$30M ARR in AI Healthtech, CEO Tells All | Jonathan Larbey, T-Pro | Startup Scaleup People

Startup Scaleup People
175 views • December 07, 2025

How do you build a global, high-impact healthtech business bootstrapped and profitable from day one?

In this episode of Startup Scaleup People, we speak with Jonathan Larbey, CEO & Founder of T-Pro, an AI-powered clinical documentation platform trusted by over 130,000 clinicians globally.

🎧 Hosted by Mario Rivas and Tiffany Shown, this conversation dives into building a healthcare SaaS business from zero to $30M ARR through acquisitions, product innovation, global expansion, and governance.

📢 About Startup Scaleup People
Real stories from startup, scaleup & enterprise leaders. From boardrooms to founder garages — we bring you insights on growth, leadership, funding, exits, and everything in between.
New episodes every Sunday at 4PM UK time.

🧭 Chapters
00:00 Jonathan’s Journey: From Rugby to Tech CEO
04:00 Solving Clinical Documentation at Scale
08:00 Global Expansion: UK, ANZ, India & More
12:00 Impact on Clinicians & Healthcare Systems
17:00 Reaching $30M ARR with Strategic Acquisitions
23:00 Governance, Boards & Private Equity Partners
29:00 Lessons in Due Diligence & Integration
36:00 Founder Advice & Leadership Lessons

💬 Key Highlights
▸ 130K+ active users, tens of millions of documents processed annually
▸ Bootstrapped and profitable from the start — now private equity-backed
▸ Strategic acquisitions in Ireland, UK, Australia, India & New Zealand
▸ Built M&A playbook and acquisition runway for future growth
▸ Solving clinician burnout & documentation inefficiencies with AI
▸ Active board with PE firm Livingbridge and top-tier chair
▸ Insights on scaling in highly regulated global markets

👥 Who Should Listen
Healthtech founders • SaaS leaders • PE-backed executives • Board directors • Clinicians • Global operators • Investors
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🧠 Keywords
startup, scaleup, entrepreneurship, business podcast, leadership, business growth, founder mindset, startup stories, scaleup journey, entrepreneur advice, business strategy, innovation, venture capital, startup founders, startup funding, executive leadership, enterprise leadership, enterprise strategy, business transformation, board of directors, fractional leadership, NEDs, startup scaleup people, AI, healthtech, SaaS, M&A, private equity, clinician productivity

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0:00 This podcast is for everyone who wants
0:02 to learn how people build their dreams.
0:06 I'm Mario Rias, founder, CEO, um, and
0:10 board advisors for organizations. Thank
0:13 you for for joining us today. I'm
0:15 delighted to introduce Jonathan Larby,
0:17 founder and CEO of Triper. It's a
0:20 AIdriven clinical documentation um
0:23 company. He has track record scaling in
0:25 NHS and af organic and acquisitions
0:30 governance focus safety and inter
0:33 operability with hospital system.
0:36 Welcome John to the podcast.
0:38 >> Thanks Mario. Great to be here.
0:39 >> Can you tell us a little bit about your
0:40 background so people can understand
0:42 about you? How you started this
0:44 business? You look quite young and you
0:46 build already multi multi-million
0:48 business. Can you explain a little bit
0:50 about your background? I'm actually I'm
0:52 actually from the UK originally.
0:54 >> Okay.
0:54 >> Oh, go.
0:55 >> I moved to Ireland um in 200 and I you
1:01 know my background prior to that was
1:03 really I was I was playing rugby um and
1:05 my rugby career sort of took a quite an
1:07 early nose dive um and then went
1:10 downhill pretty rapidly from there. Um
1:13 and I I had to I had to get a proper
1:15 job. So I I I went out and decided I
1:18 didn't really want to go and work for
1:20 the big four. I didn't see myself in a
1:22 consultancy firm. Um whilst I was
1:25 playing rugby, I sort of did a law
1:26 degree um and and scraped through that
1:29 and I was never going to be a lawyer. So
1:32 I I ended up starting two businesses
1:35 actually with um a group of friends. Um
1:39 one of them was Tro and that that ended
1:42 up being my focus. Um and the other one
1:44 was an insolveny and restructuring
1:47 accountancy firm. So for for a couple of
1:49 years that went better than TRO and that
1:51 was that was really paying the bills.
1:53 And what I was doing there was um I was
1:55 doing restructuring work for banks. So
1:58 they had distressed asset portfolios um
2:02 which basically we took control of. We
2:05 um secured the assets then packaged them
2:08 packaged them up and then resold them um
2:11 to to funds and and things like that and
2:13 just kind of you're crystallizing a bit
2:15 of a loss for the banks but you're also
2:17 improving their balance sheet because
2:18 they don't have these they don't have
2:20 their the sort of the outstanding debt
2:22 which means that they can lend on the
2:23 other side. So that was that was a good
2:25 learning for me. I learned a lot about,
2:27 you know, what happens in in the bad
2:29 times um and how businesses how
2:32 businesses behave and what goes wrong
2:33 and things like that. And after a couple
2:35 of years, Tro started to take off and I
2:38 I exited that insolveny in restructuring
2:41 business full-time in Tro in about 2014
2:44 and and haven't really looked back.
2:46 >> Wow. And for how long have you been
2:48 working on Tro like in total? in total
2:51 just over 10 11 years uh in total but
2:54 yeah so 2014 is really when we started
2:58 taking it seriously.
2:59 >> Can you just elaborate a little bit more
3:01 what do you do in in Tro?
