Integrity at Scale: Inside the Flo Health Mission | Amazon Web Services

Key Takeaways

[Music] Welcome to the Executive Insights podcast brought to you by AWS, where we address vital questions and share unique perspectives from leaders at the intersection of business and technology. [Music] Hello, this is Tanisha Randere, vice president and managing director of Europe, Middle East and Africa for Amazon Web Services. Welcome to another episode of Executive Insights, our CEO series. In this series, I will be speaking to CEOs from across the AMIA region about what it takes to transform business and society, how they are leveraging data and technology to accelerate growth and innovate, and their insights on topics such as sustainability and addressing the digital skills gap. We will also be providing a glimpse into the personalities behind some of our great leaders of industry. Technology has long promised to make healthcare more accessible, but today's guest has turned that promise into tangible global impact. Trained in the pharmaceutical chemistry area. He originally set out to become a scientist before moving into software development, teaching himself to code and writing programming books along the way. That blend of scientific thinking and technical creativity eventually led him to start a company that would go on to redefine women's health. In 2015, alongside his brother and longtime business partner, he co-founded Flow Health, the world's number one women's health app. Today, Flow supports over 70 million monthly users. And in 2024, it became Europe's first fem unicorn with a valuation exceeding $1 billion. A strong advocate for women's health and health equity, he has built Flow with a deep sense of responsibility guided by expert input, data science, and user feedback. And in response to growing concerns around reproductive health data, FLO introduced anonymous mode, becoming the first health app to offer fully private use. The feature was recognized by Time as one of the best inventions of 2023. From early product failures to global recognition, his journey reflects persistence, purpose, and a commitment to improving health outcomes for women everywhere. Dimmitri Gerski, welcome to Executive Insights. I could not be more delighted to be interviewing you today. Danish, thank you very much for inviting and your intro was so flattering that probably even my imposttor syndrome got a bit smaller. A bit, but smaller. Well, you and I both have imposter syndrome, so not a worry. I always think about imposter syndrome saying let it sit there and brush it off every now and then. I think it's a huge driver of uh your self-development and success. And most of successful people, they are pretty much insecure and they have this chip on shoulders. But it's permanent anxiety, maybe exhausting, but it's a huge driver of success. It really is. But I think your point is absolutely right. I think the idea of being vocally self-critical and reflecting on what one could do better, not in the sense of feeding oneself up, but actually in the spirit of learning, you know, just drives incredible results and development, doesn't it? And I'm sure you've been through that in this amazing career that you've had. I mean, you know, you've obviously trained as a scientist, wrote programming books. I mean, wow. And even launched, I believe, a cooking app. It's quite an unconventional journey from there to women's health. And I'd love to maybe understand a little bit like what experience or moment in time shaped the way that you lead but very importantly also led you to launch flow health. I have had quite a long career because uh I started working in university when I was 18 years old. the time I was working for 18 hours per day for years and uh probably I missed completely all this like a joy of use like I didn't date I didn't visit any parties and I was just like studying and uh writing my books and making my job and I didn't have much choice because uh I didn't have like a father to support family and I was like just a mother who was librarian but it was like one very in like page of my career took 10 years in my life. I was working in book publishing and uh I started from writing books but then I invited to work in publishing house and uh I had quite good careers there and then I started my own publishing house and part of my legacy that I was responsible for approximately 3,000 of educational books and it was huge satisfaction for me because feel like physically result of your work and each book has own like sensation or like it's because it's so physical and uh it was like a very joyful experience and uh we decided to work with mobile apps exactly because of this experience with books and in 2009 when app store was opened for third party developers we understood that it's a moment when we may build apps uh like content apps like based on our experience with books we started this direction and we had different apps for health fitness for cooking like many different apps uh that time and uh our first exit happened in 2012. not so big exit but uh it was quite an achievement and uh then we continue to create our apps by our own and invest to other apps mostly for 90% in health and fitness because of personal passion and uh like part of this journey was like starting flow in 2015 when flow was started uh uh we had had enough experience with health and fitness category because of previous apps And we had observations that this market market of female health is extremely underserved in comparison with other markets. We decided to create like a app with much bigger ambition than other players in the market because from the very beginning our vision was not to start another period tracker and there are hundreds of thousands of period trackers. Our vision was to use period tracker as a core product as a driver of retention and uh acquisition but then to build like a health ecosystem like health platform around period tracker and this ecosystem became very deep and monetizable and now I believe it has 100 million or so of paying users and it we had the same vision that uh per tracker is essential product but uh this product is just a entrance it's a driver of intention and everything will created by the ecos system around period