Boomer Living Senior Living Broadcast

Sandeep Pulim - Backend Technology Platform as a Service, Optimizing Healthcare Delivery for the Aging Population

January 10, 2021 Hanh Brown / Sandeep Pulim Season 2 Episode 79
Boomer Living Senior Living Broadcast
Sandeep Pulim - Backend Technology Platform as a Service, Optimizing Healthcare Delivery for the Aging Population
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Boomer Living Senior Living Broadcast
Sandeep Pulim - Backend Technology Platform as a Service, Optimizing Healthcare Delivery for the Aging Population
Jan 10, 2021 Season 2 Episode 79
Hanh Brown / Sandeep Pulim

Dr. Sandeep Pulim, MD is the Chief Medical Officer at Bluestream Health. He most recently served as the Chief Innovation Officer at Medici, and prior to joining the Medici team, Sandeep worked to enable cognitive technology at the point of care for HCPs and patients, to positively impact clinical learning and quality measures for healthcare organizations, pharma, and payers. Previously as co-founder of Health Recovery Solutions, he helped empower patients to better manage their health and improve quality of life using evidence-based interventions using remote patient monitoring.

Topics Covered:

  • Access to care
  • Supporting caregivers with technology
  • Challenges with technology
  • Staying healthy at home


Sandeep's Links:
LinkedIn: https://www.linkedin.com/in/spulim/
Twitter: https://twitter.com/SPulim
Health for America: https://www.healthforamerica.org/
Blueprint health: https://www.blueprinthealth.org/

Show Notes Transcript

Dr. Sandeep Pulim, MD is the Chief Medical Officer at Bluestream Health. He most recently served as the Chief Innovation Officer at Medici, and prior to joining the Medici team, Sandeep worked to enable cognitive technology at the point of care for HCPs and patients, to positively impact clinical learning and quality measures for healthcare organizations, pharma, and payers. Previously as co-founder of Health Recovery Solutions, he helped empower patients to better manage their health and improve quality of life using evidence-based interventions using remote patient monitoring.

Topics Covered:

  • Access to care
  • Supporting caregivers with technology
  • Challenges with technology
  • Staying healthy at home


Sandeep's Links:
LinkedIn: https://www.linkedin.com/in/spulim/
Twitter: https://twitter.com/SPulim
Health for America: https://www.healthforamerica.org/
Blueprint health: https://www.blueprinthealth.org/

Hanh:

Today, Dr. Sandeep Pulim is Chief Medical Officer at Bluestream Health, a leading virtual care solution with a background that spans across many health technology companies. He has a passion for improving quality of life and using evidence-based intervention, like remote patient monitoring. So Sandeep, thank you so much for being here with me today on Boomer Living and I'm excited to learn more from your background in the health tech space. So welcome.

Sandeep:

Oh, thank you again and great to be here, Hanh, and look forward to our discussion today.

Hanh:

Great. So could we start with you sharing a little bit about yourself where you're from your work experience and what are you doing right now?

Sandeep:

Sure. I'm a physician by training and unlike a lot of my colleagues after med school, due to some family medical issues, took a different career path. After dealing with my brother-in-law mother-in-law and my mom having to go through some pretty serious medical issues i found myself at an interesting crossroads. My wife was actually in her residency at the time. I was in the middle of starting my residency, took a break because I was in that natural progression of doing completing school and starting residency and then ended up finding that I had this opportunity to follow a personal passion of mine, which was nothing related to healthcare. Just needed a break from all the medical doctor visits at the time. We had just had our first daughter, convinced my wife that we'd never go see a movie and we ended up actually help. I built a little home theater in our basement. And helped... Basically to my wife. I don't think we're going to go see any movies. So let's just how about we do a small home theater and before I knew it, friends and family would come over, and this was back in the day when TVs were expensive. It was rare to see a projector, screen and movies at home. So I helped a couple of friends and family members build one for themselves. And then a long story short ended up starting a small business helping do that for others partner with the builder. And before I knew it, started making more money than going back to residency, if that makes sense. So that ended up not knowing anything, what starting a company or being entrepreneurial, but that led to some interesting venues where we started to expand into commercial opportunities. And then when the economy started to falter, in the early two thousands, mid 2000 timeframe, we ended up shutting that down. But learned a lot during that time. First of all, I didn't know, I was entrepreneurial didn't know what it was to run a business, but that kind of helped me get into where I am today, where what was interesting was back in the day Siemens was looking for ways to interact with people that are living at home, but putting in health care products. So things like connected blood pressure cuffs that were hardwired, right? So leveraging that experience that you have of building a home theater, doing a distributed audio system in the home, I was wondering why a health care company back then was interested in tapping into this pool of contractors and workers that, that customer base that they had access to, where they may be doing audio visual work, but Siemens was looking to tap into them to start deploying connected devices in the home. So this was like early two thousands. So fast forward, after we ended up shutting the company down, I got a chance to work with the, some of the founding team members of Medscape. They had joined a new company called MD Links based out of Washington DC at the time. And MD Linx was formed, and the premise of how to keep doctors updated with all the new evidence-based information. Noone has time to read all the medical journals. So MD links was at the time acquired by a company in Japan called M3, which is one of the largest physician provider portals in Japan. And they were looking to compete with Medscape and WebMD here in the US, so I was hired as a medical chief medical editor there. And the person that brought me on the team was actually one of the founding members of Medscape. So it was interesting to see how this kind of came full circle. So while I was there, we built a lot of tools and procedures and processes for making sure providers across 32 different specialties had access to the most relevant and current information to help take care of patients. And while I was there for three years, ended up going to my first healthcare hackathon at Data Palooza. We ended up building a solution there and came in third place and got a chance to go to the conference. Went to pioneering ACO session that was moderated by a tool go on day and happened to sit next to this guy who was starting an ACO in San Antonio. Showed him what we built the day before and literally had our first customer ready to go. We were ready to sign them up. But, I shared with them, look, we just built this yesterday, but he gave me his card and said, when you guys are ready, we'd love to use your solution with our diabetic population and engage them in better management of diabetes. So that's how I got into this whole digital health area ended up going to Blueprint Health which is a digital health accelerator in New York. And. Starting my first company as a co-founder there with called Health Recovery Solutions. So then that led to where I am today.

Hanh:

Wow, congratulations, what an impact and what our journey. And thank you. Yeah. Thank you for being here to share this. So I look forward to our discussion. So now, can you share with us the importance of access to care and how the pandemic has made this more difficult?

Sandeep:

Yeah, absolutely. And, where, we are at our point in life right now, we're in that generation where we're not only taking care of ourselves, our kids, but also helping our parents and in-laws, right? What. The small things that you don't think about when it comes to senior care where, they, my in-laws and my mom, they are fairly healthy, but are starting to see some early declines. So especially my father-in-law who's had some early dementia issues. My mom and mother-in-law are dealing with, the aging process and, it's a struggle. So it's simple things such as going to doctor's appointments, getting help from the caregiver side. These are things that aren't typically what you think of as healthcare issues, but they have big impact, right? Especially what COVID exposed was, their normal doctor appointments, or things that come up having to get access to these care services was a challenge and started to see how, technology could actually play a role in that. There's a company that I was an advisor for called Care Coach. They actually have a system for reminding seniors to take their medications, connect them with the right care members and team and family members to make sure that the right things are taking place at the home. So we're, we started using tools like that. And then when it came to home care services, because of COVID sometimes the home care person that was coming home to help my father-in-law couldn't make it there. They or, maybe been around someone that had tested positive for COVID. So they were trying to figure out how to leverage telehealth type services into these, Aging In Place type of modalities and things that weren't necessarily feasible before due to the pandemic waivers became this new method of connecting with and delivering care.

Hanh:

Very true. So what groups were disproportionately impacted by the lack of access to care and what long-term impact do you think this lack of care access will have?

