[00:00:28] Jay: Hi everyone. Welcome to The First Customer Podcast. My name's Jay Aigner. Today I am lucky enough to be joined by Adam Dakin. He is the president and CEO of Keriton Safe feeding.

Zero harm. Adam. Hello. How are you?

[00:00:39] Adam: Hey, Jay. How you doing? Thanks for the, invitation.

[00:00:42] Jay: What does safe feeding Zero harm mean?

[00:00:45] Adam: so the problem that we solve is the safety issues associated with complexity of feeding, neonates, infants in critical care settings, and those feeding orders and the complexities of the workflows unfortunately result in errors. Some of those errors can actually be catastrophic because if you feed the wrong milk to the wrong mother's milk to the wrong kid can get really sick and in some cases actually die.

[00:01:16] Jay: You mentioned that when we talked before and that stuck with me. Do you like, just from a layman's term, why is that so bad? It doesn't seem like on the surface you're like, milk is milk and obviously like beyond like not being your milk. Like what about that specifically would be bad?

[00:01:30] Adam: So CD. C treats that administration, we call them mis feeds or misappropriations. When the wrong milk, the wrong mother's milk is given to the wrong kid, like an exposure to a bodily fluid. So no different than if a nurse got exposed to blood, from a patient. If that happened, we would obviously have to do extensive testing because there's disease transmission, so you can transmit diseases if you give the wrong mother's milk to the wrong kid.

HIV hepatitis, there also the possibility of accidentally transmitting medications, from the mother to this other baby. You can, it can cause something called necrotizing enterocolitis, which a gastrointestinal disorder, sort of like an allergic reaction to the wrong mother's milk. so lots of bad consequences and it triggers a whole safety workflow that involves six months of testing.

You know, the mom, the wrong mom, make testing the child repeatedly to make sure the child isn't experiencing these adverse events from getting the wrong milk. So it's a never event that should never happen. But if you're a children's hospital, you're trying to manage 20,000 bottles of milk every year.

And remember, these bottles could be anywhere in the hospital. They could be a refrigerator, they could be a freezer, they could be the loading dock, they could be in the peds unit, the NICU unit, the neonatal ICU unit, the well baby unit. They could be in mom's refrigerator or freezer at home. Trying to keep track of these with spreadsheets and handwritten labels.

it's no way to run a railroad, right? It, you can just imagine mistakes are going to happen because you, beyond human capability to keep track of that many bottles, which are changing state too, because they go from the freezer to the or to the refrigerator, to the bedside. They all have different expiration dates.

Right. And what's so, so what we do is we know where every one of those bottles is at all times. We know exactly what's in it. We know who it belongs to, and we know when it expires, and we validate all of those at the time of the feed so that if a nurse is staying within the platform, they literally cannot feed the wrong milk to the wrong kid.

They cannot feed expired milk or formula to the wrong kid. And what's in the bottle is always what the doctor ordered.

[00:03:49] Jay: Yeah, you mentioned, I think, another thing you said was. kind of like a, they're like a bartender, at bedside, like trying to do all this crazy stuff. So that, that, that was a good, analogy that stuck with me too. Well, let's talk about you a little bit. where did you grow up and that have any impact on you being an entrepreneur later in life?

[00:04:06] Adam: Yeah, so I grew up in a Philly suburb in South Jersey, a little town called Magnolia. basically I saw your Eagles. Paraphernalia in the background there, Jay. So, yeah, I grew up as a big bird.

My dad took me to Sixers Phillies. I'm old enough to remember, games in the Connie Mack Stadium, if you can believe that.

[00:04:23] Jay: Oh, well. All right. You are back there. Okay.

[00:04:25] Adam: I'm a lot older than I look. I hope,

[00:04:28] Jay: You had the right breast milk Probably. Maybe that was it.

[00:04:31] Adam: yeah, maybe. but yeah, I grew up in South Jersey. went to college in Philly, then went out west for grad school, started out in sales and marketing, and yeah, doing, been doing mostly venture backed startups for the last 30 years.

