I'm a Professional Beggar, Storyteller, and Fortune Teller

I've been a startup CEO for a few months now. I'm 23, I'm employing a few people for the first time in my life, and I'll be employing a lot more. Although Pristine still has a long ways to go, I don't foresee my job changing very much as the company grows. I spend the vast majority of my time:

1. Pitching investors (begging for money and telling the Pristine story)

2. Courting employees (telling the Pristine story)

3. Selling and marketing (begging for money and telling the Pristine story)

4. Predicting the future, and adjusting the ratio of the activities above accordingly (fortune telling)

Sometimes, I let it get to my head that Pristine has already changed the world. But we haven't, yet :). I've found that thinking of myself as a beggar, storyteller, and fortune teller is humbling since none of these descriptions is particularly flattering.

We already know we're going to need to raise a few million dollars by the end of the year. That means I will continue to beg for money, tell the Pristine story, and sell the Pristine dream: redefining care delivery models on Glass, starting with surgery. I'll continue begging for money through the end of the year.

We're going to be hiring a lot of talented people, and I've got to convince them to do something crazy with their lives. Since the best people are already employed, that means I have to convince people to quit their cushy jobs. I have to be one hell of a storyteller to do that.

I'm not going to lead the Pristine sales force, but I will probably lead the first few sales. More importantly, I will be the face of the company given my energy, enthusiasm, insanity, charisma, and presence on HIStalk. Blogging has been one of the best decisions I ever made in my life: it taught me how to write and tell stories far more effectively than ever before. I've learned more than I ever could have by simply writing down what I already knew. It's counter-intuitive, but profoundly true.

As CEO, my most important job is to predict the future, and plan accordingly. Of course, predicting the future is really hard. Most people who're paid quite handsomely to do predict the future fail. I don't get paid much, but I try to predict the future anyways. All of Pristine's stakeholders will suffer if I fail at predicting the future.

My anecdotal observations are that most tech startup CEOs spent their first days as founders coding. I would love to see some data on the subject. I'm certain that the ratio of founder-CEOs that code at healthcare tech startups is lower than at more traditional, pure tech startups. I never wrote one line of code for Pristine, and never will.

During my first year at VersaSuite, I hammered away at the keyboard faster, longer, and louder (yes, louder. People used to crack jokes about my typing volume) than everyone that I knew while head banging to Skrillex. Just about the only interruptions I allowed were demos. I recall some of the early demos that I gave at VersaSuite. I would delve into excruciating detail covering every detail of the electronic health record (EHR). I have particularly fond memories demoing the nuances of the electronic drawing system that I built. When you're aware of every detail, and when every detail matters, you inevitably talk about them. Unfortunately, the world doesn't care about every detail. I didn't learn that until at least 6 months after I stopped coding. After 6 months without directly manipulating the system with my own hands, I was finally able to appreciate the forest instead of the trees.

I spent almost every night of February pouring through Android tutorials on Code Academy, Code School, and TreeHouse preparing for Glass. I had no clue what I was going to do with Glass, but I assumed that I would need to learn Android so that I could build the initial product myself. I'm actually really glad I went through those tutorials and built some simple Android apps. At least now I have a rudimentary understanding of Android development, but more importantly, learning the foundation forced me to find a cofounder that was far more technically capable than I ever will be. In those couple of weeks, I learned enough to know what I didn't know. I forced myself to keep head up and try to predict the future instead of pull weeds out of the ground.

It's fun to look back on the past few months and reflect on what we've learned at Pristine. I'm not sure how startup founder-CEOs can code for more than the first month. Meetings take up an enormous amount of time, and CEOs have to take a lot of meetings. I'm extremely fortunate to have successfully recruited an incredible cofounder (Patrick), VP of Engineering (Mark), advisory board, and investors. Thank you to everyone who heard out the Pristine story.

Now all I have to do not to screw it all up is predict the future. Should be simple enough, right?

