Sid Viswanathan On Building A $1.6 Billion Business By Creating An API-Driven Healthcare Infrastructure

Sid Viswanathan is the cofounder and President of Truepill which provides an API-connected healthcare infrastructure designed to revolutionize the patient experience. The company has raised over $255 million from top tier investors such as Index Ventures, Foundation Capital, Social Capital, and Sound Ventures to name a few. 

In this episode you will learn:

• Fundraising
• Important books for entrepreneurs
• How to get LinkedIn to acquire your startup business
• Sid’s top advice before launching your own startup

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About Sid Viswanathan:

Sid Viswanathan is the Co-Founder and President of Truepill. Alongside Co-Founder Umar Afridi, Sid founded Truepill in 2016 with a mission to transform consumer healthcare. The company shipped its first prescription five years ago and has since expanded its services to include telehealth, diagnostics, and pharmacy, enabling millions to access modern, affordable, and personalized healthcare experiences. Prior to Truepill, Sid founded CardMunch, a business-card scanning app that was acquired by LinkedIn soon after its founding. After its acquisition, Sid joined LinkedIn as Product Manager and saw CardMunch named one of Time Magazine’s Best Apps of 2012. Sid started his career in Johnson & Johnson’s Global Operations Leadership Development program, working in the medical device and pharmaceutical sectors. He graduated from Carnegie Mellon University with a Bachelor’s Degree in Mechanical and Biomedical Engineering..

Connect with Sid Viswanathan:

• Crunchbase
• LinkedIn
• Facebook

Read the Full Transcription of the Interview:

Alejandro: Alrighty. Hello everyone, and welcome to the DealMakers show. I’m very excited about our guest today. Our guest is a serial entrepreneur. He’s done it multiple times. I think that now what he’s doing is pretty remarkable, so we’re going to be learning about it quite a bit. But without further ado, I don’t want to make anyone wait any longer. Let’s welcome our guest today. Sid Viswanathan, welcome to the show.

Sid Viswanathan: Thank you, Alejandro for having me.

Alejandro: So born and raised in India, but you were not there long. You moved quite a bit around the Middle East and then landed in Maryland. Tell us about life growing up.

Sid Viswanathan: That’s right. I grew up in India, and my family moved to the Middle East soon after I was born. My dad was a computer programmer. He worked on data bases his whole life, and started off in languages like COBAL. He spent most of his life working on Oracle SQL. All I remember about growing up when I was younger is, I thought he had actually the most boring job in the world. I actively tried to stay clear of anything computer-science related and go figure somehow. I ended up pursuing a career in software and technology. But I would say my childhood was very normal. I’m a first-generation American. We lived a frugal life, but I had every opportunity that you could ask for growing up, and eventually I left home when I was 17 to go to college in Pittsburgh at Carnegie Mellon University where I studied mechanical engineering.

Alejandro: It’s interesting because in India there is a lot of cultural pressure around becoming a doctor or becoming an engineer. I’m wondering; I’m sure that you made your parents very proud when they saw that you were doing engineering, and, in fact, in one of the best universities in the world for engineering.

Sid Viswanathan: I think growing up with South Asian parents, that’s probably always going to be a pressure regardless of where you grow up, and especially if you don’t know what you’re going to do, then it becomes an easy default to just go do engineering. I don’t think I’d do it any differently. Maybe if I go back, I’d actually study more computer science or computer engineering, something more specific to my field. But by the time I figured out I had studied the wrong thing my dad was not going to pay for another four-year degree. So I was done.

Alejandro: Yeah, no kidding. In your case, right after university, you went into corporate America before going at it as an entrepreneur. At what point did you know that you were going to launch a thing on your own because you didn’t last long in corporate America?

