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Want to get into the healthcare space? Here’s where you might want to look to invest.

healthcare cost

For investors looking at the biotech space, the looming healthcare boom means a burst of new opportunities—but navigating the field won’t get any easier without a keen understanding of the market.

Connecticut Innovations’ Chief Investment Officer, Dave Wurzer, recently wrote an article for PE Hub that explores hot investment trends in the healthcare and bioscience spaces. The need for innovative health tech is growing exponentially. What are you keeping tabs on?

We invite you to click to read the article here.

What We Learn From Kids That Makes Us Better At Work

boy in tree

On the fourth Thursday of each April, Americans take their kids to work. Not only is this a learning experience for our children, there are many professional takeaways for parents too.

Our CEO, Matt McCooe, recently wrote a piece for Chief Executive that explores ways professionals can utilize effective parenting strategies to improve workplace experiences. Fostering a positive workplace culture can be a challenge, and special occasions such as these can provide fresh insight into ways to make meaningful improvements. What will you bring away from take your child to work day?

Read article here.

Now Is the Time to Press Even Harder for Immigration Reform

grads throwing caps

After receiving the best education America has to offer, many foreign-born grads have to take their knowledge and talent to countries with more welcoming immigration policies. But it doesn’t have to be this way.

Universities are in a unique position to leverage incubation spaces and attract foreign entrepreneurship, but these communities need to work to encourage highly-skilled, foreign-born graduates to stay in America.

Our CEO, Matt McCooe, recently wrote a piece for Entrepreneur that discusses how legal immigration benefits the U.S. economy, and what university communities can do to spur economic growth through academic-entrepreneurial ventures. I invite you to read the article here.

 

International startups can speed the growth of entrepreneurial ecosystems

global map

Middle America has significant advantages to offer, but cities need to learn how to sell the benefits and provide the capital needed to attract international entrepreneurs. How is your community set up to support foreign entrepreneurs?

Our CEO, Matt McCooe, recently wrote a piece for VC Journal (VCJ) that discusses ways to attract overseas startups that boost local economies. I would like to invite you to click to read the article below.

Read full article.

Insurance 101: What You Need, What You Don’t

sitting waiting for interview

When it comes to insuring your startup, the choices seem endless—and confusing. What types of insurance do you actually need, and how much? What can you skip? Daniel Struck, an experienced policyholder attorney and partner with the Insurance and Litigation Practice Groups at Culhane Meadows, weighs in.

Connecticut Innovations: Thanks for sharing your expertise, Dan. Let’s get right to it. What types of insurance coverage do high-tech startups need (keeping in mind that most are cash strapped)?

Daniel Struck: An assessment of the specific risks and liability exposures of any business is necessary to make accurate recommendations concerning that business’s particular insurance needs. Nonetheless, as a general matter, there are some commonalities in the insurance needs of startup companies. For any startup business, comprehensive general liability (CGL) insurance and property insurance (or possibly a business owner policy) likely are necessary. These two types of insurance are the most basic forms of business insurance.

  • CGL insurance provides coverage for claims for alleged third-party bodily injury, property damage, personal injury and advertising injury. In other words, this type of insurance covers claims by non-employees that a business or one of its employees has caused injury to a third party or to the property of a third party. Of particular importance, CGL insurance requires the insurance company to defend the insured for any such third-party liability claims. However, CGL policies also contain a number of exclusions that limit what would otherwise be the expansive scope of the policies. Of relevance to a high-tech startup, CGL policies generally contain exclusions for intellectual property claims, such as patent or copyright infringement. In addition, CGL policies almost always exclude cyber-related liabilities such as data breaches or the theft of personal, financial or business-confidential information.
  • In broad terms, property insurance provides coverage for damage or the loss of use of an insured’s property or business equipment as a result of a covered hazard. This is the type of insurance that provides coverage in the aftermath of a fire, a windstorm or some other casualty event. This type of insurance also may provide coverage for the business interruption (the cost of resuming operations and the loss of operations in the aftermath of an insured event). As with CGL insurance, however, property insurance typically contains exclusions and limitations that are relevant to a high-tech company. For example, the destruction or loss of data or the bricking of a device, particularly if that loss is the result of a ransom attack, is not likely covered under this type of insurance policy.
  • Some businesses (depending on size, the nature of the business and its risks, and other factors) may be able to purchase a business owner policy (BOP), which is, in general terms, a combination of a CGL and property insurance. If available, there may be cost benefits to BOP insurance insofar as the premium for a BOP is typically less than the cost of separate CGL and property insurance policies. However, those cost savings typically mean that there will be fewer opportunities for customization or endorsements responding to the specific risk profile of an insured.

