> "Everyone's being told, 'Don't go public,'" Ries said.

In my experience, If there is consensus around something, it's often a great idea to do the opposite.

I decided to take my company public last year and it has been exactly the right thing for us. As far as I can see it, there is absolutely no reason to wait if your company and your team is ready.

With a tiny chance you might answer, I'm curious.. how did Shopify come about? Did you start an eCommerce store yourself, have bad luck, but then say "hey we could take all this tech we just built and sell that instead"? Or was shopify always the goal?

Exactly as you said. I build a online store to sell Snowboards back in 2004. The business worked really well but the software was clearly even better. The snowboards ended up financing building Shopify. The first checkin into the Shopify git repository was the first checkin to the original online store (although I used Darcs as SCM back then, I converted the history over to Git ).

We actually put together a mini documentary about Shopify for our IPO Roadshow: https://www.youtube.com/watch?v=QYl8iwD-6tk It's worth the watch if you are into this kind of thing. We decided to do this because Shopify grew out outside of the Silicon Valley sphere and wasn't that well known before our IPO. That has clearly changed since.

That documentary was really interesting and beautifully shot.

I refer a whole bunch of stuff towards shopify since I get inquiries about building e-commerce stuff all the time where they have some money but not enough to make it worth doing a bespoke solution and frankly unless they want to drop serious money your platform is always going to be better.

I'm over in the UK and I saw a talk a while back by one of the shopify guys (Keir Whitaker iirc, it was a couple of years ago) that was superbly well done which made me look at the platform.

Interesting you mentioned the marketing/exposure benefit aspect of going public. This point is overlooked a lot.

How did you approach getting your first customers when you had an MVP?

I developed an early (technical) following because I was one of the people behind Ruby on Rails. That lead to the first few customers because technical people are often asked for recommendations for software. Keep in mind this was in 2006, a very different time from today.

Awesome. If you had to do it all over again, do you think you could have been successful with Shopify if you'd started today?

Building companies is 90% luck (timing, competition, demand, macro trends, technology penetration, also health & passion of the team). So... I doubt it.

> if your company and your team is ready.

And what does that look like?

Right, that's the key question. In my case, it just felt that way one day.

Running a Public company looks like a daunting task before you are ready, and it doesn't look like a big deal after you are ready. Building a company is a journey of personal growth, at some point your personal growth as a leader takes you past the point where a IPO looks daunting. Then you make your move.

Maybe. I worked for a time with Epic Systems, which is an EMR company that saw record growth in the 2000's, and they're still privately traded today because they didn't want to focus on the bottom line.

Anyone in the know could possibly argue that the CEO is also a control freak, but she's used that control to keep the company focused on a high-quality/safe user experience for patients, which isn't a bad thing IMO.

I also worked at Epic for a while; CEO was definitely a control freak at that time. I consider it very likely that she has not changed in that respect.

I was promised employee stock at hiring. The company shortly thereafter reneged and substituted a "shadow stock" plan. The rationale I was given explicitly mentioned that having too many private stockholders would trigger mandatory financial reporting, and that the company would rather give me the finger than its balance sheet.

It was just one of the many reasons why I left. The company was fueled entirely by the inherent brokenness of the US health care complex. It seemed to be metaphorically powered by shoveling fat stacks of $100 bills directly into the fireboxes of pre-Watt Newcomen steam engines. They didn't even bother with the seemingly simple expedient of converting the $100 bills into $1 bills to increase the available fuel supply.

The end product that was visible to the customer was good, but it almost certainly cost several orders of magnitude more to produce it than was strictly necessary.

> The end product that was visible to the customer was good

This would be news to my wife (a surgeon), or any one of her coworkers. The software is universally viewed as terrible by everyone I've talked to. It actively results in worse records because (at least as configured) it's so cumbersome to use that many notes are frequently kept out of the system. A management plan that takes seconds to explain verbally requires minutes of data entry.

The thing about Epic Hyperspace is that it's polarizing for those who work in the medical profession.

You either love it or you hate it, and the physicians who hate it typically hate it because of what you said - they're suddenly having to type their own notes into a computer rather than dictate it to someone else.

Personally I'm of the opinion that doctors doing their own data entry is better for liability and malpractice reasons, but I empathize with your wife and people who hate doing it.

I don't think it's quite so cut-and-dried. A lot of the anti-EPIC sentiment I hear (digital health founder here, wife is a physician at a major medical center) is kept pretty separate from the anti-notes sentiment (which is equally loud).

Instead, the EPIC complaints are about the UI and workflow, which was modeled after the typical paper H&P (history & physical) forms clinicians would traditionally fill out. It comes down to the same UX lessons we've learned about most offline-to-online form transitions: directly porting a form is rarely the answer.

