Why the mouth may be the best window into human health: Aidar Health’s MouthLab

0:03We set out to look at this in a different way. What if we didn't have to go to a lab at all? Because in our case, two of the richest window into a human body isn't a wrist or a finger or a ring, but it's actually the mouth. Because we have access to breath and saliva, which is kind of considered the mirror of the body. So that's where we are going and that's where we are different.

0:37Satya Lumalai, CEO and founder of ADAR Health. Thanks for joining me here at Startup Health. Hi, Logan. Great to see you. And thank you so much for having me. It's always a pleasure to reconnect with you. It's been a pleasure and a benefit of what I do to get to watch ADAR Health grow and change over many, many years. And so we want to get a snapshot of where you are today in 2026 and some of the issues around what you're building, this new type of biometric device, hardware plus software, and we'll get into exactly what that is. But start by giving us just a glimpse of what the product and what the ADAR Health platform looks like right now.

1:14Yeah, absolutely. I mean, I kind of demoed our product many times in your podcast and probably Startup Health is the only organization which has seen the evolution from an idea all the way to a commercialization. So in a nutshell, we built more like a breathalyzer. It's a handheld medical device. The user actually breathed into the device and we collect around 10 vital health parameters in under a minute. And we also look into taking that data and then providing essentially an intelligence where we provide a health index. So we take all the data and create a health index, which will help physicians and care managers to essentially understand what's happening with somebody's health.

1:58few days in advance, sometimes weeks in advance, so that we can predict and prevent a potential harm or hospitalization early. Okay. Well, with things like Oura Ring and with Whoop and Apple Watch, people are getting more and more accustomed to the idea of constant monitoring of their health metrics. So help us understand how a breath-based monitor that you'd use at home is different from me just having an aura ring on or one of these other commercial devices? Yeah, I think if you see everybody in health right now wants to own a lab, right? As you mentioned, even Whoop, Aura Ring, they all try to collect information from...

2:37When you say own a lab, what do you mean? Basically, they all wanted to get additional information because whatever we're collecting biophysical measurements is only limited, especially when it comes to a variable. And And these are things also worn on the, for example, I'm wearing a wool. It's worn on the wrist and mostly you have pigmentation. So shining a light and collecting information becomes a little bit more harder while it's on the surface. And also you can only collect so much information. So what all these companies are doing today is they're sending a kid home and then having the user collect their blood and send it to a lab.

3:14or actually they're giving information so that they can go to one of these third-party labs like LabCorp or others. With all due respect, I love what these companies are building and they essentially brought the people into getting a better care or they gave them that mentality that I need to take care of my health. But heart rate movement alone is not going to add any value. We need to look into the real chemistry of the body, like how the lung, the kidneys, the metabolism of every single person for which we need a lab. We need invasive data from them. So that's why we set out to look at this in a different way.

3:55What if we didn't have to go to a lab at all? Because in our case, two of the richest window into a human body isn't a wrist or a finger for a ring, but it's actually the mouth because we have access to breath and saliva, which is kind of considered the mirror of the body. So that's where we are going. And that's why we are different. So it is a more complex sort of constellation of data. And it's closer to getting lab tests than just an Oura ring. Is it like orders of magnitude more? I mean, like, if I'm just going to compare the kind of biometric data I'm getting from a watch to the mouth lab, like what kind of scale of difference are we talking about?

4:37I think significant because the main thing is right now we're measuring the breadth, right? I think breadth has a lot of volatile compounds, which I don't think any watch can capture. I don't know if you also saw the recent news where a new company has built a ring or they're in the process of building a ring that is going to collect information from the sweat. But there's a lot of complexity associated with collecting sweat and analyzing that. And if somebody is applying a cream on their hand, it's going to be harder, which is why saliva is another factor, which is far more significant. And lastly, the lips, the blood vessels in the lips, which is the easiest way to collect really good quality data without actually having that barrier of pigmentation that we have on the skin.

5:26Okay, let's shift gears towards the sort of commercialization side of this. on the aura ring side, you've got, you know, a snazzy little ring you buy, you have a med device that's maybe more challenging, it's not going to go direct to consumer, you have to work with healthcare facilities, you have to work with clinics. And so kind of describe to me what that process has been like. And where are you deploying the device today? Yeah, absolutely. So for a device like this, there are hundreds of different applications. And every single day, I get emails people talking about, hey, can I put it in even a spa, right?

6:01So all the way from a healthcare facility to a spa. But from our perspective, we were looking into where we can make an impact. We wanted to, as I always talk about, we want to touch a billion people. So our thought process, like where we are finding the most frail people, people really need some kind of a care. And we found like long-term care, specifically skilled nursing facilities, the quality of care is not really up to the mark. And most of the time people just use off-the-shelf sensors and sometimes they just like carry the cheapest pulse oxes around. So our thought was like, what if we could build such a technology?

6:41Because in addition to our data that we are collecting, here's a place where we can also get additional data, their lab data in terms of their activity, their food, their medication, everything comes together in one place. The power of our technology is actually maybe become exponential right now because of adding the additional data. So that's why we started working with skilled nursing facilities. Right now, our focus has been to deploy to those as well as other long-term care facilities. But ultimate goal is, of course, to go to patients' homes. but here is a clear market and also there is a need for better care and there's also reimbursements available so that's what we're focusing there all right let's talk about that reimbursement structure i understand there have been changes to remote patient monitoring reimbursement talk to me about what that landscape looks like is it advantageous for what you're building is it challenging what are you looking at i think especially the recent announcement for recommendation for changing the entire remote patient monitoring program and the RPM and the RTM programs is really huge because hundreds of companies, if not thousands, rely on those codes.

