Designing for Health: Interview with Joshua Reischer, MD [Podcast]

Innovation in technology is always advantageous, but without pairing it with thoughtful, human-centered design, it will only remain innovation for innovation’s sake. Understanding user needs through direct observation and empathy is essential, especially when designing for patients less familiar with technology. By focusing on simplicity and usability, organizations can develop solutions that not only meet the expectations of patients and providers, but exceed them for a positive user experience that builds long-term trust.On today’s episode of In Network's Designing for Health podcast feature, Nordic Chief Medical Officer Craig Joseph, MD, sits down with Joshua Reischer, MD, the CEO and founder of Health Note, a company known for its AI platform that collects patient information and automatically writes parts of physician progress notes. They discuss Dr. Reischer’s time at Health Note, how he’s used technology to make health visits more efficient, and how to design technology systems for anyone, regardless of digital aptitude. They also discuss unexpected design fails, bringing developers directly to patients, and what Dr. Reischer has learned since starting his company more than six years ago.

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In Network's Designing for Health podcast feature is available on all major podcasting platforms, including Apple PodcastsAmazon MusiciHeartPandoraSpotify, and more. Search for 'In Network' and subscribe for updates on future episodes. Like what you hear? Make sure to leave a 5-star rating and write a review to help others find the podcast. 

Want to hear more from Dr. Joseph? Order a copy of his book, Designing for Health.

Show Notes:

[00:00] Intros
[01:51] Dr. Reischer’s background
[07:35] Pitching the initial startup idea
[09:37] The origins of Health Note
[16:02] Reaching patients before appointments
[17:10] Biodesign and Innovation Fellowship
[19:24] Early startup challenges
[27:05] Developing the product
[30:16] Health Note’s make-or-break moment
[32:08] The current state of the company
[33:15] Dr. Reischer’s favorite well-designed thing
[35:12] Outros

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Dr. Craig Joseph: Dr. Josh Reischer. Welcome to the pod. How are you, sir?

Dr. Joshua Reischer: I'm doing very well. How are you?

Dr. Craig Joseph: I am good. Thank you for asking. Let's start at the beginning. You're an internal medicine physician. Is that correct?

Dr. Joshua Reischer: Right, that is correct.

Dr. Craig Joseph: You are the CEO and founder of a healthcare technology startup.

Dr. Joshua Reischer: That is true. That is true.

Dr. Craig Joseph: It is called Health Note. I will answer that. That is accurate. All right. What has gone on between kind of college and now? How did you get from college to going to medical school to starting one or multiple technology companies? We want all of the details. Don't skip anything. Go.

Dr. Joshua Reischer: Sure! Well, in undergrad, I didn't yet know what I wanted to do. I studied political science and business. So not at all in medicine. Ended up spending a year in Sydney, Australia. And while I was there, I was working at a children's hospital and volunteering and loved it. And very quickly thought, you know, I could see myself doing this and it felt satisfying and at the time felt like, hey, that would be the only way that I feel satisfied is to help people in that way. I think there's lots of ways to help people in various different jobs and industries, but that was the passion. And so, then I ended up going back to school, taking all the science classes that are required for medicine. I spent a year and a half doing that, and then spent a year doing research, clinical research in HIV, and then worked at a startup in biotech for a year before going to med school. That biotech startup I'd say sort of put the bug in me of, hey, startups are pretty interesting. I was the sixth person at a startup that ended up getting invested in and acquired by Johnson and Johnson. And it was fun going there. Right? I didn't know that much yet. I was only somewhat valuable given my limited experience. I got paid very little, but I loved doing it. I loved that we were creating something new. Working on solving a problem that no one had really done very well yet. And so that part of it was exciting. It wasn't about the money; it wasn't about anything else. It was just, this is fun, interesting work. And so, I think that was the initial bug in startups or interesting or what is a startup? It was not a technology startup in the sense that, software and what we do today. But it was interesting. From there, I ended up going to med school and then did residency and internal medicine. While I was doing residency and internal medicine, that's where I started my first company. Most of my colleagues were thinking about fellowships. By their second and third year they were thinking about cardiology and pulmonology, nephrology, you name it. And I kind of was like, those are all interesting, but I don't know that I want to focus on that one thing for the rest of my life. And I wasn't quite sure. I was working at the VA hospital at the time, and I saw there were areas of opportunity to make things better in the way house calls were being done. I enjoyed the house call. My dad was a pediatrician. We used to have people come to our house, and I used to go with them to other people's homes, and I saw the impact it can make on people's lives. It's not just the convenience, but also understanding the person and the rapport and the way that you can help. And so, for these older veterans, this was also really valuable. But I noticed that sometimes we would get to people's homes who didn't really urgently need to be seen. And then sometimes we wouldn't get to people's homes who more urgently needed to be seen. And there was a variety of reasons why that was a difficult sort of pattern to match and to get to the right people at the right time. And so, the first startup I worked on was related to that. It was in-home, on-demand house calls. Think Uber for doctors. There's a couple of companies that are doing something like that today. We applied for some National Science Foundation grants, tried to create some heuristic algorithms based on the acuity of what the patient was coming in for. So, there were some screenings that had to be done beforehand, and it was interesting, but it didn't really go anywhere. This is a few years pre-pandemic. During the pandemic, this probably would have taken off, but a few years before it was difficult. I also was working 60 to 80 hours a week in residency at the time, so that makes things a little more difficult to start a company.

