Heidi’s Dr Simon Kos on AI and keeping the humans in tech

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0:46Hello, Bouchigama Wara from Gadigal Land in Sydney, Australia. I'm Julie Trell, and I'm here with the fabulous... Elizabeth Holmes impersonators. Fascinator, Simon Thompson. Simon Thompson. With my dark, deep voice. Yes, who showed up resiliently to have this conversation. Thankfully, we have a doctor. I said I've been trying to rest because I haven't been feeling great this week and I just keep going. And the reply was, you have such a founder mindset.

1:17Well, who do we have today? What's going on today in the world of news? Well, the great thing is that we have a doctor coming to talk to us today, Dr. Simon Coz, who is the Chief Medical Officer at Heidi Health, is our guest. Of course, Heidi won the Scale Up of the Year, the 2026 Startup Daily Best in Tech Awards, and also the AI Game Changer Award. Incredible company. Absolutely been kicking goals since the award with a very big raise and a lot going on. And a great story and disruption happening across health. Yeah, and Simon, who was at the awards, is such a fascinating bloke to talk to. He started out doing medicine and has had a really interesting career working in big tech, working as a startup founder, so many different angles.

2:06Now, before we go any further, I do want to say that Startup Daily is supported by a deal. Hire, manage and pay anyone anywhere. If you can do that in bed, I'd be grateful right now. That would be fantastic. Just wake up briefly, hit a button and hire, manage and pay anyone anyway. Yeah. That's what I feel like. It's happening. Deal, we'll let you do that. Yeah. Should we do a little bit of a deal spiel this week? Of course, as we record this, the US elections, the polls are just closing. I know that Ohio is due to close in the next 15 minutes or so. So we don't really know what's happening at this point in time and we won't go into that one.

2:51But some huge news on Wednesday morning before we recorded this with Canva and Melanie Perkins, the CEO and co-founder, sending a message to all the staff that 22 % will be affected around about 1 ,270 people in what she's calling a refounding of the business. so they didn't disclose how many jobs are going to go but what Perkins said is that they're combining product teams removing organizational layers and bringing more roles into Sydney people are going to be spending more time in the office at least two to three days a week so the hybrid thing is going to change a little bit but the company has been dealing with AI disruption In the last fortnight, it's put two new homegrown AI products into market, Brush and Craft.

3:47And only yesterday, I did rise from my sickbed and wrote about the deal they've done with OpenAI to access the Astra models and be able to use them in a way that hopefully is cheaper and more efficient for all involved. But the company has been having a bit of a torrid time for the last few months. You may remember that in August, Mel announced that they were slowing down the product rollout so they could get their head around the costs involved in AI. And I have to say absolute credit to Canva because not only did they send this message to all staff, but then they posted it on their site. So they have been incredibly open and transparent and it would be one of the best.

4:36Whatever's going to happen for the people who are going, the departing staff will get at least six months' salary and can apply for a US$10 ,000 grant, equity-free grant, to start a business or community project. So who knows? 100 flowers could bloom from this. Yeah. All those Canva Norts could go off and become start-up founders in their own right with, what, nearly$15 ,000 Australian dollars in their initial funding. So it sounds like it's tough there for them at the moment and I think that NASDAQ listing is even further down the track as they rethink. And the word that Mel used for this was refound.

5:22They want to refound the company. Now, I don't know whether that means they're getting more founder mindset again or they lost the company and they're going to find it again. Grassroots. They're definitely having a massive change in terms of how they do the business 13 years down the track. Part of what she said was, you know, that this has been the hardest year of the decade with growth sort of basically flatlining and the hardest moment in the company's 13-year history. so best to all going through this uh luckily when you've been in media redundancy is a word you become quite familiar with but it doesn't mean it hurts any less uh and there are ways you can do it that are good you know it has to be done but you can do it well and i think canva's done it well in this moment so uh credit to them on that front now speaking people who must be wondering about their jobs.

6:23We are, of course, about four weeks away from the Victorian election where the opposition, the Liberal Party and Jess Wilson, are looking like they will take charge of the state after 12 years of Labor. One of the things that she said she would do was basically get rid of Innovation Victoria. That's the combination of Breakthrough Victoria and Launch Vic. Off it goes. And the focus there is the$2 billion Breakthrough Victoria Fund. Well, interestingly enough, Breakthrough Victoria released its annual report, which was the last year, first year under Rod Bristow, the CEO, who has a very experienced VC operator.

7:11and they had a pretty good year with a$165 million operating surplus, net assets sitting at$824 million, two profitable exits. Interestingly, both US companies. One of them was Worldview, which kind of kicked off the backlash against Breakthrough Victoria at the time, back in 2024. But it was acquired earlier this year for, I think, about$150 million and break through Victoria to put in 37 mil. And looking at it because it was a script deal, I tried to do a back-of-the-envelope calculation. And I think if they sold at the top of the market when the company that bought it was peaking a few weeks later, they would have ended up with more than 60 mil in hand.

8:03And the other one was inflection, which listed on the NASDAQ, also a good exit for them. They didn't disclose numbers on that one. Neither of them were made public, but the term use was profitable. So one of the things that the Liberals have promised to do is also sell off all of the investments. Now, as we know and as we've seen with Canva, timing is everything. So they want to spend the money on elective surgery. Maybe we'll talk to Dr Simon about this a little later on. but it's a really weird Rob Peter to pay Paul scenario they're painted. We've had some guest posts on Startup Daily talking about this and how I think important this is.

