We’re hiring a CEO: A Founder’s Thoughts on How to Sprint a Marathon
The News: We’re hiring a CEO
What’s faster? A 4x400 relay or 1x1600 race? What’s more exciting to watch? To be part of? Everyone has a different perspective. I think a lot, maybe most, people would say 4x400. Is starting and running a startup company a marathon or a sprint? Many say it’s a marathon. I’m among the founders that challenge that notion. I believe it can be both. These are my thoughts on how to sprint a marathon — when the race is a startup, and the stakes are all in.
Before I get into the meat of it, I’ll start with The News. Bottom line up front, effective November 16th 2022, I am passing the baton as CEO of EnsoData, the company I co-founded with Sam Rusk and Nick Glattard in 2015, to our current President Justin Mortara, PhD. I will continue my work at EnsoData by taking on a new role as the company’s Executive Chairman and its first Chief Research Officer. We’re doubling down.
In Justin’s new role as CEO & President, he will lead the day-to-day operations, growth, and execution across all aspects of our current and future business. In my new role as Executive Chairman & Chief Research Officer, I will continue to support our customers, partners, investors, and board, our growth, engineering, and leadership teams and culture, our work with regulatory bodies, medical societies, and research organizations, and create to achieve our vision. We’re quite bullish on the present.
We started EnsoData with 3 Co-founders and a dream.
In the last 7.5 years I served as our founder CEO, we helped 800,000 patients get a fast, accurate diagnosis with Waveform AI (artificial intelligence), we delighted clinicians in over 500 clinics, we served customers in more than 100 provider organizations, we grew from 3 to 45 full time employees, we raised over $30,000,000 in venture capital funding, we obtained one of the first FDA clearances of AI/ML software in sleep medicine, and we released 25 AI research publications to push the science of sleep forwards. I’m proud of what we’ve accomplished, but I’m even more excited about where we’re going.
This marks the beginning of our next chapter at EnsoData. We believe in making this change, we will get more from me, more from Justin, and more from our teams, organization, and company as a whole. What matters most, to all of us, is that we succeed in achieving and realizing our vision, build upon our foundation to take our mission to its furthest, fastest degree, and maximize our impact and capability to make a positive difference in the accessibility, accuracy, and affordability of healthcare.
For those that want a longer read, I’m addressing a few key aspects of the CEO transition below. My hope is that this letter will serve as a public artifact and helpful source of information, and inspiration, for the team, customers, partners, and investors that I love so very dearly, the ranks of my fellow current and future startup founders, our startup community and ecosystem members, and in general, any folks who’ve made their way here to get an inside view behind the EnsoData curtain, by documenting the rationale and thought process I went through to arrive at this decision. Covered are… Why’d we do it? What does it mean for EnsoData? In reflection, what about the last 7.5 years as EnsoData’s founding CEO stands out the most? How does it feel to pass the baton as a founder CEO? Will you choose to optimize for Impact or Autonomy? Why are we excited? A bit on where we’re going. And a testament to my conviction about the future of EnsoData and the role we will play in the evolution of healthcare AI.
In case you don’t read further, with my final words as our outgoing founder CEO, I want to say, with the deepest of gratitude — thank you. Thank you to everyone that’s been a part of my founder journey and our collective adventure, for everything you’ve done. It truly takes a village. The privilege of serving EnsoData as our founder CEO was, by far and away, the most rewarding, exciting, challenging, and truthfully only, career experience that I’ve had in my adult life. It put me to the mettle, tested my emotional resilience, perseverance, grit, and even had me on the ropes at times. It’s been a more fun ride than I could ever possibly imagine, I’ve forged friendships and relationships that will last a lifetime, and I wonder at times if I will ever do anything again that I feel as passionate about — being your founder CEO was an honor that I could and would not trade for anything in the world.
So, thank you again to the early customers that believed in us, when all we had was a vision; thank you to the early investors that bet on us, when the only proof we had was our commitment to give it our best damn shot; thank you always and forever to our current and alumni teammates, for choosing us to join on this mission, I’m humbled by your talent and leadership — you are the reason that I slam my feet on the ground and sprint to my desk every day with a smile; thank you to my friends, family, and loved ones, for being my rock during the most difficult times, and reminding me the light of dawn is always just around the corner; even thank you to the haters, for providing an unexpected source of energy and motivation, which we appreciatively channeled into bringing home the win, and made us stronger at each step; thank you finally to Justin, for the lucky confluence of skills, strengths, and experience at the right time for me to unleash my efforts on my next journey at Enso, and you for yours. I’m excited to see what we will all do together for global health. As for what’s next, keep an eye out for exciting milestones, hires, and more to come soon. Until then, I’ll be sending only Good Vibes. Embrace the Pineapple, always and forever.
