Ops I did it again by Out of Pocket

About Ops I did it again by Out of Pocket

A limited series podcast by Out-of-Pocket, hosted by Alex Dou. Each episode is a post-mortem on a product or feature that didn't work the way it was supposed to. The goal: an encyclopedia of known failures so the next generation of builders can skip the mistakes we've already made and fail at something new.

Publisher

Alex Dou

Category

business · business · technology

Language

en

Explicit

No

First episode

20 Nov 2023

Latest episode

15 May 2026

Latest episodes

15 episodes in the feed.

1. 

   15 May 2026

   Provider Directory: I will destroy your roadmap with Misha Nasrollahzadeh + Grant Veldhuis

   Strap in, young product manager or engineer (or vibe coder!). You have been tasked with the provider directory project. You have scoped it with your engineers, and you think you can get this done in a quarter. And so dutifully you make it your OKR. I'm here to tell you that this is going to be your next year. Certainly not your next quarter. And you should probably listen to this episode so that you know all the things that we have learned the hard way and can sidestep it. Provider directory is a bunch of data and feature and product raccoons all in a trench coat. What makes building one so hard is that you get trapped trying to build each raccoon. The way out is to be clear-eyed about all the different components that get lumped under the provider directory umbrella, be specific and choosy about which ones you actually need to serve your members, and be ruthless about not building any of the others.

2. 

   29 Apr 2026

   Predicting the Future (risk stratification) with Shay Sayed

   Shay has been working in healthcare AI since high school, when a cold-email to a Houston lab professor accidentally landed him in an ML research group in 2016. He went on to ClosedLoop, a seed-stage healthcare ML platform out of Austin, where he spent years training models from scratch on claims and EHR (Electronic Health Record) data, embedding them into clinical workflows, and training nurses to use the outputs. More recently, he works in AI governance: advising health systems on which tools to deploy, how to evaluate vendors, and what due diligence on healthcare AI actually looks like. This episode covers risk stratification end to end: what it is, how it gets built, where it tends to fall apart, and what transformer-based clinical event models might mean for the whole field.

3. 

   15 Apr 2026

   $400 CAC, $100 MSRP: why it’s so hard to build hardware, with Erynn Petersen

   Emme started as (and still is!) a smart pill case. Beautiful, award-winning, Apple-level-designed, beloved. It was so well-designed that nobody needed to buy a second one and they’ve only had 5 returns in 3 years The CAC (Customer Acquisition Cost) was $400 and the case retailed for $100. I think you can see where I’m going with this Erynn Peterson, CEO of Emme, walks through what it took to flip those economics and what every hardware founder learns too late: your margin isn't 80%. It's 5%, if you're lucky, and that's before you've spent a dollar on marketing. Also you should know that it’s really expensive and fraught to market in women’s health, much less women’s reproductive health The conversation covers the full stack of hardware reality: minimum order quantities before any supplier will take your call, ad channels that shadow ban women's reproductive health products, the shift from SEO to GEO that reshuffled the deck just as Emme had figured out content strategy, and the firmware versioning nightmare that AI has (only recently) made tractable.

4. 

   1 Apr 2026

   Ignore brokers at your own risk. Antagonize them at your ruin. Build a health plan with Nick Soman

   There's a specific flavor of hubris that shows up when a tech founder enters healthcare. It sounds like: "Brokers are just middlemen getting rich off of a broken system. We'll go direct to the employer." Nick Soman spent years building Decent, a health plan designed around direct primary care, and he watched a lot of smart people make this exact mistake. He also made some of them himself. This episode is the map of those wrong turns. Nick is the former founder and CEO of Decent, now Chief Commercial Officer at Nice Healthcare (Decent and Nice, Nice and Decent). I can happily say that Nick lives up to his two companies' names.

5. 

   18 Mar 2026

   PROs, UX/UI Design for trials, and the nocebo effect | Paul Wicks, PhD

   Your executive just asked your team to build a symptom tracker. It seems straightforward. Ask patients how they feel, collect the data, show a graph. Then in six months, pull the numbers: patients came in at a 9/10 on your Symptom Tracker, and after six months of weekly use, they're at a 3. Company gets a CPT code. You get promoted to Senior Product Manager. Everybody goes home happy. Paul Wicks has spent 25 years watching that plan run into walls. In this episode, neuropsychologist and digital health consultant Paul Wicks walks Alex through everything product teams don't know when they start building Patient Reported Outcomes into their apps – from why researchers should physically walk through hospitals as patients before locking trial protocols, to why your scale might use a crab instead of a number

6. 

