Revolutionizing Medical Tech with AI | Hamed Shahbazi

0:00Look, as a manager of people, as an employer, and as an entrepreneur, and even an investor in startups, I can tell you the most important important thing is the quality of all the quality of people. you hire. The best part is that great candidates are already on LinkedIn. Employees hired through LinkedIn are 30 % more likely to stick around for at least a year compared to those hired through the leading competitor. And I will tell you that the great thing about LinkedIn is that you're not just looking at random people. You're able to see the people who your friends and trusted peers and colleagues who they trust and who they've hired in the past and who they recommend.

0:42And hiring doesn't have to be complicated. Realistically, when you have a business to run, you don't want to spend hours on hiring. You want to hire the right person as quickly as possible. That's why LinkedIn Jobs AI Assistant suggests immediately 25 great big candidates daily so you can invite them to apply and keep things moving. Hire right the first time. Post your job for free at linkedin.com slash altature. then promote it to use LinkedIn Jobs' new AI assistant, making it easier and faster to find the top candidates. That's linkedin.com slash Altucher. Post your job for free. Terms and conditions apply.

1:19This isn't your average business podcast, and he's not your average host. This is the James Altucher Show.

1:37Okay, so we're talking about the Oura ring. Spell that as an O-U-R-A. Yeah. Okay. Yeah. And you're wearing one. Yeah. So basically based on, it's collecting things like heart rate variability, temperature, resting heart rate, and even minute amount of perspiration around that. It can sort of detect all these elements. And so based on all these things, it starts to infer, it has a bit of an algorithm where it determines whether or not you're more stressed or less stressed. I guess when we are stressed, things happen to our heart rate, things happen to the temperature even of our skin, you know, it can sort of go up and down.

2:10And then they've been able to basically, you know, push that into some kind of algorithm that then punches out some kind of stress response. And have you noticed that since you got the Oura Ring, because now you measure your stress levels every day, have you become less stressed? Yeah, it's really interesting. I do think it's helped because it does. I go back and I look at my day and I'm like, okay, that's interesting. I didn't really, I didn't really notice that I was stressed there, but was I, you know, what, what was I doing? You know, and it, it does sort of train you a little bit, particularly with sleep.

2:43So when you're asleep, you, you know, you're not aware of all the things that are happening to you. You're not aware of all the things that you do before sleep that impact your sleep. Right. And, and, you know, if you had drinks, if you had a late meal, if you slept late, you know, all these things impact the quality of your sleep. And so So it's really helped train me because I want better quality sleep because it's very important for health, ultimately, you know, having that rest and restoration. So I would say, yeah, it's just sort of trains you and having an active guide as to what happened during the day, the things that you did, your behaviors during the day that contributed to your stress response and all these different vitals, you know, you know, it has this kind of cumulative effect that that kind of helps you act better over time.

3:27I've been afraid to get one of these devices that track everything because I'm afraid I'll just get obsessive about how many steps did I walk? How much hours of quality sleep did I get? Is my heart okay? Am I too stressed? I'm afraid I'll just become like overly, the way people check their email all the time, I'm afraid I'll just check this all the time and get obsessed with the data. But maybe it's useful. You know what? I think you're right, though. I do think about this sometimes. I used to check my email when I woke up. Now I check my sleep score. I am pretty obsessed about it. But what I've talked to people who have had it for a long time, and they say, look, it's good to have for at least a couple of years.

4:12And then you've kind of gone through that training I just spoke about earlier. And then once you've done that, you don't necessarily need it as much. So then you can sort of put it away if you think you've gotten a bit too obsessed over it and you're tracking things a bit too closely. Because really the benefit is in that training. Once you've had the training, you know what happens when you eat late, when you drink, you know how your body works. So now you don't necessarily need all the detailed analytics every day. All right. I'm going to get one. And the interesting thing is, and this is going to drive us to one of the topics I really want to talk to you about, is the data aura the company must be accumulating is probably amazing for in terms of training AI.

4:55So, so probably really figuring out the, the, the roots of stress and heart attacks and strokes and, and, you know, maybe other things like, oh, if among the million peoples who use our ring, the people who went down in income this year only got six hours of sleep, as opposed to the people who went up and income got nine hours of sleep on average. So there's going to be all sorts of conclusions and data that the AI is going to determine from this. It's unreal. You're absolutely right. Actually, we were just talking about this earlier, but Aura's got so much data. I heard the CEO talk about this at a conference years ago.