3:03 >> Yeah so we we basically do everything
3:06 related to documentation in large
3:08 healthcare organization. So we we
3:11 capture create documents then we route
3:14 them to the the right people so the
3:16 right set of eyes looks at the right
3:18 thing gets the clinical verification the
3:21 sign off whatever's needed. We then
3:23 extract data and analyze that data and
3:25 distribute the documents to downstream
3:27 systems whether that be through
3:29 distribution routes or into the system
3:31 record and the the electronic patient
3:33 records. We're very deeply connected
3:35 into into kind of the large and wide
3:37 healthcare ecosystems of the the
3:39 jurisdictions that we operate in. So we
3:42 we then provide a usability layer that
3:44 sits over the top of of EHRs and and
3:47 patient records. And then we sprinkle
3:49 sort of throughout that automation and
3:51 AI and and various various tools that
3:54 make that process easier and simpler and
3:57 more effective for clinicians. And how
3:59 do you find that that niche that how
4:01 that
4:02 >> we we originally were were looking at
4:05 sort of processes around creating
4:07 documents? So we we looked at hospitals
4:10 and there there was this huge overhead
4:12 of people physically manually typing
4:15 documents. Um and this was done in a lot
4:18 of places with analog tapes. You would
4:20 literally record on a analog dictaphone
4:23 all of your letters after every time you
4:25 saw a patient you record a letter and
4:27 that's a statutory requirement by the
4:29 way. So these all these systems and
4:31 these processes are mission critical for
4:32 every every hospital almost globally. So
4:35 I record my little tape. I get my little
4:37 tape and I put it in an envelope. I walk
4:39 down the corridor, give that to a a
4:41 secretary or a typist. Then four, five,
4:44 6 days later that typist has typed
4:46 everything up. They print it out. It
4:48 comes back to me. I make any
4:50 corrections. I get the little red pen
4:52 and start correcting stuff. Send it back
4:54 to the typist. They redo all my
4:56 corrections. Comes back to me again.
4:58 This is now 2 weeks after I've seen the
4:59 patient. Then I sign that and then I put
5:02 it in the post and it gets sent out. And
5:03 we thought that that was probably a bit,
5:06 you know, not a great process and and
5:08 something that was right for sort of
5:09 disruption or, you know, could be
5:11 automated to a certain extent. So very
5:13 early on we decided we would do a
5:15 web-based platform and digitized that
5:18 whole process. Um we we went cloud
5:22 native before AWS or Azure even existed.
5:25 So we had we had a rack of servers that
5:28 were in an old bank building and we
5:30 plastered bank level security all over
5:33 our website. Um we had all of the
5:36 typists could dial in and type on our um
5:40 on our platform and then the clinicians
5:42 could review the type documents in the
5:45 same editor in the same platform. So you
5:47 know sort of a modern equivalent would
5:49 be sort of Google Docs or SharePoint
5:52 that type of thing where you have this
5:54 collaborative working arrangement and
5:57 what we what we basically did from day
5:59 one was we digitized the audio capture.
6:01 So people were recording on mobile
6:04 devices or digital devices. So that was
6:06 then immediately sent to the the
6:08 transcribers. We layered in AI very
6:10 early. So we had a sort of a first draft
6:12 that was produced by AI that the typist
6:15 then cleaned up and the clinicians could
6:17 make their own edits in real time rather
6:19 than that back and forth. And then we
6:20 captured electronic signatures. So we
6:22 did the sort of the docuign process to
6:24 capture that electronic signature. And
6:26 then those those artifacts and those
6:28 assets, we were able to automatically
6:30 distribute them. And so even if they
6:32 needed to go in the post, rather than
6:34 having somebody print them and put them
6:36 in an envelope, we had an API endpoint
6:39 for these sort of third party mail
6:41 providers. So we could then send those
6:43 and automate that whole process. So we
6:45 were taking a process that took 2 3
6:47 weeks to something that was sort of 2
6:49 three days max. So that's a you know
6:51 it's a huge efficiency gain for the for
6:53 the hospitals and it was a sort of a
6:56 no-brainer really.
6:57 >> Yeah. And also know for the hospital
6:58 also for for us you know that we're
7:00 patients you know we we we feel that all
7:03 the public health system takes so long
7:06 not just in the UK like but in in
7:08 everywhere
7:09 >> and and and your business is based in in
7:12 Europe in the UK. Where are you where
7:14 are you working now in terms of
7:18 >> now? We are we we we're UK, Ireland, and
7:21 some of mainland Europe. So, we're doing
7:23 a bit in Germany. We're doing a bit in
7:24 Scandinavia. Now, we have a big business
7:26 in um Asia Pacific. So, we have an
7:30 office in Melbourne and one in Oakland.
7:32 We do a lot in Australia, a lot in New
7:34 Zealand. We do a little bit in Southeast
7:36 Asia as well. So Singapore, Malaysia,
7:39 Philippines, those kind of areas,
7:41 especially in the the private healthcare
7:44 sector there.
7:46 >> And when do you start expanding the
7:48 business? Um, and why do you decide to
7:52 do that?
7:52 >> Well, I think healthcare is a a really
7:54 interesting industry. Um, it's not
7:57 surprising that investors love
7:59 healthcare businesses. So technology and
8:01 healthcare are kind of the the the
8:04 golden triangle, you know, that's where
8:05 that's where value intersects. And it's
8:07 because it's because it's so so
8:09 defensive. So there's a lot of typically
8:11 when you're selling to healthcare
8:13 organizations, there's a lot of inertia.
