In this episode, Jason Niedle interviews Autumn Kyoko-Cushman, CEO of ShiftRx, discussing the intersection of hypergrowth and mission-driven companies. They explore the challenges women face in tech, the importance of addressing healthcare provider shortages, and the innovative solutions ShiftRx is implementing to improve staffing in the healthcare sector. Autumn shares insights on growth strategies, key performance indicators, and the importance of authenticity and continuous learning in leadership.
Takeaways
- Autumn emphasizes the importance of validating business ideas through real conversations, not just friendly affirmations.
- Women in tech face significant funding challenges, with less than 2% of female co-founding teams securing venture capital.
- The mission behind ShiftRx is deeply personal, stemming from experiences with burnout in healthcare.
- Technology solutions should aim to reduce administrative burdens on healthcare providers, not just add more apps.
- ShiftRx has prevented over 15,000 medication errors in its short existence, showcasing its impact on patient safety.
- Growth metrics for ShiftRx focus on user engagement and satisfaction rather than just revenue.
- Building a strong team and fostering a culture of continuous learning is crucial for success.
- Authenticity in leadership involves admitting uncertainty and being open to learning from others.
- Networking and building genuine relationships are key to navigating the healthcare industry.
- The healthcare sector is undergoing a tech revolution, with opportunities for innovation in staffing and provider support.
Sound Bites
“Women are often underfunded.”
“Nobody needs another app.”
“We have to do something.”
BeyondSaaS Transcript
Jason Niedle (00:00)
Today we’re talking with Autumn Kyoko-Cushman, CEO of ShiftRx, about hyper growth in a mission-driven company.
Welcome to Beyond SaaS. I’m Jason Niedle, founder of Tethos. We are a growth agency, and for the last 20 years, we’ve been working with everyone from smaller companies to global brands to solve their growth challenges.
And lately I’ve taken all the things that we’ve learned from these podcasts and put them into a hyper growth playbook. And you can grab that at tethos.com/podcast or just drop the word GROWTH in the comments. I’m really excited to speak with AK today about growth and hyper growth and particularly how that relates to not just money, but having a mission and doing something good. So AK is the CEO and co-founder of ShiftRx and they’re helping solve the pharmacy staffing crisis
by connecting pharmacy professionals and pharmacies in order to provide smarter staffing, better care, more flexibility. And their platform has really hyperscaled over the last couple of years using AI-driven onboarding and workflow integration tools that not only get the right people in the right jobs, but also customize training for each facility and help create a more efficient and more flexible workforce. So think that’s pretty amazing. AK served as a hospital corpsman in the US Navy.
Consulted at the National Cancer Institute and sounds like you supercharged IBM’s Watson Health and you have a background with provider burnout, which I would love to explore more and you were recently named a Forbes 30 under 30 So congratulations and welcome
Autumn-kyoko Cushman (01:23)
Thank you so much, Jason, and thanks for having me on. I’m super excited to be here.
Jason Niedle (01:27)
Cool. Before we jump in, do you have a quick tip or a golden nugget for our listeners today?
Autumn-kyoko Cushman (01:31)
Yeah, so when we were starting the company, was actually another founder friend of mine who was like, you’re thinking about starting a company. I’m already a founder. And I had texted him because it was a founder that I knew and said, hey, I think I have this really great idea. What do you think of this idea? And he said, before I answer this, I want you to read this book. And the book is called The Mom Test. And it’s really short, easy read if you’re thinking about starting a company. But it’s basically about how you can talk to people about their problems and see if
solution you want to work on is worthwhile or if they’re just going to give you the mom answer because they’re your friend or your family member and say hey yeah I think that’s a great idea you should totally work on that.
Jason Niedle (02:08)
Mom test. Awesome. I love it. And while we’re on the topic of moms, it’s been not easy to find women leaders in tech for the podcast. Why do you think that is?
Autumn-kyoko Cushman (02:09)
Yes, it’s a fantastic book.
I think that is probably because women are often underfunded and I think that women tend to choose
other roles in tech, maybe not necessarily like tech founder and then the ones that do choose tech founder, I feel like are really overlooked, which is terrible. I mean, when my co-founder and myself went to go start fundraising, we knew the stats and it was terrifying. It’s like less than 2% of women co-founding teams are likely to secure venture capital. So if you add a man to the co-founding team, that goes up by like 30%. But if you are two women founders, then
Jason Niedle (02:48)
Wow.