In addition, for any business with employees, state law likely requires workers’ compensation insurance.

The insurance needs of a high-tech startup are different from the insurance needs of other startup companies. In addition to the basic forms of business insurance discussed above, high-tech startups also should consider purchasing the following kinds of insurance: (1) cyber/media liability, (2) professional liability/errors and omissions (E&O), (3) directors & officers (D&O) and (4) employment practices liability (EPL). In some cases, fiduciary liability insurance also may be important. Each of these types of insurance provides coverage for categories of risk that may be significant for a high-tech startup.

  • Cyber/media liability policies have a wide range of terms, but these policies typically offer a suite of insuring agreements that may include some or all of the following kinds of coverage: (1) privacy liability (covering potential third-party liabilities for the disclosure of private or business-confidential information); (2) data breach response (covering the costs of providing remediation such as notification, call center and credit monitoring in the aftermath of a privacy breach; (3) regulatory privacy violations (covering fines and penalties as the result of an unintentional breach of a privacy law or regulation); (4) first-party data recovery (covering the reconstruction or recovery of data following a covered event); (5) business interruption (covering the loss of operations and some costs of restoration in the aftermath of a covered event); (5) professional liability (covering claims that the insured committed errors or omissions in the course of providing technology-related professional services; (6) media liability (covering defense and liabilities associated with the publication/distribution of information); and (7) cyber-extortion (covering the costs of investigating and responding to a ransom attack). This list is not necessarily complete, and the scope of the insuring agreements provided under different policies varies widely. Given the range of policy terms and insuring agreements that are available, it is vitally important to be careful in selecting the cyber/media liability insurance form and insuring agreements that best fit the needs of an insured. But for a startup that is engaged in handling data, operates in the clouds, operates in the Internet of Things or provides a forum for exchanging information, the coverage provided by a cyber/media liability policy may respond to essential business risks.
  • Professional liability (E&O) polices in general terms cover the defense and liabilities resulting from claims that an insured or its employees committed errors and omissions/breaches of duty in the course of providing services to customers. For a business that interfaces with and provides services requiring special expertise or skill to clients, this type of insurance may respond to key risks. As noted above, this coverage may be offered to some degree in some cyber/media liability insurance forms. But it is important to be careful in selecting the E&O insurance that responds to the risk profile of a particular insured.
  • Directors and officers (D&O) insurance may seem like an unusual type of coverage to include in a discussion of insurance for a high-tech startup, but this can be an essential coverage for some businesses in the technology startup space. As a general matter, any business, public or private, that has officers and a board should consider D&O insurance to the extent that those key individuals may be exposed to claims that they committed breaches of duty in the course of acting as an officer or director. Moreover, it is good practice as a company grows to ask highly qualified or well-known outsiders to serve on a corporate or advisory board. The startup can benefit from the perspective of a qualified outside director. But an outside director almost certainly will require, as a condition of service, that the company backstop its indemnification obligations with adequate D&O insurance. Even if a startup decides to take the risk of going without D&O insurance, it is likely that such insurance will become a necessity as it brings in new management members and outside directors.
  • If a business has employees (or even if a business is exposed to the risk that its freelance contractors will be characterized as employees), it should consider purchasing employment practices liability (EPL) insurance. Among other things, this insurance covers the defense and liabilities associated with claims of discrimination on account of race, gender, orientation, nationality and age. For businesses that often operate in a highly charged environment and that have highly skilled and compensated employees, the kinds of claims covered by EPL insurance can be extremely expensive and may arise with some frequency.

