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Two Startups Bringing Health Innovation to Vulnerable Communities · StartUp Health NOW Podcast

• 0:00
  Welcome back to StartUp Health NOW. I'm Logan Plaster. [instrumental music] Because of the nature of the work we do at StartUp Health, we're often dealing with bleeding edge ideas and technologies.
• 0:10
  Just last week on the show, I talked to a founder creating what could be the smallest implantable devices in the healthcare market. Others are working on molecules that could cure diseases.
• 0:21
  But there's another kind of innovation that we're equally passionate about at StartUp Health.
• 0:25
  That's the kind of business model innovation that brings the best care and technology already available to new places and new people.
• 0:33
  There are many vulnerable communities that don't get to benefit from the latest technical advances, and it takes creative founders to bridge those gaps. Today on the podcast, we're highlighting two such founders.
• 0:44
  The first is Shruti Guridanti, the CEO and co-founder at Televeda. Shruti and her team are working to help Native American veterans with the goal of lowering rates of suicide and suicidal ideation.
• 0:57
  They've got a tech platform that enables community building and telemedicine style services, but what Shruti has found is that sometimes the most meaningful change is something basic.
• 1:08
  And the most revolutionary concept of all is just building trust with our community. Yeah.
• 1:15
  After the conversation with Shruti, we'll hear from Keelan Swayne, CEO and co-founder at Greens, an app that's designed to help vulnerable communities, particularly Black and brown communities in the American South, manage diabetes in a culturally competent way.
• 1:30
  For Keelan, the inspiration for Greens came when his father got diagnosed with Type 2 diabetes and met with a nutritionist. A nutritionist told him like, "Hey, you know what? You should eat more kale." Kale.
• 1:42
  My dad's like... He's a 65-year-old Black guy from Mississippi. He's like, "What the heck is a kale?" Okay.
• 1:48
  [laughs] The common thread between Shruti and Keelan is using the best tech of today to meet people where they are and to really understand what's holding them back.
• 1:57
  Sometimes it's something basic, like improving internet access or tech literacy or bringing accountability to disease management. Now let's get into the first interview, recorded live at a recent health tech conference.
• 2:11
  [upbeat music] Shruti, great to see you. Thank you so much.
• 2:15
  It's been great to watch your journey, learn how you're helping seniors, uh, with issues of loneliness with your platform, but I know you're doing a lot more than that now.
• 2:24
  So sort of level set with us, where's Televeda at in 2023?
• 2:29
  We have a very exciting project right now with the, uh, in partnership and thanks to the support from the Veterans Administration, uh, where we are, uh, building a comprehensive operational plan to help reduce suicide deaths amongst Native American veterans.
• 2:47
  Hmm.
• 2:48
  Um, and the plan or the comprehensive solution includes a culturally specific behavioral health intervention, uh, which combines Western medicine with, uh, storytelling and talking circle interventions, which are culturally specific to Native Americans, um, again, with the intent to help lower, um, suicidal ideation amongst Native American veterans.
• 3:12
  Uh, but the plan also, or the solution also includes doing something a little more basic, which is deploying internet access, broadband access, digital literacy skills within our communities.
• 3:26
  Um, and the most revolutionary concept of all is just building trust with our community. Yeah.
• 3:32
  Uh, really listening to our veterans, listening to our Native American veterans, and understanding, uh, what is it that they need, and how can we help address, um, the concerns that they have.
• 3:43
  Isn't it interesting that sometimes the, the bedrock foundation of a innovative of something as simple as trust, connection, or even a broadband, uh, internet connection? Absolutely.
• 3:54
  Here we are talking about communities that unfortunately have suffered from persistent, um, you know, structural inequities, um, that have created these suicide disparities today.
• 4:08
  And so it is absolutely important that we look at low tech solutions to help address some of these concerns, and that's why we're starting with something so basic as, okay, can we go into the communities and first give access to broadband, give access to devices, teach people how to use their devices.
• 4:26
  And even before that, uh, we, when we talk about, um, you know, how do we help bring social connectedness- Mm-hmm...
