Working With Health Plans to Deliver Value
David Smith is President and Chief Revenue Officer of Ilumivu, a company that is taking data from common smartwatches and using AI and machine learning to gain insights into the early detection of certain medical conditions. In this episode he shares how health plans are evolving, how physician perceptions of the plans are changing, how well care and early disease detection is good for their bottom line, and how Ilumivu can help individual patients and large populations.
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Episode Transcript
This transcript was generated using an automated transcription service and is minimally edited. Please forgive the mistakes contained within it.
Patrick Kothe 00:31
Welcome! We have multiple customers in the medical device field. Physicians who choose or use our products, patients who benefit and the hospitals it ends and GPIOs are by him. One customer we don't think too much about is the health plan. What I'm referring to there is a Preferred Provider Organization or PPO, health maintenance organization or HMO, point of service which POS exclusive provider organization or EPO, health savings account, or HSA or indemnity or fee for service plans. Once we get reimbursement for our device, these groups typically fade back and most of us don't focus on them anymore. However, they can be extremely important for some of us. Our guest today is David Smith, President of Ilumivu, a company that's taking data from common smartwatches and using AI and machine learning to gain insights into the early detection of certain medical conditions. What's interesting is that they're targeting both the consumer and health plans. David's spent his career providing technology in the health space at optim. Slash United Healthcare, Dakota imaging, engage point and electrify. In our conversation, we discuss how health plans are evolving, how physician perceptions of the plans are changing how well care in early disease detection is good for the bottom line. And how Aluma view can help individual patients and large populations. Here's our conversation. You've really had an interesting career so far. You started off in sales, and you moved into leadership roles with with different companies. But your experiences in in the software payer side software reimbursement, managed care dealing with managed care organizations, can you take us through your career progression and kind of why you decided to get into the field that you're in,
David Smith 02:52
it's one of those things, you end up where you're supposed to be. I've been in the healthcare industry now for almost 30 years, the industry has changed substantially over that timeframe, I started providing operational solutions to the health plans, things that help them really improved their administrative costs in the earlier days of the segmentation of health plans, and physicians. The changes in the industry over the last 30 years have been the health plans shifting more away from just being a pure payer of claims, and into a provider of health care. And I think my arc of my career sort of fits into that where I was providing technologies that would help them improve how to get claims entered into the system and the 90s. Moving into the 2000s with some of the more care management care centric components as the health plan started to take on more of that role. And then as the risk has shifted, with the health plans, sharing that risk with the providers, and really focused on what was called the triple aim and now called the Quadruple Aim incorporating better outcomes at reduced costs. I think that's an area where my career has sort of shifted from just technologies behind the scenes to technologies that help health plans, and the providers as well improve the way that they service their members and patients. And that's where I ended up today with Illumina view, where we're providing a standard internet of things in a smartwatch that you can buy off the shelf and taking that data and doing pre diagnosis and helping health plans and providers yield better outcomes for their members.
Patrick Kothe 04:54
Understanding all those changes that are going on and with with the whole health care system. Is, is an interesting thing that we all need to keep keep an eye on. You came into the industry with a sales background? How did being on the front line, so to speak, and sales inform your view of the marketplace?
David Smith 05:18
That's a great question. I, it's interesting because the way I was taught selling in my first job, which was outside of healthcare, it was about understanding where the customer's needs were, and taking the solution that you're offering and helping bridge any gaps that the customer may see. And I think that's been the most interesting piece is by listening to the health plans, it's really helped me understand where their priorities are, where their members are, and how to meet those members where they are in their care pathways. And I think that's the most interesting a piece is by providing technologies that actually yield high return on investments, that it really helps both the member in the health plan and the physician along that career pathway. And I think that's been the most interesting thing of transitioning from more of a sales role into an executive role and being able to build long lasting relationships with executives at these health plans. And I think I joked early on in my career that I have been in more Blue Cross Blue Shield plans than Blue Cross Blue Shield executives had. And I think that varied experience of seeing. My old boss used to say, when you've seen one health plan, you've seen one. And I think that's the the way in which it really helped me shape the offerings for some of the later stage companies that I've been with, to really meet the needs of the market, of the members. And of the health plan specifically,
Patrick Kothe 07:02
I've always said this, for anybody who is in any industry, get as close to the customer as you possibly can, in your roles. It'll help you down the road, it'll help inform your worldview of your marketplace, it'll help you with the individual projects that you're working on to help you understand what what is needed by the customer get as close to the customer as you can. And that'll make you a better long term player within your industry.
