Ayo Omojola, SVP of Product at Carbon Health, joins Anne Dwane and Lucas Bagno to discuss:
– What he noticed moving from fintech to healthtech.
– Advice for people working in a highly regulated industry like healthcare.
– What’s unique about Carbon Health and why healthtech is so promising.
– Why he likes to hire former founders, and his favorite interview questions.
– How he thinks about angel investing as an operator and why “angel investing is like a really expensive email newsletter.”
Transcript
Anne Dwane:
Welcome everyone. We’re delighted to have with us today Ayo Omojola, who is SVP of Product at Carbon Health, a tech-enabled healthcare startup on a mission to make care available to all. Prior to Carbon, Ayo was product and business lead at Cash App by Square and co-founder of Hipmob. He’s also an active angel investor. So with that, welcome Ayo.
Ayo Omojola:
Thank you for having me. Really glad to be here.
Anne Dwane:
Wonderful. Well, just to kick us off, can you tell us about your role at Cash App and what you did there? And then maybe we’ll put that in the context of your decision to move from FinTech to healthcare?
Ayo Omojola:
Yeah, absolutely. So I was at Cash App for almost six years. And while I was there, I worked on a variety of things. I was actually hired to build Cash App’s API strategy, which I don’t know if you all remember Snapcash, like Snapchat’s money transfer thing, that was built on Cash App. And then eventually I ended up starting and running the banking group at Cash App. So that was the portfolio, including the cash card, bank accounts, direct deposit, everything from our banking relationships to our relationships to card manufacturers. I spent about a month in aggregate in factories, getting plastics made and so on.
Ayo Omojola:
And I left in late 2019. And then right at the start of the pandemic, I was lucky enough to join Carbon Health to run the product team, which at the time was me or at the time was Eren, the CEO who said, “Hey, you are a product manager now.” It was a little bit before I think the world really understood what the pandemic was going to be. And I don’t even think we did actually. And then man, that feels like so long ago now.
Anne Dwane:
And we still don’t really know. Can you talk a little bit more about what was the decision like for you to move from FinTech where you’d spent years and been very successful to enter a new sector?
Ayo Omojola:
So I wish I could give like a really grand satisfying answer, but I don’t have one. All the answers I have are personal and minute. So in no particular order, I had a conversation with a friend of mine, this guy named Russ Fraden who is on the board of Carbon Health and now works at Carbon and he made this comment to me in early 2019 where he was, “Oh, if you’d been in Silicon Valley for the last 20-ish years, you could have been successful just doing the average thing. You’ve worked at Google and then you worked at Facebook and then you invested in your friends along the way. And then you just did that for a while. And you did pretty well and there’s dozens of those companies.”
Ayo Omojola:
But if you really think about what software has touched so far, it hasn’t even touched the markets with these gigantic terms like… And there’s seven or eight of them. It’s construction logistics, healthcare, FinTech, natural resources and mining space. I’m sure there are others.
Anne Dwane:
Energy. Yeah, yeah. Right.
Ayo Omojola:
Yeah. And his point was that these are heavily regulated spaces. The prototypical junior at Stanford isn’t thinking about doing the those things. And there’s a lot of value on the line and they touch everybody. And it got me thinking, I’d spend a bunch of time in financial services. And one insight for me early on at Cash App was just the willingness and ability to engage with the subject matter. And I would say even now there are people at Carbon who are much better at this than me from from the healthcare perspective. And I’ll describe on a second.
Ayo Omojola:
But a lot of people are not really willing to engage with when they’re in a regulated space with the core subject matter of like, “Hey, there’s a guardrail here. And what does it really mean?” People very rarely will actually look at the guardrail and form an opinion themselves. And really, that’s not to say if you work in a regulated space, you should really depend on your lawyers. But you should also be over time, building up your first principal’s knowledge base of what these regulatory constraints mean.
Ayo Omojola:
And so that conversation plus that insight from Cash App got me to think, “Oh, you know what, I want to spend more time in a regulated spaces.” I could go do FinTech. I could go do more FinTech. But for 10 years leading up to being a Cash App, I had wanted to build a bank. And then I was a Cash App and I built a bank and there were many other things that I thought of many ideas that I had that I’ve subsequently written about and invest in companies doing those things. And they were just weren’t like…. I want to spend the next decade doing this.
Ayo Omojola:
And then I met Eren at Carbon. And one of the most interesting things about us as a company is, there just really isn’t much that we’re not willing to do. You hear the comment stay in your lane. We just don’t have a lane. We’ll just eventually, we will touch everything. And that doesn’t mean we will do everything. Obviously healthcare is an ecosystem business, we’ll partner with people and so on. But that willingness to question every assumption was just incredibly appealing.
