Spicy takes on Digital Health Communities

Chris : 

Hello digital health community, I'm so excited for our guest today, Rohan Siddhanti. Rohan is currently VP of partnerships at Healthie and navigated there through his own career and healthcare startups and health systems, world class training at places like Wharton, and even other areas than digital health, like digital strategy for the White House. But today, he's going to be wearing his other hat, which is a healthcare community builder, evangelist and thought leader, Rohan leads pepper and NYC’s spiciest healthcare services community with over 500 founders, investors and operators meeting monthly. And our topic today is spicy too, a thesis that digital health is becoming a bottom up community driven industry for innovation and community is the new currency that you should be thinking about, and collecting. Rohan. Welcome to the pod please tell us a little bit more about yourself and anything you're currently working on.

Rohan:

Amazing, Chris, thank you for having me. I just want to tell you that I'm always the groomsman, never the groom, in the sense where I do the interviews, I launched my own podcast in business school, I always moderate the panels. But I'm hardly ever the guest. So thank you for this my first time. So thank you for this. Yeah, why don't I just get like a 30 second background on myself and just cut me off if you think in a different direction. But I've basically been in digital health since it was health, so my whole career. So let's call that 10 years, started out building health insurance exchanges for states. So writing the rules, implementing systems that built these exchanges, I moved to a healthcare data startup called Mana Health, which was a waiter competitor to redox back in the day, right, and mana got bought by Comcast. That was Comcast Ventures. So I found myself going to business school and consulting to kind of just level up and brand myself. And then towards the end of my two years in consulting, I knew I wanted to jump back into industry, and kind of, I tweeted my way into realizing I was a BD and partnerships guy. So we can talk about kind of how to find your voice and whatnot if we find time on this podcast, But I found myself wanting to be in that sales BD partnerships role. So I went to Bright Health for a year and changed, that was a wild ride. Glad I was there. But it definitely didn't go the way all of us probably thought it would .I try to start my own company for a bit. And then now I'm at Healthie, an API first EMR company recently raised a series of elite partnerships there. And then we'll talk about pepper, we'll get into that. But I launched pepper a year ago and recently paid community support a few months ago.

Chris:

Awesome. Yeah. And I do want to focus on that kind of parallel journey you've had on community building. But as we dive into why community may be the new currency, how about first stop? What is a digital health community? And can you share the evolution of digital health communities, what existed in and what didn't?

Rohan:

I would love to, so first of all, it's a very squishy term. And increasingly, it's going to be a very abused term, meaning everyone's going to say they're running a community. I think if you put some kind of soft ground rules around it, a community is an organization that exists solely for the purpose of the members, social interaction, learning, and go to market, rather than simply for one single company to profit and make money. So it's kind of like it exists for the collective of the members. But that can take many forms. So just to rewind the clock for a second, I didn't invent communities, like none of us today are the pioneers. The pioneers of communities were folks, patients and doctors who from the 70s and 80s started banding together around particular topics, to galvanize that interest. So be it like HIV and AIDS, or moms who wanted to not just go to have to go to a pediatrician and can make a decision, you know, health care decision for their family. That was the 70s and 80s. The 90s, we saw the rise of patient groups and provider groups. So the 90s with the internet, we saw the ability for patients to find other patients like themselves. So communities were basically listservs and forums. Okay, news groups. Yep. Right. And then it was really the 2000s where you started to see online organizing become a pillar in healthcare. So people like Matthew Holt, healthcare 2.0 and the various other and disruptive various other groups that that came up that is when you started to see people communicate and form social bonds and weren't just work. Then the evolution of accelerator culture, and really the heyday of digital health in the 2010s, all the way up to COVID. And now what I call, you know, the new community, we can go into what that is, but it's much more slack based. It's much more geography based. It's much tighter in scope, doesn't have to do with conferences, we can describe my community and others, but that's kind of the evolution of it. Healthcare has always relied on communities for its evolution.

Chris:

Right. I mean, maybe let's talk a little bit about the emergence of these new communities. Really post COVID?  And, you know, just the whole concept of community evolving, and everyone being, at first, forced to be on Slack and remote and meeting each other. And now how it's evolved into in person being an option and some of those opportunities that affords

Rohan:

Yeah, I want to take a step back, this is really a healthcare phenomenon, as much as it's a societal phenomenon. So we just just rewinding the clock, you know, when I talked about online organizing in the 2000s. That's also how Barack Obama got elected. Right. That was what he was famous for was galvanizing communities using the internet. So, to think about it in today's terms, COVID made us all much more intentional about where we apply our time, and how, and if we're going to step outside of the house, it better be for a good reason. Right? Admittedly, sorry, but it's still that way. Right? So communities are the evolution of that. You start to realize that these societal factors of massive loneliness, intentional intentionality, when it comes to stepping outside of your house, and the need for a kind of purposeful interaction, those three are all massive kinds of societal trends that intersect for people professionally. Right. So think about those, when I talk about how we birth these new communities, these new digital health communities came about mostly, mostly because they started from listservs. So people had these giant listservs, right, or sub stacks that they had pushed over time, they got very popular during COVID. And then the Slack community was born. So free, frictionless and easy to pop into one of these slack communities. Right. And it became a way to instantly connect with people you need. The evolution of the Slack community is the in person community and the hybrid community, largely geography based, we can talk through examples. That is kind of an evolution, where it's going to keep going is the hybrid model, which no one has really perfected yet, as well as the spread across geographies.