tracker. That's super helpful to understand actually the a the germs of where it came from, the the beginnings, but also how you thought about differentiating it. You know, as a male founder in fem, you've obviously relied on, you know, advisors, data, deep user research. How did you bring the customer voice into your product? We we at Amazon, we always like talking about working backwards from our customers. How did you go about doing that? I'm super curious. When uh we decided to start flow, we admitted that our knowledge and our personal experience of course was close to zero. But also we understood that uh there's like a huge gap to close and we started to make a research like and we spent first three months like just making research like talking with users reading reviews analyzing other apps like like analyzing like all issues with female health and after 3 months we had some like understanding like what's wrong with products in the market and how it should be done differently. Now like it's a big company. It's 500 employees and we have 65% of female employees and they are deciding like what to build. Not I'm not me like like I'm just like I'm setting direction and I'm trying like to find resources and I'm trying like to optimize everything but uh now nowadays everything is decided by like other people and most of them women and no problem with female voice in this company. That's incredible. You obviously have a natural pull, I'm sure, for female employees, but you know, I note that several of your leadership positions, whether it's your chief people officer, your directors of science and medical affairs, your medical officer, they're all female as well, which is incredible. By the way, the role modeling from the top is critical, frankly, to get real progress on the DEI side. Yeah. And also half of our board directors are women and it's also very significant. You know that there's a problem with female representation in boards and we have very healthy ratio and uh our female board directors they are very vocal about what we are doing how we are doing they kind of almost like kind of gatekeepers of all decisions we are making. That's incredible. The other thing that I find it super exciting is that you decided to build a digital company right from the start. Help me understand a little bit like how technology and data has helped you both first launch the startup scale it and then how you're now leveraging generative AI as you take the platform uh to the next stage. I remember when I was like writing my computer books and about action script like micromedia flash and etc. And then when I was making internet projects 25 years back, it was incredibly difficult to even like a start like a simple website. You should have like your own ser like everything was so cumbersome, so difficult, so unsustainable. It was really difficult and it was really expensive. And now like what you needed to have is pretty much like a good understanding of your audience and product. Uh and then like you have like so many like this like a tools which allows you like almost like a Lego like to create your product with a very like a low effort in comparison with previous times and and of course a simplified like the most uh difficult and the riskiest part of job with all this like a servers and now it's so simple you're just like working with this like uh solutions while you're working with the services and you're pretty much like making like most of your product like like out of the box and It means that nowadays the most significant skill is to understand the need of customer rather than even technical skill. I I think you said that really really well. It's actually enables you I think as you mentioned to support faster development cycles your deployment and testing your release frequency freeing you up and your teams to really be thinking about more architectural decisions. you know, as you say, understanding the customer better. What is the next set of functionality that we need to put in? We hope you're enjoying this discussion. To join the conversation and engage with other business leaders on these topics, follow AWS Executive Insights on LinkedIn. So, how are you thinking about generative AI and leveraging this new amazing technology into the core of flow? all this like it's a huge source of ideation it's a huge source of reflection like it's like everything has speeded up a lot already but I think like the biggest question is how GNAI will influence health and it's more a complicated question to predict and mostly because of regulations regulations in medicine they exist for a reason and they tough and they famously difficult to pass and hold it takes many years usually but in case of GI I think it will be like a quite a task for regulators even to understand how to regulate that because it's like a really like not so straightforward uh question because because they just it's a pretty much like a black box like you're making clinical trials and they you proof on practice that it's like a safe and useful and I believe that the same clinical trials will be done for GNI solutions ultimately but it will be quite a challenge to establish proper practices for that and to understand the even the borders of regulation because now the borders are very we and really nobody even understands where the territory of regulations start. Yeah, I do I I think that's right. I think that this is an area that's going to be incredible with the advance of this technology and we're still in the early days. I think it's going to be health whether it's as you say drug discovery bringing drugs to market faster fewer just improving cycle time as we both said improving productivity of health care professionals improving productivity of doctors and you know surgeons providing access to services that you can't get if you go to some of these countries in Africa you know this I'm sure you know the availability of oncologists is very low but you can do that now through you know more remote diagnostics etc. There's so many different ways that whilst it may not be like you said specifically around the actual drug production, the process and where it gets utilized to speed up and to do the analysis and all of the data that you need to look at quicker is incredible. And