Sandeep:

Yeah. So if you think about what happened, especially in the nursing homes, some of our own clients at my company where they were struggling to see their patients, right? Because of the COVID access limited access to even providers going onsite to see and evaluate their patients. They found that it was challenging at some times to access and evaluate over phone calls or not being able to go in and having to delay your kind of normal visits, not waiting for them to get sick or have an emergent situation arise. So that was one area where there was a significant impact because patients that needed that chronic care management, normal evaluation of services, they had to delay them until those institutions or organizations were able to find the more affordable or engaging ways of allowing patients to see their own providers. And that was a big area. As well as, what we're experiencing with ours and other as well, which is access to patients, patients or people that are just staying at home, who couldn't access their own primary care providers because of the restrictions on travel and the ability to interface with the kind of services. So for example, in my, from my own family, just having a doctor's appointment come up where they were struggling with basic Zoom calls, where they had to install something, download something, just the technical issues that come up that weren't using systems that weren't designed for seniors, for example, to age in place. So those are the kinds of challenges that are a huge opportunity and address moving forward is closing that technology gap, making sure everyone has access to the right technology and pieces of the technology infrastructure to make sure that those interactions can take place and then ultimately evaluating which services can be performed virtually. And which ones do need someone going out to the patient's home or how do we transport someone safely into, your doctor's office or wherever they need to go.

Hanh:

So at your company, how do you approach challenges with technology? Like coincidentally, the people that need access to telehealth the most are often those with lower tech literacy rates.

Sandeep:

Yeah, absolutely. And so that's one of the biggest things that I think we were fortunate enough to focus on was that eliminating all of the potential hurdles that typically have to think about. For example do you have the basic connectivity at home? Do you have a broadband connection? Do you have a WiFi connectivity? So these are like, that's one of the challenges. The next one would be the hardware itself. Do you have a mobile device? Do you have a phone or a laptop that you can then access the service? And then the third thing would then be actually using these applications. So how do you make sure that you're able to be proficient enough to use these tools? And then the fourth one is something that became more apparent as a pandemic went on is language services, right? If you are not able to communicate with a deaf patient or a patient with different language needs, where before you would have an interpreter available to you in your clinic, being able to address those issues. So the way you can overcome those issues are several, right? So for that connectivity and broadband, there has been some creative ways where organizations have found interesting solutions such as a nurse or a home care entity where they would drop off a tablet that was connected with 3G or 4G prior to a patient seeing their doctor so that they had that right connectivity. The FCC has put in place grant funding to extend broadband connectivity now to rural areas and underserved areas, now, where that connectivity issue is being solved. There's still a lot of work to do, but it's progress that COVID kind of accelerated highlighting the need to fill that gap. And in terms of actually using the software or applications, if you can eliminate the need for seniors to, or anybody actually to have to download, install, register, sign up, all those little things. I can tell you how many times, even with my own family and family members where we actually ended up playing that tech support role where they forget, what applications did I download? How do I turn this on? How do I log into my Zoom call? Things that we take for granted, but it's not always very easy and intuitive for the aging population to do so, if we can eliminate those needs so that's one way we solve that problem at our companie is that we don't require a prior installation or download of any software. You simply have a link that's secure. You click on it, and it automatically puts you into that secure video conversation without having that prior.

Hanh:

Nice. Nice. What do you do to make tele-health as accessible as possible for these groups? Do you have more, you would like to share?

Sandeep:

Oh yeah, absolutely. So if you think about it so there's a lot of ancillary services that the aging population needs that are great parallels are opportunities to plug into. So for example, think about visiting their services or wound care services that are touch points for opportunities to piggyback on for providing access to your doctor for your annual wellness visit or a checkup. For example, BAYADA nurses are able to carry around devices now where they're in the patient's home. And they notice foot a ulcer or a bedsore, for example, they can provide high quality care by tapping into a network of supervising entities that are specialists that are equipped to handle these scenarios and provide that oversight remotely. So if I'm in a patient's home, I can not only manage their daily living functions but I can also address any issues that I see because I'm not able to access that expertise on demand. So that's one of the ways we're seeing an effective use of that resource when they notice something rather than delay the care by tapping into the right network of experts, you can now provide high quality care when you're there with the patient without having to delay that care.

