E24: Mark Gehring, Co-Founder of HealthMyne and Propeller Health – Interview

May 17, 2016


Mark Gehring has started and built a number of successful startups. And yet he’s still such a humble guy. This podcast is about his story. He’s started and sold both Geometrics and UltraVisual which we’ll talk about. He’s also started a number of other companies including Propeller Health and HealthMyne.

Mark is a also a brilliant software developer. He talks about how he uses those talents to change industries.


Dave Kruse: Hey everyone, welcome to another episode of Flyover Labs from Madison, Wisconsin, and today we are lucky enough to have Mark Gehring with us who is actually in the same room which is awesome. So, Mark has been involved with a number of successful startups and his track record is pretty amazing, so the challenge of Mark, it’s hard give even a brief overview of his background, so I won’t even try, because we’ll get into it, but he started a couple of successful companies, Geometrics and UltraVisual, which we’ll talk about and he also started a number other companies that are going very well plus Mark is a pretty humble guy so that makes even better and he is a pretty brilliant software developer, so I’m excited to learn more about Mark and what he’s all done, so Mark thanks joining us.

Mark Gehring: Thanks for the nice intro, it sounds great.

Dave Kruse: Like I said, it’s hard to know where to start with Mark, I have a lot to learn like what he has learnt, understand how he ticks, but at the same his background is so interesting, so will try to do a mix between the two. So, maybe, let’s talk about your background and how you started your first company, and yeah will go from there.

Mark Gehring: Yeah, I don’t have a Computer Science degree, I have never taken a computer class, but in high school and college, I was into programming, I love doing that, and after college I got…

Dave Kruse: What did you program?

Mark Gehring: The first was like an apple 2 computer.

Dave Kruse: What type of programs did you…

Mark Gehring: I make games and I had a friend whose dad had a food company and over the summer we did some stuff on this NCR mainframe computers, so it was just sort of random things, way back when, but I got a degree in biomedical engineering, which I actually took for pre-med, but then I decided I want to go to go to medical school, and I was fortunate to get a job at UW Madison doing programming and there was the Department of Biostatistics that had kind of this resource of programmers that they would loan out to different grants and projects and so I got to work on this wide range of things, had two great mentors, Steve Antoine and Anand Ganguly and that’s what kind of turned me into a professional programmer and then Rock Mackie who was already a famous medical physicist arrived at UW, I think in 1988 or maybe 1987, which was just a year or so after I got there, and then we cooperated on developing radiation treatment planning software that developed into our first company.

Dave Kruse: And that’s Geometrics?

Mark Gehring: Right, Geometrics by the way is the four founders, it’s Gehring, Mackie, Reckwerdt, Sanders, those are the letters of that name.

Dave Kruse: Oh that’s good. We did talk about Geometrics a little bit with Rock who was on our previous podcast, so we don’t have to talk a ton about that because Rock gave us, but how did Rock convince you or how did you convince Rock, where did the idea come from.

Mark Gehring: In those days, radiation treatment planning was 2-dimensional, so it would be on one CT scan, so that actually limited how you could treat, you couldn’t have a beam come in through the top of the head, because you can’t get a CT scan in that plane, so you could only come in from the side of the body, so Rock came and wanted to do a treatment called Stereotactic Radiosurgery, which is for brain tumors, where you come in from a lot of different directions that don’t lie in the plane. So, the first project was to slice out planes of data that are off access and feed those into the 2D treatment planning system, and so we did that and started treating patients.

Dave Kruse: You wrote lot of the codes, the software…

Mark Gehring: I just wrote a simple code that would take a CT scan, these transverse images and slice out a different plane and feed it out to the other software where they would do the actual radiation treatment plan, but then right around that time, a paper came out, and it was the first paper where they made 3D images out of a CT scan and I was super cool and I read and it was not that difficult algorithm, so I coded that up in the basement of the hospital, which is where radiotherapy departments are, and I ran it and at the first images were pure static, no discernible image, is totally wrong, and I tried to fix it I ran it again, it was pure static but was kind of, I could see just what looked like a little bite of structure like the outline of the head, and I ran it, and went in back and fixed it again, I ran it again, and I obtained this 3D image of the patient, we could recognize the patient, it was amazing.

