BME^3: From Biomedical Engineering to Budding Medtech Entrepreneur to Building Medication-taking Equipment

Hareesh Ganesan, Class of '08, is a product manager at PillPack and co-founder of Fellow (formerly TowerView Health), an award-winning smart pillbox and healthcare navigation service to make it easy to take medications and take care of loved ones. He’s a Forbes 30-under-30 in Healthcare recipient and holds a B.S.E. in Biomedical Engineering and B.A. in Computer Science from Duke University. Sherman Leung, Class of '12, interviewed Hareesh about his experiences.

Let’s rewind back to the Magnet program, what do you remember about it? What did you take away?

Hareesh Ganesan
The two words that come to mind are “humbled” and “overwhelmed” -- I remember looking around and feeling “this is really real” and “things move really quickly”.

What is particularly unique about the Magnet is the freedom to explore and build. To get this freedom in the context of an actual curriculum was really unique and becomes a mindset that stretches beyond just high school. I got an early start building confidence in myself to try bigger projects, and I think that comes from a Magnet culture that reinforces building interesting technology projects.

I also specifically remember the Magnet CS courses, and the depth of the curriculum. Taking those courses that early just gave me more tools to build with, and a desire to explore more ambitious projects. The first "Iron Man" movie had just come out with that scene featuring holographic interfaces and gestures, and I had just come out of Computer Graphics with Ms. Collins. I remember trying (and failing) to build some of the simulation software that I saw in the movie. Separately, knowing how to use UNIX from the Blair system was a meaningful and translatable sysadmin skill.

Outside of the Magnet, I was really involved in Silver Chips. I never felt the Magnet limited me to STEM work, and I built a really deep passion for journalism. I think experiences like these show the student population is more well-rounded than publicly known. The most interesting takeaway from my time in Silver Chips was that it gave me basic training in how organizations work that I still use today.

How did you decide on this hybrid BME/CS while in undergrad?

Coming out of high school, there’s a certain romanticism around BME - “it’s got a little bit of everything” (especially if you like physics/CS/etc…). I started studying BME and ECE, but realized all of the electives I wanted to take were CS, not ECE. Since Duke was primarily a devices program, it was more mechanical/electrical-oriented (signals processing). While I enjoyed that, I missed the speed of development in CS, and wanted to build skills in both.

Coming out of the Magnet, I definitely had a leg up in computing fundamentals . If you ride the whole CS curriculum through, you’ll basically finish the first 2 years of CS in undergrad. I felt incredibly prepared for intro classes at Duke for everything because I had taken them all at Blair. In addition, being in a competitive environment like the Magnet mentally primed me for that sort of environment with fairly intense coursework even before college.

The biggest delta for me between school and college was realizing gaps in my own awareness of what I understood. What it means to truly engage with a topic, didn’t really “click” until my senior year in college -- In other words, to really have that concept lock in, this is how much you have to engage.

Socially, Duke pushed me to see many different types of study, people that didn’t focus on math/science. Things in the real world are much more abstract than “right/wrong answers” - being forced to write out my thoughts and communicate with others really pushed me.

Walk us through your early career, landing your first jobs at Accenture and APT - what were you looking for in those first roles and looking back - what did you take away from those experiences?

I knew even in high school that I wanted to start a company someday. In college, I got a lot of exposure to consulting. In a similar way to how residency builds your heuristic to practice as a doctor, and you train a neural net by building its weights, consulting is a bit like this as well. You’re fresh coming out of college, so you need that institutional knowledge/wisdom for how to operate in a professional environment - doing a rapid fire iteration on that at APT was something that was a good fit for the skillsets I wanted.

Coming out of consulting, what you really learn is time management and communication. You don’t really have to manage your time effectively in college, but you’re forced to in these jobs. By communication, I’m referring to “clarity of thought” - knowing what am I actually saying, why am I saying it? Can I say this in 3 sentences vs. rambling on and on?

Tell me about Fellow - the inspiration for starting it, learnings you’ve taken away from that experience, etc…

Founders of Fellow (Duke Entrepreneurs)
I started Fellow with 2 college roommates and a close friend that I actually met after college. We were always talking shop about ideas, and one of my friends Nick went to medical school and was diagnosed with Leukemia. They gave him a bone marrow transplant and sent him home with 10 vials of medications. Well-educated, in medical school, 23 y.o., with a blood oncologist father, Nick didn’t have any issues in medical literacy but it was still a nontrivial ask to take 5-10 meds a day. 

We went more hardware-first than PillPack did, because we saw it as two problems: (1) “how do you manage medications while in the home?” and (2) “how do you close the loop with the rest of the healthcare ecosystem?”

For medication adherence, we built automated reminders, smart pillbox hardware/firmware, (the manufacturing went to China, but we built our own supply chain). Chronic conditions were very underserved, and we originally thought that we could get payers/providers to pay for it. But we realized that we could cut through the noise by working with pharmacies.

So we ended up building fulfillment software and selling this back to the pharmacies. But the way the economics worked out, it didn’t allow us to achieve the economies of scale we were looking for.

What advice to you have for folks that might be interested in healthtech + entrepreneurship?

Specifically coming out of Blair’s background, we have an aptitude to “build first” which isn’t always the right move. It’s more important to write what you want to do, and talk to people to figure out if they actually would pay for it. Figure out if you can articulate what they really want and what they’d actually pay for.

We have to fight the instinct to solve the problem immediately -- there’s a lot of nuance around figuring out what the problem is and articulating what people do. Chances are you can hire this skillset long-term but founders need to have this attitude to start.

More generally, it’s valuable to always see things as a learning experience, everything you make (even putting PowerPoint slides together) is a craft. Thinking with this mentality has always given me the attitude of being able to make the most of what’s next and avoid missing out on learnings.

What do you aspire to do in the next 5-10 years?

I ultimately want to build products that people use. Professionally, I’ve historically learned everything by myself. So in this medium-term ... I’m excited to be at a large company like PillPack, you can learn things the “right way” and leverage the experience of folks that have gone before you.