Nick Crabbs 0:08

Welcome back to Product in Healthtech. My name is Nick Crabbs. I'm a partner and the chief community officer at Vynyl. Today we sat down with Derek Baird, the CEO of Switchboard Health, and he talked to us a whole bunch about how AI tooling and thoughts about how you organize product is revolutionizing their company's velocity to iterate on ideas. Let's jump into the conversation.

Nick Crabbs 0:34

Well, Derek, thanks so much for joining us. I'm excited to have a conversation with you today. I think for our audience, probably best to hear straight from you. Why don't you give us a little intro on your background and tell us a little bit more about what Switchboard Health does?

Derek Baird 0:47

Yeah, thanks, Nick fun to do this with you. So yeah, I'm Derek Baird, CEO and co founder at switchboard health. We're a Boise-based digital health company. Our mission is really easy to say, but tough to pull off. We connect patients with great specialty care. Personally, I've been in digital health my whole career. I stumbled into it before I even graduated from college, and so that was a few years ago, and I've spent a couple decades now trying to use technology to improve how care was delivered, and how providers operate and deliver care and get paid for care, and, you know, whole bunch of other use cases and needs along the way. There's plenty in healthcare to to work on, and plenty of areas that need improvement.

Nick Crabbs 1:32

And you, kind of, you got recruited, kind of, through the venture process to run this company, correct?

Derek Baird 1:32

Yeah.

Nick Crabbs 1:32

Which is a little different. Can you just talk a little bit about how you got involved? Got involved and how you've kind of, again, it's a little different of a process for a lot of early stage companies.

Derek Baird 1:48

Yeah, so the idea for switchboard grew up within a venture capital firm, Route66 ventures, which is based in Northern Virginia. They'd been working on this idea, and we're looking for a company to invest in that was trying to address some of these challenges. And so they're very much an invest first fund. And then if they see white space and aren't finding a company that they want to back then, and only then do they say, Hey, should we form a new co ourselves, and so they'd been grinding on this idea and doing a lot of market validation, market research, really pressure testing the concept for, depending on how you count, like, six to nine months before they said, wow - we're really on to something here. Let's, let's find a CEO. Let's put some money behind this idea, and let's launch what we now call 'Switchboard'. And so summer of 2022 I got to know them as as they were, you know, just made the decision to get to launch the business and provide the initial funding. And, you know, fell in love with the idea. And you know, love the guys at Route66 and said, Yeah, look, being a digital health CEO usually involves a multi-year journey. And you know, this felt like a great mission and a great problem that you know, finally needs to be solved.

Nick Crabbs 3:16

So like, elevator pitch, level quality here, yeah, what specifically is the idea that you guys were grinding on and now you're kind of testing and delivering on?

Derek Baird 3:26

I mean, this is, I mean, I remember this from a couple decades ago, like the way that patients are navigated to specialists is, and unfortunately, most of us have experienced this ourselves, or as dads, or as you know, caregivers for parents. Like, often you're just told by a primary care doc, here's here's where you go, and you know that may or may not be the right destination or the right specialist for you. Or, often, you're said, hey, just go find an in network rheumatologist. You know, good luck and Godspeed. And so the problem is an old one, which is about 40% of patients then just give up along the way, because they don't know what a rheumatologist is, or they don't know what in-network means, or they lose the little slip of paper from their PCP with a with a specialist's name on it, or, you know, they have trouble finding an appointment, or, Oh, that specialist retired or doesn't take their insurance after all. And so you just have a lot of dropped balls along the way, which means patients not getting getting the care that they need, which usually leads to bad, expensive things occurring. The reason why this is starting to change is either insurance companies, health plans or primary care providers are now financially responsive for specialty care costs, right? So now you're got a lot of people who are much more motivated to ensure that that patient finds the right specialist and can get in, can be seen, and could have their care needs addressed. And so the good news for us as patients or or kids, or the one footing the bill is - there's a lot more alignment around doing this in better ways. And so that's the rather long problem statement. The solution that we bring, as the name implies, is, if you tell the switchboard, who's the patient, where do they live, What insurance do they have, and what type of care so they need? That? Then comes into our system and we look at all the specialists like here in the Treasure Valley. We look at what insurance they take, we look at who has availability, we look at their cost quality data, and we say, hey for Derek with his startup CEO headaches, this is the right neurologist for him. Let's make sure he gets an appointment and gets seen, which is, you know, dramatically better than what has been the status quo for a long time.

