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Insurance – The 80% Problem: Data Without Borders | Flume Health CEO Cédric Kovacs-Johnson
73 Plays1 month ago
Today's guest is Cedric Kovacs-Johnson, the founder and CEO of Flume Health - a software platform that orchestrates data through a universal translation layer for payers. We discuss the administration problem in healthcare, Flume's product Relay, and why over 80% of enterprise data in healthcare is locked inside disconnected systems.
Cedric shares how his sister’s healthcare journey revealed the true bottleneck in care - the administrative web behind coverage decisions - and how Flume’s platform is helping health plans and vendors speak the same data language. We talk about what happens when innovation meets legacy infrastructure, why trust and simplicity are the keys to unlocking progress, and how startups can bring clarity to one of the world’s most jargon-filled industries. Cedric also reflects on his transition from 3D printing to healthcare and what it takes to turn complex systems into simple, human solutions.
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Transcript
Introduction to Healthcare Theory Podcast
00:00:00
Speaker
Welcome to the Healthcare Theory Podcast. I'm your host, Nikhil Reddy, and every week we interview the entrepreneurs and thought leaders behind the future of healthcare care to see what's gone wrong with our system and how we can fix it.
Meet Cedric Kovacs Johnson & Flume Health
00:00:15
Speaker
Today's guest on the healthcare theory is Cedric Kovacs Johnson, the founder and CEO of Flume Health, a company re-architecting how data moves to the health insurance system through their a product called Relay, which essentially is a universal translation layer for healthcare data that orchestrates hundreds of different integrations.
00:00:34
Speaker
In this episode, we explore why administrative bloat drives so much of healthcare's costs, how legacy systems and misaligned incentives keep innovation from scaling, and how Flume's platform is unlocking data and reliability for payers, employers, and health tech companies alike.
From 3D Printing to Healthcare: Cedric's Journey
00:00:50
Speaker
Hi Cedric, welcome to the Healthcare care Theory. Nikhil, thanks for having me. Happy to be here. Of course. And before we get into Flume Health, I mean, you had a startup out of college, completely different space from healthcare, and would love to hear you walk us through that. What was it like starting a company for the first time?
00:01:08
Speaker
And what did you learn from exiting and eventually selling the company that influences how you think about the entrepreneurial journey today Yeah, the awesome. all I would love to get into it. So just first all, point out, I have my daughter sitting on my lap right now. She's 18 months old.
00:01:22
Speaker
My wife had to run to the vet with my dog. So you might hear some little chirping. um But yeah, Spectrum was but was a blast. We we basically were just obsessed with 3D printers at the time, and we we tried to make them go full color.
00:01:38
Speaker
We had a pretty major breakthrough um and we were just super focused on the tech, tech, tech. and we ended up winning lots of awards, both at the like ah school level and the state level, eventually the collegiate mentors competition. And then we we sold the business or what was it even like a commercial business at the time ah to MakerBot. And that included three patents six months after we graduated.
00:02:03
Speaker
um And so it was a lot of fun. it was very stressful. But we were kind of, I think, that classic archetype of founder, like first time, really young.
00:02:14
Speaker
We just cared about like the novelty of our approach. And we hadn't really thought about the the market reality of it all. And I think what what became clear to me in the time leading up to that moment is that 3D printing was sort of this like really exciting technology that was sort of looking for the right problem to solve. I always have like a solution looking for a problem.
00:02:36
Speaker
It was never a drop in replacement for manufacturing. So until then and the real markets were like K-12 education and like prototyping, and it kind of hit a ceiling.
00:02:48
Speaker
And so not only my time at Spectrum, but then my time at MakerBot taught me like, I don't know that 3D printing is the world changing technology everyone hopes it is. I think it's huge. If you're an engineer, you're making a physical product.
00:03:01
Speaker
Um, but it showed me that whatever I worked on next had to be a massive problem space and the solution space needed to be kind of like desperate and behind. And so naturally that kind of led you to help there.