Dr. Craig Joseph: Sounds easy.

Dr. Joshua Reischer: Yeah. Super easy. I joined some startup groups in, I was living in Tucson, Arizona at the time, and the Small Business Association had these sort of free programs for people who wanted to start companies, and that's really where I started the whole pitch competition, understanding how to share an idea, whether business or otherwise, in front of strangers. But it was it was a great experience. I remember standing in line and wanted to pitch my idea, but didn't realize it was going to be in front of 100 people. And at the time, I mean, I was ready to sit down. I did not want to get up there in front of everyone and pitch this idea. I knew I wasn't going to do a good job. And, it was a pivotal moment in my life, for sure. You know, at the moment, I thought, if I sit down right now, I'm going to sit down forever. So, I stood up there, did it, and guess what? It wasn't that good. But we were still chosen to be part of this program and started the first company sort of in that manner. And if I didn't start, that, I never would be where we are today.

Dr. Craig Joseph: So, let me ask you, just a few follow-up questions. One, you were essentially a business major as an undergrad. 

Dr. Joshua Reischer: A minor. I'd say, you know, eight classes of, you know, accounting and things that were nice to know, but really not necessarily setting you up for success were actually starting a business. 

Dr. Craig Joseph: So, that didn't really ignite the passion or I mean, did that help you in any way? do you think looking back at it or just like, yeah, I don't I'm not an accountant. And that didn't make me into one.

Dr. Joshua Reischer: It's probably better than nothing. I mean, I took classes about the market and so, you know, did some investing on my own small stocks like invested in Apple early days and things like that, but really sure was probably better than nothing but hard to draw a straight line between that and what I'm doing today. But better than nothing, I'd say that, for sure.

Dr. Craig Joseph: And then I'd love to hear more about this first kind of pitch session where you were like, wait, I thought I was going to talk to three judges, and there were a couple hundred people in the room. Most physicians are comfortable, in my experience, not all, but most are comfortable kind of speaking in front of crowds. Right? You have to do that as a medical student when you're presenting and, and there's, you know, grand rounds and M&M and people kind of so had that not prepared you or was it that this was a completely foreign affair and not in the comfort of your hospital conference room?

Dr. Joshua Reischer: So, the idea for this company came less than a week earlier, and I think because I didn't know it was going to be happening in this format, it was more like that. I agree, I think being in medical school and going through the whole process has actually helped immensely in company building, especially in the early days. From a product perspective, physicians are constantly thinking about what's going on, trying to understand another person and a problem. And so, for me, that's I think set us up for how we build the company, is understand the needs from a design perspective. What possibly works and what doesn't in terms of presenting to people? There's definitely an element of that, but usually, you're a little bit prepared, you kind of know what it is, and it's usually in a small setting, at least that first round and all that, that happens a bit later. Right? And then you usually are really well prepared, and you've got your notes in front of you and everything. And this was kind of like a cold 60-second, tight pitch, which was a lot harder at that time. Now I've presented in front of thousands of people, and it feels kind of old hat, but at the time, it was definitely nerve-wracking.

