ONS Webinar: An Intro of Luma Health to the Oncology Community

ONS Webinar: An Intro of Luma Health to the Oncology Community

The Oncology Nursing Society has been a longtime advocate for improving care management and quality of life for cancer patients. In particular, the Cancer Control Continuum is a huge topic of discussion–as healthcare professionals manage care across the stages of cancer (from Prevention and Early detection, to Treatment and Survivorship). It goes without saying, effective patient communication plays a huge role in this realm.

We sat down with Sangeeta Agarawal, ONS Board Member and Advisor, to talk about struggles that the oncology community faces in care coordination, and how Luma can help.

Watch the video here and read the full transcript below!

Speakers:

Aditya Bansod, CTO of Luma Health (left)

Dr. Tashfeen Ekram, MD, Chief Medical Officer of Luma Health (right)

Sangeeta Agrawal, ONS Board Member and Advisor

Transcription:

Sangeeta Agrawal: Alright, hi, everyone thank you for joining us. My name is Sangeeta, and as many of you know I am leading the Innovation and Education Initiative with our oncology communities.

So, my goal today was to share with you some interesting challenges that we faced and simple solutions to those. And to discuss that I have the founders of Luma Health with me. This really attracted my attention because of two main challenges that I think we see in our oncology community. One is that we tend to be so busy it’s hard to accommodate all our patients on time so they have a wait period. And at the same time we sometimes have missed appointments. So, it’s a catch-22 problem. And the other issue is then how do you help people with having good care coordination because I think that’s another challenge where we’re so busy it takes up a lot of time to do care coordination. So, is there a better way to do that and I really like the way the founding team of Luma Health have healthcare backgrounds themselves. [They] solve some of these problems and try to address this. So, we’ll talk to them today about why they’re doing what they’re doing.

So, I have here with me Dr. Ekram and Aditya. Dr. Ekram is a co-founder and Chief Medical Officer at Luma Health. He was a radiologist at Redwood Regional Medical Group before this, and he’s affiliated – he has been affiliated with UC Berkeley, University of Michigan Medical School, and Stanford Hospital. Welcome, Dr. Ekram.

Dr. Tashfeen Ekram: Thank you.

SA: You’re welcome. Also, I here with me Aditya Bansod. He is the co-founder and CTO at Luma Health. He’s the Product Lead and he’s previously worked at Remind, Sencha, Adobe and Microsoft.

Aditya Bansod: Hey there, thanks for having us today.

SA: You’re very welcome. Okay, great, so let’s get right to it. So, tell me what is Luma Health?

AB: Sure, I’d be happy to. So, Luma Health was basically born out of a lot of experiences that Dr. Ekram had in his clinical experience, but I’ll let him kind of get into some of the background story in a quick second. But basically what Luma Health is, it’s a way for patients to better connect to their care providers, their doctors, their nurses, and everyone else who’s involved in their care.

And the original idea from Luma started out with exactly what you’re saying, Sangeeta, which was clinics have available capacity, but they’re very busy so there’s long wait times, and trying to match patients to be able to get in front of those care providers who have available time. And then we’ve kind of grown the product from there a little bit more into kind of a comprehensive communication platform that helps patients on their journey of care. Whether it’s pre-appointment, to getting into a specialist appointment, to making sure that the appointment they had was interesting and it was of high quality, they got the experience that they wanted, they got the information they needed, all the way to the follow-up care to say whether there’s more coordinated care that has to happen afterwards – to having to come back in if there’s any complications or whatever it might be.

So, Luma Health really started with this original idea of helping patients get in front of their doctors, but like I said it’s grown to help patients manage their journey and help clinical providers actually help them achieve the goals and results they want.

So, it’s kind of interesting to hear – so, that’s what we do. I think what’s equally interesting is where Dr. Ekram originally had some of the concepts for Luma from his actual clinic practice.

SA: Yeah, walk us through. How did this start for you?