Understanding Health Insurance Complexities
00:03:16
Speaker
Right. Yeah. Cause you always hear the analogy, like you want to build for people with their hair on fire and Of course, like you build a great solution with the 3D printing space, but healthcare, of course, like that is a problem in itself. There's so many different problems to solve.
00:03:29
Speaker
But at what point did that actually come onto your radar? and Not necessarily as a startup opportunity to build something, but just as a system that you were curious about or something worth understanding for you. When did healthcare really come up for you?
00:03:42
Speaker
Yeah, i mean, I think I just sort of acknowledged I was going to be learning a new industry and trying to get like really deep into problem space. I had healthcare in my mind. Also, I had financial services.
00:03:54
Speaker
um And I sort of went into healthcare partly because at the same time, my little sister was going through a major medical event um with with her epilepsy leading up to what would become a life-changing brain surgery.
00:04:08
Speaker
But it's my daughter. um My little sister going through the healthcare journey leading up to the surgery kind of showed me that your your health insurance is actually what's calling the shots, not really your doctor.
00:04:22
Speaker
And so I just became kind of obsessed with how how do health insurance companies run. And you peel back that way, you learn most people are employer insured. Well, there's these things called self-insured employers, and there's this whole apparatus of TPAs and utilization managers and point solutions, stop loss vendors and reinsurers and MGUs and captive group cells and yeah all this stuff that's happening behind the scenes.
00:04:46
Speaker
And everyone sort of has a say in what is ultimately your experience as a patient. And so i just became fascinated, like looking at this as like almost a game board of who are all the players, brokers are involved in there too, um and what are all their incentives and how do they operate?
00:05:05
Speaker
And where the good ideas that actually get traction and lower costs and lower and improve outcomes? And what
Personal Impact of Insurance on Patient Care
00:05:13
Speaker
are the ones that don't? And how do you maybe put together a system that works a little bit more in in line with what the patient needs?
00:05:19
Speaker
And I think we're we're seeing evidence of things that finally work. um But yeah, it started from a place of like curiosity and then sort of like anger and obsession on a personal level.
00:05:33
Speaker
Yeah. And that makes sense because as you know, there's so many stakeholders in the healthcare care insurance space. You mentioned TPAs, the brokers that are kind of the intermediaries, and then you have employer, the PCP, the employee. There's a very complicated system with somewhere some misaligned incentives that go on there. but Before we get to that, I mean, when did you kind of you spoke on how in some extent, like the insurance plan is more important than the actual provider and primary care and um the care you're getting. Like, can you can speak more to that? Like, how did you learn that that was true? Like, can you elaborate more on like what that actually looks like and why is your insurance plan so much more important than the actual care you receive?
00:06:13
Speaker
Yeah, i don't know that i use the word important. would just maybe use the word consequential in terms of driving your outcomes. um yeah yeah The question is sort of where did that come from? That was sort of my lived experience with my sister. Her neurologist was telling her this surgery would give her the ability to drive, have a normal like kind of working life, and just sort of have a normal, like,
00:06:37
Speaker
life in general um and the ability to retain memories and whatnot.
The Role of Administrative Costs in Healthcare Pricing
00:06:42
Speaker
And from that point, it was like 18 months of arm wrestling the prior off process with her insurer at the time.
00:06:50
Speaker
And they they made her go through all these like really hardcore diagnostic steps that made it really difficult to actually get care. So she had to be an expert navigating the system because her insurer put up the roadblocks to prevent her from getting the care that was sort of prescribed to her.
00:07:08
Speaker
And I understand why prior routes exist. And I understand, you know, both sides of this equation have have a ah reason for being. um But I think your care is only as effective as your insurance allows it to be.