This list likely appears somewhat daunting. And it is, because there are a wide variety of challenges facing businesses in today’s economic and legal environment. Just saying “we have insurance” is not enough—it does not mean that the business has the appropriate insurance. It is important to treat insurance not merely as an expense item but as a potentially important asset that should be incorporated into the strategic planning for any business.

CI: What type of insurance is a must, and what can startups skip?

DS: The discussion above points to the dilemma of trying to provide a list of “essential” insurance coverage for a high-tech startup. It is equally difficult to provide general rules about what types of insurance are unnecessary for a young company. The particular risks for which insurance is necessary vary from company to company, and there really is no one-size-fits-all answer. In addition, potential customers may require that a company have certain types of insurance.

Determining what insurance is a “must” or can be “skipped” really is a function of the particular footprint of the potential insured. Does the company have employees? Does the company operate in a particular place and have equipment, or is the company really based on the expertise and ideas of the founder? Does the company handle personal information or provide services in the cloud? Does the company produce a tangible product, or does it provide services? Are officers and directors of the company concerned about the preservation of their personal assets? Is the company subject to insurance requirements from potential customers or business partners? These are a few examples of the kinds of questions that must be asked in order to determine what insurance is a “must” for a young company.

 

CI: Should startups use an agent or broker, or go directly to a carrier?

DS: As discussed above, it’s important to select the type of insurance and the insurance form that are right for the needs of a business. In some lines of insurance, the available scope and limitations of coverage are fairly uniform. But in other insurance lines, such as cyber liability and technology E&O insurance, there are wide differences in the scope of the coverage offered by different insurers, and it is important to find the coverage that fits the needs of a business. For this reason, there really is not a simple answer to this question. In my view, the most important considerations in selecting an insurance advisor include: expertise and knowledge about the insurance market, the risks facing a business, and the scope and impact of available coverages; the good judgment to be able to provide meaningful counsel about evaluating risk, completing insurance forms and the difference between a perfect solution and a practical solution; and the level of trust in the reliability of an adviser.

 

CI: Which milestones should trigger a change in a startup’s insurance policies?

DS: Anything that changes the risk profile of a business should trigger a reevaluation of the business’s insurance program. Some of the events that can trigger changes in an insurance program were discussed above and include things like the addition of new employees, asking outsiders to join an advisory board or conducting business over the cloud. As new operations or markets are added, insurance needs may change. With growth and increased competition or visibility, insurance needs may change. Legal or regulatory changes may trigger a need to reevaluate an insurance program. The simple answer to the question is that the reevaluation of a business’s insurance program should be an ongoing project insofar as insurance is not just an expense item but is an important business asset that can be an element of strategic planning.

 

CI: Thank you, Dan.

DS: You’re welcome.

 

Daniel StruckDaniel Struck is a partner with Culhane Meadows and is part of the firm’s Insurance and Litigation Practice Groups. Dan advocates on behalf of corporate and individual insurance policyholders throughout the United States. Dan has represented clients in insurance coverage litigation and advocated on behalf of insureds in contested claims across the country, successfully securing the payment of defense costs, indemnification and first-party losses under a wide variety of circumstances. Reach him at dstruck@culhanemeadows.com.

Bioscience Entrepreneur on Innovation, Team-Building, and How His Company Stood Out in a Crowded Field

Per Hellsund

You asked for more stories about your peers—fellow Connecticut entrepreneurs who are making waves in their respective industries—and we’re thrilled to deliver. This month, Connecticut Innovations sat down with Per Hellsund, president and CEO of Cybrexa Therapeutics, a bioscience startup whose technology targets cancer tumors. (Connecticut Innovations is an investor.) Here’s what he had to say.

Connecticut Innovations: Thanks for agreeing to talk with us, Per. You’ve built several successful companies. What drew you to the startup route?