8:52Of course, Innovation Victoria, as it's now known, recently put another$10 million into the Alice Anderson Fund. That is the one that supports female founders and part of their remit is market failure. They go in and they address issues where people are underrepresented, where the opportunity is there. And, of course, Victoria has the third fastest growing, as they point out, startup ecosystem in the world, employs more than 60 ,000 people, has had a very important impact. The organisation, the fund has been going for five years now. I think it's just starting to hit the straps. Their point was that at the growth level, the internal rate of return, I think it's something like 22%, and that sits above the median of funds from 2021, similar funds from 2021 around the world.

9:43So I do hope that the opposition has a little bit of a rethink about this rather than making these wild promises. And we mentioned it this week. I have to say in my inbox this morning, Comsec, said, oh, hi, got some Anthropik shares, won't he? give you a good price. Is that how you're going to pay me in the future now? Yeah, yeah. You'll just get Anthropic shares. Would you like that? Anthropic is going to offer them to retail investors with participating brokers including Comsec, Steak, Sharesies and Bell Potter. That means we're going to get a prospectus out here that we can trawl through. Doesn't that make you feel special when you get a little special Australian Anthropic?

10:28Insight, yeah. Probably written by Claude. That you think. Yeah, well, you know, about sort of the 1 ,001 ways that AI is going to kill us. I can't wait. But I think I should shut up while I've still got a voice and shall we take a quick break and talk to Dr. Simon Cos when we get back? Yeah, let's do it. Okay, well, don't go away. We'll be right back and hopefully I'll still be alive. Founders scale faster on Deal. Set up payroll for any business in minutes. Hire anyone, anywhere and get visas handled fast so you can stay focused on scaling. Deal takes care of onboarding, HR, IT, EOR, benefits and compliance so your team can grow without borders.

11:16It's why more than 37 ,000 fast-growing companies trust Deal to move fast. Visit deal.com slash 360. That's D-E-E-L dot com slash 360.

11:32welcome back welcome back i'm glad i'm still here at this point i am too sniffles but um the main thing is we have a doctor we have a doctor in the house i just was going to say that so it gives me great pleasure to introduce dr saman kos who is the global chief medical officer of heidi health and he's had a really interesting medical career from in technical world as a doctor across across the globe so he is based in sydney currently when he's not on an airplane he's responsible for clinical engagement thought leadership brand ambassadorship product roadmap and go-to market enablement enablement am i am i on the mark there spot on okay that's ai um and he had a great time at the startup daily best in tech that's why i said i did yeah we talked a little bit of it at that he is an apra registered medical practitioner who practiced critical critical care medicine before moving into digital health with more than 20 years in senior executive roles, including chief medical officer at Microsoft, the CEO of Next Practice, which I actually was a patient of, one of them, and a co-founder of Lumira, Lumira.ai.

12:45And I would love to hear how it all started and a little bit more about your journey. Not just me, our audience would love to hear about it as well. Super. Thank you, Julie. So I started, a total lack of imagination, both my parents are doctors, so I'm intergenerational and I just went into it. You didn't have a choice. So they told me not to. That was an interesting conversation. I remember I said, why not? And they said, well, it's stressful and you have to work hard. And I took offence. I thought they were saying that I couldn't handle stress and I wasn't prepared to work hard. What they weren't saying was there are some challenges in the health system and I found that when I actually started practicing so critical care medicine is a lot of emergency there's a bit of ICU there's some anesthetics there are those high intensity pathways where they're team-based information matters decisions are fast and if you get it wrong people die and so I saw mistakes happen around me and I thought someone should fix this and that insight and asking the question who's responsible for this who does this led me to understand that I was looking after patients but no one was really looking after me so that became my life mission to get into digital health yeah so i wanted to just go back you were talking about your parents were dissuading you but what was your drive to want to go into it with not having the curse of knowledge tabula rasa what what it's the usual thing isn't it when your parents say you can't do something you really want to do it so that was part of it um but there was a logical part of me that said it's going to be easier to transfer out of medicine into something that does light me up than it will be if I go somewhere else and decide afterwards actually I wish I had gone to medicine so what does a 17 year old know not much and I started out in medicine and then six years later I had a degree and I was out there in the workforce I just I'm just waiting I was just wanting to hear about like people you wanted to help people and I haven't that's what I was listening for like are people important in this role?

14:46I didn't go into it for that and I didn't develop it during my undergraduate med studies so I actually found undergraduate meds are not a whole lot of fun. They take the in my day they took the top one percent of the state or the top 0.75 percent of the state and they put them together. And you're all psychopaths. So it's an interesting bunch but there's a lot of competition not a lot of collaboration and that just didn't light me up. It wasn't until I actually started practising and I'm a communicator, I'm a people person, I got to work with nurses and allied health and seniors and juniors and all the rest of it and that lit me up because I like working with people, I like working with smart, capable people and I like making a difference.

15:34And the difference in healthcare is you're helping people, you're saving lives. So that gravitated me towards a critical care pathway but it's not why I went in. Oh interesting and the problem solving part of things fixing things that are not human. Oh that's part of the frustration as well so three years they're like dog years as a doctor and I kept on seeing the same people walk through the door of the emergency department different faces different names but there's a there's a heart attack there's a complication of diabetes there's a chronic obstructive pulmonary disease from smoking and I thought I'm changing the world one patient at a time and what I was lacking was scale.

