Welcome to Tech Stuff, a production from iHeartRadio. Today, we are witnessed to one of those rare moments in history, the rise of an innovative technology with the potential to radically transform business and society forever. That technology, of course, is artificial intelligence, and it's the central focus for this
new season of Smart Talks with IBM. Join hosts from your favorite Pushkin podcasts as they talk with industry experts and leaders to explore how businesses can integrate AI into their workflows and help drive real change in this new era of AI, and of course, host Malcolm Gladwell will be there to guide you through the season and throw
in his two cents as well. Look out for new episodes of Smart Talks with IBM every other week on the iHeartRadio app, Apple Podcasts, wherever you get your podcasts, and learn more at IBM dot com slash smart Talks.
Hello, Hello, Welcome to Smart Talks with IBM, a podcast from Pushkin Industries, iHeartRadio and IBM. I'm Malcolm Glawell. This season, we're continuing our conversations with new creators visionaries who are creatively applying technology in business to drive change, but with a focus on the transformative power of artificial intelligence and what it means to leverage AI as a game changing
multiplier for your business. Today's episode is a case study of sorts as AI expands its reach to different industries, the healthcare profession is on the forefront of adoption. The integration of AI into the healthcare industry is fostering a more inclusive and efficient healthcare system. Pushkin's very own doctor Lori Santos, host of the Happiness Lab podcast, sat down for a conversation with Alice Creshy. Alice is the co founder and the CEO of fertility care provider ovum Health.
Founded in twenty twenty three. Ovum Health consists of a multi specialty group of board certified experts, physicians, nutritionness and patient advocates who are passionate about helping moms to be with pre pregnancy, pregnancy and postpartum healthcare. As an online platform, they are able to diagnose, treat, and manage conditions from the comfort of patients homes. Alice became an advocate for accessible family planning when she was diagnosed with breast cancer
at age thirty one. As a healthcare activist, author, cancer and infertility survivor. She has dedicated her life to improving access to exceptional health care, regardless of income, insurance, religion, race, identity, or location. Alice and Laurie discuss the barriers to healthcare access, the ways in which AI can be leveraged to expand the reach of healthcare providers, and how ovum healths partnership with IBM and the use of the IBM Watson x
Assistant platform has been enhancing the patient experience. Just a heads up before we dive in. This conversation touches on sensitive topics such as paternal health and fertility. Please take care when listening. Okay, let's get to the conversation.
Alice, thank you so much for joining me. To start off, tell me a little bit about your current role.
Hi, Laurie, thank you so much for having me today. I'm thrilled to be here. My current role is as co founder and CEO of ovum Health. We are a network of fertility telehealth clinics in the United States, and really my job is to make sure that all the people that we want to serve know that we exist and to make sure that I create a sustainable company so that all the good work that my clinicians are doing really reach the millions, truly millions of people who need us.
So your fertility journey began at thirty one when you were diagnosed with cancer. That must have been awful. Tell me about the days and weeks surrounding that news and what was your life like.
Yes, the way that I've always described it is that the news almost hit the pause button on my life. And the extraordinary thing was that it became my full time job just managing all the diagnostic steps involved. So truly, for the first thirty days, I was in a vortex of all things cancer related, and I was one of the lucky ones. And that a friend asked me, are you going to freeze your eggs? I would never have even thought to ask about it had she not brought
it up. I went into the fertility clinic, and really what was extraordinary is that the day before my appointment at the physical clinic, I had a telephone console. This is before the term telehealth or telemedicine was even a thing. Okay, because it was so many years ago. She called my phone. There was no video conferencing even invented yet. So it was five pm on a Tuesday, and It was already day two of my cycle, and she said to me, Alice, if you're going to do this, you have to start
tomorrow morning at seven am. So I had less than twenty four hours to make the biggest decision of my life. And at the time, I had a boyfriend who was working in the front bedroom of my home. Okay, I walk into that room and say, okay, I'm all excited. We have to freeze embryos. And he looked at me and he goes, We're not going to do that. And I said, what do you mean We're not going to do that. He said, no, I'm not going to do that with you. I said, why wouldn't you do that
with me? And he told me then that he didn't think we had a future together. And in that moment, I was on my own. So when I walked into the fergility clinic the next morning, they handed me a catalog of sperm donors. So can you imagine, Okay, I'm already dealing with cancer, completely overwhelmed, and I get handed a catalog of sperm donors and it was all these statistics. So it looked like I was picking a basketball team and being like, who do I think is going to
be MVP this year. And I had a friend with me at the appointment who said, no, I think this is going to be so much fun. And I handed the catalog to her and I was like, great, you pick. So part of the journey was such a massive learning curve so fast, But going through fertility preservation helped me focus on life after cancer. So I always fundamentally deeply
believed I'm going to get through this cancer. But I also knew I wanted to live the life I imagined afterwards, and that whole experience started that journey what is life going to look like after I get through all this trauma? But for me, I felt the fertility preservation experience was incredibly life affirming.
