64 Silvia Pfeiffer: Innovating in Health tech

Technology entrepreneur Silvia Pfeiffer has lead the way in web video innovation, and turns her original passion to be a doctor to the telemedicine space with Coviu, the video platform she cofounded and is now scaling as its CEO. We talk venture capital and challenges for women in tech.
Melinda Wittstock:         Welcome to Wings, Silvia.
Silvia Pfeiffer:                   Hi, how are you?
Melinda Wittstock:         I am great, and I'm so pleased that you're joining us all the way from Sydney, Australia.
Silvia Pfeiffer:                   It's a very long way from you, yes.
Melinda Wittstock:         Okay. Telemedicine, what made you excited about going into the telemedicine area?
Silvia Pfeiffer:                   As you explained about my background, I've got a very big background in technology, but I've always cared about the application of technology into human lives. In fact, when I was at school, my biggest goal was to become a doctor. That didn't quite turn out because as I was attending a very small operation that I was watching, it turned out I couldn't actually see blood. I basically fainted, and that was the end of my medical career. I went into technology where there's a lot less blood, but now that I've done a lot of work around video and technology, and I can see that we're ready for telemedicine, I decided this is the time for me to actually bring my passion back into this and start helping people through telemedicine.
Melinda Wittstock:         That's fantastic. Tell me a little bit about your company and how it works, what it does, and whom it serves?
Silvia Pfeiffer:                   Yes, so Coviu is a web-based platform. We're built on, if anyone's interested, on a new web RTC standards around HTML5 video, and what we've built is a really simple way for private practices to add telemedicine to their services. We don't think that they should be replacing their face-to-face consultations, but we think that slowly but surely, telemedicine will become part of everyday healthcare delivery, every doctor of every person. Coviu is a way to make it possible for them, without disrupting their workflows, to build telemedicine into their businesses.
Melinda Wittstock:         There's such a trend now towards personalized medicine, and I'm fascinated with the role that artificial intelligence is playing in some of this, in terms of being able to figure out whether we need concierge care, that we have some AI bot that helps us with our care. How do you see this industry and what you're doing with telemedicine playing out in that context?
Silvia Pfeiffer:                   Yes, absolutely. Artificial intelligence is in fact the big thing that's coming to everybody's lives across many different areas. In healthcare, I think artificial intelligence can help both the patient and the practitioners. I don't see the big thing that tied to it that we're going to get rid of doctors, and all our healthcare is going to be done through artificial intelligence. I don't see that happening in the near future. It's a human condition that we want to talk to other humans about our personal issues. I could hold a conversation with an AI bot about my mental health, but it's almost like talking to the wall rather than talking to another human being who has got emotions, who can understand what I'm going through. I think in healthcare in general, it's still a very human experience. We, as humans, will want to have a lot of that still continue into the future. I can also see a role of artificial intelligence there. It's not an either/or for me. It's a make the best of both worlds. Some things, humans are better at, and some things, artificial intelligence is better at.
One of the things we actually do in Coviu is with artificial intelligence; you can add functionality into a telemedicine call to basically supercharge the capabilities of the practitioner. That means you could have an algorithm in the call that analyzes your medical images that maybe the patient is sharing with the doctor, and the artificial intelligence points out some things about the image to the doctor, so the doctor finds it easier to make the right decisions and to provide the right kind of advice. That's the way we imagine artificial intelligence being used in a telemedicine environment.
Melinda Wittstock:         That's fascinating. Talk to me a little bit about your experience as an entrepreneur, a female entrepreneur in the realm of deep technology. I mean it can be hard to get funded. It can be hard or challenging for women to manage teams in tech. We read all these headlines. What are some of the biggest challenges? What are some of the biggest frustrations?
Silvia Pfeiffer:                   Yes, so I've been in technology for a very, very long time. Even when I started back in the last century, a long time in the last century, I was actually quite early with my studies in computer science. We were 40% women in my year, but it only went down from there, and when I left Uni [university] and finished Uni, we'd gone down to maybe 10% women in my subject.
Melinda Wittstock:         Yes, why is that? Why do you think that happened?
