Medable’s CEO: The Mission-Driven Playbook for Scaling Your Product Sustainably from SaaStr Annual

Okay, let me make sure this is working. It's a little bit low. Awesome. Well, thank you guys for coming, and I hope you have a chance to enjoy what looked like an incredible lunch. So today we're gonna talk about how mission can help drive your product vision. A little bit about me and our mission. So I'm a physician scientist. I was at Stanford as a resident in dermatology, and I was specifically researching a very rare disease called systemic sclerosis. And I was recruiting patients from all over the world to engage in clinical research, specifically looking at identical twins with rare disease. And in the clinic I was working at Stanford, we were one of a very, very small number of clinics who specialized in this disease. And my mentor, Dr. Fiorentino, was very well known for being able to subtype the disease and treat patients with either drugs that were in clinical trials or repurposing off-label drugs or utilizing the very small number of therapies that were actually approved for this condition. And it was really through this experience where I was, you know, trying to engage in a very important research project looking at what were the drivers of the disease in identical twins, one who would manifest the disease and the other who would have a different course or not develop the disease altogether, that I began to encounter really the incredible number of barriers to clinical research and specifically to how we would enable the development of new therapeutics by recruiting patients and people to engage in clinical development or clinical trials. And so here I am, a resident at Stanford, you know, seeing patients who are coming from all over the world, but also very aware that the vast majority of people, in this case women, because this affects women 9 to 1, who are living with this disease, and unfortunately which had a 90% mortality rate or fatality rate prior to discovering that one of the— a drug that was indicated for another disease had a big impact on survival, most people would never be able to get on a plane to Stanford. Most people would never be able to come to this clinic, and most people would never be able to get these new therapies that we were determining had a big impact on patients' lives. So, you know, of course, being in the heart of Silicon Valley and someone who always thought about how do you really solve a hard problem, I started to look at, you know, technology as an incredibly powerful tool to be able to connect people all over the world to clinical research. So, you know, I started on my journey as an entrepreneur and raised $25,000 from a dermatologist who believed that this was a problem that should be solved. You know, now I've gone on to raise over half a billion dollars of venture capital and, you know, a team of over 600 people who are all dedicated to solving this problem. And our mission at Medible is to enable effective therapies to reach patients faster. And we do that by disrupting and really inventing a new way of doing clinical drug development, or enabling pharmaceutical companies to test their therapies and research their therapies at a lower cost and much faster than the status quo, which is $2.6 billion and 12 years. So, you know, I think our mission at Medible is why I'm here. It's why I think everyone in our company is here. And it's certainly what has driven our product because, you know, when you look at something as complicated as the development of a therapy and what it takes to do a clinical trial, you know, being able to bring technology into this equation is not an easy thing to do. But if you've got that North Star mission, enable effective therapies to reach patients faster, it becomes a guiding light for solving a really, really, really hard problem. So, you know, I think mission drives everything. I'm guessing most people in the audience are entrepreneurs. And, you know, there's an incredible Steve Jobs video where Steve says, you know, probably, he says about half of what separates successful from non-successful entrepreneurs is pure perseverance, perseverance. And perseverance is so important because we all know this is the hardest thing ever. I mean, I went to residency. I was the last class of physicians who did, you know, 30-hour workdays, if you'd call that a day. And I've, you know, in one of the hardest careers people generally think is difficult, being a doctor. and I can tell you, being an entrepreneur is, in my opinion, 1,000 times harder. Because, you know, it challenges you in so many ways beyond just your expertise, you know, as, let's say, an expert. It's challenging you as a leader. It's challenging you as an influencer. It's challenging your creativity. I mean, it's challenging basically everything about you. So, why I bring this up is I think that it's really your mission that keeps you in the game. And I think that Steve Jobs is absolutely right. And maybe it's more than half of what separates successful from non-successful is that perseverance is so important. And to me, when I think back to, you know, the patients that I saw at Stanford and patients that I continue to see in my own practice, it's, you know what, this is really hard, but this is a problem we're solving. And our mission is something that I'm extraordinarily dedicated to. And feel like it's worth my most precious, you know, resource, which is really my time here, you know, as a human. So, you know, I think it's important for a mission to be inspirational. As we all know, building companies, we're asking people to do really hard work. We're often asking them to do this when they could go and get a much higher-paying job at another company that's much more established. You know, we know they could go work at Google and get lunches and massages and all these other great things, but— you know, when we have an inspirational mission, people are working on this for a bigger purpose. It's bigger than an individual person. It's bigger than the team. It's really, you know, the team coming together to solve something that is extraordinarily important to this group of people. So, I think, again, inspiration is important. I would say that when it comes to your product, it's equally important. And this is because when you're entering a market and you've got a customer set, you know, one of the important things about category creation is what's going to inspire someone who's to do something different, right? To spend money on something that they haven't spent money on. In the world that I operate in, a pharmaceutical company, selling to pharmaceutical companies, these are very risk-averse