A Dose of Optimism
A Dose of Optimism is a podcast dedicated to exploring the world of healthcare innovation and the optimists driving meaningful change.
Hosted by Omkar Kulkarni, this show shines a light on bold ideas, transformative solutions, and the passionate individuals working every day to make healthcare better for children and their families.
Each episode dives into the real-world challenges facing the healthcare industry and highlights the people and organizations pushing the boundaries of what’s possible. From tackling mental health and food allergies to reimagining hospital care and harnessing Artificial Intelligence for better outcomes. Listeners will discover game-changing solutions, hear stories of creativity and resilience, and gain inspiration from leaders who believe in building a healthier, more hopeful future.
From medical professionals and entrepreneurs to patients and community advocates, the podcast brings together diverse voices united by a shared commitment to improving healthcare delivery. Whether you’re working inside the industry or simply curious about the innovations shaping tomorrow’s care, A Dose of Optimism offers insight, connection, and inspiration.
“The content, views, opinions, and information presented on this podcast do not reflect the views of Children’s Hospital Los Angeles or of the sponsors of the podcast. CHLA does not endorse the views, opinions and information presented on this podcast and CHLA specifically disclaims any legal liability or responsibility for the podcast’s content.”
A Dose of Optimism
Closing the Gap in Pediatric Care
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Some of the most common conditions affecting children today remain among the most underserved, and some of the rarest are only just beginning to be understood. In this episode, four innovators share how they are rethinking the diagnosis, treatment, and access pathways for pediatric chronic conditions.
Dr. Jonathan Santoro, pediatric neurologist at Children's Hospital Los Angeles, shares his research on a newly identified condition in people with Down syndrome, a regression syndrome that was misdiagnosed for decades and is now showing meaningful response to immunotherapy in clinical trials.
Dr. Alesandro Larrazabal and Christina LaMontagne, co-founders of Clarity Pediatrics, describe how their telehealth platform is working to close the chronic care gap in ADHD, anxiety, and pediatric obesity, conditions that affect millions of children but face severe shortages of specialist access, particularly in Medicaid communities.
Matt Willis, Co-Founder of Attuned Intelligence, explains how an AI-powered voice agent is helping federally qualified health centers and safety net providers ensure that every patient call gets answered, starting with the front door of healthcare and building toward broader automation.
Episode Resources:
NICHQ Vanderbilt Assessment Scale—PARENT Informant
Epic Integration with Attuned Intelligence
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Welcome to the Dose of Optimism, where I talk to the optimists in healthcare. My name is Omkar Kolkarni, and I work at one of the world's best children's hospitals where I lead innovation. I started Kids X, which is a premier international startup accelerator for pediatric innovation, and over the years I've met thousands of startups, investors, and innovators. Every one of them has a story, and every one of them is optimistic about the problems they're solving. On this podcast, you'll meet amazing people who will share their stories and what makes them optimistic about the future of healthcare. A little note before we get into this episode: this podcast is for informational purposes only. We are not offering medical advice, and we're not endorsing any products. Please talk to your own physician about your health or the health of your children. Alright, let's get started. I'm joined by Dr. Jonathan Santoro, a neurologist at Children's Hospital Los Angeles, and a nationally recognized leader in pediatric neuroimmunology. Dr. Santoro specializes in inflammatory and autoimmune disorders of the nervous system, including pediatric multiple sclerosis, autoimmune encephalitis, and other immune-mediated neurologic conditions. His research has been especially influential in advancing our understanding of neurologic disorders associated with Down syndrome, including Down syndrome regression disorder, which is what we're going to talk about today. We're going to talk about what he's learned from the clinic and the lab and how immune-mediated disease changes the way we think about children's neurology and where he sees real opportunities to improve care for kids and families.
SPEAKER_06So essentially happy kids with Down syndrome doing their thing. And then the teen years, early 20s, they'll just suddenly fall off a cliff over a period of a couple weeks. So they go, they stop speaking, stop being able to feed themselves, incontinence, all of that. And it was just thought to be this psychiatric disorder for 80 years. It's been reported since the 40s. And we started to do autoimmune encephalitis-based workups thinking maybe this is that, and found that it was an entirely different disease, but treatable and reversible with immunotherapy.
