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Citizen Health’s Plan to Put an AI Advocate in Every Patient’s Pocket · Vanguards of Healthcare by Bloomberg Intelligence

0:20
Speaker 1: Welcome to another episode of Boomberg Intelligences Vanguards of Healthcare podcast,
0:24
Speaker 1: where we speak with the leaders at the forefront of
0:26
Speaker 1: change in the healthcare industry. My name is Jonathan Palmer,
0:29
Speaker 1: and I'm a healthcare analyst at Bloomberg Intelligence, the in
0:31
Speaker 1: house research arm of Bloomberg. I'm thrilled to welcome for reidvij,
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Speaker 1: the co founder and CEO of Citizen Health, to today's program.
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Speaker 1: He's a seasoned health tech entrepreneur who previously co founded
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Speaker 1: the aptly named citizen a platform that revolutionized data access
0:47
Speaker 1: for cancer patients and was acquired by NVTA in twenty
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Speaker 1: twenty one. His latest venture, Citizen Health, focuses on leveraging
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Speaker 1: advanced AI and longitudal data to empower patients managing rare
0:58
Speaker 1: and complex conditions, well simultaneously helping accelerate drug discovery for pharma.
1:04
Speaker 1: We've got a lot to cover today, so welcome to
1:06
Speaker 1: the podcast, Freed.
1:07
Speaker 2: Thanks so much, Jonathan, it's a pleasure being here.
1:09
Speaker 1: Well, why don't you start with the thirty thousand foot
1:11
Speaker 1: view and maybe in a couple of sentences, could you
1:14
Speaker 1: give me your words of what citizen Health does today.
1:17
Speaker 2: Yeah? Absolutely, so you know, this is something that you
1:21
Speaker 2: and many others who are listening to this can probably
1:24
Speaker 2: relate to. But I kind of got thrown into citizen
1:28
Speaker 2: health through a personal experience myself. So both my in
1:32
Speaker 2: laws are cancer survivors, and back in twenty eighteen, my
1:39
Speaker 2: father in law was diagnosed with heading that cancer. Now,
1:43
Speaker 2: at the time, he had surgery, he had radiation. We
1:46
Speaker 2: kind of had a standard of care. We were able
1:47
Speaker 2: to take advantage of things to all the advances that
1:50
Speaker 2: have been made in the cancer space the last couple
1:52
Speaker 2: of decades. But five years later the cancer recurred. This
1:56
Speaker 2: time it had metastasized all over his bones in a
2:01
Speaker 2: skull and really a very poor prognosis. I had a
2:05
Speaker 2: net cancer. Once metastatic is not something that many people survive,
2:09
Speaker 2: and at the time he was given less than a
2:11
Speaker 2: one percent chance to lib Now, I ended up reacting
2:15
Speaker 2: the way many do, which is you don't take no
2:17
Speaker 2: for an answer, and that wasn't good enough, right So
2:21
Speaker 2: for me, I was very fortunate that I'd actually spent
2:24
Speaker 2: the better part of a decade working in the cancer space,
2:28
Speaker 2: so I had something that many others can have access to.
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Speaker 2: I knew experts, I knew a thing or two about cancer.
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Speaker 2: I was, you know, I knew enough to be able
2:37
Speaker 2: to do the research to sort of figure out, know,
2:40
Speaker 2: who's a doctor, what's a trial, what's the experimental treatment,
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Speaker 2: what could we possibly do? I reached out to patient
2:45
Speaker 2: advocacy groups, I talked to the top specialists in the
2:48
Speaker 2: country and had a net cancer and we got very
2:54
Speaker 2: fortunate that we were able to find a protocol that
2:56
Speaker 2: we borrowed from a different, different cancer treat and really
3:01
Speaker 2: tried as an experiment. And you know, three years later,
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Speaker 2: he's cancer free. He's still here. We were about seven
3:10
Speaker 2: months pregnant with our first kid when we learned at
3:13
Speaker 2: this news, and now he's going to soon see his
3:17
Speaker 2: second and so obviously it's one of those stories that
3:19
Speaker 2: fortunately has a happy end name for us. Congratulations on both,
3:23
Speaker 2: no thank you and look what that really What that
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Speaker 2: really highlighted for me, though, was even just even in
3:30
Speaker 2: spite of the fortune we had of being able to
3:34
Speaker 2: sort of knowing even where to start, because what do
3:36
Speaker 2: you do when the doctor says, listen, there's not a
3:39
Speaker 2: whole lot we can try. Most people kind of hit
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Speaker 2: a wall. And ultimately, what I've also learned through research
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Speaker 2: is the number one thing that results in a better
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Speaker 2: outcome for someone who is sick, someone like my father
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Speaker 2: in law who has a bad cancer diagnosis, someone with
3:59
Speaker 2: a complex condition for which there's no cure. Rare diseases.
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Speaker 2: Where we focus right now, it's not actually do you
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Speaker 2: have the best dog? It's not do you have the
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Speaker 2: right insurance plan? It's actually, do you have an advocate
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Speaker 2: on your side? Do you have someone? And I don't
4:18
Speaker 2: mean a professional advocate you pay a couple hundreds an hour.
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Speaker 2: I mean someone who is mom, dad, brothers, sister, friend,
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Speaker 2: you know, whatever the case might be, someone who has
4:27
Speaker 2: an irrational reason not to take no for an answer.
4:30
Speaker 2: So I had that personal experience. I've seen my co
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Speaker 2: founder who spends every single day doing this for her
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Speaker 2: daughter who is an ultra rear condition. But that's not
4:39
Speaker 2: something that's democratized. And if we think about a world
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Speaker 2: in which we're learning more and more about genetics, we're
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Speaker 2: discovering more diseases, the system can't really keep up. Ultimately,
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Speaker 2: everyone should have that advocate. And so what inspired says
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Speaker 2: Citizen Health is could we really use the power of AI,
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Speaker 2: the power off all the data out they're our own
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Speaker 2: experience is truly knowing what it means to kind of
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Speaker 2: walk those shoes and put that advocate in every single
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Speaker 2: patient's pocket. And we think that you can build a
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Speaker 2: fundamentally different healthcare system if you do that right.
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Speaker 1: So, how does that work in practice? If my family
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Speaker 1: is unfortunately suffering from some sort of rare or complex condition,
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Speaker 1: how do I how do I what's my front door
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Speaker 1: into your ecosystem at citizen.
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Speaker 2: No, it's a great question. So look where we've started
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Speaker 2: right now. You know, healthcare. Healthcare has talked about here
5:37
Speaker 2: in Silicon Valley as a you know, this four trillion,
5:40
Speaker 2: five trillion dollar industry, but healthcare is not a horizontal industry.
5:44
Speaker 2: It's a vertical industry. And what that means is, you know,
5:47
Speaker 2: another way to think about it is it's actually like
5:50
Speaker 2: four or five hundred billion dollar markets versus sort of
5:53
Speaker 2: a four to five trillion market. Because what someone like
5:57
Speaker 2: myself needs for preventative care or I've got high lesterol,
6:00
Speaker 2: or you know, whatever the case might be, is very
6:02
Speaker 2: different than someone who's suffering from an ultrur condition for
6:05
Speaker 2: which no cure exists, no treatment exists, and they're having
6:10
Speaker 2: one hundred seizures a day. And so the way that
6:13
Speaker 2: we started is we first focused on what is the
6:17
Speaker 2: patient population that has served the least, and that's a
6:19
Speaker 2: rare disease. Now there our front door is actually we
6:23
Speaker 2: work very closely with patient advocacy organizations. We built a
6:26
Speaker 2: very large network of these patient foundations that are trying
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Speaker 2: to close the gap that the system has been unable to.
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Speaker 2: So you have these patients whose doctors say, we haven't
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Speaker 2: heard of this condition, by the way, well intention not,
6:40
Speaker 2: you know, not for any lack of effort. We don't
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Speaker 2: know what the condition is. There's no therapies, there's no
6:46
Speaker 2: standard of care. We could trying, but I really don't
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Speaker 2: know what guidance to give you. And so you have
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Speaker 2: all of there's been more of these patient advocacy organizations
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Speaker 2: that have been created in the last five years than
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Speaker 2: in the previous fifty years. Is patients and families. Seventy
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Speaker 2: percent of these rare diseases impact kids. So you can
7:07
Speaker 2: imagine as a parent that you're not going to take
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Speaker 2: no for an answer. They started these grounds well foundations.
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Speaker 2: They pull together the community, they try to advanced research,
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Speaker 2: They try to learn from others what has worked so
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Speaker 2: that the next family that comes along has some guidance
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Speaker 2: and some next steps. So the first entry point for
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Speaker 2: us is we work with those patient advocacy groups. So
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Speaker 2: a lot of our users have actually signed up for
7:32
Speaker 2: the platform through those advocacy partnerships. We're now expanding that ecosystem,
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Speaker 2: working with diagnostic testing partners, with others who end up
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Speaker 2: interacting with these patients. But ultimately just in some sort
7:46
Speaker 2: of episodic manner, there's no one kind of holding their
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Speaker 2: hand and their companion over an ongoing longitudinal timeframe, and
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Speaker 2: that's where we come in. We now have more and
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Speaker 2: more patients that are finding us organically through whether it's Google,
8:03
Speaker 2: We have patients that are coming to us through chat,
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Speaker 2: GPT because you know, we've we've come to be a
8:08
Speaker 2: little bit better known in the salt rare space, and
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Speaker 2: we have a lot of content and data that we
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Speaker 2: you know, provide to give these patients guidance. And and
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Speaker 2: then thirdly is mainly through other patients. Right, So rare
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Speaker 2: diseases ultimately are communities that form because the best way
8:28
Speaker 2: you can get insers is by finding someone else who
8:30
Speaker 2: may have had a similar experience. We we effectively have
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Speaker 2: made that systematic, you know, on the platform, so that
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Speaker 2: oftimes there's this natural motion for our users to be
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Speaker 2: able to bring other users on who could benefit from
8:44
Speaker 2: that same information on that same community.
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Speaker 1: So how do you guys go about I guess coescing
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Speaker 1: around that patient, you know, whether it's you know, across
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Speaker 1: labs or specialists or genetic counselors. How does it all
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Speaker 1: come together? What what what pieces you have to really
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Speaker 1: bring together to I guess build the mosaic for these families.
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Speaker 2: Yeah. Absolutely, So Look, let's take a step back and
9:11
Speaker 2: just again think about this from the standpoint of if
9:13
Speaker 2: you were taken care of you know, your mom or
9:16
Speaker 2: that you know a loved one that you care about. Now,
9:21
Speaker 2: if you've done this, typically you're going to the doctor's
9:23
Speaker 2: appointments with them. You're helping to make sure they take
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Speaker 2: the medications. You are oftentimes managing the conversations and managing
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Speaker 2: a lot of the aspects of their healthcare. But it's
9:34
Speaker 2: not just that you're a walking human EMR or electronic
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Speaker 2: health worker or something. Right, Yes, you know all of
9:40
Speaker 2: their medical history, you know what protocol they're on, you
9:43
Speaker 2: know what they were diagnosed with. You may remember something
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Speaker 2: they forget that. No, No, we did have that genetic test,
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Speaker 2: we did see that specialists. No, we actually haven't tried
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Speaker 2: this other thing. So one is a medical context, right,
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Speaker 2: So okay, let's just take the proxy of that as
9:59
Speaker 2: like the electronic health record, with what your doctor fills
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Speaker 2: out every single time you go in for a visit,
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Speaker 2: it effectively ends up telling the story of your health
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Speaker 2: from a provider's perspective, from the doctor's perspective. Now, that said,
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Speaker 2: the average patient in the US is a doctor two
10:17
Speaker 2: point three times a year, though you can't have a
10:20
Speaker 2: third of a visit, so somewhere between two to three
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Speaker 2: times a year. If you do the math on that,
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Speaker 2: that means ninety nine point eight percent of the time
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Speaker 2: what is happening with your health is happening outside the
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Speaker 2: four walls of that provider's institution. Of course, you also
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Speaker 2: need to be able to understand what happens in the home,
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Speaker 2: what happens in day to day life. Now, you can
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Speaker 2: think of this as the patient experience, which can be
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Speaker 2: everything from tracking their symptoms, but it's a lot more
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Speaker 2: than that. Where have they not gotten access to something
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Speaker 2: they should have under insurance? Where are they having trouble
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Speaker 2: navigating a specific setting. For example, a lot of the
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Speaker 2: families we support have children with special needs go to school,
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Speaker 2: they need individualized education plans, they need specialized services at
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Speaker 2: their school district. Just knowing how to avail yourself of
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Speaker 2: that or what the bumps are, that's actually really important
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Speaker 2: context to actually understand about how to help that patient
11:15
Speaker 2: achieve a better outcome. And then the third is really
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Speaker 2: like the personal preferences of that individual. So I'll give
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Speaker 2: you an example of you know, with my father in law,
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Speaker 2: who's generally a pretty private person. He lets me talk
11:32
Speaker 2: about the stuff in public, but probably won't listen to it.
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Speaker 2: I know his personal preferences. I know that he's claustrophobic
11:40
Speaker 2: and he hates getting MRIs and pet scans, which is
11:43
Speaker 2: actually really really important for his ongoing care. So there
11:47
Speaker 2: has to be a lot of context. There has to
11:49
Speaker 2: be a very good reason to be able to do it.
11:51
Speaker 2: There has to be a certain setting at a specific
11:53
Speaker 2: mask that he needs to be able to wear that
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Speaker 2: allows him to get past the claustrophobia. What typically will
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Speaker 2: happen if you don't that advocate next to you who
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Speaker 2: knows all of that, that personal preference is will show
12:05
Speaker 2: for the MRI, You'll say I'm not doing it and
12:07
Speaker 2: you end up skipping. An intervention that is really really
12:10
Speaker 2: critical is context of someone who's a cancer survivor. So
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Speaker 2: it's really those three aspects, which is what is a
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Speaker 2: medical story, what is happening outside of that medical context,
12:23
Speaker 2: which is related to your health? And then what are
12:24
Speaker 2: the personal preferences, which you know, we've talked about social
12:27
Speaker 2: determinants of health, we talked about all of these other
12:30
Speaker 2: aspects from sort of a very healthcare perspective. We just
12:33
Speaker 2: look to really humanize it, right, like how do I
12:35
Speaker 2: make that experience relevant for you as an individual, and
12:40
Speaker 2: how do we make sure our product, which effectively is
12:46
Speaker 2: fashion to be almost like a person that is by
12:49
Speaker 2: your side, how does it incorporate all of this for you,
12:54
Speaker 2: not just the medical history your ongoing experience, but then
12:57
Speaker 2: also what you prefer and in what your preferences are.
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Speaker 2: So those are sort of probably there the three legs
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Speaker 2: of the stool that really start to give you a
13:07
Speaker 2: complete picture. And by the medical story just last point
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Speaker 2: that includes your genetics and you know a lot of
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Speaker 2: those those other aspects as well.
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Speaker 1: Yeah, all the good stuff so how does it how
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Speaker 1: in the back end, how does it all come together?
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Speaker 1: And I guess what does a patien see on the
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Speaker 1: on the front end, what does there user experience?
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Speaker 2: Like, yeah, absolutely so look it's uh so. One of
13:28
Speaker 2: the things that we first set to figure out is
13:30
Speaker 2: how can we, in a frictionless way help collect all
13:33
Speaker 2: medical records, all imaging, all genetic genomic information, all of
13:37
Speaker 2: the stuff that typically gets locked up inside the four
13:40
Speaker 2: walls of the institution on behalf of the patient. And
13:44
Speaker 2: so our chief regulatory Officer, Devin McGraw, she was actually
13:49
Speaker 2: part of the Obama administration who pulled a lot of
13:51
Speaker 2: the guidance that gives every American bona fide rights to
13:56
Speaker 2: be able to go request their medical records and any
13:59
Speaker 2: information from any institution that has made a care decision
14:03
Speaker 2: about them. So that is every doctor you've seen, every
14:05
Speaker 2: diagnostic lab, every insurance company. We effectively TurboTax that process
14:11
Speaker 2: for lack of a better term, into our product and
14:14
Speaker 2: into our platform so that we can do this on
14:16
Speaker 2: behalf of patients, meaning we go back and get ten
14:20
Speaker 2: yures of historical medical records, oftentimes longer, but some states
14:24
Speaker 2: don't require you to retain it longer than that. We
14:27
Speaker 2: do it from every single facility and provider that you've seen,
14:30
Speaker 2: not just the ones you're seeing today, because oftentimes kind
14:34
Speaker 2: of that medical story goes many many years back, and
14:40
Speaker 2: we pull that all into the product. The user sees
14:43
Speaker 2: all of that information, but then our AI layer actually
14:48
Speaker 2: helps interpret that information, helps to organize and structure that
14:51
Speaker 2: data so that it's usable in the context for our patient.
14:55
Speaker 2: Because it's a patient. I'm not trying to sit home
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Speaker 2: and read all my medical record, but when I see
15:01
Speaker 2: in you provider, I need a summary of everything that's
15:03
Speaker 2: happened when I go to the when I end up
15:06
Speaker 2: at the emergency room, I need to very quickly pull
15:09
Speaker 2: up what are the medications I've been on? Have I
15:11
Speaker 2: had any historical allergic reactions to any of the things
15:14
Speaker 2: that might be required in the intervention at the er
15:18
Speaker 2: all of that type of information. The second is the
15:22
Speaker 2: product itself. It's an app that it also lives in
15:26
Speaker 2: your text messages, which means that you can text it
15:28
Speaker 2: just like you would text a friend, which means for
15:31
Speaker 2: the first time, I'm working on a product that my
15:33
Speaker 2: mom can actually use because oftentimes the fancy apps and
15:37
Speaker 2: all the kind of stuff that we do just creates friction,
15:40
Speaker 2: And a big principle for us is like, how do
15:45
Speaker 2: you meet patients where they are? How do you just
15:47
Speaker 2: make it really easy for them? Cool and sexy is
15:50
Speaker 2: not the language that they speak. They just want the
15:52
Speaker 2: job to get done right. So for a user, they
15:56
Speaker 2: can simply text Ari which is the name of the product,
16:00
Speaker 2: to be able to say, look, I need a summary
16:01
Speaker 2: of all my health. I'm going for a second opinion.
16:05
Speaker 2: But the agent itself, the product itself, can also take
16:08
Speaker 2: actions on behalf of the of the patient. So a
16:11
Speaker 2: big thing we focus on is how do we help
16:14
Speaker 2: anticipate what the patient may need and sort of guide
16:16
Speaker 2: them along those next steps. So good example is my
16:21
Speaker 2: co founder Nasha, who I'll use as the example. She
16:25
Speaker 2: plays caregiver to her youngest daughter. Now her youngest daughter
16:30
Speaker 2: has fox she one syndrome, which is an ultra rare
16:34
Speaker 2: narrative alop mental condition which results in epilepsy and intellectual disability.
16:40
Speaker 2: It sometimes of her daughter's non verbal and so a
16:45
Speaker 2: lot of challenges that they're dealing with day in and
16:47
Speaker 2: day out. A few months ago, some of Amara, her
16:52
Speaker 2: daughter's name is Amara, some of Amara's symptoms started to
16:55
Speaker 2: get worse byticuarly around her seizures, around constipation and some gia,
17:00
Speaker 2: And so Nasha, who is basically an expert on Fox,
17:04
Speaker 2: she won at this point. I mean, she runs a
17:05
Speaker 2: patient foundation, she's you know, developed a gene therapy around it.
17:09
Speaker 2: She herself, She's like, Okay, what do I do. We
17:12
Speaker 2: have to change to a different anti seizure medication. She
17:15
Speaker 2: gets a new medication from the doctor. She now starts
17:18
Speaker 2: tracking all of the activity around that with Ari. Now
17:22
Speaker 2: Ari knows every medication her daughter's ever been on. It
17:25
Speaker 2: has every medical record related to Amara, so it understands
17:28
Speaker 2: all of that context. It's now tracking based on what
17:32
Speaker 2: Nash's telling her, how is she doing all this new
17:34
Speaker 2: medication of the seizure is getting worse? Are they getting better?
17:38
Speaker 2: What dose is she on? But then Ari will do
17:41
Speaker 2: things like notice when a trend changes and says, hey, listen,
17:44
Speaker 2: I'm actually seeing an uptick in the seizures. I know
17:47
Speaker 2: we have an appointment with doctor Single next week, which
17:51
Speaker 2: it knows it is her neurologist because it has access
17:53
Speaker 2: to her portal. It tracks all of our appointments for her,
17:57
Speaker 2: so it knows the appointment is coming up, and it'll say,
18:00
Speaker 2: I've already drafted exactly the symptoms of changes we've seen
18:04
Speaker 2: and the things we want to make sure we cover
18:06
Speaker 2: the appointment. Do you want me to send that over
18:08
Speaker 2: to them before we actually show up next week. That's
18:11
Speaker 2: an example of the type of interaction that you would
18:15
Speaker 2: have with the product where it's not just collating all
18:18
Speaker 2: this information but really acting as a proactive you know,
18:21
Speaker 2: teammate in your caregiving to be able to identify these trends.
18:25
Speaker 2: Take that next step and again remove that burden, you know,
18:28
Speaker 2: from Nasha. So if you add a lot of those
18:31
Speaker 2: things up, Nasha wouldn't even know that she should have
18:33
Speaker 2: highlighted that, because when her daughter starts having five seizures
18:36
Speaker 2: a day versus four, that's hard for a parent to
18:39
Speaker 2: really track. It looks about the same, but it's actually
18:42
Speaker 2: a twenty five percent increase, right. So that's the type
18:45
Speaker 2: of thing that ARI will do, you know, for the user.
18:49
Speaker 2: And again they can use it like any other app,
18:51
Speaker 2: or they can just text with it, you know, as
18:52
Speaker 2: if they were texting a friend.
18:54
Speaker 1: Well, there's a lot of questions maybe to unpack there,
18:56
Speaker 1: I imagine and you could tell me if I'm wrong here,
18:59
Speaker 1: But I think assembling, like the medical records probably maybe
19:03
Speaker 1: the easier part. Maybe normalizing the data as a challenge.
19:06
Speaker 1: But when you think about ari and and I guess
19:09
Speaker 1: maybe some of these disease specific communities and the low
19:12
Speaker 1: number of patients, how do you contextualize that data within
19:17
Speaker 1: that community knowing that they're, like you said before, there
19:20
Speaker 1: isn't a standard of care.
19:22
Speaker 2: Yeah, absolutely so, I think Jonathan, this is the key thing.
19:26
Speaker 2: And when we think about, like, what is this future
19:29
Speaker 2: of healthcare that we're building, and I'm gonna I'm going
19:32
Speaker 2: to digress a little bit to gives a little bit
19:34
Speaker 2: of context and then answer that question. Go for it.
19:38
Speaker 2: You know, I am often talking to folks that say, oh,
19:41
Speaker 2: so you guys focus in rare disease, not broader health care.
19:45
Speaker 2: We've been talking about in healthcare this concept of personalized
19:48
Speaker 2: care and precision medicine forever, which means that Jonathan should
19:52
Speaker 2: be treated based specifically on Jonathan, your genetics, your preferences,
19:56
Speaker 2: your like symptoms, and what's showing up for you, and
19:59
Speaker 2: I should be treated based on, you know, specifically based
20:02
Speaker 2: on those characteristics about myself, not some general demographic or
20:07
Speaker 2: some bucket or some protocol or some standard or what
20:09
Speaker 2: have you. Now, think about how medicine runs though a
20:14
Speaker 2: doctor is trained out of broad condition. Let's say lung cancer. Now,
20:19
Speaker 2: thirty years ago, lung cancer was had like two classifications.
20:23
Speaker 2: You either have non small cell lung cancer or you
20:25
Speaker 2: have small cell lung cancer. Then we discovered this thing
20:29
Speaker 2: called genetics, and now suddenly there's actually three hundred different
20:32
Speaker 2: cancers that are all lung cancers. And their thought of
20:35
Speaker 2: this three hundred separate diseases they each have I'm using
20:38
Speaker 2: the three hundred number illustratively, but it's dozens and dozens
20:41
Speaker 2: of subtypes. They each have their own standard of care,
20:45
Speaker 2: they have different medications that target the different mutations. I mean,
20:48
Speaker 2: there's this huge revolution we've seen in cancer which has
20:50
Speaker 2: sort of been like the first the first big step
20:53
Speaker 2: we've seen in precision medicine. So now pull on that thread,
20:57
Speaker 2: Like the doctor that got trained fifty years ago based
21:00
Speaker 2: on lung cancer, how are they going to keep track
21:03
Speaker 2: of like all of these new conditions that have shown up.
21:05
Speaker 2: How are we going to develop standards all of them? Ultimately,
21:10
Speaker 2: if you believe in precision medicine and personalized care. There
21:16
Speaker 2: is no such thing as standard of care because nobody's
21:18
Speaker 2: sitting there and being like, here's a protocol for for Reid,
21:21
Speaker 2: and here's a protocol for Jonathan. Those things are like
21:24
Speaker 2: living breathing protocols based on what's happening with us and
21:26
Speaker 2: how we compare to everyone else. And so now think
21:30
Speaker 2: of a system where if you had a living breathing
21:32
Speaker 2: system that had everyone's longitudinal information, where you could see
21:37
Speaker 2: what medication did they take, did it work, did it not,
21:39
Speaker 2: what were their background genetics, and you could access that
21:43
Speaker 2: broader data set and contextualize what you're going through against that. Now,
21:49
Speaker 2: suddenly you can start to see a map of like
21:51
Speaker 2: if I go down Route A, other people who have
21:53
Speaker 2: had similar characteristics have had outcome X. If I go
21:58
Speaker 2: down Route B, it's been outcome. Why. That's kind of
22:01
Speaker 2: where the future is going right, where you're effectively going
22:05
Speaker 2: to have this what I would think of it as
22:07
Speaker 2: like this dynamic intelligence layer that can kind of on
22:10
Speaker 2: the fly tell you based on where you are right now,
22:12
Speaker 2: here's probably the right thing that makes sense for you.
22:16
Speaker 2: That's very different than the way that healthcare works today.
22:19
Speaker 2: But this is already happening in rare diseases. So when
22:23
Speaker 2: your doctor is telling you there's no therapy, there's no
22:25
Speaker 2: standard of care, I don't know what to do. Guess
22:27
Speaker 2: what you are now living in this future where there
22:31
Speaker 2: is not some sort of understanding about that disease state.
22:35
Speaker 2: So what they do is they go on Facebook, they
22:37
Speaker 2: try to find other families. They pull and they search,
22:40
Speaker 2: and they look at other research papers and try to
22:43
Speaker 2: construct and pull together this picture of like what should
22:46
Speaker 2: I try to do. The way that we think of
22:48
Speaker 2: that is if you think of that example I gave
22:52
Speaker 2: of Nauscha, where we have such a deep understanding of
22:55
Speaker 2: everything that has happened with themar historically, what's happening with
22:58
Speaker 2: her now, what her preferences are. Our mom is on
23:00
Speaker 2: a continuous basis tracking all of this. If you had
23:05
Speaker 2: millions of people doing that, and all of that data
23:09
Speaker 2: builds what we think of as sort of this community
23:11
Speaker 2: intelligence layer that is private, it is deidentified, it is
23:17
Speaker 2: opt in by patients. But now when Farreid has a question,
23:21
Speaker 2: when I say, hey, I'm dealing with this thing, here's
23:24
Speaker 2: what I have, it can take it can effectively think
23:29
Speaker 2: of me as a pin and think of that community
23:32
Speaker 2: intelligence as a map, and it can take our pin
23:35
Speaker 2: and put it on the map and say you are here,
23:37
Speaker 2: and here are the different pathways that we could take,
23:40
Speaker 2: and you know what will most likely get you to
23:43
Speaker 2: a better destination or to a better outcome, which is
23:46
Speaker 2: guidance now that your care team can use to figure
23:48
Speaker 2: out that next step. That is how the future of
23:51
Speaker 2: all healthcare will work. Because the reason we're discovering hundreds
23:55
Speaker 2: of new diseases, thousands of new diseases every years, we're
23:58
Speaker 2: learning more about genetics. So that story I told about
24:01
Speaker 2: lung cancer, that's happening in every disease state. Now, if
24:05
Speaker 2: you and I have what we think of as a
24:07
Speaker 2: disease today and we both have that same diagnosis, that's
24:11
Speaker 2: going to manifest in totally different ways because you and
24:14
Speaker 2: I are different people, right, So I maybe went a
24:18
Speaker 2: little bit too abstract, But my point is that by
24:22
Speaker 2: being able to map your experience against the experience of
24:25
Speaker 2: millions of others and having the depth of information to
24:28
Speaker 2: contextualize me against that broader data set, that's what can
24:34
Speaker 2: start to help give us answers and start to be
24:37
Speaker 2: able to create sort of dynamic standards of care, which
24:42
Speaker 2: is going to start in rare disease, but eventually is
24:45
Speaker 2: how all of healthcare is going to work.
24:46
Speaker 1: In our humble opinion, maybe just extending that further down
24:51
Speaker 1: the road from a maybe from a technology perspective or
24:55
Speaker 1: an eco system perspective. Is there anything else that you
24:58
Speaker 1: have to build or do you have a map to
25:00
Speaker 1: expand the aperture going forward into these maybe broader conditions
25:06
Speaker 1: that are maybe not rare disease.
25:08
Speaker 2: Yeah, absolutely so. Look, the way that we think about
25:12
Speaker 2: it is I'm going to stick with the lung cancer example.
25:16
Speaker 2: It's worked so far.
25:17
Speaker 1: Well, let's stay with it.
25:18
Speaker 2: It's worked so far, right, So we spend a lot
25:21
Speaker 2: of time, many decades looking at lung cancer, which is
25:24
Speaker 2: again a group of many, many different conditions which, due
25:28
Speaker 2: to a limited understanding we only knew so much about genetics,
25:31
Speaker 2: we thought of as like one big condition, right, or
25:33
Speaker 2: let's say one with two subtypes, and we really only
25:38
Speaker 2: had sort of three approaches to it, you know, chemo
25:42
Speaker 2: or radiation or surgery. Right. You either poison it, you
25:46
Speaker 2: either burn it, or you cut it out. Right, those
25:48
Speaker 2: were sort of the three ways that you would deal
25:49
Speaker 2: with cancer. Now we started to understand these subtypes. Now
25:54
Speaker 2: we started to build therapies for these subtypes. If we
25:56
Speaker 2: started to see which therapies are working and which ones aren't.