[00:04:45] Jay: And, do you think if anything in Philly had anything to do with that? Do you think your family had anything to do with that? Was it just you later, you know, decided you liked kind of being in this CEO role? Like what is it about it? Where did you think that came from?

[00:05:01] Adam: Yeah, so the trajectory started when I was in my sophomore year of college actually. So I started out pre-med, like a lot of folks in the healthcare world. and at the, End of my freshman year, I started a business with two other guys who were in the business school. I was in the arts and sciences program.

And so two of the guys in the business school, I partnered together and we started a small business selling hats, buttons and t-shirts, believe it or not. and so every time there was a, you know, a pen game, we would stand in front of the palestra and hawk our wares, and one night there was a pen Princeton game, the arch rival.

And we sold $2,800 worth of hats, buttons, and t-shirts over the course of whatever that was, three hours, however long that basketball game lasted. And we went back to my dorm room and literally unloaded a pile of like $1, $5, $10 bills into this pyramid on my bed. And I was like, oh my God. And the margins were actually, we were selling these hats at that time.

the painter's hats were two bucks and they cost us 40 cents to make.

[00:06:04] Jay: And I was like, wow. I looked at this and I was like, this just seems like an easier way to make a living than spending the next 10 years in school.

Right. I love that. Who would now.

[00:06:14] Adam: And it just triggered something. And I was like, wow. And I literally, the next beginning of my sophomore year, I transferred into the business school.

[00:06:21] Jay: So do you think those, do you think those business guys had some business acumen that helped then, or were they, you know, did it matter? Like who did what in that business were you guys just kind of figuring out and you're making hats and you're selling 'em? Like how did,who's the business guy of that group and why would you, did you feel like you were missing something and then that's why you went to the business school afterward?

what's the kind of transition over.

[00:06:42] Adam: No, I was definitely not the business guy at that time. but one of the guys was very sharp and. He was keeping track of the inventory, he was keeping track of the ordering, he was keeping track of the margins. all the stuff that you need to do to sort of keep score of your business. And I was impressed.

He's a very smart guy. he went on to be a sort of very successful story investment banker. but yeah, he clearly had skills and knowledge that I did not have or spoke a language that I didn't even speak, like a vocabulary that I didn't even have. Right. So, yeah, I was like, wow. I guess probably important stuff to know if you ever wanna go into business, particularly if you wanna run a business on your own, even though this was obviously on a micro scale, you know, to a much larger, more complex entity.

but yeah, he was,it helped me understand that probably need a certain basic skillset if you ever wanna run a company.

[00:07:35] Jay: Okay. And what did you come outta business school with? Did you, were you ready to just start your own business then, or did you go work for somebody else? What was the, what did you do after business school?

[00:07:45] Adam: No, I went into sales for, well, I actually went to, into a management consulting gig for a couple years. was not my cup of tea. didn't enjoy it. always. And then from the, always found medical technology fascinating. Had a roommate who's an orthopedic surgeon. Interesting, true story. He had all these orthopedic, journals spread out throughout the floor in our apartment, which I used to have to step over to get to the kitchen or get the guy who was a total slob.

But he's a real great slob, you know, great surgeon now. Anyway. I picked one up one day 'cause I had to walk through the house and I was looking at the pictures. There was artificial hips, knees, and joint advertisements in there. Showed 'em to him. I said, what are these? He said, well, those are artificial hips, knees, and shoulders.

We replace people's joints. And he said, I don't know much about business, but these reps come to the hospital. He goes, they're always wearing really nice suits. They have very expensive watches, and they drive really nice sports cars. He goes, so I think they're doing pretty well. And I was like, wow, that sounds pretty good.

