An Interview With Ken Babcock
Conviction — You must have guardrails of conviction or a mindset that says: I know within these parameters, this is what we need to do, and this is how we’ll do it. Your faith will be questioned multiple times. The landscape will change, competitors, funding and partners will change. You must believe that you’re in the right space doing the right thing and be flexible to adapt. If you don’t have conviction, then every day, you’ll be worried if you’re going the right way or not and constantly switching around.
Startups usually start with a small cohort of close colleagues. But what happens when you add a bunch of new people into this close cohort? How do you maintain the company culture? In addition, what is needed to successfully scale a business to increase market share or to increase offerings? How can a small startup grow successfully to a midsize and then large company? To address these questions, we are talking to successful business leaders who can share stories and insights from their experiences about the “5 Things You Need To Know To Successfully Scale Your Business”. As a part of this series, we had the distinct pleasure of interviewing Chris Cashwell.
For over 20 years, Chris Cashwell has led large and small healthcare information technology companies. He is currently the CEO and founder of Azra AI, whose technology identifies positive cancer diagnoses and incidental findings in real-time with an eye toward helping patients and clinicians. Cashwell previously served as the General Manager and Senior Vice President of Digital Reasoning Health and as the CEO for Lincor Solutions, where he was responsible for strategy and operations for global digital patient engagement technology solutions.
Thank you for joining us in this interview series. Our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’?
I was in a unique situation growing up. My father was a career Air Force member who was paralyzed while serving in the Vietnam War and permanently disabled. He was a great stay-at-home dad. Mother was a working mom who held many jobs in state and federal security positions, despite having only a high school diploma.
I had a stay-at-home dad before it was mainstream. Having a dad and a son spend all their time together is just a dream come true for a lot of kids. I do appreciate that and realize it helped shape who I am today.
At the same time, my mom had a reverse role. She was the primary breadwinner and had to work every day. I appreciated that she was not constrained by her socioeconomic history and being a high school graduate from a small town in West Virginia. She was always focused on bettering herself and doing more and different things. She was a small, petite lady, yet she had jobs where she managed security at federalist prisons and state security facilities. She held roles in the workforce normally thought of for big strong men. I always appreciated the fact that this was her niche, and that she was good at what she did for a living. She was proof that anyone can be successful and contribute to society regardless of their background, stature, or history.
In terms of my career, my background consists of a unique blend working at large companies and venture capital or private equity-backed startups. I was formally trained as a commercial banker and in healthcare finance, but then I became increasingly drawn to healthcare technology.
I had a unique perspective working for Fortune 500 companies in Truist, General Electric (GE) and Nuance, and subsequently, in the startup and post-startup world. There are benefits to both sides when I look back on my career so far. I try to take the best of both worlds and blend that into an ability to succeed in whichever format you’re working in. It’s that idea of trying to understand big company processes, repeatability, and scalability. And in smaller companies, I focus on entrepreneurship, flexibility, and nimbleness, and bring the two realms together.
I was at GE at a time when it was a perfect storm for those concepts working under Jack Welch near the end of his career. All these GE and GE Capital businesses operated as mini entrepreneurial centers. It was like a lab for well-funded startups and early-stage companies. If you had an innovative idea and could present it to GE management, there was a good chance that you could get your project funded and oversee the new venture, entity or expansion of an existing entity. I learned from an early stage not to lose that entrepreneurial spirit. But it also takes a plan and funding to make sure that can happen.
You’ve had a remarkable career journey. Can you highlight a key decision in your career that helped you get to where you are today?
The banking world was secure, stable and consistent and yet I saw the opportunity not just to do more and provide more for my family financially, but I also saw the freedom and flexibility in making a move to GE Capital. The area I started out in at GE Capital was entrepreneurial. GE had purchased the bones of an existing small business finance company, and I wanted to grow it organically, and through mergers and acquisitions. I very much had an entrepreneurial spirit.
My boss said: “Hey, Chris, we want you to lease an office in Nashville and be the person who oversees the Tennessee market. Here’s your book of leads and prospects. You grow it however you can.”
The most key decision in my professional career was the ability to see that kind of world with an entrepreneurial spirit, coming from a structured banking world to a company that’s even much larger. It not only gave me access to all that GE did, but it also unlocked my entrepreneurial spirit and tapped into some of my strengths that I had not yet had a chance to foster.
What’s the most impactful initiative you’ve led that you’re particularly proud of?
