Welcome to COIQ where you learn how health innovators maximize their success. I'm your host, Dr. Roxie, founder of Legacy-DNA and international bestselling author of ‘How Health Innovators Maximize Market Success.’ Through candid conversations with health innovators, early adopters and influencers, you'll learn how to bring your innovation from idea to startups to market domination. And now let's jump into the latest episode of COIQ. [00:36.1]
Roxie: Welcome back to the show COIQ listeners for another episode of our COVID pivot series. Today I am speaking with Hila Goldman Aslan with DiA Imaging analysis. Welcome to the show Hila.
Hila: Hi thank you. Thank you for having me.
Roxie: So let's start off by telling our listeners a little bit about your background and what you're doing these days.
Hila: Okay, so I'm, I'm, as you mentioned, the CEO & Co-Founder of DiA Imaging Analysis and what we're doing, is say AI for ultrasound images and I started a company with my partner Michal, she's the CTO of the company. We actually are three women founders out of four founders in the company. And then the two of us are leading the company full time in the company. And then the added, we started this company as an incubator company here in Israel and the headquarter is here. And we also have a little subsidiary in the United States and yeah, they're very busy these days. [01:39]
Roxie: So what were you doing from a business standpoint? You know what problem and need you were meeting prior to COVID and then let's talk about how you might have pivoted that some, you know now under the new crisis that we're facing.
Hila: So yeah. So when you're talking about ultrasound, immediately you're thinking about the babies and actually today you are doing, you're using ultrasound also almost to any anatomic area in the body. And ultrasound is a very safe imaging device compared to CT or x-ray that has radiation or MRI, which is very expensive. So the use of ultrasound during the last decade or even the last five years increased dramatically. [02:26]
And what you're seeing today is those new handheld Porter roll ultrasound devices that are being used all over in new areas that were never been used before. Like American institute, in ICU, Internal medicine, paramedics use ultrasound today. And what we saw is a big leap. That gap between the accessibility of those ultrasound devices that becoming more and more accessible, but still that analysis of those images is being done by visual estimation and not only in these new areas of ultrasound what we call Point-of-Care ultrasound and segments, but also in the dedicated ultrasound units like their radiology and cardiology. Still desirability between position is very, very high because they are mainly just looking at the picture and trying to analyze the images and we decided that we want to address this issue and eliminate or reduce the vulnerability between position by providing those kinds of AI solution that will help them analyze those images in a very objective, quick and accurate way. [03:38]
Roxie: Hmm…hmm. Incredible. So let's talk about what stage of the innovation process you were in or you are in.
Hila: Yeah. So we started with cardiac ultrasound because you know heart disease are the number one cause of death in the world. And actually when we were talking with even the emergency rooms in the big hospitals, they were saying that about 30% of the people entering the emergency room are complaining of symptoms that can be related to heart issue and we figure out that it's very difficult to analyze the heart with ultrasound even in the dedicated ultrasound or cardiac unit because the heart is a moving organ and still the image of ultrasound is very noisy compared to MRI and CT. Also when you take the image compared to MRI or CT x-ray, when you posing the patient and the device with the ultrasound we actually put the transducer, the patient body and trying to find the right image, which is also very subjective and depends on the user experience. [04:41]
So for us heart was the first a segment that we looked at and we developed a set of solutions to help them find all kinds of clinical indication that they are looking for by visual estimation and find it automatically and very, you know, an objective way. And those types of solutions, what we call, they'll leave a toolbox already have FDA approval and CE Mark. So we started to sell them to the market last year. [05:08]
Roxie: Hmm.
Hila: And the way that we're doing it is that we partner with channel partners and like ultrasound companies and healthcare IT companies that add these solutions to the ultrasound devices and healthcare IT system. So any physician can actually use it when they're arguing the process of taking those images. So we have partnered with companies like GE and IBM and Konica Minolta and, and we actually, and seeing those, the AI solution being used and even today with COVID being the front line. [05:45]
Roxie: So that's really impressive. Those are definitely some big brands, right? Some really well known brands around the world, not just, you know, in Israel or in the United States. And so just kind of talk about for our listeners a little bit of how did that come to be? I'm sure all of our listeners want to know how did you land someone like IBM and GE to be your partner. [06:06]
Hila: So it's, yeah, it's a very long process. You have to build this relationship. Like everybody knows it's not easy to work with any of these corporate and companies. And I think that when we started, we, we right at the beginning, I think even before we had finalized product, even when we waited for the FDA approval and to have this process, we already started to talk, we don't see it channel partners. And that also helped us to understand the market and the needs and what they're seeing as an advantage and when and how they're going to use that kind of solutions. So I think that the main thing that I learned is to talk with those channel partners as early as you can.