• 4:34
  we are looking at low tech solutions like the radio, um, to talk about, you know, the available VA resources and that, you know, we care, we're here for you, we're listening to you. Yeah.
• 4:46
  How did you get into this work, specifically wanting to help Native Americans, wanting to help people dealing with suicide and loneliness? We, uh, it's, it's a funny story.
• 4:57
  Uh, I have, uh, the privilege and the honor of working with, uh, some indigenous public health officials, and we got into a conversation about how, uh, any time we think about suicide and suicide deaths, we have to really understand that the Native American population has culturally unique, um, issues.
• 5:22
  They have historically, uh, been disenfranchised. Uh, there is historical trauma.
• 5:28
  And so when we think about solutions for suicide prevention, we have to respect the fact that we have to look into culturally unique and culturally specific solutions.
• 5:40
  And so in talking with my colleagues who are indigenous public health officials, we thought about, okay, how do we help address this problem by creating something that is culturally unique to our tribal communities?
• 5:53
  So that's how it all came about, and we're lucky to have support from some really amazing tribal communities today that are-- and of course the, the VA and the Veterans Administration to Mission-- through Mission Daybreak, um, that we're able to really, um, you know, push forward with this solution.
• 6:10
  It's exciting that the VA is funding something like this.
• 6:13
  Yes.In this project as well as your work with senior loneliness, how are you seeing the macro conversations shift in terms of, of priorities, priorities of funding, um, just across the board? So
• 6:31
  when we think about senior isolation, uh, or whether it's our veterans, I think the focus of Televeda from the very beginning has been, our overarching mission has always been how to address and alleviate social isolation and loneliness amongst our most vulnerable populations.
• 6:50
  Um, seniors just happen to be, unfortunately, folks who suffer from isolation and loneliness, um, you know, more than other, uh, other communities, I suppose.
• 7:01
  And, um, the, the, the thing that I think we focus on and do really well is we use tech as an enabler and not as the forefront. Mm.
• 7:12
  I mean, AI, VR, I mean, you hear a lot of these solutions trying to resolve isolation, loneliness, but really what people want to see and really what people need is they don't need another mental health app.
• 7:27
  They don't need another application or a software tool that'll help reduce isolation. What they really need is you and I coming to them and just talking to them- Yeah... and listening to them.
• 7:38
  And so what we really focus on is, even though it's, you know, from a scalability perspective it takes more time, but we go into people's home to teach them how to use their devices, to make them feel comfortable, to make them feel empowered.
• 7:52
  Once that digital inequity is bridged, then we can talk about closing the gap on health disparities.
• 8:00
  So that's, it's, it's a simple, but in our minds, that's the best way to address isolation, loneliness, is to empower people by doing the most basic thing. I, I- Talk to them... I love the ethos behind it.
• 8:12
  I love the direction you're going. It does cause me to ask about your, your business model. Who pays for it when it's so high touch? Yes. A great question. So, uh, we get paid by Medicaid plans- You do...
• 8:24
  and Medicare Advantage plans. And so this is, uh, something new that is coming down the pike in 2024.
• 8:32
  CMS has come out with a new rule that all MA plans absolutely have to create a digital literacy assessment tool- Okay...
• 8:42
  so they can assess what is the s- digital literacy skills that their MA members have, and B, is provide them with digital literacy, and it has to be culturally specific and culturally, um, you know, tailored.
• 8:55
  So if it's a Spanish-speaking member, it has to be in Spanish. And so that just shows to you where CMS's head is at. Yeah. They have recognized that, uh, our, uh, just providing coverage is not enough.
• 9:11
  There are digital inequities and health disparities that are being created because people don't know how to use their devices. I mean, there's such a push on telehealth, but people don't know how to use- Yeah...
• 9:23
  their telehealth. Um, it's sometimes frustrating for someone like me who's tech savvy. I have five different doctors with five different apps- Yeah... and I have to go and schedule- Me too...