Silvia Pfeiffer:                   I have no idea. It was really strange, but it seemed to be that men were really embracing the new technology while women slowly started to get, I don't know, disenfranchised or disappointed about the whole thing. I have no idea exactly how it all happened, and I'm happy to see that, that trend is reversing. With all the effort that's being put into helping women get interested in technology earlier on. It seemed to be also that there is a time during school, around the age of 12 where boys are starting to look inside themselves, and they become introverted a bit. They retrace their steps into computers and getting involved in computer programming, et cetera. It's the opposite with the girls at about that age. I think they're starting to connect with other girls and become more social, et cetera, so I think that's where the seeds are being sown. That's starting to get addressed a fair bit at schools with all the new efforts that are being taken to get girls more interested in technology. I'm really happy that, that's changing.
Melinda Wittstock:         Yes, in Silicon Valley, I mean there's a lot of talk and other tech hubs around the United States around the bro culture that girls and women just don't really fit into that. Even if they're really talented programmers and engineers, it's just uncomfortable.
Silvia Pfeiffer:                   Yes, you do have to get used to a bit of that. I've been involved with the open source community for a large amount of my life. I probably got involved in about 2000, and when you hang out on chat channels, and the talk is quite juvenile. Teenage boy kind of talk!
Melinda Wittstock:         Oh my, I can only imagine.
Silvia Pfeiffer:                   Yes, and you go, “Yes, okay.” Just ignore it, you know? I built, I guess, a thick skin towards these kinds of behaviors. Sometimes, you just behave a little bit like this world, and then, it makes it easier to fit in and to be accepted. To be honest, I don't really have any problems in this space. I know that I'm not part of that kind of culture, but I can deal with it. I can work with people, and I can work productively with people, even though the bro culture is a bit around. It's also a matter of some of the people growing up as well. Once they're in their 20's, in their 30's, the behavior changes. Particularly, once they start having their own girls and their own children, then, behavior completely changes. It's not that hard to work around it, I think.
Melinda Wittstock:         I've noticed that in my own companies as well. Verifeed, my company use a lot of machine learning, artificial intelligence, and some of the older engineers do have a little bit more of an evolved perspective, but it's always a challenge to try and go and find female coders. I would love to be able to hire women engineers and women coder, but hard to find.
Silvia Pfeiffer:                   Yes, it is, but I think we're starting to change that culture. I think there's a lot more women going through university now with computer degrees. It is also very much of a western problem. Apparently in Pakistan, I was told, the percentage of women being computer programmers is much, much higher than the percentage of men. I've not really looked into the details of it, but there is definitely a cultural aspect to the whole thing.
Melinda Wittstock:         That is so interesting. What is the biggest frustration then, as a female entrepreneur? I know for a company, a telemedicine company and a technology company, you have to go out and raise significant amounts of capital. Where are you in your funding rounds? Has it been hard to get the amount of capital that you need?
[tweet_box design=”default” float=”none”]As much as you try to put everything you have into your business, still look after yourself. Get enough sleep. Get enough exercises. Eat healthy food. #WingsPodcast #WomeninBusiness @coviuapp[/tweet_box]
Silvia Pfeiffer:                   Funding is a big challenge for me at the moment. I've been fortunate enough to have worked within the Australian research organization, the CSIRO for the last couple of years. They've basically funded our work until now, but it's time for us to stand on our own feet and to become our own start-up to spin this company out of the CSIRO. I'm currently talking to a couple of investors. It has taken us a significant amount of time to get to the level of customers that we have right now. We have roughly 95 doctors on our platform now, so that's a pretty great achievement in Australia where our market is not that big yet. The telemedicine market in particular with private practices is still developing. America is much further ahead in that respect, in the uptake. There's a lot of indecision around whether this is the right time for a telemedicine company in Australia, whether we're at the right time or whether we're still too early. I always have to explain how far ahead America is, and that we are about to see the same developments happening in Australia as there are in America.
I think the message is slowly starting to come across, and there've been a couple of developments here in Australia also about reimbursements through Medicare that are making people raise their eyebrows and get interested. I think we're ready for it. We can totally make a big impact in this market here in Australia, and then across the channel as well.
