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Our Founder and CEO, Guillaume de Zwirek, was recently interviewed by Alex Merwin, Head of Growth for Healthcare & Life Sciences Startups at Amazon Web Services (AWS) Health Innovation, about how technology can make navigating the healthcare system feel less like a maze – among a number of other topics. The conversation covers:

  • How Artera Harmony and the Artera Marketplace are integrating vendors across the ecosystem to orchestrate a streamlined patient communications experience
  • The Value of Being Customer-Centric in the Healthcare Industry and Beyond
  • The Future of Artera Harmony, which lies in delivering visibility and orchestration to health systems to deliver greater business results and happier patients 
  • Advice for Founders, including focusing on product-market fit, ensuring a scalable sales model and remaining customer-centric despite being pulled in many directions

Listen to the full episode on the Health Podcast Network, Spotify, Apple Podcasts, Amazon Music, or Google Podcasts. Below is a full transcript of the conversation. 

https://open.spotify.com/episode/00qGiP2B7moxTRpTXZV4w3?si=DYmSjZFwRdOufCgi94dbFw

[QUESTION, ALEX MERWIN]: Hi everyone, I’m Alex Merwin from AWS. Welcome back to the AWS Health Innovation Podcast. Sometimes as a patient, navigating the health care system feels like a maze. Today, we’re joined by Guillaume Deswarak, the co-founder and CEO of Artera. 

[ANSWER, GUILLAUME DE ZWIREK]: Earlier in my life, I tried to become a professional athlete. I was on my own for the first time with an acute issue and was told I was at risk of sudden cardiac arrest. So I was going in and out of doctor’s offices. I was flying all over the state trying to get answers so that I could continue working out. And it was frustrating. I loved my doctors. I loved the facilities. But the process of coordinating my care was super, super burdensome. I had to be on the phone between the hours of 8 to 5 or no one would answer. I could rarely get my questions answered the first time they would bounce me around.

So I just wound up basically having a second full-time job trying to coordinate my care. In the meantime, the rest of my life was being done asynchronously through text message. So I thought to myself, why are we not doing this in health care? I mean the closest thing I can point to is the robo calls I get at 6 pm reminding me to show up to my appointment and to press one to confirm. And to me, that was a travesty. So how can we turn on real asynchronous modern two-way communication in health care?

How can we make health care the very best industry when it comes to customer service? That was the problem statement. Perhaps naively since I didn’t see anything solving that in the market. I thought how hard can this be? Why don’t I go out and build this myself? So. That’s the Genesis story. Here we are 9 years later. I think that makes me close to a veteran now in health care. I think a decade mark is where I can claim that accolade, but that was the start.

[QUESTION, ALEX MERWIN]: Were there any parts of your background beyond being a musician and an athlete that informed your approach at Artera? What industries did you think were doing a fantastic job for communications? 

[ANSWER, GUILLAUME DE ZWIREK]: Yeah, this might sound silly in retrospect, but I thought the airlines did a pretty good job back then. A better job than I was experiencing in health care. Hospitality did a really great job in terms of customer experience and Even then, I didn’t think they were doing a great job. I thought there was a lot of room for improvement. For me, the ideal experience is you ask a question, you get an answer, and you’re confident that someone’s going to respond to you 100% of the time and that it won’t take that long. To me, it should be that simple. Let’s get rid of all the BS between the patient and the answers that they need.

I did some market research and the market research showed pretty unequivocally that there were 3 industries that were consistently rated the worst in terms of customer experience. Health care was the third worst. I’m hoping that if I revisited those studies it would be better now.

The federal government nnd then cable companies take second and third. You have the ultimate monopoly and how times have changed there, right?

Yeah, yeah, cable is actually a lot better now, the fiber wars are always here in Santa Barbara. I think it’s Frontier and Cox are battling for market share. It’s no longer a monopoly and it’s amazing how much better customer service gets when there is no longer one player in the game. So I love competition. So going back to your question, what is it about my background that I think carried through to Artera? It is the competitor. I want to do great work no matter what I do. To me delivering product, being a musician, being an athlete is not worth doing unless you can deliver something significantly better than anybody else in the market. You have to believe that. And then you have to have the grit to be able to put in the time – to actually deliver that, make that a reality. 

[QUESTION, ALEX MERWIN]: So tell me about Artera harmony. Tell me about this amazing solution you’ve created.