Dr. Craig Joseph: All right, all right. That's, I think that's kind of that, origin story is helpful. So, the first stab at entrepreneurship didn't go very far. I think you mentioned that, you were a little you were a little ahead of your time, for sure.

Dr. Joshua Reischer: I mean, we created an Android app and Apple app, but I didn't have, for example, a co-founder who was a software developer. So, we partnered with some students at the local university, which they created something, but it wasn't necessarily that great. And so, to pivot closer to what we do today, we went through with that company summer accelerator program called Y Combinator. They had something called Startup School for the summer, and that's where I met my current co-founder, Aaron, who was a software developer, lives up in Silicon Valley, had been part of multiple startups in the past, and could actually build things on his own and had built things on his own, both medically and non-medically related. And so, through this process, I joined this sort of, can think about it as founder therapy, right. There'd be 20 founders who are on a Skype call, all kind of complaining about what they're trying to do, right, trying to get their first customer or their second customer, try to get a little bit of revenue or traction and whatever it is that they're building, making. And Aaron and I just kind of resonated. And we started connecting offline and became friends over about a year. And after about a year of knowing each other, we met in person, probably three or four times in that one year, but we'd talk multiple times a month. He had ideas for me. I had ideas for him. He was working on another startup after I graduated residency, started working for a primary care group, and with that primary care group, it was actually a fantastic place to work. But I still saw a lot of areas of opportunity to make things better. And so, I was complaining to Aaron about some of my frustrations and where I thought things could be better. And then within a few weeks, Aaron came back to me with, hey, would this be something that could be helpful for you? And I look at it, I'm like, this is interesting, but most of my patients are 80 years old, so it's cool, but no one's going to use it. And so, I give him some feedback. He comes back less than a week later and I'm like, this is pretty interesting. Let me see if anyone else would be interested in this. So end up showing it to a friend of mine from residency. He had an uncle who is a GI doctor in California. It turns out they're the largest GI group in the state of California. And we were on a call. I showed it to him over Zoom, and he said, how much does it cost? And we came up with a price with them. And two weeks later, we were staying in an Airbnb, spent three days at the clinic mapping out their workflows. And that was the starting of the company.

Dr. Craig Joseph: Wow. And so how did you specifically kind of come to the conclusion that, well, first of all, like, let's talk more about what is the problem that you're solving with Health Note? Like, what were you, what did you see out in practice that you were complaining to Aaron about that he kind of fixed.

Dr. Joshua Reischer: Yeah. So I would have older, complex patients come into a visit, and at the time, we had folks who would see the patients first and gather some information. Then I would go in the room and gather more information. And the initial thesis was why can't we gather more of this information before a visit to create a rapport from the moment we walk in. So, for example, if a patient's on ten medications, maybe we could ask them what medications they're on before that, and maybe we can ask them if they're on a medication that was likely prescribed by a cardiologist. When's the last time you saw your cardiologist? why are you taking this medication, who prescribed it to you? And so on and so forth. Basic questions that seem simple but can easily take 20 to 25 minutes. And when someone has spent the time to come into a clinic, there's a lot more that can be done in terms of creating rapport from a diagnosis perspective and also an explanation perspective of hey, here's maybe what's going on in here, the next steps, the plan, etc. I'd much rather spend my time working on that rather than information gathering. Now, information gathering is always going to be part of the process. It's not like we can completely get rid of it, but if you can bring it down from 20 minutes to five minutes, or for some providers, you know, from seven minutes to three minutes, you can spend time on things that matter more. So, that was really the thesis: how do you engage with patients before they show up for a visit? And the theory and the thinking of the time was, patients just won't do it. Or we have a patient portal, but some people do, some don't. And what I very quickly realized was what was out there was very generic. There was no logic behind it. You would ask the same questions for every patient regardless of the visit type or the reason for their visit. And the theory was, well, what if we made this relevant to them? What if we actually prepared them a bit for the visit and then made it better for the physician? Maybe we could have a self-reinforcing cycle.