   28 Mar 2024

   How Photon Used Automations to Change E-Prescriptions | Michael Rado, CPO, Co-Founder, Photon Health

   In this episode of Ops I Did It Again, Michael Rado (aka Rado), Co-Founder and CPO at Photon Health joins the thinksquad aka Danielle and Nikhil to break down how they built and scaled products to support over 20,000 e-prescriptions a month. Rado shows a live demo of their build (on YouTube version) and candidly shares his learnings on how to scale with optimization and automation in mind. This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center (https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center); Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2 To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course (https://www.outofpocket.health/courses/healthcare-101-crash-course); Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9 Hosts: Danielle Poreh (https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/)) Nikhil Krishnan (https://twitter.com/nikillinit (https://twitter.com/nikillinit)) Guests: Michael Rado (https://www.linkedin.com/in/michaelrado (https://www.linkedin.com/in/michaelrado)) Timestamps: (00:00) Intro (01:45) Michael Rado and his journey to Photon (03:14) How Photon Health works (07:36) Courses by Out Of Pocket! (16:49) What photon automates and measures (24:23) The approach towards product development at Photon Health (29:25) Practical experiments for orgs to try

7. 

   18 Mar 2024

   Digital Health Ops: A Playbook for Every Growth Stage | Rahul Agarwal, COO Medplum

   On this episode of Ops I Did it Again, Rahul Agarwal (COO of Medplum) joins Danielle to share his digital health operations playbook. The “hero’s journey” playbook breaks down pro tips and gotchas throughout every stage of scale: from pre-seed all the way to scaling to 50 states. If you are building a clinical workforce, scaling your digital health operations or looking into the future on how you should be building, this episode will give you several tactical tips to implement. This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center (https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center); Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2 To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course (https://www.outofpocket.health/courses/healthcare-101-crash-course); Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9 Hosts: Danielle Poreh (https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/)) Nikhil Krishnan (twitter: https://twitter.com/nikillinit (https://twitter.com/nikillinit)) Guests: Rahul Agarwal (https://www.linkedin.com/in/rahul-agarwal-330a979/ (https://www.linkedin.com/in/rahul-agarwal-330a979/)) Timestamps: (00:00) Intro (02:23) Rahul explains his playbook (02:58)Tips for early stage operators (06:32) Leaving the jungle: finding product-market fit (08:55) Operational playbook for scaling digital health services (13:45)  Courses by Out Of Pocket! (15:20) How to define  encounters (24:10) How to develop care plans/clinical pathways (30:59) Optimizing provider recruiting and workload with EHR design (33:30) Standardize your metrics and avoid metric soup (35:50) Dos and don’ts when scaling to 50 states (39:43) Practical experiments for orgs to try

8. 

   29 Feb 2024

   Building Differentiated Patient Experiences | Kerem Ozkay, COO and Ayo Omojola CPO, Carbon Health

