#42: Charlie Lougheed (Axuall)

Charlie Lougheed (Axuall) [00:00:00]:

What we've done is focused on building really what we call a digital proof network that puts the clinician at the center, that gives them the ability to manage the most important documents of their career, their credentials, because it was interesting, they were really being left out, they're being asked to enter the same information again and again. But by empowering them with a way to manage and grow their career over time, land ultimately eliminate a lot of the paperwork associated with credentialing or recruiting and repriveleging and everything that they do that could have a profound impact.

Jeffrey Stern [00:00:36]:

Let's discover the Cleveland entrepreneurial ecosystem. We are telling the stories of its entrepreneurs and those supporting them. Welcome to the Lay of the Land podcast, where we are exploring what people are building in Cleveland. I'm your host Jeffrey Stern, and today we have a special guest on the show and with it a slightly longer and more personal soliloquy of an introduction. So please bear with me for a moment here. When my last startup spectacularly collapsed in early 2019, as startups do from time to time, I knew that there was more to my own entrepreneurial path. I knew I still wanted to build something impactful, but I was not quite sure exactly what I wanted to build. And so I set of on a journey to figure that out. A journey which ultimately planted the seeds for this podcast itself. A story that I will revisit in a special future meta episode, but more importantly, a journey which gave me the opportunity and the privilege to co found a company with our guest today, Charlie Lougheed. The journey that I embarked on involved many exploratory conversations with founders in Cleveland as I tried to figure out where I wanted to devote my time and energy going forward. Land also who I wanted to build something with. And what was incredible to me then, as incredible as it still is to me now, is that if I could have waved a magic wand and picked the two specific people in Cleveland that I would have wanted to start a company with. It really would have been lucky to Vogue, who I had come to respect and look up to as a prodigious engineer, as a mentor and as a friend. Land charlie Lougheed, who I knew to be one of the few people in Cleveland who had not only successfully navigated the choppy Cleveland startup waters, but who had done it multiple times over across different industries, and who as the crazy entrepreneur that he is at heart, somehow wants to do it all again. And so to say that I felt quite humbled that both Lucky and Charlie brought me on as a co founder of Axuall. With them is an understatement, but with a little bit of that context, here is some more on Charlie, most recently. Prior to Axuall, Charlie co founded and cofunded Explorys which is now IBM Watson. In 2009, as a spinoff from the Cleveland Clinic and in the six years since, the company became the leader in the healthcare, big data and valuebased care analytics space spanning 26 healthcare networks, 60 hospitals and 60 million patients across the US. Prior to Explorys charlie Cofounded Everstream in 1999, which later became the market leader in broadband and content analytics before being acquired by Concurrent, a public company in 2005 over there he had served as the CTO and later as the president of the company, enabling its clients to leverage their data to exponentially scale their networks and broker better deals with content providers. And Charlie had also been at the forefront of innovation within the financial services sector, having led online banking land consumer analytics before then at KeyBank National Citibank and at PNC. Charlie is also an active leader in the local community here in Cleveland, serving as the chairman of the Lougheed Initiative Foundation, vice Chairman of Friends of Breakthrough Schools, land chairman of the Gallon Foundation and PeopleBeatingCancer.org. Honestly it is very exciting to have Charlie on the podcast to share his story and the work that we are doing together at Axuall. I have personally learned an immeasurably great deal from Charlie over the last two years and I hope that through this conversation you all can enjoy and glean some insights as well. So with that, please enjoy my conversation with Charlie Lohea. Well obviously this is a special conversation. I feel like the ace up my sleeve as I have curated the stories of Cleveland entrepreneurship to tell and I've been looking forward to having you on the podcast Charlie, because a repository of Cleveland entrepreneurship stories would be sorely missing without your contributions.

Charlie Lougheed (Axuall) [00:04:50]:

Well, thank you Jeffrey, it's good to be here. It's going to be a fun experience here. You're interviewing me and you know a heck of a lot about me. So you know where all the skeletons are buried, at least in this we'll.

Jeffrey Stern [00:05:05]:

Pick the good skeletons.

Charlie Lougheed (Axuall) [00:05:06]:

The good ones. Yeah. The good, the bad land not the ugly. I like that.

Jeffrey Stern [00:05:11]:

Yeah. So we'll spend a lot of time here talking about the work we're doing together at Axuall. But I wanted to take the opportunity to explore some of your motivations land past here. Because Axuall is not your first rodeo here in the company building arena that we find ourselves land from Everstream to explore us and others that over the course of your career you've been able, it seems, to consistently best the proverbial startup odds and do it here in Cleveland. So I thought a good place to start would just be looking back on some of those endeavors where you would say your motivation stems from for entrepreneurship land what were some of those formative moments looking back that kind of put you on this path?