SPEAKER_05When did that come about? When and how that made you want to look into this?
SPEAKER_06We saw our first patients at CHLA at the beginning of the pandemic. It was April 2020. We were all in moon suits walking around in the clinic. But I had heard of this condition before. And my research had been in otherwise healthy people with Down syndrome. So it was that perfect congregation of like my training in neuroimmunology, researching people with Down syndrome, and now finding this new thing that is actually riding the difference between them.
SPEAKER_05And so what's the first symptom, or how do they come to us? What prompts a parent or the person themselves to seek treatment?
SPEAKER_06It's the personality changes. And they're pretty noticeable. The patients will stop speaking, stop talking, stop eating. It's pretty dramatic. But the problem is it's not specific. You have a seizure, you go to the emergency room. Like if you stop eating, do you go to the primary care doctor? So these patients were going to psychiatrists, to GPs, they were going all over the place, but not neurologists because there was nothing like focal neurologic to get that workout. So we found patients because they had exhausted all the other specialists. We have had patients come in from GI clinic because they're losing weight. So it should be celiac or something that people with Down syndrome get.
SPEAKER_05Wow. The research you're doing is around neuroimaging with these patients to be able to identify. Is that right?
SPEAKER_06So not just neuroimaging. So neuroimaging is part of it. We found some new things that seem to be very unique for this condition, but actually it's really mostly around treatment. So we've got uh an NIH-sponsored clinical trial that's using immunotherapy to treat this otherwise neuropsychiatric disease. And the results have been very dramatic in terms of response rates. Do they return to their pre-regression? Yeah, we just say back of their baseline. So many of them do, not everybody. And so we've got a new industry-sponsored clinical study actually repurposing a medicine for multiple sclerosis called ublitoximab. And so we're going to start using it later this summer with a grant from TG Therapeutics.
SPEAKER_05How do you all of a sudden go to something that hasn't been dealt with properly for years and years to something so innovative?
SPEAKER_06Three ways. First is people with down syndrome get all of the other autoimmune disorders. Celiacs disease, type 1 diabetes, Hashimoto's thyroid, they get everything. And we've never thought, hey, maybe their brain or neurologic stuff is autoimmune too, right? So that was just the low-hanging fruit. We also know over the last decade that people with Down syndrome, because they have extra chromosome 21, have 50% extra of whatever is on that extra chromosome. And a lot of it is autoimmune-oriented or inflammatory genes. So we knew that those two things were already like at baseline present. And so then it was if we already know this about Down syndrome and we haven't really looked and we've just presumed that this is a psychiatric disease. Let's look, right? Let's do an EG, let's do an MRI, let's do a lumbar puncture. And then when we started to do those, we very quickly found that those were abnormal and were giving us the signal that one, it was an inflammatory process, and two, could be responsive to treatment. So we on a lark tried some immunotherapy, and quite literally, patients started waking up like out of a stuporist, sit in the room, drooling on yourself to walking down the hallway talking and doing all sorts of stuff.
SPEAKER_05Is there a world where otherwise healthy, normally functioning kids with Down syndrome could benefit from this research and these findings?
SPEAKER_06So obviously, if you get the disease, now we have a playbook, which is the important thing. We're working backwards though. Now it's like we want to figure out what the exact mechanism is so we can prevent it from happening too. But also it's made us rethink hey, people with Down syndrome are 26 times more likely to have a stroke. Is the stroke actually inflammatory? Hey, people with Down syndrome have 10 times the rate of epilepsy. Maybe those are treated with immunotherapy too. So it's actually had us reframe a lot of the neurologic diseases. We've got to go one at a time. So while I get very excited and I want to give immunotherapy to everybody, it's definitely the start of something new in people with Down syndrome.
SPEAKER_05What do they typically get diagnosed as?
