#431 Neko: The Future of Healthcare? With Hjalmar Nilsonne, CEO

Welcome to the Health Tech Podcast. Here we talk about everything health care and technology, and I'm your host James Summary. Yalma, welcome to Health Tech Podcast. How you doing? I'm very good, thank you. Thank you for inviting me. You are very welcome, sir. You're very welcome. How long are you in London for? Have we got you on the first day, the last day? I just came in and I'm doing some work at our Speed of Illocation tomorrow. Demoing some very interesting things we have coming up next year. Then I have to get back to the family for Christmas prep. Oh, excellent. Yeah, it's very close to Christmas, isn't it? That's quite interesting for the family. Well, delighted to have you. delighted to have you. Neko help, I don't think there's going to be many people that listen to this podcast that don't know what Neko help is, but for those that don't give me the top line, what is Neko help? The super basic version is where a preventive health scan for your future self. So we have a 299 scan that we've developed ourselves that maps millions of data points, give you a result in minutes, looking at the most common problems across chronic disease and other things that are largely preventable if you catch it early. We're going to talk loads about that scan. Even the word scan is interesting because it's actually just a load of different tests doing different things, cross-cardiovascular, cross-metabolic, across thermological. There's loads of different scans and I have had one. So we are going to talk about it. But I want to talk about you first. And I want to talk about your journey into health tech. And so where does your story start? Because you were in climate, I know that. And you've journeyed now into health, convinced, at least in part, I think, by Daniela, if you can spotify, which is a very interesting story that we definitely want to hear on here. But yeah, tell me about yourself, man. How does this start for you? Yes, I grew up in a family of doctors. So my grandfather had his own practice in Stockholm like over 100 years ago. My father kind of went in his footsteps. Same speciality. My mom is a psychiatrist. My oldest brother is a doctor. And all of these folks were doing a lot of medical research. So I grew up very much in this kind of medical world, spending time at hospitals. At Christmas time, we would get hundreds of Christmas cards from old patients. Oh, wow. This was a day and age when the patient doctor contract was a bit different. So it wasn't like, you have to fix me. It was more like, oh my god, I can't believe you could do something for me. You can just have the same doctor for continuity of care. Yeah, exactly. So like, way different thing with family doctors and everything. That was the world that I grew up in. Growing up like that, I grew up with an absolute conviction that I would never, ever get involved in anything relating to medicine, health care, you name it. It just seemed like a very, very tough way to do your work. And like, hearing what my parents were talking about over the kitchen table, anything from peer review process and evidence to kind of, how can we get our institutions to do the right thing, even though there's set up in a way where we think that's not really easy to do. So yeah, I was convinced that I would never, ever be anywhere close to medicine. So my background was I ended up getting obsessed with climate change. So I have an engineering background. And I worked on climate tech stuff for almost 10 years, co-founded two companies in the energy space. Yeah, basically I thought that was going to be my life just doing, working on slightly reducing the ratios of gases in the atmosphere, very, very slightly. And then things-- But making a huge amount of difference during, so. Yeah, hopefully. And arguably a health intervention, kind of, but anyway. Yeah, that's on the pollution side, electrifying, you think. But anyway. Yeah, and then my life took a bit of a left turn. So in 2018, I got a direct message from Danielek. Basically, I don't know where. You didn't know him before. Never met him. Right. Like, we were not in a chat group. Do you know what I mean? Like, it was not like I saw him at the pub, but you know, we never spoke. Like, it was literally like-- And never met him. Interesting. The message was pretty curious. He was like, hey, I think maybe we should talk about maybe doing something together. It was pretty direct. So it's one of those that you say yes, too, isn't it? Before we go back to going out, exactly what I've even bought. Yeah. This is OK. This is crazy. But OK. So Daniel, you know, probably the most successful tech founder in Europe. Yeah. So we have a coffee. And basically, he tells me about what's going on in his life, which is he's about to IPO Spotify. And he's realized that suddenly he's going to have a lot of capital. And so he was thinking about, OK, what should I do with it? I mean, I have it. I should use it for something. And he had been thinking kind of long and hard about what he wanted to do with it. Looking at all the options of kind of charity and all the different things, you can kind of make a difference. He had kind of landed on the conclusion that of all the things that he had done, the thing that really had a big global impact was kind of redefining the expectations on an industry. Wow. And that industry was music. And music became synonymous, not with buying songs or buying records, but completely different listening experience. So he was kind of thinking like, oh, that's the kind of stuff I should be doing more on. But I run Spotify. So I need to partner with somebody and find someone who I can enable to go on a similar journey. And maybe that's somewhat it's you. So this is pretty cool. Like Daniel, super successful entrepreneur, willing to fund something very ambitious. Life is feeling pretty good. And the next sentence that comes out of his mouth is, the area that I would really like to focus on is healthcare. And my heart dropped just. It was just like, oh, literally. Literally. Yeah, literally like asteroid mining, go like anything but healthcare. I was pretty direct. I was like, I think what you're thinking about is wonderful. Yeah. I think you should go and do it. Don't listen to me. But basically you have no idea what you're getting yourself into trying to change the mind of kind of the medical community about how they do stuff, et cetera, but you know, best of luck to you. Yeah. And I kind of, I thought that was going to be it. But Daniel, who's very smart, he was like, okay, like, if you don't want to do it, it's not for you, you know, that's fine. But like, could you maybe help me just develop the idea a little bit further? It's, you know, okay, you know, that's, it does sound pretty fun. And I was like, well, what do you mean? Like, well, what kind of input do you need? And you said, well, let's just imagine for a second that we have, we have to start over kind of as a society. So this isn't 2018. Yeah. Let's just say, boom, there is no healthcare system. And then we're like, oh, we need a healthcare system. Okay. So we're like, we need to find it. If we had a chance to do it over. And what's wonderful about Daniel, he didn't say like, and here is what I think. Yeah. He was like, so can you go and figure it out? I was like, huh, okay, that's pretty interesting. So like, you know, it's impossible not to start thinking about it. So, so we met again over a few months and we're kind of bouncing these ideas. And pretty quickly, we landed on this idea that like, like, seems like everybody agrees. That would be way better if we get to have a healthcare system much more predicated on prevention and creating health rather than just reactively treating the sick. We have everything from, you know, how consumers feel about it, where they get very frustrated about how primary care functions today to the cold, hard stats of like 80% of the cost into healthcare system is associated with chronic disease. Chronic disease can be completely prevented or delayed if you deal with it in the early stages when it's easiest to do. But today, basically, you can't even see a doctor most of the time unless you have the late-stage symptoms. Yeah. So like, okay, this doesn't really make any sense. So, we've, you know, obviously we could do it over. We would try to figure out a way to make a healthcare system that's way more predicated on prevention and proactively helping people stay away from the risk factors. Whenever you start a company that end up looking back and realizing how naive you were, see, you know, look at the time we thought, like, oh, this is a pretty solid insight. Now, I later learned that like, if you go back to like the hypocratic oath and hypocrite's, he will suddenly know it's literally in there. Prevention is always preferable to cure. It's like the oldest I.D. in medicine. Here we have a whole book I later learned called the Book of Prognostics, where basically he's arguing that like the number one duty of a doctor is first, do no harm. And what is the best way of doing no harm is doing no intervention. And the best way of doing no intervention is to prognosticate and try to help people stay away from the need from the intervention to begin with. So like this turned out to be literally the oldest I.D. in medicine that we thought like, oh, we came up with this wonderful insight. And then the second question was, okay, great. So if this is the future, people want, why isn't it happening? What's stopping us from having this future? And we're looking at it and you know, to some degree you'd kind of see like, okay, the ultra wealthy, they have access to kind of hospitals and scans, they're doing all this stuff, so they maybe have a little bit