• 9:31
  an appointment on different apps. Me too. So if CMS is pushing this forward for MA plans, I am fairly certain that this is going to come down for, you know, all of the other- Got it...
• 9:43
  uh, Medicare, Medicaid coverages as well. But again, it goes to show that it is important that we include people and teach them how to use, you know, technology. Not everyone grew up lucky like you and I.
• 9:56
  So you see the trend, you see yourself as maybe one step ahead of that reimbursement trend, but that it's coming down the pike? Absolutely. Yeah.
• 10:02
  So plans that we are working with right now have already seen the need to create digital literacy amongst their members, and I think they're ahead of the curve because absolutely this is happening and it is coming down the pike.
• 10:16
  So when we, uh, teach our members how to use their devices, and then we connect them to our platform, which, you know, also connects them to micro-communities, and they find friends and groups and things like that, um, what we are ultimately doing is creating, you know, that member retention for them- Mm...
• 10:33
  and creating that, you know, trust factor again with the plan. Um, and we have the assessment tools that we provide to the members so that we know who, you know, how educated they are.
• 10:44
  So I think the plans we're working with, of course, are a- ahead of the curve- Yeah... but it is something that is absolutely coming down the pipe.
• 10:51
  So if I'm hearing you correctly, um, you have this platform for seniors that helps connect them into micro-communities. Yes. Right?
• 10:57
  So, but you're being reimbursed for a piece of the platform that does education, uh, literacy, patient literacy education. Yes.
• 11:06
  So we essentially, um, if you want to split what we do, we have a digital literacy assessment tool, which is our first step. Got it.
• 11:16
  So we assess members on where they stand in their literacy skills, and then the second piece is to teach them how to use their device, whether that's a phone, it's a laptop, um, whatever device that they have that they want to use, and we don't discriminate based on it's only telehealth, it's only going to be X, Y.
• 11:34
  Yeah. We teach them everything. You wanna learn how to use YouTube? Sure. Go ahead. Yeah. We will teach you how to do that.
• 11:39
  And once we do that, then the third sort of segment is we connect them on our Televeda platform to micro-communities of other people- Oh, I see... who share the same interests.
• 11:49
  So what I mean by that is, uh, we've been doing this for several years, and what we've learned is nobody wants to acknowledge that they're isolated or lonely. Sure. There is a stigma attached to that.
• 12:01
  And so, but instead, they will say, um, "Oh my gosh, I miss doing yoga." Yeah. "I miss doing, you know, my art class at the senior center," or what have you.
• 12:11
  And so once we learn about their interests, then we connect them to that micro-community of members that exist on our platform, and, uh, the one thing that I can...Almost guarantee, uh, and not almost, I can absolutely guarantee is that every micro community on our platform is extremely welcoming.
• 12:31
  Because they've all experienced that isolation and loneliness. Got it. So when someone new joins, they are all about it. They will welcome you. Nice. And they'll make you a part of the community.
• 12:41
  So, uh, we know that once someone joins platforms on our community, they're consistently coming back month over month to join that, that particular class or that particular program.
• 12:52
  Because it becomes a part of their routine. Now they have something to look forward to, to make their bed, get out of- Yeah... you know, get out and start their day. Love it.
• 13:00
  Shruti, thank you for coming by and giving me an update on Televeda. Yeah. Exciting to hear about this project with the VA and with- Yes... um- It's called Hero's Story. Hero's Story. Okay. Yes. Okay.
• 13:11
  Can they read about it on your website or? Yes, absolutely. Okay. If you go to televeda.com, you can read everything about the Hero's Story, as well as all of the other things that we're doing. All right.
• 13:20
  Keep up the great work, and we'll get an update next time we're together. Thank you so much, Logan. All right. Thank you, Shruti. Take care. That was Shruti Gurudanti, CEO and co-founder at Televeda.
• 13:29
  Next, we'll get into my interview with Keelan Swayne, CEO and co-founder at Greens, recorded at a recent health tech conference. [upbeat music] Keelan, great to have you in the studio. Howdy, Logan. Yeah, it's great.
