To celebrate International Women’s Day we’re launching the first episode of our Women in GovTech series where we interview Rachael Grimaldi, Co-founder and CEO of Cardmedic. Cardmedic is a HealthTech startup which was founded in April last year in response to the pandemic, helping healthcare professionals to communicate more effectively with patients while wearing PPE. In this interview PUBLIC’s Director of External Affairs Syma Cullasy-Aldridge speaks to Rachael about her journey from NHS anaesthetist to GovTech founder, how to become more comfortable talking about money and the importance of female role models in the tech sector. Watch the video or read the interview below.

 

Hi, I’m Syma Cullasy-Aldridge, Director of External Affairs at PUBLIC. This interview is part of our Women in GovTech series. I am so pleased to be joined by Rachel Grimaldi, who is co-founder and CEO of Cardmedic. So before we kick off properly, Rachel, it’d be great if you could tell us a little bit about what Cardmedic does.

Sure. So Cardmedic is a website and app designed to improve communication between frontline healthcare staff and patients across any barrier. So whether that’s blindness, deafness, cognitive impairment, including learning disabilities, stroke, dementia, or autism, language barriers, or even PPE, which is what inspired it in the first place.

Amazing. And I want to kind of hit on what inspired it in the first place, because the way that you’ve described yourself to me in the past is you’re an accidental entrepreneur. When you were on maternity leave, and I should say to for the audience, that you are an NHS anaesthetist. And you’ve got a background in medicine, but I’d be really interested to hear you talking a little bit more about the accidental entrepreneurship and actually, what kicked off your journey.

Sure, yeah. No, thank you. I’d be delighted to. I was on mat leave, as you said. I’ve got three children under five now, was three under four when the baby was born, and we were visiting family in the States, I used to live there when I was younger, and we got stuck there in the pandemic. So we tried to come home early, our flights were cancelled seven times, I was stuck there for nearly six months. But at the very beginning, when things were taking off, I was just desperate to do something to help. You know, I was in tears the first week, and I felt so guilty for not being on the front line. If I was back in UK, I would have just gone straight back to work. So I was kind of clambering around thinking, what can I do, and I was just glued to Sky News. I was on the news all the time speaking to my friends all the time. And then I came across an article about a patient who was terrified because he couldn’t understand healthcare stuff through the barrier that was created by PPE. This was a guy in his 30s, he, you know, no communication issues normally. So I thought, well, how are people coping? You know, what is our staff doing in critical care. We normally write notes on a piece of paper sometimes, and, you know, if there are speech and language therapists around, we can get them involved. They’re a scarce resource. So I thought, well, what about if I wrote those conversations down that people were trying to have, on a website, just a really simple A to Z list of really common healthcare topics, and essentially replicating the conversation. So they were a little bit like a script, not dogmatic just to try and support the clinicians interacting with the patients. So it was from concept to launch in 72 hours, I wrote a lot of content. My husband who’s co founder, just set up the website, we uploaded all the contents and shared it with some friends. And I thought, well, you know, at least I feel like I might do something to help. And then it kind of grew quite rapidly from there. So within a couple of days, one of my friends said, oh, you should join Twitter, which I did. A little bit sceptical, but I went for it. And then just organically, we had 8000 users in 50 countries within the first three weeks since launch. And then we had some media coverage, which was, you know, fantastic. It went bit crazy for a few days. And then overall, in the last 11 months, we’ve had over 46,000 users, and 120 countries and over 16,000 app downloads. So it’s kind of evolved from being you know, a tool to help friends to the feedback I was getting is, you know, this has to stay around after the pandemic, because the reality is that clear, safe communication is a massive issue. It’s a huge issue outside the pandemic, PPE has exacerbated the health inequalities, which we’re all reading about in the press. And so, there’s this massive gap in service provision, which is estimated to be around 5 billion pounds. And we just don’t have the resource to spend that amount on translators every time someone needs it, or speech language therapists or a learning disability nurse. So what I’m trying to do with Carmedic is bridge all those gaps. And essentially, the content is multilingual to bridge language barriers. It’s got read aloud functionality for patients with literacy issues or blindness. We’ve got sign language videos that we’re launching for patients with hearing impairments. And it’s easy to read with pictures for patients with cognitive impairment. And all of that costs money to do so.