TE: Yeah, I’d say the most challenging thing that I faced when I was more clinically involved is when a patient would come in and complain that they had some symptom that happened and it’s been going on for a long time and then they would say that I couldn’t find an appointment with you for an X number of weeks. And I knew on a daily basis that there were openings. And it was frustrating to me because if you don’t get the care you need in a timely manner, unfortunately sometimes you can reverse the problems but often times you can’t reverse a problem.

And I think that was the most frustrating thing to me because I knew that I could have seen this patient six weeks ago, but this patient was waiting for six weeks to be seen. And, unfortunately what had happened over that six weeks was irreversible. And immediately what that alerted to me was that there was a big communication breakdown between what a clinical provider was trying to convey to the patient and for the patient to receive that message. And I think that was really the genesis of this company. We were hoping to be able to automate and facilitate the conversation and in a bidirectional manner.

Because there’s often things the patient wants to tell us and is unable to, and I felt at the same thing from the providers. And I think that was the original genesis of our services. It’s obviously kind of grown from that.

SA: So, tell me more about this – you said that bidirectional conversation, right? Like, I get the appointment piece, where the schedule is not optimal for the clinician as well as it’s not optimal for the patient who’s waiting and could have been squeezed in. But you’re also talking about the communication. So, what is the communication aspect that’s a breakdown here that you’re talking about?

AB: Sure. So, there’s a lot of different components here and obviously Dr. Ekram can talk about the clinical side is a little better. From the product side, the main thing that we started to see is if you are trying to see a specialty doctor or you have a procedure that needs to be done, a lot of times if the preoperative instructions are not followed or the postoperative information is not received by the patient, additional complications can then start to arise, right? So, one of the specialties that we worked with on top of and quite a few handful is gastro and there’s many pre-op, pre-procedural instructions that need to go out for, say, a colonoscopy. And if those are not followed, then the ability to perform the colonoscopy is – then you can’t do it.

And, so one of the things that we’re able to start doing and one of the things we are doing now is actually starting to send messages ahead of time via our secured chat portal. And one of the things that we learned kind of really early on and I’m sure you and the folks in the ONS community kind of realizes from your personal experience that if you get a text, you’re going to read it.

And so we treat – we look at text as our main mechanism that we communicate with patients and we do it in a very secure way. And, so we can say before procedures like, “Hey, don’t forget–”  you can send this message exactly 24 hours before the procedure is due to happen – “You should stop eating right now. You should stop taking your blood thinners right now.” Whatever those pre-procedure things should be.

So, when they come to their procedure, those things are now taken care of or they’re not a presented problem for actually performing a procedure.

On the flip side, the bidirectional thing like you’re asking? Now, we can also send another message and one of the things we see a lot is that, 12 hours before that procedure now we can ask a question: “Hey, did you actually do that?” Right? Or “Did you actually eat something? Did you stop your blood thinners?” Or whatever the case may be. And then let the patient respond, right? Saying, “Hey, I actually didn’t do that is that going to be a problem?” And then one of the things because we have a secure communication channel, we can let the clinical staff – the nursing staff, whoever it is, know that “Hey, this patient’s trying to reach you. They’ve had some sort of thing come up that’s not normative,” and let them know that, like, “Hey, you may want to reach out to them, you may want to send them a secure message or maybe even just reschedule the procedure for them.”

SA: Hm, right. So being able to plan before – inform patients what needs to be done beforehand because a lot of times if the specific instructions are not followed, then you might not be able to see them that day or there might be an impact on the care. So, if I understand correctly, you can send them messages, you can get messages back, and you’re partnering with a hospital and their care team? So, then the care team is responsible for any messages that the patient is sending back?

TE: Correct. Yeah, and to give you actually a very clinical example – to be very relevant to oncology is – so we can send messages based on any sort of change in appointment activity. Whether when the patient shows up or when the patient schedules. And so for example, patients that are going to chemotherapy, deal with a lot of symptoms and a decent percentage of those patients end up showing up in the ER or being admitted to help them manage those symptoms.