16:14And so that attracted me about digital health, the ability to have impact at scale. And what led you down the executive path? How did you decide that was the direction? Is that because you could have the most impact? If there's a ladder there, you climb it, right? Yeah. So I started out in my first digital health job and it was a legit start-up and I was a lowly business analyst and that company kind of ran itself into the ground, ended up getting acquired and I thought, boy, I didn't have any agency in that journey. When I went across to Cerna, then I had an opportunity to step up and I learnt so much there because they actually had a methodology, they had an organisational structure, they gave me opportunities.

17:05So it naturally just ended up that I was their AsiaPAC physician executive. I was talking about digital health to people many, many years my senior, but I knew something that they didn't. So we could have an interesting conversation. Do you have any stories of some of the scale that you created at Cerner? So at Cerner, when I went in, they were a global phenomenon, but in Australia, we're a late adopter of digital health in hospitals. I actually started out thinking that we needed these things called patient records and clearly they don't exist and I could go create them. So I retrained in software engineering.

17:46That's how I transitioned out of medicine into digital health. I hadn't done my research. I didn't realise these companies already existed and they just hadn't been procured and implemented. So when I joined Cerner. They had low penetration, saturation. And in the six years that I was there, we took entire states digital. So Victoria, there was a HealthSmart program that kicked off in 2004. New South Wales deployed their statewide electronic medical record in 2005. We laid the groundwork for the rollout that Queensland are still doing today. And that felt amazing. We were introducing digital change.

18:25And there's your scale. There's your scale on fixing people. And then from Cerna, how did you end up in Seattle at Microsoft? Was that the next step? Yeah, I didn't go straight to Seattle. So while I was at Cerna, they'd employed me as a change management consultant. And I didn't know what that was. I had to figure it out. I'm still the same with journalism, some 35 years down the track. So I had learned clinical. I had learned technology, software engineering. What I hadn't learned was business. So I found myself in this role, which was all about organisational change, and I didn't understand the fundamentals.

19:02So my executive MBA was over four years, and it opened my eyes. At the end of it, I realised it's not just about putting in an electronic medical record, it's doing the change right. And doing the change right was people it was processes and there were things missing so we over indexed on the electronic medical record we forgot about communications we forgot about collaboration people were putting the data in we weren't doing anything with the data out there was no mobility strategy to take to the patient bedside no workflow optimization none of that that's why I went to Microsoft I went to a company that had a broader view of technology and how people use it for productivity and change.

19:44And I ran the health business for six years in Australia before going to the US. And so when you came back from Microsoft, what happened next? Oh, so global role was incredible. I was a global chief medical officer. There was a lot of travel. So I had my wife and young family in rainy old Seattle, and I was just on planes all the time. So the work-life balance was lacking. It was really indulgent professionally, but work-life balance, it was unsustainable. So I came back to be the CEO of Next Practice. And Next Practice was Dr Sam Prince's, I think it was his sixth business. He's a serial entrepreneur.

20:22And he had this fledgling next generation general practice. And they had three clinics. And the idea was, Simon, we need a credible doctor who understands business to be the front person and scale that. I said to Sam, I know nothing about being a CEO. And he said, well, that's easy, but you can bring some things to the role that others can't. So I had the perfect mentor to transition out of being a deep specialist into being a generalist in digital health. And it was glorious for six months until COVID hit. And then I found myself in a primary care business in the middle of a global pandemic. And that was some of the toughest years of my professional career.

21:05But you grew there. You helped it grow because there's more than three clinics now. Yeah, yeah. When I started, there were three. I was there for 18 months and we exited with 12 clinics and next practices are still around. Yeah. I think, so what we did at the six-month mark was lean really heavily into digital process change and virtual care. So we introduced telehealth and patient engagement and apps and all the rest of it. But it was a difficult time for the business. Instead of being on a growth trajectory, all of a sudden we were facing existential threat and had to pivot and change and the outlook changed.

21:51I realised towards the end, so much learning, that they needed a wartime general and they'd hired me as a peacetime general. And so it was the right time for me to say, a competent general manager who understands finance, capital raising, all the legal aspects and change, they could come in and do the job. And I went back to Microsoft. Well, it sounds like you were able to put your business work to your business practice in play and bring some of the digital stuff within the other bigger stuff and stepping away and finding that takes a lot of insight and confidence as well to replace yourself.

22:32Yeah, it was. And very unlike a CEO. Yeah. I was focused on the business and what the business wanted. And the business plan at the time was to take that business, scale it to 100 clinics over three years and potentially IPO. And we were on track to do that if we'd made our hypotheses correct and then who anticipates a global pandemic. And so I just knew that the path that they were going was not the path that I could lead them down. So it was a pretty simple decision made over months. That's great leadership though. Yeah, and no ego. Yeah. I want to take a quick step back to that Microsoft moment and the conversation with family and how you tackled that decision because great job, made out great pay.

23:22It felt in so many ways it ticks so many boxes for family except the personal cost to family. Yeah. How did you do that? I've been with my wife since I was 22. She was 19. And we've been lucky enough to work together in two companies. So we spent most of our time together. And we work best together when we're on the same page and communicating all the time. And what I found was the more I travelled, the less we talked in a meaningful way. And then I'd come back and things had changed that took me off guard. and I'd try and slot into the job of being a dad and it was too discontinuous. And so it was a mutual recognition and then we didn't make any split-second decisions.