00:07:22
Speaker
And virtually every person I've shared that sentiment with, ah I'd say kind of nods their head and said you know has some story like mine. Yeah. And that's an interesting point because a lot of people, when they think of like healthcare care costs, they think of like actually going to the primary care provider. They think of the medication or they blame greedy insurers because the cost containment obviously a huge issue. And that's what most people see. But um something you guys are targeting at Flume Health is that administrative expenses often comprise like a huge aspect and really way down in a firm's P&L.
00:07:56
Speaker
And that ends up driving costs because there's so many stakeholders and each one have their own. administrative expenses, why do you think it's so predominant in healthcare care and why do you think this cost center is um really plays such a big role in what the healthcare costs look like to the endpatient?
00:08:11
Speaker
Yeah, I'll kind of speak to two pieces here. There's both the literal administrative expense, um which we ended up eating as patients. And then there's the the administrative like opportunity to reduce costs separately.
00:08:26
Speaker
So if you look at the breakdown of a health plan, 10 to 15% of the of end of a self-insured employer is on fixed administrative costs. That's things like reinsurance, stop loss.
00:08:38
Speaker
It's the cost of the administrator, like the TPA, the utilization management, network access, point solutions, the list goes on. So you still have the vast majority of your spend on medical claims and pharmacy claims.
00:08:50
Speaker
So in a sense, that's kind of good. 10, 15, 20% operating costs. maybe is the cost of doing business. And why that cost has gotten so big though, in the scheme of like how expensive healthcare care is, 10, 15, 20% is still a humongous number. um I think kind of comes down to the fact that we treat healthcare care like we do auto insurance, like health insurance, like auto insurance. We use this construct of a claim And a claim, if you get a car accident, is something accidental happened and unexpected.
00:09:23
Speaker
And we need to all of a sudden provide evidence to insurer that who is at fault, who should be paid, how much was the damage, was the assessment of the damages done properly, and is the cost to repair justified, and was that you know done properly?
00:09:38
Speaker
So there's a lack of trust inherent in that system. And that's how we pay virtually every healthcare expense in this country. So even your primary care visits that are twice a year, supposedly, um or a prior authorized appointment still goes through this like kind of low trust process where a claim is sent, evidence is gathered, fraud, waste, and abuse
Innovations in Healthcare Insurance Plans
00:10:02
Speaker
is assessed. It's almost like...
00:10:03
Speaker
um you know You as an insurer are trusting this legion of hundreds of thousands of providers to not be ripping you off and not have incentives to to do all these crazy things. And you as a provider, your source of income is getting paid by these insurers. So both sides have become armed to the teeth, even though they should be aligned and insurers should see providers as their supply chain and vice versa.
00:10:30
Speaker
um We don't have a system of coverage. We have a system of insurance. And I would say like it looks more like car insurance. than anything else. So that's, I think, part of the reason we've gotten here is this kind low trust transaction.
00:10:41
Speaker
um But the administrative bloat doesn't come with, I think, the opportunity that it could represent. So across the board, we've seen places where patients are not getting kind of the the efficaciousness of care that they could be. You look at high cost areas like musculoskeletal care or cardiometabolic care. Yeah.
00:11:05
Speaker
These are usually the most expensive components of any health plan. And many employers have said, I'm not getting kind of the the efficiency of care delivery that i am that I should be through my traditional provider network.
00:11:17
Speaker
I'm going to carve that out and I'm going to hire providers like Hinch Health or Omada or Livongo. to be like specialty disease management providers to do these things and i think that's a positive trend that's why today the average employer has over 10 point solutions in their plan it's like this carving out of specialty care and you have mental health you have telehealth in there as well um but the administrative apparatus I believe has the opportunity to make those things much more kind of higher use and increase the rate at which we can experiment with these things.
00:11:54
Speaker
There's a long tail of like categories that goes beyond cardiometabolic health to things like epilepsy, to things like um like rare disease care. And we should be looking for better solutions.
00:12:07
Speaker
We should be incorporating them to the plan. We should get be getting patients to use them. We should be building plan designs that encourage that use. But unfortunately, we have an administrative apparatus that already bloated and expensive.
