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Welcome, Elan, to the Miami Tech Pod.
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Thank you.
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Thanks for having me.
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I think congrats are in order.
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Did you just get married?
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I did, yeah.
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I think I emailed you while you were on your honeymoon.
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Yeah.
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Uh where were you in your honeymoon?
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Uh Thailand.
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Oh, amazing.
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What part of Thailand?
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Um, all over.
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Flew into Bangkok, went up to like the mountainous areas in like Chiang Mai, and then like the island.
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We did, yeah.
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It was super cool.
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Um we went like ATVing and like alongside elephants and stuff.
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It was super cool.
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And then um went to like the islands in the south of the country, uh, like Krabi and uh Kosamui.
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Yep.
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Um, which is where they shot um White Lotus.
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Oh.
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Also the beach, though, too.
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That was amazing.
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Um and it was like as stunning as it would look in in movies, it was like pretty surreal.
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So if you can like bear the flight, yeah.
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It's worth it.
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Yeah, yeah, definitely.
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Okay, it's not overhyped.
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It's really cool.
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Well, I'm excited to chat.
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You are the founder of One Imaging, and I believe you've said your mission is to bring capitalism into healthcare.
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Yes.
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Can you tell us what you mean by that?
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Yeah, I mean, the best way to do that is to just give a pretty easy example.
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Uh, you go to the doctor, and uh I'll make it applicable for what we do.
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You need to get imaging done.
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Um uh you are having some pain, you're trying to figure out what's going on.
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Uh, your doctor just like writes an order and you have no real perception uh where you can go, how much it costs.
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So with any marketplace or with capitalism, you have choice.
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Um, and quality, uh quality and price and value are a big driver in that.
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And so for me and One Imaging, it's about introducing choice to people and letting them decide for themselves because radiology is uh heavily, heavily commoditized.
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I mean, there's still some nuance to that, but it's pretty commoditized.
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So do you care uh where you get your prescription drugs from?
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Like you just go to Walgreens or CBS or and there's a ton of options.
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Yeah.
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And it doesn't really make a difference.
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And the same thing with or you uh capitalism at um working, you can order it online from mail order or something of that nature.
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Um, and the same thing with labs, you can get it done really anywhere you want, uh, but it goes to like a quest or lab core or something usually, and you could choose wherever you, whatever location is convenient, or you could try to go somewhere else, uh, but you know you can, but it doesn't feel that way with a lot of healthcare.
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So our goal is to let people know that they can go where they want to go, um, have ownership over their images and data.
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97% of healthcare data is actually imaging data.
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Oh, okay.
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And over 70% of clinical decisions depend on imaging.
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And it's the second most used service.
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So the goal is for a service that's purchased and used that much, just make it uh make it so that people can have choice and and dictate what what have what creates value.
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Okay, so as it works now, usually you'll get a prescription from your doctor and they'll it'll be a specific location that you're meant to go to.
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The the interesting thing is like a lot of times when you think about um a pr it is a prescription, but it will be called a referral.
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Oh would you call a prescription for prescription drugs a referral?
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No.
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So they've been almost it's so embedded at this point and entrenched that the two terms have become synonymous, but it's a prescription for radiology.
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And you could take a prescription to get filled wherever you want it to get filled, right?
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Yeah.
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So it's the same, it's the same thing.
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But people don't realize that.
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So yes, your doctor writes you a prescription for radiology services at, you know, which is radiation, sometimes not, but uh they usually send it to the same place that they're employed by, the hospital, wherever it may be.
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Um, and you could go to a different hospital if you want, or you could go to an outpatient imaging center if you want.
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And our uh belief is that you should be able to go where you want.
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And is it now they just do that because of just sufficient?
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Like they just think, you know, might as well do it right here, or is the financial incentive obviously?
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No, there's of course financial incentives.
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Those services are going to be very expensive.
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And so uh they want to make sure that that service is performed inside the same place that their employee, the physician, works.
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Yeah, makes sense.