8:15 There's a lot of roadblocks there. You
8:17 have compliance, you have regulatory,
8:19 you have all the referenceability stuff.
8:22 Uh then there are budgets. There's a
8:25 huge cost of change because these these
8:27 organizations everything is such high
8:29 volume. So for me, if I'm implementing
8:31 in a new hospital, that's probably a
8:33 thousand clinicians that need that need
8:35 setting up, on boarding, training on
8:37 your application. You know, that there's
8:40 there's a whole there's a whole process
8:41 that goes around that. And what that
8:43 means is that for us to sell into new
8:46 organizations is a really big
8:48 undertaking. But once you're in, it's
8:50 just so so secure. It's such a it's such
8:54 a good industry to be in because you can
8:56 you can really drive your your
8:58 application into an organization,
9:00 penetrate into that organization,
9:03 uncover all of these all of these
9:05 problems and workflows and areas where
9:07 they're struggling. And so we we really
9:09 invest in customer success and and sort
9:11 of having that relationship and
9:13 partnering with our clients rather than
9:15 just, you know, selling them a tool that
9:17 they can sign up with their Gmail and
9:19 install online. that doesn't really work
9:21 in kind of large healthcare
9:23 organizations. You need that kind of
9:24 enterprise approach. So then when you
9:26 look at expansion, there's only there's
9:29 only a a limited addressable market in
9:32 any one jurisdiction. But if you can
9:34 expand into another jurisdiction and get
9:36 all of that referenceability, that
9:38 compliance, that regulatory approval,
9:40 then you have customers for life and you
9:43 can you can really penetrate those
9:45 customers and and establish yourself in
9:47 a market really quickly. So our our
9:50 approach has always been to target
9:52 markets where we think we can get what
9:55 we call podium position. So one of the
9:57 top three providers um and we do that on
9:59 the basis that you know when we look at
10:01 markets we we say anyone in in a kind of
10:03 a enterprise SAS model you'll have the
10:07 number one provider would typically
10:09 especially in sort of government and uh
10:11 public procurement things like that the
10:13 number one provider would typically have
10:15 50% of the market. the number two
10:17 provider would have 20%, the number
10:19 three provider would have 10% and then
10:21 the 20% that's left is just shared by
10:24 everyone else. So if you're not in that
10:26 podium position, then you're you're sort
10:29 of you're you're swimming upstream to a
10:31 certain degree. But if you are in that
10:33 podium position, you've got a really
10:35 really solid business that's really
10:37 defensible and you can really build on.
10:39 And I think that's our approach to
10:42 international expansion. Very targeted.
10:44 >> Well done. I I very like the strategy
10:46 and it's a quite very niche and it's
10:49 polished as well. I see that you well
10:51 you know you've been in the business for
10:53 10 years working very hard. So you get
10:56 with this level of granularity at the
10:58 beginning it's a little bit nervous to
11:00 get into the health you know uh industry
11:03 because of regulation and the barriers
11:06 um to get into the market are very high
11:08 too. that after you are inside of the
11:10 market and they trust you plus you are
11:12 in this sort of top position. Yeah, you
11:15 have customers for life um and a
11:19 business which is going to be quite
11:20 profitable. I I heard that you had more
11:23 than 100,000 users globally.
11:25 >> Yeah.
11:26 >> I think we with aboutund 132,000
11:30 active users last month. So it's it's
11:33 sort of it's a it's a big business in
11:36 terms of volumes and the volumetrics of
11:38 the business now are you know
11:40 significant those users produce
11:45 tens of millions of documents every
11:47 year. Um, so we've got this treasure
11:50 trove of data as well when it comes to
11:53 sort of the AI side of the business
11:55 >> and and which is the main value that you
11:58 see at the moment from from your
12:00 customers? What do they say after they
12:03 implement you know your your platform
12:06 and they work with you? What what is
12:08 like the first thing that they say they
12:10 said to you? There are three things that
12:11 we that we sort of really focus on and
12:13 it goes back to your personas and how
12:16 you how you scale and what your go to
12:18 market is. So the first the first cohort
12:21 of people we look at is the clinicians
12:22 and they you know that if people don't
12:25 like your product then they won't use it
12:27 and then no one's going to buy it. So
12:29 ultimately clinicians are not buyers in
12:31 our world. They don't they don't have a
12:33 budget. They don't have any money to
12:34 spend. They don't really have decision-m
12:37 power, but they are influential and
12:40 ultimately they're the ones who who use
12:41 our product. So, we're very clinician
12:43 focused and they're our sort of our
12:44 primary target because I think if we
12:46 build for them, then we're building a
12:47 good product and then articulating value
12:50 to, you know, execs and everything else
12:51 that comes with it is is easy. So from a
12:54 clinician point of view, it really is
12:55 around that sort of efficiency is is
12:57 probably the business term for it. But
13:00 the proxy for that is engagement and
13:02 enjoyment and and and their sort of
13:04 quality of life. So there was a there
13:06 was a McKenzie study that was done a
13:08 couple of years ago in America and it
13:10 had it had clinicians across across 100
13:14 different hospital networks. Clinicians
13:16 were spending more than 50% of their
13:18 time on admin and documentation. So that
13:20 means you know you train for seven years
13:22 to be a doctor whatever it is and less
13:25 than half your time is actually spent
13:27 treating patients and they they there
13:30 are terms that are coined for this
13:32 stuff. So there's a term of clinical
13:34 burnout which is basically you've got
13:36 all of this you know doctors are just
13:38 getting burnt out um and they they get
13:41 depressed they get there's a real
13:43 problem of clinicians leaving and the
13:45 attrition around that and and it's like
13:47 this burnout thing is a is a real
13:48 problem. They then have this term called
13:50 pajama time which is basically I don't
13:53 I'm spending all my time in work
13:55 treating patients. So I don't have time
13:57 to do all this documentation. So when I
13:58 go home I'm doing all of my all my admin
14:01 and all my documentation at home in my
14:03 pajamas on the sofa when I should be
14:04 spending time with my kids and I should
14:06 be I should be enjoying myself. I should
14:08 be going to the gym, going for dinner,
14:09 going to restaurant. So their their
14:11 quality of life is really impacted
14:13 >> you know. Sorry to interrupting you. you
14:17 know which um market they have the same
14:20 problem at least in Latam. I'm from
14:23 Chile so in Latam is the um schools all
14:26 the professors and teachers they have
14:28 the same problem they are all day long
14:30 like managing the all the operational
14:33 side of the business teaching basically
14:35 during the day and they have to go home
14:37 do all the planning all the
14:39 documentation stuff all the admin
14:41 basically at home. So it's you can
14:44 resolve that problem as well in that
14:45 market. It's it's it's the same thing.
