"I've been obsessed with improving healthcare since day one of being in it." — Dr. Sam Gharbi on riding the healthtech rollercoaster from med school to Arya Health
His company is a culmination of a decade spent asking "how can I make this better?"
In a week overflowing with Zoom calls but lacking punctuality, I received a surprising notification: Dr. Sam Gharbi has joined your meeting. This was a whopping two minutes before our planned conversation. Two minutes early, though, feels like a chasm between starting a conversation and those anxious moments spent pondering a follow-up email. I joke with Dr. Gharbi about this, saying I may have just received the best possible advertisement for his healthtech company, Arya Health. Dr. Gharbi played ball: “I’ll have to tell my head of marketing that,” he replied.
What their marketing team can already tell you is that healthcare is broken and Arya is here to fix it: “The technology used in providing healthcare is antiquated, slow, overly complex, and overpriced,” claims their site’s landing page. “Our philosophy is to build technology for physicians that is beautiful, intuitive, easy to use, saves you headaches and saves you money.”
Saving headaches and money is a fairly ubiquitous approach when it comes to building software. Healthtech, however, always has a bigger aim. You could add “lives” to that laundry list of things that need saving. The Pandemic has brought this community of innovators to the fore while our demands on them have been accelerated. The importance of teamwork and collaboration are at an all-time high amongst healthtech and society. This is in Arya’s bones.
Dr. Gharbi founded Arya with two of his closest friends and colleagues. They appear to fly in formation on their about us page—Dr. Gharbi flanked by a pair of Dr. Richards, Dr. Richard Vandegriend and Dr. Richard Sztramko. With Arya, the trio is crafting electronic health records (EHRs) they hope remedy the challenges they all face as general practitioners. Their company’s suite includes a flagship EHR supplemented by additional software specifically dedicated to patient handover.
Arya is founded upon a question Dr. Gharbi repeated so often in our conversation that it became something of a mantra: How could I make this better?
“I've been obsessed with improving healthcare since day one of being in it. I think as soon as I got into med school, I was thinking about what I could make better. I think my brain’s hardwired that way. It might be a little bit different from a lot of doctors. It goes back to probably my pops being an engineer. Engineers think that way: how can we keep making things better,” he recalled.
The locations where Dr. Gharbi uttered this phrase—how could I make this better?—have a closer resemblance to an atlas than a resume: rural and urban Quebec, rural and urban British Columbia, Northwest Territories, several States in the US and France. At each stop, he analyzed his surroundings. “One of the things I loved about going to different places was, ‘oh, how's healthcare done here?’ You hear about America, and they say ‘that’s terrible healthcare.’ It's not terrible. It's better in some ways, it's worse in other ways.”
It all stems from his time growing up in Montreal. Dr. Gharbi reminisces that hockey and a high school crush carried, at the time, a slight priority over his vocational journey. A few experiences volunteering re-routed the course of his life. It sent him down a career path he defined as a “rollercoaster” ahead of our conversation.
“I worked with the Canadian Cancer Society, and I did different kinds of fundraising drives like the Daffodil Days and those kinds of things. Then, I got into palliative care at our local hospital, working with a lot of patients who are terminally ill. That inspired me to get into health care,” Dr. Gharbi recalls. “A lot of the people I worked with at the hospital said ‘I think you'd be good at it.’ I fell into it that way.”
A Quebec doctors strike from the mid-2000’s—“Classic Quebec politics” according to Dr. Gharbi—prompted a move elsewhere. In an advertisement for the benefits of forward thinking and planning, he could look to the United States for opportunities since he had already completed the entrance requirements. Dr. Gharbi took off to another location famed for innovation: California.
“I always had this dream of working abroad: ‘let's see how medicine’s done elsewhere.’ So I spent some time in California. And every month as long as the strike was going on, I just went from one hospital to one hospital, one city to one city, one community to another…Salinas Community Hospital, just this beautiful rural hospital near Monterey,” Dr. Gharbi reminisced. “It’s the city of Steinbeck's Of Mice and Men. I went to UCLA for a while, then went to San Diego. I lived in a hostel in the Bay Area. It was a really fun experience.”
“As happens sometimes, a moment settled and hovered and remained for much more than a moment.”
― John Steinbeck, Of Mice and Men
It was during his time in California that the idea of Vancouver first came across his radar. After a road trip up the coast, he was hooked.
“I had never been. I was like, ‘a city this beautiful exists? You have beaches downtown?’ Montreal is a great city, but we don't have beaches or mountains. Ultimately, I remember thinking I'll try this [Vancouver] out then I'll come back. I just never went back to Montreal.”
