Sandeep Akkaraju Put Ultrasound on Silicon. The Bigger Idea Is Where It Can Go.

Sandeep Akkaraju was walking through West Africa with a backpack and an old itinerary. The route traced the travels of a 14th-century Moroccan pilgrim across remote parts of Morocco, Mali and Burkina Faso. Akkaraju had already participated in the Silicon Valley ritual of making the improbable commercially legible. He had helped turn a garage startup into a microelectromechanical systems company that Corning acquired in a deal valued around $750 million. Yet the lasting instruction from his trip arrived not from a chip, a boardroom or a term sheet. It came from the hospitality of people who had little access to basic infrastructure and still welcomed him generously into their homes.

The contrast bothered him. The American technology industry had begun with a taste for foundational tools, he felt, but much of its attention was drifting toward modest conveniences and advertising. West Africa supplied the counter-image: places where capable tools could alter the texture of everyday life, if only those tools could travel. The famous observation that the future is already here but unevenly distributed stopped sounding clever. It sounded like an assignment.

01 · A useful inheritance

Before the company, a family argument for service

The assignment had family roots. Akkaraju grew up in India during the 1970s and 1980s. His grandfather was a doctor and his grandmother a nurse; together, they established a hospital in Hyderabad. Their example made service to people with fewer resources feel concrete rather than ceremonial. His father worked as a space engineer and became an entrepreneur, offering another lesson: complicated technology could be made to act in public.

There was music, too. As a child, Akkaraju played music and cricket, and he once imagined the former as a profession. When he moved to the United States, Louisiana’s musical culture was part of the attraction. The professional musician never materialized, but the creative instinct survived. He later described himself as drawn to making something original and powerful. His eventual materials were less glamorous to the ear - silicon, nanoscale piezoelectric films and signal processing - but creation remained the habit.

His education crossed the same boundaries. He earned a B.Tech at the Indian Institute of Technology, an M.S. at Louisiana State University and an M.B.A. at INSEAD. Engineering supplied the physical laws. Business supplied the institutions needed to move an invention out of a lab. His later career would depend on fluency between both worlds, with enough curiosity left over to ask inconvenient questions of each.

02 · The miniaturizer

His career kept asking large machines to lose weight

In Boston, Akkaraju found an early startup before the culture had acquired its uniform and mythology. IntelliSense began as a DARPA-funded garage operation working in MEMS and nanotechnology. This was engineering close to the grain: sensors, circuits and tiny moving parts, with machinery acquired cheaply when nearby digital equipment companies failed. Akkaraju helped the company grow into optical switching and other systems that sat behind the expanding internet. Corning bought IntelliSense. In 2003, he led the unusual move of reacquiring it.

That round trip left him with a strong opinion about foundations. To create lasting value, he believed, a company needed command of the underlying technology rather than a decorative layer on somebody else’s platform. His next sensor company, Jyve, followed the same instinct. Motion-sensing hardware was becoming relevant to game controllers, navigation devices, phones and early augmented reality. Jyve worked to shrink components that had once been heavy and expensive until they could live in wearable devices. The company was later acquired in a transaction reported above $60 million.

Seen together, these companies were rehearsals in subtraction. Remove mass. Remove cost. Remove specialist machinery. Keep the performance. Akkaraju’s favorite design maxim comes from Antoine de Saint-Exupéry: perfection is achieved when there is nothing left to take away. The line is attractive on a poster. In hardware, it is a very expensive sentence.

03 · The pocket brief

Exo made simplicity the visible layer

Exo began in 2015 around a direct question: could a clinician get a useful view inside the body with a device carried in a pocket? Conventional ultrasound systems could be large, costly and demanding to operate. Akkaraju and co-founders Yusuf Haque, Janusz Bryzek and John Kokulis approached the problem as veterans of semiconductors and medical devices. Their proposed escape route used piezoelectric micromachined ultrasound transducers, or pMUTs, placing a critical part of the imaging system onto silicon.