David Smith 07:30
Well, I've found that to be the case. And I think having innovative customers in those executive positions, finding those what I like to call change agents, who are willing to take a calculated risk on a new approach, a new solution, a new way to solve their problems, and the problems of their members. And that's created a true trust relationship and a win win across the implementation of the projects and products that that I've worked been lucky enough to work with over the last 30 years.
Patrick Kothe 08:08
Well, I'm really interested to dig into the health care plans a little bit more, most of our listeners are in the medical device ecosystem and our customers, our historically, the end users, the physicians, the PAs, the nurses that utilize these products, and then the ID ends, the hospital, hospital purchasing groups, the ID ends, and some of the GPOs that do that. Were a little bit removed from the health care plan, but it's it's such a strategic player within our industry. So I'm going to ask you to kind of talk a little bit about that side of the business and kind of frame it from what do you think we don't know, people within within the medical device field don't know about what's going on within within that segment?
David Smith 09:02
I think the first thing I could say is that the health plans are not the enemy. And I think that's one of the things that when physicians and hospitals start looking at how they've interacted with health plans in the past, it's about why haven't you paid my claim? And I think over the last 1012 years is that risk has started to shift from the health plans and being more of a shared risk environment. I think the health plans are recognizing that leading with their chief medical officers, their provider relations, folks that they truly want to partner with their physicians. It's not just about how can we squeeze on the reimbursement side. It's it's about how can we work together to help our members and patients be healthier? Most Members don't trust their health plan, but they trust their providers that. So I think it's really starting to shift more recently, and just the last couple of years, where the members are starting to look to both sides have their health, both the health plan in and the physicians. And I think the first thing that I would say is the health plans are not the evil empire that a lot of folks believe that they are, are their problems. Yes, absolutely. Are there good payers and bad payers? Absolutely. But I think overall, the individuals that are working at these health plans, truly do want to partner with the providers and their networks, and make that relationship tighter, more integrated, and, and provide mutually beneficial solutions that benefit the patients at the end of the day. So I think that's the the main thing that I would say is they're they're not as they're not as bad as we all think they are,
Patrick Kothe 11:09
who are the customers of the health plan?
David Smith 11:17
I think that's a, it depends on the perspective that you're looking at it from, in some cases, it's the large employer groups that are looking to have a reduced cost infrastructure for their, for their health plans, which then allows them to provide better relationships and better health care to their employees. So I think that's the first group. It's really, at the end of the day, though, it's a b2b to see environment where the consumer, the member is their ultimate customer as well. And then the providers are also the customers of the health plan. And I think that's when I talk about not being the enemy. I think that's the main perception that has shifted over the last few years is the health plans truly do desire a relationship with their provider customer in that way, and the health plans that I talk to, on a daily basis do absolutely believe that.
Patrick Kothe 12:23
And I imagine that this shift from being an insurance company to providing benefits and doing preventive things, and managing people's health, as opposed to their sickness is driven by profits, it's more profitable to deal with a healthy population, then a sick population. Is that kind of the reason reason why
David Smith 12:49
Absolutely, and that is the reason that if you also catch some of these conditions earlier, and but and move them into care management in conjunction with their provider, you've got a win win win, where you're truly increasing your profits as a health plan, improving the health of the member, and still providing the doctors with a reasonable reimbursement for the management of that, that individual. So it's it really does equate to all of those things.
Patrick Kothe 13:26
What's curious to me is we've got providers, and then we've got payers, and this is a payer situation, and providers are are managing those patients. But some of the programs that the payers are starting to implement are crossing over a little bit into the provider space. Is that accurate? Is that what you're what you're seeing as well.