of it, but for the, you know, 99.9% of people, there isn't really that much in this category. And so what our hypothesis was basically, look, it seems like using the existing healthcare infrastructure or MRI machines and X-ray machines and all these things, it's just way to expensive and way to complicated to be applicable at a larger scale for prevention. So that was kind of, okay, that's challenge number one. Challenge number two is, okay, even if somehow magically you could, we had like all the information we need that attract people's health before they were sick, who would look at it? Like every doctor that I know is like, overworked. So who's going to sit through and look at all the charts and drawing the right conclusions from it, etc. So Nate goes really like, the two insights that made us decide to serve the company was, okay, we need to fix the data collection problem to make it really cheap, easy, convenient to track your health across time. And then we need to figure out how to draw the right conclusions from this data without adding extra work to the existing healthcare staff. And the hypothesis was simply like maybe with a rise of AI, you could imagine a future where the right conclusions can be drawn from this data without costing a fortune, which means it could be accessible. And maybe with a rise of kind of smartphones and sensors, you could imagine a future where tracking your health data across time didn't have to be crazy expensive. And if you have both of those two components, you could basically create a whole new infrastructure for primary care where proactive and preventive care becomes the norm rather than the sort of very rare exception. Yes. And when we had those pieces together, I knew I was like, "Oh, shit." I'm actually going to have to do this. Like this is maybe the most exciting. I mean, we're literally maybe for the first time in human history at a point where this could become a reality. Yes. And I maybe have a real chance of making a contribution to making it happen. Yes. Like, so then it was like, "Oh, I cannot sit on the sidelines for this. Like, I have to go out and try and do it." So we started the company together and, you know, I'm very, very happy that we did because I've been having an absolute blast ever since. And then we spent the first four or five years just focused on this first problem of the data collection. So at this point, the company didn't have a website. We didn't have a brand. Like, nobody knew that we existed. We were just focused in a bunch of clinical studies, collaboration with universities, just like looking for different ways of tracking our health data that could fit this criteria of being like very convenient, very low cost to run and these kinds of things. Interesting. After this period, we opened our first location in Stockholm where we put it all together in a consumer first experience. And that was kind of our first contact with the reality of this big mission that we had. Wow. Okay. So there's loads that I want to talk to you about here, Omar, because the way that you have described that naivety around surely this problem is simple to solve. And in fact, surely we've unearthed actually what the problem is. It's prevention before cure. It's really interesting because actually one of the podcasts that's actually just come out. I talked with the guest there about how in those days way back when doctors were incentivised and actually only paid when their patients were healthy. Right. And actually when they became unhealthy was when the doctors then underwent cost and therefore the incentives were incredibly aligned to one's prevention. And that's very different. It's funny now seeing the likes of you guys almost, almost helping us to come back round to that idea, which I think is fascinating. And also just this like first principles thinking of the ability to, you know, when you're when you're when you're Danielette looking at an industry throughout a capital and resource that he has, he can look with first principles at an entire health care industry with a genuine view of how to solve it. I think those initial meetings that you had with him must have been incredibly fun to actually be banding around ideas around disrupting an industry like health care with a family of doctors behind you. How did you talk about what you were doing to your family? Because I was a doctor and these ideas are very confronting to people that practice clinical medicine. It challenges the way that we think it challenges our values actually a lot of the time. And so I'm interested what those conversations were like with your family. I mean, it's a great question because exactly as you say you have the like the first principles, which all kind of I think make sense. Yeah they do. And then you have the practical applications of what people are taught, but also if we're being honest, like there's been tons of research done that have failed to show us wrong correlations and some of these things as people would expect. So like things can sound good, but at the end of the day is like are they actually good in practice? And of course, what we do is new, so by definition, no one has done exactly that before. So this creates this very rich, you know, dinner table conversation, as they said that I grew up with and that continues to this day about how to navigate. And I think, you know, in particular what's changing is, you know, it used to be that, you know, getting this health data was expensive and rare and these kinds of things. And now everyone can see that data in general is becoming much more abundant, but also health data is becoming much more abundant. So it's a little bit of like whether you like it or not, we're going into an age where this data will be much more abundant, whether and where the role of the doctor is much less being the gatekeeper. Yes. To being the person to help you navigate or something like this. And you know, and that would happen whether Neko is doing it or not. What I think, you know, in my family, I would say medical research has always been the like the king of like the most important things you can do is to contribute to the corpus of medical knowledge. And at the core of what we have done has always been the clinical studies and the knowledge that we're trying to kind of create that hasn't really been captured in an objective way before. So I think on that side, it was always like go go go like this is great stuff. Then you have the interesting other side, which is okay. Like what should you do with this information in, you know, 2019 or whatever it is to drive the most positive outcomes. And that's where you can take the most conservative view of saying like hey, if it ain't broke, don't fix it, you can go and be very aggressive and say any little change, you should you know, spend tons of money and time on it. And you know, I would say Neko is actually we take a pretty conservative approach. I would say one thing that's always been very important to us is the concept of actionability. So as you may have noticed with the test you do with us, pretty much everything we talk about and we show you is actionable, meaning if it's not good, we know what to do about it. Many of these things again, like when people hear these things, you should test for things and screening, they think about all kinds of different things. And many of these things have the attribute that you find out, hey, you have a higher risk of liver cancer, 7% increased risk of liver cancer. You're like, hey, great, what do I do? Nothing. You just like just worry about it. Just worry about it. Yeah. So we don't have any of those kinds of things. So we only talk about actionable things, which I think solves a big part of the problem of kind of like how do you empower clinicians and doctors to you know, do a good job rather than dumping data on them that let's be honest, like it's really sad that as a society, we don't really have the knowledge of how to interpret a lot of the data that we can't collect. And that's primarily, I mean, as an engineer, that's like a data collection problem. Like, hey, okay, if we had more data and better outcomes to correlate it with, we would know how to act on this data. But because no one has collected it at scale, we don't. And because we don't, no one wants to collect it, because it's difficult to interpret. Yes. So this is why we've always seen it as our role that on the one hand, we want to collect and really build this new knowledge about changes to human health. But at the same time, focus the interaction between the person and the doctor on what's actionable and the things that we can speak on with a lot of like scientific credibility. And that's why timing, I think, is incredibly important here as well, because like you just said, if it wasn't Neco, it would be someone else. The fact is AI is here, that processing power is here, costs are dropping. People are collecting more data. That was happening before Neco, it will happen after or around or all the rest of it. So that's always going to have happened. It's just that putting it together in the way that you have could only really have been done now and that clearly was the opportunity. I'm interested in those initial conversations and I've got to ask this when you're talking Daniel, like, about this. What was the idea initially and how did that change into what it is now? I know that you did a lot of back and forth, but I'm really interested to hear what originally was the plan and did that change at launch or actually was this truly iterated from the ground up around learning information as you were. I mean, what I haven't told you is, like, I'm a super genius who figured out everything perfectly in the first hour. No, I mean, we had, again, we, I would say like the