Hal Andrews is a lawyer turned entrepreneurial healthcare executive.
He’s currently the CEO of Trilliant Health, an analytics and data science company that provides market analytics, predictive analytics and market research for healthcare providers. It’s the fifth healthcare startup for which he’s served as CEO.
”“You’re never, ever prepared to be CEO the first time. It’s like learning to swim in the deep end of the pool.”Hal AndrewsCEO, Trilliant Health
Katie Hankinson (00:00):
Hi, I’m Katie Hankinson and I’m Mickey Cloud. Welcome to Building While Flying a Sasha Group podcast, where we interviewed business leaders about how they tackle challenges, stay resilient and navigate ever changing skies.
Mickey Cloud (00:20):
Hal, welcome to building while flying. Thanks for being our guest today.
Hal Andrews (00:24):
Thanks for inviting me.
Mickey Cloud (00:26):
Yeah. So Hal Andrews is an entrepreneurial healthcare executive with broad experience in creating vision for leading growth of and executing capital formation in healthcare services and information technology companies. Hal currently serves as the CEO of Trilliant Health and analytics and data science company that provides market analytics, predictive analytics and market research for healthcare providers, and prior to Trilliant, Hal was the CEO of four other health care companies, each of which he successfully grew and sold? So how maybe we can have you start by just giving us a little more details about what Trilliant Health does and how you guys work with hospital systems and healthcare providers.
Hal Andrews (00:59):
Okay. We work with health systems in a couple of ways. One, we refer to as marketing analytics, where we give our customers an idea of what’s happening outside the four walls of their facilities. And so obviously everybody knows what what’s happening inside their own hospital, but historically they didn’t understand what was happening outside those four walls. As healthcare has moved to become delivered in more outpatient ambulatory primary care physician based settings, they have less visibility and therefore they have less understanding of, of real market share trends. The second thing that we do is work with health systems on predictive analytics. So Peter Drucker once said that a hospital is the most complicated organism in the world because it has high labor costs. It has high capital costs, and it has a high regulatory burden. So our customers are making capital allocation decisions for buildings that should have a 10 or 20 or 50 or even a hundred year useful life. And trying to predict what’s going to happen in a market 10 or 20 or 50 years from now is really important to make sure that you allocate your capital prudently.
Mickey Cloud (02:18):
Got it. Got it. So when I be curious, knowing that you’re on w on the PR at least the predictive analytics side, you’re on kind of that longer time horizon, um, you know, be curious, I guess has, do, do, does any of the predictive predictive analysis kind of help with shorter term decision-making and I guess, and origin, I guess, stayed another way. Like what w uh, what service lines do you, do you particularly focus on? Is it, is it all service lines within the hospital? Is it certain aspects of the hospital, or is it just like, do we need to build a hospital in this area kind of thing?
Hal Andrews (02:56):
Well, it’s all of that. That’s, that’s a great question. So today we were really focused right now on a really a tin ten-year look got it. Uh, we’re working backwards now. Um, we’re, we’re gonna probably get as, as close as a three month look, and really depends on the setting. We start from the approach that all consumer industries start from, which is what’s the total addressable market for a good or service historically health systems have focused on, um, a market share definition that is derived from, uh, uh, regulation as Dr. Drucker might’ve suggested called the stark law and under the star claw, which was intended to address, um, what compensation arrangements you could have with physicians. Stark law said that your market is the smallest number of zip codes from which 75% of your inpatients originate. And so the stark law definition is almost the opposite of any other definition of a consumer market.
Hal Andrews (04:04):
And so we’re, we’re trying to encourage people to think about all of the people in a geography they could serve, and then think about the things they’re really good at, uh, health systems sometimes want to believe that they can be a center of excellence for everything, uh, that medicine does. The reality is that, uh, Dr. Herzlinger at Harvard and in the nineties predicted the idea of a focus factory, and that’s right there, there are certain things that certain hospitals are great at because they have great facilities and great medical staff, and they, they do a lot of those things. Um, you know, heart hearts are, uh, an example of that. If you, if you’re at a place where, uh, you’re not doing at least 300 heart surgeries a year, then they’re probably not doing enough, uh, to really do a good job, right. And we try to help people line up their capabilities and their services with the needs of the communities they serve.