   In this episode of Ops I Did It Again, Kerem Ozkay (Chief Operating Officer) and Ayo Omojola (Chief Product Officer) from Carbon Health join the thinksquad aka Danielle and Nikhil, to discuss how they designed and deployed product solutions. They breakdown real examples of AI tools to enhance operations, strategies for patient care, and unique top of funnel marketing approaches. Later in the episode, Ayo shares a behind the scenes view at Carbon’s home grown EHR - it’s best viewed on YouTube so you can all the magic. This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) To register for the upcoming Healthcare Call Center 101 crash course course visit: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center (https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center); Use code: ANSWERS for $100 off; Next cohort starts 4/16- 5/2 To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course (https://www.outofpocket.health/courses/healthcare-101-crash-course); Use code: IBELIEVEINME for $100 off; Next cohort starts 4/23-5/9 Hosts: Nikhil Krishnan (twitter: https://twitter.com/nikillinit (https://twitter.com/nikillinit)) Danielle Poreh (https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/)) Guests: Kerem Ozkay (https://www.linkedin.com/in/keremozkay/ (https://www.linkedin.com/in/keremozkay/)) Ayo Omojola (https://www.linkedin.com/in/omojola/ (https://www.linkedin.com/in/omojola/)) TIMESTAMPS (00:00) Introduction (01:43) 4 levers for tech-enabled healthcare (03:03) Running patient acquisition, operations, and marketing (09:34) SEO strategy and AI integration (15:36) Courses by Out Of Pocket! (17:11) The experience of scheduling (28:04) Performance metrics and feedback loops (29:54) Being 2x better at one thing vs 10x better at everything (33:53) Understanding patient acquisition and call content (36:04) The best tech for clinic reports (37:49) Convincing doctors to adopt new tools (41:02) Importance of localized patient acquisition (41:31) Moving off of slack for field based team (43:32) Automating Revenue Cycle Management (RCM) (50:44) Charting and patient care with AI (live demo) (55:05) Future of AI in healthcare (01:03:26) Kerem and Ayo’s team dynamics (01:05:38) Closing thoughts

9. 

   6 Feb 2024

   How Thyme Care Scales Care Teams | Nate Brown, VP Market Operations

   Nate Brown  joins the Thinksquad, aka Danielle and Nikhil, to share lessons learned from scaling a 90 person care team in 3 years at Thyme Care. We break down their organizational design, recruiting best practices (which includes lots of role play) and how to generally think through building alignment at different levels and stages of a start-ups evolution. This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library (https://www.outofpocket.health/course-library) --- Hosts: Nikhil Krishnan (Twitter: https://twitter.com/nikillinit (https://twitter.com/nikillinit)) Danielle Poreh (https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/)) Guest: Nate Brown (https://www.linkedin.com/in/nate-brown-50a4a625/ (https://www.linkedin.com/in/nate-brown-50a4a625/)) -- TIMESTAMPS (00:00) Introduction (01:48) What is Thyme Care & their mission (03:53) Nate's journey & role (06:22) Measuring qualitative data (08:25) The hiring process (14:38) Role play in interviews (23:17) ‘Pods' in organizational design (25:33) Measuring success and adjusting for patient needs (26:56) Company planning and aligning goals (35:17) Conclusions

10. 

    11 Jan 2024

    Aledade’s Patient Engagement Playbook | Douglas Streat, COO Aledade Care Solutions

    In this episode of Ops I Did It Again, Douglas Streat, COO of Aledade Care Solutions, joins the thinksquad, Danielle and Nikhil to unpack how they built patient engagement strategies to support over 2M patients alongside primary care practices. Doug shares his tactical advice and learnings on how to create behavior change - we also get to play a fun game during it. It’s our most tactical episode yet. This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) To register for the upcoming Healthcare 101 crash course course visit: https://www.outofpocket.health/courses/healthcare-101-crash-course (https://www.outofpocket.health/courses/healthcare-101-crash-course); Use code: IBELIEVEINME for $100 off You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center) at https://www.outofpocket.health/course-library (https://www.outofpocket.health/course-library) Hosts: Nikhil Krishnan (twitter: https://twitter.com/nikillinit (https://twitter.com/nikillinit)) Danielle Poreh (https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/)) Guest: Douglas Streat (https://twitter.com/dougstreat) TIMESTAMPS (00:00) Intro (01:31) Introducing Patient Engagement (04:29) Doug’s Career Insights (06:19) The Role of Aledade Plus (08:39) Redefining Call Centers as Patient Engagement (12:56) Key Performance Indicators in Patient Engagement (14:57) The Importance of Evidence and Experimentation (17:05) Patient Engagement Game!! (20:12) Challenges of Patient Scheduling (21:33) Role of Direct Mail in Patient Engagement (27:57) Staffing Strategies for Rapid Scaling (32:23) Importance of Characteristics when Hiring (33:56) Practical Tips for Effective Patient Engagement (37:45) Conclusions

11. 

