HIStalk Interviews Steve Shihadeh, Founder, Get-to-Market Health

Steve Shihadeh is founder of Get-to-Market Health of Malvern, PA.

Tell me about yourself and the company.

I’m the founder of Get-to-Market Health, a consultancy that helps healthcare technology companies accelerate their growth and revenue. I got my start in healthcare IT as a sales trainee with Shared Medical Systems, and through a series of growth experiences, ended up being their leader for commercial activities. I then had that same role at Siemens Medical after they acquired SMS, at Microsoft Health Solutions Group, and then finally at Caradigm, a population health company.

About two years ago, I formed Get-to-Market Health. I have a passion about the business and what technology can do. I also have a strong belief that high-quality commercial activities are an important part of any successful healthcare technology business.

What advice do you give a startup or a company that is getting into healthcare for the first time?

A big part of what we do is help people understand the market, but equally, help them understand how the market looks at them. Healthcare buyers are different. We will often have clients who want to enter a new space and it’s just not the right fit, or they need to make some adjustments. Lead generation, building a pipeline, qualifying — all those things are important, but the most important thing is figuring out where their product fits.

What help do companies need in deciding what product to bring to market or how to get it in front of the right people?

The healthcare market is incredibly complicated, in a good way. It’s not just hospitals and doctors any more. Trying to figure out who the real buyer is, who has the authority to buy, who has the budget to buy, and how to present a product in its best light is an important issue for any company, but especially smaller companies that are trying to grow.

How should companies approach a market in which Cerner and Epic have become dominant and may become even more so as providers consolidate to create a customer base that has fewer, larger players?

It’s funny how the market has swung. It used to be that everything was interfaced and people bought best-of-breed. Now the pendulum has swung the other way, where a few large companies dominate the space. But I don’t think you can keep innovation or innovators down. 

A lot of the work we do is coaching and helping innovators figure out whether they should have a relationship with one of those big companies. If they are going to compete, how? And if they are going to get out of the way of the big vendors, how do they do that and still be successful? It’s a tricky landscape.

I think of the relationship between newspapers and companies like Facebook or Google that send them much of their traffic, but also take a lot of their revenue. How can companies figure out how to cooperate with those big EHR vendors while remaining aware that they also compete with them?

We see that every day. There is coopetition, where companies are OK that you compete or you partner. But I think vendors and also providers are trying to watch the way the landscape is moving because hospitals and health systems have that same issue around digital traffic as well. It’s a pretty interesting time to be in this space.

Will big health systems succeed in their for-profit efforts to create IT companies, invest in startups, or run accelerators and incubators?

That’s the multi-million dollar question. The organizations you’ve written about, which I know well, have invested hundreds of millions of dollars to incubate businesses. They are  becoming the investor. 

I understand the argument. To have a strategic investor behind a product like that is a big deal and will clearly help with other providers deciding to do business with them. 

It’s early to declare success. You can certainly point to some great examples – UPMC, Providence, and Northwell  have made some  good investments. It’s a clear trend because they aren’t able to make the margin they want on the core business and they have valuable intellectual property that they want to leverage.

How do companies that bring in new investment money meet the accompanying heightened expectations for growth?

It may be a little overused term, but it’s clearly an inflection point. The investor is betting on a multiple and a growth that wasn’t there before the investor showed up. Often the company that has taken an investment hasn’t really thought through how they’re going to make that growth happen. It is a point in time where the business evolves. Sometimes the players stay the same but just change what they’re doing, sometimes there are new players, sometimes there are new markets. But generally when an investor writes a big check, something’s going to happen.

What catch-up work do small companies need to do once they’ve hit a higher revenue level and have to start behaving like a bigger company?

We generally get called in when there’s a realization by the leadership team or the investor that they want to do more in terms of marketplace growth. What got them to that point isn’t going to get them ahead, so they want to try something different. It could be new markets. We have one client that is bringing in an AI machine learning platform from Europe to the US. People are taking products up into the enterprise space where they just used to work in community hospitals. It’s a realization that they want to do something different and they’d like an outside point of view as they do that.

How does a company formalize its sales process?

