The Politics of Hospital Innovation - Ira Brind, Pulse Equity Partners— Full

In this episode of StartUp Health NOW!, active investor and thought leader, Ira Brind, discusses how the politics of hospital innovation impact healthcare transformation, plus a few examples of facilities taking the risk and the value he sees in trusted peer networks.

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Key takeaways from this episode of StartUp Health NOW can be found here.

[00:43] Steven Krein: Our next Fireside Chat is an addition that, is not on your calendar, but it’s a special guest. I’m going to spend a few minutes talking with a friend and mentor, and incredibly active, both investor and thought leader, around how large hospital systems perhaps innovate, as he spent the last 30 years on the board of Jefferson Hospital in Philadelphia. He’s an active private equity investor, angel investor, one of the first investors in StartUp Health. Join me in welcoming Ira Brind to the stage.


[01:24] Steve: So, Ira, I gave a very brief overview. You’re an entrepreneur for many years. And a little while ago, I say a little while ago, but I think when you were 42, and sold your company. You became much more than an entrepreneur. Quick snapshot on Ira Brind?
[01:44] Ira Brind: I sold my company when I was 42. Quite young. It was truck leasing, and I sold it to Mcdonnell Douglas and worked for them for 4 years. And then went off and did some version of private equity since then. And along the way I made the decision, actually before I sold, that I’ve been very blessed in this lifetime, and so I was going to give back. So I started spending a fair amount of time on nonprofit boards. And my criteria, I set up 3 criteria. I wanted to do the arts, I wanted to do medicine, and I wanted to do hard medical science. Those are pretty much what I’ve done, although I’ve now added charter schools, because I think it’s a problem that needs attention.

[02:30] Steve: Over the last 30 plus years you have been on the board of Jefferson Hospital and one of the things that I thought was important to talk about, especially in this environment, is sitting as a board member of a hospital. Looking at how innovation really happens. There’s no shortage of experiences by entrepreneurs in this room with struggling to figure out the politics of innovation in hospitals. And you’ve had a front row seat to this for so long. But today as you still sit on the board and look out over the next decade, how do you think hospital politics play a role in ultimately the transformation of healthcare?

[03:12] Ira: Enormous role. When I look at various bureaucracies there are the 3 worst in my opinion, and I won’t rate them in order, but is government bureaucracy, university bureaucracy, and hospital bureaucracy. Terribly ingrained, hard to change, and they’re very slow moving. So if I looked at Jefferson prior to our current president who has totally reimagined Jefferson, getting new things in it would have been very difficult. You would have had to really find a champion and hope that that champion had enough muscle and enough fortitude to make it happen.

[03:50] Ira: What’s happening across a number of different hospitals and facilities and universities are that there are some that are rising to the top and taking major risk. Jefferson has become one of those. They just recently added a fourth pillar to its mission and that is innovation. And they hired a top person, came from Duke, and it reports to the President just like the university and the medical. And they created a track for tenure for those who invent things, don’t just publish. So if they’ve invented a new company, if they created a new company, that’s a way of being promoted. Plus they start to share more of the profits with them, because they want to be an attractive place. There are a number of those fairly creative places. Cleveland Clinic, and you should really know who is moving, who is being innovative, who’s open. So that when you’re coming up with something, find that, and you’ve gotta find the champion. You’ve gotta find someone who can make it happen. Not a simple task, but it’s doable.

[05:02] Steve: I know one of the things that you look for, and so, Ira’s a private equity investor as well and as a later stage investor in healthcare, too. I thought it would be interesting to talk about the characteristics which the entrepreneurs have said wish they knew when they were starting out. And so as someone who looks at later stage companies in healthcare, what is your advice to early stage entrepreneurs that they should figure out now, versus waiting, because ultimately at the end of the day when the real capital is needed, the much larger checks as they make progress, that would help make a transformational change to their company?

