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134 Founder 2 Founder, Vinay Nagaraj, Co-Founder & CEO, Bonfire Analytics & Joshua Miller, CEO, Gradient Health

Vinay Nagaraj - LinkedIn

Joshua Miller - LinkedIn

Quick Pulses of Full Conversation: Tachyons, Soundbites, Takeaways..

Revolutionizing AI Development in Healthcare

I can start there. So we talk about AI in healthcare in terms of its applications, but not in terms of like what goes into building it. Right. And at the end of the day, it's like every AI needs to be trained on data. And healthcare data inherently it's private, right? So it's how do you build an AI that can do something like reading mammograms or reading chest x-rays without exposing it to people's data um it's it's kind of this really really tough problem and the way it works today is hospitals will hire some guide to kind of go through and manually de-identify and remove all the patient information and get the data over to these companies that want to build an ai But the infrastructure today means that those companies wait years and spend millions of dollars getting access to those data sets. What we've done is we've built large-scale de-identification of data that we can then provision to these AI companies that are building AI. So instead of waiting two years and spending $2 million to build a data set, they can wait a week and spend $100,000. And the vision there is, look, anyone that's trying to build an AI that will help patients shouldn't have to spend millions of dollars and wait three years to even get started. Because then at the end of the day, we're denying value and delaying value to patients that need it. And that's what we set out to solve. So Gradient helps connect those companies to large-scale de-identified data for doing this kind of AI development.

Mentorship and Paying It Forward

I think one of the things that jumped out to me at the beginning was just how willing people were to help if you are willing to ask for help. So I had a lot of people mentor me and help me. And You know, I was a 19-year-old kid. It's like, what could I do in return for them? Not much, right? And so when I exited that company, I kind of felt like I had a little bit of a debt to the universe, right? In the sense that it's like, here's all these really wonderful, intelligent, thoughtful people that gave me time and thoughts without anything in return. And so I think when we exited that first company, the biggest thing I felt was in debt, not financially, right, but emotionally. And so part of that was the reason I got into angel investing and mentoring, right? Because at the end of the day, it's like, if I couldn't pay it back to those people, the best I could do would be to pay it forwards to someone else like Vinay.

Inception of Gradient Health: A Personal Journey

How did you get the, where did the thought come to, like, how did you stumble upon this? So my co-founder and I, same co-founder for my first business, one day we were sitting on the couch, we're like, man, let's build exactly what we're describing, which is we were like, hey, let's build a mammography AI, right? Like, you know, my mother-in-law had breast cancer in the past, and I had been thinking about it at the time. and um we're like okay let's get started but it's not like pictures of cats like if you want to build the cat detection ai you google cats and get a million pictures if you want to build a mammogram cancer that mammography and and breast cancer detection ai can't just google breast cancer and get a million images of breast cancer all right for good reason And so we were like, wait, if we have this problem of like, we wanna build this thing, but there's no data for it, I wonder if other people have this problem. And it turned out they did, right? And so we pretty quickly found our way to product market fit based on that, because it was a problem that we had for ourselves.

Revolutionizing Healthcare: AI's Remarkable Diagnostic Abilities

Do we want to transition to, you guys are so, both of you are deep into health tech, AI, you know, adding value in this healthcare system. I'd love to get your perspective on what, what this is, the hype, really what's going on, where you see the value and kind of what you guys are both really deeply in AI using these solutions. Yeah. I mean, One of the things that I have seen for the first time in history, I would say in the last three months, is I've seen someone feed a model in an image, right? Like a CT scan or an X-ray. And the model's written a report about what it sees in that X-ray or CT scan perfectly from scratch. Meaning no human in the loop looked at an X-ray, wrote, there's a broken rib here. uh you know air and air in you know in in the chest cavity here and this other issue over there um that was wild that was this mind-blowing moment that i had right just being like okay okay it's not as good as a doctor is nor will it probably be for a very very long time but seeing an ai do that from scratch after just looking at an image i think was unlocked how I felt about the future.

The Inner Battle of Raising Capital

I think it depends on what round you're raising, but I think there's one thing that holds true to me. uh across every you know i've raised financing maybe 10 different times in my career from angel rounds up to a series a the one thing that i think remains true is it's like very much so a battle against yourself more than it is against the market or what vcs want etc because in a way you're gonna get told no 50 to 500 times when you're trying to raise money and it's very easy to get, it's very easy to get discouraged and it's very easy to get stressed out. And so raising venture capital, a lot of people think about it as this like outwardly focused thing. But the thing that trips up founders most of all is, is like lack of inward focus, right? Lack of like, Am I taking care of myself? Am I still believing in myself? Am I doing the things that I need to do to remain believing in myself even after 100 people tell me no? And I think that's been one of my greatest experiences is learning how to do that, learning how to like tune out the no's, but still incorporate the feedback to kind of iterate over time.

The Anxiety of Startup Exit: A Raw Experience

um in the sense that it boils many years of your life down to this binary outcome right so it's like i spent four years building the business and all of a sudden it was either going to be millions and millions of dollars or it was going to be probably zero dollars right um and and there's literally a moment in time in which like that that switch flip-flops one way or the other uh and and drastically changes the course of your life that's scary. Can I cuss? Yeah. Yeah, sure. That's scary shit, man. Like to spend four years of your life and have it distilled into the, just this one moment, right. Of like either poof magic happens or it evaporates into air. And I think that those two weeks, again, I, were probably the most like anxious, exciting times of my life. Absolutely. I mean, to the point that like, I was such a ball of anxiety around it. I think I didn't really celebrate until like a month after the acquisition. I was just like sitting in my shower and I was like, holy shit, man. That actually happened. Like, I just couldn't process it the day that wire transfers went through and everything got signed. Like, I kind of had to unwind from that a little bit to actually realize it.

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Topics include: startups, digital health, health IT, technology in healthcare, payers, hospitals, healthcare systems, pharma, biotech, culture, change, leadership.
Audience is healthcare executives, leaders, healthcare administrators.