Mickey Cloud (05:03):
Yep. And I’m sure the needs of the communities they serve, uh, the past 18 months has probably rocked that a little bit just with the COVID pandemic. So, you know, knowing that you guys provide kind of for, you know, uh, services that help forecast demand and things like that, I’m sure the pandemic put quite a kind of stress test on your data and predictive analytics. I’d be curious, kind of what opportunities and challenges did kind of COVID pros for children trillion as a company, um, you know, over the past 18 months.
Hal Andrews (05:31):
Well, the, the biggest challenge for us is that our customers are primarily health systems and those health systems were under extraordinary and unprecedented pressure. Um, they had to deal with the fact that they were simultaneously the, the most important provider in the community, and yet they were putting in place, uh, protocols to mitigate against the pandemic. And so they, they to both be there for folks as they were fighting a, an unknown, um, virus. And it, it just took a while for everybody to figure out what was really going on, the, the problem for the communities they serve as that, based upon again, a regulation, uh, the, the federal government asked people to stop doing outpatient surgeries, right. And the result of that is delays in care and delays in care, always lead to one of two things, either that care is foregone, uh, permanently or the condition is, is worse. By the time somebody comes back and our clients are managing through both of those things simultaneously this year.
Mickey Cloud (06:44):
How did that change, maybe how, how you guys approached clients or prospects with, with the services that, that you offer, or did it, did it change anything at all?
Hal Andrews (06:53):
No, it, it changed it radically. Uh, we, we have, uh, clients out in, in Seattle and we knew early on that there was something, um, really massive happening. Um, we had two clients out there who were, uh, who got some of the first patients from the pandemic. And so we had an early warning system that something bad was happening and that it was beyond anybody’s comprehension at that time. Right. And so the first thing we did was just to stop calling anybody and we, we just completely shut down all business development and said, if they want to call us and need help, we’ll answer the phone, but we didn’t call anybody for 60 days. And so when you’re trying to grow a business, I’m not calling prospects for 60 days is probably not how they draw it up in, in business school, but it was the right thing to do.
Hal Andrews (07:53):
The second thing was it, it allowed us to take some things that we knew from both our time at Truliant and, and in previous experiences, and really help people think about restarting because most hospitals are open 24 hours a day, seven days a week. There, there is no, uh, under new management where we got the doors for 30 days and paint the walls. And so ironically there was a chance for people to sit back and assess the way that they thought about the, their markets. They thought about relationships with physicians, and we were able to give them some, some help in, uh, really the restart that happened in may or June of last year.
Mickey Cloud (08:37):
Yep. And you mentioned that, you know, trillion, isn’t the first tech startup you’ve kind of helmed that delivers tech services services for the healthcare sector. So I’m curious, how has, how has billing technology solutions and services for healthcare different from kind of your typical consumer tech? You’ve already mentioned that, like, you know, how the consumer tech world maybe thinks about an addressable market is maybe a little slightly different than hospitals and healthcare industry. But so, I mean, what are some of those differences and then maybe what are some of the similar similarities as well?
Hal Andrews (09:07):
Well, I think the, uh, the difference is easy. The difference is mindset and, um, hospitals, you know, since Benjamin Franklin started Pennsylvania hospital back in the 17 hundreds have had a mindset that the physician was the customer, and that if you took care of that customer, they would bring their customers. And that held true for over 200 years. It’s really only in the past 15 or 20 years, that the notion of consumerism and healthcare has become a thing. And so the real transformation is that in terms of the difficulties, again, it’s really regulatory driven and it’s really driven by security and privacy concerns. The, the framework that you have to put in place to satisfy people that you will comply with law, and therefore you won’t put them out of compliance with law are pretty, pretty hard to overcome. And, you know, it’s hard to satisfy people and, and under the current regulatory scheme, a violation of the privacy laws is potentially unbounded. And so if you have unlimited exposure, what you find in a business relationship is people trying to trade risk with each other. And the technology is not nearly as challenging as it is solving for the regulatory burden of unlimited liability for a mistake, whether it’s an innocent mistake or right. Or an egregious one.