You know.
I loved the self injections because it felt like I finally was doing something for my life rather than having the medical community do something to me.
And so talk about how that experience led you to the founding of Fertile Action and med Answers.
Well, I literally walked out of the fertility clinic that same day. The business manager had handed me kind of like pushed a piece of paper across her desk to show me how expensive the treatment was going to be. It was a twenty thousand dollars expense, and I know almost flipped out. I thought, Wow, am I going to do this? And you could see the look on her face. She almost felt devastated that in my time of need,
she couldn't just give this to me. My friend Jen was on the phone with the only nonprofit that existed at the time, who basically was telling her I don't qualify. I meanwhile, was on the phone with my American Express card getting an increased limit. So that moment was the gate first game changer, because I walked out of the office and I looked at my friend Jen, and I said, we're going to start a nonprofit. We're going to fix this. I felt offended that there would be a financial criteria
to determine who gets help and who doesn't. I think, you're thirty one years old, you're at the prime of your career. You're still climbing the ladder. You haven't made it. I barely had enough years to, you know, put into a four oh one k or an ira.
I don't have a nest egg.
You know, this was not something that I felt like we needed to make people prove that they have financial need. The cancer is the need, and I was offended that insurance didn't cover it, and insurance was willing to cover a wig, they were willing to cover reconstructive breasts, and so it seemed that society was telling me it's more important to us that you look like a woman when you're done with this than actually produce offspring like a woman. I was really disturbed by that. So that was the
first pivotal moment of starting a charity. Was because I wanted to educate, I wanted to advocate, and.
So talk about how that passion ultimately evolved into the launch of oval Health in twenty twenty three.
Well, what ended up happening is I was doing all this advocacy work and all this legislative change, and I was educating all up and down California. But I also was witnessing the spread of misinformation on Facebook groups. At the time, I knew a lot of clinicians and I had them on text, and so these women were asking questions on these groups and I was able to get an answer within fifteen minutes from my professional network. So I thought, Okay, well, there's got to be a better
way to do this. So with my business partner, the illustrious doctor Santiago Munet, who's a world renowned reproductive geneticist and researcher, I emailed him and I said, we got to do something about this. There's got to be a digital way to let everyone have access to the people that he and I know, and they should be able to ask questions in a safe, protected environment by actual experts,
not their peers pretending to be an expert. We all have that person who's like, well, I had this experience and is therefore my experience pertains to your experience.
And it's just not personalized at all.
So I thought, with technology where it's at, there's no reason not to create an app that can can the public with a trusted network of professionals. That was the first thing that we did and we ran that for years. So we have over ninety thousand pieces of clinically validated content, multidisciplinary specialists who have answered patient questions as volunteers, which
is extraordinary. But what we saw in the data, because we collected so much health information on our users, we saw that they weren't being diagnosed with infertility, yet they had been infertile for more than three years, and because they weren't diagnosed with infertility, they also weren't being diagnosed with the underlying conditions causing infertility. So to me, infertility
is a frustrating diagnosis because it's based on time. It's not based on labs, it's not based on imaging, it's not based on anything except you don't have the outcome that you want in the timeframe that the professional societies has deemed relevant. If you're under the age of thirty five and haven't gotten pregnant the old fashioned way in
a year, you have a disease diagnosis infertility. The medical community wasn't telling women that in the same way that I had someone call me and say, I'm sorry to break the bad news you have breast cancer. If we don't know that somebody has infertility, then they're not looking at the underlying cause. So you have women who are trying to figure out what's going on, and they're they're turning to Facebook groups, or they're turning to other online communities.
