Best Time to Build in Digital Health. Digital Health Interviews: Vadim Gordin

In a recent “Digital Health Interviews” episode, our host Alex Koshykov had the pleasure of speaking with Vadim Gordin, a dynamic figure at the intersection of technology and healthcare. Vadim is currently at the helm of NYU Future Labs A/X Venture Studio and Catalyst, an industry-agnostic accelerator at NYU. But his innovation journey didn’t start there.

Understanding Gordin’s Background

Vadim’s path has been anything but linear. Before his current roles, he was a serial entrepreneur, launching several startups focused on healthcare devices. “I’ve raised funding twice and had an exit — a small one, but an exit nonetheless,” Vadim shares with a hint of humor. Before venturing into startups, he was a patent environmental engineer. Since 2012, he has been involved in various aspects of healthcare, working with diverse clients and developing a range of products.

When asked how he divides his time, Vadim offers a glimpse into his multifaceted role. “I wear multiple hats,” he says. “I’m an associate director for incubation and acceleration at the NYU engineering school, so my time is roughly split into three parts.” He explains that one-third of his efforts go into building new companies for the venture studio, another third is dedicated to supporting these companies, and the final portion of his time is focused on aiding graduate students and faculty in commercializing their inventions.

On Being an Advisor: A Flexible Approach

Vadim Gordin’s role as an advisor is both dynamic and unconventional. Vadim prefers a more flexible approach than many who sit on fixed advisory boards. “I tend not to like formal advisory boards for companies, especially those moving from the idea stage to zero,” he explains. He believes that a fixed group of advisors might not always meet the rapidly changing needs of startups. Instead, Vadim advises many companies in a more fluid capacity. At NYU, he supports multiple teams, from graduate-facing accelerators running 12 teams at a time to the Catalyst program, which hosts cohorts of 12 teams twice a year, and the Venture Studio which launches four companies simultaneously. Additionally, Vadim serves as an advisor for healthcare-focused programs, including the New York and Fort Worth TechStars.

Lessons from Being a Multi-Time Founder

Reflecting on his experiences as a multi-time founder, Vadim shares key insights he’s learned along the way. “The single biggest thing is to focus on unit economics for your customers, especially when selling to enterprise clients,” he emphasizes. He notes that seasoned founders think from the start about how their product impacts their customers’ unit economics. If a founder can’t communicate the business case that makes a client a “hero” for adopting their solution, then they may just be “running around with a solution in search of a problem.”

Vadim also speaks about the importance of founder dynamics. “During 12 years of startups, I’ve only met three or four folks who can genuinely be solo founders,” he says. He believes that a startup needs at least two key roles: one founder who brings the creative energy (“fireworks”) and another who ensures operations run smoothly (“makes trains run on time”). Both roles, he notes, require a deep mutual respect to create a successful team.

The Unique Energy of Co-Founders Versus Employees

Vadim explains that while it may seem easy to hire a second person to complement a founding team, the dynamic is different when someone is hired versus being a co-founder. “A hire brings a different sort of energy,” Vadim observes. He recounts his realization during the COVID-19 pandemic while working on PPE projects. With businesses paused, Vadim was volunteering at Future Labs, where he co-developed the A/X Shield with Joe Burell. The project grew to become a leading open-source face shield, with significant manufacturing support and donor funding.

Through this experience, Vadim learned the power of a co-founding team. “I pulled in exceptional founders that I knew, and the throughput and energy when you have a team that functions that way is just fundamentally different,” he shares. Vadim describes his realization that he would never be as effective as his exceptional co-founders, who were better operators. This insight has shaped his belief that the role of a startup CEO is to “sequentially replace all of the tasks on your plate with people who are better than you at those specific tasks.” For Vadim, the energy and problem-solving ability of a co-founder are crucial for startup success.

The Challenges and Opportunities in Digital Health Startups

When asked about the main challenges facing startup founders in digital health today, Vadim Gordin sees more opportunities than obstacles. “I think that now is the single best time I’ve ever seen to build digital health,” he shares with enthusiasm. Vadim believes the current landscape offers a thriving international ecosystem of experienced operators who have scaled care programs across various specialties, from primary care to obesity and asthma. “There are exceptional operators to learn from,” he emphasizes.