14:47 And then you think about the outcome of
14:48 that. So that means that your kids are
14:51 going to school and they're getting a
14:53 disimproved education. So that teachers
14:56 are turning up, they're tired, they're
14:58 not concentrating properly, they're not
14:59 spending time, they're maybe irritable,
15:01 they're making mistakes. You then
15:03 transfer that into healthcare and it's
15:05 bad enough that the guy teaching my kids
15:07 is off his game. But if the guy doing my
15:09 open heart surgery is off his game,
15:11 that's a real problem. So there's it's
15:14 it is a it's a it's a genuine concern
15:16 you know and then the other one they
15:17 kind of talk about is click fatigue
15:19 which is basically there's a there's
15:21 been a digitization in healthcare and
15:23 there's been this whole sort of tidal
15:25 wave of technology coming in to solve
15:28 problems but actually once you've
15:30 digitized all of these workflows for
15:32 clinicians it's probably easier to
15:34 scribble notes down on a clipboard
15:36 that's on the bottom of the bed then
15:38 sign into a medical record 50 clicks to
15:41 navigate through the patient record
15:43 putting all your notes in manually. So
15:45 you have this you have this sort of like
15:47 click fatigue and what it means from a
15:49 from an organizational point of view is
15:51 if I spend $100 million on a new system
15:54 it's really difficult to get the
15:55 clinicians to use it. So the adoption of
15:57 this and the value of that goes down. So
16:00 the first thing really is that you know
16:02 for for clinicians it's the quality of
16:04 life their their experience of of how
16:08 they use systems of how they document
16:10 care and it's allowing them to spend
16:12 time focusing on patients and not
16:14 paperwork. That's you know that's
16:16 ultimately that's the foundational piece
16:18 and that's that's not something
16:20 something where you have like a
16:21 financial benefit or anything like that
16:23 but that's that's really the the kind of
16:25 the core thing that drives our business.
16:27 Then you go and start looking at
16:28 operational and executives.
16:31 >> Gener generally if we see as a
16:33 manufacturing basically if you optimize
16:36 the time they can see more patients too
16:38 and also improve the quality that they
16:40 are providing to to their patients. So
16:42 it's very good value proposition. I very
16:46 like it a lot. Very well done. It's a
16:48 also it has a high impact on society as
16:51 well. So yeah very I very like it.
16:53 Coming back to to a little bit of the
16:55 figures and how the business is is doing
16:57 now. You have 100 30,000 users, right?
17:01 Around 30 million AR revenue. That's how
17:05 I understand so far.
17:06 >> Just just below. Yeah. Euros.
17:08 >> Yeah. But yeah, well
17:10 >> yeah, round.
17:12 >> Is it still is still 30 30 millions? Um
17:16 and well, you've been building this, you
17:18 know, through different like through
17:19 acquisitions. I talked some notes here
17:22 about you know this um how do you call
17:24 it like the cycle liquidity event right?
17:28 Um can you explain a little bit how how
17:31 you managed to get into a 30 million
17:33 revenue company? How many acquisitions
17:35 you did when you realized that you
17:38 needed to you know inject cash or get
17:40 you know this like you know cycles.
17:43 >> Yeah. Yeah. So we we probably took a
17:46 slightly different approach to a lot of
17:49 people. So a lot of a lot of people
17:51 especially in kind of modern SAS
17:53 companies or technology companies would
17:56 raise money early and grow quickly and
17:59 and I think what we did was rightly or
18:01 wrongly and there's no there's no
18:03 correct approach to this and we've made
18:04 loads of mistakes along the way but we
18:06 have also got lucky with a few of our
18:08 decisions but we we sort of
18:10 fundamentally bootstrapped the business.
18:12 So we're always focused on on having a a
18:15 profitable business that generated cash.
18:18 So not just not just profit on paper but
18:21 profit in the bank account and not and
18:23 in reality and our you know our sort of
18:25 focus of the first two or three years of
18:27 the business was not paying ourselves.
18:29 You know we there were tough times where
18:31 we weren't taking a salary and we were
18:33 sort of skipping payroll for ourselves
18:35 in months to make sure everyone else was
18:37 okay. But our focus was always you know
18:39 you need 3 months of payroll in the
18:41 bank. So if if Black Swan event comes
18:44 along and something happens, you've got
18:47 3 months where you can pay staff. And
18:49 that was that was always kind of a core
18:50 focus for us in terms of growing the
18:52 business. So we always grew the business
18:54 to be profitable and cash generative.
