Medsider: Learn from Medtech and Healthtech Founders and CEOs - Consumer-Facing Medtech: Interview with AliveCor Founder and Chief Medical Officer Dr. David Albert

Episode Date: October 11, 2023

In this episode of Medsider Radio, we sat down with Dr. David Albert, founder of AliveCor, which is pioneering the standard for personal ECG devices that extend beyond hardware and encompass services and partnerships to offer comprehensive personal cardiovascular solutions.Dr. Albert is a multifaceted individual — a physician, scientist, inventor, serial entrepreneur, YouTube sensation, and even an adventurous surfer. His academic journey led him from Duke University, where he completed both engineering and medical graduate studies, back to his roots at the University of Oklahoma. He already had several licensed inventions when he decided to stake it all on a new cardiovascular device. The gamble led him to found AliveCor, now a frontrunner in personal electrocardiograms (ECGs) under the renowned Kardia brand. In this interview, we take a tour down the lanes of innovation, prototyping, fundraising, and why sometimes you have to ditch the white coat to take your ideas from the lab to the real world.Before we dive into the discussion, I wanted to mention a few things:First, if you’re into learning from medical device and health technology founders and CEOs, and want to know when new interviews are live, head over to Medsider.com and sign up for our free newsletter.Second, if you want to peek behind the curtain of the world's most successful startups, you should consider a Medsider premium membership. You’ll learn the strategies and tactics that founders and CEOs use to build and grow companies like Silk Road Medical, AliveCor, Shockwave Medical, and hundreds more!We recently introduced some fantastic additions exclusively for Medsider premium members, including playbooks, which are curated collections of our top Medsider interviews on key topics like capital fundraising and risk mitigation, and a curated investor database to help you discover your next medical device or health technology investor!In addition to the entire back catalog of Medsider interviews over the past decade, premium members also get a copy of every volume of Medsider Mentors at no additional cost. If you’re interested, go to medsider.com/subscribe to learn more.Lastly, if you'd rather read than listen, here's a link to the full interview with Dr. Albert.

Clinical validation has enabled us to remain a viable growing enterprise despite increasing competition. We are the gold standard, and that's proven by the 200-plus peer-reviewed publications. That has been critical to our success. Welcome to Medsider, where you can learn from the brightest founders and CEOs in medical devices and health technology. Join tens of thousands of ambitious doers as we unpack the insights, tactics and secrets behind the most successful life science startups in the world. Now, here's your host, Scott Nelson. Hey, everyone, it's Scott.

In this episode of MedSiter, I sat down with Dr. David Albert, a multifaceted individual, a physician, scientist, inventor, serial entrepreneur, YouTube sensation, and even an adventurous surfer. His academic journey led him from Duke University, where he completed both engineering and medical graduate studies back to his roots at the University of Oklahoma. He already had several licensed inventions when he decided to stake it all on a new cardiovascular device. The gamble led him to found a live core, now a frontrunner in personal electrocardiograms under the renowned cardiacia brand. Here are few the key things that we discussed in this conversation. First, the transition from academia to entrepreneurship may not be

seamless. You need to be realistic, utilize resources to your favor, have the right mindset to continuously learn lessons and know how to cultivate strategic partnerships. Second, the lines between medical devices and consumer marketing are not as rigid as you might think. By bringing in the right expertise, being agile, and focusing on consumer awareness, and branding, you can forge a new path that is both medically sound and consumer-friendly. Third, when it comes to fundraising, understand the fundamentals of valuation and don't get fixated on high numbers. Leverage a network of allies who can help you make the right connections and include tangible

prototypes and demonstrations in your pitches. Okay, so before we jump into this episode, if you're listening to this show, I'm going to make the assumption that you're a dedicated pro looking to learn from the best in the business. If that's the case, which I think it probably is, I've got some exciting news related to our premium memberships. First, let's talk a little bit about Medsider Playbooks, your ticket to going from zero to 100 with your company or your career. You see our team as handpicked collections of the most insightful interviews with the brightest founders and CEOs, people like Nadim Yard, CEO of CVRX, and Mike Carousy, serial med tech entrepreneur and general partner at Lightstone Ventures.

