Building Software to Improve the Healthcare Journey

Hosted By Matt Watson

Full Scale

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Dan Goldsmith

Today's Guest: Dan Goldsmith

CEO - Tendo

Philadelphia, PA

Ep. #1006 - Building Software to Improve the Healthcare Journey

In today’s episode of Startup Hustle, let’s look into software that’s improving the healthcare journey. Matt Watson is here with Dan Goldsmith, CEO of Tendo—one of Startup Hustle’s top Philadelphia startups in 2022. These tech-savvy entrepreneurs talk about improving patient services through software. Moreover, they also dive into the reasons why you should work with diverse teams.

Covered In This Episode

Is there a way to know whether the decisions you’re making today can help your future? What are the major challenges in the healthcare industry today? How can Tendo serve its clients and help build software to improve the healthcare journey?

Uncover the answers through Matt and Dan’s conversation. Their insights on workplace diversity and its impact on creativity and innovation are also helpful to any and all business owners.

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Join the conversation today at Startup Hustle.

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  • Dan Goldsmith and his backstory (01:53)
  • All about Tendo (04:50)
  • The current state of patient experience (07:35)
  • The work environment at Tendo (09:47)
  • Staying true to your original mission (11:20)
  • Primary user for Tendo (12:26)
  • What inspired the idea for Tendo? (14:42)
  • Tendo’s capital journey (16:44)
  • Current valuation for Tendo (19:20)
  • Implementing the foundational customer program (20:46)
  • What is Tendo’s current state of product development? (23:13)
  • On getting recognition in the healthcare industry (25:37)
  • The biggest challenges in the healthcare business (27:00)
  • How Tendo can help increase revenue for clinics (30:22)
  • On hiring people in the healthcare industry (32:23)
  • Tendo’s hiring strategy (34:55)
  • On having diversity in the background of your business (36:20)
  • Advice for entrepreneurs (39:02)

Key Quotes

Finding people who can give you good advice and people you trust is super important. People who have done that and been there before, especially in this economic time.

– Dan Goldsmith

If you want to generate new and interesting ideas, be deliberate about bringing people together with different backgrounds and experiences and pattern recognition. If you create a culture that encourages that, you can productively tap into that.

– Dan Goldsmith

You mentioned earlier that margins are a huge problem for these healthcare providers and healthcare systems. So, as your guide is software, something that helps them increase revenue or help them save costs in various ways.

– Matt Watson

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Look into all the services our Startup Hustle partners provide that may help propel your business.

Rough Transcript

Following is an auto-generated text transcript of this episode. Apologies for any errors!

Matt Watson 00:00
And we’re back for another episode of Startup Hustle. This is your host today, Matt Watson, excited to be joined by Mr. Dan Goldsmith, the CEO of Tendo. We’re going to talk about their company, which is helping revolutionize the patient experience in healthcare. And big congrats to them for being one of the top 12 startups from Philadelphia, at least on our list. Anyways, I don’t know if it’s the official list, but congrats, Dan, on making it on the list. And in our show notes, there’s a link to all the other companies in Philadelphia, if you want to check out the whole series about the top startups in Philadelphia on the podcast. Quick reminder that today’s episode of Startup Hustle is powered by Hiring software developers is difficult. Full Scale can help you build a software team quickly and affordably. And has the platform to help you manage that team. Visit to learn more. Dan, welcome to the show, man.

Dan Goldsmith 00:48
Matt, thanks for having me. I’m super excited to talk to you today. We’re really honored to make the top 12 list in Philadelphia. And excited to share more about our experience at Tendo and my experience as an entrepreneur. So good to be here.

Matt Watson 01:01
Well, so before we get started about Tendo, you mentioned before we pressed the record that you’ve sounded like you’ve had some other startups in the past. Entrepreneurs and a lot of different things. And so, I guess, to start, tell us a little bit about your background, and kind of kind of how you got here today.

Dan Goldsmith 01:15
Yeah, thanks. So I’ve really spent the last 25 plus years helping companies go from startup to scale. In the early days of my career, I did a lot of management consulting in large companies and then helped to grow companies, mainly software companies, vertically focused companies, companies like Viva systems as part of the original team, they’re growing the company to you know, we’re today about a 40 $50 billion market cap software company was the CEO of Instructure, makers of Canvas, which many of you may recognize from the education space is the leading LMS and revolutionizing education, and now at Tendo driving transformation in healthcare at scale with a focus on patients, but, you know, alongside them that I’ve worked on, investing in and advising in and being a board member for, for lots of different companies. You know, I guess I could say I’m a serial entrepreneur, but I guess I’m a maybe a, a, someone who’s more focused on helping entrepreneurs navigate the business world and learning from my mistakes that I’ve made over the years.