18:57 And then once things started going well,
18:59 the business became more cash
19:01 generative.
19:02 Um, and that that gave us the ability to
19:05 gear up the business, leverage the
19:07 business, leverage that cash flow and go
19:09 to banks and borrow money. And that
19:11 ability for us to borrow money then
19:13 opened up lots of opportunities for us
19:16 around acquiring businesses, acquiring
19:19 other technology, acquiring assets that
19:22 accelerated that growth path. So we sort
19:25 of had this slow but fundamentally
19:28 profitable start that was then
19:31 accelerated as our debt capacity came
19:34 through. Um we we've grown the business
19:36 that way to date. We did a very early
19:39 acquisition of um of a foundational
19:42 piece of technology that we built our
19:44 platform on. So we bought a business. It
19:46 was actually um it was founded by a
19:49 doctor in the in the Middle East and it
19:52 was a bit of a bit of a vanity project
19:54 for him probably and then he brought it
19:55 to a certain stage but ultimately you
19:58 know he he had a day job and he was a
19:59 surgeon. He was never going to take it
20:01 forward and he needed somebody to either
20:03 take it off its hands or it'd get
20:04 mothballled but what he had was you know
20:07 these really fundamentally good
20:09 workflows and he done all of the
20:10 business analysis and it's kind of you
20:12 know really built by a clinician for
20:14 clinicians. So it was a great great
20:16 starting point for us. So we bought that
20:18 piece of software. We we built the
20:21 business on that. We then built the
20:23 business really successfully in Ireland
20:24 and grew it in Ireland initially and we
20:27 tried to then enter the UK market and we
20:30 thought this would be easy. You know
20:31 there are all the hospitals are exactly
20:34 the same size. They use all the same
20:36 systems and actually all the same
20:38 doctors are there because Irish people
20:39 just go over to London. They go over to
20:41 the UK. So all the Irish doctors working
20:43 in the UK hospitals, they're working in
20:44 these NHS trusts. So we had all great
20:47 referenceability. But actually when we
20:49 when we decided to do it and we started,
20:51 we found it incredibly difficult. We
20:54 were we spent two two years wasted loads
20:58 of money. We weren't on the right
20:59 frameworks. We didn't have the right
21:01 regulatory controls. We didn't have all
21:03 the compliance that you need for the
21:04 NHS. We didn't have the procurement
21:06 routes and things like that. And so this
21:09 was sort of a bit of a wakeup call for
21:11 us. And we ended up we ended up sort of
21:12 spending 2 years to go from zero to one
21:16 trust and then in the next two years we
21:18 went from 1 to 42 um just because we had
21:20 all those boxes tick. But that was a
21:23 that was a big learning moment for us.
21:26 You um we said well we can't every time
21:27 we go to a new jurisdiction we can't
21:30 spend 2 3 years doing this and you know
21:32 cost us a fortune. So what we decided to
21:34 do was go to the banks again. We ran a
21:36 bit of a debt process, found out how
21:38 much money we could borrow, and then
21:40 went and looked to acquire businesses
21:42 that had a footprint in the
21:44 jurisdiction. So, we call them pillar
21:46 acquisitions, but they basically give
21:48 you a they give you referenceability,
21:50 they give you compliance, they give you
21:52 all the route to market, and they give
21:54 you a good footprint of of of clients
21:56 that you know are you can land and
21:59 expand basically. So, we did that and we
22:02 acquired one business in Australia. That
22:05 went very well. Got us into the
22:06 Australian market. Um and we were we
22:08 were growing well. Then we then acquired
22:11 um one of our suppliers in India um
22:14 which helped us streamline our kind of
22:17 supply chain uh especially around like
22:19 our data pipelines, data cleaning, all
22:21 of that kind of stuff. It helped us
22:23 supercharge our our AI team and our our
22:26 model training capacity. Um but it also
22:28 gave us a follow the sun um support
22:31 desk. So we were able to set up a
22:33 support team in India that could cross
22:35 cover both UK, Ireland and Australia.
22:37 And then at that point we'd identified
22:39 the market leader in the Australian
22:41 market that we wanted to wanted to
22:43 acquire and we had the money and
22:45 capacity to do it but we sort of sat
22:48 down and said well we we don't probably
22:50 have the the people and the processes.
22:53 So great product that business always
22:55 comes down to product people processes
22:58 you know those three pillars. We had a
22:59 great product. We probably didn't have
23:01 the people and the processes and the
23:02 governance that we needed to scale a
23:05 business up to that sort of size and
23:07 grow beyond that. And we were, you know,
23:08 we were probably probably a year or two
23:11 late in doing that. But, you know, we we
23:14 got there eventually. And that's when we
23:16 decided to take on external investment.
