February 2024 - Culture, Cardiovascular Considerations & Craft’s Medical Bet
How Charlie is trying to create a culture of excellence and enjoyment at Bounce, Paddy gives a personal dive into heart disease and we both look at recent AI companies that piqued our interest.
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The words in this newsletter are entirely our own, but the insights and ideas have been inspired by others. Our goal is to synthesise the best information we have consumed each month, and relate it to our everyday lives.
This is our attempt to get better each day, and we would love you to join us.
Quote of the Month: “Progress is impossible without change, and those who cannot change their minds, cannot change anything.” - George Bernard Shaw
Our Challenge of the Month - Creating a Culture of Excellence & Enjoyment:
Recently, I wrote about how we developed our vision, mission and strategy at Bounce and the importance of having our team on the same page (literally).
In order for us to achieve that vision, we need to build a culture of excellence and longevity that acts as the foundation for not only driving us towards that end goal, but helps us make the most out of the journey (á la ‘the happiness of pursuit’ which is my guiding principle for life).
Culture can mean a lot of different things to different people and companies. My interpretation is aligned with Brian Chesky of Airbnb who says that “culture is simply a shared way of doing something with a passion”. To me, a culture should be built on a clear set of action-based principles and values that every employee explicitly commits to.
Most importantly, it should be what all performance and standards are set through, and what every stakeholder in the business should know us for. When done right, they act like Adam Smith’s invisible hand in economics, or the unseen forces that drive how everyone at Bounce makes decisions, treats one another and works with our customers.
The phrase “actions speak louder than words” rings true, and we find ourselves in the privileged position of having 5+ years under our belt to analyse. This means that we are building the core values that underpin our culture on the actions every employee here feels are part of the Bounce DNA.
The first thing we did when setting these values was gather detailed input from each team member by asking them the following questions:
What initially drew you to working at Bounce?
What makes you want to stay at Bounce?
Describe your team in three characteristics.
How would you describe our workplace culture to people outside of Bounce?
What's one thing we do really well today that you believe we need to protect?
What's one thing we do today that you believe we need to improve?
What cultural traits & behaviours are important to the customers we serve? (Please list as many as you like & expand to explain as needed)
Finally, what cultural traits & behaviours are personally important to you? (Please list as many as you like & expand to explain as needed)
This gave Rónán, Rob & I the ingredients for shaping these core values. We then did a series of workshops to analyse this, and summarise what we believed would be the catalyst for protecting the culture we have built and shaping what will bring continued excellence and longevity into the future.
We ended up with eight words that were delivered to the company this month, and would define how we would act as a business:
Be Sound: This involves doing everything with kindness, compassion and being enjoyable to work with, but more importantly, it means being reliable in a uniquely Irish way.
Be Relentless: This requires us to move forward no matter what, finding solutions and joy in doing something we have no right to do. There is a joyful intensity to how we do things, because we care deeply about it.
Build Trust: This is the foundation of everything we do internally and externally. It is an active behaviour and consistently worked on by each person to ensure we continue to earn our reputation.
Be Bold: This means giving ourselves permission to be ambitious, asking ‘why not?’ and thriving in a disruptive environment that rewards calculated risk taking.
Of course, we went into more detail on what each of these meant and the actions tied to such behaviours. The key here is that, collectively, we define and protect our culture as relentlessly as we serve our vision, mission and strategy.
Our Trend of the Month - Cardiovascular Considerations:
In recent months, I have learned a lot from Brad Gerstner and Bill Gurley, and with the launch of their new podcast, BG2, that trend will hopefully continue.
Generally these learnings are centred around technology, market valuations, or regulatory capture, but every so often they touch an alternative chord - in this case heart disease.
Since my dad’s heart attack a few years ago, both the prevalence of the disease and the lack of information surrounding it has become apparent. Globally, 18 million lives are lost to cardiovascular disease annually.
Source: Global Burden of Disease
But unlike many other causes of death, cardiovascular disease is largely preventable by implementing the basic boring tenets of health - good diet, frequent exercise and limiting exposure to the vices of smoking and alcohol.
Despite this, 4 million sudden cardiac events occur annually, in part due to sub-par education and derisory early detection. People learn about the issue too late, when the damage is done - quite simply more efforts are needed in early detection and risk reduction.
Source: World Health Organisation
For instance, Cholesterol levels are commonly referenced as the key risk metric, yet 75% of people who suffer a heart attack have normal or low cholesterol levels. These scores don’t look inside your arteries and assess arterial plaque.
In contrast, calcium CT scans do. Plus they are non-invasive, quick and relatively cheap, albeit there is some exposure to radiation and the scan is an imperfect test (general awareness of CT scans due to congestion of medical resources and regulatory capture).
Similarly, once higher risk factors are encouraged, statins should be potentially encouraged as a preventative measure for more people, as they can reduce risk by c.25%.
The medical advice is simple and actionable: good diet, frequent exercise and no smoking, yet too many are dying annually. Ultimately, there is no magic solution when it comes to heart disease, but hopefully, with greater early detection and improved education this figure starts to trend downwards.