Autumn-kyoko Cushman (02:54)
it’s very very unlikely that you’ll be able to secure VC capital and if a woman leads your initial raise then it’s even more likely that you won’t go on to raise another round of capital. It’s it’s it’s pretty crazy and there was this one study I think out of Cambridge or Harvard that I stumbled upon on accident when we first started and they took a group of people and they had female founders and male founders pitch the same idea and the people were much more receptive to the male founders even though it
the same same idea. And so there is definitely a bias against women. I think our generation, so I’m 29 this year,
our generation, think, is starting to bridge that gap and we’re starting to say, there is no place for a woman. It’s not necessarily in the household. It’s not necessarily at home with the kids. It’s whatever they want it to be and wherever they want it to be. And so I think we will start to see more women in venture capital, more women in tech. And another little thing is when you do find women founders, I’ve seen so many like hit pieces, whether it’s like from the information.
or a tech crunch where there are women that are being heavily scrutinized for being tough bosses or hard to work for or having a toxic work environment where I think if it were a man the narrative would just be they’re really tough and they’re killer and it’s funny to see how those adjectives change based on gender. So one of the things that you know is really important to my co-founder myself is trying to be like a leading example for what a woman should act like and
what a woman can do. I think.
once we break out of those barriers and those boxes that are set forth for us, we really start to be trailblazers. And it’s not always about like subscribing to what everyone thinks that you’re going to do or how you’re going to act. And so I’ve had people where I’ve been interviewing them and they’re like, well, I think it’d be cool to work for a woman founder. And I’m like, well, why is that? Because if they say, well, think you’ll be more empathetic and nicer and all these other things, I’m like, you are in for a crazy surprise.
Jason Niedle (04:50)
It’s interesting because we worked for six years for an A-list celebrity, but she was a business owner and she had 400 people working for her. And a lot of the stuff she delegated and some of the people ended up being not the kindest people. And that ended in a big scandal for her and what a terrible person she was out of all that. And yet you see it in male run businesses. I see it
in male run businesses every single day, but they don’t get the blowback in that way in any way, shape or form. So I’ve seen it with my own eyes. What you’re talking about is the way that a woman led enterprise is judged is completely different, 100%.
Autumn-kyoko Cushman (05:21)
Yeah, and I think if anything, just makes it so that we can work harder and perform higher. There is statistics backing up that like
women founding teams actually return the fund more often than men do or we tend to generate higher returns. And I think it’s because we’re so used to like, if the standard for men are here, like we have to hit a bar above because we have to be constantly proving ourselves. So I hope that obviously that changes over the next couple of decades sooner if possible. But in the meantime, I always try to encourage women founders and give back. And one of the things that is really cool
is that UT reached out to me about being a Kendra Scott mentor at their Kendra Scott Institute for Entrepreneurship. So I have a mentee who’s in the program right now and she was concerned about like what’s it going to be like when she goes to fundraise as a solo female founder. And so there’s always things that like challenges that you have to navigate and roadblocks but I think.
If you are a woman in this space and you’re a leader in any capacity, whether that’s your founder or in the C-suite, remembering those people who gave you those chances too, you have to really pay it forward.
Jason Niedle (06:25)
I wonder at what point people actually figure out it’s smarter to fund women and to fund people that are going to work harder and had to work harder to get where they are. It seems like it’s like this obvious path and yet still being ignored.
Autumn-kyoko Cushman (06:36)
Yeah, yeah, and there are people that I’ve talked to in the founder space because the way that we raised and our experience with investors was totally different than like my male friend co-founding teams and they were joking about it and they were like we should start a VC fund that only focuses on women because like the things you guys go through just to fundraise it’s crazy.
Jason Niedle (06:54)
Yeah, right. Tell me a little bit, we talked about purpose and mission. Tell me a little bit about ShiftRx and how you guys are driven to hypergrowth by that mission.
Autumn-kyoko Cushman (07:02)
Yeah, so ShiftRx is working on solving the healthcare provider shortage. We started in pharmacy, but we are growing each and every day and I think
on the horizon, we’ll probably likely move out of pharmacy and into other verticals as well. We started with this very simple PRN gig work platform, trying to do something better, cheaper, more competently than anyone else could. And that was get them staffed, and staffed that was prepared because that ultimately lifts that burden off the permanent clinician. And now we’re kind of focusing on like the scheduling piece and automating some of these workforce management insights and tools. And so our first evolution was again, with this PRN marketplace and independent pharmacies,
and we grew in five states and then we ended up expanding nationwide a couple weeks ago and now we’re focused on this like scheduling evolution and working on getting into some of the healthcare systems and some of larger healthcare facilities to try to make maximum impact.
Jason Niedle (07:50)
and tell me how that connects to your mission. Like, why does that matter to you?
Autumn-kyoko Cushman (07:54)
Yeah, so I was a healthcare provider and I burned out and my co-founder was a healthcare provider and she burned out. And I think our story is totally not unique. I have friends and family members that are healthcare providers. There are so many of us that often pick to be a healthcare provider. We choose to become a healthcare provider because we think this is a really stable path where you really care about patients. And hopefully it’s a mix of the two and you find that those really good people end up getting overburdened
by clerical work and administrative tasks. They aren’t there to focus on their patients, which should be their only and sole focus. And we’ve seen the stats in nursing burnout and pharmacy burnout, physician burnout, and we have this huge shortage. This crisis is compounding and it’s happening right now, but once everyone starts to pay attention to it, it’s too late, you know? So
I think for us, this mission is just deeply personal because we’re both healthcare providers. wasn’t all sunshine and rainbows like we thought it would be. We ultimately ended up totally switching our careers, which is a hard thing to do because we wanted to avoid this. And then once I had a personal experience where my mom got diagnosed with brain cancer and I had to be that patient advocate for her, I really saw what happens when great healthcare providers leave the system. And we were so lucky to have amazing care providers.
providers on her team, because I had some of those awesome connections from some of my past jobs. But I think about what happens if I didn’t have those connections and how does someone help this person navigate the patient journey and be their patient advocate if they’re not in healthcare. That is a really hard thing to do. And the healthcare providers themselves should be that patient advocate, but they’re just honestly too overburdened. And so we want to just fix so much in healthcare and this is the first step for us.
