Lessons from Pouria Sanae: scaling healthcare infrastructure with enterprise giants
Pouria Sanae, CEO and Co-Founder of ixLayer, an elegant solution for integrated health systems to easily deploy and manage affordable and reliable remote lab testing solutions.
Welcome back to Pear Healthcare Playbook! Every week, we’ll be getting to know trailblazing healthcare leaders and dive into building a digital health business from 0 to 1.
This week, we’re excited to learn from Pouria Sanae, CEO and Co-Founder of ixLayer, an elegant solution for integrated health systems to easily deploy and manage affordable and reliable remote lab testing solutions.
In March 2021, ixLayer raised an oversubscribed $79M Series A led by General Catalyst— Pear has been a proud investor in ixLayer since the pre-seed and seed days!
ixLayer’s founding story:
ixLayer is Pouria’s third startup. Back in 2007, Pouria founded a startup in e-commerce data mining while in Sweden, then founded a second startup in 2010 when he moved to the US. Prior, he worked on product at Yahoo and Flickr, but eventually became interested in healthcare. Pouria then joined Helix as an early employee, a large sequencing lab, that grew from 15 employees to 200 by the time he left.
Helix was where ixLayer’s vision began: after encountering bigger health organizations like Mayo Clinic, Mount Sinai, National Geographic, and more, Pouria recognized that every single one of these organizations creates the exact same wheel over and over and over again.
Enter ixLayer, launched in 2018: “I” stands for infrastructure, “X” stands for patient experience, and “Layer” refers to how the company connects the ecosystem—ixLayer is not an end-to-end provider, but it’s the missing layer between partners and consumers.
The three ixLayer co-founders share the same passion with different and complementary skill sets: Pouria brings product and startup mentality, Vahid Kowsari brings technical expertise, and Poorya Sabounchi, with over 10 years at Illumina, brings his understanding of the healthcare space.
From his experience at Helix, Pouria shares that ixLayer’s initial focus was on genetics and genomics screenings, but in that process, actually saw the unrecognized value of all remote and at-home lab testing and the impact on preventative healthcare.
ixLayer allows customers to launch any lab testing they want under their own brand, providing a patient experience and healthcare cloud infrastructure behind the scenes.
ixLayer powers lab and health testing outside of a clinical setting, offering remote lab testing for physicians, patients, employers, school systems, government contracts and at-home lab testing.
On the backend, there’s a long list of labs, physician networks, telehealth solutions, and partner companies like Axle Health that deal with insurance, payment, e-commerce, etc.
Depending on the customer, ixLayer utilizes existing internal physicians or provides integrations to provider/physician networks, allowing customers to launch lab testing across 50 states in a matter of weeks.
The key to scalability is being customizable and personalized to the enterprise buyer but still sticking with your roadmap
Think of your company as a service provider: tailor fit your solution to your customer as it fits within your roadmap.
Pouria shares that getting customers to trust you as an enterprise startup is very tough. IxLayer’s approach was to act as a solution provider to their prospective customers, as long as it matched their roadmap.
ixLayer’s first partner was Helix, and their first customer was ADx.
We tailor-fitted it to ADx. Through ADx, we could get a bigger, better platform with additional functionality, and our platform actually grows with every single customer in features and functionalities
Striking a balance between customizability and scalability depends on your sector, and it evolves as time goes on.
Pouria shares that he went from selling one service and feature to eventually a comprehensive product offering.
Make sure that you don't customize for the sake of customization, but your customization and your roadmap matches. That's the trick.
Leverage warm connections and referrals from domain experts and your industry network as much as possible
ixLayer’s early customers in the early days came through introductions of partners of the labs they were working with, and that was really helpful for us to be able to grow the business while we were bootstrapping it.
Pouria believes that enterprise is very relationship based— the right investors and advisors can help open doors, create credibility, and help you ask the right questions to understand the market.
Pouria’s advice is to surround yourself with people that know the industry, then ask them for warm introductions to build relevant relationships.
Fundraising tip from a Series A veteran: when raising, pitch everyone in as short a window as possible.
With ixLayer being his 3rd startup, Pouria was determined not to make the same mistakes raising that he did before. Initially, the team raised convertible notes from close friends and industry experts. For raising equity rounds, the team wanted to find investors that could provide flexibility but also help them in their next round, providing advice but not micromanagement.
ixLayer opened up their Series A round in January, and Pouria pitched 92 times in three weeks. He believes the close timing created momentum and an urgency in the investors— “there were multiple term sheets, there was a valuation that kept going up and up and up.” Pouria shares that they ended up going with General Catalyst not for valuation, but for their shared vision in building the future of healthcare
Don’t listen to everyone’s advice, you have to understand what phase of the company you’re in.
As I asked Pouria for general advice for healthcare startups, Pouria was smart enough to say that there isn’t one advice that fits all in healthcare!
Pouria believes there’s three phases (potentially a fourth that he hasn’t experienced yet):
1. Building the MVP
2. Finding product market fit
3. Building the organization
The advice for these three phases are totally different, and as a founder, you need to know which phase you’re in to filter out the wrong advice and learn what’s relevant.
Collect all of the variables, you need to learn, talk to your investors, do all of the due diligence, study it, but at the end of the day, just do it your own way… and don't idolize the previous entrepreneurs.
The future of healthcare
Healthcare is moving out of a clinical setting and into the home.
If you could meet “pre-patients” online and provide them tailored health information and education, that would reduce the number of patients in the hospital and bring a huge value to the clinical setting, reducing physician fatigue. Pouria sees a lot of value in this “pre-patient” care, also known as preventative care or low value based healthcare.
In the old days, if you had a pain or a headache or a symptom, you go to your doctor and you get advice and you get a lab test. Right now, the first thing you do is go to Dr. Google.
Pouria mentions the recent antigen at-home testing launched by the Biden administration will be a huge success for the industry. Now every single individual in the US can test and experience at-home testing. Pouria sees healthcare is finally innovating and evolving in the same patterns as Barnes and Nobles to Amazon or Blockbuster to Netflix. As people become more familiar with the process, we will see more quality and efficient care brought to the home and outside of clinical settings.
Interested in learning more about ixLayer or joining their team? Learn more on their website, Twitter, and LinkedIn.