They're trying to take this supplement that supplement, but they're not really going through a proper diagnostic journey. And we wanted to solve that. So Obi guindes. Even though we think of them as the ones that deliver the babies, they're actually not trained infertility. They're not trained in diagnostics
for infertility, and they're not trained in optimizing fertility. And then you have the IVF doctors that are the most extreme treatment possible that has helped millions of babies be born worldwide and is a wonderful treatment, but it doesn't
need to be the first line of treatment. There are so oh many conditions that can actually be treated to help restore natural fecundity, meaning someone's ability to ovulate on their own at the right time of the month, to ensure that the size of the egg is optimal, to ensure that the timing of the egg release is optimal, and to ensure that sperm has the best possible chance of getting to the egg for a fertilization event to happen. When you look at all the optimization steps that are possible,
it's a miracle that anybody gets pregnant on their own. Okay, it really is. And I think we're all raised with the idea that when we want to have a baby, we think it's going to be easy and it's going to be fine. Because we've spent all of our lives telling young people how not to get pregnant, that we make it seem like they're going to look at a man and get pregnant, and that's just not what's So we can help same sex couples optimize their attempt as well, and that is both on the male side and on
the female side. So really, Ovumhealth was created to solve a huge gap that exists, and it's not just in the United States, it's worldwide between an OBIGI and an IVF doctor, so that we can get all those diagnostics done and then we can do medical nutrition therapy first to start optimizing each step of the fertility process and then use pharmaceutical solutions to kind of take over the cycle ovulatory experience to make sure that we are helping
to craft the most effective and efficient time to intercourse cycle possible.
So your situation was just so awful right where you had to pay for your treatment on an MX card. I'm curious what the current state of access is for family building treatments in the US. Is there's still this higher socioeconomic barrier for fertility treatment compared to other health issues.
Sure, there definitely is and it varies widely. So with Ovum Health, we are practicing medicine in a lane that's covered by insurance. We're not doing anything that falls outside of your normal kind of consultative approach to accessing specialty care. Because of this, we're covered by insurance. There are some innovative testing platforms that are not covered by insurance, so we work with our patients to help them with all their out of pocket expenses. We do offer financing in house.
We offer payment plans. We try to be as flexible as possible to make sure that there is no socioeconomic barrier. I have one hundred and seventy six insurance contracts as of today in eight states. I intend to be in all fifty states by the end of next year with insurance contracts. My hunches will have over six hundred contracts. That includes Medicaid. So there are plenty of things that
Medicaid pays for. And it's not just our ability to help someone have a healthy pregnancy, it's our ability to help someone have a healthy baby, and that means that we have to support women through the reproductive continuum. So what Ovum is really creating is being the glue at kind of every step of that experience for a woman in the IVF setting. Yes, there are still huge gaps in coverage. There are a lot of programs out there, like Carrot and Progeny that have targeted large employer market
as a specialty insurance product. Only point three percent of reproductive age people work for large employers, So it's really important that we still access IVF coverage through your basic health insurance plans like the etna's and the Blues and the United Healthcares. That's where you still have coverage gap, and so much of that is dependent on who your employer coverage is through, and so much of that is if you're self insured or if you're on Medicaid, et cetera.
So Medicaid currently doesn't cover infertility services, and Medicaid pays for about half of the pregnancies and live births in America. So we have to start thinking more broadly about treatment options.
And so walk us through a typical patient journey with opum health from first contact final outcome. What are all the ways that ovum helps them build a family.
Yes, that's a great question.