David Smith 13:50
That's exactly what I'm seeing. And these are led by medical professors, professionals at the health plans, with the same having taken the same oaths that doctors your everyday physician takes and with the same intent truly to improve the health and outcomes of the patients. And so I think that's a key piece is that that shift from just being an insurer to a health provider, through some of their plans, their care management opportunities are truly with the best intent.
Patrick Kothe 14:31
That also creates a little bit of friction with the providers. Because don't tell me how to practice patent practice my you know, my medicine don't stay you stay in your lane. I'd stay in my lane. How is that kind of been playing out?
David Smith 14:46
Well, I think it's it's, it plays out through you're seeing some new reimbursement models that I think are working for both sides of the industry, but at the same time, the help plans have a really have deeper pockets than the individual physicians do. And I think that leveraging the resources that the health plans truly want to bring to bear on some of these markets, specifically Medicare Advantage, that health plans are reimbursed by the government for providing better care. And so that whole angle of, you know, stay out of my care lane, I think has blurred over the last few years. And I think the health plans and providers that have accepted that embraced it are starting to see the results in better outcomes for their for the individuals.
Patrick Kothe 15:46
So let's kind of bucket this a little bit, because there's some things that are definitely, you know, a provider decision. And there's some things that are definitely the health plans, decisions. So what fits in what bucket? And where are these gray areas? Where where are we starting to see some of you know, some of those issues come to light,
David Smith 16:08
I'm going to turn the question around just a little bit and say that what's happened over the last five to seven years with the amount of information that a member and a patient have on themselves, I think that has become the those that focus with the patient at the center of the equation, and where the the patient and member is engaged in their own health care. In managing their their wellness, they're making sure that they get their checkups, that they are monitoring their weight that they are monitoring their Awan See, I think all of these things are really shifting. And I'll give you a very specific example. My mother in law at 85, was placed on a continuous glucose monitor. And what she started watching her own agency levels, managing that and with 18 months after having been a diabetic for over 20 years and being on insulin for most of that time, after 18 months of using her continuous glucose monitor and the demand, understanding what goes in her mouth and how that affects those numbers. That correlation allowed her to own her health better, and got off, removed insulin from her routine in just 18 months of monitoring that. So I think it what's shifted. And what's happening is the members who are most engaged with their own health are actually enabling both sides of this equation to work and be more effective with each other. And I think that's kind of the shift that I'm seeing and the health plans that provide the member with those those basic transactional devices and that data, and the physicians that are embracing the data that their members bring to them actually create that synergy. And it brings that member that patient at the center of the equation to really own their own health and well being.
Patrick Kothe 18:30
I guess, that's you're describing, I'm thinking about a funnel, I'm thinking about, you know, the health, health and wellness at the top of the funnel and disease at the bottom of the funnel, and the health and wellness being managed by the individuals with the aid of health plans or physicians that are very interested in and then as you've get further down that funnel and you start dealing with sickness and disease, that's where the clinicians are really focused, is that kind of a decent way to look at it.
David Smith 19:07
That's a great way to look at it. And what we're entering is a time where remote patient monitoring devices can truly be effective in helping physicians manage the outcomes for readmission, reducing readmission rates for improving the speed with which a recovery happens. And then taking that data and leveraging it for the betterment of their patient. And I think that's one of the things that we're starting to see is that on the health plan side and even the employer side that we talked about a little bit, the use of steps trackers and using that for aid from a wellness perspective that's been in place now for the last 1012 years and you're starting to see better outcomes because the members are really just that little piece, like I talked about with the continuous glucose monitor, that actually does make an impact. And now we're able to take devices that are standard devices, and actually do condition diagnosis, and manage that inside of in conjunction with both the health plan and the position. And I think that's an important turn. That's just starting to take effect in in the marketplace right now.
