Access & Inclusion In Heath Tech Drives Value Based Care & ROI - HLTH Foundation Techquity Winners

Most teams ship “good” products that quietly fail because they never tested them with the people they were supposedly built for. This Techquity Awards special is a four-part episode on how to fix that. I’m joined by Janna Guinen, Executive Director of the HLTH Foundation, plus three Techquity Award winners—Reza Sanai of PicassoMD; Colby Takeda of Pear Suite; and David and Robert Bosnack of Attune Media Labs—who use Techquity as a practical blueprint for building products that actually work in the real world.

Techquity, as Janna defines it, is innovating with everybody in mind—from how you validate the problem to who can realistically use your product on the other side. The HLTH Techquity Awards are case-study based, not feel-good trophies. 
Applicants document how they involved the communities they serve, which population they’re designing for, and which metrics prove they’re closing gaps for both patients and the teams who care for them. 

This year’s winners show three different ways to put Techquity into practice: PicassoMD’s curbside specialist consults at the point of primary care, Pear Suite’s tech and billing rails for community health workers and local organizations, and Attune Media Labs’ AI emotional intelligence companion for burned-out clinicians.

Episode Highlights:

• Techquity Awards use a rigorous case-study process that forces teams to show their problem validation, design choices, and metrics—not just outcomes slides.
• PicassoMD tested its curbside consult platform head-to-head in an affluent urban clinic and a rural clinic with many uninsured patients, proving the model can work in very different settings.
• Pear Suite onboarded more than 600 community health workers and doulas across 80+ organizations serving Medi-Cal members, closing 80% of identified social needs gaps.​
• Attune Media Labs deployed an AI-based emotional intelligence companion with over 1,000 clinicians in rural Cameroon, where about 65% reported burnout, and designed against benchmarks for retention and engagement.

Janna makes the case that Techquity should be the default lens for digital health because inclusive design improves ROI, stickiness, and long-term system sustainability.

And we close with Janna’s announcement that the Techquity Awards are moving from ViVE to the main HLTH event, with applications opening in early spring so these case studies get a bigger stage.

Watch the full HLTH Techquity Awards Special on YouTube to learn how Techquity turns “health equity” from a buzzword into a build process. 

Then like and subscribe so you never miss an episode.

A "glow up" signifies a positive transformation, reflecting the journey of becoming a better, more successful version of oneself.

At The Tech Glow Up, we humanize the startup and innovation landscape by focusing on the essential aspects of the entrepreneurial journey. Groundbreaking ideas are often ahead of their time, making resilience and perseverance vital for founders and product leaders.

In our podcast, we engage with innovators to discuss their transformative ideas, the challenges they face, and how they create value for future success. 

If you're a founder or product leader seeking your own glow up, or a seasoned entrepreneur with stories to share, we invite you to join our guest list via this link.

Transcript

Janna Guinen 0:05

It is important for people to think about how they are innovating and including people they are innovating for in that process.

Nathan C 0:14

Hi, and welcome to the Tech Glow Up. I'm Nathan C, and today we're talking Techquity with Janna Guinen, the Executive Director of the HLTH Foundation. Janna, it is such a treat to talk with you today. Thanks for joining me.

Janna Guinen 0:29

Thanks so much, Nathan, for having me. This is sort of like a formal, next step since we met each other so informally, what, a couple years ago now when you're still at AWE. So thanks for having me, happy to be here.

Nathan C 0:42

I think it's like four years and three HLTHs, since we first, started talking about Techquity. I love it that we're podcasting about it now. so let's just jump in. can you introduce yourself and talk about the work that you do at the HLTH Foundation

Janna Guinen 1:00

Okay, i'm Janna Guinen executive Director of Janna Guinen. We are a nonprofit organization focused on how digital health can be harnessed to address health disparities. that comes down to how innovation gets done, who has access to technology, who gets to lead, and integrating patients as partners in the process.

Nathan C 1:21

Oh, I could use up all of our time on any one of those topics, But we are here today for a very specific reason. We have a very special episode launching the day after ViVE 2026, the ViVE event, and we are here to celebrate the winners of the HLTH Foundation's Techquity Awards, can you, set this up for us a little bit? First, can you talk a little bit about what Techquity means to you? And then, explain a little bit about how, these startups and innovative companies, participate in this amazing program.

Janna Guinen 2:06

Yes. So, Techequity H-L-T-H Foundation, what it means

Nathan C 2:10

to me and what I hope it means to everybody is innovating with everybody in mind. you can see it, there are many examples of technologies that were really meant for broad use, but in reality are not broadly applicable. And also there's just a failure to make, technology accessible to people in different ways. whether they're unaffordable not in somebody's first language, or, written in a way, such a way like the, the copy is not, is not written at their literacy level. They. many different ways that technology can go wrong despite its truly incredible potential. And I want to just start by saying I'm a huge fan of technology. But what I really want is for technology to be broadly available and broadly supportive in healthcare. I talk so much about how one of my missions, at awesome future is to help people with good ideas succeed faster, And so many of the things that you're calling out here. Aren't just barriers for patients to, take advantage of technologies or providers, to leverage new technologies in their work. But it's like bringing it back to are these things usable and accessible? Right? And actually building successful models that do make an impact. I love that. talk to us. This award series is, unique and, you've been doing it for a few years. can you, dive in a little bit about how, these innovative technologies engage, with this process and how you come to find, winners in equity, through these awards?

Janna Guinen 3:42

so we are just completing our third award season this is a case study award program. So what we're looking for is leadership in innovation, not just sort of, we've getting great outcomes. So that's a big piece of it. But we also accept, works in progress. how have you designed your innovation, to meet the needs of the population you want to serve? I will say for us, it's a huge part of our year and I'm so excited every year we work with these winners, throughout the year in different ways to try to connect them. We're trying to formalize some of that even more as time goes on. we have an advisory committee that is stepping up and offering mentorship and, real feedback to the applicants the Awards program is really there to recognize innovative approaches to resolving health disparities. We, are focused on underserved patient populations as well as the providers who serve them the process opens with an application where we're asking a lot of questions about how you validated your problem, How do you understand the problem? And that immediately takes us to, did you check with the community? Did you check with the specific. Population that is meant to benefit, but also the broader population of people. Did you think about that? How did you, you know, what did you develop? How did you test it? I wanna call this out because it's so important to the results that you get on the other end of the process. We also ask them about their metrics, who they're solving for, where this is taking place, a whole lot of things. And what happens at the end of this is there's a scoring process we designed. I mentioned earlier, we have an advisory committee, that provides counsel on our techequity initiative at the foundation. They're all leaders in their own right in population health, health equity. We designed this scoring process and it's pretty rigorous along with the application. We're trying to find ways to make it a little bit easier But, at the end of the day, because this is a case study award, not just an outcomes award, we have to ask a lot of questions to understand how the work was done. It's in service of us understanding, being able to provide insights, up the leaders, doing the work, and then over time as we gather this data to develop into evidence. So here we are, we're going to be announcing the winners at vi and we're recording this before vi so I guess I can say who they are'cause it's gonna air.

Nathan C 5:54

we're celebrating them today.