Roxie: Hmm…hmm.
Hila: And it also helps you with the product and to design it correctly, to understand not only from physicians but also from the industry, what they're seeing, what they're hearing. And then you build this relationship because you are getting back to them every few weeks and tell them your progress in what you're doing and, and meeting them at conferences today of course is really, really difficult to do that. [07:16]
Roxie: Right. Right.
Hila: But we did that and all the time meeting more people in the, in the corporate and in this specific unit that you're working with and once we had that kind of solution ready to implement, I think everything was also from their side sorry and ready for them to accept it. And another thing that I think that happened is the change in the market. So when we started AI was like a big word that nobody knew, knew what you you're going to do with it and also those big corporate, they thought that maybe we can develop it by ourselves, maybe we don't need somebody, maybe the market are not ready to accept or to pay more for AI solution. And definitely we're seeing in the last two or three years a big change in both segments. Both we see also the end user, which are the hospitals and clinics and physician having even asking when they're buying new system on their existing system, asking their providers what do you have now with AI? And I think it's really relating also to change in generation. [08:24]
Roxie: Hmm…hmm.
Hila: And those new physicians, new doctors are used to work with technology, are looking for technology, want to use that advanced technology that is out there. Also I see it from the vendor’s side; they're actually definitely the change. They want to partner with third party is that extended, they cannot develop everything by themselves. [08:49]
Roxie: Yeah. So, so let's go back to what you were saying of, you know, starting those conversations with channel partners and you know, people that are part of the ecosystem really early because I think that's very interesting. You know, a lot of health innovators tend to think that they need to have something, you know, polished and perfect before they get in front of anyone. Especially some of these bigger entities, you know that they have a tendency to believe we're going to have really high expectations for a startup. So let's kinda just talk a little bit about that. What were some of the considerations and how did that evolve? [09:31]
Hila: So I think there's a startup, there is a big difference and I'm sure we will talk a little bit more about it later about how well you are prepared for investors for example compared to your in channel partners or customers. I think that there is more acceptance in and we saw that with our channel partners that we started the conversation very early because they also want to be aligned with what's going on and what startups are doing and they're looking for these types of relationships and connection. So it's not for them, okay. And if you're too early they will say to you, listen you are too early. We will not do anything before you have, I don't know, clinical validation, FDA approval or whatever.
Roxie: Yeah.
Hila: So you will get a lot of feedback also of what they're thinking is more or less important. So I think with channel partners and customers, they think probably, I will not go to all of them at once, it is very time consuming. [10:32]
I will pick those were probably the leading one and the ones that you are really targeting. And with investors, I think it's different. Different thing with investors, you asked to come prepare. I don't believe in just doing introductions just to get to know you. You have the time with investors, usually they will have asked you very specific question and if you don't have the answer at that point you are losing opportunities so it’s better you have to reach out to investors when you're ready and either even if you are late, early stage A round, B round be ready for those questions and with all the materials. Otherwise I think if you are missing the opportunity. [11:13]
Roxie: Yeah. So we'll talk about that a little bit too. So I think that what you just said is just really important for our listeners to kind of grab a hold of, is that, and this is something that I advocate for quite a bit, is this idea of co-creating our solutions with our customers, with our vendor partners and you know, bringing them along in that process early on. There's two things that I've seen happen as a result of that that, you know, I'd love to hear your thoughts on is one is that, you know, a lot of times it saves the innovator millions of dollars on features and functionality that thought were going to be so important. But through that….