So really the first thing that we're looking at is a diagnostic journey that we want to get people through rapidly. So in a traditional healthcare environment, if you have to see the number of specialists that are under one roof at ovum, it probably would take you six months to see all of them, and you'd have six to twelve different appointments because that's how many specialists we're bringing onto your case. So you initially meet with our nurse practitioner
to review your medical history. We do ask you to fill out quite a bit of data because we want it to be again as efficient as possible for you. We don't want to waste your time. We want to make sure that we are well prepared to be able to ask all the follow up questions and review that medical history so that we can turn around and order your lab work right away. So typically when someone calls in to us, we actually book four appointments for them
at once so that they don't have any delays. We book that first visit, we book the lab appointment for them at their local lab. After the lab visit, then our patients get to meet with the lead clinician on their case, and that's usually when they get an initial diagnosis from the lab work and the history that we reviewed. At that point, then we probably need to send them
for imaging. We need to do fallopian tube evaluation, uterinevaluation, and ovarianvaluation, and they then get paired with a nurse navigator. That nurse navigator's job is to help them understand what their treatment options are going to be. The doctor had
already reviewed the treatment options. However, as we all know, we are trying to take in as much information as we can in that doctor visit, and then as soon as we get in the car, as soon as we get off the phone, we think of thirty questions to ask, so we pair them with a nurse navigator so that they have somebody to ask all those follow up questions efficiently. At that point, then we lay out kind of what the next three to four months of their life is
going to look like. In all cases, we assign them a regil dietitian, so they have a nurse navigator that is the glue of their case and helping to facilitate every next step. They're assigned a registered dietitian, and they even get a patient advocate who's kind of advocating for their insurance, helping them understand what else they need where they need to order it. It could be a custom supplement list, it could be an at home continuous hormone
monitoring kit. It could be their molecular sperm testing kit for their partner as well. So we line up kind of the diagnostic journey first, but in a lot of cases, we're already starting some medical nutrition therapy or medicated weight loss or working with the registered dietitian even alongside some of the other steps because we have some of the
diagnoses already. We know people who are insulin resistant, so we know what kind of diet plan we need to help them with, we know the lifestyle changes we need to.
Pair them with.
We're even adding PT into our practice so that we can customize exercise plans specific to somebody's condition.
But opal health is also launching during this pivotal moment in it, and so I'm curious. Was it always the plan to leverage this technology for ovum or was it more of an organic evolution to this point.
It was both.
It was always my intention that we needed to have AI enabled technology to be able to scale faster and to also be able to improve quality control across so many states, because how do you really do that I need to upscale all different levels of healthcare providers. Then how do we efficiently kind of manage that clinical excellence experience?
And the only way to really do that is to create clinical decisions support tools that everybody utilizes that are very easy to make sure that we're managing our care in a consistent fashion. How else could we possibly do it state by state? You know, experience level varies, So that was always kind of the plan. The area that I didn't even know was possible was this area of being able to reach the massive truly through an AI tool through the Fertility Answers app. So when IBM approached
me for that partnership, the bells went off. I always knew that I couldn't scale voluntary humans. I have a network of over four hundred medical professionals across so many disciplines. We're talking mds, genetic counselors, geneticists, psychologists, obiginnds, naturopaths, functional medicine docs. I have about thirteen different specialties, all willing to answer free questions. But relying on that voluntary basis
is not something that can scale. It's a beautiful thing that they're doing, and it's created ninety thousand pieces of clinically validated content. But we needed to move beyond kind of the initial interaction being a human answering the question and leverage.
AI to be able to do that.
So what was really extraordinary for me is that I had my eyes kind of opened by IBM to see what was possible for my practice with AI. Once that seed was planted, then the world opened up. We have four tools that we're working on right now. The first has already been integrated, which is the Fertility Answers App. So the initial experience for women and mostly women, because they're the ones download the app, but we take men.
I promise we're not excluding them. We see both. It takes two and they have the opportunity to access all that content in a personalized way through the IBM Watson Assistant chatbot, so that is incredible. We're also deploying a revenue cycle management tool. You can imagine with all these different contracts that I have one hundred and seventy six contracts and eventually I'll have probably six hundred contracts. They all have different price lists. Makes it very difficult to
forecast what's in my electronic medical record system. For that day based on the type of insurance. Now, even within one insurance contract, they might have hundreds of insurance plans that have all various mechanisms for what we can expect to build. You might have co insurance, you might have a deductible, you might have a copay, and it varies
planned to plan. We're dealing with a level of medical literacy in this country that is very low, and the layperson doesn't understand their insurance all the time.
