Episode 21: Floe Health: Sriram Muralidharan & Anirudh Perubotla

(upbeat music) - Hi, good morning everybody, and happy new year. This is the 21st edition of the Health System Fixed Podcast. The first one we are recording in 2026. I am Dr. Gaurav Mishra, I'm a child adolescent and a well psychiatrist and a health systems design expert. I also want to ask you to please like, subscribe, and share the podcast. Today we're really excited to welcome two guests. This is our first two guest podcasts. Shiram Mordley-Daran is a co-founder and CEO of Flow Health. Shiram is a builder and has been in the room building real systems. TARDIS career Tesla. He helped build the first model X. Later at Kamiyar, he led enterprise AI initiatives, working at the intersection of the product, AI and healthcare economics. At Flow Health, Shiram brings the same systems for some mentality, helping building infrastructure that can hold up at scale. Anirud Pero-Botla is a co-founder and CTO. Anirud is a product leader. Anirud is also a Forbes under 30 on Rhee and was a founding project manager at levels FYI. At Kamiyar, Anirud led the Ambient AI Strike Team. At Flow Health, Anirud focuses on turning complex healthcare workflows into systems that work in the real world. And their company, that they co-founder Flow Health, is an enterprise AI platform that delivers predictive intelligence, closing the loop on every refueling healthcare. So welcome, guys. I'm really interested in the refuel problem. It's a giant gap in our health system. And I've seen firsthand how the refuel's often just go out into the ether and takes forever for it to come back if it even comes back in every case. So maybe ask each of you, tell me a little bit about your inspiration to go down the path of developing this organization and product. Yeah, I mean, I can kick it off. And then we can talk about kind of the personal story and kind of the origin. But really, I think the biggest thing when you look from the data behind referrals and how much it powers healthcare today, or nearly a third of all visits, nearly 100 million patients in the US are referral driven visits of a world-driven healthcare. And 50% of those are falling through the cracks. For multiple reasons. Like you said, they go out into an ether. Maybe a patient doesn't know, a specialist doesn't know what's going on. And so to us, right away, the magnitude of a problem in an evolving system like healthcare just made a lot of sense to go after. That coupled with kind of a personal story that I'll let Sri Ram talk about kind of really made this the core focus for us. - Yeah, sure. I mean, thanks for having us here at your car. We really appreciate you and happy new year to everybody who's listening. Before starting with the personal journey, I mean, I work in healthcare, healthcare AI. I was hit by a drunk person on Ron Secks's way here in South Bay. It was what you call a rainy Sunday evening. And I mean, it goes without saying, we in California struggle when there's a little bit of fog and a rain. The guy was drunk. So we hit us about 55, 60 miles an hour. I mean, we got hit by him and we ended up on the other side of the road. So we had to smash the car open. Everything was like, it was just a sandwich. It took me probably three, four weeks just to get an MRI done. I mean, I had to call chase someone at every point because my referral was stuck in somebody else's fax queue. When I called my PCP, they were like, oh, I sent it and the specialist didn't receive it. They had to send it twice. It took me close to three months just to get the appointments scheduled and handled. And after that took me a year to learn how to walk back again. And so through the journey, I mean, I realized I can just sit and watch the system fail in front of me working in healthcare, healthcare AI. We decided to step out and actually build a company which solves real problems. Yeah, thank you for sharing that. And that's obviously a very tough thing to go through and the recovery and all of that takes such a long time. But that also tells you how in a health system in the first world, for somebody who has a good health insurance, it is still such a major struggle to get care even in such a difficult time. I mean, that's a fair point. I grew up in India. Oh, there, I mean, everything I can get done. For example, my MRI can just get it on like 24 hours. So again, there's something to learn for us when we work in AI from everybody. And one thing of futuristic system, like a Singapore or other countries which are coming up in this 21st century, they're starting with AI first. So what we can do is we can also do AI first here, the respect of healthcare. We can kill the facts, replace the facts, go on with like how we can digitize data first and keep it encrypted safe and everything. The facts needed to be killed long back, you know, it's frustrating that we still have situations even now that we are at places we use facts. It's a sky of the technology that when the world shuts down, then you, I guess, even then you cannot use facts. So it's not even useful in that scenario. I mean, true that because it started with this concept of if ain't broken, don't fix it. And when we started adopting facts in the '70s, probably