Firefly Health CTO on the Rise of Virtual-First Healthcare

Mimi Liu, CTO at Firefly Health, shares her experience starting a new role during the pandemic, what she's accomplished during her career, and advice for future women healthcare leaders.

Editor's note: This conversation is a transcript from an episode of the HealthLeaders Women in Healthcare Leadership Podcast. Audio of the interview can be found here.

Mimi Liu joined Firefly Health, a virtual-first primary care, behavioral health, and specialty care service headquartered in Watertown, Massachusetts, in April 2020 at the start of the COVID-19 pandemic. Through her role as CTO, she focuses on making quality and affordable primary care available to Firefly Health patients.

Previously, Mimi served as a technologist for Devoted Health and subsequently climbed the corporate ladder from senior developer to executive director of engineering at athenahealth.

In the pilot episode of the HealthLeaders Women in Healthcare Leadership Podcast, Liu shares her experience starting a new role during the pandemic, what she's accomplished during her career, and advice for future women healthcare leaders.

Mimi Liu, CTO, Firefly Health (Photo courtesy of Firefly Health)

HealthLeaders: Acknowledging your background in digital health and technology, what has been your experience in trying to make healthcare more efficient through tech-enabled efforts in your previous roles and now at Firefly health? Why are you passionate about that work?

Mimi Liu: As an engineer by training, healthcare is such a great opportunity both in terms of how complicated of a problem that is to crack, and how existential of a problem it is in this country and globally. That is why I'm passionate about the work because I think the potential for impact at scale is tremendous, from a more optimistic lens. There's so much good you can do in this area.

I was lucky to have started my career at athenahealth. I found myself at this company where it was service-focused long before it was a common thing out there. Healthcare is complicated, you can't just solve it with technology. I got a lot of early exposure to thinking about healthcare problems and tackling them from a cross-functional perspective; thinking about my role on the technology side and partnering with wonderful clinicians and operators.

HL: Why did you choose to join Firefly and what was your experience starting your new role during the pandemic?

Liu: Joining Firefly was a natural progression in my career journey. Having started at athena, I was focused on tech enabling and optimizing the moment of care within the four walls of the exam room. I spent a lot of my time optimizing and building clinical workflows for encounter visits between clinicians and patients. But it took me too long to realize that that just represents one small sliver of the overall healthcare journey for patients.

Ultimately, after a long stint at athena, I joined a startup called Devoted Health, which is in the Medicare Advantage space, in part because I wanted to have not just clinical levers, but also financial levers to help improve the experience of healthcare for people. [I had] a tremendous experience thinking about healthcare more holistically in that way.

During my time at Devoted, I abstractly understood the importance of primary care, but it wasn't until I had the breadth of data and exposure from a plan side to see through the wide range of performance in terms of financial outcomes, but also clinical outcomes, for patients based on the quality of primary care doctor they have access to.

That drew me to Firefly, because prior to that, I was at arm's length from the patient. As a virtual-first primary care and specialty care service, Firefly is the quarterback of care for the patients we serve. That gives us so much opportunity to impact the patient experience within the day.

I joined Firefly at the start of April [2020], right when COVID was on an upswing. Looking back on it, it's kind of funny because one of my main concerns heading into this new role at Firefly was, ‘Would people be ready for virtual-first care?’ In hindsight, over the course of the year, it's just tremendous how far the industry has shifted and patient expectations have shifted in terms of embracing that model of care.

HL: Can you talk about what you've accomplished in the healthcare technology space in the past year?

Liu: In the first year for any startup, it's all about finding our product-market fit. This past year has been a lot of reacting to the changes that COVID has brought to healthcare; a lot of us in healthcare had spent the year adapting.

That's why one of the things I've been proud of our team at Firefly for is our adaptability and our ability to evolve and iterate. One of the things we did was launch a return-to-work service, which helped employers bring their employees back into the workplace safely. We did that jointly across our product offering, clinical services offering, operations offering, and that was huge for us.

Meanwhile, [we] scaled up and matured a lot of our core primary care offerings and layered on additional specialty services through it all, too. So, it's a lot of exciting threads to pull on at the same time, and a lot of changes to adapt to, but we came through the other end having learned a lot and feeling accomplished in what we were able to do during that time.

HL: What has been your experience as a woman working both in tech and healthcare leadership? What hurdles have you faced and overcome?

Liu: There's a lot in that question. I would say as a woman in tech and healthcare, they are slightly different experiences.

As a woman in tech, one of the things I love is I've been in the industry long enough to see a shift in mentality around diversity and technology. When I started, there wasn't nearly as much energy and general awareness about how to better support underrepresented folks in this industry. There's just so much positive energy on that front that I am optimistic for where we're going overall, but also, I should [mention] how long it's taken us to make progress and still how slow it is.

I joined athena when there were only about 30 people in [the technology division], and I was only the second woman on the team. Throughout my 12 years at athena, I was the most senior woman in technology. I've had a lot of experiences that you hear about in the space in terms of women [people who are underrepresented] shouldering a lot of the burden of diversity initiatives. Frankly, at moments in my career, I got burnt out on being consistently the sponsor for various initiatives on that front.  At the same time, though, from a leadership perspective, [it was] a slightly different experience, whereas often I was the only person who wasn't white in the room.

Healthcare similarly has dimensions where it could be more inclusive, and that's especially been spotlighted in terms of inequity being exacerbated during COVID. So, it's top of mind for me, and it's why at Firefly, we think hard about how we build a team that reflects the patients we want to serve. There's more work to do there, but the general awareness and motivation to get there is there.

Other hurdles that come to mind include when I hit parenthood while my career was taking off, and so a lot of the harder parts of my journey have been those two things coinciding. On the other hand, it was also comforting to come across strong women leaders and mentors who have experienced some of that or decided to not have a family and realize that some of those challenges kind of persisted regardless of the path you take.

Overall, despite all kinds of challenging points, I've been fortunate and think about the multiverse of realities that could have happened for me. The [path] that I followed is one that I feel lucky to have experienced.

HL: What advice do you have for women who want to serve in leadership roles in the tech space or in healthcare?

Liu: One of the pieces of advice that has always stuck with me is to bet on yourself. Moments where I've done that, I've never regretted doing so. Taking a leap of faith and taking a role that you might not see yourself necessarily succeeding in, but orienting towards the change and towards growth, has served me well.

I encourage others to think about less so the risk involved and reframe that in terms of ‘What is the growth there for me if I do take that step, even if it's scary, or if there is a lot of uncertainty around it?’ That's certainly helped me in terms of my last few jumps and roles, especially into a startup where you don't often have the degrees of certainty that you'd ideally like.

In terms of healthcare more broadly, my advice would be that there's a lot of benefit from seeing the problem from different angles.

For me, having seen things from the software services provider side, then seeing the same problems through the payer lens, and now through the care delivery lens, has been incredibly rewarding and fun, to realize you thought you knew healthcare, but then see a whole different side to it. That makes your perspective and your ability to solve problems that much richer.