[ANSWER, GUILLAUME DE ZWIREK]: I mean, if the story didn’t give it away, were a communication company focused exclusively on health care and focused exclusively on patients. So we wanna make health care the very best industry when it comes to customer service. And we want patients to get that concierge-like experience no matter what their needs are. Unfortunately, or fortunately, in our case, health care is a lot more complicated than airlines or hospitality. There are hundreds of specialties that you could go to. There are thousands of diagnoses that could be applied to a patient and there are a lot of different organizations that you could go to then you layer in the payers and the pharma companies and life sciences, it is way more complicated than I ever thought.

We’re effectively a middleware solution that sits below every single one of those systems. We handle all the traffic. So every piece of communication, whether you’re an insurance company, your primary care provider, your cardiologist, the rev cycle department, the vendor that has a Let’s use baby scripts as a pregnancy app that they want you to download because your your partner is going through pregnancy. All of those different solutions go through our infrastructure. We’re Effectively air traffic control. I know all the people who are trying to communicate with the patient. We give the health system control over what should get to the patient and when. The patient can respond to anything.

Our bots will close the loop if we have high confidence interval that we know the answer or we can make an API call to direct you to the right services. And one that can’t happen, we put you to a live human being. What does this look like for a patient?

You have your hospital or the contact in your address book, you can text them about anything and you will always get an answer and you’ll get the right answer. And what do the hospitals get? They get conversion. When you orchestrate the perfect experience for patients, they are more likely to do what you tell them.

The alternative is 20 different departments, your payer, your health system, all the vendors. Calling you, texting you willy-nilly from different phone numbers you don’t know what to do you don’t know where to get help. It’s that classic example where someone’s calling 1 800 whatever and just yelling agent at the phone. Just get me to a human being please because this 0 0 0 0 0 0. Yeah, we saw that problem for health care and the result is conversion.

[QUESTION, ALEX MERWIN]: I moved to the UK in 2015 and the first time that I interacted with the health system here, I just discovered 111. So 111 is a non-critical care line that you can call to speak with an agent who’s going through a triage decision trip that is pretty much all it is. Depending on where you spit out, you might have a credentialed RN call you back and do the qualification and they can refer you into what we call the A and E but the ER in the US. So, how far do you go? You mentioned that depending on the interaction with the body, you pass a certain confidence interval and you can be handed off to a healthcare professional. Can you tell me where the solution stops in terms of diagnosing a condition and pulling people from the health system to do that?

[ANSWER, GUILLAUME DE ZWIREK]: So there are infinite capabilities. And configurations for our system. So we were very purposeful about building this technology stack out as a platform that is configurable. So you can actually build out complicated decision trees in Artera like the one that you’re describing with 111 and you can tag and route and assign people as options in those trees. As a company, we don’t hire clinicians and physicians so we do not build those pathways. The customers build them themselves. 

Now having the privilege of being in business for almost 9 years and having Hundreds of customers – we’ll probably have a thousand customers next year – we have now seen the workflows that work really well. So recently with our new platform, Artera Harmony, we’ve actually started templating the best practice workflows. For example, we might have a customer who’s built on an amazing workflow around Medicaid redetermination or COPD management and will actually templatize those for our customers. We’ll show what the results are and anybody else in our user base can clone those to those to their environment, customize different steps of the tree and activate it for their patient population and see how the results compare to others. So we have customers using us for clinical pathways. They usually build that themselves and then the templates become the content repository for the rest of the user base to leverage.

That’s hugely exciting because one of the biggest challenges with the US healthcare system is the immense fragmentation, right? And I mean, this can be as insane as 2 hospitals across the street from one another, right? Using completely limiting beyond the same HR, deployed at different times with different consultants, different schemas, and they might as well be distinct solutions altogether. And this is neat because what you’ve created is a way for these healthcare provider organizations to collaborate with one another to share best practices in a meaningful way that really doesn’t require doing a full HR integration, passing back and forth, patient data, getting the required consent, getting the same reimbursement networks. So it’s pretty clever. 

[QUESTION, ALEX MERWIN]: Can you tell me a little bit about the different types of customer personas that use Artera  Harmony that you know? How do you segment your customers internally?

