Darshan
Hi everyone. Welcome to another episode of DarshanTalks. I'm your host Darshan Kulkarni. I'm here with my co host Murphy who's lying down. It's my mission to help you trust the products you depend on. So as you know, I'm an attorney. I'm a pharmacist and I advise companies with FDA regulated products. So if you think about drugs, wonder about devices consider cannabis or obsessive a pharmacy is the podcast for you have to specify, I'm an attorney. So it's not legal advice. And this is not legal advice. Our guest today is a physician, but he's not giving clinical advice. I do these podcasts because they're a lot of fun. And because I know I find myself learning something new each time. So be great to know when someone's listening. So if you like what you hear, please like leave a comment, please subscribe. Please ask questions while we're talking as well. And if that conversation seems to appeal to you, please share. If you want to find me, please find me. Please reach out to me on DarshanTalks on Twitter, or just go to our website at DarshanTalks calm. today's podcast, this podcast is going to be really interesting because we're going to talk about this idea of decentralized care delivery. And it's a term that I have never heard until earlier today, and I am excited to hear about it. Because it seems to have so many implications. I mean, I think I've seen the impact, but never heard the term. So so if you are in the life sciences, you know going I how do I meet my patient where they are, you should care about today's discussion. Our guest today is really interesting. He is the CEO of sorry, the Chief Medical Officer at Blue Stream health. And if you look at his LinkedIn profile, you just realize just how well qualified He is our guest today, Sunday pull him Hey, Sunday, Paul,
Sandeep
are you Hey, Darshan, good to see ya.
Darshan
Good to have you on. So Sunday, we're gonna talk a little bit about this this concept of decentralized care delivery and and what is your role at Blue Stream health? And how does blue stream health or health sort of help with this?
Sandeep
Yeah, sure. So, you know, prior to COVID, this whole concept of how you can get access to care when you're not sitting face to face with your doctor was kind of like, telehealth or telemedicine as it was known, right, still has been around for a long time. And prior to COVID, it was kind of, you know, being seen as a way of trying out some sort of means of, you know, some patients may qualify, you know, you got to find certain requirements to get paid for doing video visits, but you're not, you know, with your patients face to face. So it was something that was used, but used in limited use cases, right. So for example, you know, behavioral health was one area that you could see this working really well. And there's been like tele ICU, you know, these programs that allow you to see patients remotely and help give advice and monitor them. And so when this big shift towards expanding and in some cases, the only way of accessing care during the last, you know, year, because of safety reasons, or not being able to see your doctor face to face, because of the pandemic, it became, overnight, kind of, like, in terms of the percentages, right? What used to be two to 3% of all visits, quickly became some cases 80 90%, right, there's a way that doctors and patients were seeing each other. And so what that created was a quick kind of education, both for the doctors and patients for first, is this doable? Can care actually be delivered? Can you request care and get access to care? And then on the provider side learning what could be done, right? How can I take care of my patients? What are the scenarios? What are the use cases? How much can I do without having to actually, you know, in some cases physically examined my patients, so there was a big learning curve. But ultimately, you know, it proved to be an effective way for care to continue to be you know, we're not have been perfect, but it allowed for those interactions to go on. Right. So even though telehealth and telemedicine have been around for a long time. So what started to happen was these, you know, accelerated learning started to take place and, and then, as this ecosystem started to get more familiar with how to do this, this whole idea of, you know, decentralized care, which is the resources now for the people that are requesting care, and the folks that are actually delivering the care, you know, no longer have to be physically in the same space, right? That's kind of what this is. And then you layer on top of that, the programs around remote patient monitoring chronic care management, technology and using data for having insights that are coming to you from the patients and then acting on that information in a team based approach with the patient in the middle, is now feasible. And, you know, we've seen a explosion of companies now that are able to engage with their patients, you know, and even not just for healthcare, hospitals and clinics, but even pharma companies in terms of decentralized clinical trials, and the ways now that they're looking for continuing to add value in a way where he's have access and, you know, also closing, you know, the that was all the good side, but also it exposed the some of the gaps right in the digital divide. And some of the ways that communities that couldn't access care were also highlighted. So it's been a really interesting last 12 months.
