Robert Stanley — Why Home Is the Next Healthcare Infrastructure Layer | FV Podcast Ep. 47

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Today's guest is Robert Stanley, founder and CEO of Cha Group, the parent company of state home nursing care services and Cha Technology.
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After nearly a decade of building one of Ontario's established home care providers, Robert recognized the problem that healthcare systems, not just in Canada but everywhere, struggle to solve.
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What happens to patients between visits when nobody is watching?
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Instead of simply adding more caregivers, he built a technology platform designed to predict deterioration before a crisis occurs.
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Today, Cha combines AI-powered monitoring, clinical response teams, and real-world care delivery in what Robert calls comprehensive health care at home, a model that could fundamentally reshape how healthcare is delivered, funded and scaled in an aging society.
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Welcome to the stage, Robert.
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Hey Maxim, how are you?
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Thank you so much for having me.
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So what drove you to pursue this problem?
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So there's a number of different things that drove me on a personal level, but on a business level.
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But the biggest overarching one is just the recognition that our system can't sustain itself the way it's going right now.
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I mean, we're we're already at a crisis point today, and the demand on healthcare is only going, and it's just mathematics.
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It's gonna get more for 25 years.
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The uh peak 82-year-olds in Canada is gonna be somewhere in 2051, 2052.
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So demand is gonna continue increasing.
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We need to do something different, is the one true fact that I think anybody can recognize.
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Understood.
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Um and so if if I asked the average Canadian what the biggest healthcare problem is, um what do you think they would say?
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So that's a great question, actually.
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I I think it depends on their mindset at the time.
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So I think one of the biggest issues with healthcare is we don't think about it until it becomes an issue.
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And that's true of the individual and the family as it is of the system.
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We're very reactive when it comes to healthcare.
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Um but when it happens, it becomes a crisis that um can be quite challenging, uh, especially in the overburdened system that we're in right now.
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So the idea of comprehensive health care at home is to have monitoring and insight on an ongoing basis for people who are vulnerable and at risk.
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And the goal, the the two big principles are more care at home because we don't have enough institutional beds, and more predictive and preventative care instead of the reactive models that we have today.
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But isn't our system designed to reward to reward visits?
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I mean, isn't the billing system such that the more times that you go to the doctor, the more billing they have?
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I mean, like you see the signs, and I'm assuming that those signs today for a reason that like one visit, one problem per visit.
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Um, so kind of like how do you view this?
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And how do you see this uh being so from reactive to preventive, from episodic to uh continuous?
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So I'm I'm coming from outside the healthcare industry.
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Actually, most of my career is in technology.
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I came into healthcare about 10 years ago and started a home healthcare company.
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So sometimes I feel like I have a different perspective than many of the other people that have been entrenched and doing it their whole career.
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The system we have here in Canada is incentivized to episodic care, just what you're saying, right?
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So we we fund ourselves, we measure ourselves on that visit, on that procedure, on that ambulance ride.
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Um, there's nothing in our system that incentivizes anybody in one of the largest industries in Canada to do preventative care.
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Um, and it doesn't have to be like that.
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So I mean, this is a broader problem than we're gonna solve at Shah, but we're we're doing a piece of it to show that it's possible.
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Uh, models like Germany have structured a healthcare system that's built around population health and trying to avoid issues before they come.
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So I think this is one of the biggest problems in Canada is that we don't incentivize prevention.
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We wait for crisis to come and then it becomes more costly and complicated to deal with and creates uh challenges for the individuals, but also for the system.
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So a couple of uh trends that they're uh sweeping across the industry.
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Obviously, with the advancement of GOP1 drugs, I I read the statistic that 2021 was the turning year when actually we started to decline in terms of obesity rates rather than incline.
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And so this is one component.
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And so on on our show, we have interviewed six or seven life sciences biotechnology founders, and the the common refrain or or kind of like the the their feedback is that the majority of diseases are uh inflammation-related diseases, and we just haven't taken the time to actually understand what's behind them.
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Yeah, so it's going to treat the symptoms.
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And this is the thing is that we we see these things building over time.
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Uh, there's a great phrase uh from Hemingway uh when he's describing how a bankruptcy happens, very gradually, and then all of a sudden, right?
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Yeah, yeah.
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So this is this is healthcare as well, right?
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Like we have all these gradual buildups that happen over decades for many of us.
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So our bodies break up to my age, and things get a little bit harder, but it's then that sudden kind of twist or transformation or illness that hits you, that weakens you, that that ends up being a problem.
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But the signs are there much earlier, and so GLP1 is a great way for general population health.
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I think at Shaw, we're focused more on the seniors and people who are vulnerable already.
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We know they're consuming a lot of healthcare dollars, we know their needs are going to be there.
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And what can we do to prevent that?
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Um, if I can, I'll give you one example that I think is pretty tangible.
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So, urinary tract infections, many people don't realize is a huge cost and challenge for seniors.
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Uh, it's the third leading cause after falls of cardiac for hospitalization.
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And when you get a urinary tract infection, if you're prone to them, you're gonna keep getting them, you know, several times a year.
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Uh, if you get$20 worth of antibiotics and you within the first three or four days, you're gonna clear it up.
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If you don't, it'll often present a sepsis.
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You'll be in hospital for eight to ten days, it costs the system twenty thousand dollars instead of twenty.
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Uh, and the worst part for me, an 8.1% mortality.
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So, out of every 12 people that go in, it costs a quarter of a million dollars to the Canadian taxpayer.
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Uh, and one of those 12 people is statistically likely to pass away early from secondary infections or other challenges.
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So we can prevent that by certain signs combined with clinical interventions with the chat technology.
