Latest / Zero Friction / Advancing Diabetes Care Through AI with Scott Hozebin || Zero Friction Podcast
Transcript
- Terry Coutsolioutsos-RevRx AI: Well, welcome to Zero Friction, a podcast which is designed to really understand where there's friction with regards to patient services and patient value as well as owners, founders, and commercial leaders that are designing these programs and are finding friction areas on in their own businesses and what they do to sort of work their way out of them. Today I've got a great guest, Scott Hoseman, who is the founder and CEO of DirectCare AI, which is really designed to take friction out of the patient pathway with regards to patients who are in need of diabetic care. So Scott, I'd love to have you kind of dig in a little bit and tell us a little bit about yourself and your personal journey and then how you know direct care actually came to be and what was the mission and the intent behind the company. Scott: Yeah, no, I'd love to. And thanks for having me, Terry. Appreciate the time. it's most fascinating topic, right? Is health care and you know, that's the formation of our company is, you know, direct care. Just it's in the name. You know, a little about me. It's you know, last 25 years been in bringing new to market medical originally pharmaceuticals and then medical technology and services, you know, started in pharmaceuticals. you know, had done four zero to billion dollar products over there, which I always find fascinating is how quickly pharmaceuticals can move. You know, then went into the medical device space with a company called DEXCOM, where they made continuous glucose monitors and, you know, is in the, you know, first 40 people employed there or so. And that was a long journey. You know, that took 10 years to make it to a billion dollars. So you could do you know, two years in a pharmaceutical company, you know, 10 years to get to a billion and, you know, a medical device. Terry Coutsolioutsos-RevRx AI: Yeah. Scott: you know, and during that time, really just super focused on patients with diabetes and and the challenges that they go through in the disconnected care process. You know, we were always thinking, well, why is it this difficult to get these continuous glucose monters? At first we're cash, then we've got insurance, but even with insurance Half the time it goes through a pharmacy channel, half the time it's going through the durable medical equipment. Patients don't know where it's going. Physicians don't. I work there and half the time I don't know. I've got to check a a spreadsheet to see where where it's supposed to go. So it seemed quite unfair that you have, you know, patients and physicians that are supposed to just innately know these types of things. And then, you know, there isn't as much help getting the you know, the device started once they get it. and then one of the bigger things to me that stuck out was okay, we made this device that's collecting twenty four seven data. Why isn't anybody using it to make proactive interventions to help people? You're getting this steady stream of data. And if you go to the best endocrinologist in the country, they might look at it for thirty seconds, couple of minutes every three months. So you have this waterfall of clinically meaningful data and it's barely being utilized. It's it's You know, patients are looking at it at some but clinically as the clinician side, not as often as you would like. And there's a series of codes for chronic care management, remote patient monitoring that came out and some companies that I was doing some consulting for were scaling in this and took over as chief commercial officer for there for a while and really identified some of the points of friction, as you mentioned, that was gonna keep them from scaling. You know, one of the benefits of being through these sort of always going from zero to to a billions is is, you know, not looking at what are you doing today, but how are you going to do 10, 100 exodus at scale. So, you know, needed some more institutional partnerships that we made to have more physicians, more payer contracts, more health coaches, more device ordering. So we could integrate a basically a intake team. a physician team, device ordering team and a health coaching team in one digically digitally connected environment so that a patient could talk to, you know, one entry point and make it all the way through. Terry Coutsolioutsos-RevRx AI: You know, what a concept creating a patient centric concept so that they can, you know, whether it's at the beginning of their journey or during their journey or at the end of their journey with your particular product or service, that you've got that fully scoped and landscaped around them where especially I'm sure with some of your patients that are elderly, maybe not technologically advanced and, you know, are challenged with, you know, kind of putting points A and B together sometimes, having that ecosystem is probably very supportive for them. Scott: Yeah, a hundred percent. I mean the majority and and we have multiple areas that, you know, we're our our goal is to bring as much care as direct as possible to the patients. You know, I I talk a lot about the diabetes side. and those patients are it's they're I'd say our average patient is probably seventy five years old. You have really one clear connection pathway, which is the phone. You know, they don't work well with You know, you're often talking with technologists and they say, Well, it'll be easy. Someone'll hit a QR code and then they'll tap in this widget and and that's you know, isn't gonna