How am I.
Expected to be able to deal with truly thousands of combinations of insurance plans based on these contracts. You have to have AI just to tackle that big data issue.
So we have a.
Revenue cycle management tool that is also helping us with an automated clinical workflow, and that's what a wonderful partner we have called cloud Astra, who is also in the IBM ecosystem. So it's incredibly exciting to know that I can come out of a startup mode profitably because we're
deploying smart tools from the beginning. Then we also have in development our Fertility Clinical Decisions Support tool to really scale the clinical experience so that we're analyzing genomic data, lab data, clinical data and even self reported data from our users in a way that helps our clinicians know what to do next. And that's all based on standard of care guidelines, all evidence based medicine, but built into a really useful tool to help them do their job
more efficiently. Recently, the International Guidelines for PCOS polycystic Ovarian Syndrome updated guidelines. There were two hundred individual points in these guidelines. Two hundred and that's for one condition. So imagine you multiply that across dozens of conditions. You can't expect a human to retain that information and to be able to recall it right when someone's in front of them. So tools that have IBMS AI enabled are really critical
to do an exceptional job in healthcare. And then the fourth tool that we're creating with IBM is a medical nutrition therapy tool so that we can scale beyond our registered dietitians and be able to help women really optimize their fertility, health and wellness by having personalized approach to medical nutrition therapy.
And that also requires AI.
So when you decided to go big and introduce AI in so many different ways to scale up your app and your business more broadly, why did you pick IBM as a partner?
IBM was an easy yes when we were approached about this partnership for so many reasons. I'm not an AI startup, I'm a healthcare startup, and it's very important that I don't waste resources trying to figure out AI all by ourselves. We needed to be very fast to market and needed to be with a trusted partner. IBM brought that to the team right away. But secondarily, the IBM team that I've been exposed to is incredible. So from a partnership standpoint,
the team has made it easy, joyful. There's some of the smartest people that I've had the pleasure to work with, and so I think the culture of what IBM's created for startups is very unique and truly every single aspect of the team that I've worked with, from the developers themselves that build labs, to the customer success team to my day to day team, I mean, my goodness, it is just a dream team. So IBM made it as easy as possible for me to say yes.
Alice really helped open my eyes to the challenges facing providers in an industry as sensitive and individualized as fertility care.
It makes sense that scalability would be an issue, but with the help of AI, ovum Health has been able to solve a few of the extraordinary challenges of bringing effective, affordable fertility care to the general public, from multiplying the impact of its medical professional network to enabling more accurate forecasting of complex contracts, patients are benefiting directly and indirectly from the integration of AI across the healthcare journey.
A lot of people have nuanced health questions that are unique to them due to their own personal health history, maybe their lifestyle factors, or the specific medications they're taking. How does the Fertility Answers bot personalize all its responses.
Yeah, that's a great question. So when we onboard our users, we do ask them to fill out quite a bit of health information, and we have ninety nine percent compliance rates on the health information that people fill out. So when you ask a question, you're asking it with all your health information already attached to it. The library of responses then shows you questions and answers of people who
are similar to you. If that doesn't answer your question, you still have a chance to route your question to the same volunteer network of professionals that existed before the bot was there.
And so some problems, especially those related to fertility and needle care, require human to human connection, right This is what we're built for as primates, to kind of engage with our families as the chatbot addresses such a personal health need. How easy is it for a doctor to interject or for a patient to request care from a doctor.
Very easy, and that was super important to me. One of the things that I love the most out of IBM was that I had the chance to infuse empathy directly into the bot experience. I didn't want something that sounded or came off as robotic, but it is incredibly easy and the Watson Assistant flow for someone to request
that immediate human connection. We have a chat feature that gets to a patient advocate right away, We have a feature where they can route their question to that network of experts right away, and we have a feature where they can book a console with one of our medical professionals right away as well.
So you have over sixty seven thousand users now, which is kind of a meat. How do you get them to feel the kind of trust and empathy people expect from their healthcare provider? Especially in the fertility space.