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So so, Robert, um you're a technology guy, and um you can solve any problem if if you have access to the underlying data.
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So, in this case, UTI.
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Um, like I was early in the week, I was talking to a founder that's trying to solve the endomitriosis.
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Um, so with the platform that you're building, how are you ingesting data and health signals from patients?
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Is it like ambient sensors or is is there like sensors that like that are on the on the on the on the patient or I guess the uh the the the person that is living in home kind of how are you accumulating data in order to be able to derive the signals that they're necessary to catch things earliest before they're developing or before they're developing to to be able to intervene?
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Yeah, it's um it there's a few different ways, and the the key is the data, but it's the inside of continuity to see those small changes over time.
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Um, everything we do today is ambient.
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We haven't um closed the door on potentially having wearables at some point, and there's some really interesting wearables that can come in that are very um you know non-intrusive to people, like clothing that could have signals built in it um that other companies are producing.
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For us, we're using uh optical sensors, so cameras in the home, combined with a bed mattress that can give us temperature and uh heart rate.
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It gives us motion, so we get a sleep quality index.
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We also a big risk for seniors uh with mobility issues, they don't move around enough at night, so get a sense for that.
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And this can lead to pressure, which is another key element for people that are aging and restricted mobility.
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So everything we do is is ambient sensors.
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Um, that's what we have today.
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We're actively engaged in various academic research partners with uh Bruyere up in in uh Ottawa.
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And the beauty of our system is it's sensible.
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So the core hub that we have going in is built so that we can bring in different sensors over time and hopefully address more and more problems uh in the home uh with more advanced care.
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So how much of healthcare technology today is solving theoretical problems rather than operational problems?
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And and kind of can you guide me through you uh decision or thinking process in terms of like you first started the the um the healthcare company, then you put your technology?
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Yeah.
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So the technology wasn't a long-term plan when we started building a home care company 10 years ago.
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Um, I saw that home care just as a business, home health care, uh one of the fastest growing areas of healthcare uh as a as a sector.
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The demographics were very clear that there was going to be more and more demand.
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Um, and it's a really interesting, just forget the technology for a second.
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It's a highly fragmented market.
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Uh, from a technology perspective, uh, we would call it a perfect market for disruption and consolidation uh because it is so fragmented.
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Um and so this was a good business, it's been a good business, it's funded the growth of the CHAD technology.
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What I think is really interesting about the route we've taken, because I'm now entrenched within the med tech industry, we're talking to a lot of other founders and companies, and I've looked at the history and healthcare technology, especially in Canada, has a long history of coming up with brilliant ideas that then fail at the clinical implementation.
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Uh, we we have all these pilots that go on, but the doctors, the nurses that are stressed and stretched and overworked and don't have time to figure out how am I going to take this and work it into my 18-hour day at the emergency room?
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I don't know how to do it.
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So we're building it completely entrenched in the clinical workflows of existing home care companies within our own for now, but we can have an alert come out, AI saying there's something wrong, but we can have a nurse or a physiotherapist or occupational therapist now respond and take some action.
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And the goal is to make it so that this can go up in any home care operation uh with the technology now kind of modeling existing home care uh standards and clinical processes.
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So, I mean, this this is really interesting because like most technology founders would go and build a technology and then try to adopt the technology to the environment.
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You're taking a different approach where your home health care essentially becomes your living lab.
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Whatever challenges you find, you go and solve by technology.
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Um I'm assuming that it's like from a product market fee perspective, you you don't have to worry about this because you're living with a problem, you're solving a problem.
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What have been the biggest aha moments?
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What have been the biggest uh, I guess, fixes that that you have been able to solve?
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Uh so I think um the biggest transformation for us was the realization, the vision's been very solid right from day one.
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So we we saw this problem, we articulated it.
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We started with a point of view, which is more care in the home.
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Um, but I think the real uh aha moment for me is is just again, it's lining up with those clinical workflows.
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It's being able to talk to, I have a fantastic director of clinical care, and sitting down with her and other members of the team and saying, okay, today, when you get a family member or one of our existing field workers coming in and saying, Mr.
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Smith is a bit groggy, he's he's got some cognitive issues, he doesn't seem the same.
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What do you do?
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And now what we're doing is we're giving an enhanced signal, the signals that we were already getting, but just sporadically.
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So now we're we're just improving the signal, but still mapping it back to what would we do in the same signal in the traditional sense?
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It's that connectivity with the existing workflows that make it much, much easier for my nurses and personal support workers and therapists to be able to say, okay, I know what to do with with that alert.
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Um, it's something that I've done in the past that's just better, you know.
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And and and how do the clinical workers consume this information?
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Is it something that shows up on their phone?
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Is do they have like a dashboard?
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Um, um, and and what what what has been their reaction to this?
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So uh positive.
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Everybody's really excited.
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I think this is one of the things that's interesting for us is that we see uh a broad need.
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So I'm now looking outside of our company.
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There's a broad awareness in the healthcare industry that we have to shift more care into home, but there's concerns about the scalability and the efficiency of home care in the face of limited resources, workforce shortages, and the demand curve, right?
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So as we go in and we say, look, we can actually work in a much more efficient way, we can respond to people.
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So we haven't really talked how the system works.
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The um the system is monitoring 24-7 in the home, it creates a series of alerts, and we can detect the specific events that are occurring.
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So we could detect a fall, we could detect a dementia patient that's exiting a cold winter night.
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Um we can predict, this is where the real magic happens.
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We can predict that UTI if somebody is going into the washroom a lot more and their temperature is elevated from the bed sensor.
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So I don't know that they've got a UTI, but now I send a note to a nurse, and your question was how do they react?