cliff notes didn't change. It's like, say it like solve data collection, like solve interpretability, build it ourselves so that we can do something that's very different from what exists today. Those things were correct. What we ended up doing, and I'm a bit ashamed of this because I made the same mistake in my previous company. We ended up saying, like, look, there's a lot of good medical technology out there. We shouldn't make it. We should buy it and just integrate it really well. Okay, that sounds great. It doesn't, like, that's pretty simple. We buy that. We buy that. We buy that. We put it together. Right. And then you buy it and you put it together and you realize, like, hey, this tech was developed like 20, 30 years ago. And no one ever thought that this would be interesting for sort of AI and modern technologies. I'll give you an example. So we were looking at at the time, one of the probably the like Rolls Royce of skin imaging. Yeah. So like, it's a system that takes really high resolution photographs. And then because we live in a world where like storing medical data is usually seen as a liability. So the company said, hey, then we're going to put the data on the server. kind of on your side, I know, by the way, we're going to down-sign-pull it by 90%, because the doctors can't really tell the difference. They'll say, well, if you want to build this super intelligent system that can track all these changes, you really want the highest possible data quality. And most of these systems we get by was designed for the lowest possible data quality that a human could find acceptable. So then we were working with the company saying, hey, could you make a custom version for us, where instead of lowering the data quality, we're going to raise today the quality. And at some point, we're like, we might as well try to build it ourselves, because this is even more slow and costing us even more than if we just sort of designed it ourselves from first principle. So we ended up building way more of the tech than we ever imagined. Then the other thing was initially we thought, hey, we're going to build amazing diagnostic tech. We're going to go out to clinics. The clinics have the patients. We have the tech. It's going to be win-win. Again, I made a very similar mistake in my previous company. This is very embarrassing when you make the same mistake twice. But after some time, the response was super positive. They were like, oh my god, we love it. This is amazing. This is exactly what primary care needs were like, great. Can we come and install it next week? Oh, actually, next week is not a great week for us. But maybe next year, we can pick up the conversation. And we just realized-- How stupid-- You can't be in control. Yeah, and when we're honest about it, like, how much better off is this clinic going to be? Because they're getting better at diagnostics, better at prevention. The reality is they're not going to get any more money from doing it. But now they have to explain to their patients what this whole new thing is. They have to explain to their staff. They have to train them. We're going to be in there every day. Like, hey, you need to do this. Hey, you need to do that. And the whole premise of the company is basically that the incentives are not there for prevention. So 90% plus of our healthcare budget is spent in hospitals. Like, a little bit is spent in primary care, and almost less than 1% is spent on prevention. So how on earth did we get the idea in our head that we could be really successful focusing on that part? So we made this big pivot towards consumer and said, OK, we know that the existing healthcare system is not going to be willing to pay for the value that we're trying to bring. The existing doctors, therefore, are not funded. So even if they think this is the best thing ever, because they don't get reimbursed, they don't really have a way to use it. So then we were like, OK, who might be able to have a budget for this? And then we made this kind of hail Maori Beth on the consumers saying, hey, maybe there are enough consumers who are willing to kind of park with their hard earned money to have a different healthcare experience. As many of these stories, we kind of stumbled our way into something that ended up really working. And because I realized immediately that when you want to appeal to consumers, you have to speak the language of consumers. And all of us as consumers, we did not act with our head. We did not think rationally. We act with our gut, how things make us feel. So we realized that, OK, we're going to appeal to consumers. The whole thing has to be conveying the precision and the scientific rigor and all this stuff, not in a chart or in something like this, but in the design and in the experience and these kinds of things. And that really made us figure out the missing piece that I think really makes Neckow work, which is the combination of being high tech, being high design, and being high touch, there's the hospitality piece. And those three pieces together is what really made Neckow take off in a crazy way with consumers. Yes. And I want to go into this in a lot of detail. And in fact, as an engineer, feel free to completely geek out with me here about this technology, because I want to talk through what a Neckow scan actually is. And in fact, I can do this somewhat because having been through the Neckow scan myself, that high tech, high design, and everything seemingly built around my experience was very clear, very clear to see. But firstly, I was intrigued as a clinician by the tests that were chosen. You're given some insight there about filtering out what's actionable and what's not already now. I can see why some of those decisions were made. But there's interesting parts of your story so far that I hadn't appreciated, which also go into this, spending four years figuring out data collection, doing studies, thinking about universities, and partnering with them, and doing things with them. That's where things-- there's a grip strength test. And I did my medical school dissertation on grip strength. And so I know all the biochemical reactions that happen, and everything that happens to the blood vessels, and if you occlude it, or everything that builds up and arrest it, but I also know the proxy for health more broadly on grip strength. So for me, that one made sense. But to a lot of people that doesn't indulge me, taught me through how you chose the tests that you chose, and why they are what they are. So I'll tell you a funny story. So well, I don't know if you all find it funny, but I think it's interesting. So when I started this journey, so my brother is very smart, he's a neuroscientist, PhD, or researcher. So I sat him down, and I said, OK, human health, you can pick five data types. What are the most important data types to understand how so many students are out. I was like, oh, that's very interesting. Maybe it's lipids, maybe it's blood pressure. Anyway, he gave me some kind of list, and I was like, this is great stuff. Then I started just buying books on medicine 101 first year books. And every book I looked at, step one is like, look at the patient. Someone comes in and look at them. And then I look at their skin tones, look at this, look at this, how are they standing? And the chapter after chapter after chapter, just looking at the patient. So I call my brother up, and I was like, hey, dude, obviously, maybe the most important data type from how someone is doing is what they look like. Because all these books are talking about how you need to look at and then see you and do different things. And he's like, well, that's not really data type, is it? And then I said, engineer, I'm like, of course, that's a data type. I mean, it's visual information about what's happening with your health. It's just today it's recorded in the brain of a very experienced trained person, but we could record the same information in other ways. So that goes to the first step of what we wanted to do was the kick-kate. The foundation of most medical examinations is looking at the patient, touching them, these kinds of things. Could you replicate that in a way that was super fast, super convenient, super objective? So that's how we ended up with our standing up scanner. So the first part of our scan is you're and you're unaware, and then you stand in this kind of tube that we've created. And then in about six seconds, we do complete mapping where we do thousands of images on the outside of your body. So those are color images of super high resolution cameras. We combine that with a 3D camera to capture the shape of your body. And we combine that with thermal cameras to capture the temperature profile of your body. So from the kind of engineering point of view, it's like, OK, now we have an objective representation of core things that tells a lot about human health in general, like very similar to what you would get. If you were looking at somebody, if you were touching them, trying to feel if things were swollen, if they're warm, these kinds of things. And we've done all of this, as I said, in six seconds, at essentially zero cost, because it's all different imaging modalities. Now, the question is, OK, how do we translate this into something that someone cares about? So then our hero use case there is like, hey, we cannot image every single mole on your body. And we can give them each and every one of them a unique number. And whatever happens to you in the future, you can now go back and see objectively what was this mole like a year ago, two years ago, five years ago. So by removing the data storage is no longer in the head of the doctor. It's now objective and saved somewhere, which also makes like objective comparisons possible. And we have this problem. So