Dr. Craig Joseph: Okay, so you know, we certainly know that when the physician asks a patient to do something, it carries a lot more weight than if they get a generic message or a request from, you know, a clerk somewhere. So that, that that makes sense. You know, another aspect that I think might, might play into this, at least I wonder if you, you agree oftentimes, you know, the medical student goes in and asks a question and gets a response and then talks to the intern, and the intern goes in, asks the same question and gets the same response. And then the resident and then the attending is now, made aware and said, okay, and goes in and sees the patient to confirm that everything's the same. And oh, so I understand you're not allergic. Any medicines? Oh, no. If I get penicillin, I'll die. And, it happens so frequently. And then, of course, you make fun of the medical student and the intern, implying that they never asked that question, even though they did. And what happened over time was that the patient had time to kind of think about that question. And they're like, oh, I do remember that one time I almost died. And maybe that's important for you to know. But I didn't remember the first one, two or three times that I got asked. And so maybe there's some benefit there as well that you're giving these questions ahead of time. And even if they answer them incorrectly, because they can recall something, in the time span between filling out the form and actually being there, they might be have, actually much higher quality information for the doctor.

Dr. Joshua Reischer: Exactly. Giving patients time to think and also not be in a clinical setting where someone's wearing a white coat and you're kind of nervous, and you just drove there, and you sort of took off work to get there, right? Because, you know, it's not easy actually going to see the doctor, right? You're taking off half a day because, you know, when you get there, you're going to be waiting for an hour and things always take longer than you expect. And so enabling a visit to be a bit more confirmatory instead of exploratory. So you're sort of skipping the process because unless you're in an academic setting, you don't always have a medical student and a resident and someone else to see the patient. And patients also get frustrated by saying the same thing four times over. And sometimes they kind of hold the information or the answer for the doctor because they're like, oh, I'm just going to see the doctor said them to tell this person everything.

Dr. Craig Joseph: Now that makes complete sense. So you started this company, and I understand you also spent some time early on in, in the company at a fellowship. Was that, is that around this time, or is that, am I getting my dates wrong?

Dr. Joshua Reischer: No, that's correct. So, about a year after starting the company, I went and did a fellowship called Biodesign and Innovation. There's a few programs throughout the country that do this. And generally, the concept is they take folks from different backgrounds, someone with a clinical background, someone with a technical background, and then someone with a business background. And these programs are typically set up into two different sort of pods or modules, sometimes even more than that. Often there's a software team and a hardware team and the hardware or biological team has typically someone who the technical person there is someone with, like a biochem background or that kind of background versus a software background on the other side, right? And the physicians can be of all different sorts. My other colleague was a surgeon, right? So he was a surgeon. They created a device that was their goal with their project. And the whole point of the fellowship is actually to start a company. It's not just to observe needs, but that is a big piece of it. You spend a year going to different hospitals, and clinical settings, understanding what's going on at these organizations, identifying needs, going through an organized process, a design process to figure out, like from a needs-based approach, what problems should we focus on and try to solve? And that's really the point of this fellowship. So it was really interesting, and so the colleague I worked with, he's now running a company that we started, at the time, helped out with, sort of like a side project. At the time, it was just me and Aaron. Right. We didn't have any other employees. We were just building on the side. We had a couple of customers, and so we were really just getting our feet wet with integrations and all of that in the interim and then ended up leaving the fellowship. It was a ten-month fellowship with an opportunity to do two extra months, but ended up leaving because we got into an accelerator program with Cedars-Sinai in LA. And that really sort of launched, okay, let's do this full time.

Dr. Craig Joseph: All right. And so was it just, you know, champagne from the very beginning? Did it all work great? How did this thing evolve? Like, yeah. Tell us the story. We want to know everything.