00:12:19
Speaker
and is so lethargic and cumbersome to change that the opportunity actually like build novel new plan designs, incorporate these new concepts, these new these new solutions is way too slow to
Employers' Expanding Role in Healthcare Coverage
00:12:34
Speaker
move.
00:12:34
Speaker
So I would break the like administrative costs into two, which is like, it's not only expensive, and I think the nature of our transactions are expensive, but the new transaction set, which is maybe more aligned, so these point solutions look a little bit more like value-based care,
00:12:49
Speaker
That administrative group is just not really nimble enough to to make use of it and to get us away from that. So unfortunately, for a lot of a lot of the the the world that we see, we think that this just continues to get bigger and more bloated over time.
00:13:06
Speaker
Yeah. And I think, first of all, on your first point about Hinge Health and Omada coming into what employers work with, I think that's interesting because you the U.S. is probably the largest user of employer-sponsored insurance because it's 50% of our healthcare. And Now we're having more and more fringe benefits, like kind of supplementing that, which is um definitely a good trend for um employees, but really segments the fact that employers are going to be that point of care.
00:13:30
Speaker
And i was really curious to hear, like, why is this administrator administrative expenses still being sustained today? Because you see these radical transformations that these companies take on, these eight figure projects that are set to like re-change everything within an organization. at least these organizations say it will. but by the time they're done with the projects, they're already behind because it's take years, it's a lot of money, implementation is difficult.
00:13:54
Speaker
We'd love to hear like, what is the inherency and why is this administrative bloat not really being solved today? What are the core issues that are Why is it not mentioning it within healthcare? care Yeah, sort of why is it not being competed away like everything else in the economy?
00:14:09
Speaker
Yeah. Well, I have a few theories. um One of them is that I don't think healthcare care is actually a competitive fair market. um Anyone who's tried to start a new health plan knows that you're entering a world where if you don't have the network, you can't really even play the game. If you don't have the broker distribution, you really can't play the game either.
00:14:32
Speaker
And a lot of the incumbents have grown inorganically And healthcare is still such a regional product, and if you will, that in some markets, it's virtually impossible to break in because then the providers don't contract with you because they have, in some cases, favored nations clauses. In some cases, they have other reasons not to even talk to you.
00:14:54
Speaker
um And then you have some cases broker distribution channels where like brokers get these override checks and they get all sorts of compensation that you may not know about. And it's very hard to compete. So what does that mean? is like in some markets, you have such a concentration that the cost of doing nothing is nothing.
00:15:16
Speaker
And the cost of doing something and trying to rebuild or really be reinvigorate your organization could be your career,
Challenges with Outdated Healthcare Software
00:15:24
Speaker
you know? So i think it's similar to politics in that way. It's it's similar to many like zero sum rather positive sum industries. There's not really much growth organically. So it's all about like protecting your base and there's all these different tactics that are deployed.
00:15:40
Speaker
um So I think there's no real competitiveness, which would ultimately drive more efficiency and transformation. um and And secondly, like I think healthcare is maybe the worst offender here, but many industries have just been built over time and sort of metastasized from different old systems. and we This is the business that we're in Many of the operating systems or operational systems, if you will, that power health insurance, like the claims platforms, ah the U.M. platforms, these are meant for single user to like make determinations.
00:16:21
Speaker
It's made for a claims examiner to to to adjudicate a claim. But all of a sudden, these systems, these software systems become a source of truth for the organization on claims, on eligibility, and they were never meant to be interoperable. This is the problem that Flume specifically focuses on.
00:16:38
Speaker
So this is the one that I care deeply about. But it's very hard to envision a world where you can do radical things and you can be really innovative if you're stuck where your source, your data systems and kind of like the heartbeat of your organization is stuck in systems that are very hard to work with and were never meant to be interoperable at all.