These proven leaders share their strategies and tactics for running a successful startup. Whether you're looking to master capital fundraising, navigate early stage development, tackle regulatory challenges, understand reimbursement, or maybe even positioning your venture for a meaningful exit. Medsider Playbooks have got you covered. And the best part, all of them are available to our premium members. Get instant access to these valuable resources at medsiderradio.com forward slash premium. Again, that's medsiderradio.com forward slash premium. Okay, here's the second thing.

I completely understand that fundraising can be one of the most daunting tasks for any startup, especially in today's environment. That's why we've created a meticulously curated database of investors right at your fingertips. Explore a wealth of VC funds, private equity firms, angel groups, more, all eager to invest in medical device and health technology startups. Access to this database is a premium member exclusive, so don't miss out. But that's definitely not all. When you become a Medsider premium member, you'll get access to every volume of Medsider

mentors, where the brightest founders and CEOs share their invaluable learnings, plus you'll unlock the entire archive of every Medsider interview dating back to 2010. So if you're serious about advancing your career or your startup and want to tap into this treasure trove of knowledge, it's time to consider becoming a Medsider premium member. visit medsiderradio.com forward slash premium to learn more. All right, without further ado, let's jump back into the interview. All right, Dr. Dave, Albert, welcome back to Medsider. It's been almost, well, not almost, probably over a decade, I guess,

since your first interview way back in the day. A long time ago, yes, sir. We were both a younger man at the time. That's right, that's right, yeah. And we were joking kind of before recording the interview, I had definitely had less grace back then. So maybe my hair was a bit shorter too. But pleasure to have you back on the program, sir, really looking forward to this conversation.

I think it'll be a fun one. Hopefully we'll learn a little bit, too, about your kind of your journey over the past decade or so. But with that said, for those that aren't familiar with your professional journey leading up to kind of sort of founding a live core, give us kind of an elevator pitch for kind of your background. Well, the elevator pitch was I went to medical school and engineering graduate school at Duke, And then I went back to the University of Oklahoma. I'm a native Oklahoma to do my training. And I had already licensed a couple of inventions, even before I left school at Duke.

And so I got there and I came up with a new idea. And that idea, nobody wanted to license it. And I went around to various cardiovascular companies at the time. And so I went to my wife and we had a small child at the time. She's now a grown woman and said, I think I'm going to drop out of my, you know, medicine and start a company. And I knew nothing about starting companies. That was the dumbest idea I ever had.

She thought it was pretty dumb, too, at the time, as did my folks. But my mentors at both Duke and at the University of Oklahoma, who were very prestigious now, unfortunately, both passed away. Cardiologist said, oh, I'll let Dave, he can always come back. And, you know, he's got a plan B. It's called MD. And so I haven't looked back. And that's, you know, not quite 40 years ago, but 35 years ago, late 1980s.

And it's been okay. I've started three four companies and had quite an adventure. And alive for is obviously my latest adventure. And, you know, today I'm, I get to have a lot of fun in that I get to be around patients and do a lot of clinical research as well as try to push the boundaries of innovation. Yeah, absolutely. And you live in beautiful Santa Monica, right? And enjoy a little surfing as well.

As a matter of fact, I have a wetsuit hanging in the closet over here. Yeah, I live on the beach in Santa Monica. It's not bad. Beats working. And, you know, every day is a pretty nice day like today. It's gorgeous. Oh, yeah, yeah. There's no doubt.

