On the fourth episode of Enterprise Software Innovators, Sreelakshmi Kolli, CDO of Align Technology joins the show to discuss data decentralization and the next generation technologies Align is using to improve patient outcomes.
On the fourth episode of Enterprise Software Innovators, hosts Evan Reiser (Abnormal Security) and Saam Motamedi (Greylock Partners) talk with Sreelakshmi Kolli, CDO of Align Technology. Align Technology’s most popular product, Invisalign is the product of 3D printing, a breakthrough technology that is completely upending manufacturing processes. In fact, Align Technology is one of the biggest 3D printers in the world. In this episode, Sreelakshmi breaks down Align’s decentralized approach to data access, the link between culture and technology evolution, and the factors that define Align’s successful partnerships with startups.
Quick hits from Sree:
On Align’s goals for data access within the organization: “Our goal is to make data so pervasive inside Align, so that it's not just for a data scientist or a small technology team to unlock the potential of it. It's been a cultural transformation as much as it's been a technology transformation.”
On using AI to transform medical processes: “The selfie app that we use, we call it the smile view. That's an AI model that takes your selfie [in] real time and shows you what your smile could look like. That's a very individualized experience. We are using it in our treatment planning, you know, we understand what the doctor's treatment preferences are, how they would like to treat the patient. And so we are codifying that using AI to generate treatment plans that the doctors can then modify in real time.”
On how Align benefits from startup philosophies: “For us, technology’s like the central nervous system of the company. And so, as a technology team, we stay on top of current technology trends and actively engage with the startup community…Experimentation is very much part of our culture, when we fail an experiment, we treat it more like learning experiences so that we can continuously iterate on the idea or, you know, we just decide to abandon it. The entrepreneurial culture is very much alive at Align.”
Recent book recommendation: Ask Your Developer by Jeff Lawson
Evan: Hi there and welcome to Enterprise Software Innovators, a show where top tech executives share how they innovate at scale. Each episode covers unique insights and stories that will help you succeed as a technology leader. I’m Evan Reiser, the CEO and Founder of Abnormal Security.
Saam: And I’m Saam Motamedi, a general partner at Greylock Partners.
Evan: Today on the show, we’re bringing you a conversation with Sreelakshmi Kolli, Chief Digital Officer at Align Technology, where she’s worked for over 15 years. Align is a publicly-traded company dedicated to transforming lives by improving the journey to a healthy, beautiful smile. They have over 20,000 employees, and their Invisalign technology has helped over 10 million patients.
Saam: In this conversation, Sree breaks down Align’s decentralized approach to data access, the link between culture and technology evolution, and the factors that define their successful partnerships with startups.
Evan: Sree, thank you so much for joining us on the show.
Sree: Thank you Saam and Evan for having me.
Saam: What are the learnings and the journey that you all have gone through to actually become a data driven, AI-driven organization?
Sree: You know, that's a great question because, you know, we are in the Silicon Valley and everybody just assumes we’re a digital company and I have to tell all of them, no, you know, we have - our clinical software was built on the desktop. And so we had to evolve over a period of time to newer technologies, to using data and integrating it into how we build products.
On the enterprise side, we are on data lakes and all the business teams are able to run reports on their own. They don't come to IT to get any work done. And so what has happened in that evolution over the last few years is that the technology teams are just focused on data infrastructure, data engineering, integrity, quality of data, and also to provide ease of use tools.
You know, we are on the journey to get business users to run AI and ML. That is available out of the box on the data lakes. You know, our goal is, like, to make data so all pervasive inside Align, so that it's not just for a data scientist or a small technology team to unlock the potential of it. It's been a cultural transformation as much as it's been a technology transformation.
Saam: What have you done to unlock the mindset in your business teams and business users of what they can actually do with the data living in these data lakes and applying ML on top of it? That approach makes sense, but I'm curious what you've done to actually get people to be oriented in that way.
Sree: So it used to be reporting, you know, we would all just run reports and they would all be batch and not timely.
And - and then the report was based on what a user requirement was. And it was almost like IT was involved in writing that. The pipeline got so clogged and the business was starving for the usage patterns. You know, if our consumer spend was generating enough demand, if we were converting all of that demand to orders. And if the orders were reaching the customers on time.
You know, one of the first things I realized was technology teams cannot be a bottleneck to be able to unravel the potential of all this data. So, you know, we went on this journey towards building out data constructs and, you know, we use power BI as a visualization tool and much of the analytics today is run by the business users themselves, and the fact that you can drag and drop and visually analyze what the data provides versus standing in line for three months, arguing with everybody, you know, why your report is more important than the other and getting it prioritized and escalating it, and then getting the data that is of little value you realize, and then again, you go back and stand in line. Like there's nothing more powerful than saying, hey, you don't have to come to IT.