Darshan
It's funny you talk about the last 12 months? Yeah, absolutely. I think we exposed a lot of open areas, used term as we were prepping for this conversation, you talked about this idea, and I love the term digital front doors, what are the digital front doors?
Sandeep
Yeah, so you know, in traditionally it's been if you wanted to see your doctor, you pick up the phone, call a doctor's office and schedule a visit, right? So as the means of making that process more efficient. What became apparent is that, you know, if I'm a doctor, if I'm a patient, a caregiver, whomever that person is, that has some sort of a need, you should be able to effectively go somewhere virtually online, or, you know, physically, right, so those are all kind of points of access. So digital front door to care is essentially how I as a health system or clinic, and I'm making my resources available to people that need my resources. So an example of that is New York City Health and Hospitals during the Pico COVID, they actually created a, an online portal called Express care dot NYC, where, you know, the people in New York City area now that couldn't go to see their doctor, or couldn't get to the emergency room, because it was, you know, being crowded by taking care of patients. So Express care to NYC allowed anybody in the New York City area to navigate to this website, click a button that says talk to a doctor now. And within 30 seconds to a minute be connected with someone that's going to help them deal with whatever issue that they're having. So it's the first time in the country in New York City, Health and Hospitals largest public health system in the country was able to create this, you know, digital access to care. And so that that's an example of a digital front door to care. And so similarly, you know, you can have these, not just for patients, but you can also have them as access points for providers as well. So think of nurses caregivers. So if I happen to be a nurse, you know, in an inpatient setting, or in a home care setting, or nursing home acute care facility, Long Term Care Center, if I have a patient that I need to get some help with, I should be able to, you know, use my mobile device or some you know, my computer in the patient's office, and then click a button and be connected to the specialists who can then help me manage whatever I'm dealing with. So it effectively creates instant access to the experts that can help me as a consumer helped me as a patient and caregiver as well as appear.
Darshan
So so if you're talking about this idea of say, express care NYC, which I think is a brilliant idea, to be honest, do you think that as as we enter into whatever version three of the pandemic go into delta, now talking about lambda? Do you see a that and that accelerate that learning curve has been addressed in so many ways? Do you see carryover? because on one hand, I love the idea. That Asha for this, I love the I love the idea that we'll be able to use these other tools, and now people are used to these other tools, do you think that'll decrease the number of people going to the ER, and therefore reducing the cost of care? But do hospitals then at the same time, expect that they'll get paid the same as an ER visit? Which seems unfair at the same time? So how do you sort of handle that? How do you handle the issues associated with that?
Sandeep
Yeah, you know, that's a it's a great question, right? And so the simple answer here is that everyone knows that more and more of these type of models are going to have to be adopted to you know, reduce the overall cost of care. And so programs like hospital at home, and other models that Medicare has been focused on in terms of reimbursements. So that's where you know the the new remote patient monitoring comes in the chronic care management programs and this new idea of a high hospital at home service. So as a health system in hospital, you know, you have to have the technology infrastructure, the resources to then have to adopt, right? So if you think about it, that improving access to care, it's not necessarily so the program the way it works, for example, with the Express care program, and you know, some of the other partners that we're working with is, if somebody is reaching out to 911, you don't always have to transport that patient. Right? So that's, that's currently what happens. So when someone calls in the ambulance takes the patient to the it, what if you could actually help triage that patient virtually. And if they're not critical, help manage that patient with oversight, right? That's the 83 program. So the emergency treat triage program that is now being pioneered piloted across, I think, 80 sites across the country, that's exactly what it does. If you have a paramedic at a patient's home, why not use them with their corporate oversight to avoid that unnecessary transport, but still have a reimbursement mechanism that gets you know, the payment models work so that the patient is taking care of the person that's providing the oversight, you know, it's all created as a payment model, that's going to effectively avoid an unnecessary transport, but it also lowering the cost of care, because you're not able to instantly like, again, create that digital front door of access for that paramedic, to have a supervised encounter with an EDI doctor so that, you know, they're able to manage that patient as effectively as possible without having to transport.