I love that you've introduced you know we talked about this earlier in the introduction but I think the guardrails that you've introduced in your technology like for example anonymous mode are you know just incredible innovations to help give people security in the fact that their data is secure that they that they're in private mode right I think that that's a phenomenal focus of yours in particular post privacy and security is a like really significant topic And uh we have like double certification uh in uh privacy and security and for my best knowledge we a single company among B2C health apps with such certifications but it's not easy it's quite difficult it's quite uh expensive like we work with uh sensitive data of hundreds of million women and it's our responsibility to invest in this uh field even if even if it delay our own like development each piece of content and each algorithm we check very thoroughly by our medical team but also we have medical board with more than 120 specialist and we are making them second check uh of uh everything and uh because of that we have a very high quality of our content and our algorithm but again it was rather bold decision at the beginning to set such a high standard I remember that on the first or second year of flow like we had very limited capital and uh I had like my choice. I decided not to buy furniture for office. We just used like some random furniture from different places but I had like my first uh American doctors to consult and I used uh this money for quality of my product. It's like maybe it's resemble a bit like a story of Amazon but I think what's true that early days and not just early days uh like all resources must be spent for product and uh but not for furniture and not for fancy things. We completely understand that thought process because we're very much about frugality and we think frugality also drives creativity actually and uh you know if you have everything you you want all the time you're not going to be thinking out of the box. I think it's super exciting that DNA of startups and the innovation that that drives by the way and of course you've now scaled to be a much larger business. How do you ensure that you maintain that? I would say that it's really difficult for any company when this company is scaling up like to steal like a fast driven like frugal just because like you're getting bigger you're starting like paying like fences salaries and you you attract like a naturally like a very different kind of people and I think at this moment it's really really important uh to assess people you're hiring for key position and I have my own framework of hiring framework is very kind of I would call it like a anti-alitist it means that I don't uh take any attention on pedigree like it mean for example I never like take to attention for example university never what I'm trying to understand is drive curiosity and work ethics and then uh I'm always trying to understand would this position for this person like a huge jump in career or not and then when I combine everything all this points I'm making my decision. All my experience shows that like just a pedigree or just like a CV like usually don't work in hiring. I love that you think about that so deeply and that it's that cultural fit. It's the drive that you see in people. It's not the pedigree. It's not the CV. And by the way, can I just say that as a as a woman, I would say to you that it really helps in terms of hiring women if you're open to more uh capability rather than pedigree or CV, right? Uh because whenever anyone tells me, well, there just isn't a pipeline there, you know, there not enough women with those skills. I'm like, really? Like there's enough women in that world with the skills that you need. It's just how you're thinking about what you want to go get. So that's awesome. And actually, it makes me ask a a follow-up question, if I may, related to that way of thinking. I heard that you um often share a reflection from your childhood about the difference between kids who pick berries and those who pick mushrooms in how that simple choice said a lot about uh how the individuals saw the world. Maybe you could shed some light on that for listeners who are not familiar with that. Yes, anecdote became like like a bit famous. Uh I was sharing like that my first job in Belus when I was maybe 14 15 years old was uh gathering mushrooms but uh we had the two opportunity to pick up mushrooms or to pick up berries and berry picking is like just like it's very stable. You have a your productivity for example 10 liters per day. You just sit on the same place but then you have a mushrooms gathering like you're like walking through the wood. You may have like a luck to find like a good like plates and you would find like a 3 kg of mushrooms or maybe like it was like a dry day before and you unlike or some other like mushroom gatherers like took all your mushrooms and you would get nothing but then it's about risk journey reward and maybe the most about journey but also it was interesting that uh most of girls were berries pickers I don't think this natural choice or something what just like a society prescribe to women like but it was just like a observation that most of berry pickers were women and most of mushroom pickers were men like boys and and what might be like it's like a big task for society is to grow girls more kind of a mushroom pickers rather than berry pickers because uh I personally don't believe that it's kind of like a very like a natural choice I think it's more kind of like what's prescribed from the very early childhood like some norms of behavior and then like it's just uh like start like developing in time and uh if like now like it's criticized that there are not enough women who started unicorns but uh it's like the very end of this like a kind of funnel it starts very early and it's very like a old societal problem like about that like what's prescribed as a good behavior and as bad behavior and I believe that like a like society should like empower women to be bolder and to be risktakers because like like what's the difference? There are many many issues why it happened and it ends with the fact that among unicorn founders maybe 10% of women maybe 15% of