customers. They are, you know, developing these therapies, investing billions of dollars in it. And it's very, it's very hard to, to drive change in this ecosystem. The stakes are high. Patients' lives are a big part of the consideration, of course, the safety, the well-being, and then, of course, the investment that's made to develop the therapy. So it's very important that our product inspires our customers. It's painting a new view of the world around what could be different in the future. By leveraging technology to solve this problem in a new way. So I think one of the, you know, keys to our success at Medible, and again, we're still in the early innings, is that our product and our mission inspires our customers to take a risk, to do something different, and to really bet on a team that is driven and committed to bringing this new way of working to the world. So, you know, in addition to your team, I think inspiration is super critical to your product and to the way that you go to market, especially if you are creating a new category. Of course, you want your mission to be and your product vision to be directional. You know, ours again is to enable effective therapies to reach patients faster. So how do we define effective? How do we move the needle on faster? And this is where, you know, we start to hone in on the very specific aspects of our product in different phases that are going to bring, you know, this mission to life. We want this to be operational. So we're looking at, you know, what is done differently by doctors who use our technology, what is done differently by patients who use our technology, and what is done differently by drug developers as they're running clinical trials. How is our mission and our product and our product, ultimately our product vision, driving change for these people in really important and beneficial ways. So it really does come down to not just a pie-in-the-sky statement, but very clear operational directives around not only what will be done differently, but what those benefits are, and then tying that benefit to reality as quickly as possible. So, you know, what we have found at Medible, and I think You know, in a sense, we're, we're really doing something that, I mean, I think every company, it's something that's very hard to do, but we have created a new category of enterprise software in the pharmaceutical life sciences space. We have been involved now in over 300 clinical trials, and we've done this in about a 4-year time span since we really began to approach clinical trials with our product. And I do believe that a big part of what has enabled us to make this progress in an industry that hasn't had a new category of enterprise software in almost a decade, where, you know, our customers are not looking to do things in a different way unless, you know, there are real, real benefits to doing it, is that we really tie our product vision and our product back to our mission, and we make that very real for our customers. So when you start with your mission, I think, that's something people can really get behind. But how that translates to your product can be a much, much, much harder thing to solve, of course. And I think that, you know, product is equal parts science and technology and art. And ultimately it's about the value you're able to bring as quickly as possible that is directional with that mission. So where we, you know, have really begun to, I think, to see progress is when we were in the pandemic, There are clinical sites shut down all over the world, and the Medible platform is really a first of its type that enables remote participation in clinical trials. And so suddenly the world went from being like, yeah, this is a great idea. People should be able to participate even if they're not living in Palo Alto. But the stakes are high. The data that we collect has an incredible implicate— has an incredible set of implications. We're not ready to do this in a new way. But when the pandemic hit the world, clinical sites were shut down all over, everywhere, basically. And the pharmaceutical industry suddenly needed to adopt new technologies. They needed to say, how are we going to connect doctors and patients to continue clinical trials, some of which had been in flight for years, to continue this incredibly important research? And this is across all categories. The majority of our work is in oncology. So you can imagine it's not really an option to stop treatment for people who are in these oncology clinical trials. And in many clinical trials, you know, these are therapies that are being utilized because it's really the next best option for a patient who at this point doesn't have a better approved therapy for the treatment of their condition. So the pharmaceutical industry really had to make a change. And they looked to companies, really to Medevol, to connect patients and sites all over the world. Now, of course, it was amazing. We're like, wow, people are so excited and need our product. Um, I think, and, and really we, you know, wanted to prove our mission, but it was very early in the adoption curve. And, you know, we encountered incredible challenges. Our product had been developed on mobile and there were global supply chain issues around iPhones, iPads, and, you know, all mobile devices. So we suddenly had to look at our product and say, you know what, this, we have to transition everything over and have every capability available on web that we offer on mobile. And we had to be able to do that, you know, through our no-code needed platform. And there were major product hurdles that we had to really address and get over. In order to meet the opportunity to, you know, really enable our product vision. And what was interesting about that is, you know, nothing was impossible. We were working around the clock to do it, but that also then set the stage for the next phase of our product vision because suddenly now we had clinical sites all over the world using our product and they were connecting with patients in over 120 different languages and in over 60 countries. So of course, with the uptake and the capacity that was the demands that were on our product, we began to see, okay, where do we really go next? What's the next phase of value to facilitate our mission? And this is where we began to see a huge opportunity to get deeper into each therapeutic area. We learned that oncology was very different than vaccine trials, which are very different than dermatology trials, as you would guess, and that our product needed to not just have a broad set of capabilities, but we needed to be able to facilitate a very rich set of scientific capabilities in each of these therapeutic