And, there’s been a recent paper showing that having regular check-ins with these patients while undergoing their chemotherapy can actually be beneficial for avoiding those unnecessary ER visits and admissions into the hospital. So, what we can actually do is, we can actually detect when the patients are undergoing chemotherapy and automate messages to them.

So that we can say for example, after every therapy – every infusion of chemotherapy that the patient gets, 12 hours after, send this message to them which will say something to the effect of, “How is your nausea? How is your – are you experiencing any diarrhea? Have you noticed any fever?” Or whatever the symptoms would be. And we can template it to some of the standardized intakes that they have for adverse effects – adverse effects for chemotherapy. And what that can do is that can keep the nursing staff connected to the patients and what it does is that often times these patients want to be able to express themselves, but they just don’t know how to. There are the phone lines that – they have avenues to do it, but it become difficult for them.

But once you’re able to enable them to be able to share their experience on a phone, it creates an easy way for them to be able to respond to you. And then what we can do, is that we can collaborate or collate all these responses so that you can quickly screen them saying, “Hey, look, this patient has been doing okay throughout their treatment process, but here’s a patient that starts to fall off the curve. We should reach out to them, we should monitor – we should adjust their chemotherapy regimen or bring them in to see them tomorrow.” So whatever it would be to help them avoid those unnecessary things. And there’s a lot of automated communications I think where it’s really powerful, particularly for patients who are at high-risk for problems.

SA: Yeah, absolutely. That’s definitely an issue sometimes with the symptoms – how people are doing. So, one of the issues, as you’re well aware of that comes up is who’s responsible if the patient sends a message right? For – let’s say as a clinical team, my schedule is full, but if they are sending a message through this text message now, then does that become the hospital’s liability? Does that become the nurse’s liability? Or are you canning the messages – like I’m just trying to figure out if – let’s say a hospital or a cancer center wanted to work with you, then who is responsible for any escalation in the patient’s conditions, right?  Like if they have sent a message and we haven’t responded, then that could be a legal liability, right? So, is that somebody on your team screening or is that the hospital’s responsibility? Because you know how some of us like data but not a lot of data. So, how are you working with hospitals?

AB: Sure, and there’s a couple levels to the way that we address this. Now, number one: we, Luma doesn’t have a clinical staff, like we have Dr. Ekram, he’s an army of one, so we are the avenue for our customer. Whether it’s the clinic, the hospital, the cancer center, whatever it might be to provide services for them. Now, what we do is there’s a couple of different things that we do. The level 1 thing, which is the most standard one, is anytime someone messages us, they say – you’re always very clear and ask, “Is this is a life-threatening situation?.  Dial 911.” Right? Like that’s level 1.

Level 2 is what we do is we escalate, and I think that’s even the word that you use, and that’s kind of what we call it internally, we escalate the most important patient replies back to the staff. And then normally what we do is we work on a workflow kind of conversation with them and saying, like look you may have had a certain amount of people who are responsible for the telephone or responsible for the inbound phone calls, whatever it might be. Those folks can – if you want, you can kind of adjust that so that some percentage of them are available so they can check messages that are coming in via Luma. That’s a level 2 triage, and then one of the things we’re working on – this does not quite answer the legal question but answers a workflow question a little bit more – which is we’re working on some machine learning and artificial intelligence so that we can actually better identify and give patients when they say what would have been like (I’m not, I’m not a doctor), but let’s say it’s like a relatively benign answer, like there’s “Oh, everything’s fine, but my left leg hurts.” Well, that’s not going to be a problem and then we can say like, “Okay, great, if this escalates in the next 8 hours, make sure to call.”

So, we can give the patients the path to actually escalate and actually de-escalates to some degree if we can. But, yes, ultimately the end goal is that our clinics do have some staff who are responsible for actually answering this as if it would be at the very highest level (that level 3) conversation as if it was a telephone call.  And many times what they do is they send the message that says, “Great, here’s our number, give us a call and we’ll get in touch with you, let’s talk about this live.”  And so it works out. Every clinic is a little bit different, as you might imagine, and so we work with them to figure out what’s the best workflow process to address this new communication channel. Patients love it, but we’re going to make sure the clinics actually are able to effectively use it as well.