24:07We waited and we looked and we considered all sorts of things, different opportunities in Microsoft, different opportunities in the US, what was there to come back to in Australia. And I always say never run away from something, run towards something and I was lit up by the idea of Next Practice. that was a mission I that resonated personally with me looking back now at your CEO role at next practice what would you have done different if anything or you're happy with how it all fell out so I knew I had the right mentor and I came into the business and um I I needed I needed some remedial skills so the I remember looking at how we were uh rolling out clinics and saying these are projects and we need a legitimate project manager and the answer was great you be the program director for six months you'll know it inside out and then you can hire someone and I thought okay I've got to learn project management fine the next insight I was talking to one of our vendor partners and he helped me understand that there's technology-led organizations then there's product-led organisations and then there's customer-led organisations and I was thinking actually we need to flip from being tech-led to product-led and I said we need a we need a product director and he said great you can be the product director for six months and then you'll know who to hire so it was very much a process of figuring things out I needed to pick up legal skills I needed financial and accounting skills I had some of them from my MBA but they hadn't been put into practice so it was actually really humbling I had competent people on the family office executive team around me to help but I ended up having to do it all and I felt the gravity of decisions and I'd turn up to board meetings every month knowing that there were there were things that we were going to talk about we were going to have tough conversations about things that should have been done that weren't and things that I was personally accountable for that were off track.

26:16So like I said, really hard learnings but great experience. You were wearing the shoes or the hats, whatever you want to say, of each of those roles and really understanding them. I love that. My desk in the open plan office was right near the door, so any time the doorbell went, the CEO went and opened the door. That's kind of epic. Yeah. So really it's an adventure in a combination of unknown unknowns and known unknowns that you spend a lot of time sort of peering into the dark? Yeah, I've got this learned belief that I can do anything. It's just going to be hard but I've got enough capability to figure it out.

26:57And so I'm generally not dissuaded by fear. The unknown doesn't bother me. I know it's going to be messy. I'll just jump in and get it done. And sometimes it's delightful. you jump in and you realise this is fabulous. I'll take back even further to my childhood. So I had a fear of heights and so in year eight I took up springboard platform diving just to try and get up to that fear of heights. I knew you were going to be one of those people. Yeah, and I loved it. It was fantastic, especially because it's a heavily female-dominated sport. It was very good socially as well. Ah, strategy already.

27:36And then later in business life, public speaking was just one of my great fears. And so the ability to take a role that had some public speaking and start to work that muscle, I got it done and now I enjoy it. So you never know what looks scary on the outside has gems and learning on the inside. And the unknown unknown, knowing what I do now, I probably would say, actually, that's not a good fit for my skill set. I spent 70 % of my time doing what any competent general manager could have done in their sleep. And the things that I uniquely am good at, I wasn't really exercising, so it wasn't a good fit.

28:16But I didn't know that without trying. But as we go through our careers, I often think that there are moments where you learn something, where you pick up a new skill that you didn't have previously, that somewhere down the track, it's kind of like the shed of tools that, you know, your wife wants you to throw out because what are they for and it's like they'll come in handy one day your career ends up being something very similar in that there's a whole bunch of things that you learn that coalesce in a moment that makes you successful at what you do that is so true so as a as a medical doctor i learned science i learned critical thinking i learned analysis i learned accountability how to make decisions and stand by them but then i also saw the flaws in the system and i thought this could be improved jumping over into the world of digital health I started at startup and I love the freedom and autonomy and the ability to make quick decisions and move but there was a lack of rigor and methodology and I learned that in big corporate that can be a good base to learn from but then it becomes a handbrake as well and if I had have known this sweet spot of scale up existed before i would have found it earlier but it's the best of both worlds it's the it's the freedom and autonomy and impact that a startup can have you can legitimately change the world but you're not constrained by um the fear that prevents the fear and bureaucracy that prevents some large organization taking those risks but then at the same time don't those experiences feed into heidi as it scales along the way and you kind of know the pitfalls and crevasses that you're dealing with yeah spot on i want it before we get into hiding because i really do i want to add also to your tool shed analogy and it sounds like you would be a great improviser improv like stage improviser because you're talking about all of the recruiting i am um the the principles of improv and not being afraid and trying things and and saying yes and i'm going to try this and the muscles that i'm hearing you have stretched are what makes you jump into the different things despite or because of or embracing the fear.

30:26And I do love that. Like we're going to try it. Oh, that doesn't fit. But, you know, I learned from it. And so I'm also curious now the scale up, enter Heidi. How did that fall in your lap? Happy anniversary. I think it was last month. Yeah, October is when I started. So I was over at Microsoft and I joined Microsoft during the kind of COVID digital transformation. And that was awesome. We were doing things that had been blocked for 10 years and all of a sudden they were happening at scale. So that was delightful to see the whole health sector embrace digital technology and new models of care and the rest of it.

31:09Then the ChatGPT moment happened in 2022 and off the back of that were born all of these incredible native AI companies. And for a while it was just the great experiment and there was a whole lot of novelty without impact. And then it started coalescing into patterns that were reproducible and scalable and I managed the channel at Microsoft so there was a good 900 partners in Australia active in the health sector either with products or services and so Heidi was one of them. I got the chance to work with Heidi for a full year, co-selling with them, identifying market opportunities, thinking about how to create connections and the impact was obvious that's what drew me there but what kept me there were the people i just love the people they were fun to work with they had energy they had ambition and it got to a stage where microsoft's focus now is very much on data centers providing the utility and then shovels artificial intelligence on top of that and that's what that's what they should be doing at the moment what it translated to was a decreased industry focus and i felt that working in the health business at microsoft i wanted to have greater impact and so i was looking for a company like heidi and there was absolutely risk coming across um but boy it's born it's borne out really well i'm delighted and it now i just want to get you to explain Heidi to people who may be thinking that it deals with a communicable disease like yodeling, what does the company actually do?