Hanh:

Wow. There's already a growth in the tele-health and I think if we implement some of the action items that you've outlined I think it's going to help the 10,000 plus folks turning 65 every day for the next several decades. So that's wonderful. So it's clear that telehealth can help patients but how can technology also help caregivers, either the loved ones taking care of an aging adult or a professional caregiver?

Sandeep:

Yeah. It's, that's one of the opportunities that I think you're going to see more and more services tap into which is empowering, family members and caregivers as the first point of contact. So one of the unique things that we found is the ability for seamlessly interacting with family members as you would in a real world setting. What I mean by that is if you go to the doctor's office, you're there with your mom or dad or aunt or uncle or grandmother. And it's easy for you to go into that exam room when the doctor or nurse practitioner comes out and says, hey, can I talk to you? Can I show you something? When you try to do that in a virtual experience, it's not always very intuitive, right? So you may be on a call with your doctor and because of HIPAA privacy reasons, you're connected to them securely. Now, if I want to bring in a caregiver into that conversation, or I want a caregiver to facilitate that conversation, it gets a little complicated, right? So that's one of the areas we've been fortunate enough to embed the same way that you would access. For example, interpreting services, family members now are able to be involved in a virtual care setting. So even though I may be living in New York, my parents are aunt or uncle could be in Florida, at the time of their appointment I am able to seamlessly bridge into that call, or if I'm at work and I couldn't be available for that appointment, I'm able to now join in and make sure I'm understanding what I need to do, or if I notice something. A lot of the times it's the caregivers that are initiating the outreach to the doctor or the care team. And so in that same way, having that on-demand access to that care team for the caregiver is something that we're seeing, taking place as well.

Hanh:

I think that would help folks, whether it's aging at home, in a community families that are available during that time, or may not be available, but to bring in that caregiver into the conversation, I mean that's going to solve a lot of problems, so that's great. I know that you have a passion for remote patient monitoring, and I think that feel is evolving so quickly today. What do you see as a future of remote patient monitoring?

Sandeep:

Yeah, I think, starting from last year when Medicare updated their policy for reimbursement for remote patient monitoring, a lot of aging in place initiatives now you're probably seeing where in the, moving forward today as well as in the future. A lot of the infrastructure to tap into blood pressure, weight scale, glucose, pulse oximetry. Whatever those metrics are it's going to become more seamlessly integrated right now in, we know with the growth of 5G technology, more of these connected devices are going to be deployed and seamlessly integrated into the home. So just, for our own example, like I mentioned, we use that service called Care Coach at Home, but there's others also now where you can connect Bluetooth devices into that seamless integration with the home environment. So my in-laws were able to check their weight, check their blood pressure, and that data is able to seamlessly be available to their care teams and moving forward; because finally the reimbursement has caught up with the need and there are more services now that are able to capture that data and make it available to your care team. This whole idea of remote patient monitoring has already seen a huge explosion within the last several months and last year due to COVID. But it's going to extend, I think, not just for chronic care, but also your typical individuals that have already been tracking their own health, but making that data now available to your doctor or care team as well. So I think it's going to be progressing even further beyond where it is today.

Hanh:

Very much needed. So now from a proactive point of view, what are some of the things that the aging adult or any one of us can do to stay healthy at home?

Sandeep:

Yeah, I think, a lot of it is preventative in nature, if, depending on what stage of health and the issues that you're currently facing. It's just the basic principles, right? If you can do the things that prevent some of the things that can become complications of a lack of a poor diet, exercise activity. So the things that you can do to stay you know, active not only physically, but also cognitively, right? So in terms of our own family our kids try to get on Zoom calls or, try to see and play games that are, keep my father-in-law mentally stimulated. So involving our kids has been great in terms of making sure that, those, these activities are continuing to happen and allows us to relieve some of the effort that my mother-in-law has to be providing that primary care to my father-in-law. So I think, that is one big challenge, right? Is that, making sure that those things that you continue to do to maintain your health are taking place and where you can supplement them with these other activities; even though we can't physically be together as much. This is a unique circumstance, but I think it also has an impact moving forward is that, leveraging that opportunity to continue to engage in, as you probably know, loneliness and isolation are a huge issue with the aging population, right? So staying connected, I think may has a big opportunity to make sure that, you stay as healthy and as active as, as long as possible.