the '80s, correct me if I'm wrong with a decade, when we started adopting that, if the focus was on encryption and data safety, I mean, that's why you couldn't open anybody's USPS mail or you couldn't open encryption. But is facts truly encrypted? It's facts truly safe. What happens if the paper gets lost is your referral document shredded, probably not. There's so many hidden layers to it. So because it's working reasonably well for them, they're starting to realize. I mean, the first way of AI companies help there. - Yeah, I think we can keep talking about facts and it's problems. But as you start approaching this, one of the biggest problems is the loop of a referral being placed, the patient getting seen, and that loop being closed with the PCP or the referring provider. How's flow of health approaching that differently than it's been done before? - Yeah, I mean, our hope promise is, how do we turn every sort of referral work flow into a closed loop system? And what are the components that go into that? What are all the different touch points from? You're being a triangle of healthcare, right? Your payers, providers, and all these people, patients itself. And so the way we approach it is, you always started the source of where referral comes from, right? Think about there's a visit between a PCP and a patient. The visit happens from there. It's a referral order, almost kitchen. If you start there as kind of the top of your circle, and then you go through all the different touch points that a patient goes through, whether it's scheduling automations or just figuring out if it's the right in network, what's the service, how do I get there? All these different points of it. You'll start to create that circle that comes back to the PCP to make sure they're run. So the way we look at it, flow health is, how do we take that from proactive occlusion? I know referrals about to get sent out. Can I determine who it's going to get set out to? Can I get there before a fact machine would? Can I get all the necessary details I need beforehand? Can I make sure the patient knows what to expect before they even call in or someone calls the patient? All these different things, can we be proactive, and be predictive about it? And obviously that includes a multitude of different NIA use cases and actual models that we have, all the way to just basic workflow integrations and what you expect from just a healthcare EMR. So that's a high level how we look at it and then you kind of map the circle and it goes over and over. - I think key point also is the setting expectation both for the patient, but also the frontline team who's sending the referral. So right now when you do that, you could have a referral that just goes out and nobody knows when that will actually end up connecting and impacting the patient. That setting expectation is a big gap that I see. If this new tool is actually gonna make people happy about using those. - Yeah, no, absolutely. You got point and that comes back to the thing about clinical adoption at scale. How do we make sure that what we're implementing on a PCP side actually helps the specialist side, what we're doing on the specialist side helps PCP and throughout those whole thing, the patient's gotta be happy, they've gotta be satisfied. We gotta just make sure we deliver outcomes from a clinical standpoint in terms of just patient outcomes, but as well as just from a behavioral psychological standpoint of just satisfaction with care. And so when we talk to a lot of our kind of early customers and a lot of these kind of large scale organizations we work with, one of the main things we do to begin with is we actually go out to the opposite side or the other end of the circle almost. And so for working with some really large specialist organizations or a large health system, we'll actually go out to all the people to get their in-bounds from, their in-bound referrals, where all the specialists they send their referrals out to. And we go sit with them as well. And we say, hey, what are your problems on your end? We're to basically piece it all together and instruct connecting it. And that's one of the things that's worked extremely well for us because we know exactly what the other side expects while we're delivering a product to one end of it. And so that's been helping us drive adoption, but it's also been helping kind of help understand how the toll referral workflow can be rethought and rebuilt from the ground up. - Sorry, Sharon, do you wanna add anything to that? - Probably not, I mean, he's on point. I mean, he's the spot disguised between us. - Also, what are you describing on a road is that you have three customers. You have the PCP and their team, where the patient, but also the receiving referral team. So you really have to satisfy each of those. And again, sometimes unfortunately, I've seen healthcare and implementation being thought about so simplistic, oh, we'll just fix this one. But then that ends up just being abandoned because you think about a flow downstream all of that for it to work well. Let me describe a real work problem that I had working in some place. So the PCP standard referrals from a mammogram to a different health system without San Diego. The