Building The “Unsexy” of Healthcare — Interview with Redesign Health Venture Chair, Missy Krasner
Earlier this year, I kicked off an interview series with leaders in the health tech space. Our industry is so vast and changing so quickly that it’s impossible to be an expert in every area. The goal of this series is to share insights, takeaways, and conversations with those that are raising the bar and building the next generation of healthcare.
I recently had the pleasure of sitting down with a dear friend and advisor Missy Krasner, who currently serves as Venture Chair for Redesign Health. Missy has one of the most impressive resumes in healthcare — including working for the U.S. Department of Health & Human Services (HHS) as Senior Advisor to the first Office of the National Coordinator (ONC) and serving as a founding member for both Google Health and Alexa Health & Wellness at Amazon. She also serves as a board member for four companies focused on delivering care both virtually and in person.
And that’s only a fraction of what she’s accomplished throughout her career.
In her current role at Redesign Health, Missy focuses on building transformative healthcare companies from the ground up. In our conversation, she shares her biggest takeaways about our healthcare system and what she’s been most proud of throughout her career.
Your career has touched almost every piece of the healthcare space, what initially inspired you to start working in healthcare?
During my childhood and undergrad at UCLA, my mom became sick and was diagnosed with multiple sclerosis. She also separated from my dad, who was a practicing physician, which meant she was no longer covered by his practice’s health insurance plan. This was before the Affordable Care Act, and because she had a pre-existing condition, she was rated out of the health insurance system and wasn’t able to get coverage. In other words, she was an MS patient with no health insurance.
Even though my dad is a successful physician (kidney specialist), I had never thought about working in healthcare. I was a Theater and English Literature major during my undergraduate studies. But this family experience completely changed my path, so I switched gears and decided to focus on patient advocacy. I went to graduate school at Stanford University and studied healthcare communications and administration. And from there, I began to learn the healthcare system from the inside out.
You’ve been able to see the healthcare industry through several lenses — first at Atena then at the Kaiser Family Foundation and eventually at Google and then Amazon. You’ve seen how healthcare works at digital health startups, large technology companies, foundations, the government, and in venture capital. How has that shaped your overall perspective on the digital health industry?
Looking back at where I started to where I am today, my take is that if you haven’t worked in the “bowels” of healthcare, you won’t be able to understand the industry as a whole. You won’t be able to understand change management, workflow, and the culture of healthcare.
As healthcare leaders, we tend to gravitate towards wanting to build something sexy. That makes sense, but when it comes down to it, those new shiny products aren’t always easily adopted. I’ve spent a big part of my career developing new solutions at big tech companies, and those innovations have failed. Why? Because healthcare has complicated and opaque buyers, it has regulatory hurdles, and it’s super hard to get those who deliver care to change their everyday work habits and workflows.
All of this has influenced my take on digital health adoption in healthcare. We need to focus on building the “unsexy” in healthcare. The back office stuff like — billing, credentialing, and better clinical documentation — to make our overall system more efficient. And that’s why I’m such a big fan of Wheel — they do just this — they help virtual health companies go faster and provide seamless workflow.
Looking back on your career, which campaign or product or initiative have you been most proud of?
I know that government isn’t the most glamorous industry, but working for the U.S. Department of Health and Human Services (HHS) was a seminal time in my career. It was a very different time in the industry. This was in 2005, pre-ACA, and we were charged with promoting the nationwide adoption of healthcare technology and Electronic Health Records (EHRs). At that time, EHR adoption by physicians in both the ambulatory and acute care environment was about 33 percent. Thanks in part to our work at the inaugural ONC office at HHS and the HITECH Act, which we helped author, the national EHR adoption rate is now at 97 percent.
It was also a very different time in politics, I was able to work on bipartisan legislation that brought real progress towards health IT for the first time. And, of course, the fangirl in me really enjoyed all the key political figures I got to meet and work directly for on both sides of the political aisle.
What is the one thing you wish the general public understood about digital health?
I don’t think people understand the complexity around what it takes to aggregate their personal medical history into a privacy-safe, consumer-centric, and easy-to-use format. Let’s face it, interoperability in healthcare is still a hurdle. We’ve had some incremental progress in the last decade, but we’re still not where we need to be. We still have perverse business incentives for why two competing health systems on two different EHRs would share data, all in the name of better care at the point of care and information arriving just in time to treat the patient.