Vadim also points out that investors are more willing than ever to fund innovative health startups, providing crucial financial support through multiple funding rounds. Additionally, healthcare systems and plans have become more open to collaborating with startups. Unlike in 2015, when startups struggled to gain traction in health systems, there are now established processes for piloting new technologies and achieving initial revenues. Vadim notes, “All those places have a defined way of bringing in a team if that team is bringing a value proposition that matters.” The message is clear: the tools and knowledge are available to build successful ventures if founders are willing to do the work. He firmly believes that the current generation of VC-backed healthcare companies could become some of the strongest in U.S. history.

Ensuring Smooth Integration of Healthcare Solutions

Alex then asks Vadim what he would do as an operator to ensure the smooth integration of a healthcare solution into a health system. Vadim’s advice is straightforward: “The question you should be answering is how do I make the lift from the part of the health system effectively zero?” He mentions operators like Rik Renard of Awell and Yair Saperstein of Avo who have made it their mission to ensure that change management is as seamless as possible. “Their goal is to build out solutions in such a way that the first moment of using the product feels like magic,” Vadim explains.

Vadim stresses the importance of minimizing the burden on healthcare administrators and providers. “The amount of human lift required to get to that first realization of ‘Man, this makes practicing in our area of medicine different now’ has to be effectively zero,” he argues. The integration of new solutions should be so seamless that providers wonder how they ever worked without them.

Navigating the Complexities of Digital Health Integration

Acknowledging the challenges in achieving smooth integration, Vadim remarks, “Absolutely! And to be fair, EPIC does not make it easy, and the health plans do not make it easy.” He understands the complexities involved, particularly with existing electronic health record systems and administrative processes. Vadim, whose family is deeply rooted in healthcare, knows that providers are often overburdened and lack the bandwidth to deal with complex tech solutions. “There are so many startups building various solutions,” he notes, “that whatever your service offering, the chances are they’ll find the one that’s going to make it easier for them to get to that first bit of magic.”

Vadim’s insights emphasize the importance of creating user-friendly, impactful solutions that require minimal effort from healthcare providers, ensuring a smoother path to adoption and success.

The Evolution and Impact of Future Labs

When asked about Future Labs, Vadim Gordin provides a fascinating history of its development and impact. “We were established in 2009 by the city and the state,” he begins, describing a time when New York was not the startup hub it is today. The goal was to create an incubation and acceleration program tied to the city’s excellent academic institutions. Over the years, Future Labs has worked with over 300 companies, helping them raise $2.7 billion in venture capital and achieve 43 exits.

What sets Future Labs apart is its deep connection to NYU and the diverse expertise of its faculty and mentors. “Everyone here has been a builder first,” Vadim notes, highlighting that they are not career academics but experienced practitioners who understand how to build, ship products, and sell. This practical experience, combined with broad university resources, creates a unique coaching and mentorship experience. Vadim himself started as a volunteer mentor before joining the team full-time, and he maintains strong relationships with the founders he has worked with over the years.

Vadim shares an example of the kind of connectivity Future Labs fosters. A company that had completed its seed-stage program sought guidance on which term sheet to accept for a $20 million Series A. Craig Wilson, Vadim’s boss, connected them with a previous founder who had successfully exited and had a relationship with the investors. The result? The exited founder chose to invest in the new round, helping to close the deal.

Future Labs also leverages the breadth of expertise across NYU’s different departments. Vadim recounts the story of Vital Audio, a company that developed algorithms to measure heart rate variability over conventional phone calls. When the founder needed help with math, they sought support from various departments, and ultimately, a composer and data scientist from the School of Performing Arts was the one to solve the problem. This interdisciplinary approach creates unique opportunities for innovation and collaboration.

Finding and Solving Real-world Problems

Alex inquires about how Future Labs identifies and tackles real-world problems. Vadim explains that in the Venture Studio, they proactively seek out problems from health systems, health plans, public companies, and physicians. For example, they are working on an implantable device for cancer in collaboration with Memorial Stone Caring. The idea emerged when Vadim approached them, offering the engineering expertise of his team in exchange for problem statements they could work on.

