ADJUSTED

Remote Physical Therapy with Raja Sundaram

May 16, 2022 Berkley Industrial Comp Season 3 Episode 36
ADJUSTED
Remote Physical Therapy with Raja Sundaram
Show Notes Transcript

In this episode, ADJUSTED welcomes Raja Sundaram, CEO of Plethy. Raja shares how remote physical therapy and Plethy Recoup are augmenting and supporting traditional physical therapy.

Season 3 is brought to you by Berkley Industrial Comp. This episode is hosted by Greg Hamlin and guest co-host Matt Yehling, Directory of Claims at Midwest Employers Casualty.

Visit the Berkley Industrial Comp blog for more!
Got questions? Send them to marketing@berkindcomp.com
For music inquiries, contact Cameron Runyan at camrunyan9@gmail.com

Greg Hamlin:

Hello everybody and welcome to adjust it. I'm your host Greg Hamlin coming at you from Sweet Home Alabama and Berkley industrial comp with me as my co host for the day. Matt yelling, Matt, you wanna introduce yourself for those who have not heard you on previous podcasts?

Matthew Yehling:

There. Hello, everyone. This is Matthew Yehling with Midwest employers casualty. And I'm joining the conversation from the banks of the Big Muddy, Mississippi and St. Louis, Missouri.

Greg Hamlin:

Glad to have you with us, Matt. We have our special guest today Raja Sundaram. He's the CEO of plenty. And Raj, I thought I would let you introduce yourself to everybody. No, no,

Raja Sundaram:

thank you very much, Greg. I'm from San Jose, California. So there's no muddy Mississippi, I don't have that, unfortunately. Thank you very much for the opportunity, really thrilled. We are a musculoskeletal care platform. Absolutely thrilled to be in your podcast this morning.

Greg Hamlin:

We are glad to have you I've heard through several different people that we needed to have a chat with you because you were doing some things that are really changing the industry. So I'm excited to have some time with you today. Before we get too far into that I would love for you to tell us a little bit about how you got into the medical industry coming from it. You know, when I when I looked at your background, I saw a lot of tech involvement there. So I'm curious, like, how did you pivot to med at the medical side, and what brought you to the space you're in now.

Raja Sundaram:

So I was I was responsible for sales at Cisco Systems, the networking guys, and I was looking at software, middleware services and industry vertical solutions. One of them was on healthcare. So I was part of the team that sold into you know, large health systems. But in order to do that, my team led the partnership with GE, medical Cerner, UCSF and so on. And through it, I kind of understood some of the challenges in the medical field. One of the trends that I saw was care moving more and more towards the home, I wanted to be part of it, I wanted to do something different. So incorporated a firm, Plan A started spending time talking to hospital CEOs, CFOs, and physicians of various denominations to seek to understand what problem to solve. So around that time spent lump sum spent some time with Virgin Hyperloop, one and Boston Consulting. And so finally decided to take the plunge and do this full time. Yeah, it's been a, it's been an interesting learning experience, figuring out what the sole, that's how I came into healthcare.

Matthew Yehling:

It's an interesting entry into healthcare, and then entry into insurance, and workers compensation. We have lots of problems and workers compensation to solve. So today, we're gonna focus on therapy, though. But tell us about Plessy. And what you do at Plessy.

Raja Sundaram:

So our focus really is how do you enable an injured worker or a patient to manage their care at home, right? And so when you look at from a health system standpoint, whether it's an injured worker or a patient, they all get six sheets of paper and asked to go manage themselves, right? Which means every day we need to have neuroplasticity to wake up and do what we've been asked to do day in and day out to recover quicker, faster. So how do you support them in doing that? So what we do at plati is our solutions called Rico, we deliver easy to follow personalized at home care programs for all musculoskeletal conditions. So think ankle, knee, hip, lower back, lumbar, cervical shoulder, elbow, wrist, other than the fingers and toes, how do we enable patients to recover quicker faster by following what the medical community asked them to do? That's really what our emphasis,

Greg Hamlin:

I think that's huge. You know, having been in the space for a while, one of the things that's frustrating, I know we've talked about on other episodes of the podcast that there's a do it for you model and do it by yourself model and the United States, we don't usually do a great job with the Do It With You. model. So like when somebody's in the hospital, they have somebody who my wife was just there, because we had our six baby, there's somebody taking the trash out, there's somebody checking the IV, there's somebody coming in to make sure you're eating the right nutrition, almost impossible to sleep because there's somebody doing everything for you. And then you go home, and then you're supposed to do all the rest of it on your own. And I think at least from a work comp standpoint, we've definitely seen the problem of that when it comes to making sure people do their home exercise therapy. You know, I can't tell you how many frozen shoulders I've seen where you have to wonder, did they follow through and do those exercises so that they didn't have those problems? So I think there's definitely a huge need for that in the space. You talked about it a little bit. But what's the difference between you talk a little bit about virtual care and home exercise pro programs, where do you Where does your company fit in that?

Raja Sundaram:

Yeah. So when you look at the continuum of care, when you look at virtual care, think about it this way, let's take a surgical patient by someone's getting their knee replaced. And if that's the case, then there is huge value and preoperative physical therapy, right? If you do that, we all know that the outcomes are better. Someone has to spoon feed to the patient, the pre op checklist, all the things that they need to do. So think in the context of being physically emotionally mentally ready for surgery. Right? Yeah, so there's a lot of there's that's your six page checklist. And then when you get into post op, all the way from medication reminders, the ability to manage pain, give them an alternative, non opioid pain management techniques to do in physical therapy, when they go to an actual physical therapist, say once or twice a week, the remaining five days of the week, twice a day, four times a day, getting the patient to actually do what the BD asked them to do, all the way to ensuring that they are able to have their activity for daily living on the metrics, clinical metrics to be able to know that you've recovered. And back to your point, Greg, normal frozen shoulders, when you start thinking about it in the context of a payer, a payer sees the same patient with the frozen shoulder every 18 months, the doctor doesn't, because the patient goes to a different doctor, because they felt that the first doctor did not do what they needed to do, when it's really the responsibility of the patient to go manage themselves. But it's not easy, right. And so that's really what virtual care is, is look think about it as everything that the patient needs to do at home, augmenting, what the doctor and the PD asked them to do is what virtual care is. Now, when you look at this construct of digital PT, you fundamentally see in the marketplace, something that is not an augmentation to PT like platy recoup is, but a replacement. Okay? There seems to be a huge cottage industry at extreme high valuation on the marketplace or replacing PT. Here's the challenge with that. The challenge with that is that that model fundamentally gets the patient to self diagnose themselves. Because when you start saying knee or shoulder, there are different issues with the knee or shoulder pain suppression program doesn't really create recovery. So when you look at it, from a payer standpoint, they see the same patient showing up again and again and again, even though they have gone through the recovery program, we are more about augmenting the PT. And the what the PT prescribe to the patient, not replacing the PT. And there's a huge difference in that V believe our approach is a sustainable cost reduction mechanism for the payer and not a short term pain suppression technique. Does that resonate with you?

Matthew Yehling:

I think anyone that's ever been to a physical therapists understand that there's a pain associated with physical therapy. So if there's not a pain, there's no gain, right? So I definitely understand that. Maybe you kind of describing the app. And obviously, we're doing this over audio. But you know, if people haven't seen it, you know, look up, obviously, your website, but maybe describing the app and the device that you're talking about in a little more detail and putting it into some context for how it how it's used in conjunction with physical therapy.

