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Kristin Nuckols, Imago Rehab
48 Plays8 months ago
In this episode, Steven sits down with Kristin Nuckols, Co-Founder & Chief Clinical Officer at Imago Rehab and Occupational Therapist
Learn more about SaRA Health: https://www.sarahealth.com/
Check out Inspired Physiotherapy: https://imagorehab.com/
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Transcript
Introduction to The Disruptors Podcast
00:00:01
Speaker
Welcome to another episode of The Disruptors, where we're arming you with the tools you need to innovate within the physical therapy space by highlighting those who have come before you. I'm your host, Stephen Cohen.
Meet Dr. Kristin Knuckles
00:00:13
Speaker
Now, let's get into it. All right, everybody. Welcome back to another episode of The Disruptors, where we're highlighting innovation within the rehab industry. Today, I am blessed to be joined by Dr. Kristin Knuckles Doctor of Occupational Therapy and the chief clinical officer and co-founder of Amago Rehab.
Dr. Knuckles' Career in Occupational Therapy
00:00:34
Speaker
Kristen, would you mind telling folks a little bit about yourself? Sure. Thank you for having me today. So um I've been an OT for close to 18 years and I have been working with
00:00:45
Speaker
people who've had a stroke, brain injury, spinal cord injury, so what we call neurologic rehab for really the whole time. um And I've been working for the last about eight years on really innovation in this space and bringing something new to the market. I love it. And so let's hop right into it. What is your why behind OT? What's driving you or what drove you to to get into OT?
00:01:12
Speaker
So to get into OT, I had a hand injury. I was a big athlete. I was a gymnast, um loved a lot of different sports, and had just a little hand injury when I was in middle school. And I had to go to an OT, and she made a splint. And we did all these cool activities. And what do you know, I got better. And so that really pushed me into OT. I thought, that oh, if that'll work for me. um And so really, since I was a middle schooler,
00:01:37
Speaker
This has been the field I'm interested in. I assumed I would do hand therapy, which is a portion of rehab. um But as I went to OT school, I was exposed to this this side of rehab that we call neurologic rehab. So you know meeting people who've had a brain injury, meeting people who've had a stroke, and just there's this magic in neurologic rehab that really captivated me. Because what you see today is not what you're going to see in the future. Something can change. And so that That just drew me in. And so I've really been focusing on neurologic rehab my whole career. that I love that. Something can change. in um you know as a my my i don't know I don't know if we've talked about this, but if not, so my grandfather has been battling Parkinson's for about a decade now in seeing the positive impact in terms of how that allowed him to
00:02:35
Speaker
maintain his independence for for quite a while, but then unfortunately also the the antithesis of that which is when he got no PT or OT for a month when he was hospitalized for a blockage and seeing how painfully, painfully ah impactful that was. I just I just want to say thank you to all the others that are family members that are patients and I've seen that contrast, that you almost perfect night and day experience for for for for my grandfather. Like, yeah, you're you're doing something amazing. And I know I'm appreciative of it and especially having, I guess,
00:03:22
Speaker
the vicarious experience that I do. um It is incredibly valuable. And so for that, thank you on on behalf of me and I'm sure a few listeners as as well. So you you had ah your own injury that got you really interested in the OT.
Founding Amago Rehab
00:03:37
Speaker
You thought you were going to do hand therapy um and had the aperture open, right? To be able to see these other ways that you could impact the lives of of people And I'd have to imagine that is you at least part of the why behind, if not all of it. So what you're doing now, but you'll talk to me about how you started to make that transition from staff therapist into the, you know, into a Mongo. Yeah, that's a great question. It's a, it's been a crazy journey. I spent the first 10 years of my career as, as you said, a staff therapist, working at a hospital, working at an outpatient clinic, um,
00:04:19
Speaker
largely you know with with the stroke population, other other as well, but mostly stroke. And really working on during that time, you know being the best at my craft, wanting to understand, you know how do we do this? I've always loved reading research. I love that part of my my undergrad and my master's degree. um I was the student who was like, wait, have you seen this article? you know ah love to read I love to read the read the results and read the methods. How do you do this? How do you make this work?