Melinda Wittstock:         Yes. It's interesting how what has happened to VC because Venture Capitalist's money used to be much more in the idea stage. It seems to me that it's getting further and further and further out, like you have to show more traction. You have to have more revenue. You have to be much more of a completed thought to get the same money, like what used to be an A round, it could have been on the back of a napkin. Now, A round is, do you have a hundred thousand in monthly revenue? Do you have how many customers? What's your percentage month-on-month growth rate? All these things, so it cane make it tough in that little … Well, sometimes, it's not a little gap. Sometimes, it could be an excruciating long gap between friends, family and angel money or university support or whatever. Actually getting that VC round, you need to really scale.
Silvia Pfeiffer:                   Yes, absolutely. People don't really understand the differences between a start-up that's doing deep technology like ours where we've built our whole video conferencing platform right from scratch through someone who is just, and I don't want to say just, but it's just a different kind of business and doesn't even need this deep technology. If you're setting up a website, and you're building an advice business or something, or let's even just stay in telemedicine. If you're offering Skype calls, and you're a doctor with a coupe of doctor friends, and you're starting a telemedicine company in that way, comparing that to what we're doing is, it's two very, very different businesses. Investors are finding it hard to compare the two and to understand the difference. I'm struggling a bit with that. Of course, then also, as you're saying, they're expecting amounts of income, large amounts of monthly recurring revenue for even a C round here. Yes, it's really difficult to get to Capital, I think.
Melinda Wittstock:         Is it more … I mean because it's difficult for men to raise money too, right?
Silvia Pfeiffer:                   Yes.
Melinda Wittstock:         Is it more difficult for women, and why?
Silvia Pfeiffer:                   I think it might be a bit more difficult for women. I've noticed that when I talk to investors, to female investors, I find it easier to explain what we're doing and easier to be understood, while talking to male investors, there seems to be a barrier about the way we talk and the way we understand each other. I try to explain too much, whereas they'd actually like to hear a little bit less and just more focused. I think there's a bit of a communication barrier that also doesn't help with getting investment for female founders. I think we need a lot more female investors as well, to get the balance for female founders when looking for investment.
Melinda Wittstock:         It's so true. You know, our brains actually work different. Men tend to be able to hold one thought at a time, whereas women do have this web-thinking brain where we can hold lots of different concepts. We also use a lot more words, a lot more words. I've seen so many women present what is a very focused, very clear vision only have the investors say, “Can you be more focused?” That may well just be the fact of our brains working differently, so what is the answer? Is it that women have to be able to figure out how to translate their more of a web-thinking, systems-thinking brain into a linear presentation for the men? How do we solve that communication gap?
Silvia Pfeiffer:                   I'm not sure. I'm still struggling with that myself. I'm trying to make my presentation clearer, more focused. Yes, it's not easy. It's not easy. I don't really have an answer to that question, to be honest.
Melinda Wittstock:         I know. We're all struggling with that. I mean on this podcast, we talk about this a lot because there is no one answer. I mean there's many things going on here, which is one of the reasons why it makes it a little bit harder to solve. I think the more we face the problem head-on, the more likely we are to find a way around it. I'd like to think there's a generational difference too, that younger men coming up are going to be more open-minded.
Silvia Pfeiffer:                   And also now technology-aware and technology-embracing.
Melinda Wittstock:         Yes, and also more amenable to look at the markets that … There's a lot of women come into tech, into technology. They're create a product to solve a problem that's relevant to their lives or address a market that's the addressable market is women, and the male VCs don't understand eh market.
Silvia Pfeiffer:                   Yes, very much, very much. Oh, I've got a couple of friends that are starting businesses in all sorts of female-focused areas around wedding, planning and clothes, et cetera. I think that, that's areas where the VCs are struggling with this world, yes.
Melinda Wittstock:         Yes, it's very true because they can't understand what the market is because they don't identify. I mean we're all humans. I remember giving an investor pitch some time back and having to say, “You're not even my addressable market. Stop evaluating this as a consumer. You should be in favor. You should be evaluating this as an investor. This is an opportunity that I'm bringing you.”