5:34He was saying that they may be one of the best predictors of whether or not someone has COVID just based on the signature of all these things that I just mentioned, heart rate variability, temperature uh you know resting heart rate and your sleep patterns and yeah they it it tells a story right and and so now what they do they is they also are able to tell you your um your cardiology age like your heart health age how how old is your heart compared to how old are you um that's interesting the other thing that it does is it it it's now starting to tell you if it thinks you're going to get sick based on some of the AI response, um, uh, in terms of, of being able to learn based on your data and other people's data, what, you know, and, and what happens to your vitals right before you get sick.

6:24Um, cause it has, cause it has a million people who have gotten sick at different points. And if you start showing characteristics like, oh, you just went down in steps per day. Your sleep went down. Um, your heart shows you probably are on a plane traveling because maybe that your heart changes there. So, so you're going to get more likely to be exposed to some, some bad air. Who knows? Well, let me ask you, can you, can you buy the data? Can you license the data? I don't know. It's a really good, it's a really good question. I think you're right though. That's probably their, their biggest, you know, you know, kind of asset as a company is that they've accumulated all this, you know, sort of first party data, right?

7:05It's their device. They've collected all of this data and they're likely looking for patterns and anomaly detection amongst all of it. So it's fascinating. I don't know if they'll ever open source it, but I know this is an area, you know, this kind of activity tracking and biometric tracking that's really, really on the rise. You know, the whole idea of our lives medically is that, you know, we used to be checked out once in a while. once in a while we'd get a checkup once in a while we'd get our vitals checked and now we're getting into a world where we're going to be continuously monitored and and and that continuous monitoring that data becomes really valuable because you know people have said hey you know my apple watch saved my life because it was able to predict that i have arrhythmia and and and and i was you know you know so we're getting into that into that stage of of life now where these things are starting to get, you know, quite, quite smart and quite continuous in sort of their, their, their evolution in terms of focusing on our data.

8:09Yeah. And, and, and using the AI or even very sophisticated statistics to kind of make, you know, and it's not like, we're looking at this as, well, okay, it's collecting healthcare data so we can make healthcare predictions, but maybe we can predict other things like, oh, the people with these health characteristics, vote Democrat. People with these characteristics are more likely to make a buy when they see an ad because they didn't get much sleep last night. And here's an ad for clothes. And somehow people who get sleep who have these other characteristics need clothes. Totally. I think those data relationships could be really interesting.

8:50I saw an ex the other day, someone had built an ETF of stocks based on CEOs that lift weights. Like they're avidly into wellness. They lift weights. And they're really dedicated to it. And it was like striking how much better than the S &P they'd performed as a group. That's interesting, right? I believe it. you know about a year ago i was i was so i was competing in um one of the various u.s senior championships for chess and somebody pointed out to me that the winners of there's like three or four tournaments that kind of are the championship for for older people in the u.s for for chess someone pointed out to me that all the winners that year you could tell lifted weights like they had you know even though it's chess is a game where you're just sitting down you don't you wouldn't think it's related to lifting weights.

9:44It does give you more stamina. It gives you more focus. And there's something to building muscles that is healthy. Absolutely. Our minds and our bodies are connected. And if we have a stronger body, I think we would have stronger minds. And also what happens is when you lift weights, you have better glucose control. We now know that glucose has a lot of insidious effects, not only in terms of our body, but also our brain. We're starting to think that dementia and neurodegenerative diseases are a form of type 3 diabetes. We started to hear that a little bit. So lifting weights is a great way of glucose control because our muscles soak up more of that glucose.

10:36So yeah, the moral of the story is you got to lift, especially as a man, as you get older, if you don't use it, you lose it. You start to get sarcopenia, then you've got other risks, you fall down and early death, all this stuff, right? I got to start lifting weights. The weights are sitting right there. I'm looking at weights, but I just never touch them. So Hamed Shibazi, I want to talk about perhaps the most important topic of our lifetime, which is the role of AI in healthcare and how healthcare is going to change, not 15 years from now, but like in the next few months or year or two years, three years, like the whole world is going to be unrecognizable.