00:04:47
Speaker
um because therapy is an art and a science is kind of the phrasing that we use. um But really, I want to know a lot of the science of it. I want to know what is going to make people get better. And that can be really nebulous in the neurologic population. So I have to get back to the question, which was,
00:05:06
Speaker
um Actually, do you mind if we stay on that for a second? So yeah we you the goal of this this this podcast is to be able to make innovation feel more accessible, right? So I actually want to stay on how did you make time to read research, right? yeah I would imagine you had a full caseload, potentially, you know, heaven forbid, had a personal life, right? Like how did you make time or how did you create that prioritization to to stay current on on research?
00:05:38
Speaker
That is a great question. And I can plug my former employers who I still love. um which by The first place I worked was Sheltering Arms, which is now the Sheltering Arms Institute, which is in Richmond, Virginia. And they had a culture for understanding literature. So that was not just show up and we're going to give you as many patients as possible. It was, we're going to be the best at what we do. And we're going to translate clinical science into um the day to day treatment. So that is very unusual. That was on purpose. um I, you know, chose the place that I, that was mission driven and that I believed in. So part of, you know, they have things like, no, I don't know what they do now cause I'm not working there anymore, but having, having opportunities like a monthly journal club where someone, you know, people bring snacks and over lunch, you know, someone brings a plate of brownies and everybody learns about a research article.
00:06:31
Speaker
right So you can make it part of your culture, um which not only do you learn something, but also you make research less scary. That's that's part of it, right? so you know I'm guilty of looking at a research article and a lot of the research I read comes out of engineering journals, because I'll get into that a little bit, but I'm a little guilty of getting to the methods and going yada, yada, yada, you know, Python scripts. Okay. Where's the result? What happened? You know, um, but at least being able to understand, you know, you, you see a new device or you see, you learn about a new treatment technique. You really need to be able to understand how does this apply to me? Does this apply to the patients I see?
00:07:12
Speaker
Are these patients 30 days post-stroke? Are these patients seven years post-stroke? Does everything apply to everything else? I mean, that's that's the idea here that i you know that really makes me love research is you want to understand what is what do you think is going to happen. It doesn't mean because this this result happened in some cohort with some intervention, it's going to happen for your patient that you see Tuesday, Thursday for a month. Is it the same? did they Would they fit in that study? Did you give them the same intervention? Was it recreatable? Did you do the same thing? like that's the That's where I get into the, you know what is it that we're trying to do with patients? And that's really what put me on my journey. So I spent 10 years in
Innovating with Robotics and Technology
00:07:57
Speaker
the clinic, hospital and outpatient. I learned how to use a lot of different technology. I love to use robotics. I love to use electrical STEM.
00:08:06
Speaker
I love to use gaming. I like to use all the things that are new and interesting because it keeps people engaged in their therapy. And that's that's number one. If they're bored, what's the point? um And so I have the opportunity to then work in a Harvard engineering lab, which is a massive right turn.
00:08:25
Speaker
you know Um, and I think I said no a few times because I was just like, what would I do? How would I help them? Um, but then once I took a leap and, and joined that research team and got to work on, you know, designing and testing wearable soft robots and the concept of telehealth and, you know, all these different things, then I was able to, to create something new, which is a startup called a Mongo rehab. And we're a, yeah, we're a seven state telehealth practice. Um, we combine this.
00:08:56
Speaker
this work from this Harvard Engineering Lab, um which is about understanding what people do at home, um and also my doctorate that I did in OT. So that's a lot. Maybe we pause and see what you want to tease out. There's there's there's one thing I definitely want to tease out. the One of the things that um I heard there was a great tip that I want to highlight is you put yourself in a position to succeed. right and so By finding a culture that you fit into and you knew would help make you a better clinician, like that seems to have created a really nice foundation for you to be able to launch from from there. cause i'd Imagine that you being on top of your game in terms of of reading research,
00:09:41
Speaker
and and knowing how to interpret findings and methods and and everything else um allowed you to progress much quicker in that Harvard opportunity than if you didn't have that that prior experience, right? and And I love how you also like, it was part of the culture, you chose that, and then it's not all on you either, right? It's ah it's a rising tide, raises all boats.