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So as if someone is trying to, they're using one imaging, they're trying to decide where to get their imaging done, what are the things that they should be considering other than just proximity to their home?
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Is there anything are there ratings like this is a nice experience?
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Yeah, uh well, one imaging like levels the playing field from the quality perspective.
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We don't work with providers that are low quality.
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And if we start to see continuous um below average uh survey satisfaction scores on providers, we remove them from our platform.
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Um and um, or like at the very least, warn them to start and then remove them.
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Um but that's so that's leveled out, and that's what starts to make it commoditized, especially when we say, okay, the equipment is above par.
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It's accredited by the American College of Radiology, and they have we've done our checks and we see that they have board-certified radiologists that are subspecialized or whatever the case is, and they have accredited technologists who are doing the scan.
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Uh, once you have all that stuff and it's a level playing field, then it's about value.
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How soon can you get in for an appointment?
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What's the cost?
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What's the proximity to your work or your home?
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I mean, what else, what else could you want?
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I mean, if you if your doctor thinks you might have cancer, and this happened to some people in my own family, um, and they're like, yeah, we're booked up.
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We can't get you in for six weeks.
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You shouldn't just wait six weeks.
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You should look for all the other places that can get you in that same week because that's the amount of time it takes from something to spread from one part of your body to another or go from stage one to stage three.
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I I believe I heard you say in another interview that the sooner you get it, the sooner someone's able to get an appointment, the more likely that they are going to proceed with the imaging.
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Is that correct?
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Do people just like put it off otherwise?
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Yeah, I I do we, I mean, I think that's with any service, you can see like a a correlation between how soon they go and and and get the exam and and actually how soon it's booked and and the follow-up to completion.
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Uh it's kind of like if you're to uh what's what's the word I'm looking for?
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Instant gratification.
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No, no, if you like put something off to like if you procrastinate, a lot of the times you'll procrastinate and you might just drop it off and say I have other priorities and things I need to do right now.
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It wasn't that serious.
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Yeah.
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And then you just don't do it.
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Yeah.
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Especially with I'm sure something as like scary as that.
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You might just even subconsciously like not want to use any excuse to try to like not find out things, maybe.
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Exactly.
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So is this why hasn't this type of marketplace existed before?
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Is now there is there something specific that now allows this to occur?
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Um, I think there's a lot of market market dynamics.
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So right now, corporations that offer insurance plans, they take the risk on.
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So they're actually paying the cost of care.
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Um and you they like hire your like the insurance plan that you see on your insurance card, they actually hire those insurance plans to provide essentially a marketplace of providers and handle all the financial transactions.
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That's what they do.
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But they're um when your core when a corporation gets larger, uh, they don't actually pay for the risk.
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So the reality is your employer is actually the one behind the payments.
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Okay.
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A lot of people don't know that.
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And so that starts to get really interesting.
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I mean, that's a huge insurance company isn't paying for this imaging.
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Your employer is directly paying for it.
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Your your employer pays your insurance comp the insurance company, which is often called a third-party administrator, to provide a network of providers that your employees can go to for medical care and handle the financial transactions.
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And when the financial transactions are settled, based on whatever the plan of your insurance is, co-pays, co-insurance deductibles, the remaining balances that are owed by the insurance plan is not actually the insurance carrier, like a Blue Cross Blue Shield or United Healthcare.
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It's actually your employer.
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They on the hook.
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They pay that.
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So I had no idea.
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I know a lot of people don't know.
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I didn't know that when I started this.
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And so there's it's a big deal.
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If medical, if you look at all these charts right now, every chart that you see of like the largest expenses in healthcare, healthcare or not in healthcare, in all services, healthcare services in the United States is the highest by far.
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It's also like, you know, it's our largest sector of our GDP and it's the highest by far.
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So the medical expenses that exist have gotten so high disproportionately to what people can afford that the people who are on the hook, the patient and the employer who are paying for that, they're trying to figure out a way to lower their costs for both the their employee and themselves.
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So if you have a $1,000 exam and it's a $20, $200 copay because you've hit your deductible, the $800 actually gets subsidized by your employer.
