Medsider: Learn from Medtech and Healthtech Founders and CEOs - AI That Fits the Clinical Workflow: Interview with Anumana CEO Maulik Nanavaty

Starting point is 00:00:00 Sometimes we forget the technology may be sexy, but the physicians have been trained in such a way that that's what they have to take care of the patient's health and they're trying to make a life or death decisions at times. And at that time, they're not going to say, well, I'm going to go and press five buttons before I get an answer. I need to know it now. And I need to have that confidence that what I'm reading or what I'm looking at is something that's going to allow me to make the best decision for this patient. And so how do you get there, I think, really has two or three things. I think at some point, no matter what, the technology has to remain invisible. It cannot interrupt or come in the way of physicians' workflow of clinical decision-making. Welcome to MedSider, where you can learn from the brightest founders and CEOs in medical devices and health technology.

Starting point is 00:00:52 Join tens of thousands of ambitious doers as we unpack the insights, tactics, and secrets behind the most successful. successful life science startups in the world. Now, here's your host, Scott Nelson. Hey, everyone, it's Scott. And this episode of Medsider, I sat down with Mollick Nanavati, CEO of Anumana. Malik is a seasoned healthcare executive with over 30 years of global experience in the medical device industry. He spent 18 years at Boston Scientific, where he led its $1 billion neuromodulation division and previously served as president of Boston Scientific Japan.

Starting point is 00:01:23 Prior to that, he held leader positions at Baxter. Here, a few of the key things that we discussed in this conversation. First, driving adoption requires more than clinical accuracy. It demands physician-centered design at the point of care. Anumana focused on the quote-unquote last mile by embedding its AI directly into routine ECG workflows, requiring no extra steps from clinicians. By aligning with how physicians already work and delivering immediate actionable and more accurate insights, they ensure that the technology added value without adding friction,

Starting point is 00:01:51 a critical move that turned technical innovation into practical utility. Second, win regulatory trust by making the risk-benefit case impossible. to ignore. Anumano secured FDA confidence by anchoring its AI approval strategy in massive real-world data sets, over 20 million patient records to be specific, to prove safety, reliability, and clinical value. Rather than leading with technical capabilities, they frame the technology around what matters most to reviewers, a defensible, data-backed risk-benefit profile that holds up in both regulatory and real-world settings. Third, when fundraising, lead with your risks, not just your upside. Mollock strategy flips the typical pitch. Be brutally honest.

Starting point is 00:02:29 about potential pitfalls, then show how you'll de-risk them. By pairing transparency with disciplined execution and realistic focus, he builds investor trust and attracts partners who value thoughtful leadership over hype. For capital-efficient growth, clarity beats charisma every time. All right, before we dive into this episode, I'm pumped to share that Volume 7 of Medsider Mentors is now live. This latest edition highlights key takeaways from recent Medsider interviews with incredible entrepreneurs like Bill Hunter, CEO of Canary Medical,

Starting point is 00:02:56 Brian Lord, CEO of Pristine Surgical, Don Crawford, co-founder of Safion and current CEO of Corvista Health, and other proven medtech founders and CEOs. Look, we get it. Keeping up with every MedSider interview isn't easy. That's why we created Medsider Mentors. These ebook volumes distill the best practices and insider secrets from top founders and CEOs, all in a downloadable, easy-to-digest format. To check the latest volume out, head over to Medsider Radio.com forward slash mentors.

Starting point is 00:03:22 Premium members get free access to all past and future volumes, plus a treasured trove of other resources. If you're not a premium member yet, you should definitely consider signing up. We recently revamped Medsider with swanky new features, especially for our premium members. In addition to every volume of Medsider mentors, you'll get full access to our entire interview library dating back to 2010. You'll also get Medsider playbooks, curated guides, path with actionable insights and topics like fundraising, regulatory challenges, reimbursement strategies, and more. And if you're fundraising, don't miss our exclusive investor database, featuring over 750 life science VCs, family offices, and angels.

Starting point is 00:03:57 We've even created three custom packages to help you with your next fundraise. Learn more about Medsider Mentors and our premium memberships by visiting MedSiderRadio.com forward slash mentors. All right. Without further ado, let's dive in the interview. All right, Malik, welcome to Medsider Radio. Appreciate you coming on. Thank you, Scott.

Starting point is 00:04:16 Looking forward to... Yeah, yeah, definitely looking forward to learning a little bit more about your journey, especially transitioning from a couple large multinational strategics to what you're doing at Anamana. currently, but let's start there. I recorded a very short bio kind of at the outset of this interview or at the outset of this episode, I should say. I like to kind of hear it from the horse's mouth, so to speak, right? Give us a two-minute maybe overview of your, your background leading up to taking on the CEO role at the company. Sure. No, I have a PhD in Pharmaceuticals Sciences and then I joined Baxter in my early days, not exactly knowing what I was going to do.

