Tips for Enterprise IT Leaders Taking the Startup Leap

The healthcare industry is rapidly evolving, with technology playing a pivotal role in making treatments more accessible and affordable. One such example is Karkinos Healthcare, which has developed an innovative technology platform to empower primary care doctors and specialists to deliver effective cancer treatment. By democratising knowledge and resources, Karkinos is tackling the high costs and limited access often associated with cancer care, traditionally available only at super-specialty hospitals.

The technology-driven oncology platform leverages IoT devices, evidence-based algorithms, artificial intelligence (AI)/machine learning (ML) powered tools for diagnosis and treatment planning, prescriptive and predictive analytics at every point of care, and a multidisciplinary approach that enables remote care. The platform collates multimodal patient data, including genomics and other omics data, into cognitive algorithms to aid in diagnosis and treatment protocols. 

The Karkinos platform can be easily used through a mobile app or website. The process begins with a risk assessment, where users answer a series of guided questions. This assessment focuses on the top seven cancer types and utilises a cognitive algorithm to analyse responses, ultimately generating a risk score for each type of cancer. This score helps users understand their individual risk levels and the next steps they should take. Once the risk assessment is completed, the system automatically identifies appropriate interventions and ensures that patients feel supported and well-managed throughout their treatment journey.

When Arvind Sivaramakrishnan, a veteran CIO with over 25 years of experience in large enterprises, joined Karkinos, he faced the unique challenges and opportunities that come with leading technology in a startup environment. Drawing on his extensive experience, Sivaramakrishnan offers valuable insights and best practices for IT leaders making the leap from the corporate world to the dynamic and fast-paced world of startups.

Embrace Agility

As an experienced CIO stepping into a startup, Sivaramakrishnan recognised the unique advantages and challenges associated with the dynamic environment.

“Startups possess the power of agility and the potential to disrupt established norms. You are surrounded by talented individuals eager to innovate and make an impact—like racehorses ready to run. However, if left uncontrolled, this energy can scatter in all directions, making it essential to channel that enthusiasm towards a clear, intended solution,” he says.

It’s therefore important to strike a balance. “Making decisions with a forward-looking perspective, while valuing the knowledge and experience gained from the past, is essential. Startups need the governance and structure that enterprises provide, while enterprises can benefit from the agility and innovation inherent in startups,” he says.

Underlining the importance of meeting healthcare governance requirements, Sivaramakrishnan says, “For data security and privacy, we adhere to the principles outlined by the Data Security Council of India, the Health Insurance Portability and Accountability Act (HIPAA), and the Health Information Technology for Economic and Clinical Health (HITECH) Act. We are SOC 2 Type 2 certified, and also hold ISO 27001 and 27701 certifications for our robust data management practices.”

For IT leaders to harness this potential effectively, it’s crucial to shake off any inertia within themselves and embrace a culture of speed and responsiveness. The startup environment allows for rapid translation of ideas into action, often resulting in higher-quality outcomes due to the calibre of talent available.

“With highly skilled individuals who were passionate about their work, we were able to move from concept to implementation at an accelerated pace. We had projects where we churned out tangible results almost every three days,” says Sivaramakrishnan.

IBRS believes in a startup environment, where the ability to adapt quickly is paramount, organisations must prioritise the use of high-level architectural toolsets and reusable components over custom coding. By doing so, developers can work at a higher level of abstraction, enabling them to rapidly adapt and evolve applications as new business opportunities arise.

However, achieving true agility extends beyond simply adopting Agile methodologies and tools. It necessitates a cultural shift within the organisation, where individuals possess the ability to navigate ambiguity, prioritise outcomes over rigid processes, and collaborate effectively in cross-functional teams. Attracting and retaining talent with these capabilities is essential for fostering an agile mindset throughout the organisation. Besides, knowledge of and adherence to healthcare governance, policy, etc is also needed, recommends IBRS.

Adopt Frugality

For an enterprise IT leader joining a startup, it’s crucial to adopt a mindset of frugality and resource optimisation.

“In a startup environment, financial resources are closely monitored, and every investment must be carefully considered. While enterprises may have more financial flexibility, startups must approach their finances with a heightened sense of responsibility and respect for their investors’ money,” says Sivaramakrishnan.

The primary goal should be to utilise investments in a way that maximises their impact and moves the organisation towards self-sufficiency. This requires a strategic approach to the solutions, architecture, and the people employed. By optimising these elements, an IT leader in a startup can ensure the organisation operates efficiently and effectively

“Understand that not all ideas or concepts will be applicable or effective for your organisation. When it comes to tools and approaches such as cloud computing, open-source software and outsourcing, it’s important to understand their individual strengths and limitations. They may not be silver bullets for your organisation. Blindly banking on a single solution without considering its effectiveness in solving your problem statement is not the most effective strategy. Instead, use each tool or approach to its fullest potential,” says Sivaramakrishnan.

At Karkinos, the technology platform was built using hybrid cloud and open-source technologies, with a focus on flexibility and efficiency. The platform’s data lake and insights are powered by open-source technologies, with API integration to the application suite and event bus. Additionally, the platform leverages the services of major cloud providers like Google Cloud, Microsoft Azure, and Amazon Web Services, while maintaining the flexibility to host solutions on private clouds, underscoring the focus on frugality.

Develop a Holistic Mindset

A common mistake many IT leaders from large organisations joining startups make is approaching everything through a purely technical lens, without fully understanding the underlying problem.

“While the technical solution may be correct, it may not align with the situational reality and the various factors at play. It’s crucial to approach problem-solving with a holistic mindset, considering not just the technical aspects but also the broader context and perspectives involved,” says Sivaramakrishnan.

“This is where seasoned IT leaders can leverage their analytical skills to delve deeper into the problem. Listen attentively, ask clarifying questions, and conduct research to understand the ground realities. Observe how things are currently being done and why. You may encounter situations that frustrate or irritate you, as you recognise the potential for technology to streamline processes. However, it’s important to appreciate that the current methods have been in place for a reason, and sudden disruption may not always be the best approach,” he says.

To effectively solve problems at Karkinos, Sivaramakrishnan took time to understand the perspectives of different disciplines, such as medicine, science, and biology, and how technology can serve as an enabler to address the core issue.

Once he had a solid understanding of the problem and the ecosystem, Sivaramakrishnan started exploring the levers he could change. “This is where an ‘outside-in’ thinking approach comes into play. Bring in ideas and best practices from outside the organisation, but ensure that they align with the specific needs and constraints of the current environment,” he adds.

IBRS notes that the born-digital companies are continuing to reinvent themselves. The advantage they have is that they are not carrying a heavy legacy of systems, procedures, creative and cultural constraints from the outset of their digital initiatives. Although, like other companies, they are still continuously seeking out efficiencies and other incremental improvements.

IBRS also advocates that technology alone is not a panacea for innovation. Successful transformation often hinges on factors beyond technology, such as a clear strategic vision, organisational culture, and effective change management.