Charlie Lougheed (Axuall) [00:05:55]:

Yeah, well, I guess I'd have to go back, way back and this is going to date me when I was a kid. I grew up in this entrepreneurial family. My grandfather, who was an immigrant, was an entrepreneur. He had his own tool and I and then a cash register business. And my dad was co owner of a car dealership and a Chrysler dealership in the middle of Ford country in Dearborn, Michigan. And he had obviously overcome not being a Ford dealer, but on top of that, he figured out how to create a really strong business led by himself being a really honest guy, which I think was something that the industry and others were really looking for. And so I got to watch him and kind of his just incredible devotion to service. Land I'll probably touch upon that a few times. I think entrepreneurs have this service gene. We really want to take care of people. Land in many cases, we want to do things better for people, offer something that truly adds value and brings joy to people. And so I just watched my dad do that for so many years, and it was really exciting to see that. And then I also had the experience to watch my brother Doug. He's 14 years older than me, so I was the youngest of four in the family. So Doug was way, obviously way further along in his career. He was also an entrepreneur, had his own business. He was focused on commercial lines, insurance, and I got an opportunity to follow him along around and meet some of his customers. And these were companies that relatively small, a lot of times small or medium sized companies that provided products or services to the automobile industry and others in the Detroit area. And I just kind of got to see him interact at a different level in a different way than my dad did.

Jeffrey Stern [00:07:52]:

Yeah.

Charlie Lougheed (Axuall) [00:07:52]:

So I got to get all this different perspective, and sooner or later, you go along on enough of those sales calls and meet some of those people, and somebody asks, hey, what does your kid brother do here? Does he work for the insurance company? Land at that time, I'm, like, 1516 years old, and he's like, no, but he does like computers. And that got up the conversation going like, can he fix my computer? Next thing you know, I'd fix one computer, another computer. And then we built a business out of it, and then we started building software around it. And I worked in my brother's building for a long time, and so I had this experience really early on that I think was somewhat unique. My other friends were working at, like, marrying around at a chess king or some of these other stores that are no longer around. I'm out doing that. I had a lawn service on the side as well. I don't know. I think I was just exposed that way. Some could maybe say wired, but it was probably a little bit of nurture in nature. Again, I just tied back to service. Like, everything I did I just wanted to bring some joy or utility to someone because that's what I watch my family do. And so that's how I sort of got started in this and kept doing it through college land. Then decided to spend a little time in the corporate world. Worked for Deloitte for a little while, went to work at Key Banks, got the experience at a really large company, wound up running the technology side of the house for their Internet banking. And then met Steve McHale. And that's the person I started well, went to work at Everstream and then we kind of did a reboot on that business and sort of refounded it. And so that was a really exciting time for me.

Jeffrey Stern [00:09:33]:

Yeah. When you and Steve, the dynamic duo kind of met and you bring this kind of bringing joy to people perspective starting those businesses I'd love if you could just take us through maybe everstream and explore us and working our way to Axuall what the joy you were hoping to bring to those people you were working with were from those businesses respectively.

Charlie Lougheed (Axuall) [00:09:57]:

Yeah, well, it was interesting because Stern, Steve sort of recruited me through a friend and Mike Anders, and Mike and I had worked at Key, and Mike knew that I had this entrepreneurial gene and I was only going to be at Key for so long, started introducing me to folks, and that's who introduced me to Steve. I remember Steve calls me up. I think he's like pumping gas or something like that. All this background noise. It's all commotion. This is if you know Steve McHale, he can operate around a ton of commotion in his life. And there he is talking to me. And at that time, I really didn't want to leave. I was kind of on the upswing there and things were going well, and he's like, Come over here. We need another entrepreneur on the team. There are a couple of other folks there Blake Squires and Sean Rick Sector, who had started the business early on. Just a month or two earlier, he's like, Come on over. This is a really interesting business model. It really was. If anybody recalls, I mean, everybody knows Mark Cuban, right? Mark Cuban's. One of Mark Cuban's most successful businesses was a company called Broadcast that was basically a streaming media company that brought it was a centralized service, centralized station. They had all a bunch of different stations and they subsidized it with advertising, obviously. And what Steve, Sean and Blake had come up with is this idea that to do it locally originally and they had found this interesting thread through it all that a lot of the advertising that was being sold regionally was being sold through newspapers and in relationship also with Radios. And so there's this relationship within these regional areas and billions of dollars of advertising were going through it. So we looked at this and said, all right, we'll be the regionalized version of broadcast. Well, that all went great. That was 2000, about eight and a half million dollars in financing. I came over the chief technology officer and we built this thing out. We were all super proud of it. And all of a sudden the bottom fell out. That was the first real bomb crash, right.com? Bomb. I think that was hard for all of us. And I think one thing I learned from Steve as a leader was you can't consider your product itself the North Star. It's got to be the company in the organization. So what we did was we really started to think about, all right, advertising is hard enough to sell in any new market or new product. It's going to be impossible to sell for the next few years within streaming media. It just isn't enough demand for turndown of the economy like that. So we asked ourselves, what else are we good at? And one of the things we were good at is building one of the largest streaming companies in the US. Believe it or not, we were like in the top ten of data pushers. We were pushing a lot of data out of our systems, streaming a ton. We had built data centers, we had built technology to manage all this, to streamline it, to reduce costs. At one point, we were burning like $500,000 a month on just bandwidth. So we had to figure out how to manage all that. We had all this infrastructure there. We had still probably $7 million in cash in the bank from our round of financing. Rather than just continue to burn through it, we decided to pivot. And that was sort of this rebirth refounding of this company that was really interesting. I tell you, not everybody wants to go through a pivot, but it's not exactly a bad thing. Sometimes it can be somewhat of a cathartic thing. Land it kind of releases you from the chains of an idea that might have been good at the time or seemed good at the time, but just timing was not on your side. And so we did that and we started to approach, interestingly enough, companies that were doing a massive amount of streaming and had super large capital, and those were cable companies. Cable companies in Telco were really beginning to push broadband to broadband. To really have broadband catch on, you had to push video on demand and other types of services that were bandwidth hogs. But we knew about that stuff. And so we started building technology to not only help them on the technology side, but also measure their media. And that just took of like crazy. And we grew to a market share about 50% and sold at a public firm in 2015. So that was just this amazing ride. It just taught me about the value of it matters so much the team that you're around than the product you're building. And if you're honest with yourself and what you're hearing from customers, if you got a good team around you, odds are you'll figure it out. At least you better your odds a lot.

Jeffrey Stern [00:14:31]:

Yeah, no, that makes a lot of sense. I remember one of the things that you've mentioned in our own journey was it's about the team that you build and their willingness to kind of stick it through successive failures and eat that for breakfast.

Charlie Lougheed (Axuall) [00:14:47]:

Yeah, absolutely.

Jeffrey Stern [00:14:49]:

So, again, working our way towards Axuall here, how does the journey kind of transpire the work you're doing there at Everstream, taking us through to explore us? And how did that actually happen?

Charlie Lougheed (Axuall) [00:15:04]:

It's like one of those things in your life, so many things build upon one another land. You look back and say, could I have done that one thing without doing the thing before? And I don't know, maybe you could. But I tell you, Everstream positioned us really well in some respects. In other respects, it was interesting. It turned out to be a blessing in disguise in that after we had sold Everstream, typically you want to stick around for a while. One thing is really important, especially from an entrepreneur perspective, is you not only want to hang in there for your customers, land your team, you also got to hang in for the companies that buy you because they stick their neck out for you and they're expecting your company perform. So you got to be there for them. And so I wanted to make sure I was there for the concurrent team who bought our company from Eversteen product. So I was there about two years, but after about two years, I was ready to go do the next thing. Meanwhile, again, Steve is talking to some folks in the healthcare space. We were both bumping into a lot of the same people in Cleveland. Healthcare is obviously a big part of our economy, employs a lot of people. You get to know these folks. We were serving on some charities and different types of boards and got to know some of the leadership there. It was really interesting to hear about big data at the time. The word big data was becoming a bit of a buzzword. Interestingly enough, we did that all through Everstream. And that was interesting because it did help an industry transform land, evolve. The data and analytics around Everstream in many ways, shaped video on demand in many ways was demise of blockbuster and other things. The being able to understand how to manage and get better content through data. And we looked at healthcare and we said, all right, we see these parallels, and maybe it sounds kind of crazy, but there are a lot of parallels into healthcare. Healthcare hadn't really leveraged big data. There were a lot of people that thought that any individual health system, even somebody as big as the Cleveland Clinic or others that you might think of, have enough data by themselves to be able to really see patterns in patient outcomes or see opportunities relative to new therapies or drugs that may interact in a more favorable or less favorable way. The reality is that because healthcare is so sparse, you really need to be able to have look at it in a very large population set. So, believe it or not, three 4 million patients isn't enough. A lot of times you need about 25 million patients. We had figured to really understand disease more effectively. Meanwhile, the whole healthcare industry was going under this under this transformation. It was moving towards a value based model, meaning you don't just get paid for the services, you get paid for the outcomes. To do that, they had to have some level of expertial understanding of the data that they really weren't the really weren't leveraging yet. We met some folks at Cleveland Clinic that were pretty instrumental in this process. Martin Harris, who was their CIO at the time, chris Colburn, led their innovations at the Cleveland Clinic, then went to Partners, and now Partners is now obviously mass General Brigham. We met a guy, a physician by the name of Neil Jane. He was an internal medicine physician, the, and also, interestingly enough, an informaticist. So he had built this solution that was kind of like a mini Google for healthcare records. And we looked at this and said, well, this is pretty cool. I mean, Google is one of those tools the search allows is pretty liberating. If we add some things and faceted search to this thing, building upon what Anil and his team had done, and then turbocharge it, supercharge it with a lot of data from multiple health systems, well, then that could be something that could be really appealing. We sort of got the band back together again. Land. Foreign explorers. It was myself and Steve and Anil and Doug Meal, who was a brilliant software engineer, still is. And we looked at this and said, all right, we think we can solve this problem if we can convince Cleveland clinic that it's in the best interest of them and healthcare to create land. Allow for a model where data can be shared across multiple health systems, even their competitors, in a way that obviously protected the data privacy and healthcare systems interest. And so we built that technology. And once we were able to prove that and show how powerful this data was at scale, things really took off. Land Explorers in many ways, just exploded over the next few years. We went from starting at Cleveland Clinic that had about 3 million patients at the time. And by the time I left Exploris, we were about 90 million patients in that data set. And so, in 2015, on our way to thinking about what's next and funding the company pair for probably either go public or something like that. Or maybe another acquisition. We bumped into the folks over at Goldman Sachs. They introduced us to IBM, and in 2015, IBM acquired Exploris, and we became the first of their Watson Health portfolio. It was kind of that big data backbone. So that was just this surreal experience. It brought a lot of jobs to Cleveland. We got IBM to commit to a building that was being built here in Cleveland for just that. And so it was a really fun experience, but just learned a lot. And I also learned a lot about the power of data and how transformative it can be for an industry and ultimately for the people it serves.

Jeffrey Stern [00:21:00]:

So with some of those learnings, how did those kind of inform as we make our way towards the present day here and the work we're doing together at Axuall what you wanted to do next?

Charlie Lougheed (Axuall) [00:21:11]:

Well, yeah, same drill in terms of sticking around. I had the same drill over at IBM. I knew I wasn't going to finish my career at IBM, but I enjoyed working with the people and we had work to do land the company. I really want to see the company scale, so I stick around for about two more years. But after that, when I exited, shortly thereafter, I went on this thank you tour, if you will. After building a startup and then selling or exiting it, and then thinking back a little bit, you do tend to reflect. You have this at least for me, you sort of have this feeling of gratitude wash over you because you just realize that there's no way we could have done this without what really amounts to a few dozen people from a customer perspective. Obviously many more from the company standpoint, but there's usually not even a few dozen. There's probably a dozen or so customers that are like, wow, they really made the difference for us. So I decided to go on this multi city tour, got on the plane, go to cities and talk to some of the folks who are really early on in the sales cycle with Explorers, and things had worked out really well, obviously, for all of us. So we just wanted to say thank you, and you kind of get to talking about what's next and what I kept hearing again and again. And these were like clinical officers and CFOs and CEOs of large health systems. They were saying, Charlie, healthcare is so much a people business. I don't think people realize that. A lot of times people think about the machines and the drugs and the devices in healthcare, but 80% of it is delivered by people. It's 18% of our gross domestic product in the US. And it's absolutely critical. We're staring at shortages down the road. Meanwhile, data on providers on the clinicians and people that provide the health care is really limited. It's siloed all over the place. We don't get make good decisions about how we logistically place clinicians to meet patient demand. And this was before COVID But obviously COVID made it just painfully clear that in order to really understand how to move people into the places where the can serve patients quickly in an elastic way, you had to be able to leverage data. And so there's a clear problem. I saw parallels to big data here because so much of the data that they were looking for, particularly in the onboarding process, required data that was from outside their four walls. And some of it was in, but a lot of it was outside. And they had to be able to bring this information in quickly. But everybody was sort of recreating the wheel in the industry. So we looked at this and said, okay, let's figure out how we bring we make this a lot easier to leverage data at the time. Jeffrey, I got to meet you, and I got to meet Lucky. And you guys got me to thinking about Blockchain. And I think the thing for me that was most interesting about Blockchain was the fact that it digitized proof. It made proof durable, it made proof secure. Meaning because of its distributed ledger technology, you could know that a proof came from a certain individual or person or entity, and it hasn't been changed since. And we looked at that and said, all right, if we can apply this to all the administrative verification that goes on in healthcare, administrative costs in healthcare exceed about a trillion dollars a year. I mean, that's a lot of money, right? Arguably, we could redirect that money in different places. A lot of people don't get access to care. If we could figure out how to reduce the costs, reduce the burden. For clinicians that spend so much time in paperwork, if you talk to a doctor, ask them about the term operating at the top of my license. When you operate at the top of your license, you're basically operating like a doctor or a nurse or any type of physician. Paperwork probably wouldn't be considered at the top, not even the bottom. It's like, been in the basement and they do so much basic paperwork right now. And we also looked at the economics. Land I think that's really important for any startup, just understanding the economics of your customers and how important it is for them economically to sustain their mission and what impact your solution might have on it. So it was this process, and it was, again, just talking to a lot of people and trying to be cautious, not to knee jerk just because one or two people said something, but waiting till you hear it from a number of people. Land that multi city tour gave me this immersion in this problem, and it was inspiring.