Patrick Kothe 20:30
So let's go back for a second, because, you know, we talked about what a traditional medical device companies doings dealing with more on the, you know, the sick care side of things. What should or what type of interface should people within medical device have with health care, you know, the payer side with with the health plans? Is, is there a natural way for us to come together? Or are they a very peripheral customer?
David Smith 21:03
I? That's a great question. I think there's, I guess the right way to answer it is follow the money, where their CPT code reimbursement, there is a lot of acceptance on both sides of the industry, because the health plans are looking to reduce their administrative costs. And if it's a per member per month charge that they're having to pass through to their employer groups, it's a little bit more of a direct cost. Whereas when you're looking at the CPT code reimbursement for a remote patient monitoring device, or some other Internet of Things device that yields benefit, it actually benefits both the provider and the health plan by being able to pass that along in a true operational cost to their employer groups or to the to the federal government, from CMS perspective for Medicare. So I think it really gets down to where the reimbursement reimbursement meets the road, both sides are in, in agreement, that, that we can meet there and have a good relationship as it relates to the remote patient. monitoring devices.
Patrick Kothe 22:22
Yeah, obviously, the the reimbursement piece is is the most important piece for us unless you get paid, you don't have a product. So that that reimbursement I was kind of referring to post reimbursement, you know, once you have that, once you have that in place, what type of relationship should industry have with the payers because sometimes you've got something that may, let's get give an example you've got, you've got a product that, you know, within a patient population can lower the overall cost of treatment within a within a group. And you can go and slug it out on Dr. By Dr. IDN by IDN. Or you can take it up another level. Is that even possible? And how does that happen?
David Smith 23:13
So it's about the use and sharing of data and valuable information. I think that's the real piece is that there's physicians and care providers don't want to be inundated with data, because people are walking in today, sharing all now that they're owning their healthcare, as we talked about, which is a very good thing. They're also bringing all of this data that they're collecting and saying how does this affect me? Utilization can increase, which is not necessarily a good thing. People get concerned. So it's I think the right way to talk about that piece of it is what information is required to be shared, what information is the right level to be shared it with the provider in order to enable care, but not withhold information that's critical to making a care based decision. And I think it's, there's so much data, we collect 5 billion lines of data on a weekly basis from our consumers that use our our app, our cardiogram app, and it's the parsing and dissemination of the right level of data from a risk score to a pre diagnosis. And I think that becomes the question is what is the right level of data to share? And it gets into a relationship between the health plan the member and and the provider to understand what that is, and I think that's Have flushing out in the industry, what is the right level of data to provide across that spectrum. And so it's not, it's about not providing too much, it's about not providing too little. And at the same time trying to make sure that the right performance measures are being tracked and captured at the health plan level. And that that is being disseminated down to the physicians at the right level of granularity for them to make care decisions without inundating them.
Patrick Kothe 25:34
But then as as the device company, they may or may not be involved in those conversations, they may not have a seat at the table, it may be the the ID ends, and and the providers.
David Smith 25:46
And if I put my sales hat back on it is the relationship of the medical device provider to get in there and have those conversations with their customers and make sure that they understand what level of granularity of data is available, and and how to how they want it rolled up to make it effective and make it not just data but make it useful, valuable information that they can then share across that spectrum.
Patrick Kothe 26:16
What you mentioned a Luma view. And I want to give you a little bit of time to explain exactly what Aluma view is, and what your company does, because it's a very interesting space that that you're living in within the consumer type of type of space. But tied in into these plants. Just give us give us a primer on who Illumina view is
David Smith 26:42
Illuma view was a 13 year old company that was started working with children with autism using a wearable device to manage the interaction between the the child and their caregiver with provider Doctor input as well. We were doing early stage outburst diagnosis and providing information for treatment during the session. And over the years we've grown into were using wearable devices for researchers throughout the world to study how ecological momentary assessments can be used to improve the outcomes of certain research studies. Over the last five years, we've taken that that data and started collecting using cardiogram is our app that we have over 5 million direct to consumer downloads. As I mentioned, we're collecting over 5 billion lines of data from a standard smartwatch. So it moving into the Internet of Things world, we're able to take an apple Samsung Garmin, Fitbit pick any smartwatch. We collect data from that and using our machine learning and AI algorithms, we're starting to do pre diagnosis of four different conditions, diabetes, hypertension, sleep apnea, and afib. And taking the data that comes from the smartwatch, and then providing an ongoing risk score that has been validated both in studies with University of California, San Francisco, as well as health plans to validate that our algorithms provide useful pre diagnosis for the health plans to move into a care management plan and help the member be better using just a standard. Bring Your Own Device, smartwatch.