Dave Kruse: Oh yeah.

Mark Gehring: It was like, I made life, It was so cool. That’s what I love about software development. In general it’s not always that dramatic but it’s cool just to make something out of nothing, out of just an idea. And at the time they were planning these treatments by drawing arches onto the patient’s head at the machine, and that consumed machine time and all the patient, the nurses, and doctors and hide this 3D surface of the head, so I could project arches onto that, and so we eliminated that treatment and that grew into Pinnacle, which was the first commercial 3D radiation planning system. So, it was a combination, it was Rock’s ideas and then the jump to 3D combined with… He was already famous for radiation dose computation algorithm and we incorporated into that software.

Dave Kruse: What year did you guys sold that company?

Mark Gehring: We formed a company in 1992 and it was sold in 1996.

Dave Kruse: Okay and after that you started UltraVisual.

Mark Gehring: UltraVisual, yes.

Dave Kruse: When did you start, in 96 or when did you start?.
Mark Gehring: No…, our company was acquired by a company called ADAC, which is a big public company and I stayed at ADAC until 2000, so UltraVisual was formed in 2000.

Dave Kruse: Oh really, okay, and Rock said you guys gave away Geometrics kind of for…, but you could have sold it for more.

Mark Gehring: Had we known, we could have certainly, I mean, well that’s an interesting story, like when do you, you know, there were multiple reasons that was sold, but one key reason was that our main competitor, which was Siemens Medical Systems, they dropped their 3D planning system just one day, but walked in and they had been inspected by the FDA and they had dropped that whole product. We were at 8% company, I’d had worked on that software for 6 – 7 years at that point. We just knew that there was a possibility of just going to zero.

Dave Kruse: Wow.

Mark Gehring: Not that we weren’t doing things right, but it just was, we are just a little teeny company, so, you know that software has had 40% market share since the mid 90s in a small market, but very significant revenue. So if you went back, we wouldn’t do that, but then you never know, had we been on our own, who knows what would have happened. What ADAC did was one reason for that software doing well, certainly so…

Dave Kruse: What did you learn from that and working with ADAC that help you start UltraVisual, any good lessons learned?

Mark Gehring: Well we learned how to run a company for one thing. When we started Geometrics, we were coming straight out of the University, we didn’t know much. We were way too intertwined with ADAC. ADAC had already helped us with our FDA submission. They were our sole distributor, we were quite intertwined with ADAC and we needed that to some extent, but we could have structured things differently had we known, so you know, when we started UltraVisual, I feel like we knew what we are doing in terms of structuring the company, raising money, actually running the company, developing the software, and selling the software.

Dave Kruse: Gotcha, and who you’re partnering with.

Mark Gehring: Right.

Dave Kruse: Okay.

Mark Gehring: How to partner

Dave Kruse: How to partner, yep. So it’s 2000, who came up with the idea for UltraVisual and how did you get it going?

Mark Gehring: We had already been working now for 10 years on this 3D imaging software, seeing what are they doing in Radiology, can we go there, is there are some opportunity, and in 2000, 80% of hospitals were still using film, so they weren’t even digital, it was, you know, shocking, where they were going into surgery and they are like where is the film, and you know, it’s in a jacket in some cart somewhere, in some guy’s desk. So it was obvious to everyone, all the film companies, the CT scanner companies, the information systems companies, everyone knew that around that time people were going to switch over to digital imaging, and so we felt like these big vendors GE, Siemens, Philips, McKesson, Kodak, Fuji, they would get their market share, but there is a huge opportunity we could get a chunk of that, and that could be meaningful.

Dave Kruse: Gotcha so, those were your competitors?

Mark Gehring: Those were the competitors, yeah.

