Reflecting on a Decade (!!!) of EMS & Fire Innovation at Beyond Lucid Technologies.

A Thank You Note to All Those Who Made It Possible (and Continue to) — Plus a Heaping Helping of Luck.

May 1, 2019 (Concord, CA):

Those who know me know that I occasionally name-drop. Not because I care that you know who I know (I know plenty of folks). It’s because I believe in giving credit where it’s due. In remembering that without just the right angels whispering just the right thing in your ear at just the right moment — everything might be different. Some things would be better, some worse.

But it would all be different, and while therein lay fodder for curiosity (who grows up in Hollywood, as I did, and doesn’t wonder what it would be like to be a movie star?), I’m joyous about life right now. Pretty darn Zen, even as bullets get lobbed from time to time, and political bombs lay about. After a decade serving an industry that is triple-regulated, if you’re lucky — as I have been — you earn the right to call some heroes “friends.” Where heroes lurk and good work is being done, you’ll also find snakes slithering, seeking to ensnare with obfuscation and false promises. This may be the Original Sin of the government business (my late professor Lester Lave had a similar philosophy that he called the “Iron Law of Government”). But after a decade, you grow a backbone, learn some nifty tricks, and meet the fickle Lady Luck.

Consider:

Without certain tragedies, like two towers blowing up on a Tuesday morning in 2001, I might not have joined in the Army. If I weren’t Tourettic, I might not have been excused from my enlistment, and I might not have pined for another way to serve. I might not have thought about attending med school, so I might not have learned that I was no good at organic chemistry. Then I might not have had the chemistry professor ask, “Why are you doing this to yourself? If you want to be in the medical business, why not get an MBA and hire a doctor someday?” I might not have applied to 23 schools but gotten into three — at one of which I met Chris Witt, a genius engineer whose father and sister tragically died in a car wreck in rural New Mexico two years prior.

Because I’m shy and Chris isn’t…wait, I think it’s the other way around?…I might not have suggested that we build a device for the rapid diagnosis and therapy of PTSD and traumatic brain injury in warfighters. Then we might not have pitched the concept to Kenneth Pitts of the U.S. Army Research Institute of Environmental Medicine, who might not have said, “We love the idea but don’t know enough about patients. Can you focus on the diagnostics?

Without that pithy, theoretical question — whose consequence we did not recognize at the time — we might not have found that as much as 51.8% of patient data are lost (only 49.2% retained) at each node of handoff in a prehospital context. Anecdotally, the data loss figure can exceed 80%.

Around the same time, our lawyer may not have advised that we apply for some unusual funding tied to the Stimulus Act, back when the recession fell out of the sky…and a month before our cash ran out, we might not have receive a beautiful letter in the mail, saying that we had receiving our first organization funding, courtesy of the federal government. If those things had not happened — so much luck and so much chance, so many things that might have gone differently — we might not be celebrating our 10th birthday today.

This is where I find faith.

10 years.

My fellow StartUp Health-er / “Health Transformer” Nadeem Kassam, founder of the remarkable company that made the Basis smartwatch and sold itself to Intel for many millions, once reminded me that he spent the first part — and arguably the better part — of his entrepreneurial career couch surfing because he couldn’t afford rent. He was an “overnight success” a decade later.

The rising CNBC healthcare reporter Christina Farr, who covered my firm when we won competitions by VentureBeat and Morganthaler Ventures, has said that she admires companies that write a post-mortem after they shrivel up. Maybe consider this the opposite, then: a celebration of life and luck.

Because I’m writing it, it doubles as a missive of thanks to those who have made our last decade possible: our partner-clients, above all. Our investors, whose faith we aim to repay greater than 10x, and in the meantime we hope they’re proud of the innovation that they have enabled. Perhaps more than anyone, though, here’s a toast to my wily band of technical wizard-misfits. The engineers who make our magic happen are the best in the prehospital technology biz. There is nothing that our larger close competitors can build that we cannot out-build, faster. Isn’t that the Law of Disruptive Innovation?

It’s not an accident: I am selfish about talent, but the talent is not mine. Like Abraham Lincoln, if I have done anything rightly as CEO, it is to construct a team where everyone wants to be the best, and is dedicated to the success of our partner-clients, and the health and safety of their patients. MIT professor Ken Morse once told me that, as CEO, I have only one job: To “hire, train, and retrain Eagles.” Done. We’re imperfect; we’re quirky; but my crew is the best.

Yesterday, while visiting Arizona, I was offered the best birthday gift that I could have hoped to receive: a longtime partner-client’s EMS coordinator sat in his Chief’s office and said, simply, “We love MEDIVIEW, and anyone who says otherwise has no idea what they’re talking about.” (Swooooooooooon.)

What’s ironic is that what makes our team extraordinary — according to our partner-clients themselves — is not just our technology (though I must, it’s pretty nifty). 😀😎 Rather, it is ephemeral, an attitude that I attribute to a poster hanging in my Dad’s office when I was growing up. The sign read: “The most dangerous customer isn’t the one who complains. It’s the one who doesn’t.”