Per Hellsund: I’ve always been excited about the opportunity to develop innovative technology to solve problems, and the best innovation happens in startup companies, where people who are passionate about applying their expertise to solve a specific challenge come together, whether that problem is in engineering, tech or biology. The flexibility, collaboration and creativity of a startup environment uniquely enables teams to do more, particularly when faced with complex challenges, and to move much more quickly than in larger companies. The energy that accompanies this type of venture is amazing and has always been a draw for me.

CI: You went from leading an inkjet company to running several life sciences ventures. What made you take such a big leap, and how did you overcome the steep learning curve?

PH: For me, the tremendous potential of technology to improve health and extend life inspired my entry into the life sciences. I’m an engineer by training, so applying science to improve quality of life has always been my mindset. In life sciences, I am doing that with a new set of tools, including biology and chemistry. For me, it is critical to bring on world-class technical folks who can fill in the gaps in my skill set. I enjoy learning about new technologies, so the chance to work in a new field was energizing. Life sciences was poised for dramatic change given discoveries in university labs, and oncology in particular has benefited from these, with the immuno-oncology and cell therapy revolutions. Oncology is poised for its next wave of innovation to bring new benefit to patients who still have high unmet need. I was excited to start a company that will be part of that next wave.

CI: You’ve been with Cybrexa Therapeutics for a few years now. What was the biggest challenge you needed to tackle when you took the helm, and how did you solve it?

PH: Cybrexa’s technology, which leverages the pH difference between tumor cells and normal cells to deliver anticancer agents only to tumors, has high potential and broad applications. That broad opportunity set was a challenge for a startup company with limited resources that was looking to quickly establish the credibility of the platform, advance a product into clinical trials, and have the greatest possible impact for patients. In addition, we needed to clearly articulate a value proposition to investors in the very crowded oncology field.

I was fortunate to join with Cybrexa’s scientific co-founders, Peter Glazer, MD, PhD, and Ranjit Bindra, MD, PhD, who are both practicing physicians at the Smilow Cancer Hospital at Yale New Haven, faculty members at Yale and leaders in their field. With their help, we were able to look across all classes of anticancer agents and assess where Cybrexa’s alphalexTM technology had the potential to enable new therapies and change the standard of care. We were focused on two types of drugs: highly potent, efficacious therapeutics that were previously too toxic to be viable, and combinations of two different drugs that were known to have synergistic efficacy, but also had synergistic toxicity that prevented their use. We identified two classes of drugs for our initial focus: DNA Damage Repair (DDR) inhibitors and toxins.

We then recruited a truly phenomenal scientific advisory board—all are world-renowned thought leaders across a variety of tumor types and leaders in early drug development, and have decades of experience bringing drugs from the bench to the patient. With their help and all of the great work of the Cybrexa team, Cybrexa developed the alphalexTM technology platform, generated a lead program, CBX-11 (alphalexTM-rucaparib), that will file an IND by early next year, and a pipeline of preclinical candidates—all in a little over two years. That’s an incredible amount of progress.

CI: You’re adept at building high-impact teams. Can you give us some tips on how you go about it?

PH: I always look for new team members to bring more than just competence and being great at what they do. Fit with company culture and generally bringing energy, commitment, creativity and, most importantly, passion are crucial—as is maintaining an environment where these characteristics are encouraged and valued by leadership.

Things change quickly in biotech, particularly in startups. The ability to embrace change and learning agility are therefore important as well. So is the ability to think and work globally.  Although we are currently a 20-person company, we work with companies across the globe, sometimes on a daily basis.

CI: Our readers are interested in learning more about expanding beyond Connecticut’s borders. You have experience growing companies that end up with an impressive global reach. Do you have advice for getting noticed on a global scale?

PH: Considering all customers and resources in all markets from the very start of product development is important. At Cybrexa, we developed an understanding of standard of care across the globe as well as the unmet need from the physician, payer and patient perspective, which differs across countries. We seek the best vendors, collaborators and partners regardless of geographic location, and plan to commercialize every product globally.

CI:  What do you like about Connecticut as a place to start and grow a business?

