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Innovaccer’s Bet on the Data Layer Powering Autonomous Healthcare · Vanguards of Healthcare by Bloomberg Intelligence

0:21
Speaker 1: Welcome to another episode of Bloomberg Intelligences Vanguards of Healthcare podcast,
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Speaker 1: where we speak with the leaders at the forefront of
0:27
Speaker 1: change in the healthcare industry. My name is Jonathan Palmer,
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Speaker 1: and I'm a healthcare analyst at Bloomberg Intelligence, the in
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Speaker 1: house research arm of Bloomberg. I'm super excited to welcome
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Speaker 1: Abanov Shshank, the co founder and CEO of an innovasor,
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Speaker 1: to the program today. Over the past decade, Innovator has
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Speaker 1: grown from a healthcare data startup into one of the
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Speaker 1: industry's most influential AI companies, and today, as healthcare organizations
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Speaker 1: are racing to adopt AI, Innovator's mission feels more relevant
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Speaker 1: than ever. I'm hoping in our conversation today, we'll discuss
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Speaker 1: the evolution of healthcare data infrastructure, what's reality versus hype
1:04
Speaker 1: in the world of AI, and why Abanav believes the
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Speaker 1: industry is moving towards what he calls autonomous healthcare.
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Speaker 2: Welcome to the program, Mamina, thank you so much for
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Speaker 2: having us.
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Speaker 1: Johnson, why don't we start off and rewind a little
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Speaker 1: bit to the origin story of innovasor what convinced you
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Speaker 1: that the healthcare data problem was something that you wanted
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Speaker 1: to dedicate I don't know, a data a decade past
1:26
Speaker 1: now of your wife to solving.
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Speaker 2: Yeah. So we started the company in twenty fourteen, and
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Speaker 2: it was not really a healthcare company. Like. Our core
1:37
Speaker 2: thesis with which we started was the fact that the
1:40
Speaker 2: production of data and information that is happening right now
1:45
Speaker 2: is just going to multiply massively. And you've seen that
1:48
Speaker 2: happen over a period of time that the number of devices,
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Speaker 2: the number of things that are producing information about business,
1:57
Speaker 2: about process, about what our interactions are, etc. All of
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Speaker 2: that is becoming digital. And therefore there is this explosion
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Speaker 2: of data and information on the digital realm quite meaningfully.
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Speaker 2: And if that's going to be the case, the ability
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Speaker 2: of organizations to really manage that data well is probably
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Speaker 2: the most fundamental attribute that would define whether they are
2:22
Speaker 2: going to be successful over the long term or not.
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Speaker 2: And so that was the simple thesis with which we
2:27
Speaker 2: started off the company. We were twenty four We thought like,
2:29
Speaker 2: I think like this is a problem that we would
2:32
Speaker 2: solve for the all industries globally. We had Disney Waters
2:38
Speaker 2: towards NASA, a bunch of I think like customers initially
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Speaker 2: which had nothing to do with healthcare, frankly, and as
2:46
Speaker 2: we worked through a lot of them, we had one
2:49
Speaker 2: of our customers in Iowa, which was a joint venture
2:54
Speaker 2: between Catholic Health Initiatives and Trinity Healthcare that was trying
2:59
Speaker 2: to solve the same problem in healthcare. How do you
3:03
Speaker 2: look at the distributed, fragmented information pieces in health bring
3:08
Speaker 2: that together so that you can understand who the patient
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Speaker 2: is that we are caring for, not as a transaction
3:15
Speaker 2: of care, but as someone who is responsible for making
3:19
Speaker 2: the person healthy. And this was like a very interesting
3:22
Speaker 2: and exciting problem to effectively solve for us, and we
3:26
Speaker 2: thought we could solve it in twenty percent of our time.
3:29
Speaker 2: But as we started going deeper into this problem, we
3:34
Speaker 2: realized this is much much larger than what we thought initially,
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Speaker 2: and there was no way like we could be focused
3:43
Speaker 2: on just like health care, like in twenty percent of
3:47
Speaker 2: our time and really go anywhere. And so we shut
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Speaker 2: down basically like ninety percent of our business and in
3:53
Speaker 2: twenty seventeen decided that we are going to go focus
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Speaker 2: and solve this problem of creating an information in front
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Speaker 2: structure for healthcare organizations to build upon what the future
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Speaker 2: of healthcare basically looks like, and decided that we are
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Speaker 2: going to go do that like for the next like
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Speaker 2: ten to fifteen, twenty years, however long it takes.
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Speaker 1: Well, so you know, I think it's taken a while,
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Speaker 1: and there's still a lot of progress to be made.
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Speaker 1: I mean, if you think about the evolution of the company,
4:21
Speaker 1: what have been some of the key milestones in the
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Speaker 1: last decade plus since you started.
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Speaker 2: I think if you look at broadly the problems that
4:29
Speaker 2: we face in healthcare, especially in the United States, like
4:32
Speaker 2: I think, and more globally as well, but more so
4:35
Speaker 2: in the United States, it's the fact that we created
4:38
Speaker 2: these systems of records that are siloing the information across
4:45
Speaker 2: various ex systems. And so what is a resultant of
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Speaker 2: that that all of the process now needs to get
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Speaker 2: run between five processes. The payers are using different processes
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Speaker 2: and systems, the providers are using different systems, And if
5:00
Speaker 2: you really go to the depth of it, like what
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Speaker 2: you understand is that a lot of the process construction
5:05
Speaker 2: that has happened today is generally because of the fact
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Speaker 2: that information is siloed, Like all of the revenue cycle processes,
5:13
Speaker 2: all of the claim processing like processes. These are all
5:16
Speaker 2: simple information exchanges from point A to point b. But
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Speaker 2: we spend like more than a trillion dollars today, like
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Speaker 2: I think, like in the United States, just solving that
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Speaker 2: information exchange from point a to point b. There is
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Speaker 2: not an industry that is more inefficient in information exchange
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Speaker 2: than healthcare. Right, So that was the starting point thesis
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Speaker 2: that we started with that healthcare does not really have
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Speaker 2: an intent problem. It does not have a data like
5:48
Speaker 2: fundamental data problem, because we are producing like I think,
5:51
Speaker 2: like more data than we have ever done. What it
5:54
Speaker 2: has is basically what was the Internet problem, that data
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Speaker 2: from point A cannot really get transferred to point B
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Speaker 2: to really drive processes better. And because of that, like
6:05
Speaker 2: we spend like I think, like trillions of dollars just
6:08
Speaker 2: with administrative complexity and all of these challenges that we
6:14
Speaker 2: see like scheduling is hard, your payment processes are hard,
6:18
Speaker 2: like getting to really know like what you paid for
6:21
Speaker 2: versus not what is happening, where do you go for
6:24
Speaker 2: a referral? All of these are basically interconnectedness problems that
6:28
Speaker 2: are being established because so much of the data is
6:31
Speaker 2: effectively fragmented and not connected.
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Speaker 1: So the interoperability problem is I guess the overarching one
6:38
Speaker 1: that you saw at the time. You know, where did
6:41
Speaker 1: you come in with your solutions initially and how those evolved,
6:45
Speaker 1: you know, to where we are today and you know,
6:47
Speaker 1: mid twenty twenty six.