The tidy phrase “ultrasound on a chip” hides a riot of disciplines. Nanomaterials have to interact with semiconductor processes. Signal processing has to turn echoes into legible pictures. Hardware has to survive ordinary use. Software has to move images and documentation through clinical systems. Artificial intelligence has to offer guidance at the instant it is useful. Any one layer can be impressive while the whole experience remains irritating.

Akkaraju’s answer has been to treat the system, not the probe, as the product. Exo Iris, launched in 2023, is the handheld hardware. SweepAI supplies on-device guidance and automated measurements. Exo Works handles review, documentation, quality assurance and connection to the wider imaging workflow. The intent is closer to using a smartphone camera than operating a control desk. That ease is the output of complexity, not its absence.

He calls the launch standard a “minimum lovable product,” a phrase with more teeth than charm. In deep tech, a minimum viable product can demonstrate that the physics works while leaving the user to negotiate the rubble. Lovability asks whether the object belongs in a real day. It requires attention to the uncelebrated seconds around the central task: finding the right control, saving an image, completing a record, sharing the result. The device may be small. The product is the entire trail it leaves behind.

04 · The people are the propulsion

A moonshot is mostly an exercise in translation

Akkaraju likes a space-flight metaphor for company building. Founders admire the moonshot and the vehicle, he says, while forgetting the fuel. Culture is the fuel. It is a fitting warning from the son of a space engineer, and an especially practical one inside Exo. A company mixing materials science, chip design, software, AI, medicine and regulated manufacturing cannot rely on every specialist independently reaching the same conclusion. Someone has to make the languages meet.

He describes cross-disciplinary thinking, curiosity and the ability to rally people around a common goal as central to his work. The emphasis falls deliberately away from the founder. Exo’s biography page carries his line: “Individuals don’t build successful companies, incredibly talented teams do.” It sounds modest, but it also describes the operating model. When a product crosses enough boundaries, coordination becomes a technical capability.

The founder’s useful job is to keep the mission specific enough to settle arguments. Make imaging easier to acquire. Make the system simpler to learn. Cut the administrative trail. Let the tool work in more settings. These directions give a chip engineer and a workflow designer a common test, even when their daily problems look nothing alike.

05 · Distribution, redesigned

The next act is larger than the object

The decade after Exo’s founding has added scale around that original pocket brief. The company acquired Canadian ultrasound AI developer Medo in 2022. Iris arrived the following year. Exo Works Connect followed with a quicker way for organizations to stand up point-of-care imaging programs. In May 2025, Exo announced a strategic collaboration with Samsung Medison to co-develop advanced ultrasound solutions, accompanied by a strategic equity investment. Omar Ishrak, formerly the chief executive of Medtronic and GE Healthcare Systems, joined Exo’s board as Chair of Strategy.

The Ishrak connection contains a pleasing bit of biography. Akkaraju remembers a conversation years earlier in which Ishrak named his two passions outside family: cricket and ultrasound. Growing up in India gave Akkaraju an immediate claim on the first. Years spent building Exo earned him the second. By 2025, a casual bridge between the subjects had become a board appointment and a partnership.

There is a recurring shape to Akkaraju’s career. A capable technology exists, but it is trapped by size, price or complexity. He learns the physics of the trap, gathers people fluent in its different walls and then asks what can be removed. IntelliSense applied the pattern to MEMS. Jyve applied it to motion. Exo applies it to imaging, with considerably more software and institutional machinery attached.

What West Africa changed was the criterion for choosing the trap. The best problem was no longer merely the one that could yield to engineering. It had to matter when it yielded. The backpacking year did not hand Akkaraju a product sketch. It handed him a stricter editorial policy for his own ambition.

He never became the musician he imagined as a boy. The consolation is better than a neat ending. A handheld imaging system is also an ensemble: materials, algorithms, clinicians and operators entering on cue, each complicated part disciplined into a simple performance. The audience should not have to admire the score. The point is that the instrument can finally travel.