GUEST POST from Arlen Meyers

Several years ago, I decided to give sailing a try. I started by going on a few local trips with some folks who owned a small boat and then, gradually, decided to improve my skills and confidence. Eventually, I completed “ground school” and then took several trips that required more and more skills, like navigation, man overboard drills, dealing with weather and un-grounding your boat.

We need to do the same thing with startups. Many have questioned the success rates of accelerators, innovation centers and innovation buildings as a way to make scaleable companies. Instead we need scalerators and scaling schools to get founders and their teams from point A to point B.

Here’s what should be included in the school catalogue:

1. Scaling schools, like any school, should have clearly defined learning objectives based on market derived competencies, and a process that delivers the curriculum cheaply and fast.
2. They should emphasize experiential learning
3. They should provide students with not just the education, but the money, mentors. leadership teams and connections to open innovation networks
4. The process should be lean
5. The idea is to not just improve existing products and processes, but to create things that create substantial multiples of user defined value. Typically, that means at least 10x more value than what you are offering customers now. Here’s what you will learn about innovation and value and how ideas are inventions, improvement or innovations.
6.  They should be laboratories to create minimally viable pilots
7. They should have clearly defined innovation outcomes and impact metrics
8. They should have a dedicated leadership team that is held accountable for results
9. The school should be closed if they are not producing high performance students
10. The sponsoring organization should have clearly defined and aligned innovation objectives and strategic priorities.

Scaling schools should be designed to get you from the classroom to navigating choppy channels in the shortest time. Sooner than later, you will be in treacherous waters with considerable headwinds so you had better be prepared to know what to do when you lose your mast.

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GUEST POST from Arlen Meyers

The evolution of the cyberintelligence driven economy-the fourth industrial revolution-is forcing everyone, including entrepreneurs, to answer some tough questions:

1. How to not just create but share the value they create
2. How to provide people with the knowledge, skills, attitudes and competencies they need to succeed and grow into the middle class
3. When and how to use technology to scale humans, not replace them
4. How to mitigate the adverse impacts of science/technology on society
5. How to live a virtuous life of meaning and happiness

In his book, The Human Advantage:The Future of American Work in the Age of Smart Machines, Jay Richards, a PhD in philosophy and religion, provides us with some suggestions.

His answer to the tough questions is human virtue, explaining that a virtue is a good, freely chosen action that is repeated so much and so well that it becomes instinct. Of course, for those of us who actually went to our philosophy classes, leading the virtuous life is nothing new and dates back thousands of years. The contemporary sound bite goes something like doing well by doing good, or, in US medicine for example, practicing compassionate capitalism.

The process starts with discarding the fatalist myth and embracing free will, driving a growth mindset. The good news is that unlike most personality traits, mindsets can be changed.

But, in addition to mindset, the good professor argues that leading the virtuous entrepreneurial life during these times will require:

Courage-the willingness to risk failure

Antifragility-the ability to learn from failure and suffering. These days we call it resilience.

Altruism-acting for the benefit of others, like social enterprise or social entrepreneurship

Collaboration-working with and learning from others

Creative freedom-mastering yourself and the skills needed to create value for others. BEET programs are filling the gaps. Daniel Pink calls it mastery, independence and purpose. The Japanese call it ikigai:

Taking the spiritual approach to entrepreneurship is not just good for your soul. It’s also good for society and your spread sheet. You and your kids should try it on for size.

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GUEST POST from Arlen Meyers

Back in the day, during the Vietnam era, the suggested credo was “Declare victory and go home”.  Some sick care entrepreneurs have taken a similar approach by hyping digital health and process solutions that will create “Uberized, disruptive, cutting edge” change. Most are too early and wrong in declaring victory.

For sick care innovation to be truly transformative, innovators need to demonstrate 4 main things :

Their solution need to be validated and verified Many innovators confuse the two.  Here’s one explanation of the difference

The terms Verification and Validation are commonly used in software engineering to mean two different types of analysis. The usual definitions are:

• Validation: Are we building the right system?
• Verification: Are we building the system right?

