Machine Minds

Unlocking Healthcare Efficiency with Physical Intelligence Solutions with Nicholas Kirsch

• Greg Toroosian • Episode 116

Share episode

In this episode of Machine Minds, we look at how physical intelligence—the fusion of robotics, automation, and software—can reshape one of society’s most strained systems: healthcare. Director of Software Engineering Nicholas Kirsch joins Greg to break down why hospital pharmacies are essentially “mini warehouses,” how automation is already quietly at work behind the scenes, and what it will take to reach the vision of a fully autonomous pharmacy.

Nicholas brings a rare dual perspective: a mechanical engineer turned software leader who spent years in Pittsburgh’s startup ecosystem building mobile manipulation systems, AMRs, and government-funded robotics programs before shifting into healthcare tech. His experience—from garage-stage startups to acquisitions and rebrands—gives him a clear lens on what it takes to scale robots from impressive demos to mission-critical reliability. At Omnicell, he now helps drive software for medication-picking systems, IV-compounding robots, and the next wave of automation designed to return pharmacists and clinicians to the work they trained for: caring for patients.

In this conversation, Greg and Nicholas explore:

  • Why hospital pharmacies operate like 24/7 logistics centers—and why automation is overdue
  • The long, largely unseen history of medication-picking robots (30 years and counting)
  • What the autonomous pharmacy roadmap looks like, and why most hospitals are still at level 1 or 2
  • The hard truth about robotics in healthcare: reliability isn’t a target, it’s a requirement
  • How systems like Omnicell’s IV compounding and XR2 picking platforms reduce waste, increase traceability, and free clinicians from manual labor
  • Lessons from Nicholas’s journey through multiple robotics companies, acquisitions, and pivots—and how software talent evolves within physical systems
  • What he looks for when hiring software engineers in mission-critical environments, including curiosity, culture fit, and growth mindset over rigid credentials
  • The promise (and limits) of AI in physical automation, and why general physical intelligence will unlock far more than humanoids

For anyone building automation in regulated environments—or simply trying to understand how robotics can meaningfully improve patient care—this episode offers a grounded, insightful look at the future of healthcare efficiency.

Connect with Nicholas on Linkedin: https://www.linkedin.com/in/nicholaskirsch

Connect with Greg on Linkedin: https://www.linkedin.com/in/gregtoroosian

Greg Toroosian:
[0:24] Nicholas, coffee, tea, or something else? What fuels your mornings? It's such a great time question, but we'll talk about that in a second.

Nicholas Kirsch:
[0:32] Yeah, always, always coffee.

Greg Toroosian:
[0:36] The reason that's so funny is as we hit record the first time, I just spilled my coffee all over my keyboard and desk and everything. So that was, yeah, very well timed. When you were a kid, what did you think you'd be when you grow up?

Nicholas Kirsch:
[0:49] Oh man, I don't know. When I was really little, I'm not sure. Obviously, you know, you go through all the different phases when you're a child, like I'm going to be a, I'm going to be a firefighter policeman, you know, or I'm going to be a professional athlete. Eventually you kind of become a little more realistic in your expectations. I think around, around high school, I started to settle in, you know, I really like engineering, you know, especially, especially mechanical, right. I like to work on something physical. Physical so funny enough right I'm the director of software engineering but software wasn't always where I started out I did mechanical engineering because I wanted to work on real physical pieces of hardware yeah but of course now I do so much more software of the hardware than I do the actual hardware interesting.

Greg Toroosian:
[1:40] Was it classes that got you into it in high school or like a hobby or how did Did you.

Nicholas Kirsch:
[1:47] Find it? No, I think it was just natural curiosity, you know, um, you know seeing cars and seeing i grew up in a really rural area you know seeing tractors and equipment a lot of machinery and just being curious about all that heavy equipment right how does it work and then from from there right it it became a little bit more detailed you know once you go to college you have more access to things you really get to to learn more about what you like and refine what you like. I feel like, you know, as a kid, I didn't have a lot of really good opportunities at my high school, especially within robotics and engineering. You know, we didn't have STEM classes, but that's also part of the reason why when I was doing graduate school, the big thing for me was actually volunteering and contributing to all these different programs in the Pittsburgh area that, you know, coaching first robotics teams, first Lego league teams, because to me it's like wow if i if i had that when i was a kid right that's what i would have done right that's that's the team i would have been on that's the program i would have worked with you know i think it would give me a big head start you know to prep for mechanical engineering major in college but

Nicholas Kirsch:
[3:03] yeah you know they have all those resources now they didn't have them back when i was a kid they're.

Greg Toroosian:
[3:09] Such great programs such great organizations what's one technology that you can't live without?

Nicholas Kirsch:
[3:16] I don't know. I mean, you got to say phone, right? Everybody has to have the phone. And especially with the fact that smartphones are so good now. I mean, they are your computer in your pocket. And so, I don't want to say I love to always be connected, but I mean, you do always have to be connected. And then, uh, you know, having, having kids as well, right. I get a phone, you make sure it's got a good camera. So you're going to go and you're going to take a lot of really good pictures. And so your, your life is so phone centered, which I feel terrible about now. And I, I try not to set a bad example for my kids where I've always got the phone out, but you know, they're reality.

Greg Toroosian:
[3:56] Yeah.

