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 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.