The following interview is a conversation we had with Austin McChord, CEO of Casana, on our podcast Category Visionaries. You can view the full episode here: Over $46M Raised to Create the Future of In-Home Health Monitoring
Austin McChord
Yeah, happy to chat. Thanks for having me on the podcast.
Brett
Not a problem at all. I’d love to begin with just a quick summary of who you are and a bit more about your background. Sure.
Austin McChord
I am the CEO of Casana, and my background actually is originally in cybersecurity. I started a company called Datto that I took from my folks basement all the way to a publicly traded business. And now I am in an entirely different space in the medtech space, delivering a really cool vision around home health monitoring in a super quirky but interesting way.
Brett
Talk to us about making that jump from cybersecurity into healthcare.
Austin McChord
Yeah, so it’s definitely nonlinear. So after doing Datto, I left and went to general catalyst, which is a venture capital firm, and they were early backers of Datto and was looking at companies there and realized that while looking companies is super fun, what I wanted to do was get my hands dirty again and get back to operating. And so was looking at what could I run? And got connected with the CEO of Vertex Pharmaceuticals, Jeff Lydon, and he really wanted to get involved in something in the senior care space. And I actually knew of Nicks project, which was a toilet seat that could get your blood pressure. He presented the idea to Jeff, and Jeff loved it and explained it like, there’s huge opportunity there.
Austin McChord
And then after spending some time talking with Nick, realized that I could actually be super helpful in building out the team and going through the process of helping get this product to market. And so I raised my hand and said, I want to go do it. And so that’s kind of like the rough story of how it happened. But I think the real magic is that this and Datto actually share something in common, and that’s that these products work best when forgotten about. Dad I was offering, you would set it up, deploy it, and then it just runs in the background. And the same is true with this seat in the. Obviously, you install it on a toilet, and then you can just forget that it’s there and it will do its job.
Austin McChord
It will track your vitals, and when things go south, it will notify your doctor that you need to make a change.
Brett
You talked us a little bit about the IPO. I was going to skip this part, but I feel like all the founders would probably hate me who are listening in if I don’t ask about that. What was it like to Ipo a company?
Austin McChord
Super, super cool, but also was, like, really bummed that it happened during COVID So I did go ring with help, but I did not get to have the big party.
Brett
Oh, that’s a bummer. That’s, like, what founders dream of.
Austin McChord
Yeah, well, I mean, it’s really the journey more than it is the party. But, the way I think about it is its motivation to do it again. And I hope that it won’t be the last business that I ever take public.
Brett
I love that when it comes to motivation and just inspiration in general, who are some founders who really inspire you?
Austin McChord
So I really think that those that are low drama inspire me. And so while he’s not a founder, like, I think about Satya Nadella at Microsoft is, like, a great example of just a leader who is kicking butt and is the antithesis of, like, the Elon Musk. I’m going to tweet my every opinion all the time and instead is low key gone from taking a company that people just thought of as like, yeah, they make Microsoft Word into something that’s incredibly hot and topical. And I built out a massive cloud business. It’s just amazing how he’s transformed. Was a very boring company.
Brett
Trey Lo Drama CEO’s I feel like that’s a relevant thing today, given all the noise that’s out there. Certain CEO’s are making today.
Austin McChord
Yeah, no one wants to be a low drama CEO, but I’m telling you, that’s where it’s at.
Brett
Makes a lot of sense. And, yeah, watching what Microsoft’s been doing the last year, it’s been pretty insane. Yeah. What about books? So when it comes to books that have really had a major impact on you and really defined you as a person, we like to steal this from Ryan Holiday, who’s an author. He calls them quake books. So Quakebook is a book that, like, rocks you to your core. It really influences how you think about the world and how you approach life. Do any quick books like that come to mind?
Austin McChord
I think the book predictably irrational is probably the one that comes to mind most. And it does a good job quantifying things you already know, but really helps cover this concept that humans don’t make rational choices. They don’t decide things the same way that machines do. And when you understand how people make their decisions and how they value different things, you can use that to your advantage in business and just in life, in all of your interactions. And predictably, irrational does a good first high level pass of starting to think about that. And just the way that biology decides stuff versus machines decide stuff, knowing that difference is really cool.