Nick Crabbs 6:08

I think you're really tapping into this cost control nature. So specialists, generally, they get used a lot more in kind of the most expensive situation in our healthcare system, which is chronic health issues, right? You have a lot more specialists involved in those. I don't know if the statistic is exactly true, but, you know, it's over 50% of the healthcare costs tend to come from kind of chronic healthcare issues, which, again, involve a lot of specialists. So you're definitely tapping into, you know, one of the big, just from a cost control standpoint, pain points that that are that there's across our health systems, one of the things we like to do on this podcast, generally, is is kind of give our guests an opportunity to, like, ring the bell on something that's that's happened to them recently that's been a big victory. And you you have something right now, which is that you recently acquired Conduce Health, and get to bring a Google alum alongside you guys. And, and some data science on the team. Can you talk a little bit about that acquisition and, and, you know, I don't have a bell to physically ring, but we'll get the cheer anyways.

Derek Baird 7:12

We can add one on, yeah, you know, we'll do it in the post editing process. So, yeah. So really, this was, gosh, the end of September now we announced the acquisition of Conduce, which was working on a similar problem set. I mean, we've left their website up there. You can go check them out at conducehealth.com but was also working to improve how specialty care is delivered and how it's connected, and how patients don't get lost along the way. They'd really been focused on developing AI and predictive models so that it's not just about who's a good neurologist overall, it's which neurologists have shown that they're really good at taking care of patients like hypothetical Derek in this situation. So, so they some really, really fantastic technology that, you know, over the last few years, Switchboard has been very focused on building a front end and getting integrated with other systems, like EMRs, right? And so the marriage just, you know, the more we looked at it, the more it made a lot of sense to take the AI capabilities that they developed and some of those team members and and put it into our platform, which is, you know, brings this magic to life in the middle of the workflow or the point of care. So for us, it's we get great technology, some great new team members that we would, you know, that would have been a long recruiting process to find data engineers and data scientists of this caliber and so. So, yeah, it's been great,

Nick Crabbs 8:49

Certainly at the stage that you guys are, you know, if you compare the the IP needs with a little bit of aqua hire, for sure, you know, you can certainly make a puzzle piece kind of slide in really nicely. Well, like I said, I don't have a physical, physical bell to ring, but congratulations. I know that was a big step for you guys. I know that was something that you'd been working on for quite a while. So kind of pivoting this conversation, and really one of the big reasons I wanted to talk to you and kind of get this recorded and get it out on our podcast, is that, you know, you and I had lunch a few months ago now, probably longer than my brain is just slipping on time. And one of the things that you had kind of piqued my interest was you were exploring this idea of, you know, almost eliminating the product management role in its traditional sense, within your organization, and really using a lot more AI tooling, and, you know, kind of spanning those things across multiple team members. And so just like hearing you kind of talk through this, which at the time was really a maybe a more radical thing to be testing, I think there's a lot of people looking at this now, but, you know, several months ago, I think you were kind of. A little bit more at the forefront of exploring what that might look like in an organization that's trying to move fast. It's trying to, like, cross bridges as quickly as humanly possible, to seek opportunity. You know, I really want to, like, check in on that experience, like I really want to hear a little bit more about so maybe we can go back to, you know, even before you and I had a lunch meeting, you know, several months ago, maybe set the stage for how you started on that journey, and then tell us, you know, where it's gotten you,

Derek Baird 10:29

Yeah, well, you know, before people turn this off because they think I'm a CPO hater, or, you know, someone who doesn't believe in product management as a function. I mean, I grew up in product, right? So, you know, 23 years ago, most tech firms actually didn't have product as its own team. So I grew up in marketing. And at the time, like what we now think of product today was sort of half of it was done by engineers, the technical product management and then marketing, and I've just, by default, did the other half, which was all the product marketing management. Turns out I really liked that the product side of things. So after starting in marketing, I then went into product for, you know, a good number of years. So I'm not a product hater. I'm one of the biggest product you know, fanboys, you'll find - as a as a discipline, and as a really, really interesting mix of art and science, right? And I used to use this line, which was like, I loved product. I think it was one of the most stimulating roles I've ever done. I also think at the time, it was one of the most thankless roles I'd ever done. But just know, I'm a big believer in that is a key function and and really, I think for many young tech companies like the key to winning, I think, largely hinges on whether it's a person, a team or a function that's diffused within the company like I really think that's the largest fulcrum for success. I just think to get to our conversation a few months ago, I think the way that you organize around that just needs to be very different in 2025 than it was, you know, even two years ago.

Nick Crabbs 12:22

Oh, for sure, yeah. I mean, like I said, I'm seeing a lot of different organizations trying to test right now. I'm seeing a lot of kind of like, you know, diffused responsibility across several other distant disciplines as a way to cover the same discipline, but not necessarily a single person or role that owns it all the way through, but you still have to cover the functions, and again, using a lot more AI tooling as part of the speed to test those ideas and get feedback quickly. So anyways, yeah, so again, pivoting back.