Jeffrey Stern [00:25:57]:

So to level set there, how do you describe Axuall today in an elevator pitch kind of format?

Charlie Lougheed (Axuall) [00:26:04]:

That's funny. It's multidimensional. So I came with people. I think Axuall's got a great elevator pitch as long as we have 1100 stories to tell it. But I think that the key here for why we formed Axuall is really three things and I touched upon each one of these. It's that, number one, patients need safe access to health care and you need clinicians to do that. And when there are shortages and what happens inevitably is patients either wait for the care land, things get worse or they go elsewhere and an issue relative to continuity of care begins to pop up. Meaning if you're seen by two or three doctors, doctors can't see patterns over time. So if you're jumping around just to get an appointment somewhere, that's not good for the patients either. And obviously they need safe. I mean, many of the listeners have probably heard of the Doctor Death podcast. We have to make absolutely sure that the clinicians that are seeing our patients, our family, our friends, our children are competent in what they can do. And there's proof of that. I think the other element of this we looked at it is physician Burnout, your practitioner Burnout Land. I mentioned this earlier. Paperwork is killing medicine. It's driving a lot of people out of medicine, not to mention if it takes a long time to replace a colleague that's left and you're working additional Saturdays and Sundays over and over again, it can get pretty hard. And in many cases people leave medicine for that and that creates sort of this downward spiral. And the third obviously, is the administrative efficiency. Your average clinician physician in a US health system generates around $9,000 a day in top line revenue. So every day that's delayed is money that's gone for that organization. And most healthcare organizations are barely breaking even and so we don't want them to go away. So what we've done is focused on building really what we call a digital proof network that puts the clinician at the center, that gives them the ability to manage the most important documents of their career, their credentials. Because it was interesting, they were really being left out, they're being asked to enter the same information again and again. But by empowering them with a way to manage and grow their career over time, land ultimately eliminate a lot of the paperwork associated with credentialing or recruitering and reprillaging and everything that they do that could have a profound impact. And so that's what we set out to do. And on the back end of that is what we provide the healthcare organizations they work with. And that's obviously insight for better planning. It's data and verified data to streamline the process to get clinicians to work very quickly. It's portability so they can work with their health systems and you can have a clinician, for instance, at university hospitals and metro work on the same patients, which in many cases is a really good thing with health collaboratives. And so we look at all this land that's really what. Is the organization we are focused on. And I'm proud to say that we didn't do that in a bubble. We built that with healthcare systems that were really our co founders, figured it out and saw it grow from there.

Jeffrey Stern [00:29:21]:

Yeah, I think the Codevelopment initiative is an important one because in my mind is how we kind of navigate the Catch 22 of being an early stage company, where, in order to get the kind of customers that we want, you need to have the references that you've worked with those customers before. But to ever have had references, you need to have had the customers. And it's hard to get that early buy in for the vision. And so getting it right just kind of amounted to working with the prospective customers and the hospital systems here in Cleveland to build the product that lets them teach us why things are done the way they are. They reveal to us the status quo if that's a result of habit or from necessity and just affords us the ability to innovate, where the answer to that question is habit. Land question, where the answer to that question is necessity and build the product together to a point of general extensibility, which I think is where we've kind of take it. So kind of just working through the history of where Axuall has gone in the past two years. So that kind of thank you tour the gratitude journey that you went on early 2019, late 2018, we kind of come together in the summer of 2019 and kind of fill us in on the blanks between then and then and now.