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We're we're sending the trigger alerts through through the same clinical um electronic record that we've been using.
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So we use a particular that's specific for home care.
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Um, you know, hospitals use Epic or other systems.
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Um, ours is just going straight into that EHR that our team has been using for years now, and it comes up as a clinical alert.
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We have different uh alert statuses if it's you know critical or if it's something within the 24 hours we can deal with.
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But they're getting the same kind of alerts they have and then responding to them.
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Uh, if it's a prediction that somebody is at risk of a fall, we're able to predict weeks in advance, up to four weeks in advance with 76% accuracy, that somebody's at increased risk of a fall.
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And so when that happens, we have a time window to now get an occupational out and maybe install grab bars or change how we look at the transfer or how we move around the house to try to prevent that fall if we can.
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Curiosity question.
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I mean, you you identified two of the biomarkers for UTI, kind of like what are the biomarkers or data uh data that you consume into predicted somebody is is it a higher risk of a of a fall?
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Fall.
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So um we've been part of our our growth curve of the past uh almost two years.
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We've been at this almost two years.
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Um we've been working with a lot of academic institutions.
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So um UHN Kite is one who has done two years, so out of Toronto, um, they're one of the premier research uh hospitals in Canada, uh, the premier research hospital in Canada.
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And they've been researching for two years now in um institutions, um, gate analysis of how somebody is walking.
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And so if you think about how somebody's walking, if they start shuffling their feet more, if they're crouching over more, um what their research has shown, they can not only detect that somebody's at risk of a fall weeks in advance with a high degree of vaccination, they can detect a risk of aggression in a dementia patient almost 24 hours in advance.
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So there's an unfortunate reality of people with dementia, some will get aggressive.
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We still have to care for them.
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But if we know that they're in an increased agitated state, there's techniques, uh, you know, for example, gentle persuasive approach.
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My staff can be primed with and say, hey, before you go in, be aware that so and so, this client might be a bit aggressive.
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Here's some we can do to try to mitigate that or avoid that and and calm the situation down.
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So it's all about just finding what there's so much you can learn from that.
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Yeah.
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Are you uh are you collaborating backwards in terms of are you sharing the data back based on like the 24-7 observ observation from the in from the from the from the in in home, um just to be able to essentially reinforce the learning with the academic institution?
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So some there's complex data sharing uh around any kind of healthcare information.
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Um and we we're following established research protocols, and we're very clear with anybody who's coming on board, um, you know, what they're agreeing to.
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Um but one of the projects we're doing that um is getting a lot of anonymized data that I think will be really powerful is uh an econometric study with McMaster University.
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So we're looking at the feasibility of uh care in the home.
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And our phase one and two is looking at how well we're doing.
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But our phase three, that that um so this is an 18-month to two-year project that that uh is underway right now.
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We want to get to the point where we're actually measuring what the downstream benefits are.
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So if we prevent the fall in the home, uh, how many ER visits are we avoiding?
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How many unscheduled overnight hospital states are we avoiding in this population?
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Versus um there's a great data set called the Canadian Longitudinal Study on Aging, um, where, for example, 30%, I think is the number of uh people over 65 will have one or more falls per year that result in a hospitalization.
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So if we can bring that down by a significant and relevant number, a defensible number, we can go to the health authorities and say we could save you you know hundreds of millions, billions of dollars possibly by avoiding these three things.
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And I'm assuming that the longitudinal status is a continuous study.
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So in two years, three years, five years, there'll be another set of data that's ingested.
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Kind of yes, you'll be able to benchmark, compare, kind of like what's happened before this, what's happening now.
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Okay, understood.
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So I I I love I love data, and um we're we're working um and really uh trying to support.
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So it's it's we're not driving this, but I'm trying to support an initiative to get a uh Canadian unified health record going.
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And there's a lot of people working on this.
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I think there's a real chance for it to happen.
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I hope it does.
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But whether we get that unified health data or we just build up SHA to a few thousand people, this longitudinal data that we're talking about, it's gonna become the best predictor we have of the next pandemic.
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Right?
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Like the folks that we're studying, even if we only have a few thousand people but scattered quite quite far across Canada, yeah, these are the most vulnerable people to a pandemic.
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And if we start to see clusters of respiratory disease, so we monitor audio, we can monitor cough events and predict somebody's increasing risk of respiratory disease, just in general.
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But if we see patterns that are happening in clusters, um, then it becomes a warning sign that.
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Canary in the coal mine for the next pandemic, potentially.
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Pan-Canadian health data strategy.
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I'm excited about data and health.
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That's amazing.
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So I see a number of different things at play.
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Um on the in-home care, um, obviously providing the highest quality of service um allows you to attract more patients.
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I'm assuming that you're going to deploy some kind of roll-up strategy there.
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On the technology side, the technology is technology, but also see the data as a data platform.
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Kind of like what's your vision about scaling Cha Group?
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So uh today it's really about scaling the clinical deployments that's gonna drive data, it's gonna drive insights, that's gonna drive improvements, which become a very defensible mode.
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Um ultimately, I think, you know, five years from now, seven years from now, the data will be our most valuable asset as a company.
00:23:00.079 --> 00:23:04.079
But uh and and it'll be the most defensible part of what we have.
00:23:04.319 --> 00:23:09.759
Um, but for today, it's really about building that base, getting clients on board.
00:23:09.920 --> 00:23:13.759
Um, we have a verbal commitment to our first publicly funded pilot.
00:23:13.839 --> 00:23:16.799
So we're hoping to roll that out by July or August.
00:23:17.039 --> 00:23:23.119
Um, and this is a pivotal moment for us because I don't want this to be a purely private option for people.