Silvia Pfeiffer:                   Yes, indeed, indeed.
Melinda Wittstock:         I want you to go back in time for me a little bit. Did you always know that you were entrepreneurial as a little girl, growing up?
Silvia Pfeiffer:                   I wouldn't necessarily say so. I knew I had an interest in developing new things and exploring new ideas. The entrepreneurial side of things involves also making money from those things. Maybe I had more of a scientific brain than an entrepreneurial brain. Although I clearly remember, we were living next to an area, oh, what's it called, where they'd grow flowers. A greenhouse? We were living next to a greenhouse, and they were making all these flowers that people were going to buy at the spring sale. Me as a young … I guess we were about 12 or so, and with neighbor's boy, together, we set up this little stall. We started selling their flowers directly to consumers when they were going to sell them in big batches. We had a bit of an entrepreneurial effort there, I guess, but really, what interested me most was to develop new things that didn't exist yet in the world.
Melinda Wittstock:         Right, but that's very entrepreneurial. I mean I call it entre-pioneering where you see a problem, and you invent something to go solve that problem. I'm thinking again about your story, about wanting to be a doctor, but “Oh, the sight of blood, no, but I'll come back.” Then, deciding to come back at the original problem and the original people that you wanted to serve in a different way. I think that's so interesting. Along the way, have you had female role models and female mentors? I mean there's so many women I talk to that didn't or struggled to find women that were supportive of them. Who have the mentors been and your role models in your life as you've come up?
Silvia Pfeiffer:                   Yes, I've called a lot of people whose work admire. I guess the first person that I admired was Mother Teresa in the humanitarian work she did. That is somewhat off the basis of my motivation. At the same time, I admire Tim Berners-Lee who created the worldwide web, and so there is the technology edge to it that drives me in my day-to-day work. Directly with the business, I have been looking for mentors to help me get through the hard times with the business. I've been really lucky to have very good friends that are in the technology space. There have been other VCs. There've been a couple of people who are actually running VCs that have said, “Look, I'll mentor you. We can't invest, but I'll mentor you through this because I can see that you're going in a really interesting direction.” I've been in contact with these people quite frequently and being given good advice there. They were men, but I really am grateful for the effort and for the support I've been given there.
I am also grateful for Springboard. I'm on one of the Springboard companies when Springboard came to Australia. That was really fascinating for me because there really isn't much of a female fandom at work here. To be honest, this is my second start-up. My first start-up, I did in 2006 in Australia as well, and there was nothing around. There were no accelerators around. There was no start-up community around. There was no talk about start-ups. It was a really difficult time back in 2006 to create a company in Australia.
Melinda Wittstock:         You know, even here. Even here in 2010! I went through Springboard as well, and I went through in 2011. Even in 2010, I was often the only woman in the room. That's not that long ago. It's only seven years ago, and there wasn't nearly as much support or resources or talk about how to do. I mean almost everything was a lot more expensive. You had to build everything from scratch. Now, I think the barriers to entry in being an entrepreneur and flying with a start-up are much lower than they used to be. It's so critical to have that network around us because without that, I mean it's lonely enough as it is, because I don't know. I think most people who are not entrepreneurial struggle to really understand what it's really like.
Silvia Pfeiffer:                   That's right.
Melinda Wittstock:         It's always lonely enough as it is without having that network, that purpose-built network around you.
Silvia Pfeiffer:                   Absolutely. Like your normal friends, you try to explain to them what it's like, but they can't relate. They'll say, “Oh, yes. It's quite amazing what you're doing,” but that's all they can do. It's almost like, “Yes. This is all too hard. Don't talk to me about this. I've got hard enough in my life as it is.”
Melinda Wittstock:         Well, everyone has challenges in their life, right?
Silvia Pfeiffer:                   They do.
Melinda Wittstock:         I joke that the entrepreneurial ones, I don't know. I mean we can have these incredible highs and lows all within the same hour. After a while, you just get used to that. It's like when there's a problem, you're like, “Oh, okay. I'll figure out how to solve that like I solved all the other ones.”