I’m really keen to talk about the money side of things. I want to talk about this wide application. And actually, where you’re going to take the business next. Listening to you talk there, my grand didn’t speak any English, and she had health problems. And it would always be me or my sister, who would be trying to explain things to her in Punjabi. And it was really hard and that’s just one example. Thinking about like, the wider applications of your technology, but also kind of the social impacts of it, what do you think is next for your journey?

Well, I think that there’s so much more so you know, as you said, the sort of the wider applications is that you know, certainly in in healthcare, this can be used anywhere, you know, primary care, secondary care, ambulances, dental practices, pharmacies, etc. But there’s so many applications and other verticals as well, which is, you know, really exciting. We’re focusing on healthcare at the moment. But, you know, there’s lots more to come. We’ve got loads more content to add lots more functionality. So, you know, at the core of what we’re doing is, as you mentioned that social impact, that’s absolutely key. We want to reduce health inequalities for people like your gran, you know, sadly that’s such a common story. And in my experience, almost every shift at work, I struggled to communicate with someone it’s usually language barrier. And then we just rely on friends and family and children or grandchildren in your case, you know, other members of staff to translate because the realities are that organising translators is tricky. There are logistical issues around it. And so the reality is it just doesn’t happen anywhere near as often as it should. So we know what we want to do is have that positive social impact, reduce health inequalities, improve patient safety, improve their experience in hospital and the quality of care that they’re receiving and that staff feel like they’re able to give them so the next steps for the journey is commercialising what we’ve been doing. So, you know, we’re essentially a social enterprise, if you like, we’re a for profit business, because we need to generate revenue to make this sustainable, it’s completely impossible otherwise.

You told me how much it costs to run the website earlier on for a day and it would be really interesting to hear about the financial growth.

So just as an example, the content that currently exist on the website, to convert that into 10 sign languages costs a million pounds. So we just, we don’t have that kind of money. So we’re working with Inclusive Fruit a brilliant organisation in London, and we’re partnering with them, and they will be doing the sign languages, and we’re just working out something that is a win-win for both of us. Because what we don’t want to do is leave the deaf community behind, because it’s just such an expensive resource to provide. So we’ve got to do something that works for everybody. So you know, that’s just one example. And, you know, it’s something that we need to generate revenue for to cover those costs. To do the translation costs hundreds of thousands of pounds. And that’s just for the content we’ve got now, you know, that will keep growing. And we’re really, really excited, we were just about to partner with Step Up One Foundation to work with refugees in Kakuma refugee camp in Kenya, to do some of the translations as well. Again, and we’re really passionate about that, you know, it speaks to exactly what we’re trying to do. But all of these things, generate costs, you know, staff, there’s, of course, labour costs. And you know, the finance is all new to me. And thankfully, I’m surrounded by an awesome team, a fantastic mentor, and chairman and CFO who were able to guide me through this, and we’ve got a really detailed financial model. But you know, it’s expensive. So we have to work out a way to generate revenue to make it sustainable. And then we’ve got our Cardmedic Foundation and I’ve just brought someone on board to run that. And we’re going to subsidise its use for low and middle income countries, refugee camps and humanitarian crises. So they get this content all for free. So we’ll have our patients and staff, public carers will always have Cardmedic for free, and we’ll still have our freemium model, but it’ll be restricted content, and then healthcare settings will pay a licence to open up the rest of the content, and it will be free.

Yes, I can see that social enterprise values are really important to you. I’ve got so many questions. You mentioned before that you are not comfortable talking about the financial side of things, and I think that is something that is replicated in other female founders as well who I’ve spoken to about it. So how do you find it? And what do you do to overcome that barrier?