Dave Kruse: Okay, so who did you partner with for that and how did you find your partners.

Mark Gehring: We started direct, we had our own sales team.

Dave Kruse: You did?,

Mark Gehring: But then I would not say that was the strength.

Dave Kruse: I should say your founders, but who were you’re founders.

Mark Gehring: None among the founder, we were not, none of us had a sales background, we hired.

Dave Kruse: You hired, okay.

Mark Gehring: Yeah, which was one of our missing element, and it was the reason that we actually merged, so this company Emageon came along, and there’s Milton Silva-Craig was the President of Emageon, and is from Milwaukee. He actually went to the high school with my sister, so we didn’t know each other but, and he was coming home for a holiday or something, said could he stop by, and this was perfect synergy, so they developed an archive to store the images. We were developing a viewer to display the images and were working on developing an archive, but did not have an archive. They thought all the value was in the archive to store the images and all these commodity viewers will be layered on top. We thought all the value was in the viewer. So these two teams, both passionate about their part of the system, and then what made them, they just were more mature and they were about twice as big as us, but they had an unbelievable sales team, just the CEO was a master salesman, a master with customers and at structuring things, and they just had the sales culture that we did not have.

Dave Kruse: It’s a good fit.

Mark Gehring: So it was two missing gaps and you know, to build our own archive and our own sales team, we probably would have had to raise 20 million dollars and the dilution from that was probably would have been more than the dilution we experienced through the merger and then we just would have had the cash. We still would have to build the sales team and build the archives.

Dave Kruse: So, did you have revenue at that point, when you merged?

Mark Gehring: By the time we merged, we had worked with them for about a year, and yes, we had revenue, we had joint deals with Emageon.

Dave Kruse: How long did it take to develop the software, did you need FDA clearance.

Mark Gehring: We did.

Dave Kruse: You did, okay. Did you have a predicate or did you have to use trials at all.

Mark Gehring: No, we had a predicate. All of our companies, even radiation therapy was a very high level of concern, high-risk device, but they had predicates, and so did UltraVisual.

Dave Kruse: So, by the time you started company to the point where you actually had a product on the market, how long did that take.

Mark Gehring: It started in 2000 and I think our first sales were in 2003.

Dave Kruse: Okay, Gotcha, so did you go out and raise money right away or did you self-fund.
Mark Gehring: We self funded initially, but then we raised a total of 9 million dollars for that company, all from Angel Inverstors.

Dave Kruse: Well, wow… how many investors did you have, do you remember?

Mark Gehring: We had a lot, I think we had 80.

Dave Kruse: Oh my goodness.

Mark Gehring: So when we merged, that wasn’t the best strategy.

Dave Kruse: Hope you didn’t need all their approvals, hopefully…

Mark Gehring: We had a big meeting at Monona Terrace and we got everyone there and we got everything signed, and it was okay.

Dave Kruse: Do things differently, maybe next time, but it worked so. So with Emageon, how do you figure out kind of the percentages, was it all based on revenue, because the current revenues are good but then there’s also potential, or did you kind of just put a value on each company and then, was that how you…

Mark Gehring: I mean it was a negotiation like any negotiation. I don’t know if that was purely by some equation, but by any measure, we did not look at revenue, we were just both too early really, but if you looked at amount of money raised, number of employees, any measure of size that roughly matched what the deal ended up being, but it was like anything. There was a lot of negotiation involved and it took quite a while to get that done.

Dave Kruse: How long were you with Emageon for.

Mark Gehring: We went public in 2005, $400,000 million IPO, which was great, NASDAQ was obviously cool and I left in 2006.

Dave Kruse: Okay, alright. Are you glad you did the IPO.

Mark Gehring: Yes.

Dave Kruse: Yes, and worth it, and had really had a lot of investors.