Hila: Yeah. [11:56]
Roxie: Dialogue and that co-creation process, they realized that it might've been really important to them, but it wasn't so important to their target audience or do those partners. And so they can save that time and save those millions of dollars, not wasting on that to maybe have that for their go to market strategy. And then of course, you know, if you're building a solution with folks that are part of your, your know your customer segments is that your, your, your ROI is going to tend to be higher, right? Because you know that you're building something that they want cause they told you what they want and they were part of that process. [12:33]
Hila: Yeah. And we actually had this experience several years ago when we started to develop something. And once we talked a lot with the industry realized now it's really a niche and it's better not to put an effort. We put this development on hold and we said to ourselves if somebody will want that, so we have something like prototype or whatever but we are not continuing. We are not going to continue to develop it anymore.
Roxie: Yeah. Yeah. So so let's also talk about access to those folks. Right? So how in the world did you even have the chance to get in front of, you know, the right people at those companies? [13:18]
Hila: So I heard recently, I don't remember who it was that talked about marketing and about business model and me, he said something like, I envy the ones that have B to B relationship because you know who you are looking for.
Roxie: Right.
Hila: You are looking for the product manager and the business development or you know the title and you know who you are looking for versus when you're selling to consumers, which is much more difficult to get to the end user at that point. So I think that we've done, we understand, we understood who are, they're usually the decision makers and who are involved in the process of deciding what to add and who to partner with and what they're looking for. And in our case was clinical specialties and product managers and business development guy, even sales. And sometimes it did even came from the R&D teams that had a need.
Roxie: Hmm. [14:15]
Hila: And they understood that it's not part of the roadmap and probably it will give them a very big differentiation advantage. And I cannot tell you that in each partner's segment it was the same people.
Roxie: Right.
Hila: But I think that the best way to target them of course, is going to those trade shows and even, you know, presenting yourself for the booth and saying, I'm looking for people that are doing that, this and that. And very quickly, you know, we are very, everybody's connected to everybody else. And then somebody there will tell you, okay, I think you should talk to this person and if this person thinks that he's not the right person, he will refer you to somebody else. So eventually you get to the right people. I think it's much easier than you think.
Roxie: Hmm...Hmm. It sounds like persistence is key.
Hila: Yeah.
Roxie: Never giving up. [15:06]
Hey, it's Dr. Roxie here with a quick break from the conversations. Are you trying to figure out what moves you need to make to survive and thrive in the new COVID economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why I created the COVID proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a 360 degree view of your business. I call them the six critical pivot lenses. As you make your way through this comprehensive kit, you'll be armed with the tools, tips, and strategies you need to make sure you can pivot with speed, without missing out on critical details and opportunities. Learn more at Legacy-DNA.com/kit [15:54]
Roxie: So you were talking about the changing and market conditions. And I want to spend a little time on that because bringing a disruptive innovation to market or something that's radical is very different than bringing it something that is just an incremental innovation. Both are incredibly valuable and both have their own place, but it's, it's a different strategy and a different path that you'll need to take. And so it sounds like when you first entered the market that it was really radical and disruptive. And so let's talk about some of the challenges that you faced before those market conditions changed and then how that really opened the door or the flood gates for you. [16:35]
Hila: So I think that the beginning as, I think a lot of startup companies in the early stage has a very big idea. And usually a lot of people tell them you're crazy, you should know that and it wouldn't work and so forth. And so I think that mainly it's, you know, we had a very passionate idea that doesn't make sense that in ultrasound you're still looking at the picture and saying, I think that, I'm seeing this and that. And every time somebody tell you, but we know, I know back then it was like the most expert ones to say, yeah but I used to it and I always felt them. But it took you years to understand what to look for. And now with technology we can, we can make it more accessible and more smarter to know those novice ones and the ones that are, and back then it wasn't that the autism wasn't in point of care. So we the market evolving and with AI getting like more acknowledgement and awareness, I think that came together and gave us the big push. [17:45]
Roxie: Hmm…hmm.
Hila: Eventually to able to implement it and actually have that and you know that the first one and the first two ones are the toughest, but then you see the results. And now definitely we see that as I mentioned, we are working with GE on their handle ultrasound device to deal with the COVID. We see physician use our AI in the front line and, and you know, I think I mentioned it before but I'm always saying that the first time that we actually in the company we're very excited and very proud and actually had tears in our eyes is that we saw a physician in South Africa using our AI tweeting about that saying how, how it helps her.
Roxie: Hmm.
Hila: And you know for us it was like that. That's it. That's the top for us.