Matt Watson 02:21
Well, and that’s the hard part about being an entrepreneur, right is we don’t know what we don’t know. And, you know, having seasoned experienced people like like yourself, being able to come in and help take the company from one stage to the next a lot of times is, is the key, you know, I’ve worked with around many companies, they get to a certain level and you know, the current CEO, like, Hey, I was great until we got to X number of employees now, it’s too complicated. I need help running the business. And I don’t like dealing with all these things or whatever. And, and, and that’s okay, that’s okay. Right. It just takes different people and different personalities at different levels. So we need guys like you.

Dan Goldsmith 02:56
Yeah, you know, I, like I think there’s an element, you know, you hit the nail on the head, like, we don’t know, we don’t know, and it’s really hard to see around corners, you know, we’re gonna see around the corners looking like crystal balls. How do we know that the decisions we’re making today are going to be scalable, and are going to help us be successful down the road? And, you know, what do they mean? I think that’s where you get people like you and me, you know, grizzled experience, entrepreneurs that maybe can share some of that experience and some of that, that, that pattern recognition, which is, which is really important. But yeah, I think for all those entrepreneurs or budding entrepreneurs, or new founders out there, you know, finding people who can give you good advice and people who trust you and good advice is super important. People have been that men done that before, especially in this economic time, by the way, I’m sure you’re talking a lot about this economy means to startups, which, you know, I can talk about, at least my opinions, but I think more than ever, it’s important for early stage companies and entrepreneurs to understand the decisions they’re making today and the implications downstream.

Matt Watson 04:00
So tell me a little more about Tendo. It looks like the company is only a couple years old, were you one of the founders or so.

Dan Goldsmith 04:07
So, yeah, let’s talk about 10 or so we’re super excited about that. And we started 10 to about two years ago, and I was there at the beginning of the going actually, my sister Jen Goldsmith, we’ve been working together for the better part of 25 years, when you work with family either works really well or it really does. You know, fought like cats and dogs growing up, but you know, we figured out, you know, you, you, there’s no one you trust more than sort of your family, and you’d never want to let each other down. And so, you know, Jen and I were there, the beginning of that company, but we actually don’t refer to ourselves as founders, like what I found out, you know, throughout time is that sort of the best, most largest impactful things are always due to teams of people and diverse thinking and experiences coming together. So I tend to talk about the founding team. And so let me give you a little of the origin story of Tendo. You know, we know, I’ve spent my career in industries like life sciences and education and things that are complex, many times risk averse, large scale regulated. And so after leaving my last company structure, decided that I want to continue to operate and this time focused on healthcare, you know, health care seem like there were some obvious things that needed to be addressed healthcare as an experienced the digital transformation, like many other industries, and especially when it comes to the patient, you know, we, I always talk about, you know, in other areas of my life, I can do a lot at the click of a button. So for example, I can see my entire financial health at a click of a button. I can’t do that for my personal health. And that’s a problem. These are, these are fixable problems, but they take focus, and they take effort and they take the right, you know, people coming together. So what we did at 10 is we brought together a founding team to start looking at this problem. There’s a saying that I have, especially in the startup world is if your gut says no trust your gut, if your gut says yes, do your homework. And so our gut told us that there were some super important things and by the way, you can apply that to hiring, you can apply that to business decisions, partnerships, all sorts of things. Maybe marriages, especially marriages, a different podcast, right? I’ve known my wife for 30 years, by the way, so we’re doing alright. So anyways, you know, we knew that we wanted to do something that we knew there was an opportunity there to improve the condition for patients and clinicians and caregivers, and health care. But we wanted to study deeply what that is and why, why technology and digital hasn’t sort of impacted or affected healthcare in the way that we’ve seen other industries. So we spent about a year on a listening tour, we talked to as many healthcare executives, physicians, patients as we could and it really formed our perspective on what could be done that would make meaningful industry level transformation in healthcare. And it boiled down to a couple of fundamental things. One is, you know, the patient experience is not adequate today, right? It’s too fragmented. There’s too many point solutions, there’s too much complexity, and patients are left to be the general contractors and managers have their own health but not given the tools to do so. Clinicians, we hear about clinician burnout all the time, doctors are spending too much time, you know, doing administration and frankly, in front of screens, not in front of patients, and how do we sort of alleviate that burden and complexity so they can do the work that they chose to and you know, helping to improve people. And then caregivers is an important part of our equation, we recognize that caregivers, you know, so many people in this country in this world, identify as caregivers, whether you’re, you know, a parent, or frankly, a child of an elderly parent, or sibling, or whatever it may be, we all feel we almost all of us as adults at least feel like we’re caregivers in some way. But caregivers are super removed from the care journey of their loved ones. So we recognized this and said there has to be sort of a new center of gravity, there has to be a platform. So it’d be a technical capability that can provide that meaningful and trusted connection between patients, clinicians and caregivers. So it took us about a year to shape that strategy. And so you know, we really started the company in earnest about a year and a half, two years ago. And after that market validation, we’ve been focused on hiring an amazing team, building an incredible platform product, and then, you know, being really selective in the amazing healthcare organizations we work with as what I’ll call foundational customers. And we should talk about that a little bit, because they’re very different commercial models to help us build the products and scale the business. So that’s really where we’re at Tendo. And then, you know, we have a board in the pandemic. So we have 20, in two different states right now. Sort of best athletes in many ways. These are people, we have concentrations in Salt Lake City, and San Francisco and Philadelphia. And then these are people who build some of the most amazing companies on this planet to workday. Instructure, Viva and others. So, you know, it’s a little bit of a homecoming for me to bring the band back together.