Mickey Cloud (10:42):
Yeah. Yeah. Those are slightly different laws than what, you know, a consumer app maybe is dealing with. Well, I know, I know prior to kind of working in the startup scene, you were, you were a practicing attorney and even some of your early experiences working within startups and running startups were, were more about, you know, taking maybe existing businesses that hadn’t gotten traction yet and turning them around. So they take off. So I’d be curious, what was it about your experience as a lawyer and then maybe as an early stage startup employee that kind of prepared you for, uh, the roles you’ve taken on where you’ve helped turn businesses around us as the CEO?
Hal Andrews (11:17):
Well, I think the first thing is that you’re never, ever prepared to be CEO the first time, and that’s the most important thing. Um, it’s, it’s like learning to swim in the deep end of the pool. I think the thing that I brought from my background in practicing law was pattern recognition. And what you really learn in law school is, is to recognize fact patterns and to be able to synthesize the things that matter and the things that don’t matter. And, and hopefully to focus on the things that matter. And in my experience in all startup environments, whether it’s a brand new opportunity with, with no baggage or whether it’s something that’s been around for five years and has lots of baggage and lots of things to fix, it’s the pattern recognition of what matters, what doesn’t matter one of the first three things that I should do.
Mickey Cloud (12:15):
Do you have like a, a roster of, of, uh, of mistakes that you, you, you look for, or how do you kind of evaluate what those, you know, first priorities should be when you’re thinking about a way to kind of turn around a business around?
Hal Andrews (12:30):
Well, the first thing is always ask a lot of questions. I tell the board that I’m going to need 60 or 90 days to just figure out what’s going on. Uh, the, the sort of general buckets, almost always a startup has over-invested in their real estate and maybe post pandemic and the adoption of virtual technology and remote work that won’t be as big an obstacle anymore. But one of the things that historically I’ve seen is an accompany gets funded, and then they go out and spend a lot of money on real estate that they don’t really need. Another one is technology, and they’re sort of a dual track mistake sort of eight times out of 10. Uh, they under invest in technology and they do something that’s free and cheap. And so, for example, uh, you’ll see a lot of companies that have application layers start with PHP because it’s free.
Hal Andrews (13:30):
And there are a lot of PHP developers out of there. It is inevitable that PHP won’t scale, and usually people wait too long to realize, oops, we should probably switch to that two times out of 10. It’s the other, it’s the other problem, which is technology for technology sake. And it is, well, that sounds cool. You know, let’s, let’s get that. And then we’ll sort of work that into our tech stack. And so there, there’s always technical debt that you have to take care of. Third thing is the market positioning is usually a little bit off. So part of what I do is to have to make decisions about whether I’m going to get involved without knowing a whole lot about it. And for me, it’s really do I, do I hear on the story, a nugget of something that could be really valuable, and it’s usually the thing that’s buried, nobody ever shows up to you and says, Hey, we want you to come lead this, this great thing where we figured out the market and everybody loves it.
Hal Andrews (14:31):
Everybody says, we went out to solve this problem and nobody cares. And so it’s really what, where’s the nugget of innovation or something that you can differentiate in the market. And, and can you uncover that? And can you eliminate all of the other noise around that thing? And, you know, from a, from a ship analogy, it is, can I just turn the rudder one or two degrees get on the right course? And as you are looking through those three buckets, you usually figure out the, the rest of the issues that need to be resolved in the next six or 12 months.
Mickey Cloud (15:12):
We, we often talk about that last point around like the positioning is making sure you’ve got a really strong core. Uh, you know, if you think about like your, your body, uh, as, as the analogy there, like, you know, if you don’t have a strong core, then nothing else is really going to be as flexible or as strong as you want it to be. Um, and so you’ve got to kind of evaluate whether it’s the mission, the vision, the positioning, the, you know, who you are as a company and what you’re trying to set out to achieve, and really make sure you’ve got that well articulated for internal stakeholders for external stakeholders or prospects. Um, and so that makes, it makes a lot of sense that that’s one of the things you have to look at. I’d also be curious about like, you know, the, the nuances of those three things and maybe how, where the company culture kind of comes in, uh, in, in terms of something you evaluate and look at and kind of, in what ways do people get it right, or get it wrong when you kind of walk into one of these turnaround scenarios?