Darshan
So it's interesting, I want to go back to that concept of visual front door because I love the concept. What I'm hearing is at least three separate places, the digital front door exists and please feel free to add to that. But I can think of the ad like you just mentioned. I can think of the the emergency technicians, which quite honestly, I'd even thought of it's a brilliant idea. Like, why do you Why didn't bring the patient in if you can address the concern right there. But but it goes to the training that the emergency technicians get, which I believe is something 15 weeks, you'd have to obviously ramp that up quite quite considerably so that they have the ability to provide the type of secondary advice, if you will, that, that if the patient doesn't come in, you wouldn't be able to provide. And then there's the pharmacists. So I think any others that you've seen use cases for conversations bandied about that sort of talks about these other alternative digital front doors.
Sandeep
Yeah. So you know, it's just think about it as three, three categories, right? One is the consumer, you and I patients, the next component to this are the provider teams, right? Anybody that's seeing or interacting with that patient in that care continuum, right? It could be a home health aide in the patient's home, it could be a caregiver, it could be a pharmacist who's trying to review medication, and he needs to get in touch with the, you know, the care team. So anybody that's involved in that care delivery chain is that next group, and then the other end of it is the inpatient nurses and doctors, primary care doctors who are trying to access specialists. So those are the large groups that you can create these digital front doors have access to
Darshan
experts, so it's fine. So what I described is three opportunities you've just described 1000s.
Sandeep
Well, you know, another good example is interpretation. Right? So one of the one of the tenants of Bluetooth has always been embedding access to interpreters for, for example, Deaf patient. So ASL 200 languages. So those are all also digital front door secure, because if you don't have medically trained interpreters able to join you in these sessions, he there's a whole a whole segment of the population that can't get access to these new care delivery models, because they can't be in in the office with the interpreter face to face with the doctor.
Darshan
So So how does it work in the context of when you're, when you're talking about allocating resources, you're now talking about 100 more opportunities to meet the patient where they are. So when you talk about allocation of resources, how do you decide should we address the needs as we know them, or the needs as they probably possibly should be? With as you are figuring this out, and sort of galvanizing a whole new platform of engagement? Yeah, yeah.
Sandeep
So I mean, that's a challenge, right? Because traditionally, that's been done through scheduling, right? So I have to schedule an appointment, make an appointment for a specialty visit, make an appointment with the doctor, because that's how it typically work. Patients have to, you know, either go online, find a schedule, find a spot that's open, but because of the disproportionate need for care and the number of people that can actually deliver that care, that's why you have long wait times, right? Because you're there's a limited number of doctors, especially in the behavioral health, mental health side, there's a limited amount of people that can actually are qualified to deliver this care. So that's why you have these long wait time so and in the way you can start to free up more time is one sorting through the needs. And the ones that need to be seen in person are the ones you go ahead and schedule for. But then the ones that not don't necessarily have to be seen but could be done console's that can be done like you and I are doing this conversation right now, virtually, if you can start segmenting those type of interactions. And then third is making sure you have that's what bluestream has is that other component told you, we have this patented provisioning engine. So as long as we know who, who your team members are, what their qualifications are, and their type of expertise, we can take care of that complexity. And so when a request comes in, with a little bit of information upfront, you can do that sorting, and within 30 seconds, have you connected to the right person. So that's that last problem that we saw, which is taking your resources and making them available more efficiently.