my daughter has a rare autoimmune condition. So we need to go to the hospital a few times a year. What we need to do is to check her joint's for inflammation. And so the way they do that is you have a very, very good doctor who's kind of warming up her hands. Then she's taking a knee. And she's kind of doing this. You're looking at like her ever expression, like something wrong. And then she said, I think it's OK. As an engineer, this would always draw me crazy, because like, what is this whole business? We're trying to do an assessment of circumference. We're trying to make an assessment of heat. Like all of these things can be measured objectively. But even worse, she had to move to Italy. So they call us and they say, the only person who actually knows the knee is gone. So now we're in a bit of a bind, because we need to find a new doctor. And they need to train up a new recollection of this specific knee. So we're still in this kind of 18th century mode of medicine, where you have these incredibly experienced, amazing doctors. But everything is stored in their head. And nothing is captured objectively or easily trackable over time. So the goal of this system was really to do this comprehensive, objective mapping on the outside of your body that would allow us in any future case to go have the rich history to talk about changes, et cetera. And we knew that mold is something that consumers really care about. One thing it's very visible. It's like you see your mold. So people think about them. It's very obvious that if you have a history, the diagnose. will be better. And when you go to a doctor they say, "Hey, has it changed?" And you're like, "If you're like me, we count them. I have like 848 modes. I don't keep track of all of my modes. It's virtually impossible." So it's very clear that, "Okay, this objective mapping will really guide you to have a better outcome here." And this has also led us to skin cancer is one of our most common. We find a lot of millington of melanomas. Maybe we'll get into the data from anywhere people age 30 to 80. So it's also one of the most common cancer types and one of the most easy cancer types to deal with from the kind of true positive, false positive, like the worst thing that can happen is you remove a small piece of skin, which for most people is a very low risk procedure. And it can be life-saving. So that kind of the standing up part of the skin. So as I said, in like six, seven seconds, we do like thousands and thousands of images of them. We all stitch them together and it turns out again, the unbelievable naivete we had going into this because it turns out like human bodies come in all kinds of shapes and colors. When you have an iPhone camera, you kind of do this. We can't do that with a physical system. So like figuring out exactly the right amount of lights and focus and all these things turned out to be super complicated. But it doesn't really matter at the end of the day. We take all of this data and then we kind of do a lot of data crunching to put it together into kind of one representation of you. Then the second part of the scan is you go and you lay down on this bed. And then the main focus or the primary focus on the bed is really cardiovascular disease. So you know, cardiovascular disease biggest killer in the world, most expensive disease in the world. But most importantly, half of all cardiovascular diseases undiagnosed. Meaning that our emergency rooms are filled with people who have heart attacks and strokes and all these things. When the doctors get to see them, they realize that this person has been walking around with untreated cardiovascular disease for decade to decades. And had they been given the appropriate treatment, they wouldn't have ended up like that. This is actually so we've been working with a great cardiologist for the last couple of years, working the system. From his frustration of seeing every day in his hospital, people come in with things that could have been prevented, but that wasn't. And he's just been on this mission like we have to change this. Like these people, if we could just basically apply the guidelines around cardiovascular disease, we could save so many and improve so many lives. So anyway, so we have the system where we do the full sort of ECG, which is, you know, traditional ECG where we look at the electrical activity of the heart. We record your heart sound to multiple places. And again, we record it. We don't store it in the head of a clinician. We have it on file, so that for anything that's changing in the future. And then we have our own system for understanding the heart pumping function and pulse availability. So how the pulse is moving from the heart through your arteries and indications of cardiovascular disease there. We also do the blood pressure in both arms and both legs. And this gets to a little bit of this funny combination because you said it's really, it's a scan, but the combination of things. So you know, we're really combined like pretty like cutting edge cool stuff with like the super basics. So like again, when you read the book, it's like you should always do blood pressure in both arms. Yes. Like most people have never had it done because there's no time. Okay, so we just built a system like hey, if we're going to do blood, let's just do both arm, both legs all in like one minute, and you know, we're done. So that's you say like that's again, like thousand year old medicine that we're just applying in a way to be just do what everyone should be doing, but just building in a way where it's super convenient. So that's the so that's the goal there really to do a very comprehensive mapping of your cardiovascular health. Then we have the green light on your arm thing. Yes, we do. So that's a microcirculatory assessment. Say, you know, you have, you kind of a perfectly functioning heart arteries, these kinds of things, but you so basically healthy macrobascular system. Yes. But have you know, dysregulation in the microvascular system. So the typical example there would be like diabetes, or you can, you know, you get very warm feet because the macrobascular is pumping down blood to your feet because you have nerves and cells that are dying because the microvascular is not working. We have been using for a peripheral arterial disease. It's another like common dysregulation. So it's essentially an apple, waltz, and steroids. So we use light projected in very specific wavelengths in a very specific pattern to distinguish different layers in the skin and how the regulation of the small blood vessels are working there. Many chronic diseases have a stronger relationship to microvascular function than what is really well understood today. So it's also data type that we believe will show to have be even more powerful in the future to predict different kinds of disease progression. Then you mentioned we do a few other things. We do the grip strength. As you know, who you probably know better than I do, you know, one of the best predictors for long-term health. So basically, if you're below average and grip strength when you're 38, which I am, I mean, not just 38, I'm below average. When you're 60 or 70, the probability that you're below average on health in general is high, which is why grip strength is a good indicator. We do eye pressure. So eye pressure, why do we do that? Well, symptoms when you have problems with eye pressure is vision loss. Once you've lost it, it's gone forever. If you catch it early, you can easily fix it. So it's just another one of those health areas where it's like it's so like, of course, we should check before you can start going blind, not after. We combine this with taking a blood draw, as you saw. The thing that we do that's on the blood draw that's unique is we have at each of our locations, we have our own lab, which means that we can process the blood in 10 minutes, which means that once you've done all of this data collection, you get rest, you talk to our doctor, you're not waiting for anything, you're not waiting for blood results, you don't get an email three weeks after saying like, hey, the bloods were fine. So we want all of your results to be ready when you sit down with our doctor so that when you leave Neco, you should have all your questions answered. It was an incredible process and I think, I know some of the criticisms which we are going to go into to get your thoughts on them. What I will say is that very shortly after having that, that my Neco scan, I went to hospital, I've got a salivary glancedone, incredibly benign, just one of those things that they just need to look at every now and again and again, it's fine. It's a hospital even that I've worked in and when I went, there was no car parking spaces, I then had to go to three different car parks. When I got into the hospital, I actually couldn't find out patients properly. In fact, I went to the wrong desk, I then I then couldn't find the room, I then had the appointment which was fine and then I got lost on the way out as well and nothing about my experience, I think it was because it was so close to having the Neco scan and of course, when you're dealing with what people think are relatively fitting well people, you don't have to design a whole hospital, a whole secondary care unit around them, you can build purpose built for the human experience, the patient experience. It just felt so wildly removed, that like you said when you were thinking about how to design Neco health, about what if none of this existed, how would we start, what would we do if we started again. I'm noticing even that conversation turning up as people talk about building hospitals in the Middle East, this idea of leapfrogging, like leapfrogging entirely, whatever system we've got going now and just