• 13:43
  How you doing today? I'm doing great. I'm, I get energy from folks who have energy like you. I'ma give you the energy then, if that's what you need. So I'm feeding off of it.
• 13:51
  [laughs] It's been great to watch your journey. Uh-huh. You're helping folks with Type 1 diabetes through your app. Uh, just, let's start with what you've built. What is Greens?
• 13:59
  So Greens is a mobile health app and SMS service. Okay. And the way it works, the tagline you say is, like, we're scaling this to vulnerable communities. Okay.
• 14:08
  It's a three-part program where one of the most unique value propositions that we actually discovered in Startup Health T1D fellowship, name drop- Yeah... is group based care. Okay.
• 14:22
  So a part of our platform or mobile app is that you're a pair. You have to do it in pairs.
• 14:30
  So for example, if you have Type 1 diabetics, you have Type 1 diabetes, it means you have to do it along with your mother or father or spouse, and that has significantly improved adherence rates.
• 14:40
  So you get paired in the app, and the reason you're paired is because we advocate for all of our patients, unfortunately, to get continuous glucose monitors, right? And also do nutrition tracking.
• 14:52
  Unfortunately, the patients that we save or we want to serve, um, they don't know why they should get continuous glucose monitors. Okay.
• 15:00
  They don't have the proper y- y- this proper paper you have to fill out when you're talking about Medicaid to get these monitors. Um, and so we advocate and make sure they get that.
• 15:08
  But once our patients have those glu- glucose monitors, right, we're monitoring when they eat, and we're monitoring nutrition tracking via the application, and we send that information to the parent and to the patient.
• 15:19
  Interesting. So there, it's a cycle of care. It's, it's, it's accountability. Extreme accountability. Yeah. Yeah.
• 15:24
  And there's some other cool psychological terms involved in it, but accountability is the most easiest way- Yeah... to think about it.
• 15:29
  It's really interesting you're tackling this vulnerable population piece because there's a lot of amazing Type 1 diabetes innovation happening. Mm-hmm. And yet what you just said- Mm-hmm...
• 15:37
  was that even in the United States, in an- Yes... advanced country, we've got communities that aren't taking advantage of continuous glucose monitors- Yeah... sort of the, the top standard of care. It's out there.
• 15:47
  It's even being reimbursed. Yes. And yet people aren't taking advantage o- of it. So let's- Yes... get everybody up to the standard. Mm-hmm.
• 15:54
  Uh, a- before we even start thinking about crazy, oh, five years out, 10 years out- Yeah... let's make sure we're all getting the best now. Yes. Uh, how'd you get into this sort of passion area? Yeah.
• 16:06
  Uh, one of the things my grandmother told me is, "It's not an advantage unless you take a- advantage of your advantages," right? Yeah. Okay. So I wa- I wanna start there- That's a good one...
• 16:16
  and double click on that because I appreciate you said, like, upskill, uh, the masses w- Yeah... who aren't even aware of the, the power of CGMs. We're talking about insulin pumps, right?
• 16:26
  That's a huge niche, but there's still a huge market at the, at the- Just basic data... at, on the lower level. Basic data. Yeah, just get your data. Get your data and, a- you gotta convince them why.
• 16:34
  But I started it, right, um, as a passion project. Mm. This is my, one of, the third business in the past seven years, and I said, for this third thing I'ma do, um, I want it to be impactful.
• 16:45
  I didn't want it to be a money grab or like, you know, a B2B SaaS type of company. Were you always in health or tech or? I was in tech. You were in tech. Like, yeah. Okay.
• 16:53
  I, pr- previously I worked at NASA as a 19-year-old. Okay. And a joke I tell people, at 18 they offered me a job, but I wanted to launch my own app or be a baseball player. Okay. Right?
• 17:04
  And so, um, I struck out that season a ton at Prairie View A&M University. I love Prairie View, but I wasn't a good baseball player there. And the app I released into the market was about physical health.
• 17:14
  It only got 300 downloads. Okay. So then next year I was like, let me work for NASA and up my skills. Um- Okay. But that journey and all the companies to now, it really went into a personal story of mine of my dad. Mm.