Nicholas Kirsch:
[3:56] Yep. You know, work, work is always happening. and you're always connected or your kids are doing something and you got your phone out because you're like, I got to be ready to take a picture, right? I got to, I got to, you don't want to miss it, but it definitely models to them that you can't live without that phone. Right.

Greg Toroosian:
[4:13] Yeah. It's interesting one. Cause you know, I've asked that question to a lot of people and phone is probably the top answer. There's some others that come up, but when I think about it and And I saw a

Greg Toroosian:
[4:24] visual that compared what it was like, I think, in the early 90s to now. And it had laid out on a table, it had your computer, a big camera, a video camera, a calculator, an alarm clock, all of these things. And then now it's just your one device. So you couldn't imagine that something like that was going to happen, right? And then now we're so dependent on it but yeah i mean it's it's it's a positive in a lot of ways but you're also just super dependent yeah i don't know for sure yeah i want.

Nicholas Kirsch:
[5:02] To give i'm sure it's the same answer that everybody gives but,

Nicholas Kirsch:
[5:05] really it it's all of those things in one right it.

Greg Toroosian:
[5:09] Is yeah it's not just calling people or whatever there's so many things but yeah it's true it's true last one if you could fast forward 10 years and see one impact that your work's made on the world what would you want that to be.

Nicholas Kirsch:
[5:23] So i the thing that i really love about being at omni cell is them trying to drive forward this vision of the autonomous pharmacy and it's something that i didn't really think a whole lot about until I started at OmniCell. And, you know, there's a whole white paper about the autonomous pharmacy vision and really just kind of understanding exactly what that means, right? Where within the world of the autonomous pharmacy, healthcare professionals are spending all of their time with their patients, right? Doing the thing that they were trained to do. Instead of, you know, you have pharmacists nowadays who spend their days in the basement, you know, counting out pills, right?

Nicholas Kirsch:
[6:06] Managing inventory, essentially, right? Every hospital runs a little tiny warehouse inside where they have to solve this logistics problem of getting all the medications to all of the patients in the entire hospital. And when you think about the scale of that, especially there are some very large hospitals. And you think about how complicated it is because every unit in the hospital is different. Every patient has different needs. It's a hard problem to solve. And when you realize that a lot of healthcare professionals, highly trained healthcare professionals, are spending time on tasks that we can do today with robotics and automation, you see this really big opportunity where in 10 years.

Nicholas Kirsch:
[6:53] I'd love to see more robotics and automation in healthcare.

Nicholas Kirsch:
[6:59] There's a big shortage of healthcare employees and, not enough people to take care of everyone and the more we can take away those tasks that, really is not something that they should be doing right um so true if you go and if you go and you you know you go and you get a an md or you're getting your you know you're going to be a pharmacist you're spending all those years in college and all that money you don't want to be doing all this manual labor around making sure that medications get from the central pharmacy down in the basement up to every single unit in a hospital right that's that's not what you went to school for but that's how you're spending so much of your day and so you know if we can use technology to really unload that physical labor that they have to do around medication management as well as that mental load that they have to deal with to make sure that they are meeting all the needs of their patients you know it's not going to get done in 10 years but that's that's something that I would like to see, at least in the position that I'm in.

Greg Toroosian:
[8:04] Love that. Love that. Well, look, welcome to Machine Minds, everyone. I'm your host, Greg Tarussian, founder of Samson Rose, your robotics talent search partner. And on today's episode, I'm joined by Nicholas Kirsch, Director of Software

Greg Toroosian:
[8:16] Engineering at OmniCell. Thanks for being on the show, Nicholas.

Nicholas Kirsch:
[8:20] Yeah, thanks for having me, Greg. Really excited to be here.

Greg Toroosian:
[8:23] My pleasure. So let's jump into the meat of the show. So, Given the background of you, because you've had this strong career path in the robotics industry, you mentioned you're in Pittsburgh as well, and then you had the mechanical side that you touched on, like that was your first interest, but what really drew you into software and systems engineering?

Nicholas Kirsch:
[8:42] Yeah, I think how I ended up in software is, you know, we talked about wanting to be working on physical systems, mechanical systems, and then finding my way to mechanical engineering. And then, you know, I had some really great professors at the University of Pittsburgh that we're teaching control systems and dynamics. I found that really interesting. And so I ended up going and doing my master's and then my PhD with a focus in control systems. And so it's really mathematically heavy, but if you're doing a master's, a research master's or a PhD, where the goal is to do these experiments, publish a paper with the results of those experiments, eventually you have to take all that heavy math and you have to implement it somehow right and so you know long ago before computers control systems were all done mechanically right they don't have flywheel systems were there to regulate velocity right that's not the case anymore right nobody nobody is implementing physical or even large electrical control systems anymore so now it's just all done with with software and so So really, you're taking all this math, and eventually you have to write all this software and then connect it up to all that hardware.

Nicholas Kirsch:
[10:01] And that's kind of where I started getting into the software side of things. And so I never took a software course, a computer science course. Really? Yeah. And I did a bachelor's, master's, and PhDs, and I had plenty of time to do it.

Nicholas Kirsch:
[10:17] All my courses. Yeah, I took some that were a part of the electrical engineering department. but other than that everything was within the mechanical engineering department and you know they'll do things like you know.