Hal Andrews (16:07):
Well, from a cultural perspective, I see that a lot of early stage ventures think that the fundraising event is success and the fundraising event is actually just the beginning of the race.
Mickey Cloud (16:21):
It’s a celebration, right? Yeah. Yeah.
Hal Andrews (16:24):
I, um, the, we raised X million dollars from Y is, um, that means that life just got hard. And I think people just underestimate that, I think from a cultural perspective, um, a lot of times the people who are true visionaries, uh, have some other characteristics that aren’t quite as attractive. And a lot of those manifest in, in cultures where, uh, there’s, uh, either a cult of personality or there’s a culture of fear, or there’s a culture of, of people who are in and people who are out. And the first thing that I do now and have been doing this now for a decade is implement, what’s called the daily update. And the daily update is something that I learned from one of my mentors again, named Jack Lord, who was at one point, the chief innovation officer of Humana and chief medical officer of Humana and the daily update, uh, Jack’s version was the first thing was progress, which is what did he do today?
Hal Andrews (17:34):
Uh, the second thing was takeaways, which is what did he learn today or observed? And then the third part was gratitude and I’ve taken those three things and added to it, um, uh, an excerpt from the daily Drucker, because that I find that Dr. Drucker just seems to have the most wisdom of any business writer out there. And so every day, uh, I do all four of those things. And the, the part about the progress is that I’m transparent about what I did that day. Who did I talk to? What did I work on? What did I think about takeaways can be really serious? They can be light, they can be a mixture of things. They can be specific to the business. They can be about world events. Um, gratitude’s the most important one. And, uh, I try to mix in things that I’m grateful for personally, maybe something out of my, uh, about my family, a success that one of my kids had or something like that, as well as, uh, things that people on the team do or things that the company has achieved.
Hal Andrews (18:38):
And I just, I find that forcing myself at the end of the day to end the day thinking about something that I’m grateful for is really good at, at grounding me in turn, everybody gets the daily update at the same time every day. And so there’s a connective tissue that builds that everybody feels like they’re in the loop. They know what I’m thinking. You can tell if I’ve had a bad day or not, you can tell if I’m fired up or not. And so, um, to some extent everybody’s on equal footing and particularly in the new environment where there’s so much more remote work, I think it’s really important, important culturally for me to communicate broadly, um, and consistently, and that’s the way we do it here.
Mickey Cloud (19:30):
Yeah. I mean, I’m sure when you come in, you know, in, in, in you’re established yourself as kind of the, the new, new management and things like that, I’m sure there’s, there’s sometimes trepidation and, and sounds like the daily update. If it’s going to everyone, like there’s a level of transparency and a level of, of kind of setting the priorities and the values of the company that you’re, that you’re living out every single day, that, that over time, I’m sure people warm up to pretty, pretty well
Hal Andrews (19:57):
At its core. It’s about transparency and accountability and, um, it’s unusual and some people are initially uncomfortable with it, but over time, people, people take a liking to it. And, uh, you know, I mentioned that it’s to grow, that’s been through a lot of things together, um, when, when people leave and then come back, one of the things they mentioned is, man, I’m glad that I’m back kind of get the daily update let’s go on.
Mickey Cloud (20:24):
Yup. Um, well, you know, we, we call this podcast building while flying because, you know, it’s kind of that analogy speaks to kind of the, the fact that entrepreneurs have to get comfortable in the uncertainty and they’ve got to be flexible and nimble and everything like that, but also because, you know, pilots are renowned for their in-flight checklist. Um, so, you know, you kind of mentioned maybe your, your, the daily update as maybe some of those four things that are, maybe you’re you’re checklist of, of things that either keep you calm or help keep, keep you transparent. But, you know, when you, when you know, you’ve got to make a tough decision for the business, what, what’s your internal process or checklist that you maybe go through that, that helps you make come up with a decision?
Hal Andrews (21:02):
Well, I think the first thing that I do is I, at this point rely on experience and, um, you know, there’s an old story about the, uh, fire chief and a rookie firefighter showing up together at the fire. And, uh, the, the rookie is trying to figure out where the hose is and, and, or the fire hydrant is. And the fire chief gets out and looks around and says, well, okay, that’s an electrical fire in the basement. And if you, a lot of the, the thing about making hard decisions is the speed with which you can make a hard decision. And usually the hard decisions are about people. And what I’ve learned is a couple of things. One is I’ve, I’ve learned that I’ve never had to go to the board of directors and say, I fired that person too soon. Right? I think the second part is it doesn’t matter who it is.