SPEAKER_06So if you see a psychiatrist, they get diagnosed with schizophrenia. If you see an adult neurologist, they might get diagnosed with Parkinson's disease or a dementia. So it's all over the place, which makes it impossible to track. We think it's about one to two percent of all people with Down syndrome. And the basis for this is in California, I pretty much know about most, if not all, of the cases at this point. And we know how many people with Down syndrome are in California between age 10 and 30, which is where we typically see it. So our estimation is about one to two percent, but that could be it.
SPEAKER_05That's sizable. That's a big, that's a sizable prevalence. And then you said 10 to 30. So are you actually taking care of people who are in adulthood? Yes.
SPEAKER_06I'm an adult certified neurologist, so it's it's not always yeah, it's not always common to have a 30-year-old or a 40-year-old coming into a pediatric hospital, but there's nowhere else for these patients to go. Yeah. So we still have to get the workups done elsewhere and then we bring them back to clinic. But yeah, I think our oldest patient is 52.
SPEAKER_05Well, and sometimes the onset of this regression can happen at that point.
SPEAKER_06Yeah, like we use 10 to 30 as the range where most of the patients are going to present, but we've definitely had patients in their early 40s where it's been very convincing where it's not Alzheimer's if it happens over two weeks. So talk to me more about immunotherapy. It's everything under the sun, which is the exciting part right now. We've come a long way in diagnosing and treating pediatric multiple sclerosis with the immunotherapies that all of the adult patients have been using for years. We're starting to use more and more immunotherapy in the hospital to treat diseases like seizures, to treat cerebral edema, all of these rare neurogenetic syndromes that come through the door. And now I think that the fun part with Down syndrome is that we're starting to look at other genetic conditions. So we just completed a study on a condition called Coffin Lowry syndrome, which prior to this study I'd only taken care of one patient ever with. But a family had reached out and said, Hey, your DSRD work looks a lot like what happened with my daughter. And I happen to know these other 15 moms out there. Can you give us a survey? And so we surveyed a hundred people with it and collected some really high quality data. It seems like they also undergo something similar. Now we have to figure out if it's immune-mediated or if it's something else. I think that there are a lot of very small pockets of people with neurodevelopmental disorders that have experienced very similar things. And now we need to kind of harness it in to see what's similar, what's not, and what may actually be treatable in the future.
SPEAKER_05Earlier you said one of the drugs it's indicated for adults, and you're trying it under research protocols with kids.
SPEAKER_06That's very common in pediatrics in general, but for adult onset multiple sclerosis, there's 22 or 23 FDA-approved drugs. In pediatrics, there's one. So almost everything we use in neuroimmunality is still off label from the traditional standpoint of the most common disease being multiple sclerosis. So it's not uncommon that we have to do drug repurposing or find therapies that would be used in another condition, but have to mirror over a little bit for our patient populations.
SPEAKER_05Without getting too technical into the pharmacomechanics of it all, how can you imagine this specific adult drug working, or is it a lot of kind of trials and data and evaluation?
SPEAKER_06It's a great question. So we don't wing it. So what we found is that, like, for instance, when we do lumbar punctures, we find elevated IgG index or oligoclonal bins. And whenever a doctor hears that, the first thing that they could think of is multiple sclerosis, because that's what we find in those similar patients. So by taking the actual diagnostics and then looking at what the patterns that could be causing this are and seeing that, hey, there may be errant antibody production here. So let's look at those types of drugs that are used in other diseases. And that's where we found this partnership with TG Therapeutics to get ublituxamab available to us to use for this kind of next clinical trial that we're running.
SPEAKER_05Now you talked about ICD 10 and billing. Is that a barrier?
SPEAKER_06Yeah, it's not easy. We probably set spend about 10%, 15% of our time fighting with insurance companies during the week. But I look at it this way is that we didn't really start publishing on what this was in earnest until 2021. The first criteria for the disease came out in 2022. So it's still very fresh. And it's not unsurprising that payers would not say, oh, this is obviously standard. Having an ICD 10 helps us for tracking purposes, but it also helps us for billing and authorizations. But I spend a lot of my time on peer-to-peer is talking about the disease itself and why I think we need to go down that road.
