In this episode, we will answer the following questions:

01:22 how anemia brought tech people together into Sanguina

03:38 AnemoCheck app that estimates hemoglobin level

05:57 the age, symptoms, and consequences of anemia

10:08 how to distribute uncommon healthcare apps

14:50 the first version of the startup (AnemoCheck home product)

17:16 getting patients' feedback

20:23 process of FDA approval

26:22 ML techniques for processing patients data and plans on EHR/EMR integrations

31:00 worldwide market discovery studies to launch the app

33:45 Rapid Fire Round (3 questions)

 

Links:

Erika’s LinkedIn: https://www.linkedin.com/in/erika-tyburski-292555b1/

Sanguina LinkedIn: https://www.linkedin.com/company/sanguina/

Sanguina Facebook: https://www.facebook.com/SanguinaINC/

Sanguina Instagram: https://www.instagram.com/sanguina_inc/

Sanguina Twitter: https://twitter.com/sanguina_inc/

 

Listen to the episode on iTunes, SoundCloud, Spotify, YouTube, Google Podcasts and let us know what you think on the topic.

The mission of our podcast is to show the real-life challenges of implementing technology in healthcare. The podcast is sponsored by Demigos, a company that develops IT solutions for healthcare startups and companies.

Ivan Dunskiy: I am joined today by an honored guest Erika Tyburski. Erika is the founder and CEO of wellness and diagnostics startup Sanguina which helps to address the anemia disease. Erika is a mother, a wife, a baseball fan, CEO, and co-founder who has had anemia since childhood. Throughout her life, she has been frustrated by the lack of simple anemia testing and management solution. And that's how Sanguina was created. Erika, thanks for joining. How are you today? 

Erika Tyburski: It's my pleasure. I am doing wonderfully. How are you? 

[01:22] how anemia brought tech people together into Sanguina

Ivan Dunskiy: Good. Erika, could you please give a brief background of who you are and what is the story behind Sanguina.

Erika Tyburski: Sure. As you said, it's come for motivation with my own struggles with anemia. So I grew up down south in Miami, Florida in the United States, and I remember going through the stages of life and actually passing out during grade school and middle school. For an elementary school child that is quite horrific because you get all this attention that you don't want and you get to go to the emergency room, in an ambulance, and it's just a huge pain.

And I remember the result always being, you have iron deficiency, you have this anemia, and so we need to get a better plan for you. So strangely enough, I was jealous of diabetics that could screen themselves whenever they wanted to in their homes, even though it was a little finger prick test.

So, having a few members with diabetes, I got to see that from a very young age. And just wanted something that could be in place for anemia. That said, I've always been interested in science and technology, and healthcare. Even from a young age, I got into a math and science high school, which then led me to get into Georgia Tech here in Atlanta for biomedical engineering.

So I did my undergrad in biomed and have been very interested in medical devices, health management, and wellness ever since. And Sanguina is a university spin-out. So we've met our original co-founders all were connected with the Georgia Institute of technology ecosystem including clinicians, doctors, engineers.

And so we're a bunch of nerds to start really. And we spun out, became a company shortly after and that was pretty much the start. So we started as an academic spin-out and our first platforms are indeed around anemia management.

[03:38] AnemoCheck app that estimates hemoglobin level

Ivan Dunskiy: It's a very inspiring story, and there's great when founders solve their own problems and issues. And when you can collaborate with the people who share that idea. Yeah, that's very valuable. Could you please tell us more about your products and how exactly you help people with the disease?

Erika Tyburski: Sure. And just to follow up on that, although it's been a very personal story for me, anemia.

And for everyone listening, it's characterized by low hemoglobin levels. And in many cases, it's due to nutritional deficiency. In the US and other developed areas, iron deficiency, B12, and folate deficiency, anemia is very common, but it can also be associated with other acute and chronic illnesses.

So going through chemotherapy for cancer, going through any sort of chronic illness, you can also be anemic. And there are 2 billion people that suffer from anemia. It's not just me. In fact, some of my other co-founders also have their own stories about anemia. So just something to point out.

Ivan Dunskiy: All of them suffer from anemia?