work at all. I it's difficult even for them to click a text link sometimes. So we we do a lot of hand holding that's to get them through the process. It I would say the number one call is they they'll there's a lost password on say their CGM app and it might be a forty minute call just to help them recover a password. And that's where, you know, in the system, the physicians don't have the bandwidth to do it. There's not enough margins for the the DME providers and the manufacturers. So it's really nice to be able to offer sort of that gap and longitudinal care between the visits and the provision of the device. Terry Coutsolioutsos-RevRx AI: If those things aren't done, the care's probably not getting delivered the right way either. So that's the you know, that's the you know, Scott: Yeah. Terry Coutsolioutsos-RevRx AI: we make all these advancements in health care and healthcare delivery and you know, at home health and telehealth and virtual health. And if we can't deliver the health, it really doesn't doesn't matter. We have to figure out on the other side what are those easy buttons that those patients need to have. So So what have you done to sort of make the easy button for these I mean is it basically it's fingers and toes and get on the phone and talking with people? Is that is that pro your problem? Scott: Yeah, yeah. So I mean just like you're saying, I mean, there's you know, we we use AI and a lot of technology in the back end to make because I think that's one of the challenges in healthcare, right? Is all these disparate systems. you know, we we don't have some one national interconnected database where everything flows, right? So, you know, on the digitally on the back end we've we've had to make customized intake forms that, you know, through series of tags and triggers go to our data warehouse and then That feeds the EHR and populates that so that the physicians don't have to go and map data over. So everything is pre-mapped for them. It automatically carries that information into a remote patient monitoring software platform. And then that data goes into a device ordering platform. So all of that stuff is happening, you know, on the technology side. But when it comes to patient contact, there's a human that gets on the phone. We we use we do have a You know, AI voice agents as well that would you can use, but for for ninety percent of the conversations, it you know, it's like you said, someone's getting on the phone and they're calling the patient. And they're calling a lot of times. Like those are, you know, areas where you someone might use AI and and you know, identifying when that patient tends to pick up more often than others to call during that time. you know, calling multiple if you know. Yeah, there's a lot of technology around the dialing system to to make it more efficient. That's where I I think it's it's not extremely there's so much technology just to get a hold of people, it seems unfair that any normal brick and mortar prox practice could could institute these types of things. Terry Coutsolioutsos-RevRx AI: You know, it's funny you just brought up the whole calling syndrome is like there's there's a lot of people I was just listening to a guy, his name's Jeb Blunt, he's a big like sales guru, prospecting guy, and he's actually talking about how AI and the call the outbound calling systems today that people are sooner or later just not gonna pick up the phone anymore. because there's just so much outbound calling getting done. They just look at it, they know it's a robo call or some kind of AI call and nobody's gonna use the phone anymore and then we're gonna be stuck with now what do we do? Right? especially with the patients in that that seeing your demographic that are, you know, probably 70, 75 years of age, they're they're not quite equipped to handle the the mobile aspects of the technology. You're using people that are engaging them every day, you know, by calling and having that voice what live interaction, which is so supportive. hopefully that doesn't you know, hopefully AI doesn't burn that bridge for you when people aren't picking the phone up anymore. Scott: Yeah, it's it's interesting. I'm on a like a national council for aging that we're we've been working through guidelines on aging in place and we were were talking about something similar the other day and how the age group and the medium that you're contacting them matters a lot, you know. So I think you know, f even now it's already burned. You know, for so if the I the chances of someone just calling me and me picking up a an unknown number is zero. I've never it's probably ten years since I've picked up a phone number that isn't already pre-programmed. Terry Coutsolioutsos-RevRx AI: Right. Scott: where the seniors they're they're better at that, right? They're the you know, the text messages are more difficult. They're they're skeptical of them. It's not a human voice. so it's interesting. And I'm and I'm, you know, 51. So it's you know, I'll be the senior soon. So I think with you know, with with my demographic, you know, Gen X. I think you know, it'll maybe you you'll end up with more text messaging 'cause and they'll c screen that way. just because of what you're saying with all the robocalling and all of those types of things, you know. Terry Coutsolioutsos-RevRx AI: Just yeah, it's just really interesting how everything kinda shifts and you know, going back to the whole sales call thing again, I don't you know, just that's who I deal with most of the time, but They actually said if you know, if you're ever a prospector and ever knocked on