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AI for Digital Health

Season 16, episode 8 of the DataTalks.Club podcast with Maria Bruckert

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Transcript

Alexey: This week, we will talk about AI for digital healthcare. We have a special guest today, Maria. Maria is the founder and the CEO of SQIN. She is a podcast host, and she was named one of the top 20 Women in AI. Welcome to the show, Maria. (0.0)

Maria: Yeah, thank you so much for having me. (25.0)

Alexey: The questions for today's interview were prepared, as always, by Johanna Bayer. Thanks, Johanna, for your help. Actually, Johanna tried the app that we'll talk about today. She liked SQIN H that the app reported. [Maria chuckles] So yeah – thanks, again, Johanna. Usually, we start the interview… (27.0)

Maria’s background

Alexey: Before going to the main topic, we start the interview by talking about your career progression. So let's start with your background. Can you tell us about your career journey so far? (49.0)

Maria: Yeah, sure. I studied electrical engineering in China, so I was always very close to the technology side of things. And then I started to work for Siemens – I did the transformation strategy for the managing board for mobility and electrical things (all their energy stuff) which was quite interesting. But I always felt like, “Okay, I want to do something, and to do a strategy for something and then do it.” So if there is a mistake or a wrong decision, I'm the one who has to deal with that. (59.0)

Maria: Then I got pregnant, and during this pregnancy, I decided, “Okay, now it's the time to change everything because my life is changing either way.” That was the moment I decided, “Okay, let's found something. Let's transform an industry that really needs to be shaped.” That was healthcare. So we started the idea of SQIN with an MVP, and then different financial rounds. And yeah, here we are today! (59.0)

Alexey: How old is your kid? (1:55)

Maria: My little one is turning five now. (1:57)

Alexey: Five. So, you went into that five years ago, right? (2:01)

Maria: Yeah. We started five years ago with the first ideas and our MVP. But we always, as founders, believe that… For us, we didn't have the idea and then we woke up in the morning and said, “This is exactly what we want to do.” It was more that we understood, “Okay, there is an area in industry that needs help from the technology perspective.” In healthcare, you see limited resources, a lot of issues, a lot of people around the world dealing with so many, many things. Infrastructure is not that good. So we always believed, “Okay, we have to understand the industry first, and then we can come up with a solution.” (2:05)

Maria: At these times, we didn't even talk about AI, honestly. It was more like, “Okay, let's create technologies that can help here.” So that's why we started in the first one and a half-two years, more or less, with discussing and getting to know all these different players – we have the regulation, we have the pharmacists, the doctors, the patients, the hospitals, the pharma companies with medication, and so on. So there are very, very different players in this area, and if you want to come up with a technology or solution, you have to deal with all of them – at least most of them. You have to understand them. Therefore, we have an atypical founders’ journey, I would say. We really spent a lot of time on this MVP status quo, or bootstrap, to really know what we have to come up with. (2:05)

Alexey: Is your co-founder also a mom – somebody on maternity leave? (3:35)

Maria: Oh, no – my co-founder is a man. [chuckles] He’s the experienced one from the two of us? I would say he spent more than seven years in the valley, discovering different startup journeys and different companies. We met at university very much earlier and then just decided… [cross-talk] (3:43)

Alexey: In China, right? (4:05)

Maria: Yeah, we then decided to go on that journey together. (4:06)

Deciding to go into telecare (healthcare)

Alexey: Oh, so you already knew your co-founder way before starting. Then you got pregnant and thought, “Okay, your life is going to change anyway. Let's start something.” So you talked with the co-founder, and then you decided to go into the healthcare industry. Right? (4:10)

Maria: Yeah. For me, that was a very interesting thing. After university, a group of all my friends – most of them are entrepreneurs now, so most of them started businesses pretty early. We just sat down together, and I said, “Okay, I feel like I'm ready to also do something,” and then discussions came up. So it was not always just the two of us, but at the end of the day, when we knew, “Okay, this is what we will come up with.” Then there was a decision, “Okay, it makes sense. Let’s start this journey together as a team.” (4:31)

Alexey: That’s quite interesting. Why healthcare? (5:03)

Maria: I think, five years ago, healthcare was an industry that was not really digitized. They just started to think about, “Okay, what could be different in the future?” There was not even data. People, at least in Germany, started to talk about the data gaps we have, and the lack of information as well. For example, medications were just tested with male people – not even all of them were women. So there was a huge change that you could feel in the way people thought about health care. (5:07)

Maria: Rural areas, for example, started to say, “Well, we have an issue with resources because in a lot of doctors’ offices, the doctors are turning older and older, and we don't get new doctors here in our area.” So it was a time where you could feel that there will be a change in the system and that it was time to do that in a sustainable way. It was not because one of us studied in that field or something. It was really more about the potential analyzes of different industries. (5:07)

