Why I joined Grand Rounds
After 4 years and 8 months I decided to leave Uber. Uber has been a major part of my life and a true “Uberversity” for my career. However, like any university, it was time for me to explore and find a place where I could continue learning, and leverage what I have learned to further the company’s mission and goals.
For me I considered:
- Mission (and my ability to impact that mission) 🥇💪
- Technical Challenges 👨💻
- Financial Opportunity 💰
- Personal Growth and People 📈 👨👩👦👦
In case you don’t make it to the end: we’re hiring (SF & South bay, all roles) and reach out on LinkedIn or email: anant.gupta[@]grandrounds.com.
Mission
“The best minds of my generation are thinking about how to make people click ads.” — Jefferey Hammerbacher, Bloomberg
Given that I planned on furthering a company’s ambitions, the mission and problem space were pretty damn important. The solutions we build today will dictate the type of problems we face tomorrow, and as someone who wants to live young for a long time, this means I should work on tackling critical problems today.
Health is perhaps our greatest treasure and one that we take for granted when young and bargain for when we’re older. We spend our healthiest years pouring energy into fleeting daily desires and activities, in stark contrast to the minimal energy invested into our long-term well-being. For example, I spend more time looking at reviews for a restaurant, than I do looking at which doctor I am going to visit. I know more about the impact of bitcoin on the share prices of NVIDIA (📈 then📉)than I do about the impact of supplements to treat my Vitamin D deficiency. I believe this trend is common for most of us, and even for those who invest the effort, there isn’t a great means to know whether the doctor or the procedure is indeed the best fit.
When you zoom out and see the stats in aggregate, what you find is much like what we see in our day to day: not all doctors are the same and not all recommendations are correct. Based on medical data observed by Grand Rounds, top quality physicians reduced the rate of unnecessary hospitalizations by over 10%, a top orthopedic surgeon has a 57% reduced spine surgery mortality rate, and visiting a physiatrist before an orthopedic surgeon led to 25% fewer surgeries. These are just a few examples of how having the right doctor and procedure can have a profound impact on our medical outcomes. There will be an inherent bell curve with a doctor’s capability and like each of us we will be amazing at some things, average at most, and have “areas of growth” in others. Shouldn’t the doctors we pick be amazing at the symptoms they’re hoping to cure?
Grand Rounds’ mission is to raise the standard of healthcare and which they are tackling by leveraging data and connecting individuals to the right doctor or medical procedure. Through their platform they cover 4+ million users. Those who leveraged platform for expert opinions had their treatment altered in 60% of cases. By connecting users to the right physician and procedure, Grand Rounds not only reduces costs, but also reduces the rate of ER visits, opioid prescriptions, and other unnecessary treatments while also improving the health literacy of users. More broadly the company’s ambition is to become our guide to healthcare, whether its helping with appointments, finances and doctors, to more complex cases in helping with not just the medical procedure but the medical care that is needed to improve clinical outcomes for the individual.
When talking to Grand Rounds and now having been here for over a week, the opportunity to make an impact reminds me a lot about the early days of Uber. The company is small, and the engineering team is smaller (<75 eng) with an enormous mission, and a team that needs to scale to help achieve those ambitions. I can see a myriad of ways that I can have an impact at the company, and also be proud of helping further this mission.
Technical Challenges
“We choose to go to the Moon in this decade and do the other things, not because they are easy, but because they are hard; because that goal will serve to organize and measure the best of our energies and skills, because that challenge is one that we are willing to accept, one we are unwilling to postpone, and one we intend to win, and the others, too.” — John F. Kennedy, 1962
This problem space is hard. The complexity here is not necessarily from regulation (as some have previously asked), rather it comes from how complicated and unstructured this data is. If you think about the exercise of finding all of your medical records, and all of your family’s and kids’ records, you quickly realize the data is fragmented, dissimilar and distributed.
Imagine if this was all available in one place in a secure environment where you determined the privacy of this data and decide who you would like to have access to this data. Not only will you have a comprehensive history of your records, you can share that with the clinic or the physician you’re visiting, meaning they would know of your history, medical issues, allergies, family history etc. Furthermore, if you add the power of technology and data, you can get a much more personalized diagnosis and treatment that is specific to you, and one that can be based on the entirety of the medical body of knowledge and not limited to your physician’s prior experience and education.
Beyond the challenges of building a longitudinally complete data set and deriving actionable and personalized insights, are the challenges of building a member experience that actively guides you through while helping you understand medicine and health in the simplest way. Imagine building a product that seamlessly presents your medical history, your care plan, your prescriptions, your insurance and your financial spend along the way. Now imagine that you’re building this for millions of users, at very different stages in their lives, with different levels of access to healthcare and different socioeconomic backgrounds. At its core, this product needs to guide anyone, anywhere, through the entirety of healthcare by bridging digital and physical worlds together.
Financial Opportunity
“The biggest risk is not taking any risk. In a world that’s changing really quickly, the only strategy that is guaranteed to fail is not taking risks.” — Mark Zuckerberg
For those who know me, I’m very interested in financial independence and early retirement. Along with the mission and technical challenges, the financial opportunity and potential is important to me. I believe the next generation of companies with outsized financial rewards will have to solve a different set of problems and that technology will permeate through our Maslow’s hierarchy of needs, disrupting each along the way. Therefore, one way to find the next disruptor company is to look at technological trends and create your own luck.
Mary Meeker in her famous Internet Trends report (slides 288–319) describes Healthcare at a “digital inflection point”. Looking at the trends, it is unsurprising. Since 2013, 7x as many hospitals provide patients access to their digital medical records (slide 299), while overall digital adoption of technological services in this field is increasing (slide 308). At the industry level, due to advancements of technology and ready access to data, the medical body of knowledge is now doubling every 3.5 years, as opposed to doubling every 50 years like it did in 1950 (slide 302). Looking forward, technology will not only be a mainstay by which we interact with healthcare, it will be an essential element to handle and utilize the growth and accessibility of data to bring us to the next frontier for health.
Healthcare spend, on the other hand, consistently increases 5% YoY, outpacing the rate of inflation and earnings. Below is the rate of price changes in the US over 20 years: hospital and medical costs have increased by some of the largest amounts.
It is no surprise to see financial investments in this space increasing at an exponential rate (Startup Health Report 2018), with tech giants like Google, Amazon and Apple leaning in. The generation that grew up with technology is aging and with healthcare becoming a more critical part of their lives, the industry is at the right spot for disruption.
Grand Rounds is particularly well positioned in this space because their business model is based on the company’s ability via tech, to bend the cost curve for companies while improving clinical outcomes for their employees. The company addresses the challenges created by the exponential growth of data and our knowledge in the medical field by building a longitudinally complete dataset and leveraging the data to inform medical decisions. At the same time, it is building a member experience that helps navigate the healthcare space efficiently and effectively. In doing both, they improve medical outcomes for the patient while reducing costs for both the patient and employer, creating a win-win for both.
Today, Grand Rounds covers millions of people with many Fortune 1000 (and some 100) companies as their customers. Looking ahead, I imagine Grand Rounds will become the Waze of healthcare navigation (though hopefully as widely used as Google Maps), by dramatically reducing the cost of healthcare and improving the quality afforded for members everywhere.
Personal Growth and People
“Tell me who you walk with, and I’ll tell you who you are” — Esmeralda Santiago
I recognize that these should perhaps be separate sections, but for someone in a people management/leadership role, these two topics are inherently intertwined (and it also helps cut down the length of this blog). The people around me (current and future) along with the technical problems that I solve together with the team at Grand Rounds will unlock my future growth as a person and in my career.
One of the reasons I joined Grand Rounds was the opportunity to work with and learn from Wade Chambers. In fact, about a year ago, one of my good friends, Dan had reached out to me about Wade as someone I should speak with. I discovered this trend continued whenever I spoke to folks within my network about potentially working with Wade. After my initial conversations with Wade, I understood what my friends were talking about and I was convinced that I can learn a tremendous amount from him.
Beyond Wade, I met with some amazing people at Grand Rounds and knew this company has people who are humble, hungry and smart, with a passion for improving healthcare. Alongside the people who are committed to my growth (and the growth of the people at the company), the problem space and the ambitious mission, it was fairly self evident that I would go through my next transformational journey here.
Building a team
I’m excited about the future and the company, and one of my areas of focus will be to grow the team. We need to build an amazing member experience on mobile and web, along with general system scale and features. We need data and machine learning engineers to understand and derive insights from the data, in addition to engineers who are passionate about developer productivity and infrastructure to scale. It is through the people and their growth, will we achieve our mission of raising the standard of healthcare for all. Of course the company is also hiring in product, data science, design, and recruiting, just to name a few functions, so fret not if you’re not an engineer😉.
If anything above resonated with you and you’re interested in learning more, please reach out to me via email anant.gupta[@]grandrounds.com or on LinkedIn. I truly believe this is like learning about Uber in 2012, the deeper you explore it, the stronger you see it.