Nicholas Kirsch:
[10:30] It's kind of a 101 to programming course where they're just kind of going through programming languages and some really basic things. But I'm not going to count that because that's very different from anybody who has actually done a computer science software engineering degree. Very different. And so I kind of had to be self-taught and learn how to write code and then learn how to actually write good code. You know i found out on my first job it's not that uncommon though to have people come from a mechanical engineering background and end up doing software uh i think when i was at iam robotics i want to say most of our team in the early days most of our team was mechanical engineers writing software which is pros and cons right definitely definitely not you don't you don't have that good solid background of a computer science education but at the same time you have a better understanding of the physical system that you're trying to write the software to control and so because you understand the physical system better, it's easier for you to think about how your software is going to interact with all of those mechanical systems.

Greg Toroosian:
[11:42] That's interesting. Yeah, I didn't think about that. That's a good point. So quickly on that, you mentioned I Am Robotics as well. Can you walk us through your career prior to joining OmniCell?

Nicholas Kirsch:
[11:53] Yeah. So 2016, I finished my PhD at Pitt and then I went on and started a little startup called I Am Robotics. That was my first job after my PhD. I was the eighth person hired at the company. At the time, they were in a small garage just north of Pittsburgh, about 15-20 minutes north of Pittsburgh. And, you know, startup culture, I love startup culture. I think I'm so glad I had the opportunity to work at I'm Robotics. You know, you get to learn so much when you're at a startup because you have to do so many different things, right? There is not a whole department in your organization dedicated to doing a certain function, right? There's no HR department or talent acquisition department that's going to help you bring on new people when you decide you want to grow. You don't have a sales department, a marketing department. So it's the engineers that are going to the trade shows and setting up the demos and all those different things. And so.

Nicholas Kirsch:
[12:58] Getting to start at a company in a garage really small and then be with them through series a all the way up to i think we got around 100 employees we have moved into a pretty large warehouse out in lawrenceville which in pittsburgh is referred to as robotics fro so that's where the majority of the robotics companies are located out pittsburgh and it was such a such a good experience to be part of an early stage company through series a in growing so you know i think The things that we were working on there were definitely ahead of their time, right? We were one of the first companies that were working on mobile manipulation platforms, doing piece picking warehouses. So working on those logistics problems of how can I automate the process of picking products in a warehouse. Eventually, the company did pivot and decided to just focus on autonomous mobile robots and then rebranded to Onward Robotics. And so they're still around. It's just that the mission and the direction is a little different. So then I think after that, I was at IM Robotics for six years and sort of got that itch of wanting to see other places, get different experiences. And at the time, somebody that I had worked with at IM Robotics that previously left ended up at RE Squared Robotics. And it was around that time that they just happened to reach out to me and said, hey, I've got this opportunity. I think you'd be great for it.

Nicholas Kirsch:
[14:28] Let's just talk about it. right so they they pulled me in with the famous last words yeah let's just have a conversation let's have a chat yeah it doesn't have to go anywhere and so yeah we had a conversation and so i i interviewed with them i i like that they are you know r squad was very culture first that was their focus really protective of the culture the ceo and founder jordan pettersen he would interview everyone right that was a part of the process was for him to speak with everyone you know prior to prior to making that offer and so you know they they preserved and had a really good culture there in the company and i was there for one month and then they were acquired by sarcos robotics and so oh wow they they couldn't tell me so they legally couldn't tell me that they were in the process of an acquisition and, They felt really bad about it. They felt like they deceived me. I told them, don't worry. That's what I was looking to get. I wanted to get more experience, more exposure, see different things. And so we went from being at RA Squared, which I think was around 150 people, getting acquired by Sarkos, which also had 150 people. They were based out in Salt Lake City.

Nicholas Kirsch:
[15:42] To now, here's a 300-person company with 20 different projects that we're working on. And so both both companies were working on similar projects they were very project focused companies so doing a lot of work with the department of defense some contracts with department of energy but both companies wanted to go from just doing all these kind of one-off projects to being a product company and so they were looking at all these projects and trying to figure out you know which one of these do we think that we have an opportunity to take and commercialized and there were a lot of different things that the company was working on at that time so we had underwater robotics we had commercial airline baggage handling robots we had exoskeletons um i remember yeah i yeah you and i have talked about it and there's there were a lot of different projects that they were working on and so, It was really hard for them, I think, to make a decision on what to go with. Eventually, they just kind of reached that point where they burned through too much money and they had to make the hard decision to let go of the majority of the company. So they inevitably, I mentioned 20 projects, right? There were about 20 projects ongoing.

Nicholas Kirsch:
[16:55] And they had to eventually make a hard decision of, well, let's just pick one, give it a really long runway. And so they went with AI brains for robots, right? So it's sort of your no-code or low-code systems where you can train it on a task in a relatively short period of time. And now you go from traditional industrial automation where it's somebody with a teach pendant connected to a robot arm and they're teaching all the different points to get it to do one really constrained thing again and again and again to I can just, through natural language, tell it what I want. Or through demonstration, tell it what I want. And it will learn it and it will perform that task for me so that's what they decided to stick with they renamed and became paladin ai so they rebranded which again i always make the joke that's how you know you're working in the tech industry right is that you have been at a lot of companies that are still around but not the same name that have been same name iterations right and so my three brands yeah yeah so am i like yeah and then and then he's got all the swag that goes with it right yeah every every brand it's a new t-shirt uh-huh.