Erika Tyburski: We all have a story if you will, there's always someone who knows somebody that has anemia. In one of my co-founders' cases, he actually has his own version of anemia, totally different from mine.

But again, it can coexist with many things. Now, as far as the management right now, what you have to do is go to a doctor's office and have a venous blood draw. So, there's a tech and they have to have the skills and the operation to get venous blood drawn out of your arm. And so there was really nothing that people could do at home on the go for themselves, for management.

So, we looked to fill that gap and we've come up with a few technologies. It's called the Anemia Check platform. And essentially there are a couple of different things that work in the management and tracking of anemia. So our first product is called AnemoCheck Home. It is a smartphone application. It actually estimates your hemoglobin level by looking at the paleness of your nail beds.

It's very cool. It is free and available on iOS and Android right now in the United States. So please, try it out. Let me know what you think. We also have a second product that we're aiming for FDA clearance on as a medical tool, which is very similar to a diabetic test in which a small amount of blood for a fingerstick would mix with a prefilled bile solution and the color would correlate to your hemoglobin level.

And so those products can work together or apart. But essentially we're providing different options for people with anemia, for management and tracking. 

[05:57] the age, symptoms and consequences of anemia

Ivan Dunskiy: Yeah. Let's maybe step back, and could you please tell us what causes this disease and what are the consequences for people who suffer from the disease? Like what's happening really.

Erika Tyburski: Sure. So with anemia, essentially you have low hemoglobin and hemoglobin is actually the part of your blood that that makes it red. It holds iron and it holds something called heme. It's responsible for the oxygen and carbon dioxide exchange in your blood.

So it's very important for any bodily function and any cellular activity. When you have anemia, you feel very tired. And you may get headaches more often, and fatigue. You may be short of breath as well. And it is at least with our company's perspective because it affects so many people in so many different ways.

It can really be treated as a vital sign. Because there's not just one reason why you have it or you don't, but it is generally something that makes you feel bad. And if it's severe enough that can progress to very life-threatening situations. So if you have severe anemia and very low levels of hemoglobin, it can actually cause cardiovascular collapse, which is unfortunately not uncommon in low resource settings worldwide.

Ivan Dunskiy: And what causes the disease?

Erika Tyburski: It's really a marker of many different potential things. So, in my case, it's less nutritional absorption. So essentially as iron and B12 and folate aren't absorbed as well as they should in my body. It doesn't allow for the hemoglobin level to remain sustained and it begins to drop.

So essentially you need iron in order for the hemoglobin level that the hemoglobin to actually bind to the cell in order to deliver oxygen and carbon dioxide. So without getting too technical. 

Ivan Dunskiy: I just wondering if it appears during life, or in the majority of cases that happens in the childhood and early years.

Erika Tyburski: Oh, sure. It's not necessarily age-dependent. In my case, I think you can have issues with absorption from a very young age and through puberty, it can become a little bit more burdensome. I know that young kids are more prone to it as they're changing from having breast milk and more liquid foods to converting to solid.

At some point, their body really needs to start having that solid food as a source of some of these nutrients. So they are at risk if that transition isn't fast enough for depletion. And then it is also much more common among the elderly. So yes, all of the elderly in the United States and worldwide are at a higher risk for anemia.

Ivan Dunskiy: So it's a kind of pretty similar to diabetics. It happens later in life, right?

Erika Tyburski: It can really happen whenever, but I do know that being older, you are at a higher risk group. So it's not totally tied with diabetes or any other chronic disease. Again, it's almost like having high blood pressure or low blood pressure.

There are many reasons why that might happen. But yes, as you get older, those risks increase sometimes. 

Ivan Dunskiy: And as you researched the disease, do you see that the trend is going up and in terms of how many patients are suffering from the disease? Isn't the number of patients growing or not?

Erika Tyburski: Yes. So, unfortunately, in the pandemic state we've been in, there's been a lot of focus on respiratory conditions and the actual virus conditions and not just with anemia or any of the diseases associated with it. I think there's been a lot of focus, shifted away from other chronic diseases that were being managed prior to the pandemic.

Which have now been managed to less, just as a result of not going physically into a doctor's office or into the hospital or clinic you'd normally go into if it wasn't COVID. So, with other chronic diseases, maybe diabetes is one or chronic kidney disease we've certainly seen some of those chronic illnesses become more complicated over time because they haven't had the attention they needed during the pandemic.