doors, and you know, my first job was I used to knock on physician door selling like lab testing in Chicago, like door after door after door, and half the battle was just getting in the door. And Scott: Yep. Terry Coutsolioutsos-RevRx AI: what Jeb Blunt was saying, it's amazing now that like when you start knocking on doors and you walk into offices today, they welcome you in. They're actually starving for the human connection. So there's a part of what you're doing that I think is really nailing it on the head is that you're blending technology on the backside. It creates efficiencies and scaly and scalability operationally, but you're still focused on the human side on the front face of the company. And I think that's gonna really go a long way. And that's just where I think everything has been, is that it's all AI, it's all artificial, it's all virtual, and people are starving for human connection, and it sounds like you're providing that in a really valuable, meaningful way. Scott: Yeah, no, no, and I like again, I think it's different demographics crave different things. So I we you know, if you look at our, you know, cash pay offerings where we we do other sort of chronic conditions, testosterone replacement therapy, hormone replacement therapy, E D, hair loss, you know, that those demographics are younger and those folks want it they wanna do a a a text based intake form. Take my credit card and just you know, you know, like for testosterone replacement, they still they they go, they get blood labs it with a human. Obviously we we don't you know, humans gotta take the blood lab, but and then they do a you know, a face to face with Yeah. Yeah, the casso. Terry Coutsolioutsos-RevRx AI: But they got these things now they're delivered to your house, you put on your shoulder and and you drop it back in an envelope and then you send it back again. So I mean there's actually, you know, there's a non human aspect to that as well these days. It's crazy. Scott: Hundred percent. Yeah, we use the Tasso devices for you know, folks that are more than fifty miles away from a blood lab 'cause you're still, you know, those work for for at least for testosterone, there's certain labs that it d it doesn't pull as accurate as we'd love. So it's you we sort of reserve it for after you know, if there's there's there isn't 'cause we do have, you know, folks that are live remotely. but like you said, it's it's amazing. Every aspect is getting turned into a remote possibility. Terry Coutsolioutsos-RevRx AI: Well, it's just it's just funny where the world the world's going and you know, with the millennial age group demographic becoming a bigger part of that purchasing population, you know, they're the biggest fan of the asynchronous relationship of anybody. I mean they're they're you know, they don't want any humans involved in anything. And so, you know, you'll see more of that I think happening over time that You know, and we'll we'll just have to be careful with it because there are parts of our healthcare system that still need people to engage. Scott: Yeah. No, I I I mean our theory and premise, I mean the the long term vision, I I truly believe within ten years, AI will be prescribing, say, eighty percent of the low level conditions. I I don't think it's really necessary when someone has, you know, the cold and you know, do they need a five hundred dollar visit to get the same you know, Tesselon pearls and nasal spray that they give every person that comes in with the same. I I don't e even then I I think people have you know a right like people talk about rights. I mean if there is we we have an ability it's it's not even in the future. You could do it now. It's really we're held back from legislation. But you know, for a lot of low level conditions, if someone even says it it is crazy to me that someone has a right to go get alcohol or marijuana or any of these other things that we we say have no negative effects, but I can't go get high blood pressure medicine like an ARB. You know, I I think someone, you know, there should be that's where I think there's that safety level that comes in with AI that, you know, downstream could it be, you know, for some low level conditions, you know, a five dollar encounter that someone could get health care versus there's a lot of folks that are avoiding health care at this point. You know, so when it comes to safety, you know, when you're blocking care, how many people that aren't getting care are getting hurt from not doing anything? Terry Coutsolioutsos-RevRx AI: Well, or just, you know, and again you think about like our healthcare economy today where it used to be, you know, you and I grew up in a corporate environment and we were, you know, we had great healthcare plans that cost us, you know, very little percentage of our salary, right? Out of pocket. And then, you know, over time, you know, our coverage ever since like the mid-90s and legislation and Obamacare and all that stuff, all of sudden like deductibles went up and care levels went down and the gap, you know, that you're writing a check for in the middle of all that became bigger and bigger and bigger. And then today's environment, you have these kids and they have these, you know, low, low premium plans with you know an eight or nine thousand dollar deductible. So you're every time pretty much you're going to the doctor, you're you're stroking a check for two, three, four, five hundred dollars. And now you have, you know, systems like DirectPay AI that you know can give you a very, you know, a great result for a fraction of the cost and a fraction of the time and a