Episode 1

Meet the Hosts: Julie Yoo

with Julie Yoo

November 12, 2021

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Julie Yoo
Member, Day Zero Advisory Council; General Partner, Andreessen Horowitz; Co-founder, Kyruus

 Julie Yoo is a General Partner at Andreessen Horowitz where she leads investments in healthcare technology, with a focus on companies that are modernizing how we access, pay for, and experience the healthcare system.

Prior to joining a16z, Julie was the co-founder, Chief Product Officer, and Board Director at Kyruus, a venture-backed health-tech company recognized as a market leader in patient access. Julie led product management, engineering, and sales and marketing for the company, and helped scale the business to reach 20M patients and over 225,000 healthcare providers across the U.S.

Julie studied computer science and pre-medicine as an undergrad at MIT and obtained an MS in genomics from Harvard-MIT HST and an MBA from MIT Sloan. Julie is a Young Global Leader with the World Economic Forum and has been recognized through numerous awards and honors from Becker’s Hospital Review, Health Data Management, MedTech Boston, and Rock Health.

 

We want to endow first-time founders with superpowers that would otherwise take them decades to build on their on, in the form of expertise and access to networks.

Transcript

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Gary Bisbee, Jr. 0:16
Well good afternoon, Julie, and welcome.

Julie Yoo 0:19
Thanks so much for having me, Gary.

Gary Bisbee, Jr. 0:21
We’re pleased to have you with this microphone and we appreciate your joining the advisory committee for Day Zero. The advisory committee members are founders as well as investors and experts. Of course, you qualify as all three of those. So that’s good news. And what we’ve asked our advisory committee to do, in addition to giving us guidance on our agenda, is to host interviews with founders. And so you actually have the first episode and the second episode of Day Zero. So we appreciate that.

Julie Yoo 0:56
Of course.

Gary Bisbee, Jr. 0:57
What we’d like to do is to get to know you a bit better. One question I’d like to ask, Julie, is, what was life like growing up for you?

Julie Yoo 1:06
Yeah, it’s such a profound question. So I was the child of two immigrants who came to the US for graduate studies from Korea back in the 70s. And so really kind of typical, in some ways, a typical immigrant life at the beginning. We lived in the Washington DC area. I was actually born in Providence, Rhode Island, my parents were at Brown University, and then we lived in DC growing up, and I honestly did not speak English until I got to kindergarten because my parents just spoke Korean to me at home. My kindergarten teacher thought I had special needs, educationally speaking, because I couldn’t speak the language. But you know, very quickly got acclimated to, you know, the language and the culture, so grew up like sort of in the burbs, you know, typical suburban life in the US. But probably one of the most significant moments of my childhood was when my parents decided to move back to Korea when I was in late elementary school. And so we made a very, you know, transformational move across the world, literally, to Seoul, South Korea, where I attended middle school through high school, and it was, culture shock doesn’t convey just the level of change that represented to my life, both, you know, kind of personally, as well, as obviously, from an educational perspective. In retrospect, the greatest thing my parents could have done for me because I ended up going to an international school that had students from, I think it was like 30 different countries across the world. And it’s, you know, just people who I would have never had the opportunity to engage with, you know, cultures I would have never had exposure to that early in life. And so, you know, again, in retrospect, it was truly kind of eye opening. And I think it really drove a lot of kind of the global perspective that I have on opportunities, and you know, kind of the open mindedness that I hope people think I bring to everything I’ve done since then. But in any case, you know, kind of finished high school there, that was kind of a foregone conclusion that I would come back to the US for school. And I wanted to be a doctor when I grew up. So this was, you know, sort of the late 90s. I applied to a number of schools, one of which was MIT. I was also kind of a science engineering geek at heart. And so there was a lot that appealed to me about kind of the ethos of the MIT culture and the educational system. So I ended up going to MIT as an undergrad initially to do pre-med, so actually was a biology major when I first arrived. This again was the late 90s, maybe not all of our listeners will recall because they’re too young. But, you know, that was obviously the first you know, sort of .com boom, the internet era. And when I arrived at MIT, of all places, of course, you know, that was kind of the center of like computer science innovation around, you know, the big explosion around the internet and software in general. And so, very much got swept up into that, which I’m grateful for, ended up finishing my pre-med requirements, but also did computer science. And that was kind of the beginnings of my personal passion for the intersection of the two areas, healthcare and technology. When I graduated, there was no such thing as digital health back then. I think, had there been a digital health industry, it’s probably where I would have gone. But, ended up doing, you know, sort of software engineering out of college in a non healthcare domain. I was building e-commerce technology back then. And for several years, you know, worked at this startup. That’s the other thing I would kind of highlight is, much to my parents’ chagrin, I, for some reason, always gravitated towards startups, and I wanted to work at a startup. And my parents, you know, they basically begged me to interview for a job at IBM and Microsoft, just to kind of check the box. And I ended up getting offers from those two companies. They ran back and told all my relatives that I was going to work at IBM. And you know, I had to kind of call my parents and be like, you know, so just so you know, I’m actually not going to go to IBM, I’m going to go to this 20 person company that you’ve never heard of that has an office in the basement of a building in Kendall Square, Cambridge.