23:19 So, we went and ran a process and it was
23:23 a it was a private equity focused
23:25 process because we'd been been through
23:27 all the hard years of the bootstrapping
23:30 and putting our own money in, borrowing
23:33 money and we generated a profitable
23:35 business and then we didn't actually
23:37 need a cash injection. What we needed
23:39 was a partner and we needed people who
23:42 would give us that governance, who would
23:43 give us the, you know, arm around the
23:46 shoulder from somebody who's just done
23:47 it 10 times before. Somebody who's been
23:50 to Australia and built a business and
23:52 scaled a business in technology and gone
23:54 to different jurisdictions and run a big
23:57 M&A
23:59 sort of strategy. And so that that's
24:01 really for us what we needed. So we we
24:04 then as you say we were able to kind of
24:06 engineer a liquidity event for existing
24:08 shareholders. We brought in a minority
24:10 partner uh in a in a firm called Living
24:13 Bridge who are sort of a a top tier
24:16 mid-market private equity house. They've
24:19 been absolutely brilliant for us. It's
24:20 really transformed our business, the way
24:23 we think about things, strategy, the way
24:25 we grow the business. And then having
24:27 brought those guys in about two weeks
24:29 later we did this acquisition in
24:31 Australia and that that probably doubled
24:34 the revenue of the business overnight.
24:36 Helped us grow. So we we sort of pretty
24:39 quickly not quite doubled but we went we
24:41 went from about 12 million revenue to
24:44 about 19 million um overnight and then
24:48 we subsequently done a another
24:51 acquisition of a business in New Zealand
24:54 um which again similarly
24:56 transformational added probably another
24:58 4 million of revenue onto our our top
25:00 line and all the while we've we've been
25:02 able to maintain that sort of
25:04 fundamentals around the profitability
25:06 We're not overleveraging the business.
25:08 Our debt capacity is is pre-existing and
25:11 it's it's sort of maintained. We've got
25:14 good sort of leverage covenants that we
25:16 monitor well. These acquisitions tend to
25:18 be self financing if they go well. And
25:20 that then that then allows us to we did
25:23 a big refi uh process at the beginning
25:25 of this year where we brought in a new
25:27 debt provider who has larger capacity
25:30 and can kind of scale with us. Um and
25:33 that gives us a runway of an acquisition
25:35 facility essentially that acts like an
25:38 accordion. So as the business grows that
25:40 facility grows with us and it means that
25:42 we can do more and more of these
25:44 acquisitions and more transformational
25:46 acquisitions as we're looking forward.
25:48 It's compounding then because it allows
25:50 you to we go back to the fundamentals of
25:53 healthcare being very slow. You've got
25:55 12 month sales cycles. It's very
25:58 difficult to displace incumbents.
26:00 organic growth in our business still
26:02 sits at sort of 20 plus percent. Um but
26:05 it's it's difficult to drive and
26:07 continue to drive that whereas that sort
26:10 of acquisitive growth gives you new
26:12 market entry gives you that sort of real
26:15 exponential growth that allows us to
26:17 sort of drive the business forward. Um
26:19 and so you know since Living Bridge have
26:20 come in we've we've more than doubled
26:22 the size of the business. Um so they're
26:25 very happy. We're very happy. Been a
26:27 good journey
26:28 >> and all these acquisitions is something
26:30 that you know it's not it's not easy to
26:32 to to make. Um I've been in two merge
26:36 um in the middle. So basically they
26:38 hired me to help them with the merge
26:40 into in different companies and it's a
26:42 big challenge you know to change
26:44 cultures to change the business
26:46 processes to leverage both sides to to
26:49 get a a better value proposition you
26:51 know and it's not it's not easy. name
26:54 and it's even more difficult when you do
26:55 it you know uh around the globe but from
26:58 the financials perspective in terms of
27:01 valuation who help you with you know
27:03 with taking the right decision and how
27:06 much is the value of that company that
27:08 you want to acquire I don't know in New
27:10 Zealand or Australia or in India who who
27:13 helped you with that process
27:14 >> yeah so we we probably look at it in uh
27:18 through two lenses so there is the the
27:21 lens of how attractive is the business
27:23 for us today. And then there's the lens
27:25 of what value we would get for that at
27:28 exit. So our our business is
27:30 fundamentally probably a lot stronger
27:32 than the businesses we acquire.
27:35 Our valuation therefore and our
27:37 valuation metrics are higher. So we we
27:40 would expect to get 20 plus times EBIT
27:44 DAR at at exit. Whereas a lot of the
27:46 businesses we're buying, you can you can
27:49 position them in a in a different
27:51 category. They tend to be less mature.
27:53 They tend to be founder leled. Um they
27:56 maybe don't have full IP and they're
27:59 buying in third party software. So that
28:01 puts them in a sort of a value added
28:03 reseller bracket rather than a a sort of
28:05 an owned IP bracket. And all of that
28:08 affects valuations. So then if you're
28:10 buying a business for 10 times EBID da
28:14 and you're probably able to sell it for
28:16 20 times if you get everything right and
28:18 do all the integration and everything
28:20 that you mentioned that's that sort of
28:22 makes that calculation a lot easier.
28:26 >> Okay.
28:26 >> So we've we've done built a team
28:28 internally to do a lot of this. So we do
28:31 we do a lot of of the deal making and
28:36 due diligence and things like that. We
28:38 do that internally ourselves. We have a
28:41 number of advisers that we've worked
28:43 with on on multiple deals, lawyers,
28:47 financial diligence guys, tax diligence
28:49 guys that would know what's important to
28:51 us. So the last thing you want to do is
28:53 get a 300page report which tells you
28:56 every possible risk under the sun, but
28:58 doesn't really give you an opinion.
29:00 Whereas the guys we work with, they know
29:02 what's important to us. They know where
29:04 we're willing to kind of take risks. So
29:06 they're able to do more of a red flag
29:08 review of things for us. It keeps costs
29:11 down, but it makes everything sort of
29:13 move quicker and smoother. And it's just
29:15 like like everything with these these
29:18 acquisitions, time kind of kills deals.