In other words, validation is concerned with checking that the system will meet the customer’s actual needs, while verification is concerned with whether the system is well-engineered, error-free, and so on. Verification will help to determine whether the software is of high quality, but it will not ensure that the system is useful.

The distinction between the two terms is largely to do with the role of specifications. Validation is the process of checking whether the specification captures the customer’s needs, while verification is the process of checking that the software meets the specification.

In sickcare, since we are creating products and services that impact patients directly, you need to validate and verify your solution not just at the technical and commerical level, but at the clinical level as well. Sick care entrepreneurs , particularly non-sick care entrepreneurs , don’t do the latter due to cost, regulatory risk, delays in time to market or simple ignorance about how to design, execute, analyze and report human subject trials.

Something that creates a significant multiple of user defined value in relation to a competitive offering, the status quo or non-users. Here are 10 things physician entreprneurs need to know about value. Defining and comparing end user value is tricky and filled with wrong turns that make innovators believe they have reached their destination, when, in fact, they are lost. Innovation has both a qualitative and quantitative part. End users won’t switch to your product unless they perceive at least a 5x greater multiple of value. You should shoot for much higher multiples.

It needs to go viral. In other words, it needs to get traction, overcome the barriers to widespread adoption and penetration, be applicable to populations for the intended use and , ultimately, become the standard of care.

You need a VAST business model

1. Validity Regardless or which elements of your model you choose, they have to be valid. In other words, the dogs have to eat the food. When the dog won’t eat the food, you’ll have to change your approach and try again.

2. Automaticity At the very start of planning your venture, you should think about how you are going to work on your business, not in it. Reducing hands on time to manage operations will give you more time to lead the company and create strategies for growth and give you more personal time to enjoy the fruits of your success. Outsourcing, automating or using technologies to ramp up operations, sourcing and distribution is a key part of scaling, and something that investors want to see…which brings us to the next piece.

3. Scalability Your business model is primarily a way to create a business machine that can produce an infinite number of products. Think of it as a device that takes in customers and creates profits out the other end and can do so at quicker and quicker speeds.

4. Time and Traction Finally, your model need to create as much profit as quickly as possible with a growing customer base that is loyal to your brand.

You can tell meaningful, impactful sick care innovation when it is valid, verified, value creating , viral and that is driven by a VAST business model. Unfortunately, the bar is set too low for most ideas and innovators stop one mile short of the destination. Often, getting doctors and patients to change their behavior means having to give them a nudge without being a noodge.

Doctors can see through the fog of war and can tell when innovation champions are just declaring victory and going home.

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GUEST POST from Arlen Meyers

Physician entrepreneurship describes physicians, or other health professionals, pursuing opportunity under conditions of uncertainty with the goal of creating user defined value through the deployment of biomedical and clinical innovation. One way to do that is to create a product, a service or a company, but there are many other ways as well.

Fortunately, students, trainees and clinicians at all stages of their career development are gradually embracing the trend and medical associations and medical schools are slowly responding by trying to provide them with the knowledge, skills, abilities and competencies to succeed.

However, based on feedback I received during a recent presentation to doctors interested in entrepreneurship, barriers persist:

1. Lack of education about how to get an idea to patients, particularly in the core areas of regulatory affairs, intellectual property, the legal environment, reimbursement, business development and building high performance teams.
2. Lack of seed stage money
3. Poor internal and external networks to find the right people for their startup or development teams
4. Poor mentoring platforms
5. Lack of social support networks
6. Poor relationships with policy and advocacy partners
7. Lack of a structured digital health clinical research infrastructure
8. Inability to find clinical care delivery partners who are willing and able to test digital health products and services
9. Significant barriers to integrating digital health products into the legacy EMR
10. Poor innovation culture, structure, process, leadership and incentives
11. Lack of promotion and tenure credit for academic entrepreneurs
12. Lack of recognition for medical edupreneurs
13. Poor entrepreneurial mindset
14. A toxic, anti-entrepreneurial culture of education and training
15. High switching and opportunity costs of pursuing a non-clinical career track
16. Ignorance about non-clinical career development opportunities
17. Difficulty matching qualified physician entrepreneurs with viable startups and scaleups
18. How to manage a gig economy portfolio
19. Understanding the tax and liability consequences of various compensation schemes
20. Risk management

International physician entrepreneurs face additional hurdles. Here are the digital health bumps in the road.