Patrick Kothe 28:55
So a couple of interesting terms that use in eras pre diagnosis. So I'd like to kind of dig into that. And it's more of a consumer play with the types of devices that are being used, whether it's apple, Garmin, whatever, those because higher fidelity input leads to better diagnosis or the ability to have more firm diagnosis, you're using a lower fidelity input. And using that to violet, you explain what you mean by pre diagnosis.
David Smith 29:35
So what we mean by pre diagnosis and we those signals, while may not be as granular as some of the medical devices are collecting, we do have signals that we're able to identify using machine learning based on those who have been diagnosed with those conditions. And we're developing others as an example we're moving into To migraine detection in the next in the next few few months as well, using the same process, but the pre diagnosis, we're saying that this individual has a high propensity based on the granularity the data that we are able to get from a standard smartwatch that using the proven algorithms in studies, and with the signals of those that actually do have those conditions, that there is a high likelihood that those individuals are would be diagnosed through a conference, confirmatory process. So if we're saying that the individual is at high risk for diabetes, then an A one C confirmation would be the standard test for sleep apnea, which is also conditioned, that is a precursor to some of these other metabolic metabolic conditions. a sleep study and at home sleep study might be prescribed there. Hypertension, of course, it's ongoing management of blood pressure. So having that routinely checked, either through a Bluetooth device. And that's sort of where we're, we're collecting all of this data, and then providing it for the for the individual to provide to their physician. So they can see all of that data at a single location. At the same time, we're providing those risk scores that we're capturing for the health plans to either perform the the confirmatory test, or to actually move them into care management so that they can help the individual manage that condition, whether it's pre diabetes, or diabetes, or hypertension, and manage that through ongoing information that may flow through the app, getting a routine checkup with their physician and managing that really helping them meet the member where they are. I think that's one of the things that when we start talking about the the low fidelity, lower fidelity of the data, we're also dealing with individuals that don't want to end up wearing five devices, just to get the data that they that the providers and the health plans want a need. And so by taking meeting those members that are already managing some of their own health, these are engaged individuals to begin with. And then if you can tap into that, and still provide an additional benefit, without the member having to do anything other than download the app, and set it and forget it like the old rotisserie chicken, add for those of us who are old enough to remember that, set it and forget it. And then the member can also provide while it's collecting that, that data behind the scenes, the individual can also provide data on are they taking their medications at a particular time, I use the app just recently, as a matter of fact, for a blood pressure medication change that that I was doing, I would monitor my blood pressure through a Bluetooth cuff, I was watching my heart rate and the variability of that heart rate through the cardiogram app, I would routinely take my blood pressure through the day. And then at the end of that two week process, I took the data printed it out, emailed it to my position. And we sat down and use that data to make the modification to my medication and the timing of the medication. The most interesting thing I found was that my risk scores did go down when I started taking the medication. But the earlier in the day I took the medication, the lower my blood pressure was throughout the day. So it was that kind of data input that allowed me and my physician, not in conjunction at all with my with my health plan. Although they're happier that I'm managing this better, but it's ultimately up to me, and, and owning it from that perspective.
Patrick Kothe 34:19
So Aluma view at this point of time, strictly software. So it's software that's taking the input from other people's hardware devices using AI to crunch that data to look for patterns to say this person is at higher risk for X, Y and Z.
