Revolutionizing Healthcare Data Management with Kevin Agatstein, CEO of KAID Health

[00:00:02] [SPEAKER_00]: Hey everybody, welcome back to the Outcomes Rocket Founder Stories.

[00:00:08] [SPEAKER_00]: So excited that you joined us again because today I have an amazing person and leader with

[00:00:15] [SPEAKER_00]: us.

[00:00:16] [SPEAKER_00]: His name is Kevin Agatstein and he's the Chief Executive Officer at KAID Health.

[00:00:22] [SPEAKER_00]: Kevin founded Agate Consulting and via Agate and before that McKinsey & Company and Arthur

[00:00:29] [SPEAKER_00]: Anderson.

[00:00:30] [SPEAKER_00]: Kevin has advised providers, payers, healthcare IT companies, life science organizations and

[00:00:37] [SPEAKER_00]: healthcare venture capital firms and private equity firms.

[00:00:40] [SPEAKER_00]: He's just an incredible person with a background from MIT.

[00:00:45] [SPEAKER_00]: I had the chance to meet him in Vegas a few years ago at one of the health conferences

[00:00:49] [SPEAKER_00]: and I'll tell you I've been impressed since day one.

[00:00:52] [SPEAKER_00]: So I'm super excited to be having him as a guest here on the podcast for all of

[00:00:56] [SPEAKER_00]: you to listen and see.

[00:00:57] [SPEAKER_00]: Kevin, thanks for joining us.

[00:01:00] [SPEAKER_01]: Thank you Saul and remember the ground rules right?

[00:01:02] [SPEAKER_01]: Whatever happens in Vegas stays in Vegas.

[00:01:05] [SPEAKER_00]: We'll start afresh here.

[00:01:07] [SPEAKER_00]: I don't remember what happened in Vegas so that takes care of that.

[00:01:12] [SPEAKER_00]: My lawyers and my company will be happy.

[00:01:15] [SPEAKER_00]: Amen, amen to that.

[00:01:17] [SPEAKER_00]: So Kevin such a pleasure to have you here with us.

[00:01:19] [SPEAKER_00]: To kick things off I want to dig into the founding story.

[00:01:24] [SPEAKER_00]: What is it that inspired your work in entrepreneurship and in healthcare?

[00:01:29] [SPEAKER_01]: Sure, two questions there.

[00:01:30] [SPEAKER_01]: What started my work in healthcare and what started my work specifically with Cade?

[00:01:35] [SPEAKER_01]: Maybe I'll break those apart.

[00:01:37] [SPEAKER_01]: In healthcare, you know I've been doing this and thanks for that bio makes me

[00:01:41] [SPEAKER_01]: sound smarter than everybody who knows me knows I am.

[00:01:44] [SPEAKER_01]: But I got started pretty early in my career for a couple reasons.

[00:01:48] [SPEAKER_01]: One I really like the complexity of healthcare and I know that sounds trite but I'll

[00:01:53] [SPEAKER_01]: do some math.

[00:01:54] [SPEAKER_01]: When I was at McKinsey, a partner who is former engineer like myself said,

[00:01:57] [SPEAKER_01]: business is pretty easy.

[00:01:58] [SPEAKER_01]: You got revenue and you got cost.

[00:02:00] [SPEAKER_01]: Make one bigger make one smaller.

[00:02:02] [SPEAKER_01]: For healthcare we're solving a much more multi-factorial problem here.

[00:02:06] [SPEAKER_01]: Obviously we have revenues and costs and don't get me wrong everything that I

[00:02:09] [SPEAKER_01]: do on a daily basis focuses on that.

[00:02:11] [SPEAKER_01]: But we have teaching, we have clinical care, we have research.

[00:02:15] [SPEAKER_01]: We're just optimizing and now more importantly staff satisfactions would

[00:02:19] [SPEAKER_01]: drive all of that.

[00:02:20] [SPEAKER_01]: We're just solving a much more complicated problem and we're doing in a pretty

[00:02:23] [SPEAKER_01]: complicated environment.

[00:02:25] [SPEAKER_01]: We're heavily regulated, imperfect buyers and I just loved that mess.

[00:02:30] [SPEAKER_01]: And then I was really what but really for me what congealed it was I was in

[00:02:35] [SPEAKER_01]: a hospital and attempted to say it was LA County Medical Center but it was

[00:02:39] [SPEAKER_01]: many, many years ago.

[00:02:40] [SPEAKER_01]: And I just took a deep breath and I looked around at the risk of sounding

[00:02:43] [SPEAKER_01]: totally corny and cheesy.

[00:02:45] [SPEAKER_01]: You know I'm not a religious person but in this building that I was in and

[00:02:48] [SPEAKER_01]: it's true for all hospitals.

[00:02:49] [SPEAKER_01]: The place of death, place of birth, of healing, of hope, of violence and fear.

[00:02:56] [SPEAKER_01]: And it was the gamut of human emotions playing out under this one building now

[00:03:01] [SPEAKER_01]: that made me kind of a believer.

[00:03:03] [SPEAKER_01]: That was my calling that I really want to do this.

[00:03:06] [SPEAKER_01]: And I stayed in the business that wanting to be part of it

[00:03:09] [SPEAKER_01]: stuck with me ever since.

[00:03:11] [SPEAKER_01]: And then starting the company itself you know I've been in the business

[00:03:14] [SPEAKER_01]: for a long time.

[00:03:15] [SPEAKER_01]: I'll give you the formal story of the studying of Cade which includes market

[00:03:19] [SPEAKER_01]: analysis and all the stuff that a good McKinsey consultant should have.

[00:03:22] [SPEAKER_01]: But the real story was I wanted my wife to come to bed.

[00:03:24] [SPEAKER_01]: Let's keep that PG rated but my wife is a pediatric endocrinologist

[00:03:28] [SPEAKER_01]: at Boston Children's Hospital so she's dealing with a lot of sick kids.