SA: Exactly, exactly, yeah. That’s really important, right? Making sure that it’s successful on both sides and I really like that. I feel like you’ve really got a good sense about – Aditya, from a product perspective, what are the challenges that different people face, and how do you try to address it? So let me dig a little bit – huh?

AB: The goal – I mean a lot of times we say that what we’re doing at Luma is to make everyone’s jobs easier. And, so I mean, if we’re not making the clinical staff, the patients, the administrative staff, if we’re not making their jobs easier, then what, like, that’s what we’re here for. That’s the point. So, we spent a lot of time trying to talk to the docs, talk to nurses, talk to administrative staff, and see, “Hey, this is how we can help you and try to build a product to fit that model.”

SA: So, tell me a little bit more in terms of when you’re thinking – okay – a certain feature is helpful, one good thing is you have Dr. Ekram who is the visionary behind it. He’s living that experience. But how are you engaging other stakeholders in not just the testing process but right from the beginning. So, how are you how are you working with various members of the team that are going to be impacted by the product in some way? So, help us to understand how this works for somebody who’s non-technical.

AB: Yeah, it’s actually, it’s not very technical whatsoever, actually. It’s – The real way that I think the best way you figure out these kinds of, the answers to these questions is you talk to real people and have real conversations. And so we have a couple different things that we do. We have a medical advisory board. And the medical advisory board includes administrators, clinical folks, non-clinical folks, everyone who is in the process of healthcare. And so they are our first line of conversation and dialogues. Like “Hey, we have this idea.” And a lot of times they’re like “That makes no sense, try again.” And then, a lot of other times they’re like, “Okay, but what if you did this,” and like, “Oh that’s really interesting.” So, that’s kind of bucket 1. Bucket 2 is where we have our existing customers and they are a wellspring of information, right? Because it’s amazing when you just sit down like “Hey, can I just have ten minutes of your time to talk to you about the problems that you’re having?” And then we can build software to help solve that problem.

And the third thing that we started doing this year which is kind of new for us is we’re actually attending a lot more conferences and shows and events and, we’re sponsoring, so we have a chance to talk to people at the conferences and say like, “Yes is is this helpful for you? If we did this, would this be interesting”?

And so we have a lot of opportunity to just get in front of real people–where software automation workflow tools and communication products can actually help make their lives easier. And that’s actually where it comes from, So we take a really humanistic approach, right?

Like, I want to talk to you, Sangeeta, and I want to talk to the folks and the ONS community and say like, “Hey, Luma does this, is that a helpful thing for your role of healthcare?” And you’re like, “You know what, these 2 things are great, but these 2 things are terrible.” “Alright, those 2 things can change for your universe.” So that’s the real way we look at it and like, Dr. Ekram, he’s kind of – we can call him our visionary, that made me snicker a little bit. A lot of times we talked about what’s our North Star? And the role is equally like–mine is product–but his role is asking “What’s the North Star? Making patients’ Iives better. And a lot of the stuff rolls up into “Does it does it actually fit with that mission in the company?”

SA: Mhm, yeah, I think that’s really wonderful that you’re engaging the community. You’re thinking about “Is the product helpful?” because I think as we know how much some of us in healthcare struggle with EMRs. There not designed for keeping the people who use it in mind.

They’re really good for billing, and documentation, so I think it’s really good that you’re keeping people involved. So, since you touched a little bit on the role of oncology nurses, let me give you a chance here. So, what – the people who watch this video or hear about it – what do you hope that we could be of help to you in any way? What kind of message or information you might have for us or what do you want us to help you with?

TE: So I think a lot of our product right now helps with the workflow issues and so that’s where we saw the original pain point was. Helping people get into the clinic, helping them make sure that the appointment is canceled, getting them get back in. And I think now we’re realizing that now that we’ve built a communication platform that revolves around the appointment or actions, we’d like to understand how we can now take it from the workflow solution standpoint to more of a clinical role.