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Speaker 2: Yeah, So I think like where we started with was
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Speaker 2: the fact that you have to create our initial thesis
6:56
Speaker 2: with no one was ready to sort of rebelieve it,
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Speaker 2: like at that point was effectively the fact that you
7:02
Speaker 2: need to separate out the data layer from your record
7:06
Speaker 2: that you can basically like I think, like create records
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Speaker 2: in twenty different systems, but having a different information structure
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Speaker 2: and a different like data layer will allow you to
7:16
Speaker 2: really deliver innovation much much faster. And we'll also basically
7:20
Speaker 2: layering like create this infrastructure that allows interoperability but also
7:27
Speaker 2: allows like like better care coordination, allows better revenue cycle,
7:30
Speaker 2: all of these sort of like things. So initially, when
7:33
Speaker 2: we went to customers, they were like, Okay, like this
7:35
Speaker 2: seems like another technology company wanting to sell us something
7:39
Speaker 2: and this really doesn't isn't going to have like a
7:42
Speaker 2: thing like any impact. But then suddenly, like I think,
7:46
Speaker 2: like what started happening was that the government started pushing
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Speaker 2: for value based care much more strongly. And now, if
7:52
Speaker 2: you think about value based care, in which you get
7:55
Speaker 2: paid to manage the overall health of a patient for
7:59
Speaker 2: the first time, there is requirement in the payment infrastructure
8:03
Speaker 2: for you to really go and look at the entire
8:06
Speaker 2: history of the patient. And as soon as you need
8:08
Speaker 2: to do that, you realize that, like I think like,
8:11
Speaker 2: one system actually does not have the entire history of
8:13
Speaker 2: the patient, Like your core EHR really has like some
8:16
Speaker 2: parts of it. Your claim systems have like another part
8:19
Speaker 2: of it. Adit feeds lab systems, imaging systems. And therefore,
8:25
Speaker 2: unless you connect all of these things, you will never
8:28
Speaker 2: get a viewpoint of who your patient is. And if
8:30
Speaker 2: you don't have a viewpoint of who your patient is
8:32
Speaker 2: or who your customer is, in any industry, there is
8:35
Speaker 2: no way you're going to drive like better outcomes. And
8:38
Speaker 2: so therefore this payment model shift towards paying for outcomes
8:43
Speaker 2: inherently is going to drive a net new architecture that
8:47
Speaker 2: will necessitate in some way to have like I think like,
8:50
Speaker 2: your data infrastructure set up in a very very different way.
8:53
Speaker 2: So that started happening very early in our journey. Some
8:57
Speaker 2: of the forward leaning like health systems really thought likegering
9:01
Speaker 2: like that, separating these layers that having a system of record,
9:04
Speaker 2: having the best in breed in that and having a
9:07
Speaker 2: system of intelligence and data are two basically different categories.
9:12
Speaker 2: And if we invest in that, the yield on that,
9:14
Speaker 2: like long term is going to be massive because of
9:16
Speaker 2: the fact that value based care payments are going to happen. Differently,
9:20
Speaker 2: remote patient monitoring is going to happen. Our revenue cycle
9:23
Speaker 2: processes are going to get evolved per se, So all
9:27
Speaker 2: of those things get better if you have this infrastructure
9:30
Speaker 2: and context layer effectively I thing like built out and
9:33
Speaker 2: that is the initial point with which we started getting
9:36
Speaker 2: a lot of traction. We now have eighty million patient
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Speaker 2: lives on top of our platform. We have hundreds of
9:43
Speaker 2: health systems using the platform. We have close to basically
9:48
Speaker 2: like I think like thirty five to forty payers using
9:50
Speaker 2: the platform, so the exchange between payers and providers are
9:54
Speaker 2: basically getting easier. We're able to run like virtual care programs,
9:58
Speaker 2: we are able to run remote patient monitoring programs. We
10:02
Speaker 2: are able to automate care coordination processes, we are able
10:05
Speaker 2: to automate revenue cycle processes. A lot of this can
10:08
Speaker 2: happen with our customers because they had that infrastructure. The
10:13
Speaker 2: challenge initially was the fact that like, no one really
10:16
Speaker 2: wants to pay for the infrastructure, only people only want
10:19
Speaker 2: to pay for the endpoint applications without realizing that none
10:24
Speaker 2: of these applications are going to effectively like solve this
10:27
Speaker 2: cross functionally, and the right way to go about it
10:31
Speaker 2: architecturally is to have an infrastructure that allows for all
10:34
Speaker 2: of this to happen rather than solving it. I think
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Speaker 2: like one silo at.
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Speaker 1: A time, I see, so is the right way to
10:40
Speaker 1: think about it. It's a data unification platform with which
10:44
Speaker 1: all these systems of record are feeding into and then
10:47
Speaker 1: I guess, for a lack of a better term, the
10:48
Speaker 1: point solutions then work off of that layer. Is that
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Speaker 1: the right way to think about it.
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Speaker 2: It's the right way and the way to like the
10:56
Speaker 2: analogous examples could basically be that if you did not
10:59
Speaker 2: have Google Maps in play, like if Google Maps did
11:03
Speaker 2: not create a locational infrastructure layer, you would not have Uber,
11:08
Speaker 2: you would not have Amazon, you would not have any
11:11
Speaker 2: of the things that we sort of really have. So
11:13
Speaker 2: this core infrastructure of data the same way, like I
11:16
Speaker 2: think like Google Maps did for locational infrastructure. Having that
11:20
Speaker 2: basically in place for your health is an incredibly important
11:24
Speaker 2: aspect for you to drive anything forward. And you would
11:27
Speaker 2: see that like in anything like Internet. Google war was
11:30
Speaker 2: sort of the first place where they created like all
11:34
Speaker 2: of these websites and you could parse it, structure it,
11:36
Speaker 2: search it, like all of those sort of like things.
11:39
Speaker 2: It created an entire economy. The same thing happened in location.
11:43
Speaker 2: The same thing is basically happening like in imaging, where
11:46
Speaker 2: cars are basically creating WEMO and others are basically creating
11:49
Speaker 2: this infrastructure. I think the same thing is needed in healthcare,
11:53
Speaker 2: and as soon as that happens, you generally sort of
11:56
Speaker 2: really see like a forward movement in innovation in all
12:01
Speaker 2: of these areas.
12:02
Speaker 1: You know, I like the Google Maps analogy. That's a
12:04
Speaker 1: good one. You know, if I think about the I
12:07
Speaker 1: don't know the key decision makers in a provider settering,
12:11
Speaker 1: whether that's a CIO or CTO. You know, they have
12:14
Speaker 1: all these different systems they're using, whether it's their EHR
12:17
Speaker 1: or claims processing all these sorts of things.
12:19
Speaker 2: Did they need?
12:21
Speaker 1: How did you kind of define the value proposition? I
12:24
Speaker 1: guess early on when maybe it looks like Innovator was
12:28
Speaker 1: just another I don't know application that sits on top
12:32
Speaker 1: of these things that you know, maybe the value wasn't
12:34
Speaker 1: as queer as it is today in terms of ROI.