Silvia Pfeiffer:                   Yes. We'll move on. We'll try the next thing.
Melinda Wittstock:         Yes.
Silvia Pfeiffer:                   That's so much, picking the next battle that you think will take the business forward, yes.
Melinda Wittstock:         That's right. Well, I'm going to segue now into the section of the show that I really like where we ask all our female entrepreneurial, well, entre-pioneers really, what their three most important pieces of advice are for other women, either who are entrepreneurs or thinking of becoming them. What are your three?
Silvia Pfeiffer:                   I think that it's very important that you are settled in your life, in your private life before you take on an entrepreneurial journey. I must say, I'm really, really lucky. I've got a loving husband who supports me in this, who also has a technology background. He's a CTO of a company, and he totally gets what I'm doing. Even if I start having to work through the night to do something or my weekend is blown because I have to do something, he totally gets it. He understands. He can sort out things around it. We don't run into trouble with that. When I did my first start-up, that wasn't the case. Try to not have to deal with two complicated situations in your life. Creating a start-up is hard enough. Try to have a simple solved private life if you can.
Melinda Wittstock:         You know, Silvia, that's so important. I mean I know I've gone through a similar thing. I'm in start-up number four right now.
Silvia Pfeiffer:                   Wow.
Melinda Wittstock:         Start-up number three was a little dicey because my marriage was falling apart at that time. I was absolutely determined that no, I'm fine. I'm good. I'm resilient. This isn't affecting me, but of course, it was.
Silvia Pfeiffer:                   Yes. That's happened to me the first time around, so I'm speaking out of experience as well.
Melinda Wittstock:         Yes. Well, it's good advice. I mean having that, not only a really supportive partner, but friends or networks that are positive, that truly have your back.
Silvia Pfeiffer:                   Yes, absolutely. You need that.
Melinda Wittstock:         Yes, and so what's advice number two?
Silvia Pfeiffer:                   The first one was about your environment. The second one, best second advice is about yourself. As much as you try to put everything you have into your business, still look after yourself. Get enough sleep. Get enough exercises. Eat healthy food. Do take a break every now and then. Maybe it's not the weekend. Some people, it's not like every person's day where they work from [spp-timestamp time="9:00"] to [spp-timestamp time="5:00"], and they have their time off. They have their weekend where they can rest. For us, it can be at random times. Maybe we have to work through a weekend, but sometimes, then, Monday comes and we have achieved something. We have got some tendering at the right time or whatever, then, we can start breathing. Maybe it's time on Monday to take a couple of hours off and go for a good walk and get some rest. Look after yourself. I think that's a really, really important one because if your brain's not working right, your company can't work well either.
Melinda Wittstock:         What are some of your routines? Do you meditate or exercise? What are some of the things that you do?
Silvia Pfeiffer:                   Yes, so every morning, after I get up, I do exercises. I don't go to a gym or something. I actually just turn on the TV. I've got YouTube on here. I've got a couple of routines, the High Intensity Interval Training or some Pilates. I do like half an hour of exercise in the morning. That, to me, works also like a meditation. It just clears my mind. It helps me physically with my health. It takes the basis for the day. It takes away all the stress from the day before as well. That's really important to me.
Then, I actually typically try to get my e-mail out of the way in the morning, although a lot of people say that's not the best thing to do. Do your highest challenging project first in the morning. I guess, for me, to balance, sometimes, when I have some deadlines, I drop the e-mail and then do the e-mail later. I focus on the challenging thing first, but oftentimes, I just try and get the e-mail our of the way so I can start working with my team, start focusing on getting into my day and the meetings and team particularly.
Melinda Wittstock:         It's so easy to have a day that gets cluttered up. I found one of the things that helps me … is that if it's not in my calendar, it's not happening. I don't do lists anymore. I read somewhere that just writing a list releases, I'm not sure if it's dopamine or endorphins or something. You feel good because you wrote the list.
Silvia Pfeiffer:                   Right, right.