Starting point is 00:04:49 I worked in everything from regulatory to clinical, to business development, to MNA, and went back to business school, the University of Chicago, and then towards the end of the doing the M&A work, sort of moved to Japan to my first business opportunity to run a business. From there, it was like in medication delivery and plasophoresis business, have worked in biologics and pharmaceuticals, drug delivery, have worked in MetTech. And then from there, having an opportunity to work at Boston Scientific. I ran the cardio business in Japan and then I ran all of Boston Scientific, which included about six different businesses. And then after that, coming into US, starting out with running the global business for neuromodulation. And it was a great opportunity because having worked in the commercial

Starting point is 00:05:38 coming back into pure R&D and then doing development, and then sort of working in the U.S. commercial side, all those things were kind of new to me. But every time it has been, different experiences sort of helped me to become better at it. And then towards the end of working in your amount almost for 10 plus years, sort of an opportunity to do something different. And I think one of the things was like you can go and become a CEO of a public company or something, and those opportunities were there. But by chance I came across, you know, Anamana and then more I learned about it, and he felt like this is the time to participate in something like this.

Starting point is 00:06:16 And I would regret it if I missed this. And then I would have gone back and said, I should have taken this chance, no matter how risky it was, because I feel that the change is coming, especially with the AI work that is going on in the field, an application that in healthcare is really accelerating. And rather be in the thick of it and be at the forefront rather than find, not just be on a sideline looking at it and saying,

Starting point is 00:06:40 man, this sounds like so much fun. So that was probably the reason I felt that I have to take a plunge. Yeah, you'd regret it if you didn't make that move. but we're recording this late Q2. So you're almost kind of two years in into your role. Yes. Time is going by so fast. I bet.

Starting point is 00:07:00 I bet. Yeah. It flies by in the world of startups for sure. Absolutely. But tell us a little bit about the company, Onamana, kind of what your core technology sort of does and sort of the major problems that you're trying to solve. Yeah.

Starting point is 00:07:12 It sort of came from my inception of early work done by Mayo Clinic, a person of Paul Friedman, unlocking the language of the heart, so to speak, from ECG and say, what is the link telling us? If you look at the advancement in cardiology, ECG machine used to be like 100-year-old technology, you know, used to cover half the room. And now you can look at your watch and Apple Watch and say, hey, what's my algorithm showing?

Starting point is 00:07:39 But the advancement of the knowledge of how to read it never really improved. And what this does is able to actually look at 10-second ECG and to be able to come up with a whole bunch of different disease states. similar to like you can go and look at a blood test and saying what are the diseases that you can see at the point of care. And normally that is most of the physicians are good at using ECG if you have a heart attack, or probably you have an atrial fibrillation or tachycardia or some abnormalities,

Starting point is 00:08:08 but most of the time is really difficult to interpret most of the diseases. And what we have been able to do is because of foundation of work we've done with access to Mayer data, almost 7 million patients, of everything from physician knows, all the way through any type of intervention. Over the life of the patient of 15, 20 years, similar to a Duke and pretty soon with Vanderbilt, Emory, and some of the other centers we're negotiating with, that really gives us almost 20-plus million patients lives of deep, clean data. And also, multimodal, that means everything from notes to images to tests, and also longitudinal.

Starting point is 00:08:47 that means it's tied from the day the patient saw the physician all the way through the life of the patient. That richness really gives us insights into what we can do. And all our focus is everything that is cardiac, total cardiac continuum from beginning to the finish. So from the diagnostic point of view to any type of intervention takes place to outcomes. And that has really given us insights starting out in diagnostic field. And then particularly in the last year, we moved into, you know, operative, that means in imaging platforms, what can you do to enhance the imaging ability and using generative AI? Can you really provide the tools in the hands of the physician?

Starting point is 00:09:29 It's been an exciting journey. We have a product that is already approved, a low ejection fraction, studied in over 120,000 patients. Got a payment for it in January of this year, and we're already in the process of commercial acceleration. And along with that, we also signed the partnership with Boston for the imaging side in electrophysiology and an instrument watch for device. And so we feel really all the things that we had worked on for all these years are starting to play out and do products. And our goal is really to build these end products and provide them in hands as a physician. And how can they use that in their practice to enhance their patient outcomes and patient care? Got it. And anumana.a.a is the website,

Starting point is 00:10:12 A-N-U-M-A-N-A-D-A-I. I'm willing to get in the full write-up on MedSiter, but I highly encourage you everyone to go and learn a little bit more about the technology. But just to kind of double-click into the product Excel. So ECG-A-I-L-E-F, I think that's the product that you've got cleared. First of you know, correct. So is this just a, is it a software layer that sits on top of devices? And then, of course, obviously, you're collecting data.