32:54So Heidi's been around seven years. It was started by three Melbourne guys. Dr Tom McKellie is the CEO and he was a vascular surgical trainee and he had been mucking around with various bits of technology. He had a medical tutoring business and then created a patient simulator and worked with telehealth technologies and practice automations none of it was really taking off and then during the chat gpt moment all of the painstakingly crafted nlp technology was obsolete overnight and tom and the company lent hard into ai scribing so ai scribing is when you go to see your doctor next they might ask you the question i'm using an ai recording device to help you do my notes do you mind if i record and if you say yes they put the phone on the desk or activate the computer's mic and they just have a conversation and Heidi will listen and collect the transcript and then it will turn the transcript into documentation artifacts and that might be a note for the doctor it might be an explainer for you in English and Hindi if that's your native tongue there were referral documents that it creates, it can fill out PDFs.

34:10And for doctors who with digitisation have become increasingly burdened by computer work, it's just unburdened them from the computer. They can look the patients in the eyes. Now they're articulating what actually happens. So rather than putting the stethoscope on and going, uh-huh, uh-huh, uh-huh, they say, I'm listening to your heart, heart sounds a dual, no murmurs. And then the patients say, what does that mean? Is that good? And then you have a conversation about heart. and heart health. And so it's changing the patient experience. Because I would say part of that experience too is, especially if you're getting some tough news, it's often a blur for the patient and they have no idea what's actually being communicated to them.

34:52So I'd imagine on that side we often use patient advocates, another person who was actually there who could take it all in. Heidi would help address that issue. It can. So there's no obligation using Heidi to print a patient explainer. but there's no additional cost or effort to do so. So many people are doing that and that's huge because when there's... Was that planned or was that something you realised GPs, doctors found value in and created themselves? We have learnt so much from our user base. So no, it wasn't planned. Yeah. But the thing that has scaled Heidi to be the most used AI scribe globally is a business model innovation that created a free tier.

35:37pretty common in other industries, but there's a myth that you can't do product-led growth in healthcare. So Heidi created a free tier and all of a sudden, instead of selling to hospitals, it was immediately accessible to clinicians themselves. And so this started in primary care general practice, but then it moved out into allied health and nursing, dental and vets, disability and social support services. And at the core, the technology allows you to create a template. So once it's collected the transcript, the template turns it into an artifact of your choice. And the community, which is thousands of people globally are creating these templates, sharing them.

36:20And that's where the idea of a patient explain came from. So before I ask a question and something that I've noticed in all of that you shared, we're going to take a quick break. Hello, it's time for Built on Oracle, our regular check-in with Aussie founders scaling up on NextGen Cloud. Today, I'm joined by Jay Haybertov, founder of DecoSecure. Jay, thanks for joining us. Thank you for inviting me. So give us a quick intro to your business and where you are on your scale-up journey.

36:50Dr Simon Kos: So DecoSecure is an Australian SaaS platform, which provides solutions for sharing and collaborating on sensitive and protected data. So we're working in countries like Australia, Canada, and US with mostly law enforcement, national security, healthcare, and defense kind of customers. So you can imagine what kind of data we deal with. So in that context, what's been one of the biggest challenges as you've scaled? So biggest challenges for scaling would be providing security doesn't matter what. That is one of the difficult things to do because security is usually add on to other products, whereas Inhal is a foundation of the product.

37:32Dr Simon Kos: And the other one is obviously scalability, how to scale from one location in Australia to multiple locations around the world and still keep the platform running and providing all the load because now we're working 24-7 across the whole world. So tell me, Jay, how has Oracle helped you scale with confidence to your next level? We worked with Oracle team for many years and they helped us in two major ways. One is with scalability, which allows it to go into petabytes of data. And the other one is SecureHeat, as providing the first computational compute solution in Australia and around the world for us to use and grow.

38:13Jay, Decker Secure is an incredible Australian story that has gone global. Thank you so much for joining us on Startup360.

38:19Dr Simon Kos: Thank you so much for inviting me. This segment is supported by Oracle. Build, test, and deploy on Oracle Cloud with a free trial. Visit oracle.com slash ANZ slash cloud slash free to get started. Welcome back. So what I'm noticing is there's a beautiful theme of all of your work. You're back to almost patient records again in a very new way. I mean, and also finding things that you're solving the problem still again in this scale. So I'm just noticing all of that. and how it works for the doctor and the patient, more human interaction, that is so important. So my first question is, though, and you posted this on your LinkedIn about the GP's right to choose their tools, and there are some challengers to that.

39:12And who owns the relationship with the GP in the world of AI? It's an evolving question. So something that characterises the health sector is fragmentation. The way we have structurally set up our health system, you've got public and private hospitals, you've got aged care, you've got primary care, you've got allied health, you've got specialists. All of them have a responsibility to collect information and keep it secure. And that creates silos of information. And then the digital health ecosystem has lent in with what's required. And it started with documentation tools. We call them electronic medical records or practice management systems that do a little more than just the record keeping.

39:57But that has been the mainstay of the backbone systems that are used. AI is quite disruptive as it comes in. It's creating a bit of an abstraction about how clinicians work. The system of work is increasingly AI. And then the system of record is really important. It sits underneath. But the question of who owns that clinician attention is pretty contentious because if you're a system of record vendor, you want that. It's a threat for anyone coming in and taking the time and attention of your end user. And so change is hard and we're working our way through that. So on the other angle of AI, I love how you explained more patient doctor conversation and understanding and taking away some of the administravia.