[00:03:32] [SPEAKER_01]: And one of the things that she does before a clinic is you know she's

[00:03:36] [SPEAKER_01]: going to have to see a bunch of patients tomorrow.

[00:03:37] [SPEAKER_01]: That night she's in her EMR which was I believe Cerner's power chart

[00:03:41] [SPEAKER_01]: now Epic and she's sitting there reviewing tons of documents for this

[00:03:45] [SPEAKER_01]: patient to get ready tomorrow.

[00:03:48] [SPEAKER_01]: And it was an incredibly laborious task.

[00:03:51] [SPEAKER_01]: And you know it's 11 o'clock and you know I was lonely.

[00:03:55] [SPEAKER_01]: So I kind of got a sense of you know not looking over shoulder.

[00:03:58] [SPEAKER_01]: Hippo we take very seriously here but ask me what are you doing.

[00:04:01] [SPEAKER_01]: Like I'm trying to digest this hot mess all these PDFs and all this

[00:04:04] [SPEAKER_01]: stuff coming in from a specialty.

[00:04:06] [SPEAKER_01]: So I can make sense so I can have an informed discussion with her with the

[00:04:09] [SPEAKER_01]: patient tomorrow.

[00:04:10] [SPEAKER_01]: And I was like well we're not going to be able to make a computer that's

[00:04:13] [SPEAKER_01]: ever going to be as nice and as empathetic and charming as my wife.

[00:04:17] [SPEAKER_01]: But maybe I can help her come to bed by digesting some of that by

[00:04:20] [SPEAKER_01]: simplifying that task for her and maybe even flagging some things that

[00:04:23] [SPEAKER_01]: get missed in that inherently noisy process.

[00:04:25] [SPEAKER_01]: So I started digging in and this is right around the time Google came

[00:04:29] [SPEAKER_01]: out with transformer technology around 2018 2019.

[00:04:32] [SPEAKER_01]: So advances in AI now made this possible.

[00:04:35] [SPEAKER_01]: So you know instead of a back rub or letting her watch Grey's Anatomy

[00:04:40] [SPEAKER_01]: or her silly TV show I decided to start a software company to get

[00:04:43] [SPEAKER_01]: to come upstairs.

[00:04:44] [SPEAKER_01]: Boston Children still isn't a customer and she's still working

[00:04:46] [SPEAKER_01]: way too much like so many providers around the country.

[00:04:49] [SPEAKER_01]: But we've been had fun.

[00:04:50] [SPEAKER_01]: Relatedly and having in parallel a group of us started a health

[00:04:53] [SPEAKER_01]: system in Florida called the village at health about 13 14 years

[00:04:57] [SPEAKER_01]: ago.

[00:04:57] [SPEAKER_01]: The villages it's the largest 55 and older community in the U.S.

[00:05:02] [SPEAKER_01]: And it's famous or infamous or both at the same time.

[00:05:04] [SPEAKER_01]: I've heard of the villages.

[00:05:06] [SPEAKER_01]: Yeah they are.

[00:05:08] [SPEAKER_01]: They have a lot of golf a lot of dancing in the streets a lot of

[00:05:12] [SPEAKER_01]: beer and let's just leave it as some friskiness.

[00:05:16] [SPEAKER_01]: What their name is for.

[00:05:17] [SPEAKER_01]: Well again we've already said we already talked about you know

[00:05:20] [SPEAKER_01]: bring my wife to bed.

[00:05:21] [SPEAKER_01]: We got to move this back towards the PG level here.

[00:05:25] [SPEAKER_01]: So we started this health system and similar to the child my

[00:05:28] [SPEAKER_01]: wife was facing they had several EMR their tradition from ECW

[00:05:31] [SPEAKER_01]: to Athena and their docs and their coding team was struggling

[00:05:34] [SPEAKER_01]: with the same problem my wife was which was all this

[00:05:36] [SPEAKER_01]: information many of which is PDF medical notes you have claims

[00:05:40] [SPEAKER_01]: coming in from the payer and you have all the structured EMR

[00:05:43] [SPEAKER_01]: data and like labs and nobody was taking ownership of pulling

[00:05:46] [SPEAKER_01]: us all together.

[00:05:47] [SPEAKER_01]: You had companies that would focus on one data set like

[00:05:49] [SPEAKER_01]: an NLP of the notes yet other companies that would focus

[00:05:51] [SPEAKER_01]: on the labs yet other companies that would focus on

[00:05:53] [SPEAKER_01]: the claims but nobody cares about that they care about

[00:05:56] [SPEAKER_01]: the patient.

[00:05:57] [SPEAKER_01]: So the same problem that my wife was solving from a

[00:06:00] [SPEAKER_01]: clinical perspective the villages was really struggling

[00:06:02] [SPEAKER_01]: with from a coding perspective a quality reporting perspective

[00:06:05] [SPEAKER_01]: and a care management perspective.

[00:06:08] [SPEAKER_01]: And you know when you start to hear something repeatedly

[00:06:10] [SPEAKER_01]: albeit in different lens as an entrepreneur sometimes you

[00:06:13] [SPEAKER_01]: just got to damn the torpedoes and try to fix it

[00:06:17] [SPEAKER_01]: and still trying to do still just trying to fix it.

[00:06:20] [SPEAKER_00]: Love it.

[00:06:20] [SPEAKER_00]: And how long have you been in it?

[00:06:21] [SPEAKER_00]: How long has Cade Health been doing what you guys do?

[00:06:24] [SPEAKER_01]: Measured in years we've started about four years ago.

[00:06:27] [SPEAKER_01]: The same four of us that started the health system was

[00:06:29] [SPEAKER_01]: the founding board.

[00:06:30] [SPEAKER_01]: Elliot Sussman from Lehigh Valley Health System.