00:10:05
Speaker
um and so I use that phrase all the time. I believe that. you know I don't want to poo-poo on other other places that you can work, but i you know i the places I've worked, I have selected very carefully because I wanted to be surrounded by a culture of excellence, not driven by you know how many possible billing units can I get in a day. That's that's not why I'm a therapist.
00:10:34
Speaker
so I could appreciate that. um And so yeah, I think that's first. we already we're We're less than 10 minutes in and we already have a really good tip and in putting yourself in a position to succeed and and surrounding yourself with with folks that can buoy you, right? And so it doesn't have to be all you forging the new path. I think there's a misconception there, right? That it always has to be you and that's just simply not the case. Agreed.
00:11:02
Speaker
oh we're we're We're on a great track. so you're You're in this Harvard engineering lab. and you said You said no a couple of times. like well Walk me through that a little bit. I would like to to double click in and there. Sure. I mean i think there now I have learned my value, which is something you and I were just chatting about before we got started with recording. um I know my value now, but I don't think that I really did before.
00:11:32
Speaker
um and so i I don't know everything about everything, but I know a lot about occupational therapy. right I know a lot about stroke rehab. I know a lot about neurologic rehab. I know a lot about translating clinical science into practice. That's that's my bag. um But I think that I underestimated myself when when the professor said, I think you should join our team and help our engineers design robots. I was just intimidated by the name Harvard and by, you know,
00:12:03
Speaker
by engineers, right because I do not have a math brain. i i That's not my skill set. um so And that's OK. It doesn't have to be my skill set, because that's not what they were hiring me for. They were hiring me for voice of customer, for experience of clinician, for but you know being the user of a technology, not for coding the robot itself. They don't want me to do that. I would have been really bad at that.
00:12:30
Speaker
um so that's you know I said no because I didn't understand what exactly I would do. and Also, I was the first occupational therapist that they hired probably ever at Harvard in general. right like that's and They don't have OT school and and they don't have OTs that do jobs for them. so I was probably the first OT they ever hired. um and so There wasn't a job description. There wasn't a clear path. you know and I had always In my 10 years of clinical care, I would show up at eight, I'd treat a patient at eight, at nine, at 10, at 11, I'd have lunch, I'd one, two, three, write my notes and go home. And that was just every day, right? So to begin this job that's more project-based, I would you know ah had no idea what to do. um And that that's maybe something we want to dig into a little bit, that there there was no there was no path that was already pre-written for me to follow.
00:13:28
Speaker
So I really had to had to figure out what was it? How do I translate my my knowledge and what I can bring to a project when no one has done it before? you know Well, it sounds like, and an advice i I give pretty consistently that was given to me is is only change one thing, right? As you're making these career shifts, if possible, which it sounds like you did, right? So your your environment was different in that you you had to change the way that you thought about delivering care, right? But your technical expertise as as a clinician, all of that was directly not only
00:14:10
Speaker
portable, which portable to me would give the illusion that it was you even, like you were bringing in something that was completely missing right front from the team. And I think we've all seen what happens when tech giants get into a room and build something right and and leave the clinicians out. right You can see in the graveyard of health tech uh, the Googles, the Amazons, uh, the Walmarts of the world that like, Oh, we'll just, we'll just do clinical stuff. Like it'll be fine. And if the tech will be so good, it'll make up for everything else. And it's just simply not reality. Right. Um, and I even see, you know, other health tech startups and I see the leadership team and I'm like, where's your, where's your providers? Uh, often don't exist. That's something that's really different about our team. You know, it was,
00:15:01
Speaker
founded by a clinician. So we are you you know we're a clinician for everything we do is to support our patient care. And I think that's so valuable, right? So you I think to even put a further stamp on the put yourself in a position to succeed, I think for others that are considering going into non-direct clinical care opportunities, right? is is looking for that clinician on the leadership team. And if it doesn't exist, hopefully you're it. Or and that needs to be a a huge consideration, right? I think for our C-suite, it is a DPT, an NPT, and then myself and a master's in computer science. So it's evenly split between clinician and non-clinician, which I think is, and not I think, I know is a a differentiator
00:15:52
Speaker
for how we come to market because we, yeah, the workflow considerations in particular, right? that That knowledge is so, so, so valuable, right? And to knowing your value, I would imagine you had multiple instances, and maybe if you could think of one, that'd be great, but I'd imagine you had multiple instances where you looked at something and were like, oh no, you can't do that because this thing happens.