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Chris:

Yeah, yeah. So you're talking about these different flavors of communities, and we're talking about digital health, some online, some in person, and now these new hybrid models, but you also talk in terms of evolution, and in a certain sense, in person opens up these new dynamics where kind of more of the magic can happen? What are the advantages of those types of in person activities? I mean, you know, hybrid or, or just in person that you don't get online.

Rohan:

Yeah, I mean, and this,this doesn't have to do with digital health, specifically, but people still crave human interaction. And these people want to make some friends. And like, that is, that is, I think, the deeper motivation here than like, oh, I want to make connections or network, it's like, people want to meet fun people. And when they step outside of their house, they're measuring the ROI mentally, on getting ready and leaving the house and having to do all that go through the anxiety of walking into a bar where, you know, nobody, there's a high hurdle rate for leaving your home. So that in person interaction becomes worth it when you know you're going to meet fun people. Oftentimes, they're roughly your age, that are in your industry and that can understand your daily life. And when you do that online, the tools and kind of the culture of internet culture in the US is still fairly transactional, when it's online. So even the slack communities when you directly message someone it's for, it's for a purpose. Right? Slack communities are evolving now to try to make more organic connections, but it's still very transactional. When you meet in person, you're opening the door for serendipity. And that and that serendipity for not just connections and networking, but like serendipity for fun, is what people want to allow into their lives and they're willing to, for twice a month, go roll the dice on that serendipity

Chris:

Right absolutely, yeah, let's dive in and add a little color to some of these digital health communities that exist today. So they're their scenes and some cities like New York and San Francisco. Others, maybe both online and offline examples. Would love to hear about some that you know about or find interesting.

Rohan:

Yeah. 100%. Before I go into that, Chris, can I actually fight and ask you? Are you a part of any communities yourself? Like, have you been or even in their past? Healthcare?

Chris:

Yeah, no, absolutely. I've been a part of communities for health care, right. We're running the digital health community podcast. So it's a mini community that we've created amongst founders and investors that, of course, we interview but we do a little bit of the, you know, continuing engagement, for example, around newsletters, and when we're all going to show up at the same place at the same time, for example, a health conference, or maybe h

ymns probably not, or a vibe that makes sure we all know we get to meet in person too. Yeah, in my past, definitely for different education related communities, which was my first stomping ground as an entrepreneur. And now, yeah, a lot of online communities and kind of split between email slack and discord.

Rohan:

Yeah. Okay. Awesome. Yeah, you've got to get and, and these days, like most people, whether it was through choice or not, kind of end up being in some kind of community, Frankly, like your biggest group threat text read is your smallest community. Right? Everybody's a part of right. Okay, cool. So I think just to set the stage, I think your question was, what are some examples of these communities? Let's dive in. The first thing I just had to either say before I go in to break this down, is that I have an extremely coastal view of what community means. Not just because I'm like a classic northeast DC guy. One, my entire network is basically the two ghosts virally lacking in my experience.

Chris:

Go ahead. No, no, no, exactly. No, I mean, yeah, you're stomping grounds or you're stomping ground?

Rohan:

Yeah. Yeah, there's so many healthcare powerhouse cities and locations that are not too close to the coast. So anyway, I just wanna bring that up. Sure. So I think yeah, they take a few different forms of these communities, but you can primarily bifurcate into online and in person, as the channel. And then you can then you can bifurcate it on another axis as sort of like, part time slash hobbyist or full time scale. So here are four quadrants, right. So an online person, full time or hobby, okay. And you're seeing sort of a lot of emergence in the part time hobbyist, and especially the online bucket. So for example, there's Health Tech founders, which is run by Maitreyee Joshi, which is a free Slack community, that she just has structuring the channels, but she kind of just let it run itself. Right. And there's hundreds of people in that community. Same with health care PMS run by some folks on the West Coast, three part time hobby. The other other bucket is full time, mostly online. So you have HTN, Health Tech Nerds as the most famous, I mean, there's more than 3000 people in there, Nick Hillke, out of pocket job, that's fun, where you have to apply to get in. But that's Nick Hill’s full time job, Kevin's full time job and they manage these communities as they make revenue. That's how they put bread on the table. Right, right. Then, moving over here, you have the full time, but also in person communities. That is sort of an empty bucket right now that's basically conferences, but I wouldn't call conferences, communities. So that's sort of an empty bucket. And then the last quadrant is these part time, but in person communities, I would put myself with Pepper, Harry Goldberg with health tech hanging in San Francisco, Gus Roman with Health Tech Homies, which is across many cities. And by the way, I put out a tweet thread yesterday in a podcast where I list all of these communities, and how do you so we can send that to your readership?