Raja Sundaram:

Right. So let's take a surgical case. And similar approach to a non surgical case. It we are in group health, and we are as much as we are and workers comp. And our app really has programs. So think knee, if you have ACL MCL to partial the scope, do total knee to arthritis as simple examples, right? Each of them has a program. There are no menus in our app, it just takes you through care sessions twice a day, at a minimum, you just click through do what the app is asking you to do. Huge emphasis is on what I said on pre op, getting your checklist getting your pre op exercises, rehabilitation exercises and post op managing your pain managing your meds or putting your meds to doing your exercises. The way it augments physical therapy is this. Think about it as Mind the Gap, right? The Mind the Gap is when a patient comes out of surgery. There's several weeks go by before they actually see a physical therapist, we Mind the Gap. But the moment that we have programs that run the moment they see a physical therapist, we immediately synchronize ourselves, do exactly what the physical therapy asks the patient to do. Okay, we've seen the physical therapist, there is no confusion between what the PDE is asking the patient to do. And what we are asking the patient to do. So one and the same. PT is love us because this replaces the age old question of Did you do what I asked you to do? Do write, instead of tons that didn't do show me your app or the PT concede on the dashboard, what the patient did. This also gives them an opportunity for the first time and musculoskeletal care to be able to tailor the care programs to the patient. Are you recovering at the pace at which you're supposed to be recovering? How do I tune the program to be directed towards it? Now, how do we do that, we do that through the sensor, the sensor with looks like think $2 coin stacked on each other. That sticks on a band aid. It's one sensor, it's the same mount, it's a sticker that you wear twice a day, and you put the sensor on it, when you're done, you take it off. And it's easy to use on any joint in the human body. So between a combination of sensor on the app, it drives the patient to do this now, you can say hey, give them a solution and let them fend for themselves. That just won't work. We do two things to support the patient. The first is that we have a coach, the coach not only on boards and trains the patient but supports them throughout their care journey. That is very important. Because what we found was just a little nudge, certain folks need nudge. Certain folks need cajole, certain folks needs to be pushed. So how do we do that the coach does that. The coach does that because the entire engagement model is based on a behavioral interview, and the archetype or the patient, which means our app or psycho linguistic written. So Greg, your experience with the app will be different Matthew than your experience with the app, in terms of how it motivates Kegels pushes you to go do what you need to do on the coach Augmon said when the way the coach engages, also is psycholinguistic. Right. And so it's not the give him some product, see if they use it, we all know there are challenges with men recharging products, for lack of a better word. So there is no recharging. A because we want to make sure using our battery last six months, when we when they're done with it, they put it back in a USPS prepaid envelope, we send them a new one. So sensor, App Analytics with a coach or behavioral driven is really how we were approached.

Greg Hamlin:

I think what you're hitting on there is really key. I don't want to admit that I've ever done this. But I think we probably all have like bought some exercise equipment with the intent of using it. And it ended up in the basement or the garage, because we didn't have a coach to follow up and say, Hey, how's that step machine going? Greg? And I just think that's the natural human response is, you know, we have good intentions, but sometimes we don't always see them through. So I love what you're talking about with the follow through and having somebody who's working with them and having the app motivate them. A question I had was if I'm doing the exercises wrong, does it know? Does it tell me hey, you need to do it like you're not rotating this the correct way? Or does it self correct a little so that I know if I'm the user that I'm probably not doing this? Exactly, right.

Raja Sundaram:

Yeah. So you look most of the exercises are unit planar, right? The injuries could we want to plan our but the exercise a unit plan are on the ability to coach the patient in how to do the exercises, the way we do that is most of the time. It's not the app telling you like and rotate this way we have on our side of the house, or DVDs who help the we kind of know but through data, that they're not doing it right. And so one of the coach brings the DPT on the call to make sure that we are coaching the patient to do it, right. Because showing them as one thing, having a conversation that they get it right using data analytics is a different thing. And that's the approach that we take.

Matthew Yehling:

That's fantastic. Very interesting. How long has this been around,

Raja Sundaram:

we started the journey with Group Health, with orthopedic groups and pain clinics. And so we've been in the market for three years, we've been in the worker comm space for the last six months and growing very rapidly. virtual care in the acute space is relatively new virtual care and chronic conditions, think diabetes to you know, blood pressure, and so on have been there for a very long time in the marketplace. It's just the acute space is, has been there for the last two to three years.