Matt Watson 09:03
Yeah, so you guys are fully remote? Like, do you have an office anywhere?

Dan Goldsmith 09:07
Well, we just open offices in our hub cities. And, and, but it’s been interesting figuring out that hybrid work, and I’m sure a lot of your listeners are thinking about, like, what do we do, like, you know, I think during during COVID, you know, working remotely in virtual was I don’t want to say invoke but it was sort of it was sort of forced upon us. And, you know, I’ll call the all virtual company creation and working environment, maybe give us a passing grade on the virtual working experiment. But what we found is there’s a lot of efficiencies that we’ve gained through this period of figuring out a work virtually and through video interactions. But we’re very organized and methodical in how we bring our teams together. So we feel like we struck the best balance of a hybrid working culture where you know, we’ll never be an office-based culture. People are Coming into the office on a regular basis, no one’s required to do that. So it’s more a matter of being deliberate around how we bring teams together to do work and collaborate in front of the whiteboard and, and get things done. And so we bring the company together annually all together, we have quarterly meetings for our product and engineering teams. And then we have some teams, like our services or sales teams that are naturally more nomadic and want them spread out more in location. And then a lot of things we do are virtual.

Matt Watson 10:29
So from where you guys are today to where the company started from the original idea, is it the same or did it kind of change from where you guys first started a couple years ago.

Dan Goldsmith 10:40
So the mission and vision is the same, you know, how we’re getting there. And so the pace at which we get there, and what we focus on as a priority continues to iterate. You know, I’ll call ourselves a learning company and we will iterate. And, and, you know, there’s a philosophy that we had, and my previous companies were applied here to attend to as well, we want a healthy mix of delivering capabilities that the industry needs and desires, mixed with a healthy percentage of capabilities that are going to where the puck is, you know, skating to where the puck is going to be. And so that means we’re constantly trying to drive that innovation and just say, what are new ideas and new ways of doing things in healthcare, and it’s a blend of those things. And so we’re pursuing, first and foremost, the patient care journey, and an application and technology solutions that facilitate patients navigating healthcare, whether they’re seeking care, scheduling, and care, engaging and following up and care, they can do that in a ubiquitous way across providers. So that’s the mission we’re on. And then we’re, I think, most importantly, we’ve taken this foundational customer approach.

Matt Watson 11:48
So can I explain that for a minute, well, so I mean, so my next question might be related as is like, so who is the customer in the user? So is it the insurance company that is at the hospital as an individual clinic? Like, where? Where does this journey of this kind start?

Dan Goldsmith 12:01
So glad you asked, so our primary customer is their health care provider, if you’re talking about the buyer.

Matt Watson 12:08
Our primary tool like clinician, like my primary care doctor is like your hospital system, which we’ll be getting over 50% of primary care practice out of healthcare systems today, right?

Dan Goldsmith 12:12
So, it could be providers large and small either. But mostly, we’re working with hospital systems, as the buyer, the beneficiary, and the stakeholder price takers, actually the patient, the caregiver, or the clinician, but we really want to anchor in and center around the patient. One of the unique things around industries like education, life sciences, and healthcare is it’s a distributed stakeholder environment. So what that means is that the buyer, stakeholder is not necessarily sort of the user or the beneficiary, right. So we may, you know, sell to health care systems, but the patient is our focus, and the patient is the ultimate beneficiary. And that creates a problem. By the way, there’s a lot of technology companies that may say, Hey, we got to appease the buyer, and we got to focus on the buyer and do everything that they want to do. But that can sometimes send you on the wrong path. And so we try to keep a healthy balance of awareness of those different stakeholders, but always with the patient interest at the center. And so that’s how we’ve oriented our focus. And then you know, payers are more in the future of our roadmap, we really want to make sure we get the patient provider connection right, and work well before we go broader.