Gary Bisbee, Jr. 4:41
Your poor parents.

Julie Yoo 4:44
Yeah, that company ended up actually getting acquired for a billion dollars. So they after the fact were very, very pleased with my decision making and my independence and conviction to kind of go against their will. So I kind of grew up in the kind of the tech ecosystem of Boston, you know, made a career change into healthcare by way of grad school right around when the government was starting to talk about meaningful use in high tech, and really kind of the opportunity to digitize care delivery, and have never looked back since. And I’m sure we’ll talk more about my experiences since then. But that’s the quick version of my my upbringing.

Gary Bisbee, Jr. 5:14
Yeah, that’s a great story for America and for Korea, actually. So what about Kyruus? That was your first co-founder, status, I believe, is that right?

Julie Yoo 5:25
Correct.

Gary Bisbee, Jr. 5:25
What gave you the idea for co-founding Kyruus?

Julie Yoo 5:28
Yeah so, you know, as I mentioned, I always wanted to be in startups, so kind of had the privilege of, you know, kind of growing up in these companies from the ground floor, seeing these exceptional founders build something from nothing. And it was extremely inspiring. And I just knew that I wanted to do it at some point. I did a couple of healthcare startups out of grad school, just to kind of cut my teeth on the industry, because I frankly knew that I just needed to learn the domain and, you know, had enough, you know, modesty and humility to know that I wanted to learn from others who kind of understood the space before trying it on my own. It just so happened that the company right before Kyruus, one of the co founders there was Graham Gardner, who ultimately became my co founder at Kyruus. And so he and I had the chance to work together. We ended up selling that company to CVS. And we kind of looked at each other and said, hey, that was fun. Like, let’s do it again. And you know, the idea behind Kyruus, so I’ve been obsessed with how do you kind of apply technology to supply demand mismatch problems? That’s been like a theme across every company that I’ve worked at, every product I’ve worked at, the products I’ve built or worked on. And, you know, we sort of married that to Graham’s experience as a clinician, when he said, you know, gosh, one of my experiences as a cardiologist was that patients would wait eight weeks to see me. He was a very fancy Harvard doctor working at the Beth Israel, you know, patients would queue up to kind of get an appointment with him. They would show up only to be told that he was the wrong kind of cardiologist, that they actually need to be referred to a different type of sub specialty because the person making the referral maybe was like Graham’s friend from medical school, didn’t really have detailed information about what exactly his area of specialty practice was. Or just it was someone who went to the hospital website and kind of on a whim, picked his name out of, you know, amongst all other cardiologists. And so, you know, we said, gosh, that is a supply demand mismatch problem, right? You’ve got patient demand that has a specific need, but doesn’t have the appropriate information at the point of referral to, you know, kind of steer to the most appropriate care option. And so, you know, from that was born this concept of Kyruus, which was ultimately a patient provider matching platform. The closest analogy that I use to explain what the system did was, it was kind of akin to the Sabre system in travel, which was the mainframe system that, you know, agents would use to book flight inventories across multiple carriers. And so it was kind of an engine that aggregated seat inventory from across multiple airlines, it had logic for pricing those seats under certain circumstances and, you know, for different classes. And then ultimately, the booking engine that would, you know, sort of book that seat on behalf of the consumer. And that’s essentially what we ended up building at Kyruus, was a system that would aggregate appointment inventory across multiple provider groups, create the logic and the routing engine to match a patient to the right provider based on literally dozens of different criteria in real time. And then ultimately, book inventory into the underlying scheduling systems. I describe it so simply. It was anything but simple in terms of figuring out, you know, the appropriate insertion point into the industry, into the buyer set, into the technical infrastructure that was, you know, necessary to integrate with over many, many years of work and effort that we did there. But it was quite literally the best thing I’ve ever done in my life, and ended up being a tremendous ride for about eight years for me.