Sid Viswanathan: Yeah, interesting. I actually started my career in healthcare, but it was definitely not a love at first site type of thing. I started off at Johnson & Johnson. I joined a rotational program where they would send you to different business units across the company to learn as a new college graduate. What I realized was that I was never locked-in or engaged with anything that I was doing at J&J. I thought something was actually wrong with me. Maybe I didn’t have the motivation or the energy, but I couldn’t get excited about what I was doing. I kept wondering, “How can I be successful in my career if I can’t find something I’m passionate about?” It felt slow to me. Obviously, it is a very regulated industry. The eye-opening thing for me happened in one of those rotations I had. One of them was in the Bay Area, and I got a chance to spend eight months in the Bay Area, and I got to see a lot of my friends that graduated from Carnegie Mellon and got these exciting high-tech jobs in the San Francisco area. It was my first glimpse into the tech industry. It was noticeably different than what I was doing. Not only was I struggling to try and figure out: what am I passionate about? What do I want to spend the rest of my career on? I had friends that were—this was back in 2007/2008 where they were building jailbroken apps in the App Store before the App Store even existed for the iPhone, which was exciting, and they were building things, and launching things. At the time, I was trying to deal with the role, trying to figure out how to manufacture diabetes monitors. It took me almost eight years to get back into healthcare. I realized that when you combine technology and software, today, I’m more locked in than ever in healthcare, and I hope I can spend the rest of my career in healthcare. But it wasn’t like that when I first got started, and that’s probably the case for many people starting off their career. You have to find your calling and find your passion. Maybe, for me, the secret is that you don’t have to be the best technologist or the best product mind when it comes to healthcare because there’s a lot of low-hanging fruit in the industry to move it forward. I found it extremely challenging and extremely interesting, and it’s a combination of products, strategy, technology, and go to market challenges that you’ll figure out in healthcare. It’s been challenging. I was probably a little naïve entering this space or entering back into this space, but I fell in love with it, and I hope, again, that I can spend the rest of my career in it.

Alejandro: Tell us about that moment where you realized, “I think I’m going to give my notice here. There’s this idea that I have” that ended up being called Cardmunch. Eventually, you went at it all in, and you pursued it.

Sid Viswanathan: I remember, still, to this day, vividly telling my dad; I didn’t tell my mom first. She wouldn’t have understood, so I told my dad first. The first thing he told me was, “Sid, by the time you come and tell me about something, you’ve already made up your mind, so the only thing I can do is say good luck and support you.” That was something that struck me. I do spend a lot of time thinking about things, and when I do put my mind to something, then I tend to give it a go. When I made that decision that I was going to start something. I didn’t have any software skills. That was a dilemma and a challenge at the time, and I had a limited amount of savings. So I had to figure out, “How do I build something, presumably in software and technology? I have no software skills. I have a limited amount of savings. I need to stretch that out for as long as possible.” I actually did something. In retrospect, I’m not sure I’d do it again, but I actually moved to India. I figured my cash could go a lot longer then. I wasn’t going to ask for any loans or anything from my parents at that point because, at that point, I had to prove to them that I could do it. I moved there and spent about nine months there building my first prototype. I hired a software engineering firm out there. I learned a little bit of software skills. Not enough at that point. Then I came back to the Bay Area and decided to show off my prototype. There was much there, but that was during that trip where I met up my eventual co-founder in Cardmunch. He was a college acquaintance of mine, and we eventually became friends more after college. He was building one of those jailbroken apps that I was mentioning earlier. We eventually formed the initial idea for Cardmunch together. It was a very unique story in that we were pitching Manu Kumar, our first investor. We were telling Manu about the idea that I was working on, Boye was telling Manu about the idea he was working on, and Manu actually came to us and he was very direct and said, “I don’t like either of your ideas, but I think if you two work together as a team, you can build an interesting company. Why don’t you solve this problem for us, and I’ll fund it today? He had a stack of business cards that he literally threw in front of us and said, “Go figure out how to solve this.” It was coincidental that I was working on something in contact management. Boye was working on something with the iPhone camera, and eventually we formed the idea for Cardmunch with Manu, which was take a picture of a business card and have it transcribed by humans around the world. As simple as it sounds, that’s how it started. 

Alejandro: With Cardmunch, which I mentioned to you, I was a user, and I loved it. I was disappointed when I could no longer use it. It was very fast. Everything that you guys did there from the founding to funding to exit, that journey was insane and literally in one year.