Reflections: Patient Access, Clinician Delight, and the Team Making it Happen
When I reflect on EnsoData, who we are, as individuals and as a collective that make up the heart, soul, and cultural DNA of our company, what we’ve done, and where we’re going, there’s a lot we accomplished during my past 7.5 years of service as EnsoData’s founding CEO that I’m extremely proud of. I thought it worth recounting a few today.
Foremost is our impact we’ve enabled for patients, having helped clinicians with accurate, efficient diagnosis of sleep disorders for over 800,000 patients so far on our journey. Today, our AI and workflow tools help with diagnosis for 35,000 new patients each month. We started EnsoData with a vision to make it possible for everyone, everywhere to access high quality, affordable healthcare services; no matter where in the world they live or how much money they make. We still have a very long way to go to achieve this vision for global health, but we do believe this to be possible well within our lifetimes, and things are going in the right direction.
Equally important, is the impact for our loyal, mission-driven, and vibrant base of customers and clinicians, including the physicians and sleep technologists that use our tools every day to power their practices in over 100 provider organizations with more than 500 clinics across the US, alongside clinicians in Canada, Colombia, and others to come. Our mission at EnsoData has always been to help make healthcare more accessible, accurate, and affordable, by harnessing Waveform AI, device and data interoperability, and cloud native workflow solutions, to create tools for clinicians that streamline end-to-end diagnostic workflows, starting in sleep medicine. Clinicians in general, and especially sleep clinicians, are some of the hardest working people on the planet — among any profession in any industry, and it’s been immensely rewarding to contribute to making their lives just that much easier, simpler, and more enjoyable, while enabling an even greater impact on the sleep and health of the communities they serve.
Most of all, there is our brilliant, passionate, hard working, and innovative team, along with the core values we share that establish the foundation of the vibrant culture at EnsoData we live, breathe, and appreciate every day. As we nearly tripled our revenue last year, and continue growing at a pace to about double our revenue again this year, we’ve grown from 20 to over 45 full-time employees in the last 12-months alone, with all-time staff retention well above 90% hired.
What’s kept us aligned during this kind of growth, and also during the inevitable setbacks of a startup, is what drives not only what we prioritize, but how we do it — and that is the true north set by our values of action to Make Healthcare Better, Put Customers First, Be a Great Teammate, Get Shit Done, and Embrace the Pineapple.
While simple, these have proven easy to remember, powerful to embody, and productive to ask yourself as a question, to determine what to do and how to do it to advance those dimensions with intentionality each day. The result has been an incredibly collaborative, transparent, action-oriented, fast-paced, and fun work environment where everyone supports one another sincerely and also stretches to grow, improve, and learn constantly.
My experience in leadership and service as EnsoData’s founding CEO has only reinforced the commonly held notion that in a high-performance organization, it’s the people that matter most, and it is far more important who you have on the field right now, than it is how many “points on the scoreboard” you had last season. The people on our team are the number one thing that gets me to jump out of bed, slam my feet on the floor, throw on my metaphorical jersey, and sprint to work every day with a smile on my face. When you build an organization where the whole sum is truly greater than the parts, where the mission brings real purpose and meaning, and real innovation and learning is happening at the edge of knowledge, that’s when the magic happens. And Good Vibes are contagious.
Reflections: Venture Funding, Strategic Partners, and Healthcare AI Innovation
Mostly driven by those three things — our ongoing patient, customer, and clinician impact, and the team that makes it happen, there are other milestones that have resulted that I’m very proud of too.
