Cal Brouilette recalls a sleepless night in Houston, speaking at 3 a.m. with someone from Blackstone about a purchase-and-sale agreement and transition-service agreements. It concerned a power-plant portfolio sale at Direct Energy, a Centrica subsidiary, that Brouilette places in 2013.
According to Brouilette, the assignment arrived in late September, when the CEO wanted the portfolio sold and announced before year-end. That left at most 120 days. Brouilette says he was managing finance and accounting, functioning as a business-unit CFO and loading up on MBA classes at Rice because his job had seemed stable.
The new assignment changed that calculation. Brouilette says he ran its finance work “soup to nuts,” covering the valuation taken into negotiations, management presentations, purchase-and-sale terms, and transition-service agreements.
The transaction presented him with what Brouilette describes as a $700 million “go or no go” decision. “Yes, this was hard,” he recalls thinking, but the experience prompted this realization: “I can do this job. I can make these decisions.”
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Brouilette says the moment gave him confidence to make high-stakes decisions quickly while recognizing that he could “still keep learning.” He describes it as his shift from operator to strategist.
At Flatiron Health, Brouilette says his focus as CFO is not to “make a decision and let it ride,” but to consistently track results before the organization travels too far down “the wrong path.”
His remarks present strategic confidence not as certainty, but as the discipline to decide, keep learning, measure results, and correct course.
Made Possible By
CFOTL: Right now, for listeners who might be new to Flatiron Health, what does the company do? What does it provide? Whom does it serve, and where’s the opportunity here?
Brouilette: Yeah, so I’m going to try, as everyone has here, to take something that’s quite complex and make it as simple as possible. Fundamentally, Flatiron Health is a health-tech company focused on oncology. Our goal is essentially to do whatever we can to learn from every oncology patient to generate better outcomes for oncology patients. So, for all people who get cancer, we want to learn from as many of those people as possible. Ultimately, that will lead to better care and better outcomes for those people. That is our goal.
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How do we do that? In its simplest concept, we have a two-sided P&L. We’re not a single-product company. On the left side—it doesn’t really matter, left and right, but just for labeling purposes—our biggest customers are community oncology clinics.
For those who don’t know, community oncology is basically where between 50 and 60 percent—and, depending on some estimates, more than 60 percent—of cancer care is administered in the U.S. That is hugely, hugely important. The other setting is the big hospitals and hospital systems that we’re all used to. If you live in New York or another big city, that’s where you go to get your cancer care. But community oncology represents more than half. More than half of the people who have cancer are treated in these spaces.
Through software and technology, we help those community oncology clinics be as efficient and effective in delivering care as possible. The primary way that we do that is through our core OncoEMR product, an electronic medical record product with a bunch of services and technology around it. That is the left-hand side of our P&L: doing what we can to support those clinics so that they can provide the best care they possibly can in the most efficient and effective way.
On the right-hand side of the P&L—again, just because I’m labeling things—we serve pharmaceutical and biotechnology companies with real-world evidence. Real-world evidence is learning from all the data collected from our community oncology clinics and from partnerships that we have with bigger academic medical centers.
All the data captured when someone receives care—structured or unstructured—exists over the lifetime of that care. Our technology and oncology-specific expertise—the scientific expertise that we have in-house—take all that data and turn it into really, really useful information.
What that results in, at the core, is disease-specific longitudinal datasets that we can learn from and use to work with our partners to understand oncology’s biggest questions in the real world. These aren’t scientific settings; these are real-world settings, and that information is just unbelievably invaluable.
Flatiron Health | www.flatironhealth.com | New York, NY