Chris:

And we'll put in the show notes for sure. Cool.

Rohan:

So I kind of made those quadrants for you. So you can get a sense of how things are evolving. Those types of communities exist in all the cities like San Francisco, New York, Austin, etc. But so let me pause there any questions on that? I want I am yeah,

Chris:

yeah. No, I would love to know how some of these communities are structured. Yeah. So for example, let's just take pepper, you guys meet in general monthly. And these are 500 people that could be, you know, different motivation. So the entrepreneurs or the investors or the operators that are running innovations, what do you guys talk about? Or how do you decide what you do when you get there?

Rohan:

Yeah. So let me just sort of answer that question by telling you that communities don't scale. Okay. They simply do not scale. And what I mean by that is, in order to actually provide deep value for your community it needs to be very focused on what the value prop is and why they're showing. So I'm, I'm painting this picture to answer your question, because when you do meetups, you need to give people a clearer understanding of the value they're going to get when they show up. Right. So for pepper, we do different types of meetups so that people understand the ROI before they leave their house. Okay. The general Meetup is the once a month open invite at a bar. That's really just like fun and serendipity. Oh, that I Rohan, the founder of Pepper have pre selected the group and there's a high chance of you meeting like good, smart, fun people there. So let's just roll the dice and go have some fun, right? That's why most people show up. A separate type of Meetup is founder only. So it's founder only it's pretty obvious you're sharing tips on how to keep your company alive and raise money. Right? Sometimes I bring VCs there, sometimes I don't. Right. Then there's small group dinners, where around a very particular topic, people know it beforehand, they sign up beforehand. And the host facilitates a group discussion for that dinner. So those are the kinds of three primary types they do, right? The discussion center, excuse me, center around the value prop for why you're there? Does that all make sense?

Chris:

Yeah, no, it does make sense. And, yeah, I'm curious how to contrast that or our audience with an online community. So that is very structured, and kind of topic based and mission centric. So people know what they're getting into if they're going to leave the house, and congregate. And maybe contrast that with either like a health tech founders, or a health care PMS, where you mentioned, yeah, there's a little bit of structure in terms of the channels, but really, the value is going to be spontaneous and organic, depending on the conversation threads.

Rohan:

Yes. So let me walk through what I see as the three layers online. There's the top layer, which is kind of a hobby, a hobbyist community, meaning it's a side hustle. And it's online. So that would be some of the ones I mentioned, like health tech founders, or all they do is set up channels, and your talk channel. Pretty simple. There's very little management there. Okay, that's level one. So peep the meaning the bar isn't very high to meet your members expectations. Got it. It's free as well. Level two in the online community is HTA. So while there are 1000s of members, they have a lot of channels and micro channels. They do some programming and content. They have tools to facilitate one on one matching within the community around either serendipity or specific topics. Okay, so that's kind of level two. Level three, which is Nick Hills out of pocket, is purposely kept at a smaller size. He has structured content that he releases in a cohort based fashion, and he has homework. Okay, you have to actually participate in order to spy. Okay, that's level three. And Nikhil will probably admit this, it doesn't scale, nor does he want it to scale to 1000s level, which is heaven. And Health Tech Nerds is at 1000s. But because it's sort of this middle ground of value, Prop, and level one is like, well, I don't care if I have 30 in my slack group, Slack group, or 3000. I'm not moderating or managing this. So here are the channels, just go ahead and go for it. Right. So those are kind of the three you need to find your flavor that fits for you.

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Chris:

Right, right. And so with that tier three of an online community, for example, you have homework and everyone's going to do it and contribute. That's more like the small focus topic based dinner. Yeah,  you coordinate with pepper.