Flume Health's Journey in Data Integration
00:17:00
Speaker
um So I think it's kind of twofold. I think it's competition and I think it's really old software that um i makes it difficult. Yeah. And also there's also information asymmetry where we don't really know like exactly if you're buying a plan, you don't know exactly what it'll look like with your day-to-day care and you don't know what type of care you need as a patient.
00:17:19
Speaker
And I mean, getting into Flume Health, I mean, when you first started thinking about the solution, you had this problem, right? There's no data unoperability between all these different complicated systems, whether they're like with ah pharmacy benefit managers or TPAs, brokers, they all these different systems that want to speak to each other, but they just can't speak each other very well.
00:17:36
Speaker
And we'd love to hear, like when you first started thinking about solving this problem, What were the core like first principles or constraints you set out for the product? And um now today, what does your relay product at Flume Health actually do?
00:17:49
Speaker
Yeah, so we we actually didn't set out to solve this problem in particular at first. I think it was sort of hidden from us. I saw all these different solutions that were coming forth, these point solutions. my first When I first was conceiving a flume, I actually was excited about like medical tourism, the idea that you can get expensive surgeries.
00:18:09
Speaker
for cheaper if you go abroad and that's very true but there are like so many categories of like these our healthcare are healthcare ARB opportunities where you can ARB better cost you better quality whatever and it was in my opinion not a shortage of opportunity it was a shortage of the ability to put it all together So the first you know go and the first time we raised money was to build a next generation TPA.
00:18:33
Speaker
And we we did that. We built a TPA that served 13 different health plans. ah many were it So we had the Flume Health Plan, which served employers.
00:18:45
Speaker
And then we had different health plans that were white labeled that used our tech to to launch their own health insurance service. right So we had quite the diversity. I think what we realized along the way is that this was the core problem, is that moving data in and around the health insurance ecosystem was incredibly challenging.
00:19:04
Speaker
Every single partner, and on average, a health insurance, a health plan will have over 150 different partners that they have to trade data with. Every single partner used the same approximately seven or eight data types. So these are things like eligibility claims, Rx claims, authorizations, accumulators, and the like.
00:19:25
Speaker
But they all have different standards and protocols. So one may use an EDI standard. Most are using custom standards that they invented at some point in the future in the past. And they all have like different business rules.
00:19:37
Speaker
A lot of them move. It's like they're flinging um kind of like spreadsheets around and CSV flat file over SFTP. Some are API native. So like that mismatch makes incredibly difficult to to to integrate.
00:19:53
Speaker
um And so when we when we were doing this at Flume, remember I had our product leader at the time came to me and basically said, dude, we have to integrate like 50 point solutions this year.
00:20:05
Speaker
And our entire product roadmap just got basically eviscerated. Like we're not gonna build anything this year because we're just gonna do integrations. So we took a step back. We actually spent basically six weeks sprinting to build an integration product just for our own use.
00:20:22
Speaker
And it became so applicable. And when we were selling the platform to big insurers, they were like, that integration product is actually what need. And so we made the decision to make that the sole focus and also realizing like we were never going to be 10 times better at processing a claim or answering like customer before calls.
00:20:41
Speaker
But this was a universal problem that feel like only we could see. And we had a really novel approach that really accelerated all data integration flows, made all these integrations hyper reusable and pointed all the data sources as well into central data lakes. So that we could like do all sorts of interesting analytics on it as well.
00:21:00
Speaker
Of course, yeah. And that's, um it's it's surprising, right? Because it's such a big problem, but it's somehow it's like still like overlooked and you guys were one of the first to do it. But we'd love to what were the main challenges in building that product? imagine that during that sprint, there were a lot of ups and downs as you kind of navigated your way through that. But I would love to hear the major roadblocks that were in implementing and building that solution and how did you overcome that while running through the problem?
00:21:27
Speaker
Yeah, building um building the data trading product was and you know in some ways like easy to start and difficult to to scale. um So we were a fully scaled operational TPA. And what that meant is we processed you know hundreds of, I think it was like hundreds of thousands of claims a week and hundreds of millions of records of data per month.