So I think part of the reason I feel uncomfortable about talking about finances is sort of twofold. I think part of it’s the math, I’m don’t feel that confident on the maths. I mean, I got an A in my A level, but I just one of those things. When I was younger, before A-levels, I had a series of not fantastic maths teachers, and I just lost confidence with it, I worked really, really hard at maths A-level, and I’m just, I’m not confident with that side of things. So I just find it really stressful. And I think the other side of it is I also I feel bad talking about money. What I’m doing, I’m doing with goodwill and passion and dedication, and then it feels a bit like money is a dirty word, like asking people to pay for this, but we have to pay for it. Because if people don’t pay for it, there won’t be a Cardmedic. So it’s a kind of necessity. Thankfully I’m surrounding myself with amazing people who are confident and good at talking about it. And learning through them and having having them in our meetings with me, it’s giving me confidence as well to approach things. And I did this incredible market access accelerator at Oxford University Hospitals. It’s called The Hill and they were brilliant. And my mentor from there is now my Chairman, and he has got this unbelievable financial model that he was gifted years ago by an FD from a venture capitalist. And it’s so detailed, and it served us really well and I’ve got you know, our CFO and Tim, my husband, my Co-Founder, and we have worked on it in great detail. And it’s really allowing me to kind of unlock the myth behind it all and just gain a bit more confidence. But part of it, I think, is just practice – practice the conversations and practice going through the model.

So your advice to fellow female founders or people thinking about becoming a female founder is practise and surround yourself with the right people. And actually, it’s not that you can’t do it, it’s just that you needed to build up your confidence in doing so.

Yeah, definitely. I think for me, for sure, there was an element of imposter syndrome. I’ve found that in my medical my clinical career, you know, for a long time I, when I was much younger, in school, I was told, you won’t be a doctor, and you’re not gonna get the right grades. And I did get the right grades. And I did become a doctor. But it was through a lot of hard work- blood, sweat and tears and two degrees at university. And then I spent the best part of the first decade kind of questioning, did I belong in medicine? I’ve always done well, I just haven’t had that kind of inner confidence. And that’s grown. When I started the business, it was the same thing. I was thinking, you know, I’ve had no training, I’m suddenly in the business world, you know, who’s gonna take me seriously. But having done the accelerator programmes, having gotten innovate UK grants, having won some awards, having all the traction, we’ve had, all that kind of validation, the amazing feedback, and just having more and more meetings with people. Over time, I kind of feel like the past year has been really fast tracked. And I think COVID had a lot to do with that, because things have just happened really quickly because they’ve had to. But I just think through that process, and through having more meetings and mentorship that’s definitely given me the confidence and that kind of imposter syndrome is sort of abating now.

It’s great to hear of the positive things that’re coming out of your experience. But if you look at the statistics, from a young age only 3% of women say that tech is their first choice as a career. And when they’re going through school, and they’re having their career choices spoken about only 16% of women say that career tech was given to him as a career choice compared to about 35% of men. So there is a difference there. There’s a lack of female role models in this space as well. And part of the reason why we’re doing this series is to showcase them. I’d be really interested to hear your thoughts about what more can be done, and what’s been your experience? And from that, what you think can can change?

Yeah, I mean when I was in school, I was focused on medicine, and I had the careers chat advice, and I was told you’re not going to be a doctor. And I think, partly, it’s about having the right career advisors in place, who are very much tuned into the career opportunities that are available, the more sort of cutting edge ones, if you like. Women in tech shouldn’t be cutting edge. But, you know, it definitely feels like a space that’s just starting to be explored and opened up. And I think part of it is having female founders and female tech founders coming to schools and doing careers chats and I’m part of an awesome network of women’s founders who are so inspiring and so powerful, and doing some incredible things. And, you know, have definitely had their struggles over the years. And I think having more representation of that in schools, having lessons, you know coding for girls. I’ve got three children, I’ve got a boy and two girls, and we’re very gender neutral, you know, where girls can do exactly the same things as boys and it’s second nature so we don’t even think about it. But perhaps having coding classes that maybe are for girls, because if, you know, it might be that girls don’t feel confident going into a class that is mostly, if not all, boys. So I think certainly having coding classes available, and maybe just, you know, having specific ones for girls, perhaps having after school clubs related to the STEM curriculum and all those sorts of things, I think can only encourage it. And I think there’s a place for industry as well to maybe do internships or work experience for pupils at school, to come in for a week or two and, maybe that could be government related and for kids to spend some time with female founders.