Hal Andrews (21:55):
It doesn’t matter when they leave. It doesn’t matter how they leave when they leave. There are always things that bubble up that you didn’t know. And the tricky part about being the person in charge is people are inclined to tell me what I want to hear or what they think I want to hear, or at least not tell me the things they’re pretty sure I don’t want to hear. Right. And so it really goes back to the culture of a key part of our culture is that we surface the bad news quickly. And it’s hard for new people to believe that. And fortunately, we have a lot of people who’ve been through the wars together. And one of the things that I celebrate in the daily update are the people who come and report the bad news, and we, we celebrate them for reporting it. And then we get to work on fixing it. And all of those things serve to give you a better sense when things are starting to go awry, or when there’s, there’s somebody who’s reached their limit. And I’ve just learned through experience that when, you know, you should just act it, it never gets better waiting and it never gets better for that person or that problem waiting is never, ever the answer.
Mickey Cloud (23:12):
Awesome. Well, thanks so much for sharing that and thanks so much for your time today. It’s been a great, great insight and appreciate you sharing.
Hal Andrews (23:20):
Thanks for having me on. I appreciate it.
Katie Hankinson (23:24):
Well, now that we’ve finished that thoroughly interesting interview, we’re getting ready to land, but before we do Mickey and I caught up on some of the themes and topics that stuck out to us,
Mickey Cloud (23:34):
Yes, we liken this to the post game show where we break down the key lessons we all can benefit from, including us here at the Sasha group here is the Sasha sidebar.
Katie Hankinson (23:50):
Hey, Mickey, great conversation with pat, what an impressive credentialed career he’s had.
Mickey Cloud (23:58):
Yeah. I had to be on my game to talk to how, as he’s just very smart.
Katie Hankinson (24:04):
Yeah. This stuff. Yeah. I thought it, it’s funny the way he described healthcare, the beginning, you, the conversation like it, once you can solve problems within the infrastructure health care, you can basically sell anything. It’s the most complicated business in the world to run. Um, and also just, I, I was really interested in what he was saying about how that big, if it shifts is up with the industry about it used to be about centered around physicians, and now it’s much more centered around the consumer and what that means for how hospitals or the sector overall has had to shape itself.
Mickey Cloud (24:37):
Yeah. And it’s, it’s super interesting cause I’ve had, I have, my dad works in healthcare. He’s the chief medical officer at a hospital in Memphis. And then I’ve got friends that work in this space. And when they’ve, I, you know, over the past decade, plus they’ve kind of asked me about like consumer marketing and things like that. And like this idea of consumerism in healthcare is really so new. He said like, it’s only been in the past 15, 20 years, but this is an industry that’s been over 200 plus years of, you know, we take care of the doctor. And as a hospital system, we tear the doctor and the doctor will take care of the patient, we’ll deliver the service to the patient. We don’t need to worry about that. We just make sure that the system is built around the doctor’s needs. And what’s kind of changed is this idea that, you know, consumerism and healthcare, how can healthcare deliver directly to people and make their needs, the patient needs kind of what you build the system around.
Mickey Cloud (25:29):
And, you know, and it’s, it’s such a highly, highly regulated space, obviously. Um, there’s, you know, it’s, they’re there. How, how does technology, what role does technology play in that, in that transformation of putting kind of consumers at the heart of it? Um, you know, things don’t move as quickly as probably technologists think they should. Um, but it, it is, I mean, it is a paradigm shift when you start thinking in that way, as opposed to like, let’s build it for, to make the doctors, you know, uh, what the doctors needed for some of the patients need
Katie Hankinson (26:03):
Now with what tech data can do. And some of the new platforms arise arising, you know, and some of them really gigantic organizations like Berkshire Hathaway and JP Morgan getting involved in Amazon. Interesting thing. What happens with the healthcare ethics?