00:23:23.200 --> 00:23:30.720
I I want it to be a option for people, um, privately, but I don't want it just to be a private option.
00:23:30.799 --> 00:23:38.000
I'd I'd like to justify to our publicly funded system that this is something that actually benefits you, public system.
00:23:38.640 --> 00:23:42.640
Yes, it does your clients and then the population at large.
00:23:44.079 --> 00:23:53.920
I mean, if that happens, it would be really interesting to experiment to just compare patient health, patient outcomes, patient satisfaction.
00:23:54.240 --> 00:24:06.000
I call them patient because I'm not exactly sure what is the right word for it in this case, because they're not necessarily the hospital setting, but it'd be interesting to judge the both people that are using the technology versus people that are not using the technology.
00:24:06.319 --> 00:24:10.079
And that's the long-term goal of the McMaster study that we want to get to.
00:24:10.240 --> 00:24:16.480
So stage one is really measuring the feasibility, measuring the results, seeing what we're getting, uh, measuring adoption.
00:24:16.559 --> 00:24:24.559
So a big part of that study is also um a key question, which I from what we've seen so far, I'm not worried about.
00:24:24.880 --> 00:24:31.200
Um there will be privacy concerns, there'll be many people who will never want to have a monitoring system in home.
00:24:31.599 --> 00:24:48.720
Yeah, but we have hundreds of clients already in our home care operations, and I don't have an exact count, but it's about one in four already have cameras in place that a son or daughter or family member has put in place to watch mom or dad.
00:24:48.960 --> 00:24:57.519
Um, and we're we're getting from these people already who say, Yeah, I've got the camera already, and I'm worried because I can't watch it all the time.
00:24:57.680 --> 00:25:00.880
And and I I saw your system, I heard about your system.
00:25:01.200 --> 00:25:10.079
And so the the adoption curve, I think, is going to be quite fast as we as we start to get more and more press and awareness and visibility.
00:25:11.039 --> 00:25:25.759
Is the acceptance um same, similar between the people the being uh the people in the bean carry thing, their homesetting versus the their their family, so their their loved ones?
00:25:26.720 --> 00:25:30.079
Uh it's a different sort of acceptance across the board.
00:25:30.240 --> 00:25:38.799
So I had a call actually just last week from a gentleman who's uh in his mid-80s, and he was calling on behalf of himself.
00:25:39.039 --> 00:25:44.720
Uh he's single, so uh he doesn't have anybody living at the home with him.
00:25:44.880 --> 00:25:46.480
His son and his family are close.
00:25:46.559 --> 00:25:54.880
He doesn't have any health issues, but he does walk every day, he stretches, but he was proactively, I was really impressed by this.
00:25:54.960 --> 00:25:58.240
He was proactively thinking, you know, what if something happened?
00:25:58.319 --> 00:25:59.759
I don't want to be a burden.
00:25:59.920 --> 00:26:04.960
I'm worried that if something happened and my son's half an hour away, it's still half an hour away.
00:26:05.440 --> 00:26:06.640
He doesn't know.
00:26:07.119 --> 00:26:13.039
Um, and so we started having a conversation about how proactive monitoring uh might work for him.
00:26:13.200 --> 00:26:15.920
Um, so there is an acceptance among that.
00:26:16.000 --> 00:26:27.680
Uh, we are dealing with clients who often have what are called substitute decision makers because cognitively um they're they're not uh able to make a decision like that.
00:26:28.240 --> 00:26:36.720
But the families and the person themselves before cognitive decline made it very clear that they wanted to stay at home as long as possible.
00:26:36.960 --> 00:26:46.000
Um, and so putting this in place is sometimes the only option compared to going in a nursing home or a long-term care setting.
00:26:47.440 --> 00:26:48.240
Understood.
00:26:48.400 --> 00:26:53.279
Um don't know uh the the specific numbers.
00:26:53.440 --> 00:27:12.319
Uh I was talking to uh a doctor that's uh uh here in Khabi, and one thing that really surprised me based on what they said is that it's surprisingly high number of people when you when they fill out the the forms, they don't have an emergency contact to put on.
00:27:12.559 --> 00:27:17.839
And so I would think this is a great solution for people that that are in that predicament.
00:27:18.240 --> 00:27:32.720
Yeah, yeah, and and there's there's many people that are in today's society, especially in Western society, uh, there's more and more people that are either living alone, or in many cases, this was the case with me and my mom before she passed away.
00:27:32.880 --> 00:27:37.440
Um I was living in Singapore, um, and she was in Canada.
00:27:37.839 --> 00:27:44.720
Uh when she got ill, my sister was close by and and had the burden of caring for her during that time.
00:27:44.880 --> 00:27:56.079
I was supporting financially and and um morally and and coming back as often as I could, but that distance was really painful for me and and for her as well.
00:27:56.400 --> 00:28:03.200
Um it's more common today than than the opposite of people living close to each other.
00:28:04.079 --> 00:28:05.039
Yeah, uh yeah.
00:28:05.119 --> 00:28:10.960
I mean, as you're saying this, this is very much top of mind for me.
00:28:11.119 --> 00:28:25.119
I live in Bulgaria, my mom lives in Switzerland, my grandma lives uh sorry, my my mom uh and and uh grandma live in Bulgaria, I live in Canada, my brother lives in Switzerland, so he's a little bit closer, but it's this is constantly on my mind.
00:28:25.359 --> 00:28:34.000
Like I'm at best 16, 18 hours, even if all flights line up uh from being here to being there.
00:28:34.559 --> 00:28:42.559
So my VP of technology um is amazing, he's an incredible man and and has been a huge support for everything we've been rolling out.
