Scale Like a CEO

Revolutionizing Healthcare Technology with Alex Koshykov | Scale Like a CEO

• Justin Reinert • Episode 42

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Imagine a healthcare system where the first mile of care starts at home—and the data is so clear your doctor can act with confidence. That’s the future we explore with serial founder and CEO Alex Koshykov, who moved from building bespoke tech for clients to launching a medical device company born from a volunteer telehealth project supporting Ukrainians in wartime. The lesson that changed everything: software alone can’t diagnose; accurate data can.

We break down how Alex’s team shifted from services to product, why clinicians kept asking for better signals, and what it takes to design devices that work in the real world. Alex explains the core healthcare data problem that limits AI today and shares a grounded approach to machine learning—use AI to amplify good information, not replace clinical judgment. We also dig into the scaling playbook behind his flat, high‑retention organization: careful hiring for excellence, cultural fit that outlasts hype cycles, and organic growth triggered by real demand rather than headcount vanity.

If you lead a startup, you’ll hear practical strategies for delegation, remote collaboration, and protecting focus while running multiple ventures. If you work in health tech, you’ll get a candid view on data quality, patient access, and how home diagnostics can bridge care gaps globally. Alex’s vision is simple and ambitious: make reliable at‑home diagnostics as common as a blood pressure cuff, then let AI deliver timely insights that help patients and doctors act sooner.

Subscribe for more founder stories at the edge of healthcare, AI, and product building. If this conversation sparked ideas, share it with a colleague and leave a quick review—what’s the one data signal you wish every patient could capture at home?

Speaker 01:

Welcome to Scale Like a CEO, the podcast where successful entrepreneurs share their scaling strategies and leadership insights. Today's episode features Alex Koshykov, a serial entrepreneur and CEO who's revolutionizing healthcare technology. With nearly a decade of experience building tech solutions, Alex is now focused on democratizing medical diagnostics through innovative devices that bridge the gap between patients and quality healthcare.

Justin:

Alex, thank you so much for joining me on Scalex CEO. Just to get us started, if you wouldn't mind, give us a 90-second intro to you and you work in a few businesses. So tell us what you're up to. Sure.

Alex:

Almost nine years ago, I co-founded a service business. We built tech for companies mostly in healthcare and wellness industries. It's software, hardware, and AI solutions. And then at some point we thought that it's time for us to move into the product business as well. So a couple of years ago, we started building our own medical device startup called Yod, your online doctor diagnostics. And that's that's the one I'm mostly working on right now as the CEO.

Justin:

Great. And what do you see as some of the biggest challenges in your industry and how are you solving them?

Alex:

Oh wow. How much time do we have? Healthcare and challenges? That that's gonna be your spotcast for sure. There's a lot, to be honest. And I think a lot of people know that healthcare in the US has some issues, let's put it that way. Even though some people say that it's working really well for 10% of the population, probably mostly the richest part of the population, but for everyone who is in other 90%, there are definitely lots of challenges. The cost, the transparency of prices, so many. And I think one that I'm trying to solve is the data problem. Because I feel like with all the AI stuff happening right now, people think that AI is gonna solve everything, but AI cannot really solve much without data. So with my medical device, we're actually working on provide that data to potentially LLMs to make predictions and analysis and many other things. So yeah, there are lots of challenges, but I'm trying to solve one at a time.

Justin:

Yeah. And you know what makes you unique in the way that you're helping others?

Alex:

All the projects came from my home country, which is Ukraine, and we initially came to the platform as a volunteer project to help Ukrainians affected by the war. And basically, there are many Ukrainians who literally cannot get offline medical help. Either they live close to the frontline, or there are not enough healthcare professionals in in their region, or people are refugees in other countries and just they literally don't know the language of the country where they moved to, so they cannot really go to a doctor and understand what he or she says. So we build this telehealth platform and it works well, and we got lots of feedback from doctors. And they said, yeah, software works funny, and we we don't see any bugs or anything, but it's still hard to diagnose patients without accurate data, and that's how the idea came to us. We literally built the device that can help get the data to doctors. And I think because we decided to solve the problem for free Ukrainians literally in the middle of the war, I think that gives us uniqueness and understanding of why we're building this. It's not just another tech business to make millions of dollars. Well, maybe hopefully, but we even if it's not gonna happen, at least we're already helping Ukrainians that need that help.