One is funding. When we started EnsoData straight out of the biomedical engineering graduate program at the University of Wisconsin, it’d be an understatement to say we didn’t have much in the way of resources. We’ve since been fortunate to have raised more than $30,000,000 in venture capital funding (via Crunchbase) to help accelerate growth across our Series Seed, Series A, and Series A Extension rounds from a world-class roster investors that includes VC funds from San Francisco to New York City, Madison, Chicago, Boston, and more counting Zetta Venture Partners, Venture Investors, Supermoon Capital, HealthX Ventures, Colle Capital, M25 Ventures, Dreamit Ventures, and Necessary Ventures, among others, publicly traded strategic investors and partner companies, earned our early stripes with a few well known angles like Avram Miller, Bob Stearns, and Fred Robertson, M.D., and accelerators including the likes of Y Combinator Fellowship, Gener8tor gBETA, Dreamit HealthTech, and Healthbox Studio.
A second is our partners. With our interoperable AI engine and cloud workflow solution, we integrate with major diagnostic and therapeutic medical device manufacturers to collaborate and expand customer adoption, workflow integration, and enable new features and functionality for clinicians. We’re excited about what we’ve done and where we can go with our current partnerships with leading diagnostic and therapy device companies like Inspire, Cadwell, Respicardia, and others in the works we’ll be able to announce more on soon. One exciting externality of our interoperable approach to the diagnostic workflow and the modular AI components accessible within it, is that in addition to big companies, we’ve been able to partner with a lot of medtech and digital health startup companies too, to help bring the next generation of comfortable, convenient new diagnostics and therapies to a larger number of clinicians and enable personalized care experiences where more choices and options can be made available to patients at each step of their care.
A third is the work we’ve done to help pioneer the clinical use and adoption of AI and machine learning technology to solve real-world problems at the heart of diagnosis and treatment in healthcare. Nature Journal of Digital Medicine author’s systematic review of FDA cleared and approved AI and Machine Learning technology in healthcare cited our EnsoSleep platform as the first FDA clearance for AI/ML software in the area of sleep medicine.
Subsequently, we received our second FDA clearance last year to dramatically expand upon our diagnostic workflow solution support for sleep study management, as well as our support for at-home diagnostics with an AI/ML module for accurate total sleep time measurement using respiratory sensors. All the while, our cloud database for AI/ML for dev and testing has continued to grow, now closing in on 2,000,000 patient sleep studies, which provide over 10,000,000 hours of second-by-second brain EEG, heart EKG, respiratory airflow, effort, blood oxygen, and more, in terms of the real-world physiologic data we can learn from.
As we helped to pave the way for the clinical adoption of AI/ML in sleep, we also sought to advance the science of sleep and its role and influence on health and diseases, contributing more than 25 peer-reviewed original AI/ML research publications and conference abstracts in collaboration with some of the largest and most well respected health systems, academic medical centers, and integrated delivery networks around, including Kaiser Permanente, Stanford, Rush University, Northwell Health, Washington University, and the University of Wisconsin to name a few.
Summarizing nearly a decade of our work on AI research, the highest-level conclusions have been; there is no form of pathology known to man that is not made worse in some way by poor sleep; in part because of sleep’s cohesive relationship with health and wellness, and the depth and breadth of data that can be conveniently collected overnight, sleep is a powerful window through which we can look deeply across the entire spectrum of human health and disease; and when it comes to the true extent of the health information content that lies embedded within medical waveforms that we as a field can access and use today, we’ve so far barely scratched the surface, to the point that perhaps the bulk of what’s possible with physiologic signals has yet to be revealed. Although it’s been challenging, it has also been almost uncomfortably exciting to see the initial results and these fruits of our labor along the way, as we iterate and experiment to push the boundaries of what’s truly possible in the early innings of AI, ML, and Big Data in sleep medicine and healthcare broadly. To extend the baseball analogy, from what I’ve seen in these first innings, there will be many home runs to come for healthcare AI.
Our work has not gone unnoticed either — we’ve been grateful for the recognition EnsoData and our teammates have received, and 2021 was another big year for accolades with our co-founders being named to the Forbes 30 Under 30 in Healthcare list, the company being named to Inc. Best Places to Work list for the second year in a row (one of only three Wisconsin companies to make the list), for the Wisconsin Innovation Award in Healthcare, the InBusiness 40 Under 40 list, among a few other venues. We hope to connect more of what we’re learning at the cutting edge of Sleep AI and the importance of sleep’s role on health and longevity to the public consciousness through knowledge sharing avenues including peer-reviewed clinical and research publications, as well as to bring more of these conversations into the mainstream with our writing and contributed content for channels like Forbes, SleepReview Magazine, and RTSleepWorld. Though it’s critical to stay focused on what’s most important in driving the company and the vision forwards — Patient, Customer, and Clinician impact, and the Team — the greatest value of these outside perspectives can be to help us to take a step back and appreciate the scope of what we’re doing, attract value-aligned talent and partners who will accelerate our rate of success, and remind us of the value of all of the professional and personal experiences, skills, and relationships we’re constantly developing along the way. Especially in a startup, it’s easy to keep moving so fast, you don’t think to stop to smell the roses. Life is precious and I’m thankful for every day.