Mark Gehring: Obviously that was great, we all read some of the accounting things and so on, you know things like revenue recognition, we already were dealing with some of that kind of stuff, where you know, you need to ship the entire product before recognizing formally the revenue things like that, you know, frankly I was only around for a year or two after and so I didn’t get into the dealing with any kind of quarterly issues with worrying about results, you know, the stock went up and then the market flattened out and the stocks started going down, and it was 2008, when all those companies had trouble, they were acquired and brought back private by another company.

Dave Kruse: Oh really! okay.

Mark Gehring: And eventually that company AMICAS was acquired by Merge and now Merge has been acquired by IBM in the last year or so.

Dave Kruse: Gotcha, do you remember how much it was acquired for, by the private company.

Mark Gehring: I don’t.
Dave Kruse: We weren’t around.

Mark Gehring: We were onto something new.

Dave Kruse: Gotcha, any lessons learned from that company, around fund raising, around technology development, or choosing your partners.

Mark Gehring: I would say things went pretty well with that company. We did raise a bunch of money and I would say we hired too many people. It was kind of, it was just post.com, you know, we immediately hired 5 engineers, and I think in the long run only 2 of those engineers kind of stayed with the company and really contributed, so…

Dave Kruse: Where you the CTO or what role were you playing ?

Mark Gehring: I was the CEO of UltraVisual, and then I was the CTO of the combined company. Again, the lack of sales, you know, bringing in the right sales leadership, we found that through Emageon, which is good, but that was just a key element of the company that we lacked.

Dave Kruse: Yeah so it was tough and right usually the start ups are fairly technical in nature, but they may not have a ton of sales experience, and it’s probably rare to find somebody who is pretty technical and love sales.

Mark Gehgrig: Yeah.

Dave Kruse: And they probably should be doing both, if they are that good technically.

Mark Gehring: You are not going to finance, we need the right mix of people that are passionate about what their roles are, and you got to be passionate about to be good at them.

Dave Kruse: How do you find your Founders for UltraVisual, like, did you know them for a while

Mark Gehring: Two, Praveen Sinha and Roger Chylla, the two Co-Founders worked at ADAC at the time which had acquired it.

Dave Kruse: So you would have worked with them.

Mark Gehring: Yeah worked with them, and so actually they weren’t too happy with the three of us leaving.

Dave Kruse: Yeah I bet.

Mark Gehring: Because they were actually being acquired by Philips Medical System, so Philips acquired ADAC, and that was happening at the time that we left and they were just not happy. We got legal letters and then we always had to explain that during our fund raising why we…

Dave Kruse: Why you left…

Mark Gehring: Why it was all cool and we hadn’t taken any technology or anything, which of course we hadn’t.

Dave Kruse: That’s good you cleared that up, that was pretty messy. Alright so 2008, what did you do after Emageon

Mark Gehring: So 2006 it was.

Dave Kruse: Cause 2008 was when they sold…. so you left in 2006, they still…

Mark Gehring: Public in 2005, I left in 2006, it was 2008 or maybe it was 2009 when they were …

Dave Kruse: 2006, that’s right, alright.

Mark Gehring: Sharendipity is 2006, and that was four of us. We said, you know, we are sick of this medic, we are sick of the FDA, we are sick of all this regulated process and let’s do something new, so four of us, all from UltraVisual, former UltraVisual people, all engineers left, and we actually formed the company, and self-funded without knowing what the company was going to do, and it was actually great for 3 months, we sat around the table and we brainstormed, and we did prototypes, and we did research, and these little mini business plans, and it’s kind of cool, a number of the plans, you know we were going to look at, try to detect the motions through the webcam and maybe translate that into your Avatar and a video game. We were going to have this group chess where people would vote on moves, a number of those things like the chess things, and a few years later, we didn’t do it , but it came, somebody else actually did it, so it’s kind of cool, but what we started to do was, we wanted to make kind of an algebra work bench where kids could learn about Math through shapes and obviously one plus one is two apples, but you can do more complex things with geometry and we are working on that and the idea was to generalize that. What if we could create an environment where people understood a Match could create that, but other people could create other types of software, so the big idea, you know, why is it so hard to develop software, like the spreadsheet for instance, allowed people do their own financial analysis, where you sit with the accounting department and say run this analysis and get back this bar chart, and our spreadsheet which is a form of programming let anyone do that and we want to do the same for software that was the concept with Sharendipity.