We gotta do, what do you gotta do? Get that job? Like, well, you probably gotta know a little bit about orthopedic implants and surgery. The short story is he took me under his wing, took me into his animal lab, taught me sort of the basic fundamentals, you know, anatomy, physiology of and, you know, orthopedic implants 1 0 1, so that I could then go out and interview.

with companies that sell the implants. Ultimately, I got a job and I sold implants in Philadelphia for a couple years, which I loved being in the operating room all day. One of the few jobs back then where a surgeon would look at you and say, what do I do next? Right? That's not so much true anymore as it was back then.

The rules have changed a bit, but for me that was you know. As a wannabe doctor surgeon, that was kind of the best of both worlds. Got to, you know, got to be on the business side, but got to be in the operating room doing procedures. So that was a great experience. Loved that job. But, ended up going back to business school, thinking I wanted to get into the venture capital world, at the time.

[00:09:46] Jay: Did you ever dip your toe in the venture capital world?

[00:09:50] Adam: I did, so I didn't mention in my background. You know, it's really 25 plus years as an operator. Started five companies along the way, raised venture capital for all of them. A couple did, well, a couple failed horribly. jury's still out on the last one. I'm not too involved in that company. but. that, and that's when I actually moved back to Philly and that's sort of from the west coast startup I was with out there.

Got acquired, and moved back to Philly. And that's like all the companies I've started have been Philly based. but I did that for about 25 years. and then an opportunity to go become a partner in lead health tech investing for DreamIt, which is a Philly based venture fund, health tech fund focused really on healthcare, it, medical devices and diagnostics.

so that was a great opportunity. Timing worked out great. I was exiting a company after you begged for money for 25 years, you think, wow, maybe it'd be nice to be on the other side of the table for a

while, but with a tremendous amount of empathy for what it means to fundraise. I mean, I got mistreated and abused by countless venture capitalists.

I think, I hate to say it, but most venture capitalists deserve their reputation. you know, I'm not, I don't know, I think there's a, you know, when people kiss your ring for 20 years, maybe it. Affects the way you think. but I went in with a very different attitude 'cause I know how difficult and painful the process is to go out and raise capital.

So it was a great opportunity. and I spent seven years as a partner at DreamIt, led about 20 deals while we were there. That was fun. Three. and then I left there in late, well early, early 24. Keriton was a portfolio company of 

Familiar with the company, they, the investors were looking for new leadership.

And so that opportunity created itself and I joined Keriton as the CEO, in April of 24.

[00:11:36] Jay: So do you, are those transitory kind of roles typically when a portfolio company, you know, you're in the investment side of things and then you, I've seen it a bunch of times and I'm just wondering, is it You are there to fix things and then you're gonna find somebody else to run it and move on, or is it, is the goal to kind of stay there for a while?

Like what's the thought behind, you know, becoming the CEO of one of the portfolio companies?

[00:12:03] Adam: Yeah, I mean every, it's very situational obviously, so it's an obvious, it depends answer. in this particular circumstance, they actually asked me to come in and what I consider serving sort of in more of an executive chairman role. 

I've done multiple times. I think it's a great if, particularly with younger CEOs of less experience, where, you know, they're open to mentoring and coaching, that relationship can be extremely productive and valuable.

so the initial conversation started with, Hey, are you thinking about maybe would you consider being an executive chairman? And the short version is, you know, I spent about a month in hardcore diligence, came up with about, call it 10 recommendations. and the former CEO was not supportive of those recommendations.

Not saying he's right or wrong, just saying I had laid out a plan that was different from his vision of the company. and I gave that to the board and said, here's the way I think this should work. Probably not a great fit for me as executive chairman because I'm giving this guy a plan that he doesn't wanna execute and he doesn't believe it.

They said, well, basically we think the plan makes sense. How would you feel about executing the plan? And at that time, after a month of real hardcore heads down diligence, I was sold on the mission of the company.

It's not hard to get enthusiastic about our mission because really what we do is very, what we do really matters.

Preventing, you know, the most vulnerable kids, infants, and children from getting injured. And preventing complications and improving safety is important work. I mean, we really do have a major impact and I had a son in the nicu, so I know how stressful and difficult that experience is. so it's important work that we do.