Matthew Yehling:

That's our organization uses the word innovation quite a bit. I mean, this seems like a very innovative idea, a very innovative product. You know, with innovation, there's always disruption. So, you know, how has physical therapy facilities and others embrace that disruption? Are they embracing it? Or are they kind of actively talking about the disadvantages of of this device? Like kind of walk us through kind of the good, the bad, the ugly of you know, what you've experienced in this last six months getting into the workers comp,

Raja Sundaram:

right? So so look, I think one of the things that works for us really well is that we are starting the journey as a beer augmentation to BT. We're not a replacement. Matthew, we are a combination of Greek and Greek people, the geek people all came out of tech, right. So think, analytics, IoT IOP, blah, blah. And every other acronym there is the Greek side of our houses, our co founders, head of Neurosurgery at OhioHealth. We have deputies on staff, we have NPS to LBNL pIans, on staff and so on. So we have medical half decades, right? So we don't even when medicine, we understand the value of physical therapists, we respect them immensely. And we have them as part of our team. And so we kind of talk about ourselves as an augmentation of physical therapy. Right? So you go to PT twice a week, the remaining five days we got to do and from that standpoint, it works really well. That's a good another bad is that there is a lot of noise and kerfuffle in the marketplace with regards to do you really need PD, PT can be replaced. Here's your digital PT solution with vision AI. Right? And that exists. And you'll have to always go down that path because PT is always asked the question, wait a second, your algorithm is really good. We published by UCLA at 94% accuracy on our sensor, they're like, Hey, man, a year from now you're going to your algorithm is going to be so good that it's going to take where we actually explained to them that we really understand medicine, and we're not trying to invent medicine, and we are merely an augmentation, for care protocol, think real time telemetry of how the patient is doing and giving that insight to everybody. The ugly part of it is this, it's a change. It's a change management process, right? It will, I always think about it this way, a practitioner, the provider, falls into one of two categories. They're either eminence based or evidence based, and every eminence based person has been taught how to do something a certain way. And no amount of data or insight is going to change that. And it's a huge change management process, compared to a provider who is evidence base, right. And so the moment we see an eminence based, we pull out our change management textbook and kind of go through it line by line. And yes, it takes time and patience. But if you want to be in healthcare, and you want to make a difference in people's life, that's what it takes. It's a journey. That's the ugly.

Greg Hamlin:

So on that journey, do you feel like COVID? And maybe the difficulty getting into certain places that you've seen this? Maybe accelerate? I felt like, in general, it seems like a lot of these types of ideas that may have taken 10 or 15 years for people to grab on to you seem to be accelerating? Post COVID? I don't know if you've noticed that in this space or not?

Raja Sundaram:

We do absolutely do. Because, look, the issue of care at home is not new. Right? It's been always there. As I said, like people in chronic condition, diabetes management. I've been doing this for a long time. We are not telehealth. But if you see the telehealth folks that have just been there for 11 years, right. And so what did what COVID did to your point, Greg is really brought it to the forefront. So think about it in the context of from brick and mortar moving towards click and mortar, that transition COVID really brought to the forefront, because whether it was fear of going to the provider or not, or the need for flexibility, it all came into the forefront. It made a huge difference for us. And from an adoption standpoint. Because now providers who fundamentally the brick and mortar who did face to face had to towards maintaining revenue, find an alternative. And so it just brought it to the forefront.

Matthew Yehling:

How are you seeing this adopted in the workers comp space?

Raja Sundaram:

So we started the journey with self insured pairs, because it gave us an opportunity, as opposed to working with intermediaries. And we are now in conversations with them, though. But it's a question of like, someone's got to prove it. Because there's an interesting philosophy that I'm still running with the sun, which is Wait, wait, it works in Group Health, it works for patients, workers are patients to tell me again, what is it that you're asking me to prove once again, right? If I'm able to show clinical outcomes, quicker recovery times, and sustainable cost reduction in Group Health. Now I have to prove the same thing that workers comp just because the buying center is different, even though the human being is the same, right? No, no, no workers comp is indeed different. I understand the difference. I understand the outliers of malingering. That's not the normal distribution. We all know that. Right. Right. And so the conversation has been about looking at the data and the outcomes in Group Health. And we have I think, early adopters, highly innovative leaders, Matthew and Greg Hugo, you guys know some of the folks that we're working on working with. It gave us an opportunity to shoot, show and prove the same clinical outcomes that we they're having in group health into workers comp, while offering the flexibility of click and mortar. Right. And that's been the difference. Now, as you start expanding into intermediaries, then it becomes the conversation of what is their role in it? How does this fit in the portfolio? What does it mean financially to the pay, or those are the kinds of details that we were kind of working through, but it's a new buying center, that's kind of how we look,

