Gaurav Nukala is a product and technology leader. He began his career as an engineer at Motorola Mobility before transitioning to product and engineering at Apple, where he worked on iOS software. Gaurav then moved to leadership roles at Flywheel Software and Curology before rejoining Apple as part of the Apple iOS product team. Most recently, he started a consulting practice advising Fortune 100 and high-growth startups, such as J&J and Snappt, and serving as an Interim CPTO and AI consultant.
In our conversation, Gaurav talks about his passion for both the healthcare and public sectors and how he’s working to influence technology and AI in each of them. He discusses his efforts to build personalized experiences in the healthcare industry using factors like patient demographics, geography, and more. Gaurav also shares experiences from his time working at Apple and shaping startups-turned-unicorns.
Absolutely. I’ve built a consulting practice advising Fortune 100 companies and also startups on various things, such as product management, technology, and AI. Currently, I’m advising J&J Innovation Medicine Group. They rebranded from pharma to innovation medicine. I’m helping build their digital therapeutics platform for rare diseases. Prior to that, I played several product roles in various capacities as a C-level exec and as an IC at multiple companies of different sizes — as large as Apple to three different startups that went on to become unicorns.
My interest in product management started during my time at Apple. This was back in the early to mid-2010s and I was fortunate to have worked on various products within the company. Apple has built the best products in the world, and what was interesting for me was how much rigor goes into product building and cross-collaboration with various teams. How do you work with engineers? How do you work with designers? How do you work with marketers? How do you work with sales?
Across the board, I found it interesting in terms of talking to executives, as well as your own team, to come up with design and product ideas and take them through the rigor of user discovery. I felt like I could be working very closely with various teams — not just in the weeds of the technical details, but being up at the 30,000-foot level one minute and the 10-foot level another.
Health has always been an important and integral part of my lifestyle — not just for myself, but for my family and others too. At one point in my career, I was thinking about mission-driven industries where you feel like you are really being able to contribute at a level that has a large-scale impact. Healthcare came to the top.
Healthcare is such a broad industry, especially in the United States. It’s supremely complex — there are so many players and regulations. For someone like me, who comes from a systems engineering background, I always think about various parts within the system and how they come together to work on it.
There are tons of applications. In the United States, we spend something like $4.3 trillion, which contributes to 80 percent of our GDP, in healthcare. If you think about the waste, around 20 percent or ~$800 billion is wasted for various reasons like administrative overhead, lack of care continuity, lack of care, etc. There are a lot of reasons why we spend a lot more than any other developed country on healthcare.
AI can really come handy to reduce this waste. AI drives workflows that eliminate the need for humans to coordinate with each other, which unlocks a ton of value. Additionally, physicians within the United States are heavily overworked. There’s a lot of administrative overhead for them to take care of. The Journal of the American Medical Association reported that roughly 42 percent of physicians at any given time are experiencing burnout, which is extremely high. Many physicians over 50 years old are actually retiring and taking up a new profession.
There’s a ripple effect in terms of more physicians feeling overwhelmed, more physicians dropping out of the industry, and fewer physicians entering the healthcare system. AI can alleviate some of the stress by helping with clinical diagnoses or opportunities for care that physicians don’t have sufficient time for. And, it can produce valuable nuggets of clinical information for better diagnosis and better care.
AI can also help reduce healthcare operating costs. If you look at hospital systems, there are a lot of front office workers. AI can augment them, or in some very aggressive scenarios, even replace them with the AI agents. There’s a ton of potential for how AI can add significant value to the healthcare system.
During my time at Curology, a direct-to-consumer telemedicine platform, we realized that AI was going to shape the product strategy and get the company into the next level of growth phase. We had to figure out various go-to-market strategies, including launching Curology in different states where there were new regulations. In California, which is where I live, telemedicine is relatively easy because the patient fills out a questionnaire, the physician or dermatologist looks at it offline, and based on that information makes a recommendation for care.
In other places like Washington, D.C., a live initial consultation, either through video conferencing or through audio, is required to connect the patient and provider. The doctor gets patient consent, listens to their issues, and then makes a diagnosis. That flow is a little different. We have to build those new experiences for the patients. We also started to think about how the product is applicable to different age groups. Skin problems aren’t unique to teens — they evolve as people age. We had to figure out how to extend our reach to more patients who have different kinds of skin care concerns.