Derek Baird 13:02

And I think, I think that, and I think for a seed stage company like the CEO, should be playing a very active role, you know, maybe my team might quibble with how active, how active that should be. I think even for later stage companies like, if you're not acting as an individual contributor in the mix of Product Strategy and prototype development and UAT, like, I think you as a CEO are failing your business and so, you know, we've sort of moved away from having product as a team or an individual, and have said, look, the way that we prioritize ideas is going to be diffused ultimately. You know, I have decision rights on that. Often I'll change my mind because the team convinces me that my original idea is the wrong one, and so it's not like ruling by fiat, but ultimately, like I make the calls on what we do and what it looks like. I think that has helped us go faster. I don't always make the right calls, but no one does, and it has just brought real speed and clarity and alignment to the process.

Nick Crabbs 14:23

Well, it seems like when I talked to you before, and you might have been getting there, so I didn't mean to cut you off, but you know, so many of the decisions you were talking to me about at the time were really about, you know, opportunities that you had in the marketplace that were coming directly from either perspective or current clients, right? Which is when you think about the discipline of product management or product generally. So much of it is about, how do you make good choices on what to build, and how do you get the feedback from either the market generally or directly from your existing clients on how to get there? And then there's just a velocity question, yeah, like, how, what's your speed to design, build, and then go put that in front of the people who've now given you write the feedback. And I think what really piqued my interest is when I was talking to you, is your your belief in the CEO's role in understanding at a really deep level what the market or your clients are asking for. And that's, I think a lot of times, something that a CEO is involved in, but they're hearing it almost second hand, right? And that did not seem to be your philosophy, which I thought was really, really interesting, right? Yeah, maybe you could talk about that for a minute.

Derek Baird 15:44

Yeah. I mean, I think I again, I think this day and age, like the CEO has got to be, like, at the coalface and just, I mean, out there in the market, hearing firsthand. And so I think that's going to continue for, well, for as long as I'm at the helm, I think that's regardless of stage or maturity or how many current clients you have. I think the the way to compete and win, where the tech is increasingly commoditized is in the way to earn, you know, an unfair advantage versus competitors big and small, is just being out in the market and hearing those insights firsthand. Then I think from there, like, okay, a lot of CEOs or product leaders have been doing that for years, but in the past, it's like, okay, well, then let's like, let's write up a PRD, and let's have several weeks of meetings, and then let's, like, build some wire frames, you know, and maybe we'll, maybe we'll feel like overachievers, and we'll have some clickable prototypes. And then, like, eight weeks later, maybe, if you're lucky, you go back to the client and are like, is this what you mean? And they say, 'no, you got it wrong', and then, and then a six week redo ensues. And now it's like, look, I fly to Florida tomorrow. I'm going to learn a bunch in the two days that I'm running around down there. I'm going to come back, we're going to have one meeting and decide on at least one thing that we're going to build a prototype on that'll probably be measured in days, not weeks. And then we're back at the client six days later with a real clickable application saying, did we hit the bullseye or not? And they'll probably say no, but you're on the dartboard, right? And then the next cycle is three days. And I think the just the pace that you can reach and maintain with that type of with those types of loops, for me, is, like, really exciting, and invigorates the whole team.

Nick Crabbs 17:52

Well, and just from a, maybe just a purely blocking and tackling standpoint, I mean, once you it sounds like you've gone and done learning with this client, which is great, you know, and then you come back, you have one meeting with your team. Can you talk a little bit about, then how the work actually gets dispersed, right? And what, maybe, what tooling you're currently using? I mean, this is changing so fast, right now. Yeah, you reserve the right to be wrong in a week, right? Like, right now today..

Derek Baird 18:16

Yeah, right now. If it's something with a front end, like, we're partying and lovable, right? And we've, we've used V-0 for some of this, but right now, like, you know, for rapid iteration and stuff that even I can do. And, you know, I'm a non-technical founder, and, you know, knock on wood, I have yet to break one of our lovable apps with a terrible series of prompts, and I say apps, we really think of these as prototypes, and that just, you know, gives you an idea of the contours of the idea that you're exploring in a way that I don't think you can get from an old fashioned, you know, written document, or even a bunch of, you know, flat static wireframes in Figma. And so, you know, I know Figma has tooling that allows this, but a lot of our action has moved out of, well, Google Docs and Figma, and into, well, let's just jump ahead and the quickest way to pressure test some of these ideas, both from a feasibility, can we build this standpoint and a will the client be delighted by it standpoint is, using lovable and then for more back end and more of our automation use cases, you know, we've got some safe spaces to spin up some models or some orchestration routines that, again, we can show to the clients, and if they don't love it, that's okay. We didn't spend eight weeks on it, right.