Jason Niedle (09:32)
Wow. I’m sorry about your mom and brain cancer. I navigated that with my stepdad and I was probably about your age. I was about 27. So it was not an easy moment in life. Help me understand this connection that you’re talking about, about like burnout to technological solutions. Like my brain doesn’t say I was burned out, therefore, you know, the app is going to help me. Like, how does that solve that problem?
Autumn-kyoko Cushman (09:57)
No, 100%. Nobody needs another app. It’s
all of the little things that go into being a healthcare provider. So when I was working on the nursing side as a corpsman in the Navy, know, our job is to go into clinic and see patients and act like, you know, support staff. And you’re also having to take care of a lot of other admin stuff. So that might be joint commission related and making sure that your clinic is up to regulation so you guys can maintain your joint commission accreditation. It might be ordering supplies at the end of the day. It’s certainly charting and then taking care
of any of the credentials that are about to expire, any of the training certs that people need. All of these little things take up time in your day. And so if you’re there spending eight, 10, 12 hours in clinic or on shift, and then you have three, four hours of admin work after, you’re pretty exhausted. And sometimes you’ve got to do back to backs. And so it’s like, how do we just totally unburden the clinician with any of those administrative processes? And so I don’t think another app
Jason Niedle (10:51)
Mm.
Autumn-kyoko Cushman (10:54)
is the solution and one of the things we’re doing right now is totally reworking our product and trying to make it so that there’s the least amount of friction as possible. We’ve talked about entirely getting rid of the app and you’re just interacting SMS or phone. I think so often two clinicians are really bogged down by dealing with crappy software and so that’s another thing we’re trying to avoid because
Jason Niedle (11:11)
Right, everything
is so old in that industry usually.
Autumn-kyoko Cushman (11:15)
It’s old, it’s complicated, and it’s like if you’re learning something for the first time, you’re a float clinician, you’ve got to go in, you’ve got to figure out where the chart is, how to add the patient, how to send this to the doc, how to look up notes. If you’re a doctor, charting is even more like nightmarish. I can’t even imagine. And so I think like the technology solution here is trying to automate a lot of these back office tasks before they even reach the clinician. Like the scheduling part is basically the computer playing Tetris, which it’s fantastic at.
It can do that so that the clinician doesn’t have to worry about it or so the healthcare administrator doesn’t have to worry about it. Auto balancing like PTO and sick days and their float pool, their permanent people. This is really like our goal here and I think it just starts there and it’s like, okay, if technology can do this, then it can do X, Y and Z and we’re seeing all these like AI tech platforms pop up and healthcare that are taking care of medical coding and billing or patient reimbursements or claim codes. Like these are all really important things.
because ultimately it will automate some of these non-clinical jobs in healthcare, which I understand can be scary for some people, but at the same time, that money can go back into the budget, and healthcare systems are running on notoriously thin operating margins, so if that money’s back in the budget and turnover is their biggest problem, they can reinvest that into burnout and turnover and incentivizing new healthcare providers to join their organization.
Jason Niedle (12:33)
Yeah, I love all that. Two quick stories. I was subscribing to the super high-end fancy health service where you pay 150 bucks a month and then you can go to the clinic whenever you want. There’s always a doctor and they serve you quickly and they actually in their app, you could message them. And really high-tech when you go in there, they had this cool monitor and this giant, the biggest monitor I’ve ever seen that was a touch screen and the doctor would come and touch stuff on the touch screen.
And it was so funny because they’d come take your vitals and every single time I went in there for two years, they’re like writing them on a piece of paper and I’m like, why are you writing the vitals on a piece of paper? You have like the most amazing tech I’ve ever seen. They’re like, yeah, it doesn’t work right, it’s too hard. And it’s like so ironic that everything looks so perfect and then you find out the reality is it’s like still clunky in the background. ⁓ And then just a quick side note, two podcasts ago, two episodes ago, I talked with someone who has an app called
Autumn-kyoko Cushman (13:14)
Yeah.
Jason Niedle (13:21)
Duniya Health and he aggregates cancer services for people so the cancer patient can go to their app instead of having to schedule and there’s like five or eight different things that are all aggregated in one place just to make their life easier for them and it’s interesting to have this meta perspective and I can see that with you as well of like how do we reduce friction and I hadn’t had that perspective on it because I’m obviously not there but someone who’s working 10 hours on a patient and then has to go do three hours of paperwork like that’s
that’s pretty devastating, I imagine, at the end of the shift. You’re like, you’re done.