Alexey: In Germany… I live in Berlin, and the doctors still communicate with each other using fax. I go do an MRI, and then they do the analysis of the MRI, and send the results by fax to my doctor. It prints and everything. It's 2023 and we're still using faxes. (6:11)

Maria: Yeah! I mean, look at the papers for the pharmacies that are still printed out. Of course, we all talk about electronic prescriptions, but where is it in real life? So it's still something we are working on, even if we digitize in very different areas, but healthcare, due to the regulations and the sensitivity of data, is always two or three steps behind. I’m sure that you’ve noticed how a lot of startup innovations are coming up in the last few years. But most of them, from my perspective, were too innovative because, of course, healthcare is one of the oldest industries and you cannot change the whole ship with just one wave. Right? (6:37)

Maria: You have to keep the people on board, you have to understand the whole system (the ecosystem) and then you need to try to design something that keeps what we have, but it's still going into the future. I think this is the main challenge in healthcare. The second thing is that every area works differently. Not just every country, but also the cities, or the areas (like the rural areas). You need to see what you have. In the area where I come from, we don't even have dermatologists or doctors for eyes or something – you have to go to the next big cities to find some. So there are a lot of specifics, and you have to understand them before creating a solution in healthcare. (6:37)

Alexey: Which area are you from? (8:11)

Maria: I'm from Southern Brandenburg. So from Berlin, just going to the south. I mean, my parents are still living there. The situation’s not that easy. My mom's always going to Berlin to see a doctor. It's about a two-hour ride. I mean, we're talking about Germany, so we can imagine how other areas have issues. (8:13)

Alexey: From Berlin, in two hours, I can be in Rostock or Dresden. (8:37)

Maria: Yeah, true. [chuckles] (8:41)

Current difficulties in healthcare

Alexey: It's a lot of time, two hours, if we think about that. Also, in big cities, it’s sometimes very difficult to book an appointment because all the doctors are booked in advance. (8:44)

Maria: Yeah, definitely. That's why we always thought that we should not start with the idea and think “Okay, how can technology be used to do the services doctors do?” We should think more about how to make them more efficient or to make the whole system more progressive and more adaptable to new situations and the load of people.” Instead of saying, “Okay, we need to change something.” Because there are a lot of good things. They are quite good, educated doctors here, so why not support them first? Why not get them on board to come into a new chapter, a new era of healthcare? (8:58)

Alexey: So you realized that there is a problem, “This is definitely an area where there's a lot of potential for digitalization.” Then, because you come from the south of Brandenburg, and your parents are still there, you see the state of health care there. We also talked about the state of health care in big cities like Berlin, where it's also not the best. (9:37)

Maria: Yeah. What is very important to understand is that while I studied in China, I also lived for a while in Brazil. So I know other healthcare systems as well. Honestly, they're working pretty much differently and sometimes much more connected. I will always remember when I was invited to a conference in Stockholm (I would say, three and a half, four years ago) and they already came up with these kinds of good connections, data sources. They already thought about how it can be done because the country is wide, so people are definitely in different areas. I mean, there's so much going on around the world that, as a founder, I think one of the most important things is become aware of the things that are going on and not just be stuck in your own in industry, or country, or bubble (like the LinkedIn bubbles, where we always see these great success stories) but to keep yourself open to other perspectives and try to understand what is going on. (10:03)

Maria: You can see me – I'm currently in Jakarta, and before, I was in Singapore. Honestly, I've had moments like, “That was so crazy!” Just a quick example – we always talk about how robots could probably change our life or make our processes more efficient. But I was in Starbucks getting coffee, and one of the robots just came to me and was asking me, “Okay, do you have something I can put in the rubbish?” So it's very much normal already there. The things we are afraid of, are still talking about, are still conceptualizing – they already exist in other places of the world. So bring yourself to the hotspots of your industries and try to understand, “What could be the next level? What is the next step?” Or probably. “What could you learn out of that?” I mean, my little one was with me, so for him, it was quite normal to see these things. But back home, it's still a huge discussion. (10:03)

Alexey: So what I got from this is, while you were in Jakarta, there were already robots helping people, while in the south of Brandenburg, there were no doctors. Right? (12:01)

Maria: [laughs] Kind of. Yeah, you could say that. Yes. [chuckles] At least from my perspective. (12:14)

Getting into the healthcare industry as a lifestyle brand

Alexey: Yeah. [chuckles] Some five years ago, you realized that there is a gap and, together with your co founder, who you already met before, you started learning more about the industry. From my understanding, you didn't know much about this industry. You just saw that there was a problem and that there was potential, but you still needed to get time to learn about the key players – pharmacies, hospitals, the patients, regulations, etc. So how did you approach that? What did you do in these two and a half years? (12:20)