women but it's not like a it's like the end of story ultimately the story of flaw despite it was founded by men it's a very good story for fim and women because 90% of companies in our industry in in fimha have been started by women but we now like by our success We help them benchmark of success. They may show something to investors that it's possible to build unicorn in this industry. Because when we were fundraising, the biggest issue was that investors didn't believe that it's possible to make success in this business because of absence of unicorns. I just want to pick up on what you said about, you know, those early learnings when you're, you know, young girls and, you know, the choice of STEM or not. uh you know where they're where they're kind of suggested to go versus not you know frankly there is no industry now that isn't a tech industry and if we don't have every woman and by the way not just gender you know if we don't have every builder out there whatever their background whatever their diversity uh involved in society fully leveraging this technology being part of the digital economy you know we'll end up with even greater data divides in the future. And so it's super important actually for all of us to lean in and make sure we role model those behaviors and not have women put in a box, you know, of the safe box, right? I was very lucky. My father pushed me to do anything. He was like, you can do anything. And that role modeling really helps. And so I have to tell you, I think there's just so much here and so much purpose built in to what you've created with FL. And I think your success is driven by that purpose. I mean I think people see it, they engage in it. Of course the product's great and of course all of the other things. But I think uh you know in the end purpose and performance are very very closely related and you seem to be living that every single day. I'm very big believer in uh STEM education and in this like early impulse for children and when I lived in Belus I started my charity and our mission was to show like because like very often you just what you need is just you need to understand that there are like a choices and there are opportunities and the problem with this like children from poor villages that they see own world and they don't understand like opportunity out of this world and trying to not like maybe to train from them like a coders but more kind of like uh to empower them to see this like opportunity out of like a poor Belucian village and we opened maybe 30 or 40 such educational centers in Belucian villages. It was a really really interesting experience and uh really satisfying experience that uh that time and uh I I think such activities are really significant for future super important and you know we share that purpose by the way in terms of education of the underserved communities and democratizing access to technology. I did want to ask you maybe one last question. You've launched Flow. You had a couple of experiments that didn't work and you know Flow was your third iteration I believe early beginnings global growth unicorn status uh and I'm sure more to come. How has your leadership style evolved? It's a really different kind of a job to run a company with 500 employees than like with 20 30 or 50 because when you're running like small company you are directly working with the product customers but then like it's your primary job but as a co but then your primary job changes and it's about that like now like your product is organization organization builds like your product but you you build organization organization is your product and it's like a huge change in mentality that you're not like a you stop spending time with like experiments with maybe markups with even like maybe like not so much with customers but then like your primary focus is like a key people key processes vision alignment like financing and it's a I may say like that like you become like a kind of builder of machine and this machine like kind of should be very welloiled and very well run because like if you have more than 150 people and it's not your primary focus to build this machine then you would just have like a mess and I can't say that I'm not missing like some elements of early times when like most of job was more about product ideas and now when like most of my job is kind of like different aspects of bureaucracy yeah just builder or machine rather than product itself yeah and then engaging your builders your talent to you know engage on the product I'm sure you get involved in product conversations but that's True. As you scale, you have to start thinking more about ways of working culture and how do you maintain that culture as you grow, you know, a unifying purpose and vision. Uh the evolution of that vision and the long-term impact that you want to create and the legacy that you want to leave behind. I mean I've been really inspired by the conversation Dimmitri and you know the impact that you're having uh not only on all the women that are using flow health today but actually on the on the domino impact that that's happening around the world on empowerment of women. I think that is the ultimate message I'm getting through this conversation. Our proposal was to open floor for 1 billion women between 13 to 50. Like we had this number like who can't pay like to open it for free and up to this moment we gifted uh like 25 million subscriptions and we have six million pain users mean that we gifted much more subscriptions than we sold and uh we are very satisfied that like dozens of million like women who are less privileged they use this available product for free and uh we like don't worry that we missed like we just like we had to lose millions to do that because it's very satisfying to feel you are building something available. Ah that's incredible Dimmitri the reality of your vision actually which I know you always talk about in this way which is to build a better future for female health where every woman feels understood and supported regardless of her location or economic status. Thank you so much Dmitri Gerski. It's been a pleasure speaking with you today. Thank you very much. Thank you for inviting me. Thank you. 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