fraction of the you know resistance to go get things done and waiting weeks for appointment. And I think that's where the whole thing is really changing. And I think you're spot on in how you're positioning care, where it's you're making it easy, you're making it affordable, and you're providing a high level of service. So, and then the other part is I just was on watching TV the other night and it made my head snap. I was listening to an advertisement where you could actually buy an urgent care box that actually had pharmaceuticals in it. Like so you don't even need a prescription anymore. Like you literally it's like a telehealth kind of survey, I'm sure, but you literally get an urgent care box for your home that has, you know, basic, you know, low grade pharmaceuticals for colds and things like that. So it's the world's coming. I mean, what you just mentioned, there's ways to go do that already, which is kind of crazy. And Scott: Yeah, no, I it's in it's i it's it's interesting. I've seen that, you know, and I I you know, but that's where you'll you will have this evolution, right? You know, because in the same you could have you'll have two sides of the coin. You're gonna have someone that's gonna go and someone's will get in trouble for that and someone else will lobby to say, Hey, someone has a right for that. You know, where is the the line? I mean, that's for, you know, policymakers to decide. But they're I to to say that there is no valid argument on both sides is you know, is crazy. Terry Coutsolioutsos-RevRx AI: So what what what does the service look like today? you know, what are the service offerings and what what what lanes are you trying to fill and then where's direct care AI going tomorrow? And tell me a little bit about what the future of that looks like. Scott: Yeah, so you know we went live in November. We've helped about seven thousand folks, you know, obtain their CGM and coordinate them with distributors that work with their payers. We keep you know, twelve hundred of those patients are in our chronic care management program where we do continuous following and help them with their if their alerts are high, low and you know, care coordination. Then we We've just recently launched all of our cash pay offerings. You know, so all of that focus was in in our insurance based programs. And that's, you know, largely because it's the 20 year passion of of, you know, trying to solve this one problem, right? How do I I I it seems crazy to me that people with have diabetes and it's this hard to get their continuous glucose monitor. I still, you know, struggle to comprehend how it could be twenty five years out and only twenty percent of the folks that have take insulin are qualified for getting a C Gm with their insurance or using a C GM in something that reduces ER visits by forty to eighty percent. You know, I mean it seems the the outcomes are so pronounced, you know, with with these Terry Coutsolioutsos-RevRx AI: Yeah. Scott: C GMs, it's just it's gotta be where everybody's on one. Terry Coutsolioutsos-RevRx AI: So why why is it so hard to get it from twenty percent? Like to me that would be something that you know, the twenty percent would be the number that would be on the other side of the equation where you know Scott: Yeah. I y you know, I've and not to go off on a a side tangent, but I'll give you the the numbers. It's you know, so even what I find interesting in working with durable medical equipment companies, fifty percent of the people that contact them an from an advertisement saying I'd like to get a continuous glucose monitor and that DME reaches out to their their clinician, only fifty percent of the time does the clinician ever even write back the prescription because they don't get paid. to to go and write a script. They don't get paid to write a what what they call an SWO or you know, think of it like the DME script. a lot of them aren't aware of what it is, so they go, I'm not dealing with that. So you have something that's you're just showing someone their blood sugar numbers and half the people just say, I'm not giving you that. No, doesn't doesn't it's crazy. So then of of those 50%, 10% of the patients that get the order, Get the order and then never order it the second time because no one helped them get it started. So they send all these elderly people, these devices, and say, Good luck, hit the QR code, watch a YouTube video, and you'll be fine. Well, it doesn't exactly fly right for everyone. So then you have another third of those patients by the end of the first year, if they're on Medicare, will fall off of their continuous glucose monitor by the end of the year because no one's there to hold their hand when. They don't know where to order from. They don't know how to restart a sensor. They lost, you know, something. And you know, there's no longitudinal support for the device. It's really watch a YouTube video, ask someone for help. It's really minimal. So that's where you know, I've been just really focused on and we'll stay focused on on that. but as we, you know, go in and and a lot of the other popular offerings, because it's it's honestly like they're There's sort of subpassions. It's I don't know if you've seen in the news, it's it's almost like a in a conspiracy movie. The the government has come out and said, Hey, I know for 20 years we said testosterone therapy is really dangerous and bad and it causes all these cardiovascular effects. Well, we misinterpreted Terry Coutsolioutsos-RevRx AI: Yeah. Scott: the study. And especially Terry Coutsolioutsos-RevRx AI: Yeah. Scott: in women and and in men, it