[00:06:33] [SPEAKER_01]: Steve Clasco was now advising general catalyst Larry

[00:06:35] [SPEAKER_01]: Howard another physician private equity guy and myself

[00:06:38] [SPEAKER_01]: measured in hairline.

[00:06:40] [SPEAKER_01]: I know audio video.

[00:06:42] [SPEAKER_01]: It is audio.

[00:06:43] [SPEAKER_01]: My hair I had about I've lost about three inches.

[00:06:48] [SPEAKER_01]: That trend continues a little bit of a tough time being

[00:06:51] [SPEAKER_01]: in health tech right now.

[00:06:53] [SPEAKER_01]: More importantly we are doing good and we're doing good

[00:06:55] [SPEAKER_00]: for the patients not for sure.

[00:06:57] [SPEAKER_00]: I love it.

[00:06:57] [SPEAKER_00]: Hey thank you.

[00:06:58] [SPEAKER_00]: Thank you for sharing that.

[00:06:59] [SPEAKER_00]: And you know what Kevin it's a personal story inspired

[00:07:03] [SPEAKER_00]: by those emotions you felt in the hospital then being

[00:07:07] [SPEAKER_00]: at home with your wife.

[00:07:08] [SPEAKER_00]: The opportunity has really evolved with the

[00:07:12] [SPEAKER_00]: advancement of technologies and in particular I would

[00:07:15] [SPEAKER_00]: think Gen AI.

[00:07:16] [SPEAKER_00]: Talk to us about how that has impacted your business.

[00:07:21] [SPEAKER_01]: Sure we are technology there are two I try to avoid

[00:07:25] [SPEAKER_01]: hyperbole although at least I say I try to avoid

[00:07:28] [SPEAKER_01]: hyperbole whether or not I accomplish a different

[00:07:30] [SPEAKER_01]: story.

[00:07:30] [SPEAKER_01]: But there are two fundamental shifts going on

[00:07:33] [SPEAKER_01]: shaping health care and health care right now.

[00:07:36] [SPEAKER_01]: One is technology and I'll get to Gen and a

[00:07:38] [SPEAKER_01]: moment the other one is kind of care model reform

[00:07:40] [SPEAKER_01]: or payment reform from the technology perspective

[00:07:42] [SPEAKER_01]: we see three things that are really converging

[00:07:45] [SPEAKER_01]: to make this particularly interesting.

[00:07:47] [SPEAKER_01]: The continued digitization of health information.

[00:07:50] [SPEAKER_01]: You know when I first started we had no EMRs.

[00:07:52] [SPEAKER_01]: I mean I used to do work in operating rooms

[00:07:54] [SPEAKER_01]: we had paper anesthesia logs and we'd pay a

[00:07:56] [SPEAKER_01]: put them into Excel so we can do analysis.

[00:07:59] [SPEAKER_01]: Now we have the opposite problem there's so much

[00:08:01] [SPEAKER_01]: digital information out there being captured by

[00:08:04] [SPEAKER_01]: Fern and Athena and the other players.

[00:08:06] [SPEAKER_01]: The second problem is it's getting worse.

[00:08:09] [SPEAKER_01]: Many hospitals are investing in this EMR

[00:08:11] [SPEAKER_01]: interoperability so that you can get records

[00:08:13] [SPEAKER_01]: and share record with other providers and it

[00:08:15] [SPEAKER_01]: makes perfect sense at the same time it

[00:08:17] [SPEAKER_01]: exacerbates this data overload problem.

[00:08:21] [SPEAKER_01]: Fortunately we have this third technology large

[00:08:23] [SPEAKER_01]: language models AI including generative AI

[00:08:28] [SPEAKER_01]: that's hopefully the saving grace here which is

[00:08:30] [SPEAKER_01]: the ability to digest and homogenize these

[00:08:34] [SPEAKER_01]: disparate data streams remove conflicts and

[00:08:36] [SPEAKER_01]: really understand not just what's up with the

[00:08:38] [SPEAKER_01]: patient but the context claims data problem

[00:08:41] [SPEAKER_01]: lists in the EMR etc.

[00:08:43] [SPEAKER_01]: Tell you the what this patient has disease X

[00:08:45] [SPEAKER_01]: this patient has lab value Y this patient

[00:08:47] [SPEAKER_01]: takes medication Z the real power of Gen AI

[00:08:51] [SPEAKER_01]: and large language models is especially when

[00:08:53] [SPEAKER_01]: you have so much more data on the patient

[00:08:54] [SPEAKER_01]: as you can start to understand the context.

[00:08:56] [SPEAKER_01]: You know this patient is a poorly controlled

[00:08:58] [SPEAKER_01]: diabetic because of X Y and Z.

[00:09:00] [SPEAKER_01]: This patient behaviorally seems to be very

[00:09:04] [SPEAKER_01]: reluctant or scared of treatment for various

[00:09:06] [SPEAKER_01]: reasons and by able to get to these

[00:09:08] [SPEAKER_01]: motivations in the clinical context we're

[00:09:10] [SPEAKER_01]: able to do so much more to understand the

[00:09:12] [SPEAKER_01]: patient to help the patient and candidly also

[00:09:14] [SPEAKER_01]: to take risk and code the patient.

[00:09:16] [SPEAKER_01]: So that's the real power of AI.

[00:09:18] [SPEAKER_01]: It's not just to do more of what we're

[00:09:20] [SPEAKER_01]: doing today reviewing a chart dropping a code

[00:09:23] [SPEAKER_01]: filling out a quality report or calling a

[00:09:25] [SPEAKER_01]: patient say I'm here to help.