Hanh:

I'm very thankful of technology and here's an example, right? It allows you and I to connect socially and have this conversation. And we, as a family also have been using technology to stay in touch with my mom who has a later stage of dementia. But I'll tell you, I am just very much looking forward to the day that we can just sit down, have a meal. Because there's certain things that technology doesn't come near. The disposition, the, it's sometimes it's not about words, right? It's about just being present. So I'm very much thankful for technology. But I'm very much looking forward to engaging One-on-one. On a personal level, what do you think is your biggest strength that enables you to have a unique, impactful effect on older adults, maybe something that is not widely known about you.

Sandeep:

Yeah, it's just that I grew up in an extended family before we moved to the US when I was younger. And I think that connection we had with the older generation always embedded in me that sense of responsibility for making sure that we provide that access to care. Maybe it's just a cultural thing, being from, Indian descent, but it's one of the things I think we've, similar to other cultures were being responsible for providing that level of care and support to our elders has always been something that we've been growing up with. So I think it's something that hopefully we're passing on to our kids as well.

Hanh:

Yeah, I share your sentiment. That's how it is with our folks as well. Our upbringing instill in us to care for our parents and grandparents. There comes a point when it's no longer safe. You have to consider other means, but like growing up we were internalized to care for our parents and grandparents in our own home, as long as we could.

Sandeep:

Yeah, absolutely. And, no, it's a great point. And we were fortunate enough where my my, my wife's own grandmother, my kids' great-grandmother was able to stay with us for a little while before she ended up passing on, but it was, they got to see and it's good. I think also in the fact that when you have that. I can't remember now, that there was a recent study that actually showed the impact that grandparents have on your kids and your family. And I think it's something that there's actually a great company that I came across that actually provides seniors with in-home. Quote unquote, like virtual family, right? So there's actually people that come to your home, hangout, for family members that don't have that extended family support. They will actually play that role of that adopted grandparent or grandkid.

Hanh:

Generational families, I think is so important, because like right now, when I listen to my mom talk, most of her conversation, although it's very limited, but I would say most of our conversation is always back to some kind of an event when her grandkids and kids sitting around having a meal together. So it's always multi-generational, sharing that moment. And, to her who has the later stage of dementia, that's her memory, that's her memory of her life. So I think having that parents and grandparents and grandchildren around, that does a lot for your health. So, it isn't, and isn't just specific to a given culture. I think it's humanity.

Sandeep:

Yeah, no, I agree with you there.

Hanh:

I'm familiar with a lot of tech for aging, whether it's in-home or in a community. What I'm seeing is that it's, I'm not sure if it's the right word segregated? But it's certainly not orchestrated, for a smart home.

Sandeep:

Yeah, they're all siloed.

Hanh:

Yeah, siloed. I like to have a conversation with you and perhaps a few other of my colleagues. How do we orchestrate that, coordinated?

Sandeep:

So what happened was in March COVID forced people to put something in place, right? Because they needed a way to connect with their patients and family members are doctors and nurses. And, before you knew it just like you're finding in the home, in the senior care market. There are now all of these verticals for, okay. How do we get a virtual visit in the ER, how do we get a virtual visit for our nursing program? How do we get a virtual visit for our ACO? How do we get a virtual visit for our RPM program? So they put an all of these different systems, and they can't talk to each other. They can't seamlessly. So what you want to happen is if I have a patient who's calling me into say a 911 system, how do I take that 911 call, make sure these patients need to transport to the hospital? If not, how could we provide them with that virtual care right there, and then connect them with that home care agency, connect them with that home nurse, connect them with the family member seamlessly. So believe it or not, that's what we do. Our platform seamlessly allows you to connect and integrate services on the fly in real time. So as I'm talking to you right now Hanh, I can actually click a button and bring on a Spanish interpreter, bring on a sign language interpreter. I can bring on your primary care doctor. I can bring on your nurse. I can bring on someone who needs to address your, your utility bill. So we can take a HIPAA compliant solution and plug in other services so that you can do that seamless handoff.

Hanh:

Awesome. So that sounds great. What other things do you want to add?

Sandeep:

A lot of the systems today weren't built to handle the way healthcare delivery is changing. So when you think about a value based care approach, especially in the senior and aging population, like it's that 80 20 rule, right? So 20% of population takes up 80% of our resources to deliver that care, and, aging in home is going to be the hottest new area for home, for care delivery because look what happened, right? People found out with the right systems in place. You don't have to put someone in the hospital. You don't have to put someone in a nursing home. Delivering care in the home is the best place to take care of the senior and aging population.

Hanh:

I wholeheartedly believe that. So let's put our effort and energy, and all of the skills that we've acquired over the years into best serving the aging at home and the aging population. I use the podcast to surface all the issues, whether it's telehealth, at home monitoring, long-term turnover. There's so many issues that's being uncovered right now. So not only do we want to uncover them, but we want to have leaders come together and be more proactive, provide solutions. I took that on for the aging older adult demographic.

Sandeep:

Yeah. I didn't know it was an issue, was especially, with these, when you dealt with these senior aging living communities, they didn't have the infrastructure in place for residents to have connections with their providers. I didn't realize that didn't even exist. So some of them didn't even have wifi, believe it or not at the senior living communities. So that's where our doctors that were using our platform, they said, hey, is there something that can give the nursing home? Can I give them an iPad that they can use to contact me because they don't have anything. So that's literally what we ended up doing for them was, because like how we're talking, this web based platform, is exactly how our system works. As long as the staff and the nursing home or care center community had access to a mobile device, they were able to allow their patients to connect with their doctors.

Hanh:

The folks who are in development, they're very real estate focused, and it's not as strong as the technology focus. So that's what you were describing. So we need to bring in the technology upstream in the construction, in the forefront. If you're talking about seniors, older adults, sure. They need affordable housing. They needed to be in a good location. And but I would say 80, 90%, it's all on the care side. Do you know what I mean?

Sandeep:

Yeah, it's huge. Yep.

Hanh:

It's huge. It's on the care side. I wanted to bring into the forefront of all the caring, the operation, the technology; bring that to light.

Sandeep:

Yeah. It's so funny. You said that. So we talked to a large, you probably know these guys, they're in Canada. They're one of the largest senior living facility, like there, they do what you're describing. They develop communities they build these centers where seniors can go and live. And, after we talked to them, they were really interested in building, just like you have a gym or workout or, like a pool they're there. Yeah. There, they wanted to build like a genius bar type of experience. Like you go to the Apple store, but for medical devices, like you walk into this kind of environment, that's very similar to an Apple store, but you get to go in there and talk about, okay, what are you trying to do to manage your health? And they actually are going to give them the devices that are able to stream, collect that data and then connect that back to their provider so that it closes that gap between wellness and actual healthcare.

Hanh:

I think there's more and more of that evolving. Some of the folks who already have the communities either under construction or already developed. I'm not sure how readily they're able to adapt. I think a lot of people are still in the mode of absorbing the impact of COVID. The loss of revenues, the loss of occupancy, it's dropped below even 80%. We all know that it's necessary, but it's just difficult for them to take on new expenses when they're at a negative. I believe in everything that you're doing. I, this just speculation, get over this hurdle and then taking the lessons learned and applying it and also doing better. And what you're describing is a part of doing better.