Autumn-kyoko Cushman (13:50)
Yeah, you’re exhausted and I think.
it gets old really quickly. And I don’t want to say that there are clinicians that do this, but it’s like everything you do needs to be documented. Right. And so I have to imagine there have been scenarios tragically where, certain things aren’t done just because you can skip the documentation for it. Whether that’s like reporting an adverse side effect with a medication or a vaccine. Like these are things where it’s like hours and hours worth of paperwork. It doesn’t really incentivize the clinician to do it, even though that data
that is really significant and important for patient care. So incentives in healthcare are totally misaligned. And in order to realign them, I think we are going to have to have this huge tech revolution, which I believe we are in the middle of with healthcare right now. Like I think it started a couple years ago, and right now is like, we’re in like the dot com almost, like golden age of the internet, but with AI and healthcare.
Jason Niedle (14:44)
I feel like you could probably talk for many episodes about this misalignment and the effects that that’s causing because that’s just huge. That’s the whole American medical system,
Autumn-kyoko Cushman (14:52)
It is actually the US spends the most amount of money per person on healthcare, even though we rank 37th globally for outcomes.
Jason Niedle (15:00)
Misalignment. So can we talk growth about ShiftRx? What can we get into the details of growth?
Autumn-kyoko Cushman (15:05)
Please.
Jason Niedle (15:07)
Tell me, first of all, what are your KPIs? You said that it’s just not pure cash. How are you looking at hypergrowth? What matters to you?
Autumn-kyoko Cushman (15:15)
Yeah, so what matters to us is usage. Are people using the product? Do they love it? Are we growing on usage? The main KPIs we track are how many clinicians are using the platform? What is their experience like? How many healthcare facilities are using the platform? What is their experience like? And how do we keep reducing friction points? So that first friction point of onboarding, that was where we were competitive with the traditional staffing agencies. They’re not well-incentivized to train new people on the healthcare systems or the healthcare facilities, entire clinical workflow, what
EHR EMR system they’re using, they’re just trying to get someone in the door. And it was like, this is a problem that’s really easily solved by generative AI, and we think it can do actually a pretty dang good job. And so that was our first test and how we were implementing these temporary clinicians into new clinical workflows. It was going off at that hitch and we’re like, okay, great, test completed. And so how many hours can these onboarding modules save? Another big KPI we like to track is how many medication errors we can prevent. There are 2.1 million patients annually — and this stat
is a little bit old, so it’s probably much more — affected by medication errors and that leads to thousands of deaths. And how many medication errors are we preventing by making sure that they have competently trained staff on time, the schedules are balanced, they’re not having any staffing gaps, there’s less turnover, less burnout. And so, you know, when we look at like historical data for us, we have not even been around yet for two years. So this time two years ago, I was just coming up with the idea with Leann [Haddad] and we were like,
maybe this is good idea, maybe it’s not, let’s do some research. We didn’t launch until mid-August of 2023, so we are not quite yet two years old, but we have already prevented over 15,000 medication errors, which I think is a huge, huge win.
Jason Niedle (16:49)
And if, and I’m sure there’s some stat, like if X percent of those were life threatening, then how many lives is that?
Autumn-kyoko Cushman (16:55)
Yeah, that’s right. And that’s how I like to measure it as well. When people talk about that patients are always measured in patient lives or patient number. But behind every patient number or patient life, there is a person there. And I think that’s really important to put back into health care and the perspective of tech, whether that’s, you know, a VC or an operator. If you’re operating the health care space at all, instead of saying to yourself, I’m going to measure this by patient lives, think about it as like you’re saving your grandma or your mom or your sibling, because
Whenever someone is harmed by a medical error and unfortunately passes away, you’ve just affected an entire ecosystem. And so how many of those are preventable? That’s something we really want to solve for. And I know that this ShiftRx solution is not going to be the big bandaid that fixes US healthcare for now, but it is definitely aiding and trying to make huge impact when and wherever possible.
Jason Niedle (17:46)
and you have to do something.
Autumn-kyoko Cushman (17:47)
Yeah, you do have to, we felt like that. We have to do something. Honestly, we had these overwhelming feelings of guilt where we were like
We’d switched careers. We thought the short staffing thing wasn’t going to bother us anymore. But we were still pretty segmented into health care and we were seeing it affect all areas of health care. And then, you know, being a patient advocate for my mom was incredibly difficult and challenging. And I’m so grateful that I’d had that prior medical training and experience. I can’t even imagine having done it otherwise. But it really gave me that empathy perspective of how are other people handling this as patients themselves or for their family members or friends or spouses as a, as
patient advocate. And so like, what can we do to make impact on that? And you know, my mom, she’s okay now, thankfully. She’s a healthcare provider herself. She’s an occupational therapist. Leann’s sister is a pharmacy technician. Her mom works in healthcare. I have a sister-in-law who’s a nurse. We see every single day how this is affecting healthcare providers and watching them go through that when they were so eager, so excited to be working in that profession and then just watching the breakdown, it’s horrible. There’s nothing like it.