 So unfortunately we are seeing an increase, and I know that the healthcare systems worldwide are trying to catch up with that. 

[10:08] how to distribute uncommon healthcare apps

Ivan Dunskiy: Got it. Could you please tell us how your users become familiar with your products and how they really start using your products?

Erika Tyburski: Sure. So, as I mentioned earlier, with our app, we are available on both Google Play and Apple Store. 

Ivan Dunskiy: Is it like the usual way how users find you? Just googling? 

Erika Tyburski: We have a fair bit of users that find us like that. We also have a website, so it's www.sanguina.com.

And we do a lot of social media interaction, as well as finding people digitally. You know, we launched this product back in December of last year. So we've only been on live if you will, for five months or so, but it was in the middle of a pandemic. So really we've done everything digitally to reach out and engage with our users.

Ivan Dunskiy: And do you do any distribution through healthcare providers or insurers? 

Erika Tyburski: Not yet. The app product is positioned as a health and wellness tool. It's designed to help you track and monitor, it's not intended to replace a doctor's visit. It's almost like a support tool that you can use with your doctor.

The user has everything in their own hands. So if a user wants to share any information or data with the healthcare provider, they are able to but we're not linked to any healthcare provider networks right now with that product. As for the product that we hope to get FDA clearance on, there are certainly opportunities to be working directly with physicians and their satellite clinics, and point of care settings, where they might want some testing onsite. So again, because anemia is so widespread, there are several different use models and who could use it. 

Ivan Dunskiy: And the current product is mostly used for diagnostics, right? So it helps the patient to understand what is current status of him and then to do some action. That's the main case, right?

Erika Tyburski: The app is being used as a health and wellness tool. It's another piece of information in your health journey. So there are many things that people track now, steps, blood pressure, pulse, sleep even.

This is just another thing you can add in, and especially for people with nutritional deficiency, or anemia, it's well-established that you should have a certain amount of nutrition, and daily values for certain vitamins. The vast majority of people, actually know that they already have some sort of risk factor for anemia.

So for them, it just helps to have some additional information. I need much at home. The one that we're aiming for FDA clearance on, would be more of a diagnostic test that could be used for hemoglobin level determination to help inform decision making.

Ivan Dunskiy: And what are the next steps for the patient after he got the numbers and sees the data? Like to take some medication or what are the possible outcomes?

Erika Tyburski: It depends. So with any home-based products, we're going to recommend you consult with your healthcare provider, whoever that may be, a physician, someone who's your caretaker.

Ivan Dunskiy: You see some threshold was reached. And you suggest using to go to see the specialist.

Erika Tyburski: Yes, there should always be follow-up, especially though there's something alarming that is seen. And again, that'll change based on the person. So for some users, they may have a normal baseline at a certain level and say, if I have a chronic condition, my baseline might be lower, but that might be okay. My doctors and I might talk about it and we might understand that I live lower than what a healthy person is, but when I get even lower than that, then I've got problems. So, even in some cases, you can get too high.

So it's something that you really have to follow up with your physician or caretaker on because there could be so many reasons why you are going up or down. But in general, most of the people that find us are like me, they know why they have this problem. And usually, they know what treatment they're on.

Perhaps they're already on a regimen of some kind, and then they can bring this information to their doctor and say: "Look, maybe I need to go up or down but let's assess together again." It's especially in a pandemic world. It's just nice to have a little bit more remote access to information so that both patients and doctors can make decisions together.

Ivan Dunskiy: Yeah, it also can help you to do some predictive actions like to act proactively rather than reactively?

Erika Tyburski: Yes, very much so.

[14:50] the first version of the startup (AnemoCheck home product)

Ivan Dunskiy: How did you develop the first version of the product? Because that's an essential part of every startup journey to kick off the project and have that first version that helps you to get traction? What was your story? 

Erika Tyburski: Sure. We have a unique story. Because I, myself had this motivation to be working on it. I got paired with a professor at Georgia Tech (Georgia Institute of Technology). His name is Wilbur Lam. He runs a bio-engineering lab, but he is also a clinical hematologist-oncologist and on top of that works with pediatric patients. I was in a very lucky position to have access to clinical populations in very early testing and development, it's a very fortunate position that I was in. That said I started working on this as a senior design project.