While there are commonalities between the clinical and entrepreneurial mindset, there are significant differences. Business people, for example, make lousy doctors.

Since medical schools have little or no interest in teaching innovation and entrepreneurship to students, trainees are finding what they want somewhere else. In some instances, for example those that don’t do a residency, the result, some think, can be counter-productive. For others, e.g. intrapreneurs- those employed physicians trying to act like entrepreneurs- the result is a frustrating wheel spinning as a member of the cast of their local innovation theater. For independent small to medium size professional service entrepreneurs, failing to innovate and/or adapt can spell the demise of their practice.

So given these roadblocks, how should you get started? Here are some tips:

1. Connect to the right people and organizations in the nearest innovation ecosystem and begin to research potential areas of interest and opportunities
2. Start a personal branding campaign using social media and communication tools to make people aware of your interests and skills so they can find you
3. Arm yourself with the education, resources, networks, mentors and experiential learning you will need to advance your entrepreneurial career. Start by developing the right mindset and practice habits that will translate it into action.
4. Set yourself up as a business entity and separate your personal finances from your business finances and activities
5. Start small, consulting or advising to a company or entrepreneur that fits
6. There are many ways to practice physician entrepreneurship or intrapreneurship, so take a high level view. The point is to create user defined value, not companies.
7. Engage others who are like minded in your region to develop a community of interest. Talk to business schools, medical associations, economic development professionals,venture or angel networks, industry associations or patient groups interested in advancing biomedical and clinical innovation and entrepreneurship
8. Find a mentor or sponsor
9. Get as much business “clinical” experience as possible, realizing that the initials after your name really do not mean much. Start to come down off the mountain.
10. Pass it forward

Attempts to fill these gaps will need to be integrated and systemic as the culture of medical innovation and entrepreneurship slowly gets engrafted onto an already change and risk averse medical system that preaches creating value but, in reality, values the now over the next or the new. The mixed message is payers will pay you for value but they won’t teach you how to create it.

Image credit: forum.facmedicine.com

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GUEST POST from Arlen Meyers

A recent article by Juruzelski, Loehr and Holman from Booz Consulting (www.strategy-business.com) noted that there is no statistically significant relationship between financial performance and innovation spending. What’s more, they identified that the two primary elements of innovative companies are 1) a focused innovation strategy, and 2) an corporate culture that is wired for innovation.

There has been a lot of talk about innovation as a way to get us out of our sick care spending mess. Almost every CEO in any industry, including healthcare, cite superior products and services and quality as their #1 strategic goal. Whether you are in private practice, a coporate entrepreneur, a social entrepreneur or one of the rising number of employed physicians, you should ask your whether you or your company has an innovation strategy and culture to execute on that strategy. The Booz consultants mention three core innovation strategies. The strategies are based on the approach to incremental v breakthrough innovation and the role that end customers play in defining future product or service needs.

Need seekers actively and directly engage both current and potential customers and patients to help shape new products and services based on superior end-use understanding. For example, doctors interact with patients directly and via social media to g

Thus, depending on whether your are marketing new or old products to new or old markets, there are four boxes in the 2×2 matrix.

Here is another model.et feedback about their care and how it might be improved.

Market readers , sometimes called market perceivers, closely monitor their customers and competitors, but are more cautious and incremental in their approach. They are “fast followers”. Are you following other industries, like telecommunications, IT and other service industries for the next “new,new thing”?

Technology drivers , also referred to at technopreneurs, They seek to solve the unarticulated needs of their customers (think Steve Jobs) through leading edge technology. They don’t do focus groups, because they anticipate, not respond to customer needs and wants. They create new drugs and devices that leapfrog the competition.

In other words, are you working inside out, inside in or something in between?