Because there is a lot of communication that happens just getting you in and things of that nature, but there’s a lot of things that happen in the clinical world that have nothing to do, per se, with the front staff, in just trying to get you into the seat.

So, for example, getting patients their medication refills. Getting patients their biopsy results, they’re wanting – they just had they had some blood test done. There’s a lot of different clinical scenarios that still involve a lot of communication and some of it’s – a lot of it is a little bit rote. What we’re really interested in is what of this can we help you on.

And it’s – the more we can automate on these things – actually it’s interesting, it’s a win-win situation because patients get their answers much faster. And the second thing is that it frees up time so that the clinical staff, on-call staff, can actually focus on other things. They can focus on the patient sitting actually in front of them rather than – they having to sit at the end of day and spend 4 hours going through the voice messages saying, “Here’s your lab results, here’s your lab results.” Oh, “We’ll see you tomorrow,” or whatever. And there’s a lot of tasks.

Interestingly enough,  if you look at the incoming calls that come into any sort of clinic, they can be bucketed. And two-thirds of them have to do with clinic questions that are just repeated over and over again. And in these kinds of situations, they’re very ideal for a computer being able to it.

And I think it would be excellent for us to understand what are your pain points in the clinical world that we can help to automate. And I think one of them that we kind of talked about earlier was that making it easier to track patient symptoms. And that has a real impact because it can help patients not show up in the ER. But there’s a lot of clinical scenarios, and I am not in the weeds of oncology. I have friends in oncology, but people who are just day in day out, they know what the problems are and where we can potentially have a significant impact.

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SA: Okay, yeah, definitely. I think so. Understanding what are the biggest pain points for you or your team and then some ideas about how it could be potentially automated, right? So that people can get the answers and it’s a better utilization of the team’s time when the work that can be automated is done that way. Great. So, then moving on, I want to ask a little bit – we talked about what Luma does. Can you give me some examples, you said you have some customers – so can you give us some examples of places you’re live and the kind of problems that you are solving and what results are you seeing? How is it benefiting the team or the hospital?

AB: Yeah, so actually, one of the things that Dr. Ekram has been working on is actually some of the raw data analysis. He’s got a mind for that. But I will walk you through some of the samples, some of the high-level [stuff] and he can give you some of the details here. So, we work across a large variety of primary care and a large variety of specialties today.

I’ll use a couple specific examples to kind of highlight a general impact of what happens when Luma gets deployed in the practice. So one of our customers is a 15 or 20 provider GI clinic in Georgia, and one of the things that they’ve been able to do with Luma is a couple things. And the way the story actually evolved I think is equally interesting. We were talking with our staff, and we’re saying like, “Hey, we’re running some data, but before we share some of the data with you, I wanted to get a sense like, intuitively like what do you guys think after using Luma – has happened in your practice?” “Well I think we’re getting a lot fewer no-shows. It feels like the appointment books have been more full. It feels like, things are kind of just working a little bit better.” And we’re like “Yeah, actually what turns out is…” when we went in to share some of the data with them. But what ends up happening with Luma is a handful of things.

So, the first thing that happens is with our cancellations and appointment reminder system, we’re able to basically reduce the amount of an inbound phone calls that come into a clinic?  Because that’s all become automated. The actual show rate of patients, the true show rate of actually who’s actually coming for their appointment goes up. So that’s just one component.

And the other thing that happens is because these are specialty clinics in this specific example, we have a way to help manage their referrals so that anyone who’s inbound to the practice can automatically get scheduled and get notifications that their referrals were approved to come in to, say, this GI clinic. That actually helps increase capacity utilization. And on the other end, patients are getting this pre-op, pre-procedure, post-procedure messaging.

And so we’re able to get a lot of different things that get them, the patients into the clinic, very satisfied when they’re in the clinic, and then also the care and the messaging they need after the clinic. So, there’s some really great results when we’re looking at this one specific clinic and it’s kind of what we’ve seen whole basically across the board.