So after being paired with Wilbur, the prompt was to create a test for low resource settings for people that have anemia. As soon as I saw anemia, I said: "Okay, I have to do this project." And I got paired with him. I started actually working on our AnemoCheck home product. So the chemical and blood test first, in 2017, we actually got FDA clearance for it, for clinical setting use. Which I know I haven't mentioned too much on this call, but interestingly enough, on that journey, I met a guy named Robert Menino who was doing his Ph.D. also in Wilbur Lam's lab. And he has his own story of his own struggles with anemia, very similar passion and drives to mine. And it was actually his Ph.D. project behind the mobile app that's currently available on the market.

And so we actually developed technologies in parallel, that would attack anemia from a different angle. It's very interesting because I come from a background of nutritional deficiency and I'm really in need of a general wellness tool. And his background is anemia from a chronic condition.

So it's very interesting cause we actually created products for each other more so than for ourselves. Because the app is something I can use a lot more than something that is more medical diagnostic in the context of chronic disease. But that said, we decided to join forces when he finished his Ph.D.

That was back in 2018, late in the year. And since then, we've been able to create paths for development and marketing for both of our products together. So it was a happy marriage of our team if you will.

[17:16] getting patients' feedback

Ivan Dunskiy: Cool. And how did you ship the product to patients? How do you get the feedback? What was the process of doing that?

Erika Tyburski: Sure. We've had access to clinical populations. What that means is that with the collaborating clinical institutions we were actually able to start, what's called a study, a clinical study, several actually with both of those technologies in order to test them on real patients that had different degrees of anemia for different reasons.

So what that means is creating a study protocol. Getting it approved by an institutional review board and then going into the clinic and actually having people use the different technologies. So we were able to do that even still in the context of the academic setting, which is very early.

 There are many stories wherein you have to fully spin out and do it on your own. And because of our situation with Georgia Tech and its relationship with Emory University and its hospitals and clinics which is all made possible because of our, honestly, just fortunate luck to be paired with Wilbur who has this clinical service piece to what he does.

He was able to connect dots a lot earlier for us. We were in the clinic actually testing on patients during development. It was very good. 

Ivan Dunskiy: How did the product change after you got the feedback from patients? Was it similar to your original vision or changed during that process?

Erika Tyburski: In both cases, we received a lot of information on how to make it better. So for the physical products and the apps we did, what's called a usability part of our study were in we'd actually ask people, okay, use it yourself. And we observe them and see where they had difficulty, and what was confusing. And for an app, it was very different for me because I came from more of a physical device development background, but there are many different intuitive things that you can do to make your app more usable. So, truth be told when we first started testing the app looks so different than what's currently available to you guys on the app stores today.

Different colors, schemes, and sizing, where it's intuitive to click. In our case, we're capturing an image of nail beds. So instructing a user on how to do that correctly so that the nail beds are not too close, not too far. And you have the right conditions around that. That proved to be something we learned with respect to the app. 

And then as far as the color-based technology, it requires a fingerstick for a small amount of blood. Performing the fingerstick, although it's been done a hundred times, you still want to tell the user very clearly, this is the tips. This is what you should do. You should wash your hands, you should warm your hands.

Ivan Dunskiy: Do you have a video tutorial?

Erika Tyburski: That's absolutely right. So it spurred us to create instructional videos for both the app and the physical products. So yes, usability testing and feedback completely changed what our products look like.

[20:23] process of FDA approval

Ivan Dunskiy: Cool. Could you please tell us, that you already mentioned the study, so did the first product also require FDA approval?

Erika Tyburski: So historically, right we've had our AnemoCheck, we call it Gen 1, and it was a color-based test with a blood finger prick. We do have FDA clearance on that as a hemoglobin determination test, again for US use in clinical settings. And the AnemoCheck home product that's currently in process, that's the one that essentially uses the same exact core chemical technology as the Gen 1. But we've put it into a user-friendly embodiment with an onboard control in order for someone at home to use it. So those are some of the big requirements you need for a home test. Someone needs to know that the test is working and it needs to be very easy to hold, you minimize the chances of any spilling or error.