Dave Kruse: Interesting, and how did that go and how long was Sharendipity around for.

Mark Gehring: Not too long, I mean for a while that went great, but it was, you know, we were the early adaptor for the Facebook API, we met with Mark Zuckerberg.

Dave Kruse: Seriously ! ,

Mark Gehring: Yeah it was very cool. We were starting to build up customers, we had a lot of discussions with Disney, Disney has all these assets, so they wanted to make, you know, they could make a Cinderella site, where people could mash up that content into games, and so it was actually going well to some extent, but it was tough for one thing, not only were we not sales or marketing experts, but this now is consumer marketing, right, just trying to get individual users, which is tough, and we had worked in regulated industries, you know, there is a big barrier to competition, we mentioned that. With UltraVisual competition with GE, Kodak, and we could say, we can build better technology than those guys we know it and get some market share and there won’t be other competitors, because there is a small company, because there is a FDA barrier that keeps people out, we’ll just have high quality, and that was true, we had only one other small company significant competitor. Well, with Sharendipity, we did not have that barrier, so there were small companies who were doing things, Microsoft and Electronic Arts, big companies, everyone coming out with these turn yourself into a programmer with this drag and drop, kind of the same concept, but all of them failed. Sharendipity was called Sharendipity because it involved sharing, it assume there were some, in the community, some percentage of actual programmers, we weren’t trying to turn you necessarily into a programmer, we enabled you to piece together content, but use content from other users. None of these other sites had that concept, but we couldn’t attract attention and as those failed the whole market in terms of investors was looked at poorly at its user generated content, it is all failing, so it was tough, and we were already in a risky position, and then it was 2008, the whole world economy collapsed and that was the end of us.

Dave Kruse: Yes gotcha okay. So did that help refrain your startups after that, like what ideas you want to work on?

Mark Gehring: Well, yeah, it gave me an appreciation for medical software where there is, you know, it’s one thing to be making this game environment. We did have this big concept that we would change how software was developed, mostly it was people developing these little games. It is easier to get motivated when it is helping a radiologist treat a patient right, and it’s his tool, and that FDA is something I did not realize until we did Sharendipity how much I appreciated that, it is not just that it’s a barrier that keeps out low quality competition. It also forces you to follow a good development process and things that you would do, the FDA basically says; you follow a good development process and we might show up at any moment to make sure you are doing that. So, you do it right, but that process is what you should be doing anyway, and everyone wants to do, but is easy to let go by the way side, you know, you should write requirements and you should review those, and you should have a bug tracking system, and you should code review all the code, you will save a bunch of time and you will have better quality software that meets the requirements, but when you are in Sharendipity, we had to get stuff done, it is just easy to let that slide, it’s like a personal trainer, you know that you could do your workout, but when the personal trainer is there you actually show up because that guy is waiting and you’ll do it that much harder, so I really came to appreciate the value of that regulation and the value of having your whole software process really under control.

Dave Kruse: That’s definitely a refreshing way to look at the FDA, like you said you want the Sharendipity to stick with their regulated environment, I like that, yeah that makes you think about the value the FDA adds, even beyond just making sure people are treated well by therapeutics or medical device, but kind of the whole development aspect too, it’s interesting. Alright, so we are now running out of time here and like I said Mark has a lot, so we are just going to go on, we have about 5 minutes, so after that was it Propeller Health.

Mark Gehring: It was Propeller Health with David Van Sickle, so that was David Van Sickle, who is the Primary founder, but I helped get it going. He is a PhD asthma epidemiologist and it’s putting sensors onto asthma medications and the third Co-Founder was Greg Tracy who was at Emageon, he was at Sharendipity and then Propeller Health. I was there for about 3 years, they started in 2010 and they are doing great and they’ve adapted to all these different vendors, medications, and it’s out in the field getting great results in terms of bringing patient’s asthma under control.