There is a fourth, more common strategy, which is to sell more existing products and services to more existing customers and just call it innovation.

Here is another model

Any of these strategies work. However, of the top 10 innovative companies surveyed, 60% were need seekers. In other words, they focus on being a problem seeker before being a problem solver.

Here are Google’s nine rules of innovation.

Health care and biomedical innovation will drag until we move from a reimbursement driven model to an innovation driven model. It will happen, but there is no way to know how quickly, or what the unintended consequences will be. Regardless of when it happens , you should be creating an innovation strategy in your company, probe leadership in your organization to create and adopt one, and build a culture that can execute. Your future , and the future of US healthcare depends on it.

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GUEST POST from Arlen Meyers

The Theranos story continues to unfold in the headlines and will likely be the stuff of Harvard Business School cases for years to come. Here is a brief history of Theranos. and where they find themselves now. According to the WSJ, Theranos Inc. said it will shut down its blood-testing facilities and shrink its workforce by more than 40%.

Now, she has been indicted for fraud.

The moves marks a dramatic retreat by the Palo Alto, Calif., company and founder Elizabeth Holmes from their core strategy of offering a long menu of low-price blood tests directly to consumers. Those ambitions already were endangered by crippling regulatory sanctions that followed revelations by The Wall Street Journal of shortcomings in Theranos’s technology and operations.

The shutdowns and layoffs could help the closely held company accelerate its shift to developing products that could be sold to outside laboratories. Ms. Holmes announced in August a new blood-testing device called miniLab, which is about the size of a printer but hasn’t been approved by regulators.

Unless you reside on a remote planet, by now you know that the Centers for Medicare and Medicaid Services has fined the Palo Alto startup, banned Holmes from owning and operating a lab testing company for two years and yanked the CLIA certification of its lab testing facility in Newark, California.

If you would rather have the cartoon version, try this.

You decide

Now, she won’t be going to jail, but will be fined and barred instead.

Many journalists have offered lessons to be learned from the Theranos ordeal. Yet, we continue to see examples of people who develop businesses and technologies that, it seems, have ignored them.

The latest postmortem is Bad Blood: Secrets and Lies in a Silicon Valley Startup John CarreyrouKnopf (2018)

For those just getting started, beware :

1. Digital health companies that create products that are not clinically effective
2. Companies that continue to tug on the FDA’s cape in an attempt to bypass regulatory rules that they don’t think should apply to them
3. Unbridled hubris of some sick care entrepreneurs
4. Just not doing the right thing, particularly when the company interest is placed above the patient interest
5. Not knowing when and how to tell the truth to authority
6. Massive PR and crisis mismanagement
7. Getting caught up in the techno-hype and smelling too much of your own perfume
8. Not acknowledging truth, regardless of its source
9. Building a company around a personality instead of a product that makes a difference
10. Not recognizing the difference in sick care compared to other highly regulated non-sick care industries

We have not seen the last of companies like Theranos who are fueled by dumb money and a rapacious technomedia industrial complex.

Doctors suffer from the same faults when they try to manage a patient with complications that are spiraling out of control. Many times, one bad decision leads to another. It is never comfortable presenting at Innovation Morbidity and Mortality Conference.

Physician entrepreneurs should take a breath and apply the lessons they learn at the bedside to crises in the boardroom. The clinical mindset is not that different from the entrepreneurial mindset.

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GUEST POST from Arlen Meyers

Dear Susan,

Congratulations on your recent graduation. I’m sure you are thrilled to start medical school in August and are looking forward to taking a break this summer.

The usual commencement speech I’d give, had I been invited, goes something like this:

Given your interest in building the company you started in college,however, you might want to rethink that vacation in Europe. You probably can’t afford it.

You see, while things are gradually changing for budding medical student entrepreneurs like you, don’t expect that you will have neither the time nor support to pursue your entrepreneurial endeavors. Medical school is all consuming, so you’ll need to squeeze in any extra time on your own. What is more, it is extremely unlikely that your medical school will offer the knowledge, skills and attitudes you will need to be successful as a physician entrepreneur i.e creating user defined value through the deployment of innovation.

