How We Recruit Talent

This post was originally featured on the Pristine Blog.

At Pristine, we don't believe in paying for job listings on sites such as LinkedIn, Monster, GitHub, and StackOverFlow. All of these sites, and many others, use the same model: pay a fee, usually $350-$450, to post a job for 30 days, and pray that good candidates apply. After posting the job, we can try to optimize the ad, but at the end of the day, it's still a matter of praying that good candidates find the listing, read it, and apply.

There are a few problems with this model:

1. There are no incentives for performance. The job sites run off with our money regardless of the success of the job listing.

2. Exceptional candidates have to find the job listing among dozens of job listing sites. The probability that a given exceptional candidate will find our job listing is slim.

3. It's hard to stand out. Yes, there are ways to make the title of the ad stand out, but at the end of the day, our job ad is just another blue link on a page with 24 others. We can't even include a picture of Google Glass to appear on the index of our listing to try to draw attention. We are bound by a monotonous wall of blue text.

4. The most important reason that job listings aren't great at finding exceptional candidates is that the best employees are usually already employed. By definition, exceptional talent is always employable, and thus almost always employed.

So here's how we recruit talent:

We dig through hundreds - perhaps thousands - of profiles on Linkedin, AngelList, and GitHub by hand. We skim through the profiles of every candidate, looking at previous work experience and types of projects they've worked on. We ignore education entirely. We generally don't spend more than 10 seconds on the first pass at a given profile. We employ slightly different strategies for each site. These are our favorite sites because they have large numbers of candidates that we can effectively target:

On LinkedIn, most developers don't list their technical skills in detail (so that we can search for them). Thus,  searching by language or technology stack leads to poor results. Instead, we filter against companies that we know use the technologies that we use and that are located in Austin. If we find a candidate that we think might be qualified, we message them. We never use LinkedIn InMail (LinkedIn's built-in mail service) unless we cannot find another form of contact information. Talented developers smartly ignore all recruiting related InMails on LinkedIn. Most talented individuals provide links from their LinkedIn to their Twitter, personal website, or some other online profile. We dig through these other profiles to get a better sense of who they are and what they're capable of, and to find an alternate channel to reach out. If all else fails, we even resort to guessing their email address for their current job by using the Peep tool and some basic intuition. We only resort to LinkedIn InMail when all else fails.

AngelList - AngelList is an excellent recruiting tool because of the self-selection effect. Unlike LinkedIn, which is filled with garbage, AngelList has a high proportion of talented individuals who're hungry and eager to work at startups. On AngelList, we use the talent filters, "looking for" filters, and geography filters to find qualified candidates. Once finding a potentially qualified candidate, we reach out through AngelList (which sends an email). Talented individuals tend to respond to AngelList messages because the nature of the site lends itself to more friendly responses. That may not hold true as AngelList continues to scale and the overall quality of the applicant pool decreases, but it does for now.

GitHub is our favorite recruiting website because it provides direct links to projects that developers have worked on. We can very quickly assess developers without calling them. GitHub provides utilities to filter by location and programming language, which while not ideal, are sufficient. Perhaps the best aspect of GitHub is that most developers tend to list their email address publicly, making it very easy to reach out.

So, once we've found a potential candidate, how do we go about engaging them? We've A/B tested our opening messages. We've tried emails that detail why we're magical and revolutionary, and we've tried emails as short as "You look like a rockstar. We make awesome stuff. Call now." As in most facets of life, a middle ground is best. Our opening message is concise, sincere, and provides just enough of a tease to intrigue candidates:

"Hi, my name is Kyle Samani. I'm Founder and CEO of Pristine, a well-funded Capital Factory startup in Austin that's developing apps for surgery for Google Glass.

I was just perusing your LinkedIn / blog / AngelList / GitHub. [write comment something relating to their blog/profile/linkedin/angellist]. You rock. You're exactly what we're looking for.

Do you want to spend the rest of your life [something related to their current job], or do you want to invert healthcare delivery models through Glass?

PS, feel free to learn more about me, the company, and our recruiting practices."

Why is this message so effective?

1) I introduce myself as Founder and CEO. Most talent is sick of hearing from recruiters. They will take the request a lot more seriously coming from the CEO.

2) We let them know we're funded, and in a well-established institution in Austin (Capital Factory). This lets them know that we can pay them, and that we're legit. No one wants to work for a loser.

3) We tease them with "Google Glass for Surgery." If that doesn't intrigue them, nothing will.

4) After intriguing them, we make a sincere, informed comment about something they've published on the Internet (blog post, GitHub project, tweet, etc).  That shows that we took the time to read about them online and get to know them a bit before asking for their time.

5) Then we pull a classic Steve Jobs by asking them to dream about the future. It's a teasing ask. It lets them know we want them, but puts the ball in their court.

6) The "PS" clause establishes one of our company values up front: transparency. We make it easy for them to learn more about me, the company, and if they're so inclined, the very message they just finished reading.