And what came out of the diligence was that customers love this platform. One, one nurse who, works at the NICU at Abington Jefferson. this was before I started with the company. I just said, tell me how do you feel about the platform? Do you use it? What do you think about it? She literally said to me, if you took this platform away from me, I would retire.

I cannot run my practice without this. And I heard that sort of same sentiment over and over again. and so that got me even more enthusiastic about, you know, the opportunity with the company.

[00:14:25] Jay: Who was your

kind of first customer? You don't have to name names, but just who was your first customer after you came in, kind of laid out your plan and started executing?

[00:14:35] Adam: so we target, we tend to target larger enterprise healthcare systems. We have smaller ones too. so the good news was there was a, you know, there was an established pipeline when I showed up. Not gonna lie. There are a lot of headwinds in selling to enterprise healthcare right now. Budget constraints.

A lot of market pressure hospitals are holding onto their, you know, their purse is pretty tight right now.

but fortunately we had, you know, we had several accounts in process, that we were able to close. And it was actually even more important to close those because we had, we literally had three accounts that were late stage in the pipeline.

And part of my agreement with the investors was they would have to put some additional capital in if I was gonna join. And they agreed to do that, but they did it in two tranches and they said, well, you'll get half the money when you join the other half. You don't get till you close those three deals.

So you can imagine when that third deal closed, and that was actually about six months after I started. I slept a whole lot better. the next day after that third deal closed.

[00:15:48] Jay: So who was, gimme just like the high level points and maybe the most important ones, from your plan. Like what were you trying to change when you came in and like, how have you done that so far?

[00:16:02] Adam: Yeah, I mean, one, you know, when you're in a situation like that, the first thing to do is get control of your finances. Get control of your burn. Make sure you understand the finance and the accounting. Make sure you understand your margin profile. Get, make sure you're getting reliable and accurate financial statements.

so that's, you know, I, shortly after I joined, I brought on a CFO. who has done an awesome job getting control of those things. So I did a round of layoffs, which was unfortunate. I had a layoff four people when I first started. but that was all in the mission of getting the company back to being cashflow positive.

So, you know, fir first order businesses, make sure you're gonna survive, right? Like, I've run outta money before. There is nothing worse. I mean, I've spent sleepless nights staring at the ceiling wondering how it's gonna make payroll. I don't ever want to go through that again.

so the bridge capital that the investors gave was enough to keep us going for a while, but it wasn't gonna be enough to get us to, we needed that second tranche and then we needed some deals to close.

So cutting the burn and then getting the right people in the right seats. Right. I did a pretty significant reorganization in terms of roles and responsibilities. the team is a really good team. We have an awesome team. Most of the people from that original team are still in place. The entire senior leadership team except for one, is still in place.

and that was critical. It's a very competent, skilled team. and then finally I came up through sales. It's one of the areas that I love, but the sales and marketing structure just didn't make sense. the resources, the. The way that this was outsourced, this is not a product that can be sold through distributors, in my opinion.

It's too clinically intensive. And there was a preexisting relationship with a distributor that had half the country, but was selling products that were kind of unrelated, even though it was the same call point. So, you know, next transition was to bring the sales marketing response, you know, responsibilities inside and go direct.

And that was, I think, an important part of building momentum, you know, and investing in sales and marketing, you know, all the traditional stuff that you do to create brand awareness, customer trust. So we spent a year kind of heads down brand building, creating awareness, you know, and sometimes it's better to be lucky than good.

we were super fortunate. I mean, it was a combination, I guess, of being lucky and good. We closed Intermountain Healthcare. 32 hospitals double the size of the company overnight. but in addition to the revenue that came with that, that came with a certain amount of imprimatur, of being selected in this very competitive process to go into such a large enterprise healthcare system.

And, that was a, that was like a huge booster shot, you know. Doubling us overnight, but also the credibility that came with winning a big order like that.

[00:19:02] Jay: How do you sell into the enterprise healthcare space? Is it, I mean, is relationships the way in or is it kind of traditional sales stuff? Like how are you landing these big deals?