00:16:22
Speaker
Day one. Okay. Do you remember? Because I'd love to to learn about it. Yeah, sure. So when I joined this Harvard team, they were working on two robots for the upper limb, very you know pretty early stage. They'd written like ah one paper on each. So they had tested with some people to see what does this robot do? What can we do with it? So um one of them was the was the glove device. That one is further ah it was further along when I joined that team. And it is now kind of what our our team that started Imago Rehab brought that technology with us. So there was another device that's still at Harvard now, which is more of a robotic shirt. It's one way to think about it. So when you put on this shirt, it has some chambers that will help you lift your arm up. But you but you can wear it around. So it's like clothing that helps you move.
00:17:09
Speaker
So, but you know one of the first days I was there, um they had a participant, ah ah actually a young lady with spinal cord injury wearing this shirt and you know it's it's lifting up her arm and everyone's just sort of inspecting it visually.
00:17:28
Speaker
And I was like, are we measuring the angle of her shoulder? Are we measuring how like how high can she lift her arm with how much speed, with how much force? like Can she do a task she couldn't do without the shirt? And they were all like, oh, we were just seeing if we could inflate it. And these are really smart people. They made clothing lift an arm up. Crazy, right?
Merging Clinical and Technical in Rehab Tech
00:17:52
Speaker
That's very crazy. But what about the user experience? the How does she feel in it? how does you know so there's Just like my initial instinct was, hey, what's the patient's experience here? Is this clinically relevant? Does this tell us anything? Does it make her function better? like How would we do that? So then you know that's what I brought to the team was you know I know how to assess patient function. So I you know selected assessments that would show if something was different or not, and then did all the communication with the patients, um not their participants really, not patients for us. but
00:18:25
Speaker
you know, bringing people in, talking to them, consenting them, kind of doing that human experience, which is, again, like you mentioned, what I would do in a clinic, I would onboard them to the clinic, I would assess their function, you know, the the difference here was the and the therapeutic intervention was, hey, want to try on this robot shirt, as opposed to, let let me lead you through exercises or something like that. How was was it instantaneous when you you joined and you were able to have the confidence to to express that those questions and opinions? Or was that a a gradual process that took a little bit of of getting comfortable with? I'm not a shy person. So for me, it was like, you you know you need me. I could i could see where where the gaps were. and we And we did this for each other, right? So the teams of engineers and myself, and they were designers and
00:19:20
Speaker
fabric you know apparel designers and electrical engineers and just this whole you know this whole team. Everybody has their part, but we really had to learn to speak the same language. You know this. That's important to you as someone who's working with, like you said, computer science, PT, business. you know You all have to speak the same language. and thats you know I would give lectures maybe once a month on anatomy. like We're working on a you know robot shirt. Do you know how a shoulder functions? Do you know what happens when it doesn't function? Do you know what muscles we're talking about? What are the positions we're talking about? so i you know i I'm a person who just asks, I'm usually like an ask for forgiveness person, not ask for permission. so I think that goes with entrepreneurship. You're like, well, this is what I'm going to do. and If someone doesn't want me to do it, I suppose they can tell me.