Sid Viswanathan: Yes. It was about a year to a year-and-a-half. It flew by. It was definitely an intense year, and it was the year that we definitely paid our dues and worked extremely hard. Fortunately, LinkedIn came calling and we sold the business. You could look back and wonder if that was too early before we had enough product/market fit or traction, but it was definitely a lifechanging event for all of us at the table. We were still a very small company. But you’re right. We raised a small amount of money and sold to LinkedIn in 2011.

Alejandro: How much did you raise prior to the acquisition.

Sid Viswanathan: I think we raised $100,000 from Manu. We were in the process of raising a seed round. If I remember correctly, we were trying to raise a million dollars, and I think we closed half of that, maybe $400,000 to $500,000 was in the bank. We sold the business to LinkedIn, even before we completed the seed round at the time, so right around that seed funding, if you will.

Alejandro: How did the acquisition by LinkedIn come about?

Sid Viswanathan: Interestingly, we actually stalked a number of LinkedIn developer meetings. We were trying to get in touch with some folks on the API team because we had trouble accessing these guys or had some bugs trying to connect with the [10:24] infrastructure. We saw that LinkedIn was hosting a meetup. I think it was a Ruby on Rails-related meetup. We just went there. It was at Mountain View, and we were right down the street. We found a couple of engineers who ultimately helped us debug and solve our issue from the API side. A few weeks later, Manu, our investor, got a call from a board member at LinkedIn that he was friends with, who said, “Our team ran into you guys at LinkedIn. We’d love to learn more about what you guys are doing.” So we walked in naively thinking the initial conversations were around how do we get more API access. There was this very special API that we wanted that only a few other companies had access to. From there, over the course of several conversations, they came out and said, “Would you guys be open to an acquisition.” We said, “Yeah, we’re happy to chat about it. We’re also trying to raise a seed round.” That’s how it eventually happened.

Alejandro: I guess looking back, how do you reflect on that? What do you think you would have done if you could go back in time?

Sid Viswanathan: I think we were very fortunate to have someone like Manu guiding us through this process. We knew nothing about startups, fundraising, and acquisitions. The best advice he gave us was, “It’s a rollercoaster. There will be moments where you think things are going to go great, and other moments where you have really low lows, and people aren’t using your product or downloading your app. So all-in-all, I wouldn’t necessarily trade anything in for doing it differently. I learned a lot from it. To a large extent, I’ve taken all of those lessons that I learned during CardMunch, as well as during my almost four years at LinkedIn, and all of that has built up to what went into Truepill and what we’re working on today. It’s hard to go back in time and rewrite the story. Certainly, I wish I had known everything I know today ten years ago. I think I’d get a lot farther and sooner, but that’s life. You don’t know everything when you get started. You have to stumble your way through it.

Alejandro: First company, first exit to a company liked LinkedIn is pretty good stuff. In your case, you did a little bit of the vesting and resting, as they call it. I’m sure there was not a lot of resting because those were crazy growth years for LinkedIn. But in this case, you were a product manager there. Here you go from doing a startup to now being on the tech side for another company, but a little bit bigger. What did you see? What was that experience like at LinkedIn?

Sid Viswanathan: It was my first time in a large tech company. You’re right. We were going through LinkedIn’s hypergrowth years. I think when I joined, it was slightly under 1,000 people. Three years later, it was probably close to 10,000 employees, so there was a huge amount of growth in those three to four years that I was there. Really, as founders, when you get started, you’re doing some version of product management, but you don’t even understand what product management is or the fundamentals of it. For me, coming into LinkedIn and seeing how a larger organization runs product and how it’s a discipline process to how they think about building and prioritizing their products. It was sort of a bootcamp for me. It was the first time I had learned what formal product management looks like in a larger organization. I think I’m much better for that now. That was my formal training in product management, and I took that on for me and will have that with me for the rest of my career, and if you keep building on those over years is as a product person or product leader, you build on those instincts that you formed very early on in 2011. Before that, you think you’re doing product management. It’s a haphazard, chaotic version of product management as a startup founder, and then you learn more structure and discipline, and you take that with you for your next opportunities.

Alejandro: Talking about the next opportunity, Truepill is your baby now that came knocking when you were at LinkedIn. As they say: once an entrepreneur, always an entrepreneur. I’m sure that you had all types of ideas coming to you while you were at LinkedIn. Why did you decide to go with Truepill and what was that process like of bringing it to life?