Maria: I would say we started very rough. We reached out to people or brands, or hospitals, or whatever institutions – you want to know more about most of them. Of course, you can start with Google and you could start educating yourself, but we really did it in a cold way. We just called them or left messages like, “Hey, we're currently analyzing the industry.” We got some things out of that. If you really try, you will always meet these innovative or early adopters outside that are really open-minded and let you come in and give you some good advice. (12:55)

Maria: I remember we had several different meetings, in hospitals, we went with the doctors, we tried to understand the process that they are really going through – not just what you see as a patient, but what are they doing in the backend and in their systems. Of course, our jobs in previous companies helped us – we were “business proven” that we are not just someone, but that we really wanted to do something. Also, we used a lot of accelerator programs to understand the markets better and to understand the players better, especially about regulations – because lawyers and so on are a huge investment for a very early idea. So accelerated programs really helped us a lot. Then, we found two or three big players that said, “Yeah, data (or AI, or technology) is definitely one of the future things. Why don’t you create a prototype first?” So we started in the AR area together with two or three brands. (12:55)

Maria: First, we created an AR filter, and just did a quick MVP to collect some data. We came to a fair with these things. It was a lipstick try-on – very rough, but very innovative at that time. We were so proud because that was one of the first try-on on Instagram that was ever published. We just had a lot of people using it on Instagram, but also at the fair. So we collected tons of data. But at that time, we didn't even know what it was worth, nor what we could learn from it. (12:55)

Maria: Then we took the second half of the time to make these things first, understandable, “Okay, what kind of data do we have now? What can we learn from it?” And then we discussed that back with the partners to see, “Okay, what does it say for possible solutions?” At that point, we stopped doing AR for a reason, because this is what we learned out of it. But it was a perfect, very easy entry for us – a gamification entry to collect first data and first users at the beginning. (12:55)

Alexey: Maybe this is a stupid question, but how is a lipstick try-on app connected to healthcare? (15:39)

Maria: Yeah. What you do when you try on lipstick is a sequence – it could be a picture or video of your whole face. So what we got out of that was not really about... We, of course, saw how lipstick fits you in terms of color, but we also saw the issues on the skin. We recognized, for example, that 80% of people didn't know their type of skin at this time. So that was a huge educational moment. We also understood, for example, the health issues people have on their skin that we can recognize. So things were already changing early in this short sequence. We saw, “Okay, it's nice to know which color of lipstick fits you. But honestly, what we see is much more about the status quo of your health from your skin.” (15:49)

Maria: That was the moment we realized, “Okay, there's much more we can do with the data.” Of course, we didn't have the algorithms then to do anything but that was so much that we got out of it. There was so much more to explore and this was definitely a more interesting market than focusing on just lipstick or makeup. But it was a perfect entry point to get connected to people and users. Because I think you can have a very good technology but if people don't have fun using it, or don't see a benefit in using it, why should they do so? When you tell people, “Let's do a health check,” for most people it's like, “Ugh, I don't like it. I don't even like to go to a doctor. I don't want to talk about that.” But every woman… [cross-talk] (15:49)

Alexey: But if you just use your phone to do the health check, that's a different thing. (17:33)

Maria: Yes. Also, from the marketing perspective, it's much easier to get people on board saying, “Hey, do you want to try out your next nice lipstick color?” For example, or, “The next eyebrow trend?” People, and especially women, think, “Oh, that's nice. Before I buy it, I can try it.” But meanwhile, you can do so many more things and educate people about so much. That's why we thought, “Okay, that was the second really big learning out of that.” The first was, “There's much more we can explore. There's much more we can do from the technology perspective.” And the second thing was, “It was a very good entry, because people are very much likely to discuss makeup and these kinds of lifestyle things.” Yeah, it was a very interesting time and that was our starting point. (17:37)

The importance of a plan B and being flexible

Alexey: I'm just curious. For me, I see the connection – you take a picture, or probably a stream of data, like a video, you try the lipstick and, at the same time, you recognize that there are some skin problems on the face. Right? [Maria agrees] How did you know that this is what you needed to do before you did the lipstick app? Because you wanted to do the healthcare thing, yet you created a lipstick app. Then, with the lipstick app, you collected a lot of data and then you started [the healthcare part]. Did you do this on purpose because you knew that while you try on lipstick, you see other areas of the face? (18:27)