Rohan:

Yeah, no, you're tying together well. The thing is that I'm glad we're breaking down the tie. Each year, like, we just take one step back and not know how people want to join these communities. So there's a whole cohort of people roughly between 22 and 36, who are each in like four to eight slack communities and like to discord, and they're sick of it. Yeah. And so whether it's healthcare related or your friends or your group chat, you have so many WhatsApp groups and all this stuff going on. You're sick of another slack group, another sub stack, right? Yep. So for that reason, this isn't just about which medium is right for you. It's which medium Are you not tired of and actually excited to participate and engage. And this is sort of why pepper has had any success at all. Okay, pepper only really succeeded, because of the desperate craving people have for in person interaction that's meaningful. But also because of the backlash against the rise of these plethora of online communities. Right, online communities became a bit dime a dozen, there's this every Tom, Dick and Harry can launch a slacker. But a few of them are meaningful, and are managed. But very few people have the kind of gumption to keep doing meetups. And there's a consistency and level of effort required for in person, it's hard to man. And so the bar is low. And that's another reason why pepper is able to succeed. But it's really because it's a backlash against this, the online movement. And as more and more of our life moves online, we want the ability to be in a group that we can meet in person and care about those people. Like, we need a new religion, you know, in a way, we need to show up every month to something that we care about. And it's not true. And it's not right for most Americans. So I'm not I'm not equating religion through religion, what I'm trying to say is, we need groups in person that tie us to a feeling that we matter and that we're part of something bigger than us. Communities, is that in person communities kind of that response.

Chris:

Yeah, that makes a lot of sense. And I think something else you touched upon, is, of course, there's different sizes of meetups too. And then, you know, I think even if you think about content, as there is so much content out there, what really started to matter was curation, right? So someone saying, Hey, this is the thing that you should find valuable, and then you become a trusted influencer, right? That, oh, this person usually finds valuable things, instead of going through the list of 1000, I'm gonna go go to that person for this curated, crafted experience. And it sounds like these online communities, and these in person communities like pepper, I kind of have that same spectrum. So with pepper, you're very much crafting the different events or dinner tables, to make sure that you provide value and people have come to trust you to do that. And in the case of these online communities, yeah, there's the free for all, but people are getting a little tired of it, because they have to find their own value in this sea of community versus something that's very structured, and hey, you want to move something forward? You know, here's the vehicle to do it. And so I'll crack on it together.

Rohan:

You got it. I think another thing we need to remember is that millennials and Gen Z, millennials, especially are starting to come into positions of power in healthcare, and Gen Z are starting to become like the analyst level person in healthcare. Right? So let's say Millennials extend up to like age 40. Right? So those like us, we're a pretty significant part of the workforce now. So why I'm bringing this up, because each of these cohorts likes to interact with their professional groups interface. I think most Gen Z would prefer a direct online path to first like meeting people. Like it's comfortable for them, because they can look at your LinkedIn profile. They can see what you've commented on in the past. And they can like to go to your LinkedIn and they can analyze, like, should I reach out to this person and they feel comfortable? Right, right. But a lot of millennials are like, there's still plenty of millennials that are like they meet you. And then they say, Let's get coffee. Where's your business card? That's still pretty common. Right? So giving people different avenues that make them comfortable to engage is increasingly kind of becoming the master engagement mechanism. Right, right. And so communities will keep springing up, but people will self select into the ones that fit their engagement style. So pepper, just give an example. Like I always branded it as pepper because it's based on spicy hot takes. So it's like, I purposely didn't have the word health in it. It's hard to find. I've never tweeted about it. I never sent any caps I had tweeted, I've never, you know, sent any calendar invites or tried to push it out, because I want people that are self-selected really want to show up. I've self selected for that type of person in the community, you see what I mean? So you, you kind of need to send out a certain signal value to attract the right membership.

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Chris:

That makes a lot of sense. Yeah, and I'm just wondering, and then there's this other scale of massive online community that evolved during COVID, but not necessarily within healthcare, but that actually moved markets. So for example, like these Reddit, Wall Street bet communities or the crypto communities that literally all would get behind something like, let's say GameStop. And, you know, kind of changed the world. But I'm just kind of curious, is there anything that could be analogous in healthcare? Or is it just that the average person is so not empowered in healthcare to make that difference at a mass scale?

Rohan:

Yeah, I don't think I love where you're going with this. I don't think it'll happen with respect to markets. I think it'll happen with respect to rights. Okay. Well, you know, things like Roe v. Wade, and getting women access to certain things. Of course, they need that, like, there will be communities that spring up to support those issues, right. The other community that will spring up, where you'll see online activism translate to offline action will be for local or regional specific legislation. For example, the one of the largest unions in the country of the SEIU is called 32. BJ mas, it's sort of like think of it like the doorman union, okay, extremely powerful, super smart, health savvy, healthcare savvy leadership, they dropped one of the largest hospitals in New York City from their network, because they did the analysis. And they're like, We got to drop them right there. Jay is pushing for certain legislation and price transparency in New York City. They're dropping Twitter ads, they're galvanizing the community to write into their senators, and March and you know, organize and all kinds of things. That's where you're seeing the activism play out. I think there won't, I don't think there'll be a corporate level, kind of Wall Street pets ex esque activism for a while. But I do have other theses on how communities will evolve. I'd love to get to that in a second. You want to cut into it really quickly, just like? What makes communities valuable for different people just doing that differently?