[ANSWER, GUILLAUME DE ZWIREK]: Yeah, so we have the traditional enterprise health systems. These could be academic facilities or otherwise, we then have large independent, usually specialty focus groups that could be a large cardiology chain ophthalmology chain things of that nature so large private practices we do a lot of work with federally qualified health centers. That’s an area that is especially meaningful to me. My mom worked in CHCs her whole life with underprivileged populations, big Medicaid populations. And then we do a lot of work with children’s hospitals. So it runs the gamut, the ambulatory and acute.

I would say there’s more usage as a whole in ambulatory. That’s where kind of a lot of that visit volume happens and then you were put into the acute setting, but really across the board and those are the 4 main segments. So, enterprise Health Systems, specialty groups, federally qualified health centers and community health centers, and then children’s hospitals.

[QUESTION, ALEX MERWIN]: So at Amazon, we’re customer-obsessed and we love hearing about customer stories and trying to find the little hints and secrets in there to help inform our approach and how we develop products and services. Can you tell me about a few of your customers? Can you share a few stories and how their use of Artera has changed how you think about developing the product?

[ANSWER, GUILLAUME DE ZWIREK]: So I’m happy too, but I want to comment on your customer obsession thing first because I am such a believer in that as well. I talk to a customer every single day. I was on the road last week. I did 5 states on the East Coast, probably 3 customers a day that I was speaking with. This is So ingrained in our DNA, it’s the most important thing.

We launched our first Customer conference last year. We brought up, you know, a couple 100 people together for the first time. And the epiphany I had at that conference was I’m customer-obsessed, right? And I’m talking to all these folks one-on-one, but they actually want to talk to each other. And I haven’t had that unlocked yet. So this idea that we were just talking about with the content and templatizing those and making those available to the base. We’re starting to think about ways to help our customers interact with each other because there’s so much learning there as well. It’s not just you and I at Amazon and Artera. It’s also our customers engaging with each other. 

I’m glad you said that. So as you can imagine, because I’m talking to a customer every day, I’m learning a lot of things every single day. I’ll just give you an example. We are starting to do more work in population health and value-based care.

And this is an area that we’ve been interested in for 3 or 4 years. I hope the American health system pushes further and further into the BBC arena has been a little bit slow to adopt. And this recently got steam. We have a pilot going out right now with 5 different health systems and it got steamed when we realized that we had dozens and dozens of customers that were using us for BBC use cases and we had no idea. We just did a query of our data and we were like, oh my gosh, this customer is using us for annual wellness visits and well-child visits and chronic care gap campaigns. We had no idea. So we sat down with them and went, how can we do this better for you? You’re already using us for this. What are the gaps that would make this even easier and more effective? And that has turned into a new product for us. And we just weren’t looking, we were talking to them, but we weren’t looking at what they were doing. So that’s one example and I’m really excited. About the work that we’re doing there.

Another is we had a customer who had a problem with leakage. So they were referring their patients for specialty care and those patients were going out of network basically to get that work done. So they edited one of the workflows in our builder. And they made one small edit. Which is when the patient said, no, I don’t want you to help me schedule my appointment with imaging. They asked why. And the results were astonishing. This was a group in Wisconsin. And the number 2 answers for why were transportation and lack of access to warm clothes. What an unlock! And now they have a coat program, like a free coat program, and we should see that move the needle in terms of those patients staying with that system. To, you know, complete that additive care. So those are the stories that really excite me and just the agility with which they can make those changes in our system.

And now, going back to the very first point I made, and now we just need to evangelize that to the rest of our base to elevate the entire industry to perform at that level with those new insights.

[QUESTION, ALEX MERWIN]: Gui, you’re 9 years into this. Entrepreneurial journey as a co-founder. It sounds like people have always been customer-obsessed. This is something that’s in your DNA, but can you tell me about how that customer obsession and how you maintain it has changed over the last 9 years as the organization has grown. How do you ensure that the rest of the organization has that same customer obsession and how is what you do today with the broader organization different than what you were able to do when you were just a few employees. I asked because we have a lot of early-stage founders listen to the podcast and it’s a kind of thing that of course you can be customer obsessed but then you get into the day-to-day work and there’s this ask, but it’s really expensive to license that technology or we’re gonna have to deprioritize these features or we need to raise capital and we know that this investor really wants to see this new relationship. Come on board before they’re gonna react. There are pressures that come on board, so I’m curious to hear about how you manage those trade-offs and how you’ve had to adapt your approach over time.