00:20:09
Speaker
yeah so And I recognized where my clinical skills were the thing one of the things that was missing. It was missing in how a device was being designed. you know um So I didn't wait for people to ask me those things. I just provided that information in a friendly way and in a, hey, over lunch, I'd like to give a lecture on you know how the shoulder works, how the hand works. you know These are things you don't know. And then you guys can tell teach me about you know raspberry pie, which is not a dessert.
00:20:41
Speaker
It's a controller. So we both had to learn things about how how we're going to have this working is the relationship operating system for physical therapy practices, driving better patient outcomes, improved arrival rate, and improved financial margins. If you'd like to learn more, check them out at sarah, s-a-r-a, health dot.com.
00:21:11
Speaker
Sarahhealth dot.com and if you'd be interested in advertising with us and helping us produce even more great stories, please let us know at steven at Sarahhealth.com now back to the episode I I'm so glad that you're giving these very tactical you know very discrete examples because I I mean it as someone who grew up in the Midwest and like oh like you know Startups, like a tech startup is for other people and you know going to UCLA for me is is for other people. right um it I think there's a lot of people, but especially the more and more I work with therapists, like there's such a tendency to downplay the amazing knowledge that you've built, not only like across a few different dimensions. right because And you've already described a few.
00:22:08
Speaker
you describe the clinical knowledge, right the basic anatomy and in advanced anatomy, the clinical experience right of how a clinician is going to interact and a patient is going to interact with something. um and like That and is so, so valuable or else do you have a bunch of tech folks sitting in a room and be like, wow, that's so cool that we just did this.
00:22:33
Speaker
like but who's gone And you know, like I went to state school. I didn't go to a fancy university. I love my university, but I shout out to JMU. Um, so I went to state school. I did my master's right then. I, you know, was an AB student. I was not a phenomenal academic. I actually so had a conversation not that long ago with, um,
00:23:02
Speaker
the gentleman who was our program director when I was there. And I said, did you ever expect me to get a doctorate? And he said, honestly, no, I'm not this academic person, but I have a major passion. And I found that when I did my doctorate, boy, it was it was, you know, I'm going to say easy because I loved it because I wanted to know everything there was to know about my topic. So that you don't have to be the smartest person in the in the room.
00:23:31
Speaker
You don't have to be the most academic. You don't have to be you know type A. i'm noted to I'm not type A. and Everyone that knows me will tell you that. so You don't have to be that most organized, most everything put together. No, you just have to know a lot about something and really care um to bring you know to bring it to more people. I like that. ah yeah It makes me think of the the quote of Hard work beats talent when talent won't work hard, right? And and you letting your passion be the fuel, it'll let you, it'll fuel you to to work harder and smarter than than others and and to put yourself in this position. I really like also, you know, you gotta to get your hands slapped every once in a while. That was actually a um one of my mentors when I was at Deloitte Consulting that was, he consistently said that. Like if you're not getting your hands slapped every once in a while, you're not trying hard enough.
00:24:25
Speaker
um And I think that is proven to be correct not only in the corporate world, but also in the startup world where yeah, if you're not creating data through interactions, right? And data is is not just numbers in an Excel sheet, right? It's it's conversations like this. It's conversations with patients. it's It's asking questions, especially the tough ones like, oh, like, why would you not wear this shirt? It's like, oh, well, because of XYZ. Oh, well, we could fix all three of those things. you see Yeah. How will you know if you don't ask? Yep.
00:24:59
Speaker
Um, I heard your enemy also have a quote about imposter syndrome
Embracing Challenges and Imposter Syndrome
00:25:04
Speaker
that I read recently that said, if you're not experiencing imposter syndrome, you're probably not putting yourself out there enough. I like that. I like that. Um, that would, there's a point I feel that way sometimes, but usually just means I'm really challenging myself and I'm, you know, not saying no to any opportunity that comes to me.
00:25:25
Speaker
i like that I like that a lot and and couldn't agree more. There's ah a book I'm reading right now called Aurete by Brian Johnson and it it goes into into that and in a lot of detail um and I would suggest that's it to anybody. It's just it's it's so fantastic. Sorry, we'll come back. so you're You're working in this lab and you this glove device, like oh there's a lot of a lot of opportunity for this to in the real world. right so Walk me through the process. I'd imagine there's tech transfer involved if I had to guess. The process that you went through to to bring that into patients' homes, like what's where it is today. so I'd love to to learn a little bit more about that that journey.