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Chris:

I mean, let's Why don't we dive into startups or healthcare innovators. And you've talked a whole lot about the different types of communities and we've broken that down. But normally, startups are focused on just a few things. One is accumulating proof that their idea has value, the other is achieving viability, if they've gotten that far. And then the third is raising money. Now, our thesis today is that community is the new currency. So why would community be so important to healthcare startups or innovators? 

Rohan:

Yeah, I agree with the value prop, you said, I want to add one more, which is learning. I get one founder healthcare, because of its complexity and the institutional way of chain. So for founders and operators in healthcare startups, if they can go happier and have one conversation, where they learn about a hard problem they've been trying to solve, that is 10x faster, and makes them feel more confident than anything they would learn on the internet. Right? It's even better if they learn that they learn the same thing from the same person in person versus awful online, they will trust you in person interaction more, right? Because they can go back to that person, that relationship with them. Right. So I'll tell you about how I've built what I think I built value for founders and operators at startups. First thing they need is access to capital. So what I have is a spreadsheet, an air table where you can see all the other folks in the community including 75 fees, and you can request a double opt in intro to any VC in there. And you got it, you know, not just there. You can see what stage they like to invest in as well. All right, if they haven't, that's capital. The next one is hiring. So I don't do a great job of this, but HTN and Nikhil do where they have job boards, so they continuously surface talent that startups can pull from right. The next one is to go to the market. So putting your startups in a position where they can land partnerships or land just customers. Right? Right. And this is sort of where communities are going now. So communities are now going to start partnering with old school healthcare in order to partner the innovative startup with the true buyers, which is the payers in the hospital systems. So let's get to that. But that's where I think communities are headed. Those are kind of the main value props. The other one is just like, ideas, learnings, meeting your co founder, like I've, we've several stories of people that have met co founders or first employees within their communities. And then the last thing I just had to bring up is, like, startups anything like before Series B, is just such a grind. And so silly, not just for the founders, everyone who works there, just grinding every day, right? Yep. And to be able to go somewhere where, you know, most of the other people in that room know, the grinders. Yeah, they know, they're, like, know, how you

feel accepted. And just like, at home and comfortable. It is a very hard feeling to come by. And you don't get that online. Right. So that's the other thing. I tried to create an environment where everyone just kind of like, puts their shoulders down and can chill. Right. So yeah, does that kind of answer your question? Like the main value props for startups?

Chris:

Yeah. And I think it absolutely does. And you've talked about this evolution and go to market. How is that evolving? Because I would say if the number one challenge startups we work with have is fundraising to close. Number two, is how in the world do I get to my first n number of customers? Yeah, and we are in this age of consumer driven adoption, zero CAC, distribution partnerships, if these are necessary now, to get off the ground? Are our communities and partnerships really the new distribution? And how are they tied together?

Rohan:

Yeah, yeah. So what I would say is, right now, digital health communities are helping with go to market for companies who sell to other digital health companies. So basically, companies who sell intra-industry, for example. You know, I like healthy, Healthie sells on EMR platform. And digital health startups are some of their biggest customers, right? So communities help companies like healthy because they give you access to that digital health customer base. So in that first regard, digital health selling to itself, communities are doing quite well. They facilitate introductions, HTN has this like a vendor table where you can give a percent off and that to the whole community, they kind of facilitate digital health buying digital health. That's today, where we're gonna go is we're going to start to see payers, major VC arms, with LPs, hospital systems and regional kind of community systems start to partner with these kind of regional innovative, because they all do the top ultimately controls the purse, and the bottom ultimately controls the innovation. Right? So I don't have an example of this yet. I'm gonna give you kind of one or two that are light examples. But I don't have a strong line where a hospital has just pulled in from pepper and said, I'm buying that. Right. But let me give you two examples to kind of tell you how things are moving. There's a massive community, it's an order. It's a full time business. So it's, you know, it's a hybrid in person and online, full time business called Medical Alley. And you got to look up, Frank, Jay, out there shout out to Frank at Medical Alley, what Medical Alley does is they think of their sort of LPs. And I put that in quotes, as are all these healthcare institutions that exist in Minneapolis. Okay. Think of that as their sort of LPs, if you will write in quotes, and think of their users as all the startups, vendors, customers and stakeholders on the on the ground ecosystem. And what medical ally does and what Frank does every single day, is essentially connected to Okay, he goes to these big corporations, and he says, What are your healthcare needs? How do we solve them? And he connects them to that on the ground innovation that's happening, whether it's investment, whether it's pilots, whether it's partnerships, whether it's customer sales, that's literally what medical elite does, and they do 1000s of these intros meetings a year. Right. They are the only community that I know that has really nailed this and has scaled to three. That's just impressive, right? So let me pause There any kind of questions about how that works? 