other health system, a mammogram department, the people who will actually do it, don't recognize this PCP's name because that person is not in that system. The second system has to have one of their physicians reorder this. So you already see the clunkiness in the steps. They reorder this, it goes to a mammogram. Let's say mammogram gets done. Sometimes the weight is six months in the US, by the way, to get a mammogram done. Report is generated. Who does it go to? It goes to the reordering physician in this second system. And by that point, nobody has a clue who is the original person who ordered it, who needs to see it. So does Florel think about this kind of a clunky system? - I mean, this is a common place with a lot of inbound radiologists and specialty organization efforts. So what really happens is the information is not transmitted properly and could be for various different reasons. I mean, it could be that they have different EMRs, different ways of handling a fax. Or I mean, for what is worth it, that a referral could be even a USPS post. We don't know there. But what we do know that, I mean, with Florel health, we trace the workflow daily and we normalize the workflow before we handle anything. So we are behind every referral, which the specialist handles on their inbox. So what that means is we know what the doctor name is. And quite often it has to relate to their medical number or could be so many things which insurance. They're coming from, so once your specialists have that information which they need, they probably don't have to create an inbox. They could most likely go ask for more information. So that's how we do it at Florel. And we provide the transparency and the tools to, the specialist as well as the PCP to send the right referral the right way. And for the specialist to handle the right referral, the right way. So that makes it fairly simplistic and fairly straightforward. And it goes back to what you said. Don't try to recreate a new workflow. Understand the workflow and solve the problems with the workflow which is existing. Do you find that when you're implementing the technology maybe the same the way you have implemented in every system is different? Is that what you're finding when you're implementing this solution or it's very similar across the world? Yeah, I mean, there's definitely differences. I'll say a lot of health to everyone. It's a little bit differently. There's a lot of commonalities that we're able to tap into. But for the differences, what we've done is how do we standardize referrals? What does it look like if I was the facts machine today? Flowout was the fact that what does that mean? And so that's how we kind of approach it. So there's a few differences with even basically the form they fill out for referrals a little different for every site or every sort of provider who they go out to is a little bit different. When they send referrals is different, how they handle prior odds is a little different. And so we look at this from our experience in Chinatown Care is how do we build the scale, right? And so when we see these differences, we try to match patterns across them. And so a lot of flow health and what's been really working for us these past few months, especially, is the fact that we've built a lot of the infrastructure across the board for these referrals. So even if someone comes in and says, hey, I do things a little different. It's very easy for us to almost pop that in as a module or pop that in as part of the platform itself. And it's not a major task on RN and obviously it's not a major disruption to the workflow on the provider's ends. And so that's how we've taken a whole approach and that's what's allowed us to kind of scale quickly over these last few months. - One of the things I often see is that the idea is great but the implementation has not been thought about like it needs to be. I was listening to both of you guys interviews yesterday and I think Shridam, you mentioned psychological safety for change and I'm a psychiatrist. And then also you mentioned trust in making sure the flaws are obvious and visible to people. I think by the way, I've never heard a technology, it's the CTO mentioned those words ever. So I was actually very happy to hear that because I think that's really a very thoughtful way of thinking about implementation. I don't know if you want to talk on the way you think about that. - I mean, I think being honest, being transparent, we will flow health saying we're going to bring transparency through the process. So as founders, there's a part of us we're saying, okay, we have to be transparent with what we're doing with our customers. Yes, it's going to work 90% that 10% is a partnership. And when you're honest with your customer, they understand. And when you go into a large health system, you say this, they're more likely to have you to use it. It comes back from our experience. I worked in the airline industry, I worked with Tesla. The first model has a problem for what you call is the Falcon wing doors. It's got pivoted two points. And so which means this, if you put through a car wash, you're going to get a shower inside the car. And how do you sit and fix it? I mean, every VP, every like SVP