00:21:56
Speaker
So it was like fully at scale. So when it came to understanding like the user, we were the users. That meant we could really build for ourselves. I think it became challenging understanding really the service model expectations of large enterprises.
00:22:14
Speaker
So this kind of goes back to my comment on Makeup, like when you're just so focused on the on the novelty of your approach or the product itself, you maybe miss the surrounding components of what customers want.
00:22:28
Speaker
And in our case, we found that the historic way that integrations were built for large health plans is they would cobble together a handful of pieces of off-the-shelf software.
00:22:39
Speaker
And we were more competitive, but in many cases they had MuleSoft or Informatica or a few other pieces of software. And then they would hire a systems integrator, like an Accenture, a Cognizant, a Deloitte, to actually go in and configure that software.
Overcoming Integration Hurdles in Healthcare Plans
00:22:56
Speaker
And they didn't really necessarily have teams that knew how to or wanted to go and build those integrations. Sorry. Yeah, you're okay. okay You're okay.
00:23:06
Speaker
It's Don't worry. I can edit anything out. Don't worry. You said it's not video, right? uh it doesn't have to be i wasn't planning on it but like if um and if it was video like yeah it probably won't be video don't worry and i'll if it was i i'll ask you about it you're just gonna see her a lot okay okay that i'm actually that's gonna be a good thing for this show i okay sorry hopefully a little more relatable it will probably yeah um okay so we were saying about
00:23:39
Speaker
um Sorry, where was I? last thought um You're talking about like how like you're you're a TPA and how... I forgot the exact sentence you left on, but about how Deloitte and other like system integrators were... the You're asking about what the difficult... um Yeah, what the main challenges in building the product out.
00:23:59
Speaker
Yeah, so we we we more or less realized that most of our customers did not want to do this work at all. Like you the integrations were always in service of some broader initiative.
00:24:10
Speaker
And many cases, like the integration is actually where many initiatives go to die. um We talk to plans all the time that an integration workflow will take them six, 12, 18 months.
00:24:22
Speaker
And if you're a large kind of regional called million life health plan, you're generally budgeting a quarter of a million dollars to build a new integration, which is insane.
00:24:33
Speaker
That's a single one, right? And then you have to pay to maintain that over time. So one of the challenges was for us, like finding the right kind of offering, which meant it was not just about selling software.
00:24:45
Speaker
It was about selling integrations, which meant using the software to deliver integrations that were done less expensively, that were higher quality, and they were done fast.
00:24:55
Speaker
And so for us, We get integrations done in 18 days. They cost about 80 to 90% less on average. um And we typically find requirements or specifications and build validations that like the the organization's never even knew.
00:25:12
Speaker
So this data is the heartbeat of enterprises, and it's really important to get it right. And once you've built out this like universal translation layer, I assume when you're you're a TPA, you guys probably had already spoken to other big insurance players, but as you shifted right to building out this engine, this data orchestration engine, like what how'd you know to who you prioritize your initial a customer outreach to?
00:25:37
Speaker
And like what was your exact pitch to them as you're kind of going to market with this new product after you pivoted? like What exactly did that look like on on your end? We went straight for the large enterprise. oh no There was some good and bad. i think you know that there's like this reputation of really long sales cycles.
00:25:56
Speaker
um And it's true, like it takes it takes a long time. But we felt that if we could go to large enterprise customers, we'd have the stripes on everything from security and then case studies to really kind of do whatever we wanted. And that's sort of been the case.
00:26:13
Speaker
um Interestingly, health plans are an important customer for us, but even more important are actually the solution providers that sell into health plans. So these are the payment integrity vendors, the fraud, waste, and abuse vendors that need to be integrated with this data in near real time.
00:26:32
Speaker
They need it bi-directionally. And for them, they're actually in a very competitive market space. So they actually want to move very quickly. um And so what we found is Going big earned us the right to go kind of anywhere, ah going for large enterprise.