Sid Viswanathan: I was at LinkedIn for about three-and-a-half years. I probably got the itch three years in; maybe even sooner, and it just came, and it felt like it was the right time to leave and go back to the drawing board. It wasn’t that I was not thinking about startup. You’re in the startup ecosystem, so you’re meeting friends and thinking about startup ideas, not necessarily actively pursuing anything. I just never found the right opportunity or idea. I wouldn’t recommend this in retrospect, but I left LinkedIn without any plan on what the idea was. I just decided I wanted to work in some co-working space and just think through some different ideas with some friends and prototype ideas. But it turned out to be about a year of frustration of banging your head up against the wall trying to find the right problem to pursue, and I built different prototypes. I was working with a really close friend of mine, and we had a lot of fun building a bunch of stuff, but ultimately, it didn’t turn into the right business opportunity. About a year to a year-and-a-half into that journey, I eventually met Umar, who became my co-founder at Truepill. Umar was a pharmacist, someone with a completely different background, completely different work experience, and I had a chance to go deep into the pharmacy space with him. What I noticed that was different working with Umar was that after a month, you’re still asking questions. Two months and three months go by, and you’re still trying to peel back all of the layers of this new industry that I knew nothing about and trying to assess like, “There’s something really interesting here,” without even knowing what might be there, without actually building anything. There was no prototype involved. There was no code being written yet. I was drawn to something about the industry that was, “Wow. There’s a lot of stuff underneath the hood that I think could be done, and we ultimately, together, formed the thesis for building pharmacy infrastructure, and our role model companies were, and still are to this day, companies like a Stripe and Trulioo. We would ask questions like, what would it look like to build a Stripe for pharmacy or a Stripe for healthcare? Who would use that? It was purely a theoretical concept, at the time, until we got our first customer, which we spent the better part of 2016 building toward.

Alejandro: What ended up being the business model of Truepill?

Sid Viswanathan: We started off as a backend pharmacy infrastructure for a variety of reasons. There were a number of direct-to-consumer pharmacy companies in the space. The two founding principles when we got started were pretty simple. 1) We were going to do something in pharmacy, otherwise, we were the wrong founding team. 2) We were not going to do anything direct to consumer. It had to be B2B and platform-focused. So we had to go find our first customer because we didn’t want to be another direct-to-consumer player. At the time, there were probably three or four venture-backed companies doing something direct to consumer and the pharmacy world. We didn’t want to be the fifth one trying to raise money for something similar. So that forced us to go to a different model.

Alejandro: In this case, how did you go, as well, about capitalizing the business?

Sid Viswanathan: We actually bootstrapped the business for about year to a year-and-a-half. I was full-time working on it, but Umar was still nights and weekends working at CVS. We really needed to prove it to ourselves. It takes about nine months to a year before you even have your first pharmacy set up. You’ve got to go through the regulatory board of pharmacy approvals. You need to get insurance contracts set up, and that takes a solid 12 months in California. And we needed to get that launched to see what it could look like and prove it to ourselves that there was something here. There was a model to pursue. That involved setting up the pharmacy and landing our first customer to give us confidence to then think about: what’s next? How do we think about capitalizing the business? For the better part of a year-and-a-half, we were entirely bootstrapped.

Alejandro: How was that feeling about securing that first customer?

Sid Viswanathan: It was good. It was definitely an aha moment for us. It’s still a large customer of ours today. When we spoke with Eddie and Hans over at Nurx, they were really innovative, a birth-control company in San Francisco, and still to this day, one other company and them were the pioneers in this new model for healthcare, this new asynchronous telehealth. It was [18:46] and they became our first two customers. This proved out the model and from there, over the course of two-and-a-half years, there was a proliferation of about 100 different brands that we started working with that needed our pharmacy services. It was the right time, the right place. At the time, it wasn’t obvious that this would be a new model in healthcare that we latched onto and there were only two customers in the market that we saw that were doing it.

Alejandro: How much capital have you guys raised to date?