[00:19:16] Adam: Yeah. It's not, it's not as relationship driven as you might think. The relationships may open a door for you, but these are system-wide sales. And a whole, it's a very complex, in some ways convoluted stakeholder network that gets involved. And every, we sort of jokingly say every healthcare system is a snowflake because you can't really, you can't go by titles like the, you know, the chief metal officer at one institution may have completely different roles, responsibilities, and a completely different remit than the CMO of another hospital.

So you really, you sort of, it's one of the huge challenges of enterprise healthcare sales is the scalability of the sales process because every single sales process is different.

[00:20:03] Jay: It's a lot of work to sort of figure out that stakeholder network. And you know, with us, the IT department is very important, right?

[00:20:12] Adam: We, we do an EMR integration. We're software and. You know, we have to train nurses on that software. We have to make sure the IT department works together with us to implement and integrate our software. Often we have, you know, we're feeding kids, we get stakeholders from dietetics and nutrition who have to weigh in on the platform, right?

Every nicu, picu, neonatal, pediatric, ICU, the workflows are different, right? And. Those workflows have evolved over several years and been optimized by very smart clinicians who believe they're doing things in the best interest of their patients. They're always different, so there's no cookie cutter like, Hey, here's a box of software.

Call us if you have any problems. No, every single time it has to be configured and customized to their specific requirements and their workflows. So, you know, it's not for the faint of heart. But once you get through that process, we're sticky. Like we would have to do something really egregious, you know, to get replaced or kicked out of a hospital because the good news is our platform provides tremendous value.

We, we drive safety, we really improve the workflows. We save nurses time, we remove cognitive burden. I mean, this process that can be. Very stressful for a nurse. 'cause look, no nurse ever wants to feed the wrong milk or formula or the wrong kit. and so they have to go through without a platform like ours.

It's a very manual labor intensive process to go through all the checks and balances and to validate the feed with us. You don't even need to think about that anymore. This is all fully automated. I got a green light on my phone, my mobile device. It says I validated. It says I'm good thoughtless, or what you were mentioning earlier.

We say nurses are like bartenders at the bedside because all times they have to mix all these recipes up by the bedside.

There're 20 variables in one, you know, in one feeding order. Little bit of this, a little bit of that, a little bit of this. And they actually get a calculator out to figure out how much of each they're supposed to add based on the doctor's order.

So that's a cumbersome, awkward process as well. And with us all that becomes just completely thoughtless. So we remove a lot of the cognitive burden of, you know, of these workflows from the. From the nurses and one of the reasons why they like us so much.

[00:22:36] Jay: If you have to start over tomorrow. Same business, same product from square one. What is step one tomorrow?

[00:22:49] Adam: You know, I think what is so critical is, you know, there, there's an expression in healthcare it that you can move at the speed of trust. A lot of startups, I think they try to get velocity in their pipeline and, you know, create awareness, get customers. But this is a brick by brick kind of business.

You, you need to scale the platform somewhat, incrementally and going sort of aggressively going far and wide. If you have a complex piece of software that involves a lot of different stakeholders and not understanding all the needs of those different stakeholders, 'cause you're in such a hurry to get to the market and start generating revenue.

So to answer your question, I think the early process maybe would've gone a little, we would've solicited a lot more customer feedback and stakeholder input. Before launching the first sort of generation of the product, making sure that it was really, you know, addressing the concerns, the major bugs were vetted and addressed.

and, you know, we were building very strong, lasting relationships because, you know, in this business there's no such thing as MVP. You can't launch A MVP and like, well, it's good enough. Let's see how it goes.

And the doctor's nurse is like, yeah, good enough. Is not even close to good enough. Like, I don't have time to deal with your clergy software now alone.

The fact that I'm responsible for people's lives.

Right.

So if it's not working exactly right. We're done here.

[00:24:34] Jay: Yeah.