was there on, I mean, even Elon was there just to fix it. So that's you is learning which you trace back to where you started a year journey in the industry. So being transparent goes along. By the way, what you're saying is very uncommon in healthcare. Being transparent is very uncommon. And this is not by outsiders. Healthcare insiders are not transparent. There's oftentimes executive teams will have these amazing plans and they'll bring in this new technology. And oh, we'll implement this. We'll spend 20 million dollars on this. Nobody stop to the frontline about what their problems are. So the same clunky system is just replicated in a new technology with the same clunky system. So it doesn't really solve the problems of the frontline. So when you have those discussions, how do you make sure they exact you're talking to? Yes, they want the new technology. They want things better. They're actually thinking about it. A little more like in depth, like you were talking about. I mean, there's two parts to it. When you start off in strategic discussions, yes, I can go down to Stanford. I mean, I live a block down from Stanford. I live a block down from El Camino Health. John Mayer is around the corner. Yeah, we can have all these conversations. But 80% of all these organizations still have clinics in rural America. Onnie and I, we went to what you call this place called Hemit in southern and so on. Like the blazing hot sun we draw on a mid-off note, understood what the problems were. I mean, what does implementation look like? This goes back to what Onnie said. I mean, how do you sort of build a system and an infrastructure which can scale from grounds up? And it has to work for 99% of the time. And then the 1% is the accuracy improvement which you keep doing over and I didn't repeat. When we're thinking about our name early on, right? Like what do we want to call ourselves? We want to be this like dot AI company. Do you want to be a health company? What really was amazing about the name flow for us was it's not just the referral workflow itself or just clinical workflows. It's flows across organizations to what is a admin staff workflow with their providers. What is an execs workflow with basic dashboard for analytics. What is that execs workflows with their staff and their providers. So when we say full help, we really mean across the board from personnel to actual operations to then the product and the referral aspect of it. That's our kind of goal, right? We make sure everyone's aligned talk down and we've been used to talking to different people and different audiences and so we kind of know what the tailor here. When a health exec is not getting it, but he's going to pay your company, how do you get him to get him to get it? I've had this problem. So I've tried to solve this problem within healthcare, but how do you as a service provider make sure you have to get them to buy the product, but how do you make sure they're not causing hurdles in your implementation? - I think if you have a good plan, I mean, start with the sports. I played cricket soccer all my career. So when you start with a game, I mean, you start with let's say it's Arsenal Man City. You're not going to go into Man City and beat them and at the art stadium. Arsenal has to have a plan. So you have a plan and you stick to the pieces of the plan, track the plan and make sure you execute on the plan properly. Just don't deviate from it. And it comes down to a little bit of common sense implementation, which just be very thorough and detailed. Somewhere in this approach for speed, a lot of folks lost out on how to execute with your end goal at sites. It's like the tunnel view. I mean, there is light at the end of the tunnel. You just don't have to hit at 100 miles an hour. Just go at 65 miles an hour. You will get to the end of the tunnel. So speed does not make sense without good execution. - Yeah, this is music to my ears because last several years, a lot of my work has been around building behavioral health and addition medicine programs. And even as a physician within the system, if I try to rush to implement a new program to my own team who generally likes me, even there, if I rush it, it is not going to get executed well versus take a very thoughtful up front approach and honest approach. Not a rose colored glass of the approach to make sure the team trusts you. - We consider trusting a leader who knows everything and it's certain about everything is gone, right? I mean, do you guys agree? You have to be more honest and open today for the generation of workers to actually trust what they say. - Very true. I mean, goes back to this. What do you call it with generational workers? It's more about ownership. I mean, I can pay the big bucks. I can hire everybody in the valley. But you have to give them the ownership of the process, the product and the relationships which they're working with. If I'm going to have meetings every other day, every day, which is to micromanage to them, I mean, it's not going to really work. - Any and I are seven, eight years apart. So I'll piss off if I did that. So that's one part of it. And the second part, quite often, we also say this and we also say the claim that, okay, we're going to