Darshan
So I love the concept of that. But it's one of those things that I almost worried for you guys like how do you the liability that you possibly take on something that starts to welcome? So
Sandeep
we're the we're the technology? That's it? We don't actually so we partner with health system in hospitals that have these resources already. So we're not doing the care delivery itself, we are enabling providers to who implement this solution to be able to use those existing resources efficiently. But But
Darshan
how you're using that using your proprietary prioritization engine, if you will? Oh, no,
Sandeep
no, no, no, I'm saying de do that, right. So you can What I mean is like so you're not actually using an algorithm to prioritize, when that call comes in, it could be a triage nurse that's actually taking that call. And then once I determine what that level of services using bluestream, I'd be able to do a warm handoff with the patient and the cardiologists with the patient and the nurse practitioner. So it improves that efficiency of handing off that it's a warm handoff. So you're not talking to a robot, you're actually talking to a human being, but that human being has the resources at their fingertips to then connect you with the right level of care for that next segment.
Darshan
Which sounds amazing in principle, and I have two questions. I've thought of that. But let me ask the first one, which is the obvious one to me, I love the concept of you know what I make one phone call one digital call, whatever you want to call this thing. And that will connect me to the one person who can connect me to all these resources. The question is one of the resources and available
Sandeep
Yeah, like so. So they actually, so the end. So that's where we have our predictive models to tell you as the health system, you set your service level agreement, right, your your threshold, I want these sessions are called request to be handled within 30 seconds, 60 seconds, 90 seconds. So our predictive engine behind the scenes, is giving you two choices. So we can tell you ahead of time, hey, guess what, four of your five cardiologists are engaged, if the next call comes in, that requires cardiologist, you're at risk for you know, violating your SLA. So you have two choices either bring on additional capacity, or you increase your response time. And then that's clearly displayed upfront. So if I'm a patient who's trying to reach a doctor, I can see it's going to take me 30 seconds, 60 seconds, or 90 seconds. So as the system I get to manage how I want that experience to be do I bring on additional capacity? Or do I increase that potential wait time for that person to be available?
Darshan
But but that I love them? I love the opportunity to do that. But wouldn't that take a while for the hospital to go? turns out we have more more of a need for cardiologists. So we need to hire someone that's a 6090 day process? Do you have resources that can jump in almost immediately?
Sandeep
Yeah, and that's where you know, a lot of these new companies that have started up right in the last year or so there are now networks available. So you can actually so this happens all the time for interpreting services right Darshan, so think about it, I may not have every interpreter that I need for any type of language, because I don't know if I need a Portuguese interpreter, a French interpreter or a Chinese interpreter. But our technology allows for seamless rollover. So if I use all of my existing internal resources for delivering interpretation, behind the scenes, you have existing contracts for overflow, right? So hey, if I can't, you know, help a Spanish patient because my Spanish interpreters fully engage, we know because it's determined during implementation that we hand off to an external network. So similarly, you can have relationships with groups of networks of providers, right. So companies like we'll and others now that are building these virtual networks of providers. So I can have a contract in place that says if I can't meet my required demand, then I'm going to tap into your network. So bluestream manages that behind the scenes so you don't have to go hire new people. You just have to have existing relationships in place that says I'm going to tap into your, you know, bench of doctors if I need them. So
Darshan
what this is gonna sound obvious for someone who's doing doing this, but I excuse my knowledge at the base level right now. But I can't imagine these highly trained doctors are sitting around waiting for next phone call. So are these people walking around? And they're just gonna like when they get a beep? They're gonna sit somewhere and just pick up their phone? Or is it? You just have teams sitting in rooms addressing questions?