26:01
Speaker 2: When you start to if you think of lung cancer
26:04
Speaker 2: as like a multi varied equation, like a very difficult
26:07
Speaker 2: equation which has lots of different variables that result in
26:11
Speaker 2: some symptom or some outcome, think of every subtype as
26:17
Speaker 2: just one of those variables, right where Like now, if
26:20
Speaker 2: you can start to solve those individual variables and say, hey,
26:22
Speaker 2: here's what happens when you have an alt mutation, Here's
26:25
Speaker 2: what help happens if it's egfr et cetera, et cetera,
26:29
Speaker 2: Now you can start to construct and sort of walk
26:31
Speaker 2: up the tree to be like, now I can get
26:33
Speaker 2: a better understanding of broader lung cancer. So in our world,
26:37
Speaker 2: I talked about neurodevelopmental conditions, right, These are conditions that
26:41
Speaker 2: typically impact children that end up missing their developmental mouthstones
26:47
Speaker 2: when they walk, when they crawl, when they roll over,
26:50
Speaker 2: and the intellectual ones as well, for the ones that
26:53
Speaker 2: impact intellectual ability, well, they all have seizures as a symptom.
26:58
Speaker 2: So we started by first working in these rare and
27:01
Speaker 2: nearrow developmental conditions, where epilepsy just happened to be one
27:05
Speaker 2: of the main symptoms that parents are dealing with day
27:07
Speaker 2: to day. I like, how do I manage seizures? Well,
27:10
Speaker 2: fast forward two three years, we have over one hundred
27:13
Speaker 2: of these conditions on the platform. We have thousands of patients,
27:17
Speaker 2: which in the world of ultra rare where there's only
27:19
Speaker 2: like a couple hundred patients in the world, is a
27:21
Speaker 2: massive number. We suddenly understand more about pediatric epilepsy than
27:26
Speaker 2: almost any other data set out there. So now we
27:28
Speaker 2: can start to provide support to people who have generalized epilepsy.
27:33
Speaker 2: They may not have that monogenetic condition, but they've been
27:35
Speaker 2: dealing with the symptom. And so that's a little bit
27:37
Speaker 2: how we think about it, where like start first with
27:41
Speaker 2: you know, it's a little bit like map every ZIPGDE
27:43
Speaker 2: in the city, and suddenly you can get a map
27:45
Speaker 2: of the entire city. Do that for the cities, you
27:47
Speaker 2: can get it to the country and kind of like
27:49
Speaker 2: if you if you pull on that analogy, like that's
27:51
Speaker 2: a little bit about how we think about it. So
27:54
Speaker 2: we and the example I gave is a real example.
27:57
Speaker 2: So we you know, our initial one of our main
27:59
Speaker 2: areas and ultra rare disease space to start was these
28:02
Speaker 2: new developmental conditions we move to like broader rare diseases.
28:05
Speaker 2: Now we've proved into a broader epilepsy, we're starting to
28:08
Speaker 2: do the same thing in cardio for example, where you know,
28:12
Speaker 2: heart disease is one of the top two killers of
28:16
Speaker 2: the US after alongside cancer. Well, it turns out that
28:22
Speaker 2: we think fifty percent of heart disease might be cardiomyopathies,
28:25
Speaker 2: which which were thought of is these rare things. So suddenly,
28:30
Speaker 2: like when we started to work in cardiomyopathies, we believe
28:33
Speaker 2: we'll be able to show the same thing. As we
28:34
Speaker 2: start to understand all these different cardio myopathies, you can
28:37
Speaker 2: again sort of walk up the tree and start to
28:39
Speaker 2: understand broader heart disease. So that's that's kind of how
28:43
Speaker 2: we approach it. But for us again, like we are
28:47
Speaker 2: trying to support every individual patient on their journey, and
28:50
Speaker 2: so it's really important that that map is being built
28:53
Speaker 2: in the background so that when a patient comes on
28:57
Speaker 2: we have enough context and information from from others like
29:02
Speaker 2: them that can help to inform kind of those next steps.
29:05
Speaker 1: Well, Fred we've been talking a lot about the patient
29:07
Speaker 1: aspect of the platform, maybe just switching gears a little bit.
29:10
Speaker 1: Can you talk about it from an advocacy group perspective
29:13
Speaker 1: and also the Pharmer partners that you're working with.
29:16
Speaker 2: Yeah, absolutely, so look patient advocacy groups and you know
29:21
Speaker 2: they they truly do some of the most critical work
29:26
Speaker 2: that just goes completely unseen. So you know, you have
29:30
Speaker 2: these large organized nonprofits that you and I would have
29:33
Speaker 2: heard of that have been around for years. I'm talking
29:35
Speaker 2: about these groundswall organizations that effectively a parent or a
29:39
Speaker 2: patient ended up starting because they got tired of hearing
29:42
Speaker 2: there's nothing we can do about this, and they said, well,
29:44
Speaker 2: I'm going to do something about it. Now. There's three
29:46
Speaker 2: things that these foundations try to do. One is they
29:50
Speaker 2: find and build community. Right, So, taking Nasha's examples, she
29:53
Speaker 2: got tired of hearing from the top specialists that she
29:56
Speaker 2: had access to in the country that listen Fox she won.
30:00
Speaker 2: I think it impacts a couple hundred people. There's really
30:02
Speaker 2: not a lot of research that's going to be done
30:03
Speaker 2: around it. So the first thing she said is like,
30:06
Speaker 2: I'm pretty sure more people have this thing, And she
30:08
Speaker 2: found two thousand people globally that end up having it. Right.
30:13
Speaker 2: The second is then helping with support a navigation. So
30:17
Speaker 2: a lot of these families have sort of trudged through
30:20
Speaker 2: the mud, seen what's worked, what hasn't worked, and the
30:23
Speaker 2: power of those shared experiences is something that they try
30:26
Speaker 2: to ensure it gets passed on to the next family
30:29
Speaker 2: that gets diagnosed. A perfect example is eighty percent of
30:34
Speaker 2: genetic sorry, eighty percent of rare diseases are genetically driven.
30:38
Speaker 2: So simply making it very clear to someone that may
30:42
Speaker 2: end up having one of these rare diseases, you need
30:44
Speaker 2: to advocate with your provider for genetic testing, or here's
30:48
Speaker 2: how you can get access, or here the question. Just
30:50
Speaker 2: that one thing can get you diagnosed yours earlier and
30:53
Speaker 2: can completely change the trajectory of your outcomes. Right. So
30:56
Speaker 2: that's an example of the type of information that they
31:00
Speaker 2: want to make sure the community is aware of. And
31:02
Speaker 2: then the third is research, which is they want to
31:05
Speaker 2: find a cure, they want to find treatments and therapies,
31:08
Speaker 2: so they want to pull the community together. Then they
31:10
Speaker 2: want to start to pull researchers and data together so
31:13
Speaker 2: they can actually eventually one day, you know, get to
31:16
Speaker 2: get to and approved therapy for the condition. That process,
31:21
Speaker 2: optimistically today takes about thirty years from the time that
31:25
Speaker 2: you actually start. You find the community, you get a
31:29
Speaker 2: little bit of funding for basic science, you do some
31:31
Speaker 2: early research, someone publishes one paper. We know the pace
31:34
Speaker 2: at which peer reviewed peer reviewed data gets out there.