11:19And like people talk about AI with robots and self-driving. I don't care about that at all, but healthcare is going to 100 % change. You're the founder of Well Health, co-founder of Heal Well, which is spinned out of Well Health. These are both public companies, but HealWell does a fascinating, fascinating thing with AI and healthcare, which we'll talk about. But first off, you started out as an entrepreneur, classic story from nothing. Sold your first company, I think it was your first company, for$340 million to PayPal. What's the story? We're going to talk about healthcare and AI, but I just really want to know, how'd you become an entrepreneur?

11:56Thanks for asking. And it's just, I'm delighted to be with you. Love your show. your broadcast it's great to be here um look i i i love solving problems as an entrepreneur um you know i was always just curious about solving problems i i i kind of consider myself to be a tech generalist so the first place where i was applying technology to help improve processes and you know different businesses was it was in fintech where we were trying to speed up payments lower the latency of having them post to the back offices of different billers like utility and wireless billers. This was important because a lot of people were paying a lot of money for last minute bill payments, these emergency bill payments.

12:40And we sped that up and we started to save consumers hundreds of millions of dollars because we were able to do that. I don't understand. So what was it doing? So I'm a consumer. So let's say you need to pay your utility bill or your car bill. And if you don't pay it today, you're literally going to get shut off. Like, like someone's you've, you've kind of blown through your due date and whatnot. And, and, and you would, you would typically go to like a Western union or a money gram, and they would do like a money transfer for your bill payment. And they would charge you like eight, 10, 12 bucks for, to do that.

13:15Um, and, and we came along and we said, that's, that's egregious. That's crazy. You know, we should be able to competently post a payment to someone's back office, um, you know, for a lot less than that. and we established links into the back office of lots of different billing companies. So how would I make my, so let's say I'm past my grace period, utility company has sent me five notices. I'm about to get my electricity shut off. A, how do I hear about your company as opposed to just going to Western Union like I always do? And B, what do I do? We actually became an option for a lot of the billers.

13:53You could go to the biller site directly. You could go to the convenience store. We actually had self-service automated kiosks spread around where you could actually put cash into those kiosks. And you could then, if you were under banked, or let's say you were cash preferred, you know, there was a bunch of these different ways that we could acquire the transaction, mainly outside of the bank channel. So that was the thing that we were focused on is the low to moderate income demographic that was paying outside of the bank channel.

14:24Take a quick break. If you like this episode, I'd really, really appreciate it. It means so much to me. Please share it with your friends and subscribe to the podcast. Email me at Alcatra at gmail.com and tell me why you subscribed. Thanks.

14:45Look, as a manager of people, as an employer, as an entrepreneur, and as even an investor in startups, I can tell you the most important thing for your business is the quality of the people you hire. The best part is that great candidates are already on LinkedIn. Employees hired through LinkedIn are 30 % more likely to stick around for at least a year compared to those hired through the leading competitor. And I will tell you that the great thing about LinkedIn is that you're not just looking at random people. You're able to see the people who your friends and trusted peers and colleagues, who they trust and who they've hired in the past and who they recommend.

15:28And hiring doesn't have to be complicated. Realistically, when you have a business to run, you don't want to spend hours on hiring. You want to hire the right person as quickly as possible. That's why LinkedIn Jobs AI Assistant suggests immediately 25 great fit candidates daily so you can invite them to apply and keep things moving. Hire right the first time. Post your job for free at linkedin.com slash altature, then promote it to use LinkedIn Jobs' new AI assistant, making it easier and faster to find the top candidates. That's linkedin.com slash altature. Post your job for free. Terms and conditions apply.