Sandeep
Yeah, no, it's, it's, it's a more simpler than that, right. So you set the level of availability. So for example, you think of it in stages. So if I, everyone knows this idea of being on call or backup, right, so if my doctors fully, you know, engaged, then we the next level up that we send these requests, who is the doctor on call, if they happen to be fully engaged, and you have external networks that that you can then access. So our engine looks at the current availability and response time. So it all goes into an algorithm that streamlines how you alert these doctors to so for example, I may be available, but not sitting in front, my computer logged in. So I can get a text message, email, or a phone call, letting me know that hey, you know what, someone needs a cardiologist service. If you're free hop on, or we can blast it out to 200 people and the first person that can take it can come into. So there's different ways that you can escalate and expand the pool that you can access for making that person. It's all about making it as seamless and efficient and as fast as possible for whoever needs that care.
Darshan
So I have a question from someone, Ellen. But denko, insurance companies pretty much have been dictating how care is delivered in the US. I wonder if the insurance companies are now coming up with a guidelines regarding visual doors and digital care? And if yes, how do they align with the best clinical practices and patient's best interests?
Sandeep
Yeah, no, that's a great question. So there have been several health plans that are using our back end platform technology to help address improved access to the people are actually helped them, right. So if you have a concern, you should be able to reach whoever it is that helping coordinate this care or care navigator or care coordinator. And in most cases, they can then help you connect to the person that's within your plan, who is going to help you address this and a lot of the health health plans now are becoming more vertically integrated, so they have their own primary care groups, they have their own specialty group. So having this seamless ability to have an encounter with your primary care doctor, who can then instead of have to, you know, create another appointment or, you know, come back in, you know, see this, or here's a referral for specialty care, you can have this kind of care coordination aspect to this, right. So, health plans, you know, it's there, if they're now more incentivized to make sure that they're able to deliver this care as quickly as possible and as efficiently as possible, because, you know, they have this thing called the medical loss ratio, right? So they are, you know, the goal with that is, whatever care delivery, the premium plan, members, right, you know, everyone pays a premium, whatever those dollars that are not going towards the care of the patient. If you're below that ratio, there has to be returned back, you know, to the to the plan member. So there's incentives in place to make sure that health plans are thinking holistically in terms of how to make that patient experience better.
Darshan
But how does that work in the case of like capitated payment, and the like, where it's, you get one fixed fee for the type of work for the product? For the patient? Who's come in for a specific indication? How does medical loss rate, how do medical loss
Sandeep
ratios and it's different, right, so Medicare Advantage is, is the best kind of the plant where you get a fixed amount for taking care of all of your patients? So in that case, you know, it's it's, this is a different model, so I was just talking the fee for service model question.
Darshan
Got it? Got it. Okay, thank you. I don't enough to be dangerous. So I'm gonna clarify that. Thank you. Um, so so we're not talking about building these teams. As you're setting this up, are you finding that clinicians are unprepared? I mean, obviously, there's a big learning curve, but we still have people who haven't quite caught up to the curve. So my first question is, are you finding that there are people unprepared for this? And secondly, for the students, for the for the medical students, pharmacy students, nurses are coming in? Are they being prepared for this? And if so, what's happening?