Bringing new products to the healthcare information technology (IT) market is something I’m proud of. Looking back, I’ve been at the forefront with a team or individually to help create three or four new products that have been installed into the ecosystem of healthcare IT.
The first initiative that comes to mind was nearly nine years ago when I worked for Sean Carroll, a wonderful CEO of Webmedx. He knew the true power of healthcare IT and that data was not just about processing the data through transcription and coding but also pulling out the unrecognized value.
Sean put me in charge of productizing and commercializing an academic research natural language processing (NLP) engine to start solving problems. We tracked core measures in healthcare, including if a patient received aspirin when they first walked into the emergency room or a procedure within the first hour of diagnosis.
Seeing the ability to unlock that information and do something that helped people, not just from a compliance standpoint but also to see where we were missing out on giving patients the best care possible, that was really exciting. That manifested itself.
When we sold Webmedx to Nuance, it was gratifying to hear their leadership praise us. They told us that even though we had a smaller company with fewer resources, we had commercialized AI and NLP solutions that they found themselves struggling to get to market.
That was incredibly validating. It was the start of what I felt could be an impactful way to use technology and healthcare workflows to create a better win-win for patients and providers.
Sometimes our mistakes can be our greatest teachers. Can you share a mistake you’ve made and the lesson you took away from it?
You must be comfortable in your own skin, and if you’re part of a family, you have to be comfortable with partnering in a family. I was extremely comfortable in my banking career, and I had a good network of friends and family in Nashville. The only reason I moved to take a promotion was for the promotion itself.
Looking back on it, I was away from my family and friends for a couple of years. Because I was successful, I was able to say: “I want to move back and do this from a different location,” before remote work was in vogue. That taught me to stay true to myself and stay true to what I believe in.
How has mentorship played a role in your career, whether receiving mentorship or offering it to others?
I was fortunate to have several wonderful mentors on a personal and professional level. Through high school and college, I had mentors who helped me understand what I was good at and what I liked to do. They offered me internships and summer jobs.
All these mentors made me feel special. They were quick to point out where they thought my talents were and which paths could lead me into a successful career.
After I graduated from college and went into the working world, those mentors who were there in the early years were particularly important to me. The country was in a recession at the time. Lots of people were worried about being laid off, for good reason. There weren’t as many new and inexperienced people being hired. So, to be able to navigate through that situation and launch a productive career gave me the self-confidence to say: “If I can excel in this environment, I can handle just about anything.”
The biggest aspect of a mentorship that I appreciate is the time spent. All my mentors were extraordinarily successful, and they got extremely busy. Despite being pulled in many different directions, they still took the time to have that 30-minute conversation at the end of the day, or we had coffee or breakfast. I appreciate that more now than anything else.
Developing your leadership style takes time and practice. Who do you model your leadership style after? What are some key character traits you try to emulate?
People draw from multiple public figures or individuals, whether you’re in business, watching sports, coaching or whether it’s family members. One of the overarching themes for leadership style is that in different ways, people display traits including servant leadership.
To me, servant leadership is simply saying: don’t ask other people to do something you’re not willing to do. If they see you do it, it goes a lot further than telling them that you did it or asking them to do it. Especially in an early-stage company, that’s important. But it’s not exclusive to a small company.
Rob Phillips was my boss at GE, a large corporation, yet he was very much a servant leader as well. Empathy is extremely important as a leader. We never know what someone is going through, and what we can learn from them.
We are often quick to dismiss other peoples’ situations. The more empathetic we are as leaders, we will receive a lot more kudos and praise for team building. Mission-driven companies and cultures thrive around being empathetic, giving people a chance and understanding their circumstances. That compares or contrasts with being vindictive and a hardliner and only seeing the black and white. Life is a lot of gray and in between.
Sean Carroll was a great CEO at Webmedx who patiently focused on the end game and didn’t get distracted. He would ask: What are we trying to accomplish and where are we trying to go? This outlook is important to me.
The earliest leader I strive to emulate is Will Vance, a leader in private banking in Nashville. His understanding of how positive relationships pay off in the long run sticks with me. He never dismissed anyone, no matter how unknown they were in the industry. Ten years from now, you may see a person’s leadership and entrepreneurial abilities. In the meantime, you treat that same person in a kind, professional manner. The next thing you know, they’re the next big success in town.