Matt Watson 13:31
So I’ve seen, like, my doctor has some kind of portal I log into, and I can send the messages or I can view lab results. And so is this all similar to that sort of problem you’re trying to solve?

Dan Goldsmith 13:46
So it’s, it’s, it’s yes and no. So there are pieces of what we do today in healthcare, but our expectations have been set really low. You know, if you make it really simple, it’s really, it’s really simple. And it’s not connected, in other words, but if you think about it, the type of experiences we have in healthcare, we would never tolerate another industry. Let me give you an exact example. In a vignette, I went to the doctor a couple months ago, visited a doctor got through the being seen by the doctor and the doctor, you know, just like we’ve all experienced that, hey, I’d like to see you and in six weeks and walked out to the the lobby area, I waited in line for someone at the front desk when I got to the front desk. I said to the person Hey, the doctor wants to see me in six weeks and they said okay, let me look here. Let me look here and they said, Oh, six weeks would be July. Your July is not loaded in our system yet. And I’m sitting there with my phone calendar about, you know, putting an appointment in the calendar. They go Do you mind if we call you back in a couple of weeks when June is in our system and I can make an appointment for you. And she takes a post it note in a pen and writes My name and number down. That’s crazy. It’s insane, right? So there’s so many experiences. Everyone in healthcare has a story of how it’s been complex to get care, it’s been a, you know, the anxiety has been high, the uncertainty is there. And so when we start looking at the health care experience for patients, the fragmentation, the uncertainty is really difficult to deal with when you join Tendo if you start seeing all of those things and all of those problems. And so you know, if you want to turn a blind eye, you shouldn’t join Zendo. But we’re looking to fix that we’re looking to make that patient experience in Tendo, as seamless as Amazon as easy as Open Table and as you know, comprehensive to handle the complexity as what we would have in other areas, our lives, navigating things like, you know, financial dynamics, and how we do banking or other elements. So that’s what we’re looking to do.

Matt Watson 15:49
So if I’m reading this, right, am I reading this? Right? And this is like public information? Oh, no, it was always accurate. Have you guys raised $69 million?

Dan Goldsmith 15:58
We have raised $69 million.

Matt Watson 16:01
So which is insane, and over a two year period? So that’s a lot of capital.

Dan Goldsmith 16:06
Yeah, we actually, you know, if I talked about our capital journey, you know, I think doing your homework pays off. First of all, because you know, if you if you, you know, for all of the entrepreneurs out there that have done pitches, by the way, we’ve done zero investor pitches. For those of you who don’t pitch, you know, it’s not just about having a good idea. It’s having a team that can execute and a plan to execute on and being really, capital efficient and responsible. So when we talked about raising capital, we developed a plan, we developed an approach, we started with some bootstrapping. And then we met him in Tunisia from General Catalyst, one of the largest VCs in healthcare, and then the laws of berry from Lux. And we realized that we all think like and see a similar vision of opportunity for change in healthcare. And then it was very easy from there. You know, they wanted to be part of what we were doing. And they wanted to underwrite that story and that long term ambition. So we put 70 $70 million, and about $70 million on the balance sheet. Our last raise was done on May of 21. It was done at a $550 million valuation. And so I like to say we’re super, super smart and predicted this economic downturn. But with that, combined with our foundational customers, which I’m happy to talk about, we have a three year runway, we are 110 people, we’re doing really well we got a three year runway, if we win no more new customers, we still have a three year runway. So we have a lot of upside. And that the most important thing around what we’ve done from a capital perspective is we wanted to make sure we can invest deeply in r&d, and build something substantial, and that’s scalable and extensible. You know, there’s no interest in being a small company or one hit wonder, we want to build a company that’s enduring is making an impact and is frankly, a great place to work. And so my job as a CEO is to make sure that we have the money to do. Part of my job is to make sure we have the funding to realize that vision and put the right governance in the company to protect that vision over a long period of time.

Matt Watson 18:09
Well, I’m going to take a second to remind everybody that finding expert software developers doesn’t have to be difficult, especially when you visit, where you can build a software team quickly and affordably. Use the Full Scale platform to define your technical needs and see what developers are available or what developers are available to start your team today. Visit to learn more. Well that part about that that impresses me so much is like you’re gonna just company was like, a year or two years old Max and you’ve got a $500 million valuation to me, that’s, that’s pretty insane.