Crossing Paths: the Brief Backstory of How I Met Our New CEO Justin
While these are all great accomplishments, we are ambitious, hungry, mission-driven people with audacious goals and a bold vision for the future. Among those dimensions of who we are, what we’ve done, and where we’re going, with my startup founder, entrepreneurship, and engineering tilted worldview, I have always biased towards looking to the future. We’re in a fortunate place, but by my assessment — we can do better. And it’s about where we’re going and our conviction for EnsoData’s current and future opportunity that brings us to the CEO transition we’re making effective today.
It was around the time of our Series A in 2020 that I met, rather serendipitously, Justin Mortara, PhD, EnsoData’s current President, and now incoming CEO, so we had the benefit of having worked closely together and gotten to know each other and our team for the past 2-years prior to considering the transition. The connection was made by a major investor, so it was more so the nature of our first interaction and all that followed that took us on a fortuitous and unforeseen journey than it was our two crossing paths. I had heard of Justin prior to meeting. I knew he had a PhD in particle physics from UC-Berkeley, so he’d be technically competent enough to talk shop. I was aware he had decades of CEO, commercial, and product experience in the world of medical waveforms from sleep’s sibling speciality of cardiology and particularly ECG, so he’d know the healthcare industry and our provider customer market exceptionally well. And I’d seen that during his time as the CEO of his company Mortara Instrument, he’d helped to lead their team and organization from around where we are today to over $100,000,000 in annual revenues in a few short years, prior to a successful acquisition with Hill-Rom for $330,000,000 in 2017.
What I did not necessarily expect to result, is the partnership, the collaboration, or especially the fun times that would ensue. At our first meeting I remember Justin peppering hard technical questions at me, of the like I had never been asked before in an investor meeting — the kind of penetrating questions that cut so deeply to the heart of a priority issue that it immediately demonstrated a depth of understanding and grasp on the tech and business strategy that’s rare to find.
That started a working relationship in which we brought on Justin as our first Executive Chairman in 2020 coinciding with the Series A. In this capacity, Justin served as an invaluable and increasingly deeply involved advisor, mentor, and special project owner for EnsoData. Not only was this productive, on an experiential level I believe we are both having a great time making it happen as well. There’s an earnest love of the game there. A little more than 6 months ago this year, we decided to bring Justin on in a full-time role as EnsoData’s President, at which point he took lead for our growth team including Sales, Marketing, Customer Success, Business Development, Product Management, Operations, Finance, and Human Resources functions. Now that we’re closing in on our current slate of milestones to reach 1,000,000 patients helped, 1,000 customer clinics live, expanding our diagnostic workflow solution, and quietly preparing to launch some new AI capabilities that will be game-changing for our clinician users, we’ve been thinking hard about what’s next. These meetings of the minds, through several discussions, reinforced amongst myself and my co-founders that there was an attainable opportunity to work better as a team by simplifying and aligning the full org under a CEO, considering seriously that we’d propose we work with Justin to become that CEO, and together doubling down to take EnsoData to the next level. But how does a current founder CEO finalize the CEO hire decision?
Impact or Autonomy: a Founder’s Thoughts on How to Sprint a Marathon
It’s a true test of humility, vulnerability, and self-awareness to navigate and arrive at the decision to pass the baton as CEO of the company that you started, love deeply, and these things often go, comes to define not just your career but much of your adult life by quantity of time. In the end, we made the decision to maximize our ability to bring our vision for healthcare into reality. In the beginning of a startup, it’s important to decide if you want to optimize for impact or autonomy.