I grew up in the Midwest and we've been out on the West Coast for, gosh, the past seven or eight years now. It's been about six years in Orange County and then recently moved to the Tahoe area. But would greatly miss the sunshine. right, right, if we move back to the Midwest and at some point in the future. So I'm right there with you. That's super helpful overview. And let's talk a little bit more about a live four, or at least set the stage, right, for the rest of the conversation. Probably most people that are listening have some level of familiarity with a live core. But if you can kind of give us

an overview of kind of the three different devices that you're commercializing now, that would be that'd be helpful. Sure. Well, first of all, many people know us as Cardia, because of our television as that we've been running now for a number of years. We've developed a brand and Cartia is the brand, while a lot of course the company name, a lot of people know us as Cardia or Cardia Mobile. And that stems from the original product we had, which back over a decade ago was a case that fit over a smartphone. And in 2011, smartphones weren't very prevalent. They were starting to gain traction. The iPhone was relatively new. You know, androids were new. And we had a case that turned your smartphone into a personal single EDCG.

Since that time, we've expanded our product line. Today, we have our Cardiomobile, which is available in places like CVS and Walmart and Best Buy. And it's a single lead ECG that works with any smartphone via an app or any tablet. Then we have our Cardiomobile 6L, which is a half the 12 lead ECG, the standard ECG you get in the doctor's office, and it fits in your pocket. And again, it works with any smartphone or tablet. And then the latest innovation is our Cardiomobile card, which is literally the size of a credit card and is a single lead ECG that fits like mine does, right into my wallet along with my credit cards, except you can't charge anything for it. Those are our three products. We continue to work on new

innovations and you will see new things coming from LiveCore, but we've also surrounded those hardware products with a series of services. So we have hundreds of thousands of people who subscribe to our services that provide them, cardiologists overreads, advanced algorithmic determinations, reports. And so we've offered, we don't just, we're not just a hardware vendor. We're a solution vendor and we're a personal cardiovascular solution vendor. And we have partners. So one of our partners is a company called Omran. People would probably be very familiar with them if you go into a drugstore to buy a blood pressure cuff.

Your doc says, hey, your blood pressure a little high. Well, that's probably going to be an Amron. They're a large Japanese company, but multinational. And they're a partner of ours, an investor in ours. And we utilize some of their blood pressure cuffs, as well as they have integrated some of our ECG technology into a product called Amron Complete. is available in retail and over the web. And then we have, you know, a new partner, a little company called GE Healthcare,

that in January became a standalone entity away from what used to be the huge GE's been slowly contracting. And GE Healthcare is our partner to bring a live course out of the hospital information into the in-hospital workflow, into the EMR, into the ECG review process, that's already the workflow that's established. And so this was both of us realized that to get the full benefit for patients who are consumers, and not every consumer is a patient, but every patient's a consumer. For them to get full benefit, we needed to integrate that information that could be very life-critical

into the traditional workflow and get their physicians aware of whatever changes might be important. And so partners like that have helped us expand our reach as we've built more services to surround our hardware. You got it. So, so I like a live court no longer just kind of like a one or two trick pony, right? I mean, there's a lot going on with the company to say, say the least. And I definitely want to circle back around to that phrase that you use, not every, not every consumer is a patient, every patient is a consumer. Yeah. That's correct. It's a great line. That's a great line. I mean, we have our customers are not 30-year-olds. I'll just tell you. And many of them are customers. And we know, because we've done surveys, that somewhat greater than half,

buyer device because their doctor tells them to get it. And today, you know, it's an interesting notion, but in the single lead ECG business, we have some small competitors. There's a company in Cupertino. There's another company in Mountain View where our headquarters is. There's one from South Korea. And yet, we continue to grow dramatically and strongly because we're the experts. We have over 200 peer-reviewed publications. Millions of people have become our customers. And we have well over 200 million ECGs that have been recorded using our devices. So we're no longer a tiny startup. And we're accepted by basically, the world's cardiovascular experts. And I think that's enabled us to continue to prosper,

despite having what you might think were very strong competitors. Yeah, no doubt, no doubt. I have a hunch that I kind of, I think most people are loosely familiar with a couple of those companies that you, that you may be, didn't maybe mention by name, but you know, I've heard of them. I don't discuss our competitors, but they may have heard of those companies. Yeah. Well, nonetheless, we have time. I mean, I think that's a really, really, it's been fun to see a live core. I'm sure it hasn't been all fun, right? For those of like you that have been close to the company,

I mean, there's probably been ups and downs. But to see kind of a live course progress over the past, you know, decade in the face of like some pretty intense competition, you know, really continue to do quite well. I think that's a, that's a kind of a testimony to look to a goal.