Justin:

That's great. And such uh mission and purpose that you have behind the work that you're doing, that's incredible. I want to pivot a little bit and talk about, you know, you've you've grown multiple businesses. And so, you know, on the podcast, we like to talk about, you know, scaling and challenges and strategies for scaling. So I'd love to hear a little bit about, you know, as you know, any of the other businesses that you've been scaling, you know, what are some challenges that you've faced in scaling up and growing through people?

Alex:

All all the all the business owners, they want to scale business really fast. And obviously there are lots of lots of challenges come with that scale, and uh as you rightly um it's much harder to manage the the more people you have under the one rope, it's much harder to manage. And that's why you have to learn how to delegate, how to build really good managers lower level, so you can actually you don't need to talk to each of your employees on the daily basis. And right now in our first company, VK, we're close to 50 people, 50 employees. And we we on per purposely we decided to build a very flat uh very flat organization where you literally anywhere from junior developer or junior specialist can talk to CEO or COO and ask any questions. And that I help, I think it helps transparency and like the culture of the organization shifts when you literally know that you can give a call to a CEO and a minute and ask questions that really bothers you. I think that helps a lot as well.

Justin:

Yeah, I I mean I love the the idea of that transparency and the flat organization. One challenge I think that often introduces is that the CEO is kind of solving everyone's problems. I'm curious how you've managed through that.

Alex:

We really are very careful with selecting people to work with, but that paid us off because most of our employees have been working with us for many years. And actually, I think we recently calculated that almost half of the company of the current employees work with us for more than five years, which is pretty insane, especially in the in the tech industry. So I think these people who've been working with us for many, many years, they really understand the level of complexity of questions you can ask CEO. So no one is coming to you right now asking, like, hey, like what what type of coffee should we order? Like, I don't know, something like that. But people understand that if if you want to pin CEO or any other top managers, it's gotta be an important question problem for you personally or for the team every time they have like a small issue. And that helps a lot to kind of have this understanding between team or teammates, what what should be asked and what shouldn't.

Justin:

Well, that's great. It sounds like you've got a group of people that are fairly empowered to solve their own problems, and only when they're not able to do they do they escalate those. And amazing that you've got such a population that have been with you for over five years. I'm curious if we if we think about, you know, you you mentioned that you were very careful in the selection of people. So I'd love to talk about that then. You know, what were some of the things that you were looking for as you were hiring and building the team?

Alex:

That's a good question. I don't think we ever had like a list of requirements with like check mark, check mark, check mark that the interview. I feel like the main goal is to choose literally the best candidate we found out of out of all. And with with all the stuff that's happening like in politics right now, and like all that woke stuff that people say, it's we're literally we literally don't care if a person of gender or sexual orientation, whatever, whatever it is, the color scheme, we literally try to find the best candidate with the best knowledge for that specific position. And and everything else, it just does doesn't matter. And I think it's working out great for us. And to be fair, I think more than 50% of the management positions are we uh females in our company. And yeah, we we had a few cases when women went for their maternity leave, we waited for a year or a year and a half, and they came back and still working for us. So we had a few cases like that. So I think looking for the best talent out there and that fits your internal culture as well. I think that's that's the the only ingredients that we use to find talent.

Justin:

Yeah. And if you think back to the beginning, you know, what was it? What were some of the key key things that led you to to start hiring? Because that's also a challenge, right? Like, is when do we hire? How many people do we hire? I'm curious, you know, what process you went through to decide how you grew.