Gary Bisbee, Jr. 8:39
Yeah, it’ll be foundational going forward, too. So congratulations on that. After having worked around venture capital for off and on, I would guess, for a number of years, pretty much throughout your career, you decided to to join Andreessen Horowitz, a preeminent venture capital firm. What caused that decision Julie, what was the driver there?

Julie Yoo 9:02
My co founder, Graham, had previously been a venture capitalist. And I told him famously, many, many years ago that I never wanted to be a VC, I always wanted to be an operator, and, you know, the fun, the action was all kind of on that side of the table. So when I stepped down from Kyruus, I actually moved out west with the desire or the intention to start another company, frankly. And so, you know, came out west was essentially networking conducted with the firm here. And at that time, Andreessen Horowitz didn’t have a dedicated healthcare practice. They had a number of opportunistic investments in this space that had done quite well, but you know, didn’t have a dedicated effort. And they were just on the cusp of raising a new fund, and got to conviction that actually healthcare is the next big sub sector that, you know, they wanted to kind of go after in a big way. And so they said, Julie, you know, first of all, all the partners at the firm are pretty much ex founders. So there was a very specific archetype of person that they were looking to bring on to kind of spearhead that effort. I initially, you know, sort of signed on almost in kind of a consulting type capacity to help build out the thesis. And I kept saying, you know, guys, once I figure out what I want to build, I’m going to go build that, and then I’ll help you kind of hire in the team. And we can go our separate ways. Long story short, I completely fell in love with the value proposition of this platform. Again, we’re ex founders and operators. In my experience, I had wonderful investors, but they were all financial investors who had not really operated companies. And so the fundamental sort of lens, and, you know, just the nature of the dialogue that that, you know, my partners bring to the boardroom was just completely different than what I experienced in the past. And I thought that was such a special, unique value proposition. And our platform approach, we have a pretty extensive platform where, basically, our whole premise is that we want to endow, you know, first time founders with superpowers that would otherwise take them decades to build on their own from day one in the form of both expertise, as well as access to networks. As we all know, like the biggest challenge with healthcare companies is distribution. And so this notion of, you know, how can you build a network-based approach to plugging companies in and reducing friction to distribution from day one, as a competitive advantage was extremely compelling. So again, long story short, ended up saying, gosh, what a privilege it would be to sort of be in this platform building a really differentiated new kind of product, so to speak, for founders to be able to back the next generation of digital health and health tech companies. So made the leap and haven’t looked back since.

Gary Bisbee, Jr. 11:21
So the HITECH Act spent roughly $35 billion to digitize medicine. And most people thought that this decade would be the decade where we’d see that actually begin to pay off. What is the supply of founders like these days? I mean, you’ve got the longitudinal view of this going back 10 or 20 years, what’s the supply of founders these days, Julie?