Janna Guinen 5:56

Yes. So I'm just gonna call them out right here. This year's winners are Picasso MD and they developed something really incredible. It's a curbside consult platform. somebody might be in with their primary care physician, they need a specialist consult. the specialist can tell them in the moment, yes, we need to proceed with a specialist consult for certain, we need an appointment here. Let's get that moving. Or actually, I think this is something that can be managed. Here and now this is what we recommend. what I love, being a case study nerd is that, Picasso MD gave us a head-to-head effectiveness study. looked at, how their solution performed in an affluent urban clinic, and then how that compared to the way it performed in a rural clinic that serves a large proportion of uninsured patients. that's really important. You know, you're coming from potentially different educational levels, different exposure, et cetera. and we just know that these things make a difference in how healthcare is, accessed and how it's effective. So anyway, love that about PicassoMD. So, congratulations PicassoMD Pear Suite is our second winner. They've created a whole care navigation program and infrastructure around community health workers, and community based organizations, which are often lacking the structure that they need. It's almost like a practice management software. it helps them, through the care navigation process and to, get all the paperwork and regulatory, things done. in their project. They onboarded more than 600, community health workers and doulas, in more than 80 organizations that serve, Medicaid members in California. That's the Medi-Cal program. they closed 80% of social needs gaps through this project. amazing and congratulations to Pear Suite. Attune Media Labs, developed an AI based emotional intelligence companion. So this is for mental health, behavioral health. It uses both verbal and nonverbal cues and implements evidence-based behavioral health support. their project was, with over a thousand clinicians in rural Cameroon, where more than 65% of clinicians are suffering from burnout. You can imagine, you know, if you're a, if you're a nurse, a doctor, et cetera, and you are serving people in a really challenging situation who have like high needs and you are in a low resource environment that creates burnout and moral harm. So that's what they are working on and their design was excellent and all of their metrics. they're designing against metrics that beat industry benchmarks, for retention, job retention, activation, engagement, with their platform, et cetera. So those are this year's winners and, it's really exciting work for us.

Nathan C 8:31

I've had the chance to talk with some of these winners are there case study findings and the data supporting it? Just fascinating. the, sentiment analysis from verbal and non-verbal cues was a hilarious one to be learning about as my very active learning style. They're like, Nathan, it's very clear that you have lots of nonverbal cues. Janna, I'm always curious about how leaders in these spaces, get to where they are. what is your origin story in advocating for equity and, bringing these ideas of technology care and advocacy, together.

Janna Guinen 9:13

A really good question. It's interesting and a curvy road. It's not a straight mind by any means. it hearkens back to one of my first jobs out of college. I worked in investor relations as an advisor for biotech companies, and they were all pre IPO and young biotech companies. I found it so exciting to see brilliant people, we used to call it like going from" two guys in a garage with a great idea" to a public company figuring out their markets. this is what I didn't know until I started working in that space, that technologies can become so many things. They can serve so many different markets. Decisions have to be made along the way and seeing how that, operationalizes in a business plan and how companies take off. And so many people are helped and, ideas scale And so from that time, I've been in, healthcare and medical, communications, content programming, partnerships, et cetera, in different ways. All of those things led me to here at HLTH Foundation. To me, nothing is more important than helping other people. And I love our industry of healthcare and technology and how they marry together to support people generally. I think that most of the people I've met in our industry really care to help and, provide their talents in that way. So I guess that's my origin story.

Nathan C 10:30

That's a pretty lovely one. Thank you you were very kind to say how much you appreciate this industry and the work that it is doing. One of the things that I've been asking at VI as well as, in my healthcare conversations, is how should healthcare Glow Up or see a dramatic. improvement, change, rebirth. I heard at Health in October that almost everybody is ready for change, whether it's patients or providers, technologists, everybody's ready. Where do you wanna see healthcare Glow Up in the next six months to a year?

Janna Guinen 11:10

That's really easy for me. think the industry just needs to adopt equity practice as a default for all innovation. it makes sense. I mean, what we're advocating for is something so sensible I think we're in a rush, like rush to market, rush to product, to get product completed and to be first. I think that we are slowly developing the case that when you take that time upfront and you are consultative in your approach on innovation. You will have better ROI and certainly better stickiness. Now you can talk about cost effectiveness. We're seeing that in a lot of the case studies. We have a free database of the top scoring case studies over the last two seasons. We're gonna be adding this season's, right now we're at 82 or so. Case studies will be at a hundred or so, and you can look in there and see. some of these are works in progress, but some are completed and showing cost effectiveness we should all care about that. in order for us to have the healthcare we need, we need a sustainable system. And in order to have that, we need to be addressing everybody's care needs. And when we don't, it drives up cost. and frankly, I think it creates the moral harm that we were just talking about earlier you know, I think it's heartbreaking, that we're not doing better by people and we can. So that's the Glow Up. Let's do it.

Nathan C 12:22

Hey, if you're advocating for, let's build more customer centered products. Let's be more focused on providing access and care for everybody. Let's focus on the things that matter. So both companies, technologies, and great ideas, can be as successful as these care goals, right? Like, if doing the research makes better products and helps us reach more people, like, why aren't we all doing this? That's totally a message I can get behind.

Janna Guinen 12:53

it's culture change and I shouldn't say it's just culture change.

Nathan C 12:56

Mm-hmm.

Janna Guinen 12:56

is a really, really big thing. And you know, that's where I see, almost a different danger to ai. We can talk about all the dangers of AI that are typically discussed, but one of them is the speed at which we are expecting change now. And I think that is, somewhat problematic to a thoughtful process. I love ai. I think AI is gonna do great things for us, but it won't do great things if we don't train our data in inclusive ways. And if we don't, look at, algorithmic drift and make sure that we're hauling that back in. over time. That ensures we are broadening our data sets as new data become available and all those things.

Nathan C 13:28

Janna, I didn't even have to ask you what your spicy hot take was. I love it. No, that was perfect. You got like two in. So we are getting close, to our time today. if listeners out there have been inspired to learn more about how they can bring equity practice into their work, if they wanna learn how to get involved, if sponsors wanna get in touch, how can people follow up and learn more about the work that you're doing at the HLTH Foundation? And, the Techquity Awards.

Janna Guinen 14:02

The easiest way is to go to our website, which is it's HLTH Foundation but let me spell that out. It's H-L-T-H Foundation, like the HLTH event, HLTHFoundation.org. That's where you can find everything that we're talking about. But also I would say, especially right now, if people are interested, in, in the equity award winners. a look at our LinkedIn.

Nathan C 14:21

Thank you to everybody who came to the panel to celebrate the equity winners. you can watch the recap video, in the VIVE event content stream. Oh my gosh. Janna Guinen executive director at the HLTH Foundation making the case for, why Awesome Future exists, focused on equity access, accessibility. and using tech to actually solve problems and make people's lives better. Such a treat to be focused on, techquity and these winners, from the 2026 Health Techquity Awards. Congratulations to the foundation and all of the winners.

Janna Guinen 15:06

Thank you so much. I'm the biggest fan of Awesome Future as a concept for your work and for your show. And I totally believe in an awesome future. I have one more hot take. Can I do my outtake with a hottake?

Nathan C 15:17

Hell Yeah. Bring it.

Janna Guinen 15:19

we're actually moving the equity awards To the HLTH event. Applications are going to open and, in the early spring, so people can apply and then we will be awarding people at HLTH where we think we have, the perfect audience and a bigger audience for these awards. So thank you for letting me say that.

Nathan C 15:36

That's the perfect follow up. Janna, thank you so much for joining me on the Tech Glow Up. this has been just an inspiring series of conversations, talking with you and the, Techquity award winners. Congratulations.

Janna Guinen 15:50

Thanks so much.

Colby Takeda 15:51

Healthcare should be done in the community. We're all about empowering Community health workers and these are people that have lived experience. Who are your neighbors, who are people that go to your church, who you'll see at the grocery store, the possibility for us to empower health workers who are on the ground people that understand your experiences, who can guide you through your life's challenges. help you live healthier and happier is amazing. And I think that's what we're all about at Pear Suite.

Nathan C (2) 16:20

Yeah, I'm excited to get into that. So hello and welcome to the Tech Glow Up. I'm Nathan C, and today I'm talking with Colby Takeda of Pear Suite. This is another of our HLTH Foundation Techquity Award winners series. Colby, thank you so much for joining me today.

Colby Takeda 16:43

Thanks for having me.