Greg Hamlin:

I think you hit on a couple things that I think are pretty common in our space. And one is, we're not always the fastest to change. So there's that. And then the other thing that you talked about, you just sort of mentioned a little bit, there was cost. And obviously, when you're dealing with insurance carriers, you know, ideally, we would always want to do the right thing. And that right thing might cost more sometimes, but if it helped the injured worker, we'd be fulfilling our promise. Unfortunately, sometimes I think people get caught on costs. So talk a little bit about the cost of this program, and compared to maybe a traditional one, and I'm sure your competition is going to try to say, well, if we're cutting out PT, and we're just going fully virtual, then we're saving you money, right? So I'm just curious, I see the value of having the therapist there to teach and help and make sure you're doing it right, as well as the home exercise. And I see how both these fit together. Talk to me about the cost of adding these two together,

Raja Sundaram:

there are two ways to think about it, right. And so if you're a payer, you fundamentally are looking at the overall cost of the claim, right? Um, think about it in the context of a self insure, you're not only looking at the cost of the claim, but you're also looking at the risk of re injury. And then you're looking at productivity loss work days, and then you're looking at what you're going to pay the reinsurer right. Now, if you look at it holistically like that, and you're a risk manager of any sore, then you fundamentally want to manage all these risks, what we are coming in and saying this for really a small amount of money on the claim side as an incremental cost, you're able to get the following outcomes. Number one, you're getting the employee to return to work quicker, faster, yeah, you have insights into where you need to close the claim quicker, faster. But you also have the opportunity to now know that your risk of re injury is low, all of this occurred, because you have insights into how the patient or the injured employee is recovering. And this gives the care providers and ask the opportunity to tailor the care plan, if you're on the 75th percentile of where the population ought to be in the recovery or be too. And this person is not recovering at the same pace, you know, for the first time have the opportunity to tailor the care plan, which you never did before. And that's the huge advantage. So look at it from a business standpoint, as a claims manager as a risk manager. What is it that you're looking to manage in your risk and in a sustainable manner, that is what we are driving towards. Now, as people said, the cost of what we charge per month per injured employee who's engaged is less than what it costs for a PT for a week, right? Just to give you that in context. Now, sure, one of the big things that we are bringing in into the equation is we found that the traditional approach of looking at height, weight, BMI, on pre existing conditions, which are what care providers use, we are bringing in ethnicity into it into our data and analytics, because a combination of ethnicity, along with height, weight, BMI, pre existing conditions, and mood, and their socio economic archetype and their personality archetype. All of this leads to personalized care plans. Now, it's not the one sheet of paper with stick diagrams off you go right, follow these six things twice a day, it's more tailored towards what it takes for the individual human to recover. And that if I'm a risk manager, or if I'm a claims manager, my payer, I'm a self insured, that's of value to me, and that's the value we're delivering. Does that resonate?

Matthew Yehling:

Yeah, I can think I can think of plenty of times where we paid for a gym membership. And I never know if the people went to the gym like, I'm guilty, like Greg confessed earlier about his own little, you know, buying weight equipment. I belong to several gyms and it's like, you know, you're all gung ho at the beginning and then kind of things kind of wane and fade, and all sudden, it's like, you know, 12 months later, wait, what we're paying this gym membership, and we're not using it. I mean, I could definitely see something like that, in this space, knowing people recovering and doing their therapies at home and with this device, there's no line about it. You can't say oh, yeah, I went to the gym twice. Last week, like No, you didn't. So yeah, I personally see a lot of a lot opportunities and advantages for this. Look,