12:37
Speaker 2: I think like an initial thing was. And this happens
12:40
Speaker 2: in every technological layer that you start with one application
12:46
Speaker 2: that is like your leading application, right, Like sure anyone
12:50
Speaker 2: who's basically tried to build a platform would realize that
12:53
Speaker 2: selling a platform initially without the set of applications on
12:57
Speaker 2: top of it is an incredibly hard thing. So therefore,
13:01
Speaker 2: like we went through that journey, like the first couple
13:05
Speaker 2: of years, we tried like like selling the platform, Hey,
13:08
Speaker 2: this has all of these great capabilities you can build
13:11
Speaker 2: on top of it, you can do all of these things,
13:13
Speaker 2: and no one bought, Like, no one was basically ready
13:16
Speaker 2: to like invest any money. And then we really like
13:20
Speaker 2: I think like anchored in the on the fact that
13:22
Speaker 2: if value based care is going to happen, then we
13:25
Speaker 2: need to anchor on our star leading application to be
13:29
Speaker 2: value based care operations. And let's basically go do that
13:32
Speaker 2: like like well while building the platform in a very
13:36
Speaker 2: very meaningful way. Uh. And once we sort of really
13:39
Speaker 2: like did that, we then had people buy the application
13:45
Speaker 2: and as a result of that also get the platform.
13:48
Speaker 2: And so over a period of time, what we've been
13:50
Speaker 2: able to do is that because now they have the
13:52
Speaker 2: platform up and running, we are now doing contact center
13:55
Speaker 2: transformations for them. We are now doing revenue cycle transformations
13:59
Speaker 2: for them. We're also doing like I think, like n
14:01
Speaker 2: number of app these applications. We now have like I think,
14:04
Speaker 2: like sixteen different applications running on top of our platform
14:07
Speaker 2: that are first party. We also have like I think,
14:09
Speaker 2: like five new applications that are third party that we've launched.
14:14
Speaker 2: So we're now creating this like as a framework for
14:17
Speaker 2: value creation on top of this core infrastructure rather than basically,
14:21
Speaker 2: like I think, having it as closed system. So we'll
14:24
Speaker 2: have first party, third party. All of these things and
14:28
Speaker 2: all of these lead to ROI. But you're right like
14:30
Speaker 2: in saying that, like I think, like if you're ever
14:32
Speaker 2: thinking about building a platform company like the Chicken and
14:36
Speaker 2: the Egg, problem that you face generally is the fact
14:40
Speaker 2: that do applications come first? And am I application backwards?
14:44
Speaker 2: Or do I build the infrastructure and platform? And therefore
14:47
Speaker 2: it takes a long time for platform companies to start scaling,
14:50
Speaker 2: and once they do, there is just no stopping right,
14:54
Speaker 2: like you can have like I think, like so many
14:56
Speaker 2: of these problems solve for your customers on a common
14:58
Speaker 2: infrastructure and chassis, some first party, some third party. We
15:03
Speaker 2: want to open up the platform as much as we
15:05
Speaker 2: can so that people can build and do more things
15:08
Speaker 2: on top of the platform. But like eventually, like I think,
15:12
Speaker 2: like the value creation happens over a longer term period
15:15
Speaker 2: in platform thesis. So that's the journey that we've sort
15:18
Speaker 2: of really evolved, I think, and learned through. It's been
15:22
Speaker 2: sever eighty years of hard building, like healthcare is not
15:29
Speaker 2: necessarily the easiest place to build, like a tech company,
15:35
Speaker 2: and I think like we've gone through all kinds of
15:40
Speaker 2: those pains across the multiple years that we've sort of
15:44
Speaker 2: really built. There has been the high cycle of twenty
15:46
Speaker 2: twenty one where digital health like really had like I think,
15:50
Speaker 2: like hundreds of billions of dollars getting invested in it,
15:53
Speaker 2: and then there was twenty twenty three where like I think, like,
15:55
Speaker 2: oh my god, like digital health like nothing in digital
15:58
Speaker 2: health is ever investable, et cetera. So I think the
16:01
Speaker 2: markets have also been like like very fickal to a
16:05
Speaker 2: certain extent, like in the healthcare infrastructure. But the reality
16:08
Speaker 2: of it is that we spend five and a half
16:11
Speaker 2: trillion dollars like on healthcare in the country. It is
16:14
Speaker 2: not in a state where we can call it to
16:17
Speaker 2: be great. A lot of that pain is being caused
16:22
Speaker 2: by administrative complexity, which is an information problem to effectively
16:26
Speaker 2: like like solve, And if you go through basically that
16:29
Speaker 2: through line of logic, there is going to be a
16:31
Speaker 2: large company that effectively gets built up like in the space.
16:34
Speaker 2: We think we are like very far ahead in the
16:37
Speaker 2: build up of that architecture and deployed it like like
16:41
Speaker 2: at so many of these places, and that we get
16:44
Speaker 2: a right to basically build something that could be very,
16:47
Speaker 2: very meaningfully different and solve meaningful problems in healthcare going forward.
16:52
Speaker 1: That was a great Synopsisam and av I was thinking about.
16:55
Speaker 1: You know, you talked about value based care being I
16:58
Speaker 1: guess maybe the tip of the spear, and initially, how
17:01
Speaker 1: have those conversations changed over the years. You know, you
17:03
Speaker 1: talked about it a little bit about the different cycles
17:05
Speaker 1: that we have. What are your customers or potential customers
17:08
Speaker 1: asking for today that might be a little bit different
17:10
Speaker 1: than I don't know twenty twenty one or even you know,
17:14
Speaker 1: twenty sixteen. What's the key ask from inn A Vaser today?
17:20
Speaker 3: Yeah, I think like the most pressing issue right now
17:26
Speaker 3: for health systems or payers in general, like has effectively
17:32
Speaker 3: been the fact that we are.
17:33
Speaker 2: Now at a breaking point, right Like, the government realizes
17:36
Speaker 2: we don't have any more money to spend on healthcare.
17:39
Speaker 2: We're at five and a half trillion. Maybe it goes
17:41
Speaker 2: to six, maybe it goes to seven, but there is
17:43
Speaker 2: not too much more like money to effectively spend in healthcare.
17:47
Speaker 2: So you're seeing the government effectively leering like push down,
17:50
Speaker 2: whether that's like through the Medicaid rulings that have basically
17:54
Speaker 2: come in, whether that's site neutrality. All of these payment
17:57
Speaker 2: infrastructures are evolving towards the point that there is signaling
18:02
Speaker 2: from both the employers and the government that there is
18:06
Speaker 2: not too much more money for us to basically give you,
18:09
Speaker 2: right like, So if that's going to be the case
18:12
Speaker 2: for the first time, I feel healthcare leaders need to
18:15
Speaker 2: think about the fact that how do I run this efficiently? Right?
18:19
Speaker 2: Because that was never the conversation. Healthcare has always been
18:23
Speaker 2: a thing you need more money you'll get it right.
18:27
Speaker 2: And if for the first time there is going to
18:30
Speaker 2: be some degree of forced efficiency that the buyers of
18:34
Speaker 2: healthcare are going to put in, we are going to
18:37
Speaker 2: start seeing and we are already seeing that, like I
18:42
Speaker 2: think like in our larger customers, that people are starting
18:45
Speaker 2: to think about, how do we do this differently? Is
18:49
Speaker 2: data going to be a lever? Is AI going to
18:51
Speaker 2: be a lever? What is the efficient ways of running
18:55
Speaker 2: this process that we are running, whether that's the care
18:58
Speaker 2: coordination process, whether that's scheduling, whether that's revenue cycle, whether
19:03
Speaker 2: that's ambulatary operations, all of these things. How can we
19:08
Speaker 2: knit this together more meaningfully, have a jointed view on
19:13
Speaker 2: what our business basically layering like looks like, and think
19:16
Speaker 2: about operational efficiency in a very very meaningful way. If
19:21
Speaker 2: you just look at the data, right, like forty three
19:25
Speaker 2: of the hospitals are losing money today, right and if
19:31
Speaker 2: the payment pressures are going to be even more going forward,
19:35
Speaker 2: then we are basically at a point where if you
19:38
Speaker 2: don't run this efficiently, you're going to lose money. And
19:43
Speaker 2: consolidation has like allowed us to basically layering like be
19:48
Speaker 2: okay for a little bit, but you can consolidate only
19:52
Speaker 2: that much. Operational efficiency is basically the name of the
19:56
Speaker 2: game right now, Like every customer that we are going
19:59
Speaker 2: to is start to think about what are my processes?