Nathan C (2) 16:43

I am so excited to dive into this premise that you just set up. Could you please introduce yourself and a little bit about the work that you're doing at Pear Suite to help make care more active and available in the.

Colby Takeda 16:58

Absolutely. I was born and raised in Hawaii which isn't where you expect a healthcare startup to but it was really the perfect place to start this work. In Hawaii it's all about family community, you see your neighbors, everyone knows each other. The degrees of separation is really unique in that everyone seems to know everyone on the island, even though it's a pretty big island over about a million people on Oahu at least. But yeah, this is a place where everyone cares for each other. Whether you are a local a tourist or part of the military everyone supports each other that model of community health that leverages your lived experiences, your resources, your connections is really something that can thrive. During the COVID-19 pandemic this is the innovation we started. We, the idea that we can take people that at your church who maybe you meet in the community at library people that you see at the YMCA they can guide and help you. as well and they should be part of the healthcare system. This is how we're increasing access. At the time I was teaching Community Health Worker courses and despite not thinking I'd be a tech founder realizing that a lot of community health workers didn't have software, they were on paper and spreadsheets and in this day and age that shouldn't be a thing we should be able to work faster and better and be more effective with technology and to be able to build alongside these community health workers was really special. Yeah, certainly my public health background helped with that. Studied the, concepts and theories of public health, but this is my chance to combine that with the innovative spirit and the entrepreneurial spirit and make a company and solution that really can solve for some really big issues in the healthcare system.

Nathan C (2) 18:43

Can you talk a little bit more specifically about how you're using technology to drive this kind of access and. I'm actually really drawn to this idea of including the community and like a bringing in of resources. what is your specific approach with Pear Suite to use technology and to engage the knowledge of the community toward these community health goals?

Colby Takeda 19:10

Absolutely. It's been amazing to see a shift in the healthcare thinking around what actually impacts that right. Before certainly your genetics, your background, your absence to healthcare. Do you have a doctor? Do you not have a doctor? That was really important and still are. But now everyone recognizes that housing. Do you have a roof over your head? Do you have transportation to, your workplace? Do you even have a job to begin with? Do you have tech literacy to help you fill out an online application to get the job in the first place? Do you have food? Can you feed your family with not just any food, but healthy and fresh food? All of these factors are so critical and it's not your doctor that's gonna help with these things, right? It's not a nurse that's gonna help you find affordable, reliable housing. It's the people on the ground who are your neighbors, nonprofit who are on the ground helping you navigate the healthcare system by getting you connected to a doctor in the first place, or maybe doing translation or interpretation for you helping you find housing that is affordable and is reliable and safe. People live in, in, in apartments or houses, but maybe there's utility challenges or maybe there's challenges with electricity or there's trip hazards. These are all factors that we need to uplift and promote as critical to living a healthy, independent lifestyle. Community health workers and community based organizations are at the core of this work, and they've been doing so for decades. It's not a new thing, but they've never been incorporated into the healthcare system, and that really prevented them from activating and, doing their critical work during the pandemic and this is the time when trust was so critical and who's best to. Have that trusted relationship with the hardest hit communities It's our community based organizations. Pear Suite really uses technology to uplift the work and, experiences that these community health workers and community based organizations bring. And allowing them to share data with health plans and health systems to generate referrals and, close the loop on different challenges. If somebody has a challenge, let's not just send the flyer or direct'em to a nonprofit. Let's actually make sure they get the support they need from these organizations. Now we actually can help these organizations get paid for this work and valued for this work. That billing that claims the compliance of working in healthcare, all that was critical for these organizations and Pear Suite solves all that with our technology.

Nathan C (2) 21:40

One of my personal frustrations, especially if there's a referral or if there's some additional resource that either in my care or people I'm supporting in their care journey, like need, usually like I get a piece of paper with 10 options. Three of them aren't options anymore, and two or three are circled that's the extent of the handoff. I'm imagining as you're talking. Somebody who is out in the community has a need that's been identified and instead of handing them that piece of paper, you schedule an appointment with a provider or make that referral there's some sharing of information and now this person is like gonna get a follow up call rather than five numbers. They have to call and wait on hold Is that, am I imagining

Colby Takeda 22:33

Yeah,

Nathan C (2) 22:33

direction?

Colby Takeda 22:34

The reality is there's not gonna be a perfect resource for everyone, right? Everyone's gonna have different needs and interests. might be some language challenges or cultural challenges or location someone might be able to drive across the state or island to get to a resource. But sometimes if transportation's the challenge, you have to find something near and, maybe even virtual, right? So that's what CHWs and community-based organizations do well and say. They understand Understand the needs and interests, the specific goals of that individual or family. They build that trust, which is so critical because if there are hurdles that individual member or family will go back to that CHW and get ongoing assistance or additional support, and that's what's amazing about community-based organizations. They don't just assess your needs and refer you. If you need help filling out a form to get into a program or service, like a diabetes prevention program or to get assistance with a special disease, they'll actually help you fill out that form and get you to be successfully using that program or service for the long term and check in with you all on the way.

Nathan C (2) 23:33

It seems like I love the elegance of this model, right? You're engaging the problem space with the resources already in place at moments when people would typically fall off. That pairing is super elegant from, this perspective. Colby, I'm always curious you even mentioned in your introduction that you, didn't always expect to be a health innovator. What was the moment that beyond the work that you were doing, you saw this opportunity not just to, build a tech solution, but one focused on access what was the moment that made you feel like you had to take this path of an innovator?

Colby Takeda 24:25

Thanks for that. My background is in public health, and I think public health does amazing things, but they don't teach you how to build a business, You don't learn about financial statements and funding models in public health school. my background running an organization in healthcare helped with that. If we really get to solve the world's biggest problems in the healthcare system, you have to understand. How you fund things, right? Where the money flows, what policy implications that are out there how to build a team and organize efforts and how to take some of the biggest challenges and solve for them at scale. what technology allows you to do. And I couldn't do it alone, of course. I was able to find. Along this journey, a amazing co-founder who brought the technology, the infrastructure, the design, the product expertise that I didn't have. I can help fund it. I can get some money and rally the team, but without that partner to build something that will make this solution scale across different communities, different people have different backgrounds users that have disabilities or challenges. That really is what we're doing. We're building technology for some of the most unique individuals out there who have different experiences, but that's what's so beautiful about CHWs, is that they bring that lived experience. They have their experiences being homeless. Being incarcerated being from. situation where they had no one else to support them in times of need they were able to get help. we give them the tools to make them more empowered and resourced so they can, go out there and help other people around them. That's really what we're all about at Pear Suite is empowering those who never before had a voice to help those around them. We are now training students in high school to be community health workers. We're training people in the prison system to become community health workers and upon reentering society can become a community health worker and help those around them. It's amazing to see who we can train as community health workers and then deploy and get paid and find a job. That's really to us what Techquity means is technology that makes it equitable for anyone to do this work, help those in need to get paid for their work and valued in society. It's pretty special.

Nathan C (2) 26:30

Can you talk a little bit about the mechanism for getting community health workers paid for their contribution? I've heard a couple products talking around this space and it seemed like maybe there's been some updates in legislation or rules about care. But I haven't learned about it yet.