Dan Goldsmith 18:40
Yeah, and I think look, I think there’s look, valuations are a little bit of a numerator denominator equation, right? When you look at the valuation like the money you’re raising, and I think it you know, our investors look at Tendo the market, we’re focused on the approach we have in the team and were bailed on thinking that we could be a 30 to $40 billion company right? Now, you know, no one’s taking cash to the bank on that valuation. At this time, there’s a lot of work we need to do. But I think the most important thing for me about the capital and the valuation is its fuel for the company to do what we need to do that is not highly diluted. So it gives us a long runway and the ability to invest to get the best people to focus on the right things to tackle hard problems, right? And, frankly, you know, you’ve been through this man, you know, when you go through the gauntlet of small fundraisers over and over again, you’re more susceptible to economic fluctuations and sort of the fundraising environment. And frankly, it can be really disruptive to the momentum of the business. You know, if teams of people are having to step aside and go out and fundraise and do things often it’s really hard it’s a full time job in itself.

Matt Watson 19:46
That’s right, well more than anything my my point is like you guys must be seeing some you know, explosive growth you know, over the first couple years of the company you know, so that’s that’s huge kudos to you guys. You know, Cap capital raises things aside, I mean, you guys, you guys must be seeing some major, you know, market adoption of your guys’ product.

Dan Goldsmith 20:06
So well, we will. So here, let me let me bend your brain a little bit more we’re not generally available yet. So we don’t have a product for the Lean market. So this equation will get to be more puzzling to you, right? So when I talk about having an amazing team and amazing vision, people are underwriting that. But the other piece is this foundational customer piece. Let me explain now that I’ve teased you a couple of times. So the general approach we’ve taken, you know, I, you know, myself, my team were experienced people who have built companies before. So I think there’s just some credibility that helps with our investor base and the market and market access. But we’ve decided to implement what we call this foundational customer program. And the basic philosophy is this or ratio approaches this, many tech companies will start by building a small product and trying to get lots of customers, because that’s how you get revenue flowing. That’s how you get out of this, this frequent fundraise, that’s how you create stability for the company, what we said is, we’re going to have a really ambitious vision, we’re going to invest deeply in r&d, and we’re going to select, you know, two, or three or four healthcare systems to work with exclusively during the early days of the company. And they will be our proving grounds and evangelists. They pay us money. So they’re there, they sort of, you know, subscribe over the long term to Tendo. And benefit from being able to influence our product roadmap, not own it, but influence and help prioritize. So we’re working with amazing organizations like health first down in Florida, which has an incredible integrated delivery network for health care, doing incredible things around patient experience there. And another one is rush in Chicago, you know, working with no more Latif is the CEO there, and team to reinvent the patient experience and introduce new analytics into healthcare as well. And so working with those organizations gives us focus, it also means that 85 to 90% of our investments, and our capital is going to r&d. So we’re not having to spend lots of money on customer success and go to the market so we can be super targeted. And so with us being able to generate an early stage of fairly large global scale and revenue, have a good capital base, and have customers that are those what I call proving grounds and evangelists. It significantly de risks business. And so that’s how we’ve set ourselves up for success.

Matt Watson 22:26
I mean, I’d love to work at a company that had like a massive budget for r&d like that. That’s a dream job for me. We need to go build some products.

Dan Goldsmith 22:37
Yeah, we have some money, let’s go to ADS, we do have some pretty incredible engineers. So it’s, it’s, that’s where we’re making our investments, really great engineers, UI UX, and product people. Absolutely.

Matt Watson 22:46
So we’re Where are you guys out in the phase of this? So do you have those two or three, you know, kind of early early customers working very closely with? Do you guys have a goal for like, general availability, or kind of the next step of this or?

Dan Goldsmith 23:00
Yeah, so what we’re doing is we’re moving out of the foundational customer phase now, which means we started deploying product and production. So we’re putting the product in the hands of patients and getting a really good response. And, and what we’re doing at our foundational customers, and then we’re moving into what we call our early customer phase. So we’re still gonna be somewhat selective in the customers we choose to work with. Because, you know, customer success in this business is everything, right? Your reputation is everything. And so what we want to do is we want to be moving reference selling as soon as possible. And you know, if we have case studies, proof of value, and customers that can, can speak on our behalf around the benefits, but we’ve been able to deliver, that’s the most valuable thing that we can get to write and it keeps us grounded, as well. So we’ll move into the early customer phase, we’re moving into that now, over the next 12 to 18 months, we’ll bring on another five to 10 healthcare systems and customers to work with, and we’re already contracting with a number of those. And then past that period of time, we’ll move fully into GA and our first product or two, and we have a new stream of other other products and ideas we’ll work on as well build on top of our platform. But that’s how we’re working on our expansion and going to market. By the way, if you want to have some fun, I call it the velvet rope approach. So you know, we talk to a lot of customers, we tell them we’re doing and they get really excited. We let two or three in the club when we’re sort of setting things up and building it. But you know, we’re keeping engaged with a whole host of other healthcare systems and potential customers, and they help inform what we’re doing too, but they get excited about the vision and, and that’s how transformation happens. You know, it doesn’t happen a Big Bang moment. It happens incrementally over time as people build trust and, and, and proof of value. So that’s our approach.