My friend and mentor Lisa Suennen (this was fun…) — whose husband gave me the book Strategic Selling — once prodded me to define Beyond Lucid Technologies’s culture. It took a while, but I realized at last that we have only one litmus test for citizenship at BLT, and technical expertise is distant down the list: We care most about how voraciously one obsesses over the field user’s experience. Taste is in the eye of the beholder, so we don’t always agree. Lord knows we don’t always get it right. But our open-door policy is not optional. To the contrary, we work hard to train our partner-clients to lean on us. We have gone so far as to refrain from bidding on contracts that would position us as a mere “vendor,” since doing so would short-circuit all that we do best. We excel as a compatriot in the foxhole, a partner in innovation; when we get to co-author the research paper, rather than just providing the study dataset:

A few days ago, a fire captain overseeing EMS technology for a large city in Arizona asked me if the market had ever looked sideways at the fact that most of our team members are not clinicians. Of course, I explained — for at least the first five years. Then the market began turning toward economics and information science, which are to a pair of CMU MBAs what the Sun is to Superman: Data are our fuel and happy place. Suddenly it’s fun to be a geek in the prehospital game (prove you’re one of us by reading “The Geeks Shall Inherit the Industry”). Five years after the data inundation started, I see that the evaporation of concerns about our clinical expertise had little to do with software. Rather, it pertained entirely to our team’s answer to one question:

How do you evolve a trust-based, tradition-bound industry from outside?

ANSWER: You don’t. You need empathy. Ride the truck. Ask questions but only if you plan to LISTEN to the answers. No need to “sell,” since technology should be a source of efficiency, not fear (and sell itself).

When a company busts through the 10-year mark, it is serendipitous but not accidental. It is powered by sweat and steam, prayers and faith, and funds from families and friends who support the difference we’re working to make.

Trust me when I tell you we’re just getting started. My friends at StartUp Health (once known as the Academy of Health & Wellness Entrepreneurship) made it acceptable to tell investors — who generally do not understand the Fire & EMS market any more than the public does — that “good things take time.” Thus we return to Lisa, who taught me more than I can write in one essay. She encouraged us to seek as little VC as possible early on, staying fiscally disciplined and obsessed with exceeding partner-clients’ expectations before we get distracted by others’ money in the mix. Keep partner-clients happy. Answer calls personally (Who needs a phone tree? It just frustrates people). Follow-up as promised. Confirm what users really do in the field. Ride the truck.

When you do these things — and relish the chance to see your innovations in action — you can achieve results rarely seen in Silicon Valley, like 95% year-on-year partner-client retention. You get to incubate a company that creates lasting change, with the freedom to look to the future, not just into a tin cup.

I can recall every up, down, and sideways of the last ten years, despite that they were a ridiculous blur.

Some failures we take personally; others were not our fault. We had near-wins and near-misses, opportunities that evaporated and bullets dodged. Points of pride, times when we licked our wounds, and a few good floggings.

There was knowing that we had helped some services grow 3x since they implemented our software. There was knowing that we had slashed an agency’s documentation time by 66% (even in the air, we reduced charting time by 50% over 5 months). We got to meet with the San Francisco Airport team as part of the San Francisco Entrepreneur-in-Residence program after the Asiana plane crash. Despite being teeny teeny tiny, after two years of negotiating we licensed our software to the Company Formerly Known as Xerox to use as its own. There were awards, and the day we moved out of the garage office. The moment we went international, and the day that hospitals started calling to ask how much it would cost to start using our “pre-hospital pipes.” (Credit where it’s due: Investor Anne DeGheest gets shy when I point out that she once suggested leveraging HL7 standards so that EMS agencies could leave digital data just inside the ED door, allowing hospitals to grab it if they wanted to. Turns out that’s a totally viable approach to interoperability!)

The day I met our partner Sunny Lu Williams at the American Telemedicine Association conference in L.A. One of the fastest-talking (she makes me seem quiet!), whip-your-head-back brilliant SMEs on labyrinthine aspects of the American, European, and Middle Eastern health care systems — things like federally qualified health centers (FQHCs) — Sunny’s knack for government contracting and vision for a connected healthcare system gifted us a chance to show the impact that longitudinal charting can have on both chronic care and drug-addicted patients. The timing may have been ideal — funny how that happens —since there is rampant fear in the EMS & Fire community that Community Paramedicine (a.k.a. Mobile Integrated Health) will inevitably fail to achieve sustainability. Sunny has empowered us to prove otherwise.

And then there’s Gale Porto: Oh, Gail…one of my favorite people in this business — the first person in the United States to prove that EMS data could be converted to hospital-consumable information in as little as 30 seconds.

There’s the team at the CHCF / CHCF Innovation Fund / Margaret Laws, who empowered us to build a data sharing method, and inspired us by measuring success first-of-all in terms of impact. And Chief Kim Roderick, our longtime friend, who encapsulated BLT’s mission to touch all facets of the healthcare diamond, then to underscore prehospital care’s vitality at the tip of the spear:

Our friend, colleague, and partner-client Art Groux, rocked my world with one question: “I wouldn’t hire a medic to change my tires, so why would I hire one to write my software?” When we had already been in business for three years, thus we were old-and-gray by Silicon Valley standards, former Marin County Fire EMS Battalion Chief Mike Giannini looked me in the eyes and said, “Maybe now you know what you’re talking about.” Julie Papanek bestowed our cherished moniker: “Silicon Valley’s Emergency Medical Technology Experts.” And then there’s Bruce Graham, our late friend and confidante, without whom our company might not be, let alone be what it is.

The Internet scarcely has room to acknowledge all those who deserve our thanks, so let me try to repay our debt with a promise: If you sit back and watch what’s next, you’ll enjoy the show. Thank you the privilege of letting us do what we do — and here’s to tomorrow, which is always interesting.

Yours in service,

Jonathon

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Jonathon.Feit@beyondlucid.com

(650) 648-ePCR [3727]

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Multi-award-winning health and safety technology firm developing software packed with innovations to make Fire, EMS and Community Paramedicine safer, more efficient and more cost-effective. The BrainTrust of Fire & EMS Technologists is a Beyond Lucid consultancy. BeyondLucid.com

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Jonathon Feit

Jonathon Feit

Beyond Lucid Tech CEO. Software to connect First Responders with care facilities. Served in White House OMB. Advocate for rights of fellow disabled Americans.