For us, was like, this is like a sense of duty, like we have to go do this and we have to give it our all and say we tried to do something towards fixing the problem. Otherwise, you’re just idly standing by.
Jason Niedle (18:57)
Absolutely. So it sounds like you have at least two ideal customer profiles, ICPs. You have the providers and if they’re not using it or they don’t want to use it, then you’re stuck, right? And then you have the facilities and of course investors. How do you look at those different ICPs and how are you reaching out to them? How do they get to find out about you when the world is so noisy right now?
Autumn-kyoko Cushman (19:19)
Yeah, it’s really difficult. It is hard. One, ICP, the providers, that has been really easy for us to get mass marketing to the providers because we just shared our story. Leann and I were like, hey, we’re you. We’re literally the you. We want a better thing for us. We want to put ourselves and shift the power back to the providers. And we’re building the product from the perspective of a provider. So.
that I think we’ve really figured out and unlocked. Getting the healthcare facility has been much harder because healthcare facilities are notoriously large and slow and archaic. And so that’s one of the reasons we started with this PRN Marketplace and on the independent pharmacy owner side, because you could get to an independent pharmacy owner, if you could figure out their phone number or fax them or whatever, you could get this in front of them and say, hey, is this something you need right now? And if it is, sign up. Yeah. And so now, you know, in this next evolution, we’re just focused on the staffing side of things when it comes to scheduling. It’s much
Jason Niedle (19:55)
mmm
and they can make a decision.
Autumn-kyoko Cushman (20:10)
more straight B2B. We still have the PRN marketplace. still running and it’s fantastic. It’s a huge value add to so many of our independent pharmacies. We have over 700 and that is continuing to grow every day. I would say though this next thing is like this next challenge. How do we fix the scheduling with AI and machine learning algorithms? And once we can unlock that, that’s value that we can then deliver again to the independents and some of the mid-sizes that we work with. But the healthcare system
I mean, it’s tons of political bureaucracy. They’re slow to move. They’re large. They’re fragmented. You don’t know who’s been bought up by a P.E. You know, have multiple champions ushering you through. And so it’s definitely a difficult, low, slow, long sales cycle, and it’s painful. But we have this awesome awareness with clinicians, and so we’ve been able to get champions inside the healthcare systems that were clinicians on our platform or that knew about us because they saw our branding and our marketing.
and they’ve seen us on Facebook or TikTok. We have a huge following on TikTok and it’s totally unhinged. I have an intern who just also happens to be my 19 year old sister and I let her have full autonomy on what she’s going to post there and so I cannot be held responsible for it.
Jason Niedle (21:17)
Beautiful.
It sounds like then you actually break down your facilities into really two different ICPs. Maybe you have the independence, you break it down into five different groups.
Autumn-kyoko Cushman (21:24)
five. Yeah, it’s
it’s difficult. Yeah. So you’ve got the independence pharmacy so
Jason Niedle (21:28)
But I like that, that’s interesting for me.
Autumn-kyoko Cushman (21:32)
diverse. I think when people think pharmacy, they think a pharmacist or technician at CVS. But the truth is that pharmacists and technicians are everywhere. They’re in every part of health care. They’re in clinical consulting, skincare, formularies, insurance, PBMs. They are in these large drug companies or pharmaceutical companies. They’re in urgent cares, primary cares. They are everywhere, not just the retail chains or the grocery stores. so, yeah, our ICPs are independent
Community retail and then we’ve got specialty which is could be an independent specialty or it could be mid-sized like call it a hundred to two hundred employees specialty pharmacy compounding central fill we have the healthcare systems community hospitals, and then you’ve got like the pharmaceutical companies and PBMs and insurers
Jason Niedle (22:17)
Wow.
And what specific things are you doing to reach some of those bigger and more enterprise organizations?
Autumn-kyoko Cushman (22:25)
I’m hanging out at the golf course most, no, I’m just kidding. So ⁓ I should be, honestly, I think that might be where they’re at. No, you know, we’ve got a great advisory board of people who are really well connected in the pharmacy space. I LinkedIn cold DM people. We message people on.
Jason Niedle (22:28)
Are you?
By the way,
on that, have you tried voice notes for them?
Autumn-kyoko Cushman (22:45)
I have heard of that and I have not done it yet.
Jason Niedle (22:48)
It has such
a high reply rate.
Autumn-kyoko Cushman (22:49)
I bet it does and I actually said this a couple months ago that we should do that because I’ve always play a voice note if I get it, but I don’t want to freak people out. I’m actually really old school and I put my little FBI hat on and I will stalk the heck out of someone that I want to talk to like I’ll try and find their Facebook their reddit like they’re all their social profiles and then I will come up with a really really really like tailored cold email and then find if I don’t hear back from the email then I’ll
old call them and I’m like, hey, I know this is crazy that I got your phone number, but I would love to chat. And most of the time they’re actually pretty receptive to that. Sometimes they’re not, but most of the time I would say that’s been a pretty good success rate. You got to shoot your shot. You always have to shoot your shot and you don’t want to sit and say like, I wish I would have done that or I wish it would have been crazier. And I think we’ve taken that approach with everything that we’ve done. We’ve always tried to think out of the box, even when it comes to like.
marketing tactics, the TikTok account being unhinged, some of the conferences we went to, we worked with local zoos and we had an alligator and kangaroo and like things at our booth that we thought would get people to come see us because we couldn’t afford a ton of swag that people were just going to throw into a landfill. So it’s like always thinking creatively and trying to do things that are not boring. So you can, if you can just try to grasp their attention for 10, 15, 25 seconds, then you’ve got an opportunity to tell them what you’re all about.