Roxie: Right. [18:36]
Hila: And that's so exciting to see that that eventually, you know, physician are using it, getting value out of it, helping them in their decision making. And that was for us to say, okay it was awkward for to wait for that. And I always say that the same in life, you know, you cannot say that you are happy all the time, you have happy moments. And in the startup it's the same way. You have the happy moments have to be pointing in the startup that you say, okay, this is why I'm here! This is why clear, why we're doing that! [19:08]
Roxie: Yes, yes, absolutely. So let's talk about that, right. Keep down this path of a changing market conditions, right. Because you said, you know, you first started and people were like, what is this AI thing and how would that possibly prove valuable? And then the market kind of caught up and so that was kind of a pivot opportunity for you. And then we're thrust into all things COVID really over the last couple of months, which is another opportunity for pivoting. So let's talk about you know, where, where, what was that like for you when this first started to happen? What were like the early stages of that process of thinking I need to pivot? And then let's talk about what's, what are some of the pivots that you've done? And you know, when I use the word pivot, you know, it could be where I changed the business model, right? Something really major or it could be just pivoting around messaging.
Hila: Hmm…hmm.
Roxie: And that's a lot more surface. Reframing how my solution might meet a different need. So talk about that a little bit for our listeners. [20:14]
Hila: So yeah, so we, we didn't leave it to anything about our business model, but we did do some upgrade or updates to our messaging and we did see very quickly through our channel partners that they are selling even more and to the end users to those, those in the front line in Point -of -care ultrasound, their system with our solution. So very quickly we understood that we are part of this you know pandemic, we are giving value to those front liners and we are partnering, we need to do to make everybody know that there is an advantage of using AI in the front line. So yeah, very quickly we design a webpage all around COVID and you can see it in our website.
Roxie: Yeah. [21:05]
Hila: And we prepared for all of our channel partners a one pager collecting all the information that we got during the last few weeks about the important and the use of our AI because those channel partners that are in front of the end users, which are the hospitals and clinics, we wanted them to have those messages in front of them to help those front liners understand how they can use our solution and how it can help them today with the COVID. For example, we talked about that we have those solutions for for hearts, for the cardiac surgeons and we saw a lot of information and studies even from China and Italy showing that about 30 or 40% of the people that eventually died from COVID died from issue relating to heart issues. And everybody think lungs but it's not only lungs. The lungs actually affect the heart. [22:03]
Roxie: Hmm…hmm.
Hila: And then you getting all kinds of issue around the heart. And the ability to use our ASM sense for the three hours and for monitoring those patients achieve the treatment getting them better or a worse when you cannot bring CT MR to these areas and ultrasound is very small, it's hard to, it's very easy to clean.
Roxie: Hmm…hmm
Hila: And it's very accessible in terms of looking at the body inside the body and see what's going on here. So having those AI solution and those physician at the front line are not radiologist, they're not expert in taking images and be able to help them and say, okay, put the transistor, look in the heart, press one click, see that what the AI telling you. And then you can monitor the patient. We even talked to one of the biggest hospital in New York and they say we are opening now tents outside and using ultrasound to screen who gets to get in the hospital, who stays out. [23:02]
Roxie: Wow.
Hila: And for that to have those kinds of AI solution that that's mainly what we're doing now is addressing these messages and giving them a lot of information through those, through our channel partners at our website, other social media, trying to educate the market about the use of our AI in this stage and in this pandemic. So I think that also another thing that I see in terms of market or marketing is that their awareness of those AI solution in imaging, even after this outbreak and we'll be in a different level.
Roxie: Yeah.
Hila: Before we knew that this Point-of –care ultrasound and AI is emerging and people understand more and more now we are in a different, like in the different times now there is a peak now you know, everybody's stressful and want to get educated. The awareness will be in a different level after this outbreak.
Roxie: Yeah.
Hila: So we expect to get even more interest after that. [24:10]
Roxie: So how humbling to know that something that you and your team innovated is really valuable on the front lines of this global pandemic. Like who would have ever imagined three, four years ago that you would be able to have this kind of impact on people's lives and isn't that why we're all doing what we're doing anyway, right? Is to really be able to help people in a way that there haven't, the healthcare system hasn't helped them previously. [24:41]
Hila: I think this is the advantage of working at a startup company in the healthcare area. I think also when we interview employees to the company and candidates, the main thing that we hearing all the time is that, you know, I used to work in a gaming company. I used to work in. And for me, you know, the meaning of understanding that what I'm developing eventually go to the physician's hands, eventually affecting the patients is, you know, what what, what, what helped you woke up in the morning and say, I have a great job.