[00:24:35] Adam: So I think a lot of companies are, you know, understandable. You're out there, you're an early stage company, you're running out, you know. If there's an, like one of my mentors used to say, definition of a startup is a race against insolvency.

It's totally true if you think about it, right? You gotta hit milestones and before you run outta money. So there's a huge amount of pressure to get to that revenue generation stage in a company. In healthcare, if you launch stuff that's not really ready for prime time, it's gonna bite you in a big way.

It'll hurt your relationships, it'll hurt your reputation. and you know, it's much better to do it right. You know the expression right? There's always, there's never time to do it right, but there's always time to do it over. And I feel like a lot of software companies are so anxious to get to that revenue generating stage.

They're just, they just wanna get in the market and start to get feedback. But this is not like other products where you can just, oh, got some feedback, let's go back to the lab and fix it. And I did a lot of stuff with medical devices there. It's a whole lot different. Like the surgeon might be like, okay, I'll try this.

You know, this handle doesn't feel quite right. And you know, I don't really like the way the tactile feel of this. Alright guys, go back. Y. Software is systemwide deployments. It involves so many stakeholders and users. You cannot get away with 

[00:25:54] Jay: Well. A QA guy. I appreciate that very much. wait. It is, it's gotta be buttoned up. and yeah, I've done a lot of healthcare, so I can attest to that. All right. Adam, you being you, Adam, being Adam. this is not a business related question. This is not a character related question.

just about you. If you could do anything on Earth and you knew you wouldn't fail, what would it be?

[00:26:18] Adam: If I could do anything on Earth and I knew I wouldn't fail, what would I be? Okay. And I'm gonna take the like. The obvious humanitarian,

[00:26:31] Jay: Yeah. This is more just, yeah. Something you, I actually

[00:26:34] Adam: not like cure, you know, say cure cancer 

[00:26:37] Jay: I mean, those are 

[00:26:37] Adam: eliminate world

[00:26:38] Jay: yeah. 

[00:26:39] Adam: comp. Right. We're taking those 

[00:26:40] Jay: We're taking those out. We know you would do that. That would be a non-starter. Of

course. You that totally. 

[00:26:45] Adam: Correct. So I would be a professional tennis player.

[00:26:49] Jay: Oh, there it is. See, somebody gives me an honest answer. I love it. I love that. You

[00:26:54] Adam: you know, I, so the truth is when I, I. College tennis and had aspirations of being a professional tennis player one day.

took a little time off after college to give it a shot, but there's only one thing that stopped me from making it

[00:27:10] Jay: What's that?

[00:27:11] Adam: talent.

[00:27:12] Jay: That'll do it every time. Every time it'll get you. You gotta be good enough. I appreciate that answer very much. But in this scenario, you can't fail. So you're the number one tennis player in the world. Look at that Adam Dakin number one tennis player in the world and CEO of Keriton. Could you believe it?

He did it all. that's a great answer. I love when people gimme a real answer about something that like they actually wanna do. I get a lot of those like, well, I would save the whales or whatever. Like, it's fine, but like, I love that answer. That's a great, or, you know, be in the NBA or something. That's another great answer. Adam, if you wanna find out more about you or anything you talked about today, how do they reach out to you directly? How do get in touch with heard anything?

[00:27:49] Adam: Yeah, so Keriton.com. Simple enough, and yeah, reach out to me through LinkedIn. you know, I love working with entrepreneurs, founders, avoid making a lot of the mistakes that help founders avoid a lot of the mistakes that I made. and I made a lot of them, which isn't false modesty. It's just I didn't have a lot of good mentors when I was starting my companies.

but for me it's very rewarding to kind of work with the next generation of founders and entrepreneurs. So, yeah, I mean, just reach out, ping me with a note through LinkedIn.

[00:28:20] Jay: Beautiful. Love it, man. All right. Well Adam, you are fantastic. good luck to you and care the team. We'll be following closely along. Have a good rest of your week, and we'll talk to you soon. All right. Thanks Adam.

[00:28:30] Adam: Stay well.

[00:28:30] Jay: See you. 

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