29:20 So you want to once you've made an offer
29:22 and you've got an agreement, you need to
29:24 execute very quickly because if it
29:26 extends more than let's say 3 months,
29:28 all of a sudden something's changed in
29:30 your numbers and you're either up or
29:32 down and then we're renegotiating and it
29:34 becomes a a bit of a disaster. So sorry,
29:36 we we do use advisers, but we we use
29:39 them as and when needed rather than sort
29:43 of pulling them in on on every deal
29:45 because ultimately you have to own you
29:48 have to own the deal and then only
29:50 integration plan internally because
29:52 we're the ones that have to have to
29:54 deliver on that. Where we have used
29:55 advisors very successfully is in is in
29:58 market mapping and origination. So we've
30:00 used corporate finance guys to go out
30:01 and and sort of find us targets. and you
30:05 give them a criteria and they'll come
30:06 back with a big long list of potential
30:08 targets. Um, and they're, you know,
30:11 that's really that's a really useful
30:13 exercise.
30:14 >> I think that that makes sense because in
30:16 the end when you because you're building
30:17 a acquisition machine basically in a in
30:21 a regulated very complicated market,
30:24 which is the health, you know, industry
30:26 plus trying to plug in into what you
30:28 have already because you have a product,
30:30 right? which is makes things sometimes a
30:32 little bit more more complicated because
30:33 sometime when you do merge between
30:35 operations like production factory of a
30:38 product like you know like whatever like
30:40 meat it's easier but when you have a
30:42 tech product that you have to align the
30:45 functionalities and the architecture is
30:47 very very complicated John moving into
30:50 the the governance um because as you
30:54 mentioned you were bootstrapping
30:56 basically having your board meetings
30:58 with your founder with your partner and
31:00 then You brought in like a few
31:01 companies, investors. Now you are very
31:04 well established, right? Very mature
31:06 after 10 years of running the business.
31:08 Can you talk a little bit about how is
31:10 the your board um how many board members
31:13 you have or non exact you have there and
31:15 how you're managing that because that's
31:17 the like main function which allows you
31:20 to to have a clear strategy, clear
31:22 governance goals.
31:24 >> Yeah. Um, so yeah, as you as you said,
31:27 we spoke offline and you you sort of
31:29 quite um generously referred to them as
31:32 board meetings that me and Mark were
31:34 having before we got a before we got
31:36 living bridge in and actually it was
31:38 sort of, you know, it was it was sort of
31:40 Friday night in the pub, couple of
31:41 Guinness and make a decision. So we
31:44 didn't really have governance, we didn't
31:45 have board meetings, we didn't have
31:47 those structures in place. So when
31:48 living bridge came in that was one of
31:50 the things they really added was a bit
31:53 of professionalization and a bit of
31:55 compliance and governance as you say um
31:59 they took two seats on our board. So the
32:02 way typically these these private equity
32:04 firms work is they'll have one
32:06 investment director and then somebody
32:08 from living bridge call it their value
32:10 strategy group but the the operational
32:13 side of the business which is you know
32:15 can we help with you know the various
32:17 different functions whether that be
32:19 recruitment and talent and that kind of
32:22 thing or whether it's sales processes or
32:25 optimizing other areas of the business
32:27 they tend to have somebody who's more
32:29 focused on that and a media the exit
32:31 planning and then they have somebody who
32:32 is who is really the sort of the
32:34 investment director who's more about the
32:37 numbers and that side of things. And
32:39 we're very lucky that um both the guys
32:41 that we we have on our board are great.
32:43 They're really really supportive. The
32:45 guy who's the investment director who
32:46 led our deal team is actually an ex
32:48 doctor which makes a huge difference for
32:50 us cuz he really understands the
32:52 product, understands the industry,
32:53 understands the use case. So it's you
32:55 know it's a it's kind of a good marriage
32:58 there in terms of that. We then went and
33:01 hired a chairman and that was a that was
33:04 a very collaborative process. It wasn't
33:07 sort of a it wasn't a Henry Ford
33:09 decision where you can have any color as
33:11 long as it's black. There was no there
33:12 was no Living Bridge list of people. We
33:15 actually run a proper talent search. We
33:18 got a long list of people. Living Bridge
33:20 really helped with market mapping,
33:22 knowing who's available, knowing who's
33:23 not available, who's done similar things
33:25 before. Uh and I think we got really
33:27 lucky with our chair who's you know very
33:30 very experienced has run has shared
33:32 healthcare businesses has shared big
33:35 growth assets that have you know gone on
33:38 that journey from 100 million to 500
33:41 million in value. He's he's worked for a
33:45 bigger fund in in H where he was, you
33:49 know, he was one of those kind of
33:50 partners there and he's run his own
33:52 businesses from big PLC's through to you
33:55 know very very successful tech companies
33:58 that that have exited to private equity.
34:00 So he he's brilliant and I think he
34:03 probably took one look at me and Mark
34:04 and decided that, you know, we needed a
34:07 guiding hand and sort of put his arm
34:08 around.
34:09 >> Listen, I think we're probably a we're
34:11 maybe a bit of a pet project for him. So
34:13 he
34:13 >> No more no more no more beers at the
34:16 pub.
34:17 >> No, no, we still we still have a beer.