Roxie: Yeah.
Hila: Because I actually make a difference. [25:17]
Roxie: Yeah, yeah, absolutely. You know, it's certainly unfortunate that it's taken a global pandemic to elevate the different use cases and value of digital health and technology and AI and, you know, all of the different solutions that we have that had been available for a long time. But, you know, for, for a variety of reasons you know, we haven't seen the type of adoption that, that we'd like or that, you know, for folks like you and I.
Hila: Yeah.
Roxie: Know could be really valuable. And so I think that, you know, it's interesting to see these use cases of how, you know, technology in your solution with AI can really do things that humans don't need to do.
Hila: Hmm…hmm.
Roxie: To free up them up to do the things that only humans can do. Right? [26:14]
Hila: Yeah. We also always say that we are not going to replace those positions. We actually giving them another instrument in their toolbox. If they had blood tests and they have ECG and they have all kinds, now they have an AI that they can use to make better decisions to, to give them confident about the decisions. And I don't see that we are replacing them. As you mentioned, there are human interactions that you can replace. I don't think that he who will be able to replace it, at least not in the near future.
Roxie: Right.
Hila: Yeah. I also think that in terms of investors and VCs, what we, what we will see after this outbreak is more interest to invest in digital health companies and we will see more VCs that have never thought of investing in healthcare.
Roxie: Right.
Hila: Now saying, oh really? Now I understand the value.
Roxie: Hmm…hmm.
Hila: And I want to be part of this game. [27:11]
Roxie: Yeah. Yeah. I couldn't agree with you more. So the other thing that I wanted, you know, just kind of touch on is one of the big value propositions of AI in any application is really scalability, efficiency and be able to do something fast.
Hila: Hmm…hmm.
Roxie: And wow, what, you know, those three attributes aren't needed any more than they are now. Right?
Hila: Of course.
Roxie: Like we'll be able to act fast, we need to be able to scale and we need to be efficient in order to continue to meet the needs and the burden that's being put on healthcare systems. So what an incredible opportunity we have to leverage technology like yours.
Hila: Yeah.
Roxie: And meeting a need. [27:54]
Hila: Yeah, definitely. I think that the AI is just at the tip of the ice now and I think the next decade we will see so many implementation of addressing what you just mentioned about the efficiency and accuracy and making those physicians, you know, be more efficient in terms of making decisions and the time that they're spending. Because right now they are expended by trying to mark things and and look for things or calling an expert and then waiting for that expert or sending the patient to another exam when everything you know will be, we did with AI solution I think the stealth system of course will be more efficient and definitely efficiency reflects the patient's management. [28:43]
Roxie: Yeah. Yeah. And I think, you know, time will tell but I don't know that we will ever go back to the current state of healthcare innovation before this pandemic. Will we be as far as we are now, who knows? You know, we'll see. But I definitely think that, you know, the silver lining in this is that it is certainly a springboard for greater awareness like you mentioned in greater good.
Hila: Yeah. The awareness is going to, you know, now we, all of us are very stressful and everybody trying to understand where we are going and when we're going to get back to normal. First I'm not sure we will, we will ever get really back to what we were before.
Roxie: Right.
Hila: Well, we understood that there already, but in terms of awareness, definitely different story than it was before. [29:35]
Roxie: Sure. So let's talk about the Israeli ecosystem and support for healthcare innovation. You know, this is something that you and I talked about previously and I think it's definitely a worth mentioning here for our listeners. You know, we talked about this 95% of innovations that go to market fail to reach any adequate level of customer acceptance or financial ROI. And you had some really great feedback in response to that conversation about what's different, where, where you're living and where you're innovating. So, so give us some insight on what's going on there. [30:12]
Hila: So yeah, Israelis being concerned and as you know, as the startup nation, and today I think in an every given time you have 6,000 startups and the population is 8.5 million people, which is the ratio is like, I think it's ever very similar to the Silicon Valley I think.
Roxie: Yeah.
Hila: Maybe the second.