And it's the same core technology, but just packaged differently if you will. The app came in between them. So truth be told, when the pandemic hit, we actually flipped around our company strategy. We were initially planning on going for the physical products first and closing the session. But when the pandemic hit all of the clinical sites essentially shut down unless you were testing for COVID.

So, a lot of other chronic diseases just kind of fell by the wayside. And so we realized for the app, we could, we had this opportunity to create something that was remotely accessible in a world of social distancing and not being able to go to hospitals. And so we flipped our idea.

So, we actually had the app in between those and it's currently available now and it's been okay for our company. We were able to make the switch and we luckily had the support of many different sorts of remote access via the patient groups and even support from different clinics and doctors that realized in the pandemic, we would have to do some things remotely.

Ivan Dunskiy: Could you tell us about this process of FDA approval? How difficult it is, maybe what are the stages for you and what challenges you've faced? 

Erika Tyburski: Sure. It is an achievement to get what FDA calls a clearance. If you go the 5 to 10k route, which most devices do essentially it is different for every device.

So that said, I'm not in a position to give regulatory advice on this call. But what I can say is at least in our case you have a predicate device, essentially you're comparing to something that measures the same parameter you are. You do a lot of different studies to show that your device is robust and that it works in different conditions.

And you go head to head in a clinical study usually, to show that your test does equal to or better than your predicate device. And so, that's usually the biggest piece of it, you know, somewhere between 300 and 500 different users or patients that are in this study. And essentially you show FDA that I'm substantially equivalent to this other test that's on the market.

And you go from there. When you talk about the home test, there's also usability that's involved. So they do want to see that you've observed users. You know that the test is reasonably going to work for them. There are many studies that go into it, but those are the big pieces.

Ivan Dunskiy: Does it also require seeing the feedback of the larger population or like 300-500 enough to get the clearance?

Erika Tyburski: Well, I guess it depends. So, when you set up testing, you are testing about that number for a 5-10k, at least in our case that said for other conditions, FDA might want more even allow less to go through.

And that's just the actual physical testing. There's also a risk-benefit analysis that you may do and show FDA that this is the situation that's going on in the field. This is why our test could be useful. And that's where you can really highlight the big populations that you're going for. That said there's a balance between how many people you can literally test. Cause it could be a very expensive study versus getting on the market. So there's a balance.

Ivan Dunskiy: How long did it take? What was the length of this process for you?

Erika Tyburski: Well, it depends. Cause development is a lot of it. 

Ivan Dunskiy: No, I mean approval.

Erika Tyburski: So again, it will depend. In our case we submitted, we got some feedback and after around 90 days we answered more questions and around another 90. So, between six and nine months, there was a bit of back and forth. 

Ivan Dunskiy: Got it. Could you please tell, share your plans on distributing the products? Like, will you do that? Using healthcare providers, and payers, will you do that directly to patients? What is strategy?

Erika Tyburski: Sure. We were starting direct to consumer, and that's evidenced by our first product on market right now. We're going direct to consumers and right now building a population of advocates and users that love our work.

Ivan Dunskiy: This is the best strategy to get more word of mouth. 

Erika Tyburski: Yeah, that is the truth. Especially, in the space, we're in. So we're not really tackling the lab testing arena. Our goal again, if we go back to the mission of people like Rob and myself is really to bring things more accessible in the home setting. So that said, I think there are a lot of techniques and learnings we can take from the consumer goods space to really understand how things reach different people in the home setting or in the word of mouth set if you will. That said, we are planning with our physical products. It'll likely be sent out via subscriptions, but directly to your home. And once we achieve mid-sized volume on any sort of those product strategies, we'll certainly consider help from big distributors.

But to start, we are going to be doing it on our own. 

[26:22] ML techniques for processing patients data and plans on EHR/EMR integrations

Ivan Dunskiy: Got it. Do you already have, or maybe you plan to use machine learning to work with your data? 

Erika Tyburski: That's a great question. I think as of right now, All of our trade secrets and machine learning techniques are trade secrets if you will. But we do intend to use them, especially with app-based technologies.