Dave Kruse: Do you know how many patient’s they have worked with or how much money they’ve raised?

Mark Gehring: I know how much money they raised, I don’t know how many, I mean, I’m out of the loop on how many, I mean it’s public knowledge that they raised $ 23 million.
David Kruse: That’s a chunk and did you help write a lot of that software, were you also CEO of CEO of Propeller Health.

Mark Gehring: No

Dave Kruse: No you weren’t

Mark Gehring: No, David Van Sickle was the CEO, I was President, and Greg Tracy was CTO and heads Engineering.

Dave Kruse: Okay.

Mark Gehring: So, I wrote some of the software; it was a different type of software that doesn’t as well match kind of what I do. I wrote some of the mobile apps initially until we hired professionals that really know what they are doing.

Dave Kruse: What’s a good match for your development skills?

Mark Gehring: It’s kind of imaging, so it’s medical imaging, and navigating these 3D data sets and user experience, making that user-experience, you know, intuitive and efficient and enjoyable.

Dave Kruse: Yeah, we talked a little bit about that with Rock, and, you know, Rock just said what you built was amazing, like you know, that helped a lot. So, I could see why that’s your specialty.

Mark Gehring: In my last minute, current company is HealthMyne, which is with Rock, and is with Praveen Sinha and Roger Chylla from UltraVisual, so it is all of us together, which is awesome and it’s Oncology Imaging Informatics. So it starts out being something similar to UltraVisual, a diagnostic imaging workstations, but also has this built-in analytics capability that helps characterize how the patient is doing for the radiologist today, we can automate some of the measurements they’d like to get today, but then produces this database of data that is very useful for biomarker research down the road.

Dave Kruse: Gotcha, and how many people are here at HealthMyne, and are you raising money now for Healthmye

Mark Gehring: Yeah, we are raising money, and 23 people work for the company.

Dave Kruse: Okay, So that, did you write a lot of that software.

Mark Gehring: Yeah, this is actually great because I’m Chief Strategy Officer, so I’m not the CEO, and so I spend a significant amount of time developing software which I love, but then I am involved in fund raising and sales presentations, and kind of business development stuff.

Dave Kruse: So, at this stage, do you kind of weigh out the requirement and have other people do the actual coding or do you actually do the coding.

Mark Gehring: No I’m their coding.

Dave Kruse: That’s great alright.

Mark Gehring: That’s great, we’ll l have some big and high level investor meeting and I will walk back to my desk and fix the most trivial bug you could manage, it’s great.
Dave Kruse: That’s awesome. I would think investors are like that too, instead of one of the people in it exactly really like deep into the code.

Mark Gehring: Roger Chylla one of the co-founders also heavily involved in development, so it’s cool, we are really moving fast.

Dave Kruse: Alright, well, we are almost out of time here, the last question is kind of like personal one and I don’t except any answers but what education or books, you know, how do you stay up-to-date on what’s going on, especially around software and 3D imaging, and is it more like you just always building stuff so is that how you stay up to date or how…

Mark Gehring: I would say I am not good at keeping… it’s working with smart people that have a passion for seeing what’s going on and then when they post something on our review slack, nobody uses that now, really looking at that, but I am not, of the 23 employees, we have 7 people with PhDs who are into looking through all the latest research and so I have got those filters and that’s my main day source.

Dave Kruse: Alright, fair enough. Well I think that just about does it and Mark thanks for coming on the show.

Mark Gehring: Alright.

Dave Kruse: This is awesome. As I promised, Mark has a lot going on and we could talk for another hour or so, maybe in a year I’ll invite him back see what’s going on.

Mark Gehring: Alright.

Dave Kruse: Thanks everyone for listening and will see you next time on Flyover Labs. This is Dave and Mark from Madison.

Mark Gehring: Thanks Dave.

Dave Kruse: Thanks.