00:28:42.880 --> 00:28:54.480
Uh, the first client we had, uh you know, about now 14, 15 months ago, was his mom, um, who is 95 years old, living on her own.
00:28:54.720 --> 00:29:00.960
Uh, his brother lives close by and can watch him, but it's the exact same story that is very human.
00:29:01.039 --> 00:29:11.519
This is this is one of the most amazing things for me as I go out and I talk to people, senior level people in healthcare, individual, it doesn't matter who you're talking to and what their capacity is.
00:29:11.839 --> 00:29:14.160
We all have a story like this.
00:29:16.240 --> 00:29:28.480
Okay, what's what's like how how do you envision in home care five years from now, ten years from now?
00:29:28.559 --> 00:29:29.599
How how would it be shaped?
00:29:29.680 --> 00:29:31.200
How would it be different?
00:29:32.160 --> 00:29:34.640
So um uh it's a great question.
00:29:34.880 --> 00:29:42.400
The when we say comprehensive health care at home, this is something I've been learning an incredible amount about the the broader healthcare system.
00:29:42.480 --> 00:29:50.720
So going far beyond home care, it's uh fascinating for me to learn how the Canadian healthcare system is set up with silos upon silos upon silos.
00:29:50.799 --> 00:29:55.759
We have silos at the provincial level, and then we have silos within that as well.
00:29:56.400 --> 00:30:08.319
And um, under the Canada Health Act, as Canadians, we're all guaranteed four things: uh primary care, specialist care, acute care in the hospital, and long-term care.
00:30:08.480 --> 00:30:18.720
Home care is not guaranteed under the Canada Health Act, but every provincial health care provider offers home care of one degree or another, but it's not guaranteed.
00:30:18.960 --> 00:30:31.119
And when we get our new budgets each year in Alberta and in Ontario, uh there's a huge arm wrestling fight over I need more money for hospitals, I need more money for long-term care, I need more money for community.
00:30:31.920 --> 00:30:35.839
We all work in our own little silos and we try to get this.
00:30:36.400 --> 00:30:49.440
When I talk about competitive health care at home, it's not more home care, it's every one of those five pillars primary care, all of that in the home.
00:30:49.839 --> 00:30:53.920
So uh you asked five years down the road, 10 years down the road.
00:30:54.240 --> 00:31:08.160
I envision um an uh opportunity for us to build robust hospital at home where you can get the same level of care that you would get in a hospital in downtown Toronto in Pickle Lake, Ontario.
00:31:08.799 --> 00:31:10.720
And this is not a pipe dream.
00:31:10.880 --> 00:31:16.319
Um, the UK already has over 10,000 of these, they call them hospital wards in a box.
00:31:16.559 --> 00:31:25.599
So imagine these big cases uh like cardiac ward, pediatric ward, respiratory ward, oncology ward.
00:31:25.920 --> 00:31:29.440
And they can deploy these out to any homes around the UK.
00:31:29.759 --> 00:31:36.079
Um the problem that they have right now is they don't have the integrated care and the monitoring.
00:31:36.240 --> 00:31:43.279
In most of these hospital-at-home programs today, there's a tablet, like a tab or something, with a big green button on it.
00:31:43.359 --> 00:31:49.359
And if you have a problem, you press it and you're connected with somebody at a remote call location that you can talk to and get some help.
00:31:49.839 --> 00:31:54.960
This is not great if you just had a stroke or a cardiac event or fall that's your head.
00:31:55.839 --> 00:32:12.319
And that's where I think RAI, combined with some of these other initiatives, get to the point where we can offer a full range of healthcare to individuals in locations, which the Canada in particular, I think, will be an amazing advancement.
00:32:15.759 --> 00:32:16.400
How?
00:32:18.319 --> 00:32:27.119
Um how receptive are the funders to adopt this and to uh move in that direction?
00:32:28.079 --> 00:32:32.079
Uh so um it's good and bad.
00:32:32.160 --> 00:32:40.160
Uh, I'm having amazing conversations, and we talk to people about what we've done so far, what data we have, what proof points we have.
00:32:40.400 --> 00:32:44.720
Um, there is an enthusiastic response almost across the board.
00:32:44.880 --> 00:32:46.960
Um people are excited about this idea.
00:32:47.039 --> 00:32:49.279
They recognize that it's the way we have to go.
00:32:49.440 --> 00:32:57.279
There's also a recognition at the top levels of healthcare that we have to change, but they're not sure how in many ways.
00:32:57.359 --> 00:33:02.079
So they're they're kind of looking around and trying to find different solutions, which is good.
00:33:02.160 --> 00:33:04.240
It means they're they're receptive to it.
00:33:04.480 --> 00:33:17.759
The problem that I think we we're overcoming now, but I'm I'm worried a little bit about the disconnect between who's benefiting, who's paying, and what the results are.
00:33:18.079 --> 00:33:31.680
Um, so somebody pays for preventative home care and pays for our solution, the benefits are accruing to the publicly funded system and the hospitals that avoid having somebody in them.
00:33:31.920 --> 00:33:32.240
Yeah.
00:33:32.720 --> 00:33:34.559
Well, how do you measure those KPIs?
00:33:34.640 --> 00:33:46.160
How do you say, hey, this is a successful program unless you bake in KPIs and incentives around population health and preventative measures, which we don't really have in our system today.
00:33:46.400 --> 00:33:59.119
So that's challenges to help develop those with uh you know provincial and federal parties to try to build out a vision of population health and and uh how we avoided healthcare issues.
00:34:00.799 --> 00:34:06.000
I don't know, but it's it's a good initiative.
00:34:06.720 --> 00:34:08.000
No, I agree.