Thank you for sharing that with us. Let’s talk about scaling a business from a small startup to a midsize and then large company. Based on your experience, can you share with our readers the “5 Things You Need to Know to Successfully Scale Your Business”? Please give a story or example for each.
Flexibility — When you’re trying to scale, you must be flexible with your plan. Your plan may have been for you to go in one direction, but you may need to tweak that and be flexible with everything from workforce to execution. One plan may be more heavily focused on development engineering, but it ends up that product and implementation are where you can differentiate yourself.
Conviction — You must have guardrails of conviction or a mindset that says: I know within these parameters, this is what we need to do, and this is how we’ll do it. Your faith will be questioned multiple times. The landscape will change, competitors, funding and partners will change. You must believe that you’re in the right space doing the right thing and be flexible to adapt. If you don’t have conviction, then every day, you’ll be worried if you’re going the right way or not and constantly switching around.
Historical Knowledge — You have historical knowledge that started before your new business or enterprise that you can use. Even if you’re leading an early-stage company, every single day you’re learning something, which is fun in this environment. Capture those things that you’re learning and start the library of historical knowledge to include what you tried, said, who you met with in terms of partners, and what types of technology you’re using. We get moving so fast as an early-stage company, we forget we’re building historical knowledge every day.
Trust — If you’re managing a small startup or even a midsize company, you have to have trust. When you have 15 or even 150 employees, that’s still a very small company. If there’s not that basic, implicit trust between departments and individuals, you’ll have an exponentially larger problem. It slows down operation speed, stifles innovation, and creates inefficiencies. The most significant advantage you have as a small business trying to scale is you’re nimble and can react faster than a larger company. A lack of trust can erode all those advantages quickly.
Simplicity — Things get really complicated fast in technology, healthcare, and fintech. Remember to keep it simple. We must handle complex issues at the leadership level and keep it as simple as possible so that your teams can run at the highest speed possible. In the world of sports and athletics, the athletes that perform and excel the most are the ones who think the least. They’re just executing when it’s time for the game. They do all their planning, teaching, and learning in practice. Then, when the whistle blows and the game is on, they’re keeping it simple, focused exactly on what they are supposed to do. They can execute faster and at a higher level than their opponents. We need to do that in business. As we’re expanding rapidly, things get messy and complicated in a good way. But as a leader, we’ve got to keep things as simple as possible for our teams.
Can you share a few of the mistakes that companies make when they try to scale a business? What would you suggest to address those errors?
Early on, we’re such a slave to growth and revenue that we have to sometimes understand what the cost of that revenue can be. It ends up being red revenue, costing you more than it’s bringing in at the top line. That could be relational, it might not necessarily be a financial metric. It could be how that potential revenue filters through the company in other negative ways.
You must stay true to your mission and focus on that from a go-to-market strategy. If it deviates from that — and it’s okay if it does — you need to be very intentional in your decision about why you’re pursuing that revenue or that angle versus what your original focus was. Chasing the wrong revenue can create a short-term victory but it can exponentially hurt you down the road.
The other mistake is believing that today’s circumstances are not going to change. It sounds like an intuitive comment, but we’re seeing this every day in the stock market and seeing the failures of that mindset.
We have to not only, as business leaders, look at where the business is today and the circumstances are today, but we also must consider how the business will thrive and flourish in other economic, competitive landscapes or when a world event or disaster occurs. That could be the most extreme situation of a COVID-19 pandemic or something more typical. But understanding that your business will not always be competing and winning and going to market in the circumstances that we’re in today is very important. We must understand how we would pivot, react, and what our plan is. How do we anticipate some of those situations ahead of time?
Scaling includes bringing new people into the organization. How can a company preserve its company culture and ethos when new people are brought in?
Culture is very intentional. It may seem overly simplistic and almost elementary, but it’s the same reason you see the same commercial on TV repeatedly. The messages are trying to reinforce something at a basic level.
As a leader, you must reach people from various levels, and you have to be overly communicative with new employees to make sure they’re getting that cultural buy-in consistently.
Everyone says things in a unique way, and everyone connects in different ways. Assume everyone is on the same page from a leadership standpoint with your culture and your mission, but how you communicate that to an employee may be different for me versus another leader on my team. It’s important for employees to hear those messages from different perspectives and from people with varying life experiences.