[ANSWER, GUILLAUME DE ZWIREK]: So I’m gonna give you a learning. And then I am going to give your audience a hack. So my learning is that I was customer-obsessed at the beginning. We found product market fit. And immediately it was about scale.

Like know the problem, we know the buyer, we know we had value, let’s get this to as many people as possible and frankly, the vast majority of my time shifted to thinking about that and getting market share. And I think I made a mistake. We’ve been very successful, so it’s, it’s hard to complain, but I wish I had reserved at least 30% of my time – I think that’s the lowest you should go in terms of time with customers back then – to continuing that relationship because I think we would have launched new and different products sooner. Because I would I would have known what the future looked like in the mind of my customers and I missed that for a couple of years. I came to the realization during COVID that needed to change. And I was meeting with my executive business partner and I posed a challenge to her, which was how can we create a system here at Artera where I am talking to a customer every day – and I can actually deliver on my commitments to that customer? Because the problem is scale, right?

I’m in 10 hours of meetings a day. Realistically, that is what my day looks like. So I don’t have time after a 30-minute or 1-hour meeting with a customer to do the 5 follow-ups, send a follow-up email to the customer, get 5 teams racing, and make sure those insights actually turn into action. So we actually designed a system and we call it the executives engagement program. And I hold myself to the standard and then all of my executive team is also expected to meet with some subset of customers – it’s probably at a minimum on a weekly basis or a monthly basis. 

And I actually do all those meetings with my business partner. She is able to chase a lot of those action items for me. So I’m moving on to the next meeting. She’s actually putting those into practice. I have a draft email that I can send at the end of the day to the customer – I tweak it a little bit. I get it out the door. Every customer has my cell phone number. I pick up every number and because I now have a system in place behind the scenes where if somebody needs help, I’ve got somebody who can turn that into action. And it really delivered and feel free to dig in on how we actually turn this into practice, but we have a whole practice that before every customer meeting, I have a 2-page briefing sheet. Or the main points of contact, where they using us for, what do they want to use this for? What are their problems? If there’s one thing that you could get out of this call, what would you want me to do with this customer?

So I’m reading a two-page document before every meeting. I’m having the meeting. Then I’m sending a summary to all of our internal teams. I’m sending a recap to the customer and then a couple weeks later I’m following up with a customer to make sure we have delivered. We have delivered on our promises. And they’re probably getting a handwritten thinking note for me a month later. That was literally the level of intensity with which we take this customer obsession and we’ve had to build a process out of it. That’s the only way that you can do this at scale.

So in Amazon, there’s something called the question mark escalation. So when I started at Amazon advertising, I, this is like the dreaded thing you don’t want to happen and it happened with our team. So we managed to program, we deprecated a feature, we didn’t communicate appropriately with customers. And so there was a customer who was materially impacted by this and they emailed Jeff at Amazon. Calm and they expressed their disappointment and that email was forwarded by presumably Jeff’s office. I don’t know if it actually is just Jeff. To the, you know, director of our business unit with just a question mark, right? That triggers a process that ends with a narrative review. Where you identify the root cause of what is going on with that customer and that durable mechanism, which was a tool that’s inspected at adopted to make sure that it never happens again. So they always have good intentions if you believe that people are good and have merit you can accept the premise that we all have good intentions. So if I make a mistake, it’s like, I, I had good intentions. Of course you had good intentions, right? Yeah. The way you fix a problem verbally over time is by deploying and implementing a mechanism.

[QUESTION, ALEX MERWIN]: So that’s music to my ears. The other thing is that provides a really interesting talent development opportunity within your team because I don’t know how you select and fill those sponsor roles and if you rotate them but you know for your star achievers internally you know that’s a fantastic way to get exposure and visibility with the executive team and you’re developing your internal talent pipeline. You look at the GE model and CEOs are always recruited internally. What are you doing to support and develop your next batch of leaders?

[ANSWER, GUILLAUME DE ZWIREK]: You know what? That’s a good point. We’ve had a lot of our executive team in the layered down. It was developed internally and I’m probably proudest of that. We still use one other hack from Amazon, which helps with mobility internally, which is the memo format. We used to do decks for everything. Everything’s a memo now. Everything we write, is a 3 to 6-page memo. If it’s any longer than 6 pages, it’s 2 different meetings, 2 different topics. Like it’s too much information.