40:47Will that then cause a speed up of more patients where you then lose some of that time together? Or how is AI going to change that doctor-patient relationship pro and con? Yeah, that is really interesting. So what we've shown with Heidi is we can save time. Documentation takes time. We can save that. and so in general across all disciplines in an eight-hour shift in Australia and New Zealand clinicians are saving 59 minutes that might be over time so at the end of the day they do their we call it pajama time they do their notes at the end of the day and get it done it might be during the day where they're actually getting in these 15 minute appointment blocks everything gets done for the first time.

41:37The question is, how do you reinvest that time? Now, clinicians are pretty burnt out at the moment. During the COVID period, it was already hard. And then we asked a lot of the healthcare providers. Everyone was looking for the light at the end of the tunnel. And we got there and everyone's just still working as hard as they ever have before. Part of burnout is administrative burden. And so in addition to being a productivity tool, returning time, this is a wellness tool. It decreases cognitive burden. It increases the meaningful work that they do. It reduces the low-value stuff that they do. So clinicians like it.

42:18But when an organisation like a hospital needs to make a business case, generally it's made on productivity. So they want to see the emergency doctor see an extra patient or in the outpatient clinic, per provider you see an extra patient and the world is moving faster. When you move fast, that can be exhausting. So we've got some ways that we're tackling that as well. Heidi's gone beyond being just a simple scribe. Now we've introduced evidence, which helps bring clinical grade evidence sources in to help with your decision making. And we've also got a piece of hardware called a remote and you can put it on a lanyard, you can clip it to yourself and now you can go mobile.

43:08So you can go where the internet's not and still have Heidi look after your patient consultations. We've been in the corporate side of the world and plenty of startups don't have the runway to last that long. How do you bridge that gap between what hospitals really adopt now and what AI can do in the future? Yeah, so there have been a few pressure points at Heidi. One was how do we make it out of Australia? And so we globalised. Second is how do we break out of general practice? And that's moving into the enterprise. And we've done that. And the third is how do we go multi-product? On moving into the enterprise, you're right, it's totally different.

43:45Product-led growth works out there in the community in a retail model because you can say, I need a scribe and there's a scribe and I can sign myself up and I can get provision myself and I can get working. The enterprise sales cycle, especially public health, is 18 months, two years long. They need to have foresight that these changes are coming. They need to carve out budget and orient. So it's an entirely different game. You need a different team to go after those opportunities. What we found is that because Heidi is democratised in how you can access it, And because clinicians don't just stay in one place, they might be out in the community one day and then they're into the hospital the next day, these technologies are walking their way through the front door.

44:35We call that shadow AI, but it's ungoverned use of technology that the organisation hasn't sanctioned. We haven't really seen this before, but what it's created is a dynamic where we actually have pretty strong use of these products already in the hospital. and instead of being deterministic, the organisations have to be a bit reactive and responsive. So although we typically see the traditionally two-year timeframes, we're finding budget is being carved out. New South Wales Health carved out$37 million in their last budget and now they're looking at AI scribing statewide. That happened because the ungoverned AI use was there.

45:20So that's the clinicians speaking about what they want and need. I want you to get a little bit political for a second because I did write on Startup Daily this week about Innovation Victoria and we know that the coalition, the Liberal leader, Jess Wilson, is looking at getting rid of Innovation Victoria and selling its stake. Talk to me a little bit about that relationship between government and the private sector and how it can work because I feel in a little bit of this debate and promise and, you know, dangling a carrot over here whilst sort of taking the dog outside and shooting it over there is kind of not particularly strong public policy.

46:05Yep. Healthcare is always going to be politically contentious, high visibility and there's quite a bit of bipartisan support. You need to fund the healthcare system. The fundamental challenge is we've got a healthcare system that was designed last century for today's problems and it's not future ready. So McKinsey have done some studies and they estimate that 30 % of what we do in healthcare is waste. So that's duplication, that's error, that's manual processes. That's the opportunity. Now, our health budgets are blowing out because the challenge we're trying to solve now is not battlefield trauma or infectious disease so much.

46:47It's lifestyle-induced chronic illness. And that's best addressed out in the community rather than when it's too late in the hospitals. But that's where all the spend is. So the states fund the hospitals. so if we've got an unsustainable health system it's politically the optics are good about funding kind of beds building new hospitals and humans but we're chasing our tail we're never going to be able to fill that leaky bucket so my perspective is technology is the great enabler it's the great lever now we need to be a little careful about humans in many other industries ai means cost out which means you can actually decrease your workforce and we've seen a little bit of that just recently in healthcare though we've fundamentally got a workforce shortage crisis so this just means i go back to burnout that you mentioned before it doesn't solve that problem and the frontline workers yeah um and so digital in health has been a bit risky you put it in and it takes a long time to get the benefits and you're not sure whether the clinician's going to be happy so you're not necessarily going to bank the win um i think now the current crop of ai technology that clinicians love and provides immediate benefit is far more palatable and that's why we're seeing government spending directed towards it.

48:21Now I'm going to take you from the state to the federal level and the R &D changes that are going on because any health technology is a lot of compliance, a lot of testing. The thing for me right now is the time frames and scales that the federal government is looking at for what we can achieve in healthcare, I want you to talk about that from a clinician's perspective because, again, I don't feel the government, the federal labour government, understands what they're actually trying to do as they try to solve a tax and housing affordability problem. Yeah. We have the luxury of playing on a global scale.