Maria: Definitely not. I mean, that was what we learned out of that. As founder, you probably also know that – you have a plan, but most of the time, you have to go to Plan B or Plan C. When we started having discussions with all these players of the market, we were lucky enough to find some that said “Okay, here's a budget for you to do something,” or, “Here are the resources we could provide,” or, “We could do the marketing campaign together, if you do this and that.” So it was a little bit of an opportunity to decide, “Okay, let's give it a try.” I mean, at least there are no investors or no one saying or forcing us to do specifically these things or those things. It was really more about learning about the market, technologies, etc. (19:09)

Maria: Also, AR was, at that time, a very new, very hard thing, so it was a lot of fun getting to know all these developers and AR haps and all these experts to see what is possible already. Imagine, now we are using filters on Instagram and TikTok every single day, but at this time, it was really, really new. For us, it was like an opportunity – we went on a path, and we were lucky that at the end of the path, we came back to the initial idea. This is what I always say to other founders I meet, “Of course, you have a plan, but you cannot always get stuck on a plan. You have to also be kind of flexible.” Because who knows if plan A is going to work? Yeah – follow the path. (19:09)

Alexey: For you, it was an opportunity to experiment with AI technologies – VR (virtual reality/augmented reality) and with these sorts of things. You could experiment and you had some sort of budget to do that, so you thought, “Okay, let's just do a lipstick app.” Then with that… Because I immediately see how it can generate attention. Even with these stupid apps – I remember one where you take a picture, so you have a selfie of yourself and then it shows how you would look 30 years from now. Or you take a picture of two people and then it shows what your baby would look like. [chuckles] I mean, it’s kind of stupid, right? (20:42)

Maria: Yeah. All these kinds of things have been coming up over the last few years. But, as mentioned, we started with the lipstick thing – nothing was there. That was so crazy. When we published the thing and had it at the fair, I really remember that most people said, “I’ve never done something like that before.” That was also an amazing drive for us from a mental perspective. People really gave us the feeling that, “This is new, this is hard, this is fun. Let's continue this way.” It was like we came from one point to the next one. There were definitely a lot of things. You could see it – most of these features or apps were not really focused on a business case at the time. But from a technology perspective – and it's the same thing you can see with AI now – there are so many different things going on. (21:32)

Maria: Everybody says “Here’s an algorithm. My algorithm is better.” But it's not just about technology, you also need a use case or a business case at the end of the day, One that makes money and makes sense for the society of our environment. I would say, with technology, always go first – you can explore what is possible, but then you need to find the right case for the company. That's exactly what we have done. We tried different things with AR, with AI – whatever, all these kinds of technologies – and then finally, we came up with a product or a technology that really makes a lot of sense now. Very early in the process, after already founding the company, we were then profitable. That was kind of unusual for startups in that phase. But we took the time before to really explore and understand what we had to do. (21:32)

Alexey: So the lipstick app was making money. (23:11)

Maria: No, but the lipstick app… [cross-talk] (23:14)

Alexey: There was something else, right? (23:16)

Maria: Right. As I said at the beginning, the lipstick was more like an MVP. After that, we understood what to do, and then we established the company. After establishing [the company], with the new idea (or the renewed idea), pretty much after launching the technology, we were able to make the whole thing profitable. (23:19)

What is SQIN and the importance of communication

Alexey: Can you maybe tell us more about… Okay, you did the app, you collected a lot of data, you realized that there's a lot of people that have skin problems without even knowing about it, so you saw that there was an opportunity. Then, after you realized – what happened after that? How did you go from that point, to the point where it's profitable? What actually happened? (23:40)

Maria: After that, we worked on two different areas. The first was, of course, the technology – how to really prove that you see things that are different on your skin now, and how to prove that this might be a disease and that you’re having issues with your health. That was the first area. We sat down together with a lot of doctors. Telemedicine was just invented at this time – it just started. There are three parts. The first was really the AI itself – how to see from a picture that there are diseases. The second one was creating an application or a flow that makes sense, so that the user could benefit from the technology. Because just knowing that you probably have acne doesn't give you anything. You need a real environment, and this is when we came up with our app, SQIN, which is a digital clinic. You can get everything from diagnosis, to consultation, to treatment. We also have pharmacies there, so you get a prescription. (24:08)

Maria: Everything is digital – in one flow. This is really where users benefit. It’s not just giving them information, but also giving them a treatment, and an ecosystem where they can grow themselves. That was part one and two. One very important part, for me specifically, was the ethics and communication of our solution. Because if I tell you from the first moment, “Hey, I think you have skin cancer,” you will close the app and say, “What was that? I don't want to hear that.” It's a very sensitive field, so you have to, of course, not just keep in mind the regulations, (they're very strong, also) but you also have to think about what you are talking about. I feel a lot of responsibility dealing with this information. We put in a lot of effort and onboarded communication experts [to establish] how to communicate that to people via an application. It’s very short – I mean, you just have three or four seconds before people lose their interest in the information, but also not dropping it too hard. (24:08)