00:34:08.079 --> 00:34:35.199
Uh, I think in our last conversation was mentioned that one of the earlier startups that I was involved with a company that was using blockchain tokens as rewards, and the tokens were being awarded by primary care physicians for healthy behavior to incentivize, and and those tokens were being paid by insurance companies because the healthy the individuals, the lower the payouts.
00:34:35.360 --> 00:34:47.039
Um, so in in this case, I mean, I suspect that it needs to be a coordinated effort amongst a multitude of stakeholders to achieve some consensus around how to deal with this.
00:34:47.679 --> 00:34:59.280
This is why I get excited, and I don't want to kind of distract from the core conversation, but the the idea of a nationalized unified health record, there's a lot of traction for that.
00:34:59.360 --> 00:35:09.360
And to me, this is the foundational layer that would allow Canada as a whole to start innovating in multitude of ways, right?
00:35:09.519 --> 00:35:23.440
So when we have that data layer that knows for me exactly what blood tests like cradle to grade, every blood test I've taken, every MRI I've had, every doctor's visit, and the results of every test and annual checkup.
00:35:23.599 --> 00:35:33.840
Um once we have that, we'll we'll be able to make a lot of transformations towards this vision of preventative care, I think, because we'll know what we are preventing.
00:35:34.400 --> 00:35:34.559
Okay.
00:35:35.119 --> 00:35:44.719
I mean, one of the hottest problems that many companies are trying to solve at the moment is what's called the company brain, right?
00:35:44.800 --> 00:35:51.920
Like if you're in a company setting, how do you aggregate all of the information to be able to enable decision making?
00:35:52.159 --> 00:35:52.960
This is no different.
00:35:53.119 --> 00:36:06.400
How do you aggregate all of the personal data or in this case health data into one unified record so they can make the right decisions rather than having orphaned or siloed the information here, here, and here?
00:36:06.800 --> 00:36:07.119
Yeah.
00:36:07.360 --> 00:36:09.199
I mean, just think about this, Maxim.
00:36:09.519 --> 00:36:13.119
You've had this, I've had this, we've all experienced this in one way or another.
00:36:13.360 --> 00:36:22.480
You go into a healthcare setting for something, and you're talking to one person, two people, three people, you're asked the same questions over and over and over again.
00:36:22.719 --> 00:36:26.079
So what you're talking about is memory.
00:36:26.239 --> 00:36:30.880
How do we create institutional memories that will persist?
00:36:31.360 --> 00:36:33.519
Shaw is creating individual memory.
00:36:33.599 --> 00:36:40.639
So what we're doing is we're demonstrating how it could work for Robert, for Maxim, for John Smith.
00:36:41.440 --> 00:36:45.440
We're demonstrating on a small scale what it can do and how that can prevent.
00:36:45.599 --> 00:36:58.239
And we're advocating for the the larger scale in parallel with what A is still there?
00:36:58.480 --> 00:36:59.440
Yeah, yeah, sorry.
00:37:00.480 --> 00:37:01.519
For a moment, you throw us.
00:37:01.760 --> 00:37:04.079
So I mean, it I I couldn't agree more.
00:37:04.159 --> 00:37:05.599
Uh, but we need to get to that vision.
00:37:05.760 --> 00:37:25.360
It's almost kind of like having a data lake where you have different, like what it like to your point, whether it's emergency acute, what it's uh in-home, like all these providers, everybody that's touching a patient or or is in contact that's essentially pulling that data into this unified record so that people can have access to it.
00:37:25.440 --> 00:37:47.440
And and and you can layer, you can layer different technology to kind of analyze and say, hey, how do we best because I I I I keep going back to this conversation with um um Gregory Mouse that was the founder of uh milestone dynamics, and I couldn't believe that women up until 1992 were not allowed to participate in clinical trials.
00:37:47.599 --> 00:37:53.920
I couldn't believe that a woman can go undiagnosed for endometriosis for 10 to 12 years.
00:37:54.079 --> 00:38:02.000
I'm like, but there's gotta be some kind of a data there that's that allows you to say, okay, well, there's a problem here, there's a problem here, there's a problem here, there's a problem here.
00:38:02.079 --> 00:38:08.239
And work in the court so that we don't have people suffering for 10 to 12 years before they breach diagnosis.
00:38:08.480 --> 00:38:17.440
Yeah, here's the the irony is Canada has one of the richest data sets of anybody in the world because we have national health care, we have quite a broad set.
00:38:17.679 --> 00:38:23.519
We have institutions like uh KaiHide, the Canadian Institution for Health Information, that's gathered a lot of this in.
00:38:24.000 --> 00:38:36.639
Um, what we're lacking right now, what we've done really well is we digitize a lot of our um health data, but we've digitized it in the exact same silos that we had before when we were on paper.
00:38:36.719 --> 00:38:39.920
So we've kept the silos and we haven't connected the data.
00:38:40.480 --> 00:38:55.599
So the vision that I'm I'm advocating for, that others are advocating for, I'm I call it a national utility, like your electrical utility, the electrical grid across Canada, like the highways or the telecommunication grid.
00:38:55.840 --> 00:38:58.400
Let's build something that's across Canada.
00:38:58.719 --> 00:39:06.400
The provinces still run, the provinces operate the roads, yeah, but the federal government helps build it out.
00:39:06.639 --> 00:39:13.280
And you know, we want to preserve that provincial autonomy, and I think that's an important aspect of Canadian healthcare.
00:39:13.519 --> 00:39:30.400
But let's let's connect those dots in something that is um building project across, you know, so that when I go out to visit you in Calgary, or if I'm going out to BC to visit my sister, if I have to go to the hospital, they know who I am, right?
00:39:30.639 --> 00:39:32.000
Yeah, and we can do it.