That just was so empowering to the users because they own it. And once we got a few teams on it, the sales teams, the marketing teams, the commercial teams, the manufacturing teams, then we are on a flywheel now.
We've been showing how out of the box AI and ML can be used. And, you know, you don't need to go to this data science team because I would rather use the data science team to focus on - on the product and core clinical aspects. So it's been a journey, but it's been really good culturally to showcase the empowerment of the users when they learn how to run the reports and analyze it themselves.
Evan: How do you kind of encourage more autonomy and get teams to more focus on IT being a platform provider versus kind of like a service organization?
Sree: The first part of it is for everybody in the company to feel that it's everybody's data, that the data is available to anyone who wants to use it and make something actionable out of it. Because in the past, what used to happen was it was almost like, oh, that data is owned by the Salesforce team or the SAP team or the treatment planning team or the clinical team. And it's like, no, no, no. Everybody owns all the data.
That was a big leap of faith. So there were some foundational elements that we had to make sure that we took care of in terms of security and quality that we felt comfortable to be able to go speak up and say, hey, it's everybody's data. Here’s what you have access to and do whatever you want to do with it.
Evan: Was there a specific moment where you were like, okay, we have to change things around here, or was it more of a gradual shift?
Sree: It was more a journey. Like I said, it was built out of frustrations. They would say, oh, go hire more people. And I'd be like to do what? You know, you should be hiring people who can run your own analytics and inform you.
Like making the teams understand that the focus of the technology teams is to get the right technology in place, to get the right foundations in place. You know, whether it's data or identity or our evolution to a DevSecOps model, breaking up the monolithic code into microservices. All of these have had technology evolutions, but much of it has also been cultural evolutions to say, you know, it’s as de-centralized as possible in how we build out products.
Evan: Can you maybe share, like, what are some of the unique applications of AI that you're using that might be kind of surprising to people that were, you know, not super familiar with your business?
Sree: The selfie app that we use, we call it the smile view. That's an AI model that takes your selfie, segments it. I mean, you're talking real - almost real time and shows you what your smile could look like. That's a very individualized experience. We are using it in our treatment planning, you know, we understand what the doctor's treatment preferences are, how they would like to treat the patient.
And so we are codifying that using AI to generate treatment plans that the doctors can then modify real time. And, you know, all of these used to take days. It was very helpful during COVID times, you know, for the patient to be able to take a picture of their teeth, send it to the doctor and the doctor can say, you know, if the treatment is on track or not on track, was a huge benefit.
And also, taking the consumer demand and the preferences of the consumer, sending them to the doctor, who will help them through the choices. Across the value chain, there's just so much more room to keep improving.
Saam: There's a narrative out there when we talk to entrepreneurs and product builders that they shouldn't actually go try to serve folks like Align because Align operates in a regulated industry like healthcare and therefore would be slow to move. And in the experience you've had is quite the opposite. So what's your take on that trope around healthcare being slow to move?
Sree: For us, technology has been at the heart of everything we do. We are also helping the doctors transform their practices, using digital tools. Something like our journey to deliver continuous innovation using like an agile, dev sec ops model, so far, you know, we always think of healthcare and med devices like on waterfall. You know, you go through all these stage gates, you get all these permissions and we can still continue to do agile and follow all of the privacy and regulatory requirements all over the world. And it's about the mindset shift that we need to make.
And it's not some external party that is preventing you from doing it. It's almost all the time internal, you know, like I remember when we started the transition to go from waterfall to agile, it was like, oh my God. You know, we have all these gates that need physical form sign-offs and the access to production is like impossible for an engineer to get.
And we have been able to get all that with all of the controls in place, right? Auditability, observability, feature-based releases, and the commercial teams have figured out, you know, how do we commercialize all of these features versus this one big launch that was usually tied to an event, you know, you try to put all your releases and now it's like we're releasing continuously and the doctors, like, absolutely love it.
Evan: Are there any things that you've done right, that looking back has had like a disproportionate impact in kind of driving this culture of innovation?
Sree: You know, for us, technology’s like the central nervous system of the company. And so, as a technology team, we stay on top of current technology trends. You know, we actively engage with the startup community.
We’re backing up monolithic desktop apps. You know, building out microservices. We understand the agility and the flexibility of the platform that it provides. We have fun hackathons.