    28 Dec 2023

    Holiday Special: 12 Tactical Healthcare Ops Tips

    This episode is sponsored by Out of Pocket, because no one is prouder of us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library --- Hosts: Nikhil Krishnan (twitter: https://twitter.com/nikillinit (https://twitter.com/nikillinit)) Danielle Poreh (linkedin: https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/) twitter: https://twitter.com/danielleporeh (https://twitter.com/danielleporeh) ) Guest: Sandy Varatharajah (twitter: https://twitter.com/sanvrajah?lang=en (https://twitter.com/sanvrajah?lang=en)) TIMESTAMPS (00:00) Introduction to the 12 Gifts of Ops Christmas (01:30) Gift #1: Think like a product person (02:49) Gift #2: Run a drip campaign (04:12) Gift #3: Give people sight into the problems (06:01) Gift #4: Face your hidden factories, make swim lane maps (08:50) Gift #5: Start an offboarding doc (10:42) Gift #6: Prove something can be done before hiring a team (12:58) Gift #7: When in doubt, fly out (15:20) Gift #8: Build an ops roadmap (18:05) Gift #9: Before effort comes focus (22:43) Gift #10: Upgrade your software to AI features (26:33) Gift #11: Contracts create choke points (30:53) Gift #12: The power of schedule sending

12. 

    19 Dec 2023

    Real Gen AI Use Cases in Healthcare | Matthew Woo, Co-Founder & Product at Summer Health

    Matthew Woo, Co Founder and Head of Product at Summer Health joins the thinksquad, aka Danielle and Nikhil to unpack how Summer Health builds an AI first company. He breaks down how they think through operationalizing AI, instilling an AI first culture throughout their team and how you can start applying it now. This episode is sponsored by Out of Pocket (https://www.outofpocket.health/), because no one is prouder than us than us. You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101). Referenced websites: https://www.summerhealth.com/ (https://www.summerhealth.com/) https://www.raycast.com/ (https://www.raycast.com/) https://audiopen.ai/ (https://audiopen.ai/) OpenAI Customer Story: https://openai.com/customer-stories/summer-health --- Hosts: Nikhil Krishnan (twitter (https://twitter.com/nikillinit)) Danielle Poreh (linkedin (https://www.linkedin.com/in/danielleporeh/))) Guest: Matthew Woo (LinkedIn (https://www.linkedin.com/in/matthewedanwoo/)) -- Timestamps (00:00) Intro to Matthew (02:10) About Summer Health (03:04) Achieving SLA for SMS Response Time (04:28) Evolution of SLA and Scaling (05:55) Improving SLA through Staffing and Routing (08:42) Managing On-Call Operations (09:36) AI Integration in Healthcare (16:19) Adopting GPT Models in Summer Health (19:44) Process of Obtaining a BAA with OpenAI (21:29) Availability and Cost of BAAs (23:49) Exploring Other Large Language Models (26:34) Designing Effective Prompts for AI (29:53) Embedding AI in Company Operations (32:43) AI Tools and Workflow Optimization (36:51) Expanding to Multimodal AI (43:02) Scoring Empathy in Conversations (44:44) Choosing the Right Problems for AI (46:09) Bringing AI into an Organization (47:07) Starting Small and Proving Use Cases (48:05) Implementing AI into Clinical Workflow (49:03) Monitoring and Reviewing AI Output (50:01) Doctor's Excitement and Adoption of AI (51:27) Takeaways

13. 