David Smith 34:39
Correct. And I'll use that as the shameless plug to say any medical device manufacturers that would like to feed in through this to our to our consumer base or to our health plans base. We would have to leave talk about API integration and bringing the data from that and centralizing it through our platform as well. But yes, that's The process that we take today is, we're not a device manufacturer. We're a software company. And our approach to using standard wearable devices, and then ultimately integrating with other specific devices for other conditions, or more specific remote patient monitoring, we're, we're happy to go down that path and include that in our process.
Patrick Kothe 35:28
So software can be a medical device, the term pre diagnosis has me thinking in one direction, but let me ask his question is your software a medical device,
David Smith 35:43
it is not a medical device today, we are not FDA cleared. And so not saying we won't move down that path. But as of right now, we're simply providing the conduit, and we're not trying to be a medical device company. We are a software company that is providing the benefit to the members and to the health plans across the spectrum. So that's not our intent to be a medical device.
Patrick Kothe 36:11
So let's talk about the two customer groups that you just just described. One is the patient themselves and getting involved in doing doing more self self assessment, self management of their own health and the other the health care provider, the health, the health care system, how do you interact with both of them.
David Smith 36:30
So today, in a direct to consumer, any individual can download the cardiogram app on the App Store or the Google Play Store. And they can begin managing their heart health better. We have very specific groups of folks that use it for condition management, like pots POTS is a condition where that is very difficult to obtain a diagnosis. And a tilt table test is the only true confirmatory diagnosis process that's in the industry. And it can take individuals 18 to 24 months to get to get a confirmed diagnosis. During that time. Our app kit is being used today. And we have Facebook groups that are condition specific where they talk about how they're using the cardiogram app. But it's a process for them to help get their their own diagnosis. And by logging and tracking symptoms that may occur. Watching the heart rate and the variability of that any medications that they're taking how that might affect it. So individuals can take that and manage it on their own for any of their conditions or heart rate recovery as an example. On on those who are providing the care, we would love it if a physician started prescribing cardiogram as a way to better engage with their own heart health. And they can do that on an individualized basis. And it's a very low monthly or annual cost for an individual to do that. On the health plan side we work in partner with because that's my background, we do a lot of work with various health plans to integrate this into their either their wellness offering, or into their care management offering. Some plans are starting to use this as a way in their plan designed to help recruit and especially in the Medicare Advantage market to recruit new individuals into their health plans by offering this as just like SilverSneakers would for some of their for some of their services, integrate that into their plan designed to help entice members to come and have that as an added benefit. As well as the condition management. So
Patrick Kothe 39:07
SilverSneakers is an interesting comp another comp could be the car insurance companies who asked you to put a tracker inside your car to to monitor your speed, your acceleration, your deceleration to see what kind of a driver you are and an offer a discount off of that. So there's a positive side of things. But people also can look at that and the negative side of things and say hey, they're tracking me and giving me benefits but they're also seeing when I'm being a bad boy. And I may end up giving it to myself so to speak. By exposing myself to or expose expose myself to these companies to say I'm I'm not being a very healthy person. So now I'm not making good choices now, my premiums may end up going up. So talk to me about both the positive and the negative side of the customer perception.
David Smith 40:10
That's a great, that's a great point. And I think, you know, we're even starting to see this some interest in cardiogram on the life insurance side as well. And the long term care it how can I help individual age in place longer and reduce the cost of a long term care company paying for a nursing home later rather than sooner. But on the on the premium side, the health plans are truly the ones that I've talked to are not looking at this as a way to actually wearily increase their revenues or premiums. And I think that's part of that trust, that we talked about a little bit earlier that the health plans aren't necessarily the bad guys, that there is a true desire for better health outcomes, their savings, their ROIs, as a health plan isn't in the premium side, it's in the reduction of the cost. And I am one that is I said, I use the app regularly, and I am seeing an increase in my sleep apnea score. I'm a bad patient right now, because I'm not doing anything about it, even though I probably would have a confirmatory test, and it would be positive. So I think it's that trust that we have to know that we have to have in this industry that we're all in it for, for the wellness and well being of the patients and the individuals. And there's not really a mal intent from that perspective, to increase premiums that I've seen, from the health plans,
Patrick Kothe 41:59
it will be it it is a it is an issue, it will continue to be an issue because it's in the back of people's minds. Because typically, you know, this type of information, you know, you go and you go and get your you screened for 23andme or, you know, whoever does that, it's fine, they're not going to make a health decision, a payer health health decision on you at this point in time. But they can make a life insurance decision, you've talked about that. I mean, if you've got certain propensity to have cancer, or heart disease, or whatever, life insurance companies, if they get a hold of that information can use that information against you, not the health insurance groups right now, but the life insurance groups. So it's, it's it is an issue that's out there. And it whether it's true or not, it's in consumers minds.