Sandeep
Yeah, that's a great question. So I'll take the first one. So in terms of Yeah. Being prepared for these to these kind of new models. So the the advantage that you know, we provide to existing organizations is that you don't have to change what they're currently doing today. Meaning that workflow, right, it's all about efficient. When you introduce new methodologies, new technologies, that adoption curve, you know, is usually longer because you're changing what they currently do. But if you can keep that Existing workflow in place and adopt your technology to what they're already doing. It's a faster adoption rate, right. So that's the first piece of advice is don't change how the doctors are getting to the patient meaning like, you know, if you want introduce this, if there's a check in process where there's a, you know, a team member that texts the patient and checks their vitals, updates their meds, and then you know, in a physical clinic, then they're then taken back to the exam room, they wait for the doctor to come in doctor does their thing, they see a nurse or PA, and then there's a checkout process. So if you can, try to keep as much as that that, you know, without me changing what I need to do, meaning the doctor isn't doing the intake, right, because the way the appointment scheduled in a virtual appointment, I can click a link and be with the patient right away. But that changes what I'm typically doing as the provider where I'm not, you know, I'm doing the intake and my job as evaluating what the patient's need, if you can keep that workflow in place where team members doing the check in. And then rather than walk the patient back, what if I could bring that doctor I'm scheduled to see seamlessly into a warm handoff, in the video call so that the intake person does their part brings the doctor onto their part, they drop off the doctor and the patient connected, the doctor now can bring on a family member bring in other resources into the call. So that's what we enable. And because it's done in a way that doesn't change what I'm used to doing today, it gets them comfortable to kind of adopt these new means. And as they get comfortable, they then started thinking through Wait a second, if we can do this, how could we do it for you know, these other use cases. So that's usually what happens we start with a simple use case. And then as they quickly get comfortable, they start the complexity starts increasing. So you know, it goes from one workflow to that more complex workflow. And then finally you're doing, you know, multi regional, large distributed, you know, you got these multiple access to care that, you know, for different front doors of access. So that's where it starts. So you typically start, you know what the immediate pain point is, and make the providers and the patients comfortable. And, you know, fortunately know, some of our clients have shared with us, you know, they've done surveys of 150,000, doctors and patients after the console's are done, and providers surprisingly, have given this, you know, these kind of encounters, I think 97% have given them a five star rating in terms of how this has helped them with their patients. And on the patient side, I believe it was 95% of patients given a five star rating, and the rest were for below, I mean, four or five. Wow, it's all about keeping it as disruptive, minimally disruptive as possible to your existing workflow. So you're not changing what doctors are currently doing. You're just making that process more efficient for them.
Darshan
But do you think that as we start getting the students who are currently students coming on and becoming actual providers, they should be trained differently? Oh,
Sandeep
yeah, there are Yeah, that's that there's been a couple of studies you know, a couple of my colleagues just released a paper that showed how that needs to change and what some of the gaps have been that you know, future practitioners need in terms of training right, so you heard this term website manner, it's about how you use these virtual consoles and how do you engage with patients so there's actually a technique and you know, those are now I think, being incorporated and hopefully, it'll become more incorporated into your training as you go forward in the next couple of years.
Darshan
Um, well well beyond the time I used the allocate for our conversation, so I apologize but I have to ask one last question before I let you go. Do you see a time in the in the near future where these digital doors on digital front doors I love love that term? The visual front doors are not just engagement via a EHR of some kind and instead it's using tools like Siri and using tools like Alexa I'm afraid to say that because mine will go off
Sandeep
Yeah, I mean look, it's you know, they're already it's already happening right? So you have companies like Babylon Ada chatbots, right. So it's it doesn't matter how you're requesting access to that it's knowing that you have the ability to get connected to someone right so it could be at a kiosk in a mall or a grocery store, it could be in a on your mobile phone. And that's where things are going right when you say decentralized access to care, it really is right? The you know, you have these centers of excellence that are going around the country where you know, you can go to Cleveland Clinic for all your heart issues or, you know, fly down to Houston for your cancer. So, so that's kind of where things are going where you have, you're going to get these centers of excellence where everybody can get to, but you have access to that level of care pretty much anywhere you are. And so yeah, so it is going to become, you know, it's not going to, you know, the means of how you get to that care. is not going to be limited. So you know, you can be sitting in your car driving, the car is driving you, right? You can get a console while you're sitting in the car with it's just amazing, like, you know where, and think about it right in the aging population, you know, you pretty soon you no longer have to go and, you know, sit in the doctor's office to have your exams because you can actually have those resources come to you. So that companies like circulo, and ours are working on, you know, care at home. So so it's already happening,
Darshan
which would sounds great. But to me as lawyer that makes all my concerns on privacy sort of go Wait a second, these are like I I love the concept and the ease around getting my care in a grocery store in a car. But what happened to my privacy, though, the reason I like my doctor's office was not just because my doctor was there, but because no one else was listening. And do I start losing that? If I use a Siri, and and I know, Apple's listening, or Google's listening, whoever else was listening. So I just wonder how that plays out. I have to explore that with you at another time. I really want to explore clinical trials, because you're hinted at that and I want to talk about what that could look like in the clinical trial world. There's more questions, good
Sandeep
pharma in general, too, right? You know, pharma has been watching for the last year, a couple years now trying to understand how they can start playing a bigger role as more and more care becomes virtual.