The anti-note sentiment has to do with the fact that they're copying-and-pasting from previous notes (often the vast majority of a note's content is pasted in), they're using MS Word to draft the notes because of a buggy editor UI, and then when they're in a situation they actually have to read the note, they're sifting through a pile of duplicated, pasted content.

There's a ton of opportunity for change here. There's an equal amount of risk involved, and selling these types of products into healthcare is about as fun as removing your fingernails. That's the piece EPIC does well, and why they're still a behemoth, even if their product is a five out of ten.

Watch your doctor doing his own "data entry" next time.

First, he'll spin away from you on his stool. Then touch a keyboard with his boogerhooks to re-log-in. (A shared KEYBOARD in a room of transient often-sick people ... did you ever do the biology experiment in high school where you swab surfaces and inoculate a petri dish? The keyboards came out worse than the toilet seats.) Then he'll mouse around on a bunch of screens showing inconsistent or at the least confusingly presented data (listing, for example, all medications you've ever been prescribed with no obvious way to highlight which ones are current). Finally he'll find the right text box for the notes.

As your doctor types in this text box, various auto-completes will come through. Your doctor will then choose from these auto-complete options, which generally make a mockery of the English language and basic grammatical agreement (gender pronouns, etc.).

The idea that Epic has empowered, or even in any benign way nudged, doctors to begin doing as good a job of data entry as they once did of dictation and charting is just complete hooey.

I have also personally had a physician using Epic Hyperspace enter an incorrect immunization for my then months-old child. This doctor in fact had the correct immunization schedule for children memorized and could have written it out longhand perfectly. But it wasn't until the next visit that they detected the out-of-order sequencing of the immunization series. This was perhaps not the fault of Epic, exactly, but was certainly mediated through Epic Hyperspace and it did absolutely nothing to prevent, flag, or otherwise mitigate this completely detectable, violation-of-deterministic-formula situation. (Everyone was fine and no harm ... this time.)

Way off the original topic, here, but let's just say regarding Epic -- whatever it is that's driving adoption of that system is not naively comprehensible to those of us coming from tech/software. It's not quality, cost, UI/UX, safety/accuracy, interoperability, standards, network effect, viral effect, or the rest.

Yet, whatever Epic is doing (or whatever esoteric motive their buyers have), it seems to be turning out well for Epic.

So attempting a tie-back to the OP -- it's not clear that long-termism of a business necessarily has any salutary effects on the rest of the world.

The data entry just gets dumped on residents, adding to their already absurd workload (and realistically gets done at the very end of their shift after being on call for 24-30 hours). There is no plausible way that this results in better accuracy.

The idea is great, but it just runs into an absolute brick wall of realities of the health care system and human behavior.

Has your wife ever come up with solutions? I've thought about trying to solve this data-entry problem in healthcare before, but it seems to be almost an admin/process issue.

i think you can dump audio files into dragon(nuance) and get the transcript back for data entry.

Yeah, I almost mentioned dragon but I didn't because I wanted to avoid anchoring the question. They seem to be (or were) a market favorite.

Yes but doing that takes some time, and then correcting the numerous errors takes more time. So it's not necessarily more cost effective than using template data entry forms. Some doctors now dictate, and then rely on transcription services which use speech recognition to generate a rough draft followed by human transcriptionists to fix most of the errors.

The thing that makes EMRs actually hard to pull off is that each hospital wants to implement its own workflow. So EMRs are less off the shelf software and more a toolkit that an army of implementers can use to encode a hospitals workflow into software. I don't have any experience with EPIC but got to watch a slow motion train wreck that was a Cerner implementation. Every department wanted everything customized just the way it wanted and there wasn't any introspection into if what they were doing was even the "right" or best way.

The problems with EMRs are really just a symptom of a real problem in medicine which that every department head wants to do things their own way. And there isn't really a good way of selecting which is best amongst the various processes/methods. The more prestigious the institution the larger this problem typically is.

My wife, also a surgeon, had a slightly different report. Of the 3 EMRs she has used, she said Epic's sucked the least. A low bar to clear, but they must be doing something right, or at least less wrong than the competition.

Ha! I said "customer", not "end user". The customer is the hospital and/or HMO administrator!

And I used "good" to damn with faint praise. It generally meets customer requirements, and probably doesn't cause as much iatrogenic harm as whatever systems it replaces. For what it costs, I would personally expect quite a lot more out of it than it delivers.

But there's only so much you can do with a perpetual parade of recent college graduates that generally turn over after about 2 years.