Chris:

Yeah, no, I think there's something implicit in what you're talking around. And what Frank does is that it's almost become necessary to surface above the crowd as far as healthcare startups or health systems bear, because of all of this history of them getting pitched by each and every startup. So it comes back to curation and relationships. If you could expand upon that.

Rohan:

Yes, I agree with you. It does come back to curation relationships, it comes back to having the tech stack support, what each person needs. So figuring out things like, what is your corporation's needs, buying ability, what areas of focus to care about diabetes, MSK, and then kind of startups there. By the way, it's not just Medical Alley in Minnesota. In Minneapolis, there's another venture fund called bread and butter ventures, friendly with a partner Mary grove. This is literally their model: their actual lps on fortune 500 corporations invest in startups where they can bring those and then healthcare is one of their focus areas and bring them to the company. Right. I'll give you one more example closer to home. Bunny Ellen, who is arguably the like, oh gee of Digital Health in New York City. I don't think anyone comes close to her. She has been a pillar of the community for 15 years now. She now runs an organization rebranded as DH, NY digital health New York. Okay. It has in it it sort of like a very souped up pepper. It has it in it. Many of the buyers and participants from not just large digital health startups, but payers and hospital systems in the area as well. She is actually bringing together a lot. So meetups have all the stakeholders, mine is just startups, VCs operators, hers also has buyers and sellers in the same room. Hospital exact digital health execs in the same room. So that's another example of how someone is kind of bridging that gap today.

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Chris:

Yeah, no, absolutely. And I mean, anyone familiar with going to the big? Any industry conference, right? What are the models connecting buyers and sellers? And it sounds like now that's becoming more consistent and regional, and probably topics specific in some of these communities that are built for that.

Rohan:

Yeah. And I think the other thing you have to remember is when you walk into one of these meetups, and you're like, you're an actual functioning member, like, you know what the meetup is, you know, who started it, whatever. You walk in with a fairly high trust factor. And that also you cannot get on the internet. So there's kind of a high trust and low trust environment, right? When you walk in, I'm not saying everyone in Pepper trusts everyone, you know, completely, but you kind of walk in with this belief that like, people, there are good people, they're not there to screw you. And they're probably interesting and have something to offer you. You don't think that's a high trust scenario in your life, there are very few rooms you walk into that are high trust, definitely not any conference, right? I mean, that's super low trust, right. So the ability for these communities to add value, relies on the high trust environment, and then relies on the curation of the people, and then relies on the matching ability of the technology platform or the founder of the community. And if we can escape, the way you're gonna hit escape velocity is when that matching ability, and that high trust environment isn't reliant on the founder of the community is reliant more on the brand. So when the brand can stand alone, outside of the founder of that community, as I believe HTN has done and Nick Hill is starting to do, okay, then we will start to see kind of the true evolution where we'll be able to connect with buyers, were a hospital system. What's your li J like? Large, hot, I'm making this up, right. A large hospital system in New York will say, I want to partner with Pepper, because I trust the brand. Like, it's hard to even conceptualize that right now. But that's where we're going. Because that's, that is sort of the natural way that I think innovation will start to occur.

Chris:

Right, got it. And now there's some I don't know, you could call them community based organizations that have been trying to establish their brands in particular for healthcare innovation, but that could be the health of any healthcare project coming out of Y Combinator or redesign. I'm curious Yeah, how you delineate , you know between communities as we've been talking about them, and their communities as incubators and accelerators

Rohan:

Yeah, are saying it's easy to lineage open versus closed. Okay. I'm a huge fan of redesign. I have friends there, I've worked with them in the past like big fans, okay. But their leadership would tell you, they're kind of, they're kind of a closed system. Okay, so here's what I mean by that. redesign and similar type, you know, like, let's say, incubators, accelerators, they have their LPs and their clients, okay, then they have their workforce. And then they have this talent pool that they pull from to create these companies. That's sort of their full vertical pipeline, right? Rock Health, I would say, is fairly similar, but I don't know rock as well. What they do is, if you get pulled into sort of a walled garden, then yes, you're in the community. Meaning if you get pulled in and recruited as an advisor, an investor and LP or management team of one of these companies you're in, and you then can attend, they probably have internal happy hours and dinners. But it is within that walled garden, the vertical is contained. There is no page where you can apply to join the redesign community, that page doesn't exist on the internet, because they don't need that page. They know they're good enough at finding people on their own. And, the results speak for themselves. Whereas HTN pepper, all the communities we talked about, there's a page where you can say, apply to join, or click here to join now. So that's the fundamental difference, the open close, both are great models, we need both, we need many more of both. But ultimately, you have to be recruited to join a redesign, unless you're applying to work there as an associate ventures or you have to recruit, or be coded as an LP. For pepper, it's the reverse, anyone can apply. And if you meet the criteria you're in, if you have four years of healthcare experience, you're not a consulting lawyer, banker, and you live in New York city you're in. Right. So does that tease out the difference? Like we need both types, but they are quite different?