Maria: So this is a balance you have to find – how to make good use of communication. Then, of course, there’s also the ethical part. If we're talking about healthcare, it's crystal clear that you have to create a solution that fits everyone. This means that no matter where you are, what time, which color of skin, or ethnic group, or country of origin, (like, you want to name it). Also, there are people who may not be able to see or to hear or to whatever – there are so many different kinds of people – and healthcare is there for everyone. I think this is the main challenge: creating a solution that is inclusive, and an AI that is capable of dealing with all the types of people around the world. That was also a very strong concept on the part of our business – how to achieve that. Or, at least, once you know your limitations, how to create something that will still benefit people or so that people still get a response. That was a huge, huge concept for us. (24:08)

Alexey: When you start a company, you usually need to think about a niche, right? Yet, with this ethical problem, you kind of want us to be inclusive and solve it for everyone. How did you solve this dilemma? (27:34)

Maria: It is a dilemma, definitely. That was one of the toughest discussions with investors, of course, but we made it in the following way: we focused on one market at first (you could say, one country of origin for the algorithm). (27:45)

Alexey: Germany? (28:00)

Maria: I would say European SQIN. I mean, it's a little broader. It's not just one market, but more like… European. Then, we decided to integrate a kind of plan B, so if there was something else detected, the algorithm has to say “Okay, here are my limitations,” or, “I need further information. So you can do other things – other experiences. We just thought about fallbacks. I think that's the most important thing. Not just saying, “Okay, you are out – you cannot use the app,” but you can find other ways or you can recommend other things. Of course, we had the idea of being inclusive, but with the core technology, we definitely had to focus on a specific market. As you probably know, if you want to create a good AI, you need the data to train as well. It was nearly impossible at that time to have all the data for all the different ethnic groups, for example. I mean, there was no money, no resources – nothing – so we had to [have a] focus, of course. But this doesn't mean that you cannot find solutions for all the other possibilities. (28:01)

Going from lipstick to skin health analysis

Alexey: I’m wondering, was it even possible to get the data from the lipstick app? Because people who tried to lipstick on themselves probably didn't know you would be using this data for other reasons. Right? I guess for your case, you needed to start collecting the data from scratch for this project. Right? (29:18)

Maria: Yeah, definitely. And we did. The only thing that was very helpful was – with the lipstick app, of course, we created a community. You can introduce different things to communities. Therefore, of course, we could have started from zero – we could not use what we have done, but we could use the I would say the reach, or the community, we created to then get started pretty easily (or at least not from zero). (29:43)

The importance of community and broadening your audience

Alexey: Yeah, that's… I keep hearing about the importance of community. Sometimes it's clear why. Here, it's a super good illustration of why it's important. These two apps are somewhat connected, but the community is the same, so people want to help you. It's the same users (some of them) – there’s an intersection. (30:13)

Maria: Yeah, that's why I said that sometimes it's also important to go on paths that you don't think about in the first moment. Of course, if you have a health application, you don't have to go to the doctor every single day, and your skin is not changing every single day, and your skin diseases are not there every single day, or you don’t have upcoming new ones every single day, but – especially women (not just women, but especially women) are dealing with makeup, skincare, and haircare every single day. Still, they are doing something every single day. That was exactly what we thought with the community. This is the border between both things we have done. (30:44)

Maria: Your skin health is not just related to diseases, it's also about how you treat your skin. Why not combine a lifestyle issue that people are really doing on a daily basis with a health checkup? That is what you see now in our application. You have much more things to do than just talking to a doctor. We believe that you have to interact with your community on a daily basis. It's not just specifically in one doctor's case, what you could do. So community is definitely important and we are working quite a lot with our community. We develop features with them, we ask them for feedback, we try to see (through their behavior) what they like and what they don't like. Of course, you can improve the whole company and the whole concept of your application moves over time. Just because you have good technology, you cannot stop developing. You have to think about tomorrow and the days after already. It's very impressive what you can learn out of your users and your communities. (30:44)

Alexey: Is it only for women or for both genders, or for many genders? (32:34)

Maria: It's for both genders. For women (for me) it's sometimes easier to give an example [chuckles] because I'm doing it in the same way. For men, it was very interesting. Very soon we had more male users than female because, I think, the point is that they hate going to doctors – most of them. They don't want to know other people seeing them going there, they want to do it more privately, so applications like ours are very much for them. You would not imagine – men really care about their hair, the beard and, also, they don't want to age and get all these wrinkles and stuff. It’s a very male dominant topic. It's the same thing here – you can achieve both target groups, but you have to think about the content, which, again, comes from the community. So just try to understand what they are interested in. (32:40)