Scott, it is all about being considered the gold standard. Yep. And, you know, we were first and we were the most validated. So you can't go to any of the major cardiovascular or centers without them having lots of patients who utilize cardio. And a number of the doctors have a cardiomobile card in their wallet in case they're on an airplane and there's an emergency like my friend Eric Topal who's did multiple times. So we've benefited by the fact that we're the experts and we're going to continue to innovate with things like the Cardiomobile card and the

6L. And you'll see other innovations from us in the near future. Yeah. On that note, I want to kind of step inside what I like to refer to as the old MedSider time machine and kind of get your take on some learnings that you've had across, you know, some of the core functions, you know, that most MedTech companies, at least in the early stage, just try to tackle. But before we do that, you showed me on video, right? And for those listening, they're not going to be able to see that. But you can definitely go to a live course site and take a look at the new, one of the new devices, which is the Cardium Mobile card, right, which literally looks like a credit card. Touch on that before we kind of, you know, get a into, you know, kind of some of these different functional topics. That's new. Like, when did it launch? Like, what was the kind of the origin for like that particular product? Well, I mean, you know, we in America, my European friends and Asian friends have said we in America are laggards because we only got chips on our credit card within the last 10 years. They've had them for a long time, which made us much more vulnerable to stealing of your credit cards and things like that. So we finally joined the rest of the world and our debit and credit cards got chip enabled and you can tap to

pay. It's much more secure. Well, that technology made me think, you know, why can't we put an ECG into that same form factor? It fits in your wallet. It goes with you everywhere. And so literally, it wasn't, we started working on it in 2015. And it wasn't until a year or more ago that it was finally out in the market FDA cleared because it's the technology is very hard. I mean you can imagine something the same the width of a credit card that has what a Bluetooth and microprocessor and ECG electrodes and battery and this thing has more than a two-year battery life so it's it's really a it took a lot of technology a lot of work for us to bring that to market but now that it has the standard response one I give it to someone or show them, it's just, wow, you know, they can't believe. But, you know,

we're hopeful that they appreciate the innovation because it was a, it was a major effort to make it that small. And we learned a lot of lessons. Like you said, it's not always up, up into the right. You know, there are oftentimes challenges. And from, you know, 10 years ago, when I first met you to today, a live course, many tens of times larger. to many tens of millions of dollars from revenue. And I mentioned some of the metrics. But the reality is it hasn't been a straight line. And there are challenges, which a lot of medical device companies enter,

it's a little thing called the Food and Drug Administration. That is a challenge in many instances. Then there's the world regulatory environment. And now we have something called, you know, our MDD is going to MDR and in other parts of the world, do things like the NHS and nice guidance and CE marks. It is a challenge to scale globally medical devices when you're a small company. And so now we're available in well over 40 countries. I don't know the exact number, but that's a challenge. And it has taken a lot of time and a lot of

effort. And there have been some starts and stops. Again, we have partners like Amron and GE Healthcare who can help us with that, but a lot of the burden just still falls to us. And so we don't just face the FDA. We face the regulatory bodies from around the world and, you know, localizing, translating, making sure it fits with their practice of medicine. That's all a challenge. And one that stands for any medical device company that wants to go global. Yeah, no doubt.

Well, let's talk about some of those challenges. But before we do, for everyone listening, definitely encourage you to go to a livecore.com. So a live, just as it's spelled just as it sounds, and then core, C-O-R, LiveCore.com. And you can check out sort of the product line as well as the newest device, which is the Cardio Mobile Card, which literally looks like a credit card.