Starting point is 00:10:37 So there's, you know, an L-L-L-L-M kind of component or aspect to this product. So we train the algorithm using the data that's there, and then we run retrospective clinical studies, we run prospective clinical studies. Like in this case, you know, 22,000 patient prospective clinical studies, and showing the outcome and what is called area under the curve, that means the accuracy of the algorithm. For example, or 80 under the curve is like 0.94. If you get to like one, that is like perfect. And if you look at a stress test, that's at like 0.82 or 0.83.

Starting point is 00:11:14 If you look at a marker like B&P marker, that's like at 0.7. So it gives you an idea that we're able to get to a very high level of accuracy and not really disrupting any clinical workflow. They're already doing an ECG. All you're doing is press in a button to be able to get that information for your patient at that time really can change the life of the patient in terms of what therapy you're going to provide or support you can provide. Got it. And you've got this little, this cool little graphic on the website that I'm looking at right now that kind of walks, walk someone through sort of the patient journey before Anamana and then after. And in essence, you're just providing sort of that, that interpretation of that ECG.

Starting point is 00:11:52 Exactly. So someone, so someone could intervene earlier in the kind of that life cycle or the journey of that particular patient. That's cool. Very good. So give us a sense for, you mentioned that you've, this current product is cleared already, but give us a sense. for kind of where the company's at, you know, as of kind of Q2 of 2004. I'm sorry, 2025, I should say. I'm a year behind. So we're actually accelerating our portfolio offerings. So we're how close to almost 10 algorithms by second half, the first half of 2026. We're in a process of completing a lot of the work and allowing you to provide almost a full menu by the same click of the button to be able to identify multiple.

Starting point is 00:12:37 different types of diseases, everything from atrial fibrillation to things that are pulmonary hypertension, amadilosis, and ASCBD, and you name it. And that should really help to provide a much better point of care decisions for the physician triaging and how we see the future. And then the second one is after the signing of the partnership with Boston Scientific, we're already in works of developing the imaging platform for the watchman device and their electrophysiology platform. And we see some of that coming into the market at sometime at 26 and 27. And that will really help to see how we can provide much more needed comprehensive imaging solutions to the physicians when they're doing very complex procedures. Can you touch on that a little bit more? I'm not sure

Starting point is 00:13:23 exactly how much you can share about that particular product. But I'm assuming it's an algorithm that looks at what type of images? Yeah. What we're able to do is take the images that are, you know, normally when you do the watchman device, for example, you can use a transatlantic as a specific of that go, but it's a very grainy image, and you really have to be trained to interpret that. And even then, you really are sometimes questioning if you're taking the right approach on the positioning or right approach in terms of size of the product, et cetera, to avoid any type of leakage, position, and making sure that security of when the device is implanted. And if we're able to generate using edge computing and in the procedure immediately and

Starting point is 00:14:04 provide a whole image of the whole heart just by that. small sweep that completely changes the physician's ability to make much more informed decision and improve their clinical workflow. And so what you're doing is truly democratizing the procedure in a way that can improve the standard of care and improve the patient outcomes. That is an example. We would do the same with intracardiac echo and this associates with electrophysiology. and we see those solutions coming out in the marketplace in the next two years. Got it, that's cool. That's cool. So I'm assuming this could be applied even to like other diagnostic tools like Ivis or OCT or.

Starting point is 00:14:45 The future, absolutely. Our goal is that what can we do in the current solution right now is like, no, when you look at a physician doing any of the procedures, they look at five, six different screens while they're managing the, using the hands to sort of navigate and to take the surgical applications. approach. Most of the cardiology procedures have moved from open heart surgery 20 years ago to everything sort of minimal invasive, but it also means all of them are image guided. And so if you can change the ability to bring that all together in information that is easy to, easy to process,

Starting point is 00:15:19 easy to understand, and then tie that to the procedure that they're working on, you can really change the improvement, improve the workflow, but also a very good chance of somebody who is not the top 5% of the KOL, doesn't do the cases like 100 cases, you know, a month or something. They really have the, can you provide them a tool that changes their ability to do the outcomes as good as someone in the top academic center. And I think really what we'll be able to bring, yeah. Yeah, that's super powerful. Because even, you know, my suspicion, and this is maybe a little bit more specific to PCIs, but a lot of the, I guess, the lack of adoption of, of imaging modalities oftentimes comes down to that very thing.

