Leading a startup, ‘you are constantly against the clock’: Q&A with Astrata cofounder Girish Chavan

Chavan is the cofounder and CTO of the Pittsburgh-headquartered UPMC spinout, which is behind a natural language processing-based quality measurement tool for the healthcare industry. RustBuilt Pittsburgh caught up with the entrepreneur this spring, and since then, Astrata has been focused on scaling (and hosting a slew of informational webinars about digital health — watch its LinkedIn page for more).

Read Chavan’s full Q&A below. The transcript of the interview has been edited for length and clarity.

1. How did you come to do this work, and why is it so important to you personally?

I worked at the University of Pittsburgh for over a decade building products using clinical natural language processing (NLP) systems to search and analyze clinical notes. We were one of the few clinical NLP research teams in the country at the time. Our work at the university, however, was a few steps removed from the patients and healthcare providers to have a direct impact. Moving to UPMC Enterprises in 2017 enabled us to expand the impact of our work and move at a faster pace, which then led to Astrata spinning out as a company in January 2021.

I have always been passionate about doing work that is impactful and a net positive contribution to society. I don’t think I would be happy being a cog in a wheel of a giant corporation. At Astrata, I get to do such amazing work with a smart and humble group of people and I couldn’t be happier.

2. What was your lightbulb moment for Astrata?

Health plans always want to improve the quality of care they provide for their members. To do this effectively they need to first measure it and to do that effectively, they need to understand what is happening to a patient. This requires highly trained people who understand clinical language to spend hours reading through clinical charts.

We spent more than a decade building one of the top clinical NLP systems in the world and it was perfectly suited to solve this problem. We could not only expand quality measurement to be faster and more accurate at scale but also help improve clinical quality by surfacing insights that would, otherwise, be difficult to extract from this data.

3. What is the elevator pitch for Astrata?

Astrata provides its customers with the technology and expertise to transform quality measurement into a powerful accelerator of population health and value-based care. We have a best-in-class NLP-driven solution to enable year-round quality measurement on the entire population and the first-of-its-kind quality measurement engine that uses the latest digital measures from the Center for Medicare and Medicaid Services and the National Center for Quality Assurance.

Using our products, our customers can spend less time measuring quality and more time improving it.

4. Talk through your strategy for building a team around you.

My cofounder and president, Dr. Rebecca Jacobson, and I made a conscious decision on Day 1 to define the values of our company. These values defined the culture that made our team successful at UPMC Enterprises and we wanted to replicate that culture at Astrata. These are:

• Make an impact.
• Create community.
• Be stable and fast.
• Embrace the unknown.

We evaluate all potential candidates on these values. We have a culture fit interview which is conducted by people across the company, not just the hiring team to ensure that who we bring on is not just amazing at their job but also has the right approach and motivations for being part of our team. Fifteen of us chose to leave the safety of a “corporate job” at Enterprises to join Astrata when it was formed. Since then we have more than doubled the headcount while maintaining the culture. I am very proud of that!

5. What has surprised you most about starting your own business?

I had to adjust to a much faster pace when I moved to Enterprises from a research environment at the university. And if Enterprises was fast, Astrata is significantly faster! Anyone who works in startups knows that you are constantly against the clock. And it is not just the pace of change, the number of ups and downs that you go through in one single week is incredible! You may achieve a significant milestone on Tuesday and before you have had any time to digest that, by Thursday you are dealing with a big fire.

One of my biggest learnings has been to accept this as the new norm and not be too impacted by it emotionally. You have to believe that you and your team will figure things out no matter how challenging they may seem.

6. Talk through one of your daily rituals.

I wake up early and work out to start the day. I find that it puts me in a positive frame of mind and feel like I have achieved something before the workday has even begun. Another ritual is taking my dog, Leo, for a 20-minute walk at lunchtime. I work from home 100% of the time, so any time outside during the day helps give me a mental and physical break from the home office.

7. What is a recent challenge you’ve faced as an entrepreneur and how did you overcome it? What lesson(s) did you take away from it?

As someone without a green card, one of the biggest challenges has been not being able to start my own business due to the restrictions of my US work visa (H1B). Things got pretty bad during COVID as visa renewals stopped for a while, and my wife and I had to move to Canada. It turned out to be a blessing in disguise as my new status in Canada enabled me to take up the role of the CTO of Astrata, which I would not have been able to do in the US. Funny how these things work out!

This wasn’t the first time I was impacted by immigration-related issues. Over a decade ago, in the early days of mobile apps, my wife and I built an app for online shopping and it was hugely successful. We had over 30,000 downloads in the first week and were featured as one of the top apps in the App Store. But we couldn’t commercialize it because of visa restrictions.

After that setback, my wife and I decided that we had to do something about our situation, so we got actively involved in immigration reform advocacy. This meant meeting with our local congressman and senators and also making several trips to Washington DC to push for immigration reform. That experience taught me a lot about how advocacy works and how laws are made. The other thing I learned is that despite doing everything you possibly can, sometimes things just don’t work out the way you intended them to, but you have to roll with the punches and look for the silver lining. While it was heartbreaking to leave Pittsburgh, it has allowed me to appreciate the positives of moving to Canada and making the most of living here.

8. What does the next year look like for Astrata?

Growth and scale! We are growing fast and acquiring new customers, so scaling up the company’s processes and technology to stay two steps ahead is our focus. We are also bringing to market a new quality improvement product this year, which is pretty exciting!

9. What is a key piece of advice you’ve received that you’d want to share with other founders?

A key difference between being a startup founder and having a typical 9-to-5 job is that your role and responsibilities are very fluid, especially in the early years. For example, even though I am CTO, I have been involved in marketing, HR, sales and business development, etc. And being in charge means that you have to make decisions in all these domains without having all the information or the experience you would prefer to have.

When the company was newly formed, I would always feel the need to “ask for permission” or validate any decision I was making that was not in my domain with my cofounder [also, ex-boss]. It was at that time that she gave me this key piece of advice: “Look around you. If you don’t see anyone, then it is you who needs to make the call.”

This really helped me give myself the permission to make decisions, even when I didn’t have all the information or experience, without second-guessing, and it helped me settle into the role of a startup founder.

10. How can our regional startup community help your efforts?

We are always looking for great people who share our passion. Check us out at www.astrata.co and reach out if you want to learn more!