And I know we've spoken a lot about our anemia platform. There are other platforms that are under wraps right now, but we're working on them for other parameters. And we'll certainly be using machine learning for them with any smartphone application that's capturing images or videos. There are little tricks you can learn as you get more data.

And we are collecting a lot of image data if you will. And we're learning a lot about how people take pictures, what's the usual beyond in the picture. So we are going to be taking that data and making the app better and more effective as best we can with it, which is likely to include machine learning.

Ivan Dunskiy: And actually do you plan to integrate with the existing EHR and EMR systems to pull data from Sanguina to their systems and like tune, reach data, patient data, which physicians see? 

Erika Tyburski: Yeah. See, it's a good idea. And I think a lot of companies have tried to integrate with different medical record systems.

I don't think the resistance will come from the Sanguina side. I think there's a lot of logistics to work out on the medical record side. And from what I understand, there are thousands of different systems out there that different hospital systems use. And I know that many companies have tried to do that. So, at least initially we're not looking to make that a core part of our business model.

 But I'm hoping, you know, in general, outside of my own company, I'm also hoping that there will be some more integrative solutions with medical records and how people can interact with point of care and home tests, how to keep all the information streamlined. I know that's a big project though. 

Ivan Dunskiy: Could you please tell if you plan to provide any tools for physicians so that they can see patient data on this side, or how actually patients show their data to physicians?

Erika Tyburski: Sure. So in our current app, you can actually share all of your information. So it's tracked and it's held right there for you. It's essentially exporting it and it can be emailed to yourself or whoever you authorize. So it is a pretty simple download and export. And from there you know, physician and patient may just talk about it.

The physician may incorporate it into their records. It's really on a case by case and really depends on the physician and patient relationship.

Ivan Dunskiy: So yeah, in this case, not much of importance of integrating it with EMR.

Erika Tyburski: Right. It's again, if we can streamline sharing on our side, it's what we can do right now.

And we definitely aim to, you know, make that accessible for both the patient, but if they choose that they want it to be accessible for the doctor, we're making it possible on our side as much as we can. But yeah, getting other parties to buy in. It's just not something we control.

Ivan Dunskiy: How many users do you have from other countries?

Erika Tyburski: From other countries. So we are only live in the US right now. So that said, we do have a few studies going on and we are looking to launch in a few other countries likely in Southeast Asia or Africa. There's a lot of anemia in those areas. So it is something we're acutely aware of.

We've done so much to understand the US market and how people use it here. We do want to do our good bit of due diligence in other countries before launching, so hoping to have a launch internationally, but not quite yet. 

Ivan Dunskiy: And what about Europe? 

Erika Tyburski: Yep. EU is also on that list. I know we're doing some studies with them and, you know, from a company perspective, we're also looking at potential B2B interactions and contracts we can make.

Ivan Dunskiy: To find distributors who distribute the product, you mean? 

Erika Tyburski: Well, to be honest, they've all come to us. We've got a lot of interest from supplement companies, from different drug companies that have different reasons to worry about anemia and different reasons to target anemia.

And so we're in a lot of discussions right now with countries. But with all sorts of countries to try and understand whether we can make our app available. But again, it is something that we pride ourselves on being backed by science and making sure that we've done our due diligence to make sure the product is going to work for the intended user.

And so we're in the process of doing that diligence for a number of different countries and regions we would launch in potentially with partners to make it simpler. 

[31:00] worldwide market discovery studies to launch the app

Ivan Dunskiy: Is it required to make a study if you want to launch a product in every country? You've just mentioned that you are doing a study for Europe and for Africa. So, does it mean that you need to make study for every geography or how does it happen?

Erika Tyburski: In my experience, it depends on the use case. So again, we've spoken a lot about the US FDA and our understanding of that. Each country has its own regulatory authority and they may or may not have different rules in the US. So, that said, it is part of our process to understand what if any regulatory issues we should be thinking about.

And there are some countries that, you know, won't require any sort of testing. So, it's something that's case by case, and it really depends on what the user wants. If the use case is highly clinical, that's going to have a different context than if it's more of a health and wellness wearable, like a Fitbit or an Apple Watch.