Greg Toroosian:
[18:09] It's so fun yeah looking back through them people like why do you keep these it's history it's nostalgic right you look back yeah.

Nicholas Kirsch:
[18:16] So within within my nine-year career you know after my phd within robotics i have to tell people that i was that i am robotics but that's now onward robotics and i left there to go to RE Squared Robotics, but they were acquired by Sarcos Robotics, which eventually rebranded and became Paladine AI. And now I'm in RE. So... It sounds like a lot, but it wasn't. It wasn't. I'm not job hopping or anything, right?

Greg Toroosian:
[18:44] Especially a month and then an acquisition. That's pretty wild. What made you decide to move into the healthcare technology space?

Nicholas Kirsch:
[18:53] Yeah, I think it was a little bit of opportunity, right? That I saw the position that was available. At the time, like I mentioned, Sarko's Robotics had, they were shutting down Pittsburgh. So you know i was i was looking for whatever i could whatever opportunities i could in the area, and you know i mentioned this earlier that whole idea of the autonomous pharmacy just saw so much opportunity that within the framework of the autonomous pharmacy a lot like self-driving cars they have different levels they go level one to five right and so five would be the full autonomous pharmacy one is no automation nothing and you know i i looked at this this white paper read it and really saw a ton of opportunity right i i think that most hospitals today are ones and twos right really very very minimal automation that is used in health care and so i just see so much opportunity for omni cell to just become that company that is within every single hospital you know you don't you don't always see them the same way that you don't see, amazon's robotics and automation right right but when you get a package there's a good chance that.

Nicholas Kirsch:
[20:14] That was a big thing that we did at IAM Robotics. When we had our first deployment in Rochester, one of the things that we did was we would put notes in some of the bins, right? Hey, your product was picked by a robot.

Greg Toroosian:
[20:27] I like that.

Nicholas Kirsch:
[20:27] And that's the thing that you don't always think about. And I think even within healthcare, you're not going to think about that, right? Is that somewhere down in the basement of the hospital, there is a, you know, like I said, a small warehouse where there's robots that are picking medications for you, you know, so that they can actually make their way up to the unit. You've got autonomous mobile robot companies, AGB companies that are working on the problem of how do you transport medications through the hospital. You've got some people, like Diligent Robotics, that they're working on mobile manipulation platforms that can do a little bit of that medication transport, but can also, when you get to the location where you need to drop off the medications, you can do that all autonomously. So yeah the technology is is starting to to get there but like i said there's still so much opportunity and, it's it's a good it's a good mission as well right the idea of of course i i can help people have better health care indirectly right no one will ever see

Nicholas Kirsch:
[21:33] it no one will ever appreciate it but i'll i'll i'll know the role that it plays right yeah.

Greg Toroosian:
[21:39] Yeah i say that to people all the time like you know when you're in the industry and you just speak to someone that's not they're like oh when do you think robots are actually going to be around all that i was like chances are things in your house have been touched by a robot when they come to you like fulfillment center stuff like that now medicine there's so much that goes on behind the scenes it's just like not frontline or it's not in your home where you don't see them on the streets but it's happening every day so is this the main product the main thing you've been focusing on since you've been there in in this role right.

Nicholas Kirsch:
[22:09] Yeah so the the focus of at least omni cell here in pittsburgh is robotics and automation and so like like my own work history robotics and automation of omni cell here in pittsburgh also has a complicated history so because it actually it actually started 30 years ago so okay a cmu graduate 30 years ago built the first medication picking robot right and so that that was the beginning of it what you think about it is you know that that was a long time ago it was pretty early on and so that company was automated health care which was acquired by Kessin, Divestin became Ascent, which was then almost 10 years ago acquired by OmniCell. So there's been a long history of autonomous pharmacy robots here in Pittsburgh. For a while, they even had one of the original automated healthcare robots in the science center down in Pittsburgh. And so that was the thing that when I went to OmniCell, when I was interviewing with them, and I went and I saw some of their older products that they had, you know, they keep around. I recognized that automated healthcare robot. And I said, Oh, I've seen that before, like, you know, going down to the science center, I've seen it around before. And so, It's always, you know, it's been there for a while, right? And like you said, when will robots begin to impact your life? They already are, right?

Greg Toroosian:
[23:37] Yeah.

Nicholas Kirsch:
[23:37] 30 years, there has been robots picking medications in hospitals, right? So they're a big part. They've always been a big part of, you know, manufacturing and logistics has gotten very big. You know, I always tell people about being an eye on robotics and going to ProMAT and Modex and watching how those logistics train shows have changed over the few years that I went to them. It was such a big change, right? Logistics just used to be, it's conveyor belts and really big shelves and racks, right, and forklifts. That was logistics. You go to ProMAT and Modex today, it's all robotics. It's robotics everywhere, right?

Greg Toroosian:
[24:18] Yeah.