areas and be able to do that remotely in over 120 languages. So again, we're, you know, encountering this massive challenge in just even being able to ship product on an ongoing basis in this number of languages, in this number of geographies. But now what is so exciting that I can say is looking back, you know, for the last 2 years, we've worked with the Tufts Center for Drug Development, who is a group that is the foremost researchers in clinical development. And they looked at 2 years of our data, you know, when we're getting our product into hands of patients and sites, we're working with pharmaceutical companies in in all sorts of clinical trials, including COVID, oncology, dermatology, cardiovascular disease. And they looked at the 2 years of that data and they determined that there was a 13x return on investment or net present value for the use of our technology. And, you know, I believe that this is the first time that technology has shown such a big impact in clinical development. And when you look at where we are from a scientific perspective, there are— the science of therapeutics is at an all-time high. You know, you look at the mRNA vaccines, the immunotherapies. Science is offering so much to treat and cure human disease. But when you look at the number of drugs approved each year, it's only been 50 to 55 for the last decade. So what we can see is that Moore's Law has not been applied to clinical trials, that we're not seeing a big breakthrough in the number of drugs approved because of technology being able to lower the cost and time it takes to test and to prove the efficacy of therapies. In our work with the Tufts Center for Drug Development, I think we're seeing this first data point that actually is indicative of a Moore's Law-like trend. Showing the impact of technology in the development of new therapies, specifically in the clinical trial part of that process. And it was really through, you know, our initial mission—enable effective therapies to reach patients faster—understanding what our product needs to be at each phase of that, that then we determine what are those specific features and capabilities that then comes back to to the proof points that actually are showing we're making progress on our mission. And I can tell you that of all the things we've done, you know, whether it's a press release with a new customer or hiring an amazing executive or a new team member, the work we did with Tufts that is, you know, a very credible third party who's looking at the impact of our technology and the way that that validated what our product did in alignment with our mission, nothing has propelled our business as much as that. And that's why I am a huge believer that, you know, it really is, it's not just our products, it's not just our features, it's what is the impact to your mission and how we're able to prove that, learn from that, iterate on that, go bigger on that mission in the next phase that actually enables us to create new categories, enables us to do things that people thought were impossible, build companies that have products that, you know, I remember I was told once, you know, secretly, not secretly, but confidentially by someone over at a16z that no one in pharma will ever buy your product. And, you know, now we have 13 of the top 20 pharmaceutical companies in the world as our customers. And it's not to discredit them, but people thought this was impossible. Possible. But what we've been able to do every step of the way is actually prove that this mission is worth solving. Our product solves this and it makes progress on this mission. And as a result, you know, we're showing real progress in establishing a new category. So clearly, I'm, you know, very bullish on the idea that mission should shape your product vision. I think that this also is what establishes your product-market fit, which is, you know, how you really go deeper into what that mission looks like, the value it provides for your customers, the things they need today, the things they need tomorrow, and really establishing, you know, what is that shorter list of capabilities and how does that then track back to that mission. So in summary, um, you know, I think, The more you can really tie your product, your story around your product back to your mission, the more that you can have really tangible data and evidence around how it supports that, the progress that you're able to make. And ultimately, you know, the narrative you create around that, it will not only kind of serve you in your journey as an entrepreneur, because again, this is so hard. It will enable your team to really stay in the game and stay focused on that bigger purpose. And it will inspire your customers to help you create a new category. It will inspire customers, some of whom, you know, maybe haven't done something differently in a decade or more, but it will inspire them to do something new and to try something new. And ultimately, it will be what will facilitate your accomplishment if that ever actually happens, of your mission. Thank you guys. Are there questions? No. I don't know if we have time. Cool. If anyone wants to ask a question, I'm happy to answer. I don't know if I'm, like, going off script with— if the question and answer is a part of it or not. But it looked like there was a hand. Sure. [Speaker:AUDIENCE] How do you, once you write down the mission, how do you make sure that everybody knows the mission? [Speaker:JASON M. LEMKIN] Yeah. So it's a great question. I mean, and I think, like, when they survey most companies, most people in each company don't know the mission. So I think you really have to evangelize it. And, you know, I think one thing I've learned as a CEO, and I could still do much better every day, is it's that repetition is really important. And I think also bringing it back to the specific examples of, you know, what, what this really looks like in day-to-day life. But, you know, our mission to enable effective therapies to patients faster, to reach patients faster, it probably took us 2, 2 years to, to solidify that. And then once we got it, we put it into our onboarding, We have every all-hands. It's a part of every all-hands. And it's something that we always return to, even in our, the way we communicate with our investors. So it becomes a really common narrative and something people can really point to. I think it's something in our company we, now people are really aware of, but it takes a lot of deliberate kind of, you know, you wanna deliberately bring it into many of the important forums. And I think specifically into the employee onboarding. Cool. Any other questions? Awesome. Well, thank you guys. Enjoy Saastr.