solve. Only mention that there's like 150 billion being lost. I'm going to get all the money back. If I said that, I'm going to be cancelled very fast. You have to be more thoughtful, like five, 10% increments. As you get into increments, the increment compounds very fast. - Going through med school for me, at that point, thinking what money was like a no-no. You don't talk about money in healthcare, right? Obviously, everybody wants to make money, but you don't talk about money. Because it was a very idealistic thing and it took a while while I was practicing and then starting to build programs understood the flow of money, how to improve. All of it has to happen at the same time. So let me ask you both about differences and implementation of your ideas and products in other industries versus healthcare. What difference did you see? - Yeah, I think let's, I mean, I'll answer part of it. I'll leave the remaining to Any. The first part in healthcare is the regulatory. With the get-go, I'm pitching into enterprise. You already have a bunch of compliance stuff. The respect to your stock to high trust, all that regulatory and data privacy, data security is a very important part. So for example, I mean, if I'm selling an app to a consumer and I sell everything and then worry about it later. So there's what you call, and healthcare is a very structured and a well-read crowd. Everybody in healthcare has at least got a masses, probably a talk trade degree. So you have to be very scientific, very data-driven about how you pitch your idea, how do you implement your idea as well? I need you to want to. - Yeah, I'll add one part to that. I think one of the big things I've noticed is we take something like say a tech compensation platform that we're rolling out to HR departments, versus something like FlowHealth that we go into into a health system with. In healthcare, you almost have to justify your ROI before you can actually justify it with your product. As opposed to other industries, I can go in and implement and then show the ROI. I think that altar's implementation and altar's a lot of openness for implementation as well. Something that some exec today might not believe in, which does justify ROI, is something you have to now wait out and you have to convince them as opposed to, in any other industry, I could roll it out pretty quickly, get people on it, get users, and prove that it works very efficiently. So a lot of those motions start to become very different in healthcare, especially in enterprise healthcare. So when you think about our go-to-market motions, our implementations, our timelines and pilot phases, a lot of it is driven by, yes, making sure every user is happy with their workflow, everything is intact. But also on, am I just finding that they will be ROI? Or can I show a tangible path for ROI for the execs before I actually show them the dollar value they get from this party? And so I think it makes it infinitely harder. I do expect we'll see some changes coming with more and more adoption in AI and kind of more openness to AI solutions, but I think that's one of the main things in healthcare that I've noticed. - Yeah, but well described, because even within healthcare four, healthcare leader, the way I talk about a new project with my execs and then my team is very different. Like for you, you're fixing the referral pathway and how you talk about your PCP who's or a patient is different than how you talk about the executive team and everybody wants the patient to get better. But at the same time, how they measure it may be different, right? So you have to approach it differently. - True, and at your point, I mean, in our conversations, we've seen like with an exec, you just have to say, okay, time to care is proportional to the cost you spend on that. This healthcare is a very cost sensitive industry and over time, because with the rising cost, we have that narrative in place for them so that have those metrics. - It is cost sensitive, but that doesn't stop it from the cost from going up. What I found is there is more reluctance on, if you tell people we'll save you money, they're not that excited about that. If you tell people we'll make you money, they're a lot more excited about that in healthcare. It's just an observation I've seen over time. - I mean, having spent time talking to a bunch of execs and health tech, we got to conquer with you on that. We have that messaging too. Making what is better than saving money. I mean, how do you thoughtfully pitch it? I mean, there's a learning curve every time you do something. - I know that both of you are coming from experience that come here and are personal experiences. And I'm gonna, I'm thinking of this analogy. It may not be a good analogy. So tell me if it's not. I was thinking that let's say, if I, today, as a physician with no IT or coding experience, I'm gonna build my own AI model, right? And I don't have those very basic ground level skills or experiences, right? But I'm thinking of a big level. If I compare that to how you guys come in and then how you guys hire people, how does this person think about this problem and solution at a very concrete level of a patient experience? So you both are obviously driven and you