You will also need to think about paying off that debt. A 2017 survey conducted by AMA Insurance indicates that 35 percent of medical students expect to have loan debt in excess of $200,000, while 21 percent indicated they will have between $150,000 and $200,000 in debt. It is no surprise, then, that 43 percent of students indicated that paying off medical school debt was their most pressing financial concern. Other significant financial concerns among students surveyed included providing for elderly parents (25 percent) and funding college expenses for children (21 percent). Still, the significant debt load can play directly into those secondary concerns. If you marry another medical student in debt, that further compounds the challenge.

Do you really want to borrow more money to get an MBA, and, if you do, how will that debt burden affect your future entrepreneurial activities?

Perhaps you should consider taking a digital health internship in a top tier digital health ecosystem like Prime Health in Colorado.

Here is some advice:

1. Do an internship with a startup this summer before you start medical school in the Fall and, if possible, between your first and second year of medical school. Here are some examples from medical student entrepreneurs.
2. Network as much as you can and find a mentor. A good way to do this is to join The Society of Physician Entrepreneurs at attend local chapter meetings.
3. Be sure to use social media aggressively to find like minded students around the world.
4. Take advantage of free MOOCs being offered in bioentrepreneurship, medical innovation and digital health.
5. Identify others in your class who are interested in biomedical and health innovation and entrepreneurship and start a special interest group or student club and invite members of your local cluster or ecosystem to speak at lunch and learn sessions.
6. Focus on getting education, access to resources, networks and mentors and experiential learning. Find out whether your school offers bioentrepreneurship workshops, courses or degree programs and rethink getting an MBA. You should also look into iCorps training.
7. Keep your head down and focus on medicine. Don’t tell faculty or other students about your entrepreneurial endeavors lest they think you are not taking medicine seriously enough.
8. Factor in your entrepreneurial career objectives when it comes time to choose a specialtyor employed or independent practice arrangement.
9. Be sure to complete a residency and several years of practice to understand the problems beguiling sick care and possible opportunities to fix them.
10. At this stage of the game, stay fixed on being a problem seeker, not a problem solver. Start by developing your entrepreneurial mindset and practicing entrepreneurial habits. Here are 10 crucial steps to becoming a “pre-entrepreneur”.
11. Start to learn about the business of medicine particularly innovation, marketing, the use of health information technologies and business models.
12. If you are not internally motivated to do this for some time, then quit now and save yourself a lot of heartburn.

You should start taking care of your financial health just like you would take care of your personal health day one in medical school. Creating and following a risk management plan means educating yourself and getting the right professional help as soon as possible. The likelihood is that by the end of school , you will be burned out and somewhat cynical and unaddressed financial burdens will only add to the weight on your shoulders.

You should also consider taking a leave of absence, or a mid-gap year, to pursue your entrepreneurial dreams like these medical students.

Here are some more tips.

The good news is that several medical schools are rethinking medical student entrepreneurship education so you are lucky to be where you are at this time.

Remember, you were not admitted to medical school because of your creativity. You were admitted because of your ability to memorize things, take standardized tests and conform. Simply put, you might not have what it takes to be a physician entrepreneur and , if you are, you will most likely fail.

Again, congratulations on your achievements. Hopefully, when you complete your residency and possibly fellowship training 10 years from now, the environment will be less hostile and more supportive of your initiatives. Please send my best regards to your parents, who, I’m sure are very proud of you.

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GUEST POST from Arlen Meyers

During residency, Dr. Jones, realized there were many surgical problems that needed innovative solutions. During his chief year of residency, he started his first company and created and acquired patents around a more convenient surgical instrument. While working on this project, he identified several other clinical problems that needed to be solved and began to add to his portfolio of products.

A short time after completing his residency, Dr. Jones combined all of his devices into a new company, hired an experienced management team and raised his first round of funding. Because of the demands of the business world, he left full-time clinical practice to become the Chief Medical Officer for the company.

You probably think the next step is to find investors, and you would be wrong.