PH: For a life sciences company, Connecticut has the ideal combination of highly skilled, experienced talent, outstanding research universities, proximity to venture capital and a reasonable cost base for facilities and equipment. Although Connecticut does not yet have the same high profile in biotech as our neighbor to the north (Boston), life sciences startups seeking to stand out in an ecosystem that supports innovation should consider Connecticut.

CI:  Thanks for your time, Per.

PH: My pleasure.

What You Need to Know About Non-Competes

white board meeting

You have trade secrets, and keeping them out of the hands of your competitors is critical to your business. But with ever-changing laws, not to mention recent criticism levied at noncompetes, are they still the best way to go? We asked experienced attorneys for advice. Here’s what they said.

 

“Noncompetes sound like a great idea for startups [because] they allow you to prevent employees who leave from taking the knowledge and experience they gained at your company and using it somewhere else. But the devil is in the details. Many jurisdictions view noncompetes negatively, because they don’t want contracts to stop people from getting work after they’ve left a job. States like California completely disregard any kind of noncompete language. Other states take a different approach, allowing noncompetes as long as they are reasonable. This generally means that noncompetes last for less than two years, are narrowed down to just other companies that directly compete with you, and apply only to a reasonably small geographic area. Even so, I recommend checking with the local state laws and court precedent to see what counts as ‘reasonable’ and whether noncompetes are even recognized at all!”

Zachary Strebeck is an attorney who works with video game and software startups at Zachary Strebeck Law

“Companies often require their employees to sign restrictive covenant agreements that include noncompete, nonsolicitation and confidentiality clauses. A noncompete prohibits a former employee from working for a competitor, while a nonsolicit typically prohibits a former employee from soliciting customers or employees, and a confidentiality agreement prohibits the disclosure of confidential information. The Obama administration estimated that about 18 percent of American workers are covered by a noncompete agreement, about 37 percent of American workers have worked under such an agreement at some point in their careers, and about 14 percent of American workers making less than $40,000 a year are subject to a noncompete. Congress recently passed the Federal Defense of Trade Secrets Act, which prevents the misappropriation or misuse of a trade secret. Many states also have their own trade secrets act.

“Because noncompete agreements impact the marketplace, courts carefully scrutinize these agreements. Due to the potential harm to both the company and the employee, these situations are often expedited, so noncompete cases proceed very quickly. To determine whether a noncompete is enforceable, judges evaluate several factors, which vary by state. These factors include how long the employee worked for the company and whether the employee received enough of a benefit for the noncompete, how broad the noncompete is in terms of time, geography and the restricted activities; the types of clients the company [has]; and the employee’s access to confidential information.

This area of law is constantly changing, and several states have recently passed new laws to restrict noncompetes, especially for low-wage employees.

“Companies concerned about protecting their vital information should craft creative agreements that evolve with the law and have strong remedies. Businesses should also determine their goals to help shape their agreements. Is the goal to prevent competition generally or with a specific entity? Is there a concern about losing clients or employees? And what do the restrictions indicate about the business to potential employees, clients and the general public? The answers to these questions can help companies determine the right agreement to protect their business.”

Amit Bindra is a partner and employment law attorney at the Prinz Law Firm

“There are better ways to protect your intellectual property. Noncompetes are treated under state business law. This means that what works for a noncompete is going to be different, sometimes extremely different, for each state. In the modern world, where startups often have virtual employees in many different states, this creates problems. The noncompete you write for employees in your home state might not hold up in the state court of your virtual employees. You can try to solve this with choice of law clauses, but these might not always hold up. State courts generally have jurisdiction over people working in their state, even if the companies they are working for are out of the state.

“Patents and nondisclosure agreements, however, are national. The same patent can be used to exclude a company in California or a company in North Carolina. Under the federal nondisclosure law signed by Obama, nondisclosure agreements can also be used across the country to prevent employees from sharing business secrets, even after they leave the company.

“If you use a noncompete, use it only for high-level employees. Courts have taken a dim view of lower-level employees (production line employees, for example) being forced to sign noncompetes. [Also,] the noncompete needs to be reasonable in geographic and time scope (what this means is different for each state)—a noncompete covering the entire world and all time will not work.”