Pretty cool. So we'll link to it in the full summary write-up for this particular episode, but definitely encourage everyone to visit the site and check out the product. So with that said, let's transition to kind of some, some functional topics and really love to get your take here. As you mentioned, you're kind of a prolific entrepreneur,

started multiple companies, you know, a live core being the latest. But there's a lot of MDs, PhDs that are in academia that have a great idea, right, and want to take a swing at a startup, but are, you know, in probably an otherwise, you know, pretty well, well paid job.

What key pieces of advice would you have for them as they consider maybe, you know, stepping into the world of, you know, the entrepreneurial world? Well, you know, I can fall back on my personal. experience of they have a plan B and they can always go back to their previous job of being a physician, a scientist. What I would tell them is I was incredibly naive when I started my first company and I learned I have a masters of bruises and pain instead of an MBA. And I would tell them that, you know, if you really believe you can start a company, there are many resources

today to help you in that process. They're accelerators, there's Rock Health and MedStar, there are all kinds of resources to help people, and as well as it is far more accepted today. When I did in the late 1980s, it just didn't happen. And today, I have literally medical students, residents, fellows, faculty member coming to me saying, I've got an idea and I want to start a company. I could tell you I had the chief medical officer of a very prominent company come to me yesterday or day before yesterday saying, I've got an idea I'm thinking of going out on my own. And the first thing I'm going to tell him is, have you had a psychiatric visit or have you talk to you another? Because it is a challenge.

And there are many things that you're not usually prepared or trained for in being a physician. or physician scientists in academia. And so they need to have their eyes open, their ears open, and go seek advice and counsel. The other thing is, you know, human resources, marketing, sales, regulatory, manufacturing, these are all aspects that most physicians have very, you know, they may have a great idea, but they have no experience in that. And so the other thing I would say is if you really are determined to do this,

go find a partner. Go find somebody who's done it before, who has the chops in business, who knows how to functionally start a company, the tactical, and who can be side by side with you to implement your idea and turn it into a true innovation. Right, right. I think there's a lot of folks that sort of, they see the appeal, right? And sort of the compelling nature of joining or starting a company, but to your point, you know, going into it eyes wide open is pretty critical, right? Because it's not all, certainly not all glints and glamour. But with that said, it's a lot of fun, especially if you're, you know, you're running a startup in the healthcare space. You know, it's not like you're, you know, you're building T-shirts or shoes, not to underappreciate,

you know, that, that, you know, those, those verticals. I mean, these are, these are, I wear T-shirts and shoes. Or sweat or, you know, body suits, you know, for those, for those for those lucky that serve. But, yeah, certainly can be, be rewarding. But, you know, it's interesting. Although it sounds relatively basic. I was listening to one of my favorite podcast these days is my first million. I'm not sure if you've heard of it. But it's a great kind of entrepreneurial podcast that's sort of, it's not healthcare specific per se. But they interviewed the manager of Conor McGregor, who's kind of been behind, you know, throughout his kind of rise in the world of U.S. And they were talking specifically about the, it's a proper 12, I think, is the whiskey brand that he started. They sold it for, I think, a reported 600 plus million or so, something like that. But one of the comments he mentioned, he was like, you know, look, I've got a team around me that, that is, that's exceptional, right, from when it comes to business, but we had no idea how to start an alcohol brand, you know, he's like, so one of the keys to that success story was bringing in an absolute black belt, right, that could actually, you know, take that sort of an idea,

right, and actually build something around it. So do your point about like finding the right people that can fill in the gaps, you know, really, really crucial, you know, for it's absolutely critical in medical, medical technology. You've got so many aspects that are, you know, in medicine, we don't usually deal with the FDA. We are given products that are, that have been through that process. And going through that process is an education in and of itself. Right, right, no doubt. Let's transition a little bit to kind of your experiences, you know, taking an idea, right?