31:40
Speaker 2: Then you add the whole drug development cycle, so you
31:42
Speaker 2: know you're at thirty years before this happens. So most
31:44
Speaker 2: of the people who start us are doing it for
31:46
Speaker 2: the people that come after them. We saw an opportunity
31:50
Speaker 2: to fundamentally change that because we said, listen, a lot
31:53
Speaker 2: of the technology we build actually serves us the infrastructure
31:57
Speaker 2: that can allow these advocacy groups to be able to
31:59
Speaker 2: move way far. So now they have a community platform,
32:04
Speaker 2: they can actually get a much deeper understanding of what
32:07
Speaker 2: their patients are going through. They suddenly are generating incredibly
32:11
Speaker 2: valuable data which patients can choose to consent, and most
32:14
Speaker 2: of our patients ninety eight percent can sent the data
32:17
Speaker 2: for research because it's transparent, it's above a board. Their
32:20
Speaker 2: advocacy partner is also trying to like push forward to
32:23
Speaker 2: a cure, and that ties us to the pharmacide. And
32:28
Speaker 2: so when we go to pharma. If you look at
32:29
Speaker 2: some of the most promising breakthroughs that we've had, Chris Burr,
32:35
Speaker 2: gene editing, gene therapies, you know, there's a lot of
32:39
Speaker 2: activity CNBC Curess, you know, is a big program that
32:43
Speaker 2: has sort of like shine shown a light on, like
32:45
Speaker 2: all those work aptaing in rare disease. There's been other
32:47
Speaker 2: initiatives as well well. All of those are basically tailor
32:51
Speaker 2: made for rare diseases, effectively trying to solve you know,
32:57
Speaker 2: genetic errors in our genetic code that could result in
33:03
Speaker 2: curing the disease, which is you know, just eighty percent
33:06
Speaker 2: of these rare diseases. The problem is pharma has no
33:09
Speaker 2: way to get access to these patients. There's no data
33:12
Speaker 2: out there, so they don't know how to design the
33:14
Speaker 2: trial or you know, actually set up the program, and
33:17
Speaker 2: so it ends up taking them fifteen years to do it.
33:19
Speaker 2: And they say, well it's only a few thousand patients.
33:23
Speaker 2: I'm going to go work on a bigger condition instead.
33:26
Speaker 2: And what ends up happening is what I call the
33:28
Speaker 2: medical equivalent of the rich get richer and the poor
33:30
Speaker 2: get poorer. So the folks that are where their therapies
33:34
Speaker 2: already exist where they're broader populations. We keep investing there
33:37
Speaker 2: and these rare diseases get left behind. So it's your
33:39
Speaker 2: fundamental market failure problem. Because if you could actually curtail
33:45
Speaker 2: that thirty year timeline to seven or eight years, everything
33:49
Speaker 2: from the time that we find these patients and discover this,
33:52
Speaker 2: we understand the data, we develop the understanding of the disease,
33:57
Speaker 2: we pull together the population, and we can actually run
34:01
Speaker 2: a full clinical cycle. As a drugt development company. You
34:05
Speaker 2: can bring these therapies to markets in six, seven, eight years.
34:08
Speaker 2: I mean, you can shave timelines off by sixty seventy
34:12
Speaker 2: eighty percent off of that and so that's real. That's
34:16
Speaker 2: really are the ecosystem of the world that we're building
34:19
Speaker 2: is on one side, we have these patients and communities
34:22
Speaker 2: that don't have seven or eight years to wait, dealing
34:25
Speaker 2: with the stuff day to day, and our primary focus
34:29
Speaker 2: is how do we give them the data, the technology,
34:31
Speaker 2: the tools, and the guidance and an ecosystem that allows
34:34
Speaker 2: them to navigate that data day challenge. In the meantime,
34:39
Speaker 2: all of this data is generating this intelligence about the disease,
34:42
Speaker 2: about the patient experience, how do you make that easily
34:45
Speaker 2: accessible to the researchers that want to understand the disease
34:50
Speaker 2: when they need to find these patients for the studies
34:52
Speaker 2: and they need to understand what their preferences are and
34:55
Speaker 2: like how to design the trial. They're all sitting right
34:57
Speaker 2: here on our platform. They're the ones who shared the
34:59
Speaker 2: data with you to be with. So that's sort of
35:02
Speaker 2: the that's really the the kind of vision we have
35:06
Speaker 2: is that you actually can do both things and incentives
35:10
Speaker 2: are aligned. Because if you went to a rare disease
35:13
Speaker 2: parent today, I promise you what they will say is,
35:16
Speaker 2: I wish there was at least of therapy for my kid.
35:18
Speaker 2: I wish there was something that we can do. And
35:20
Speaker 2: by the way, that extrapolates along all the way to everyone,
35:24
Speaker 2: including myself who's on a statin that is really excited
35:27
Speaker 2: about Lily's new phase one drug and all these other
35:30
Speaker 2: things that are coming out that you know, maybe one
35:32
Speaker 2: day I'll just have to take one shot and then
35:34
Speaker 2: my cholesterol issues will be fixed forever. Right, So there
35:37
Speaker 2: is alignment that that that you can extrapolate from from
35:41
Speaker 2: from what we're seeing in rare disease, which which ends
35:45
Speaker 2: up applying to everyone.
35:46
Speaker 1: Well, I'm at a statin too, so hopefully your pronunctication
35:50
Speaker 1: is true and a couple of years from now we're
35:53
Speaker 1: both off with them, maybe switching gears again. You know,
35:56
Speaker 1: can you talk about the business model? You know, we've
35:58
Speaker 1: talked a lot about the the operational focus and where
36:01
Speaker 1: you're interacting with the healthcare ecosystem, but how does the
36:06
Speaker 1: business actually generate revenue and what are the kind of
36:09
Speaker 1: key weavers to that.
36:11
Speaker 2: Yeah, absolutely so. Look, we're an early stage company. We
36:15
Speaker 2: raise a couple of rounds of funding to date, about
36:17
Speaker 2: forty four million dollars to date so far. And the
36:22
Speaker 2: business model is the first principle is we fundamentally believe
36:26
Speaker 2: that the data belongs to the patient. Now facilitating access
36:30
Speaker 2: to it, we're facilitating use of it, and we invest
36:34
Speaker 2: a lot of time, effort, and dollars to build that
36:38
Speaker 2: infrastructure to build that technology. When patients choose to consent
36:42
Speaker 2: their data, a de identified version of that data can
36:45
Speaker 2: be made accessible to researchers for non commercial research. We
36:50
Speaker 2: try to do we we do this at no cost
36:53
Speaker 2: because we want to democratize that data. We want more
36:56
Speaker 2: to be done for commercial use. When biofil Armor, for example,
37:00
Speaker 2: wants access to the data, or they need to identify
37:03
Speaker 2: patients who might be eligible for a clinical trial. Those
37:08
Speaker 2: are the types of interactions where they would pay a
37:10
Speaker 2: licensing fee or they would pay that's where most of
37:14
Speaker 2: our revenue comes from. But there's two core principles. No
37:18
Speaker 2: patient has ever contacted and no data has ever shared
37:21
Speaker 2: unless they explicitly opt in and consent in. And it's
37:24
Speaker 2: a while you're signing up, check the box and like
37:27
Speaker 2: you don't realize what you're agreeing to. We really want
37:30
Speaker 2: to be above board because our most sacred thing is
37:33
Speaker 2: the trust that we build with these patients and families,
37:35
Speaker 2: and we have a very high touch relationship with every
37:38
Speaker 2: individual user, which is different than healthcare, where typically you
37:42
Speaker 2: know your kind of arm's length from that individual or
37:46
Speaker 2: that family. The second is, whenever we make money, the
37:49
Speaker 2: patient makes money. Okay, so it's not our data, it's
37:53
Speaker 2: fundamentally your data. So I'm totally making up this example,
37:57
Speaker 2: like pink your pharma, a fizer pays us a million dollars,
38:00
Speaker 2: you know, to get access to some information. Every person
38:04
Speaker 2: that contributed to that should get a portion of that. Interesting,
38:08
Speaker 2: So that's our business model today. But if you kind
38:12
Speaker 2: of zoom out a little bit, the ecosystem we want
38:15
Speaker 2: to build is that you have patients that have all
38:17
Speaker 2: of this data and all of this information that's really
38:19
Speaker 2: valuable for others that they can almost use as a currency,
38:22
Speaker 2: if you will, where they may share it with someone
38:26
Speaker 2: for research purposes, they may share it to get a
38:28
Speaker 2: second opinion, they may share it, you know, whatever the
38:32
Speaker 2: goal may be. So in the future we anticipate working
38:36
Speaker 2: with a lot more folks at Pharma. We have a
38:38
Speaker 2: lot of providers that say, hey, could we get access
38:42
Speaker 2: to that that aggregate data, because then we could use
38:44
Speaker 2: it for decision support. So we found that very interesting.