Matt Watson 24:42
Well, I can’t wait for you to see how excited they are. When you tell them we were one of the top 12 startups from Philadelphia on the Startup Hustle podcast, you know, it’s that’s got to help you get three or four of these big medical groups like that feather in your cap. That’s going to be the thing.

Dan Goldsmith 24:57
Yeah, well, you know what, it’s interesting that those things do help. Like, honestly, you know, when you when, when you get recognition especially in like health care, you know, this is a risk averse industry man, and rightfully so you know, I mean, there’s, there’s not as many industries where you’re literally talking about life and death stuff, right? I couldn’t be a doctor, I don’t know about you, but like, you know, if I have a bad day or you know, I, I miss a calculation, you know, you know, maybe maybe you spend an extra $10 here or there, maybe there’s a bug in the code or whatever, but I couldn’t be a document, I have so much respect for clinicians and healthcare workers and what they do, that’s life and death stuff. So, so anyways, and you know, in this risk averse environment, they want to work with organizations like Tendo, who are very steady and on the rudder, very responsible we’re doing, and he can really count on Tendo as an organization, being respectful, being humble and working in line alignment, their culture and values and caring about what they care about taking care of people’s lives. So, so, yeah, recognition, like being in the top 12 does help.

Matt Watson 26:08
Well, so glad you were able to join us today for that. And so what do you guys see as your kind of biggest challenges at this point, kind of in the face phase that you’re at?

Dan Goldsmith 26:20
Yeah, so So I’ll give you two challenges, maybe three challenges, right, one of them. The first one I’ll give you is more of an existential challenge, given the environment, right, we’re all talking about the economy and fluctuations in economy. You know, that is no, no less impactful, you know, in health care is one of the most impactful areas where the economy is impacting things, you know, there’s, there’s only certain prices you can try. There’s fixed pricing and healthcare in many ways, but inflation is impacting the cost of goods and you know, salary and wages are going up. So you know, health care right now is in a bind, I think one of the consulting and strategy agencies said like over 50% of healthcare companies are going to be running negative margins this year. And, you know, if you average them out, you’re like, maybe a half a percent or 1% margin. So this is an industry that is under a lot of economic stress right now. So challenge number one is making sure that we do not take lightly the ability to quantify our value proposition. So patient experience, everyone recognizes we need a better patient experience, everyone recognizes we need a better patient experience. But correlating the improvements of patient experience to economic value, and sustainability to healthcare organizations is not an easy thing to do. So that’s one of our challenges. And that’s an environmental challenge. Internally, you know, I wouldn’t say it’s a challenge, but a priority for us has been building a good team and having amazing people who can be entrepreneurial and be visionary, right, we’re not trying to be a me too company. And, you know, one of the challenges for us, if we lose the ability to challenge the status quo and sort of poke at things, then we won’t, we won’t realize the vision we have, we won’t make progress as a company. And that’s a hard thing to do. So I think part of the challenge is continuing to have that edge of innovation, while still being respectful to the healthcare organizations, you know, and the industry that we’re partnering with. So those are the two primary things. You know, I think that the third thing for us in terms of challenges is just making sure we’re paced and thoughtful in what we do, and we prioritize customer success, right? If we have successful customers, then we will have commercial success. Something your listeners might want to be interested in, like I’ve thought about, I’ve seen a lot of companies. I truly believe in a company that starts with a mission at its core, and we think of ourselves as a mission oriented company, improving people’s lives. If you start with a mission or your core, I believe you can be financially successful. I think the opposite is not necessarily true and is very hard to do. If you start a company with a financial goal, it’s much harder to be mission successful. So for all of you that are out there that think about being mission driven, and being purpose driven, really embed that in the core of the company, or it’ll change who you hire, how you hire, how you think about building things and what your ambitions are. And so that entrepreneurial spirit, especially applied in industries, like healthcare, you know, is a little bit of a different flavor than I think in some other industries.

Matt Watson 29:21
That’s fantastic advice. I love that. You mentioned earlier that margins are a huge problem for these health care providers, healthcare systems. So as your guide is a software, something that can help with that can help them increase revenue or help them save costs in various ways. I mean, are you part of the solution there to help them?