Alexey: One of the reasons I asked about that is because I imagine that the lipstick app – the community you built around that was woman-dominant, because men typically don't try lipstick on themselves (most of them). But yet, the new community (the new users) are both genders, right? [Maria agrees] So you somehow needed to acquire more male users. (33:35)

Maria: Yeah. I mean, healthcare is a topic for everyone, so everyone is here. And lipstick – let's say makeup in general – was more for a specific type of group. It helped to have the early adopters and the first users going with us, but very soon, this group also definitely understood, “Okay, now there's a benefit for my partner, my brother, and my dad as well.” So it was more like a rolling effect here – like a snowball. One came to the other and soon, we had more male users than female when we launched the healthcare part. (34:01)

Alexey: Also, to your point of men not liking going to doctors – I, myself, sometimes go to a dermatologist. In Berlin, it's not really possible to find a dermatologist that is covered by public insurance. You have to pay. [Maria agrees] And not only do you have to pay, but you also have to wait for the appointment – three months or four. So it's not just [that you don’t like it], it's difficult to go there. Then you wait for four months… Okay, in four months, your skin will probably change. (34:42)

Alexey: For example, I wanted to go to a dermatologist – in May, I booked an appointment for the end of August. Then there’s the sun, all this stuff, and the problem I had before no longer existed. So I go there and they say, “Okay, you have spots on your face.” “Okay, thanks. I waited for that for four months. Thanks.” [chuckles] And they’re like, “Okay, give me 100 euros now.” [chuckles] With the app, I imagine that you can just not wait for four months – that's already an advantage. You don't need to go anywhere, you don't need to pay 100 euros (hopefully [chuckles]). I can only see benefits. Right? (34:42)

Maria: What you mentioned is the core benefit already, but it's a little bit more than that as well. As mentioned, you can get the prescription directly – you have the online pharmacies. Also, if you need medication, it's directly coming to your home, if you like it to. Of course, you don't have to [have it delivered], but if you'd like to. The second thing is – very often doctors say, “Okay, here's the medication. It would be very nice if you come back in two months so we can see if it's working or not.” In the application, both the doctor and patient have the chance to see the development of the skin. So you don't have to go there [again], you don't have to wait for your next appointment. If there is a huge thing going on, you can directly ping the doctor again. So the whole process is improved. It's not just a moment [of your life] – we can cover the whole story. Also, if there was something heavy going on, if the algorithm or the doctor sees that, of course, we will say “Let's go to the doctor. Let's see him in person.” (35:57)

Maria: Sometimes it's necessary, and that's fine. But if a doctor is able to put some of his patients into an online solution, he has more space in the office to see the people who really need him. Especially for dermatologists – more than 80% of patients are… I don't know the English word for it, but in German, it's called, “I see you and know within 10 seconds what you have.” But they have to spend some time on the people, of course, which is a good thing from the social perspective side. But from an efficiency perspective, that could have been much faster. Digital solutions – not just our app, but most of the telemedicine things – that's a huge, huge thing that saves time, so the doctor can treat more people. Therefore, we can really change how long you have to wait and how the whole process is done. (35:57)

Alexey: If it's less than four months, it's already helping. [chuckles] (37:56)

Maria: It's more like 24 hours. (38:01)

The importance of feedback and communicating benefits

Alexey: There is a comment from Gregoire. The comment is, “I tried the app yesterday and it didn't work for me. I find the idea cool.” I guess what… What I'm wondering is – is there any way to get in touch with you and give this feedback directly? Because from the chat, it's probably not easy to describe what exactly did not work and what worked? Is it okay to contact you on LinkedIn? (38:05)

Maria: Yeah, of course. On LinkedIn, that's always fine. You can also use our website, where we have the support. (38:35)

Alexey: That’s even better, right? (38:41)

Maria: Yeah, you can also write them so they get the feedback and take it seriously, and try to, of course, make it better. As I always say – it's technology, there can always be bugs and something can happen. But in general, from what I know, everything should work. I'm very happy to get information or feedback when things are going wrong so we can improve and get better. (38:42)

Alexey: Yeah. Going back to communication. You mentioned that you needed to find people who can communicate – experts in communication. If I open an app, take a selfie of myself and it says, “You have acne.” I feel like, “Okay. I knew that already.” So how do you do this? (39:07)

Maria: First of all, we analyze the so-called archetype principle. This means that different groups of people communicate differently. Therefore, you also have to give me information in a different way, and then I have to give the information to you in order to give you a call to action. That was the first thing. Without knowing a person, how can you measure very easily how to communicate with them? That was the first part. The second one is then, of course, giving you some benefit. But it cannot be more than one or two sentences. So I probably have to not just say, “This is acne,” but I have to tell you, “Oh, here's a cream that perfectly helps you with dealing with your acne.” So it's the same information… [cross-talk] (39:30)