00:39:32.079 --> 00:39:34.559
So we we actually have a lot of the pieces in place already.
00:39:34.639 --> 00:39:36.159
We have a lot of the data.
00:39:36.320 --> 00:40:01.360
Um we need a federated system where you keep all of the data in the existing silos, but you insist on interoperability, you mandate it, you enforce legal uh requirements, and then you build up the the transit layer that can pull it all together when a physician in Alberta needs it or a physician in Toronto needs it, we we can pull out the relevant sections.
00:40:01.679 --> 00:40:03.920
Um I think it can happen.
00:40:04.000 --> 00:40:06.320
I'm I'm optimistic on that front.
00:40:06.960 --> 00:40:11.039
Well, I think that with uh with the current environment and AI, everything is accelerated.
00:40:11.119 --> 00:40:29.840
So if there are uh and and I continue to be optimistic that we're going to solve problems faster um and better, um, if they're founders that they're listening, kind of like what where where are the opportunities for them to get involved and help solve this uh this challenge more holistically?
00:40:30.719 --> 00:40:34.400
So uh I mean I think there's so many, it's a hard thing to answer.
00:40:34.559 --> 00:40:46.719
The um on the technical side for med tech, there are so many opportunities for data analytics on on records, on looking at predictive technologies, the um investments in drugs and new drugs.
00:40:46.880 --> 00:40:53.199
I I think it's just gonna explode um with the support of AI and the ability to test on this side.
00:40:53.440 --> 00:41:05.119
Um I think for anybody that's looking at it, you have to look at where the data can come from and what benefit utilizing it has in the immediate future.
00:41:05.760 --> 00:41:07.360
That allows you to build the data.
00:41:07.440 --> 00:41:22.880
That's what we're doing at SHA is we're we're providing something in real time that gives benefit today to the individuals that are getting it, but allows us to build up a holistic picture of aging in a much better way that will be useful in a lot of different ways.
00:41:23.039 --> 00:41:26.480
And um I like this is I haven't planned for this.
00:41:26.559 --> 00:41:30.480
I don't know how we monetize it or where whether we monetize it.
00:41:30.719 --> 00:41:38.559
I think it's just something that could be a net benefit to Canada and and to the citizens here, and you know, we'll figure out the role from there.
00:41:40.880 --> 00:41:43.440
Yeah, I mean, I I I I couldn't agree more with you.
00:41:43.519 --> 00:41:45.920
Uh just kind of looking through our portfolio of companies.
00:41:46.079 --> 00:42:07.360
We have seven life sciences by technology companies, and it seems at the moment that uh well, the guidance that or the direction that is going is like the companies we're working with are going to particularly Scandinavian countries or Western European countries proving out technology because there's a lot more appetite there, and then coming back to North America to prove it out.
00:42:07.519 --> 00:42:19.119
I don't know if there's a greater appetite for innovation and advancement, um, but it's certainly interesting to see kind of like what is happening in the space and how companies are advancing their journeys.
00:42:19.760 --> 00:42:27.840
So, I mean, your podcast is about founders and and scaling and and growth, and um I mean this is the the stage that we're in.
00:42:28.079 --> 00:42:33.920
I've had feedback for the past two years as we've been building of why are you doing it in Canada?
00:42:34.079 --> 00:42:41.360
Uh, I've talked to people on the so we haven't actively considered uh investments, but I've had conversations obviously with people.
00:42:41.519 --> 00:42:43.920
We've bootstrapped everything so far.
00:42:44.400 --> 00:42:53.599
Um we probably will benefit from from raising capital in the near future as we start to get some of these pilots going in and accelerate the scaling.
00:42:54.320 --> 00:43:06.320
But um conversations I've had in the past have always like I've several of them, we only fund in Canadian companies that are completely focused on the US market.
00:43:07.280 --> 00:43:08.480
And I understand why.
00:43:08.639 --> 00:43:19.360
I understand the logic of that if I'm a if I'm an investor, if I'm a venture capitalist, I want the best return for my portfolio and uh my my shareholders.
00:43:19.679 --> 00:43:24.400
And that's gonna be from the much larger market that's more rapid at adoption.
00:43:24.880 --> 00:43:30.800
But I like to think that we've got Canadian AI special, Canadian technical talents, clinical ones.
00:43:31.440 --> 00:43:33.440
Let's put it to use in Canada.
00:43:33.920 --> 00:43:34.400
For sure.
00:43:34.559 --> 00:43:36.400
I mean, a couple of data points there.
00:43:36.639 --> 00:43:46.960
The sovereign wealth funds or um export innovation funds, but it's normal, like they are very actively involved in supporting companies in in Europe to go and establish their.
00:43:47.360 --> 00:43:59.760
I get that the US market is ten times the side uh the size of the Canadian market, but um I I I think that it it's an amazing proving ground with amazing talent, especially with what happened with.
00:44:00.159 --> 00:44:03.360
uh with the tariffs with the B1 visas.
00:44:03.679 --> 00:44:16.880
Like I think that what we saw was a net migration to Canada of PhD research and scientists coming to Canada because like essentially they they they saw the the door being shut to them uh in the United States.
00:44:16.960 --> 00:44:19.519
So I think this is the opportunity in the moment to seize.
00:44:19.840 --> 00:44:27.440
I I think so and I I think Canada can actually start innovating and leading in many different ways especially in healthcare technology.
00:44:27.920 --> 00:44:30.400
We have a fantastic unified market.
00:44:31.039 --> 00:44:44.079
We've got there is a lot of support so I'm you know I'm I'm casting a little bit of challenges to our investment community but that being said there's a massive investment in AI that's been announced.