Daniel W. Cole is an intellectual property lawyer and patent attorney with Olive Law Group

“One of the most common mistakes startups make when instituting noncompetes relates to timing. Generally speaking, noncompete agreements (and other restrictive covenants) must be supported by consideration to be enforceable. When hiring a new employee, the offer of employment provides the necessary consideration to support the noncompete agreement. But startups often neglect to use employment agreements of any kind early on, so it’s common for a startup to present noncompete agreements to employees after they’ve already been working there for some time. When this happens, it’s imperative for the startup to offer additional consideration—usually in the form of a salary increase, bonus or promotion—to ensure the noncompete is enforceable. The promise of continued employment is not sufficient consideration to support the noncompete.”

Mark Tyson is the founding attorney of Tyson Law, a business law firm

“Startups working with proprietary technology should include confidentiality and nondisclosure provisions in their employee contracts in addition to company policies. Many courts do not look favorably on noncompete provisions, and even when they are included, there usually must be limitations on scope, geographical area and how long the company expects the noncompete period to last. Courts will also look at whether there is additional compensation as consideration for the noncompete.”

Caroline Conway practices business and family law at The Law Office of Caroline A. Conway

Eric Rosow, CEO of Diameter Health, explains why building the right team is so critical to success, and how do you make it happen.

Eric Rosow, CEO of Diameter Health, explains why building the right team is so critical to success, and how do you make it happen.

 

Read full article: Connecticut Entrepreneur Talks Technology, Teams, and How He Applies a Concept Called “Swing” to His Business.

Connecticut Entrepreneur Talks Marketing, Sales and Why Big-Company Experience Doesn’t Work at Startups

brainstorm sketch on wall

Dr. Steve Shwartz is co-founder and executive director of Device42, a Connecticut Innovations portfolio company that was named the fastest-growing tech company in Connecticut from 2015 to 2017. (Device42 was acquired in early 2019 by a private equity group.) He’s also a serial entrepreneur, investor, patent holder and author of a book on artificial intelligence, and has participated in multiple IPOs and exits over the course of his career. In other words, Steve is exactly the type of entrepreneur one can go to for insight and advice. We caught up with Steve recently to get his take on hiring, marketing and why Connecticut is a great place to grow a startup.


Connecticut Innovations: Thanks for agreeing to talk with us, Steve. You have an impressive background as both an entrepreneur and an investor. Do you think there is a certain personality type that chooses the startup life instead of, say, working for an established company?

Steve Shwartz: Over the years, I’ve discovered that when I hire someone with only large company experience into a startup, they nearly always fail. Here’s why: First, people in large companies make decisions slowly. Decision-making [there] tends to be a very bureaucratic process. Startups can only succeed against established companies if they are nimbler. As a result, decisions in startups have to be made quickly. Big companies create committees that take forever to reach a conclusion. In startups, decisions are often made on the spot by individuals or in impromptu meetings that might last a half hour.

Second, jobs in big companies tend to be narrowly focused. Tasks are well defined, and anything outside an individual’s focus area is done by someone else. To some degree, in a startup, everyone does everything.

Third, in a big company, no one sticks their neck out or takes risks, because a mistake can get you fired. In a startup, mistakes are—or should be—expected and tolerated. Learning from mistakes is one of the ways startups find their way.

Finally, every employee in a startup has a significant impact on the company’s success. Therefore, it’s very important for startup employees to be highly motivated by that success. In a big company, an individual employee has virtually no impact on the success of the company. Too, employees at large  companies are often motivated by political gain rather than company success. Politicians coming into startups discover that the other employees quickly start to ignore them.

CI: Why did you choose the startup route?

SS: I got into startups accidentally. I had moved to the New Haven area to be an AI—artificial intelligence—postdoc at Yale. Roger Schank, a well-known AI professor there, decided to start an AI company and convinced me to be the first employee rather than pursue an academic career. I’ll always be grateful to him for that advice and opportunity.

CI: Why did you found Device42? What was the problem you saw that needed solving?