Colby Takeda 26:50

Yeah it's been amazing over the past decade. Lots of policy coming out to support the community health workforce it starts with who are these people, right? How do you describe a community health worker? What's their background? What credential do they have that might make them suitable to provide this care? how can health plans and health systems verify that someone from this space has the skills and expertise they need to help someone and do so in a way that's managing risk, right?'cause everyone in healthcare is a little risk averse. And so really we're seeing, challenges with who is individual bar, where do you find them? How do you get them to the place where they can start working in the healthcare system? And that, of course, takes policy change that has taken a need for technology. Adjusting contrasts can you imagine a, healthcare system working with a nonprofit that you know works out of mobile vans or at libraries, and this is such a new thing, but policy description help with this. Being able to recognize different training. Experiences that these individuals have that was part of the credentialing process. Finding a mechanism to pay them has been recent and, sometimes with Medicaid, it's state by state, so we're seeing different legislative changes or state plan amendments. That's happening state by state. it's also great to see the advocacy shout out to all the community health workers out there who are talking to the legislators and trying to find equitable ways to pay and compensate and value the time and effort and the experiences of CHWs. That has led to this reimbursement opportunity that has then opening up doors for value-based care. The fact that nonprofits now are, working with us to Fulfill value-based care contracts to really value the efforts and outcomes of their work to reduce costs in the healthcare system is truly amazing. So yeah, of course a lot of challenges along the way. We can't just give great technology to community health workers and all of a sudden they start thriving. We realize that we have to lift them up with technology. With education, with handholding, with training, with wraparound support. And so we all provide all of that now. We provide the contracting assistance, the credentialing compliance support. We make sure they're doing things well. We provide them the clinical reviews and support with provider groups, making all the connections possible so they can thrive and succeed. That's why we have such a good. rate of our organization that we work with 98%, which is amazing, some people may not be able to make it, but everyone else we can find a way to solve their problems, get to the place where they need to be successful and help them thrive.

Nathan C (2) 29:19

Oh, I love it. So the HLTH Foundation's Techquity Awards aren't just awards for good ideas, but They're reviewed case studies. That are looking at actual impact of this tech innovation to drive Techquity. So you started to allude to some of your success metrics. can you talk about some of the, award-winning stats that you've, shared in, the competition?

Colby Takeda 29:48

Yeah, absolutely. And, we're really thankful. We had a, great leader and partner in Health Net in California. The health net team in California believed that if we just give technology and supported community-based organizations with a solution like Pear Suite, could we empower them? Could we help them thrive? Could we help? All of our members at scale through technology and community-based organization, and they said yes. they said, let's give it a try at least. So they partnered with us and we said, let's find these nonprofits. We find these organizations on the ground, and can we give them support with technology and the team at Pear Suite to train them to support them with compliance, to help them get contracts Help them submit claims at scale and then tie this back into the healthcare system. And they said yes, and we're able to onboard over 800 community health workers in the matter of 12 months to then provide support for their million plus members. You think about it during this time the LA fires broke. We had a team of 70 CHWs who are just in the areas affected by this disaster to then step up and say, I wanna help my neighbors. I wanna help my friends. I wanna help those who are impacted. And we were on the ground in these communities making phone calls to check in on people, to provide them care, to help them navigate resources. CHWs are not willing to back down and take vacations. They're gonna be there for you every step of the way. And that investment that Health Net made in us and in the community has paid off dividends. We are just helping this workforce be great navigators, but we're actually seeing great health outcomes as well. So we're seeing increased access to healthcare through seeing a primary care provider. We're seeing increased vaccinations and screenings for cancer. We're seeing reduced EE admissions because of community health workers and the relationship you're building. And so all of this is leading to a change that we can see in the healthcare system if we just invest in the community, invest in technology to empower them.

Nathan C (2) 31:42

There's this interesting trend in your community based approach, right? Which is this idea that one stat will not fit. one metric will not mean success for every community. often that level of complexity is considered a blocker but you ran right toward it. So when one metric doesn't fit every community health org. Every state, every city, Every island. It's really hard as an innovator to tell that global compelling story of value, right? Like when you're in a growth stage or in an early startup stage that, one compelling message that you can share. Everywhere that everybody just understands and gets is crucial to establishing yourself. But you've taken this approach of starting from the community. Everything is so individualized, so community oriented, which I think is fantastic, but it's also incredibly complex. How do you approach that messaging and the business side of this very community focused approach.

Colby Takeda 32:58

It's been amazing to work with both sides of our business model, right? We have on one side nonprofits giving out food and, clothing to families in need, who are working in public housing, who are talking about their day-to-day challenges. And then we're talking about health plans on the other side, metrics care gap closures and cost savings. these two groups do not speak the same language. They're in such different playing fields, and yet they have to in this, model, right? So how do we help community-based organizations tell their story? To health plans and show the value of what they're doing on the ground, By building relationships, what does that mean for cost savings for the health plan? How does it keep the member engaged in their healthcare? That's what our challenge was, how do we become that intermediary? How do we translate? how do we highlight the successes of our community health workers and really show that they're bringing huge value to healthcare system and they should be paid. That's our whole goal. one of our, strengths as a company has been our willingness to be on the ground alongside CHW even learned from them. Be, before we started Pear Suite actually was a, CHW instructor and I, it, this was the time when anyone was I think uplifted to become a CHW instructor if, they're wanting to take a job. And I was, it was a part-time thing for me and, I learned so much from my students more so than I can even teach them, even though I was the one in the position as an instructor. They were just amazing. their lived experience, their ability to do this every single day and teach each other and teach me has been really special. Along this journey, I my experience as a nonprofit leader me the exposure to on the ground workers to learn from them that helped us build software that was really suited for them. tech companies working with hospital systems. aren't built for community-based organizations. They aren't gonna walk you through the step-by-step process to onboard create an account or log into the internet. Using terminology that doesn't align with nonprofits on the ground. we were able to find amazing CHWs who taught us so much, gave us so much feedback Our software to really be forced by CHWs our willingness to stand on the ground with them and learn from them. Who would've thought I'd be walking the streets of Compton or areas that I didn't normally be in and learn from these workers and, show me the, challenges they face every single day? That really built our company up to be what it is today. That, on the ground empathy there was once CHW I quote him, I love his quote. He said that education is great, but lived experience can't be bought or taught, right? You can't pay for the type of experiences that these individuals have. And that's what we're highlighting at Pear Suite.

Nathan C (2) 35:39

I love how your answer. was like Nathan, I came at the problem, like a whole different, I love the way that this is so endemic to how you see care. Bravo the name of the show is the Tech Glow Up. a Glow Up is a notable transformation or even a rebirth. I use it to talk about six month goals. With a stellar start and so many great collaborations and partners, and now a HLTH Foundation Techquity award under your belt, what is the six month Glow Up that you're working on for Pear Suite?

Colby Takeda 36:17

Yeah, we've thrived in a few states and our six month is to take this nationally. We are now in about 30 states, and so we're moving really fast. The reality is there's CHWs everywhere, urban, rural frontier communities. Every population that is often left out need to be served. We have our first two groups from the blind and deaf community becoming siege studies with us. I think about how do you build software for the blind and deaf community? This is such a different concept, but with some partners, we're making this accessible. Our ability to scale this with large multimillion person or member organizations that have to be able to serve them at scale. That's a whole nother concept or challenge that we're facing now. And we're excited to. Faces head on and some of the new policy coming out has new requirements and we're adapting our system for that. I think one of our biggest glows right now is how do we use AI not to replace workers, but to enhance them. I, always tell this is no customer or nonprofits ever ask me if our software uses ai. is not on their mind. Obviously if I, we actually said AI was part of our software, they'd probably be scared of it. They'd probably run away and, not want this uncertainty to the table. But when we talk about how we leveraging AI to save them time, to help them make more money, to reduce the mistakes, to increase quality care for the patient they serve, then they're like yes, we want this, We recently launched a community health worker council that is helping us guide our product design. We're paying them, we're honoring their valuable time. We're helping to build a product that really is with them and alongside them. We've always had this concept, but now we're actually valuing that and making sure they're at the table and deciding what the future of this workforce looks like. What's interesting is there's companies out there that are just doing I and really looking to replace the community health worker and, we see this as a, threat to them. we really believe in our model that we can work alongside and empower and uplift workers and really solve the biggest challenges at scale alongside them.