Start-Up / Founder of the Month - Peter Hayes of Humanloop:
Over the last year, we’ve spoken a lot about the rapid developments of AI. It has rightly dominated our ‘Content Corner’, but also raises questions as to what new AI companies are solving problems versus just chasing the latest trend.
Humanloop is an Irish co-founded company set up in 2020 by a team of preeminent computer scientists from UCL and Cambridge, providing the picks and shovels of the AI gold rush.
Co-founder and CEO Raza Habib said the company “want to democratise access to AI…by allowing any company to take its domain expertise and distil it efficiently in a machine learning model”. It might not be as sexy as Sora or any of the ‘gold’ new products being launched on a weekly basis it seems, but it really connected with me as a non-technical founder.
Their lead investor, Index Ventures, explained their investment by framing the problem: “what many people don’t know is that it’s not the lack of appropriate algorithms that’s holding back AI from being ubiquitous in every workplace – it’s the absence of properly labelled data”.
“Machine learning itself is becoming increasingly commoditized and off-the-shelf, but it’s still really hard for non-technical people to transmit their knowledge to a machine and help the algorithm refine its model.”
I’m always fascinated by the types of companies that come out of a new technological revolution, as it shows how different thinkers approach problems and opportunities in a whitespace. Who knows if they’ll be a winner or a loser of the AI wave, but I love their approach, and it’s great seeing the success of Peter and the rest of the team to date.
Investment / Fundraise in Focus - Craft’s GenHealth.ai Investment:
Whenever I read about a business lately, it seems as though they are leveraging AI in some capacity, such as adding a new product feature. On the one hand the AI space seems to open a world of unimaginable transformational potential, but on the other the space seems frothy and oversold too soon.
Despite this, the rational optimist inside cannot help but get excited for the profound potential of AI in healthcare (also delved into within our September 2023 letter), so in keeping with the medical theme, this month we highlight GenHealth.ai’s $13m seed round.
It appears I am not alone in this regard with AI being mentioned on 36% of earnings calls last quarter, according to GS data.
Source: Goldman Sachs Global Investment Research
After all, the use of large scale neural network transformers has been progressive in many industries and the market opportunity in healthcare is immense. As Craft pointed out in their “why we invested” piece, the healthcare industry sits on vast datasets that are difficult to access due to regulatory/privacy barriers.
Today, prior authorisation requirements result in a lot of administrative bureaucracy, but GenHealth’s pioneering pre-authorisation medical policy database can allow anyone to better understand their healthcare requirements and the team has already started to unlock databases in a compliant way.
The GenHealth team are using the funds to build their LLM on a mass of medical longitudinal data for a population of patients. Their model would then allow the team to predict future diagnoses based on medical history, age, gender and various additional demographic data.
Source: Company Website
Unlike others, GenHealth.ai are not training their models on doctors notes or medical research (only the tip of the iceberg). Instead, they are training their models on healthcare specific terminology, allowing their model to take in patient history and predict future events.
The various implications on the healthcare industry are incredibly exciting. Will these models highlight correlations between previously unlinked diseases and conditions? Or increase awareness of previously unknown harmful activities? Or just allow better risk assessments from medics, who leverage the models for risk calculations?
Content Corner:
The Irish-Australian Migration: More than 21,000 Irish citizens were granted Australian working holiday visas in the 12 months up to July last year — the highest recorded figure in at least 16 years here.
Eire Accelerationism: This month, a techno-optimist movement was launched in Ireland on David McWilliam’s podcast as Will O’Brien spoke to it’s ideology and plans for sculpting the future of Irish prosperity. Worth a read here and listen here.
The Economic Implications of Immigration: Economist, Cormac Lucey, wrote an interesting piece highlighting how the benefits of immigration won’t close the holes in our pension system, and the key considerations for the Irish government.
Acceleration of Addictiveness: Matt Mullinweg, founder of Wordpress & Automatic, points to this Paul Graham essay as his favourite. Graham highlights that technological progress makes more things do more of what we want, which in turn, also drives addictiveness - what does this mean for society?
Bill Gurley on Regulatory Capture in AI: If you want to listen to the techno-optimist viewpoint on why regulation is bad for new technologies that drive progress, like artificial intelligence, this talk by Bill Gurley is worth a watch.
OpenAI Commits to Dublin for European HQ: Following in the footsteps of those that have gone before them, OpenAI has committed more investment in Dublin, with Altman stating that Ireland “blends a talented workforce with support for innovation and responsible business growth”.
Elon Musk’s Neuralink Implants Brain Chip in First Human: Yes, you read that right. The first human patient has received an implant from brain-chip startup Neuralink. The company has stated its initial goal is to enable people to control a computer cursor or keyboard using their thoughts alone.
Thought Provoking Graphics:
MANG using their cloud credits to invest in early-stage companies. A changing dynamic Bill Gurley has highlighted.
Population shifts between Ireland and the UK between 1821-2019 highlights an incredible difference between us and our neighbours.
Apple VisionPro revenue compared to other tech companies, a reminder of just how powerful a company Apple is
People rarely understand the true scale of Africa, it is only when you see it in relation to key countries that we can truly grasp the scale.
Meme Corner: