Venture Partner Perspectives: Elizabeth Jennings (Principal, International Portfolio Services at Venture Atlas Labs)

Welcome to FundRx Venture Partner Perspectives, where a FundRx team member conducts a brief interview with a FundRx Venture Partner, with the aim being to share the knowledge and opinions of a diverse array of healthcare clinical and industry experts. Subsequently, we hope these interviews spur further thought and potential innovation and action in the areas discussed.

This interview features Elizabeth Jennings, Principal of International Portfolio Services at commercialization and research firm Venture Atlas Labs. She founded Venture Atlas Labs to provide strategies for startups and skunksworks, due diligence and risk mitigation modeling for investors, and business intelligence playbooks for programmatic scaling within growth companies. Their forte is in health tech and emerging technologies, particularly in diagnostics, Class I-III medical devices, payer-provider-end user software, and fast-tracked molecule development.

She is also the founder of Vend for Yourself, an investor readiness studio; Vice President, Marketing for Neurolex, a voice diagnostics startup; and Founder of the Knee Initiative, a company dedicated to developing a better knee brace. She serves as an advisor for startups and speaks at workshops, panels, and keynotes on marketing, commercialization, and international business strategy.

Megan Beck: How did your professional career lead you to healthcare?

Elizabeth Jennings: My career has been a reasonably unlikely path, driven by luck and curiosity about larger driving forces. Prior to entering healthcare, I was in full-throttle agency marketing with a healthy dose of technology — analytics and business intelligence tech before it was WYSIWYG.

My entrance into healthcare was actually my first position in the US, and San Diego was the ideal place to learn the industry (and recover from Canadian winters and South American summers). After working at one of the top diagnostics innovators in the world there in sunny Southern California, I moved to Europe and widened my perspective on health systems. Upon returning to the US, I’ve stayed about 80% focused on answering healthcare-centric challenges.

Megan: As someone who has been both an operator as well as an advisor to early-stage health technology companies, what advice would you give to first time entrepreneurs in picking the appropriate advisors for their companies?

Elizabeth: I think this is one of the hardest things about being an entrepreneur. You can read about business models and learn management theory, but the truly hard work comes quietly, in the mid-morning in the boardroom when personalities and perspectives move the company’s “attitude” — its direction and capability to execute consistently among unknowns and changing environments.

I’ve seen advisors make and break startups: their advice can pit co-founders against each other or pull the team together. Learning to create that constructive boardroom by discerning salient advice from nonsense is one of the most crucial and challenging skills for entrepreneurs — and there’s no shortage of free advice out there.

This is what I’ve told entrepreneurs I’ve advised in the past on choosing both their advisors and team members: never ask anyone to do anything for you that you wouldn’t do for them. When you ask someone to join your company as an advisor, you’re really asking them to invest. Entrepreneurs always position it as if it’s an honor — and it can be — but it’s really a request for time, experience, and hard work in exchange for equity.

The best team members, regardless of role, understand that this is a serious business we’re in. Requests that would be unreasonable in the corporate world are a matter of time here. We’ll each be up at 3 in the morning working on a critical problem; we’ll work through mistakes, embarrassing pitch gaffs, partner politics; we’ll pull together to create what hasn’t been created before. It isn’t a light request just to make a team slide look better. Your relationship with your advisors (and the rest of the team) must be such that you would be willing to do the same, should the scenario ever arise.

I also urge entrepreneurs to consider what problems they need their advisory board to solve and work backward from there. Titles cancel out. A highly varnished success story from 20 years ago may not be an applicable template for success now. Look at what they’re good at solving, consider how they would contribute, and be mindful of your request for their investment.

Megan: Given regulatory pressures and reimbursement landscapes, commercialization of a product within the context of healthcare can be quite complex. The challenges can seem daunting for entrepreneurs. Are there any frameworks or “goalpost” type rules that you find useful when devising go to market strategies for healthcare startups?

Elizabeth: It’s extraordinarily complex — but that complexity, in a strange way, lends itself to the simplicity of pathways. Some things simply won’t work. Some pathways have more resistance. The biggest challenge is that our predictions for how the environment is a few years down the road are always changing, so understanding which pathways have the most opportunity within a certain timeframe, or which have the most resistance, is not always obvious, particularly as technologies blend and create new use cases.