00:26:49
Speaker
And then not being too like dogmatic about this is just for health insurance companies. It turns out it's for anyone that has to deal with health insurance companies, whether you're the insurance company yourself or you're you're working with them.
Unlocking Healthcare Data for Future Advancements
00:27:02
Speaker
And of course, like a lot of people complain about how health insurance is like complicated because you have like TPAs, you have brokers. Thanks for listening to the healthcare thing. Every Tuesday, expect a new episode on the platform of your choice. You can find us on Spotify, Apple Music, YouTube, any streaming platform you can imagine. We'll also be posting more short form educational content on Instagram and TikTok. And if you really want to learn more about what's going on with healthcare and how you can help, Check out our blog Again, i appreciate you tuning in and I hope to see you again soon. Healthcare care insurance like ecosystem and experience.
00:27:42
Speaker
Yeah, so for us, healthcare is really kind of the the the tip of the iceberg here. If we zoom out just a little bit, More than 80% of the world's data is locked up in these big enterprise systems that are what we call like kind of highly inaccessible, meaning there's no clean APIs, and getting in and getting data ah in or out of these systems kind of requires like 12 months of work and a system integrator, right?
00:28:10
Speaker
um We think that the things that will make our lives better in healthcare and elsewhere are pretty much data dependent initiatives. Think of everything from AI agents to make your healthcare care experience more more enjoyable to better analytics, better drug discovery, whatever it is, ah data is kind of the epicenter of of most initiatives that we see that have legs, right?
00:28:34
Speaker
So our goal is to make that data have context and bring it to the place where it needs to go. So half of our product is the data movement and transformations and sending it from point A to point B. And that's fantastic.
00:28:51
Speaker
But the other half of our product is our context engine, which actually goes in onto an old system and understands what the data represents.
00:29:02
Speaker
So you as an organization can have four claim systems, one could be 30 years old, but you can make sense of how that data relates to claim system B, C, and d so you can merge that and have one holistic enterprise-wide view of what's going on at a single moment in time.
00:29:18
Speaker
so I think that if you look at the world of of ah data integration aggregators, API aggregators, like the five trans of the world, they're big organizations, but they're really only addressing about 20% of the data space.
00:29:34
Speaker
The 80% of the data space is so untapped. And when that gets unlocked, I think possibilities are endless. And as far as we can tell, nobody's really doing the hard work of figuring out how to contextually understand these systems.
00:29:49
Speaker
and move data in or out over a variety of protocols to make them accessible. And I think this is also coming at a moment where you could argue data accessibility is also 10 times more important. if If you're an organization and you want to bring, I'm just like spitballing here, but like an AI customer service agent, that agent needs to be able to answer real questions, many of those using data that's currently sitting in a system that you would need to click around with a human for grid for example, that is just an example. so
00:30:23
Speaker
There is no shortage of good ideas in healthcare. care I've heard so many things that are goingnna that promise to bring down the cost and quality of care. Some of them may work, some of them may not.
00:30:34
Speaker
I would love to see us as an industry like increase the rate of experimentation and make healthcare a little bit more personalized, a little bit more contextually aware, not just for you as a member, but your service providers, your your your doctor, your like everyone in your ecosystem should have a better picture on you as a patient.
00:30:53
Speaker
Your insurance company knows so much about you. They see every claim, every prior authorization request. Now they're pulling medical records in as well. If you as an insurance company can sort of be the ah hub of data,
00:31:07
Speaker
and move that data throughout the ecosystem, I think so many things become possible. Thanks
Advice for Aspiring Healthcare Entrepreneurs
00:31:12
Speaker
for listening to the Healthcare Theory. Every Tuesday, expect a new episode on the platform of your choice. You can find us on Spotify, Apple Music, YouTube, any streaming platform you can imagine. We'll also be posting more short-form educational content on Instagram and TikTok. And if you really want to learn more about what's gone wrong with healthcare and how you can help, Check out our blog, thehealthcaretheory.org. We'll love to get your thoughts.