Nick Crabbs 19:45

And that's you know. And if you just think about startup land and failing fast, and iterating quickly, and again, a lot of this is just about, what is your velocity to get through ideas and test those with with the marketplace and whatever form that. Takes. I mean, you're going directly to individual clients, but there's a lot of different marketplaces you test a different way on how you get that feedback. And so, you know, again, it's very interesting how quickly that philosophy now do you typically have your engineering team managing kind of the the clickable prototypes? Are you still holding on to that yourself as CEO?

Derek Baird 20:23

Yeah, it's, it's both, I mean, you know, the thankfully, the engineers have been, you know, leaning into this and want to be kind of on the, on the leading edge of this prototype development and, you know, working on things that may then graduate to mainline product. So we even call it Switchboard Labs, just to make it really clear to us and everybody, and the client and the prospect like, hey, this isn't production grade, you know, we're a high trust certified company. And so, you know, in order for something to make it into, into, you know, our core infrastructure and mainline product like, don't confuse that with what we're playing around with in the lab. But you've got a great mix. You've got, yeah, I'm in the mix, but I would say I'm more of a supporting actor than a lead actor. We have people who are like me, recovering product managers that have other roles within the company, but then are able to participate in that process and bring you know that you know, some really great insight and a really great way of thinking. And then we have engineers in the mix, kind of keeping us honest and doing the lion's share of the prototype development, just to make sure we're not like charging down a cul de sac, so that if and when it becomes time to promote something to, you know, mainline product, we haven't gotten all excited about something that's not going to be feasible when, you know when we decide to promote it. So I think it's a fun I mean, look, we're a 12 person company. I mean, a lot of this is like, we're all together on the line, riffing on this, which I think is pretty invigorating for everybody, no matter what your job title is, at Switchboard,

Nick Crabbs 22:08

I think every company, regardless of size, you know, we've seen this a lot at Vynyl, when we work with like fortune five hundreds, right? This idea of, how do you make decisions quickly? How do you iterate quickly? How do you get the buy in quickly? What stakeholders have to be there? You know, for a long time, we used to use the like Google venture sprint process. And you know, the truth is, is that that process, it's not dead, right? Like I would say, that there's still a lot of value in why you go through those steps. But certainly there's a, there's a lot of ways to shortcut the output of a process like that that, you know, I don't know that I would recommend that book now, right? Yeah, and for a long time, I used to walk around like, have you read this?

Derek Baird 22:56

Maybe specific pages.

Nick Crabbs 23:00

They have a lot of stuff in that book about how you get the right stakeholders and to get the buy in you need in order to make decisions quickly, to have something to test. And I think the bigger an organization is, some of that stuff is still very relevant, right? But then the actual learnings that you're taking from whatever the prototype is that you're taking out into the world like that is all super shortcutted, and you can do it man cycles in what used to be maybe one or two tests that you'd get, you know, you said eight weeks. I mean, it all is variable depending on the organization and what you're doing. But you know, now you could run a similar process and maybe have 20 tests that you could do and take up the same amount of time, right? And that's, that's a that's a pretty unique advantage for companies and individuals who are taking advantage of this, of this aggressive, I mean, a lot more aggressive way of testing this stuff.

Derek Baird 23:57

And it's not like me or a product person, like, off in the woods, you know, toiling away for a few weeks, and, like, everybody's in the mix the whole time, which, again, I think helps us go faster, but also leads to a better, like, better product, right? And you know, you can shortcut a lot of that like, Okay, I'm, I'm re emerging from the woods, and now as a product person, I need to spend a few weeks like getting everybody bought in and catching them up on what I've been doing, right? You know, all that just, thankfully gets a lot simpler and easier, and I think more fun for for everyone. Well, in

Nick Crabbs 24:40

The technology space, there's plenty of roads that get built to nowhere in this stuff, but at least in this world, like you didn't have to spend a lot of resources to, like, put those two miles of pavement down and be like, Eh, you know, yeah, not that one. So, you know, I think you touched on something that's maybe a little bit interesting to dive a little bit deeper, and that's trust in this new way of doing it right? And so you've literally, like put some marketing language around this to kind of sequester or head off maybe a trust issue that you could run into with a prospective client, and using new methodologies or new tools. And again, for you, this is all about trying to gain margin, market, signal on on new pieces of your product. So it's that's an interesting dynamic to navigate. Can you talk a little bit more about, you know, either the advantages or disadvantages on why you put together, you know, Switchboard Labs to communicate this idea while you're going out and and bringing a new methodology into your organization?