20:03
Speaker 2: How do I run them efficiently? I think that is
20:05
Speaker 2: a net new conversation in healthcare that has started to
20:08
Speaker 2: appear over the next last few years. Se I think
20:13
Speaker 2: like the intensity of that is going to keep increasing,
20:16
Speaker 2: and so most of what we are hearing our customers
20:19
Speaker 2: basically ask us is that, Okay, I have these big problems,
20:23
Speaker 2: like how do I run my contact center, how do
20:26
Speaker 2: I run my revenue cycle processes? How do I improve
20:28
Speaker 2: patient experiences? How do I sort of really think about
20:32
Speaker 2: like getting paid on time? These are things that yes,
20:36
Speaker 2: we're problems like always, but not really like at the
20:40
Speaker 2: forefront of what would be like in an executive conversation.
20:44
Speaker 2: I think it's very very in a boardroom discussion like
20:48
Speaker 2: at every place right now. And as much as everyone
20:51
Speaker 2: basically like it's talking about AI is the solve for it,
20:55
Speaker 2: the reality of it is you do AI wrong. Architecturally,
21:00
Speaker 2: AI can also be the cost for bankruptcy for you,
21:04
Speaker 2: like because the cost structure of inference, the cost structure
21:08
Speaker 2: of tokens, et cetera. I don't think like health systems
21:11
Speaker 2: are structured in a way where they can take a
21:13
Speaker 2: lot of that, Like, if they are not architecting it right,
21:19
Speaker 2: it might lead to tens and hundreds of millions of
21:21
Speaker 2: dollars of net new cost introduction for them without any
21:24
Speaker 2: ROI effect like coming into play. So I think like
21:27
Speaker 2: a lot of these things are starting to happen. We
21:30
Speaker 2: are seeing the right questions being asked, which is, how
21:33
Speaker 2: do I get more efficient? Can AI make us like
21:36
Speaker 2: more efficient, et cetera. But then also basically this trepidition
21:40
Speaker 2: like across the board that if I basically just went
21:44
Speaker 2: and like I think, like did everything with a large
21:46
Speaker 2: language model, the cost structure is unsustainable for me. So
21:50
Speaker 2: I think like this is the next evolution that health
21:53
Speaker 2: system technology leaders would need to sort of rethink through
21:57
Speaker 2: that there is an opportunity right in front of first
22:00
Speaker 2: to transform the industry very very meaningfully. What is the
22:03
Speaker 2: right architecture, how do I go about it? And if
22:07
Speaker 2: you do it right, like I think, like you could
22:09
Speaker 2: be removing hundreds of billions of dollars of administrative cost
22:13
Speaker 2: structure and redirecting that into more care delivery type things,
22:18
Speaker 2: which then basically, like I think like gives you more
22:21
Speaker 2: margin to really work with and make your business models
22:24
Speaker 2: effectively more sustainable.
22:26
Speaker 1: That makes a ton of sense. I mean, you've talked
22:28
Speaker 1: quite a bit about autonomous healthcare. I mean, as from
22:30
Speaker 1: where you sit as a technologist yourself, you know, where's
22:33
Speaker 1: the well lying fruit for the system and where do
22:36
Speaker 1: you think maybe it's going to take a little bit
22:38
Speaker 1: longer than maybe some market pundits are estimating.
22:42
Speaker 2: So I think we are at the place where administrative
22:45
Speaker 2: auto processes definitely need to be autonomous to a certain degree,
22:50
Speaker 2: like we generally look at like we generally look at
22:54
Speaker 2: like I think like autonomy and like these four levels
22:57
Speaker 2: level when autonomy is where you create visibility. You're you
23:01
Speaker 2: can see stuff like you can act on it. It's
23:04
Speaker 2: copility like I think, like type of things software does
23:07
Speaker 2: that like for you. The impact of that, generally in
23:11
Speaker 2: our studies is that the cost structure probably goes down
23:17
Speaker 2: by nine to eleven percent if you just basically, like
23:22
Speaker 2: I think, like, do that do that well like in
23:23
Speaker 2: a structured sort of really like thing like way, like
23:26
Speaker 2: you get some degree of yield from that, Then like
23:30
Speaker 2: I think like L two autonomy is where like I think,
23:32
Speaker 2: like you come to some degree of like iting like
23:34
Speaker 2: supervised identification and automation in general, Like as you start
23:40
Speaker 2: basically like I like doing that, like you can really
23:43
Speaker 2: shave off like I thing like get every process to
23:45
Speaker 2: be thirty to thirty five percent more efficient, And I
23:50
Speaker 2: think like that is the state where people need to
23:52
Speaker 2: sort of really like I thing like aim for today,
23:54
Speaker 2: Like I don't think like we are going to get
23:56
Speaker 2: to like I think like fully autonomous, like I think
23:58
Speaker 2: like pieces in very year term like per se, but
24:02
Speaker 2: like getting to L two autonomy, which is like L
24:04
Speaker 2: four autonomy, which is like like seventy to seventy five
24:07
Speaker 2: percent cheaper, right, Like every process that you're running you
24:11
Speaker 2: can run at twenty five percent of the cost if
24:14
Speaker 2: you went to like full stack like autonomy in general.
24:18
Speaker 2: But I think like the aim that we should have
24:21
Speaker 2: as an industry is that can we get to supervised autonomy,
24:25
Speaker 2: like thinking about like the scheduling calls, like anything that
24:29
Speaker 2: is administrative in nature that does not require very deep
24:35
Speaker 2: degree of clinical judgment per se. Right, Like we are
24:38
Speaker 2: able to schedule most of what we do through MX
24:42
Speaker 2: and through United like through basically like an AI assistate,
24:46
Speaker 2: like I like call. And so if we can connect
24:48
Speaker 2: the systems enough to create like that degree of autonomy here,
24:53
Speaker 2: I think we'll make forward progress. So our general suggestion,
24:57
Speaker 2: like I think, like to our customers, has been that
25:00
Speaker 2: think about these autonomy frameworks, right, like, where are you
25:05
Speaker 2: Most health systems are basically at L zero autonomy? Can
25:08
Speaker 2: you get yourself like I think like to EL one autonomy,
25:11
Speaker 2: L two autonomy, L three autonomy. Yes, there is a
25:15
Speaker 2: pathway like I think like where these administrative processes could
25:19
Speaker 2: be fully autonomous, But I don't think like that is
25:23
Speaker 2: a near term goal that people can sort of really
25:25
Speaker 2: run towards.