Yeah, the stock "options" were a joke, but it's decent experience and pay for entry level, which they hire in droves.

I only recommend working there to people if they're right out of college and not in an engineer role, since their MUMPs/Cache stack is pretty dated.

every engineer i ever met from EPIC was fresh out of school, one of them told me thats almost entirely what they hire.

Again I definitely don't recommend it for engineers. They'll get locked in on their tech stack since that's their experience and no major tech company uses it anymore.

For entry-level business roles they tend to be better suited, especially those looking to go the consulting route.

And that's by design of the CEO, who explained (paraphrasing) that such people are far more eager to drink her personal flavor of the corporate Kool-Aid if they haven't already been tainted by tasting someone else's.

I'm glad you're reaffirming the thoughts I had back in 2010 when, after the phone screening, I was invited for an on-campus interview to which I said no after reading some scathing reviews online.

I very distinctly remember it seeming a bit like a cult with the overbearing CEO that answers to no one creating a sprawling campus out in rural Wisconson that's so comfortable and with so many amenities you'd never want to leave!

Sounds like I made the right choice to decline, even though I'm currently working for a private company with the same type of CEO, only with revenues at half of one percent of Epic. But hey, I read a couple of weeks ago that they were hiring a sushi chef, and I do love sushi!

It's not exactly rural Wisconsin. It's effectively in a suburb on the the southwest side of Madison. Rural Wisconsin is at least a 15 minute walk from the parking lot.

The Epic campus is very close to the epicenter of the best place for a typical HN reader in Wisconsin. Since the UW-Madison campus is on the west side of town, the geometry of the lakes almost assures that people who work in high tech businesses or academia commute in from the southwest quadrant, if they don't live in the city proper: Cross Plains, Middleton, Verona, Fitchburg, Oregon.

I loved living in/near Madison for the 6 months of the year that it wasn't either winter or unsubtly hinting that Mr. Winter had only just stepped out for a moment, and would likely be back any minute now to finish hitting my other kneecap with a lead-free pipe and then drag me around on a chain behind his Prius for a bit.

The immediate environs are great. But I had to leave for financial reasons.

If you have the opportunity to take a job in Madison, Wisconsin, that is not with Epic, do consider it.

> If you have the opportunity to take a job in Madison, Wisconsin, that is not with Epic, do consider it.

Shameless plug! https://forteresearch.com/

6 months?! My experience was closer to 4, 5 in good years and 3 in bad.

But summers were idyllic.

they are also heavily propped up by the fact the gov will cover a large portion of the costs of install and migration. if these costs wasn't covered or subsidized, i believe the picture would look very different.

...and monopolistic control over that EMR via no HL7 integration.

Epic Bridges sends/receives HL7 messages to just about any software with an interface. I'm not sure what you're talking about.

I wasn't on the team that implemented this at a large healthcare provider, but i remember that team bitched about it a lot. its also mentioned as a compliant on EPICs wikipedia article.

That's because healthcare interfaces are terribly difficult to work with, because they're the worst of two worlds - mountains of bureaucracy mixed with different tech stacks from different eras.

You don't have to search too hard to read horror stories about interfacing with Epic. In practice EMR vendors are financially disincentivized from interfacing with anyone.

To your point, why, specifically, is it so difficult to interface with these systems? Could it be by design?

Right, because you're searching for stories about interfacing with Epic and they have 50% of the patient marketshare. That's how appeals to popularity work.

You still didn't elaborate on why you said Epic has no HL7 integration.

In addition to that, they are well underway to supporting HL7 FHIR (the new version of HL7).

When I can do bidirectional programmatic interface to Epic let me know. I won't hold my breath.

Stop it you're breaking the narrative.

I guess it's not only a matter of revenues. I don't think Uber really cares about divulging revenue - they've done it over the last months for some geographies to prove they're right. I think they care more about where the focus must be = if you're private, you can keep growing without thinking too much about the bottom line/EBIT/EBITDA; when you're public, that's another story, investors (not only individuals) carry about dividends to make their ROI - of course value of the stock is another key element

I have heard that there is the impression that the values they have gotten from private investors(i.e. VC) are higher than they would get on the open market. Which means either VCs are much better at investing than the market at large or there is a bubble(or a bit of both).

Those two things are related: oftentimes, being innovative in ways that might, in the future, unlock huge revenue opportunities, can make short term revenues look pretty bad. Imagine Google reporting revenue prior to the launch of AdWords.

Divulging revenues is not bad in and of itself, but when executive compensation is tied to market performance you have a problem. LTSE, as described in the article, is doing a lot more to combat that problem than just being long term.

Accounting innovation is still innovation.

Because they're too busy chasing the QER.