If you want to optimize for autonomy, one extreme is working as a self-employed consultant, where you set your own hours, and work as much or as little as you want, accountable only to yourself, your personal and lifestyle goals. On the other extreme, if you want to optimize for impact, you’ll want to hire really good people — people that have multiple attractive opportunities to do something important and interesting elsewhere, could start their own companies, or otherwise have the means not to do anything — to get those people on-board, you’ll likely want to incentivize them join you versus someone else with ownership in the form of equity in your company, and probably also sell equity to raise investor capital along the way too, to make progress in adoption at a pace that would be extraordinary difficult to maintain organically; then out-work, out-execute, and out-innovate everyone. The smaller slices, bigger pie startup strategy, what Simon Sinek calls the infinite game. At EnsoData, we’ve always bet on optimizing for impact, and in some ways today’s decision is our ultimate manifestation to that end.
I also acknowledge there are different kinds of CEOs with different types of skills and strengths, for example founder CEOs, that are often exceptional 0-to-1 prototypers, build-measure-learn adoption phase optimizers, early stage Doers-in-Chief, and key visionaries, evangelists, and sources of willful inspiration. In the pre-revenue, pre-product stage startup days, this means doing things that don’t scale, like writing your own FDA submission in-house to keep costs low, like we did when we were still a 3-person company, when with no prior FDA filing experience amongst the 3 of us and the help of a few good advisors, we worked through 1,000 pages of software documentation over Summer 2016, and ultimately through FDA 510(k) clearance, for less than $250,000 in about 12-months.
Startup CEO’s are not made in the classroom, they’re made in the streets, typically either by starting a company or by getting hired or promoted to the CEO role at an existing startup company.
Another type of CEO, we might call a commercial-operational CEO, that bring a different set of skills and strengths slanted towards aligning and scaling commercial execution, leading performance management, guiding individual and organizational career development, streamlining day-to-day operations, effective collaboration, the process, rhythm, cadence, and flow of getting shit done, adding structure where helpful and removing where its not, exceptional resource allocation, budgeting, and financial planning, and enabling adaptability for individuals, teams, and the organization move and respond to new opportunities and risks swiftly and effectively. This kind of experience is more common among people who have been CEOs of existing scaling companies. Eric Schmidt, PhD, comes to mind as a good example of a commercial-operational CEO, when he became CEO of Google shortly after their $25,000,000 Series A round to help the company more rapidly and sustainably scale its growth and customer adoption.
We like to think about milestones in 10x increments. For EnsoData, getting to the next level means going from from helping with diagnosis for almost 1,000,000 patients per year today to next helping 10,000,000 patients per year, growing from 100 provider organizations today to 1,000, among 6,500 health systems total in the US, and we have line-of-sight to a team headcount that exceeds 100 full-time colleagues within the next 24–36 months. I am certain we can and will get there, but it shines light on the scope of the work we have ahead for our next lap around the track.
To reach our current mile-marker, we went through different stages many startups go through, which can be marked around the points in time where the fundamental flow of how we communicate, collaborate, and get work done as a company more-or-less break all at once, and must be redesigned to effectively grow with the size and number of teams in a fast growing organization. Some notable stages of our evolution, many in common with other startups, were: 3–5 co-founders and first hires — the garage band phase of telepathic communication, not even requiring non-verbal cues, when the hats per head ratio is the highest, and the CEO is effectively the captain of a canoe; 5–10 early employees — thrive operating in a quasi-chaotic, hive-mind state of constant communication, with fluid hand-offs captured on a single whiteboard or excel sheet that fits the entire company’s strategic plan and execution tracking, then scrummed by a team that fits neatly into one conference room on a daily-weekly standup cadence; 10–20 teammates — the “write things down” phase, now that the company no longer fits in one room, meetings and verbal venues for important communication have gone from the most to the least efficient medium of all available alternatives, as asynchronous communication takes reign as a critical enabler of organizational learning and on-boarding, collaboration cross-functionally and among larger groups, and better systemization of cultural values and practices to preserve alignment across an increasingly specialized collective of individuals, especially as we shifted from an in-office to a remote-first work environment; 20–50 staff — the name of the game is alignment, starting with clarity and simplification of goals to focus the company, the OKR toolset in our case, to harness the best work possible from the minds, hearts, and energy of a team while increasing capacity, maintaining agility, and optimizing on the pace and quality of execution; as for the 50+ workforce lessons, time will tell. Interestingly I, like may startup founders, feel like I’ve observed the paradox of headcount play out, whereby when your team gets larger, your output gets slower; i.e. the larger the vessel, the slower the turn seafaring analogy. And that’s just at an organizational level.