Experimentation is very much part of our culture. And, you know, when we fail an experiment, we treat it more like learning experiences so that we can continuously iterate on the idea or, you know, we just decide to abandon it. Right. So I think that that entrepreneurial culture is very much alive at Align.
Nobody has done what we were doing before. So it's not that there is a path for anyone to say, oh yeah, it did not work in that company, so it's not going to work here. Everything we do is first for the whole industry. So, I think it's important for us to keep at it and ensure that we are able to deliver for the doctors so that they can deliver for the patients.
Evan: Sree, how is your innovation affecting the world around you, and maybe raising the bar for what consumers expect in healthcare today?
Sree: So the consumers are driving much of this experience, right? Like if I don't have an app today for a consumer, you have lost the consumer. Today's generation is not going to find the time to walk into a doctor's office to figure out the options around a smile, right. I think the disruption from COVID accelerated the need for more of those tools. But I would say that the consumers of this generation are actually driving all of those experiences.
Evan: What's kind of going to be the takeaway for other CIOs, right? Is it that consumers are also likely kind of driving their markets forward, and they need to think about how to adapt and react to that?
Sree: Yep. Consumerization of everything is the norm these days. Even when we are building tools for doctors, doctors have been consumers. I mean, they use Amazon, they use Google, they understand what a slick user experience could look like. And so they are expecting the same from us.
In the past, a B2B user experience was not as important as the feature sets you would deliver. But right now, the mobile experiences, both for the doctors and the patients, the enterprise experiences inside the practice, all of that ease of use is all naturally being expected just because of how everybody's a consumer of some well done tool.
Saam: One of the things you mentioned earlier was creating an entrepreneurial culture and I'm curious what’s the role of partnering with early stage technology companies is in creating that culture?
Sree: Very important. You know, from my perspective, the partnership is very symbiotic because we have very practical business and technology problems to solve. And the tech companies want to ensure that their products and roadmaps can solve for us. The relationships are very important to understand where the technology is moving as well.
Saam: When you think about the earlier and newer technology companies that have been most successful in having an impact at Align, what were some of the shared characteristics they’ve had? And what hasn’t been as effective?
Sree: The most important or the only success criteria is being able to solve a problem that we have at Align. You know versus trying to sell whatever your product was trying to do. Right. Which may or may not be a problem for me. The starting point has always been that there is a core problem that needs to get solved and it's solved beautifully by that solution. And then from there on you just grow.
Evan: That's really good advice. I guess when you think about how startups can drive innovation inside of a company, are there any myths that your peers might have that are holding them back from really taking advantage of startups?
Sree: You know, I think one of the things is not to view the companies as merely sales calls or sales relationships, or be afraid that if you pick up a phone from a startup, it's because they want to sell you something and you're forced to buy something. There's a lot of nervousness about having a very transactional relationship and pretty much the first assumption going in is oh, my God, like they want to sell me something like I'm so done. I can't take any more. But I think if we were a lot more open-minded and said, hey, in this area, like I have problems that need to get solved. You know, whether it's for security, whether it's for scalability, cloud engineering, product engineering, data space.
And then you say, if we had a good idea of the problem that needs to get solved, I think we will be more open-minded in the kind of - in approaching startups or established partners to come in and help solve for us.
Evan: What can startups be doing to kind of better contribute and partner with large enterprises?
Sree: Putting yourself in our shoes is critical. If the intent is to expand on the product, is to get more feedback, embed yourself with the teams that want to use your product and that give you very critical feedback. So that's in the early stage. I think as the startups mature, this dilution of focus happens both in terms of the feature set, as well as in terms of relationships. Right.
You know, I’ll pick monitoring as an example, we have so many tools with us right now. When they were all startups, it was a great partnership because they showed us a problem that they were going to solve. And we were so desperate because we have no inventory.
Our systems needed to be up 24 by seven. And you know, real-time manufacturing is not easy by a stretch. Let's say over a five-year period, all the tools have expanded in their feature set. Everyone is on - overlapping each other.
And then I'm sure we are just now one of the many enterprises they serve, so they are not in front of us every day or every week telling us, hey, here are your new features, here's how we should expand. So that personalized touch is gone. So now I'm sitting there and thinking if somebody comes to me with one more tool, I am not signing up until you go rationalize those other tools that we already have.
So somewhere along the line, and I don't know what the right balance between scaling the startup and also keeping those relationships important. But I think it's very critical. Because what you're going to do is you're going to start losing all of the early adopters, simply because it's overwhelming for the number of releases the teams are doing because everybody's on the continuous release model.