Brett
I just finally read that book about six months ago, and its such a great read, Jeff.
Austin McChord
Yeah, I think its just amazing how, again, on its surface, its something like, oh, well, you would help your friend move for a great bottle of wine, but youre like, oh, yeah, will you come help me move today for 80 or $100 youd be like, no, thats stupid. But technically, a good bottle of wine has way less utility than 80 or $100. But it’s like the process of, like, making a selection and down selecting into something, like, gives it actually more value than just, like, the cash as is. And there’s just so many examples of stuff like that.
Brett
Totally makes so much sense. One final thing to ask about your background before we dive a bit deeper into the company, havoc robotics. Talk to me about this, a new category of competitive sports. Tell me more about what you’re doing there.
Austin McChord
Yeah, so this is a bit of a passion project and was kind of a case of like, if you build it, they will come. And I had always seen, like, the battlebots tv show, and I got to know some people who were competing in the tv show, and they’re like, hey, there’s actually these smaller robot competitions with, like, robots that you could build, like, in your garage that are like three pound or twelve pound or 30 pound robots. And so I went to one or two of those competitions and was basically like, these are not very well run, and I don’t have time to, like, sit around and wait and deal with this.
Austin McChord
And so then it was like, actually, then I could run my own competition, and I bet I could run it better, and I bet I could produce content that’s just as good as the tv show off of this, because the fights are just as interesting. And so that became havoc robotics, which is now probably the world’s largest, like, regularly held robot competition. And it’s nuts that I’ve got this huge facility in Connecticut where this happens, and people travel from all over the world to come fight robots there. And it’s just a really cool thing and just wild, like, the community and world that has come up around it.
Austin McChord
And for me, it’s such a cool opportunity to bring all these people together and, like, these are the engineers that are going to be designing the next autonomous vehicles and making all the things in the future possible. And, like, this is the chance for them to, like, get their feet wet with the actual technologies that they’re going to be using.
Brett
I’ll make sure to link to the. The website in the show notes because it’s awesome. I have the video playing in the background right now as we speak. There’s one with, like, a sparkler spraying out. This is cool. I didn’t even know this was a thing.
Austin McChord
Yeah, it’s crazy stuff.
Brett
That’s awesome. All right, well, let’s switch gears here and let’s dive a bit deeper into the company. So I know you touched on the problem quite a bit there and what you’re solving, but let’s talk about the business model here. How do you actually make money?
Austin McChord
Yeah, so the scenario is that we are building a medical device and this med device will go out there and basically serve the same standards as the gold standards that your doctor would use. And our goal, we’ve got clearance for heart rate and blood oxygenation, and we’re working with the FDA to get a 510k through that would allow us to do blood pressure as well. And we can track these vitals over time. And Medicare will pay to have a lot of those vitals tracked for the right patients because it couldn’t matter so much. And so there’s an ability to get reimbursed both by the government and by private insurance for being able to track these core important vitals in at risk populations.
Austin McChord
And that’s really what we’re looking to do, is to run this more efficiently and capture those dollars that are set aside to track these vitals. And the reason why those dollars are set aside is because people don’t do this. And then when they don’t do it, they get much sicker and it costs the system a whole lot more.
Brett
Can you talk to us about the FDA clearance process and what that looks like? Maybe just like a behind the scenes look for those who aren’t in the space?
Austin McChord
Yeah, I mean, I think it’s a level of regulation that it was certainly not used to. And I had experience dealing with the FCC and other regulation associated with cybersecurity. But med device is a whole different thing. And there’s so much emphasis and focus on safety. And the challenge is that the FDA is put in this really hard spot where if anything goes wrong in any approved appliance or device and somebody gets sick or somebody dies, that could come back on the FDA. And so by their nature, they’re very conservative. And it means that everything that you say that you’re gonna do, everything that you say that you do, and every caveat associated with what you do, like, you have to test and proof.