38:48
Speaker 2: We know from a payer and insurance perspective that people
38:51
Speaker 2: that use our product end up with better outcomes, They
38:54
Speaker 2: end up with fewer er visits. The interventions are being
38:59
Speaker 2: highlighted and and taking advantage of so that you know,
39:03
Speaker 2: there's lower costs and better outcomes. So over time, as
39:06
Speaker 2: we scale, we see a clear opportunity to work with
39:09
Speaker 2: state programs like Medicaid that end up paying for a
39:11
Speaker 2: lot of these very sick patients, or even commercial insurance. Uh.
39:17
Speaker 2: And so that's that's kind of that that's kind of
39:20
Speaker 2: the evolution of the business model, but today varsity through
39:22
Speaker 2: through through research funding.
39:24
Speaker 1: So in that vision, would it be fair to say
39:26
Speaker 1: you're creating a marketplace for the data in the future
39:29
Speaker 1: or now you've created it now. But the hope is
39:31
Speaker 1: to maybe further contextualize that going forward.
39:34
Speaker 2: Yes, and and I think but I would, I would
39:38
Speaker 2: I would slightly edit it to say, like, not just
39:41
Speaker 2: for the data, almost think of it as like, how
39:44
Speaker 2: can you create a marketplace for healthcare? And what I
39:46
Speaker 2: mean by that is you and I probably my guess
39:52
Speaker 2: is you are a member of Amazon Prime, Amazon Prime
39:56
Speaker 2: subscription and you probably have you know, anywhere from TUDA
40:02
Speaker 2: two to two dozen Amazon boxes that show up door
40:05
Speaker 2: every month, right, because well, what does Amazon have with you?
40:09
Speaker 2: Amazon has a direct relationship with you, Jonathan the individual.
40:13
Speaker 2: They know everything you like to buy because they have
40:16
Speaker 2: all your history of all the things that you bought
40:19
Speaker 2: on their marketplace, and now they start to personalize and
40:22
Speaker 2: tell you, hey, these might be some of the things
40:24
Speaker 2: that are elevan for you. A healthcare version of that is,
40:27
Speaker 2: if you have a direct relationship with every consumer, with
40:30
Speaker 2: every patient, with every family, you have a deep understanding
40:34
Speaker 2: from those three lights of the stool, their medical history,
40:36
Speaker 2: their personal preferences, and like what's happening, you know, outside
40:40
Speaker 2: of outside of the doctor's office. You can now start
40:44
Speaker 2: to really personalize like what is the right provider, the
40:47
Speaker 2: right diagnostic test, the right system you should be part
40:50
Speaker 2: of the right health plan. And so it's very much
40:55
Speaker 2: a marketplace type concept that we are eventually building to words,
41:00
Speaker 2: but not just for the data. The data is almost
41:02
Speaker 2: a currency that drives the personalization. Ultimately, it's to drive
41:06
Speaker 2: that personalized care experience that we're all looking for in healthcare.
41:10
Speaker 1: Well, do you do you have the capital right now
41:12
Speaker 1: to you know, deliver on that vision?
41:15
Speaker 2: Do you? You know?
41:16
Speaker 1: I think I mentioned it before or asked about it before,
41:19
Speaker 1: kind of the roadmap to the future. You know, what
41:21
Speaker 1: do you have to build to make that vision come
41:23
Speaker 1: to life?
41:25
Speaker 2: Yeah, no, it's a great question. So look, one is
41:28
Speaker 2: like we need to be able to scale, to be
41:32
Speaker 2: able to get that community intelligence layers as robust as possible.
41:38
Speaker 2: And so no, I don't think we can build a
41:40
Speaker 2: future of healthcare and forty four million dollars. I think
41:42
Speaker 2: we will definitely be you know, we will definitely require
41:46
Speaker 2: more investment over time. But I think the key thing
41:50
Speaker 2: of like what it is that we need to do,
41:52
Speaker 2: we first see to expand the number of communities that
41:54
Speaker 2: we have on the platforms are in twenty five today.
41:57
Speaker 2: We started an ultra rare because it is actually the
42:00
Speaker 2: hardest place to solve this because there is no data
42:03
Speaker 2: out there, there's no therapies out there, the patients are
42:05
Speaker 2: really hard to find, and we started to show really
42:09
Speaker 2: good success and traction there. Our next step is now
42:12
Speaker 2: moving to these rare adjacent conditions. I mentioned epilepsy as
42:15
Speaker 2: an example, but you know the statistic that always sticks
42:19
Speaker 2: out in my head, Jonathan, is we have a five
42:22
Speaker 2: trillion dollar healthcare ecosystem and everyone talks about that, but
42:27
Speaker 2: nobody talks about kind of the distribution curve of that cost.
42:32
Speaker 2: And the sickest one percent in this country account for
42:36
Speaker 2: twenty five percent of that spend. The sickest five percent
42:40
Speaker 2: in this country account for fifty percent of that spend.
42:43
Speaker 2: It's then ninety five percent account for the other fifty percent.
42:46
Speaker 2: So if you do the math on that, that means
42:48
Speaker 2: between three and a half and seventeen and a half
42:50
Speaker 2: million people are causing a result It results in two
42:55
Speaker 2: and a half trillion dollars of health care spend every year,
42:58
Speaker 2: and unfortunately that number keeps going up. That's where we're focused.
43:02
Speaker 2: So we want to focus on that five percent, on
43:04
Speaker 2: the people that are sick, the people that are trying
43:06
Speaker 2: to navigate the system, the people who frankly have their
43:09
Speaker 2: life on the line and need to be able to
43:11
Speaker 2: get to those better outcomes. We think that like getting
43:15
Speaker 2: to that seventeen million is the pathway to be able
43:18
Speaker 2: to do it. It doesn't have to be one of
43:22
Speaker 2: my colleagues describes as the worried well people like me
43:25
Speaker 2: wearing rings like this, you know steps. I think that's
43:30
Speaker 2: very important. I think preventative care, you know, is something
43:34
Speaker 2: we need to keep making progress on. But for us,
43:36
Speaker 2: it will be like moving from rare disease to these
43:39
Speaker 2: broaderwaar conditions and then to these chronic and complex conditions.
43:44
Speaker 2: And the biggest unlocked for us is building those communities
43:49
Speaker 2: as quickly as possible. We don't build our own foundation
43:52
Speaker 2: models today. The reason we think that we are so
43:57
Speaker 2: uniquely positioned because there's trillions of being spent by these
44:01
Speaker 2: labs and by others that that are developing incredible AI models,
44:06
Speaker 2: but they don't have that trust in relationship with these
44:09
Speaker 2: individual families. They don't have this level of deep context.