Nicholas Kirsch:
[24:18] I mean, once the big industrial robot manufacturers start showing up at trade shows like ProMAD, Modax. The more main brand people like Boston Dynamics, they got into logistics automation as well. You really saw this change of technology and logistics. I think healthcare is one of those places where it's what ProMAD and Modax looked like 10, 15 years ago. Then in a couple of years, you're going to see a lot of different applications of robotics and automation you know not not just surgical robots but a lot of different applications of robotics and healthcare and you're going to start

Nicholas Kirsch:
[24:56] to see them more and more actually in the right real deployed systems yeah.

Greg Toroosian:
[25:02] Yeah it's very true obviously omni cell i've been doing this for a long time and like you just mentioned some deep history in the space from your perspective what differentiates their approach to automation healthcare compared to other players in the industry.

Nicholas Kirsch:
[25:20] Well, I think one thing that is actually new to OmniCell is the Innovation Lab. So OmniCell just created a new office down in Austin, Texas. And the focus of this office is to do new innovations, right? And so they've recognized that there's a big opportunity in healthcare and a big opportunity to take all of this technology and apply it to solve problems in healthcare. And the innovation lab is that kind of step in the right direction right wanting to be more innovative in the space wanting to try new things to experiment you know not not just sitting back and you know being being in that position of the innovators dilemma where it's you know you're a big company you've been around for 30 years i'm i'm making money off of this product why would i do anything different right yeah why change i can just sit here and keep making money but But, you know, I mean, we've seen it and I think everybody recognizes it now that if you don't keep moving forward, if you don't keep innovating, eventually someone is going to come in and disrupt your space, right? And so you've got to be willing to disrupt yourself before somebody else does.

Nicholas Kirsch:
[26:36] And like I said, there's so much opportunity that that's where I think that the Innovation Lab is taking advantage of this opportunity and taking advantage of OmniCell and all these hospitals around the world. And so we have access to the data to the customers, tons of opportunity for the company to release new products and to innovate within the healthcare industry.

Greg Toroosian:
[27:02] How do you balance the complexity of integrating advanced automation with the obviously critical need for reliability in healthcare?

Nicholas Kirsch:
[27:13] I think that's one of the hardest problems, and I think a lot of people don't understand that, because... You watch a video of a robot doing a task, you know, and especially with all the humanoid robots, right? Now we're seeing a new video every week where a robot is doing some new incredible thing, right? Whether it's Boston Dynamics that the robot's doing parkour or, you know, Tesla's robots going and, you know, driving cars and being bartenders, right? All these different tasks that they, in theory, can do, right? And that's true. They can do it, but can they do it to a really high level of reliability? I think there's some industries and some places where you don't necessarily need high level of reliability, where it's okay to be at 97%, 98%. But when you're in healthcare, that's not acceptable. And so when a patient needs a medication and they go to an omni-cell cabinet to get that medication, they need to get it, right? High level of reliability because in the situation where they don't have that medication, where they can't access that medication.

Nicholas Kirsch:
[28:27] That is going to severely affect some person's health outcome. And so really critical, high reliability. Another product from OmniCell is their IVX station, which is a robotic system that is actually compounding IV solutions. And so it's taking IV bags and syringes and vials, and it's using a six-axis arm to actually compound an IV bag. And so now robots are making your medications, right? And so high reliability is really important, right?

Greg Toroosian:
[29:01] Yeah, you can't mess that up.

Nicholas Kirsch:
[29:03] There's no room for error. And I mean, but it's also an instance where robotics and automation makes a lot of sense because it's very easy for humans to make errors, right? And so when they're measuring out medications and drawing it in a syringe from a vial, they're looking at the marks on the syringe. And that's how they're measuring it visibly, right and so there's lots of lots of opportunities for them to make errors and when you're doing it with robotics and automation you can do it with really high levels of consistency you know we incorporate grab metrics so that we can take more accurate measurements of the medications that we're putting into the id bags it's a big iot device which of course means that you're collecting all this data and you're creating a record of the work that was done so you know what you put into a bag because at the end they get labeled and they have barcodes so you can go back and you can see the work that was done in producing that IV solution. Yeah.

Nicholas Kirsch:
[30:05] It's one of those areas of a really good opportunity to apply robotics and automation, but it has to be done with a high level of reliability because there's such a severe outcome when you make a mistake. Yeah, that's true. I think that reliability is important to make sure that the patient's safety is guaranteed. But also, when these systems go down, these people working in pharmacies, these healthcare professionals, they're doing this all day, 24 hours a day. It's a lot like logistics, where logistics is also running 24-hour operations. And so, downtime cannot be tolerated.

Greg Toroosian:
[30:48] And think about that.

Nicholas Kirsch:
[30:49] Five minutes is a big deal when you're moving products through very quickly. And so, yeah, reliability is also really tied to a return on investment. So if the system goes down for a couple of minutes, that is severely going to impact something like your pick rate or the rate at which you produce these IV bags, which impacts the return on investment that you're giving to a customer. So it's important for patient safety, but also for the business case.

Greg Toroosian:
[31:20] Would you say that reliability is one of the biggest technical challenges in healthcare automation today?