thinking how do we literally just build this entire thing? And in part it's disheartening because I am a clinician on from that system and I know and I can feel that we are removed from the expectations of a consumer, someone that was actually putting their hand in their pocket and paying would this be good enough or probably not, it is a public health care system though and we have to give concessions for that and so it is very it is very confronting a lot of this but it shows the gap I think, or it showed for me anyway the gap directly between the two and this idea that by building a health care system, a preventative health care system from the ground up, with the resources that you have, the level of things that we can learn about how best that is done, which brings me I guess in part to what have you learned because you guys have been doing this for a while, you mentioned some anecdotes of people that have been through this and thank you for sharing about your daughter by the way, how should I ask you this? When you designed Neck-O-Health and you're asking your brother those questions and you've applied an engineer's first principle thinking to well you've actually just described observing and you've described some of your internal algorithms of how you observe skin colour, how you observe what's around the bed, how you do, you know, all these things that we are taught in medicine and turning those into data types. I think we are, you are very much in the business of doing that right now, do you think that's a trend that will keep going? And the reason I ask the question is because I think as it particularly I used to work in intensive care and I did a lot in A&E and things like that, you would have an intuition and I can remember there was someone that everybody wanted to discharge and for whatever reason. power is the distance from definite ignorance to if it's a perfect ecosystem perund advance L develop rgan sefy naut nol i 'Da' Aren狵ayeon? 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I'm going back to, like, Hippocrates, it's like the book of prognostics, it's like what, you know, we always talk about kind of, these are all the findings we have in our scans, we have the life-saving, but we always say that, like, the most important group for us is to help the group, because that's the group where we can still make a difference. So the people who are not yet sick chronic disease have these problems, that's how we turn public health around, and how do we do that? It's by having the data, then showing them the prognosis of where their health is going, then we don't preach. If they, if you say, Hey, I don't care that I have a bunch of risk factors, great, that's your life. You're free to make your own choices, but now you're informed. And this is also why, like, you know, with the neck-go- way of doing things, you spend more time having a conversation with a doctor, then you do in a scan room collecting data. Why? Because the most important part is not having the data, it's communicating well with somebody what they need to understand. Just to interrupt you, sorry. Yes. I didn't actually think this at the time, but I remember telling my wife afterwards about the scan, and I. [laughs] It was a conversation. It was actually just a chat. And actually, I don't want this to, you know, sound like I'm trying to advertise for you guys, because we will come onto some critiques. But I genuinely. I didn't feel judged, I just felt listened to. And actually, it became like, give me the context on this. You know, what's your diet like? What do you actually do? Do you think this is a problem for you? Do you want it to come down? Like, that was the conversation. And by the way, like, I'm not saying that doesn't happen everywhere else, particularly in a public health system like the NHS, you know, time with the GP, conceding to your care, etc. That's definitely what we want to be aiming for. I did notice that. Yeah. And I don't know if that's necospacific, but I know that that might be clinician-specific to those people that you've hired. And I definitely appreciate it, though. And look, a typical GP, you need to see a 30, 40, up to 50 people a day. Yeah. When you work at necospac, you see maybe nine people a day. Yeah. So the amount of time and depth you can go into is just very different. Yeah. And then you combine that with you don't just have the time, you also have the information. So, like, you have the person in the room, you have the bloods and the ECGs and the, you know, whatever you want of the foundations of talking about your health, it's all there. So, we're setting, I think, both the member and the doctor up to really have a meaningful conversation. And, you know, the sort of one-to-one of communication is like, it's not about what you say. It's about what other people hear. Yeah. You know, and I think it's kind of funny. And so, like, why do you go and see a doctor? Well, you go there because you need some answers. And then it's like, how much of time will the doctors visit? Was sort of given to the answer part where you learn what you need to learn. And usually it's a final like 30 seconds. So, it's like, you did all the stuff, the phone is ringing, and then it's like, okay, you need, here's the deal. You need to go to, we think it's this, probably not that. You need to go to the pharmacy. You need to pick up this thing. You need to take it on Wednesday, but not everywhere other Wednesday. And then you take like two pills and like, oh, if you go. And if you're me anyway, you're sitting there like, first I'm like, yeah, I totally got it. And then I'm out of the door and I'm calling my wife and I start to explain to her. And I realized I didn't get it at all. I can't even remember half the thing that was being said to me. And so, like, what is the point of doing all the work if I didn't understand the things I need to understand? So, we wanted to kind of flip this. I mean, there are two big things that we're doing to flip it. One is the time. So, like, let's make sure that every person who leaves Neco has had the time to ask their questions. And they learn what they need to know. And the other is just the environment, you know. So, I grew up in doctor's offices. And usually you just want to do this. There's like papers everywhere. Like the phone is ringing all the time. And you walk in. And you're kind of disturbing. Someone, they're like, okay, I was in the middle of something. Okay, but okay, come in. Who are you? You know, that's kind of the feeling. And again, if you're like me, you have this kind of rehearsed story in your head. Like what you're going to say to not feel like an idiot of wasting their time. Like, okay, would you have to understand this? You know, you get into it. So in our version of the doctor's office, as you know, there's no desk. There's no phone. There's no paper. There's just like, okay, actually the doctor is waiting for you. You're not disturbing anybody. And it's really to flip you. Flip the mindset to like, let's make sure you are empowered to understand your health. And let's be honest, like the problem with public health. You can put in an ad saying don't smoke. Like it doesn't help. Okay. So the person who's in the middle of the office, The problem with public health is we want to have ice cream and the groany and like these are the choices we want to make in the moment. But if we zoom out and say, hey, when you're 60, you want to be able to have a good life in retirement. We also say, yes. So there's attention there. And most people don't think like, I want to spend like 299 pounds to think about not having an agrony or whatever. So making that whole experience pleasant enough that they not only come once, but they say, actually, I'm going to come back and I'm going to make this a habit of checking in on my health. And that to us gives us the chance to make a difference. That bit that you said at the end there's interesting to me because when you said that, so nine people a day, there's obviously going to be attention here, your CEO, you'll have a CFO that's reasonably. Could that be 10? Could that be 11? Could that be 12? Could that be 18? Surely we could get more throughput here. Do you really need that long in the consultation at the end? Surely that becomes a pressure. And when you're running a business for profit, these exist as pressures, as pressures. But holding firm on this is the number we want to see because we want to make sure we have the highest possible quality of product. It's interesting because I guess it's a sliding scale of overall impact, right? If every Neco-Clinic saw twice the amount of people, you could argue it makes twice the amount of impact. But I guess the question is, or would it? Because is adherence, is the time spent at the end focused on adherence, actually, the most important time. And so how did you arrive at that? How did you arrive at your model? Do you go P&L first and figure that out? Do you have a margin that you're aiming for there? Like, Neco is the business. Talk to me about Neco is the business. For us to be here to care for your health for the long term, the company has to be here for the long term. Absolutely. And if we're losing money on everything that we're doing, we're not going to be around. Because who would want to finance an operation that's just losing money? So on the one hand, we need to figure out a way to do this sort of preventive and proactive health service, where it's financially sustainable. But on the other hand, we need to make sure that the quality is there, so that we're doing something we're proud of and it's positive. And the very honest answer is the time that we had was what we could afford. So we can afford about 20 minutes for the doctor, so that's what we have. Anything