Ayo Omojola:
And I think, yeah, I would say two more reasons. One thing that was really compelling about Eren as a founder is, he described problems in a way that made the solution seem obvious. And it was a quality that I hadn’t realized existed until I met him. And then I’d say the last thing is, there were just some ways that I wanted to try and some muscles I wanted to flex and things I want to learn in ways that I wanted to try building a team that I just didn’t get the chance to at Cash App. So it was an interesting opportunity to do it. And then both my parents are doctors, I’ve had a bunch of wide spectrum of interactions with the healthcare industry. And the opportunity to change it for the better is just going to pass up.
Lucas Bagno:
And Ayo, maybe it would be worthwhile to maybe just spend about 30 seconds describing what it is that Carbon Health does? And how is it unique?
Ayo Omojola:
Yeah. So the easiest way to describe it is, we call ourselves an omnichannel healthcare company. Omnichannel, meaning we meet the patient wherever they are. And the easiest way to think about what we do is, we control… Carbon Health, the company, has doctors that works for it, owns clinics and owns the entire technology stack. And that’s just, in healthcare that’s like fairly rare.
Ayo Omojola:
I think there that are a few full stack companies doing really high value care like musculoskeletal, cancer, et cetera. And then there are a lot of highly operational companies that buy software off the shelf. But finding a company that has high quality clinical discipline, high quality, technical discipline, and high quality operational discipline in the same company, that’s just pretty rare. And that is focused on the mass market.
Lucas Bagno:
Right.
Ayo Omojola:
So let me maybe paint the picture. So five years from now, we’ll have 1,000 clinics in every state. We’ll have 1,000 clinics, we’ll be in all 50 states and you will be able to walk into a clinic in Oklahoma, or two days later, walk into a clinic in Albany. And the system will know about, you we’ll have context on all the care you’ve received and be able to treat you the same. And we’ll give you the same high quality of care regardless of where in the system you are.
Anne Dwane:
And can I ask a clarifying question on that? Are you a new interface layer on top of the healthcare infrastructure that exists today? Or is it replacing some elements?
Ayo Omojola:
It’s replacing a lot of others. I’ll put it this way. We have, I think now 100 Carbon clinics that are Carbon and the employees work for us. The technology that they use to chart your case, we built it ourselves. The technology that sends the claims to to the insurer, we built it ourselves. The physical design of the clinic are ours. The doctors work for Carbon.
Lucas Bagno:
That’s amazing. And Ayo, something we’ve discussed privately in the past that actually sparked this conversation that we’re having today is that healthcare today seems in some ways like FinTech five years ago, which is something I’ve heard you say. What do you mean by that? And what knowledges can you draw on your experience?
Ayo Omojola:
Yeah, so I think the first thing I’ll say about that is, everyone’s a hero in their own story. And I’m no different from anybody else. So obviously I’m viewing this stuff through a certain lens. There was a dynamic in financial services. Like when we started working on the cash card in 2015, a lot of the infrastructure that exist today in FinTech didn’t exist. So Marqeta was the state-of-the-art, Unit didn’t exist. Lithic didn’t exist. Synapse didn’t exist. Alloy, I think was barely getting started. Persona didn’t exist. All these things that you would use to build a modern bank didn’t exist. So a lot of them, we cobbled together or built from scratch.
Ayo Omojola:
I think healthcare is similar in that if you wanted to rebuild Kaiser today, the building blocks are only just coming online. I talked to a founder maybe a couple of days ago that’s building a new prescriptions routing layer to rival Surescripts. That’s modern and REST API-based. And I’ve talked to a founder, who’s building new insurance infrastructure so that you can like launch a new Oscar without having to build all the, all the underlying pieces yourself. The, the, to me, the similarities are, and this is the thing that I really understand. So like, I don’t have clinical background, so there’s just clinical stuff that I don’t get. That’s just true. But the technical infrastructure required to operate a business. Like a lot of the building blocks are just starting to come online now. And that’s, that’s what I think is interesting. And I think there’s, there’s also a, there are like new things. There’s like, , I’m going to use such a gross analogy, but if you think of you think of like FinTech as, as sort of new technology doing the same actions in financial services.
Ayo Omojola:
So that’s like, there are credit cards and JP Morgan has them and Chime has them. And then there’s like a whole new set of technologies in crypto that are new ways to do old things. And then new ways to do some new things. And I think one analog that I’ve, that the analog in my mind in healthcare is like one is there are these new tools around like personalized medicine.