25:25
Speaker 1: Right now, that makes sense? And then when you think
25:28
Speaker 1: about it, I mean I think about it across a
25:31
Speaker 1: couple maybe different vectors or groups, you know, I think
25:34
Speaker 1: about the providers, the payers, the patients, and then I
25:37
Speaker 1: guess maybe the system as a whole. You know, do
25:40
Speaker 1: you see it that all stakeholders will win in this
25:45
Speaker 1: as we move towards these more autonomous business models? Can
25:50
Speaker 1: everybody win?
25:51
Speaker 2: So I think there is a short term answer and
25:53
Speaker 2: a long term answer to that, right, like fair enough,
25:57
Speaker 2: Like I think what is going to happen is like
26:00
Speaker 2: agentification and like autonomy, people are going to push for it. Right,
26:05
Speaker 2: So in the near term, what is going to happen
26:06
Speaker 2: is there is going to be a little bit of
26:08
Speaker 2: like battle of agents because we've made the system like
26:12
Speaker 2: fairly adverse area, like the fee for service economic system
26:16
Speaker 2: is like an adversarial system where the pair is like
26:21
Speaker 2: against the provider. And that's what's basically Like I think,
26:24
Speaker 2: so someone is calling from the provider office, someone from
26:27
Speaker 2: the pay office is basically like answering most in a
26:30
Speaker 2: lot of cases, these are people sitting in the same BPO,
26:33
Speaker 2: like I think, like answering calls from each other. Right now,
26:37
Speaker 2: imagine that this is basically going to become agentic, right Like,
26:42
Speaker 2: So now like I think, like this battle probably like
26:44
Speaker 2: I think, like increases quite dramatically and like gets accelerated,
26:48
Speaker 2: like I think, like quite quickly. Like we're already starting
26:50
Speaker 2: to see that, like we saw like some of the
26:53
Speaker 2: larger pairs announce the fact that now agents will call
26:57
Speaker 2: provider offices. Providers are now basically like I think, like
27:01
Speaker 2: having the same denial sagents, like I think, like all
27:03
Speaker 2: the pay offices, et cetera. So now like I think
27:06
Speaker 2: like you're going to see, like I think like some
27:07
Speaker 2: bit of escalation of this tension happen in the near term.
27:12
Speaker 2: As that sort of really I think like happens, people
27:15
Speaker 2: are going to realize that this is of no use,
27:17
Speaker 2: Like this is of no value, Like we need to
27:20
Speaker 2: figure out ways to basically make information flow directly and
27:23
Speaker 2: build in systems that would allow for payments to happen
27:27
Speaker 2: based on like a judgment framework, right, Like I think
27:32
Speaker 2: people are starting to think about that as that starts
27:35
Speaker 2: to happen. I think like there are new payment infrastructures
27:38
Speaker 2: that would sort of really get set up in case,
27:42
Speaker 2: like those payment infrastructures are set up in a value
27:45
Speaker 2: based care environment where you are getting paid for the
27:49
Speaker 2: outcomes and there are very clear ways of defining the outcomes.
27:52
Speaker 2: Per se, you are going to see a massive efficiency game.
27:56
Speaker 2: And if efficiency gets created, then I think like everyone
28:00
Speaker 2: with so like the pair wins because like I think,
28:03
Speaker 2: like the administrative loss would sort of really get lower.
28:07
Speaker 2: The providers win because like all of this five percent
28:11
Speaker 2: cost structure of revenue cycle actually gets like gtting like
28:14
Speaker 2: shifted into like clinical care from et cetera, and therefore
28:18
Speaker 2: those are more net new revenue hielding opportunities, and therefore,
28:22
Speaker 2: like if you look at the longer term picture of it,
28:25
Speaker 2: where this evolves to, I think everyone gets to win.
28:29
Speaker 2: But I think like in the short term, like there
28:31
Speaker 2: is pain like and there is like a struggle like
28:36
Speaker 2: around this.
28:37
Speaker 1: I like that. That's that's a good one. I'm thinking
28:40
Speaker 1: of something like a robot Wars video or something like that.
28:43
Speaker 1: But it's not the it's not the robot, it's it's
28:45
Speaker 1: the algorithm stooking it out in the ring. As we
28:49
Speaker 1: think about the market structure, could you maybe dive into
28:52
Speaker 1: or unpack a little bit, you know, how the framework
28:54
Speaker 1: is today. I mean, we have companies like your own
28:56
Speaker 1: innovasor but then we have the legacy companies who are
28:59
Speaker 1: involved in the space, the EPX, the cerners or I
29:02
Speaker 1: guess o're called Cerner now, and then big Tack obviously,
29:05
Speaker 1: whether it's you know, Google, Microsoft, Amazon. Can you talk
29:09
Speaker 1: about where where you're playing and maybe where the other
29:13
Speaker 1: some of the incumbents are playing in the space, And
29:16
Speaker 1: how do you I guess maybe keep as a newer
29:18
Speaker 1: player or newer entrant, you know, how do you define
29:21
Speaker 1: your moat and make sure that those incumbents don't you know,
29:25
Speaker 1: come into your space.
29:27
Speaker 2: Now, I think like our general view like on this
29:31
Speaker 2: is that the space is like so large and the
29:35
Speaker 2: problems that are so large that there are going to
29:38
Speaker 2: be multiple companies. Like even when the HR like evolution
29:41
Speaker 2: effectively like happened right like for a really really long
29:45
Speaker 2: period of time, there was like epic concerner from and
29:49
Speaker 2: all Scripts and Athena Health and Meditech and all of
29:53
Speaker 2: these players. Now over a period of time, like I
29:55
Speaker 2: think like one has become more dominant like than the others,
29:58
Speaker 2: et cetera. But I think like this autonomous operations space
30:03
Speaker 2: is actually like ten x larger than what like the
30:05
Speaker 2: software space was, and therefore, like for anyone to assume
30:11
Speaker 2: that one company is going to go do it all
30:14
Speaker 2: is I don't think like that's how it's going to
30:17
Speaker 2: pay play out, right, like so so I think like
30:20
Speaker 2: that's the first thing our general view, like I think,
30:24
Speaker 2: like in this entire thing is the fact that context
30:29
Speaker 2: and data is the most important like crank piece in
30:33
Speaker 2: this everything else, like you're seeing Claude and open AI
30:38
Speaker 2: and all of these sort of rethinks where user interface
30:42
Speaker 2: creation is becoming the cost to create a user interfaces
30:46
Speaker 2: dropped dramatically, And what a lot of the hrs had
30:51
Speaker 2: done was to build thousands of user interfaces right like,
30:56
Speaker 2: And if the cost of building that user interface has
30:58
Speaker 2: now dropped down by one hundred x per se, and
31:02
Speaker 2: the time to basically develop that user interface has dropped
31:06
Speaker 2: down by one hundred x, you are going to see
31:08
Speaker 2: like evolution and emergence of net new companies in this space.
31:13
Speaker 2: So I think, like the if from our standpoint, the
31:17
Speaker 2: way we sort of really learning like look at it
31:20
Speaker 2: is that data and context is basically going to be
31:23
Speaker 2: the real value creation opportunity here. How do you basically
31:27
Speaker 2: take that? What our visualization views, how does the user
31:30
Speaker 2: interface look, how does the exchange effectively like happen? All
31:34
Speaker 2: of those things are like I don't think like our
31:37
Speaker 2: more in the medium to longer term period, the people
31:40
Speaker 2: who basically build for the right data architectures, the right
31:44
Speaker 2: right like context pieces, et cetera, they will create a
31:48
Speaker 2: lot of long term value both for their customers and
31:50
Speaker 2: their shareholders per se versus Basically, the companies that get
31:55
Speaker 2: stuck on like this is the one user interface that
31:58
Speaker 2: I'm going to effectively solve for because the underlying data
32:01
Speaker 2: and processing of that like is where all of the
32:03
Speaker 2: value effectively resides.