Dan Goldsmith 29:40
We are Yeah, we can be. You know, there’s a challenge. There’s a challenge especially in healthcare. I think any industry where change presents risk, and we’re in a situation where healthcare changes are inevitable because you know, if you stand still in health care costs will continue. To increase, innovation will continue to happen. And there’s disintermediation occurring right now with the traditional sort of AMC or healthcare system. So with Tendo, we can help bend that cost curve and change the economics of health care, you know, things like reducing no shows there. I don’t know if you know this, but on average, sir, patients don’t show up to their appointments, even complex things like surgery, you know, on average, like 20% of the time, right? Well, I don’t know about you. But, you know, here’s the bizarre thing about health care, my schedule, I don’t know, $100,000 procedure, and I don’t show up, I don’t have to pay for that thing. If I booked a movie ticket at a local movie theater, and I don’t show up, I’m still out. 12. But yeah, so So the economic equation is very different in healthcare, but with Tendo, in the work we’re doing, we can help reduce things like no shows, we can make sure patients are better prepared for their appointments, we can do better matching of patients to clinicians, we can better optimize scores sort of scheduling, and load balancing. So you’re applying the right resources to the right problems, you know, we can help prevent readmissions of patients, which become very costly for hospitals. And then when you look at hospitals and hospital systems that are working on value based or at risk contract, where they’re basically saying, Hey, I’m gonna, I’m gonna take care of Dan Goldsmith, and, and, you know, cover his costs at a certain sort of fixed price, if you will, how do we help to make sure you have the right outcomes to take care of Dan Goldsmith proactively so helping hospitals organize and engage with patients and make sure patients are curating their care and following through with therapy? There’s a lot of dollars in that there’s a lot of reduction of cost, because a lot of expansion in revenue and margins as well.

Matt Watson 31:45
So as you mentioned earlier, you know, hiring talents has been a big focus for you guys for the last couple of years. So have you guys poached a lot of people from Cerner and Epic and those types of companies? So I’m in Kansas City. So we’re home to Cerner. Right. Like, Cerner is such a big, you know, big company here. It’s like everybody knows somebody who works at Cerner. You know, there’s like a couple of degrees of separation there. So I would imagine there’s, there’s a lot of talent in Kansas City for you, I’m sure.

Dan Goldsmith 32:12
So there is so there is but you know, certainly we haven’t actually poached a lot of people from from Cerner epic, or others, we have a number of people on the team that maybe have worked for those companies in the past at some stage or another, but we actually have very good relationships with Epic and Cerner and Athena and, and all scripts. And so, you know, whereas, you know, EMRs role is really about the clinical workflow and clinical documentation and revenue cycle management, you know, where we focus on this this deep, you know, horizontal, we call horizontal and vertical. So, you know, very, the end to end patient experience, as well as deep experience, whether you’re going through a cancer journey, or an orthopedic journey, whatever it may be, we really cover the patient side of that in a very proactive and deep way. So we work really hand in glove with the EMR. And there’s an important role, you know, connection there, between that patient experience, and then sort of the clinical workflow and what they do within the EMR. So it’s been important to bring some of the skills in our team that come from Epic or Cerner, that EMR and healthcare world, we’ve, we’ve hired some awesome people from there. But generally, we have a very good partner relationship. So we probably don’t want to be poaching too many people from those companies. Yeah.

Matt Watson 33:26
Yeah, actually, one of the first jobs I ever had, it was the second job I had as a software developer was building a laboratory information system. And so yeah, so it was, it was, it was pretty cool. It was interesting, you know, learning about all these blood tests and pathology and all this stuff. And, of course, at that time, I’m like, 20 years old, 20 I never even had my blood drawn for anything, you probably didn’t know what any of that stuff was, you know, yeah. And it was, it was cool to learn about and build a, you know, build a whole system from, you know, bringing in lab, lab test tubes and stuff and printing barcodes and, you know, dealing with the instruments and producing reports and all that stuff. And it was fascinating. So, there’s, there’s a, it’s fun, it’s fun, space to, to work in. And there’s a lot of people in the Kansas City area that work in health care software.

Dan Goldsmith 34:16
So, you know, and it’s interesting. So if we talk about vertical SAS for a second, right, you know, one of the previous companies I was with and helped scale Viva systems, you know, we’re now a $40 billion. Company rights are the grandfather verticals, as you know, I talk a lot about what vertical SAS is and what it means what it takes to be a successful vertical SAS company. One of the primary things is you need to have a good blend of what I call Silicon Valley DNA with industry expertise. And so a Tendo actually, our hiring strategy has been combining that you know, people from these amazing technology companies that have seen, seen scale and seen managing complexity with that industry expertise. So for example our head of engineering was one of the first 100 employees at workday and over a 16 year period helped to build many of their platforms and solutions over that time, a really incredible individual. And then our head of informatics is one of the leading, you know, analytics and informatics, healthcare people in the country, Dr. Bala Jota. And, you know, it was a leader during the pandemic, and has helped at national scale, sort of think differently about healthcare data and information and processes as well. And so, Matt is really exciting when you bring together, you know, and this is interesting for companies too, if you want to generate new and interesting ideas, be delivered around bringing people together with different backgrounds and experiences and pattern recognition. And so if you create a culture that encourages that and can tap into that in a productive way, you end up coming up with some really interesting solutions. And I think that’s embedded in the core of who we are attending to, as well. It’s sort of that constructive discourse that happens as we design products and bring them to market?