Inside startup teams, at the individual level there’s just as much and more change going on in the day-to-day flow, coinciding with multiple continuously changing variables as new roles, levels, departments, functions are introduced, strategies are created, refined, and resolved, and responsibilities are reshuffled, new ones are recognized, and Legos are given away. Out of all of them in absolute terms, it’s the CEO job that tends to change the most and the fastest in a startup. Y Combinator’s definition breaks the startup CEO down into three distinct stages across first the Doer-in-Chief, second the Company-Builder-in-Chief, and third might be called Company-Reinvestor-Reinventor-in-Chief, at the fortunate point where resources generated from the core business can be reinvested new, transformative products, and significant resources allocated to new dimensions of expansion and strategy. Meanwhile, we were growing rapidly, and approaching our next process-breaking shift.
In that context, we were having lots of timely strategic conversations. The original catalyst was a Board member question and suggestion as to whether Sam, Nick, and I had ever seriously considered “the Google path,” which by that they meant hiring a commercial-operational CEO to help us in leading EnsoData to reach the next level. After some initial thought, I set about on a deep-dive to read a lot, study a lot of data, and get a lot of advice, to evaluate the course of action that would give us the best odds of the biggest impact.
First, I struck out for Data on startup CEO transition outcomes and best practices, to expedite the depth of my understanding and perspective on the matter, and to get as well informed as one can. After systematic review of the online troves of HBR, YC, SpencerStuart, and other sources, I gained an initial grasp of opportunities and risks based on a cohort view of data from startups past, and prioritized my next actions from the 12 best articles out of 50+. In fact, I was actually surprised to see how much academic research and seasoned opinion was out there on this very topic, including an impressive volume of business outcomes data among diverse industry sources, so much so a more detailed discussion of these resources and relation to our strategic rationale could very well be a worthy topic for a future article if I find folks are interested. To distill these to one key takeaway, this data reinforced for me, there is no one right way to build a successful startup company. For every Zuckerberg, Benioff, Bezos, and Gates, the archetypal solo-founders that remained steadfast at the helm for decades, there is a Larry Page, Sergey Brin, Reid Hoffman, among enumerable other startup hall-of-famers that succeeded in opting to follow an approach different from the traditional startup CEO path, as well as the Steve Jobs, Jack Dorsey, and Alexis Ohanian thematic founder group, that were later passed back the CEO baton for a second run at companies they started, in each of their cases to great effect. All this means is, founder CEOs are probably the best type of CEO a startup can have at the very beginning, there are other types of CEOs that have been very successful in taking forwards the baton at our stage, and it also doesn’t mean founders are only for the beginning, where to Y Combinator’s prior point, as with our examples, founder CEOs have also proven to be instrumental and industry-defining leaders in the big company reinvestment, reinvention, and transformation phase as well.
With all that data in tow, next, I entered the process I call the “Advice Matrix,” which is followed by aggregating as many diverse perspectives as you possibly can, qualifying the sources, analyzing patterns, then applying your own best judgment and original, independent thinking to make your own final decision. Among the learning opportunities over the duration of my career, the value of peer-to-peer learning has often stood out at least as valuable, and certainly uniquely so, in comparison to the sage advice from been-there, done-that folks with a bit less recency. I tapped my network to quietly run some peer-to-peer learning, ultimately having the privilege to exchange notes and war-stories from the front lines on both sides, with 6 startup founders, and 6 commercial-operational CEOs that took the baton at startup companies, to gain a cohort perspective and clear-eyed view on what worked well, what didn’t, and what unlocked or prevented yield on intended results. My learnings from these activities, in tandem with lots of board member advice and discussions, and lots of independent thinking, while staring thoughtfully into the lake, brought me to my final step — formulate thesis and prescribe recommendation. I wrote it up, sent it, and that was the jump off point for Justin and I to jointly optimize — message, socialize, pre-sell, and close.