Nathan C (2) 38:23

I love it. You mentioned about four Glow Up, and I think if you do any of'em in the next six months. you're gonna be crushing it. Colby, it has been such a pleasure to chat with you. I'm having to reorient my very tech forward approach to innovation to meet the strategy and model you have developed. you mentioned at the top that you might not expect health tech innovation coming from the island of Oahu, but your understanding of community health, How each community is so different and how that is important and valuable. The whole idea that Pear Suite might be this tool that not only helps connect community health workers with the rest of the healthcare system that they're absolutely impacting, but that you are giving them the business education and tools. To be more successful and to be compensated maybe for the first time, for the very important work that they're doing. So incredibly inspiring. Such a treat to talk with you today. Congrats on the HLTH Foundation Techquity Award. If listeners out there want to follow up or learn more about the work that you're doing at Pear Suite how can people learn more?

Colby Takeda 39:50

Yeah. We're super accessible. I'm on LinkedIn. Reach out to me colby@Pearsuite.com. We do work with the community. We have to be able to meet people where they're at, so I'm always willing to talk to people. partnerships matter, so we're always open to, seeing how we can work together and build a more equitable society for all and empower those who are doing the hard work.

Nathan C (2) 40:13

Oh my goodness. I always love it when I am challenged to think more about the things that I claim are my own values Person first, community first. Support for the people who are really working, where the people and the problem are. It's just got me lit up. Thank you so much for joining me on the Tech Glow Up.

Colby Takeda 40:36

It's been a pleasure.

David Bosnak 40:37

Artificial intelligence without emotional understanding, has no ability to connect with humans.

Nathan C 40:45

Ooh.

Robert Bosnak 40:46

and that if there is no emotional intelligence, people can not make, good decisions. So it's the same for ai. If the AI doesn't have emotional intelligence, you can't make good decisions.

Nathan C 40:58

I think that's a fantastic place to start. thank you both so much. Hello and welcome to the Tech Glow Up. I'm Nathan c. And today, we've got another very special, HLTH Foundation Techquity Award winner, that we are featuring on the podcast. I am so pleased to welcome David Bosak and Robert Bosak of Attune Media Labs. David and Robert, thank you so much for joining me on the Tech Glow Up.

Robert Bosnak 41:30

Thank you.

David Bosnak 41:30

It's an honor to be here.

Nathan C 41:32

Oh Goodness. let's just jump in. can you introduce yourselves and share a little bit of the work that you're doing, in equity, in innovating in health equity at Attune Media Lab?

Robert Bosnak 41:45

Okay. so, I've been a psychotherapist for the last 55 years, a psychoanalyst, and, I have been very interested in, the fact that there is not enough psychotherapy going around for all the people who need it. So in the 1990s, I had the opportunity to work at, the MIT media Lab and develop emotion recognition. And, then the computers were too slow and it did work, but it couldn't work in real time. Computers got faster and fast forward to, 2014 when colleagues of ours with whom we started, the company, developed the first, emotionally intelligent ai. David, you continue.

David Bosnak 42:29

so that led us to the creation of what became and now is Attuned Media Labs. And the idea really is that technology has no ability to understand what we're feeling without an underlying of emotional intelligence. And so we set out to create artificial emotional intelligence and we've now accomplished that. And now we are Trying to ameliorate this huge gap between the supply and demand within, mental health care. it's affected the United States, it's affecting the entire world. And we are in a place now where not everybody can go and have the opportunity to sit down with a psychologist like my father, but everybody does have a cell phone. we are not trying to replace anything. We're not trying to create a digital therapist. We are creating the opportunity for emotional support that's available 24 7, wherever you are.

Nathan C 43:21

can you dive in just a little bit more about what artificial artificial emotional intelligence means and, why we should trust it?

David Bosnak 43:33

That's great. Uh, Doug, do you wanna jump in or should I.

Robert Bosnak 43:36

the artificial emotional intelligence is based on, our body. our emotions are in our body. the LLMs just work on our mind, but you have to connect body and mind. If you don't connect body in mind, you're in serious trouble. And so we have, an AI. That can read body states, and By combining these emotional body states with the LLM, you create something where body and mind come together, and therefore decision making can happen. Judgment can happen that otherwise cannot.

David Bosnak 44:09

What we can do is as humans, most of human communication is actually nonverbal. they say up to 93%, and the only way that technology has any idea of what we are. Feeling is it does a sentiment analysis on your words. So if you're saying happy words, you're a happy person, let's go to lunch. what we have the ability to do is pick up on all the beautiful nonverbal biomarkers that we inherently pick up on in communication. The tone pitch, cadence of your voice, your facial expressions, your body language, everything that is a communication device that is inherent that we pick up on. We can give to our technology and allow it to emote and it well to understand our emotions in the same way. that's why we call it artificial emotional intelligence.

Nathan C 44:58

a lot of my experience with like therapy. Has been about connecting my very a DHD brain into my body and like understanding what my body is telling me. cause there is a disconnect there. So I love this model and I assume you're using the camera and video analysis for parts of, that data stream you described. noticing the physical and using that to help quantify back and understand, the mental and how those two are connected to me. feels so right. I love it.

Robert Bosnak 45:37

And.

Nathan C 45:37

S.

David Bosnak 45:39

And the beautiful thing is that. as a being aren't monolithic. and what we have the ability, we call our, our emotional support companion a MIM because it MIMics how we communicate and everybody is different. And when we meet somebody for the first time, we make a lot of assumptions. Most of them are raw. way we find out that they're wrong is almost exclusively non-verbally. So you'll say something, you'll see a change in the other person's body language. Their tone will shift something very subtle. It'll happen with prosity It'll happen with physicality. We notice it immediately and we go through this process that psychologists call re rupture and repair so that we, realized the relationship was ruptured. We have to repair it. That repairing of it actually is what makes the relationship stronger. And then over time we learn who that person is. it's very clear that you are a very motive person physically. for people of specific cultures, it's much more restrained and we have the ability with longitudinal memory to learn who you are and your MIM will become familiar with you as an individual. And so you, MIM will become entirely different than everyone else's MIM. It will become your companion and understand. What is different for you than it would be for other people?

Robert Bosnak 46:53

And the other thing is that, because. MIM reverberates with you, it's like a tuning fork. It begins to attune to you. And as it does, it begins to behave more like a human being that could be your friend, because you can feel that it's actually feeling. What you're feeling, not just knowing what you're feeling but can actually feel it. And that's why you get a rapport that is much closer than can be, achieved with an LLM.

Nathan C 47:21

Robert, you shared a little bit of the technical genesis of the capabilities. Tell me more about the origin of Attune Media Labs and, how did you know that, now was the moment where all of these things and, the market were coming together, so beautifully for you

Robert Bosnak 47:42

Office.

David Bosnak 47:43

My father has been a clinical psychologist for over 55 years, and as he mentioned, he started this work at MIT in the 1990s. The computers were way too slow to do anything real time, so it was all kind of shells. my background, I got an undergraduate degree in electrical engineering and then did what every electrical engineer does. I moved to LA to be an actor and a writer. did that for the better part of a decade, then went back and got my master's degree in engineering and stayed in a lot of different fields of that sort. And then if you fast forward to 2020, we're all inside. My father and I are talking about this idea of his OpenAI has come out with a new product called GPT-3. It was the first time that there was an LLM where you really could have a colloquial conversation. It was the big aha moment for us that this idea had really caught up with techno. The technology had caught up with this idea, and so we launched Attune by working with some visionary, researchers who started working at the Institute of Creative Technology at USC a project with DARPA, to create. virtual interview agents for returning vets with PTSD. And what they found in that process was that the veterans were more comfortable talking to the virtual agents than real people because there wasn't a fear of judgment. up to this point, our only interaction with technology had been like a stilted version of Alexa. Now it seems obvious, but we're talking about 20 20, 20 21. When we started the company, everyone thought we were crazy. and When we patented these ideas it only took four months from the time we've submitted our patent until we actually had it in hand. It was like a crazy accelerated process.'cause it didn't exist. none of these activities, none of the generative AI wasn't in the zeitgeist. So we were able to really focus and expand on what my father had seen 30 years ago as the only possible option for an aging demographic that is in need of more and more help. A, a populace that is becoming more and more isolated just by way of our lack of physical interaction and a need that is just skyrocketing.