Jason Niedle (24:05)
So I love the fact that you came from a healthcare side of things, but then you’re talking about it like a professional marketer over here. You’ve got your five ICPs, you’re doing everything from trade show booths to TikTok to stalking people, quote unquote. And it’s such a wide range of things. how did you gain all that knowledge?
Autumn-kyoko Cushman (24:21)
Honestly, I have no idea because when I started off the company, was also like I was our CEO CTO and I had been a
hobbyist like coding websites. I liked graphic design when I was young. I was always, on the computer. I lived on the computer. I had a really cool MySpace page. That’s where I first learned CSS and HTML. And then, I had a little business when I was in high school and then another one when I was in the Navy where I would call up, small business owners and be like, hey, I didn’t find you guys on socials. I didn’t see you had a website. I’d love to do this for you if you’re willing to pay me X amount, which was totally undercharging
I think I was charging like 300 bucks or something. Spin them up a website, come in, photograph some stuff for them, put it on Instagram, put it on Facebook. And this is before you could get an offshore team doing it for like, you know, $9 a day. And so I always had that like hustle of trying to figure things out. And I’m a really, like I really love science. I’m a big data person. And so I was reading some of the science behind like reward mechanisms and the algorithms and like how they keep people’s attention and when
trending times are and it’s funny because during this whole time I didn’t have personal social media. So I was just learning as I went. Now I have a Facebook and I have a LinkedIn and Twitter because I need them for work. But yeah, I’ve always loved trying to figure out how things work and I’m a very visual person. So I am a huge appreciator of fantastic product design. I love things that just look like someone has put
a lot of effort into them and it’s really clean, really frictionless, and I get really excited about that stuff. So I’m a total snob when it comes to tech. When this podcast thing came out and it said I had to use Google Chrome, I had to go download Google Chrome, because I am a strict loyalist to the Arc browser, and I’ve been trying to poach a designer from the browser company for the last two years. They’ve done a fantastic job. And so I think having that appreciation for it has helped me learn.
But I often refer to myself as a food critic when it comes to design and branding and marketing and even the technical side. I know what I like. I know what I don’t like. know what I think is good. But don’t ask me to do it. the marketing stuff.
Jason Niedle (26:24)
Although you were doing it at some
level,
Autumn-kyoko Cushman (26:26)
Yeah, yeah, but it was terrible. It was like a food critic turned amateur chef, right? Like I would have been laughed out of the big leagues, but I really do have a love for it. And so the marketing stuff
I don’t even think I took a marketing class in college. just, it really did come naturally to me because I was like, I don’t want to see stuff that I think is spammy. I don’t want to see stuff that I think is scammy. What would make me double look at this and say, this is interesting to me. And so maybe that’s like an empathy thing, but I think one of my superpowers is being able to put myself in someone else’s shoes and say, well, how would I react to this if I were them? And so I try to craft it from that.
Jason Niedle (27:00)
I mean, that’s kind of the key
to marketing, right?
Autumn-kyoko Cushman (27:02)
Yeah, I try to craft it from that perspective. Even when we got onboarded my intern, I was like, look, watch these commercials that have lived in my head forever. Why are they so catchy? What like the Daisy sour cream jingle, the orbit gum, there’s an orbit gum commercial that I make every marketing person, whether it’s a contractor or whatever, who comes to work for us, I make them watch it. Because I say this commercial has lived rent free in my head for 20 years.
Jason Niedle (27:23)
Mm. That does the
best.
Autumn-kyoko Cushman (27:25)
And it’s the one where she goes, you you lint liquor and then she’s chewing the gum and she goes, dirty mouth, clean it up with orbit. Why does that stick in your head? What about that makes it stick in your head? And so it’s like trying to do things that are creative and funny and out of the box, but that are also relatable to people and makes your product memorable. I think so many people right now, especially with AI, you can build a product pretty quickly. You can pump and dump it. You can get it out there very lazily. You can just
Jason Niedle (27:34)
Right.
Autumn-kyoko Cushman (27:50)
build a couple of things see what works what doesn’t work see what people are willing to pay for but when you put yourself in your customer shoes, You’re constantly talking to them and you’re designing the entirety of the product with their feedback always. My team is doing 10 to 25 feedback calls a week and we’re all doing them everybody at the team does feedback calls with customers and understands yeah what it looks like for them. No, they don’t they don’t want to talk to their customers Which it’s like if you don’t want to talk to their customer your customer. Why why do you want their money?