[05:44] Ira: Well, I think the last speaker was quite brilliant listing out the things that become important. So the big vision becomes important. The team you’re building. And the advisors you bring on. I’m a very big fan on any company we buy and start to build out, we bring on outside board members. And we give them, and we align them on the same side of the table. We give them options and stocks, so that, and some little money to pay, but it’s not about the money it’s about, there will be a payoff, if this company is successful and they help make it successful. And I would urge all of you to say, who can you bring that knows things that you don’t know? That has connections you don’t have? Give them a piece of your company. Make sure that they’re worth it. Do it. But really, you need more advice than you can get. And if you’re not talking to peers, then you’re talking to yourself, and that’s always a very limited conversation. No matter how smart and how good you are.

[06:48] Steve: So my guess is that over the last 30 plus years the board has ebbed and flowed and some makeups of that board have been incredibly successful, and some probably incredibly frustrating. What is the ideal board and I know it’s a hospital, but when you invest or when you have participated on boards you must have looked at this and said I can see a trainwreck coming because of the the way it’s set up, and then other times when you look at it and say this is not only a pleasure but it’s no reason, it’s no, it’s not surprising that it’s successful.

[07:20] Ira: My first answer is that it’s never the board it’s always the management and the entrepreneur who is shaping the dialogue, and it was pushing the board. The board becomes very important but it’s, it’s there to help. It’s not there to do. So, I’ve watched Jefferson go from somewhat more abundant and exciting playsets reimagining all the parts of education and medicine, slower than our CEO would like, and slower than probably our board would like, but faster than any of us could have ever imagined, including him. So a board becomes important but it’s a tool. It isn’t, it’s the management, it’s the CEO. When we look at a board I always want to know what are the skill sets you need, that this company needs, this non-profit needs, and make sure that you fill them with specific skill sets that are helpful.

[08:15] Steve: Shifting gears a little bit, we talked a little bit with Vinod about trusted peer networks. I know that you’ve been a member of YPO, Young President’s Organization, like myself, and now are in WPO, but have always tapped into that peer network as you both built and invested in companies. Again, how has that shaped your life?

[08:01] Ira: Well, that’s a great question because it has actually shaped my life. I joined YPO at the age of 32 or 3. It was a very small company. I had no peers working for me and I didn’t know what I didn’t know. Which is always the worst thing. And so I joined YPO, looked around, then became very friendly with those people whom I thought did business with a class, success and style and wisdom. And really learned from them and I went to a lot of education. I joined the YPO forum and it was invaluable because until I grew the business large enough to have some peers, they were the people that I could get advice from, I listened to how did they solve problems? As I have matured and gotten somewhat older, it’s also extremely invaluable on a personal level. Because you can really grow personally, learn from what other people have done, and I’m still in a forum. At this age and well in my 70’s and it’s a great experience.

[09:43] Steve: So last question. What makes you so excited about the transformation of healthcare today? You’ve been obviously around and around healthcare for so long, but today looking at, and you spent the last two days at the StartUp Health Festival. What makes you so exciting about the next decade and what we’re doing here in this community?

[10:02] Ira: I agree with Vinod that healthcare is harder to disrupt because it’s so ingrained in certain ways. But it’s it will happen. It’s necessary. And so, I think trying to figure out how to disrupt it is, is fabulous. Along the way, learning how to disrupt it and figuring that out becomes a “how do I bring something interesting to the marketplace.” And it requires a real analysis of what forces, what actors can really help you disrupt, as opposed to just come in and fix things. [10:40] Ira: Now, fixing things are great, so I’m not against that. But clearly the more exciting ones are disruptive. And who’s, who’s your best partner or partners in bringing disruptive technology who will adopt and try it, as opposed to, to changes as they go on. Which again, I’m all for an easier to do. So it becomes really who. And you should really look at Google and say which of the institutions that are moving? And there’s a number of them that are really thoughtful and much more open and much more accessible to entertaining disruption.

[11:17] Steve: It sounds like that was a set up for our talk with Nick Turkal from Aurora Health Care. If I ever heard one. Ira, I know we only had a few minutes. I appreciate not only us spending a few minutes sharing your wisdom with us, but the last couple of days here, and more importantly what you done over the last several years helping us build and be supportive of StartUp Health and the mission that we’re on. So thank you very much.

[11:39] Ira: It’s what’s fun in life.


[11:45] Chime

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