34:19 We still have a beer. I always say to
34:20 people the sign the big sign that our
34:22 board is good is um before every board
34:25 meeting the guys all come over from the
34:27 UK. So they come over the night before,
34:29 we all go for dinner, we have a few
34:31 beers and we've never had a vote. So
34:33 they're the they're the two they're the
34:35 two kind of key things for me. It shows
34:36 that you've got a good dynamic around
34:38 the boardroom table. We then built out
34:40 our internal management team. So we've
34:41 hired people into the business that have
34:43 experience that have done it before. We
34:45 did a big gap analysis and we did a big
34:48 sort of asis 2B. So you come up with
34:50 this target operating model of what my
34:53 organizational structure needs to look
34:55 like if I want to exit at this point.
34:57 And so for us, you know, we we had to we
35:00 had to bring in some additional
35:01 expertise in our finance department. We
35:03 had to bring in DRRO in our sales and
35:07 marketing department to manage that sort
35:09 of multi-jurisdictional sales
35:11 organization where you've got individual
35:13 sales directors in different different
35:15 jurisdictions and you need someone over
35:17 the top there. So we now we now have um
35:20 a couple of the guys who sit on our
35:22 board permanently. Our CFO is brilliant.
35:25 He's very experienced. He's been through
35:26 a number of PE businesses and PE cycles
35:29 and he he really helps me particularly
35:31 sort of run the business and
35:33 strategically and and stuff as well.
35:34 He's he's very commercial, very good.
35:36 And then we've recently brought in a
35:38 non-exec as well and it's it's somebody
35:41 again from one of the larger funds who
35:43 used to used to do an operating role in
35:46 the fund where he ran all of the go to
35:48 market teams. So he used to look after
35:51 all of the portfolio companies and their
35:53 CRO's and the different go to markets
35:55 and that kind of stuff and he's come in
35:57 to help us shape for exit. So he's he's
36:00 got a really good understanding of what
36:02 these bigger funds are looking for, how
36:04 we need to report on our sort of
36:06 pipeline, our forecasting, looking at
36:09 different leading and lag indicators and
36:12 stuff like that. So he's come in now and
36:14 and that's a again it's another real
36:16 value ad but everyone everyone sort of
36:19 plays a role you know there's there's no
36:21 there's no passengers on the board and
36:23 it's a really collegiate environment
36:25 it's really useful for the business and
36:27 it's it's one of those things that I
36:29 probably didn't have any appreciation of
36:31 before we got one but it's a real value
36:33 driver for us now. No, it's essential
36:35 when you want to scale to sell a
36:38 business around a billion as you want.
36:41 You have to put all these, you know, um
36:43 artifacts in place to to make it happen.
36:46 Very good story. Congratulations, John.
36:48 And to your team and everyone who is
36:50 doing this and not only because of
36:52 business, our money or profits is also
36:55 because it's high impact as well. We're
36:58 we are like heading to the end of the of
37:01 the um of the episode. would you like to
37:04 to give some tips or lesson learners
37:06 that you would like to to share with the
37:08 audience and for everyone that's going
37:09 to listen to you?
37:11 >> Yeah. Um I think for me there's there's
37:14 a few there's a few fundamentals that
37:16 have always steered me in the right
37:17 direction and however you decide to run
37:19 the business whether you go for kind of
37:21 growth and um or you run it as a sort of
37:24 a profitable business and try and
37:25 maximize profits from day one. I think
37:27 pace is the key thing. pace and urgency
37:31 and that doesn't necessarily mean doing
37:33 things quickly and badly but having the
37:36 urgency to just get things done and move
37:38 stuff to the right hand side all the
37:40 time. Um I think a lot of people can
37:43 strategize forever and have a lot of
37:46 time wasted by trying to come up with a
37:48 perfect solution and actually you just
37:49 need to move forward. So pace and
37:51 urgency is is the first thing. And then
37:53 one thing I've I've kind of learned with
37:55 Living Bridge coming in and and having,
37:57 you know, a more professional
37:59 organization is is actually knowing when
38:02 to spend money. And we were I like to
38:05 think we're cost cost conscious. Um my
38:08 chairman always tells me I'm cheap. Um
38:11 so I think there are certain things that
38:13 are worth spending money on. If you get
38:15 the right advice, if you get the right
38:17 people around you, get the right people
38:18 in the room, they'll add add four, five,
38:21 10 times what you're spending on them in
38:23 terms of in terms of value. Um, and and
38:26 especially as a you know, as a founder
38:28 and talking to other founders, you you
38:30 the tendency to try and do everything
38:32 yourself or want to do everything
38:33 yourself. And when you realize that, you
38:36 know, there are there are people that
38:37 have done this all before and you don't
38:39 need to solve these problems. you can
38:40 just buy in the expertise that's really
38:43 worth spending money on and you know
38:45 there's our board refers it to it as
38:48 being reassuringly expensive. So spend a
38:51 bit of money when you can on on the
38:52 right things and
38:53 >> the right things.
38:55 >> Yeah.
38:55 >> Cool. Sounds a very good advice also for
38:59 in in life. No, as for business.
39:04 >> Thank you. Thank you so much for for
39:05 your time, John. It was a very good
39:07 conversation. I very appreciate that
39:09 your time. I know you're you're very
39:10 busy with all this. I would like to
39:12 obviously to to have you in the future
39:14 just to to know where you at one year
39:16 more. And if you are in London, of
39:18 course, happy to go for a Guinness 2
39:21 here and and have, you know, a good
39:24 chat. Well, thank you so much for your
39:26 time. Um and let's talk soon. Let's
39:29 let's be in touch.
39:30 >> Brilliant. Enjoyed it. Thank you.
39:32 >> Thank you. Cheers. Bye-bye.