more than that, it becomes quite challenging because now basically you're using up two slots. And then the price, it doesn't need to go from like 2.99 to like 3.49. It needs to go from like 2.99 to like 500 or something. So this is like, okay, here is something where it's financially sustainable within the experiences there. So like the vast majority of people will have a great experience. Yeah. Some people have, could spend hours in there. So they will be a little bit disappointed. But I would say for most people, it's who, where the alternative is getting 5 minutes, you know, in some other context or with a telemedicine thing, whatever, that like this feels still very sort of unnoticed. And proving the model at that point, at that price point at that time with clinicians, at that level of impact of what patients go on to improve, proving that model. I'm interested in the future of that and whether there's an integration with a public health care system that you can do when you, when you, what you're essentially doing is proving ROI. Because for every pound spent on prevention, it delivers more in lack of morbidity and all the rest of it and the amount of tax they pay and all the rest of it. So at kind of a national level, you can scale up the data that you've got to go, well, this is now purchasable as a service by an entire national public health system. Is that something that you guys think about? We didn't start this company because we thought the world just has two few like lecture clinics or something like this. You know, that is like the big burning need we have in the world. Like the big burning need we have in the world, as I said, it's like 80% of what we're doing in our health care system is associated with chronic disease. Yeah. And still we're running a basically reactive sick care system than something more prevented. So that's 100% where we want to go. Now, the incentives, as I said, are not there yet. And so this is one of the reasons why we put on our website all of our outcomes, like because people have concerns, maybe we'll get into it false positives this false positive that so all of the data is on the website and people can draw their own conclusions. But the factor kind of the facts. Now, we think we want to live in a future where, you know, access to preventive health care is not dependent on what kind of work you have or how much money you have. The only reason we are 299 is that we are in the unsubsidized part of the health care system. I don't know if this is true, but someone made a post kind of comparing us to what they were doing in their GP practice and they said that they get about 160 pounds per visit in their GP practice. And I thought that was interesting because that means we're about a 2x higher. And then when you look at kind of what we can do in one of our visits compared to like just a visit of chatting with someone for a few minutes, it's a big difference. And then I think we're like miles off to begin with. And then I think, you know, we we'll share what a year ago. So I think we're still pretty early in our journey. What I think is wonderful with technology is if you think about like something like a smartphone, you know, in the 1980s, like the Wall Street guys to have these big like what's the movie called. And then you know, they're all running around with these big phones and everyone is kind of those kind of a silly thing. But then you fast forward like 20, 30 years later and basically every single person on the planet, even the poorest part of Africa, they have now a phone in their pocket. And what's even more interesting, I think, like if you are, you know, Barack Obama, you don't have a better phone than I do. And then you actually have a worse phone because you probably have security concerns. So the difference and actually like if you like live in Ethiopia, my phone probably isn't that much better than your phone. You probably have a cheaper Android phone. I probably have like a better camera, but it's not like you can watch YouTube. You can do pretty much the same stuff. So when you apply technology to a problem and you're able to reinvest over a significant period of time, suddenly it's not crazy to imagine a world where actually a lot of the underlying tech around prevention and primary care could be quite similar in, you know, Ethiopia, Washington, DZ, and London, because it's driven like ultimately it's driven by the capabilities of the tech. And then, you know, rich people always find things, ways to spend their money. So you know, they buy phones with like in gold and they put diamonds on it and stuff like this. So I'm sure even in that future, there's going to be like some super fancy services, but what's going to be different is not the tech or the information. It's going to be the like surface level stuff. So you're more human than do you honestly believe in this future of abundance where we all would have access to a similar excellent level of preventative health where everyone would have what NECO could do now, for example. I mean, my question to you would be like, can you tell me constraints that makes it impossible? I don't know. Again, like it's not obvious to me that it's impossible. Now is it certain? No. So well, I mean, this is why like we and many other folks like us will have to do a lot of hard work. Yeah, coming decades to usher in. Yeah, you know, something new. Yeah, but again, you I haven't seen anything that would lead me to believe that like you couldn't do it. Well, I would say it depends who pays and how much ultimately because we've talked about this gap between the rich will always experiment. They always have the resource to experiment. And now you know, your class, concierge medicine, people spending 100 grand a year on private GP and every referral going and all the rest of it, you know, you put that in that category now and longevity drugs and all the stuff that whatever weird and wonderful stuff they are doing. And then you have sort of public screening programs and NECA almost sitting above that as certainly not near that concierge stuff, but it's certainly an out of pocket for people that can afford it. And so I guess one of the critiques obviously is that is this widening health inequality? Do we then have a two tier system where there's people that can afford 2, 9, 9 a year that can do this? And there's the people who can't and are we widening equality that way? If that is the case at the moment, then what is being done to make that not the case and accessibility for everybody? Yeah, so as I said, like our vision is very clear that we want to create something that eventually, I mean, if we just go back to the basics, it's like, I think my belief is that a country like the UK would be way better off if everybody had the ability to get a free scan like NECA every year. And that's just on like health economics. If you just look at the cost benefit, I believe that already to be the case. But obviously there's a journey that we have to make to convince the rest of the world that this is the case. And it's a journey that we have to do on one side with facts, with showing our data, which we're doing. But on the other side with a consumer of taking them along for the journey and one of the things that I learned. like working climate change for 10 years, it's like a lot of these things, we think it's up to politicians to do things, and we think it's up to big corporations to do things. But actually, what ends up driving a lot of the big changes in the world is the consumer, and kind of the heart of minds of the consumer, the consumers, we're always voting for what kind of future do we want. We vote with our wallet, we vote with our time. So a big part of what we're trying to do with necklace, like to inspire people to say, hey, like the future could be very different. You could have a healthcare future where you looked forward to going there, the experience was like brutally efficient with your time, you know, all the results were done when you were there, and of course it's preventive in nature. Like that future is possible, how do I know that? Because it already exists. Now it doesn't exist everywhere for everybody. So then the question is, okay, we know it can exist. So what is the journey from existing in a few places to existing in many places? And as you say, that's one part of that is a tech question because for the last two years, we've been working like absolute maniacs just to build more centers because we have a wait list that's growing and growing and growing with consumers voting saying, hey, I'm into this. Like, and a lot of them, like they don't quite know what it is, but whatever it is, this is something, you know, like it's resonating with something that I've been looking for. And then the other part, as you say, it's a reimbursement question of like, how long will it take to convince parts of the systems to say like actually we would save a lot of money if we offered, and I think we'll start with certain groups, like men who check box X, Y, and Z on risk or whatever, let's start with them. And if Neko can help them, have a better trajectory. I think very interestingly, a couple of months ago, now we posted our first date on what happens between Scan 1 and Scan 2. - Yes, so. - So our first two data stories, where would you can see easily in the first year, which is what did we find? So we said, okay, we have all these like life-saving interventions that we found, et cetera, et cetera. But then the other question is, okay, does there seem to be any point of doing this scan if we didn't find anything? And I wouldn't say we have conclusive evidence to show that this is exactly like the percentage that we did and somebody else did, but what we can say is as a group, our cohort got healthier between