    7 Dec 2023

    How House Rx Builds Product | Denali Cahoon & Mina Iskarous

    They share their lessons learned and core principles that made the build happen so quickly. We go deeper into interview tips, building flexibility in product and frameworks to ensure alignment along the way. This episode is sponsored by Out of Pocket, because no one is prouder than us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library Nouns and Verbs Framework Example: https://www.figma.com/file/12KN4gcVbGMRZ8rPAkia47/Nouns-and-Subnouns-(Ops-I-did-it-again)?type=whiteboard&node-id=0%3A1&t=91gvKyCbIfPcwnNg-1 --- Hosts: Nikhil Krishnan (twitter: https://twitter.com/nikillinit (https://twitter.com/nikillinit)) Danielle Poreh (https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/)) Summary In this episode, HouseRx discusses how they built their product and created a flexible and massive software from scratch. They emphasize the importance of taking the time to learn and build relationships within the team. They also highlight the value of recruiting product-minded individuals and empowering them to provide feedback and contribute to the product development process. The team shares their experiences in building the MVP and the investments they made early on. They discuss the importance of flexibility in the product and the metrics they used to measure success. Overall, their approach focused on collaboration, continuous improvement, and delivering a better experience for pharmacists and patients. Takeaways Take the time to learn and build relationships within the team. Recruit product-minded individuals and empower them to provide feedback and contribute to the product development process. Invest in building a flexible product that can adapt to different use cases and workflows. Measure success through metrics such as support tickets and time to fill. Chapters (00:00) Introduction to HouseRx and its departments (01:57) Early activities and building a relationship (03:23) Creating a better experience for pharmacists (04:23) Learning from initial experiences (06:19) Recruiting product-minded individuals (07:44) Coaching and empowering the team (09:40) Assessing product-mindedness in candidates (10:36) Recruiting from large, structured organizations (13:13) Encouraging feedback and collaboration (14:12) Iterating on the product and gathering feedback (15:37) Timeline for building the MVP (17:30) Starting to see patients on day one (19:52) Investments made early on (21:21) Flexibility in the product (23:37) Nouns and verbs framework (25:03) Building flexibility into the product (28:49) KPIs and metrics (29:17) Improving support tickets (33:31) Time to fill as a North Star metric (36:20) Investing time and space for learning (37:18) Being present and physically involved

14. 

    30 Nov 2023

    Text your patients | Ajay Haryani, MD

    In this episode, he shares his clinical and operational playbook for executing on the channel effectively and even laughs at Nikhil’s jokes. We go deeper into how they measure value, track SLAs and how the channel has evolved. For folks who are in the value based care world, looking to incorporate texting into their care model or curious about how Galileo tapped into the channel so effectively, this one is made for you. -- This episode is sponsored by Out of Pocket, because no one is prouder of us than us: https://www.outofpocket.health/ (https://www.outofpocket.health/) You should also check out our courses, including ones taught by yours truly (How to Build A Healthcare Call Center and Healthcare 101): https://www.outofpocket.health/course-library --- Hosts: Nikhil Krishnan (twitter: https://twitter.com/nikillinit) Danielle Poreh (https://www.linkedin.com/in/danielleporeh/ (https://www.linkedin.com/in/danielleporeh/)) Timestamps: (00:00) Intro to Ajay (00:59 What Galieo does and Ajay’s role (3:11) What field based teams do (5:36) Lessons learned building a field based team (09:10) How Galileo builds comradery to avoid burnout (11:00) What Ajay does on roadtrips (12:00) When to use and not use SMS (13:56) Ajay’s take on what makes SMS so valuable (17:57) Should we charge for texting? (22:14) Triage protocols for SMS (25:12) Bucketing SLAs for SMS (27:48) QA on triaging and continuous improvement (29:26) The flow of a single SMS (30:52) How to get started with SMS (33:46) When it’s time to centralize the function (34:34) The galileo care team (36:56) Determining outbound SLAs (39:17) Preferences in population (40:00) Groupchats (42:22) How to sound like a human & 24/7 care (43:31) Measuring value in SMS (47:26) Speed matters (49:01) Hot takes (50:57) SMS in a virtual based care model (52:56)  Making sure people have your number (56:12)  Ajay’s Mike Jones moment

15. 

    20 Nov 2023

    Introducing Ops I did it again

    Introducing Ops I did it again, a limited series podcast by Out-of-Pocket, hosted by Danielle Poreh and Nikhil Krishnan. We interview builders in healthcare operators breaking the mold (aka solving problems all ops people are facing) First episode dropping soon! Links: Out of Pocket: https://www.outofpocket.health/ How to Build a Healthcare Call Center Course: https://www.outofpocket.health/courses/how-to-build-a-healthcare-call-center Knowledgefest 2024 Waitlist: https://www.outofpocket.health/knowledgefest-lp

Reach and audience

Public platform figures. Ratings count people who left a rating, not total listeners.

Apple Podcasts (US)

5.0 / 5

5 ratings

Spotify

4.8 / 5

10 ratings

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Guest appearances

Books guests

Based on episode analysis; this does not confirm that the show is currently accepting guests.