SPEAKER_05What's the future? What's next for your research? And what are you most excited about?
SPEAKER_06Yeah. Two things I'm most excited about. So one is just a broad application of immunotherapy in people with not just downseni, but neurodevelopmental disorders. So I think that there's a lot of diagnostic overshadowing that happens in that population. And so now bringing this whole new toolkit to this population is going to be the next big jump. And if we combine that with all of the gene therapies that are now in the pipeline for these conditions as well, I think that this is actually going to be a new age in terms of how we think about autism, Down syndrome, neurodevelopmental disorders like that. And I think that the second piece that I'm really excited about is how we can actually prevent disease. I think preventative neurology is going to be what we're really talking about in five years. Right now, a patient has a seizure and they come to me and I start them on an anticonvulsant. I say, you have epilepsy, and here's your new therapy. And that's the end of it, right? You still have epilepsy. I think in the future, in a combination with genetics, family risk scores, all of that sort of stuff, we're going to find ways to actually prevent the actual neurologic disease from happening. Some of that screening for it early and identifying. So if you have a stroke condition, we're piloting a study that uses transcranial Doppler. You just put an ultrasound up to the side of your head and you can identify stroke before it happens. We're doing genetic testing to say you are at risk or not at risk for these three diseases in the futures. So the idea of personalized medicine is right at our fingertips and we're starting to be able to use it more and more. And I think that how we will use that is to actually prevent the diseases from actually happening as opposed to selecting better therapies down the line. I think that's the shift that we're actually going to see over these next couple of years, where it's been more personalized, especially in oncology. We've got this very specific therapy for this very specific type of tumor. Now it's in the future, it's going to be like you have to take this medicine for three years and you will never develop this tumor, or you never develop this neurologic disease. Thank you.
SPEAKER_05Our next guests are the co-founders of Clarity Pediatrics. Christina La Montagna is a CEO and she helped build Clarity to expand access to high-quality insurance-covered pediatric care at a time when families are facing long waits and limited options. Dr. Alessandro Larazabal is a pediatrician and cardiologist who serves as the company's chief medical officer. Together, they founded Clarity Pediatrics to reimagine chronic care for kids, starting with ADHD and anxiety and soon getting into obesity management. They're using evidence-based virtual care models built around the needs of children and families. So ADHD and anxiety are really important topics, particularly for adolescents and for young people. Why did you decide to focus your company in these specific types of conditions?
SPEAKER_04If you look at the epidemiology of pediatrics in general in the United States over the last four decades, there was a big shift from infectious diseases as the main reason for a pediatric visit towards chronic conditions. Chronic conditions is separated chronic conditions in two main groups. There's the one that is my specialty in cardiology, which is low prevalence, relatively high complexity chronic conditions. And within that group, you have cognitive heart disease, you have pediatric cancer or complications of prematurity, for example. And those are the ones that are diagnosed and treated the best within specialized tertiary centers such as exchange hospitals. Then the other group, the opposite group within pediatric chronic conditions, are the ones that are termed high prevalence, relatively low complexity chronic conditions. And those are the ones that have really significantly increased in prevalence over the last four decades. And there are a combination between neurodevelopmental behavioral conditions such as ADHD, anxiety, autism is starting to get there as well, and depression, and medical conditions such as pediatric obesity, prediabetes, and asthma. So just based upon that epidemiology that really has shifted towards the high-prevalence chronic conditions, that's what really built our thesis to start with those. And we started with ADHD and then anxiety, because those were really statistically the most underserved with the longer wait lists, with the least access to comprehensive evidence-based care for those kids. But really, our goal is to serve all those kids that have those high prevalence conditions.
SPEAKER_05Okay, so let's start with ADHD. Give me a basic description how your solution helps a child with ADHD.
SPEAKER_04To diagnose a kid with ADHD, you require some documentation. There's no precision diagnosis for ADHD, so there's no blood tests or MRI or electroencehalogram to diagnose someone with ADHD. You need someone with specialized training to evaluate them, and you need what we call standardized questionnaires that have been validated to determine if a child has anxiety or ADHD. And in the case of ADHD, we had the most commonly used questionnaires are the Vanderbilt questionnaires and there's others. And they need to meet criteria for the symptoms and signs of ADHD, at least in two different settings of life or contexts of life. And typically for a child does either at school and at home. So that's how we approach it. We can see kids from age five up until age 18. And the way we work is really to try to enhance the medical home of those kids. So we receive referrals from primary care, pediatricians, family medicine practitioners, and they, whenever they have a concern for ADHD, some of those colleagues are confident enough and they have time allocated in their practice to diagnose those kids themselves. And then they send them with a diagnosis for us to treat them. Some of those colleagues don't feel comfortable or for different reasons, they don't diagnose those kids. So they send them to us for us to perform that diagnosis. And then within our practice, we have a multidisciplinary team that has child psychologists, therapists, and MDs to perform those diagnostic assessments and then wrap them into the evidence-based treatment, which we follow basically the American pharmapediatric guidelines. And for kids with ADHD, the highest level of evidence calls for a combination of behavioral interventions. In the younger patients, those behavioral interventions are really trained the trainer. A lot of those are parentraining based. That's how we do it. And then if they have the diagnosis of ADHD, also when appropriate, prescription for ADHD-specific medication, there's the first line of those are stimulant medications, but there's also other medications that we can use. And just briefly to add to that, the behavioral interventions that we have, one of the things that really helps us help more families is that there's the case of evidence that group-based interventions for behavioral conditions are as effective, if not more effective, than individual therapy. And especially for ADHD, group-based behavioral parent training has great outcomes. So we created a program that is telemedicine-based for parents where they can attend. And we have typically six to eight parents with a therapist or a psychologist, and they meet for one hour every week, and they learn all these specialized techniques to support their kids with ADHD, to enhance and modify their parenting to in a more productive way to support those kids and to help them at home and at school.
SPEAKER_05So, Christina, let me ask you a question. There's many solutions on the market that are related to mental behavioral health and various behavioral health conditions. What separates your company from the various solutions out there?
SPEAKER_03Several things are different about Clarity Solutions. To start with, we really focus on those pediatrician referrals. So building trust with the pediatrician who already knows this child and family extremely well and is in the best position to refer the patient to the best place for care. And Clarity is established now as an expert provider of ADHD care. So we have a very tight relationship with the referring pediatrician, the referring system that creates a comprehensive holistic approach to care. The second major differentiator is something that Alessandro just got to at the end of his last statement, which is around a group-based treatment. So group-based treatment is absolutely evidence-based for ADHD, anxiety care, obesity care, all the conditions that we work in. And what we find is that in addition to the expertise from the clinician, the parents are really benefiting from that community environment. These are stigmatized conditions. The validation, the collegiality that's felt with other parents is real and it engages parents at a different level than perhaps one-to-one care often can. We have both medical and behavioral in the same place. Parents don't need to go to a one provider for an evaluation, one provider for a therapy, one provider for medication. It's all in one place. And then the final point I'll make is that it's very unusual for a telehealth provider in pediatrics at our stage to be so invested in the Medicaid population. And we really have been serving the Medicaid population from our earliest days. All of our services are offered in Spanish by native speaking clinicians. So we see ourselves as really meeting the needs of the current pediatric population.
SPEAKER_05Do you cohort your groups together so that there's families with circumstances?
SPEAKER_03We do. We cohort the groups based on gender, based on language. We have dozens of groups running at any time. And as time goes on, we're able to personalize even further into particular family structures. Religions has been something that people have asked for. So yes, we have an ability to do that. And that level of personalization drives even more engagement when you're with families like me.
SPEAKER_05Medicaid's a great point. So you're able to bill for group-based therapy. Is that the bill that you dropped? Give me an idea as to the approximate size of the ADHD. What's the prevalence? What's the unmet need? How long is the access typically take in a community, particularly a Medicaid community, to get these services?
SPEAKER_04Yeah, absolutely. The prevalence of ADHD has increased from less than 5% in the 1980s to 11.4%. Is the most recent statistic from the CDC from a little over a year ago?
SPEAKER_05Do you think that is related more to better screening, or is it also is there something else environmentally that's driving up the prevalence?
SPEAKER_04This is a very interesting debate that exists within the scientific community. It's an excellent question, probably a combination of both. Both improvement in awareness, not just from the scientific community, but also societal awareness of the symptoms that lead to ADHD and screening methods, as well as potentially there's some hypotheses for environmental factors that are the term that are leading to this. And there's a lot of concern in the most recent years with exposure to technology, early exposure to technology, too many hours with screen time, with the electronic devices, et cetera. But there's really no one thing that has demonstrated to be the driving factor for that, just really significant increase in prevalence.
SPEAKER_05And then for anxiety, which is the other thing you focus on, have you seen that post-COVID those rates amongst middle school, high school kids has gone up?
SPEAKER_04Yes. So there's some data that is starting to come out to show increase in prevalence. The prevalence right before the pandemic was similar to ADD at the time, 9.5% for anxiety in the youth. But the medical community knows that during and after the pandemic, that prevalence has to be much higher now because we've seen a lot of concern in the youth with anxiety. Just one more thing about that, those statistics that I think are important. If you look at the number of specialists that have been trained in the United States to take care of kids with ADHD. And this is something that at 30 we call the chronic care gap. And that's the difference in between the estimated number of kids with a given condition, with a given chronic condition in the US, and the number of specialists that are available to diagnose and treat them. So that's the gap. And if you look at ADHD and that parallel that I mentioned, there's about 1,200 kids with ADHD in the US per child psychiatrist. There's about 2,000 kids with ADHD per child psychologist. And if you look for the younger kids with ADHD, oftentimes they need to see a developmental ambural pediatrician, but there's only about 750 of those trained in the US. So the ratio is really staggering. It's about 12,000 kids per developmental and behural pediatrician in the US. So that sort of explains why there's so much challenges to access care.
SPEAKER_05So there's telehealth-based therapy that you do. What's the cadence typically for an ADHD HD patient?
SPEAKER_04We have created, I think, a pretty reasonable model where we see patients for a diagnostic assessment twice because of those standardized questionnaires that I mentioned, oftentimes the parents need to, and we have created technology to help them with that legwork to get the information from themselves and then from the teachers. So we divide the diagnostic assessment at least over two separate visits. And then for the core behavioral intervention, the behavioral parent training program, they come once a week for a total of eight weeks. And we have pretty good clinical outcomes that decreases challenges at home, increases parent self-efficacy when it comes to helping their kids with ADHD. But of course, an eight-week course and eight-week program is not enough. So we have follow-up programs that target specific challenges of ADHD, such as executive function, organizational skills. We have another program specifically for that is also eight weeks. We try to keep our programs at eight weeks. That seems to be the sweet spot for parents' engagement. And we have all our programs for managing big emotions. So for the emotional dysregulation that these kids have. And then when it comes to medication, when kids meet criteria and the parents are interested in the medications, we see them on a protocol that follows pretty closely what the American Cardiatric Guidelines have called upon. So we see them initially a couple of times on the first month when we prescribe medication. And then we space that out to once a month. There's like a national benchmark, the heated measure to see how closely you're following those kids that you put on similar medication. And at the national level, that benchmark is unfortunately only about 40, 43%. But within our model, because of uh the adherence and the show rates at our medication program were close to 90%. So we followed them very closely when we started on the medication.
SPEAKER_05It seems like you've gotten to nearly 25,000 virtual sessions across the country. You're in Texas now, very high improvement rates. You're tracking three out of four parents or seeing behavioral improvements in eight or so weeks. And copays are reasonable. It seems like around$25 for a session, which for many families is probably within their means. Do I have that right?
SPEAKER_03Yeah, those are all about right. And for our Medicaid patients, the copay would be zero. But we work with thousands of pediatricians in the states of California and Texas as well, who are actively referring patients.
SPEAKER_05That's great. And then now it sounds like you're expanding into a really important area, which is obesity care.
SPEAKER_03Yeah, that's right. Back to some of the things Dr. Lara Zabel started with, we look at this category of disease that is increasing in prevalence without a commensurate increase in supply of care. And obesity is a really strong example of that, unfortunately, where we now have over 20% of children obese and overweight in the US. And despite the fact that we now have guidelines from the American Academy of Pediatrics on how to treat these children, we do not have a great system of care yet built in the US. And so our excitement is this system that's been built for chronic diseases in the behavioral space, like ADHD and anxiety, is also very well suited to treat children with metabolic disease today and in the future, immune disease, neurological disease, other chronic conditions. But for now, obesity is the immediate next focus for the company.
SPEAKER_05So it sounds like you have these synchronous touch points for ADHD for anxiety, and perhaps you will for obesity care as well. So these are live sessions with either one-on-one or with group therapy. What about in between? Seems like you have an opportunity to engage with patients in between to manage symptoms, to track progress, especially as you get into weight management and weight loss, perhaps, or obesity management. Are you thinking about remote patient management and engagement with patients asynchronously in between visits?
SPEAKER_04From the very beginning, we always talk about the in-between moments, opportunities to engage and support families when they're outside of the clinic. And we have ways to do it that are still rather primitive, but they work, including reminders. We have some of our technology is via email, some of it is via SMS. And we have information that we provide in between the sessions to the families so they can follow off with the new techniques or learnings that they received. And we've been working on mobile app that will have some of that implemented into it that will come at some point soon.
SPEAKER_05That's great. Well, thank you both for joining me. It's great to see what you're doing to help children with chronic conditions, whether it's ADHD anxiety or soon to be obesity.
SPEAKER_03Thanks so much for having us.
SPEAKER_05A few months ago, my colleagues Hong Chong, she's the principal at Define Ventures, and Dr. Jeff Fergales, at the time he was leading innovation at UVA Children's Hospital. We were talking to the founder of a new AI company helping improve access to pediatric care. The founder of the company, which is called Attuned Health, his name is Matt Willis, and you'll hear from him. I wanted to end today's episode giving you a glimpse into our conversation with Matt.
SPEAKER_00At Attuned Intelligence, we're fixing healthcare's front door of the phone. So every day patients call because they need care, but call centers are often understaffed and overwhelmed. And so, too often, the call simply goes unanswered. So we built a conversational multilingual AI voice agent for healthcare call centers and patient access teams. And it ensures that every call is answered, engaged, and handled quickly, reducing wait times and connecting patients to care. So in July, we went live with the hospital in New England, and within a few weeks of launch, we were handling 100% of their inbound call volume. Actually, on day one, without any EHR integration, we were offloading up to 20% of calls just through an intelligent routing agent. Now we're partnering with them to automate up to 70% of calls. And those include epic integrated use cases. So we're moving from an immediate impact to long-term automation. And why it matters is by offloading straightforward call types, we elevate and not replace patient access teams. And this is especially critical for federally qualified health centers and safety net providers where more than one in 10 US patients seek care. These organizations face severe staffing shortages, unique budget constraints, and oftentimes language barriers. So by layering AI into the patient journey, we deliver faster, more equitable access to care. So no patient is left waiting on hold. So that's a two intelligence.
SPEAKER_02Hey Matt, I really appreciate the topic that you're taking on here. I'm curious how you have done any integrations with the system.
SPEAKER_00So the beauty of starting with the front door is we actually get to capture all call types. And one of the things that federally qualified health centers often lack is that data and the information. So right away we're able to expose to them all the call types, call average handle times, and help them plan an intelligent roadmap for what would be the next logical use case to take off to drive more automation. And with this hospital in the Northeast, that's exactly what we're doing. We built out a roadmap to go from intelligent routing to 70% automation. And it's starting with the next integrated use case with Epic in this case, will be appointment confirmation and cancellation. So just sort of one layered API access that we can get. And then we're working on the next layer. And we've gotten buy-in with the COO and the CIO that this journey is the one they want to go on. So that's how we're approaching it. And I would say Epic is obviously an ecosystem that we're prioritizing based on current customers, but there are other EHRs that are on our roadmap as well. So we're not just constrained by Epic, but it would be other systems. The AI is actually built to integrate. And so that is part of our journey for sure.