Answering the Existential Startup Question

I've been following the tech startup scene for years. I read so many funding and product launch announcements that I had been completely desensitized to the effort and energy that went into each one. I saw ridiculous valuations and hyper growth stories every day.

I had been contemplating my own startup since October of 2012. As I talked to people about getting started, I heard a central theme interwoven through everyone's comments: the hardest part of running a startup is getting people to give a shit. That means finding a cofounder, bringing aboard investors, hiring employees, and acquiring customers. No one wants to work with a loser. By definition as a startup you're a loser until proven otherwise.

Although Pristine faced the same problem, the time we spent in that phase of life was remarkably brief. I can't pinpoint exactly how long it was, but it was a length of time measured in days, not weeks or months. After refining the Pristine story over the course of telling it a few dozen times, my vision took shape. I thought the vision was crystal clear from day one, but the more I told the story, the more previously unconsidered variables I found. Each new variable contaminated the purity of the Pristine story. Luckily, with my background in healthcare IT, the water wasn't too toxic, and I was able to purify it pretty quickly.

The reactions to my last dozen orations of the Pristine story can be described in one word: superb. I've refined the pitch to a tee, the concept is beautiful, Glass is sexy and new, the concept of "Glass for surgery" (or healthcare) is potent, and most importantly, we have a broad range of pilot sites, doctors, advisors, investors, and employees substantiating a coherent dream. It's pretty difficult to coerce employee #3 when there're only two crazy idiots making outlandish proclamations about something buggy and weird. But when 20 people believe in unified vision, many of whom are smart, sophisticated, and talented in their own right, it's much easier to persuade person #21 to jump aboard.

Out of my own arrogance and naivety, I was never prepared to deal with the challenge of getting people to care that Pristine existed. Over the past few months, I've gone to dozens of developer meetings, co founder meetings, investor meetings, and hung around Capital Factory and TechRanch for hours on end. It was only after seeing hundreds of startups struggle to answer the question "Why should I give a shit that you exist?" did I realize that it's actually an extremely difficult question to answer.

I'm extremely blessed. I was lucky enough that I didn't have to do much to answer that question. Google did the vast majority of the work for me. "Glass for surgery" sells itself. I just happened to know a little bit about software engineering, the healthcare IT industry, had enough craziness in me, and I always had an infectious smile on my face.

For any startup folks reading this, please let me know what I can do to help you answer the existential startup question. I'd love to help in any way that I can.

The Pristine Story: Sprinting a Marathon

The past few weeks have been some of the wildest and most fun of our lives. Things are picking up, and they don't look like they're going to slow down anytime soon. The Glass app market will be a gold rush, and we're gold miners. By the way, we're looking for folks to sell us pickaxes and solve theauthentication problem that every enterprise Glass app must deal with. If you were looking for a free million dollar Glass idea, there you go. Pristine will be your first customer and partner.

A quick recap of the past few weeks:

1) We hired our first non-founding employee, and we're in the process of hiring two more full time engineers. These days I spend north of 50% of my time recruiting so that Patrick and the engineering team can continue to make the magic happen all day everyday. We're looking for crazy. If you know any crazy engineers, we're hiring. Folks can apply here.

2) I also listed a job posting on the HIStalk jobs boards for Director of Sales and Business Development. I know that finding an exceptional sales-director will take a couple of months. I'm excited to play poker with lots of these folks over the coming months before placing a bet.

3) I presented at the MedCity Converge Conference in Philadelphia and CouchSurfed for the first time ever. It was awesome. I met a host of talented and connected individuals, partners, and my only non-anonymous HIStalk colleague, Dr. Travis Good, for the first time. Also, I need send out a huge thank you to Chris Seper and Veronica Combs from MedCity Media for organizing the event and inviting Pristine. Thanks Chris and Veronica!