Starting point is 00:16:04 They just, you know, physicians don't feel that comfortable with it. They're not that skilled in reading. And so they just simply don't use it, right? And they feel like, you know, fluoroscopy is enough. When in reality, the data suggests otherwise. So really, that's really cool. So again, anumana.a.a.a is the website. Highly encourage everyone to go learn a little bit more about the technology.

Starting point is 00:16:24 It's really, really cool stuff. And it sounds like there's going to be even more, you know, algorithms here being developed over the next year or so. So with that said, let's spend maybe the next half hour talking about, you know, a few cross-section or cross-functional, I should say, topics, you know, that every startup is going to have to kind of navigate at some point kind of in their life cycle. And we'd love to kind of have you layer in some of your experience at some pretty high-level leadership roles at some large strategics as well.

Starting point is 00:16:52 And the first one is really kind of on that topic, right? There's a lot of folks that listen to this program that are biased towards startups. Maybe they want to eventually take a swing at a startup at some point, but they've spent 10, 15, 20 years at a large strategic. So tell us a little bit more about your transition, right, going from Baxter than to several significant leadership roles at Boston Scientific than to running your own startup. What are maybe a few of the key lessons you learned during that transition? Yeah, I think the advantage was that my career passed on somewhat random.

Starting point is 00:17:25 So having a chance to work in everything on the development from regulatory to clinical, then going and do business development, doing M&A, then going and running a business, in multiple therapeutic fields, really help you to, in one hand, to get uncomfortable. In other hand, you're pushed to the edge where you really need to make sure that you don't get fired and you come out the other end. And so that has really gives you a much more better context of looking at things and how do you really, synthesize it down to what what are the hurdles in front of you, what decisions you need to make and clarity of thinking, just make sure that you come out at the other end. And so that has really

Starting point is 00:18:06 been the part of the consistent experience base that I've had in different places, in different parts, different countries. And coming into the startup, I think that makes things a little bit easier versus just working in a function or working in a large company and spending 20 years, not necessarily having the diversity of experience. And the only difference then becomes like when you come in, the ability to go and can you go and tell a story? Can you go and raise the money? Are you able to really make it a win-win situation

Starting point is 00:18:40 versus just winning for yourself so that you become a true partner to whoever you're going to work with? And the other piece is that, you know, you don't want to have a large department of anything. And so, you know, you have to really get your hands dirty and everything from HR to finance to Hoholi to all other things. And having those variety of experiences then come in handy to say, okay, well, I may not know everything,

Starting point is 00:19:04 but at least I understand what I need to do. Those aspects were the ones that really came in handy coming in, and it wasn't that difficult. The biggest thing was I didn't understand the technology as much and learning about the really rapidly moving pace of AI, a field of AI, and how its innovation is taking place is still something that will take time for me. Those are such great points with respect to kind of the sort of that,

Starting point is 00:19:33 that experience across different areas of the business. Like this is a question that sometimes comes up when I, or that I even get from like, you know, people that are younger in their careers. Like, you know, they want to go, they want to go directly to a startup, right? And kind of skip over, you know, spending any time in a large strategic. And my advice back to them is actually, no. it's actually highly, it's highly valuable to spend time in the largest tree to you to kind of see, see how the sausage is made, so to speak.

Starting point is 00:19:58 But the key for my, anyway, in my opinion, is to get that cross-fructural experience, right? Don't just say, you know, if you're in marketing as an example, right, or R&D, try to like get uncomfortable, right, in a different, in a different, you know, part of the business. So you'll just, you know, sometimes people don't appreciate this. So I'm going to get experience just by going to this different company. But, you know, if you work in the same company, you're building of equity, there's a much more willingness for you people will tolerate when you take risk. He's done well here.

Starting point is 00:20:26 I think he'll be okay. And those are like side moves. They may not be a natural promotion and all those things. But I think that's where you actually learn the most because you're really pushed in an area where you don't know anything. You've got to really survive. Yeah. Yeah.

Starting point is 00:20:41 Yeah. Over and over again. Such a good point. Yeah. That sort of that sort of the trust, right, that's built up over a period of time inside inside one company allows you to kind of, again. You're a good bank account on equity that you have built with the company. Yeah, it's a good way to describe it.

Starting point is 00:20:59 And no doubt you'll need all of that different, those different types of experience in a startup, right? Because there's so many hats that you have to wear undoubtedly. Hey there, it's Scott. And thanks for listening in so far. The rest of this conversation is only available via our private podcast for MedSider Premium Members. If you're not a premium member yet, you should definitely consider signing up. Here's why.

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Medsider: Learn from Medtech and Healthtech Founders and CEOs - AI That Fits the Clinical Workflow: Interview with Anumana CEO Maulik Nanavaty

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