David Smith 42:59
Fair enough. And it's it is a very slippery slope for us to go down. And I think that's it's just something that the industry, from an ethics perspective has to manage, and monitor, and, you know, artificial intelligence and machine learning, there's all kinds of concerns around around that. I just, I go back to my mother in law and the management of her agency, I see the positive benefits, and I think they far outweigh the negative directions. And I think that's just, there's a trust factor that has to has to rely there. So
Patrick Kothe 43:43
I think you're absolutely right. I mean, we do look at some of this macro data and using it to identify people with disease early and get that handled before it becomes an issue. That's tremendously valuable. And then individually, as we manage our own individual health better, there's tremendous value in there. What I'm saying is that it's just an issue that's out there, that all of us need to be aware of, that will help or hurt driving adoption. It's just just kind of a reality out there. But you know, I wear a fitness tracker, I have all of the data go back and use that, you know, I'm, I'm generally a trusting person, when it comes comes to that as well. And I utilize it too. So I'd like to ask you a little bit about what is the difference between if you're using in the in the Apple ecosystem, if you're using the software that they have to look at different different things versus what exactly Illuma view does, how is it different?
David Smith 44:50
It's different in that we are using the machine learning algorithms to do a to provide a risk score for The individual that truly allows them to see how they compare to others in their age range. And that pre diagnosis capability and managing that is what truly sets us apart. As an example, you can AFib is a condition that you can check and monitor with an Apple watch, you can take your ECG, and see that what we're able to do is look at the changes in the risk score over a period of time, that if that starts to increase, we can inform an individual when it might be a good time to, to do that, to do their own ECG and prove and see check that do they have afib. And so it's, that's the kind of thing that I think it's sick separates us apart, is that you can see those changes over time and your risk score, and then make your own personal decisions about how you confirm it, when you confirm it, and and provide the individual with the power to make those choices.
Patrick Kothe 46:19
So from a consumer standpoint, you said there's a monthly fee to have your to have your your software solution in there, approximately, how much are we talking about?
David Smith 46:30
Well, we're talking about 699 on a monthly basis, or $49, over the course of the year.
Patrick Kothe 46:39
Fantastic. And then, if a health health plan adopts this, it's typically going to be a free freebie for the people who
David Smith 46:47
wish it would be a freebie for the individual. And generally speaking, either the employer would pay some portion of it in an administrative services only model, or the health plan will make this up in true reduction in administrative costs for providing care for claims that they don't have to pay. And that's the that's the real advantage of the data that's flowing in.
Patrick Kothe 47:19
Let's talk a little bit about that interface between the patient and their physician, their their care provider, the last thing a doctor wants is for a patient to walk in and say, hey, look, you know, let's look at my steps over the last last 100 days and go through, go through a spreadsheet of all of that stuff, because it's useless. Same thing with, Hey, I had a PVC for, you know, four weeks ago, premature ventricular contraction, many of us have them and it's not, it's generally not a serious thing. If you trend it, and you see that there's something going on, then that becomes important actionable information. So going back to you know, we talked earlier that physicians are inundated and you have to be able to separate you know, what, what true signal is from all of the noise that's out there? So how do you develop software and develop actionable information that that a patient can bring and put in front of their clinician?