Sid Viswanathan: We’ve raised $156 million to date over several rounds. I guess that’s a long way from bootstrapping, so we’re no longer bootstrapped, for sure. We’ve raised several rounds of funding today.

Alejandro: How have you seen the expectations and also the process shifting from one financing cycle to another one?

Sid Viswanathan: I think the ambition for the company continues to grow with each successive financing or each stage of the business. I don’t think financing in itself is success or a marker of success, but as we’ve raised at each point, there’s always been an inflection point of the business. Last month, we just crossed 1,000 employees, and we’re continuing to grow extremely fast. We just completed five years of operating, a number of milestones that came together in our fifth year of operating. We crossed ten million prescriptions shipped and over a million lab tests shipped to our patients. It’s that lab test that I’m really proud of because it probably took us two-and-a-half years to get to a million prescriptions, and we achieved that on the lab testing side in under two quarters. A lot of growth has accumulated. A lot of components of our business are growing quickly, and it’s been fueled by many of our customers who scaled really fast and we’ve been trying to keep up with the demands because if they weren’t growing fast, then we wouldn’t exist as a company today.

Alejandro: The other thing that I thought was really interesting is that your Series B, your Series C, and your Series D, you did them very close from one another. Your Series B was in July; your Series D was in October. Do you think that this crazy growth also perhaps was caused by what we were seeing with COVID?

Sid Viswanathan: 100%. I think there was this thing with the pandemic happening. You never plan for something like that, and when it happened, it was a huge catalyst of growth for our business, and we saw large customers that maybe take years to do something that were moving in weeks and months, and they would turn to Truepill for our capabilities. This was hugely energizing, this idea that, at this moment in time, you can never predict something like the pandemic, but when it happens, the company and the infrastructure that you’re building is actually perfectly suited to match the current crisis, the current needs during the pandemic. It created a new level of excitement and growth for the business that we latched onto and said, “Okay. COVID, let’s ride this wave and continue to grow.” That led to several successive financings. Today when you look at COVID, it’s been a broad shift in the market, and we’re still in the midst of COVID and don’t know when the end is near. Six months ago, it felt like the end was close, and then here we are with another variant. I think it’s here to stay, and the mentality of all of our customers and the partners that we work with is, a lot of the changes that are happening now are not just going to bounce back to what it was before COVID. We’re entering a new wave of how healthcare will be delivered in our country, and it’s going to require a completely new set of tools and infrastructure. That’s what we’re setting up to build.

Alejandro: Typically, between rounds, you leave anywhere between 18 to 24 months from one financing cycle to another one. We were alluding to it. It was just so close in you guys’ case. I’m sure there are a lot of people that are listening now thinking, “How did you guys arrive to the decision or to the thought that it made sense to raise money so quickly between one financing cycle to another to go even faster on the growth side?” So what is that thought process typically like?

Sid Viswanathan: For us, we’ve been fortunate that all of our financing have not been driven by: we have x-amounts of runway left or six months of runway left; now we have tot go fundraise. It was always driven around an inflection point in the business. For our Series A, it was all about we were growing very quickly with the initial set of direct-to-consumer brands, and we needed to scale our operations across all 50 states with multiple facilities. Then our Series B came around, and it became clear that not just these direct-to-consumer brands, but large incumbents, like large payers and other parts of the healthcare economy. They need something from Truepill as well. So we raised our Series B. Then our Series C was expanding our business units. We were just pharmacy for many years, but then we expanded into telehealth and diagnostics. Fast-forward now to the recent Series D that we closed. It’s a continuation of that story where now we see across the entire market, whether it’s life sciences, provider groups, health systems, direct consumer brands, which we started with, which continue to grow really fast, all parts of the segment. They need a version of what Truepill has to offer. So we’re trying to align the business to go after and grab as much of the market as possible. 1) You need time of going through this consumer-driven shift in healthcare. We don’t know how big this opportunity can be, but that’s what’s exciting is we’re gearing up to try to go get as much as possible, and look back in a few years and hopefully make a dent in healthcare.

Alejandro: As we’re talking about looking back and also looking ahead, imagine that you go to sleep tonight, Sid, and you wake up in a world where the mission and vision of Truepill is fully realized. What does that world look like?