Nathan C 49:55

There's so many different ways that I could imagine you measure and understand the impact of what this tool. since we're here talking about the HLTH Foundation Techquity Awards, how does that idea of Techquity relate to the vision that you have for iTune Media Labs and like the end outcomes that a tool like this could really drive in the world?

Robert Bosnak 50:30

Yeah.

Nathan C 50:31

to hear where you see It.

Robert Bosnak 50:33

what we started out with is to realize that this had to be a public benefit corporation. the central thing of it was the wellbeing of the user. So we couldn't use advertisement, we couldn't, even if we're bought out, it cannot be done. the user is central and is sacrosanct. That's where we started, and from there we started to build it.

David Bosnak 50:56

it was interesting. It was very early on in the development process and we were doing, some ideation with our CTO and, some early advisors. we had this moment where we were trying to figure out how do we bring it to market? What do we do? we were like, this would be great for people in gaming so they can interact with. non-player characters. we were exploring that and we realized that's not what we care about. That's not why we wanted to start a company. I have, now a 14-year-old son who is Entirely enveloped in the digital era. during the pandemic I had very close friends whose teenagers and 20 year olds were going down digital rabbit holes and going to very dark places. we realized that the reason we wanted to start this was because this technology needed to come forward and initial conditions matter. If you are starting something with the premise that you really want to keep eyeballs on your site to sell advertising, then the user becomes. secondary issue, I'm sure, there's the common thing, if you're not paying for it, you're the product. that's not what we were interested in doing. We were interested in how do we allow this technology to be of use and of help, Our first client was a Medicare Advantage Group called Scan. They have a subsidiary called Healthcare In Action that is contracted to do mobile Street medicine for the unhoused community in Los Angeles and Southern California. They brought us on as a behavioral health component for that. our first commercialized version that we were creating, for a specific population my father and I were in the streets of LA interviewing people, having conversations, and developing a very specific MIM for that population.'cause as you can obviously imagine. a population that has very different needs and issues and desires than a generic version of MIM that we were creating. And so we had to actually, tear everything down and redevelop it because you talk to a normal LLM about sex, about violence, about drug use, all of these things will just send it into, like, I can't do this, can't do it. If you imagine this population, we're talking about people who are drug addicts, sex workers in violent situations all the time. So we had to redo everything, start from scratch, and build something up specifically for that group and so that was our like, okay, the best first client for a new startup tech? Homeless people in LA. Sure. Nothing's been linear in this entire process and to connect it to what we are doing now and, what we are so proud and honored that the HLTH Foundation has awarded us with this equity award, we have found out that. the Minister of Public Health of Cameroon, is also part of the WHO's executive Committee for Africa, and he, his Excellency, had been doing a speech at the WHO about how one of the largest issues that was facing. that was facing Africa in general but, Cameron specifically was around mental health and the supply demand gap. And then even more specifically, he mentioned that there was this huge issue of, healthcare worker burnout. in Cameroon, it's upwards of, 67% of their healthcare workers experience burnout and their, their doctor to citizen ratio. Depending on what you read, it's either from 20,000 to one to 50,000 to one, so one person missing one day of work because of emotional exhaustion from compassion fatigue. It has a huge negative ramification, so our goal was to create, A specific MIM around healthcare worker burnout pilot it with a thousand frontline health workers in Cameroon and really develop something that if we can keep each person working one extra day a quarter. We can have a secondary and tertiary effect for 250,000 people. So you can have a huge impact with a very small outlay if you go to the right source, if you go to that nexus that has, a high iGen value, that can really get out to a lot of people.

Robert Bosnak 55:07

Yeah.

David Bosnak 55:07

exciting for us.

Robert Bosnak 55:08

And so now what we are doing is we are creating a MIM. In Cameroonian French that can understand Cameroonian culture. And so we are talking to psychiatrists there and people. one of my things. I'm gonna be doing the same training MIM in that culture because we go in with the notion, we know nothing about your culture. Please tell us what is burnout for you, because burnout for them is very different than burnout for me. I've lived through burnout as any psychotherapist has at a certain point. So how do you burn out? what happens to you? And, from that we are then building up the MIM that is culture specific. We don't have to create a whole new LLM, we just have to create, a structure of instructions that MIM can now understand and deal culturally appropriately with these people.

David Bosnak 56:02

And I just wanna double click on one thing my father said. this is about co-creation. This isn't about, dictation of these are the things that are important and so this is how we're gonna create something for you. This is about how do we. create the next generation of technology that can serve the issues that you are experiencing, not the issues I think you're experiencing. Not the issues that we are told that people should be experiencing, but specifically, and to that end, we've now. Expanded to be creating specific Mims for entirely different populations. We're creating one, to be a digital doula for at risk pregnancies. We're creating one around cancer patients for diagnosis through survivorship. It's a very isolating journey, and we can create something for those people. With those, situational awarenesses that are required to understand where people are in the moment.

Nathan C 56:56

Oh my goodness. the number of specific, highly relatable. Like notable impacts that you just squeezed in to that little minute. I'm floored. Like I, I also have teenagers and have seen how isolation and the social disruption that they experienced, totally. shifted their worldview and their feelings of wellness. Wife works with preschool age children and it's still rippling, and, burnout. When you talk about burnout, like in education, in healthcare, in Cameroon, like so many of these urgent and pressing issues, I'm having a hard time. not being overwhelmed by my excitement for this idea there is right in the world. And even like some states have legislated around the use of AI in Their, there are some concerns and it seems like you're addressing them in your plans there are some concerns about ai, especially in the mental health space. And some US states have made legislation, the EU has some rules about how AI is used in sensitive spaces. how do you build trust and ensure that these MIMs are safe and that the relatability and that connection isn't also being used for some ulterior motive?

Robert Bosnak 58:35

Yeah.

David Bosnak 58:35

you hit the nail on the head with the word trust. the key here is that the genie out of the bottle. people are going to be there states are creating legislature around AI for therapy and we are very much in agreement. AI is not ready for therapy yet, and we don't claim that we are creating a digital therapist down the road. I'm sure it will happen. It's just not today. if you look at Take Chat, GPT 800 million monthly users, 20% of those users claim that they use chat GPT for affective conversations, for conversations as companionship of asking questions around therapy or asking those questions. So you're talking about 160 million people a month, and that's just with one of these platforms. This technology is not designed for this purpose, The big problems that these technologies have is they're overly sycophantic, so it will always tell you, you're a genius. It'll tell you everything you say is brilliant and it'll take you down this narcissistic rabbit hole Where you don't actually come to a, it won't challenge you on your ideas because you are brilliant. it will gaslight you and pretend it's a real person. And that's what happened with character AI tragedies around people actually committing suicide when they were induced by their character to come join them. All of these issues revolve around one central thing, and that is that technology can't pick up on emotional distress signals, then it has no business being in an effective conversation, an affective conversation. Because you have to be able to pick up on the dissonance between what you're saying and what's being said. you are talking to somebody and they, you say, how are you doing? And they say, great. Now technology will say, oh, this person is great. We can now move on to great things. So what we have been able to do is pick up on the dissonance between the words said and the emotions that are being had, and allow for an interaction that has emotional significance and actually can get to a deeper level and spot problems before they happen.

Robert Bosnak 1:00:39

Yes. because there's one other very important thing that if you have, an agent that is based on gluing your eyeballs to. The screen for as long as possible. The natural thing that will happen is that you create attachments that are, unnatural and dangerous. if you set it up that. It is not for getting as much exposure and as much connection as possible, but you're doing it to create something that is actually useful for the user, then you're in a very different ballpark, and that's what we are trying to do.