Now, in my work with Johnson & Johnson, we are building a digital companion platform for patients with rare diseases. Disease management is significant for these patients; the diseases have a big impact in terms of the patient’s overall day-to-day lifestyle. Some questions we ask are:
We’re currently working on building that personalization experience.
Absolutely. I think that’s why this initiative becomes an opt-in, rather than mandatory, type of program. There is always an option to call a nurse companion. This is important, because older generations are often more comfortable with talking to someone in-person, while younger generations are more digitally savvy.
We try to create experiences in a way that works for everyone. We can set up SMS alerts for patients who are comfortable with that but who may not know how to set up an online portal. We meet customers where they are and practice an inclusive product design methodology.
Apple is a phenomenal company. I have great respect for the extent that the company focuses on user problems and how design intensive the company is. At the same time, Apple has an ethos of doing very few things but building them extremely well. There’s an intense focus on building a few things, building them right, and building with a passion that does not compromise on user experience.
The company also markets its products well. Apple has always been the trifecta of design, marketing and technology. When I rejoined the company, the size of the organization had changed a lot. In my first tenure, the company had around 20,000 employees, and the second time, it was up to 160,000. Naturally, there were a lot more people to work with, but I would say not a whole lot of other things had changed. To this day, Apple is still a very operationally intensive company, it cares about a lot about the users, and it cares about building few things and building them right.
Nearly all of the leaders who are running the company today were there when Steve Jobs was still alive. They started or shaped their careers during their time at Apple, and they really live and breathe the company values. It’s almost like when you work at Apple, you internalize so much of the Apple culture that Steve built even though he’s not around anymore.
I’d been thinking a lot about the public sector. The federal government and state governments have become laggards in terms of technology adoption. But with AI, they can start to take a front and center position. There’s a lot of momentum happening right now on both on the federal and the state side.
USDR is a volunteer organization that helps state and federal agencies on projects where the agencies don’t have bandwidth or the talent. I thought that was a low-weight way for me to start getting involved on the public side. Right before our call today, I was talking with states who are looking to deploy a chatbot as a medium for the internal staff to figure out Medicaid eligibility for children with autism and other conditions. I find this work very invigorating and fulfilling.
I’ve also volunteered with the Center for Public Sector AI in partnership with USDR. They were thinking about building a framework to help state or federal departments evaluate AI RFPs. We’re working with them to help define that framework and then develop this initiative.
I classify customer feedback with two approaches: a qualitative and a quantitative. In the quantitative bucket, you’re doing a lot of user interviews. This means talking directly to the users and paying very close attention to what they are saying. A second way you could get qualitative feedback is your customer relationship management tools. Existing customers and potential customers who don’t covert can provide valuable feedback here too.
On the enterprise or the B2B side, there are customer advisory boards that can serve as industry experts. Companies talk to them about strategy and what they think about it as a means for validation. You can also do surveys on a broader scale.
On the qualitative side, it’s about really instrumenting every single interaction on your product and really understanding how users are interacting with your product. I like using heat maps and funnel performance to see how users move along based on goals. What needs to be changed? You can look at these tools and figure out if there are any aspects to the experience that need to be changed.
Ultimately, it’s crucial to marry quantitative and qualitative research together. Let’s say you get a hypothesis from the quantitative side to see why there’s a 50 percent dropoff in this part of the app. By reviewing the qualitative research and talking to users, you can understand why they are dropping off, what is not working, what is working, etc.
Just because someone is a product manager or the head of product doesn’t mean that everything around the product needs to be decided by them. Product management is a team sport. Whether the product manager is a quarterback or running back, they’re part of a team that needs to come together to think about ideas, innovation, and what’s next. They’re also bringing executives into the loop to get a feel for the market conditions.
At the same time, the initiatives need to align directionally with the company strategy and business objectives. That becomes an anchor point for everyone to go after. Making that connection ensures everyone is grounded to that one single direction. Based on that direction, let ideas bubble up and think strategically about how they connect to each other. This is a very systematic approach to innovation where you put one layer on top of another so that the foundation sustains it and nothing falls apart.
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