doesn't cause all these cardiovascular effects that we're saying. This was misinterpreted. So you have and then estrogen, they come out with a whole nother press release. Hey, this the study was misinterpreted. So so from a hormone perspective, it's fascinating to me to have and in generations of people that have been basically withheld a medication that we now find out is wildly beneficial. I mean, I don't know if you saw in like women the The reduction in like UTIs for women taking i estrogen is massive. you know, so it's Terry Coutsolioutsos-RevRx AI: it's crazy. Yeah. I mean the biohacking industry is like a hundred billion dollar business in the US, whether it's you know, prescribed or unprescribed supplements, whether it's peptides or hormone therapy or GLPs, any of the kind of that biohacking stuff, that's a hundred billion dollars a year business just in the US. Scott: Huge. And it's probably a fraction of what it should be, right? I mean, it's there's so many people that I think we're, you know, we we're moving away from this concept of like only if necessary, you know, like, you know, you only deserve anything that's going to keep you from dying, too. Hey, maybe people can take things that make them feel well and and you know, improve their quality of life. And I I I think that's a a really neat evolution. to support it wholly. I mean it's so we you Terry Coutsolioutsos-RevRx AI: Yeah. Scott: know we have the you know hormone replacement therapy for women, testosterone replacement therapy for men, E D, hair loss. we have all if you wanted to do your own blood labs, you can go on there and and do, you know, request panels and then we have doctors that interpret those panels so we don't have Terry Coutsolioutsos-RevRx AI: Awesome. Scott: to wait. We have We have like a pharmacy discount card. So if you do get a prescription from a traditional physician or us and you go to C V S, you can check it actually checks nine different programs and finds the lowest cash pay price. Yeah. Terry Coutsolioutsos-RevRx AI: How cool is that? Like I'll have to definitely like tap into that myself, just personally. That's just something that, you know, Scott: It's easy. You know, and you know the goal is to map, you know, in long-term vision, like you say this, you know, we we've just been approved for insurance, you know, and we're we have some agents coming on for that. You know, the goal is can we map as as many healthcare offerings in one place and then unite that with a social application? So we have an app in the app stores where you can ask a health question and the AI gives you an instant answer, and then other folks can put in their two cents. and then it connects to our what you'd call like the health store, your website for the different offerings. Terry Coutsolioutsos-RevRx AI: That's really cool. Like AI and, you know, getting medical insights from AI is really and I've used a couple platforms that myself just 'cause I'm I connect with Hume, I connect with my garment, I like every day, I'm, you know, t total body analysis and and it's really interesting. And I connect with this other thing called Sava. And what I've been actually really finding what's really interesting, Gemini for those people out there is a really interesting, very positive AI, motivating, uplifting kind of AI when it comes to your health. So I've just kind of discovered that in the last couple weeks. Like what I'm eating. And and I've really found that like Gemini really kind of gets into this inspirational kind of mode. when saying, Man, that's a great day. for you and you really did well with your calorie burn and your diet was fabulous today and you can afford you know an extra scoop of berries and your dessert so it's just really kind of an interesting thing how the whole world is moving around AI and and medical insights and medical care and it's becoming real world everyday stuff and like direct pay AI is going to be right in the middle of all that. That's that's an exciting place to be. Scott: Yeah. I think i you know, Gemini, I don't if you saw there was a really interesting paper around analysis of like rating frontier models versus specialized models. So like Gemini versus like open evidence. And Gemini actu performed extremely well. It actually outperformed open evidence in in like health questions. You know, there's areas so it's it's opened up a lot of interest, I think. You know, even on the using these frontier models and medical applications. Terry Coutsolioutsos-RevRx AI: But e but even beyond the informational part, I would just tell you the way they deliver the info is very inspirational and positive. Like it's a very like it's a cool energy that it's delivering, not just great insights and great info, but the energy that it brings it, it's not like any other AI that I've worked with. And I work with a lot of AI models in my business every day. And I've just found Gemini to be a really superior personal coach with my health. It's really been kind of kind of a fun experience in the last couple of weeks working with it. Scott: Yeah, no, I I think it's amazing. I I I personally I use Chat GBT with I you know, I have one of the scales that with the bio impedance Terry Coutsolioutsos-RevRx AI: Yeah. Scott: that checks and it tracks all my metrics and I load that in and say, Okay, like, you know, where are we? I'm trying to get to you know, yeah, Terry Coutsolioutsos-RevRx AI: X Y Z, right? Yeah. Scott: you know, I I wanna be, you know, ten percent. I'm at fourteen percent body fat. What do I do? And to you know, lose no muscle and you have this sort of conversation, I