• 17:28
  Um, he was, three years ago, um, during the pandemic, he gained pandemic weight and he, uh, he was, he got diagnosed with Type 2 diabetes, right? Mm. And so this was, this has been apparent in my family.
• 17:42
  About 30% of my family either had diabetes of some sort, Type 1s and Type 2s, or like some type of heart condition. So I didn't take it personally because that wasn't my dad, right? Yeah.
• 17:52
  That was aunties, uncles, cousins. Yeah. Like, you know, you're... That's not my problem to s- you know. And it's so prevalent today. It's so prevalent, especially in the Black and brown community.
• 18:01
  It is extremely prevalent, and I wanted to make that aware. But he got it, and then he went to, uh, Medicare Advantage, 65 and up. He went to his nutritionist, first thing he went to.
• 18:11
  They, uh, appointed him to, and the nutritionist told him like, "Hey, you know what? You should eat more kale." Kale. My dad's like, he's a 65-year-old Black guy from Mississippi. He's like, "What the heck is a kale?"
• 18:21
  [laughs] Okay? But he did know greens. YeahCollard greens, mustard greens, and that really helped him out for the first eight weeks. But that didn't really translate to the nutritionist very well?
• 18:33
  No, it didn't translate to nutritionists very well. It was just a lack of, you know, cultural competency- Mm... on the nutritionist side that identified.
• 18:41
  That was a big a-ha, and then just looking at most of the marketing in the nutrition space, there's just a gap. So- Yeah... you know, for African Americans, it may be comfort food. That's what we're used to, too.
• 18:50
  But LatinX, it may be how do you do that with His- uh, Latin, Latin food, or, um, Indian food. Yeah. And so every culture has their own food types, but it...
• 19:00
  And it's not necessarily the American way, or California way, or New York way, or, you know, the base of nutrition. But- I ju- I just talked to somebody- Yes, go for it...
• 19:07
  where a nutritionist told, uh, somebody who was from Mexico, like, s- "Stop eating tortillas." You know? How? There was no conversation- How?... of what your life could look like with this cultural sort of paradigm.
• 19:19
  Yeah. Just cut it out. The... So the thing that really helped my dad be long term is, is one of inf- in- inflection points on why we do groups is my mother. So my mother, uh...
• 19:31
  He fell off the band, the bandwagon after nine weeks. It's, it's, it's a diet. Like, fad diets don't really last unless you have a strong system. My mother was like, "You know what, Tommy?
• 19:41
  We're not gonna allow you to, you know, lose your legs, or lose your eyesight, or get CKD," chronic kidney disease, right? Yeah. Which startup companies are here talking about today. "I'ma do something about it."
• 19:51
  So she started to adopt the diabetic diet. Okay. And she started to, like, understand- The buddy system. Yes. She bought nothing but, you know, keto-friendly, low-carb meals is in the pantry.
• 20:02
  Threw all the other Ding Dongs, all the other barbecue sauce with like 20 grams... I'm from Texas, we love barbecue. Yeah. But we t- put too much damn sauce on there, right?
• 20:10
  And cleaned the refrigerator, started to learn how to cook in that way, and systematically, he was able to do that for two years straight because unfortunately he had no other options. Yeah.
• 20:19
  And so we see that as a huge opportunity at scaling the diabetes community. It's not for everybody. Everybody doesn't have, like, a pair or a group that they can work with. Yeah.
• 20:28
  But it's a good start to create a strong system that's culturally inept from somebody who's influential. Mm. So in our, in our T1D market, there's a ton of mothers, right, that love their kids. Yeah.
• 20:39
  That don't wanna see their kids in the hospital.
• 20:41
  But there may be a small gap in how to properly and systematically, like, cook, educate, and, like, medicate their kids in a way that doesn't make them feel like a helicopter mom. Yeah.