4) I went to LA, and signed one of the most desirable pilot sites ever. They jokingly asked to start piloting the very next day. Even the IT team was excited. It was amazing to witness an IT team drive a bleeding edge, non-government mandated project. They're even more excited about Glass's potential in the OR than we are, if that's even possible.

5) Patrick and I went to Phoenix to speak with another super-incredible pilot site. We're working through the paperwork now. I really can't express how qualified these two organizations are to pilot our software. They are some of the best conceivable organizations that could possibly pilot Pristine's software and services. Monday July 15th (LA) and Wednesday July 17th (Phoenix) were quite possibly the best days of our lives, though they may not be for very long as things pick up :).

6) We raised an additional $100k in funding from a number of angels, bringing our committed total to $200k, and we've found an angel that wants to close the rest of the round ASAP. The dollars are flowing! It's not too late to invest though. If you or anyone that you know would like to invest, please reach out offline and I can walk you through our investor package.

7) The media has been nothing but supportive. I've done video interviews for a handful of media outlets, and folks have been writing about us on almost a daily basis for weeks, especially the MedCity folks during the Converge conference. Additionally, I'd like to give a special shout out to Dr. Charles Webster, blogger and tweeter extraordinaire, for running a 10-part series on Pristine. Thanks Chuck!

Looking forward, we have some exciting stuff in the pipeline:

I'm going to San Fransisco July 25th - 29th to meet with a host of angels, VCs, partners, and for a family wedding. Then I'm going to NYC July 30th - Aug 5 for more angel and VC meetings. I also won free tickets to SXSW V2V in Vegas through an online video contest (Thanks to John Lynn from The Healthcare Scene for posting the contest!). I'll be there August 11 - 14 selling the vision of Glass in healthcare. If there's one thing that I've learned over my first few months as an entrepreneur, it's that you never know who the other guy is: throw yourself out there and you'll find a soft landing, and always smile. I'll make it back to Austin from Vegas just in time to give a major live presentation on Glass use cases and usability, development, monetization, and Glass app markets back in Austin on August 14th.

We're still on track to start our first pilots in August. The engineering team is working frantically to make sure we hit our deadlines. Everyday we think of new use cases for our apps. We can't wait to find out to what users make of them on site in a live environment.

We're lining up some national-scale media as we approach the Glass launch at the end of the year. We can't talk about which media outlets we're working with just yet, but I can promise that it will be big-time. Glass is THE hot exciting new thing of 2013, and we'll be doing everything we can to fuel the hype and ride it out. Glass will change not only surgery, but entire care delivery models, and we want to educate the public on how Glass will change the world.

And of course, I'm still blogging as actively as ever. Tim, Travis, and I at HIStalk decided to can three posts I'd written in the past month. I've been pushing myself with writing and trying some interesting new things, and sometimes it just doesn't work out, but that's ok. I'm actually proud of this because I learn more from the "no's" than from the "yes's." Over the past few weeks, I've written extensively about app development and monetization on Glass. I think at this point, I can safely say I've written more about Glass than anyone on the Internet :)

HIStalk

HIStalk Interviews Andrew Farquharson, Founding Principal, VentureHealth (I'm conducting and editing the interviews)

HIStalkConnect Interviews Gregory Jacobson, MD, Founder, CEO, Kai Nexus

Passwords be Gone!

How Does One Herd a Few Hundred Thousand Sheep?

The Pristine Blog

The Enterprise Glass App Gold Rush

The Challenge of Developing Engaging Consumer Apps on Glass

The Challenge of Developing Contextual Consumer Apps on Glass

The Price of Glass

The Cost of Wearing Glass 

My Blog

The Marginal Value of Google Glass, Continued

The Enterprise Glass App Gold Rush

This post was originally featured on The Pristine Blog. 

I'd like to posit that the enterprise Glass app market is going to be a gold rush. Many folks disagree. They argue that Glass volumes will be low, at best a few percent of smartphones, and that there can't be a gold rush with such low volumes. The first assertion is accurate, but the second isn't. Interestingly, most of my remarks and bearishness about Glass as a consumer product would seem to contradict the notion of a gold rush as well.

