Action beats fortune: How one ethos revealed our potential in 2020 ??

One year ago we were putting the bow on our Ten Year Plan to make IKONA Health the leader in virtual reality-based kidney education by 2030. Then, the world stopped turning, needs and priorities shifted, and by mid-March we — like so many of you — awoke to a new reality. We were no longer following the right path, in part because we were no longer tracking towards the same destination, and partly because…well, we suddenly needed a new map. ??

This article has one overarching theme, brought to life through four examples from our experiences at IKONA over the past year. My aim is two-fold: first, to give those of you who might be facing similar “mapping” challenges of your own a few possible action items completely within your power to take; and second, to show you how we came to be so optimistic about IKONA’s future through a combination of tactical strengths-finding and strategic course-plotting.

Know what you can control

Our unifying theme today is about deliberate, immediate action. You’re likely familiar with this Chinese proverb: “A journey of a thousand miles begins with a single step.” This is true, and an inspiring adage for many of us — but I want to dig a bit deeper on why the choice to take that first step is so critical. A recent edition of the Daily Stoic newsletter reminded me of another quote, credited to a personal hero, Democritus, who said:

“Boldness is the beginning of action. But fortune controls how it ends.”

Rarely is there a better time for boldness than when the world seems consumed by fortune — good, bad or otherwise. Today, that message rings true for every one of us. We can easily think about how much of 2020 felt beyond our control. Know that much of 2021 will likely remain outside of it as well. In fact, that will always be the reality we live in; fortunately, we can control our actions. Over the long term, fortune calls the shots. But especially in times like these, deliberate actions will win.

We started IKONA nearly four years ago, blissfully less aware of this eternal struggle between fortune and action. We, like countless other healthcare-focused immersive technology companies, had a lengthy list of unknowns: Which VR hardware will even still be around in 2–4 years? What will our target market look like then? Which clinical use cases, if any, will actually qualify for reimbursement? How exactly do you start and grow a capital-intensive business in a risk-averse sector with multi-year sales cycles? Will a contact lens render us useless a few years into this journey? At what cost? Will the snake oil-esque XR marketing videos ever end?

We each have choices to make in the days ahead. Those choices have everything to do with taking the first step and doing actions you can control before the passage of time cedes your power to fortune. Establish your goal, determine the appropriate first steps, and take them while you can. Your actions today are the only things you can be sure will stand tomorrow.

Four actions we can control today

We are now a year into our quest to launch 10 million personalized kidney education journeys over the next decade. While our mission remains the same, how we will go about it has shifted considerably for several reasons, chief among them the pandemic and stakeholders’ evolving needs. Here are four areas we decided to take back control and what each means for our company and our future:

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1 — By building a more accessible platform

Before taking this action, accessibility to our product was a limiting factor for our customers and their patients. People needed to have a virtual reality headset to use our platform and content. We had a powerful product, and it even increased access in other ways (e.g. clinical simulation economics and enterprise training scalability), but the pandemic threw a wrench in a fundamental assumption around location-based interactions and workflows.

We decided to zoom-out and place virtual reality (VR) as a single, powerful feature within a far more capable and comprehensive learning platform. We realized the underlying mechanisms that had driven such postitive outcomes within our VR experiences were missing from most standard learning tools. And most importantly, the benefits of these features were not able to be experienced outside of VR, and we felt confident in their transferability. This realization paved the way for our decision to start building something anew in the short term that could solve a key pain point and ultimately get us closer to our ten year vision. Our learning platform is the future, and VR is a part of it.

2 — By conducting multi-year R&D efforts

A second order effect of placing accessibility first came in the form of longer-term thinking and planning efforts — this is where tactics turned to strategy. What used to be a conversation around the next logical VR content module suddenly turned into a broader discussion on the possible role of available technologies in addressing the largest unmet needs in our market. Said differently, when we stopped thinking about iterating our feature sets and started asking (our customers) which problems kept decision makers up at night, we had the beginnings of a research and development plan.

This type of thinking, enabled by our initial zoom-out, has led to significant support from those who experience these pain points most. We received research funding from the National Science Foundation late last year to support these efforts and to continue building meaningful relationships with our industry partners who are shaping the future of this space. Prioritizing R&D in our product roadmap is a deliberate action that lives at the core of our business, our culture and our future.

3 — By choosing teammates for the road ahead

Perhaps no single action is as important as this one, and we’re still in the early innings of realizing its full potential. A few months before we stumbled face first into the ‘must expand user access’ realization, we had established the company’s Scientific Advisory Board with key leaders from the areas of medicine, industry and academia. One of my asks of this group was radical candor and a commitment to tell it like it is, and how things in our industry ought to be. They delivered, and it helped me identify new gaps between our internal capabilities and IKONA’s long-term goals.

One of the lessons that has struck me most in recent years is the intentionality required in building a team. It feels daunting yet attainable with a great plan. My recommendation for any early stage, resource-strapped team leader who feels this way at times is as follows: write down your vision (what is it and how is it defined?); identify a “dream team” of potential advisors (industry leaders, founders, investors, operators) along with specifics of how they might support your vision based on your research about them; then connect the dots. Whether or not you end up working with anyone directly, there is something to learn from every person you meet, so keeping those possible lessons targeted just might help your bandwidth and speed-to-insight (or your next stage of growth).

4 — By accelerating current market trends

The future of kidney care is value-based. Recently, a wave of payment model changes (e.g. ECT and KCC) have gone into effect following the Advancing American Kidney Health initiative, which was announced in July of 2019. Clearly, this represents a significant shift and will impact stakeholders across kidney care settings, from hospitals and dialysis clinics to nephrology practices and transplant centers. Much like the rest of us, each of these groups has to prepare a path forward into this new value-based paradigm, and will seek support along the way to ensure challenges are properly addressed and opportunities met.

One such opportunity lies in rethinking education. Though it is well understood that patients who are better able to understand and use important health information will feel more empowered and experience better health outcomes, that is far from the norm. Barriers like low baseline awareness, the relative complexity of the disease and low health literacy continue to drive a wedge between communication and coordination. We have shown that effective education changes everything, and it starts with identifying the specific, measurable indicators that contribute to the overall trend. The result of ten million personalized kidney education journeys will not be captured in a single metric, but in millions of years lived and billion of dollars saved. At the end of the day, a macro trend is made up of countless interactions and their outcomes. Start small, measure specifics, and build for scale.

Map redrawn. Path identified. Actions taken.

To launch 10 million personalized patient education journeys over the next decade, we had to start with what we could control: our platform, our research plan, our team and our micro momentum. If ‘boldness is the beginning of action and fortune controls how this ends’, then we choose action every time. We cannot say where we will be or what our destination will become by 2030, but even in the absence of fortune we each have the power to say with confidence that we chose to take the first step towards our vision, and chose action over fortune.

Our dreams are counting on it.