SS: I didn’t start Device42. It was started by Raj Jalan, and I joined him shortly thereafter as a co-founder. Raj had been a data center consultant helping customers perform digital transformations. Back then, it meant helping customers move to server virtualization and/or new blade architectures. Raj would ask his customers how all their IT assets, such as servers, network components and applications, were interconnected, but no one ever knew, so he would spend 60 percent of his billable hours figuring it out. He felt there had to be a better way, and that was the genesis of Device42.

CI: You’ve been at the company more than seven years. How drastically has it changed since you founded it, and what has been the biggest challenge so far? (And how did you solve it?)

SS: Raj and I started out by renting a desk at The Grove coworking facility in New Haven. For two years, we were a two-person company with a few offshore resources. We wrote code and sold systems over the internet. By the end of 2014, we had 80 customers in 20 countries—and had never met any of them. That was when we raised our Series A funding round led by CI.

For the first couple of years, we spent nothing on marketing. It was all organic search engine optimization; customers would find us via Google Search. Following the Series A round, we started buying Google AdWords, and that was our primary marketing focus for this past four years. Most of our customers came in through this direct channel. However, we were mostly attracting individuals and small teams in the IT department, and our average subscription sale was relatively small.

In order to continue doubling revenues every year, we realized that we couldn’t continue to rely on small sales. So we developed a channel program in which large global system integrators use our product to service their large customers. 
We had to do a lot of trial and error to find the right formula, and we were fortunate to have two very capable channel sales vice presidents who established the relationships.

CI: You have an impressive blog, with frequent, informative posts. Does the blog drive new business? What goes into managing the channel?

SS: We don’t have a lot of hard data on the effectiveness of the blog posts. However, my suspicion is that the blog posts have a much bigger impact on existing customer satisfaction than on customer acquisition.

CI: How else do you market the company’s products and services?  

Steve ShwartzSS: Oddly enough, we’ve had a lot of success without doing any marketing other than inbound marketing through Google AdWords. We just hired a vice president of marketing whose job will be to develop new marketing channels such as trade shows and analyst relationships, so stay tuned.

CI: What do you like about Connecticut as a place to start and grow a business?

SS: I’ve started a lot of companies in Connecticut and think it’s a great place to start a company. There are fewer qualified people for hire, but there is also less competition. There are also a lot of people who commute into New York City who are very happy to stop commuting for the right job.

CI: Thanks for your time, Steve.

SS: My pleasure.

Connecticut Entrepreneur Talks Technology, Teams, and How He Applies a Concept Called “Swing” to His Business

rowing crew in boat

 

In competitive rowing, there is a term called swing. It refers to an elusive feeling of near perfection and synchrony among a crew, in which all rowers in the boat are in a “symphony of motion” and there is no wasted energy. Eric Rosow, CEO of Farmington-based Diameter Health (Connecticut Innovations is an investor) and a competitor in the 1987 Pan American Games, is no stranger to swing, in rowing and in business. CI sat down with Eric recently to learn more about his company and his experience as a serial entrepreneur.


Connecticut Innovations: Thanks for agreeing to talk with us, Eric. You have experience working for large organizations as well as startups. What drew you to the startup route?

Eric RosowEric Rosow: I founded my first startup in 2000 after working at Hartford Hospital in biomedical engineering. It was an amazing experience to build a great organization. I had the good fortune to remain on board as a general manager and divisional vice president when we sold the company in 2008 to Eclipsys Corp., now part of Allscripts, a leading electronic health record company. But I found that I really missed the excitement of a startup. I’d seen firsthand what small, nimble and passionate teams can do to effect change in health care, and I wanted to try my hand again. So, in 2014 I bootstrapped what became Diameter Health with co-founder John D’Amore, another Eclipsys alumni. We joined UConn’s TIP program in 2015 and just closed our series A-1 with strategic investor Optum Ventures, which joined our original investors including Activate Venture Partners, Connecticut Innovations, Excelerate Health Ventures and LRV Health.

CI: Why did you found Diameter Health? What was the problem you saw that needed solving?