TE: Yeah, I think one of the most important statistics that we look at is utilization. So for practices, there’s a fixed cost. You have the staff that aren’t there physically everyday that you’re paying for. There’s a physical space, there’s any equipment. And so when a patient doesn’t show up, when there’s an opening in this in the calendar that doesn’t get filled, it’s unfortunately a cost that’s not contracted by some incoming revenue.

And so to really look at just the overall impact of Luma on a practice, we look at just resource utilization, or just number of appointments that are actually completed. And we see on an average anywhere between 5 to 15% increase in utilization – across practices.

And we’ve seen this pretty consistently across a variety of specialties, starting from primary care all the the way up into multiple specialties. So, and that’s really exciting, because what you’re able to do is you’re actually able to see more patients without actually having to add any more capital costs. Which is usually the greatest cost going into establishing a clinic. So, we can help you become basically more efficient without actually having to actually invest in anything.

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SA: Right, yeah I think like you said that the team cost is already fixed that the center is paying for, right? So if you can better utilize the time, then you can have better response, you can have higher patient satisfaction because they’re not waiting that long to get their appointment, and you can make the most of the team’s time. I just think sometimes from a practical perspective, I know that, at times I will have, as an oncology nurse, 4 or 6 patients show up at the same time that I have to take care of, and other times I have a 30 minutes block that’s free and that’s not what I had anticipated. So, I think even just in terms of the stress that someone goes through on the clinical team side, it’s definitely helpful to have a routine or have a schedule as much as possible. And we can provide better care when the patients are spaced out well.

I thought it was interesting also when I was looking at the ROI document that you shared with me that typically there are about 50 visits a month that are missed. Just at a couple of locations I believe, like, 3 locations they were like 50 visits missed in a month and that came to about $2,500 lost revenue in a month.

AB: Yeah. I think what we see there is – it depends on the clinic and the specialty, but we see and luckily we have a couple hundred customers, couple thousand providers in the system, so we actually have a very like horizontal view across specialty about what the true cancellation rate is. And we see in the best managed clinics it’s still 10-12%. Which means 10-12% of patients who said they’re going to come just never show up and that’s unused capacity. In the worst clinics, it’s anywhere up to 25-30%.

So, that’s one of those things what excites me about what we’re doing here at Luma is to see the arch of cost in health care. Here’s a clear opportunity to keep that cost down and work to increase efficiency. And now we’ve seen it across many, many specialty types, many primary care types, different types of care settings. Whether it’s individual practitioners down to academic medical centers – across the board – the cancellation rate and the no-show rate are one of these truisms in the healthcare that we think we are making a pretty big impact in trying to fix. And it’s one of those things where like you said, like sometimes you get slammed with 4 people and the other times just sit there for 30 minutes, well there is supposed to be 3 people here right now.

SA: Right, very true. Also, talk to me a little bit about MIPS. I know that it impacts MIPS outcomes and of course that’s really important to the clinical and the leadership team. So, can you shed a little bit of light on that?

TE: Yeah, so what we can help you do is – we don’t help on the reporting side, but we can help you act on any of the MIPS categories that directly impact patient scheduling. So, also on the clinical side so you can kind of bucket them into 2. So, on the scheduling side, there are things where they asked about percentage of referrals that are completed, or a percentage of when patients are brought back in for certain types of exams. And what we can do is we can start pulling in procedure codes to help you figure out where those gaps are and make sure that those gaps are filled.  I’m not, I actually don’t offhand know any of the MIPS criterias that particularly pertain to oncology, but for example, diabetic patients, we can help you identify patients who have not been seen in the last month for their diabetic foot exam or their diabetic eye exam. And what we can do is we can automate messages to those patients to help them get in. So, for example, we’ll scan your records and say, “Hey, look these patients haven’t been seen in the last year, and they’re supposed to be seen on a yearly basis.” What we can do is we can identify those patients and start sending them messages. And what’s really useful about our product is that we can send messages to the patient saying, “Hey, look, you missed – you’re overdue for your appointment.”