00:31:36
Speaker
ah healthcare care me dot org in your first Again, i appreciate you tuning in hope to see you again
00:31:44
Speaker
kind of execution right it's not just coming up with a good idea as you mentioned and personalized care like personalizing insurance plans personalizing the way we deliver care and we do diagnostics like all that stuff is becoming more important than ever, but we'll have to kind of take a step back. Like for these um younger, like other entrepreneurs or younger people in this space, like how do you, what are the, what's your main advice and overall advice on how to be able to execute well in building a startup and really um get conviction and build something in the healthcare space? So is there anything that really worked for you or anything that you heard that helped kind of change the way you think about building a healthcare care startup today?
00:32:21
Speaker
Yeah, I'll give you general advice than healthcare advice. um So my my general advice is just get started and just yeah like don't be shy about putting yourself out there, especially if you're you're younger or you're a student.
00:32:36
Speaker
So many doors open to you just because you're you're eager, you're asking for advice. And I have so many people I get to thank early in my journey that just kind of opened doors for me and took a shot at me.
00:32:48
Speaker
So I'd say just get started. Don't overthink if it's the right thing. Just motion will clarify. And it's it's hard to kind of like let someone else, let life take the wheel in a sense.
00:33:00
Speaker
But I would say that that's that's an important thing. um It's get started, grind and like, don't be too dogmatic, but also don't give up too too quick. And that's a really tricky part. And having good friends that keep you honest.
00:33:14
Speaker
Healthcare care for me as an outsider was an incredibly confusing place to start. There's so much jargon, there's these big words that mean nothing that describe virtually everything you see.
00:33:28
Speaker
And I found that the more I spoke like a lay person, the better the better things actually went. So I'll just give you an example. yeah I remember going to so many of these healthcare care websites and be like, what the hell do these people do?
00:33:41
Speaker
And they would describe like, we improve patient outcomes by optimizing communication pathways and like, that like drug adherence protocols. And you hear all these like words and you're like, those sound like words. i don't know what the hell they mean.
00:33:55
Speaker
And then it turns out like it's an app that sends patients a text message to remind them to take their drugs. Right. Of course. Something simple like that. Why didn't you just say that? Like that makes sense. And I'm sure there's some complexity. Maybe it's not that hard. I don't know.
00:34:08
Speaker
um And so I'd say if you're starting or you're interested in health care, don't get dissuaded by like that jargon and that like amount of it feels like very intimidating if you don't know what what people are actually saying.
00:34:22
Speaker
And it takes time to like read through the lines to understand what what things actually are. And in fact, use it to your advantage and be a bit naive and describe things in plain English. And you'll find the number of people that actually like really respect that and really are tracking what you're saying.
00:34:39
Speaker
um And it's easy to get tricked and duped into thinking like, you don't know what you're talking about, when in reality, this stuff is not that complicated. It's actually really simple. There's just a lot of terminology that makes it seem difficult and
Conclusion of the Podcast
00:34:54
Speaker
sophisticated. And it's generally not the case.
00:34:58
Speaker
Of course. Yeah. and And thanks for the advice. And hopefully I'm on that third point, by the way, um about building like a website that's easy to understand for a layperson. have Flume House website link below. It's it's much easier to understand than a lot of these other jargony websites with throw like random slang and since it got you to not really help move and show you what the product is. But I really want to thank you, Cedric, for coming on today and sharing your story, not just with your first startup, but I mean, developing and pivoting within Flume Health and now like solving this interoperability and data problem that's, of course, going to be huge with these larger enterprises going forward. And it already is today. So
00:35:34
Speaker
Thanks again, Sandra, for coming on. It was great to have Thanks, DPL. And thanks for letting Yaya make her first podcast appearance. I think she had a blast too. know she was kind of yapping the whole time.