00:26:15
Speaker
sure so At that same time, I was also doing my doctorate in OT. So i when you do a post-professional OTD, um you can either get an entry-level OTD or you can get a post-professional. So I already had a master's, so I could just do an online OTD. um And so you go in with an idea for a thesis and then over about you know a year and a half, two years, you shape that idea that you had, that thing you want to learn more about, into something that is tangible and usable. So you have to create either
00:26:47
Speaker
a program that you can implement or you know a grant that you could write or something that you've you've learned just everything there is to know about that topic and you're you're identifying a need and what you're going to do about it. So I did that and my my need was stroke rehab just does not work the way that we think it should work. People don't get better enough.
00:27:10
Speaker
In person, you know, the the idea that like you need to come to me and I'm going to do stuff to you with my hands and then you're going to go home and then you're going to be better. That that is not working. um So there's a lot of literature research that says if you do X, Y and Z, people will have this result. Usually when we compare that to traditional care,
00:27:39
Speaker
traditional care, you don't see a lot of change and then you see some kind of change with a better plan. But traditional hair is just like everybody does what they are trained to do and there's no protocol and there's no specifics. And it's just like whatever you feel like doing with a patient that day, it is really dependent on a therapist being like, we are going to do a lot of reps. We are going to be intense. It's going to be interesting. You're going to do it at home too. You're going to carry it out. That just doesn't happen.
00:28:10
Speaker
Because therapists are put, there's not the structure for that usually. yep And I don't know, what if the therapist is tired that day? Like what if they're kind of burned out, right? So there's just not the structure to make that usual care. That should be usual care, but it's not.
Developing Telehealth for Stroke Rehab
00:28:27
Speaker
So that was really my problem that I wanted to fix. And I heard that from from patients over 10 years who would say, I can do this.
00:28:34
Speaker
when I'm with you, but when I'm at home, i I can't do it. I don't know where to do it. I don't know how to do it. I don't know what stuff to use. And so pre-COVID, my solution was about using a telehealth platform to do post-stroke care. So I say pre-COVID because gosh darn it, it was the idea that I really wanted to implement before COVID happened. And there's a lot of, you know, when COVID happened, people just went, oh, everything we do, we can do virtually.
00:29:05
Speaker
But that is really not true. it You have to have a and a program that is intentionally virtual ye for it to be successful. So that's what we're doing now. I exited the lab. We had some you know startup funding. um I launched in Massachusetts only. I treated the patients myself um who could self-pay for my services. And now, you know two and a half, three years later, two and a half years later, we are and open in seven states and billing 22 payers for our services with a team of therapists usually using the protocol that I wrote. And patients get better in ways that we've never seen before. Do you get chills when you say that? Because I'm getting like goosebumps. like That is so cool. That is so It's so cool. so cool And really, i mean I say this all the time. It was theoretical.
00:29:59
Speaker
But it was really well researched and really well, the problem was really well understood so that the intervention fits the problem and it it works. So it's not it's a random accident that this telehealth program works. And it's not to say that every telehealth program is going to work. It's very specific. It's very nuanced and it fits the problem that we have, which is Patients have a really hard time figuring out what to do at home, how to do it, where to do it, how often to do it, what to do when they run into a problem. That's what our program does. We help them solve those problems in real time and then when we're not there. There's a couple of things there that I wanted to hit on. um One is the
00:30:49
Speaker
Intense focus that that you had or have sorry is not past tense Because I think people get into this Oh I need to be able to be everything to everybody and I really like how you've laid out like we you saw a gap between where patients were ending up and where you thought they could be because there was a delivery problem, right and so the and and I like Alex from OZ I know he has some you know detractors as as well, but I really like it. and yeah One of his things is about niche slapping people. It's like, no, get really niche. Get really niche, especially to to start. And then you can add on from there. yeah um And so I love how
00:31:33
Speaker
you had this, okay, we're going to help stroke patients. We're going to be virtual first. Like you just start ticking away like, okay, this is our bullseye and we're not getting away from this. And that was you two and a half years is no time at all. So from two and a half years to do that, to go from, Hey, I'm treating in this virtual first environment and Now you're in seven states with 22 different payers, you know starting with self-pay to go to the like that. I think that it's so fast. It's so fast. It's so amazing.