Alex:

When you're an early stage company, obviously you you do it all and wear as many hats as possible, but then you realize that uh you probably need to sleep more than two hours a day. And that's when you're like, okay, I think I think we need more people that can be involved and help us out. So the growth was pretty organic. Like, for example, we we found another client and we realized that to implement that project, we need additional three people. So we just open three more job openings, find those people and start growing. And then it kind of organically grows. So the idea that we're not managing and we're not capable of doing all the work that we have at the moment is fairly simple. And once you realize that, yeah, you you you still try to have that life work balance and get enough sleep. So I think we managed over the past nine years to find that sort of balance. And yeah, if if we need more people, we're not gonna ask one person just to take three projects and set up one just because we don't have enough people, we'll we'll we'll open a job opening and we'll hire someone else.

Justin:

That's great. So so very much organic growth, kind of based on the volume of of work that you have. I'm I'm curious, you know, if you can think about a time when you felt overwhelmed by decision making, and what strategies did you use to overcome that?

Alex:

Daily basis. Yeah, there's lots going on and like having multiple businesses, and you pointed it's it's hard. You gotta learn how to how to manage a schedule well, how to delegate properly. And I think there's there is an advantage and disadvantage to that. I think the disadvantage right now is that I do spend much less time with the team than I did before. Well, and especially we back then, I don't know four years ago, we had our office and we were in person, it was a completely different story. Like I had a much better connection with with the team, literally, I don't playing table tennis in the office or or or um, football or soccer, whatever, whatever you call it you call that. Uh it helps to build that relationship. And now being remote and being overwhelmed with lots of products and and businesses, it's definitely hard to maintain that level of relationship with with teammates. But on the other hand, yeah, I think the level of um delegating and uh proper management is on a much different level right now than we had multiple a few years ago. So it it comes with with both sides, both positive and negative.

Justin:

Yeah. And so looking forward, what's your vision for the evolution of the business?

Alex:

I guess I I would have to answer separately for for different businesses, but because for for the medical device startup, the vision is pretty simple to bring our device to every patient's home across the globe. Like everyone has a regular monitor now. Many, many years ago, no one nobody had one, but then somehow it everybody has one now. So I think with all the technology and digitalization, everybody should have our devices similar to ours device that can help diagnose um a patient remotely. So that's that's our little ambitious, but that's our goal for the product. And for the service business, obviously we we rushed into AI as many companies as well. I think AI is gonna be crucial and transform every industry. And we we don't want to be late product party. So we are working hard with uh AI for the past couple years. We've been implemented in a few projects already. So what we wanna be, I wouldn't call the best expert. I don't think AI is fairly young technology. I don't think people should call them experts at all, whoever is doing that, but because it's it's like we added this case a few years ago when a client was looking for a specific developer, and like, yeah, I want this developer with five years of experience, and the technology was only three years old. So, like, if you cannot find a developer with five years of experience for something that appeared only three years ago, similarly, uh yeah, I don't think anyone like is an actual super expert now because it's still so young and everybody's boring, and so we are as we, yeah.

Justin:

Yeah, I I love that you make that point. I mean, I I have a problem with the word expert in general. It and like I don't like it because it seems terminal to me, like you've reached some pinnacle of knowledge that's more than anyone else. But to me, that's a very fixed growth mindset, or sorry, a very fixed mindset position because it says, you know, I'm done learning, but there's so much more that we can learn about anything. And so, especially in AI, anyone claiming to be an AI expert right now, you know, I want to challenge that because have you really been working in it that long? Uh, there are very few people that have. So I agree with you.

Alex:

100%. I agree.

unknown:

Yeah.

Justin:

Well, Alex, I've really enjoyed the conversation today. If folks want to get in touch with you, what's the best way to do so?

Alex:

I'm pretty active on LinkedIn. So if you want to uh reach out, just shoot me a message on LinkedIn. I usually respond pretty pretty quickly. But also, yeah, there's our website, bkey.io. Website for for our startup is yodyod.hel. Any of those channels, whatever works best for you, yeah, please don't hesitate to reach out as questions. Happy to answer.

Justin:

Great. Well, thank you so much, Alex.