Alexey: For my specific type of skin, right? For different types of skin, you need different treatments. (40:11)

Maria: Yes, definitely. And not just the type of skin. There are also other parameters like hydration, for example, wrinkles, pores, all these kinds of things. We started doing a kind of gamification element to give you the information and some education to make you understand the information. Because honestly, I have dry skin, you have oily skin, for example – what does this mean? This doesn't change my life. Right? If I don't know what it means, I will not change anything. So I need to tell you, “Okay, you have dry skin. For you, it is very important to act like this, this, this – or do this, this, and that.” That was the first part. Gamification, education, and, in the end, benefits. It's all about benefits. People perform actions because they want to benefit from it. So you have to be crystal clear about what you are offering and how they will come to the benefit from the very first moment. For sure, right? You spend time, you give data, you sometimes pay money – of course, you want to know why. (40:18)

The current state and growth of SQIN

Alexey: Yeah, exactly. How large is your company now? (41:20)

Maria: What? (41:26)

Alexey: How large is your company? How many people work there? (41:27)

Maria: Around 20 people now. (41:32)

Alexey: 20 people? [Maria agrees] How did you…? I imagine that two and a half years ago, it was just you and your co-founder, right? How did it start from there till today? (41:33)

Maria: Yeah. We went on with financial rounds. With every financial round, we could grow the company. We also do freelancing in specific areas – project-wise, of course. I would say there was very sustainable growth over the last few years. So it was not like in one day we went from 2 to 10 people or anything like that. It was more like, “Okay, let's see when we need new resources. What is important now?” For example, we just closed our last financial round for now – it's very specific for tech, because we have good vision and very important things to do on the technical side, so we started to grow the technical team. We are not one of these companies that say, “We really quickly need a lot of people.” We want to grow it sustainably and we want to see how we can develop our resources as well. (41:47)

Alexey: Who are you looking for? What kind of profiles do you need? (42:45)

Maria: Currently, AI developers, but also backend. Full stack. That's definitely the most important thing. I will say those are the main parts. Full stack and AI – so, data scientists and data analysts. (42:51)

Alexey: There is a comment from Benjamin, “I would love to be a part of that. I'm a data scientist.” Do you hire data scientists? (43:07)

Maria: You can definitely send [your CV]. Also, on the website, you will find info@SQIN.co. You can just send your CV – I'm happy to review it. (43:14)

Alexey: The way you spell “skin” is not the usual way, right? (43:27)

Maria: Yes, that’s true. It's “S-Q-I-N”. [chuckles] You can also drop it to me on LinkedIn if you cannot make it work. That's also fine. Every message is reviewed there. (43:30)

Convincing investors and the importance of proving profitability

Alexey: There's a question that’s also related to my question about the size of your company, “How did you convince the investors to fund your project in digital health? What were the main challenges?” (43:44)

Maria: The main challenge, at first, was from the technology side. So [the question was] “Are you really able to do that?” Because my co-founder and I are non-technical, so [the investors] were kind of afraid. But that was easy to handle. We onboarded a great CTO, we did the technology, everyone could test it, so it was approved. I mean, it was not that easy, but at the end of the day, these were the milestones. The second thing was that what I already mentioned – people don't really believe that healthcare solutions can be sustainable from a business perspective, so that they can earn money. We understood that we can also use AI in B2B projects. That was a changing point. We made clear that we are able to earn money with what we do and then it was a much easier discussion. (44:00)

Alexey: For your latest round, you were already profitable, so it was easier to convince investors that they should give you money. (44:56)

Maria: Honestly, we had to. Because after all the crises we had in the world, investors also changed. It was not enough for them to just see good visions and good papers and good slides, they also want to see that you are able to run a business, that you can earn money. Over the last months and years, that became very important for them. I think nowadays, that's one of the main things you have to do as a company or as a founder – you must really prove, “Okay, we have the possibility to make money and not just a good idea. We don't need 100 million to get the first money. We also have good business cases already here.” But honestly, [cross-talk] that's a tough way. I mean, you need to find first customers who are willing to pay money, even if you're probably not ready with everything. But it's an operational problem you can definitely solve. (45:04)

Alexey: How do you earn money now? Is it by affiliation with something or people need to pay or recommend? (46:00)

Maria: We integrate our AI to different partners. We do the health checks on different points of sale. First of all, of course, in our own application, SQIN, where it’s a digital clinic – but we also have other applications and other points of sale, where people are using our technology. So it's more like, I would say, a software as a service model. This is definitely where you have better use cases. (46:08)