Especially for our next class of 10x milestones, we need tightly coordinated execution and masterful resource allocation to grow and scale the value of what we do today. We also want to introduce new features, functionality, and products for clinicians and customers, expand the depth, breadth, and quality of our AI platform capabilities, the scope of problems we solve, and generate new data, evidence, and clinical validation to continue to lead the way in Waveform AI. And whether running numbers on the talent pool for a founder CEO or a startup commercial-operational CEO, the pool of strong candidates is very small. But in an abstract assessment of skillset fungibility, it’s possible that the healthcare AI innovation skillset required to actualize our vision may be even smaller. Fortunately, we already had both of those skillsets well represented on our co-founder and leadership team, and now in passing the baton as CEO, we can lever-up and double-down on the unique and essential skills each member of our team can bring to the company. At all levels of the organization, it’s hugely helpful to have the right buts in the right seats, as they say. Ben Horowitz explores this notion with rather poetic analogies, recognizing from time to time we just need different horses for different courses. If you’re chasing impact, don’t let your ego get too bruised, that’s just life in the big city. As it relates to the fungibility of startup CEO and healthcare AI innovator skillsets, one way I look at it is that this transition frees me up in a major way to help launch the next big thing for Enso, and contribute meaningfully to seeing that through faster. The opportunity seemed to provide a natural fit for two of the key parties, that could be characterized well by the Ikigai framework, a Japanese concept meaning “a reason for being” that exists at the confluence of what you love, what you’re good at, what the world needs, and what you can get paid for. Strategically, the framework implies we could advance both aims in a greater way. These Ikigai and talent pool realizations proved to be a key factor in the final decision. It stands to reason a healthcare focused BigTech scale company can (and likely will) exist by solving several of the myriad of global health problems we face in diagnosis and treatment today. As such, we’re motivated to be among the first that get there. I believe it will be worthwhile in the end.
After thinking critically about it for a long time, I formalized my conclusion that the skills, strengths, and mindset Justin’s demonstrated at EnsoData as a maestro conductor of the organizational orchestra, perhaps in contrast to a composer or first chair violinist approach, his experience and healthcare street credibility to help hire and lead the senior leadership and executive talent we need to do it, and the special case of our opportunity to build into this evolution of roles with a foundation of shared experiences and trust, will be the best fit for the CEO baton at EnsoData, as our commercial-operational CEO, to take our rapidly growing organization through and past the next set of 10x milestones, make a larger impact in leading the way for diagnostic workflows with Sleep AI and Healthcare AI, and make it happen faster too. Therefore, with the support of my co-founders and our board, I’m helping to lead and promote Justin’s transition into the CEO & President role at our company, which brings our story back to the present and the letter you’re reading today.
Zen and the Enso: Inspirations that Resonate through Past, Present, Future
As I noted in the beginning, as for me — where am I going? What will I be doing? I’m going nowhere. I’m doubling down on EnsoData as part of the transition, as is Justin too. In the grand scope of our vision, to me it feels like we’re just wrapping Act 1, Scene 1, and thus it’s far too early for the cast we’ve cultivated to cue the closing credits now. In my new role as Executive Chairman, I’ll be continuing to support our growth, engineering, and leadership teams, recruitment, hiring, and culture, engage on external affairs with key regulatory, medical, research, and growth capital stakeholders, and take on projects with our board and our new CEO.
In my other new role as our first Chief Research Officer, I’ll be tapping into my Ikigai, to support our Sleep AI and Healthcare AI technology and market leadership, lead R&D initiatives resulting in new product realization, and continue to collaborate and partner even more closely with our customers and research colleagues. I’ve always had a true passion for learning, teaching, collaborating, creating, building, and proving new things, and the most exciting prospect about my new Research hat is the ability to help us translate breakthroughs and findings from the AI/ML-Big Data “lab bench” to the patient bedside, to see real-world impact with hundreds or thousands of clinicians. As part of this, you’ll probably see me sharing and learning more at healthcare, sleep, and AI/ML conferences, on webinars and podcasts, and in research, journals, and writing. In a lot of ways, this brings me full circle to my roots at Enso.