8:00And the biggest challenge with that was people were really outsourcing it to some other countries, some cases, and some other organizations are actually monitoring the patients, which is really challenging. It's not outcome based anymore. They're more focused on how many measurements was taken, which is what CMS taken a step in terms of reducing fraud and abuse. If that ruling comes true in 2027, I think probably thousands of companies will run out of business. For us, it's a very significant change. But also more importantly, I feel that these changes are more to clear out some of the noise and have real companies who are focused on outcomes to deliver that.

8:47And which is why we're also really honored to be selected into a new CMS program called Access. It's primarily focused on outcomes. They don't care about how many minutes you spend, what you do, what devices you give, but the objective is, are you generating outcomes? And your reimbursement is based on the outcome you generated versus how many minutes you spent with someone or how many measurements you took from a patient. In terms of measuring those outcomes, what do you feel like is an ideal use case for MouthLab, for your device? Where do you feel like, you know, top of the heap, where you're able to see the most savings and also the most benefit to the patient?

9:31So I think mostly COPD patients, chronic pulmonary disorder, and also patients with chronic kidney disease. These are two areas that we're really looking into. And also we are using the device to help. Can we predict worsening of health, especially in patients who have like diabetes and hypertension? They eventually land into also having chronic kidney disease, which is a cycle. So we are really focused on like, hey, can we prevent, can we detect like before CKD, somebody gets CKD, how we can monitor and actually extend their life instead of giving them another device just for them to take another set of vitals.

10:17Is there a way that you can quantify for us that you've been able to maybe shorten that time, the diagnostic time or catch CKD earlier? like how much better is it if you're using a device like this? I think honestly, there's nothing there today to like detect something early other than normal lab tests. Sometimes the detection happens probably when they're like stage two or stage three CKD, right? Which has kind of happened to both my parents. Like honestly, when they were diagnosed first, they were like stage three. And then before they actually did something about their condition, they went to stage, like almost end stage renal disease and they needed dialysis, which is what we wanted to avoid.

10:57So you're saying there's no baseline for remote monitoring of these metrics. The standard of care is nothing in many cases. Yeah, especially once before it gets diagnosis. What kind of reaction are you getting from these skilled nursing facilities? What's it like to deploy these in real places with real patients and real nurses? Yeah, I think initially it was a huge shock for everyone, right? I mean, using one device to collect such comprehension information. But then we learned it the hard way. We spent like almost two years right now in these settings. We went in very green saying, hey, here's a great device.

11:35It helps you. But nobody said like, hey, I don't care. Like, I mean, we use a cuff or like a pulse ox. We are good. So we had to work around understand what's the real problems are. And right now, that's why we fully transformed our business model in terms of not just collecting data, predicting diseases or hospitalization, but also can we help them to improve their star ratings? And then specifically, there are three domains of star ratings, and we want to see how we can touch every domain. If our device is not directly relevant to a particular domain, let's say staffing, what can you do about staffing?

12:12But we can do a lot. First of all, the platform has a lot of intelligence to help with better managing the staff, but also burnout, right? So many people get burnout because of overworked. With our device, we are cutting down the time from like 12 minutes per resident to less than a minute. That's the kind of time that we can cut down, which means the nurses and the care team has more time to really take care of patients and not sitting and like writing something on a piece of paper or taking another vitals. When someone uses the device and they breathe into it and it collects 10 metrics, you are collecting a mountain of data.

12:51And thanks to modern AI, you can decipher more of that data more quickly. How much of a challenge is it to figure out how to make the most of the data that you're pulling in? Is that kind of obvious and you figured it out? Or is it sort of like, no, we have this body of data and part of our job is to figure out what to do with it? I think this was a constant challenge before. But now with all the advancements in AI, I'm really excited now more than ever in terms of how we can use the data. Because we can, I always talk about like a mind map. I was thinking where all these data could come from, what happens.

13:33But now we can simulate every single thing. And right now we have data from every source. We can pick and choose what is actually working. it would have taken like days, months, sometimes years to figure out if this parameter is going to add additional value. Now I can just do a stress test and then I can get it done in like 10 seconds. So right now we literally identify exact parameters, exact tests and exact kind of care and also the kind of food that people need to take that'll improve their health. Everything is right there in one place. Very interesting. Last question, anything we should be looking forward to from ADAR Health this year?

14:12Any announcements that you're excited about? Yeah, I think the biggest of all, as I said, like the access program, which is huge, we are actually hoping to deploy our solution to the masses. And this is the first time where we can build Medicare directly instead of relying on physicians to build for us. And which means like we can also do a much better job of actually giving the technology and using AI in a more meaningful way because we have the data to prove. And I think we probably have the largest data set coming from each patient, every single measurement, which means combining with everything else that we collect on a single day, which is going to be really a game changer.

14:56And hopefully the next time when we connect, I'm going to be having more information in terms of number, how many lives we touched, how much outcomes we created and how much revenue made. Excellent. Safiya, great to get the update. Developing a device and not just a piece of software is a long, complex journey. And so I applaud you on the FDA process and developing all of the product pipelines. You've done so much to date. And yet I know there's a lot more to do. So we'll be watching the next couple of years. Excited for what you do next. Thank you so much for having me again and look forward to talking to some of your listeners.

15:32I mean, if anyone from rural health who are managing rural health contracts or interested in the access program or even like caregivers like me who wanted to give a more meaningful life to your parents and loved ones, just reach out. Looking forward to connecting with everyone. All right. Sounds good, Satya. Thanks a lot. Awesome. Thanks, Logan. Bye-bye. and finally an invitation to all of the extraordinary health transformers whether you are a startup someone building the future of health or whether you are an investor funder or buyer of the solutions out there in the marketplace this is an invitation to you to join the startup health member community learn more at startup health.com look forward to hopefully seeing you soon.