Blitzscaling 14: Elizabeth Holmes on Managing Product Strategy, Regulation, and the Media

Executive Summary:

  • Theranos' mission is to provide affordable and accessible healthcare through innovative technology, transitioning from reactive disease diagnosis to proactive early detection and prevention.
  • Elizabeth Holmes founded Theranos based on personal experiences, leaving Stanford to fully pursue her passion for developing new healthcare testing systems and empowering consumer engagement with their own health data.
  • Theranos took an incremental, strategic approach - starting with pharmaceutical companies, obtaining early FDA approvals, and expanding to serve retail consumers with $2.99 tests - all while building towards its broader healthcare technology vision.
  • Elizabeth Holmes emphasized the importance of building a mission-driven, communicative culture, promoting from within, and persevering through challenges with a relentless passion for the company's purpose.

Meeting Notes:

Theranos' Mission and Vision

  • Providing affordable and accessible healthcare through technology
    • Make early detection and disease prevention a reality in healthcare
    • Empower individuals to engage with their own health information
    • Transition from a reactive disease diagnosis model to proactive early detection and prevention
  • The mission was driven by Elizabeth Holmes's personal experiences of losing loved ones, motivating her to change the healthcare paradigm

Theranos Founding and Early Days

  • Elizabeth Holmes was studying chemical engineering and electrical engineering at Stanford
    • Conducted research on handling tiny fluid volumes and sensor systems
    • Realized traditional diagnostic methods were outdated, driving her passion for the healthcare technology field
  • Elizabeth Holmes was obsessed with solving this problem of enabling early detection
    • Filed early patents around new concepts for healthcare testing systems as a freshman
    • Left Stanford after first quarter of sophomore year to fully focus on building Theranos and realizing her calling
  • Convinced parents to let her use the money saved for Stanford to start Theranos instead

Theranos' Product Strategy and Approach

  • Started by serving pharmaceutical companies as a lab for new drug testing and clinical trials
    • Allowed iterating on technology and generating revenue to build the company
  • Developed proprietary devices, software, chemistries and consumables for low-cost, automated testing
    • Enabled expanding to serve retail consumers directly for a $2.99 test price
  • Took incremental steps, applying sub-components of technology to different applications while building toward the broader mission
  • Worked extensively with governments and regulators like the FDA
    • Proactively sought FDA approvals for devices, tests and methodologies (first FDA approval in 2015)
    • Viewed regulation as critical for ensuring data integrity and enabling consumer access responsibly
  • Helped pass legislation in Arizona allowing individuals to directly access and pay for lab tests
    • Viewed as empowering consumers and driving better pricing through market dynamics
  • Lobbied for regulation to demonstrate integrity, believing unregulated companies making health claims were concerning

Building the Theranos Team and Culture

  • Focused on hiring passionate, mission-driven people over credentials when scaling rapidly
    • Looked for "fighters" with personal links to the healthcare mission
  • Prioritized promoting from within to maintain the culture as company grew
    • Supplemented with outside hires as needed for specific roles
  • Emphasis on real-time communication and open discussion of ideas/emotions
    • Held regular all-hands meetings to discuss challenges, celebrate wins
  • Flat organization structure, instilled values as vehicle for decision-making

Challenges and Personal Perspective

  • Elizabeth Holmes stayed focused on the mission despite public doubts and challenges
    • Viewed this as just "part of the innovation process" that should further unite the team
  • Expressed that loving what you do is key to persevering through difficulties
    • Theranos was her true calling that she would keep fighting for, no matter what
  • Emphasized finding your passion - what you'd do even without being paid
    • That drive helps you push through roadblocks when pursuing an ambitious mission