Building a Healthcare System from the Street Up
Prashant Samant is the co-founder of Akido, a human-centered health tech company that leverages data and artificial intelligence to break down systemic barriers and build high-quality preventive care for all patients and populations, including the most vulnerable. Prashant has always believed in the power of social enterprise and has dedicated his career to developing companies with a soul. Through entrepreneurial ventures, Prashant has provided technology to some of the most notable private, public, and non-profit organizations in the world.
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Imperfect Show Notes
While these notes are not perfect (AI translation is still improving), they give you the gist of the conversation. Enjoy!
My conversation with Prashant:
Morgan Bailey 0:02
Hello and welcome to the profit meets impact Podcast where we explore the intersection of doing well and doing good in the world. I'm your host Morgan Bailey and I'm excited to bring you the wisdom of entrepreneurs and thought leaders that are using business to create sustainable and meaningful change across the globe.
Hello, hello and welcome back. Today we're talking with Prashant Samad, the co founder of a Keto, a human centered health tech company that leverages data and artificial intelligence to break down systematic barriers and build high quality preventative care for all patients and populations, including the most vulnerable. Prashant has always believed in the power of social enterprise and has dedicated his career to developing companies with a soul through entrepreneurial ventures, Prashant has provided technology to some of the most notable private, public and nonprofit organizations in the world. Excited to get into this conversation. So let's just dive in,
Prashant. Man, I've been really looking forward to this conversation. Welcome to the show. Oh, thank you, man, thank you for having me. Appreciate you doing some amazing things, and some really complex things within the healthcare space. And you know, to start, what I'd really like to ask you is what are the what are the experiences and stories you know, of, you know, of your life thus far that have kind of led you into doing what you're doing right now?
Prashant Samant 1:27
Gosh, that's a
that's a good question.
I think that
I think that the most
immediate thing that pops into my, my mind is, or the most emotionally resonant thing that pops in my mind is, it's working in Alameda County Medical Center, where my mom was a physician. This is during the 90s, to choose a doctor there. The most of her career and Alameda County Medical Center is in the East Bay of San Francisco, for people who aren't familiar where that is, it's a major county infrastructure. And it's just, you know, like a, one of the, like, the centers of the AIDS epidemic, it is a massive part of the safety net, in, you know, around that region, which has gone through periods of extreme violence and a lot of poverty. And so, you know, during, during the 90s, you know, my parents are both work physicians, and so, like, my summers are just like going into Alameda County Medical Center and working in a volunteer clinic or a volunteer program there. And I just, you know, I just remember meeting amazing people that were doing pretty complex work in hindsight, you know, working with people coming from a marginalized background, living with HIV living with AIDS. And the whole, you know, looking back on it, it felt kind of like a war zone. And so I feel like that, comparing that to my own experience in the healthcare system as a kid, just seeing that juxtaposition kind of made this idea of, and something is systemically unequal here, that I am not living with myself, you know, does that make sense?
Morgan Bailey 3:38
Yeah, absolutely. So, you know, what I'm hearing is, yeah, I mean, from very early age, you were pretty steeped. And I mean, I guess experiencing the healthcare system, and in particularly having your mom as a physician, what are the sorts of what sorts of things that you saw, like in terms of inequity?
Prashant Samant 3:55
Well, I think that, you know, one is the I guess there's there's two ways of thinking about me. One is that there always seem to be a never ending line of patients or people in programs because in Alameda County, my planner wasn't just seeing patients there's also providing social service support. And so there was a never ending line of people waiting. And the conditions of that waiting line just if you're just looking at it, it's kind of like wow, I can't believe this is happening in America, you know, was that feeling and I again, I wish I had more my memories of it or like these emotional rushes as opposed to like, specific facts. I was a kid I didn't really understand what I was seeing, you know, but I just remember experiencing like, wow, there is a lot of people every single day, never enough capacity to to take care of everybody. See that wants to get help in whatever way they needed, whether it's connection to a behavioral health specialist or a connection to other services program or a food program or something, we just never enough time to service everybody every day. And I remember the staff feeling very overwhelmed and people like looking burnt out, feeling burnt out, you know, I remember providers being concerned about their pain and vomiting, I just remember it always feeling like, there just isn't enough. And, and then when you look at who's not, you know, getting, quote, unquote, it isn't people that are coming from my context, people that are coming from what is very easy to imagine a pretty rough context in their lives, you know, whether they're coming from violent household, whether they're coming from, you know, like, single family, or single parent families, but you know, with people that with parents that just aren't in a position to be able to provide them, the right nurturing or the right support, you know, people coming from violent crime backgrounds, and my mom had a patient that came in with a gunshot wound to the head. They are pronounced brain dead. They had a kid that there was brought in with them. And they were also pregnant, like eight months pregnant. And so like, that's the context, you know, and my mom's the gynecologist, in, you know, kind of in that promised circumstance, and it was just kind of a never ending flood of that, if that
Morgan Bailey 6:46
makes sense. Yeah, absolutely. You know, and, and I imagine as, especially with sounds like an emotionally attuned child like, that made a big impact. Definitely,
Prashant Samant 6:58
definitely, definitely made a big impact. And I, you know, the other thing that I think about is, my mom also had a clinic in India, that she had kept, even after moving to the States. And so oftentimes, we would be going, I'd be going back there. And again, just seeing kind of that context, and the experience of being a patient in that context versus my own context. Like I'm living in a relatively, relatively wealthy area in San Francisco, and, you know, my experience of care is was quite different.
Morgan Bailey 7:41
So let's fast forward a little bit, right. So you had this early childhood experience, just been immersed in the healthcare system and the inequities that comes along with it, you fast forward a little bit, how did you start to hone in on and decide the hey, you know, I want to play a role in this, and this is how I want to play a role.
Prashant Samant 7:58
Well, so I think that there's sorts of two, two to two dimensions to it. One is, I think that seeing that as a kid, living in that context, hearing my parents narratives, my dad was an ER doctor, also in a county hospital, it's kind of just hearing that I don't know makes me feel ashamed in a way where I get to live it. I have so much. You know, when it comes to feeling protected, and well, when there are so many people that do not have that, and it's a little bit of a shame inducing, I guess I don't have I don't have a better word for you right now. outrage to do some shaming dissing. So I think that kind of stuck with me. The other thing is more from a from a systems point of view. There's $3.3 trillion spent on health care every year. And we know that 80% of the health issues 80% of what emerges as a health or wellness or the concern is due to what's you know, the the term, the social determinants of health, which is a, you know, an acronym we can unpack in a second, but only one actually less than 1% of the US budget is actually spent on SDOH programs. And so, you know, if you want to create a systems shift, and address, sort of this never ending waiting line, this experience of care that is really disheartening and shame inducing. Do you actually have to work within the system of health care, or working with Minister of Health Care can drive the biggest shift? Because there is that inextricable tie between what happens early on in people's lives and their health care outcomes?
Morgan Bailey 10:20
So So let's, let's dive into that a little bit. And you mentioned the acronym SDOH, or social determinants of health. You know, talk to us a little about what it what is that and why is it so important?
Prashant Samant 10:33
So, social determinants of health are, you know, the the social factors that whether accessibility to health care, nutrition, education, kind of the social context that one develops in access to housing, for instance, and then the health care outcomes that are connected to that. And so, you know, it's, there's a, there's a number of examples around this, that that can make this very visceral, but like, we know that if a person accumulates a certain amount of adverse childhood encounters, that can be abused, that can be growing up in a nutritionally ineffective household that could be experiencing, you know, a, a circumstance where there's more domestic abuse, we know that when that happens, later in life, they will likely develop a number of chronic health conditions. And it's not a one to one thing, it's just that the environment that that person is, is developing in will inextricably tied to other intermediate steps that then result in worsening healthcare conditions. And so the reason why it's an important insight is that if we really want to tame the costs of the healthcare system, we really want to address the chronic conditions that, right now we're just spending more and more money taking care of having less than less capacity to take care of, you have to address these upfront social environments that people are developing.
Morgan Bailey 12:35
And so, you know, this kind of brings us into, you know, kind of leaning into what you do, right. And and I guess, one of foundational elements of EQ, which is around using data around the social determinants of health, to help inform the healthcare system, to talk to us and bring it bring us through that story a little bit about, you know, how did you get into the data insights piece with what you're doing with Aikido labs? And how has that evolved since? Well,
Prashant Samant 13:02
so we, you know, we started before we started to keto, we started the University of Southern California D health lab. And the goal of that apparatus was to, you know, be in an environment where we could look under the hood and see what's happening. You know, both from healthcare operation standpoint, from a data standpoint, you know, like, why, why aren't there basic things like scheduling apps used within healthcare? Why is how it was everything within this environment, so antiquated. And it's more, but it was an open question. It wasn't an aggressive question. I was just like, why is it the way it is? And so we started the lab in 2013. With this with this question of like, well, we know that there's more and more data that's being generated, we know that data can be utilized in a number of different ways, you know, but to support coordination between different services, better insights, to figure out what a person needs better insights to figure out how to operate more efficiently, you know, how do we make that more available to be used in healthcare? And so, once we looked under the hood, it became clear that there was two underlying challenges one, you know, you have this world of the, you know, this academic world understands this, this inextricable link between social factors and the health care outcomes later, but because of the way that the data has been developed, the desams have been developed and healthcare becomes very difficult to actually utilize information to tie that to a patient's So what do we do for this set of patients now, unlike other industries, where our systems of data have developed, you know, towards more harmony, you have kind of a chaotic environment within healthcare. And when other government oriented organizations, or government support industries in general, it's very fragmented. It's like jigsaw, it's like a puzzle that has pieces missing everywhere. And so without having more organization, you're not going to be able to actually harness this insight. Does that make sense?
Morgan Bailey 15:39
Yeah, and,
Prashant Samant 15:40
and the second thing is, you have this, you have a capacity issue, you have an underlying issue. There aren't enough healthcare workers, we can increase education, all we want, but the pace of workers that we need versus the pace of workers that we can, that will produce that of our healthcare, our education systems is unequal. And so we have to find a way to operate more effectively operate more efficiently. And also, if you can do if you can create care that is more focused on prevention, you will, you know, kind of stem the tide that, but at the end of the day, you're still our, our demand for care is outpacing our supply of care.
Morgan Bailey 16:36
So, kind of like me summarizing a little bit, I mean, you identified this gap, which is to really look and like how we might prevent bring down costs, like we really need to understand a basis level what's causing some of the stuff and we need to be able to have access to that data in a way that's pre actionable. And in a little bit more of an adaptable or agile healthcare system, which we don't currently have, unfortunately. So how did you determine or how did you decide to turn this into like a business? And and what did that process look like?
Prashant Samant 17:13
Well health care. So I think one of the things you're asking is why a business versus philanthropically oriented project versus a academically oriented project and find product? Does that? Am I reading the question the question accurately there?
Morgan Bailey 17:38
Yeah, I mean, I guess as you look for, and you looked at this information, like imagine you're thinking like, well, we spent all this time this research trying to understand this problem. Now we want to make an impact with it. Like, you know, how did you decide, hey, I think I think business is the way to go for this.
Prashant Samant 17:55
So there's a broad shift that's happening within the healthcare industry. And, to me, this sets the stage for a number of different businesses, whether they're healthcare services, or businesses, or whether they're technology businesses within healthcare, but we are having this broad shift from a volume based world of healthcare to a value based world of healthcare. What that means is, you know, the economic model of health care is slowly but surely shifting. And historically, volume is what drives the success of a business. If I see more patients, if I do more surgeries, I make more money that is shifting to if I provide more, if I take care of a patient, better if I'm more prevention, focused, if I keep somebody out of having chronic illness will make more money. And so that that's been happening for awhile accelerated by the Affordable Care Act, and really kind of created a moment where there was a lot of energy in new health care services, businesses that were trying to fit into this shifting model. And then a lot of technology, you know, that was making it possible for healthcare organizations to operate in this value oriented way, whether it's technology that was trying to support the coordination of different services that you need to to be able to operate nickoli this way or, you know, more discreet or you know, or just make different really expensive operations more automated because in this value based world, you you know, you're not going to just make more money the more patients you see you have to be efficient in your cost structure and so that created kind of this like, explore version of businesses in the first digital health wave. And, and so it made sense that there could be a business model in, in this in how we think about this, the shift how we think about creating more of a social determinants focused healthcare system. When we first started, we weren't sure what that business model was going to be. But we knew that if we could pull together a lot of this disparate sources of data, that would be a really valuable property to create businesses on top of.
Morgan Bailey 20:37
So the initial the initial idea was, I mean, it sounds like you had longer term goals, originally, it wasn't just simply to collect the data and sell it back to the healthcare system.
Prashant Samant 20:48
Right, right. The idea was, when we first started, the question was, man, this data is really hard to work with. Man, this data is like scattered everywhere. There's got to be a valuable piece of infrastructure, we can create it, we can find ways of organizing this, pulling it together. Like just basic things, like coordinating care, between two different kinds of doctors is made possible if you can make that bridge, or if you're, you know, it trying to do a, you know, an outreach program for the unhoused. Within a city, you have the fire department, the police department, you have social service workers, you have like 15 different kinds of people that are involved in this effort, without having the ability to just basically share information and see, you know, and unhoused person in their context, like how the heck is a person, you know, a police officer going to know whether they should take this person to the drunk tank or call their caseworker because, you know, they clearly haven't been on their meds for some time, like, these basic decisions are going to become so much easier to to do if we have a way of assembling this poorly organized or a managed data together. So
Morgan Bailey 22:19
talk to talk to us a little bit, and you started getting into like the possibilities a little bit there. But talk to us about some of the successes that you've had.
Prashant Samant 22:29
So well, when we first started the company, we started under this, this premise that we're going to focus on, on building these bridges of data between the various organizations that we just talked that I just just just referenced. So it's healthcare organizations and other social service organizations. And so we focused on using our technology that we built out of the uscg health lab, and working with the some of these amazing programs that were just kind of coming to fruition under this broader shift of a value based care. And the example that I just gave you around the unhoused population is a very real example. You had the City of Santa Monica, that was launching this homeless outreach effort. And they were struggling to, to coordinate very basic information exchange between all of these various departments, all of these different social service organizations had different compliance and rules around what information could be shared by when who and that's, that's really hard, they were doing it, basically, you know, through pen and paper and phone calls and text messages, just kind of a really chaotic way, you know, relative to what you think happens in our in our world today, and that, you know, in the the internet era. And so, you know, that was one of our really exciting wins of helping launch that program and facilitating that exchange of information. And as a byproduct. We were organizing that information and providing a better and clearer picture of what's happening to these these citizens in a more complete and holistic way. And so it's kind of like taking, you know, we know that a person experiencing homelessness, and unhoused person has had lots happened to them in their life, but that picture is, is not assembled anywhere, right? You every single social service has a snippet of what's happened to that person so you don't really get To see the totality of things this person has gone through. And so and really exciting byproduct of that work. And kind of the whole point is to be able to bring that that those different pieces together to provide a holistic view of oftentimes the trauma that someone has gone through that. Does that make sense?
Morgan Bailey 25:21
Yeah, yeah, absolutely. So what, in essence, like what, like from these, from the support that you've been offering? What are the sorts of things that these these various organizations and actors have been able to do that they have not been able to do before?
Prashant Samant 25:38
Well, in the example I just gave you right now, you know, it's a, again, it may sound, it may sound, sound, sounds simple, but a lot of these initial challenges were, were simple things that could be addressed by by, by basic uses of modern technology, but limited by the, by the infrastructure, right? So, it, you know, before, there would be no way for a police officer walking a beat, to know what to do what the most effective choice to make, if they encountered somebody, you know, who was unhoused, and maybe, you know, behaving in a symptomatic way, their only option would have been to take them and take them into some sort of, of captive environment, right? You know, we're gonna put you in a drunk tank, we're gonna put you in jail, we're gonna put you overnight, then it's going to take you out out of this context, where you might be a harm to yourself or harm to others, it's kind of a binary interaction, after you're able to have a much more nuanced interaction, whether it is interact, you know, contacting their, their, their, their social worker, whether it is calling a different kind of specialist, whether it is health care intervention, whether it's no intervention, whether it's the conversation, but there's just a lot more context to what's happening to that person. And so somebody who has, you know, the most, you know, positive intent can actually act in a way that that is that has a benefit the individual.
Morgan Bailey 27:27
Yeah, and, you know, I could see, and it sounds like, you know, particularly, you know, you played a role during the pandemic. So, talk talks with a little bit about how you did that, and supporting, I guess, the unhoused population.
Prashant Samant 27:39
So during the pandemic, I mean, there was a lot of different urgency, you know, across a lot of different dimensions of public health. With, you know, by that time, Akito, had been operating in nearly 100 cities, and one way or the other, supporting a number of different public health and health care programs. And so the level of data that we could bring to any engagement was pretty tremendous, pretty profound. And so a few of the things that I'm really proud of, during that time, had to do with helping coordinate, and the limited number of supplies of testing and vaccines that we had on the earliest, in the earliest phases of the or the earliest time of the pandemic, and helping make sure that the right vulnerable populations got what they needed. Not just to make sure that we can maximize their health and well being but also towards preventing a wider outbreak. And so, you know, one initiative involved hotspotting, which is basically utilizing data to figure out across a vast region like LA County, where COVID is showing the likeliest signs and popping up. And remember, we had a big testing issue when when COVID restarted, and so you wanted to maximize testing to verify where there's the highest chance of an outbreak, because then you can deploy additional public health resources to contain that outbreak. And so hotspotting you know, basically predicting where there's going to be an outbreak becomes really, really crucial and very dependent on data. And because we demand so much data at that point in time, doing a number of different initiatives, like the influenza analysis across the country that we've that we've been doing, we were able to help arm that hotspotting effort. Can you visualize that? Yeah, yeah,
Morgan Bailey 30:03
absolutely. No. It's really fascinating. And I'm a little curious, like to step back for a second from kind of like the content and back into like maybe putting on the entrepreneur hat. Because it sounds like you clearly identified an area of need. You started filling state, you built the partnerships. And my mind, I'm just imagining like this all happened, like nice and smoothly. Talk to you know, maybe, you know, explain to us for a minute, what was it like from the business building side at this point? How are you getting funding? How are you building partnerships? What are some of the lessons you learned from that stage?
Prashant Samant 30:40
Okay. Yeah, I think that there's there's a, there's certainly a lot easier ways to make a buck than trying to build a healthcare or a government services focused business. So it's certainly not for the weary. But there's, there's sort of three distinct phases to us as a business. What I've just been talking about was mostly phase one, a little bit of phase two. So phase one is using our technology as platform to facilitate data sharing and data integration. In support of programs like the outreach program, I was talking about. Phase two became utilizing that data, utilizing the corpus of data that we've collected to create a platform that can do preventative prediction better, like the hotspotting initiative I was talking about. And then phase three, which we haven't talked about, has been using this capacity to do better, more efficient, more prevention, focused care, and taking care of our own patients. So those three phases make sense at a high level. Yeah, absolutely. Okay. So phase one, which is using our platform to support data sharing in support of other programs, like the Santa Monica, I wish program, that model was a kind of a b2b SaaS business model. So we would sell our solution powered by our platform, to a program that was either run by a government agency, or by a healthcare system. So in that example, that I just gave you, Santa Monica was technically our customer. And there was a number of Santa Monica and non Santa Monica oriented services and healthcare organizations, they were all a part of a Santa Monica led operation. Right. And so that world, it's like a, you can think about it, like a b2b Saska. Right? In phase two, where we're standing up something like a county wide hotspotting Initiative, or a county wide vaccination coordination initiative, is it still feeding the healthcare organization, or the government organization, as our customer, but the business model is a bit more traditional enterprise software. And depending on the situation, it could be enterprise software, or enterprise software with kind of programs support, so a little bit like Palantir, if you're familiar with that company, where, you know, they're, they're thinking about them selves as a partner in driving a particular outcome. And in driving that outcome. You're providing both kind of expertise, as well as technology. And those contracts can be structured as traditional enterprise software contracts, or contracts where you're connected to the performance of the program. Does that make sense?
Morgan Bailey 34:18
Yeah, yeah, absolutely. Yeah, so I'm hearing that evolution from an essence you were providing, you know, in some way, like data and insights, you're filling the gap, to then being able to provide more more of a platform as well as sort of advising and helping drive towards those outcomes will be more involved with the partners. That's
Prashant Samant 34:39
right. That's right. And the business model at phase two, as opposed to phase one, can be connected to the outcomes. So you can do a sort of performance based pricing around around the or outcomes based pricing, and I use Palantir at As an analogue to that, because I think they're probably one of the more modern tech companies that have done that at a really high level, a lot of their government contracts are already kind of tied to missions. Like we believe that this is the ROI based on our involvement. And those structures are contract based on that ROI. Now, moving on to phase three, in some ways, it's kind of an extension of phase two. So we knew earlier on, that we were going to, at some point, want to take more and more financial responsibility for outcomes. This performance based contracting is a way of doing that. But the biggest way of doing that is as sort of being on the being responsible for financial outcomes on a per patient basis. Right? And so the question was, when would we get enough validation and up crack record, to show that, hey, we can really, you know, do a better job, or our technology, our programs can do a better job taking care of patients in a more preventative manner. And that'll have an implication on the well being of the patients and also have an implication on the costs faced by an insurance company or by the government, Medicare, Medicaid. And so in 2022, we had accumulated enough of that track record, and are able to enter into arrangements with payers, and with other parts of kind of this value based care payments world, which is it's really wonky really fast. So I'll spare you on that. And but earn had earned enough credibility, to be able to enter into contracts and to take direct financial responsibility of patients. And we used that, that set of contracts to launch our own health care network, where we have our own doctors not providing care to our own patients in a more preventative manner, utilizing our technology, utilizing insights from our corpus of data, to be able to do a better job or less money, particularly for the more vulnerable populations.
Morgan Bailey 37:38
Yes, I want to pause here, because I mean, it's just kind of recapping a bit on this journey. I'm just imagining you as a kid looking at these long lines and being like, wow, this, there's something wrong here. To you saying, Okay, well, you know, what, you know, how do we actually know what to do? Let's look at all the data, what that looks like. Let's give people that data. Now, let's work with them on that data to like, now, let's actually build a healthcare service provider using that data. So that you're in essence, you're the one in charge of the line. Which is just Yeah, it's pretty tremendous. So talk a little bit now, I mean, what is the size and the scope of what you're doing on the actual provider front?
Prashant Samant 38:16
So now Akito, is responsible for over a quarter million patients. You know, we have over 100 healthcare providers that are responsible for those patients. And, you know, we're, we're rolling out care models that are more attuned to the needs of our more vulnerable citizens. And in a, for instance, in the world of the unhoused, touched on a number of times, that we're rolling out a street medicine care model, which has, you know, it's not just providing direct health care, but also behavioral health support social service, or kind of a whole person view of what that unhoused person might need. Now, in addition to that, as we take more financial responsibility, from, you know, the payers in the ecosystem, we can do things like fund and create housing, affordable housing, or permanent supportive housing rather, for that same population. And, you know, at a glance, you'd be like, wait, what you're talking about housing, but the reality is that if a person is housed or has a consistency in housing, their hands Health care costs are going to go down, they're going to have less chronic illness, they're going to be easier to provide direct care to, right. And so going back to sort of the social determinants of health, you know, housing, and this is a, a kind of a manifestation of that theory being put into practice where you can provide somebody who's, you know, chronically announced a house, and it will directly impact their healthcare outcomes, which then also impacts the profitability of our business.
Morgan Bailey 40:39
So I mean, in many ways, I, it seems like you, I mean, you're, you're turning the healthcare model kind of on its head, which I appreciate, from going from a very, from a situation where you know, somebody has an ailment, they go and get it treated, and then they walk away to, hey, let's let's back up and first actually treat something that's, you know, prior to that ailment and actually invest in things that are, you know, obviously, I mean, much more preventative and preventing them in a way that maybe is different than most people think with a preventive like, like preventive health care is like going for a walk or doing this and you're like, Let's back out all the way up to education. Or, you know, let's back it up all the way to housing, right, like, so as you're, as you're trying to flip this model on it on its head there. How is the market responding to this? How are investors responding to this?
Prashant Samant 41:32
Well, I also want to touch on the what you mentioned, it's sorry, to the you know, what you mentioned before, is generally flipping the model on its head, or I think that it kind of, it makes me think about that stat that I've mentioned in the format, like there is over $3 trillion spent on health care right now. And these, you know, the vast majority of that is, is on what happens after person gets very ill. And so this, this sort of redirection of funding is what gets me really excited, because it's not saying that what people are doing, or what doctors are doing, or what my parents did for their careers is, is bad. It's more saying that we have to look at wellness in a more holistic manner. And, and, and we do have the funds to do it. It's not like it's, you know, you have to, you know, rob Peter to pay Paul. It's we have it, it is a it is an integrated pool of money that we have allocated to address this problem at a pretty amazing level. societally, it's just not necessarily optimized properly right now. So, to tie that into your second question or not, second question, your question you asked around how investors are thinking about this, I mean, it again, there is a, the better that we do in prevention, the better that we do in addressing our cost of health care, the better, we do more business standpoint, in this new paradigm of value based care, where you're going to get a fixed amount of money to take care of a patient. Or you're going to get incentives to take care of a patient in a more preventative fashion. And so, you know, investors right now are very excited because you're, you know, their language is, you know, is gross margin, right? It's going to be going up every single time, you can find a way to reduce the the ultimate healthcare services costs. That's the most expensive cost of care at the end of the day. It's just healthcare services costs, right.
Morgan Bailey 44:29
So, you know, I think this, this makes a lot of sense. And personally, as someone who's been a public health practitioner and has studied public health, this model really excites me because one of the things that I think we know from a lot of walks of life is that it's it's cheaper to prevent something than it is to to clean it up. Which is often a it's a, it's a hard lesson we continually have to learn. So as you look, I do look forward for IKEA labs, right? How do you see this scaling and You know, is this, you know, how do you see scaling to the general population? What's that look like?
Prashant Samant 45:06
So there are there, to me, there are kind of two to two societal challenges. And I think that we're really well poised to tackle both of them. You know, one thing is, kind of go back to that, that that question, or that the observation that I had as a kid, which is like, Man, this is a never ending line, there's never enough workers. I think that that is still an issue. Even if we do things in a more preventative fashion, we are still very short on health care workers. And, you know, even if we do stuff in a more preventative fashion, and there's less of a demand, we still need to provide more holistic care to a wider number of people. Right now, things like concierge care is predominantly reserved for people that can afford it, you know, it's Yep, be people that are wealthy are able to get more personalized levels of treatment and be able to see more specialists. So I think that the capacity issue is, is is is a systems level issue. And I think that the second issue is that, you know, healthcare is so big, it's so vast, that, you know, the, the biggest health care company in the country is UnitedHealth. And, you know, they're they're monstrously large, but it still is not all of the country. You know, it's not like Google, where it's ubiquitous, everybody searches on just Google, right. And so, you need to have a cultural shift in how these healthcare organizations operate towards this social determinants oriented way of thinking, and social factors way of thinking. And so, you know, a larger and larger percentage of that $3.3 trillion, just, you know, should be needs to be shifted intentionally by his healthcare organizations towards an earlier and earlier, you know, focus area in patients lives. So, one Akito is going to keep expanding its network presence. And our our hope there is that as we establish ourselves in a new medical market, and begin investing in SDOH, oriented programs in that market, like, for instance, the housing program that I mentioned, that housing programs, a real program where we're launching, you know, that will drive other organizations within those medical markets to follow suit. And I don't mean just because they're inspired to, but I think that there'll be more and more pressure for them, just based off of, you know, their, their, their desire to be competitive from a cost standpoint. So, you know, that's our hope, in driving that shift from reactive to more proactive care. The other thing is that, you know, Akito, has built a pretty incredible artificial intelligence training environment. We have this really diverse corpus of data. We have a amazing force of providers across various specialties, cardiology, endocrinology, primary care more, and we have these these providers working on a unified platform. And so you know, we're really excited about the neural networks that we're developing to automate a larger and larger percentage of care so we can provide the doctors that are on our team, you know, the ability to see more patients and spend their time on the most difficult challenging cases. And so, that is towards addressing that capacity issue. was talking about AI. That is, you know, there's a really amazing time in, in kind of the history of technology right now, large language models are becoming cheaper and cheaper and easier to work with. And so organizations like ours that have the data and that have the workforce to help sort of tune those models are in a really exciting moment.
Morgan Bailey 50:34
I mean, it sounds like there's just, there's obviously a lot of potential, I think it's gonna be really interesting. I mean, obviously, with, with what the the evolution of AI and the role that that's going to play in healthcare, and and I think the continued ability to leverage this data information is I think, is really going to start to shape healthcare. And I'm deeply hoping that we're able to shift and I guess, you know, as opposed to turn the healthcare model on its head, it almost seems like right size it or to like write it, to focus on things like the social determinants of health, the things that are actually going to that makes sense and where to invest in an effort to improve health outcomes. So I could continue to dive into this for for a long time with you, because so many other questions around you know, how you actually build a business from it from nuts and bolts perspective. But as of right now, time, I will say that you did an amazing podcast with Paul Zeller, and His word printers, podcast for any of those who are interested in the nuts and bolts pieces of the business building. But as we come to close, I'm kind of curious Ale, on what you know, to our audience, what are the asks and offers that you might have? What might you ask the audience? What do you have to offer?
Prashant Samant 51:49
Well, you know, I really, I am part of your audience, I believe. And I, you know, I, I'm, I might ask is that for all of the social entrepreneurs that have had an inkling or a thought of, hey, you know, maybe I should try this or do this? My ask is that you say, you commit to building whatever project, whatever initiative, whatever business that you're envisioning, because, you know, it is it is really, individual actors, I believe that, that create the changes that we that we need, and particularly in industries that are slow, are reluctant to change because they've become entrenched. I guess second question is, what's my offer? Is that right? Yep. Well, I guess there's two offers. One is that connected to the first thing is that a lot of times people say, Hey, I am, I am not ready yet, or I haven't done the experience yet to start something or I don't know, I need to learn more. I need to do more. I need to have more credentials. And my unsolicited offer of advice is that you don't you really need to start right now. What's it is that is like, there's very, very few circumstances that where you actually need to wait before you, you start on something or accumulate more information or more credentials, restart something. And if my other offer negative that is that if you are unsure about that, even after hearing my unsolicited advice, I'm happy to hop on a call with you. And explain to you why that is true in your perspective.
Morgan Bailey 53:58
Well, that is quite the generous offer for Shawn and I really appreciate the conversation. I appreciate the intentionality and the level of investment of time that you've you've put in here. I think one thing I'm hearing is that like, you know, you, you saw something early on in life, and it's something that you were fascinated with. And you know, despite the in the enormity of the challenge around the healthcare system and and how we drive towards better health outcomes, you really did. So just really appreciating for that and and I'm sure it's, you know, there's many grateful people out there that you've impacted.
Prashant Samant 54:33
That's very kind of you to say thank you for, for bringing us all together and educating us all. Thanks
Morgan Bailey 54:41
for listening to another episode of the Prophet meets impact podcast. If you enjoy this experience, please subscribe wherever you find your podcast and leave a positive review. You can also find out more about the podcast at www.profitmeetsimpact.com