Mickey Cloud (26:18):
Yeah, no, I mean, I mean that example, like they’ve even started to shut that down. Right. Even when they like two, three years into it, they’ve already made some
Katie Hankinson (26:30):
Yeah. Well, um, yeah, I mean, he, it was fascinating to hear how he really jumps in and really helped some of these startups as well, kind of.
Mickey Cloud (26:40):
Yeah. And that’s kind of the, that’s his, his role and, and, uh, you know, he is kind of the turnaround CEO. So he’s been the past 15 years, he’s been, you know, working with a private equity group in Hampshire. He’s got some sort of relationship there where they essentially identify these healthcare startups, where he comes in and, and, and they kind of take over a controlling interest and he comes in as the new management, right? Like the classic PE situation where they, they take over the ownership and they installed their new leadership team. And so I thought the most interesting things were kind of the pattern recognition that he’s gotten from one of the mistakes that generally startups make. And he mentioned like they over invest in real estate, they under-invested technology. They don’t truly understand kind of what they’re building in terms of product market fit. Um, but to me, the, the cultural stuff, the communications was what was so interesting. And like the daily update he talked about was, I wish every, you know, if every company operated that way, think about how transformative that could be.
Katie Hankinson (27:38):
I thought that was wonderful. It was such a great combination of, well, just a quick 1, 2, 3 punch the, what was that again? What, what did I do today? What have I learned and what am I grateful for? I actually an incredible practice, the mindfulness in general,
Mickey Cloud (27:57):
Right. And then to share it on day one with everyone in the company, like everyone in the company gets that email and then it comes again the next day and then the next day. And, you know, and it’s just like this thing where he’s like, yeah, it can be jarring at first to people that have been there, but he’s like, it’s something I have every day I’m working. I delivered.
Katie Hankinson (28:18):
Yeah. Ooh, well maybe that will be our question for a community who out there has their own daily practice. Is there something that you communicate out to your company or your teams with, um, what is it like,
Katie Hankinson (28:33):
Thanks for joining us for building while flying today. I hope you learned as much as we did. We’ll meet you right back here next time for another flight.
Mickey Cloud (28:45):
If you’d like to hear more about how business owners and brands are navigating these times, tune in to the next episode. And if you’re so kind, please rate and review us, plus we’d love feedback. So let us know what you think, what you’d like us to dig into next on building while flying, across brands, businesses, marketing, and more original
Katie Hankinson (28:59): Music by Fulton street music group.
Welcome to Building While Flying!
This weekly podcast is brought to you by Sasha Group. We’re the consultancy meets agency arm of the VaynerX family of companies. We help ambitious companies build strong brands that flex with the times through strategy, branding media and marketing.
In ever-changing times, businesses and brands have to shift and adapt. And across all sectors, there is an air of experimentation. Business owners are trying new things out in the wild; building the plane while flying.
Our pilots, Katie Hankinson and Mickey Cloud, will be talking to a diverse range of business leaders and founders. They’ll explore how these guests tackle various challenges while staying resilient and committed to growth. Through these real-life examples of strategies put into practice, we hope to inspire you to experiment and develop your own strategies as we all navigate these uncertain times together.
Where is the nugget of innovation or something you can differentiate in the market?
Hal Andrews is a lawyer turned entrepreneurial healthcare executive. He’s currently the CEO of Trilliant Health, an analytics and data science company that provides market analytics, predictive analytics and market research for healthcare providers. It’s the fifth healthcare startup for which he’s served as CEO.
On this week’s episode, Hal joins Mickey to talk through each step of his career, and how his experience as a lawyer helped prepare him to lead healthcare startups as CEO. He shares a surprising move his team made amidst the early days of the pandemic, and how it helped them help their customers better. Hal also shares his first steps when he joins a new startup and emphasizes the importance of pattern recognition in business. Lastly, Hal discusses company culture, and how his “daily updates” provide direction and grounding for himself and his team.
Other in-flight topics:
- Trilliant Health’s services (1:00 – 2:18)
- Challenges and pivots during the pandemic (5:30 – 8:40)
- Tech services for healthcare vs. typical consumer tech (8:45 – 10:40)
- Applying attorney experience to startups (11:05 – 15:12)
- Company culture and the Daily Update (16:00 – 20:25)
- Hal’s in-flight checklist (20:45 – 23:15)