49:03So I get to nest Australia's policy and position against the rest of the world. From a regulatory and compliance perspective, Europe is far more stringent. Nested in the middle is the TGA's position. And what they've done, I really appreciate. They know that this is happening and they're watching it. And rather than trying to put the handbrake on and stifle innovation, they're asking us to telegraph our activity and our product roadmap ahead of time. They've been super helpful feeding back on what's likely to trigger a regulatory problem and we've modified our product strategy accordingly and we've actually found them really good to work with.

49:49Now if I was an Aussie company I would find the regulatory posture difficult. To your point about healthcare this is sensitive of information. It's 17 to 1 ,000 times more valuable on the dark web to get someone's health information than just their financial information because you can do full identity theft rather than just getting access to their finances. So health is traditionally a soft target. We're known for paying ransoms. We've got this fragmented ecosystem, a long tail of old systems that aren't ready. And you know what the most advanced digital industry is? It's cybercrime. The cyber criminals are ahead of big tech.

50:36And so we actually need to take this seriously. That means regulation. It means compliance. For a company like Heidi, given that it's our core business and we've got a global market, we lean into that. We expect it. But it's not the fast and loose world of maybe retail or consumer where you can learn and fail in the market and pick yourself up and get moving. Or save sales and pay the fine and move on. As a doctor, there are different kinds of fuck-ups that doctors make. But I'm just curious, what is one of your flurnings? Now you can share a fun learning and a failure or a fuck-up of your learning that you're most proud of.

51:17When I was a junior doctor, they said you've got one year as an intern to make all the mistakes under supervision and we all make mistakes and it's very human. That kind of oriented me that you can learn and it's not the end of the world. So I'm not too concerned about mistakes. I think about them in terms of above the waterline and below the waterline. I try and make decisions that are above the waterline and then if it's going to have the potential to sink the ship, that's when I'll get other people involved and I won't be autonomous in the decisions that I make. But from a career perspective, when I was in my first digital health company, I didn't have any idea about career and growth and where I wanted to go.

52:06So I found myself geeking out on the technology. And for a doctor working in digital health, that is just selling myself short. The role a clinician should play is sitting at the intersection of technology, business and clinical and you should be a translator. And if you're not doing that front of house, you're actually wasting your talent and potential. So that was a career learning that I figured out when I was at Cerner. When I was at Cerner, I found a fundamental mismatch between the impact that I wanted to drive and the company that I was working with. So I think about impact in terms of three overlapping Venn diagrams.

52:49You've got your skills and experience, you've got the role that you have and the company you're with. And if they're all in alignment, then impact is in the middle. I found myself working for an electronic medical record company and I'd gotten there to make the lives of clinicians better and safer and I found what I'd actually done is I'd put in a system that challenged how much time they had and the learning curve and the rest of it actually made life harder. And so I had the right skills and experience. I had the right role. But I was actually at the wrong company and that changed my career decision to go across to Microsoft and learn a whole lot more.

53:35I learnt in medicine that you need to have a degree before you can practise medicine. But in the wonderful world of digital health, that's not the case. You don't need to go and get more qualifications. You just need to apply the ones you have. So I probably over-indexed on getting that MBA and going out and getting a Diploma of Software Engineering. Probably didn't need all of those things to be effective. Well, you certainly didn't need the Diploma of Software Engineering once AI rocked up, but, you know, it's okay. From the learning in practice perspective, and I've shared the personal learnings about work-life balance, from a professional perspective, the hardest lessons I learnt were in those 18 months at Next Practice when I went into a role that I didn't have the right skills and experience for but I was prepared to back myself and learn on the go and then the context just went to hell in a handbasket and I had to work through that.

54:34Had to reorganise, restructure, let some people go. That was really tough. Had to fundamentally think about the company, You had to make some tough decisions about the strategic areas that I wanted to do that we couldn't and figure out how we were going to work through it. Those were hard learnings but they're essential. That's how you grow. I come out the back of it. I remember I had a sales leader, he said, and I was on the leadership program at Cerner, and he said, Simon, my goal is to try and scare you this year. And I said, Kevin, the last time I was scared was during a cardiac arrest and I didn't have an anaesthetist there to help me intubate.

55:17And he was like, okay, maybe not scare you, maybe we'll stretch you. So for me, those stretch opportunities are learning opportunities. They might not be fun, but I'd rather be stretching myself and growing than sitting back and forth. Those stories sound like you've stretched. They're great examples. Tell me, what's your favourite piece of digital technology that you love using? I've recently discovered how Claude can help me with my PowerPoint presentations and that's just enormous for me because so much of what I do is storytelling and there are different ways to tell stories but classically I'm up doing kind of keynote presentations and that sort of stuff and I've had to fall back on either my own rudimentary PowerPoint skills or more likely existing slides and tell stories around them.

56:15For the first time, I can, in high fidelity, just do a brain dump of ideas and have someone come back with a story arc. It's never good enough. I never take it at first blush, but we iterate, we iterate. And then when I get to the final product, I strip out 50 % of the complexity because there's always too many words and too many slides. But for me, it's now allowing me to tell authentic stories. and that's been a game changer for me. So just as a tip for other founders, what would you say to them about what an authentic story looks like and how it lands in a way that does have impact? For me, I'm generally speaking to health audiences so they need to know who I am.

57:02So I credential myself first, often in a humble way, before I launch into the challenge and make that challenge real. So there's generally a story around a system failure or a change or a burnout story that people can relate to and then introduce what the learnings might be. And if there's a case study I can lean on, I'll do that because everyone likes to unpack real stories and do that. And always, always I try and create room for questions because that's where the most interesting stuff comes from. And then in the questions I'll lean back on my personal experience as well. They're all stories.