Derek Baird 25:39

Yeah, I think, I think, from an external standpoint, like, it just makes it really clear to clients. I mean, look, there's too many companies in tech that, you know, present features as if they're fully baked and ready to go. And, you know, look, selling is a thing, it's still a thing, right? Selling futures is still a thing. And so I think this just makes it really clear, like, No, this isn't ready. We could not we're not going to ship this to you tomorrow. And so I just, I find that that's made it very black and white versus what has often been shades of gray. And I think the clients really appreciate that, because many of them have been sold gray things that truly weren't ready for prime time. And so I think it's refreshing for them to know, like, you know this is to use the old fashioned term, like, this is still in beta or in alpha, or just in prototype, like internal prototype.

Nick Crabbs 26:41

Sometimes this also helps in the sales cycle too, because, you know, when clients, either prospective or current in almost any organization, feel like they're part of the feedback loop on what's being built, when it actually comes time for them to pony up and sign up for it, if they've been part of this iterative cycle, they're usually, they're usually much quicker to adopt and much assuming that you're selling features in that way, but like, they're much quicker to be like, Oh, yeah. Well, I've seen iterations of this for a long time.

Derek Baird 27:11

Yeah. And even if they don't adopt or buy that new feature, they see like, wow, Switchboard is like, they are moving fast. They're always working on new stuff. Like, I may not want the thing coming out of the lab, but, you know, it sort of shines a light on, in a good way, on, you know, the fact that, like, we're really, really busy testing new ideas and working on new stuff. And then I think internally, you know, that distinction between the lab and something that's GA I think, also makes it really clear, like, what processes and methodologies are we using? Obviously the QA and the security and the way that we treat and compliance, you know, you know, is and should be very different than when we're, when we're, you know, working away in the lab. And so I just think sometimes, you know, I've seen this where products sort of end up in between, and people are like, well, do we need to we like, multi factor offing that thing or not, like, it's sort of like in the no man's land, and so I think it's been helpful for us internally.

Nick Crabbs 28:28

To separate the two out.

Derek Baird 28:30

Absolutely. Yeah.

Nick Crabbs 28:31

So in that same vein, if, you know, if someone's watching or listening to this podcast right now, and they're, you know, maybe they're currently a working product, or they're trying to think about how to, you know, add some, again, velocity in this cycle. Or they're trying to bring new methodology into their organization. Or they just want to learn more what's what's like, maybe one piece of evergreen advice you would give to that person trying to explore, not maybe just how to use some of the tooling themselves, but to get some organizational buy in to do this in a different way.

Derek Baird 29:05

Well, I'm not sure it'll be evergreen. You know that the

Nick Crabbs 29:09

We reserve the change our minds.

Derek Baird 29:14

Part of them not aging well. But I think right now, if I were still working in product, I think what I would be thinking about is, is expanding the scope of what I can and should be doing and and I think there's two ways that I think about that. One is, you know, if you're not playing around with prototypes and building using tools like V-0 or lovable, I think that's a big mess, because I think you you need to get in there to really understand the contours of these applications. Just the same with the, you know, the llms and the frontier models, like you can't just read about them or listen to podcasts about them. You know, the best engineers and product people I know on the weekends are like building stuff for themselves in these applications and using the LLMs for personal reasons, because then I think you can figure out where they're, you know, really succeeding, and where they're not quite there yet. And so I think if you're a product person, and you're not building, I think that's a real miss. And I think separate from, but related is like is from a design and UX standpoint, I think I think about it similarly. So I think successful product people will be able to thrive as the kind of lines between engineering, UX, and traditional product management like, those lines are already blurring. I think they're going to collapse altogether.

Nick Crabbs 31:05

Oh, I think you're completely right.

Derek Baird 31:07

And so I just think you've got to be a lot more versatile. And I just think the learning really compounds on this. And so you've just got to get into learning and playing around mode, you know, to keep pace with, you know, what state of the art in, you know, wherever the heck we're going to draw the box around product management going forward.

Nick Crabbs 31:31

Well, hey, I think that's a pretty great place to lead this conversation. I know you and I will probably meet up and continue to have it after this podcast over, I just want to say thank you for coming down and having a quick conversation. This is again invigorating and interesting to hear you talk about your company and the things that you guys are up to right now. You know, I appreciate you a ton, and we'll we'll see you around soon.

Derek Baird 31:54

Yeah, thanks, Nick. Appreciate it.