Maybe we need to set up the first Women in GovTech work experience. You need to get them before they get to university, when they’re making their choices.

Yeah, definitely, I think 14 upwards because you can pick the right GCSE’s and yeah, the right A-levels. And definitely I think, start early for sure. 

Definitely. And I wanted to come back to you as said, you’re in this kind of group for female founders. And before that, you mentioned this Oxford medic accelerator. I wanted to just get your reflections on your experience in those and how they’re different or how they’re the same and how they’ve actually shaped what you’ve done going forward?

Yeah, definitely. So the women’s founders group, I became a part of it off the back of my experience in The Hill, the accelerator from Oxford. And they’ve just been an amazing source of support and inspiration. And you know if you’ve got any questions, you just post it on the chat, and immediately several people will come back saying I know someone in the space, or this is what we’ve done for X, Y and Z, and they’re just a hive of knowledge and experience, it’s unbelievable. That The Hill accelerator that I went on, was run out of Oxford University, Oxford University Hospitals. And it’s a mixture of startups at various stages, some are kind of idea stage, some are a bit further down the line. And it was, it was a programme run over about six months, I then did their follow up Open API Interoperability Bootcamp, which was much more of a deep dive into tech stuff. And the two programmes were incredible, the mentorship, the support, and it wasn’t just the sort of talks and webinars on specific topics about how to grow a business, how to pitch financial models, all that stuff was in there. And it was all about kind of letting ourselves figure out how to think and about doing motivational maps to learn about what kind of things motivate you and what kind of personality you are. So it was a brilliant programme I’d recommend doing something that like that so highly. And, you know, I’m now on the NHS clinical entrepreneur programme, which is  just unbelievable. And it’s a network of specifically clinicians. It was embarrassing, I got off my first session with them and I just cried to my husband, I was like, oh, my gosh, I’m with like minded clinicians, you know, that’s been the one piece of the puzzle that’s missing. I’m now back in the NHS as well. And so, I found my tribe. It’s amazing. So I think that The Hill was a mixture of organisations and companies working in the healthcare space. But most of them weren’t clinicians, and I’ve now kind of bridged the gap. And now with a big 700 plus group of clinicians, so you see, I think it’s just having an awesome team or some mentors. You know what you don’t know, you don’t know what you don’t know, you know what you know, so it’s kind of having people to fill in the gaps. 

Definitely. And just thinking about The Hill, do you feel like the experience that the other people in the programme had was similar to yours?

Yeah, I’ve just begun the NHS clinical entrepreneurship programme. And I think people’s experiences have been really similar because I think innovating in health care, being a clinician in the NHS, I think it’s challenging. And so I’m just starting my journey of learning with these entrepreneurs, but the messages that have been flying around left, right and centre already is that, we’ve all got shared experiences, which is amazing. With The Hill, I think, because it’s, most people weren’t clinicians, I think it was a different approach because a lot of people were going, how does the NHS work and how do we infiltrate the NHS to understand the pain points and speak the language? It’s not like, how are we going to make money out of the NHS at all, it was, how can we help fix problems in the NHS and have cost effective solutions. And so I think they just have come from completely different angles. And, you know, I feel like doing The Hill has given me a really awesome foundation and skillset to now go on to the entrepreneurs programme, because I’m going with, you know, more of a developed product and a bit further down the line. And therefore, there are people that I feel I’m able to maybe mentor a little bit on the entrepreneur programme, because I can just share, you know, what I’ve learned.

I’m really interested to hear you talk about NHS innovation, and actually the clinical entrepreneurs programme, thinking about what the NHS can learn from itself and from its own staff. But COVID has shown us that the NHS needs to innovate, and there’s been a lot of stuff happening. My concern is is it going to continue? What can the NHS keep from this kind of fast moving innovation that they’ve had to have, and how do you think that’s going to be in the future? And what more do they need to do?