32:05
Speaker 1: Maybe segueing into a little bit of a different subject matter,
32:08
Speaker 1: you know, you guys have been doing this for a
32:10
Speaker 1: decade plus, how have you thought about company construction and
32:15
Speaker 1: building your organization given that you've seen, you know, a
32:18
Speaker 1: massive amount of change in this industry over the last
32:21
Speaker 1: ten years.
32:22
Speaker 2: I think the one thing that I've realized, Jonson, is
32:24
Speaker 2: that healthcare is a game of patience. Like, if you're
32:28
Speaker 2: going to build something in healthcare, you can build very
32:33
Speaker 2: very large companies, but you can't basically do that in
32:36
Speaker 2: a very short period of time, or at least not
32:39
Speaker 2: sustainably right Like, So, I think the thing that we've
32:43
Speaker 2: sort of really learned and really like anchored on is
32:47
Speaker 2: the fact that we have to be long term thinking
32:50
Speaker 2: about this. What we are trying to do here is
32:53
Speaker 2: an incredibly important problem to solve. If you could become
33:00
Speaker 2: the context and data and the AI infrastructure for healthcare
33:04
Speaker 2: going forward, I think it's something that could be very
33:07
Speaker 2: very large over like a three, five, seven, ten year period. Like,
33:12
Speaker 2: our advantage was the fact that we started when we
33:14
Speaker 2: were twenty five so like we have time on our hands,
33:18
Speaker 2: we want to do this like for the really really
33:21
Speaker 2: long term, Like we want to create something that is
33:25
Speaker 2: like a strong business built over a period of time.
33:28
Speaker 2: If you look at like like companies that have like
33:31
Speaker 2: Epic and United Optum like, or if you look at
33:37
Speaker 2: basically like roh sure Danaher like, a lot of these
33:42
Speaker 2: companies took time to really get to some degree of scale,
33:46
Speaker 2: but then once the compounding started happening, you could create
33:49
Speaker 2: basically layering like value for a really really long period
33:52
Speaker 2: of time. So our view on this like has been
33:56
Speaker 2: a lot more long term thinking than basically like a
33:59
Speaker 2: lot of the venture world generally like looks at right,
34:04
Speaker 2: And therefore we've sort of really regretding like chosen investors
34:06
Speaker 2: like that. Like we've partnered with some of the largest,
34:10
Speaker 2: like sovereign wealth funds, We've partnered with some of the
34:13
Speaker 2: largest like health systems, who all have vested interest in
34:17
Speaker 2: solving this for the lost long term rather than basically
34:20
Speaker 2: thinking about what happens this quarter and what happens like
34:23
Speaker 2: next quarter. Ra. So that's the cultural shift that we
34:27
Speaker 2: are trying to really make that how do you evolve
34:30
Speaker 2: yourself from being like I think, like this startup where
34:33
Speaker 2: speed is everything to where I think like sustainability and
34:36
Speaker 2: long term value creation for your customers is the anchoring point.
34:41
Speaker 2: And if you do that well over like a five, seven,
34:43
Speaker 2: ten year period, shareholder value would basically like like follow
34:47
Speaker 2: rather than basically chasing shareholder value like thing like in
34:49
Speaker 2: the short term and then basically messing this up, which
34:53
Speaker 2: healthcare technology has had a history of.
34:56
Speaker 1: Two there's a graveyard of companies out there with the
35:00
Speaker 1: with who followed that tact I mean thinking about the
35:02
Speaker 1: value creation piece of it. I mean, of wight, you
35:05
Speaker 1: guys have been started doing some more acquisitions, can you
35:07
Speaker 1: maybe talk about your m and a strategy and what's
35:09
Speaker 1: the hurdle I guess for you to do a deal.
35:12
Speaker 2: So the way we sort of rethink about it is
35:15
Speaker 2: that we are building up this autonomous operations as a category,
35:19
Speaker 2: and what does that effectively like like mean in the
35:22
Speaker 2: long term, is that all of the operations that are
35:25
Speaker 2: health system or a payer effectively runs. We should have
35:29
Speaker 2: all of those operations available on top of the platform.
35:32
Speaker 2: So we started with population health as a category. We
35:35
Speaker 2: then basically like I think with Cured, went into patient engagement,
35:39
Speaker 2: then we basically like I think like did Humbi, which
35:41
Speaker 2: was actualal operations. Then we did story Health, which was
35:45
Speaker 2: specialty care and chrowdiccare management, and then we've done Conducers,
35:50
Speaker 2: which is revenue cycle management. A lot of what we
35:54
Speaker 2: end up sort of really doing is that we get
35:57
Speaker 2: best in breed small companies who have really high customer
36:02
Speaker 2: satisfaction and really layering like bring that on top of
36:05
Speaker 2: our platform and offer that value to our customers, right,
36:09
Speaker 2: and if we can basically solve because we feel like
36:11
Speaker 2: we can solve the distribution piece like for them, like
36:14
Speaker 2: really really a lot of our customers basically really trust
36:18
Speaker 2: us fairly deeply, and therefore, like if we bring something
36:21
Speaker 2: to them, like they feel like we've done the wetting,
36:24
Speaker 2: we've done the technological evolution and all of those sort
36:26
Speaker 2: of like things, and converting these companies into an AI
36:31
Speaker 2: first organization and taking those autonomous operations to our customers
36:35
Speaker 2: allows us to basically layering like compound value creation not
36:39
Speaker 2: just from like a revenue or a top line perspective,
36:43
Speaker 2: but also from a customer perspective. That we were solving
36:46
Speaker 2: only population health for you, now we can also solve
36:49
Speaker 2: contact centers for you. Now we can also solve ambilaitary
36:53
Speaker 2: revenue cycle for you. Now we can also solve like
36:55
Speaker 2: these five things for you. So for the customer, now
36:58
Speaker 2: you have like I think, like one vendor that can
37:01
Speaker 2: solve tens of these things for you rather than effectively
37:04
Speaker 2: like I think, like going to ten points solutions and
37:06
Speaker 2: then figuring out interoperability between them and security structures and
37:10
Speaker 2: like is that AI first or not and all of
37:13
Speaker 2: those sort of like things. So that is like a
37:15
Speaker 2: little bit of our longer term thesis that we want
37:17
Speaker 2: to build, Like a autonomous operations is the category that
37:22
Speaker 2: we want to sort of really own and build like
37:24
Speaker 2: over a longer term period. And I think they are
37:26
Speaker 2: going to be multiple companies that do this, but we
37:29
Speaker 2: want to be like I think, like one of the
37:30
Speaker 2: more comprehensive ones to sort of redo that like over
37:34
Speaker 2: a longer term period for sure.
37:35
Speaker 1: Now that makes sense. You're filling the gaps and then
37:37
Speaker 1: and then leveraging the platform. Really, I think at the
37:40
Speaker 1: end of the day, you know, as a financial analyst,
37:42
Speaker 1: I always have to come back to some business questions,
37:45
Speaker 1: you know, as a as the CEO of a leading
37:48
Speaker 1: company from a KPI perspective, What are you looking at
37:51
Speaker 1: in the business? What's important to you when you manage it.