Sid Viswanathan: That’s a great question. I think we’re going through a massive consumer shift in healthcare right now. We’ve seen these similar shifts in other industries. If you take, for example, eCommerce, where you have large and iconic platform companies like Shopify and Stripe that emerged. Or even take a more recent example in consumer finance with a company like Plaid. You look at all the platform companies that have defined their consumer shifts in their respective industries, and you look at healthcare, we don’t see that platform company; at least, not yet. When we look ahead five years, hopefully, we have interesting stats similar to those other platform companies where four out of five Americans or hundreds of millions of people have been impacted by the work that we do. That’s the vision that we have here with infrastructure and ecosystem that we’re building at Truepill and that’s the future that we invision. We think it’s one that’s worth pursuing.

Alejandro: Sid, what a remarkable journey. You’ve been, now, with your second rodeo with Truepill, and you’ve been at it since around 2016. But before that, you were, as we were alluding to before with CardMunch, were you got started in 2009, you’ve now been in the entrepreneurial and intrapreneurial, too, with LinkedIn, side of things for close to 12 years. That’s quite a lot in dog years, especially when it comes to startups. So imagine if you had the opportunity of going back in time with all this wealth of knowledge that you’ve accumulated, and you had the opportunity of having a sit-down with that younger Sid that was at Johnson & Johnson, and thinking about doing something of your own. If you had that opportunity of sitting down right next to your younger self and giving yourself one piece of advice before launching a business, what would that be and why, given what you know now?

Sid Viswanathan: I think that the best advice I would give myself is to do your best work in your current role. I think as founders, you’re always thinking about, what’s the next startup? What’s the next venture? How am I going to leave my job to go start a company, and you lose sight that I couldn’t have predicted that I would start my career off in healthcare and eight years later, I would be back in healthcare, while certainly cultivating those relationships and doing your best work in that moment is really important and something to not lose sight of. The second is take the long-term view on entrepreneurship. In that moment when you’re in your early 20s or mid-20s or whatever it may be, you think about your next company, and that’s it. But the reality of it is, you can spend your entire career pursuing entrepreneurship. So if you take this 20-30-year view on pursuing entrepreneurship, that means you might have some failures along the way; you might have a success; you might work full-time at a company, and then you might start a company later. You come in and out of these different cycles and it’s important to keep this mindset of continuing to grow in whatever function or area you’re in, and pick your thoughts carefully. For me, it would be going back in time and doing my best work at every job possible because you never know what’s going to happen. You never know what’s next or what’s on the next horizon. So, for me, I was lucky to get that early exit under my belt with my first company, but even if that didn’t happen, I think having this mindset that you have the next 20 years to try to build a successful company. You only need to build one successful company, really. That’s something I would tell myself is: stay calm. Take the long-term view. It’s not just this next company. If you’re going to pursue it for the next 20-30 years of your life, the good new is that you have many, many shots on target. You just have to plan it out in accordance with your life and your goals.

Alejandro: I love that. As you’re thinking about growth, as well, it comes with lessons learned, and that learning is part of the journey. Now, as you’re thinking about perhaps a book that you wish you would have read sooner, what book would that be?

Sid Viswanathan: I’ll pick two. One that I love is Working Backwards. It’s a story on Amazon’s playbook and how they operationalize their business. It’s very tactical and helpful advice that if you read it today, you can apply some of those lessons tomorrow in any business, in my opinion. I think certainly from an entrepreneurship standpoint, I read a lot of inspiring founders. I think my favorite one is probably Shoe Dog, the founding story of Nike. It’s a brand I love, and I just love that story from where it started to where it is today. So maybe two for you there. One inspiring one, and one more tactical to help with you job tomorrow.

Alejandro: There, we got the bonus book, so good stuff. I’m sure the listeners are going to love that and really appreciate that. Sid, for the people that listening, what is the best way for them to reach out and say hi?

Sid Viswanathan: You can reach me on Twitter @SidViswanathan, or you can drop me an email at [email protected].

Alejandro: Amazing. Well, Sid, thank you so much for being on the DealMakers show today.

Sid Viswanathan: Thanks for having me, Alejandro. It was a lot of fun.

 

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