Ivan Dunskiy: Sure. Cool. Yeah, we come into the end of the interview and I have a question for you. What kind of advice can you give to early-stage entrepreneurs who want to build and launch their healthtech products?

Erika Tyburski: Coming from the medical device background, I would have a good understanding of the use case who would pay for it if there is any regulatory involved those tend to be the stumbling blocks when someone has a great idea. So just consider all of them and balance them out so that you create a path to market. And, with any entrepreneurial venture, be adaptable. I mean, we were faced with something unprecedented in this pandemic, and as I went through our business strategy, totally flipped.

And, you know, we were able to read the information, understand our options and then progress forward. Honestly, on a pretty successful path so far. So it's been a silver lining for us that we made that choice. You know, and the other thing is if I were to go back and see myself 10 years ago, I would say just, don't be afraid as much.

You know what you're talking about, you're going to learn every single day from many different angles. And you know, you really will be the master of your own products, the expert of it. So it's okay to put yourself out there to ask questions. And, I don't know. I wouldn't be as afraid.

Ivan Dunskiy: Yeah. And I think that you are a bright example of how you solve your own problems, you experienced the problem and you understood clearly the problem. That's I think very important and also a team of skillful people that you had from the early, early beginning. That's precious. Thank you.

[33:45] Rapid Fire Round

And I would like to end this interview on a more personal level and I have a little exercise called rapid fire round. I will ask you several questions and you give answers, whatever you come up with. Do you have a hobby? What is your hobby? 

Erika Tyburski: I have several, so I like to jazzercise. If you're not familiar, it's a cardiovascular group exercise, really popular in many places of the world.

So I jazzercise, I also like to garden quite a bit. It doesn't mean I'm very good at it, but this year I have a goal to keep an orchid alive.

Ivan Dunskiy: Cool. What is the location that impressed you the most? 

Erika Tyburski: I went snorkeling off the coast of Costa Rica one year and I actually saw wild sea turtles, which I've heard is very rare to see wild sea turtles. So that was very exciting for me. And I love snorkeling and anything aquatic and Marine.

So I would say probably a snorkeling trip and that one was the best.

Ivan Dunskiy: And what is the piece of advice you would give to your 20 years old?

Erika Tyburski: I stole this one from you. I wouldn't be as afraid. I would take more initiative and not be afraid to ask questions and not be afraid to pursue different things. Because again, you on an entrepreneurial journey, you really are the expert of what you're doing and you're going to learn more. You know, the worst thing usually people can say is no. And it's okay with me now.

Ivan Dunskiy: I don't believe that you afraid of anything as you were afraid of in your twenties. 

Erika Tyburski: I've graduated quite a bit. It's been a good, a good time for me, but yeah, coming out of school, I think everyone's a little bit nervous. And what am I going to do? Do I go into industry? And in the US having student debt, it's like, what am I going to do?

And I definitely took a chance in working on this and pursuing this company as opposed to doing normal job. But it's proved good. And I've gotten a lot more confident. 

Ivan Dunskiy: I think that's perfect way to end today's interview. Thank you, Erika, for sharing your story. I think that's very valuable how we showed your path from the early beginning through all the stages. And what are the stages could be and how it could be prepared for each stage. Thank you for your precious advice. Before we finish, what is the best way to get in touch with you if somebody would want? 

Erika Tyburski: Well, I think as I mentioned, we have a digital presence, so we have live Instagram and Facebook pages, our website. 

Ivan Dunskiy: No, I mean personally you.

Erika Tyburski: If you reach out via our channels, it'll come to me so I can connect with you. I'm also on LinkedIn as well. So if you just search for my name, I'm happy to talk to you guys and give advice as I can.

Ivan Dunskiy: Yeah, all the links will be included in the description. Thank you, Erika. Thank you all listeners. And we will get in touch in the next episodes.

Who is behind the HealthTech Beat podcast

We are a team of IT professionals who like sharing technical knowledge with healthcare industry people.

At Demigos, we generate ideas on how to improve product performance, design, and positioning based on our experience building complex health tech solutions.

Check our blog with articles on the related topics, and our cases in healthtech. Also, connect the podcast host and the CEO of Demigos Ivan Dunskiy on Linkedin.