connect it to the work, but how do you, how do you make sure you're team? But they're thinking about it very personally, as a product which is gonna impact lives in a very real way. How do you keep that messaging for your own team, don't you? - I mean, I'll answer this in two parts. I mean, qualitatively, majority of our employees have dealt with reference. Somebody has had a pain. Somebody had to be referred to some specialist and they had dealt with. And it's basically this. If your mom approves your company, you, you probably your company has got to wish it. That's, that's all we see it. Our first pitch was to Arnie's mom and then my mom, then a bunch of our aunts and uncles, you just go into these holiday parties pitch. Hey, this is a great idea. I don't, if you hear anything less than I, I don't understand this idea, you're not gonna build that idea that that is not gonna work. But the second part, answering your question, anybody can build an healthcare. There's no that doctors can only build all season enterprise leaders in healthcare or the only ones who can build. They want people or the only ones who can build. Good example is, I mean, a shiver of a bridge. I mean, this has been a great individual. It's quite for the longest period of time. I mean, probably got one of the best healthcare companies around in the market. So it's about how you think about a problem and how you solve for solve the problem and how do you think about scale. And if you start solving problem only in this room, it probably would not scale to the other room. So think about how to solve the problem in the entire building and then the entire community before you, you probably want to implement it. And this is where we're seeing a lot more thinking at scale is starting to take place and healthcare and business and industry. And I mean, I leave the qualitative partner. - I mean, from a employees standpoint, it goes back to ownership and transparency. You know, we're not keeping conversations. We're not gatekeeping problems that maybe someone had or feedback. Everyone knows from engineers to your CSM, to your designers. They understand, you know, for every customer, what do they like? What do they not like? They old them and kind of what are the learnings from there? And so from a company and team standpoint, everyone understands where we're at in terms of the market, how the marketer looks at us and how our systems look at us, how providers look at us. And so they're very aligned and they feel like they're part of the cause, they're part of the vision. They're part of the mission. They're not just a number or another busy bee just to be kept busy. And so that's one of our big philosophies, right? We really fuel this team with ambition and kind of jack passion into them to our product building. - That's a great point, because I think in healthcare, sometimes people think that we know the answers. And I think it's really important to partner with people who have different skills and different perspectives on technology, even as a clinician, I partnered with our chief financial officer. Let's think about improved financial planning for our services, so that we can predict better. We can, so it's not just, oh, we're making more money, saving more money, yes, but also we are doing more services for the community to get understood. So really thinking about partnering well, and the people who actually can ditch those worlds are probably key. Sometimes you don't have that in a large population, but people who are a little bit understanding about technology in healthcare or are willing to learn, that helps a lot. - I mean, that's a very two point. I mean, it goes back to the company culture what you talk about. Some of my best conversations have always been with my CFOs and the head of finances. Personally, I mean, I was very close to coming here, CFO, you want to understand different perspective. You want to foster that open culture of loving people to have those conversations, and quite often, I mean, engineering gets into this silo, you want to prevent those sort of things. If you go into a product or an engineering silo, you're just stuck in that same infinite loop, just becomes an hamster on a wheel. But if you're open to more conversations, and if you understand, if you thoughtfully process the information, you're already ahead of the game and when you come to solving the problems. - Okay, what future do you envision for healthcare? - Through full health and also in general, like where do you see it going, where do you want it to go? - Yeah, I mean, there's lots of exciting things that I can give this crazy dream vision of what I see. But I think for tangible results, full health, a lot of it is how do we rebuild the referral infrastructure entirely across how the system uses it? Like I mentioned, 100 million patients, a third of all visits. What does that look like in this new digital age? Whether it's connected on all ends, patients are informed, they're transparency, we're closing the loop. That's our kind of whole big mission throughout full health and what we're building towards and kind of every single provider that steps on every exact that signs off on us, that's kind of one step closer there. So I think