Charlie Lougheed (Axuall) [00:30:39]:

Yeah. Come 2018, it was pretty clear that healthcare had a real problem to solve around Credentialing and all the inefficiency that came with it. That's when you lucky. Jesse and I started to build what essentially become the first prototype of Axuall. If you recall, those are pretty fun days. Our first office was on the heiress Lean Dog boat. For those that may not be familiar with the Heiress Lean Dog Boat, it's a pretty cool floating office building development lab, land way before us, that boat was the Hornblowers Restaurant, and before that, it was a working Lake Erie barb. So lots of history. Coincidentally, that boat was also the home to the Unified Project for Those that may not Know Them. That's a nonprofit that I helped get off the ground, along with Steve McHale and Jim Hickey back in 2017, doing some pretty amazing things as it relates to the future of work and getting people to participate in the economy at a greater level, things that are all really important in our community. So, suffice to say, there was a lot of creative thought going through that boat, and it was just a great place to get things going. It's really fun being around other co founders. It's just this energy. But if only half of your time is spent with that. And the other half of your time is spent with customers just trying to sell them on it. You're kind of missing out, especially in the early days. So we said, all right, we need help. We need perspectives. Like you said, Jeffrey, we need some insight into this. We don't understand all the intricacies of credentialing and Privileging and onboarding yet, so let's bring some others into the startup garage, if you will, or the startup boat. And so there's really several organizations here in Cleveland University Hospitals, and that team were incredibly important. There we had David Sylvan, who's the president of the Innovations Group, dr. Eric Beck in the very beginning talking about what could be here, and it was really interesting. And we talked to folks like Dr. Brian Rothstein about what would this be like for you and others? It was really inspiring to hear that we were on the right path and that clinicians really needed this kind of thing as well. So I think that was really exciting. That was verified with others, dr. Miller and others at the organization. And so we had validation, but we still knew we needed a co founder and all this that was a customer. And that sounds odd, but it shouldn't be. It should be more commonplace, especially in the Midwest. It's kind of our secret weapon against the coasts that have so much more money. If we can streamline a lot of the early R and D by getting it right the first time with these kinds of people, it's really important. Metro Health was really pivotal in that as well, and Tricia and Brittany and Julie were supportive of us there, and I think that was just really important for us to get a perspective from their side. Another startup, Higher Medical minojabri and his team were really instrumental with that as well, and they helped us really understand the staffing side of the house and the, of course, others along the way. MedStar came in a little bit later. They were a large health system on the Eastern seaboard. We got to get some really good perspective from that group. I had worked with them in the past, Melissa, Joe, and Jeff over there. MedStar was one where the head of the Innovations Group, Dr. Mark Smith, and just again, having people like this kind of wrap their arms around us, take us under their wing because they trust us and they knew the had a problem. It's just this exhilarating experience, Jeffrey. I don't for you, but it's not a burden, but it's definitely a responsibility that you get up every morning with and you say, we got to figure out how to make this work because so many people are calling us.

Jeffrey Stern [00:34:28]:

Oh, for sure, yeah. I mean, you hear all these clinician stories. Part of the thing that we're trying to do is build empathy for them, and it's very easy to do it because you see what they're doing and what they have to deal with. And it is a motivating force for us, for sure.

Charlie Lougheed (Axuall) [00:34:46]:

Yeah, it's amazing. You were there along with the journey every day, right? We had to get to MVP. We had to try this out on some clinicians. We started out in three phases. Every phase we got a little bit better. After seeing this 100 plus times, we really did begin to build a really great experience for not only the clinician, but we got really good data into the health systems in a 10th of time. And so that was enough to begin to build out the commercial agreements. Once we started signing commercial agreements last year, getting in 2021, we recognized that we got to put some fuel in the engine here to continue to grow the business. We set out to raise around a financing that at a time that would be four to $5 million and wound up being over twice that much. And it had so much to do with the healthcare community getting behind us. It was flair, capital and Michael Greeley and that team. I had known Michael from the explorer stays. He represented a lot of investors that saw the value in this and of course others in the syndicate as well. Intermountain and University Hospitals and MedStar, these organizations literally, again, in some cases not just giving us their time, but then giving us commercial agreements and money and revenue there, but also investment. I'm going to have one heck of a thank you tour someday when this is all over again, because it's pretty amazing.