That stereotypical sales guy or sales gal from the past still exists, I guess, but they are a dying breed. One of the biggest changes I’ve seen in my career is how much more capable providers are getting as organizations and as buyers. They are pushing and demanding more from their salespeople than just buying lunch and overseeing a good demo. It’s clearly gotten better. Often we get called in to help them improve the deliverable that their sales team provides to the buyer.

How much of a company’s success is based on the skill, personality, or perseverance of a superstar salesperson whose traits can’t be easily replicated or obtained elsewhere?

It’s an interesting point. I suspect that the head of engineering has a few people he or she really relies on. The head of services has a few key people they rely on. I can’t argue against salespeople who are stars.

However, it’s more of the whole commercial mechanism —  how the company presents the product to the marketplace, how it prices it, how it creates product awareness, how it names and positions the product, and how it approaches buyers. You have to approach the CIO IT shop with your act together. You have to be able to answer the security questionnaire. You have to answer how it integrates with the EMR platform. You have to be pretty buttoned up in order to be successful today. It takes more than just a great salesperson. Although they are good to have and everybody wants them, it’s far bigger than that.

How do you advise companies to fit user surveys from companies like KLAS and Black Book into their marketing plan?

Really small companies don’t have to worry about KLAS, but they have other activities. Big companies have to invest in KLAS, Black Book, and various awards. Folks on the buying side really do use it. You may not be number one, but you had better not be off the list. It’s an acquired skill to be great at both delivering customer satisfaction and managing your relationships with those companies.

Do vendors call you because they haven’t done a good job at developing relationships with their existing customers?

One of the cool things we’ve been doing a fair amount of lately is running focus groups with clients and potential clients, to help them understand how they are perceived and how their product comes through. It gives them a safe zone to test ideas and get honest feedback. We facilitate that and help them hear what the potential buyers say.

Cerner hired KLAS to convene some of its big customers to tell the company how to improve its revenue cycle product and to ensure accountability as they did so. Will other companies do something similar instead of just talking to those customers themselves?

I’m not sure I fully understand the Cerner-KLAS thing. I was reading something about it this morning, in fact. One of the most important things a healthcare technology company can do is to get honest feedback about what’s working and what isn’t working. However you do it, I think it’s great. We seem to be getting more and more requests to help with it.

How do you see your business changing over the next few years?

It’s an exciting business. I have learned over the years that I don’t know as much as I think I know. It’s going to change in different ways. You look at some of the big companies that are spending money and hiring people and doing things and clearly there will be some shakeout from that. I hope they have the staying power and don’t get exhausted before they deliver some real products and capabilities. With the IPO activity and the buyouts that have happened, there will be more investor appetite for innovation. That guy or gal with a great idea won’t have any problem finding investors. It will be interesting to see where the products have an impact.

What goes through your mind when you walk the HIMSS exhibit hall?

I’m one of the people who actually enjoys going to HIMSS. Not because of the environment, but because it’s the business I’ve been in my whole career. I love the energy. You can clearly see who’s doing it right and who’s not doing it right. There’s a bunch to be learned from it. It’s a pretty amazing business, and a fun thing about the business I’m in now is that I can have a broader view of it. The roles I had before, in hindsight, were fairly narrow considering how wide the healthcare space really is and all the ways it is interconnected.

It’s clear that companies need to have their A-game for HIMSS or they shouldn’t go. We’ve helped several clients get ready for HIMSS and to do it right, but we’ve also counseled some clients not to go to HIMSS. They wouldn’t be heard above the noise. Awareness and creating client interest is a key opportunity for any company. They really have to pick their spots, whether it’s HIMSS or HLTH or any of the other regional or local shows. They have to have their act together.

Do you have any final thoughts?

You and I are fortunate to work in a business that’s evolving, growing, and consuming technology. It’s a business that all of us will depend on at some point in our lives. My view is, let’s make it better. We get to work with diverse business leaders to simplify the complexity and buying patterns of the healthcare technology market. That simplified buying process, with a clear understanding of what a product does or doesn’t do, is good for everybody. It’s win-win. No one, especially today’s providers, has time or money to waste. We think effectiveness and efficiency matter. That’s what gets us up and going every day.