16:04This message comes from Capital One. With the Spark Cash Plus card from Capital One, you earn unlimited 2 % cash back on every purchase and get big purchasing power so your business can spend more and earn more. Steven, Brandon, and Bruno, the business owners of SandCloud, reinvested their 2 % cash back to help build the company's retail presence. Capital One, what's in your wallet? Find out more at CapitalOne.com slash Spark Cash Plus Term Supply. so in 2003 one of the first articles i ever wrote about stocks and finance i called it in retrospect the name maybe is not so good but i called it the poverty index and i i recommended because there was a recession it was 2002 there was a bear market as recession was happening and uh i recommended like dollar stores rent-a-furniture stores uh pawn shops and um payday lender stocks and those stocks actually did do very well and they were they were they were good businesses because like you say the the underbanked when when you're banked you don't understand that there are actually a large percentage of the population that don't even have bank accounts or or bank accounts they can regularly use because they're expensive there's all these fees so so services for the underbanked do do very well um and and And because they're local and community-based, it's surprising how few people default on, like, let's say, rent-a-furniture situations or payday loans and so on.

17:42Yeah, absolutely. And, you know, it's expensive to be poor, unfortunately, right? And so it's sort of counterintuitive. You know, I shouldn't have access to cheaper services because I don't have as much money. But no, I actually have to pay more just to expedite a payment. And so this issue of accessibility and technology is a really big thing. And this is what we've tried to do at Well Health is to try to give that higher end experience to just normal primary care visitors. that allow them not to have to come in and sit for a couple hours for their doctor to show up, to be able to respect their time through digital technologies, allow them to book online, allow them to feed information into the clinic to save them time, allow them to check in on their mobile phone.

18:38So we've developed all this digital patient engagement to help patients and clinics interact with each other. and then we've applied that to an enormous owned and operated network. So we're the largest owner operator of outpatient medical clinics in Canada and we own a significant number in the U.S. as well. So overall, Wells have about a billion dollars in revenue this year, very profitable, 130 million EBITDA is likely what we'll get to generating pretty significant cash flow. And And we're doing millions of patient visits. And our worldview is tech-enabled healthcare. It's incredibly important to us.

19:20We're not just out there just trying to be an owner-operator. We really want to be as tech-enabled as possible so we respect people's time and deliver a better experience. And I want to talk about Well Health, your clinics, but also Heal Well, which is you also, as we were talking about with the Oura Ring, You have millions and millions of patient records that you've been able to create an AI model on. And I want to talk about how this is going to literally change the future. But I still am fascinated. How did you start your first company? Like, what was the transformation that took you from, you know, whatever to entrepreneur to successful entrepreneur?

20:06Thank you. Well, I think, you know, I think it was just, I think as an entrepreneur, you have to be, have a bit of audacity to think you can make a difference. But what was happening in your life? Like, what were you doing? You know, it's interesting. This was really right out of school for me. I had just finished my engineering degree and I did engineering because, you know, growing up in a Persian family, I was sort of given the choice of being a doctor or being an engineer. And my dad was an engineer. So once I finished engineering, I loved it. It was very interesting. But I just really realized that I don't want to be an engineer.

20:48I realized that I want to be a businessman. And so it was around the time when, you know, we started to see really the rise of, you know, the graphical Internet. And I just knew that I really wanted to be part of that of that growth. I wanted to be involved in and this is before iPhones. You know, I'm not I'm not in my 20s or 30s anymore. Right. So and I could just see that the Internet was going to disrupt everything. And so, you know, it became a really, really big priority for me to get involved in this technology revolution and apply, you know, the digitization and modernization theme to different businesses.

21:32And that's really what I've done all my life now. I've applied it to fintech. I'm now applying it to healthcare. It was remarkable that I even had the chance to do that with healthcare. It just goes to show you how much lag there is in adoption of digital technologies. Particularly with healthcare. Like healthcare, I feel is 30 years behind the times. A hundred percent. And so, you know, in 2017, 2018, you know, around the time that I'd sold my previous business, I remember having these experiences in doctor's offices and I was thinking, this is unreal. Like I could have had the same experience 10, 20, 30 years ago.

22:08The doctor came in, was handed his, you know, paper folder and he wrote paper notes and And I got a paper, you know, kind of referral that I had to then use to call someone else with the phone. And it's just like everything about it was not digital. It took forever for me to get in. There were people running around everywhere in the clinic. It didn't look very organized. And I was like, you know, I wonder if this is like an anomalous situation or is this the state of play in healthcare? And so I started to do some research and I was like, I was just floored. And at that time in Canada, we had 0.25 % penetration in telehealth throughout the country, which is unreal.