• 20:52
  And so we like to be the mesh in there, The Greens Diabetes Companion, where it's, it's a team sport. I play baseball, I love team sports. Yeah, yeah. I'm a firm believer in it, and my goal is to scale it, right? Yeah.
• 21:05
  And, and, you know, as long as there's a mother or spouse involved, I think we have a strong shot- Yeah, or-... of, of doing something s- extremely impactful... lo- a loving family member.
• 21:13
  Talk to me about how the market has responded, your traction. I see the Techstars T-shirt. Hey, yeah, yeah, yeah, yeah. That's exciting. Yeah. And kinda what's coming next. So, uh, we've done multiple pilot programs.
• 21:24
  We're on our version two. We've been able to get above a 50% adherence rate. That means for our patients, we can take their medication every other day, which is phenomenal. The standard is 30%. Okay.
• 21:34
  So insurance plans have been taking us very serious when we say 50%. They be like, "Oh, what? Really? Prove it." So we have two letter of intent with MCOs. Nice. That's our, you know, go-to-market strategy.
• 21:44
  Medica- uh, MCO is a managed care organization that manage Medicaid members. Yes. We're currently, uh, launching in the state of Texas, howdy, and Alabama. That's a huge healthcare desert in the Southeast. Mm.
• 21:56
  And we're con- we're c- we're constantly looking to add more managed care organizations into our pipeline, because that's where the masses are.
• 22:02
  That's where the major distribution of our diabetic patients are, and we wanna, you know, we wanna be right there. And like, like you said, that group, what we know is there's a pattern. There's a huge inequity when...
• 22:14
  And it may be on the CGM health literacy or tech literacy, or it may be on the transportation issues to go to a pharmacist or go to the doctor to get the education.
• 22:23
  But the providers, like, providers are low in these states. Mm. But the demand is extremely high. Yeah. And we want, The Greens wanna m- be able to really close that gap.
• 22:35
  Are you finding that the, the appetite for innovation is growing with these MCOs and the people you're talking to?
• 22:41
  Yes, because MCOs are inherently value based, and they get judged on outcomes, right, and not necessarily fee schedules in, in correlation to health systems. You know, if you...
• 22:52
  We found if you got, if you have a program that can, is competitive and better than their stats, and you have something to say, like, "We can reduce A1C," or, "We can help hit these HEDIS scores or utilization scores," you're gonna get a lot of...
• 23:07
  You just gotta be able to prove it. Yeah.
• 23:09
  So all the IP, all the support, all the resources is really doubling down in our own pilot programs and, and, and proving that this thing work, because to be honest with you, there are a ton of digital health companies, but how many of them actually work- Yeah...
• 23:24
  at scale? Yeah. Like, that's the novelty. It's not, you know... It... We have AI in it. I didn't talk about AI. We have all these little different things. Yeah. But does it really work- Does it work...
• 23:33
  for the community you're trying to serve is what we learned. Awesome. And if you can solve that, man, you, the, the sky's the limit. Yeah. Well, Kelyn, I think the sky is the limit. Thanks for coming by for an update.
• 23:42
  Thank you for having me. It's exciting to see how you grow. I know you're still in the early innings. Yes. You, you played baseball. Yes. Oh, okay. And, uh- That's... Okay. [laughs] All right. All right. Yeah.
• 23:49
  But you're, but you're, you're doing great work, and it's gonna be exciting to see what you do next. I'm excited to learn. Keep us up to date. Yes.
• 23:56
  Next time we do this, uh, I'll be excited to see who, you know- Next year, we'll have even more resources... who's gotten in line. Right? Exactly. Exactly. We'll do it again. How about that? Are, are you raising?
• 24:04
  Uh, no, we just closed. Fantastic. So we just closed our early stage round with Techstars- Fantastic... Jumpstart, NSF. Okay. All of my initial backers.
• 24:11
  So now you can just work on your, uh- I can just work on the thing... go to market. Exactly. All right. Thanks, Kelyn. Likewise. Good meeting you. Take care. [upbeat music] Thanks for listening to Starter Health Now.
• 24:24
  We'll be back again with another episode next week. [upbeat music]