Nicholas Kirsch:
[31:26] I would say so. Yeah. I mean, it's the biggest problem you always encounter. I think it's such a big problem mostly because it's so underestimated. And it's kind of the 80-20 rule, right? Where the last 20% of the work, last 20% of a thing is actually 80% of the work, right? And so you get to that first product, you get to that first article, that first demonstration, people see it work and they say, okay, great, ship it. Right and it takes a lot of time and effort to test something to actually measure its reliability right how well is this going to run through 24 hours how well is it going to run through one month right how how frequently are you going to encounter these errors and have to have some manual intervention to fix them yeah so the the difference between i know that it works because i saw it work and it just works all the time without any issues right

Nicholas Kirsch:
[32:23] that's so much more work than just making the first one yeah.

Greg Toroosian:
[32:27] Yeah very true can you walk us through some of the most exciting software systems or projects that you and your team have been working on anything that you can share that is.

Nicholas Kirsch:
[32:36] Well that i think that's that's the problem right i i can't talk i can't talk about the really cool and exciting stuff i mean i think the ivx station is a really exciting product the xr2 is a really exciting product so the xr2 is uh it's a six axis arm on a linear rail that actually is picking medications and so it's using barcode reading and you know using computer vision to do optical character recognition and and read off expiration dates and so one of the biggest one of the biggest wastes of money in a hospital is just wasted medication because really because i mean yeah so because you have to have right you need to have medications on hand and you don't always know what you're going to need because patients have different needs patients move through the hospital right so the the patients that are in the hospital are changing every day so the demand for what you need is changing constantly but you also can't be in a situation where you don't have a medication on hand. So you always make sure that you have a large enough inventory.

Nicholas Kirsch:
[33:45] Obviously some of some of it's going to get expired right yeah uh or or even in a situation where if there's a recall a medication recall and so now you have to go through and every medication that is from a certain lot number you have to pull every single one out of the hospital so for some hospitals that takes months to do because you you know again in the vision of the autonomous pharmacy, the perfect autonomous pharmacy, you would have total transparency in where your medications are at all times, right? So visibility into everything. And like I said, we're not at that level, right? So inventory is not accurate everywhere. You don't know where everything is. You don't know where all those lot numbers went. And so what happens is you have to go to every location in the hospital that you have medications stored, go through all of those medications, sort of in that location, find every single lot number and pull it out. Right. And so with the XR2, right, that's part of the value proposition is it knows what those medications are, knows their expiration dates. It knows the lot numbers of those medications. And so when there's a recall.

Nicholas Kirsch:
[35:00] Yeah, it's just going to dump all the medications that it has inside from that lot number. Or it'll do things like when it dispenses a medication, it'll dispense medications that are closest to their expiration date. So that way you're doing first in, first out. So whatever medication you got in first to your pharmacy, that's the one that you're sending out to patients first. So it's helping reduce waste in the hospital. And so, like I said, it's all these different aspects where robotics and automation can have such a big impact in healthcare.

Greg Toroosian:
[35:35] I love those like sometimes unforeseen or unplanned for benefits because when you talk about inputting some of these solutions with a end user, you know, maybe if you're not in the healthcare system, you don't work in a hospital or whatever, and you're producing this like automation system, you think, hey, this is just going to make things smooth, seamless, and you don't need the pharmacist down there. And then well actually it reduces waste actually it does all of this stuff in real time we know where everything is it's like wow there's so many other levels benefits that something like this can produce and then it becomes a no-brainer right to implement it exactly let's let's shift gears a bit because you obviously you lead the software engineering team at a company of operating very regulated and mission critical industry right when you're looking at hiring what what qualities do you look for when building the teams and or bringing people on and.

Nicholas Kirsch:
[36:30] I mean i i feel like that's to me it's a personal question right that every i think everyone has their own personal preferences and what they look for i mean i think what what i always look for is you know i'll start with culture fit you know i feel like i can i can teach people these skills and in terms of technology, software development, robotics. I can teach these skills pretty easily. I've gotten good at it. In fact, part of the reason I went and I did a PhD was because I thought I was going to go back into academia and teach.

Greg Toroosian:
[37:04] Oh, really?

Nicholas Kirsch:
[37:04] I feel like those technical skills, I can teach. The soft skills are so much harder to teach.

Nicholas Kirsch:
[37:13] And in some ways, I don't want to change who a person is. I've got no intention of doing that. Everybody can be their own person, and that's totally fine. But you want to have people that are going to be a good fit on your team. People that are going to get along, that are going to work together, that complement each other's skills and abilities. And so for me, I'll, I'll focus a lot on the soft skills. I'll focus a lot on the culture fit. Obviously you've got to have some background technical skills because, you know, you don't want to have a long time to ramp a person up. But if I find somebody who has that continuous learner mentality that I see as not just currently a strong technical ability, but someone who is curious and it's going to continue to grow and to develop, to me, I look at that as, well, I'll invest time in you. Even if you don't meet my requirements today, I will invest time in you because I'm going to see that growth over time and you are going to be such a high impact employee in a year or two years in comparison to somebody who comes in with a very static mindset of, this is what I do. I'm very good at it. I don't need to change it. Right?

Greg Toroosian:
[38:36] Yeah.

Nicholas Kirsch:
[38:36] You hire people that you know are going to grow, that are going to continue to develop, and eventually they'll overcome those other people the more static fixed mindset people yeah i like that so that's i mean that's like i said that's that's my approach, And I think it's hard, especially we have so many different skills that we need on our teams. It's hard to say exactly technical wise, what we look for. But yeah, the soft skills stuff, I mean, that's going to apply to any role, right?