I mean It's it's really fascinating. I mean it's that was one of the genesis of even creating a basic health question interface was you know, I found it's nearly I think it's like eight percent. There's a hundred and twenty million health questions a day asked online in the United States. Terry Coutsolioutsos-RevRx AI: Crazy. Scott: I think it's eight percent of chat GPT's traffic. None of them actually connect to to care. So we have this this organic existing behavior that shows Terry Coutsolioutsos-RevRx AI: With it with the with the with a dead end. Scott: Yeah, with a dead end. So it's like, you know, long long term goal of the company is can I connect, you know, the Terry Coutsolioutsos-RevRx AI: Yeah. Scott: two things together? Can I connect this user behavior asking questions online to then be able to give you know some sort of care that that leads to if if they're interested. Terry Coutsolioutsos-RevRx AI: So tell us that, you know, you've had a great journey building a unique business model. What have been some of the biggest challenges for you bringing direct pay AI to market and like what's been sort of, you know, it's growing great and it looks like you got a really solid foundation, but what's been some of the challenges, you know, for you? Scott: Yeah. Yeah, with direct care AI, I would say, you know, c you have a lot of things. I I'll walk through you know, i from beginning to end. You know, initially anytime you're trying to connect disparate systems, one if you're doing it on a small and you're working with small partners, you can move fast. Now you're working with large hundred million plus dollar a year companies and you want to partner. you know, it takes a really long time. So that's where I think, you know, we we had a major advantage because I'm very fortunate for a very strong ecosystem of of leaders to reach out to. I mean, there were contracts that would have taken a year that took a month because it's but even then it's it's long, you know, because you can make the contract in a month and then it goes to legal team, their legal team, my legal team. Nothing's ever fast when it's going over to the legal teams. so those you know that's one whole piece, right? You're going to multiple companies making contracts, you get the contracts, and now you've got a you've got someone hand you APIs. So, you know, that's your that's your doorway to connect my digital environment to your digital environment. And now you the development team has to go in place. So you've got you know, creating you know, I I I say everything nowadays runs on contracts and APIs and you know connecting that is is really complicated. Yeah, yeah. I mean Terry Coutsolioutsos-RevRx AI: That's pretty scary, by the way. Scott: it's you know, on the positive, I think you can be really innovative in healthcare. There's Lego blocks, they're all out there, but to assemble them, it's contracts and APIs. And putting that together, okay, that's step one. Now getting it to work properly from and and every every new connection adds a new possible failure. So when you're taking A and B, and now you add C, something new could go wrong with the connection from A to B. So you know, going and then testing those things, and now you've got A, B, C, D, and E and F. You know, so we've got every one of those is a new connection, new contract. new testing environment. So, you know, I would say that is one of the most complicated things. I you know, hands down. Terry Coutsolioutsos-RevRx AI: You know, your business being dependent upon attorneys and data architecture. That's a pretty scary framework, right? Scott: Yeah. And I I'd say from there you're and now you're asking entities that operate in a certain way, you know, which is another difficulty. When if you're trying to create anything new, there's friction, right? You're asking, you know, sort of conveyor belts or companies that operate in one specific way to make a slight shift here and a slight shift here because you're leveraging their large ecosystem to do good and At the end of the day, their ecosystem is larger and doing something else. So now you have to get and and you're trying to get process improvements and you know different standards that are important to us that you know, like we we like to focus a lot on NCQA standards, HEDIS ratings, and things like that. so now you're trying to incorporate new frameworks into these large entities as a small entity. you know, making any kind of shift is very hard. And then you have, you know, outside of that, it's y you have you're do any shift in healthcare is extremely difficult for people to understand it, what's going on. you know, so the i every every point of anything new is is its own friction point. Terry Coutsolioutsos-RevRx AI: Friction and inertia and and you know, you're bringing change and that that always takes, you know must have a lot of great change leadership on your team in terms of being able to implement all these things and build systems around it because that's that's the name of the game, what you just described there, which is all change and transformation and coming in into somebody else's ecosystem and just shifting just a little bit man can just throw the whole balance off of their practice, right? Scott: Yeah, I mean it's you could have well you say you could have the cure for death and it would take you five years to get it implemented in any healthcare system. It's you know, it's very difficult to change the conveyor belt, you know. So you have to you know, one, have thick skin because you you know, you get a lot of nose and you have to be comfortable