Cover Story: Joe Kiani and the Audacity to Care: Reflections on Principle, Persistence, and Patient-Centered Innovation

Joe Kiani stood before the packed ballroom at LSI USA ’25 in Dana Point with a speech in hand. But he never delivered it. Instead, he told a story—unscripted, emotional, raw. It was a story not just of companies built or innovations commercialized, but of the angels who showed up along the way, the systems that tried to shut him out, and the patients whose lives gave meaning to every battle he fought.

“We have a real responsibility and an opportunity to change people’s lives for the better,” Kiani tells the audience. “And it’s not easy. But it’s everything.”

This is the story of Joe Kiani—a founder whose first company, Masimo, grew from a “garage startup,” as he calls it, to a global medical technology powerhouse, and whose new company, Willow Laboratories, is set on reimagining diabetes care. But more than that, it’s the story of a leader guided not by market share or IPO timing, but by something far more enduring: the North Star of doing what’s best for patient care.

The Angel at Indian Wells

Just days before his keynote, Kiani had a chance encounter at the BNP Paribas Open tennis tournament in Indian Wells, CA—a moment that would reframe his keynote message.

For 10 years, he’d been greeted at the tournament by the same woman, a graceful, 75-year-old fan of the sport—and of his story. This time, she handed him a small angel figurine.

“You’ve been an angel for so many people,” she said. “I think you need one to look after you.”

That quiet act of recognition cracked something open. “It touched me,” Kiani said. “But it also made me think. Maybe I’ve had angels watching over me this whole time.”

The more he reflected, the more names came to him: mentors, early team members, fearless IP attorneys, and angel investors who bet on him when logic said not to. This angel wasn’t just a gift. It was a reminder.

“Sometimes the unintended consequences of what we do are greater than the consequences we planned. But if you keep your compass set on doing what’s right for patients, good things can happen,” says Kiani.

From a $40K Loan to a Global Standard

Irvine, CA-based Masimo’s origin story is the kind of myth-making that only happens to those who refuse to quit. Kiani started Masimo from his garage with a $40,000 loan and a mission: solve the problem of pulse oximeters that failed when patients moved. It was a niche problem—but a critical one. In NICUs, faulty readings were leading to blindness in premature infants.

The solution—Masimo SET (Signal Extraction Technology)—today the industry-leading, clinically proven pulse oximetry technology that enables accurate monitoring of oxygen saturation and pulse rate of more than 200 million people a year—broke new ground. It filtered motion artifacts and saved lives. 

But it ran up against a wall: group purchasing organizations (GPOs) that had locked up hospital contracts in the U.S. for a fee, shutting out innovation in favor of incumbent industry giants.

“It’s not easy to make a true difference. Our product was saving babies’ eyesight—and we still couldn’t break into U.S. hospitals because of greed,” says Kiani. So Kiani did the unthinkable. He went public. Not with an IPO—but with the truth.

In 2002, he exposed the GPO stronghold in a series in The New York Times, with multiple Pulitzer prize-winning investigative reporter Walt Bogdanich, who years ago broke the infamous story about tobacco companies adding addictive nicotine to cigarettes. Kiani then testified before Congress, triggering Senate hearings that would crack open the market for Masimo—and countless other innovators. 

“Our business grew 10,000% in three years. But more importantly, the market opened up to other innovative medical technology companies, which benefits patients,” Kiani told the LSI USA ‘25 audience.  

Angels in the Courtroom

Victory wasn’t easy. The Masimo story is marked by years of legal battles in the early 2000s—against Nellcor, Covidien, and even Apple. Kiani didn’t just protect his patents. He protected a principle: that ideas, when built to serve patients, deserve to see the light of day.

Masimo won its patent and antitrust cases and walked away with an astounding billion dollars in damages and royalties. But that wasn’t the end. Kiani did something few founders do.

Instead of buying out his early investors, as advised, he paid them dividends. He handed $35 million in bonus checks to employees as if they were shareholders. And then he went public, ensuring that everyone who believed in the mission had a stake in its future.

“The investors that believe in us are at least as important as the ideas we try to bring to life,” Kiani says. “It’s important that we give back to those people. We walked into the office with a suitcase of checks. Some people used them to buy their first homes. It was really fun to see the fruits of the labor of our whole team come together. That was a good day.”

Losing Control, Keeping Principle

Despite the success, there were hard lessons. Chief among them: never give up control.

After going public, Kiani found himself at odds with some of his investors—many of whom had large holdings in companies like Apple. When Masimo sued Apple and won, Apple’s stock fell 2%. Masimo’s rose 10%. The market sent a message. So did some of his shareholders.

“They killed products that helped babies. They let go hundreds of amazing people.” 

Kiani’s advice? Structure your company to protect your mission. Dual-class shares. Clear governance. Investor alignment. Because in healthcare, staying in control isn’t about ego. It’s about outcomes.

Willow Labs: A New Chapter, Same Mission

Today, Kiani is channeling that same purpose into Willow Labs—a stealth-mode startup located at the University of California, Irvine’s Research Park office campus, aiming to reinvent diabetes care. The goal: prevent the disease before it starts. Empower patients before they fall through the cracks.