And we have a strategic meeting every week and we review 3 or 4 memos. We document all the decisions and it is amazing how effective it is because 2 months later, we’ll revisit a decision and we’ll realize we weren’t aligned. And then literally we raise our hands and we go, let’s look at the memo. And then see what the memo says we agreed to. And we can usually figure out where the disconnect happened. So it’s been such an effective model for us. I also adopted that too late. So I wish I adopted that 2 years into this company. It took me I don’t know, 7 and a half years. I probably activated that model about a year and a half ago. But it’s a great opportunity for folks who aren’t on the executive team because we have team members write memos and send those to our team. We review them. We have a discussion with them. We make a decision. And every time we review a memo, we end with a decision. There’s always a decision. So it’s such an effective model. And it democratizes information and knowledge sharing as well.

Not everybody has the extroverted personality type to say host a podcast on health innovation just kidding but not really see but there are individuals who have different personality types and they may not feel and frequently don’t feel comfortable being in a room of 12 people. And saying a idea. Or they may not have the space to war feel encouraged. And with a written narrative, they have a format that they can communicate in a way that is just the same as everybody else, right? It’s democratized. And it’s also more difficult to hide bad thinking in writing, whereas a great deck and great slides. May not be a very good idea, just very well delivered, but as soon as you read it written down, see very easy to see.

[QUESTION, ALEX MERWIN]: Let’s shift back to Artera Tell me about the marketplace and the role of the marketplace within the Artera Harmony platform. So what’s it all about and how does it make the whole worth more than the sum of all the parts?

[ANSWER, GUILLAUME DE ZWIREK]: Yeah, so if you go back to the problem statement from earlier, which is health care is complicated. A lot of things need to be communicated to patients. They never come from one system. They come from a lot of source systems and the status quo today is every system can communicate on their own fashion. The idea of the marketplace is to make it plug-and-play. To route all of those vendor communications through our platform so we can take over. We have a series of APIs that can deliver communications on behalf of those vendors.

So again, let’s use kind of example of rev cycle, right? You’re a hospital, you’ve purchased some sort of payment processing tool and patients are expected to download an application to pay their bills. In the status quo, that patient will get a text from a random 5-digit code telling them their bill is ready. Very few patients tend to respond or click or act because they say it looks and feels like spam. In the marketplace example, those communications would be delivered via our platform – they would come from the hospital’s phone number in the same thread as every other interaction that you’ve had with the hospital, you can either pay your bill directly by clicking on a link or you can respond and say, hey, what is this about?I actually disagree with my coverage. And they’ll be routed to a human being. So we close the loop.

So our marketplace already has 40 best-of-breed healthcare IT vendors. Our API’s are open – they’re accessible to anybody, so you don’t have to be in our marketplace to use them. And it delivers just that, which is unifying communication. It’s a win-win. Our hospitals can integrate these solutions a lot quicker. We don’t have proprietary standards and the vendors. Frankly save time and money because they’re not having to build their own communication stacks and the patients win because they’re getting communications from a trusted source and they can engage and they can be routed to a human being when it’s appropriate.

[QUESTION, ALEX MERWIN]: Can you give me an example of a partner with whom you have a better together story where you know having the benefit of that inherited trust because the communications coming from the same number really helped them out. Anybody come to mind? 

[ANSWER, GUILLAUME DE ZWIREK]: Yeah, I can give you a couple. Intake forms is a great one. So, there’s a solution called tonic that delivers really amazing rich interactive registration forms and a bunch of other kind of intake type forms for the patient. And again, in the status quo example, they’d either be texting or emailing you from their own phone number. Tonic is not a texting or emailing company. There a forms company. That’s what people pay them for their best to breed at that – And success for tonic is getting the maximum percent of patients filling that out before they arrive at the point of care.

So we deliver those communications natively via our platform. Patients again get that text in line with everything else they’ve received. They tap on the link. We pass through all the parameters that need to be passed through so they were taken through that rich experience they can complete the forms. We know whether the form has been completed or not. So we can create hierarchy rules where we remind the patient, hey, it looks like you haven’t completed this paperwork yet, your appointments in a couple hours. Can you finish the form? That’s a great example. Response rates went up significantly. 