Austin McChord
So it means you’ve gotta run lots and lots of studies, and so you can’t do something like, say, our toilet seat is made out of the same stuff as other toilet seats, so it’s safe. And so instead, we had to do biocompatibility testing, where they literally have to tape parts of the toilet seat to the side of a living animal for a period of time and determine that, yes, it does not get a raft from this. And so it’s like every little detail has to be tested, which is just an enormous amount of work.
Brett
How long did that process take you from start to finish?
Austin McChord
Well, we haven’t finished yet, so I’ve been at it for three and a half years, since I joined the company. And the actual time cycle of a 510 clearance is relatively short. But performing all the validation trials necessary to get there takes a long time.
Brett
What was the FDA clearance I read about on your website? Was that for a specific use case, or what was that?
Austin McChord
Yeah. So we are currently cleared for a version of our product which supports heart rate and blood oxygenation. What we are seeking clearance for is blood pressure.
Brett
Got it. Okay, that makes a lot of sense. And is it harder to get blood pressure?
Austin McChord
Yes. Blood pressure is a more difficult measurement to capture and is one that’s more clinically valuable. And typically, the way that a blood pressure cuff works is it squeezes your arm and look, can feel and sense blood pressure. But in our case, we have to get blood pressure in a different way because we’re not going to squeeze you while you’re sitting on the toilet, and instead, we’re looking at blood flow through your arteries, and we’re measuring the electrical signals from your heart, as well as actually feeling your heart pump with very sensitive weight sensors in the seat.
Brett
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Austin McChord
I mean, I think actually the onerousness of the regulatory environment and what’s involved in meeting, like, the quality systems that medical devices must do and, like, it’s just a level of regulation that I am deeply unfamiliar with and is surreal coming from software and cybersecurity and just that everything must be documented, every change and the reasons for the change and how you test to make sure that the change doesn’t affect things you want the change to not affect, like the amount of work that’s involved. That is massive. And it’s given me a whole other level of understanding on why you encounter so many med device products. And it’s like, man, these things feel like they’re from the past. And it’s like, yeah, because it probably took them years and years to get it through because of the level of regulation that exists there.
Brett
Do you ever feel like you lack control of the company’s destiny because of the heavy regulatory environment?
Austin McChord
Yeah, absolutely. It’s super frustrating.
Brett
What do you do to get through that? How do you navigate that when you’re just thinking about the business? Because it sounds like you could do everything right. You don’t get this clearance, and then all that stuff that you’ve done right doesn’t matter. So how do you think about that in your head, and how do you just proceed forward knowing that’s the case?
Austin McChord
I mean, it’s existential risk, right? And it would be the same as, like, if all of a sudden you’re running an AI company and you couldn’t get GPU’s no matter how much you wanted the GPU’s. So it’s just out there. I mean, this one is a little closer, and it’s making sure that you work with and understand the requirements that you need with the FDA, and you just take that step wise process. But it’s been a learning for me, and it has been frustrating, but you learn new stuff and you got to keep moving forward.
Brett
What’s a typical day look like for you?
Austin McChord
Oh, man, my days are crazy, and no two days are the same. So I do a bunch of stuff, and that’s kind of what happened, is I joined Casana during COVID and I’d left general catalog during COVID and there was this window where I was doing nothing, and I was like, oh, my gosh, I guess I will do all the things. And so I started the robot league. I got involved and became CEO of Casana. I started a venture capital fund. And so now I have, like, all of these bets going in all of these directions all at once. And so my day is like death by contact switching, and I’m constantly switching to do different things in different places all the time. But it’s really interesting. And for me, what keeps me excited and engaged is just all of these processes.
Austin McChord
I’m learning something new all the time. And Casana has taught me so much, and I’ve learned so much about the process and so much around delivering med device and so much around physiology and my how to do statistics at a level that I just never would have imagined in the past. And it’s fascinating. And so, like, it’s that learning that keeps me motivated every day.
Brett
I love that. How do you describe, or how would you define the marketing philosophy at Cassana?
Austin McChord
So one of the things that the FDA cares a lot about is what you say about your product. And so we walk this really interesting line where we have this quirky product that every time you hear about it, you’re going to laugh because it’s a toilet seat. So, like, we’ve heard every bathroom joke you can imagine. And it’s fun because we get a ton of earned media, because everyone wants to make a bathroom joke. But at the same time, we are a serious medical device. And so we cannot say that we do anything we do not do. We cannot claim anything that we do not have approved by the FDA. And so you have to be very careful in what you say. And that’s an interesting sort of mix of these two pieces.