Our hiring process is extremely time consuming. I don't enjoy it, but I do enjoy the results of it. It's perhaps the single most important tactic we employ. Our team is mind-blowingly awesome, and I wouldn't have it any other way. I can't do the scouting forever. When I no longer have time to do this, I will ensure that whoever does will scour the Internet just as fiercely as I do. As the company grows, we must scale our talent, and we'll do whatever it takes to achieve that goal.

PS, here's my inspiration for Pristine's recruiting practices. This is one of the best blog posts ever written on any subject.

Computers Are Eating Healthcare, Part 2

This post was originally featured on HIStalk.

This is the second in a series of posts that outlines how computers are eating the world. Check out Part 1.

Humans do three things and only three things: process information, store information, and share information. Everything in life, both virtual and physical (firing neurons drive physical movement), can be understand in these terms. Humans never can and never will do anything else.

Computers do three things and only three things: process information, store information, and share information. Computers never can and never will do anything else.

Unlike humans, computers excel at jobs that are intrinsically repetitive across all three dimensions of performance: processing, storing, and sharing information. Computers process, store, and share at infinite scale.

Because computers excel at these repetitive functions, they’ve dismantled most repetitive administrative and information distribution jobs that aren’t propped up by politics or regulations. Computers were the empowering tool that led to the dismantling of Blockbuster, the travel agency industry, the newspaper industry, and many others.

Healthcare is intrinsically repetitive. Will computers eat healthcare too? If so, how?

In the first post of this series, I argued that computers will eat radiology first. Radiologists look for patterns in images and cross-reference the EMR. The job requires almost no patient interaction. Occasionally radiologists query the PCP. Computers can perform those functions better, cheaper, and faster than radiologists ever could. Radiologists are slowly acknowledging that fact. This explains one of the themes of the most recent RSNA conference: interact with patients. Computers are still years if not decades away from naturally conversing with patients and providers. Radiologists want to interact with patients after decades of avoiding patients to avoid being eaten by computers.

Sedasys has built a new anesthesia monitor with a unique twist. It intelligently and automatically administers anesthesia during surgical procedures. Anesthesia, like all other forms of medicine, is intrinsically repetitive. Intra-operative anesthesia is at its core a negative feedback loop. Computers can automate that process.

IBM’s Watson is attempting to do the same thing with diagnostics. We are probably a decade away from that, though. Automated diagnostics are extremely difficult for a number of obvious reasons: conversing with the patient and understanding context, asking the right questions, natural language processing, processing enormous amounts of data, and many others.

Airplanes have been flying themselves for over two decades. With airplane black boxes, airlines have second-by-second records of millions flights spanning every conceivable weather condition in every conceivable geography. Planes automatically adjust flight paths based on what they’ve learned from every flight since the inception of black boxes.

And yet we still have pilots. Why? Regulation, and to respond in case the computer fails. Although I can’t find data to back this up, it seems reasonable that pilots boost safety metrics from 6 sigma to 7 sigma. Computers are responsible for the first 6 sigmas.

Computers will eat providers just as they’ve eaten pilots. Providers should look to the airline industry to understand what that means. The airline industry is medicine’s harbinger in a computer-eaten world.

In the future, providers will monitor computers, just as pilots monitor planes. This begs the question: will providers tell a computer what to do, or will providers be told by a computer what to do?

The Pristine Story: Heads Down Through the Holidays

Pristine is growing into a bonafide company. We're now actively executing, refining, and strategizing across most common business fronts: piloting at UC Irvine Medical Center, managing a substantial sales pipeline, executing on a marketing and PR plan, raising capital, refining the products, and establishing internal infrastructure and processes as the team grows. Speaking of which...
 
...Our team continues to grow. We have 9 full time employees now, and a few part timers. Buzz began full time on November 1st as our VP of Sales. In his prior life, Buzz built the nation's largest non-state based health information exchange spanning more than 300 hospitals and 14,000 doctors. We've also hired two more full time developers - Derrick Hinkle and Devin Fee. Derrick has a strong background in real time web communications and experience with our technology stack. Devin is one of the most talented dev ops guys in Austin, and brings a healthy dose of entrepreneurial experience to the team. He founded and ran a startup for a year prior to joining Pristine.
 
Although we're not actively hiring developers today, we continue to passively search for them. If any exceptional developers find us, we'll figure out a way to make it work. Devin actually joined this way. If you or any friends are interested, feel free to apply at careers.pristine.io.
 
We're also looking for qualified candidates who can lead a wave of upcoming Pristine deployments. Since we don't have the scale to segment job functions to different people, we're looking for someone who's well rounded that is reasonably technical, that can train, and that can support our early clients.
 
Since DEMO, we've raised an additional few hundred thousand dollars from a host of angels. If you or anyone you know would like to invest, please contact me privately.
 