I think, you know, a video on YouTube, you know, 10 plus years ago, you know, that kind of, that went viral, right? Which is, I think, I think, some of the original sort of like idea behind a live course products today. but you've seen, right, the story, you know, throughout your career of kind of this napkins, this idea on a napkin, right? And you know, taking it through, you know, the initial concepting into alpha, into beta, et cetera. And so, you know, when you think about all of your experiences, are there, you know, a couple things that really have been, you know, helpful or maybe, you know, a lot of key lessons learned, you know, being capital efficient, right, in those early days, you know, when you are, you know, trying to turn your idea into something tangible.

Well, you're absolutely right. First of all, my experience is that you can talk to your blue in the face and you can have a golden tone, but there are a lot of people who have no vision. So until you show them something physical, demonstrated to them in reality, they won't get it. And so I had exactly that experience. I had made some prototypes over in Asia, and I was going to go to the Consumer Electronics Show. I had talked to people. This was literally a Thursday.

I went into my office with one of my prototypes I had just gotten on my birthday. And I made an unscripted four-minute video. And I was going to upload it to YouTube. My nine-year-old had taught me how to do that, literally, fact. And I just happened to click the box that said, send the link to my LinkedIn connections. And I had three or four hundred. They were my professional from when I was at GE Healthcare.

throughout my professional career at the time. And by the way, I was old. I was 55 years old, starting a company. I clicked that and I went home. And the next day was New Year's Eve, and I went on a date with my wife. And then suddenly, I got called and said, what did you do?

I said, what do you mean? What did you do? In 48 hours, I had 300,000 views of that video. And people, all of a sudden, I had Good Morning America and Fox and Friends and all these people calling me to come to CES and be, I'd put my email address. in this damn thing.

I was not smart. And in this video, and people were bombarding me, and I was getting bombarded to come to CES. I had to get up at three in the morning because I'd be at the convention hall. It's four in the morning, which was seven in the morning on the East Coast

for all these good, you know, the TV shows all dues from CES, the latest innovations. And that viral video, and I knew zero about, to me, a virus was something that you catch and make you see. And we've all learned.

a lot more about that in the last few years. That started the cascade that ultimately became a live core. And what it taught me was be opportunistic. I probably was not as opportunistic about that video and the virality as I should have been just because it was foreign to me. You know, social media was foreign to me. And so be opportunistic. Have your eyes and ears open at all times looking for opportunities to advance your idea and your innovation. And so, you know, from my perspective, we were very capital efficient up to that point. I think we had spent all of $200,000 and building these prototypes that were fully functional, building the app, everything.

And so that then really catapulted us into what's become a live core in a pretty significant business. Right. That's the story. It sounds romantic today. Back then, it was anything but romantic. Yeah, I can only imagine. I'm looking at the Cardiomobile card.

And I mentioned the LiveCore site previously, but you can also check it out in more detail at Cardia.com. So K, Cardio with a K, K-A-R-D-A, Cardia.com. You know, thinking about that story, you mentioned the opportunistic, and you're likely going to have much better success if it's something tangible, right? Because a lot of people can't see the same vision that you may have.

And it reminds me of something that another physician, entrepreneur, or Dr. Chris Ramdu with Tempa Health. I mentioned, I recently had him on the show. By the time this is published, that interview will likely be live as well. But he mentioned something very similar. Like, that was one of the keys to their success early on was like he had to develop something tangible, right? In order to get, to get, you know, meaningful feedback, not only just from, you know, other stakeholders, but in order to really kind of accelerate the progress for the company.

Like, that was one of the key, you know, looking back, that was one of the key things. is like he had to build something tangible. You know, and I highly doubt that that video that you uploaded to YouTube way back of the day would have gone or I would have had sort of the level of virality if you actually didn't have a thing, right? I mean, I recall that video. I mean, we'll probably link to it maybe in the show notes. But it was like you actually had a thing to showcase, right?

Which is pretty crucial. 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. You'll get full access to the entire library of interviews dating back to

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