making people feel uncomfortable by showing them a better way and and sort of being firm in that, you know, that's And and any new medication, any new device, it's it's really saying like, hey, this is what's best for patients. Let's you know, going back to standards and reasons and you know, and finding what's what's everybody's motivator, because everybody has different motivators in the system and navigating that's y you know, its own learning. Terry Coutsolioutsos-RevRx AI: Well, that's a big job. I mean, and like I said, you must have a lot of people really skilled at that because that's a you know, I don't know how many practices you've I I forget the original conversation, how many practices and partnerships you've incorporated into your business, that's gotta be a big part of what you do every day. Scott: Yeah, I mean we we've mostly focused now on the direct to consumer. You know, we work with some physician groups that have an interest in just referring patients because they're quite honestly overburdened. And in endocrinology, they're they're really you know, it's it's its own tangent for me. You know, it's they're overburned. It's not fair. They don't they don't get good compensation. Endos make less than primary care. They're havis and they're a specialty. You have yeah, they Terry Coutsolioutsos-RevRx AI: Really? Wow. It's crazy. Scott: Yeah, there's thirty million patients with diabetes, five thousand practicing endos. Most endos have, you know, a thousand, maybe two thousand people. So, you know, you're short. You know, each endo would need to have four or five thousand more patients per practice to even remotely have everyone go to them. and then imagine you're you're making less money than a primary care doctor. It's really it's Terry Coutsolioutsos-RevRx AI: Right. Scott: and they're much more complex diseases and and visits. So, you know, they they need help, you know, they so you know, if we can then go prescribe the continuous glucose monitor, help the person get started, deal with the paperwork, the insurance, the device, you know, you know durable medical equipment companies, you know, it takes a lot of burden off of some of those folks. So they'll where they'll refer directly to us. Terry Coutsolioutsos-RevRx AI: So you're taking friction away from a lot of the ecosystem, not just the patient. So you're you're removing friction from the patient, you're removing friction from endocrinology, you're removing friction for your DME companies. I mean, you're really kind of elevating a lot of, you know, smooth and efficiency for these other these other elements. And and you're finding a way where it fits into your business model really well, correct? Scott: Exactly. I mean that's the at the end of the day, right? There's no margin, there's no mission. So you can can you do these things? I think that's one of the the major problems in most healthcare discussions is is people come up with all the what we should do without thinking of the reimbursement environments, you know, because they're the margins are extremely thin. I I think all of healthcare you know, even you know, I I people like to beat up on the insurance company, but you You know, they're they're operating at you'll see seven percent margins and no one you know, and they're an evil guy, the doc no one's supposed to make money in healthcare, yet you can have Microsoft with seventy percent margins and no one cares. It's fine, you know, and so it's for some reason everyone is is you know, is working really hard and there really aren't giant margins. There there are in certain specialties for sure, but in general, You know, especially with support and support for the elderly, it you you have to have a passion for it. There's no honestly no business reason if you're just about the money, it doesn't make sense. You should go help go sell hats on Shopify because it's it's very hard to work with with elderly patients with complicated diseases and very slim margins. Terry Coutsolioutsos-RevRx AI: Well good stuff Scott. what's this kind of closing up thing, you wanna leave any closing thoughts for the the program and the audience a little bit? Scott: No. you know, I'm h happy to talk to you, happy to talk through all these things and appreciate what you're doing and looking through all of the different areas of friction throughout healthcare. I think that's, you know, everything that we're we're trying to do, right, is is map as many healthcare offerings in one place so that it's as convenient as direct as possible. I mean, that's the name of the, you know, direct care AI. So we wanna use AI over Terry Coutsolioutsos-RevRx AI: Direct Air AI Scott: time. I think you're gonna see over the next five, ten years where there's just a lot of places where AI is gonna make much more efficient healthcare. Terry Coutsolioutsos-RevRx AI: Well, and gotta have a model that can deliver it too. So AI is gonna support it and put build infrastructure around it, but it takes the innovation of commercial leaders like yourself and having direct care AI be at the forefront of, you know, where people are and again, I think your model plays very well in today's marketplace where people are they're choosing lower insurance premiums because they see little value in the insurance policy other than the catastrophic. And then everything left in the middle is with your credit card and your wallet, right? And and you're and you're building yourself and your infrastructure around that, which is amazing. So congratulations to you and the team and appreciate everything you do. Thank you, Scott. Scott: Thank you. Thanks,