Dr. Joshua Reischer: Yeah so building a company takes time, effort, and money. So nothing is ever simple and easy. You need money to build things, especially in software. It's often money-intensive to build things. You need to hire people. And good people are expensive. And so it's quite typical if you're trying to move faster to go out and raise outside capital. So that's one big piece of the early days is can I get the money to then build the things that we're trying to build? Right? And when you're a new company, the first thing that people ask you is like, they can kind of sniff you out, right? Like, okay, there's two of you building this thing, right? And they don't want to invest their time, effort, and dollars in something that may not exist in a year. Right? So I still remember every single one of the first customers who worked with, the fourth customer, or the fifth customer or the tenth customer, and you start to build up as you go along. But it's really hard, right? Because, at first, you don't have any credibility. And, you know, once you start building credibility for us, we work in multiple different specialties. So, every new specialty was a first, right? Oh, you've never worked in orthopedics. How do we know we should work with you? Oh, you've never worked in urology. How do we know we should work with you even once you've had 20 customers? Now there's always a first. Right? And so, it's a constant, uphill battle, sort of proving to people that, hey, there's something, that might help. And building that credibility. Now, once you get to a certain size, people stop asking becomes a little bit more obvious in the materials that you have, website that you have, the product becomes a bit more polished, but then you have new and different products. Right? But it's definitely challenging from every single angle from the beginning.

Dr. Craig Joseph: So let's, let's talk about the design of the product. Your goal was, to confirm, not explore, which I love, by the way, I want to start a company and use that as our motto. So you might want to copyright it or trademark it or something. Sooner rather than later. But, you know, I love that idea of, hey, I'm just going to walk in and tell the patient what I already know about them and have them tell me where I'm wrong. Maybe I got it wrong or they communicated there was some communication problem. So how do you design that? Is that on a phone? Is that on a big screen? A lot of your patients are elderly, as you mentioned. How do you make sure that it's clear to them? How does that work?

Dr. Joshua Reischer: Yeah, I think one of the most important components is: you can have the coolest technology in the world, if patients don't use it, it doesn't matter in health tech, right? You can have all the AI, all that, anything. But if it's not easy to use and you don't have a high uptake, it doesn't matter, right? You can bring a lot of value, but if it's only for 10% of your patients, you're missing out. And so from day one, we realized that very, very quickly. I, I'd say that very quickly. I started talking to older folks who were maybe less tech-savvy. My dad was one of those people, at the time, he was 72. If you asked him to turn on a computer, he'd say, where's the on button? Right? So he really just didn't know how to use it, he also had Parkinson's disease. He was left-handed. His left hand would shake. So just to give a visual here of someone who really doesn't know how to use the computer or a phone very well, but does a little bit of texting and can call friends, family, and, you know, is working in the modern world, and so very quickly started to show it to folks like him and patients and got feedback right away. And what I learned is sometimes patients will give you feedback on just people in general. And sometimes you just have to sit and observe. Right. And you have to watch, like, is the person hesitating? Is there a hand sort of not sure where to tap. Are they thinking how long is it taking? And then trying to figure out and iterate as quickly as possible? What does this need to look like? Right. And so some of it is, hey, it needs to have really big font, because if people are squinting and they're holding it right up to their face, it's probably not going to work very well for people. If you have to instruct people what to do, you've already lost sight. So very quickly it was, we found the simplest way is to text message patients. Okay. They're already using text messaging. So answer rates are in the 90 plus percent, right. You get a text message, you usually open it versus email or phone call much lower than that, okay. You got them through text message. Great. Now get a text message. You click on a link okay. Now what's in there is what matters next. Because every point is a point of failure. Right? And so there were things like large font and arrows pointing to what to do. And really just having an explanatory product. So it was really if you can use any technology, you could use this. I would say that now there's always going to be some folks who can't use anything, and you can't design 100% for everyone. Making something that had no download had no password. Right. But you want something secure, but you didn't want them to have a username and a password. So reconciling those two pieces was a challenge, right? And things that we designed around over time to make it easy for patients to use.

Dr. Craig Joseph: Okay. So were there any times where you thought you had the answer and, it was going to be brilliant, and then you took it out into the field and watched people and they're like, uh, I’m not sure what I’m supposed to do?