Sandeep:

Yup. Absolutely. Yeah. And it's the same thing that's happened to hospitals, right? They're losing a billion dollars a day in revenue because of COVID and all the elective procedures, surgeries, and, and, it's, it, everyone's been talking about it, right? Everything is shifting to the home Hanh, right? So, the, your industry and your experience in building these centers can translate to how those services, that the staffing needs, the services that are needed. And the model that's going to be successful is saving that infrastructure for the patients that really need it. But there's this huge segment of population that really has learned now. I can do a lot of this at home. So that's really, I think, where the focus needs to be moving forward.

Hanh:

On a personal level I agree, because for me, I want to be at home as long as I can. And I want to have all the amenities that I would in a, let's say, a continuum of care. But first I want to be at home. I want to be near my grandkids or, I don't have grandkids right now, but what I'm saying is that's always just the first choice, and I think I will have to choose if safety is in question and that's the only time that I would want to be away. As long as I have the socialization, the safety, the, the activities, the engagement. Oh, absolutely. I really think there is not a one solution for all. You have to apply it unique to the situation and to the person.

Sandeep:

Yeah, absolutely. Just, so one last thing, when we were doing our readmission prevention program with our RPM company, we stratified which patients qualified for this home service. So we didn't give this our intervention. So what we did was we would, if a patient was in the hospital with heart failure, we would give them a tablet. And we would learn which patients were able to engage with this tool, which patients are able to use it because they were using it to learn what caused their heart failure to go so bad that they ended up in the hospital. It was education. So when they were reset, recalibrated, and they're ready to go home, not to a a skilled nursing facility or a long-term care center, then we would send the tablet home with those patients and then help them manage their CHF at home. So we were stratifying which patients. So I think the same thing could happen with what you're describing. You'll you were able to figure out what are the best ways to engage with this subset of the patients and if their preferences aligned with the care that you can provide with these different tools, then I think they would be, like, just like you're saying, it's a segmentation problem at that point. Right.

Hanh:

I also am surrounded with developers, operators, technologists. So my hope is that as we move forward, more and more we'll uncover what is needed. What's more important is, how do we execute, not have it be in a silo? I want to be a part of, I don't think we can continue to have individual services. It needs to be orchestrated.

Sandeep:

Yeah,

Hanh:

How do we package a service, whether it's at home or even in a community? I think those are very strong points.

Sandeep:

No, it's absolutely. It's a very analogous to how a nurse or a care navigator in a hospital system manages that experience for a patient before the visit to the hospital, during the hospital visit, and post-hospital visit. A lot of that now, used to be siloed. You can now do it seamlessly, and that's how we prevent readmissions. So you have a care navigator who's a nonclinical entity that's making sure that the patient's getting plugged in. So if you replace that with an activity coordinator or a social coordinator for senior care, you fill those same roles, but that technology underlying it is already there.

Hanh:

That's great. I'd like to learn some more. What are your goals, you want to implement this?

Sandeep:

In terms of where we've been. So for the last year, our company's grown from 40,000 video minutes before COVID to over 4 million a month now is how many video minute consults we're doing? Not, we don't deliver the care we're a technology company. So hospitals, doctors, groups, those health plans use our backend technology to deploy their services out there. And, when everything I've shared with you is applicable in nonclinical and clinical settings. That's why I was excited to talk to you because especially after I've seen what we've been struggling with my own in-laws, I'm like, gosh, there's gotta be someplace that this works in a bigger scale. I'm just trying to understand where the opportunities are in your area, where, you need that bridge of that engagement, the health care, but also like you said, making it a seamless integration so that all these other services can live on top of it. So we're a two platform. So we're a platform as a service.

Hanh:

Do you have anything else that you would like to share?

Sandeep:

No, just like you said can't wait til things, get back to some sort of normalcy, hopefully fairly soon, we're glad that we were playing a small part in whatever ways that we can continue to support and engage with our parents and our family members. I've been fortunate enough to be able to help in that sense given where we are today and know that we're actually doing some good to maintain some sense of normalcy.

Hanh:

I congratulate you and just thank you so much for doing what you're doing in making an impact on the aging population.

Sandeep:

Yeah. Sounds good. Thanks, Hanh. Nice to meet you.

Hanh:

All right. Take care.

Sandeep:

Bye. Bye.