Greg Toroosian:
[39:07] I think that's key. Whenever I do an intake with a client, I always focus a lot on that section because, you know, the must haves, nicer haves and all that on the technical experiences. Is if you're just looking for that sure you'll be able to find a lot of things but if you're looking at you know continuous learning culture fit maybe someone who's demonstrated a great trajectory before and new challenges and then they're going to come in something brand new especially if it's super innovative or it's something that no one's done before right how do you assess for that without having some sort of openness

Greg Toroosian:
[39:44] to upskilling and and learning right Right. So, yeah, that's really cool.

Nicholas Kirsch:
[39:49] Yeah. And I think even even just, you know, sometimes a lot of companies that will use degrees as as a barrier to entry to a position. Right. And I totally disagree with that. I mean, I've I've seen people without college degrees that are better software developers, better engineers than people that have gone through actual engineering programs. programs, right? And so sometimes it's, you know, people get really focused on these are the check boxes. And if you don't check this box, you don't get to move past this point in the interview. Yeah, I think people that are so caught up in that and can't like make a real assessment of an individual and what their skills are, right? Look, look past the degrees that you think they have to have uh i think people miss a lot of really good strong candidates.

Greg Toroosian:
[40:40] It's very interesting that you would say that and kind of refreshing being someone who's, you know, gone all the way through and got their PhD because usually I see the other side, you know, there's hiring managers that haven't and then they're like, I know firsthand there's great people out there that don't have the traditional path or have, you know, been self-taught or whatever it is, or might have a degree in like music or arts and then have gone into engineering, right?

Nicholas Kirsch:
[41:09] Um they they just they get into it and they become really passionate about it and i mean they just take off right and and that's really amazing to see you know that the people and like i said that that is somebody who's going to be really high impact because they don't need structure to learn something they're capable of going out and being curious and doing it on their own i think that's a really that's a really tough thing when you're hiring recent college graduates that the big transition that they have to make is from being in a college course where there's a question and there's an answer to coming out in the industry where there is a question there's a problem and no one has the answer right right or there's more than one answer and which one's the better one and so now now it's really testing your your critical thinking skills and your ability to step into a completely open-ended problem right and learn totally independent you know of having a structure and having a book that somewhere in that book is the answer right like that's just it's not always the case it's not real so.

Greg Toroosian:
[42:17] True what advice would you give to engineers interested in transitioning from like hands-on technical role and something more leadership focused in their career.

Nicholas Kirsch:
[42:28] I think, and it's not for everyone, you know, I think that there's a lot of people that think that the only way that you can move up in your career is through a leadership role. And I don't think that's necessarily the case anymore. I think it definitely used to be, but now I see a lot more opportunities for people to grow in their roles just as an individual contributor working on the technology. Uh yeah now i mean if you want to be a leader a manager you know again this goes back to all those soft skills which again when you went through your engineering program there was probably not a course that you took on soft skills right how to manage people that that's not a true right it's really unfortunate that that they don't have that and i think one of the other of things that I participate in for, I think about six years now, I've been a part of the University of Pittsburgh's alumni residence program, which tries to fill that need a little bit of this is your academic program where you're learning these technical skills. But it's really important that you talk to some of these other alumni, they're going to give you advice on like, what are you missing, right? What's the missing piece in your education that is going to make I think that transition from being in academia to being a professional working in an industry, it's going to make that really hard for you.

Nicholas Kirsch:
[43:50] And so, you know, soft skills is a big one, right, that if you want to be a manager, you've never taken a course on it. It's really hard to step into that role because when you apply to management level positions, what they're going to ask you is, have you had experience managing people before? Right yeah so it's it's the constant chicken and egg problem with you know moving forward in your career show me that you've done it before i let you do it yeah so i think usually there's a lot of opportunities that you can find within the organization times that you can step up and say you know yes i'm an individual contributor but i'd like to guide some of this development and work with some of the younger engineers the newer engineers you know maybe it's it's managing interns, maybe your company has an internship program, just saying, yeah, I'll step up and I'll manage that intern. And finding ways that even though it's not your job function to manage those people, but finding ways that you can demonstrate that you're capable of doing it in your current position. And so sometimes you have to get a little bit creative at how you find that. Usually the opportunities are there so.

Greg Toroosian:
[45:02] Love that yeah i i tell people the same thing you have to kind of in your current role in your current company where you're a known entity and you've already built up like good faith and shown your abilities that's a great way of trying to move into a new role or level up.

Nicholas Kirsch:
[45:17] I think you know pick pick up a book as well right so yeah pick up a book listen to some management podcast right harvard business review you know dale dale carnegie how to win friends and influence people right you know surrounded by idiots was a good one i don't know if you've read that one the title's a little bit it's a little bit misleading in the title but essentially the the title comes from a story that this person had where the author was trying to help a company who was struggling i forget the industry i think they were maybe manufacturing and so this this manager was really struggling with managing his employees right and so he was getting really frustrated and he said to this person now well how how can i ever get things done how are things ever going to get better i'm surrounded by idiots right and obviously the author then kind of replies to him well I mean who hired these idiots right and so take some account yeah that's that's the story to the title of the book but what it really focuses on is just it's kind of.