Saam: Sree, one thing that's unique about you is you've been involved with some of the most important technology companies over very long time horizons. I know you spent a lot of time advising Salesforce and Starburst Data and other companies. Maybe talk about what the hallmarks of that symbiotic relationships have been with those companies.
Sree: The consistent, underlying theme of those long - long-lasting relationships have been that there is an equal interest on their side as well. You know, they're very, very interested in how we use their products and if it's driving the value. They're not just looking at it from, oh, I've made this great deal with Align, but they're more interested in is my software generating enough value and more, and what should we be doing in the next releases and in our roadmap to help customers like Align service the doctors and patients even better.
You're always going to get an interest from our end, from the enterprise CIO, CDO end, right, because all the businesses are moving fast and we are looking for partners who will fill the gaps that we have. And so what's important from the other end is an equal understanding and an equal empathy and an equal want and the willingness to help all of the customers grow and get more ROI from the software they’re selling.
Evan: Those are wise words. So now Saam is going to kick off our lightening round of questions.
Saam: What's the number one thing every new CIO, CDO should be thinking about when they join a new company?
Sree: How strategic technology is in driving great experiences and product outcomes.
Evan: What would be like the biggest misconception that people have about technology in healthcare?
Sree: That technology can solve it all. It's as much a cultural change as having a right solution at the right time that helps both the doctors and the patients.
Saam: How do you measure the performance of a technology organization?
Sree: I measure it based on the adoption of products and the experience that we can drive both for our own engineers, as well as our customers.
Evan: How would you recommend CEOs or boards kind of measure the performance of technology organizations?
Sree: So for the technology organization, the software engine room needs to be fully functional with continuous release velocity and good quality delivery. Once that engine room is on a good flywheel, you can develop as many features as you want. And if one feature works and the other feature doesn't work, it’s fine, because you're in this continuous delivery cycle and in this continuous feedback loop that would help get more experiments out the door. So for me, the most important metrics is as much as the number of features, the types of features, the product adoption are all important.
It's equally important for a technology organization to make sure that technology debt is continuously decreasing. You know, the short-term design choices that we are making to help go to market faster, we come back and actually fix it. You know, the release velocity that we can provide by making sure that the engineers are productive is very important because at the end of the day, the engineers are a very constrained resource all around the world. So it's very important that there is enough engagement from them. The workplace is great. The productivity is great. So those metrics around engineer engagement and productivity are critical.
Evan: Yeah, I think you're right. Like sometimes the speed of innovation kind of gets lost over just like, what are we doing?
Saam: Definitely. Okay, next question: what is a book you’ve read that’s had a big impact on your approach to leadership?
Sree: One of the most relevant books I've read is the book by Jeff Lawson on Ask Your Developers. In fact, I gave that to my CEO and he thoroughly enjoyed it. It shows how technology as a discipline is very critical to companies these days. Simple language, very easy to read and very impactful.
Evan: Is there a particular technology or product or kind of new innovation that you feel particularly excited about?
Sree: Oh, there’s like a ton of stuff. You know, you never ask - you never ask the person driving a technology which child to pick, you know, who's your favorite child? You know, ton of cloud, AI, web, UX design tools.
You know, like what people tend to forget in all this is how much the foundational technology is so critical, because we all like the bells and whistles and, you know, go after the next new technology. But if you don't get your identity right, if you don't get your APIs right, if you don't get your data right, you cannot build on any of this, right? Like voice is a new system that's coming up, a ton of AI around translations, you know, for a global company. So everywhere we looked there is like a ton of opportunity.
Saam: Thanks for joining us on the podcast. I’m just thrilled our listeners are going to get to hear about your journey, how you partner with technology companies, and the role technology has played at Align. Thank you.
Evan: Thank you so much, Sree, for joining us.
Sree: Thank you very much. This was a fun conversation.
Saam: That was Sreelakshmi Kolli (Shree LOCK-shmee KOH-lee), Chief Digital Officer at Align Technology. Thanks for listening to the Enterprise Software Innovators podcast. I’m Saam Motamedi, a general partner at Greylock Partners.
Evan: And I’m Evan Reiser, the Founder and CEO of Abnormal Security. Be sure to subscribe, so you never miss an episode! You can find more great lessons from tech leaders and other enterprise software experts at enterprisesoftware.blog.
Saam: This show is produced by Luke Reiser and Emily Shaw, and mixed by Veronica Simonetti. See you next time.