[00:09:27] [SPEAKER_01]: It's being able to take that discussion

[00:09:28] [SPEAKER_01]: or that interaction or that code to the

[00:09:29] [SPEAKER_01]: whole next level and an entirely new level

[00:09:32] [SPEAKER_01]: of detail that was just never possible

[00:09:34] [SPEAKER_01]: when you have somebody manually writing

[00:09:36] [SPEAKER_01]: a note another person manually reducing

[00:09:38] [SPEAKER_01]: those to a few simplistic claims and then

[00:09:40] [SPEAKER_01]: hoping that the truth can be gleaned on

[00:09:42] [SPEAKER_01]: the back end payment reform as I

[00:09:44] [SPEAKER_01]: mentioned is really all innovation takes

[00:09:46] [SPEAKER_01]: cash and it's the payment reform and

[00:09:49] [SPEAKER_01]: frankly Americans purchases to government

[00:09:51] [SPEAKER_01]: employers and patients getting just

[00:09:52] [SPEAKER_01]: dissatisfied with paying for more and

[00:09:54] [SPEAKER_01]: getting less that's prompting that

[00:09:56] [SPEAKER_01]: investment in these tools.

[00:09:57] [SPEAKER_00]: Yeah I love that and is there anything

[00:09:59] [SPEAKER_00]: in particular in payment reform that

[00:10:01] [SPEAKER_00]: stands out as an opportunity or

[00:10:03] [SPEAKER_00]: game changer for you.

[00:10:04] [SPEAKER_01]: Yeah a game changer and also a

[00:10:06] [SPEAKER_01]: little bit of a you mentioned this was

[00:10:08] [SPEAKER_01]: focused on founders so you know I'd

[00:10:11] [SPEAKER_01]: love to share a couple of scars

[00:10:12] [SPEAKER_01]: related to that without a doubt as a

[00:10:16] [SPEAKER_01]: general movement and I'm sure your

[00:10:18] [SPEAKER_01]: listeners have heard a nauseam about

[00:10:19] [SPEAKER_01]: this is is the move to providers

[00:10:21] [SPEAKER_01]: themselves taking financial clinical

[00:10:23] [SPEAKER_01]: risk on the patient.

[00:10:24] [SPEAKER_01]: They're the ones between the payer the

[00:10:26] [SPEAKER_01]: employer and the pro on the government

[00:10:28] [SPEAKER_01]: and the provider in the exam room.

[00:10:29] [SPEAKER_01]: The provider has the most ability of

[00:10:31] [SPEAKER_01]: those four to effectuate better care

[00:10:33] [SPEAKER_01]: to recommend the right treatment to

[00:10:34] [SPEAKER_01]: more empathetically guide the

[00:10:36] [SPEAKER_01]: patient to either her journey to

[00:10:38] [SPEAKER_01]: impact resource utilization.

[00:10:40] [SPEAKER_01]: So this movement of pushing more and

[00:10:42] [SPEAKER_01]: more financial risk on the provider

[00:10:43] [SPEAKER_01]: just makes a ton of sense.

[00:10:45] [SPEAKER_01]: Kaiser's been doing it for years.

[00:10:47] [SPEAKER_01]: A lot of providers like the villages

[00:10:49] [SPEAKER_01]: have done a great job of implementing

[00:10:51] [SPEAKER_01]: these models and the movement that

[00:10:53] [SPEAKER_01]: the general movement from fee for

[00:10:55] [SPEAKER_01]: service to accountable care

[00:10:56] [SPEAKER_01]: organizations, cavitation.

[00:10:58] [SPEAKER_01]: It's been wonderful and it's a

[00:10:59] [SPEAKER_01]: general the right very supportive

[00:11:01] [SPEAKER_01]: of that.

[00:11:02] [SPEAKER_01]: There was a lot of enthusiasm for

[00:11:04] [SPEAKER_01]: that model of providers taking full

[00:11:06] [SPEAKER_01]: risk early on particularly in

[00:11:08] [SPEAKER_01]: private Medicare Medicare Advantage

[00:11:10] [SPEAKER_01]: and that's when we started the

[00:11:11] [SPEAKER_01]: company that's really where we

[00:11:12] [SPEAKER_01]: focused initially and the lesson

[00:11:14] [SPEAKER_01]: learned there was at the end of

[00:11:15] [SPEAKER_01]: the day the government still the

[00:11:16] [SPEAKER_01]: biggest buyer of health care services

[00:11:18] [SPEAKER_01]: in the U.S. and when the government

[00:11:19] [SPEAKER_01]: liked something you want to be selling

[00:11:21] [SPEAKER_01]: that.

[00:11:21] [SPEAKER_01]: You know we were supporting people who

[00:11:22] [SPEAKER_01]: were selling this model of

[00:11:24] [SPEAKER_01]: full risk in Medicare Advantage.

[00:11:26] [SPEAKER_01]: When the government changes their

[00:11:28] [SPEAKER_01]: mind whether or not it's for policy

[00:11:29] [SPEAKER_01]: or politics as an entrepreneur

[00:11:31] [SPEAKER_01]: you ain't going to be able to

[00:11:33] [SPEAKER_01]: shape governmental behavior.

[00:11:34] [SPEAKER_01]: Lobbying is for the United and

[00:11:36] [SPEAKER_01]: the Ascensions of the world and

[00:11:37] [SPEAKER_01]: even they have only so much

[00:11:39] [SPEAKER_01]: voice.

[00:11:39] [SPEAKER_01]: You got to be able to adapt and

[00:11:41] [SPEAKER_01]: move quickly.

[00:11:42] [SPEAKER_01]: When CMS really changed

[00:11:44] [SPEAKER_01]: some of the payment methodologies

[00:11:46] [SPEAKER_01]: for Medicare Advantage it

[00:11:48] [SPEAKER_01]: became a moment that really forced

[00:11:50] [SPEAKER_01]: us to say what is it in our DNA

[00:11:52] [SPEAKER_01]: that we really want to do here.