Roxie: Uhhh….huhh.
Hila: The second one in the world. And part of it is then also government support. The government in Israel is very, very pushing startups to merge. Putting a lot of investments in things that they know that in 99% of the case it will not emerge.
Roxie: Hmm…hmm.
Hila: And putting a substantial amount of money, like half a million dollar, even $100 million for you to start even $50,000 so you can start them doing something. There's so many programs and so many applications that can be a price you can apply for and when the government is pushing you to to actually try and it's fine if you fail because they know that the statistic is there to going to fail and you can apply again. And for different things that you're doing also and when you are a part of the university and also the university urge you to try and apply for those grants. [31:33]
Roxie: Hmm…hmm.
Hila: In order to try to get out of what you developed with something. So DiA is a very, a very similar example. And my partner, Michal she, she studied her second degree in one of the biggest university here in Israel and she had a great idea. We did say AI for ultrasound. I met her back then and the end we said, okay, well what, how can we start? And we said, okay, let's apply for government funding. And we applied for the incubator program here in Israel that is a two to three years program and that gives you money and an expert and more of an accelerator environment for you to try it on and see how you work with that. And this is what gave us actually the push and the first opportunity to try to do something with this and you know, invention or, and it came out of the, you know, second degree, a master degree of my partner and now look where we are. So so yeah, it's the environment here, the ecosystem here, a lot of support from also the government, also the big companies here that having our dissenters and inviting startup to meet ups and all kinds of events and so, and helping each other. I think that's also part of it. [32:57]
Roxie: Yeah, that's incredible. It's really wonderful to see and you’re right. There's certainly a lot of healthcare innovation that is just flourishing over there. So as we wrap up, a lot of our listeners are healthcare innovators that are in the trenches day in and day out like you and experiencing this COVID crisis. What advice or other lessons learned do you want to share with them before we end? [33:23]
Hila: So I think the first thing, and we talked about it a little bit, is about messaging. Be very sensitive about what you're posting and you know, nobody now wants to read about the things that are not really aligned with what all of us are going through. You have to understand, you know what, I'm, I know that a lot of the people right now in terms of the statistic and don't have maybe even friends or family that are sick from this virus, but there's a lot of sick people and a lot of the family that are affected from that.
Roxie: Yeah. [33:57]
Hila: So I think being sensitive about what you're writing, more educating the audience, then trying to really aggressively sell. And I, you have to, I think that's the first thing that I would say that is very important. Think of what in your product and your offering can help the end user right now and and if there isn't, so mainly invest more on your B2B relationship and than to just go out and try selling something that right now people may be not really interesting to, to look at.
Roxie: Yep.
Hila: And that that's one. And and on the other hand, if there is an opportunity to change the business model and think of a different pivoting it to different direction and I think it should be considered.
Roxie: Great.
Hila: Another small thing. I think they also, in terms of the your employees, I think very being very transparent and what is going on and why are you doing changes. Being very transparent with your employees is very important. You know, everybody wants to and be together and everybody's is having their own difficulties. We talked about a little bit that there are some people with very small children at home trying to be flexible there and give them the space of working early or late or whatever is needed. And because we are all of that together and we have to keep staying strong together. [35:34]
Roxie: Yeah. I think that leadership is more important than ever in, in really being able to be a great leader during this time and being human and understanding because we're all people at the end of the day.
Hila: Definitely, yeah.
Roxie: Yeah. Well thank you Hila, so much for sharing your wisdom with our listeners today. How do folks get a hold of you if they want to follow up with you.
Hila: You know through our website also, I will leave you my email so if everybody, anybody wants to, they can reach me directly I'll be happy to talk to anybody that needs any help or want to learn more.
Roxie: Do you want to give your email address here or do you want to just.
Hila: Yeah. hila@dia-analysis.com.
Roxie: Excellent. Thank you so much.
Hila: Great. Thank you. [36:23]
Thank you so much for listening. I know you're busy working to bring your life changing innovation to market, and I value your time and your attention. To save time and get the latest episodes on your mobile device automatically subscribe to the show on your favorite podcast app like Apple podcasts, Spotify and Stitcher. Thank you for listening and I appreciate everyone who's been sharing the show with friends and colleagues. See you on the next episode of COIQ. [36:52]