Raja Sundaram:

it has more to do with accountability, self accountability with the right support and Manage, if you will, right. 100%? Yeah, we have not looked at it as a neither do we use it as a surveillance mechanism. Look, at the end of the day, I want you to think about it in the context of workers comp, specifically, we always get asked this question, oh, you know, you'll be able to know whether they're doing it or not. And we don't want to go, that's not what we are about. They go, what are you about, and they said, Look, in Group Health, and I'll get into workers comp and Group Health. Our youngest patient is 16 years old. And our oldest is over 90 69% of our patients, or our parents age, the Medicare age population, we genuinely care about their going back to daily life, right? We have this system in our company that fundamentally says always caring. And we also think about it as like, Look, our solution will enable you to follow the path life takes you or forge your own path, right. And it's not just a throwaway for us. Because when you start thinking about the group health population at Medicare age, the kids have left home, they are in Boston, or they're in San Francisco or in New York, right? They're alone. VRF, right. So the coach plays a huge role in supporting now take the same construct in workers comp, we have an agricultural workers that we support. So we do the white collar and blue collar workers, the agricultural workers looking at it as they are eager to get back to work, because they want to provide for their family, they got a partner, they got a spouse and two kids, right. And they're like telling me I'm ready to go back to work again, we want to support them and really recovering and getting them back to work. So we kind of never looked at it as dealing with the outliers, but more than normal distribution, that people want to do the right thing want to get back to work want to keep low, and how can we enable them to do that in an accelerated manner? And yes, Matthew, it does what you said it does. We call it the golden retriever test, which is you can't put it on your brother on fake.

Greg Hamlin:

That's great. I just I felt like the accountability is a big deal. And I think no one I look at my own personal life, when I want to achieve a goal, I know I'm going to have a higher chance of achieving it. If I tell a lot of people I'm working on it, because then I'm going to be feeling like bad that I didn't follow through. And it's more about me just knowing that other people are going to be like, Hey, Greg, why are you eating that? Or Hey, Greg, are, you know, I see you're studying on your cpcu because you want that designation. But the more people I tell, the more committed I feel about what I'm going to do. And then the way I think this can act in that manner, and that it's it's another support system in I mentioned this earlier, I think our healthcare system has do it for you model and the do it yourself model. But to do it with you walk alongside you. There's not a lot of that. And I think that's where we need to see innovation like what you're offering, dude,

Raja Sundaram:

I'm sorry, go ahead. No, go ahead. No, I just talked about it. I know exactly what archetype you're gonna fit in our portfolio. Should you ever need our product? Like, I got a lot of questions. Yeah, no, I think but I think one of the advantages, you know, both Greg and Matthew, we were talking earlier about how I got how we entered workers comp. It's not only having the right advisors, but the way we started down this path is several leaders and workers comp, who you guys know, very well recovered on our platform, right? You personally experienced what it meant. And therefore went back to their risk manager, or the risk team and say, You got to take a look at this. It worked for me, right? And so fortunately, for us, we have we have all their archetypes in our platform. So we know the we know how they for lack of a better word, how the animal behaves, and how it will behave. Okay.

Greg Hamlin:

So with that, is there a candidate that's best for this kind of treatment? Or is it really going to be custom tailored, no matter what the situation is?

Raja Sundaram:

Yeah. So look, our criteria today is you need a smartphone. Right? Nothing more than that, because we do this today in English and Spanish. And we are very rapidly moving towards Mandarin and Tagalog. And so what we found was that our coaches are all bilingual. Because we found that it's a lesson that we learned in Group Health, it's helping us on our health. In Group Health, what we learned was that someone would walk into a doctor's office, get diagnosed with a knee replacement as a simple example, or a shoe or a rubber shoulder, and really didn't understand what the heck the doctor said kind of some I understood, but when I was freaking out, right, and so we would have our coaches, and our folks would actually explain to them what the diagnosis was, and therefore what they need to do in the language that they are in their first language for lack of a better word, right. And so we see the same thing we see even the physician first report shows up along with our RFA BC In a body part, and the ICD codes and the diagnosis to go along with it, you know, we have folks who claim power poles and folks who are working in department stores say, tell me again what this means, right? And so we are there we are like, look, they understand, not only do we explain what it means to them, then we articulate in their first language that we genuinely are going to be there every step of the way, on the recovery trajectory. And on that it's a notion of a difference. You can see, like a weightlifter from their, from their minds going, okay, I can do this, I know how I'm going to on these folks are going to be there every step of the way to support me. And that makes a huge difference.