We can also send messages to the clinical staff and the clerical staff. And so that way it actually creates a lot of buffer to make sure that this patient indeed gets in. And so what we can help you do is we can help you identify those gaps. We can help you identify those gaps in any of them – in MIPS criteria. Particularly ones that revolve around getting patients into the clinic and then help to send tailored messages to patients to help them get back in. And unfortunately, I’m not completely familiar with oncology MIPS criteria but if there are similar things, we can definitely address those – particularly, what I think what’s interesting about our platforms is that we can actually pull in diagnostic information and procedure information, which can help us really interpret a lot of things about what’s going on with the patient and then be able to drive the appropriate messaging for those patients.

10-12% of patients who said they’re going to come just never show up and that’s unused capacity. In the worst clinics, it’s anywhere up to 25-30%.

SA: Right, yeah. And I think a lot of people will see value with that even in an oncology space. As you know, some of our nurses who might be watching. There is a lot of different places where you want the patient to have gotten certain diagnoses or tests or screenings or monitor certain side effects or toxicities. So, I think there is some value to that and it could help with helping MIPS scores.

So, let me switch gears a little bit and talk more from an entrepreneurial perspective. It’s very clear that you both are very passionate about what you’re doing. You saw a real problem, you’re trying to solve it. It has high potential for impact or it does have impact. You’re already seeing that. At the same time, we know it’s really hard to get into the healthcare space and really be successful.  

I think a lot of people – entrepreneurs as well as some of the top people in the health innovation space – have talked about the graveyard of healthcare companies. So, we know that it is a real challenge.  And what I want to understand and help our audience understand is from a real human perspective.  You both chose to jump into this and put your career at stake to do this – to do this bigger vision, implement this for better outcomes. What are the real challenges that you face so we can have that honest conversation and try to understand each other, right?

So, what are the challenges you face and what do you wish that people in the clinical community understood about being an entrepreneur or starting a company?

AB: Well, I think in terms of challenges – I think one of the biggest things is actually understanding how your solution and your product is uniquely different and better than what else might be out there. Because, I mean, we talk about this a lot at Luma.

Which is ultimately everyone’s effectively in the business of healthcare to make patients’ lives better, right? Healthcare doesn’t exist without unhealthy people. And so while it is altruistic, it’s not sufficient. And one of the things that I think we work with really hard is how do we make Luma unique? And one thing we learned really early on, some really good advice that we got is if you want to have a successful company in healthcare, you have to tie it to clinical revenue.

Like, if you want to have a business, if you want to have a business with healthcare. And so like simply saying – and you’ll see if you look on our website and stuff like that we don’t necessarily talk always about like better outcomes. We don’t necessarily talk about like the things that are very – that are commonly spoken about because I think a lot of people – that’s what we’re here for. That makes sense. What really aim to do is – there are concrete things that Luma can do for you and I think that’s what kind of guides us as a company to actually make it – to hopefully drive any success that we may have.  Because it’s going to drive revenue, we can quantify everything that we’re doing, and so I think that – those are the 2 main things I think when I think about from a company product perspective and a go-to-market perspective.  

Like if it doesn’t drive revenue, if it’s not clearly quantifiable, then you’re going to be running up against – like, you’re selling hopes and dreams. Like, “Hey we will make patients’ live better.  Well, you know there’s a thousand other people who want to make patients’ lives better.

But, “Hey, we’re going to help drive 8-15% more revenue into your clinic and we’re going to increase your MIPS scores and we’re going to drive better online reviews and we’re going to help schedule your patients online and we’re going to help your referrals come in, etc. etc. etc.” It’s like, “Okay, I can actually see that.” And at the end of the month, I can give you a report that says “Yes, I did those things,” right? And you saw an 8% lift in your capacity utilization and your incoming phone calls drop by 10x? “Yup, okay, cool, then it makes sense.” Then what ends up happening is the ROI, the cost of what Luma is to the clinic is or 1/10 or 1/15 or 1/40 whatever you’re coming in on the top line. And I think that’s kind of one of the big things that has helped us  – that’s driven us in terms of the business.