Scan 1 and Scan 2. And the group actually had benefited the most where those with pre-existing chronic conditions, those who already had diabetes or cardiovascular disease or metabolic syndromes, they had a three to five times bigger improvement, something like this, than the average member. What's really interesting about that is, and again, I can't prove the exact correlation, but what I think is happening is you have people walking around with a chronic disease, and for the first time in a long time, someone has sat down with them for 20 minutes and really talked them through what this means for them and what they can do about it. And that has really inspired them to make it bigger change them for the average person. So we think that's pointing to the fact that this kind of thing, it helps chronic, it helps help the people and it definitely helps people with undiagnosed conditions that we find. - I suppose to these people as well, is it that someone is actually party to a mixture of data that's not come at the same clinician at one time before because of all the different tests that you're doing? It's a new collection of data, isn't it? And therefore that clinician, that they won't have had that conversation in that way, and I'll simply because they won't have had the same amount of data points. So it's potentially that as well. - Yeah. - Anxiety in the worried world. I saw the reports. Four out of five people didn't actually need any intervention which is great. That's also a lot of healthy people wanting to get scanned out of their own interest and that side of things. What do you say to criticism that you're creating anxiety in the worried world? - Well, first of all, I would say, if you look at our marketing, we almost only talk about health and not disease. So the typical like, hey, we want a lot of worried well, it's like, you probably have a cancer, come get a test. You will basically never see us do this kind of marketing because Neko is all about health. It's not about disease. To me, the concept of the worry well doesn't really exist, but we can get into that. But I would say in general, like, the reason we have, like an avalanche of consumers wanting to come to Neko is that we've created a completely new way of experience healthcare. It's not because finally you can find a time with a doctor. So if you're very worried, you can always go to Harley Street or wherever. Like, there's no shorted of options for someone with flights, health anxiety to be somewhere and talk to somebody. So I'd say the reason we have had this enormous interest is not because there's so many of them, it's because we have this new experience. We estimate that about 70% of our members have never done any kind of health check before. So it's folks who are not traditionally thinking about this, but they're drawn into what they're seeing and building a new interest in their long-term health. Now the reason I would slightly disagree with this idea of the worried well is I think like if someone wants to put time and energy towards their long-term health, isn't that great? Isn't that what public health should be about? I think that the idea of the worried well-being kind of a blemish on society is a little bit strange. Like if you were worried about your finances and you're saying, oh, I want to act responsibly for future generations of my family. I don't think anyone would say, hey, that's-- - I see a point, yeah, I see a point. So I see a point, I see a point. - Interestingly, it just comes to my mind. What do you think about full body MRIs in that case? 'Cause obviously when you add a blank piece of paper with Daniel, anything was on the table, right? Why this rather than that? - Well, look, I think every imaging modality has great uses. So like, I mean, it's amazing what these technologies can do. So X-ray has a great use, MRI has a great use. The reality is if you look at like what are people dying from? It's like cardiovascular disease, diabetes, metabolic syndromes. Like, can you see that in MRI, the answer is no. - Interesting. - Like, what you can see in the MRI is some cancers. And cancers is up there. Now, if you look what kind of cancers are up there, it's like breast cancer, prostate cancer, skin cancer. So also not all of them are like skin cancer, for example, you can't do in the MRI. So I would just say for us, that's a little bit of like a niche use case and it's also very expensive. So we don't have, you know, we don't have a beef with a full body MRI. I think if you want to do that, you can go and do it. But if you want to look at like what really is driving, again, 80% of the problems in the healthcare system, those are no things that you've seen in MRI. It's not an image that you kind of study like that. And I would also say that the MRI, when you can see something wrong, big thing in your heart, that's wrong, that by definition is pretty late stage. So like, when your heart has a bunch of like plaque and builds up, that is going with years or decades, with cardiovascular risks, I'm mitigated most of the time. So I would also say that for us, the MRI is like a later stage tool, once you have a lot of problems. Interesting. And we also just haven't found a way where we could say that like, hey, everybody in Britain, let's give them an MRI scan next year. Yeah. I just didn't know how that could ever be. You could afford that or even practically do it. So it's a very, very powerful imaging technology, but it's not obvious that it's suitable for like broad prevention or that it could ever be affordable at a larger scale. Makes a lot of sense. I'm not going to get away with not asking you about AI. You're an engineer. You obviously understand it. And AI is probably not the best tool to use, not the best term to use for you, because it means a lot of different things, a lot of different people. It's a casual term. And LLMs obviously have clouded that massively, because everyone now just uses it to mean LLMs. But for you and your business, so for Neco Health, where's AI genuinely being used right now? And what's in the roadmap? So first of all, there is no clear definition of what's AI, what's not AI. So what we focus on at Neco is like, hey, we want to build the best possible tools for our doctors to get the right information, to draw the right conclusions and then be able to talk about it with our member. And in doing that, we do a lot of data processing, we do a lot of data analysis and all these things. Like, if you wanted to do marketing, you could call some of those things AI. Is it AI or signal processing? Like, it doesn't really matter. And if you go to our website, I don't even think we mentioned AI. So I would say in the near term, like, what we care about is like, are we building great tools for our doctors to draw the right conclusion? But when you zoom out a bit, then it's pretty obvious, like the healthcare system in 10 or 20 years will be heavily, heavily supported by huge data sets, computation that helps you draw the right conclusions from these data sets. And without the doubt, Neco will be one of the companies at the very, very kind of cutting edge of doing that, because we do this broad data collection. So it's a huge part of our mission to say, hey, how do we make sure that we draw the right conclusions from that? And again, it will, like, if you look at what humans are good at, like, looking at 10,000 rows in Excel and drawing the right conclusion, is not one of the things we're good at. So humans should probably not be too much in the business of looking at huge, big complex data sets across referencing that with, like, you know, tens of thousands of publications. They are pretty good at, like, doing the judgment call. And, yeah, I mean, again, like, when my daughter got her diagnoses, like, I didn't need an LLM. Like, I needed to sit down with a doctor who has sat down with family like ours many times and I needed to ask this doctor like what is it? is mean for our family. - Yeah. - Like what is our life gonna be like? And that's not a conversation that I wanna have with NLLM, okay? So I do think there are like scientific conclusions that probably over time will be able to support better and better with big data sets at AI. And then there is, I think I cannot imagine a healthcare future, actually, let me put it differently. I think a healthcare future, where it's like, "Hey, you just get an email with a PDF with all the results "and you don't talk to anybody, nobody cares for you." To me, that's a bit of a dystopic vision of the future. - Yes. - So to me, I can't really imagine a healthcare system that doesn't have compassion, that doesn't have care, that doesn't have interpersonal connection. But I also think that if we're gonna do things way better, like we need to use technology to do a lot of the heavy lifting. - Thank you for saying that. I, that is a really big exhale moment for me hearing you say that, because I think you're going to be one of the most important people, arguably in the world that gets listened to on things like this, because you're actually building it, and you're building it at a real scale. And you have the ability to define what will be looked at as an held up as the optimal patient experience. Like that's in your power. And that's a very privileged position to be in, incredibly privileged position to be in. And I think the care that is required to navigate what AI does and what humans do, what AI is incredibly perfect for and good at versus what humans are perfect for and good at. And the gray area in between of how we split those roles. There is no global or even national strategy on that from any healthcare system that I have found or seen. Nobody is understanding all of the different interactions, all of the different points at which