Since the beginning, we’ve drawn threads of inspiration from Zen meditation and mindfulness practices, as seen in our company’s name, whose “Enso” was chosen in appreciation for a Zen symbol of the same name, a singular, uninhibited brushstroke which also comes full circle to reach its conclusion, and expresses a moment when the mind is free to let the body create; where embodying the Enso means embracing imperfection, simplicity, modesty, fluidity, profound grace, freedom, and tranquility. As I’ve reflected leading up to this transition, there’s another part of this journey that feels very Zen to me too; the idea that “in the beginner’s mind, there are many possibilities, but in the expert’s there are few,” attributed to Zen master Shunryo Suzuki. Suzuki’s Zen mind, Beginner’s mind axiom teaches us, no matter how expert we become, what we know, or attain, approaching each opportunity with a fresh and open mindset can be the most powerful asset in guiding us to magnify the learning value, creativity in problem solving, and resourceful inventiveness at each step on our path. I’ll be striving to live this mindset in action with the work ahead in these new roles, focused on learning — both ours as humans, and through our AI machines — to make healthcare better. With more time to breathe day-to-day, I get to roll-up my sleeves and create even more going forwards. I may go so far as to dust off my old Python programming gloves in the process… only time will tell.
My commitment to continuing to help Justin, our team, customers, partners, research collaborators, board and shareholders, and broader stakeholders in achieving top-class results and outcomes remains unwavering, and Justin is similarly committed to helping us to achieve our ultimate vision for EnsoData, in driving towards a future that makes it possible for everyone, everywhere to access high-quality, affordable healthcare services. In this way, I believe when we look back, I believe the net result of today’s transition will be a refined EnsoData equipped to get more from Justin, more from me, and most importantly more from our teams and organization as a whole. We can think of it rather accurately as “Pineapple with an Edge”, the same cultural values, vision, and mission, fine-tuned for more focus on alignment and pace of execution centered around the Get Shit Done pillar we’ve always had. We will work tirelessly to allow the company to go the furthest, the fastest, and maximize its impact and capability to make a positive difference in the accessibility, accuracy, and affordability of healthcare worldwide.
Thank You, Sincerely: My Tribute to the Early Believers that Bet On Us
I conclude this personal note with the deepest of gratitude, and a sincere, heartfelt thank you to, well, everyone for everything, I think would be the most accurate way to say it. My past 7.5 years as EnsoData’s CEO have been a more rewarding, exciting, and challenging career adventure than I could have possibly imagined, and by far and away represents the collection of both professional and personal experiences that I’m most proud of in my life to date.
The relationships I’ve formed inside and outside the company, with colleagues, customers, partners, investors, startup community and ecosystem builders, and others have transcended what I thought was possible within the context of “work.” Serving as our CEO has been an honor, has been humbling, and imparted to me a quality and quantity of learning that will be difficult to surpass, and a sense of purpose and meaning that, while I do love to write, I simply can’t convey with words. Needless to say, the feeling is bittersweet, as I enjoyed my run as EnsoData’s founder CEO immensely, but I am even more excited about what’s next for EnsoData from here. From all of my time at EnsoData since the beginning, I can say with confidence that our future has never looked brighter.
So, with my final words as your outgoing founder CEO of EnsoData, I want to say thank you. Thank you again to the early customers that believed in us, when we were just a napkin and a vision, your foresight has proved right so far, and we simply wouldn’t be here without you; thank you to our early investors that bet on us, when we looked more like a garage band science project than any sort of formidable business people; thank you always and forever to our early, current, and alumni employees, who in each case turned down far more immediately lucrative opportunities they could’ve gone with to come together and push forwards EnsoData’s mission to make healthcare better; thank you to my family, friends, loved ones, and others in the community who have been amazing supporters, at times listeners, and who often didn’t hear from me enough as I was always sprinting as EnsoData’s CEO; even thank you to the haters that said it was impossible, would never work, and wasn’t worth trying, that provided us with a form of motivation and gasoline that helped to make us stronger at each step. And thank you to Justin, for the stars aligning a unique confluence of skills, strengths, experiences, and opportunity at the right time to allow me to take on a new adventure at EnsoData, and in the process to create the dream job and challenge for you as the new CEO to take on, and in this case a highly seasoned, freshly recharged, and battle-proven, commercial-operational CEO; I’m excited to see what we’ll do. To each of you, I hope one outcome and positive externality of our CEO transition at EnsoData today is you get to hear from me more, and as a result we get to stay in touch more closely, than was possible in my CEO days — at least as far as I’d figured out. Keep an eye out for exciting things to come. I’ll be sending all the Good Vibes in the meantime.
Yours Truly,
Executive Chairman & Chief Research Officer