We don’t think about our medical records until we have to interact with the healthcare system — like getting pregnant or ending up in the hospital due to an acute diagnosis or roadside accident. It’s like your credit report — you only pay attention to it when you have to make a big purchase, like buying a house. All of a sudden it matters and you’re scrambling to make sure you have all the right information in one place.
We haven’t yet answered the question of how to make health records easily accessible and portable. I spent a lot of time in government, at Google, and even at Box and Amazon, trying to work on this problem. Consumers want it but have resigned themselves to having a less than stellar experience interacting with their doctors, insurance companies, and hospitals. They simply anticipate poor service and legacy technology.
Can you tell us more about Redesign Health and how the program works?
When I left Amazon, I wanted to go back to early company creation and venture. I had worked in a traditional venture firm, Morgenthaler Ventures (now Canvas Ventures), before Amazon. While there, I helped make several early-stage investments in companies like: Practice Fusion, HealthLoop, Viewics, Doximity, and Vida Health. I loved my time in venture, but I ultimately wanted to be more operational and help our portfolio companies scale faster.
Redesign Health offers that model. We integrate a historically complex process of ideating, developing, funding, and launching healthcare companies into a streamlined platform — one that creates and scales companies without the friction traditionally found in the business-building process.
We launch these companies in collaboration with extraordinary entrepreneurs and corporate partners. We’ve assembled an industry-leading team of nearly 90 healthcare operators, technologists, and investors to redesign healthcare during a time of urgent need and unprecedented change. We have raised over $300MM in capital since inception and are backed by Declaration Partners, the family investment firm founded by David Rubenstein, and several prominent VCs.
We have built 20 ventures to date, 13 of which are publicly launched, across a diversified set of business models, including B2B2C, enterprise software, consumer, reimbursement models, and marketplaces/platforms. Our platform team provides deep expertise across every functional area relevant to launching and growing healthcare businesses.
What do you think makes a great healthcare founder?
It boils down to three things. First, you have to know how your company is going to make money over the long run. And if you don’t know that yet, you need to be willing to pivot to find it.
Second, invest in or hire a team around you that has healthcare expertise. You want to surround yourself with leaders who have played in the industry sandbox. I am all for innovation and tech leaders being in healthcare, but at least one Co-founder or someone from the management team has to be an industry veteran. If not, I highly suggest you get a deep bench of industry advisors.
Third, align around investors who have the stomach for investing in healthcare and digital health. They’ll know where to invest in relationships, how to get large incumbent brands to partner and pilot your solution, and they will understand the longer B2B sales cycles in payor and provider. They will also know how a digital health startup CEO leader will need to deploy capital and fundraise over time.
What is the best part of your job today?
I love the diversity and optionality of my everyday work at Redesign Health. I get to work on very early concepts and help bring them to fruition, recruit and build out founding teams, and coach stellar CEOs. It’s a nice blend of drawing on my past Operator, Government/Policy, and Investor experiences.
What’s the hardest part of your job today?
There is so much popping up in our industry right now due to the global pandemic, I just wish we all had more hours in the day to respond to demand and need. There are still many complicated problems in healthcare that need to be addressed — we at Redesign Health, strive to launch companies at an extremely high velocity, but it would be great to figure out a way to go even faster in order to tackle these immediate problems.
What’s the best or most impactful thing you’ve read lately?
I just re-read The Art of Possibility by Rosamund Stone Zander and Benjamin Zander. It’s a very quick and simple read, and it’s about changing your mindset to what is possible. It invites readers to learn how to be passionate communicators, leaders, and performers.
Name something that you can’t live without and tell us why.
My journal. Every morning I set a timer and write for ten minutes. Some days it may be a list of things I need to do, other days, it may be more creative or intentional. The point is that I’m writing and focusing on getting out of my head and really giving myself time to “think big” and “dream.” I found that the act of physically writing or scribbling on lined paper and not typing on a computer or phone opens my creativity and centers me to start my day.
Thank you, Missy for sharing your incredible journey with us. You’ve really done it all in healthcare and I’m sure you have inspired our readers to continue learning about healthcare from all angles.