We've been trying to maintain a steady presence with the media. I was recently on with news anchor Taylor Baldwin in San Diego, and another segment on KEYE in Austin (we're in the 3rd segment in this link). We've also been working with some major national publications and analysts to help educate them about the opportunities for Glass in the OR and healthcare more broadly. We'll continue to pepper the media for the foreseeable future.
 
We attended FutureMed in San Diego, which was quite possibly the best conference I've ever been to. I wrote about it on HIStalk. We also just got back from the Digital Health Conference in NYC. And I just finished pitching at Hatch Patch in Houston, where Pristine won. Looking forwards, I'll be attending the mHealth Summit in Washington, DC Dec 8th - 11th (please let me know if you'll be there and we can catch up), and Buzz and I will be travelling to medical centers all over the country throughout December.
 
We're working on a couple of strategic partnerships that we're planning to announce by the end of the year. Although we can't go into any details yet, we believe that these deals will really accelerate our growth going into 2014. Stay tuned.
 
And to wrap things up, here are some blog posts for your enjoyment. I was recently picked up by Svbtle, an online magazine that provides industry experts an avenue to publicly discuss their respective industries. Buzz and I are working on some deep analytical dives into the state of health IT and health delivery. We can't wait to share those with everyone when they're ready.
 
PS, I'm going to be reducing the frequency of the Pristine Story to once every 4 - 6 weeks. As the company grows, it will be more pertinent to space things out.

What Does The Future Of Medical Process Control Look Like Through Google Glass?

This post was originally written for the HATCHpitch TechStreet Houston contest, where Pristine won.

Google Glass and other eyeware computers will provide a foundation to deliver the ultimate process control in medicine. As doctor Atul Gawande has written, checklists are the simplest and most effective form of process control.

Broadly speaking, checklists should be implemented when the following conditions are true:

1. There's a repeatable process that must be followed
2. The cost of being wrong is high

There are an enormous number of areas throughout hospitals in which these conditions are true. Some examples:

Endoscopic scope processing

• Preparation of complex drugs in pharmacies
• Patient preparation for many diagnostic imaging studies
• Wound care

Although checklists are commonly implemented in perioperative environments today - where the cost of being wrong is astronomically high - checklists can and should be implemented in every environment in which the conditions above are met. Too many patients are seriously injured or die every year from simple, preventable mistakes. If implemented correctly, checklists can save thousands of lives.

If the process of implementing checklists introduces too much friction into a given workflow, it's unlikely that checklists will be successfully implemented in that context. Although we've seen ORs implement checklists pre-op, the methodology is generally quite poor. Most ORs today simply have a poster on the wall. Paper checklists, although a step in the right direction, provide no guarantees, no checks, and no audit records that checklists were actually adhered to. Google Glass and eyeware computers more broadly present the ideal form factor to implement checklists into sensitive clinical environments. Using eyeware computers, providers can work through checklists hands-free, and can even incorporate rich media such as audio, images, and videos into checklists.

Our mission at Pristine is to shape a future such that in 5 years, we'll look back and wonder how medical providers performed their jobs without Glass.

What Does The Future Of Medical Communication Look Like Through Google Glass?

This post was originally written for the HATCHpitch Tech Street Houston contest, where Pristine won.

Healthcare delivery is an increasingly collaborative effort: there are virtually no environments today in which a single person provides all of the care for a given patient. Healthcare providers are working in cross-functional, cross-disciplinary teams more than ever before.

Increasingly large care teams lead to more opportunities for miscommunication. Medical professionals need the right tools to communicate seamlessly in real time at the point of care. At the same time, providers are doing their best to keep their hands sanitary. They're struggling as they frequently touch dirty devices such as their phones, pagers, and other walkie-talkie like solutions.

Glass is ultimate communications tool because it:

1. Is always there
2. Wireless
3. Hands free
4. Supports audio, video, and text based communications

Medical professionals have never been able to share what they see in real-time. Now they can. This is a profound concept with uses throughout virtually every avenue of care. Just imagine:

• Surgeons will use Google Glass for remote consults, and for teaching and training.
• Anesthesiologists will use Google Glass to communicate with their CRNAs across ORs.
• Nurses will use Google Glass to collaborate and share patient information to expedite workflows and connect disparate parties.
• Residents and fellows will use Google Glass to receive consults and support from attendings.
• ICU nurses will use Google Glass instead of rolling around telemedicine carts.
• Emergency room (ER) nurses will use Google Glass to beam in physician consults instantly.
• Nurse practitioners and physician assistants will use Google Glass to beam in MD consults.
• Providers in the patient's home will use Google Glass to beam in consults without interrupting their workflow.

The opportunities to open new avenues of communication and collaboration are immense. We're just at the tip of the iceberg of what can be done.

Our mission at Pristine is to shape a future such that in 5 years, we'll look back and wonder how medical providers performed their jobs without Glass.