Matthew Yehling:

If I'm a physical therapist, what do I need to be entered in the augmentation process? Is it just a smartphone on their enter? Or, you know, how does the therapist kind of enter that?

Raja Sundaram:

Yeah, so look, we found the physical therapist are very, very basic, right? Can we just just assure, you know, on the hour, every hour, patients lined up. So we made it pretty simple for the PT the following ways. One, we give them insights on data the way they would like to get it, we personally, so they can get it on a dashboard, they can get it on a on an app, the patient app is also a provider app. So the provider logs in on the same app, there's only one app to download in the iTunes Store, or the Google Play Store. When the provider logs in, it shows all his or her patients and what they did on certain PDS wanted it printed out on a folder and we give them you know, reports and PDF, right encrypted. So it's the way they want to consume it as what we found. But most of the time, what we find is that the PT asked the patient, Hey, show me your app. Because on the patient tab, there's a summary of the days the patient did, how many times they did, what is the range of motion? What is the walking distance? Did they take their meds, what was their pain that they reported? Everything is there. It's a one plot one stop shop. And if they are in a hurry, they would they quickly take a look at it and do it. On the flip side, we also found that it was very hard for the PTE to pause and give us the prescription that they gave to the patient. So we made it pretty simple, from a process standpoint, that we get that insight from the patient themselves, or we integrate into whatever the PT system is as appropriate. If it's possible to understand what the PTE did that way, we've taken the workload away from the PT, which is the other important thing marking, you asked about the barriers to adoption, you're asked about the good, bad or ugly, as far as we're concerned, a quality. It's never the technology because yes, we have we done computer vision for plantar flexion dorsiflexion thing push pull the ability to match. We've done that. It's not about that. Obviously, we're Silicon Valley geeks, right? The problem real problem is twofold. Number one, it's patient behavior on one side, and how do you drive engagement day in and day out? And the real other problem is workflow, how do you fit this in a physician's workflow? They're either he or she, they're pas, they're Ma's their MPs are running around with their head on fire every day with the volume of patients. And the same goes for the btw, we found if you really simplify the workflow for them. So they don't have to press three or additional buttons. It makes a huge difference. So much of our learning in this journey is not about we created the most vital fabulous technology. Yes, we have Fanta fabulous algorithms. But our real emphasis has been what on earth that takes to get patients to do what they need to do. And what on earth does it take to really simplify workflow for the provider, whether it's a doctor or a PT on the same for the claim state, give them reports that actually makes sense in English, even though there are paragraphs and right. And that's really where we put much of our effort.

Matthew Yehling:

And our focus is primarily the injured employee, how to. And I like that you're putting it back in their hands in their control, and, you know, they're responsible and accountable. And with the guidance and with the coach, I mean, you know, I am sold, if somebody you know, this is not an infomercial, I love the conversation. And learning more about this myself, you know, if somebody's looking for more information, and I know Greg has a final follow up question too. But if somebody's looking for more information about policy, you know, maybe give them where to go to how to get to your information and, and learn more about this than what we've talked about for the last 35 minutes.