00:44:44.480 --> 00:48:41.519
Here in Ontario we got all these local provincial projects and and programs and investments several federal ones and um we're benefiting from some of those we've engaged with a lot of folks in NRC and program called Envisage and so it it's a fairly robust system and and there is a lot of um support different ways that that help us out so we talk to investors all the time uh probably in in this course of a week we probably talked to 15 20 investors yesterday had a conversation with a uh a very big healthcare investor and the the kinds of technologies are very very interesting to them um they're looking at diagnosis they're looking at the uh the the aging longevity solutions so um i think that the at least based on our conversation where it's around med tech life sciences biotechnology oncology the they it there it's probably one of the hottest areas in terms of companies look actively looking to employ capital yeah yeah and it's it's um again it just comes back to the math we started the conversation with it's clear math right like the the aging population is going to increase and the healthcare demands for the next 25 years full stop so how are we going to address that that's where innovation comes in and that's where uh you know hopefully capital is going to be deployed to come up with new solutions yeah but i i in in the case of what you're building it's it's not like let's say the US market it's not subject to regulation because I wouldn't think that it would be considered the metek device of any sort it just it's it's just biometric so it's it's like ai it's technology it wouldn't fall fall I don't know I see you smiling is this something yeah so look um we are like uh an Apple iWatch in terms of an assistive device that helps gather information and the clinical people are still making the decisions and at a certain point in our journey we are aware and we are looking at and investigating we probably will have to go in and get medical device certification as we advanced in the diagnostic capabilities and I that's fine I think that's a reasonable step to take at a certain point but I also look at it you know kind of an adjunct to what you're saying um this is something that will be useful in almost any Western market right like the European market the Italian the German the um Singapore is doing some my my alma mater basically where I live for many years they're doing some of the most advanced uh research and investments into aging in place um and yeah I think there'll be a robust market for this sort of stuff outside of Canada once we get it to scale prove it yeah what are you most excited about um in the that think it's coming out in the next 12 to 18 months uh from perspective from from our perspective i i think you know i am focused on a time horizon of deploying the clinical solution of today it's it's the bundle care and I think this is the next 24 months so uh what we're deploying you you you have to understand it's it's a complex mix of things right there's a technology physical component that's going into the home we have to worry about installation deinstallation maintenance support yeah we have the data flowing in we have to get predictive analytics and the software on that going and making sure that we've got uh accurate feedback and uh robust results from that but then it's the clinical side as well so there's three big pillars that all have to work together on on all of this stuff and we're proving it already so I'm I'm quite confident we have models and solutions for all of them.
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But once we have that the next big thing for me and and where I'm most anticipating is then being able to take the technology component with all of the clinical integration learning packaged up as a set of documents and go to somebody you know down in California or over in London and say here's this technology and you can license it from us you can also license this bundle of policies procedures training manuals and everything so that you can do the clinical workforce deployment uh effectively as we have yeah that gets really interesting at a global scale yeah I I agree um we're recording seven o'clock Cowboy time and it's nine o'clock in Ontario um so you're recording from home but I I I almost wish that we were recording with your background showing all of the the cameras and sensors that they're kind of watching everything that's happening because then people get to appreciate how much technology it's packed into a few square feet.
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Yeah we we um we like to joke we've uh built uh many people work from home we we built a home in our office so we have a 10 foot by 12 foot seniors apartment and I love having people to come over because then I get to fall down and do pretfalls and everything to show how the technology is detecting this and and what I can do.
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But it is it is nice there is a lot of technology in it it's quite expensive.
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But when you amortize it over the the lifetime of the the equipment monthly cost bundled care with people coming into your home and looking in a mom or dad on a on a daily basis and real time 247 intervention is less than the cost of going into a long-term care home a public long-term care home even um yeah and people want to stay at home so I I think we'll have a robust market of of people as we scale up 100% Robert I like to close conversations with uh a choice of questions um you have a choice of two what is the best advice that you have ever received or what's the kindest thing that somebody has ever done for you oh um they're both good questions um i i i think the um kindest thing somebody's ever done for me uh it was actually a comment and and it really touched my heart as I was building the home care company uh we've had so many of these instances this is what really gives me a lot of passion with the people who are helping the real kind of tangible individuals but we we were working with this um client this woman who um had been this robust force of nature through her whole life um she had declined and had dementia and had really a lot of her had slipped away but she had a beautiful family uh three daughters who were just loving her and and and it was tearing them apart to see her doing that and we came in and we started helping them and I I remember sitting down and having a tearful conversation with one of the daughters who said before you guys came in here I had a responsibility to my mother and you've now given me back a relationship um it it it was something that just touched me so deeply of of what the meaning is of this on a human level on a one person the one person level wow amazing I mean this is the weight that sits on your shoulders when you have somebody that in that's in your care is immense yeah yeah and and um but it it's it's heartfelt as well and um you know you really feel like you're doing something I worked in technology for most of my career we did fascinating projects I was working with big banks and and and telcos and airlines and doing these IT projects and it was great I I loved it I had a great career but doing this where you're actually and and we grew it from scratch.
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So I was going into people's homes there was a point when I knew every client by name I knew every caregiver by name we've kind of grown beyond that but I still I still try to get out of business every now and then and um yeah it's uh it's it's meaningful amazing um I couldn't agree more I mean it's it's impact you're you're driving impact not just for the patient but for society at large um love the conversation love having you here there's nothing more than me wanting to cheer you on because what you're doing is incredibly impactful.
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Well thank you so much and it's it's great having a conversation with you it's um it's always you know uh wonderful to kind of explore these ideas I gain something from every conversation we have so uh thank you very much for inviting us on my absolute pleasure thank you Robert excellent