The company’s first digital health product, Nutu (Latin for “nudge”), is designed to do exactly that—help people with prediabetes avoid the full-blown condition. Research shows that losing just 5% of body weight can reverse prediabetes. Willow wants to make that not just possible, but engaging. (Nutu, introduced last month, is an innovative health and wellness app that empowers individuals to take charge of their health thanks to its unique Nutu Score, a tool within the app designed to help nudge users into optimal balance. It also offers a Healthy Living Program and a Diabetes Prevention Program, all starting with a prediabetes risk assessment.)

Kiani offers a thought-provoking question to the LSI USA ‘25 audience: “We spend so much money at the end of our lives trying to live another year or two. What if we invested that energy earlier?”

Willow is already home to 90 employees and growing. The team is full of “purists,” many from Masimo, says Kiani—engineers, clinicians, and operators who care more about the mission than the money.

He won’t reveal what’s next in the product portfolio. But if history is any guide, it will challenge the status quo—and demand a different kind of leadership.

Lessons from a Life in the Arena

Kiani has built companies, fought monopolies, battled in courtrooms, and still sees himself as someone who hasn’t done enough.

“We haven’t done anything yet. The future is bright—and we’ve got to get there fast,” he says.

 So what does it take to lead like Joe Kiani?

• Attract Purists: Surround yourself with people better than you—people obsessed with their craft, not their paycheck.
• Stay Principled: When the market tells you to compromise, don’t. Principles don’t just protect your mission. They protect your legacy.
• Work Like It’s Life or Death: Because in healthcare, it often is. “The only time success comes before work is in the dictionary,” he says (sage advice that is enshrined as his senior quote in his high school yearbook).
• Remember Why You Started: Kiani’s “why” was personal. His sister suffered a preventable injury as a child. He spent summers in hospital waiting rooms while she underwent surgeries, watching not just patients suffer, but families.

“That’s what got me into medical technology. That’s what made me care about patient safety. It’s not just the patient. It’s the people who love them,” he says.

Why He Thanks Himself

In a moment of quiet defiance, Kiani closed his keynote with a nod to a 17-year-old tennis champion at the recent Indian Wells tournament who had the confidence to thank herself.

“I’m going to thank myself,” he said. “For not giving up.”

The audience rose to their feet and applauded. It was more than deserved.

Because in a world of quarterly reports and diluted missions, Joe Kiani is proof that you can still build something lasting by doing the right thing—over and over again.

Even if it takes a decade. Even if you have to go to court. Even if you lose sleep and friends and titles along the way.

“Don’t fall in love with the technology. Fall in love with the problem to solve. Then fight like hell to fix it,” he advised the global medtech stakeholder audience.

What Healthcare Innovation is Really About

It’s fitting to close Kiani’s story with insightful gems from his recent post on LinkedIn:

“Healthcare innovation isn’t just about technology. It’s about caring people. It’s about ensuring every patient feels seen, heard, and cared for, no matter where they are. The real measure of success isn’t how advanced our tools are but how much in the hands of skilled and caring hands they improve lives.

Telehealth and remote monitoring are improving lives—no more long commutes to appointments or waiting weeks for a check-in. Now, patients can connect with their providers from home, track their health in real time, and get the care they need before small issues become big problems.

The result is:

• Happier patients
• Better outcomes
• Healthcare experiences that feel more personal, even when powered by technology.

The future of healthcare isn’t just about innovation—it’s about making care more human, more accessible, and more proactive. When technology enhances connection rather than replaces it, we create a system where every patient feels valued and supported. A truly patient-first approach doesn’t just treat illness—it empowers health, transforms experiences, and ensures care is always within reach.”

Joe Kiani

Founder and Executive Chairman Willow Laboratories

Joe Kiani is committed to transforming yesterday’s impossibilities into today’s realities. This is precisely what he accomplished at Masimo and continues to achieve with Willow Laboratories, which was founded in 1998. 

Kiani founded Masimo in 1989, a global medical technology company renowned for noninvasive patient monitoring technologies. Under his leadership as Chairman and CEO, Masimo transformed from a “garage start-up” into a publicly traded, multi-billion-dollar enterprise listed on NASDAQ (MASI). To name just one successful invention, Masimo Signal Extraction Technology (SET) is the primary pulse oximetry that can be found at the top 10 hospitals in the United States and throughout the world. Today, Kiani is leading Willow Laboratories as the team prepares for the commercialization of several new groundbreaking technologies.

Kiani has received numerous awards for his work in technology and patient safety. In 2024, his W1 Medical Watch was named one of TIME’s Best Inventions of 2024. In 2023, he received the Robert Wears Patient Safety Award from University of Florida Health. He has also received the Hubert H. Humphrey ‘Dawn of Life’ Award (2014), which is presented by the Newborn Foundation to individuals who have significantly impacted infant mortality rates. In addition, Kiani was honored with IP Champion Award in December 2018, the Society of Critical Care Medicine Innovation Award in 2000 and Ernst & Young’s Entrepreneur of the Year: Life Sciences Award in 2012.

Kiani received his Bachelor’s in Electrical Engineering from San Diego State University (SDSU). He also earned his Master’s in Electrical Engineering from SDSU. Kiani has received Honorary Doctorate Awards in Science from SDSU and Chapman University. He holds more than 600 patents related to patient monitoring technology, and his technology is used to monitor more than 200 million patients worldwide each year. Kiani remains tirelessly dedicated to improving the lives of patients, their safety, and the healthcare system they interact with.