[00:11:54] [SPEAKER_01]: And what just support one type

[00:11:56] [SPEAKER_01]: of patient and one type of payment

[00:11:57] [SPEAKER_01]: model.

[00:11:58] [SPEAKER_01]: But it was really retrenched back

[00:11:59] [SPEAKER_01]: to our roots of understanding all

[00:12:00] [SPEAKER_01]: this data for clinical purposes

[00:12:01] [SPEAKER_01]: and ended up being a blessing

[00:12:03] [SPEAKER_01]: in disguise.

[00:12:04] [SPEAKER_01]: We now have a bigger

[00:12:05] [SPEAKER_01]: vegetable market and really an

[00:12:07] [SPEAKER_01]: entirely new set of customers

[00:12:08] [SPEAKER_01]: that we have and are going after.

[00:12:10] [SPEAKER_01]: But a lesson for the founders

[00:12:11] [SPEAKER_01]: here is aspirations

[00:12:12] [SPEAKER_01]: ambitions are great but at the

[00:12:14] [SPEAKER_01]: end of the day if you're going

[00:12:15] [SPEAKER_01]: to work on health care pay

[00:12:16] [SPEAKER_01]: attention to the regs and watch

[00:12:17] [SPEAKER_01]: the winds in Washington in the

[00:12:19] [SPEAKER_01]: state house because it will

[00:12:20] [SPEAKER_01]: matter to you.

[00:12:20] [SPEAKER_00]: Yeah that's a great message

[00:12:22] [SPEAKER_00]: Kevin and congrats on being able

[00:12:24] [SPEAKER_00]: to shift with those

[00:12:26] [SPEAKER_00]: regulations

[00:12:27] [SPEAKER_00]: and really just build a new

[00:12:29] [SPEAKER_00]: business with the I

[00:12:31] [SPEAKER_00]: don't know would you say new

[00:12:32] [SPEAKER_00]: value prop or modified value

[00:12:33] [SPEAKER_00]: prop.

[00:12:34] [SPEAKER_01]: I would say our North Star

[00:12:36] [SPEAKER_01]: guiding principle was still

[00:12:38] [SPEAKER_01]: how do we aggregate the 80

[00:12:40] [SPEAKER_01]: percent of data that lives in

[00:12:42] [SPEAKER_01]: that a patient has that's

[00:12:43] [SPEAKER_01]: unstructured with what's already

[00:12:45] [SPEAKER_01]: structured to create a unified

[00:12:46] [SPEAKER_01]: picture of the patient.

[00:12:47] [SPEAKER_01]: That's our North Star.

[00:12:48] [SPEAKER_01]: As I mentioned you know that

[00:12:49] [SPEAKER_01]: was my failed attempt to get

[00:12:51] [SPEAKER_01]: my wife to come sleep with me.

[00:12:53] [SPEAKER_01]: That's not changed how we

[00:12:55] [SPEAKER_01]: monetize that platform whether

[00:12:56] [SPEAKER_01]: or not we're focusing on

[00:12:57] [SPEAKER_01]: Medicare advantage risk

[00:12:58] [SPEAKER_01]: adjustment key disinquality

[00:13:00] [SPEAKER_01]: recording beef with service

[00:13:02] [SPEAKER_01]: coding clinical trials prior

[00:13:04] [SPEAKER_01]: authorization care transition

[00:13:06] [SPEAKER_01]: care management.

[00:13:07] [SPEAKER_01]: There's lots of different users

[00:13:09] [SPEAKER_01]: of clinical data beyond

[00:13:11] [SPEAKER_01]: just creating a bill and it

[00:13:12] [SPEAKER_01]: really forces us to open our

[00:13:14] [SPEAKER_01]: lens a little bit.

[00:13:14] [SPEAKER_01]: It wasn't a pivot I mean we

[00:13:15] [SPEAKER_01]: still earn our keep primarily

[00:13:17] [SPEAKER_01]: in the Medicare billing

[00:13:18] [SPEAKER_01]: accuracy and completeness space

[00:13:20] [SPEAKER_01]: but it really allowed us to

[00:13:22] [SPEAKER_01]: remind us that stop focusing

[00:13:25] [SPEAKER_01]: on the commercial problem.

[00:13:26] [SPEAKER_01]: Stick to the roots of the

[00:13:27] [SPEAKER_01]: clinical problem and have that

[00:13:29] [SPEAKER_01]: faith that if you do the

[00:13:30] [SPEAKER_01]: right thing for the patient

[00:13:31] [SPEAKER_01]: you keep your eyes open for

[00:13:33] [SPEAKER_01]: what your purposes are saying

[00:13:35] [SPEAKER_01]: success will come out of the

[00:13:36] [SPEAKER_01]: back end.

[00:13:36] [SPEAKER_01]: And we've just had a great

[00:13:37] [SPEAKER_01]: quarter several new wins

[00:13:39] [SPEAKER_01]: and I'm really a believer.

[00:13:40] [SPEAKER_01]: Do right by patients do right

[00:13:42] [SPEAKER_01]: by docs protect data security

[00:13:44] [SPEAKER_01]: overall and good things will

[00:13:45] [SPEAKER_01]: happen.

[00:13:46] [SPEAKER_01]: Keep innovating.

[00:13:47] [SPEAKER_00]: That's awesome.

[00:13:48] [SPEAKER_00]: No I think that's great and I

[00:13:49] [SPEAKER_00]: appreciate you sharing that

[00:13:50] [SPEAKER_00]: Kevin.

[00:13:52] [SPEAKER_00]: Ultimately it got you guys

[00:13:53] [SPEAKER_00]: focused even more on that

[00:13:55] [SPEAKER_00]: North Star.

[00:13:56] [SPEAKER_00]: Kevin I love that.