Dr. Joshua Reischer: We built this app first for the iPhone, but then very quickly we created an iPad version, brought this into the clinics. Well, an iPad is a lot larger than an iPhone. And so the beauty of our product at the time was we're only showing one question at a time, which is the truth on a an iPhone, but an iPad, you can now see three or four things at a time. And again, you or I might know what to click on. But for an older patient who's not sure where to press, we were losing the simplicity that we built on an iPhone because once you brought it to an iPad, now you're seeing 400% more information than you were on an iPhone. So we had to now then completely design around that and say, wait a second, you can't just translate this to another device. It actually looks totally different. And the way people interact with it is totally different. So the initial design theory worked, but that was totally wrong in the clinic, and we would not have known that if we weren't sitting with patients. So I remember the patients I was sitting next to the one that I tried to explain to our design team was, I'm sitting in between a 77 and a 79-year-old former farmers who didn't finish high school in rural Arkansas. And so how do you make this really simple for these folks? Because we're not just designing for folks in New York and San Francisco and LA. And so getting into the mindset of these folks, also, you know, patients would bring in a shoebox of medications, right? And they might be on ten medications, but they brought in 30 bottles. Right. And so, like, how do you make that easy for them to enter information? And by the way, for older folks, like if there's an iPad it's a little bit heavy. So now it's going to be sitting on their lap versus they're not just holding it in their hand like they would their phone, so now it's even further away. And so things like that you just don't think about unless you're in person watching them use the product you cannot design from just, you know, calling people on the phone. You have to actually be there.

Dr. Craig Joseph: Did you bring your developers to the patients, or were you kind of like the middleman and then going back and describing? Or both?

Dr. Joshua Reischer: At first it was me, and then we started to bring developers as well. Okay, what I realized it was sometimes a little bit more challenging for non-clinical folks to feel comfortable in a clinical setting. For me, having gone through med school and, residency and obviously working as a physician, plus doing a year of this, this Biodesign program was literally built around just observing. Whether we would observe at the front desk or in a surgical center or in the operating theater, wherever we were like, that's what we were doing and meant to feel comfortable there. And so not everyone always feels comfortable in those settings. Like, I felt comfortable a patient, you know, entering their personal information and could create a rapport with them really quickly. Right. For a software developer, they may have never done anything like that. So sure, it was often easier for me to be there with them and say, hey, I'm Doctor Reischer this is X, Y, Z. You know, they're going to be watching, observing. Is that okay? Right. We're trying to make this easier for folks like you. And typically, they'd say, yes, it's very rare that someone would say no, but it's sort of the confidence and also clarity of what we're trying to do, which, you know, seems intuitive but not necessarily to everyone.

Dr. Craig Joseph: Yeah, you know, my experience, working for an EHR, vendor, like, we really need to, to get our engineers and developers out there. And often they would do everything in their power to not come, for the reasons that you just outlined right there. Very, first of all, a lot of them are just not that comfortable around lots of people. And, and B, even if they were, this is an office or a hospital or an operating, you know, theater, like, you're around, and in areas that you're uncomfortable with, with people that you're uncomfortable with. However, the benefits of kind of getting them out there, and seeing the frustration or, you know, kind of feeling the pain is I found it much more, much so beneficial. I could not accurately represent what I was seeing. You know, I could try, but, it's completely different to, to kind of see it. And, when things go wrong, public shaming is, is quite effective. Yeah.

Dr. Joshua Reischer: It's helpful to feel the pain. I totally agree. Getting an email. Hey, something's not working is very different than. Oh, things are backing up, and you're watching it happen. You feel it, and then you fix things really quickly, right?

Dr. Craig Joseph: Oh, yeah. And it kind of can reprioritize when you when you have a picture of someone. It's one thing to have an avatar like we're describing this group of people, but boy, it's completely different when you remember, you know, Mr. Smith and talk to him for a few seconds and, learn like you give us some of that personal detail about, he's been a farmer, and, you know, he's had a tough life, and that gives you some empathy for, you know, make you want to do better than you normally thought you could.