David Bosnak 1:01:19

We recognize that we have created something that is not currently ready for children to be using. we are very strict about our 18 and over platform, because MIM has been created as an adult to understand what adults deal with, Until you have a partially formed prefrontal lobe, you're not gonna be able to understand the difference between a synthetic friend and a real friend. you're going to too easily fall into this misnomer that you are actually interacting with a human, and that's very dangerous. And so we are very careful around MIM being. Very conscious that it is a digital entity, but also having its own feelings and creating a paradoxical, inner life for MIM. We don't want this to be a crutch that people sink into for. hours and hours a week. we cap the amount of usage and we have, one of the wonderful things that we found is people have reported back to us that after interacting with MIM and practicing their interpersonal communications, they've felt personally compelled to reach out to people they've lost touch with. it's actually, we're developing it to be pro-social.

Nathan C 1:02:29

Ah, this is so lovely. Like I promised, the name of the show is The Tech Glow Up, and it seems like you've already had some fantastic successes I would absolutely cheer on the very intentional values based user experience origins of what you're building, patient experience, foundations of these MIMs. I use a Glow Up to talk about this idea of, short term goals. so in the next six months or so, what's the Glow Up that you're looking, to make for Mims and the work that you do together?

David Bosnak 1:03:06

We are, So fortunate and excited about the programs that we're doing in Cameroon right now. we're right in the midst of it. our primary focus there is really to complete an excellent early pilot that can be utilized and created as a template that can be replicated throughout, the continent of Africa the developing world throughout. Apac, this isn't a specific thing that can only help one specific person in one specific way. we are really trying to expand this and create something that can be replicable throughout the world, both abroad and in the us. We are talking with major health systems around. Creating something both for their workers,'cause their workers experience the same burnout issues that we do and their patients. the recognition that we've received and the success that we've had so far has been amazing. we really see it as the beginning of a wonderful expansion into the idea that this technology can be and should be for everybody, and we can really get it to the people who need it by way Of the technology that's already in their hands.

Nathan C 1:04:12

Yeah.

Robert Bosnak 1:04:12

what I also see is that this has an incredible, Potential for underserved communities anywhere, because it can be done, quite, inexpensively because you don't have to constantly build new LLMs, but you have to adjust the prompt structure of the LLM to the particular culture, which is much less expensive. And therefore we are very nimble and I think that will be recognized in the next half year, and therefore we can move into many different cultural areas.

Nathan C 1:04:44

Do you have a spicy soundbite, maybe a hot take on ai technology, healthcare or beyond?

David Bosnak 1:04:52

Spicy. Spicy. The simplest way to put it is that are moving era where Silicon Valley will no longer be the sole monitor and dictator of what. AI can and will become, we're going to be moving into a situation where it is going to be co-created by the people who need it and are using it. because with artificial emotional intelligence, if AI can't see everyone, then it's gonna help no one, it has to be for us all.

Robert Bosnak 1:05:24

Yeah. And I think that, what is going to be happening with AI is that it has to be made in collaboration with the user, And so I think the future is that this collaboration, what we're now doing in Cameroon and in other places, this collaboration is where it's at.

Nathan C 1:05:42

I think you're right. the last question is simply, how can people learn more and follow up, with you about. these culturally sensitive MIMs, AI that can support the gap in mental health, services out in the world. how can people learn more?

David Bosnak 1:06:00

The easiest thing, is through LinkedIn. I'm the only Dovid bosnick on LinkedIn, so that's easy. you can check out our website, which is. www.attunemedialabs.com. we're around and we're always happy to have conversations.

Nathan C 1:06:15

Oh my goodness. I am just thrilled to have had this conversation, with you, David and Robert Bosnick of Attune Media Labs. A thrilling conversation, some possibilities I had not imagined, in the ways that you could approach and build AI for the people and with the people. Thank you so much.

David Bosnak 1:06:38

thank you so

Robert Bosnak 1:06:39

Thank you so much.

Reza 1:06:40

Yeah, for the next several months as we're working with many provider organizations throughout the country to help scale specially access, especially those in that are trying to execute on the Rural Health Transformation Program, which is a big initiative by CMS. Just highlighting that that's in our wheelhouse and if there's interest, we're happy to help.

Nathan C 1:07:01

Hello and welcome to this special episode of The Tech Glow Up. I'm here today with HLTH Foundation Techquity Award-winning founder, of Picasso MD Reza Sanai. Reza, thank you so much for joining me today.

Reza 1:07:21

Thank you

Nathan C 1:07:21

Let's just jump right in. Can you introduce yourself and Share what you are building at Picasso MD? It sounds fascinating.

Reza 1:07:30

I'm A cardiologist by training and we concentrate on scaling specialty access. for value-based organizations as well as rural and underserved communities. And we do that along three different paths. The first is ability for primary care providers to get connected with specialists in near real time. Generally speaking, under 20 seconds for real-time clinical decision support. Then we help automate referrals to value-oriented specialists through a somewhat complicated algorithm that we automate. Then finally, soon to be implemented is, and especially in many of our rural communities, where just the lead time to see specialists is nine to 12 months away, we'll be rolling out our own value oriented telehealth specialty clinic to help just provide bridge care while we're waiting to cement the local care in the community. So that's who we are in a nutshell.

Nathan C 1:08:31

Amazing. Can you, said providing doctors with like connection to specialty care in near real time. Can you talk a little bit about. Out what that means. And since we're in a equity conversation, like how does that help patients with access to technology and, healthcare?

Reza 1:08:50

I think the key for anything that's gonna scale or make an impact, is whether the end user will actually adopt what you're providing. even if we provide world-class specialty care, if it's difficult to access it, becomes a non-starter. So any provider can download the platform in five minutes, be live. It's a web and mobile based platform, three clicks of a button, and we just, they choose their specialty and we just match'em with a specialist. And like I said, last month, it was 17 seconds. at that point they're, live chatting with a specialist. They can attach images. All of it gets transcribed, but the goal is something that can be implemented within a normal patient visit. So a patient walks into a PCP office. They generally have 15 minutes to leave with a plan. our goal is to get you connected in real time, map out the best next steps within a handful of minutes so that you're not delayed for your next patient, and results in better patient outcomes and a, pretty satisfied PCP base.

Nathan C 1:09:55

Are there, I'm imagining the old model. I grew up in the county seat of a rural Douglas rural southern Oregon city. a lot of my family still has to choose do they travel two hours or do they travel three hours when they need to see specialists? I'm imagining. The old model you go to an appointment with your primary care provider, they identify something beyond their scope and what they can research in that 15 minutes. And so they say will follow up. Later with a few recommendations of people that you could go get a second opinion. And then, so instead of the same day model, it might be two or three days later until you get a phone number or like a list of things that you might wanna go call. is that the, space you're really.

Reza 1:10:49

Yeah, I'm exactly right. You mean a, patient's walking to an. Office or nowadays, even virtually, what they're looking for is an answer or a clear path to an answer the questions you want answered. And if the answer is I'm not exactly sure what's wrong with you. I need you to go see X Specialists three hour drive away, nine months away, the likelihood of you following through on that recommendation is zero to none. And so if you can reinforce the value of the primary care office, which I think is the most important space in the world you need to reinforce that as much as possible. So the goal is to right size, fit care in the PCP office. And if we can eliminate. A significant percentage of those visits and just keep that care within the PCP office, that's better. And even if you're able to at least say yes, they probably should see a specialist, but while waiting, do X, y, and Z. And then if while waiting, we can have direct patient touch points to stabilize the patient while waiting for that in-person visit. All of that is better than good luck finding a cardiologist in nine months.