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A lot of people don't know that.
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That's a ton of money.
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Could you imagine?
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Yeah.
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So corporations, it's their second largest line item after salaries and payroll and all that is healthcare benefits.
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And is is the kind of part of the pitch to the employer because you're you're selling one imaging to the insurance providers or the other thing?
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We offer it to um corporations that typically have more than um 2,000 employees who are in this uh self, it's called self-insured employer.
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We also do sell it now to um independent insurance companies.
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We also sell it to large insurance companies too.
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And even in the case when they're taking on the risk, the insurance companies and um and providing that that risk management for employers and their and their members, they actually also are dealing with the same thing where the medical expenses are higher than the premium.
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The premium is really just, if you think about insurance, it's just subscription as a service, B2B SaaS.
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They're offering a marketplace, they're dealing with the financial transactions, and they're basically making the bet based on data and um based on data and population health that the subscription fees that they take in are slightly just high enough that they're higher than the total medical expenses that you'll receive.
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So isn't that kind of interesting to think about it that way?
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No one realizes that insurance companies to some degree, although large financial institutions, are some version of B2B SaaS.
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Yeah.
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The original.
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That's a great way of looking at it.
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Yeah.
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And so, you know, also for them, and again, it's so interesting because a lot of, you know, a lot of people don't understand that in many cases, not all, there's nuance, but in many cases, it's an unpopular opinion that I'm gonna say this.
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But it's a opinion that I have that in many cases, the insurance company's incentive and the your employer's incentive and the patient or benefit members' incentive actually all align really well for a lower cost of healthcare.
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And so you have all of these people and they look at one imaging, this second largest line item in or second most use service, um, third or fourth highest expense category in healthcare.
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And if we can lower the cost of it a lot, especially for something that's critical at the point of the continuation of the rest of their healthcare journey, you know, what happens?
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You if if your knee is in really bad condition, how do you know if you should get physical therapy or surgery if you can't look inside your knee?
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People really underestimate how significant of an invention seeing inside your body is and the power that unlocks.
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And no one really cares about it until they need it, unfortunately, but the power that unlocks is pretty substantial.
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And the unit economics behind our business align really well with everybody.
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Except except for providers that are charging way too much money.
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Okay, that's what I was wondering.
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Like who who loses here?
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And it's the people overcharging.
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But that's correct.
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Can you speak to kind of the revenue model?
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Yeah, we have a really great uh model um where we can look at your radiology spending.
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And if we will say, hey, we can reduce your spending from, you know, 10 million to 4 million or something.
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I'm just using arbitrary numbers here.
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And so that $6 million in savings will take a piece of your savings.
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Um it's dollars found, uh, dollars lost now found.
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Alternatively, we'll charge a subscription fee.
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And um we'll you know, say, hey, this is gonna create a three to one ROI for you if you put this in.
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Um and that it's very much similar.
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And the real savings is you're kind of ideally helping redirect some of these folks to cheaper places to get it done.
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Um I would say less expensive, yes.
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Um redirection is up to the the individual.
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So we don't tell people where they can and cannot go.
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What we do, however, do is we enforce that people know what their options are.
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They can then choose where they want to go.
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They can choose if they want to go to the same place their doctor originally wrote the order to.
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Um, that's completely up to them.
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I'm not, we're not here to tell people where they cannot can and cannot go.
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We're here to give them information.
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Um, imagine if you needed a prescription to get a Uber, to get to get transportation.
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And you could choose, do you want to use taxis?
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Do you want to use Uber?
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Do you want to use Lyft?
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Think about one imaging that way.
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Yeah.
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If you needed a prescription to get transportation, instead of that uh prescription only going to, I guess you could say the taxi system, we're saying that prescription is going to go to Uber and you can order whatever type of car you want, even.
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It's a good way to think about it, I suppose.
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Yeah, that's a really good way.
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I think I I try to put um the complexity of healthcare into understandable terms.