Transparency is huge. In a smaller business that you’re trying to scale, you’re not going to have all the answers. You’re going to have to adapt and learn from each other. Be transparent about what you’re doing well and not doing well. Admitting what you have the answer to and what you’re still seeking to find the answer to builds credibility for employees that are new to the organization. They’re going to be more likely to speak up and point out when something isn’t going well.
It’s an easy word to say, transparency, but it’s more difficult to enact. Many people say they are transparent but instead of saying they don’t know, or they’ll find the answer, or it is confidential right now, they act as if everything can be answered. I see leaders make that mistake. That comes across as patronizing to your employees and very top-down. It’s something people need to make sure they do not do.
In my work, I focus on helping companies to simplify the process of creating documentation of their workflow, so I am particularly passionate about this question. Many times, a key aspect of scaling your business is scaling your team’s knowledge and internal procedures. What tools or techniques have helped your teams be successful at scaling internally?
With today’s technology, one of the most important things is to never lose any documentation, correspondence or brainstorming that occurs among your teams. Those items can potentially be turned into better internal procedures or serve as institutional and corporate knowledge.
An overly simplistic example is to take advantage of the ability to do everything in the cloud from a shared drive, including having a team edit and prepare work products. Allow access to all these documents, and be able to share, store and edit everything you do.
You can then classify these documents within various operational and functional areas of the company and rely on them in the future. You may not have time to create a large number of processes or procedural manuals, but you have the content at the ready when you have the right number of resources and the right scale.
Ensuring that everyone can access documents appropriately and share, edit and learn can save a lot of time and allow employees to teach each other, especially new hires, to grab a document and make a copy before adapting it. This can even help with a sales presentation if you find something similar that you didn’t know you had.
It’s simplistic, but it can benefit your company and employees in a straightforward way every day.
What software or tools do you recommend to help onboard new hires?
We have been fortunate and happy with the ability to outsource a lot of onboarding and payroll and human capital processes at Azra AI. That may not be right for everyone, but it’s certainly right for our company and size, to not worry about the scalability of that as we grow. We can use templates, platforms and customized materials to help with that onboarding process. It is a nice win-win for us, and we’re working with ADP.
We still have control over customized content, and we can make that personal experience better for our new hires. Still, we have the infrastructure of a nationally recognized corporate human resources expert that can help facilitate this work.
Having said that, the most significant way to make sure you are successful with onboarding is human interaction. Communication is key, whether it’s picking up the phone, walking into someone’s office or jumping on a Zoom call, or whatever you use to interact with your team. It’s important to do that outreach during the first few months or introductory period for employees with the company.
Because of your role, you are a person of significant influence. If you could inspire a movement that would bring the most amount of good to the most people, what would that be? You never know what your ideas can trigger.
If I could inspire any movement, I would like public, private and religious organizations and individuals to focus on how to get children aged two years and older access to high-quality education and learning. Funding pre-K and early childhood education and development is of utmost importance when you think about the ripple effect and where you can invest time and money to get the most widely dispersed impact. We need to make sure that young children have early interventions to learn to read, write, and work on their social skills.
Our socioeconomic status is by far the greatest predictor of our success or failure, kids lost to crime and violence and lower than expected income. Access to education and opportunities that override these indicators.
We must figure out how we get to kids early enough to educate them and reduce that gap early on when it has the biggest impact. Post-COVID, we’re seeing that those statistics are going to be exponentially greater. The earlier we’re able to interact with children and discover their different learning styles, and if they have any learning disabilities, the more likely they are to be successful later in life.
Our brains are so powerful and formative from age two to five. How can we all get out in our communities and help young kids not start off at a disadvantage, and become what they are naturally gifted and blessed to become?
How can our readers further follow your work online?
@AzraChris and @Azra_AI_Health on Twitter, and on Facebook: https://www.facebook.com/AzraAIHealth
This was truly meaningful! Thank you so much for your time and for sharing your expertise!
About the interviewer. Ken Babcock is the CEO and Co-Founder of Tango. Prior to his mission of celebrating how work is executed, Ken spent over 4 years at Uber riding the rollercoaster of a generational company. After gaining hands-on experience with entrepreneurship at Atomic VC, Ken went on to HBS. It was at HBS that Ken met his Co-Founders, Dan Giovacchini and Brian Shultz and they founded Tango.
Chris Cashwell Of Azra AI On 5 Things You Need To Know To Successfully Scale Your Business was originally published in Authority Magazine on Medium, where people are continuing the conversation by highlighting and responding to this story.