The first rule of healthcare commercialization is to check all assumptions as objectively as possible. Design and execute experiments that will allow you to weight variables; repeat the experiments ruthlessly as time progresses. Market research has to be designed around the questions you need to be answered so that you can apply it in a way that helps you make the smartest possible decisions. Multiplying CPT codes to get a volume of procedures or tests may tell you that there’s a viable market, but it’ll do very little to help you take it.

The market landscape isn’t homogenous either, so “just securing 1%” of it isn’t a useful thought experiment; the real world doesn’t fragment that way. Creating a pricing strategy has to account for potential copycats, multinational corporations, and the reimbursement numbers behind the actual target market — in addition to operating, manufacturing, and market entry costs. Ultimately, go-to-market is much more than getting a paid pilot. Because it reflects the development of every other aspect of the startup, it’s the buoyancy test for the health and the potential of the business.

The second rule of healthcare commercialization is to plan to think laterally, because technical risks, regulatory hurdles, and sheer adoption time will force you to find cash flow sooner than you might have hoped.

The third rule is to check your assumptions again.

Megan: What areas of healthcare innovation are most exciting to you in the next 5 years?

Elizabeth: Digital health is an obvious answer. I’m most excited for its telehealth applications, as the potential for driving down associated costs and democratizing access to a provider is tremendous. In many rural populations and in developing regions with a large unsettled demographic, having remote access to things like a peer-to-peer EMR or a molecular diagnostic for a neglected tropical disease is huge.

Megan: What does your current day-to-day look like? What’s most exciting to you and your team right now?

Elizabeth: I’ve lived in a suitcase since I moved back to the States from Italy a little over three years ago. I rotate between Austin, a far-flung ranch in Central Texas, and coastal or international business travel — each about a week each month, more or less. It’s a peculiar lifestyle that was extraordinarily difficult to accomplish, but it suits me. It means I’ve written analyses from boats, trains, airports, stairwells, consulate foyers, cafes. Depending on where I am and my travel schedule, the immediate impact is that I rarely take a day “off” — but I have the opportunity to continually redirect my attention to new areas to learn and new projects to which I wouldn’t otherwise have visibility.

The suitcase lifestyle means I get to learn every single day and learn how to push myself and our clients forward in a non-traditional but extremely agile manner. It’s not for everyone. It also means I have a pretty healthy grasp of quality suitcases, a decent phone plan, and an up-to-date immune system.

We’re extremely excited about our international economic work with trade organizations and VC and PE funds. As we expand our practice into more international trade exercises, we’re hitting our stride — it’s a great blend of challenges that puts us in our element. We’re also giving more workshops and talks on global healthcare innovation, which is always fun. One of the things I’m most proud about is how multicultural, multilingual, and culturally-experienced our team is.

One of our focuses this quarter is on week-long optimization sessions with trade missions to refine commercial strategies and strengthen investment opportunities. It’s a new exercise for many organizations, but it’s making a world of difference in increasing the efficacy of those missions. Every morning, I wake up excited to lead those.

Megan: In order to stay up to date in those areas and healthcare generally, what are some of your go-to resources?

Elizabeth: My RSS reader is, like Austin, full. I couldn’t even begin — but if you’re local to Austin, we do run a quasi-regular newsletter with healthcare and venture capital events for the community. Talking to folks who are on the ground making things happen is one of the best ways to stay informed. Feel free to shoot me an email at elizabeth@ventureatlaslabs.com with the subject line “Add me to your newsletter.”

Megan: How do you utilize your expertise, by giving back to communities?

Elizabeth: Fortunately, it’s easy to give back in this line of work; the tough part is balancing everything. This year, my active efforts are around mentoring and giving workshops with several accelerators, including MassChallenge Texas and TMCx. I’m a proud member of SWAN, so there’s always a social impact startup that I want to invest time into.

I also do pro-bono workshops in developing economies in Latin America to help encourage entrepreneurship. And, of course, there are passion projects that I love to dive into: anything regarding neglected tropical diseases, equatorial ethnobotany, and international development are easy to get my interest.