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How Being an Industry Outsider Helped PocketHealth Revolutionize Medical Image Sharing

The conventional wisdom says you need deep industry expertise to disrupt healthcare. PocketHealth CEO Rishi Nayyar proves otherwise. His journey from investment banking to healthcare tech demonstrates how being an outsider can be a powerful advantage when reimagining broken systems.

In a recent Category Visionaries episode, Rishi shared how PocketHealth transformed medical image sharing from CDs to a modern digital platform by applying consumer tech principles to healthcare – precisely because they weren’t constrained by industry assumptions.

The Outsider’s Fresh Eyes

The catalyst for PocketHealth came when Rishi’s brother encountered healthcare’s antiquated image sharing methods firsthand. “He’s in the Valley in Mountain View, playing tennis…and at the end of his MRI, they handed him two CD ROMs,” Rishi explains. “He was kind of stunned, like, how are they burning CDs? There’s Netflix up the road, YouTube down the road, and CDs are the state of the art here.”

What initially seemed like an isolated clinic’s problem turned out to be systemic. Rather than being discouraged by their lack of healthcare experience, the brothers saw an opportunity to apply modern consumer tech principles to solve it.

“We felt that, look, this is file sharing. Yeah, it’s healthcare. Yeah, it’s complicated and messy, but it’s just file sharing,” says Rishi. This outsider’s perspective allowed them to see past the industry’s self-imposed limitations.

The Consumer Tech Advantage

Instead of studying existing healthcare portals, PocketHealth drew inspiration from successful consumer applications. As Rishi notes, “Our bias is, how are these problems solved in the entirety of tech, in the entirety of consumer applications? Not, hey, what are other patient portals that we can look at?”

This approach led to a fundamental insight: while healthcare portals were complex and cumbersome, consumer file-sharing platforms like Dropbox had cracked the code on making sharing simple and intuitive.

“You want to be meeting the bar where the patient can go from Uber into pocket health,” Rishi explains. “And they feel that these are applications that feel similar, that have been thoughtfully designed in the same way.”

Starting Local, Thinking Big

Despite their outsider status – or perhaps because of it – the brothers took a methodical approach to market entry. They started in Canada, focusing on building relationships and gathering user feedback before expanding to the larger U.S. market.

“Being starting locally was important for us,” Rishi shares. “Starting in Canada, starting locally in the Toronto area, that was really important for us to get that early feedback, early revenue, and be able to get to the point where we felt we had a product that was heavily chipped away and refined not by us, but by the market.”

The Results Speak Volumes

The outsider strategy has paid off. PocketHealth now serves “over a million patients on the platform” and is “in over 700 different hospitals and imaging centers across North America,” according to Rishi. The company continues to grow multiples year over year.

Key Takeaways for Founders

1. Fresh Perspective as Advantage: Being an outsider allows you to question industry assumptions and import successful solutions from other sectors.
2. Focus on Universal Needs: As Rishi notes, patient needs are remarkably consistent: “They get high anxiety before an exam. They want to know how to prepare. They get an exam, they want to know what the results are.”
3. Start Local, Refine, Expand: Use your outsider status as motivation to gather deep user insights before scaling.
4. Raise the Bar: Don’t benchmark against existing industry solutions – aim to match the best user experiences from any sector.

The healthcare industry is notorious for its complexity and resistance to change. But PocketHealth’s success shows that sometimes it takes an outsider’s perspective to solve long-standing problems. By applying consumer tech principles to healthcare challenges, they’ve created a solution that works better for both providers and patients – proving that fresh eyes can often see what industry veterans miss.