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Or Airbnb, let's say you needed a prescription uh and it was you could only go to a hotel versus, hey, now I can go to a hotel, or I can go to any of these different types of homes and I can choose how much I want to pay or how close it is to where I want to be.
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That's the value, right?
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And that's what we're doing.
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That's why I say that we're introducing free market capitalism into healthcare or and specifically into radiology.
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And is part of the pitch like the second order effects of like if we help them get an appointment sooner, we can potentially get them diagnosed sooner.
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Ideally, it's before anything progresses.
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There's a lot of really amazing second order uh effects.
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That is the first and foremost.
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Um the numbers are obviously crazy.
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Like people who have a healthcare background that are listening like will know like 35% of people will delay or forego imaging or healthcare due to cost.
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So that's even the first barrier.
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It's access.
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And people don't realize cost is a big part of access.
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Medical debt is, I think, the largest source of debt or whatever of bankruptcies in the country.
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It's like 75% of bankruptcies.
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So when I talk about the most expensive service that exists today, the most expensive services in the US, it is literally healthcare.
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And so the second-order effects are by making it less expensive, people who wouldn't get imaging before are now getting imaging.
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So when you think about people in traditional industries, especially, um think about the person who's bagging your groceries or whatever it might be, uh, or the person, whatever, you know, that might be making less money than they could be or would want to be making, and they're in a tough spot.
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This gives them a way of being healthy and knowing because they wouldn't have been able to afford the exam without it.
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So a lot of it is that.
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But yes, you can be healthier, and then there's a lot of things you can you can do when 97% of healthcare data is imaging data, being able to create predictive outcomes.
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I mean, you could just get your images and you could plug them into Chat GPT or XAI or Grok or sorry, Grok or Claude, whatever one you you want to use, uh pick pick your model for the day.
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And you can get a whole bunch of extra stuff from that too.
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And people are doing that.
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And that's what we're trying to give people more access to.
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Yeah, I'm I'm a kind of a freak when it comes to this kind of thing.
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I love tracking.
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I love now this movement where we are getting more control of our data.
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I'm also one of the ones who like opted and paid for a full body MRI just electively to make sure everything looked good.
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Yeah.
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Uh how are you feeling about kind of that movement of more folks kind of taking control of their healthcare, doing these like elective uh imaging, like the Ezra's and the Pernovos?
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Aaron Powell Yeah, I'm a huge believer in that.
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I helped write the first whole body imaging protocols for Ezra when I was working at Siemens.
00:16:57.279 --> 00:17:01.600
Um and um I mean I try to get them done whenever I can as well.
00:17:01.600 --> 00:17:03.679
Uh they're just super expensive.
00:17:03.759 --> 00:17:12.160
Aaron Powell Well, I know one of the concerns they say is like, oh, you something might come out that would never amount to anything, and you might then like drive yourself insane.
00:17:12.160 --> 00:17:13.200
How do you feel about that?
00:17:13.519 --> 00:17:16.319
I mean it's whatever people want to do.
00:17:16.319 --> 00:17:18.240
I'm I'm just about maximum freedom.
00:17:18.480 --> 00:17:18.720
Yes.
00:17:18.799 --> 00:17:24.000
I so like if you're gonna go do that, you're a person who wants to know.
00:17:24.000 --> 00:17:28.400
Um I I don't believe in like uh telling people like people know that.
00:17:28.400 --> 00:17:32.960
Like they know the like there's this like disclaimers are obvious.
00:17:32.960 --> 00:17:42.880
Like they're it's clear that they there can be incidental findings and things of that nature that can cause unnecessary biopsies, we can c which can cause issues, whatever it might be.
00:17:42.880 --> 00:17:47.519
Uh as someone who has a lot of cancer in their family, like I opt for it.
00:17:47.519 --> 00:17:52.240
I think everyone uh I think people are smart enough to like all the LLMs are free.
00:17:52.240 --> 00:17:55.039
You can pop it open and make the assessment for yourself.
00:17:55.039 --> 00:17:58.640
My biggest uh issue is just it's super expensive.