Koda CEO appeared on the Venari Podcast
For Dr. Tatiana Fofanova, the journey towards founding Koda Health began ‘because of what we saw prior to the pandemic’, and took off in earnest during COVID. ‘The clear inequity in those emergency and ICU departments’ laid bare the stark divide between those who did and those who did not have access to advanced healthcare and medical power of attorney documents. These patients, therefore, could not receive ‘certain treatments and protections of their choices when it came to serious illness care.’
Tatiana spoke to Cristian Owen, our Specialist Digital Health Consultant, on an episode of the Venari Podcast’s Healthtech CEOs series. She explained that Koda is ‘a B2B enterprise company that has a patient-facing web application that navigates these conversations’, giving users more control in their healthcare options by letting them autogenerate and notarise documents on the platform to send to physicians and family immediately. ‘This was already a problem during the pandemic, and then it became a huge issue’ when COVID swept the globe.
Challenges in the startup space
For Tatiana and Koda, startup life has been a ‘rollercoaster’. The challenges to secure funding in this space are well known, though as a female founder and CEO Tatiana has a particular perspective on how difficult it can be. She often hears male investors and founders talk about how they can’t seem to bring in diverse talent to their teams – but ‘when you have women and people of colour and all sorts of diversity in leadership positions, people from those backgrounds gravitate to those companies.’ Koda receives applications from many diverse candidates, which is important for the business’ purpose. ‘We serve populations that are minoritized, that are low socio-economic status. And to bring a diversity of perspective helps us serve those patients better.’
A 2018 report by Boston Consulting Group found that women-led startups generated 10% more in cumulative revenue over a five-year period than those founded by male entrepreneurs – despite the average investments for female-led companies being less than half of the average $2.1 million invested in startups founded by men. Tatiana notes that the reason for this often comes down to ‘pattern matching’ in venture capital – that is, investors identifying trends among successful businesses and exits in the past. ‘The problem with pattern matching is that the patterns are historically set,’ she says, ‘and therefore, when history is primarily white male-funded companies, these benchmarks and metrics and “patterns” that they’re looking for tend to follow a very specific rhythm.’
Has the fundraising environment changed – especially for women leaders?
It’s no secret that the funding environment for startups is strained, Tatiana says. ‘What that means realistically, for women founders, black founders, people who are historically underrepresented,’ is that there is ‘less funding and more conservatism.’ She cites figures from a recent Pitchbook report to the effect that less than 2% of all venture capital funding went to women-founded teams, while adding one man to the founding group significantly increased funding opportunities. In this tricky financial sphere, ‘a lot of the work that we have done to funding towards these groups that have demonstrated success in these studies has really taken a bit of a pause.’ When underrepresented healthtech founders do get investment traction, it is all too often in the guise of a minority or specialty fund, which usually entails smaller amounts of cash. Tatiana has mixed feelings about this; it’s something that she loves ‘in concept, because it makes sure that there’s a share that’s cut out.’ On the other hand, in practice it can mean larger groups fighting for much smaller reserves of money. ‘I love the idea of women supporting women and women mentorship, but I don’t necessarily want to be part of the women’s fund. I want to be part of the general conversation.’
Are things beginning to change?
Tatiana notes that ‘a lot of louder voices’ and ‘powerful thought leaders’ in the healthtech industry are showing how things are starting to change. Still, the biggest shift, in her view, must come from the funding side – that is, VCs and private equity firms bringing women in as leaders and partners. She cites an example of a male-founded European startup who developed a women’s hygiene product with the help of VC funds also run entirely by men. ‘And when it hit the market, all of the women were like, “Have you ever talked to a woman? No woman would ever use this.”’ That the company nonetheless managed to raise millions of dollars shows that having women involved in leadership or partnership (or both) might have that money and directed it towards ‘something that drives value for customers and for people.’
What advice does she have for female founders and CEOs?
For Tatiana, the most important moment of her career was when she found ‘a true mentor’: Dr. Toby Hamilton, a physician at Texas Medical Center. Having someone who is genuine about wanting to help you and your cause, who goes out of their way to support you, is transformative: ‘I think surrounding yourself with the right people, the right mentors, is absolutely critical to breaking those historical patterns on which people pattern match.’ She also notes that women leaders don’t have to mimic traditionally masculine leadership styles. If you don’t fit this style, ‘you can lean into your natural strengths’ to just as much effect – if not more so.
Finally, most importantly, Tatiana believes that ‘you’re effectively married to your investors. So, you should choose incredibly wisely.’ It’s better to have a good partner and less investment than a large cheque from a difficult investor: ‘Not all money is good money.’