Ayo Omojola:
So this would be concepts like sensor driven care. You can now slap a continuous blood glucose monitor on your body, and it will track your blood glucose continuously you and those companies are building things to do, to are building similar technologies for new analytes. So ketones, stress, like hormone levels, et cetera, et cetera, that can fundamentally change the kind, the way that a provider can like understand what’s happening with the patient and change decisions they can make for that patient for the better. So for me, at least a lot of the similarities come from this new infrastructure layer just coming online and founders are ambitious enough to tackle it. And then these new technologies that can also change the way we deliver care.
Anne Dwane:
Question for the product manager – you’re making probably build versus buy decisions all the time and in a rapidly evolving ecosystem. How do you think about that?
Ayo Omojola:
Oh yeah. I think that there are two lenses. One, is it strategic for us? And if it is, then we have to own it. And then is if it’s not strategic for us, then the build versus buy is, does something exist that actually solves the problem, the way that we want it to be solved. And if, yes, we’re totally willing to buy it. And if not, then we probably have to build it.
Anne Dwane:
Yeah. Good answer. And you talked before about regulation being a factor in FinTech. How have you seen regulation of FinTech or in healthcare?
Ayo Omojola:
Sorry. So I think a lot of the times the regulation itself, isn’t the thing, isn’t the problem or the stumbling block, the real stumbling block is the practitioners and operators perspective on the regulation or their perception of the regulation. So a lot of the times we hit aren’t that like, we read some law and the law said we couldn’t do X. A lot of the times it’s somebody had been doing something a certain way in their old, like previously in their career. And they, they kind of have a belief like their, the path of least resistance for them is to just continue to do it that way, continuing to do it that way. So I’ll give like a really like, really simple example that, maybe you’ll get it. Maybe you won’t, but it like will illustrate the point when you go visit, like the way healthcare is regulated in the United States is at the state level.
Ayo Omojola:
So if you go do a virtual visit with a provider, it’s like, really, really, if you think about it, so like backwards, if you go do a virtual visit, like a video visit with a doctor in the US, they have to be licensed in the state that you are in. And in the in clinic context, you never have to worry about that, right. Or you rarely have to worry about that because the provider has to be in order for, for the healthcare comp be need to not take on liability. That provider has to be like licensed in the state. One process that lives on from the in-person context is when you walk into a clinic, they say, Hey, give me your ID and your insurance card. And then they take your ID and insurance card and they take copies of it. They give it back to you right now in the video context, how do you verify what state the patient is in?
Ayo Omojola:
Right. And so the default answer of a lot of operators would be like, Hey, show me your ID. Right? Another answer would be, Hey, let’s just check this person’s IP address. A third answer might be let’s check their geo. And a fourth answer might be let’s if, if they previously had a visit with us, let’s just see them. And then now, now it’s just a liability question. And so we like early on at Carbon, we had this argument about this ID thing, because like the default discussion was, Hey, let’s just use the flow that we know that works in the clinic. And then as we’ve sort of dug deeper, it’s like we don’t actually need that.
Ayo Omojola:
And on the margin, it probably doesn’t matter. Right. But for us who, when we care about experience, forcing a person to take their wallet out, take their ID, snap it, line up the phone. It’s just like why. And so much of the sort of innovation and friction reduction that we did at Cash App was just around these, like these points of, if you go the path, the path of least resistance for us is not actually the best experience for the customer and in healthcare. I’ve given you that example, but there’s, at Carbon, literally hundreds of things like that, where we’re, where we just have to pause question, pull back and then sort of figure out if we can do something original.
Lucas Bagno:
And if healthcare five years from now, doesn’t end up being as successful as FinTech has been over the last couple years, what do you think could have gone wrong?
Ayo Omojola:
Oh, good question. I think it depends on what you mean by success. So one of our clinicians makes this comment. He says 100% of people will be consumers of healthcare in their lifetimes. And so if by successful, what you mean is digital health doesn’t start to consume a larger portion of care and market share versus incumbents. The reason I think that might happen honestly, is like, I think it can, it can only be a regulation or under-execution. Because if you, if you look at a lot of the companies that I would say are, are leading in digital health, like Color, Carbon Health, Ro, et cetera, on this straight direct to consumer side, I don’t know if you, like, you can make arguments about their mission and their business. I don’t think you could really argue about their, their competence and execution quality. Do you know what I mean?