00:32:12
Speaker
And what a great example like this microcot of a microcosm of start really, really niche and be absurdly good at good that thing. We're both doing this because that's how it looks and that's you know that was that was recommended from our our advisors and our investors as well. because As a therapist and i tell them this a lot you know as a therapist if i worked at the clinic down the street i would i would treat everybody that came in. I might have ah one patient with stroke and somebody with parkinson's and somebody with the rest fracture and somebody with generalized weakness that we don't know why they're having a hard time and um you know it would just be really open and random and maybe that's one reason why. People you know maybe don't get the results they want is because we have to be.
00:32:59
Speaker
generalists and specialists all at the same time, and that's really hard. um So you know it's it's almost like the therapists are saying to me, we can treat more stuff than just stroke. we can We can do this with stroke. We can also do it with brain injury. We can do it with Parkinson's. We can do it. we can We can expand and expand, and we want to get there. But like you said, we have to start by showing our our skill and our ability in ah in a niche, and then we can we can expand that.
00:33:27
Speaker
Yeah, because I mean, there's going to be complications just move from moving states, adding there like, there's going to be complications there to have to complexity to have to solve for. And so yeah, just changing one thing, right? Like, okay, we're gonna, we're gonna still do this one thing, but now we're gonna do Massachusetts and New York. Okay, perfect. exactly Okay, well, now we got to take Blue Cross Blue Shield Empire.
00:33:49
Speaker
yeah yeah Yeah. What's different between the two state stack say practice acts? What is different in licensure? What's different you know geographically, culturally? like we These are things we have to know so that we can expand state by state. That's a great point about you not not being not being everything. That is really number one in startups is that I am not scalable.
Scalable Systems in Startups
00:34:15
Speaker
So everything that I need to do or everything that everyone on our team needs to do, it has to be documented and trainable, which makes things take a long time. Sometimes that feels really frustrating sometimes because I'm like, Oh, I've got this great idea. I want to change, you know, so however we do such and such task, but I can't just do it once. I have to document it in our training and then train everybody and then make sure that's the training going forward. So,
00:34:44
Speaker
Sometimes that feels I want to just make a change and keep going, but every change has to be scalable and put into a system. So the day that we hired our first intake team member was the best day of my life because the intake department was this, yeah you know, um, every, every call, every email, every referral came to me for the first year and a half.
00:35:13
Speaker
you know, two years. so but yeah you skill right oh Oh, yeah, you you not being scalable that I feel that like i have a physiological response to to that statement. um And you're 100% right on documentation because You have a series of lived experiences, both personally and professionally, that have led you to this moment, right? And you it's easy to forget about those things. Like, oh, why don't you just know that? It's like, well, like, Steven, not everyone works in the oil fields when they're in high school. Like, oh, yeah, I guess that makes sense, um right? And I'm sure you have those type of of experiences in your past that, yeah, makes some things easy and some things harder. um
00:35:58
Speaker
this Oh, Krista, i this has been fantastic.
The Vision for Free Rehab
00:36:01
Speaker
I want to flip to my favorite question to ask, which is, if you had a magic wand and could fix one thing within rehab, what would it be?