Chris:

Yeah, no, I think it absolutely does. And I mean, I think, you know, the, the delineation is interesting, because it seems like the, the I mean, really, in this case, the older model, is this incubator accelerator model, which is a, you know, closed, graded admissions or recruiting type of model. And now these newer communities are the thing that is really a merchant that's more grassroots and organic.

Rohan:

Yeah. Now I want to knock. I want to argue against myself, kind of like not my own model here for a second. Sure. I would say the redesign slash closed closed models are much more effective. So they literally go to their customers, or their LPs, wherever they are, and they say, What do you want, and then they literally go make that thing. And a year later, they have a functioning company that solves the exact problem that their customer wanted, and half a quarter of the time it would have taken that a pepper will never do that. Like that's incredible. The apparatus that they built is just wild. Right? Right. But that's serving a very specific function for a very specific group of people. It doesn't exist in order to facilitate social bonds or community ties or serendipity, it doesn't exist for those things. We both model to keep the industry going. Digital Health is a pretty niche industry. This is kind of my next thing I need to write about. But I believe that I like the net dollars of the net lives that flow through like digital health versus old school, healthcare is very small. It's like 10%, or 20%, or some number like that. If digital is going to break out and become healthcare that the two are going to merge, we're going to have to need we're going to need more of both open and closed systems. We're going to need more of both, we're going to merge, we're going to be partnerships across them. We're going to need old school, you know, hospital systems to partner with new school communities, we're going to need this whole ecosystem to thrive. And that's kind of my big agenda this decade is like, how do I get the two old schools and new school to kind of merge together?

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Chris:

Right, right. Yeah, no, I think you've made a comprehensive case for why communities matter. Or AR can definitely be viewed as a new currency and digital health. But I'm curious, you know, you're saying you want to work on this for the next decade. What, what would you want to see really or what is your what is your prediction about the digital health communities and where there'll be In the next five to 10 years,

Rohan:

Yeah, I mean, predictions wise, I think first of all, every every city will have digital health communities be they small or large, every single city will have this because, frankly, America in general is moving to become a community based country, communities are springing up across industries. As religion dies, communities spring up again, and come back to the topic, Greg, like we need like in person, places to feel like we belong. So every city will have a health care community, there'll be a mix of online and offline, that's kind of production one, prediction two is VCs will get in the game. So VCs will start to more aggressively launch higher directors of community and launch their own community. I think you'll find more success if they have communities that independently branded their venture fund name, because then it becomes a little obvious, it's just there for deal flow. So VCs will get in the game, I think another prediction is these regions in person, communities will become a lot stronger. Okay, so people will realize, just like for pepper, that the bar for success is actually quite low. And then the market need is quite high. Right. Another prediction, I think we'll see our first like, look, call it 100 to $250 million exit for the community this decade. So someone will sell their community for something interesting. Simply because like, it's a lot easier to monetize these things than you think. You can, you can get like with some decent value profit, you can get like a yearly subscription for oil, you can charge corporate subscriptions. And you're giving people the commensurate value. And so you create a real business off of this, right. And then my last prediction, I would say is like, I think there will be the community that really crushes it this decade will be the one that strikes partnerships with what I call old school health care. Like, if pepper were to strike a partnership with a large MSO, or some multi specialty group in the New York City area. And quarterly, that multispecialty group said, these are like the innovations I need to give me startups in this area. For a big payer, a big hospital system regionally said that, that means that pepper has finally crossed the chiasm, where it doesn't just provide that value within the community. It provides value by giving you buyers and giving the buyers access to innovation. And I think like this isn't as much about me personally making pepper great to get there. It's also about where the industry is in its arc of innovation, to be able to request something like that. So those kinds of which of those

Chris:

predictions Yeah, no, no, no, I think they're all on. I'm just curious when you say where the industry is in their arc of innovation? Where is healthcare in their arc of innovation?

Rohan:

I mean, well, pretty far behind every other industry could agree with that. Thankfully, digital health has now been around for a solid, solid 10-12 years, but you could even stretch it to 15. So we've gone through some like, you know, the Gartner curve of Trove, this disillusionment, we're kind of leveling out now. But when I say Arkham innovation, I mean, I don't mean how innovative are we? I mean, how do we find and interact with innovative ideas? The Arc I'm more interested in I've never, I, it's unlikely I'm going to like think of the most innovative company in the industry. But I have a shot at changing the model for how influential people find and interact with innovative ideas, that model, that framework they have in their head, I have a shot at changing that over the course of my career. Right. And so I think some of your previous guests Jessica DaMassa is another example. Like her, she first of all knows a lot. So she knows enough about healthcare to be dangerous. But then her personal connections and the people she interviews are both like Glenn Thomas, who are super innovative selling and the old school book, she does both. And her personal network bridges both right. So she's a boundary Spanner. So I think she's also influencing this. Anyone in that realm is influencing this arc of how do we find these companies? How do we evaluate them? How do we fold them in more quickly into our buying cycles and pilot cycles? That's kind of the thing I'm working on. Right and that's kind of the long game.