[00:13:57] [SPEAKER_00]: And so you know I was

[00:13:59] [SPEAKER_00]: actually before getting on

[00:14:00] [SPEAKER_00]: with you looking through your

[00:14:01] [SPEAKER_00]: site and back to sort of

[00:14:04] [SPEAKER_00]: what you were talking about

[00:14:04] [SPEAKER_00]: with your wife right.

[00:14:06] [SPEAKER_00]: It's the reduction of time

[00:14:08] [SPEAKER_00]: looking at charts often times

[00:14:10] [SPEAKER_00]: called PJ pajama time.

[00:14:12] [SPEAKER_00]: I saw on your site that it

[00:14:14] [SPEAKER_00]: was reducing it on average

[00:14:15] [SPEAKER_00]: from 55 minutes to nine

[00:14:16] [SPEAKER_00]: minutes. Talk to us about that.

[00:14:18] [SPEAKER_01]: Yeah. So if there's a

[00:14:19] [SPEAKER_01]: leitmotif running through most

[00:14:21] [SPEAKER_01]: of our kind of discussions

[00:14:22] [SPEAKER_01]: at the time I mean health care

[00:14:24] [SPEAKER_01]: we sell time right.

[00:14:25] [SPEAKER_01]: We're trying to sell years of

[00:14:26] [SPEAKER_01]: healthy living right.

[00:14:27] [SPEAKER_01]: That's that moral product

[00:14:28] [SPEAKER_01]: for physician time and

[00:14:30] [SPEAKER_01]: clinician time why we

[00:14:32] [SPEAKER_01]: started cage and if you

[00:14:33] [SPEAKER_01]: indulge me the genesis of

[00:14:35] [SPEAKER_01]: the name cage is come from

[00:14:37] [SPEAKER_01]: the Hippocratic oath which

[00:14:38] [SPEAKER_01]: is I'll remember that

[00:14:40] [SPEAKER_01]: medicine as much as an art

[00:14:41] [SPEAKER_01]: and a science and that

[00:14:42] [SPEAKER_01]: warmth empathy compassion can

[00:14:44] [SPEAKER_01]: often outweigh the surgeon's

[00:14:46] [SPEAKER_01]: life or the chemist drug.

[00:14:47] [SPEAKER_01]: One way to say there's a

[00:14:49] [SPEAKER_01]: lot of technology that

[00:14:49] [SPEAKER_01]: helps with surgery and

[00:14:51] [SPEAKER_01]: procedural medicine decay.

[00:14:53] [SPEAKER_01]: There's a lot of technology

[00:14:54] [SPEAKER_01]: that helps with the D the

[00:14:55] [SPEAKER_01]: drugs that third treatment

[00:14:57] [SPEAKER_01]: pillar procedure drugs

[00:14:59] [SPEAKER_01]: warmth empathy and compassion

[00:15:01] [SPEAKER_01]: can't commonly carrying our

[00:15:02] [SPEAKER_01]: empathy.

[00:15:03] [SPEAKER_01]: That's the one that's been

[00:15:04] [SPEAKER_01]: artist to automate right.

[00:15:05] [SPEAKER_01]: You know we have Pfizer

[00:15:06] [SPEAKER_01]: that's been billions on

[00:15:07] [SPEAKER_01]: technologies and we have

[00:15:08] [SPEAKER_01]: DaVinci robots and all this

[00:15:10] [SPEAKER_01]: stuff for cutting.

[00:15:11] [SPEAKER_01]: What can AI or technology

[00:15:13] [SPEAKER_01]: in general do for that

[00:15:14] [SPEAKER_01]: third treatment pillar and

[00:15:15] [SPEAKER_01]: let humans be humans and

[00:15:17] [SPEAKER_01]: free up the rest of the

[00:15:18] [SPEAKER_01]: crap that fills up the

[00:15:19] [SPEAKER_01]: physician time in the

[00:15:20] [SPEAKER_01]: clinician time.

[00:15:21] [SPEAKER_01]: So we do a lot of time

[00:15:22] [SPEAKER_01]: and motion studies here

[00:15:23] [SPEAKER_01]: at Cade for technology.

[00:15:25] [SPEAKER_01]: The one fact I think you're

[00:15:26] [SPEAKER_01]: alluding to is for

[00:15:27] [SPEAKER_01]: retrospective chart review

[00:15:29] [SPEAKER_01]: when you have a big pile

[00:15:30] [SPEAKER_01]: of thousands of pieces of

[00:15:31] [SPEAKER_01]: paper.

[00:15:31] [SPEAKER_01]: In that case we were

[00:15:32] [SPEAKER_01]: reviewing cardiovascular

[00:15:33] [SPEAKER_01]: codes.

[00:15:34] [SPEAKER_01]: You know they were spending

[00:15:35] [SPEAKER_01]: 55 minutes looking at a

[00:15:37] [SPEAKER_01]: chart and they were able

[00:15:38] [SPEAKER_01]: to get that down to eight

[00:15:38] [SPEAKER_01]: minutes and in doing so

[00:15:40] [SPEAKER_01]: they were able to find

[00:15:41] [SPEAKER_01]: more than they were finding

[00:15:42] [SPEAKER_01]: in the 55.

[00:15:43] [SPEAKER_01]: So you're able to do a

[00:15:44] [SPEAKER_01]: lot more or less other

[00:15:45] [SPEAKER_01]: situations haven't had

[00:15:46] [SPEAKER_01]: quite the profound results.

[00:15:48] [SPEAKER_01]: You know oncology charts

[00:15:49] [SPEAKER_01]: are a little bit harder to

[00:15:50] [SPEAKER_01]: read pre and post

[00:15:52] [SPEAKER_01]: operative notes take a

[00:15:53] [SPEAKER_01]: little bit longer but

[00:15:54] [SPEAKER_01]: you're always seeing the

[00:15:56] [SPEAKER_01]: 20 40 50 percent

[00:15:57] [SPEAKER_01]: compression of time with

[00:15:58] [SPEAKER_01]: no degradation of quality.