SA: Mhm.

TE: Yeah, I think on a practical level, one of the other challenges we ran into is just a question of data. (AB: Yeah) And obviously there’s big moves to try to help to normalize it, make it easier, and access, but even that was, I think, one of the biggest challenges when – and it’s still actually a challenge to this day. There’s a lot of rich information that sits in EMRs, and unfortunately it’s often in silos that it’s hard to get into. And I think that’s one of the other challenges that a lot of other entrepreneurs see too. That you wanna, you have a great idea, but in order to be able to drive that great idea, you need to get access to data.

I think one advice that I would give to anyone who’s thinking about this is to see if you’re able to access that data because sometimes – just because you can view it doesn’t mean you can actually access it. And the other challenge also is it’s not very normalized, meaning like it’s not very structured or it’s not in a way that’s interpretable by a computer. And so being able to get access to data that’s interpretable by a computer is actually important. We learned this very early on and fortunately we’ve been blessed with a great product team that’s been able to get into, hack into whatever system we need to get into to get our data.  

And fortunately, a lot of data we’re working with is actually pretty structured. So, scheduling data and diagnostic and procedures, which is kind of by its necessity very able to be able to interpret by a computer. But if you’re looking at other pieces of data, it can be very difficult to be able to make sense of it. It’s just something like free text, notes, and things of that nature. But I think the data question is always going to hang there and I think the industry is slowly moving towards becoming more normalized and being more standardized but it’s still going to take a long time till we get to a point where we can all work with it easily.

AB: Yeah, we basically spent 3 years building our data ingestion pipeline. So it’s a pretty big thing that we’ve built and we can connect with about 50 EHR and PM systems, which is a pretty – it’s a reasonable number. But we think we’re maybe only half or a third of the way there, and so maybe there’s another 3 years of that ahead of us, where that’s just – it’s very true – like getting – the data is there – it’s in the EHR, and the PM system, it’s just having other vendors get to it is very challenging.

SA: Yeah. Having access to data is hard for entrepreneurs. I hope that health care systems understand the opportunity here in working with various companies such as yours. And being able to share the data and use some of the security and interoperability platforms that are coming out and making it easier and easier to have more openness to sharing that data because then the value you provide in terms of the insights and automation will save time and result in better outcomes. Yeah, totally.

So, I think one is to become a champion for access to data. And secondly, I think what you were saying, Aditya, is being able to be a savvy shopper. So, learn more about different technologies, different companies and how they can help you – see how they can improve the care or the cause that your center – and then being able to champion that. (AB: 100%) So yeah, those are very good insights. Thank you so much Dr. Ekram and Aditya for your time. And to my fellow oncology nurses I hope this was insightful for you to see a simple problem that we face day in and day out. I think most of us have experienced these gaps in appointments and care coordination challenges and places where automation can help, right? So, I think these are problems we re-see day to day and it affects us or it affects our patients or our cause. And you have seen one example here with Luma Health of entrepreneurs who get this space and are trying to solve this.

So, I hope it inspires you to look at more digital health to see what solutions are out there for your pain points and how you could potentially leverage them to improve the outcomes at your center. And become a leader, become a champion. Shop around, see their reviews, see their results, and then let’s champion for them so that we can have better outcomes and we can support entrepreneurs who are taking that risk and that leap of faith in improving healthcare for all of us. And that can only happen if we all work together. If we join hands to make these outcomes better.

So, I hope this was helpful and insightful. You are always welcome to feel free to reach to the Luma team on their website and I’ll be back with more ideas, insights, and companies for you. If you want to help out Luma team in any way, I will post whatever information that they’re going to give me on to the description here of the video, so you’re welcome to reach out to them there or I’ll post it on the forum. Thank you so much for joining us and you have a wonderful day.

AB: Thanks so much, it was a pleasure.

TE: Thank you.

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