information is exchanged. We've not listed those out ever and said, which is human, which is AI, which is a mix and what percentages that mix, what ratio is that mix and what exactly. Let's shrink the task, let's break that into 10 things and tell me exactly what humans AI do. We've never done that. And so I think the, ultimately, that the power that you have to really lead thought globally on that as to what works is so, so, so important. So I very much appreciate the way that you've communicated that because if we lose human to human information exchange or touch or soft communication to efficiency, if we lose that, I think we're in real trouble because it's a very slippery slope that when you think that 20 minutes at the end of the consultation and you being potentially under pressure to drop that for efficiency in different things and this could be done by AI and that could be done by AI. I actually, you know, you're your personal experience with your daughter and your family being clinicians and all that stuff replays into this. It make, I'm glad that you think about it in the way that you do and I would encourage you to never lose that and so please keep hold of that, of always thinking like, okay, where are we, best of humans? Ultimately, what do we actually want of healthcare? What is healthcare? What is the vision of perfect healthcare? Because yes, it is perfect diagnosis and treatment but it's also patient experience. That's part, that should be part of the definition and in that case, should we ever have an AI in front of us at the point of suffering alone, you know? It's interesting, it's interesting. It gets very philosophical. It does, it does. What is the doctor? Like what is the doctor? No, no, I completely agree. I completely agree and it's very relevant. To you actually and you sound well read in that, in that you've read down to her pot critis and forwards. So it feels like you've taken care with that, right? Like you seem to notice your power in this. The philosophical nature of thinking about what is medicine, what is it for and what's the role like between the doctor and patient and these things. Now I think we have a little bit warped. If you look at kind of popular culture and like, but they imagine as kind of heroic doctor, I think today mainly have two flavors. You have sort of the pit, I don't know if you know the show, it's like an emerging server room show. Where it's like every episode I think follows like one day or one shift I should say. Like people are coming in and this chaos and someone is dying and you know, the heroic doctor so like saving lives and it's like a war zone and they're almost like war heroes. And so like that's one image of like the heroic doctor. Then I don't see you have the other, which is more like the doctor house, which is like you're on a kind of a murder mystery. And it's a complete opposite. You have a team of like eight people trained like, is it lupus and like it's all this stuff. And they're all what they have in common is they're doing all these like inject them with this or doing all these like crazy interventions. I mean, these are both great doctors obviously. Like my dad was like the emerging server room style doctor very much show very like. Yes. You know, if your head is still like on your shoulders, you're doing fine. You know, so that's a great guy. But when you look at like what's actually driving, suffering into like in our health care, so like it's as I said, it's like cardiovascular disease, diabetes and like what are these heroic doctor roles that we imagine do to help with that? And the you know, the answer is basically nothing. And then you say, okay, what are the risks that lead to that? Well, it's like high blood pressure, it's high lipids, it's high body mass, it's alcohol, it's tobacco. And then it's like, what are those kind of heroic doctor types doing to solve for that? Well, basically nothing. So I do think we have this like big void in kind of our, like our general idea about what heroic doctors do around actually driving like long term health. And that is seen as kind of like boring or whatever. And we're trying to make it fun. And I think like this whole thing we're talking about with a role of the doctor with the AI, I think we'll bring back a lot more thinking about, you know, out of the like the emerging server room into the more day today, where we're going to be able to support each and every individual way better. But I think still anytime when you really need it, there's a person there, so I'm going to care for you. And that person going to be able to do the like 10 times better job when they're equipped not like the experience you had in the hospital. But again, like my parents have worked like that my entire life. They're working super hard. Everyone in that hospital is trying, but everyone in the hospital ends up going, you know, cross some, you know, all this stuff, getting lost and what not. So I think this, like to me, this future of abundance, there are ICI don't think the tensions are that big, but not everybody sees it yet. And nobody, not everybody thinks that, you know, the future can be much better than the present. In particular when it comes to healthcare, like I think there's a lot of sort of doom and gloom and every year it gets worse and every year the costs are spiraling out of control. And you know, in the US they had to shut down the whole country because it couldn't figure out how to pay for healthcare. So I get it, like the trends are not looking fun, but I think, you know, again, it's within our powers to steer away from that and steer into a different kind of future. But I definitely agree with you, like doing that in a very thoughtful way is very important. And, you know, maybe not everybody working in AI right now, I just say, you know, just ask health questions for a thing that has never been validated for health questions. You know, that's pretty, yeah, maybe not the most responsible. It's gonna be fascinating. I think you guys are at such an amazing point of this. It's an incredible point in time to be doing what you're doing. Building a business model in prevention is hard. You've managed to do it. You've had to build vertically an incredible amount of stuff yourselves. So yeah, it is difficult. It's, it's capital intensive, but you've, but you've managed to do it. It's incredible what you've achieved so far. I'm so interested in seeing how this plays out in the long term. I'm interested in seeing how this longitudinal data feeds into value. I'm interested in seeing how any future ROI of this entire system is determined to the point at which we can see that world of abundance, where we can start to see this reach the masses, so to speak. There's so much to be excited about in prevention. And this really is a movement. It's more than just you guys doing it, as you've said. There's a lot of people that want this to happen and believe it can. It's just that so many of us are, I guess, struggling to see the way that plot the path, as you've said, between now and then. My final question is, if you have any takeaways for the health tech community from what you've already been able to achieve, there'll be a lot of founders thinking about business models in prevention or ideas or how to turn their ideas into reality. You've done all of this and more to the point of revenue generation and clinics worldwide. What advice do you have for other people building in the prevention space? I think what most often goes wrong is that you start with an idea of kind of like, what can you get paid for? So let's say, hey, we can help some group improve a little bit on some disease. And that's, there's a payment code or something for that. And then they work backwards and then you spend years saying, oh, now we have an FDA approval or where MDR approved them. We're allowed to do it. rather than saying like what would be an amazing product? Like what would be an experience where people go like holy cow? I can't believe you can do diabetes prevention that way or whatever. Because at the end of the day, like you can have all the regulatory approvals in the world, you can have all the stats in the world, you can have even have the reimbursement. If the product isn't worth talking about, and I don't mean it's bad, I just mean literally, if it's not so good that people say you have to see this, like I'm sorry, but it's probably not going to go anywhere. And it's very easy in a highly regulated environment to focus like on making the regulatory stuff great, rather than making the product great. And the reality is like you can be a hundred percent, three thousand percent compliant and not be commercially successful. So at the end of the day, but it's the same as for any business. Like if you want to succeed as a startup, your product has to be like really exceptional and very, very different from what it says because the inertia, otherwise, it's just that people are not going to care. That will be in my only advice. It's not much of an advice because it's like, build a great product. But when it's solved the problem and then bring joy, isn't it? It's doing both, ultimately. Yeah, Mark's been absolutely pleasure. Thank you so much for joining me for people that want to learn more about Neckah Health. They want to book in for a scan. Where do they go? Yes, if you want to try the scan, just go to our website. If you want to work with us and experience the product, you should definitely check that out as well. We're hiring across not just London, but other places in the UK as well. So I would say anyone is interested in seeing kind of our take on prevention. I would highly encourage you to get in touch. It's been a pleasure. Thank you. Thank you so much. 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