Vadim shares another example involving an implantable stent for post-stroke patients, initially proposed by the chair of neurology at Langone. The stent was meant to monitor blood oxygenation and adjust blood vessel dilation accordingly, but the original idea faced several practical challenges. By collaborating with other researchers at NYU, they adapted the technology to use a patch placed on the patient’s neck, effectively achieving the same goal. This project progressed from a problem statement to a 15-patient pilot study in just 14 months and won the top prize in the Health Tech Venture Competition at NYU.

Selecting Exceptional Talent

When asked about how he selects specific people to be the main researchers and founders, Vadim explains that it varies depending on the project. For example, when looking for a CTO for Vital Audio, he used a test involving Eulerian Video Magnification, an algorithm developed by MIT to measure heart rate based on changes in skin color. He challenged candidates to implement this algorithm themselves, knowing that only the most exceptional candidates would succeed. Out of 150 applicants, only three managed to complete the task.

Similarly, when selecting a COO or other executive positions, Vadim looks for candidates who can operate independently and handle ambiguity. “For me, to be effective, first like three or four people into a startup operator, you need to be able to look at a blank sheet of paper and lay the dots out on your own,” he states. The process involves setting challenging tasks without strict deadlines, to see who is self-motivated and capable of managing their time effectively.

Vadim emphasizes that this approach naturally filters out those who may lack the drive or capability to thrive in a startup environment, leaving only the most committed and talented individuals to take on the challenges of building innovative digital health solutions.

Characteristics of a Successful Startup Founder

When asked about the essential characteristics a founder should have to build a successful startup, Vadim Gordin reflects deeply on the topic. He believes that one of the most crucial traits is native curiosity. He shares an example of a founder named John, a PhD physical therapist who took a break from his career to build a gourmet kitchen in the back of his Toyota 4Runner so he could enjoy gourmet meals while camping in Colorado. “The majority of effective founders have a story like that,” Vadim notes, emphasizing that this kind of curiosity and drive is fundamental to the entrepreneurial spirit.

He also stresses that successful founders are self-starters who look at the world not just through the lens of what’s wrong but through what’s possible. This optimistic and solution-oriented mindset is particularly vital in healthcare, a field fraught with challenges.

Vadim goes on to highlight the importance of being able to attract and convene high-quality operators. He describes successful founders as being like the Pied Piper, playing a tune that draws exceptional people to follow them. These are the founders who can persuade top-tier professionals to join their mission, even if the financial incentives aren’t immediately obvious. “It’s a founder whose story, ethos, and vibe someone can get behind,” Vadim says. This ability to rally a team creates a tailwind that helps the startup navigate through tough times, making it more likely to survive and thrive.

Is That Charisma Innate?

When asked whether this vibe or charisma is something a person is born with, Vadim responds with a practical approach: “I do not believe that I’m an exceptional communicator,” he admits, but he emphasizes that these qualities can be learned. Vadim recommends three books that he believes are invaluable for any aspiring founder:

1. The Charisma Myth — A guide to developing charisma and understanding its components.

2. Nonviolent Communication — Focuses on empathy and effective communication, especially in difficult conversations.

3. Never Split the Difference — Teaches negotiation tactics, particularly in confrontational situations.

Vadim suggests reading these books one chapter at a time and then spending a week implementing what you’ve learned into your daily interactions. He acknowledges that this process might feel awkward initially but stresses that the key is experimentation — figuring out what works and refining communication skills over time.

Developing Your Unique Voice

Vadim underscores that each founder’s voice and style will differ, and that’s a good thing. The process of learning from these books helps founders find their unique approach, which is essential in building a strong, authentic leadership presence. He shares that he has personally read “Never Split the Difference” multiple times, about once a year, finding new value with each read. He emphasizes the importance of continuous learning and growth, particularly for founders in high-stakes environments.

In addition to these books, Vadim also recommends “Lean Customer Development” by Cindy Alvarez, which offers more practical, startup-focused advice on customer discovery — a critical component of any early-stage venture. However, he still considers the first three books on interpersonal skills as the most foundational, particularly for attracting and retaining top talent and building meaningful relationships with stakeholders.

Vadim’s final takeaway is that charisma, empathy, and effective communication are at the heart of successful leadership, and they can be cultivated with intention and practice.

Our previous episode was with Ankit Jain: The Intersection of AI and Healthcare: Challenges, Innovations, and Investment