SPEAKER_01Matt, I'm a physician. And as a physician, the last thing I ever want to give up is the front door. It's the thing that we panic the most because it's first patient contact and first point of contact for a patient. And if you look at Google reviews and press Gaini results and stuff, constantly over and over again, people talking about, oh, the providers were great, the healthcare was great, the front office was terrible. I'm curious what kind of KPIs are you guys looking at to be able to track whether or not that's actually enacting some change.
SPEAKER_00We're very clear about success metrics. And when we're starting an engagement, we really are upfront about what we can help track and what's important to the customer. In the case of fairly qualified health centers and safety net providers, Jeff, oftentimes it's actually just answering the phone. So in many cases, I'm talking to hospitals that see 20% call abandonment, which sounds really high and it is, but that's actually the first problem they're trying to solve is actually answering the phone. And then you also ask about hold times. And in many cases, there's 10 minute plus hold times that patients are experiencing. So immediately we step in, we provide a very natural sounding and feeling AI agent. And I think it's a huge improvement from a patient experience standpoint. And also part of the success metrics, again, are average hold time, call answer rate, and call abandonment, but it's also patient satisfaction and staff satisfaction. And we're implementing these surveys, but from what we've seen, it's been a big improvement both on the patient satisfaction side and also with staff satisfaction. Those are super positive metrics on our side.
SPEAKER_02Matt, there's been a number of companies that are funded in this space. Call center, voice AI, healthcare, a sort of they made the news for just the amount of funding and price tag of the business, a handful of others that are really greatly scaled. Totally. So I'm curious about how you think about the market and your differentiators here.
SPEAKER_00I do think there have been companies working on this problem for almost a decade now. And Dominic and I came into this from a full AI background, and we've since partnered and brought on to our staff some folks with really deep healthcare expertise. And it's been a great partnership. I think the thing that we we think about that's different for us is first and foremost, just the focus. Again, we think about federally qualified health centers, safety net providers. This is where we're moving very quickly. And we're able to come in and say, not let us like take on one use case that's hidden behind a phone tree, but literally let us come in and immediately provide value by answering 100% of calls. And I think that is a unique starting point. And then we're able to build out a very fast automation timeline that helps them achieve measurable impact. So going from no automation essentially to 50 to 60% of simple call automation is a huge lever for them operationally. So that's a big differentiator, just our focus. I think that one of the other big ones is there's no integration required to start. So when we talk about getting started, it literally can go from introduction phase to like live agent in less than two weeks. And it's pretty profound because most healthcare organizations are used to long IT projects, longer pilot timelines. So to be able to come in and provide value and relief within a two-week time frame is unique. And that's that's through the way that we've designed the agent.
SPEAKER_05Matt, can you talk a little bit about why you've chosen FQHC as your primary go-to-market?
SPEAKER_00So Cambridge Health Alliance is one of our early customers, as is as are a number of FQs. And so we think about the patient access team is the front door. There's multi-channel opportunities, yes, for sure. But right now, it's a multilingual audience. It's many times not more than 60% English speaking. And so the AI is really perfectly tailored to come in, provide immediate relief by providing a great multicultural experience and multilingual experience. And you can answer such a broad array of questions and route patients directly that the chief operating officers and the CIOs that we're working with, they have to take action. They're in a really critical time, as everyone knows, relative to funding and just budget constraints. And so the solutions have to be effective and the ROI has to be super apparent. And so when we talk about ROI, we're literally not charging for service until we're delivering ROI. Our whole sort of business model, if you will, is predicated on delivering a huge amount of operational value to the organizations we're working with.
SPEAKER_05Matt, thank you. We appreciate your time and looking forward to learning more about all the great things you guys do.
SPEAKER_00Thank you so much for this opportunity. It was a pleasure to meet everyone.
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