Julie Yoo 11:44
Yeah, it’s such a great question because I think that’s one of the unique aspects of timing of why right now is such a unique moment in time in healthcare. So for the first time, it used to be the case, when I was a founder, I was, you know, a kind of tech native founder, I never had experience really in healthcare prior. And so I was kind of coming in from the tech lens. And then, of course, you had folks like Graham, who were coming from the clinical side, you know, had kind of the healthcare delivery experience, but not the tech lens. And, you know, that was a big challenge. I would say there was a huge culture clash, if you remember the first wave of, you know, folks coming in from tech saying, we’re gonna fix healthcare, you know, why are you guys so dumb and can’t figure this out, but you know, didn’t have the appropriate level of both hubris and just, you know, willingness to kind of dive deep into the laws of physics of healthcare to really get it right. Now, you have this unique, I call them digital health, native founders. So because we now have a robust number of publicly traded companies in digital health, scaled companies, and digital health, that are kind of the gross scale, that are producing talent that have grown up in digital health as an industry, and actually have seen the power of the intersection of healthcare and technology, kind of in a native fashion. Those are the folks who are now coming out and saying, I want to go start a company based on that experience set. So the quality, the level of rigor of understanding of the healthcare domain with a tech lens is orders of magnitude greater than it ever has been in the past because you now have these new pools of talent that are coming out of these, again, these digital health environments that, you know, truly understand the intersection of healthcare and technology.

Gary Bisbee, Jr. 13:13
How are we doing on diversity of founders? It used to be that, 20 years ago, they all looked like I did. But how are we doing on the diversity side?

Julie Yoo 13:22
Yeah, I mean, admittedly, it’s still early days. I think that there are plenty of stats available out there, whether it’s gender diversity, whether it’s you know, socio-economic diversity, etc, ethnicity. So, you know, still lots of headroom for improvement. I would say that, you know, one of the silver linings of the pandemic was that, in many ways, it was a great equalizer in terms of access to capital. You know, it used to be the case that you’d have to buy an expensive plane ticket and come to Sandhill Road and, you know, try to get a meeting with someone in person to be able to pitch and raise financings for your company. You know, I think what happened the last couple of years has clearly, you know, flipped that on its head and said, you know what, we have to go find the founders, you know, we have to go connect with them through digital means, and, you know, make ourselves accessible on social media, on, you know, kind of virtual channels, etc., which I think has really flipped the dynamic in a positive way. And therefore makes capital accessible to many folks who would have otherwise not had the wherewithal to, again, get on that plane and kind of physically come to the centers of gravity of venture capital. So I think there’s lots of tailwinds like that, that I think are a very positive force and, you know, continuing to drive much of that needed change.

Gary Bisbee, Jr. 14:28
Good. Well, we need to do that. Turning to Day Zero, why did you join the advisory council of Day Zero, Julie?

Julie Yoo 14:38
So first of all, it’s a bunch of my friends who I’ve had an amazing time, you know, building, you know, stuff with, folks like Gary. Gary was on my board, Aaron is actually on my board as well at Kyruus. And, you know, folks like Lynn, who are just icons, you know, from kind of the venture capital space in healthcare. So, first and foremost it was just a great, you know, kind of fellowship opportunity to be with the best and the brightest in the industry. I would say the kind of more fundamental reason is, you know, as an as someone who was an entrepreneur, basically the only sort of business book that I read and like kind of treated as my bible was Ben Horowitz’s book, “The Hard Thing About Hard Things”.

Gary Bisbee, Jr. 15:10
Right.

Julie Yoo 15:11
The reason that it resonated for me was that every other business book talks about, you know, after the fact looking back romantically on the experience of building a really tough business. You know, here are the learnings, everything seems very clean, very principled, very high level. Ben’s book was like, alright, we’re going to take off the gloves, and we’re going to talk about the real shit that happens, and really how hard it is, and waking up in the morning in a cold sweat, not knowing whether you’re gonna be able to make payroll the next day, like that visceral description of what’s really happening on the ground in the earliest days of company formation. That’s real. That’s what I went through. And, you know, that’s why it resonated. So I love the notion of Day Zero in that, rather than interview founders after the fact, when they’ve had their glory and can talk, again, romantically about their past experiences and from arm’s length, let’s talk to the founders who are in the arena right now, and going through the real stuff, and really get a visceral feel for what that’s like. So, that concept really resonated.

Gary Bisbee, Jr. 16:03
High five on that one. Julie, thanks so much. We can’t wait for your interviews of these founders. It’ll be very, very interesting for our audience. So thanks again for your time.

Julie Yoo 16:15
Thanks so much for having me, Gary.

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