[00:16:00] [SPEAKER_01]: That is really Cade's

[00:16:02] [SPEAKER_01]: gift to the ecosystem

[00:16:03] [SPEAKER_01]: and the hope is not

[00:16:04] [SPEAKER_01]: that we're able to just

[00:16:05] [SPEAKER_01]: make people work harder.

[00:16:06] [SPEAKER_01]: It's like if you cram more

[00:16:07] [SPEAKER_01]: seats into it you know

[00:16:09] [SPEAKER_01]: if you make an airplane

[00:16:10] [SPEAKER_01]: bigger you can need people

[00:16:11] [SPEAKER_01]: more legroom where you

[00:16:12] [SPEAKER_01]: just cram more seats in.

[00:16:13] [SPEAKER_01]: We'd like to think that

[00:16:14] [SPEAKER_01]: our customers are maybe

[00:16:15] [SPEAKER_01]: they're adding a few more

[00:16:16] [SPEAKER_01]: seats to make more money

[00:16:17] [SPEAKER_01]: but they're also given the

[00:16:18] [SPEAKER_01]: docs a little bit of legroom

[00:16:19] [SPEAKER_01]: to do what they do.

[00:16:20] [SPEAKER_01]: We get that warmth

[00:16:21] [SPEAKER_01]: empathy and compassion

[00:16:23] [SPEAKER_01]: that only they can do.

[00:16:24] [SPEAKER_01]: If we do contribute to

[00:16:26] [SPEAKER_01]: that it'll be several

[00:16:28] [SPEAKER_01]: years and several inches

[00:16:29] [SPEAKER_01]: of hairline walls.

[00:16:32] [SPEAKER_00]: No that's fantastic.

[00:16:33] [SPEAKER_00]: Kevin really appreciate

[00:16:34] [SPEAKER_00]: that. I love how you've

[00:16:36] [SPEAKER_00]: summarized this and

[00:16:37] [SPEAKER_00]: really giving people the

[00:16:39] [SPEAKER_00]: ability to care and be

[00:16:40] [SPEAKER_00]: more compassionate is

[00:16:42] [SPEAKER_00]: one of the biggest gifts.

[00:16:43] [SPEAKER_00]: I couldn't agree with

[00:16:44] [SPEAKER_00]: you more.

[00:16:44] [SPEAKER_00]: This is revenue by the way.

[00:16:46] [SPEAKER_01]: I mean don't think I mean

[00:16:47] [SPEAKER_01]: all the theory aside we

[00:16:48] [SPEAKER_01]: still find a lot of revenue

[00:16:49] [SPEAKER_01]: for our customers too right.

[00:16:50] [SPEAKER_01]: So I mean we're dropping

[00:16:51] [SPEAKER_01]: code left right.

[00:16:53] [SPEAKER_01]: So you know I don't want

[00:16:54] [SPEAKER_01]: that to get lost

[00:16:55] [SPEAKER_01]: but there's more to this

[00:16:56] [SPEAKER_01]: industry than just dropping

[00:16:58] [SPEAKER_00]: codes and that's what

[00:16:59] [SPEAKER_01]: we're trying to do here.

[00:17:00] [SPEAKER_00]: And nowadays that's the

[00:17:01] [SPEAKER_00]: table stakes right like

[00:17:02] [SPEAKER_00]: you have to find that

[00:17:03] [SPEAKER_00]: revenue.

[00:17:04] [SPEAKER_01]: You have to do both.

[00:17:05] [SPEAKER_01]: There's this expectation

[00:17:06] [SPEAKER_01]: that you know you see

[00:17:07] [SPEAKER_01]: things like phrases in

[00:17:08] [SPEAKER_01]: the literature like vendor

[00:17:09] [SPEAKER_01]: consolidation or cost

[00:17:10] [SPEAKER_01]: reduction or in-sourcing.

[00:17:12] [SPEAKER_01]: You have to have financial

[00:17:13] [SPEAKER_01]: clinical operations and

[00:17:15] [SPEAKER_01]: data security.

[00:17:16] [SPEAKER_01]: You have to serve all

[00:17:17] [SPEAKER_01]: four of those masters or

[00:17:18] [SPEAKER_01]: you're just not going

[00:17:18] [SPEAKER_01]: to make it.

[00:17:19] [SPEAKER_00]: And who typically works

[00:17:20] [SPEAKER_00]: with you guys if you

[00:17:21] [SPEAKER_00]: want them to hear this

[00:17:22] [SPEAKER_00]: message who's the

[00:17:22] [SPEAKER_00]: stakeholder.

[00:17:23] [SPEAKER_01]: Typically it starts

[00:17:24] [SPEAKER_01]: with the head of

[00:17:25] [SPEAKER_01]: revenue cycle or the

[00:17:26] [SPEAKER_01]: head of population health

[00:17:27] [SPEAKER_01]: or quality reporting

[00:17:28] [SPEAKER_01]: at a provider organization

[00:17:29] [SPEAKER_01]: that has every day

[00:17:31] [SPEAKER_01]: has a pile of thousands

[00:17:32] [SPEAKER_01]: and thousands of pages

[00:17:33] [SPEAKER_01]: that they need to get

[00:17:34] [SPEAKER_01]: through to understand

[00:17:35] [SPEAKER_01]: the patient and that

[00:17:37] [SPEAKER_01]: there's some money to

[00:17:38] [SPEAKER_01]: make it better.

[00:17:39] [SPEAKER_01]: When you put those two

[00:17:40] [SPEAKER_01]: forces together we can

[00:17:42] [SPEAKER_01]: usually have some fun

[00:17:42] [SPEAKER_00]: with them and help them

[00:17:43] [SPEAKER_00]: along the way.