00:36:16
Speaker
ah There's a lot of things to fix, which is why you asked this question. but um I think this this answer is going to speak to my um more of my mission as a therapist and less of my experience as an entrepreneur and business person now, but I wish rehab were free. No one asked to have a stroke. No one meant to get in a car crash and have a brain injury. The stress of having a financial burden, be tied maybe to your dosage of therapy is is really
00:36:54
Speaker
dark. Um, so if I could make rehab free where people didn't have to worry about their finances, allowing them to get the rehab that they need, I would, I would fix that. I'm going to say that you are making that a reality. Um, now granted that's going to take time too, but the way that you do that, right? And and we've had this experience in the remote therapeutic monitoring world, right? We're now,
00:37:24
Speaker
We're building the outcomes in the studies and doing our own data collection to be able to say, hey, commercial payers, you actually save money if you do this. And so if we can at least make our piece free, right, to the patient, then I think we've done our job. Now we are a long way away from that. There's still a lot more work that that we need to do. And thank goodness for us, I wouldn't have anything to do. And I don't know, a bored Steven probably isn't something this world is ready for.
00:37:50
Speaker
and definitely my wife isn't, so yeah know let's just not have that happen. the but You're on that path because as you show the better outcomes, then it's, well hey, long-term care insurance, or whoever it is, right like i i can keep you I can keep your your member in independent living for five more years or whatever it is, right? As you come up with that data, holy cow, that's going to be easy. It's like, yeah, ah you're what? Like a couple grand? like Done, right? it You start making that really easy. So i I appreciate that as your magic wand, but I also
00:38:34
Speaker
want to commend you on it not being a something you're tossing over the you know the other side of the wall and that you're doing something about it. I think that's truly amazing. Yeah. I think that's how we describe what we do is we make rehab accessible to people. so they don't you know they I don't want to go too far, but just you know the way we see rehab is that it's geographically isolated and it's hard to get to and it's expensive. so We're trying to make a change there by making it accessible and making people really understand what they can be doing when they're at their house. So thank you. Yeah, no, thank thank you, right? ah and you i I hope not to have to use your services, right? But if I do, I'm calling you. Or your intake person that you, or people, yeah. The intake team. I'll call the intake team. I will follow the standard operating procedure. I will be a good patient. um Or a decently good one. ah
00:39:34
Speaker
Kristin, thank you. This has been a fantastic interview, and I appreciate you spending time with us. I think there's ah a couple of really, really good tidbits that that I want to highlight as as we come to a close. so One is putting yourself in a position to succeed. right so so You did that early on. You found the culture that you fit in well and was going to push you to be excellent, to be world-class, and in a specific area. right and and so what that your your early employers were to you could be different employers than somebody else. right But finding that culture that you're going to be able to elevate yourself and not at against the grain. right I think finding that is is extremely important. And then following your passion and allowing that to fuel the tougher days. right Because you're going to have them. You're going to have down days. you know In the the startup world, every day is a roller coaster.
00:40:30
Speaker
Right, it just depends on if an up and down is in within the same day or hour or minute. Yeah, or um yeah yeah it sometimes even you know smaller cadence than that. But following your passion allows you to break through those tougher days. um And so those are really, really good tips for folks. And how can people learn more about Amago Hug and they learn more about you? Yeah, where can people find you?
00:40:59
Speaker
Sure. So our website is ImagoRehab.com. Imago is I-M-A-G-O. It's a phase of metamorphosis. um It's not random. It's actually, to get really specific, it's the phase of metamorphosis when the creature emerges as something new. So let that cook for a little bit. um So ImagoRehab.com is our business website. Feel free to look at that. You can find me on LinkedIn. Kristin Knuckles. Connect with me. Have a conversation.
00:41:28
Speaker
And people should. you know we We've had multiple interactions you and I have, and I've been continuously impressed. And I gotta admit, I do love your magic wand. ah I think the reason I like it so much is that it's not just something you're waving, but you're going out and making happen. And I think that's that's something to be admired. and And I know I definitely have respect and admiration for for what you all do.
00:41:54
Speaker
Um, so with that, I'd like to say thank you so much for for joining me today and I hope you have a great rest of your day. Thank you. Thank you for listening to another episode of the disruptors. I hope that you were able to take one or two things away that you can apply immediately to your own innovation journey. As always, I'm your host, Stephen Cohen, sponsored by Sarah health. Let's keep moving.