The slide above is taken from the Pristine investor deck. The thesis of the slide is that 92% of Fortune 500 companies were using iPads within 18 months of launch, and that Glass adoption will be even faster. The iPad saw incredible adoption despite the fact that: developers tools and communities weren't that mature at launch, existing enterprise IT infrastructure wasn't very cross-platform or Android friendly, and that the launch hype of the iPad, although significant, was less than what we're seeing out of Google with Glass. In hype terms, Glass will be the largest consumer electronics launch of all time (iPhone 5 wins in dollar terms). It will be a spectacular show for the ages. I can't wait :).

So how does the above translate into a gold rush? Well, we know that enterprises adopted iPads quickly for their employees in the field, and all indications are that they'll adopt Glass even more quickly, especially at a sub-$400 price point. Glass will make a lot of employees better at their jobs, and employers would be stupid not to adopt a technology that can solve problems that are pervasive 8 or 10 hours / employee / day. Glass is the ideal device for individuals who are running around all day, using their hands, and accessioning and sharing information. Healthcare is indubitably the largest vertical for Glass, but there're many others.

The Explorer Program is giving developers, including my company, Pristine, a 6 month window to develop and test their apps before Glass's launch this holiday season. By the time Glass is commercially available, most of the obvious, high-value add enterprise apps will be tested and ready to roll out at.

Let the races begin.

Passwords be Gone!

This post was originally featured on HIStalk. 

One of the least-talked about aspects of Google Glass is the proximity sensor. It’s extremely powerful and will change healthcare workflows.

Glass knows when the user takes the device on and off, meaning that the user has to authenticate only once per wear. Contrast once per wear with traditional computing platforms that require users to type in 2-3 passwords to unlock the device and access the EHR. Every clinical professional I know types their password in at least 30 times per day. On Glass, they will log in once per day, or perhaps twice if they decide to take Glass off for lunch.

Of course this begs the question — how does one type in a password on Glass? Glass doesn’t exactly provide the most robust input options. People won’t type passwords at all. A lot of Glass security developers are experimenting with asking users to take a picture of an instantly-generated QR code on the user’s phone. They are modeling this authentication mechanism after how users configure Glass to join Wi-Fi networks.

This is silly and overcomplicated. Why not just ask the user to repeat a programmatically generated sentence (one that couldn’t have been pre-recorded), and cross reference the user’s voice? Children’s diaries have implemented primitive forms of this technology for over a decade. Much more robust voice-authentication libraries exist. I’m sure developers such as Silica Labs are building voice-driven authentication solutions that other Glass startups can implement. This is a significant problem with an obvious solution that every Glass app must deal with. That screams that the function should be outsourced and licensed. Sell pickaxes during a gold rush.

The power of authentication isn’t limited to Glass itself. Once a user is logged in, Glass can authenticate other devices on behalf of the user via Bluetooth. That means that an authenticated user on Glass could auto-authenticate against any other service on any other platform. Glass — the most secure, personal, and intimate computer — would become the authentication tool for the all other computers. That simple use alone is a compelling enough reason for hospitals to purchase Glass units for every employee.

There are lots of companies selling proprietary, single sign-on authentication hardware mechanisms, but they will be just as expensive, if not more so, than Glass. Glass will be cheaper than almost everyone expects. Coupled with Glass apps that deliver real clinical operational value, Glass will streamline virtually every human-computer interaction in healthcare.

It’s a good time to be a healthcare Glass startup. There are incredible opportunities for Glass. The iPhone App Store just hit its fifth birthday, and at least 75 percent of doctors are using smartphones at the point of care. Glass will change healthcare in ways that we can’t even think of yet.

Healthcare Glass startups, make yourselves known. Join Stained Glass Labs, list yourself with theGoogle Glass tag on AngelList, and engage with the healthcare Glass startup community.