Another good one is satisfaction forms after the visit. There’s a company called Refugee that does great work here. Again, it’s delivered natively. When the Visit is finished we get a trigger from the EHR that says the visit has been completed, patient gets a text. Hey, can you rate your experience? Tell me about the provider, all of that. All those questions, all that information is coming from that downstream partner. So there really are infinite use cases and a ton more to get excited about. 

Listen in as as de Zwirek discusses the two largest gaps Artera Harmony is solving for: visibility and orchestration.

[QUESTION, ALEX MERWIN]: Tell me about your ambition for the future. So what do you want to see from you and your team in 5 years’ time? Where are you going?

[ANSWER, GUILLAUME DE ZWIREK]: We want to deliver on the mission. Right? I want unequivocally for the average American to go through their health care experience and for it to feel totally seamless. We’re not there yet. So where’s the biggest gap? 2 things, visibility and orchestration. Our customers and frankly our non-customers. I really have very little visibility into what’s going on in their organizations. They know that their patients are getting a lot of communication. They’re not sure where it’s coming from. They’re not sure when it’s happening and they have no idea. 

We’ve released a series of tools recently that provide that visibility. You can search for any patient in our system and see every single communication that has been sent to them from every practice and from every vendor that’s integrated with Artera. We’ve opened up new capabilities including extracts for vendors that won’t integrate with us. I think would be a great example. So we have an epic extract that provides a ton of value to our customers. That’s the visibility piece. We’ve also delivered new reporting dashboards that show them aggregate level. Visibility across their entire system. So I can log into one place and see I have 200 patients that are clearly getting overcommunicated with. Here is the impact it is having. Now the next question is, what do I do with this information?

So that’s the visibility, which nobody has. Everyone’s blind. We’re changing that and we’ve launched tools to deliver that for our customers. The next piece is orchestration. So I now have insights. Now, how do I actually fix the things that aren’t working well? So our new platform is introducing this concept of rules, orchestration rules. Where you can actually create master criteria that will suppress communications, prioritize communications, create limits: hey, do not ever let one of my patients receive more than 10 communications in one day.

I’m just giving you a random example. Hey, if a care gap, a bill, and a satisfaction form or all queue to go out at the same minute on the same day, prioritize the care gap, suppress everything else, and alert my team. So the orchestration is what is going to allow our customers and our prospective customers to actually deliver that premium experience, right? Because they will know what’s going on and now they can actually act set the rules and they will see the impact on conversion rate, the impact on patient satisfaction, and so on and so forth. Just less anxiety for patients. I mean, there’s there’s bill anxiety and financial anxiety that can be associated with treatment. And so the ordinal delivery of these messages can really have a big impact that you do not want to get your financial billing information before the course of treatment that could really materially impact the adoption.

Let me give you a practical example, right? I have 2 young kids. I have a daughter who’s a year and a half. I have a son who’s 3 years old. When my daughter was 4 months old. One night it was maybe 2 in the morning. Her breathing was super labored. It sounded like she was breathing out of the straw. And we were about to go to the ED. What did I do? I pulled out my phone. I texted my pediatrician. Right? Using our software, just text the phone number said, hey, my daughter has super labor breathing. She hasn’t been sick. I’m going to the ED. What should I do? So I sent that text, what do you think happened? Our system saw that. Followed a workflow which was this sounds urgent it’s after hours it needs to go to on call nurse it was routed to a nurse a minute later had a phone call, Hey, I just got your text. You need to go outside with your daughter. And if the breathing gets better within 3 min, you probably don’t need to go to the EDs. I forget what the thing is RSV or something like that. If it doesn’t get better, go to emergency care.

She saved me a trip to emergency care. If I was on a risk-based contract. She just saved her organization, I don’t know, 3 grand? I don’t know the average cost of an ED visit is. So the real world applications of delivering great care are phenomenal for patient access. They’re phenomenal for return on investment and savings. And there’s a thousand other examples like that, that that’s what I want 5 years from now. I want that for every single use case for every single patient in America. It’s a lot better than opening up chat bots and saying, hey, you know, this is what I’ve got.