David Smith 48:25
And I think that's a great question, because it's about being able to roll that up. We're working with physicians today, to understand what level of data that they want in that process, making sure that if it flows from the health plans working in that triangle between the patient, the health plan and the physician to get the right level of data over to them and I think that's, it's a constant challenge, and then it's the process of how you get that over to them. You don't want to I think that while most health plans and physicians still have faxes in their offices, nobody wants to get data that way anymore. So how do we use an HL seven connection to provide that in a standard format? That the practice management system that the physician side can see? Or do they just simply want an email with from the patient that has that data that they can then I look at and make care decisions based on that and it really gets into getting the data standardized, but at a level that the positions want. And we're honestly that's an ongoing process for us. We're still still working through a lot of that with the with the providers. So
Patrick Kothe 49:39
it has to be at a level and it can't take too much time because at this point, they're not getting we're getting reimbursed for analyzing that data and making your decisions based on that they may end up with you doing further testing with that, and it may end up lessening the amount time that they have doing their, you know, their interview with with their patient as some of this data is auto auto populated, but it's got to be, as you said, it's got to be at a level that they want. And it's not something that is going to make their 15 minute office visit, go to 20 minutes.
David Smith 50:20
You're absolutely right, it can't, hopefully we can, we can make that time with the patient more valuable. We can work to provide them that data that allows them to get more specific, more quickly. And I think that's the what we've heard from the positions that we've spoken with. That's the key is how can I separate the noise. That's, that's coming in. And if I can find those two or three important pieces of data, that I can then expand on test on and act on both me and the member than were much more valuable relationship in that in that perspective.
Patrick Kothe 51:02
So David, you've you've had a different view of the medical industry than many of the listeners have had. So I'm just wondering if you can summarize the changes that you've seen, some of these changes have been fast, some of them have been slow, some of them are still going. But if you could kind of summarize from your standpoint, what you think would be important takeaways to people that work within the medical device industry, and and how you view how medicine is evolving.
David Smith 51:35
I think we are at a point in the industry where the data that's flowing in, is valuable. And I think the the relationship between the provider, the patient, and the health plan, and the use of that data is at a point where we can yield better outcomes. And I think looking at the reimbursement process, and the sharing of risk, we're all in this together. And I think that's a key takeaway, that as new technologies come to bear, that there's an open mind in terms of new words like pre diagnosis, as opposed to a diagnosis. And listening to those lower frequency signals as a way that, if proven out, and demonstrated, can actually be of benefit to everyone. And I think meet, the main thing is that you have to meet the patient and the member where they are in their health care process. And that by taking an individual that's already wearing a smartwatch of some sort, the data that can be collected is a value, and we can work together to to deliver that value.
Patrick Kothe 53:02
David brings a unique perspective about a customer, many of us don't often think about a few of my takeaways. First, be open to changing your opinion on health plans, something that many of us don't often think about. And we may have an opinion that was informed by something that happened years ago. Remember that they're changing, they're evolving like all of us. It's not just you know that they're there to deny coverage. But they've discovered that healthy patients mean greater profitability for them. So it's in their best interest to deal with the health, not just administration of a program that deals with sick patients. Second, the Aluma view product is not a medical device. But the lesson here that you may be able to use in your own product is the same strategy that David's employing so does the adoption of your technology help the profitability of a health plan? And if so, what data is needed to support that? And then if if you've got great data, and you've got a great story that can benefit that health plan, what clinicians need to be involved, as you may not be the person in the room that's helping to drive the change, but you may need to work with clinicians to help drive that change and benefit your company. Finally, the term pre diagnosis a very interesting term that is put out there to help people be in compliance with regulation. blurring the lines between what you can say with regulated and non regulated devices is going to be something that we're all dealing with in The coming years. These non regulatory or non regulated devices may impact your company. And this term pre diagnosis may have a positive impact or a negative impact on on on your companies, but it's definitely something that you need to keep an eye on. Thank you for listening. Make sure you get episodes downloaded to your device automatically by liking or subscribing to the mastering medical device podcast wherever you get your podcasts. Also, please spread the word and tell a friend or two to listen to the mastering medical advice podcast as interviews like today's can help you become a more effective medical device leader. Work hard. Be kind
