for most consumer products that win, it’s simply because people love them and not because they have to use them. I talked about like people have to use certain things in healthcare earlier. Um, in a B2B environment, you need to meet minimum capabilities usually to play, I’m required to play in a market, I need to have X, Y, Z feature. And then they don’t really, they do optimize for business performance and patient outcomes, but then like NPS is like a luxury, uh, metric. Like it’s a luxury if you’ve done a good job there. So. In D2C, if people don’t really like the experiences of a B2B focused product, but a D2C one, like the experience matters a lot, and if people don’t like it, they just won’t use it.

[00:38:59] Omar Mousa: Um, so that, I think that’s the difference.

[00:39:02] Brendan Iglehart: You’ve recently been focused on enabling value-based care at Ventricle Health and specifically tackling some of the challenges of enrollment with VBC workflows. So could you share some insights on strategies you’ve implemented to improve patient engagement with that?

[00:39:17] Brendan Iglehart: With that problem?

[00:39:18] Omar Mousa: Yeah. And not that like we’re perfect and we figured it out, but you know, I’ve seen a lot of people mess this up, right? I think they view this differently than a sales motion, and I think that’s inherently wrong. Run this like a sales funnel. Get a CRM, like CRMs are very good at doing the function,

[00:39:34] Omar Mousa: a lot of the function, they have the features required to deliver this service at a very high quality. So get a CRM that you can push PHI into, and then build on top of that enrollment workflow. Build competency in a call center workflow. So like use tools like Dialpad, right? That are very good at that thing.

[00:39:50] Omar Mousa: And then they have AI to understand sentiment analysis and learn from like how those calls are going. And build like a traditional tree structure, empower people with data. We leverage ADT feeds, we lever le leverage HIEs, we talk about claims data, we get referral data, we get transitions of care data.

[00:40:08] Omar Mousa: Like all of that is super relevant and should be incorporated into the scripting somehow. Right? Like contextualizing, Hey, I’m Ventricle and I’m reaching out because you were recently discharged from the hospital and oh by the way, we know your primary care doctor. He’s cool with us. We are friends, right?

[00:40:24] Omar Mousa: That is a compelling message that drives better engagement and performance, and so win the hearts and minds of everybody around you as well., Like, multiple people touch the patient, whether it’s a caregiver or a primary care doctor or their cardiologist or other specialty providers, like you want to be friends with all of them.

[00:40:44] Omar Mousa: So like work with the payers to get the provider attribution file and like call every primary care doctor and say, Hey, you have X amount of patients with heart failure. Like I’d like to be friends, like, I’m not here to take business away from you. I just wanna help support your patient. Can you help the messaging of, like Ventricle or whatever care management product is helpful, right?

[00:41:07] Omar Mousa: And then make it seamless, right? So like the funnel should just feel easy for both the enrollment person facilitating, the Ops person facilitating and then the actual patients. Use local phone numbers so that it doesn’t feel like they’re getting spam calls. Um, try out different call scripts. Even experiment with AI Chatbots like ElevenLabs makes a really mean LLM for this, and I think people should play with that. Now, try, this is an ongoing experimentation, you should treat it as such. Just because it’s very clinical in nature doesn’t necessarily mean like we need to think too differently about it. I think we need to maintain regulation and be thinking about PHI. But other than that, like help the Reforge content always talks about like retention is a byproduct of activation. Like think about activating the patient, get them quickly to that aha moment of what the value is in your product or your service, and use your enrollment workflow for that.

[00:42:07] Brendan Iglehart: So Omar, stepping back to perhaps a last formal question that has nothing to do with healthcare, technology or products.

[00:42:14] Brendan Iglehart: What’s your morning routine? I’m curious for someone who knows so much about this stuff, you gotta be a go-getter in the morning, is that right? Or Or Tell me about how you start your day.

[00:42:22] Omar Mousa: Ooh, I don’t know if I’m a go-getter in the morning, I do the typical hygiene things, like I have to shower. My hair’s longer than normal now, and I used to think it was funny when my hair would just look all disheveled on calls.