Instead, if you are like Dr. Jones and have the urge to commercialize a new idea, invention or discovery, then you will need to follow a defined pathway to insure your success.

You will need to follow a process to assess your new idea, identify potential pitfalls, and follow the pathway to commercialization. The roadmap to success has several phases.

First, you need to answer The Three W’s: Why are you doing this? Is the opportunity worth it? How can you win at it?

The first is problem identification, understanding and analysis. Most doctors, engineers and scientists create solutions looking for problems. At the early stages, the idea is to be a problem seeker, not a problem solver. You need to have a thorough understanding of the market, customer segments, their market pain and the competitive landscape. Identifying customers involves interviewing and observing potential users, including vendors, distributors and ,particularly in healthcare, those involved the multi-sided market like payers and patients.

There are several ways to understand the problem, the competitive industrial landscape and potential market segments you intend to dominate. A common one, doing a SWOT analysis(Strenghts, Weaknesses, Opportunities, Threats) 

SWOT analysis is a methodological tool designed to help workers and companies optimize performance, maximize potential, manage competition, and minimize risk. SWOT is about making better decisions, both large and small. It can help you determine the efficacy of something as small as introducing a new product or service or something as large as a merger or acquisition. Again, SWOT is a method that, once mastered, can only enhance performance.

John Mullins, Professor at the London Business School, suggests The New Business Road Test, specifically analyzing the macro and micro elements of your intended industry and market and team and identifying your potential new opportunities.

The next step is Idea Generation. New ideas generally come from two sources. The first source is from discoveries, inventions or designs that result from basic or clinical research. Those who create these new technology-based ideas, called technopreneurs, are usually solution focused and have little or no understanding of the market demand or need for their products. A typical example is a university- based researcher who creates a prototype of a device incorporating a new paradigm, such as a nanoprobe to image head and neck cancer in vitro, or an optical probing device to be used in surgery to detect molecular margins. The inventor’s main focus is proof-of principle, not market acceptance. Likewise, a clinician who designs a new instrument for endoscopic sinus surgery is more interested in solving a particular surgical problem, not how many customers will buy the product.

On the other hand, market perceivers identify a market opportunity or problem and try to develop solutions. While the former, like doctors and scientists, are more problem solvers, market perceivers, typically with a background in marketing, finance, or business development, are problem seekers. They usual are more interested in market size, growth and customers and whether there is sufficient “pain” in the marketplace to warrant identifying a solution.

Dr. Jones is a little bit of both. He recognized a clinical problem that might have a broader application and had the training and technical background to invent a potential solution. Biomedical innovation is like identifying a big enough and important market lock and creating and inserting the right technical solution key. Only by inserting the right key into the market lock can you open the door of opportunity.

The third step on the roadmap is Idea Assessment. The developer takes a high-level look at the commercial potential of the idea with a focus on the market size, potential customers and market growth. At this point, the bioentrepreneur or clinical champion does an initial analysis of the primary market, technical and intellectual property risks involved in moving forward with commercial development.

At this early stage, the principle questions are:

• Will the product or service work?
• How will I protect my idea?
• Is there enough of a market for my idea?
• What kind of people will I need to move this idea forward?
• How much money will I need and how do I plan to use it?
• What are the regulatory and reimbursement issues?

A useful tool at this stage is creating a business model canvas, where you define core underlying business model hypotheses and then test and validate them.

The keystone of your business model canvas is your value proposition, the promise you make to your customers. Use one of the templates explained here to craft your initial value proposition. As you learn more over time, expect it to change substantially.

The fourth phase, writing a Feasibility Plan,and developing a business model canvas, comes next. Lean startup methodology has three basic components-creating a minimally viable product, executing your customer development process (compared to a product development process) and devising and validating the business model canvas.