Jason Niedle (28:05)
I love that.
Super important. People don’t do that enough. Companies don’t do that enough.
Speaking of crazy wild ads, have you ever seen these Sabri Suby ads? His name is S-A-B-R-I, Suby, S-U-B-Y. Sabri Suby, I’ll send you one. His ads are the most insane things I’ve ever seen and they’re on Instagram and I should watch for five seconds and then I end up watching his whole three minute ad every single time because they’re just out of control. I don’t know, maybe you’ll hate them, maybe you’ll love them, but I’ll send you one, they’re great.
Autumn-kyoko Cushman (28:37)
I’m sure I’ll love it and I’m excited to check it out.
Jason Niedle (28:40)
What are you looking for in growth for this year? You’re in this crazy trajectory. Where do you hope to be at in terms of either revenue or percentage in the next year?
Autumn-kyoko Cushman (28:47)
Yeah, so not sharing any revenue goals right now, but in terms of usage, we have about 700 pharmacies up on the platform and trying to really increase their usage overall, especially as we build out the scheduling tool and moving not just the PRN floaters that were on the platform, but everybody there, their internal team, their established float pool, as well as the PRN marketplace and fully integrating that in and then landing some health care systems so we can get this up and running with hospitals. I think for us, like
what success looks like in the next year is working with a dozen healthcare systems and this tool is being used to schedule all of their pharmacy staff across these different pharmacy locations whether that’s their compounding or central fill or their outpatient or their internal clinical staff.
and the pharmacy for inpatient and making sure that it works. Like it’s okay. It’s okay to be in this hyper growth stage and always be like, we gotta grow, we gotta grow. That obviously comes with the pressure of raising venture capital. But one of the things that we did, we really took our time. I think we could have gone way quicker with the independence, but it was like, we start in this state and we figure out all of the ins and outs down to like credentialing. Like what is required of that temporary provider? like in Texas, it’s required that a pharmacist or technician does human trafficking
Training modules and so like making sure those are up to date, learning the intricacies can take you a long way and sure, maybe that stagnates some of your growth but at the same time it goes it back into building this really incredible product with an awesome moat and really adds value to the customer because if you’re not adding huge value for them. Then you might burn really really hot, but it’s going to be quick and it will go out.
Jason Niedle (30:20)
Yeah, you have the churn and then you’re run out of clients at some point.
Autumn-kyoko Cushman (30:23)
Yeah, 100%.
Jason Niedle (30:25)
So if we took one element of what you said there in terms of growth goal, like 12 healthcare systems, what’s the constraint on that? What’s holding you back? Why, or what won’t hold you back? What’s stopping you from getting there?
Autumn-kyoko Cushman (30:34)
Well, I just started on this journey of us, our next evolution going to the healthcare systems.
What will hold me back is getting stuck in procurement or not being able to get past some of the legacy systems that exist or having people that are blocking innovation because they’re nervous about it, which is totally understandable. And that’s going to be a failure on my part to educate. But I think what will get us there is this team’s determination. I am running sales here solo right now, but we’ve got everyone helps when it comes to sales and go to market and marketing,
and ops and customer feedback. And so I just, we have a really incredible team. Most of the people on our team are former healthcare providers. And we really care about what it is that we’re doing. And so the healthcare systems are slow, they’re painful, they’re hard to get through to, but you just have to keep chipping away at that block, building that network, and it will come.
Jason Niedle (31:26)
What do wish other leaders knew about growing a company?
Autumn-kyoko Cushman (31:29)
God, no one.
I don’t know. And I think that’s what I wish everyone knew. Nobody knows what they’re doing. I do not know. In fact, I sent out an offer letter this morning and the candidate who I think is accepting asked me a couple of questions about how I chose title or whatever. And I was like, you can make your title whatever you want. And he was like, what? And I said, yeah, you can make your title whatever we want. I mean, you can’t be on the C-suite, but if you want to be like a VP or a head of like, it’s all the same thing to me. You can call yourself whatever. And he said, King. And I said, go ahead.
And I said, I just want to go ahead and squash any illusions right now that like we have it all figured out. We do not. And that is so okay. And the second that you just start accepting that and saying, I don’t have it all figured out, but I’m going to figure out as much as I can because it’s important for fixing this problem or this problem or solving this issue. I think it’s good for your mental health. I think it’s good for your business. It’s good for your leadership skills. It shows vulnerability to your team to say, hey, I’m not the smartest person in the world. I’m not the most creative person in the world.