ER: In 2009 the government poured some $30 billion into promoting the use of electronic health records (or EHRs). We’ve largely achieved that goal in 2019, with more than 95 percent of hospitals and 90 percent of office-based physicians using an EHR. But the nationwide effort to move all health records from paper to the digital realm has created the unintended consequence of what we at Diameter Health call “clinical data disorder.” The symptoms of this condition are causing a lot of pain in our healthcare system. The most urgent “symptom” is a lack of what we call semantic interoperability between and among EHR systems. Even the government has taken note and has written rules that require health systems, practitioners and health information technology vendors to adopt standards that make these systems talk to each other. The goal is to make it possible to go from one healthcare service provider to another and have your medical history immediately accessible. But even with pipes laid down that connect health systems, we are still stuck with the issue that the way one provider documents is not the same as another. This makes it difficult for systems that depend on that data to do their work. For example, identifying gaps in care such as the need for a flu shot is impossible for a computer when some say “influenza vaccination” and others say “flu shot.”

“Diameter Health software is aimed squarely at solving the problem of all this variability so that we can truly optimize the use of digital data to keep people healthy.”

CI: What are some of the greatest challenges you’ve faced so far in starting and growing the company, and how did you address them?

ER: Determining the right product-market fit for your product and/or service, coupled with relentless focus and execution, are challenges throughout a company’s life cycle. In my experience, these attributes, coupled with managing tight cash flow and building a great team, are critical and especially challenging during the early years of a company. I’m super proud of how capital-efficient we’ve been as we scaled Diameter Health over the past few years, but I’m much prouder of the team we’ve built and continue to build throughout the company. In his book The Hard Thing About Hard Things, Ben Horowitz said, “One of the great things about building a tech company is the amazing people that you can hire.” While it can be extremely challenging to find and recruit the best talent, it’s the most rewarding aspect of being an entrepreneur.

CI: Diameter Health wasn’t your first foray into entrepreneurship. What did you learn from founding Premise that you carried over to Diameter Health?

ER: While it may be trite, I cannot overstate the importance of building the right team. Startups are team sports, and I believe assembling the right athletes, in the right positions, with a clear strategy and game plan is the single most important aspect of ensuring success for the customers, the employees and the investors.

CI: Entrepreneurs often have a hard time delegating. As an elite competitive rower, you have experienced a concept called “swing,” where all the rowers in the boat are in symphony and there is no wasted energy. How can founders get into swing with their teams and learn to let go and delegate?

ER: As a longtime oarsman and rowing coach, I feel that I have a built-in advantage as an entrepreneur and business leader. I consider the sport of rowing to be a metaphor for life since it teaches us that the core principles of teamwork, strategy, commitment, trust, empowerment, balance and execution are essential attributes to success. But more than simply a metaphor, competitive rowing offers practical tips for founders. A rowing team needs its members in the right seats, working together and doing the jobs they’re most suited to do. For example, the coxswain steers the boat and sets race strategy, the stern pair sets the pace for success, the bow pair in the front are responsible for the boat’s stability, and the engine room are the athletes in the middle of the boat responsible for the boat’s core power and propulsion. Founders should look for the right people, hire them and not be afraid to move them into the right positions if the initial lineup doesn’t work. I’m a big believer in Colin Powell’s advice that it’s key to hire for strength rather than lack of weakness. Once you get the right people, keep working on optimizing their contribution, so you will achieve the “swing,” where everyone’s synchronized and there is no wasted effort.

CI: What’s next for your company?

ER: Right now, I’m 110 percent focused on Diameter Health and working with this amazing team to realize our potential and build an important and impactful digital health company that supports the Institute for Healthcare Improvement’s Triple Aim framework by (1) improving the patient experience of care (including quality and satisfaction), (2) improving the health of populations and (3) reducing the per capita cost of health care.

CI: What do you like about Connecticut as a place to start and grow a healthtech company?

ER: Great quality of life, easy access to Bradley International Airport and train stations, great colleges and universities to draw interns and employees from, and a fantastic ecosystem of health systems and payers to partner with as we develop new products and solutions and validate market need.

CI: Thanks for your time, Eric.

ER: My pleasure.

 

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