Jeffrey Stern [00:36:19]:

It is pretty amazing. One of the things I wanted to ask you about was so obviously we have not picked an easy problem for ourselves here. This is a very ambitious thing that we are working on with a lot of opportunity to affect clinicians and economics of the whole space. And it's also a place where there are a lot of people who can say no to what we're doing and very few that can say yes. And one of the kind of privileges I think of working with you over the last few years is kind of witnessing your superpowers in action, or at least what I perceive them to be. And one of them that I wanted to talk about was you seem to have this endless supply of what I would call productive impatience that lets you run through multiple and successively thicker brick walls where you attack these. Obstacles where others kind of feign from the I'd love to just hear your perspective about how you think about this ability that you have in the context of what we're doing here.

Charlie Lougheed (Axuall) [00:37:18]:

At Axuall Jeffrey, it's funny because somebody a long time ago, a manner mentioned to me, he said selling into B to B is especially a large enterprise, is a lot more of emotional sale than you'd ever think. And for a long time there, I didn't really understood what he meant there, but it's actually not as logical as you'd think. I mean, when you and I go out to buy a car or a computer or a phone, we look at a lot of different specs and we say, I want that one. Yeah, sometimes color and things like that brand matter. But you look at a lot more data in large corporations and large organizations. There's more than just the features, functions, and data. There's psychology, right? There are reasons things have evolved over the years. There are explanations for the inertia that people scratch their head and say, this bureaucracy is killing me. I think it's just really important to recognize that the larger organization is the greater risk there is of just dysfunction. And it's not any kind of one nefarious plan. It's just the way that things work out over time. And I think for us, one of the things that I think is really important is understanding, starting with, all right, let's all get around a mission. Let's all get around a mission. We're going to need to improve health care. We've got shortages of clinicians. We better make it easy for them to grow in their career. And I'm not just talking about physicians. I'm talking about the 16 million healthcare workers in the US that can move from aid to nurse to nurse practitioner and wherever right. And move around in your career and do kind of things you want, that's going to be really important. And we've got to fix the data problem that exists out here, because if we don't, patients aren't like I mentioned before, patients aren't going to get served and we're going to burn out clinicians. So we can't let that happen. It's too important. And I think making sure that we root ourselves land how important this mission is helps to kind of get up off the ground after you've been knocked down because it happens a lot. I think the other thing, too, is from a psychology perspective, is really just understanding all the different stakeholders. And for us, we've had to do that, and it's still a journey. But typically when we talk to executives inside of organizations, they're like, yeah, heck yeah. This makes a heck of a lot of sense. The ROI is sound. It's been proven this aligns with our values as an organization. Go do it. But as you get further down, further down into the organization where a lot of things are getting done on a day to day basis, they may not be motivated. The may not be part of their because it's not part of their job description. In some cases, what we do may be their job description, which can be pretty threatening. And so a lot of this is just have to understand people and have a little empathy for the way that they're looking at it. And I think if you can do that because a lot of people arguably do, is a lot of manual tasks all day long and I think all of us know in the back of our mind that's going to go away over time, that a lot of those jobs will be replaced by automation. But I think it gets to what one administrative person said to me once. She said when I was a little girl, I didn't wake up in the morning and say, oh boy, I can't wait someday to become a paper pusher. But it sort of worked out that way. But I think the thing that the responsibility of any innovation company is to try not to leave people behind but let's figure out how we also put data in front of people so they can move from being pure administrative to now analytical because those are a lot of the jobs of the future. And so I think part of our success, again, any startup is you've got to have this, you got to think about humans. It can't just be about technology. It also can't just be about the mission. By the way that I just mentioned, you got to think about the humans involved in it. And that's I think the thing is probably the toughest for me personally, I'm learning of trying to learn every day and pay attention to that kind of.

Jeffrey Stern [00:41:22]:

Stuff because I really do think it's important right internally. It speaks to the kind of company that we're trying to build as well. So I think we've kind of caught up to the present here. We can turn the retrospective lens towards the prospective future and I'd love to just get your perspective less for myself, more for our dozens of listeners here about how we're thinking about the future of Axuall and the vision for the company going forward.

Charlie Lougheed (Axuall) [00:41:54]:

Yeah, I think as we think about the future of Axuall, first off, we are a data company. We're also a networked data company that puts the subject of that data in charge of their data. I think one of the things for us that's really important is that because we're built on such a strong consent model, making the life of the healthcare worker a lot easier by helping them leverage their own data land others use that data based on their terms, I think are really important. And I think as we continue to build that out, I think that's going to be really key for our future. That the healthcare space. The whole US healthcare sector will start getting smarter about how we deploy human capital. I mean think about it. We've got a baby boomer population that really wants to stay in their home. Just obviously everybody would as long as they possibly can and innovation is going to be a key part of that. But so are people and in many cases I think it's going to be the future of work.