Ayo Omojola:
So, and then I think they also have an advantage where they just, they don’t carry a bunch of legacy costs along the way. So a company like Ro deploying their like really strong and mobile consumer acquisition, it’s just unlikely that Kaiser will be great at that. For example, my guess is something could happen regulatory that would clamp down and even then I think it would be, it would, it would be most likely to affect Ro or the digital health players directly. Because even in what you consider incumbents, they’re heavily reliant on software like payers, United Health, Aetna, BCBS, et cetera. They’re, they’re investing very, very heavily in technology to improve margins, improve care delivery, et cetera. So I just, I think it’s very hard for me to disentangle how like those companies, which have to continue to exist, like the payroll must be filled, succeed and the, and the upstarts don’t. Does that make sense?
Anne Dwane:
Yeah. So interesting. And, and also there’s been some consolidation on the digital side, right? Ro has made a couple acquisitions. Which suggests that maybe the digital stack pulls together or something.
Ayo Omojola:
Exactly. Exactly. Actually actually let me, let me add one more thing. So I think a thing that is true is capitalization of these businesses is complex because at, at heart, the atomic unit of value that a healthcare company provides is a patient and provider interacting around that patient’s health. It’s not software. And so I think like the VC model struggles to capitalize businesses, that where their top unit value is healthcare.
Ayo Omojola:
And I think we’ve, we’ve done a good job cause like Eren’s an amazing founder. And we have a really strong bench around him, but a lot of the times I look at startups that are looking at care delivery. And the thing that I think is you just literally are scaling humans’ time. And it’s not as though, like none of the innovations that you look at around care, unlock, more human, more people becoming doctors, every like that number is still just like growing at a certain rate. It’s not going to inflect. And so I think there’s also some risk there. If, if some of these new models around personalization and some driven care don’t pan out, like I should be just transparent that I think that will it might be a 10 year thing instead of a five year thing, for example.
Anne Dwane:
Right. Well, it’s interesting. A lot of software businesses do not have a third-party payer in the loop either.
Ayo Omojola:
Yeah, exactly.
Anne Dwane:
And that’s yeah. So it’s an extra complexity to, I guess, prove the value at the time. Switching topics a bit, you’ve talked before about your approach to hiring and how your secret to hiring is hiring former founders. Can you tell us more about that?
Ayo Omojola:
Yeah, sure. I would say it’s so, so when I mentioned earlier about like when I left Cash App, this was one of the things that I really was interested in trying. Cause I went through this cycle where I came out of YC I had a lot of friends whose their companies had ended either they’d sold it or they’d they wound it down and then they were mission list. So they were just wandering around, like trying to figure out what to do next. And I watched a couple of them like bounce against these big companies. Like they’d go to Amazon and go to Facebook and they have a grab back of skills that, unless you’re thoughtful about it, you don’t know how to apply. And if they have any non-traditional background, they’re not like Stanford, Harvard, whatever, even getting successfully through recruiting screens is challenging.
Ayo Omojola:
And so to me, I was like some and actually here’s, what’s funny, some of these people have gone on to like start companies that are incredibly successful now since, and it just was crazy to me is that companies haven’t figured out how to, how to harness this kind of talent. And so I don’t think it’s specifically about hiring founders, even though that’s one manifestation. I think it’s about figuring out how to hire and retain talent that the average company doesn’t really know how to cater to. And so founders are founders are a good one cause they’re obvious and Silicon Valley but I think the same is true of like parents who’ve been out of workforce for a while. Because a lot of the times you find that there are these really, really talented, really, really driven people who they’re out of the workforce for a reason that has nothing to do with their performance or execution quality. And you have to create environment where they can thrive.
Anne Dwane:
Can we dig into that? So what questions might you ask in an interview and or what conditions as you were saying in the environment, do you create for them?
Ayo Omojola:
Yeah, so, so, well, I’ll focus on founder thing and then I’ll focus on like, moms, who’ve not a workforce for a second. So for founders and this is actually my general interview process, but for founders that like works really, really well. Usually there are public artifacts of their work that you can try. So like, I can literally like play with their apps and be like, Hey, how did you decide this? Right. And so you don’t need to, you’ve removed the question from the table of, do they know how to perspective and are they kind, and the introspection is for, it’s basically trying to ensure that they can learn fast. And then the are, they kind is for just like, I have a real hard time with people who are not nice for lack of a words, I struggle with assholes and think-
Anne Dwane:
You guess, we’re in trouble.
Ayo Omojola:
And I think if you want to build an organization where people can take risk, they have to know that they’re not going to get shot at when things don’t work out. So the, like really those are the sort of parameters. And then I think, I think Cash has now done this, but this is a thing that I was really interested in is building. And I think particularly in the pandemic, this is interesting. And we’re, we’re, we’re investigating this now at Carbon, but building programs that allow parents who’ve been out of the workforce, primarily moms for a few years, land back in a job. And like, and it’s not the same as I was at this company on Friday. And then I left and I started at Carbon on Monday. There’s you have to create like something different for them. And so for that, I don’t actually yet know what the answer is.