Now that you have done a risk analysis during the idea assessment phase and have decided to proceed, your task now is to do more research and a more detailed analysis of the business opportunity. During this part of the process, you should describe:

Management Team Analysis

Current management team

Ideal team

Staffing plan

Product/Service Analysis

Purpose of product/service

Stage of development

Proprietary aspects

Government approvals

Product/Service legal liability

Reimbursement issues

Related products/services and spin-offs

Marketing Analysis

Total market size

Growth potential

Competition Profile

Features and benefits

Customer profile

Target markets

Market penetration

Pricing/cost

Financial Projections

Price list

Sales estimates

Cost of product/service

Gross margin

Startup expenses

Capital expenditures

Feasibility Plan Evaluation

Positives

Negatives

Value of opportunity

At each step, you should decide whether to proceed, modify your idea, or abandon your idea. Your task with each of these stages is to identify those issues that are “deal-killers” early in the planning process so you can move on to something else and not waste precious resources and time on an idea that will predictably fail. Most importantly, you should validate your business model assumptions, not just technically and commerically, but clinically as well.

The final phase, writing the Business or Commercialization Plan, is intended to tell your business development “story” to potential stakeholders and investors. If you have done your homework, most of details of the business plan will already have been addressed in the feasibility analysis. Now is the time to identify how much money you will need, what you will do with it, how you will structure the company and how you will execute your sales and marketing plan.

So, if you have an idea, what should be your next step? You should identify your next critical success factor and find the people and resources who can help you achieve it. It could be finding an IP attorney to help protect your idea. It could be finding seed money to create a prototype. It could be finding a regulatory affairs consultant to help plot your strategy. Or, it could be finding advisors or co-founders to help you create the right product-market mix and business model. Here are some tips on how to find them.

Here is a process for deciding and then actually taking your inspiration from an invention idea to a sustainable business:

1. It all starts in your head (think it). Start with what you know, but think outside the box. As you think and explore and imagine the possibilities for new products, remember that it should have a broad opportunity, appeal to people who have money to buy, and needs to have pizzazz to get people’s attention in this age of information overload. Innovation starts with the right mindset.
2. Now get real (cook it). Before you get too excited, it’s time to do some homework. Find out if something very similar is already selling, and who your competition would be if you proceed. Ask some potential customers to see if there is real interest, and start thinking about price versus cost. Look hard at the technology for feasibility and risk.
3. Keep thieves away (protect it). Limit your disclosures to people you trust, and learn the use of non-disclosure agreements (NDA). File at least a provisional patent and one or more trademarks. Be wary of crafty shysters who will flood your mailbox with official-looking mail offering to help for a fee, or demanding fees you forgot to pay.
4. Make ‘em want it bad (pitch it). “Pitching” is the insider term for presenting your product idea to people who could conceivably buy it or fund your efforts. Start by developing an “elevator pitch” that you can deliver in 30 seconds to hook a potential investor. Attend trade shows and network to find the right players and pitch your product.
5. Factory in the garage (make it). This is the point where you work on the specifics of being able to deliver your product or service. Relevant questions include the type of business entity (LLC or C-Corp), licensing or manufacturing, sales and marketing, and staffing. It’s also time to build prototypes to make the product come alive.
6. Continuous improvement (replace it). Once you have a real product, and it’s actually selling itself online, or on store shelves, you may think you can just sit back, relax, and collect your riches. But remember that complacency kills, and you always need to be thinking of the next product iteration, new territories, and new competitors.

In other words, fail it, nail it, scale it and sale it. 

Remember that a technology is not a product and a product is not a business. Plus, an idea is not an invention nor is it an innovation. The keys to biomedical business success include a compelling value proposition, a business model that makes sense, a management team that can execute and customers willing and able to buy your product. By following a clear business development pathway, you will identify and address potential landmines and limit your risk of failure.

The life science innovation roadmap filled with hazards. But, if you take the journey a step at a time, you will either discover early the errors of your thinking and kill or change your approach or move forward with some level of confidence.

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GUEST POST from Arlen Meyers

My parents were traditionalists. I’m a boomer. I work with a lot of Gen-Xers. I teach a lot of millennials. We are all trying to understand each other and adapt to how we teach and learn.

Some teachers have to deal with helicopter parents more than the kids.