through that process, what I'd love to see is more timely care delivery. Just reduce time to care for patients. I think patients being more informed and just obviously delivering better outcomes across the board. And so what I'm personally excited about, I think that's where we've been taking full health. And we've been doing for like the last couple years now. And then I think the next year and this year, what we're going for is going to be very exciting for how we'll push that. That's right. - To add to it, - Itreative and thoughtful innovations will always win in this healthcare market. It's a very well-read, very well-dated-driven market over any sort of like what you call shooting first stars in the points. And that's how healthcare will evolve over time. And so healthcare at the end of the day is a deeply integrated service industry. There's a lot of learnings for founders and for leaders across about how other service industries evolved. A good example of what I can talk about is in the airline industry. I mean, we introduced the Clare, the TSA-3. Everything was manual. Today, you can upload your passport on your Clare app and just go through it. I am from Canada. So I used to work with the CBP, CBSA here across and saw that in real time. And also help them understand that I'm not going to replace you. Quite often when I used to cross the LAN border, does the Face ID replace me? What's the question? Either of the CBP offices ask. You address that human psychological aspect of it. So that's where iterative innovation really wins in this space. - So Android, what's the crazy vision you said? That you went with the realistic one. That's here, way crazy one. By the way, I've heard that if your ideas make smart people think you're crazy, that's a good idea. So that's all, go ahead, let's death test. - Yeah, I like that. No, I think that the crazy idea at a high level really is how do we essentially almost provide instantaneous access to every part of healthcare to every single stakeholder? A PCP that sits in a visit, would I be able to almost predict that a referral is needed? A prior, it's going to be attached to that referral. I'm going to send a lab order and a prescription, which I already know where the patient is. So that it'll be ready by the time, the patient even leaves the clinic or leaves the hospital. And so I think the crazy vision is almost healthcare infrastructure as a whole, rather than just referral infrastructure and making everyone, again, transparent, aligned in the entire system across your stakeholders. So that's the big goal. I think we're far away from it. There's a lot that needs to happen to get there for kind of everyone to be aligned and all the technology has to catch up to get there. But we start bit by bit, right? We're starting with referrals. We'll get to the next step. We'll get to the next step and so on and so forth. - That's not very crazy, but it's totally needed. And the fact is I think it's all in the implementation. So that's where I see all great ideas falter where you can have some amazing vision, but they're not paying attention to the implementation like right in front of them. Okay, so maybe a couple of the questions I have is how can healthcare leaders be better partners with your organization with other kind of new innovative products in the company? How do you feel like they could be better partners for you and the industry? - A lot of the big things I can mention really is openness to what these solutions are. I'm not just asked, but like the whole wave of these digital health and healthcare AI companies coming. A lot of us are kind of solving very hard problems and they're very complex. So I think openness to partner to co-develop whatever that looks like for your system and for your organization. But a willingness to say, "Hey, I'm gonna work with this team because it's gonna help us drive whatever outcomes, whatever ROI." For us, I think that's the biggest thing. And that's kind of what we've been working with health system leaders too as well. And giving a chance to open up there. And I think that's what we've seen a lot where, if you don't have everything solved and I don't really want you, but if you have everything solved, you're not really tailored for my kind of workflows and use cases either. For us, that's kind of the big thing that I want to see and I think it's a learning curve for everyone for us as well. - Yeah. - The willingness to fix it is starting to get up at the percentage of people who are willing to fix things. And this has to be a little more speed and to like how they want to fix it and go back to what Tony said. You're not gonna have tailor-made solutions for your organization. And you're gonna have to work with a big tech company, smart tech companies, to try to work with it. This goes back to a psychological aspect too. I mean, my brother is a neurosurgeon. I mean, every time I kind of transfer his iPhone, if it's not fully completely done, tell me when it's completely done. So we have to get over that thought process, okay, it might not be completely done. You need to do some work. - So you're smarter than a neurosurgeon for some things for sure, right? - I was IT tech support that is why. - So what is the most exciting or challenging problem because they're working on today at the local health? - I mean, that's a really good question. I would say from a four product standpoint, when you look at a referral, a referral is not just one form that gets sent out. It's almost like a packet of materials. And so one of the problems that we've been very focused on is there's a lot of back and forth because maybe you missed the prior off and it comes back to the PCP and they say, hey, I need a prior off of this. Or maybe it was sent to a specialist who maybe is not optimized for that patient. Maybe there's a better specialist. So what we're really, really solving and especially going into this quarter here in 2026 is how do we build a referral packet immediately instead of just that one referral form? And who needs to be involved in that process, right? Do your payers need to be involved when you get prior off to pre-approved? What does that look like for eligibility style, patients and kind of having context on the patient? And so a lot of it's a challenging problem 'cause there's so many various, so many variations of it. But our goals are pretty close to almost standardizing that such that pretty soon on flow health, if you're sending a referral, you're sending everything that goes around a referral and you'll never have a back and forth. And so it's one of the challenge from I think it'll be super rewarding once we kind of officially launch everything there, but that's kind of one of the big ones we've been working on. I mean, healthcare landscape is in the same way it was like five, six years ago. There is the willingness to adopt and there's a willingness to think and the expectation is also very high. Ambient AI is an amazing product, a truly innovation which works at scale. I'm sure if you see the sentiment across this mixed in. So as we get into the next generation of AI products which are more closely embedded into these workflows, you'll start to see more the satisfaction factor from like all these health systems, stakeholders which you talked about. So that is the biggest learning curve across both and both the founders, both the execs, everybody around in the industry. I mean, somebody will say my scribe is not great. I mean, someone will say my scribe is great. Sometimes we just have to think about where we start it off and where we are today. - People forget that very quickly, that where they start it off. And you're right, I think the openness is definitely over there. I'm actually very excited about new technology in AI and those technologies can do for both the frontline and the patients because I think for patients a lot of times despite the amount of money getting spent in our system, there has been a major gap in how they get services, refills for sure, but many other parts of healthcare. And the frontline is also really pressured to perform in with low resource and more enough staffing and not enough technology or technology implemented without thoughtfulness, right? Something that you guys are trying to do. I think that is hugely lucky. And I'm hoping that this techniques democratizing healthcare access. Is it using Uber versus calling a cab at 3 a.m.? - I could tell you a story there. So when I first moved here, I was chanted in Madison, Wisconsin. I may have enter school in Wisconsin. I was 2 a.m. in the night, there was no taxi. You had to call a green cab or a black cab. I had no phone. I mean, this is like back in the day. Somebody from the student community actually came in and picked me up. So I remember those days and Uber never showed up to Vancouver until after COVID. So there's a lot of parts of the world where Uber is a stiller. What you call is a luxury or a non-existent product. You don't call ride apps. You call Uber. You don't call lift up. People don't know what is lift across the different parts of the world. So that's how synonymous Uber as a product is a being. So we want to get there as big tech in healthcare. - And also the look, it's about the convenience hugely about whose hand is the power on the leg end. The power needs to shift to the person who's receiving the service with the power's now in hands in mid-to-zoomal. - I mean, over a period of time, we'll come to a balance. I can read everything on Google, but I still have to call my oncology friend for any advice on anything and you still have to call. If I ate junk food, I'm probably sick. I'm not feeling well. You still have to call my doctor friend. I could trust what you call online search platforms and go get a prescription from Costco. Probably that might not work. This is a well-read crowd. So you have to put respect into the process. - My parents believe they got their doctorate when I did mine. And so they just get lapsed on and they don't, they won't go to see the doctor. I said, no, they won't be handed out one MBS degree. They do not hand out three. So yeah, thank you so much, Sri Ram. And I wrote that it's a pleasure talking to both of you. And good luck. I know you guys are doing some important work, some difficult work. So good luck and hopefully keep seeing you progressed. - Yeah, perfect. - Thank you so much, Garv. Thank you so much for having us. Have a nice day. - You too. (upbeat music)