He did depart from Vancouver but stayed out west, completing a master’s degree in Portland, Oregon. “I did a master's in health informatics, because I thought ‘how can I do the most good?’ You can fix medicine educationally. You can fix it administratively. You can fix it with research,” Dr. Gharbi outlines. “But for me, the lowest hanging fruit that fit with the way that I was thinking about things was the tech boom of the past 20, 30 years. How can we better use technology within healthcare?” Upon the completion of the degree, he returned to Vancouver and started working as a physician for Vancouver Coastal Health.
During this time, the relationships with the two Dr. Richards blossomed and an entrepreneurial flame was ignited. “By the time we were staff, we were like, okay, ‘we have some influence now to help improve healthcare.’ Delivering healthcare is great but let's keep looking at our pain points.” Like many entrepreneurial journeys, a first startup of Dr. Gharbi’s failed.
It was known as Virtual Ward. The startup focused exclusively on the problems with handover Dr. Gharbi and his colleagues noticed as they embarked on their careers. Handover, the time when one doctor’s shift ends and another begins, is exactly as it sounds—the patient is handed over to the incoming doctor. According to Dr. Gharbi, there was a regular communication breakdown during handover. But, as young entrepreneurs, they didn’t go about building the solution-providing startup in the correct fashion.
“We went live with it at a couple of hospitals in Vancouver. It was super popular, like 700 people within a month or two of it being live. Then it got shut down because we hadn't gone through the appropriate measures. There's a lot of paperwork to getting something approved to be used at the hospital,” he concedes. “We naively went to doctor friends and were like, ‘do you want to use this?’ It was a great example of us being enthusiastic, but obviously we needed to learn a lot more.”
This experience is the DNA of Arya’s handover product. Dr. Gharbi found a notable doppelgänger for Virtual Ward: “Like Lazarus, it's come back from the dead.”
With the early stage kinks worked out, Dr. Gharbi and co. embarked on what would become Arya. If handover was a thorn in Dr. Gharbi’s side, EHRs were an entire rose bush. In what he referred to as “death by 1000 cuts,” Dr. Gharbi and hospital staff would trudge through painful and outdated systems to implement patient records. “It was the worst part of my day. I'm sure with a better system, we can automate certain processes.” There’s that mantra again.
“This is the greatest comeback since Lazarus!”
― Sid Waddell during a darts broadcast on the BBC
Dr. Gharbi and the two Dr. Richards started building Arya in 2016. The trio were friends first, colleagues second. According to Dr. Gharbi, they are “two of the smartest, nicest people you'll ever meet. I'm not that nice. But, they're the nicest, sweetest, smartest people. I love them to death. We couldn't have done this without each other.”
It’s necessary to consider, too, the landscape surrounding the hierarchical nature of the profession. “It's very similar to the military,” Dr. Gharbi acknowledges. “Actually, our McGill internship book, the first page literally was white and had one sentence and it said ‘obey the hierarchy.’” Further still, Dr. Gharbi acknowledges the lack of diversity in his own experience.
“The people that I trained under, and who to this day, even in 2021, even in Vancouver, our medical director, our Chief of Staff, the Chief Medical Officer…here, McGill, UCLA, everywhere I've been, is not very diverse. They're all white males.”
Looking forward, Dr. Gharbi is hopeful that this change will be a reflection of his classmates. “It is starting to change. It's quite slow and it's behind the other industries, I find. I think we're on the right track. You know, I kind of looked at our med school class and residency classes and they were very much more diverse than administration at our universities or hospitals.”
With these experiences in tow, Arya blossomed. The team grew.
“2017 was when we hired an offshore team to build a minimal viable product that we could show other people and be like, here's this idea in our heads, take a look at this. Michelangelo...” Dr. Gharbi continues, before interrupting himself: “I’m not comparing ourselves to him. But if he's describing the Sistine Chapel versus saying ‘look at what I painted,’ it's very different. From there, we were actually able to get a team in Canada, build that out and hire more people.”
Capital investment initially came from friends and family for Arya. But the investment of actually working with Arya’s technology can be credited to Dr. Gharbi, Dr. Vandegriend and Dr. Sztramko. The trio were in a unique position as solution providers for the industry they currently work within. So, they started Arya by implementing it in their own clinics. Learning from Virtual Ward, they took their time and checked all the boxes. By 2019, they were ready for a formal launch. “We had our soft launch and then by 2019 we’d formally launched.” This took them through the, as Dr. Gharbi puts it, “stages of getting to where we are today.”
“Today,” of course, is unprecedented. Healthtech has been called upon in dramatic ways since the course of society shifted due to COVID-19. Vaccine rollouts, discourses around vaccine passports and contract tracing only scratch the surface of healthtech and health-adjacent tech. We will all need healthtech innovators to step up. May they even arrive two minutes early.