[00:17:44] [SPEAKER_00]: Amazing.

[00:17:45] [SPEAKER_00]: Appreciate that.

[00:17:46] [SPEAKER_00]: So for all of you

[00:17:46] [SPEAKER_00]: RevCycle leaders,

[00:17:48] [SPEAKER_00]: POP Health leaders,

[00:17:49] [SPEAKER_00]: take a look at

[00:17:50] [SPEAKER_00]: katehealth.com

[00:17:52] [SPEAKER_00]: to find out more

[00:17:53] [SPEAKER_00]: about what Kevin

[00:17:54] [SPEAKER_00]: and his team are doing.

[00:17:56] [SPEAKER_00]: Kevin it's incredible

[00:17:57] [SPEAKER_00]: to hear your story,

[00:17:58] [SPEAKER_00]: how you guys started,

[00:18:00] [SPEAKER_00]: the things you've done

[00:18:01] [SPEAKER_00]: to innovate,

[00:18:01] [SPEAKER_00]: to add more revenue

[00:18:02] [SPEAKER_00]: and more time

[00:18:03] [SPEAKER_00]: to providers

[00:18:04] [SPEAKER_00]: and leadership teams.

[00:18:06] [SPEAKER_00]: What closing thought

[00:18:06] [SPEAKER_00]: would you leave us with?

[00:18:08] [SPEAKER_01]: I think it all comes down

[00:18:09] [SPEAKER_01]: to pulling together

[00:18:11] [SPEAKER_01]: healthcare entrepreneurship

[00:18:12] [SPEAKER_01]: at least healthcare

[00:18:13] [SPEAKER_01]: IT entrepreneurship

[00:18:13] [SPEAKER_01]: really comes down

[00:18:14] [SPEAKER_01]: to great technology.

[00:18:16] [SPEAKER_01]: And these days that includes

[00:18:18] [SPEAKER_01]: plumbing, block

[00:18:18] [SPEAKER_01]: and tackling movement

[00:18:19] [SPEAKER_01]: of data and interoperability

[00:18:21] [SPEAKER_01]: as well as AI.

[00:18:22] [SPEAKER_01]: Great clinical

[00:18:23] [SPEAKER_01]: to the extent that

[00:18:24] [SPEAKER_01]: your product is informed

[00:18:25] [SPEAKER_01]: by clinicians or coding staff.

[00:18:27] [SPEAKER_01]: People still matter.

[00:18:28] [SPEAKER_01]: It's not just technologists

[00:18:29] [SPEAKER_01]: but the clinicians

[00:18:29] [SPEAKER_01]: that can bridge

[00:18:30] [SPEAKER_01]: that world really matter.

[00:18:31] [SPEAKER_01]: And I'm a healthcare geek

[00:18:33] [SPEAKER_01]: right so maybe I overvalue

[00:18:34] [SPEAKER_01]: domain expertise

[00:18:36] [SPEAKER_01]: but more and more innovation

[00:18:38] [SPEAKER_01]: gets, you know,

[00:18:39] [SPEAKER_01]: as the problems get

[00:18:39] [SPEAKER_01]: more and more complicated

[00:18:41] [SPEAKER_01]: the whole model of

[00:18:43] [SPEAKER_01]: entrepreneurship.

[00:18:44] [SPEAKER_01]: Oh, I was my dad

[00:18:45] [SPEAKER_01]: with a patient

[00:18:46] [SPEAKER_01]: and the system was broken.

[00:18:47] [SPEAKER_01]: So I'm going to fix it,

[00:18:49] [SPEAKER_01]: you know, which we saw

[00:18:50] [SPEAKER_01]: a lot of during

[00:18:50] [SPEAKER_01]: certainly during the dot com boom

[00:18:52] [SPEAKER_01]: and then most recently

[00:18:53] [SPEAKER_01]: in Silicon Valley.

[00:18:54] [SPEAKER_01]: There's a role for that,

[00:18:55] [SPEAKER_01]: but it needs to be tempered

[00:18:57] [SPEAKER_01]: with an intimate understanding

[00:18:58] [SPEAKER_01]: of the regs of data security

[00:19:00] [SPEAKER_01]: of provider workflow

[00:19:01] [SPEAKER_01]: existing IT infrastructure.

[00:19:03] [SPEAKER_01]: So there's a role for us

[00:19:04] [SPEAKER_01]: geeks still to help

[00:19:06] [SPEAKER_01]: do some stuff.

[00:19:06] [SPEAKER_00]: Love it.

[00:19:07] [SPEAKER_00]: Yeah, so well said

[00:19:08] [SPEAKER_00]: and so well wrapped up.

[00:19:10] [SPEAKER_00]: Kevin really appreciate

[00:19:11] [SPEAKER_00]: you jumping on with us.

[00:19:12] [SPEAKER_00]: Love the work that you

[00:19:13] [SPEAKER_00]: and your team are doing

[00:19:14] [SPEAKER_00]: at Kate Health.

[00:19:15] [SPEAKER_00]: Folks take advantage

[00:19:16] [SPEAKER_00]: of reaching out,

[00:19:17] [SPEAKER_00]: check out the show notes.

[00:19:18] [SPEAKER_00]: We'll leave ways to get

[00:19:19] [SPEAKER_00]: in touch with Kevin,

[00:19:20] [SPEAKER_00]: his team

[00:19:20] [SPEAKER_00]: and the Kate health

[00:19:22] [SPEAKER_00]: dot com website.

[00:19:24] [SPEAKER_00]: Kevin, appreciate

[00:19:24] [SPEAKER_00]: you being with us.

[00:19:25] [SPEAKER_01]: It was fun, Saul.

[00:19:26] [SPEAKER_01]: Thank you so much.

[00:19:26] [SPEAKER_01]: Really appreciate it.