57:52And some of the concepts are pretty complex. But if you're good at doing what you do, you'll make something complex seem easy. I want to double highlight and bold what you said first. So know your audience. Know who your audience is first before you start to tell that story. And I love the fact that let the audience know who you are as well. Important to know your audience. Well, you got any more or you want to bring it home? Well, let's do one, the future question. Where do you see the world with Heidi in it in, let's pick a time frame, two years? Because the world's moving pretty fast. Two years.

58:29What sort of horizons do you like to work on at home? Yeah. Next week. I used to be a health futurist. Okay. And 10 years ago, as a health futurist, what you could do is you could show what the world would look like in 10 years. That is what happened in the US five years ago. That's where Australia had been. Another five years you could work on, 10-year horizons. Since the world of generative AI, I can't see with confidence beyond two years. There's a lot of change coming. Health will be slower to change than some of the rest, especially at the top end of town in the hospitals. What's really clear for me is traditional mechanical input, output and data entry is going to go to more natural user interfaces.

59:18There's going to be a lot of voice. And right now it's one way. We just talk in and information spits back out digitally. I think it'll become interactive. I think there's a focus on administrative efficiency and productivity at the moment that'll change to quality and so I'm pretty excited about how we might be able to layer in evidence into decision making so that we provide better care I think the biggest change globally is actually going to happen with patient literacy and so we've got tools now that you can ask about your health condition and contextually it'll know you it'll be able to provide you a very specific answer and if you don't understand it you can query it i think about developing nations i lead the health equity portfolio at Heidi i think about certain condition groups especially stigma groups that you won't go and get health care for i think about regional isolated communities, including Indigenous health, I think these are pockets where we might be able to scale AI technology where you can understand the condition that you might have and what you should do about it.

1:00:34That will do more for our health outcomes than any policy decision we've made in the last decade. So what we're doing is moving the Dr Google needle closer to having an actual GP? I think so. And I'll say it with a caveat. So once upon a time, this information was in textbooks and you needed a medical degree to even understand what was being said. Then we've geared up organisations who have generated patient-friendly information, but it's very specific. And as a consumer, you get given it. It doesn't find you. As a result, patients have turned to Google and it's a question of finding the website.

1:01:18and it can be a bit hit and miss and you don't know the credibility of those sites. Now we're at the stage where we're getting really confident sounding answers but these are not medical practitioners and even though they're right most of the time, it's the situation like that Seattle engineer who was counselled to stop her epilepsy medicine and she ended up dying. We're going to see some of that as well. So on balance, there's potential for incredible good, but we need to make sure that we do it safely and responsibly so we don't get those unfortunate incidences too. So tell us, Simon, Dr Simon, what brings you joy?

1:02:02What brings me joy?

1:02:07In my life, all I've ever wanted to be is a dad and I've got three wonderful kids and they're all in high school at the moment. I couldn't do what I'd do without my wife just helping so much. She's in her last year of studying nursing at the moment, so she'll be out in the workforce again. And our kids are grown up enough that they can start to look after themselves a bit. I love spending time with my family. So we live down at Coogee. The beach is close by. The surf is a big part of our life. and I'm really looking forward to summer because this has been a busy, busy year and generally in the December-January period there's a few quiet moments that I can grab with the kids.

1:02:54And tell us if the kids come to you and say, Dad, I think we'd like to be third-generation doctors in the Cos family, what would you say to them? So kids, there's so much nature versus nurture. So my eldest wants to become an actor or in film and media somehow, and I don't know how to guide him through that, but that's great. My youngest does want to become a nurse. So she's had some of her own experiences where she's lit up and that's where she wants to spend our time. My middle guy, I have no concern that he'll find his way, but he likes the electric guitar at the moment. It's great to see him indulge his passion.

1:03:38Amazing. Fantastic. What a great family. Dr Simon Coz, thank you for joining us on Startup360. All the best with Heidi Health. And, again, congrats on being not only Scale Up of the Year in Startup Daily Best in Tech Awards but also the AI Game Changer. Continue to keep changing the games. Thank you, Simon. Thank you, Julie. It was great. Now, any plans for the weekend? I think I'm going to go do some op shopping. There's like an op shopping trail around Sydney of different, I still need more stuff for my flat. Now the Swans women are playing the elimination final at Henson Park on Sunday. I'm hoping I'm going to be okay and the weather is going to be okay and the two of us can meet at Henson Park to see how they go and press on.

1:04:23All right. And tonight, well, Friday night, I'm hoping I'm also well enough, speaking of health tech, to go and see. I'm thinking this is my Elizabeth Holmes voice right now. It's quite dark and, you know, mysterious. So I'm going to see the documentary, the three-hour documentary. You can see everything which involves her in the month before she ended up in jail. So I'm quite curious about that one and see how that turns out. I'm also curious about what's happening in the US as we speak. Yes. Well, hopefully we'll find out by the time it's Friday. By the time this airs. how long some of the counts can take.

1:05:07But that is it for Startup 360 this week. This, of course, is a SmartKM Media production produced and edited by the fantastic Matt Jackson. Thanks also to Pearl for her work, to Ella, to James, and, of course, to Deal for their support. You can subscribe to the show on Apple, Spotify, and watch us on YouTube. And, of course, do head to StartupDaily.net for all the latest news as it happens. We'll see you next Friday. Have a great weekend. Bye for now.