Jeffrey Stern [00:42:54]:

Yeah, no I'll see an open ended closing actual question here for you, but anything you feel like we should cover here that we haven't yet talked about with regards to Axuall and what we're doing together.

Charlie Lougheed (Axuall) [00:43:07]:

I think one thing that'd be kind of interesting that we really haven't talked about and we're bouncing around a lot is obviously Axuall is a Cleveland based company and we pride ourselves in that this is a wonderful community. I've raised my children here, many of us have, and it some degree echoes our entrepreneurial ingenuity and spirit from the industrial age. I mean, the city grew as fast as it did because we figured how to solve problems, figure out how to operationalize around it, and we need some more of that. We need to support the startups. But it's going to be interesting to watch Axuall over the next few years because despite as much I love Cleveland, it's going to be hard to hire more than 60% of our staff from Cleveland. COVID and work from home has changed a lot of things. The were changing to begin with, but now it's really accelerated it. I think every tech company needs to look at this and say, all right, the world or at least I time zone has to be my oyster. Meaning we've got to be able to pull people the best talent we can as quickly as we can. And sometimes, fortunately, they're not going to be local. But as much as we can draw from the local community, I think it helps our community. I think our emphasis around education is so absolutely key. It's why I'm involved with the metropolitan school district and breakthrough. I think these things are really important. Education is the only way forward to participate in the economy and we need these skills and we need people doing that. I think it's going to be interesting. The companies in the past where 80 90% has been Cleveland, this one could be 60 40 or maybe even 50 50. It's going to be interesting to see that evolve.

Jeffrey Stern [00:44:59]:

Yeah, it definitely will be. But I think it's a good segue. Here to our closing question, which is uniform and is about Cleveland and painting a collage here of not necessarily people's favorite things in Cleveland, but of things that other people may not know about, the hidden gems, if you will. So with that, Charlie, some of your hidden gems in Cleveland.

Charlie Lougheed (Axuall) [00:45:25]:

Yeah, Jeffrey, I think one of the ones is a lot, right? Food is great here. We've got great art, we've got great sports. For me, I need to be able to decompress, go for a hike or a run and I've always seemed to do that along the Chagrin river land. A lot of that has to do the fact that some of our metro parks I think are definitely a hidden gem afford you the ability to do that. I mean, there's so many amazing spots along that south chagrin land, squires Castle. And it's had such an influence on me that last year we decided to build a house on the Chagrin River. So I look at it every day now. And so, yeah, I think to me, that's one of the hidden gems. Everything along that way and it's been something that's inspired me over the years.

Jeffrey Stern [00:46:14]:

The Metro parks are pretty fantastic. Well, Charlie, I appreciate you very much coming on. Like I mentioned, have been looking forward to this one for a while, having kind of been part of your journey here in the last few years, but hearing about it in the past. Yeah, I'm excited about where we're going to take Axuall, but appreciate you coming on and sharing your story.

Charlie Lougheed (Axuall) [00:46:37]:

Thanks, Jeffrey. All right. It's a lot of fun.

Jeffrey Stern [00:46:39]:

Yeah. If folks have anything they want to connect with you about, reach out. Where's the best place for them to do that?

Charlie Lougheed (Axuall) [00:46:47]:

You'll probably blinked in is the best place. Always willing and excited to connect with people in the entrepreneurial space and happy to answer any questions you may have along the way.

Jeffrey Stern [00:46:57]:

Yeah, I'd be remiss also if I didn't mention that we are hiring at Axuall and so for anyone listening, if you're interested, reach out to Charlie. Reach out to myself. Happy to chat about that.

Charlie Lougheed (Axuall) [00:47:11]:

Absolutely. All right, Jeffrey, this has been awesome. Thanks a lot and I'll see you again in like ten minutes.

Jeffrey Stern [00:47:19]:

I'll see you a bit, Charlie.

Charlie Lougheed (Axuall) [00:47:21]:

All right, thanks. Bye.

Jeffrey Stern [00:47:23]:

That's all for this week. Thank you for listening. We'd love to hear your thoughts on today's show, so if you have any feedback, please send over an email to Jeffrey at layoftheland FM or find us on Twitter at @podlayoftheland or @sternjefe. J-E-F-E. If you or someone you know would make a good guest for our show, please reach out as well and let us know. And if you enjoy the podcast, please subscribe and leave a review on itunes or on your preferred podcast player. Your support goes a long way to help us spread the word and continue to bring the Cleveland founders and builders we love having on the show. We'll be back here next week at the same time to map more of the land.