44:13
Speaker 2: And because we are we have so much context and
44:16
Speaker 2: data on every individual, the level of personalization that we
44:19
Speaker 2: can do only gets better with every new individual that
44:22
Speaker 2: comes on because that a community intelligence becomes becomes that
44:26
Speaker 2: much more robust. So all that to say, like it
44:30
Speaker 2: is all about increasing the number of communities that will
44:33
Speaker 2: require you know, more investment in terms of the different
44:36
Speaker 2: data models we have to build the needs that people
44:40
Speaker 2: have in other areas that may be different than some
44:43
Speaker 2: of the rare diseases we're focused in. And you know,
44:47
Speaker 2: over the next twelve months or so, we'll you know,
44:50
Speaker 2: continue to bring in more dollars into the company to
44:53
Speaker 2: be able to start to expand a lot more rapidly.
44:56
Speaker 1: That was very well said. You know, we've got a
44:58
Speaker 1: great vision of the future there. But maybe turning back
45:01
Speaker 1: to the past, if I think about your journey from
45:04
Speaker 1: the original Citizen to now, is this where you thought
45:07
Speaker 1: you'd wind up? Did you have this vision in your head,
45:11
Speaker 1: you know, starting in oncology and cancer that you would
45:14
Speaker 1: somehow maybe get the original company to this point you know.
45:18
Speaker 2: The original company, the vision behind that. It's funny you
45:23
Speaker 2: talked about a marketplace. So one thing to talk about
45:26
Speaker 2: from pretty much day one is why has every other
45:30
Speaker 2: industry kind of been transfer You know, everyone talks about
45:33
Speaker 2: technologies transformed, transformed every other industry and those technical advantages,
45:40
Speaker 2: excuse me, those technical advances have fundamentally changed the business
45:43
Speaker 2: models of all of the verticals, and that hasn't happened
45:47
Speaker 2: in healthcare. So we always talked about this marketplace concept
45:50
Speaker 2: that hey, look if you could, if you could somehow
45:53
Speaker 2: get to an endpoint where you have all of these
45:54
Speaker 2: individuals with all their data that that is so valuable
45:58
Speaker 2: in healthcare. They're walking around with that in their pocket,
46:01
Speaker 2: and now you could connect them to the ecosystem where
46:04
Speaker 2: they can use that data as a currency to be
46:06
Speaker 2: able to get care back. Because if you think about
46:10
Speaker 2: every other stakeholder and healthcare, they want access to this data.
46:13
Speaker 2: Pharma wants it for research, insurance wants it for you know,
46:16
Speaker 2: figure out risk. Providers want it to be able to
46:20
Speaker 2: provide better care, and you know, have an advantage in
46:23
Speaker 2: terms of delivering outcomes. We always talked about that. I
46:28
Speaker 2: think this idea of hey, the real unlocked to that
46:32
Speaker 2: is this advocate would sound so simple, and if you
46:36
Speaker 2: if anyone listening to those thinks about a personal experience
46:40
Speaker 2: they've had taken care of a loved one, they will
46:43
Speaker 2: realize it was their intervention. Actually that often results in
46:46
Speaker 2: like getting to the right test, getting to the right doctor,
46:49
Speaker 2: et cetera. That's something I didn't realize would be the
46:53
Speaker 2: unlock up front until I saw Nasha doing it day
46:56
Speaker 2: to day. I had to do it for my father
46:58
Speaker 2: in law. But I think this idea of and I
47:01
Speaker 2: think now with that unlock, that's sort of like, you know,
47:05
Speaker 2: a dreamy eyed vision of like, oh, there'll be a
47:07
Speaker 2: marketplace in healthcare one day, but now there's a very
47:10
Speaker 2: clear path we see to being able to get there.
47:13
Speaker 2: That's great.
47:13
Speaker 1: You know, we're coming up to the end of our time.
47:15
Speaker 1: And one of the ways I like to wrap up
47:17
Speaker 1: these conversations is to ask the guests about something in
47:20
Speaker 1: their personal or professional life that they see is maybe
47:22
Speaker 1: a great lesson or something that really drives them in
47:26
Speaker 1: terms of their mission for reed, What do you see
47:29
Speaker 1: that maybe would fit in that vein in your own life?
47:33
Speaker 2: You know, I'd probably pull it from the personal experience
47:35
Speaker 2: that I've shared with you.
47:37
Speaker 1: Of we did do a lot of with service to that.
47:41
Speaker 2: Yes, we talked about that a lot. But you know,
47:44
Speaker 2: the thing that I always try to orient around is
47:48
Speaker 2: the biggest thing that we can do is try to
47:50
Speaker 2: create a path. We can't always control the outcome, but
47:53
Speaker 2: how do you actually create a path that allows you
47:56
Speaker 2: to be able to achieve things that previously weren't possible.
48:00
Speaker 2: It's how I've thought about building companies in terms of
48:02
Speaker 2: I have no idea of the vision if what I'm
48:05
Speaker 2: thinking about is completely crazy, but I know I can
48:08
Speaker 2: create the path. I know I can bring the team together,
48:10
Speaker 2: I can bring the funding together, I could bring the
48:12
Speaker 2: idea together to be able to do it all the
48:15
Speaker 2: way through. Like the outcome from my father in law,
48:17
Speaker 2: I didn't know if the experimental treatment would work. But
48:20
Speaker 2: can you create a path that we at least have
48:22
Speaker 2: a shot. Can we at least do what it takes
48:24
Speaker 2: to be able to get to something that we can
48:27
Speaker 2: try and and you know, maybe maybe it will result
48:30
Speaker 2: in something that that that does work. And in our
48:32
Speaker 2: case it did. So that's that's a little bit the
48:35
Speaker 2: monthrow that I try to focus on because I think.
48:39
Speaker 2: I think when you're trying to do meaningful and ambitious
48:41
Speaker 2: things and when you want to change the world, you
48:45
Speaker 2: realize very quickly that a lot of what is needed
48:47
Speaker 2: for that to happen is not in your control. And
48:51
Speaker 2: so how can you stay really really focused on what
48:53
Speaker 2: is in your control to try to you know, create
48:56
Speaker 2: that path if you will, to have the best shot
48:58
Speaker 2: of achieving that outcome. And so that's what I tried
49:02
Speaker 2: to live in, live in my day to day, which
49:04
Speaker 2: is what can I do today, what can we do
49:07
Speaker 2: this week? And then slowly, you know, you look back
49:10
Speaker 2: through four five years later and you see you've chipped
49:12
Speaker 2: away and you're a lot closer where you want to
49:14
Speaker 2: get to.
49:15
Speaker 1: Yeah, it sure sounds like you manifested it, you know,
49:17
Speaker 1: not owing in your personal life, but your professional life
49:20
Speaker 1: as well.
49:20
Speaker 2: I think we've a lot more ambition to get to
49:23
Speaker 2: so so hopefully a lot more we'll be able to do.
49:25
Speaker 2: That's great.
49:26
Speaker 1: Thank you so much for sharing that story about your
49:28
Speaker 1: father in law and your family, and thanks for all
49:30
Speaker 1: the color you've given us about Citizen Health.
49:32
Speaker 2: I really enjoyed it. No, thank you, Jonathan really appreciated
49:35
Speaker 2: the time. Well. With that, will wrap up.
49:37
Speaker 1: That's for Reid Vish, CEO and co founder of Citizen Health.
49:41
Speaker 1: Thank you so much for joining us on our latest episode.
49:43
Speaker 1: Please make sure to click the follow button on your
49:45
Speaker 1: favorite podcast app or website so you never miss a
49:48
Speaker 1: discussion with the leaders in healthcare innovation. I'm Jonathan Palmer,
49:52
Speaker 1: and you've been listening to the Vanguards of Healthcare podcast
49:55
Speaker 1: by Bloomberg Intelligence. Until next time, take.
49:57
Speaker 3: Care uses as bases US and Moss bases