Yeah, I think that’s a really good question. I think people have been innovating in the NHS for years, they’ve got the NHS innovation and improvement programme, and there’s the NHS accelerator now. And there’s all the kind of things that link it up, the academic health sciences networks, knowledge transfer network, all of which I’ve been a part of in the last year and they’ve been brilliant. But I think, you know, the NHS is such a huge machine, it just naturally can be slow to move. But I think what COVID has done, NHS digital has had to fast track its innovations, you know, they’ve got more done in a matter of weeks than they have done in years, because the red tape has gone. I think it’s been a huge leap forward for the NHS, and people having digital consultations, being able to book and manage their appointments and remotely manage their results, I think there’s a lot that’s going to stick now. And I think, you know, part of what will happen in the coming 18 months or so will be kind of unpicking with a bit of retrospect, right, you know, what worked really well, what can we push forwards? What do we need to improve on, what didn’t work well, and why and how can we improve on that? So I think, digital literacy, and that’s another thing that hill runs, lots of programmes on staff and getting you improving digital literacy. I think people maybe previously some people might have lacked confidence with digital literacy. But I think people just had to embrace it. And I think clinicians, healthcare professionals, allied health care professionals, anyone that’s working in the NHS, they want systems to improve, they want things to move forward, we all know, budgets are extremely tight, but everyone goes to work to do a good job, they go to do it to their best of their ability. And I think if there are really cost effective digital solutions out there, then it’s providing the infrastructure and the IT to support that, which is fundamental and which NHS digital are working really hard to do. And I know that they are working flat out. But it is really challenging. And so you’re never going to please everybody, but there’s a lot of work going on behind the scenes. And I think the biggest leap forward that’s going to happen in the next few years is interoperability. So getting all these different systems to talk to each other. And, you know, for patients to have proper control over their own records, and much more openness and transparency around that. So I think that is a big leap forward.

One of the things that we’re trying to highlight in this series of interviews is a lack of female role models in this space. So 70% of students who were surveyed couldn’t name a famous female working in tech, which is far too many that couldn’t name one. And when female students were spoken to, 50% of them, which is the highest higher proportion in the male sector, said that social impact is really, really important for them when they’re choosing a career. I think it’s 80% of millennials say that. So all of that kind of encapsulates you and what you’re doing. So I think my parting question to you would be what do you say to these females for whom you could be a role model? 

Well, first of all, thank you so much, that’s a massive compliment. And, you know, it means a lot to hear that. So thank you. I’ve never seen myself as a techie, if anything, I’m a bit of a technophobe. So if you’d have told me a year ago, that I’d be essentially running a digital health tech company, I would not believe it. I found since having children, that life changes and you realise that life is really short. And it’s what you make of it, as potentially cliche as that sounds. And you know, the biggest part is to follow your dreams. So if you have an idea that you’re passionate about, the idea I had for Cardmedic was just born out of I want to help my friends. And it just then grew and grew. And if you’ve got something that you’re passionate about, that you believe in, that has that positive social impact, and that’s what drives you. It’s certainly what drives me to really make a difference bringing humanity into people’s lives. If that’s really at the core of what you’re doing, then go with it. You know, surround yourself with amazing people, have faith, have confidence. And just run with it. Don’t question it too much. Say yes to everything, you know, all these opportunities that come your way. I’m now having to learn how not to say yes to everything. I’m still no good at it. But say yes to everything, do loads of networking, believe in yourself, be true to yourself and just follow your dreams. So cheesy, but it’s great.

My takeaways are, you have to be true to yourself, you have to be brave. So if there’s something that you want to do, do it and find your tribe and find your team.

100% that sums it up perfectly.

Well, thank you so much for your time today. I really appreciate it. For those who are watching this it’s actually half past nine in the evening, because Rachael has been in the hospital all day today and then put her kids to bed. And then we’re doing this. So it’s really really, really appreciated. And I’m excited to see where you go. Thanks so much.

Thanks so much for having me.

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