Matt Watson 36:01
Well, that’s the key to diversity of background and business, right? It’s having people that have the playbook of doing these things before working at places that have seen things done the right way before and done the wrong way before, right, they can come in and, and bring that playbook. So I know exactly what we need to do and how to do this, not like all on the job training or like, we’ve never done this for, we’re just gonna sort of figure it out. It’s like having the experience of people makes a big difference.

Dan Goldsmith 36:25
You have to do that. And, and, but you want people to have that experience, but also are really good at listening and collaborating. Right? I know, for me, as a co-founder, one of the things that is important to me, and people have different styles, right? I’m not a cult of personality person, like I don’t like being in bright lights or on stage and everything else. Again, I think the best things happen due to a team of smart people coming together. And so, you know, I think for all you, you know, CEOs and founders out there, one of the first and foremost things you need to focus on is hiring an amazing team. And so the litmus test that I use all the time is saying, hey, the people on my team, my management team should be better than me in every single way in their domain, right? If I’m better than our head of marketing, or head of sales, or head of engineering, or whatever, and I probably don’t have the right person, you know, I have my own domain expertise here in there. But man, especially when you’re a CEO, or president or leader of the organization, the number one thing you can do is to your point, hiring the right people on the team that have had that pattern recognition and really get things done.

Matt Watson 37:31
Well, if you need to hire software engineers, testers, or leaders Full Scale can help we have the people in the platform to help you build and manage a team of experts. When you visit All you need to do is answer a few questions and let the platform match you up with our fully vetted, highly experienced team of software engineers. At Full Scale, we specialize in building long term teams that work only for you to learn more when you visit Well, I’ve really enjoyed having you on the show today. And a big thank you are big congrats, again to being one of the top 12 startups from Philadelphia. And amazing what you guys are off to all the capital, you’ve raised me able to go and build out this big vision.

Dan Goldsmith 38:18
And I really appreciated the little anecdote you had earlier about was this about your gut, if your gut says that says No, trust your gut. If your gut says yes, do your homework.

Matt Watson 38:22
Yeah, I like that. I think I think that’s a great takeaway from today’s show. And do you have any other final nuggets of advice for other entrepreneurs that are listening to the show today?

Dan Goldsmith 38:35
Yeah, I think the, I think for other entrepreneurs, the advice I would give to everybody is, is as you pursue the vision of what you want to create, you’re gonna you’re gonna have a lot of people tell you what you’re doing is impossible, or hard, you’re gonna kiss a lot of frogs, but I think persistence is necessary for entrepreneurs. And for me, you know, when I hit resistance, it’s a motivator. And so you know, you’re gonna have as an entrepreneur and founder, you’re gonna have good days and bad days, man. Don’t quit on the bad days.

Matt Watson 39:12
There’s a lot of bad days. It’s one of my, one of my favorite quotes ever is the mike tyson quote, you know, everybody has a plan until they get punched in your face. Yeah. And I feel like as an entrepreneur, that’s, you know, every week.

Dan Goldsmith 39:23
It’s absolutely true. But you have those. The thing for me, you know, I’ve worked in big companies like IBM and startup companies. The thing about startups that is so amazing is, you know, Matt, if you have such a tactile connection to the successes and the work that you do every day. And so you can just you can feel that, that impact that you can make and in all the work you’re doing and I think that’s something that’s important that you want to try and create a, I talked about creating a family room culture when more people’s voices are are welcome, and everybody’s heard and you know how to have an argument every once in a while, but still Love each other in the end. Yeah. And so you know, as you’re working things, and you’re creating a culture, you know, you want to incur, encourage that entrepreneurial spirit and passion and bring things to the table and that, again, that discourse and that, that those arguments or whatever they are, they will ultimately result in better decisions and better outcomes that in that culture everyone can really feel attached to. And there’s the rewards, right, so.

Matt Watson 40:26
Well, thanks again for being on the show today. And again, everybody, this was Dan Goldsmith, CEO of Tendo. And congrats again for being on the top startup list. And thanks for being on the show today.

Dan Goldsmith 40:37
Matt, thanks so much. Glad to be here. All right. Thank you guys.