[00:42:33] Omar Mousa: So now I try to get clean, at least look presentable for cameras. I’m a bit obsessed with making coffee. I like a good pour over, so I’m always trying out new beans. My 23andMe, if you’ve done it, it has a caffeine report. That caffeine report suggests that I am more likely to consume more caffeine than the average human who’s done that test.

[00:42:57] Omar Mousa: So I think that’s pretty cool. I play, this is weird. I, I play a few rounds of like three-minute chess in the morning when I drink my coffee. So it’s, you know, quick, rapid fire. I don’t really care about the outcome. It’s just like a nice, think about something, but not really in the morning. And then I will start my work day with either meetings or deep work.

[00:43:18] Omar Mousa: Just depends on my schedule.

[00:43:21] Brendan Iglehart: All right, and as we wrap up today’s discussion, I’m gonna shift the dynamics here a little bit. So you’ve shared with us, Omar, a wealth of knowledge about your background in scaling operations and navigating the complexities of health tech product development, and then pushing the boundaries of BBC.

[00:43:36] Brendan Iglehart: Now, I’d love to give you the four. So do you have any questions for me?

[00:43:40] Omar Mousa: Oh, that’s different. Yeah, I do. I, this is actually self-serving and for concept of care, I, I always wonder like, from a product manager’s perspective in healthcare, like what are the, what do you think are like the most important things that like a product manager or product management function should be thinking about when building in health tech?

[00:44:05] Brendan Iglehart: I think this is perhaps like a, uh, the easy answer and, and the one that a lot of people would give, but I really like to be centered around the patient experience and I think that that is rooted in the fact that we are all patients and I’ve had a lot of experiences personally among my family in the healthcare system, and there’s just,

[00:44:24] Brendan Iglehart: there’s just so many things that you encounter as a patient that are not designed around you, whether that be digital products or, you know, the insurance system or all sorts of things like that. And it’s, it’s so meaningful to me as a patient when I encounter something in healthcare that does seem like it was designed for me and was designed around the needs that I have and the concerns that I have.

[00:44:44] Brendan Iglehart: I like to keep that really in focus in my work to make sure that we’re ultimately serving the people that are, they’re getting the care and, and the reason that whole healthcare system exists.

[00:44:55] Omar Mousa: That’s awesome. Thanks.

[00:44:57] Brendan Iglehart: Omar, I really appreciate our discussion today. If people wanna follow up on anything we discussed here today or reach out to you, what’s the best way for them to do that?

[00:45:06] Omar Mousa: Yeah, it’s been a ton of fun. I’m, I’m very responsive, so my email is omousa16@gmail.com. If you DM me on LinkedIn, I will likely respond. I’m, I have a pretty high response rate Concept to Care. Check us out. It’s a really good podcast about building in health tech. I have an amazing co-founder and co-host.

[00:45:26] Omar Mousa: Her name is Angela Suthrave. She’s a product leader building in healthcare and AI right now. And both her and I have just like these awesome conversations that we want to share with other folks, and we’ve decided to bring people smarter than us to come talk about those conversations, and so we hope people are getting value.

[00:45:44] Omar Mousa: Yeah. I also have a Twitter, it’s called Omar M Health. I, I will respond there too. I’m not as active there as I wish I’d or I’d like to be, but. Yeah, and there’s a substack Concept to Care has a Substack, so check out our sub Substack follow, subscribe. Um, there’s some good content there that we publish, so I’m very accessible.

[00:46:03] Brendan Iglehart: Omar, thanks so much for sharing your perspective on strategic product management in healthcare with us. I really enjoyed the conversation, especially around the key factors for deciding whether to build or buy.

[00:46:13] Brendan Iglehart: Um, very, very insightful there and I think your work at especially various scaling companies, really frames the importance of considering lots of different viewpoints when developing products. So thanks for that.

[00:46:24] Omar Mousa: Yeah, same here. Thanks so much.

[00:46:26] Brendan Iglehart: To our listeners, hope today’s conversation was insightful and inspirational to your own product journeys.

[00:46:33] Brendan Iglehart: Thanks for joining us on Hard Problem Smart Solutions, the Newfire Podcast. I’ll see you next time.