Austin McChord
But our strategy is really to, like to catch you with the humor, but then win you over with the science. And it’s really important that we’re able to show the amount of rigor that we put into this. And that while it sounds funny, like, the science is super serious and the ability to change lives is huge. And that’s what’s the most motivating in all of this, is that this product, unlike almost anything else you could work on, like, we’ll directly save people’s lives when it’s in the market. And so that’s such a cool opportunity and it’s what motivates you through all of the regulatory challenges that you’re going to face to get it there.
Brett
When I was spending some time yesterday on your website, I did notice that on the about us page, when you go over the team members faces, that it shows the toilet seats or switches over to the toilet seats. And I thought that was a lot of fun. So it’s serious at first, and then it gets fun when you go over it. So that was very well done. Thank you. When we talk about market category, how do you think about the category? Is it in home health monitoring or is it something else?
Austin McChord
No, it’s in home health monitoring. I think that’s exactly the case. And COVID is really what made a lot of this possible. And then all of a sudden, people became so much more comfortable doing health stuff at home, and doctors became so much more comfortable thinking about readings and data that people generate at home. And that’s what’s unlocked the possibility for this product.
Brett
Can you share any numbers, metrics that highlight adoption and growth that youre seeing?
Austin McChord
So were not in the market yet because we need clearance. We have run dozens of clinical trials, and clinical trials is basically your only path to beta testing a med device kind of product. And clinical trials have been amazing and really awesome to get it out there and get it under people or have it on people’s toilets and from that have, like, learned a lot. And I think the biggest thing is just how many times people are like, oh, man, I want to get one of these for my mom or dad or somebody they know. And it’s so cool that there’s just so much pull in the market for a product like this.
Brett
As I mentioned there in the intro, you’ve raised over 46 million to date. What have you learned about fundraising throughout the journey with Cassada?
Austin McChord
I think that med device is in a class all its own. If were a software company, that would be an enormous amount of money, and we would have had to demonstrate a ton of traction in med device. We raised this money on $0 in revenue, and that’s not uncommon. And you think about it like the very first product that Moderna ever really shipped or sold was the COVID vaccine, and they were around for over a decade before selling that. And so it’s kind of wild how these journeys play out and the milestones that generate value in med device. And so it’s been really different sort of learning about that, getting good at talking about that and explaining progress in terms that aren’t CAC and LTV, et cetera, associated with sort of a more normal business.
Brett
Based on everything you’ve learned so far, what would be the number one piece of advice you’d give yourself if you were starting over from scratch?
Austin McChord
Oh, man. I mean, I think I would write a letter with the amount of different things. I think at its core is probably just like, trust your gut more. And I think that the places that I’ve stumbled most are the places where I’ve been talked out of something, or, like, experts have said, don’t do it this way. And then, like, went with the experts when my gut was like, oh, maybe we’re different, and here’s why we might be different. And I think that those are sort of the cases where I’ve been like, wow, we lost six months because of that. And so it’s hard when you have a contrarian opinion, and I guess you’ve always got to be good at justifying it because you can’t just tell people to do it because you’re the boss.
Austin McChord
I think that we assumed time following some paths that we potentially didn’t need to follow, and I should have fought a little bit harder on the contrarian opinions.
Brett
Final question for you. Let’s zoom out three to five years into the future. What’s the big picture vision that you’re building?
Austin McChord
I think there’s hundreds of thousands of seats in the world, and they’re saving lives every month, every week, every day.
Brett
Amazing. Love the vision. All right, Austin, we are up on time, so we’re going to have to wrap before we do. If there’s any founders or CEO’s that are listening in and they feel inspired or just want to follow along with your journey, where should they go?
Austin McChord
Well, they can go to casanacare.com and see everything that’s going on in Casana, or they can obviously check out the robot league at NHRL.io
Brett
Awesome. Thanks so much for taking the time. It’s been a lot of fun.
Austin McChord
Thank you.
Brett
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