22:49It's really, really low at a time when... How do you define telehealth? Telehealth is a patient physician consultation that occurs in any other format rather than an in-person consultation. So it could be over the phone. It could be an audiovisual kind of link like this. And, you know, 16, 17, we've got iPhones everywhere, all over the world. And so the idea that there wouldn't be, you know, video calls are commonplace, but they had not really made their way into healthcare. Some of the different HMOs were doing this, like Kaiser Permanente in the US had had already quite a bit of growth in telehealth and whatnot.

23:34But as a country here in Canada, we were quite low. And just for contrast purposes, two years later during the pandemic, because of physical distancing, we got to a high of 80 % penetration of telehealth. So 80 % of all visits were attributable to telehealth and 20 % will not. And now it's now post-pandemic, we're back down, but we're not back down to the same levels we were before. Pretty much in all industrialized countries, we're in that 40 % to 50 % range. So forever, this industry has now changed as a result of the pandemic. You can't say that about too many industries where forever they're changed.

24:11Now there's an entrenched kind of behavior and preference to see physicians online for certain types of appointments. That could be mental health. It could be chronic disease check-ins. It could be for prescription renewals, all that kind of stuff. Yeah. And it seems like, well, first off, it seems like the general trend for humanity is we don't ever want to leave our house. like you know right now i can get a chef to cook me food and somebody else will then pick up that food deliver it to me and then i can watch a newly released movie streaming right into my house like i just never have to go anywhere and i can have a telehealth physician to you know give me a prescription for something and i can go out and get antidepressants and testosterone and whatever just deliver to me.

25:02All delivered perfectly. Yeah. Yeah. And if you want someone to actually give you the shot, there are actually people now, there's all kinds of businesses across the country. They'll come over and they'll give you that B12 shot or they'll give you, and they'll administer the shot for you if you don't want to do it yourself. Yeah. I just applied for life insurance. So someone came here and took my blood and did all the blood tests. And then also I used used the, I haven't used this lately, but the IV doctor where they come over and give you like vitamin C and whatever. You know, I would do that before traveling, but also with telehealth now, you have more opportunities to collect digital records, right?

25:42So like what sorts of data did you, once you were doing, having millions of patients do telehealth with your clinics, what sorts of data did you start to collect? Yeah. So I'm really glad you brought that up because thematically speaking, electronic medical records have been around for a while. And while there has been less usage in the past, that's growing tremendously. And for a long time, doctors have been entering in all this data, right? Entering in their observations of the patient, what they're dealing with, what the assessment of the visit is, what the care plan is, what drugs they're taking, whether or not they're working, all this kind of stuff.

26:23All this information is going into the patient record. And, you know, if you're seeing a specialist or you're getting labs done on your blood, all that stuff is coming into the primary care record. And the problem is all this information has been going in and very little value has been coming out. And this is where our partnership with HealWell, our spin out of our data into HealWell has been tremendous because we now have, you know, physician co-pilots, like AI co-pilots. What is AI really good at? Taking a vast amount of information, very complex, very complicated, and being able to actually create very simple insights and be able to deliver those to people at the right time and generate those insights based on that kind of anomaly detection and learning from data.

27:11What's an example? There may be a certain pattern, a certain signature to a certain disease. Let's say how your blood tests come back, the types of vitals that you exhibit in terms of your enzyme levels or whether or not you're prone to diabetes or your BMI. All this kind of stuff could inform the view that maybe you have some kind of diabetes or chronic kidney disease or anything like that. Maybe the doctor hasn't picked that up because they have not been able to review all the information. there's so much information in the patient record it's really hard for the doctor to go in and connect the dots and integrate the information on the fly especially when you consider that here in Canada doctors are getting paid 30 40 bucks for primary care visit in the U.S.

28:01it's not that much more right so it's a lot of work to do for a little for a little bit of money and so um so so basically this software will will you know what we call risk stratify the patient for particular diseases. It'll say, hey, these are the patients that are red, yellow, green. They're at risk for heart disease. They're at risk for diabetes. They're at risk for chronic kidney disease. Or they're red, meaning like... I'm sorry I keep interrupting. I know I'm going to get complaints later from listeners that, oh, you're going to interrupt too much. But I just want to, I get curious about, is the problem that...