[tweet_box design=”default” float=”none”]You have to make sure that your co-founder and you want the same thing out of the company, that you're going, that you're running in the same direction because if you're running in the same direction, it's like both your efforts get multiplied exponentially. #WingsPodcast #WomeninBusiness @CoviuApp[/tweet_box]
Melinda Wittstock:         Then, I think a lot of people, men and women, can write these incredibly long lists. You get to the end of the week, and you haven't done them. It just feels bad, so a list without tying it to your available amount of time … Yes, it doesn't work so well.
Silvia Pfeiffer:                   That's true, yes, yes. I do this thing where if I have a deadline or something, I actually block out a day. I write it in my day. This is when I have to do this thing. Then, in the morning, I get up and I know what I have to do in that day. That's when it happens. Then, also, I really try and avoid letting any meetings slip on through that day. That's just a blocked out day. That seems to work quite well, yes. I do have a lot of lists though. I'm not writing lists. Then, at the end of the week, I rip them up, and I throw them in the bin. Whatever's still left on, that goes onto the next list for the next day.
Melinda Wittstock:         That's awesome. Well, you're getting dopamine hits from that, apparently.
Silvia Pfeiffer:                   [crosstalk [spp-timestamp time="00:32:02"]
Melinda Wittstock:         Okay, so, I know you've got a third piece of advice, which I think is really, really good. I know this advice already.
Silvia Pfeiffer:                   Yes, my third piece of advice is around your company and who you run the company with. You have to make sure that your co-founder and you want the same thing out of the company, that you're going, that you're running in the same direction because if you're running in the same direction, it's like both your efforts get multiplied exponentially, stronger running in the same direction whereas if you don't want the same thing and your angles are slightly off or you're running in opposite directions, you're actually completely slowed down. Your business will go nowhere. For me, that is really important that you and your co-founder are on the same page and want the same thing.
Melinda Wittstock:         Oh, that's so important, especially when it gets to decisions like about when to exit the company or all of that, so like being really, really clear. Yes, so you're going in the same direction, that you're aligned in every way. That's very, very important. Silvia, resilience is a really big part of succeeding as an entrepreneur. What's your mindset? How do you stay resilient? How do you cope with the ups and downs?
Silvia Pfeiffer:                   After a big down, I tend to go for a walk just to clear my mind. I do struggle a lot with getting over negative things, so I give myself the time to come to terms with it. My mind will go back and forth on what I did wrong, what I did, what I did well, what I could have done better and why all these happened. It just wants to know, but then, after a while of walking it off, let's say maybe 20 minutes, it goes, “Okay. This is tiring. It's not getting me anywhere.” It stops thinking about it, and then, I can start focusing on other things again. I need that out-time to be able to move forward again. I think that gives me resilience to look forward, rather than always looking back.
Melinda Wittstock:         Right, and just shake it off. I think we often, as women, tend to take things personally. Even sometimes things that we can't control! What does it mean about me? For that, often, I have to look at how my golden retriever behaves when someone doesn't like her, ignores her, and she literally just shakes it off. I just try and summon my inner-golden retriever.
Silvia Pfeiffer:                   That is just a great idea. Oh, that's awesome. I wish I had a golden retriever that I could model on. Now, I take those things very personally sometimes, but I also have a limit to it. I go, “Okay. I have fretted about it enough now. That's it. I can't change it anymore. Just move on.”
Melinda Wittstock:         Silvia, how can people find you and learn about Coviu?
Silvia Pfeiffer:                   Coviu is available at coviu.com. Go to the website, and I'd be very happy to give you free advice about how to set up a video consultation business, a healthcare video consultation business. Just submit. There's a form on our website. Submit a request, and mention this podcast, and I'll get back to you when we can set this up.
Melinda Wittstock:         That's awesome. I just want to spell Coviu for everybody. It's C-O-V-I-U.com, so C-O-V-I-U.com.
Silvia Pfeiffer:                   Yes, thank you very much.
Melinda Wittstock:         Silvia, it was awesome talking to you today. Thank you for putting on your wings and flying with me all the way from Sydney, Australia.
Silvia Pfeiffer:                   Thanks for having me. This was amazing. I enjoyed talking with you. Thank you so much.
 

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