Raja Sundaram:

The best way for anyone to understand is, you know, go to our website plati.com. And if you couldn't read, you can reach us through that as well. No, I want to I want to have you think about it this way. This is not an infomercial about plotting I want you I want us to think about, you know, Greg, you started the conversation with where care is going and where transition of care is gone. If you want sustainable cost management and tailored care, personalized care, a few of us can afford concierge service, right? It has to get to the masses, the only way it can get to the masses, is if you look at the entire transition of care, whether it's, it's a hospital, to a physician's group, to a BT, to an OT, to an 80, everyone has to have real time visibility into where the patient is, and how the care needs to be tailored for them. That's the way to be able to bring in personalized care and have sustainable cost reduction. I think the message really is we are just one sliver of the ecosystem. We don't think of ourselves any bigger than that. So at the end of the day, we kind of started this journey because we genuinely care about musculoskeletal because we looked at it as we're all growing older living longer, by the way, that is for all medical conditions. And if care is really moving into a virtual manner, into the patient's home, and there's more responsibility that we are putting on the patient in managing his own care that VR but a sliver in the ecosystem of delivering care. But we are an important sliver only because we provide real time telemetry, of the last bastion of darkness in data, which is what on earth is the patient doing at home. So this is not about planning. So if I'm looking at the next generation of eight entrepreneurs getting into the space, or I'm looking at the claims and risk team, or providers, or health systems of bears, then I will challenge them to begin to start thinking about what really leads to sustainable cost reduction. It's the outcomes, it's getting the productivity back, getting the employee back, not having to backfill carry the risk of re injury, all those things, which are the ROI models I know exist already with all the payers, then I'm going to challenge them to really think about cutting to PD sessions ain't going to create a suitable cost reduction mechanism in a large multinational, I have played that game before, that is not a sustainable model, sustainable model really is tailor care personalized, that get an individual back to work quicker, faster and supporting it, we are just a cog in that equation right now providing real time visibility, as are others on this game. Right? We are not it alone. But that prefer to look at it. Yeah, plenty.com v or one solution in the marketplace looking at this, there are many others. And I think that's kind of where care is going towards. That's the key.

Greg Hamlin:

Well, I just applaud you for what you're doing with your company and the steps that you're taking to really try to personalize that care and provide the support that I think is missing in between the visits. So I really, really have enjoyed our time with you today, Russia. This year, one of the things I've been asking each of our guests is to share a memory of a time they were truly happy. And while that's not directly related to workers comp, I just think the world needs it. So I've decided that this year, we're going to do that and put some good vibes out in the universe. So if you don't mind Russia, I would love for you to share a memory of a time you were truly happy. What were you doing? And who are you with?

Raja Sundaram:

I'll give you two examples, work, non work and work. From a life standpoint for me. Well, my daughter is now 10 years old since he was born because we not thought about having kids. We got a golden retriever. The gold here we've got a brother and then before the human showed up, right. Number three in the plan the family because I think it's the it's the responsibility and then bringing up a human being who's who I hope will be a good citizen and the planet and it just just sheer joy and awestruck and surprise. Greg, I know you just went through that again. Oh, yeah. The second part is from a work standpoint, look, prior to this, it used to be closing the biggest deal is negotiating the right contract. It used to be things like that. I think before or not, I think what I have experienced now be it and Group Health on workers comp and musculoskeletal is. I've had people who held my hand and said, You know, I'm able to walk to church without a crutch. Because of you guys or I'm able to go back to work and someone who worked in one of my favorite wineries in Northern California and workers comp, being able to say look, you know, I wasn't sure how long I would be in a TD and and being able to get out of it. To go back to what I'm passionate about, which is making wine now It has made a huge difference for me. Because as evident I don't shut up most often, right? And these are times when I drive by three hours, four hours back after having that conversation with no radio on and my car just completely. I don't found it. Right. And but what it does is it drives the result for us on our team to want to do this again and again and again. It matters.

Greg Hamlin:

I really love that. And I think that's a good place to wrap up today's that it matters. It does everything we do, and whether that's with our our 10 year old or our company, we can make a difference. And so I appreciate you doing what you do. We've enjoyed having you with us. I just encourage people to continue to listen, we release every two weeks, on Mondays and on the off weeks. We do have a blog. So if you don't have time to listen, you can do a five minute read and catch all of the highlights. And just remind people to do right think differently and don't forget to care. Thanks, guys.