Dr. Joshua Reischer: Yeah. You remind me of a story. Actually, the first patient that we showed Health Note to who was part of a clinic. So, this GI group that we started with, the doctor said, this is really interesting, but I don't know if any of our patients are going to use this. So he said, let me show it to one of my patients. So, we ask the patient, hey, is it okay? Would you want to try something? I go in there the guy is a 75-year-old veteran, I was like, oh gosh, I don't know how this is going to go, he’s a little older. Is he going to feel comfortable with the phone? We explain to him what's going on and hand over the phone, and he's filling it out for, you know, he's answering questions for about five minutes and the doctor asks him, and this is kind of a make-or-break moment. The doc said, yes, we want to try this. He said yes to having us come in the clinic. But then it was like, oh gosh, most patients think this is terrible, this is not going to work. And after using it for five minutes, the patient goes, “So you're telling me that instead of playing phone tag for three days and spending 20 minutes on the phone with one of the folks who was calling me, I could have just done this?” So that patient sold the whole product and the idea for us, right? It was just such a no-brainer after that. That really made it honestly, like that one moment was the start of the company, I'd say. 

Dr. Craig Joseph: That's great. And how did you slip the $100 to him ahead of time? Maybe you don't want to answer that question. That's fine, that's fine. Well, that's great. I mean, that's, boy, you know, you got the right patient, and he was feeling the pain. And then he was able to describe that pain in front of the physician, that's beautiful.

Dr. Joshua Reischer: It easily could have gone the other way. He could have said, I'm not sure, or he could have gotten confused. So, you know, there's an element of luck in everything, right?

Dr. Craig Joseph: Absolutely. So, kind of we heard about the origin story. How’s the company doing now?

Dr. Joshua Reischer: Since then, it's grown significantly. We're now in clinics around the country having millions of patients using the product every single year, in multiple different specialties and everything from small group practices to large health systems. So a lot has changed. We've learned a lot. But the core thesis actually remains the same of what we do. We've added features and functions, and continuing to innovate in terms of using the latest technologies to make what we do better. But the core components are still a big piece of what we do.

Dr. Craig Joseph: That's awesome. Well, congratulations on the journey so far and look forward to the continued success. And you'll be like the Time Person of the Year at some point. That would be my wish for you as we as we get to the end of the pod. Let me ask you a question that I'd like to ask everyone who we interview, and it's around design, and I'm curious if there are one or two things that are so well-designed that they bring you joy and happiness.

Dr. Joshua Reischer: So when I moved to Los Angeles and went through this Cedars-Sinai accelerator program, I lived about a mile away, and I realized I was driving in there every single day, which kind of didn't make any sense. And walking was fine. LA weather is always beautiful, but I decided to buy an electric bike, and I bought this bike. It's called the Stromer bike, and I bought it used, but it was and is still amazing. It's one of these bikes that can go 100 miles on a charge, which is pretty incredible. I think 100 and something miles, actually, can go 28 miles an hour. Beautifully designed. It has all these interesting sort of little features and functions. So, like there's a GPS built into it. So if someone steals it, you can track it. There's like a locking button on there that you can press and automatically locks. That makes the whole thing unusable. So it's both beautiful and functional. And you also get some exercise doing it right. So you're it's not electric in terms of, oh, you just press a button, and it goes, you're biking. But it's kind of like having someone behind you, like Superman's flying behind you and pushing you a little faster. So like, if you were riding your bike and going 10 or 12 miles an hour, now you're going 25. So it's a lot of fun, and it's beautifully designed and well worth it.

Dr. Craig Joseph: Well, that's awesome. We will endeavor to put a link to that in our show notes. And so people can buy either new or used, do you still have yours?

Dr. Joshua Reischer: I still have it four years later. It's awesome. I use it all the time. I don't own any stock in that company. So people who click on that link, it'll be whatever it is. But, it's a great bike.

Dr. Craig Joseph: That's fair. And, you know, maybe we'll, you'll auction it off at some point, it'll be worth a lot of money if a lot of people want that bike. Awesome. Well, it was great having you, Josh. I certainly learned a lot. And your application of kind of taking healthcare and technology in design and putting them together and kind of turning things upside down, so that people can spend time, quality time answering questions before they get to the clinic so that all the work is actually done in the clinic and less time kind of investigating the problems and more time solving them. So seems like a recipe for success. I compliment you and again, look forward to seeing all the successes that you're going to have in the future. 

Dr. Joshua Reischer: Thank you so much.


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