Nicholas Kirsch:
[46:28] Dumbed down psychology. And so my wife has a doctorate in psychology. So her and I have talked about this a lot. It is dumbed down psychology that makes it a little more accessible to people like you and me that don't have a doctorate in psychology. And it's really showing you how you can identify different people based on their behaviors and how you can better work with those individuals, better manage those individuals, take advantage of people's strengths and their weaknesses right and figuring out how do you put people into opportunities where they can be successful right so it really is how do you how do you better manage people book but the name sounds a little off-putting.

Greg Toroosian:
[47:08] Yeah no that's that's awesome i really like that i'll have to find that one i was actually going to ask you what advice you have like books podcasts or resources and so i'm glad that you jumped onto that um well look i'm conscious of time podcast.

Nicholas Kirsch:
[47:24] Is a great resource if you're not listening you know.

Greg Toroosian:
[47:26] You're saying that you are the first person that i met out in the wild at a conference that mentioned hey i listened to the podcast i think is awesome and i i get so much from it and i was like wow this is real this was like very early on and it meant so much to me so i'm glad that you

Greg Toroosian:
[47:46] shared that and i'm glad we could finally get you on the show as well and.

Nicholas Kirsch:
[47:50] Then and then we bonded in the most bostonian way that you possibly can right with a beer and lobster rolls, right?

Greg Toroosian:
[47:58] What else are you doing?

Nicholas Kirsch:
[48:01] But now I like, I mean, yeah, podcasts are such a great way. I mean, it can be tough to identify ones that are good for you. But that's where I think, right, you go out, you experiment, you listen to new things. If you like it, great. If you don't like it, that's, that's fine. Move on. Right. But I mean, so many people are producing podcasts now that you're going to find something that that fits that need that you're trying to grow in some way in your career. And that information is out there. And there are people that are trying to help and guide.

Greg Toroosian:
[48:29] You just have exactly find.

Nicholas Kirsch:
[48:32] It you've got to find your people find your group that are going to enable you to improve yourself love.

Greg Toroosian:
[48:38] That i love that before we wrap i wanted to ask what's what excites you about the future of software driven automation and medicine and healthcare and what you're looking forward to in the coming years.

Nicholas Kirsch:
[48:53] I mean, I think AI is definitely causing such a big acceleration in everything. I don't know. It's exciting and then also not exciting because you see a lot of people chasing these AI applications that are making sense that there's a return on investment. And then you see people chasing these other applications where it doesn't really work, right? That they're not really focused on solving the problem. They just think, I have this tool and I need to use it. So, you know, AI is getting thrown around absolutely everywhere, right? And I mean, it is great because you can do things so much faster than you used to be able to do. And there's so much investment going into it now that that industry itself is booming, right? And so, I mean, we're very focused on robotics and automation. So for us, it's more about that physical AI, right? How do we perform all these different tasks with robots so that we can automate it and get the healthcare professionals, people back to spending time with their patients? How do we do that? How do we enable that? And so, ChatGPT doesn't do that task, but because there is so much investment into these large language models that.

Nicholas Kirsch:
[50:11] It's making the technology better for robotics as well right yeah nvidia is developing all these great systems because you know everyone now has their own llms or there are so many different ai enabled apps and so nvidia has this really big boom right but then you see what they're doing with their technology where they're you know they're building these new systems that are really focused on real physical robotics right so intelligence but physical intelligence and so and other other than humanoids i think it doesn't get a whole lot of focus but either with the booming investments in humanoids i mean that's gonna that's gonna bleed out into other industries and other than general physical intelligence there's a lot of ways you can take that technology simpler applications you can apply it to where it's going to work at.

Nicholas Kirsch:
[51:09] A really high level of reliability where you're going to be able to do this task right and train something to do it very quickly and you know it doesn't have to be i want to human right a robot that does everything around my house it's i just want a robot that can pick and move these pieces here right simpler applications but you're taking that really high level physical intelligence that could be used to do really complex tasks finding those simpler applications where you can work and you can do it at high levels of reliability you know i think that that in the technology industry is exciting but again like your phone quite like like your piece of technology that you can't live without question i feel like i'm just answering the same way that probably everybody else has before so i think it's it's good to caution people though that right ai is exciting but just remember it's a tool, not the solution to everything.

Greg Toroosian:
[52:05] I love that. I think that's a great place to end. Thank you so much for being on the show today, Nicholas. I appreciate it.

Nicholas Kirsch:
[52:11] Thank you for having me.

Greg Toroosian:
[52:12] My pleasure. How can our listeners learn more about you and stay in touch and also find out about what OmniCell is doing?

Nicholas Kirsch:
[52:18] Oh, yeah. I'm pretty active on LinkedIn, so you can definitely find me on LinkedIn. I'm not the only Nicholas Kirsch on LinkedIn, so make sure you get the one at OmniCell.

Greg Toroosian:
[52:27] We'll put it in the show notes for sure.

Nicholas Kirsch:
[52:29] Yeah, yeah, yeah. So I think that's a great way to get in touch with me.

Greg Toroosian:
[52:33] All right. This was awesome. Let's keep in touch. I'll speak to you soon. And thanks again.

Nicholas Kirsch:
[52:38] Yeah. Thank you.