Since we are all, mostly, products of our environment and the cyclical events of history, we all look at the world through that lens and, unless you have the right optician, you can have a hard time seeing what’s in front of you. Plus, we all change as we get older so, in many ways, generational stereotyping is stupid.

Here is how I have changed my lens prescription:

1. Make it personal. Link learning to experience.
2. Embrace technologies, but don’t let technologies get in the way of learning. Hey! Stop checking your cell phone while you are reading this. You will learn more if you take notes by hand and it shows respect for the instructor.
3. Prune to fit. Limited attention spans means you have to hit the high points and list them in 2 minutes, like what I’m doing in this post.
4. Practice what you teach. You just can’t fool those folks and they will see through your hierarchical facade. In fact, those that do really do teach and students really like a view of your real world and making connections to working domain experts so they can get jobs.
5. Be social. The org chart these days looks more like a network
6. Demand the same respect for your outlook the same way others demand you value theirs. Play nice together
7. Use immediate access to information to your advantage. Why memorize anything when it’s at the tip of your thumbs on your mobile device? Move from recall to interpretation to problem solving to wicked problems that have no real solutions. Flip the classroom and use the lectures as the start, not the end.
8. Encourage creativity and drive out fear
9. Learn to engage using educational technologies that improve learning like reflective questions, hierarchical learning, role playing, video and gamification and team based learning.
10. Learn to give and receive feedback. Radical candor is the feedback flavor of the month. Glasses are not the only thing you need as you get older. You will also need a better way to hear and listen. It’s a two way street.
11. If you want to learn something, try to teach it. The problem with expertise is that it doesn’t necessarily come paired with an openness to new ideas.
12. Create a space to give students time to think instead of falling into the trap of filling every moment with lessons, practice, trips, sleepovers and homework.
13. Unless a student has a learning disability, make students turn off their cell phones and laptops during class, since research shows you learn and retain more by taking hand written notes
14. Use PPT presentations as little as possible. Class should be a creative exercise, not a funeral after death by Powerpoint
15. Every class should the right mix of informing, entertaining and interacting. The most impactful interventions for student success are someone who cares, experiential learning and , in the case of adults, repetition, repetition, repetition.
16. Find a millennial to be your mentor, particularly to keep you in touch with trends and technology

Teaching to learn requires learning to teach. Unfortunately, most of us think it is easy, everyone can do it and we should not pay for it. It’s time to get our hearing and seeing prescriptions checked.

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GUEST POST from Arlen Meyers

Startups, in general, fail for many reasons. One observer mentioned his top 5 reasons as 1) lack of capital, 2) expanding too soon, 3) heavy reliance on debt, 4) poor strategy, and 5) poor business model and plan.

Ultimately, there are two basic reasons: 1)They make stuff no one wants to buy, and 2)they have a business model that is not valid repeatable, scaleable and profitable.

Digital health startups. be they telemedicine, data and intelligence or remote sensing companies, suffer from the same symptoms, but, because of the unique and complicated sick care and health care ecosystems, there are other reasons too:

1. Entrepreneurs underestimate the complexity and special challenges of USAsickcare, Inc.
2. They don’t involve end users early and often enough to develop and validate their business model. They don’t listen to physicians and other members of the care team.Cumbersome, frustrating, maddening products result.
3. They don’t satisfy the needs of mulitple stakeholders, instead focusing on just one
4. They overestimate patient healthcare IQs
5. They make products that interfere with physician workflow instead of making it easier
6. They create products that save neither time nor lives
7. They launch products that are not clinically validated and simply don’t do what they are supposed to do
8. They rely too much on changing human behavior
9. They are designed to scale quickly and do not have a sustainable business model
10. They are not different or offer a compelling value proposition

There are many digital health design, development and deployment gaps. Most companies don’t close them and that is why half don’t last 2 years. . The results are failed startups and digital clutter in the marketplace, further confusing doctors and their patients. Digital health is still in its infancy so we can expect to see a lot of failures. What we should not expect is for the situation to persist much longer . We need digital health infrastructure and ecosystems to reduce the cost of failure and that result in inexpensive, easy to use, effective products.

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