[QUESTION, ALEX MERWIN]: Now speaking about that in generative AI, one of the challenges with these large language models is they’re not interpretable and it’s almost as if we need to do new fundamental science. On the nature of mind, if I can even use that term on these LLMs. And so we’re pretty far from this being software with medical device. You know, I mean, like it’s really tempting to think of it as a clinical decision support tool, but I just don’t see it. I mean, it obviously nothing’s been approved yet and I just with how the technology works. I think we got a ways to go. But with the work that you’re doing, I think there’s actually quite a lot that could be done there.How hard is it for your customers to actually write the content that is going up through the messaging platform? Are there opportunities to optimize that content delivery for different patient personas or demographic groups and could generative AI be used to help alleviate the burden because not many hospitals have teams of copywriters? Have you thought at all about this? And is there a role for generative AI in Artera’s future?

[ANSWER, GUILLAUME DE ZWIREK]: So we have a whole team focused on this, but we’ve been very cautious about putting the cart ahead of the horse, so to speak. There’s a lot of marketing hype around AI being used. We’ve chosen to stay styling and just do our experiments at the end of the day. Our only objective with these experiments is to increase conversion. Conversion could be patient getting the answer they need, the care they need or not having to talk to a human being.

I’ll give you a couple examples of some of the things you’ve experimented with. I need to send a care gap message to every single patient who is eligible for a colonoscopy and that might be a workflow that I’ve written out with a series of questions. Now I have a lot of information about all my patients. There might be a hundred 1,000 patients who get that communication in any given year. Now I don’t have the time to create 100,000 different versions of that based on Alex’s zip code, socioeconomic information, background in terms of coming to seek care and being responsive and engaging, but you can give those criteria to an LLM and you can say, give me a version of this workflow that is more likely to convert for Alex. And you can imagine that at scale, 100,000 times, if that can increase the response rate from 70% to even 72%, it is very meaningful. So that’s one example. 

Another example is the really the classic simple use case of auto-complete. This is what Epic is doing with their in-basket, right? It’s suggesting responses for their physicians. I’ve got, I believe it’s 30,000 active hospital users on my software every single week. These are call center workers back office. These are mid-levels and they’re responding to patients, right? So we are testing with these same ideas. The patient asks a question, we suggest a response. The beauty of this model is that we can actually train the model because the staff sees the suggested response and they edit it and they send it and that is training our model. So we actually have this amazing workforce that doesn’t work for us of 20 or 30,000 people every day who will be able to see these suggested responses and train the model and at some point The confidence interval is going to be near 100% and we’ll just send it to the patient.

But we’ve been very cautious. Health care has wonderful staff. In some cases, you could argue that with modern technology, it’s even overstaffed from a call center and back office perspective.

So let’s put those folks to use. Let’s elevate their pay grade. Let’s get them responding to higher acuity patient questions. So that’s what we fall back on and those are the folks that are gonna be training our system to automate more and more of that journey.

[QUESTION, ALEX MERWIN]: So, when we wrap up today and as you go home, you hang out with your kids and you think you’re thinking back on this conversation – are there any questions you’re going to wish that I had asked you? 

[ANSWER, GUILLAUME DE ZWIREK]: The question that will come back to mind is ‘What would I do differently or what would my advice be to somebody who is at various stages of their Startup journey, whatever startup means, right?’ 

Uber was a startup until it went public. So I think there’s a pretty broad definition for that term. So that might be the question. Yeah. There are some things we did right. So looking at the very early days, look, the truth is starting and running a company is a roller coaster. And you will do things wrong and the things that you do wrong shape you and make you a better leader and make you a better company. They probably have more influence on you being a successful company.

Now, as a whole, you need to do more right than you do wrong if the roller coaster is going to keep going up. In the early days focusing on finding that product market fit and then really making sure you had a scalable sales model is key. I mean so many founders who spend too much time to see if they have product market fit and they want to go on to the next thing.

The best products rarely went in health care – in any industry for that matter. It’s the products that can get distribution and can get used that win.

So that has to be figured out in the early days. So that would be my learning lesson number one and I’m fortunate that I stumbled into that naturally and didn’t learn anything dangerous mistakes. And then the second lesson, which we kind of already talked about, is At some point, you’re gonna get pulled further and further away from your customers and that will cost you. So threading that needle and realizing when you need to create systems to get in front of your customers and spend that time is really important. So. I guess they audience already learned this today, but there’s my summary and I hope that provides some value to somebody. 

[FINAL THOUGHTS, ALEX MERWIN]: That’s fantastic. You’ve left me inspired. I hope that everybody’s rethinking how they communicate with patients and get in touch with you soon.

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