Darshan
As I'm sure you it's not just virtual care, but decentralized care. I'm sure you heard that CBS announced that they want to do clinical research, which means they become decentralized pharmacies. What is the implication in the impact of that? So that's a whole other beast, but and we'll tackle that when we when we talk soon. But somebody thank you so much for coming on. I have four questions for you, as we, as we've discussed before, based on what we've discussed, what would you like to ask the audience?
Sandeep
Yeah, you know, as you've been trying to implement virtual care programs would love to her, you know, hear what it's been working, what challenges you're experiencing? And yeah, no, it's just been great to see and learn from a lot of you know, there's a lot happening, it's, it's gonna be interesting to see what what programs are being. There's a lot of studies that are going on right now to kind of everyone can learn from together. So just learn, we'd love to hear from how you implement successful programs.
Darshan
So I usually try to answer the question, at least to give my unvarnished opinion to at least help start you off and to help other people sort of jump on? My answer would be I've been hesitant. I've been hesitant to use virtual care, because I don't have a clear enough understanding of what the ramifications are for my insurance. So does my insurance is going to pay for all of it, or am I suddenly on the hook for it. And until I have my insurance, I'm a solo practitioner. So I worry that my insurance isn't as great as I'd want it to. It gives me this breakdown of care all the things you have, but it doesn't have a telehealth option in there. So having that explanation would have been really useful for me, I recently needed some some healthcare help, and having that access, that information would be very, very useful. But that'd be my first response. My second question for you. What is something you've learned in the last month that you think our guests Oh, sorry, our viewers would enjoy hearing.
Sandeep
get vaccinated, and it still surprises me that how many people are not, you know, following the advice? And so yeah, and unfortunately, it's just what it is. But you know, every opportunity that you have to kind of reinforce that, so yeah, that's, that's a that's a big, insightful understanding for, you know, this, this whole understanding of the benefit of vaccines and why we should get them.
Darshan
So I don't respond to that, which I usually don't for most most of these questions, but I do in this case, I just read yesterday before that, in the south, what they did to improve vaccination rates was they had a lottery, and I figured out the name for it was, and turns out, they had like 100,000 more people getting vaccinate because they could play the lottery then. I just thought that was a brilliant idea. Like it's truly meeting patients where they are not where you want them to be. We tried the education thing. Yeah, but we're not getting very far. Here's a lot of your play is great. And then I found out that Amazon's doing the same thing internally, where they're saying, if you get vaccinated, you can enroll for all these other things. You might win. I was like, That's brilliant.
Sandeep
Yeah, no, look, it's a it's all about behavior change. Right. So whatever incentives are out there. I think it's, that's awesome.
Darshan
Oh, my third question, what's something that made you happy in the last week? Oh,
Sandeep
I guess getting your daughter ready to go off to college. shopping and Yep. So, so actually going. New York City, St. Louis, New York. Very, very cool. Congratulations to her
Darshan
and Sunday, the last One is actually something I usually ask, but it's available. How can people reach you?
Sandeep
I'm on LinkedIn. I'm on Twitter, at Twitter at S polam. And then it's just search for my name on LinkedIn. Thank you.
Darshan
Awesome. Thank you so much again for coming on. This was wonderful. As always, I hope we can have you on again soon.
Sandeep
Now look forward to it. There's always something exciting talking to you.
Darshan
Thank you.
Sandeep
This is the DarshanTalks podcast, regulatory guy, irregular podcast with host Darshan Kulkarni. You can find the show on twitter at DarshanTalks or the show's website at DarshanTalks.com