Alexey: So if I detect some skin problems, and then the app recommends a specific treatment (a specific cream or something) and I buy it through the app, then you get a cut. Right? (46:37)

Maria: Yeah, also. (46:49)

Alexey: Right now you have enough money to… [cross-talk] Sorry, go ahead. (46:53)

Maria: I just want to say that, of course, healthcare is more regulated, so you have to make the difference between a lifestyle product – like skincare and skin health – but I mean, for now, that is pretty much too much. The only thing I just want to let people know is that, of course, it depends on the market, the regulation, and the software you created, but make sure that you can show that your technology has the potential to earn money. (46:57)

Alexey: This is what my dermatologist recommended to me. I'm not sure what it is exactly. [chuckles] It’s like a spray. [Maria chuckles] I think they also get a cut because, when I go to the office, the products are on a stand. So I am pretty sure that there are some deals. They also give free samples. (47:25)

Maria: Yeah, definitely. They also have to think about how to earn money, right? It's also a business. (47:48)

Maria’s role at SQIN

Alexey: Yeah, exactly. Who was your first hire? (47:54)

Maria: The CTO – the technical lead. But it was not specifically AI – it was really more about the full technology thing. I'm the CPO in the company, so I needed someone who's coding all my ideas and… [cross-talk] (47:59)

Alexey: The product officer, right? (48:14)

Maria: Yes. (48:16)

Alexey: And then your co-founder is the CEO, I assume. (48:18)

Maria: Yeah. I mean, we share the positions a little bit. But over the years, it became that I'm more the product one with the team and he's more like on the CEO level. (48:20)

Balancing a newborn child and a new company

Alexey: I know that we only have three minutes, and the question I have might take more time. You have at least one kid, right? How did you even manage, even with one kid, especially when the kid was growing up, to do anything, let alone start a successful company? [chuckles] (48:34)

Maria: Yes. That was a challenge. Definitely. I mean, COVID was also there. So he was at home with me. But I have a very supportive surrounding. So, honestly, I take him to the company if needed. I take him to business meetings if needed. He's there and he's part of it. He was there from the beginning. I think it's the new generation and a new style of work we have. Of course, you have to be concentrated. I'm not saying I can do everything at the same time, but you need to be kind of flexible sometimes. Also, what works really well for me is to structure my day. There are hours I really just spend with him and there are hours when I definitely just work. It doesn't mean I'm working from eight to four – it's more flexible in my case. Because I have to pick him up from the kindergarten – there is no other way. Right? (48:53)

Maria: So I'm doing a flexible working model. But it works out pretty nicely. All our investors have known him from the beginning. Like I said, if we have an investor reporting meeting and I have to take him with me, he's on the side doing his things. He knows the procedure from the beginning. He's always telling me “Mommy, it's our company, right?” So he feels like he’s part of it. I think if you are relaxed, he or she is relaxed – you can handle it. But it's definitely a balance you have to find, and you need people around you to take care sometimes. I think the hardest part is to not be upset always – not feeling that you cannot reach all for the company, you cannot reach all for him. I think if you integrate things as both are part of me, that's the most important lesson I took. (48:53)

Alexey: I have a son. He's seven years old. Now I can kind of negotiate with him, “Okay. Now, go draw something. I’ll have a one hour podcast interview and then we will play.” But when he was like four years old, or three, I couldn't really do this because he demanded attention now – not later. I guess with age, it becomes easier. (50:42)

Maria: As I mentioned, there's no right or wrong. It's more like an integrative journey that you spend together. I mean, being a founder is a decision, running your own business is a life decision – it's not just a job. So everyone is affected. That can be tough sometimes, but it also has good sides – very good sides. For example, I remember last time we talked about kindergarten-having issues with a new place and stuff and so on. (51:07)

Maria: My little one just said, “Oh, mommy, we can open a business and sell and buy products for them, so they can earn more money to renew the classroom.” What you get out of it is that he just got an entrepreneurial spirit from the beginning. I mean, it's not a good thing for every child. I know that. But what you teach them and show them as what their mindset is getting through. Sometimes, just don't be afraid and protect them too much. They can handle a lot of things and they're very interested, so keep them on the journey. That worked pretty well, for me at least. (51:07)

Alexey: So now he'll go to school soon and start selling wooden sticks or something. [chuckles] (52:12)

Maria: Yeah. I hope so, at least. (52:18)

Alexey: Now you need to go, right? [Maria agrees] Thanks a lot for joining us, for sharing the story. I'm not keeping you any longer. So, enjoy the weekend. Bye, everyone. (52:18)

Maria: Yes! See you next time! (52:27)

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