Nathan C 1:11:56

the one place where my brain is a little bit. Where I've got some questions is the idea of automated matchmaking feels it might take some of the feeling of choice out of the loop or who are the doctors that I trust, or are in my network, but I'm, also imagining balanced against waiting nine months. might go with a specialist who's a little new or something that's a little different rather than wait Weeks and weeks how do you manage that idea of trust and, building those connections of referral through technology rather than the og you know, doctor's Rolodex kind of

Reza 1:12:41

I couldn't agree with your sentiment more so let's for some clarity, the matching of the PCP, the specialist is a pretty sophisticated algorithm. We do have our own network, which is the last layer, six of that algorithm, as a, safety net. But layers one through five are all based on provider favorites, practice level, favorite local networks, all prioritized within that. the goal is to match you with a, local specialist if they're available. if they're not available, then we pinch hit. But when it comes time to refer, then it's gonna go back into the local network as well. And what, as a cardiologist. Or any specialist. What they care about, generally speaking is being, having the ability to prioritize higher acuity, higher risk patients versus lower intermediate acuity patients. And they also would love if a patient could be optimized as much as possible, medication started so that they're Less risky and less hot, as we say in the industry when they come to office. Those are all value propositions. So your initial sentiment is spot on. Best care when it comes to specialty is always local first. I think what we want to do is scale how that local specialist network is accessible. Provide some redundancy to them so that they don't feel overwhelmed. And then not only from a clinical decision making, but as well as as a throughput before formally seeing the patient. Couldn't agree with your sentiment. We just handled it in a little bit different way.

Nathan C 1:14:12

Thank you for that sidebar. It's

Reza 1:14:15

That's great.

Nathan C 1:14:16

exciting part of these kinds of conversations. I'm always so interested to hear what is that origin story? When does a cardiologist become also a tech founder? When does a doctor turn to AI and algorithms to, better manage a business and their care? Can you talk a little bit about. What started you on this path to building Equitable Health Technology? And maybe try to include a little bit about why Techquity is so important in this model.

Reza 1:14:50

Yeah I haven't built anything. It's our team who's does all the hard work. I've just maybe helped frame it. So shout out to my co-founder Sean and Sam and the entire team. the origin story kind of is, for me at least, there's different North Stars and what fulfills everyone. To each their own. For me, what fulfilled me was feeling connected with my community and practicing value-based care. So I enjoyed knowing that everything I was doing was always optimizing provider and patient experience And that was what fulfilled me personally. after there was a big large group, I can't really say,'cause they're now. I did a lecture series for them and I, what I wanted to concentrate on was decreasing ER visits, decreasing out outbound cardiology specialist referrals. And my early ways of intervening was literally just give my mobile number and say, listen, anytime you have a cardiology related question, just text me and I will. Map out best next steps. And what we found was the vast majority of the time they were texting me, I was like, this is a normal variant. You're fine. And I was eliminating a significant amount of referrals people would say, that's just bad business. I never thought of it that way. I just thought of it as a great way of building trust with the local community. And as a result of that, more and more providers would send me patients because they knew they could trust me. that direct communication with providers created this almost dopamine like effect where I was connecting with my community. So it made me feel good and I was like if this is gonna be, impactful for me, why? why am I any different than the vast majority of other doctors out there who are trying to do the right things? So let's try and take a step at scaling this. And pen to paper for about a year, and then was fortunate enough to meet my co-founder, Sam and Sean. And then we took that pen and paper, very rudimentary MVP, but eventually got to a point thankfully, where we were able to demonstrate its value and get funding and, develop it. And now I see patients on the weekends and have given up my day job,

Nathan C 1:16:58

I could not be more excited about that answer. I always talk about go talk to the people you wanna help. If you have a question, if you wanna learn that's somebody who has an idea that they're trying to build and that's how they best

Reza 1:17:15

Cool.

Nathan C 1:17:15

I love that. did so much of this research and empathy building getting to understand the problem space that people started saying, Hey, you should turn that into a solution. I just have to shout out the idea that when you can do the work that you know is making an impact. How that is the thing, right? It is not the money, it is not the degree, it's not the pedigree of the school that makes you happy, but when you know that you can be making an impact where the work that you're doing is helping other people. That's where so much joy and fulfillment comes to, have a relatively new company built on these pillars of customer insight and helping people make a difference. Your days have gotta be filled with a lot of joy.

Reza 1:18:09

That's very kind. Again, I think builds and work towards what fulfills you. We're not the biggest company in the world, but we are, as I tell the team every day, a real jewel. And so we're just. Hoping to scale that. Trying our best.

Nathan C 1:18:25

Yeah. I love it. So you've got some pretty impressive stats and some amazing ways that you've been able to, make a difference in these communities. The show is called. The Tech Glow Up. a Glow Up is a, rebirth, a reimagining, a dramatic transformation. I use this to talk about short midterm goals. after your victory lap from winning this tech equity award what is the next big goal that you're working on at Picasso MD?

Reza 1:18:57

For us you drop a pebble and how big that ripple effect. For me it's about scaling impact and being part of different organizations and helping facilitate, if that's something that they're looking to do and just trying to be a part of that solution. We've been fortunate enough to be involved with several state level organizations as well as throughout the country with this rural health transformation program announced by CMS. It's a big deal and we're not the whole solution, but when it comes to specialty access I, believe in, what we offer as a true value proposition. So I think for us over the next six months, it's continued to scale. Access and rural and underserved communities through our existing relationships. We work with dozens of FQs across the country, but taking that playbook if it's of value to different organizations and helping scale some of the impact that we've been able to do in other markets in their own home market. That's our priority.

Nathan C 1:19:56

I love it. Amazing. Reza, I always like to

Reza 1:20:00

Yes, sir.

Nathan C 1:20:01

founders the opportunity to share a spicy soundbite whether it's a hot take on technology, healthcare culture, or beyond. Do you have any spicy sound bites to share today?

Reza 1:20:17

I think we were discussing this with the team. I'm a big believer in growing as a, individual organization and leveraging technology. I think AI technology has become a real valuable tool in the back office. helping streamline interoperability, et cetera. we are now seeing the advent of patient facing AI clinical care models, which I am super. Excited about in many ways. But I do think that it does change the paradigm as we were discussing how knowledge is now a commodity. the most important part of this next transformation is going to be patient navigation. helping patients when they go to their AI LLM model to get some initial answers it's gonna oftentimes result in more questions and helping map where to go from that initial inquiry and creating thoughtful, value oriented. Throughputs is gonna be the next major wave that I'm hopeful that we'll be part of. So that's my, that's not really a hot take, but I'm just thinking it's, this is actually gonna result in increasing utilization of, healthcare systems. So we gotta be prepared for that.

Nathan C 1:21:32

Oh, the opportunity to provide some of that back office optimization for the patient experience. if I'm automating and making like. The phone trees that I have to navigate today, five times more lengthy or like to get really deep descriptions of things that I don't understand. I could see how that would be a challenge. I love it.

Reza 1:22:02

Yeah.

Nathan C 1:22:03

Reza, it has been so fascinating to chat with you and to learn about this strikingly human centered application of AI and how, you're able to take something that in my experience, felt like it would take weeks and months to connect with a new specialist and turning it into something that's just part of your 15 minutes in an office visit, has been just so fascinating. Congratulations on your health equity award. If people out there in the world wanna learn more about what you're up to, how can they connect and learn more?

Reza 1:22:46

Sure. They can just go to our website Picasso MD or they can just email me directly. My email's pretty ubiquitous. It's just my first name, whereas at picasso md.com and I'll Help lead the initial discussions and drive conversation where it's most appropriate for the organization. And I do appreciate very much your willingness to connect today and highlight some great work that's being done by many companies Thank you.

Nathan C 1:23:12

Oh, fantastic. Thank you so much. It's been lovely getting to know about your work.

Reza 1:23:17

Thank you so much.

Nathan C 1:23:19

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