37:53
Speaker 1: I don't know day to day, month to month, quarter,
37:56
Speaker 1: I guess probably not quarter to quarter, but year to year.
37:59
Speaker 1: What final metrics matter the most?
38:02
Speaker 2: I think, like there are financial metrics, but there are
38:05
Speaker 2: also basically like I think, like coverage metrics. Right, So,
38:09
Speaker 2: we now have eighty million lives running on top of
38:12
Speaker 2: the platform, right Like, So from a coverage perspective, like
38:17
Speaker 2: that has grown over the last two years from thirty
38:21
Speaker 2: five million to eighty million, and I think like we
38:27
Speaker 2: will probably be one hundred and twenty hundred and thirty
38:29
Speaker 2: million lives like over the next couple of years. So
38:32
Speaker 2: what does that mean? It just generally means that we
38:34
Speaker 2: now have the opportunity to serve eighty million patients today
38:39
Speaker 2: with various autonomous operations like I think, like capabilities that
38:42
Speaker 2: we can deliver on top of it. Some could be
38:45
Speaker 2: care navigation and directly like I think like patient centric capabilities,
38:49
Speaker 2: some could be administrative and back end. But it's all
38:52
Speaker 2: basically like solving for the better, like I think, like
38:55
Speaker 2: patient experience at the end of the day, so that
38:57
Speaker 2: the quality of care, like I think like gets better.
39:00
Speaker 2: So if that's the goal, then one of the metrics
39:02
Speaker 2: that we definitely layering track towards is how many lives
39:07
Speaker 2: do we have on top of the platform. And I
39:09
Speaker 2: feel like, I think like we are among the larger
39:11
Speaker 2: players right now in terms of the number of lives
39:13
Speaker 2: that are effectively covered on top of the platform. The
39:17
Speaker 2: second thing that we sort of layering like track towards
39:21
Speaker 2: is value creation for our customers. And if you look
39:26
Speaker 2: at last year, we basically published this report. We do
39:29
Speaker 2: this like like every year that how much cost have
39:35
Speaker 2: you been able to remove from the healthcare ecosystem while
39:39
Speaker 2: improving quality? So last year that number for us looked
39:44
Speaker 2: like one point seven billion dollars. So all of our
39:47
Speaker 2: customers basically layering like broadly last year removed one point
39:50
Speaker 2: seven billion dollars I think like cost structure using our products, right,
39:54
Speaker 2: Like they would have done something separately as well, but
39:57
Speaker 2: on top of our products, we've been able to remove
40:00
Speaker 2: flaggering like one point seven billion dollars annually, like on
40:02
Speaker 2: top of the platform. One of our goals is that
40:05
Speaker 2: how do we get that like in the very near
40:07
Speaker 2: term to ten billion dollars? Right? And if you're removing
40:11
Speaker 2: this ten billion dollars of I th like cost structure,
40:13
Speaker 2: you will capture some of that fliger thing like as revenue.
40:17
Speaker 2: So a lot of flaggering, like our business model is
40:20
Speaker 2: generally built on the fact that if you remove waste,
40:24
Speaker 2: you should get paid to remove that waste, and then
40:29
Speaker 2: that becomes like a win win structure because the customers
40:31
Speaker 2: effectively likeing like realize ROI from that, we basically layering
40:35
Speaker 2: like make revenue out of that, and everyone basically layering
40:40
Speaker 2: like gets better like quality and efficiency per se. So
40:44
Speaker 2: that is how we generally think about it. It is
40:46
Speaker 2: actually like very counter to how a lot of other
40:48
Speaker 2: companies are basically layering like structured that they would make
40:52
Speaker 2: more money if the healthcare costs go up, whether that's
40:56
Speaker 2: revenue cycle, whether that's like the HRS, whether that basically
41:00
Speaker 2: claim processing systems, et cetera. We actually make more money
41:04
Speaker 2: if the cost goes down, right Like, So I think
41:08
Speaker 2: like it's a fundamentally different way of like thinking about
41:12
Speaker 2: it because our general belief on broader healthcare is the
41:17
Speaker 2: fact that we don't have a increase the cost structure
41:23
Speaker 2: like I think or revenue based laggering like problem. We
41:25
Speaker 2: have an efficiency problem in healthcare, and that's the thing
41:28
Speaker 2: that we've sort of relayering, like being focused on how
41:31
Speaker 2: do you do it better? How do you do it
41:33
Speaker 2: in a more connected way, how do you do this
41:35
Speaker 2: in a more digital way, how do you do this
41:37
Speaker 2: in a more AI first way. Because you do those things,
41:40
Speaker 2: your cost structure effectively layering like gets better. That costs
41:44
Speaker 2: or that piece of dollars then gets redirected into more
41:48
Speaker 2: clinical care, et cetera. Everyone gets more access. We're all
41:52
Speaker 2: for the better. So that's how we sort of think
41:54
Speaker 2: about the financial metrics. So number of lives on the platform,
41:58
Speaker 2: value that we've been able to like on those lives,
42:02
Speaker 2: and then that inherently leads to more revenue that we
42:05
Speaker 2: can like, I think like create because of the value
42:08
Speaker 2: that we are creating for our customers.
42:10
Speaker 1: So to the majority of your contracts then have that
42:13
Speaker 1: risk component built in on the saving side, Like.
42:17
Speaker 2: More and more of them are basically starting to have that.
42:19
Speaker 1: Okay, and then I guess you talked about this a
42:22
Speaker 1: little bit, but I think I know the answer. But
42:24
Speaker 1: the weverage in the business model is in terms of scale.
42:27
Speaker 1: Right as you get more wives, the scale increases, the
42:30
Speaker 1: profitability increases. Is that the right way to think about
42:32
Speaker 1: the business model as well?
42:34
Speaker 2: Yeah, Like I think, like I'll give you examples, right,
42:37
Speaker 2: Like the first deployment that we did integrating all of
42:42
Speaker 2: the data systems across that first customer actually costed us
42:47
Speaker 2: like thirty five million dollars. Now, the reality of it
42:52
Speaker 2: is anyone who tries to do that, it will cost
42:55
Speaker 2: them that. Right. But now, because we've done that like
43:00
Speaker 2: tens of times or hundreds of times, like I think,
43:03
Speaker 2: across the leading health systems in the country, we can
43:07
Speaker 2: do that like thirty five million dollar thing, like at
43:10
Speaker 2: probably three million dollars, right, Like so effectively, Like I think,
43:15
Speaker 2: like all of these processes structures that we've sort of
43:17
Speaker 2: really layer thing like built out, allow us to do
43:20
Speaker 2: things in a very very fundamentally different way, right, Like
43:26
Speaker 2: you can connect hundreds of HR systems, you can run
43:29
Speaker 2: multiple processes on top of it, and anyone who's basically
43:32
Speaker 2: done like data infrastructure creation, you should, like I think,
43:35
Speaker 2: like go and ask them that, Like it is probably
43:38
Speaker 2: the hardest problem in healthcare, and we've now basically gotten
43:43
Speaker 2: to the point where we've gotten like all of the
43:46
Speaker 2: technology and AI capabilities built into that that you can
43:49
Speaker 2: create this infrastructure in a three month period rather than
43:53
Speaker 2: what used to take like I think, like a three
43:55
Speaker 2: year period. Right, So therefore value creation is basically becoming faster.