My job as a founder is always to be constantly sourcing people that are smarter and better than me at what I’m hiring them to do. And it shows them you are human and you’re a person and makes it so that you’re able to bond with them And it so you know it’s okay to show people that like you don’t have it all figured out you’re winging it I think most of the really really successful people that you meet are so full of crap when they go on these types of podcasts and they’re like well I knew from a young age, I was going to be a billionaire, and then I just
manifested it and I did it and I wake up every day at 4 a.m. and I put my head in ice water like come on be so for real so I genuinely think it’s just like the second we all stopped the charade and we’re like none of us know what we’re doing most of the time but
we have this awesome ability as founders or in the C-suite or as leaders to figure things out. That’s what sets us apart from everybody else is saying, hey, I don’t actually know how to do that, but I can go to YouTube University. I can Google it. I can read a book on it. And now I think I have a pretty good idea of how to do it. And I will go figure that out. But starting that square zero to say, I have an idea of how I think I could tackle this, but I don’t know. And I don’t know if it’s going to be correct. And I don’t know if what I’m going to do is going to pan out. think showing people more that vulnerability and just being real
goes so much further. But you know, I’m probably showing my age here because I’ve definitely done this with some of the healthcare execs I’ve met along the way and people in this industry. And I, for sure, am an acquired taste. Some people can’t handle it and they’re like, you are crazy. And I’m like, I know, right?
Jason Niedle (33:50)
But that gets back to authenticity, which I think people are craving for and you’re not going to get authenticity from an AI. It’s impossible. And so I heard you say three things in there that resonate with me, like that be real, be authentic. You know, some people will like it, won’t. Continuous learning, which you keep alluding to, right? You’re always learning. And then just listening.
Autumn-kyoko Cushman (34:07)
Yeah, 100%. And at the end of the day, you just need to do what you feel best about doing. For me, it’s working on this problem. It’s being authentic. It’s being real.
And that I can go to sleep at night on the nights that I do get to go to sleep and feel happy with myself. I don’t think I’d feel happy with myself if I were living like an illusion of being always put together and being like, I wake up every morning and I work out and I eat the best and I super prioritize my health and I have everything all figured out and I’m so great. It’s just, that’s not the truth. I wish it were the truth. It would be, my life would probably dramatically improve. And now this conversation has inspired me. I’m probably going to go to the gym tomorrow.
morning but it’s okay to keep figuring things out along the way and that’s going to happen at every stage of life.
Jason Niedle (34:48)
I just had a CEO who coaches CEOs and he’s literally coached thousands of CEOs and he was on two episodes ago, which hasn’t been released yet when I’m talking to you here. And it was so great because he was talking about how critical it was to do those things for yourself, to do the workout, to do the family things, not necessarily for the excuse of, I look good on Instagram or whatever, but that even if you’re just looking at your mission is like that makes you better at your mission. If you’re not healthy and you’re not balanced, you’re not going to be 100 % on your mission.
and he had a really great rant, it’s not really a rant, but a very emotional way to put that that was fantastic, so I’ll send that clip to you as well.
Autumn-kyoko Cushman (35:24)
Yeah, I would love to see it. It’s true. It’s totally important. I do go on a walk every day. My team and I take walks. We take like strategy walks. They’re important and you definitely need to make sure that you’re always in that like best space. I think for me, it’s just again, like not trying to show like I’ve got it all figured out. I think most people don’t. And that’s how I live authentically. And I think we’d all be better off if we just cut through the crap and the small talk of being like, it’d be so great to have coffee with you.
Where are from? Yeah, the weather’s hot there. Like, tell me what’s interesting. What’s interesting about you? What’s interesting about what you’re working on? Why do you want to talk to me? Is there something I can help you with? That’d be great. Is there something you can help me with? That would be awesome. Like, I want to hear about your kids. I want to hear about your first dog. Like, I like really getting to know people and building those like zero-to-one relationships.
Jason Niedle (36:10)
Last question, What do you see ahead? Like the world feels turbulent and chaotic and funding’s cut here and there and that’s, I’m sure affecting your industry quite a bit. So how do you navigate through all this chaos? And what do you see as any trends ahead for growth?
Autumn-kyoko Cushman (36:25)
Yeah, I’m not worried about it personally. I know there are a lot of people that are being affected by tariffs or if they’re consumer brands or if they need funding right now. And so that’s hard to secure.
I think for us, we’re on a good growth trajectory and again, we’re doing this thing with the provider at the sole focus of everything that we develop in the product and that will ultimately allow us to win and to survive. And trying to build a generational company or a category defining company, there are so many ups and downs and so these things too shall pass.
Jason Niedle (36:58)
That’s great. I’ve loved our conversation. This has been amazing. Where do our listeners find you?
Autumn-kyoko Cushman (37:02)
I’m on LinkedIn. I’m on Twitter. And they can find me at shiftrx.io. I’ve got a contact me form on there. But I always love connecting with other founders in the SaaS or any founders in general. I love talking to other people and learning about their business.
Jason Niedle (37:16)
And that website for the listeners out there is shiftrx.io. it’s Autumn Kyoko Cushman. AK, thank you so much for being on Beyond SaaS. For those tech listeners out there, we’re committed to exploring growth and conversations like these. So we drop episodes twice a week on Tuesdays and Thursdays. And you can find me, Jason Niedle, at tethos.com, T-E-T-H-O-S.com.
So if you got some value today, tell a friend we appreciate that. And until next time, this is Beyond SaaS.
Autumn-kyoko Cushman (37:42)
Thanks so much, Jason.