Ayo Omojola:
We’re just exploring what it is. But I think, I think there’s something around having good champions inside the organization for those things, having, I want to say extensive training, but it’s not really a skills thing. It’s an onboarding thing for like, Hey, here’s how this organization works. Here are the ways that you might have to think about these things that are, that like you might not be used to. And then for, for more technical roles, there is training and tools, because those things like the types of work that engineers and data scientists and designers do those, the tools they use, like flip relatively free.
Anne Dwane:
That’s exciting. It sounds like you could unlock just amazing talent from those approaches.
Ayo Omojola:
I hope so. I really think this, it’s one of the craziest things Silicon Valley to me. People with kids, they just care more about their kids than their job on average. And so making it really easy for them to do the right thing by their families and still work for you, I think you’ll build an insane amount of loyalty. I don’t know if that’s true. I just think it is. And if we have this conversation in a year, I’ll be able to tell you.
Lucas Bagno:
Awesome. Well, so I wanted to ask you one question, Ayo. So you’ve worked directly with, what’s arguably one of the best tech founders of the last 10 years, Eren Bali, what have you learned most from him specifically on the subject of hiring?
Ayo Omojola:
I don’t know if the thing that I’ve learned the most from him is a hiring thing actually. There’s a thing I didn’t really appreciate about startups with multiple technical founders, which is, they have access to a feedback loop that’s really, really hard to match. So all of carbon runs on our own EHR, which we call the provider app that Eren built and so much as, and it, and EHR is just like an insanely complicated piece of software, like outside of Slack. What other thing do you think people use every day for 10 hours a day?
Ayo Omojola:
And that’s like what our providers are doing? I didn’t realize until I probably had been here 18 months as, and in 18 months, I’m just sort of peeling back to layers of the onion of what this app is. And in that process, realizing that there’s so many things that we have now that were just some experiment he had and he built over a weekend five years ago. And that thing’s just really like, look, I think I’m a pretty smart guy and I’m pretty good at stuff. But think the output you would get with me and a strong technical co-founder versus two strong technical co-founders working on something actually is like really, really different.
Anne Dwane:
Amazing. And let’s wrap with one last question. So you’re an operator angel. How do you think about making time for angel investing both the time to meet and decide about backing founders and then the time to support founders you to back?
Ayo Omojola:
Yeah, so I think two things like one is just recognizing that in practice, I’m not really a capital provider. So like for the most part, whether or not I wrote an angel, a check would make a difference. A company check would make a difference to like whether they were successful or not actually just because they’re not like I’m not the anchor, I’m not the round lead. Do you know what I mean? Like my, my check size isn’t large enough for, for that to be true. And so I try to be like pretty low maintenance. And so that’s like one, two, I think what a company needs from you just changes depending on the stage and like, depending on what the company’s going through. So for a lot of stuff that I do in FinTech, I’ll use FinTech and everything else as like two examples, all a lot of stuff I do in FinTech, I’m useful because I’ve thought about these problems before often longer than the founder has.
Ayo Omojola:
And so I can like help them see on corners and my network will be useful to them. And sometimes when, when necessary, we get like really technical and I’ll look at a database table and tell them how to think about certain things for a lot of other stuff that I do. Like I’ve invested in a couple of space companies. I actually just don’t know anything about space. So for me, they’re bringing me along for the ride and like, I’m, I’m there to learn. And in all cases, like my evaluation process is, I guess I have a few, but I try to be decisive and just either commit or get out of the way just to not waste their time up front. And then downstream when I’m involved. I joke with a friend of mine that angel investments at the pre-seed stage are like a really expensive newsletter where you get a letter from the front lines once a month from a person who’s really like in doing the hand to hand combat.
Ayo Omojola:
And then there is an option in there if the company does well that like you might make some money. And when I, because I have that mindset, like mostly what I try to do is say is where, like, where I don’t understand something, probably other people on your cap table also don’t so I ask about it. And when I think you’re not thinking about something, I try to just force it into your consciousness and you might decide, Hey, I’ve thought about that. Please leave me alone, which is also fine. But, those are like what I think go as my responsibility and I try to make it like pretty, pretty lightweight and high level
Anne Dwane:
Super. Oh, well, I thank you so much for making time today and sharing your wisdom and growth ideas with, with our audience. And we really look forward to staying in touch and tracking your progress.
Ayo Omojola:
I appreciate it. Thank you for having me on.