44:00
Speaker 2: We can basically learning like grow faster, tra and our
44:04
Speaker 2: customers can basically see like I think, like value much
44:06
Speaker 2: much faster today, like per se. All of that financially
44:10
Speaker 2: means that like I think, like there is leverage that's
44:12
Speaker 2: starting to show in the P and L like as well,
44:14
Speaker 2: where we used to lose like a lot of money
44:17
Speaker 2: to where like we are now starting to basically, like
44:20
Speaker 2: I think, like class across a little bit, like I
44:22
Speaker 2: think like into the green as well.
44:25
Speaker 1: Oh that's great. Passing that threshold is a huge milestone.
44:28
Speaker 1: So as we think about in a baser and you
44:31
Speaker 1: talked about, you know, the cycles are getting faster and quicker.
44:34
Speaker 1: You know, if we think about where you want to
44:35
Speaker 1: be in five years time at a very high level,
44:38
Speaker 1: you know, what's the roadmap from now through I'm picking
44:40
Speaker 1: an arbitrary date, but twenty thirty one, where do you
44:44
Speaker 1: want the company to be five years from now?
44:47
Speaker 2: I think like the way we sort of rethink about
44:49
Speaker 2: it is that we feel there is a very clear
44:52
Speaker 2: paths to a billion of aarr like over a four
44:56
Speaker 2: five year like iting like period, which inherently means that
44:59
Speaker 2: we should be creating like I think like ten billion
45:01
Speaker 2: dollars or more like I think like of value for
45:03
Speaker 2: our customers. Like that's the general rule of thumb that
45:06
Speaker 2: we like, I think, like think about any dollar of
45:09
Speaker 2: revenue that we sort of really like create, we should
45:11
Speaker 2: be creating like I think like anywhere between seven to
45:13
Speaker 2: ten dollars of like I think like ROI like for
45:16
Speaker 2: our customers in the longer term. So if that's basically
45:19
Speaker 2: the metric that we sort of really like think about,
45:22
Speaker 2: we think the business is basically like I think, like
45:23
Speaker 2: a fair line of sight on how it could basically
45:25
Speaker 2: get to a billion of air or in a five
45:27
Speaker 2: year period. And then like the more important metrics that
45:32
Speaker 2: we sort of really like think about is that how
45:35
Speaker 2: many lives are covered? Like same thing, basically how many
45:39
Speaker 2: lives are covered. We hope like over a five year
45:41
Speaker 2: period we can get to all three hundred million lives
45:44
Speaker 2: like everyone in the US is basically like I think,
45:47
Speaker 2: like served by some of our products one way or
45:49
Speaker 2: the other. And the number of autonomous operations that we
45:55
Speaker 2: can enable for our customers move from one point four
45:59
Speaker 2: where we are today to effectively like four or five six,
46:03
Speaker 2: basically operations that we are helping them get to an
46:06
Speaker 2: autonomous date. So the two vectors in which we tracklag
46:09
Speaker 2: like growth more number of lives, more autonomous operations, laggering
46:13
Speaker 2: like for those lives we do that like the area
46:16
Speaker 2: under the curve, effectively lagerting like becomes how we track progress.
46:21
Speaker 1: That's great. You know, we're getting to the top of
46:23
Speaker 1: our time here and I feel like I need another hour.
46:26
Speaker 1: So maybe we'll have to do this again in a
46:28
Speaker 1: year or two to see where you are. But avanav
46:30
Speaker 1: one of the ways I like to wrap up these
46:32
Speaker 1: conversations is to ask if there's a lesson from your
46:36
Speaker 1: personal or professional light that really guides what you see
46:39
Speaker 1: as your mission or your north star. Is there something
46:42
Speaker 1: that comes to mind in your background that you would
46:44
Speaker 1: point to.
46:45
Speaker 2: No, I think like we've had the advantage of the
46:48
Speaker 2: fact that we started very very early, right like, so
46:51
Speaker 2: the reason we pivoted into healthcare from or like narrow
46:55
Speaker 2: down our focus into healthcare after shutting down ninety percent
46:58
Speaker 2: of our revenue base was primarily one thing, the most
47:04
Speaker 2: important thing in our lives, which is our health, is
47:08
Speaker 2: still using technology that everyone else used like fifteen twenty
47:13
Speaker 2: years ago, right, and it should scare everyone, right like
47:19
Speaker 2: that your doctor has more outdated technology than your uber
47:24
Speaker 2: driver does. Right.
47:27
Speaker 1: So from that she always comes up.
47:29
Speaker 2: Yeah. And so if that's basically going to be the
47:33
Speaker 2: state of affair, like a lot of my mission personally
47:36
Speaker 2: effectively becomes that, Okay, I'm going to live through basically
47:40
Speaker 2: all of this, I hope my daughter does not, right right,
47:43
Speaker 2: like she gets basically like I think, like the kind
47:46
Speaker 2: of care that like all of us deserve. Were spending
47:48
Speaker 2: five and a half trillion dollars, like I think, like
47:50
Speaker 2: in the country to keep all of us like healthy
47:53
Speaker 2: and well, and the outcomes are not necessarily like I think,
47:56
Speaker 2: like where they need to be. And so if there
47:59
Speaker 2: is one thing that drives me is the fact that
48:02
Speaker 2: I am not going to let, like I think, my
48:04
Speaker 2: daughter experience like I think, like the same degree of
48:07
Speaker 2: like frustration about care Era that I did, while I've
48:11
Speaker 2: sort of really like I think, like experienced Carera. So
48:14
Speaker 2: that's been like a little bit of like I think,
48:16
Speaker 2: like the driving force in which like I typically think
48:20
Speaker 2: about things, this has been one of the most interesting
48:25
Speaker 2: and basically, like I think like deep things that I've
48:27
Speaker 2: ever solved for. Technically, there are hundreds of areas where
48:31
Speaker 2: AI can effectively have an impact. Data can have an impact,
48:34
Speaker 2: Technology can have an impact. But like, if you can
48:39
Speaker 2: do something to improve the overall health and well being
48:43
Speaker 2: of all of us, I think that is a mission
48:46
Speaker 2: that like I feel like very very excited about, like
48:50
Speaker 2: waking up to every day and coming to take the
48:53
Speaker 2: pain off, basically building that like in this broken healthcare
48:56
Speaker 2: ecosystem of today.
48:59
Speaker 1: That's great. Thanks for sharing that. It really resonates with
49:01
Speaker 1: me as well. I mean, there's so much, so much
49:04
Speaker 1: that we could be doing to fix this healthcare system,
49:06
Speaker 1: and you're you're really on the front lines and your
49:09
Speaker 1: enthusiasm shows through. It's it's been great speaking with you
49:12
Speaker 1: on this.
49:13
Speaker 2: Oh, this has been great. Thank you so much for
49:14
Speaker 2: having us Johnson.
49:15
Speaker 1: That's Abanov Shashank, co founder and CEO of Innovator. Thank
49:20
Speaker 1: you for listening to this episode of Vanguards of Healthcare
49:22
Speaker 1: by Bloomberg Intelligence, and don't forget to click the follow
49:25
Speaker 1: button on your favorite podcast app or website. So you
49:28
Speaker 1: never miss an interview with the readers rewriting the playbook
49:32
Speaker 1: on healthcare innovation. Until next time, take care,