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Chris:

Yeah, absolutely. And cash outside of healthcare. Do you know of any communities that have pulled that off in terms of those that that type of relationship with the old parts of the industry are connecting the buyers and the sellers and innovators?

Rohan:

I don't yet know. I started to put feelers so FinTech, I think, is the place where I will find this first, right? Where someone out there, and it's probably in New York City is starting to connect banks, with innovators. Right? I think that's where I should go to look for my model. But transfer No, I have not found this. There are ways to like, pull this off. Actually, in the short run in the interim, like, let's say, this year at health, I get five buyers from the New York City ecosystem in a room with with, you know, 20, hand selected founders from pepper, what I'm going to room together at health and pay for drinks for an hour and see what happens. Right, right there, I've probably, it's likely that I've given both sides more access to the other than the otherwise I've gotten in a whole year. You see what I'm saying? So that like, there are easy ways to do this. And then there are much more structured ways to do this. And I'm going to kind of play with it and sort of figure it out. And if you if you or your listeners hear of anything, I'm always open to ideas.

Chris:

Awesome. Now, for our listeners, if they're curious about how to find the right community, for them, let's say within healthcare, where do they go?

Rohan:

Yeah, there is not a definitive resource. I did the tweetstorm, just for you for this sign off. And 15 other communities I know. And I welcome other people to add to them, they should start there and anything is you just start off with the online ones. There. They're usually free. They're quick and easy to join. And you can get your feet wet. If you're in a city like SF, or New York or Minneapolis, you know, reach out to me or look at what I posted. And I'm sure you can join one of those. I have one in Austin as well. That's kind of how to start. I think the other is like get on some of these healthcare newsletters, the healthcare newsletters, they're all free. They're all out there. I'm sure you've published them before they often sponsor or put forward these events. So it's an easy way to find out oh, what are the communities near me just for just for signing up for these free newsletters?

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Chris:

Got it. And then you personally, and hopefully our listeners can learn from this. When you wanted to build pepper or you wanted to build your first community? Yeah. How did you go about it? Like, what did you think about what role models what resources?

Rohan:

Yeah, absolutely. I probably should have looked at role models and resources. Okay, I'm just not that type of guy. I don't always use the instructions when I'm assembling furniture. So I kind of just started doing meetups. So the way it worked is I texted 15-20 of my friends in New York City. And I said, Let's just start meeting up once a month outdoors, and just talk about health care, and bring like an opinion with you that you think is controversial. Okay, and I did that for four or five, six months. And then more and more people wanted to keep showing up. So that was step one, step two was to brand and launch a site where people can at least find you have some criterion for what value you provide. So therefore what kind of people should show up. And then step three is just regularity. I mean, you need to meet up every month. Whatever you do, you need to have some kind of monthly cadence so that people know they're part of something that is real, right. And then from there, every community will be different. But that's kind of how I did it. Now I've done meetups for probably a year and six months almost now. And after kind of branding it and kind of almost nine months ago, I started to get sponsorship opportunities, okay. which anyone can really access, which is just like, hey, 2030 bucks, $500 pay for this bar tab and people will show up. So that's continued to evolve. We're now this guy. Most of our meetups are sponsored and they're very focused.

Chris:

Okay, that's cool. Are there any other words of wisdom or advice that you have for our audience that could be around communities that we haven't covered yet? Or as a startup? Yeah, we haven't covered.

Rohan:

I think the main thing is like, it's really obvious, but just like join join one. Okay, gotta join one and there's no age limit. There's no , there's nothing holding you back from joining. These are the platforms in which the real conversations are happening in terms of like, our little innovation corner for the industry. This is where it's all happening. These are where the connections are happening. So if you're in our little sandbox, our little corner of digital health that I believe is this like, small kind of corner of the industry, eaten, it's hard to be in that meaningfully participate in that without being in one of these communities. That's my real stake in the ground I like to put in, they're all. They're all out there and accessible and they want you to join.

Chris:

Got it, well, Rohan, really appreciate your coming on. You've been a fabulous guest. I think you've convinced me and probably many listeners, into believing communities are currency when it comes to healthcare innovation. And ultimately, yeah, they both kind of level the playing field and allow for more or got organic and bottom up ideation and hopefully distribution that healthcare needs today. I hope our listeners check out pepper NYC and the communities that you share that will retweet and paste into our show notes. Thank you for coming on man.

Rohan:

Amazing, thanks so much for having me.

Chris:

All right. Have a great day.

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