In our case, we have a very human brand, so from the moment that someone interacts with our content, they're already experiencing clinically validated answers in the form of video. We don't ask people to download and register our app upon the first touch point. We are infusing medical education into the community through video so that they can start to build that brand trust with us from the beginning. What I've noticed is that because our brand is such
human connection, we've built up so much trusts. And it's not just about the app experience. It's also how active our Instagram is, where we answer live questions for people in Instagram lives, so there's multiple ways for people to get served for virtually free and an unlimited fashion. Did all the providers for them so they don't have to do that. So I think that there's multiple things that go into building brand trust, and that's why.
We show sort of the profile.
Of someone who asked a similar question already, so that they can find themselves in that Oh wow, that person who asked my similar question or almost my exact same question also is thirty seven years old, or also has PCOS or also has ENDO, so there are different ways that we are able to kind of get into the psychology of our community to make sure that they feel heard. And I think whenever anybody feels truly heard, then that trust is possible.
So this season of Smart Talks features new creators, visionaries like you who are creatively applying technology in business to drive change. I know that you have a Bachelor of Science in Media, Arts and Design. How does this creative background inform what you do is CEO of OPM Health.
Oh, that's such a great question.
They use my degree every single day and I'm not a chickens, so I've had that degree for quite a while, Lorie. Every CEO has kind of a I would say leading skill set.
You know.
There are some that are leading financial type people. There's some that are leading kind of business to business salespeople. I am very much a leading marketing type CEO. So for me, the patient experience, the user experience, that human experience is kind of everything that I stand for and I'm about and it must be authentic. And because of the background that I have, I love nothing more than co producing with my chief storyteller, Joshua Noonan, Who's been
with me forever. We love co producing content. It could be a twenty two second video that that's educational, it could be an hour long course, you know, for professionals. And so I do feel that I bring that media, arts and design background to kind of my type of leadership.
And storytelling is kind of everything. You know.
Being a great story tell no matter what your brand is or no matter the type of leader you are, is the way that kind of attracts and connects people to us. And it's fortunate that social media has created this visual world that we live in and this video based world that we live in as well.
So you're an activist for accessibility and inclusivity and healthcare. If you could look years down the line, how do you see creative applications of technology like fertility answers changing how we talk about women's health.
Well, first, I think that these tools need to be covered by insurance. So I think what is going to be the game changer in the value based care market is that insurance is going to figure out that by creating a reimbursement mechanism for more digital therapeutics but also for digital diagnostic tools, is going to lead to a much more cost effective healthcare society no matter what kind
of insurance type or plan that we have. So on the accessibility side, those tools are really meaningful to the future.
Of health healthcare.
I would also say that technology creates a more democratized health care environment. A lot of our patients live four hours from a type of specialist that they need four hours, you know, a lot of them are at least an hour an hour and a half from a major lab. So leveraging these types of tools gets them the answers that they need faster, which will lead to better intervention earlier. And that's where we come down to healthy mamas, healthy babies, make happy families.
Awesome. That's a great way to end. Thank you Alis so much for being with us on smart Talks today. It is such great work that you were doing to help women in families, So thank you for all your work and thanks for our chat today.
Thank you, Laurie.
It's such an honor to get to be on Smart Talks and it was a delightful conversation.
That about wraps up today's episode. I want to send a huge thank you to Laurie and Alice for deepening the way I think about AI's expanding role in the future. Of healthcare. It was illuminating to hear a first hand account of how providers are already integrating the power of transparent, human centric generative AI through Watson X. It's enabling telehealth platforms to multiply their impact and is quickly becoming essential
to offering comprehensive care to patients. As our conversation with Laurie and Alice showed, accessibility has long been an issue facing patients, particularly in the fertility space. With the help of technology from IBM, ovum Health is meaningfully expanding its reach to women who previously may not have been able to access personalized fertility care. Steps like these are helping to usher in a new age in healthcare, one that
holds incredible potential for both patients and providers. Yet, as new technology is implemented, it needs to be done with responsibility and care. Using emerging technologies in sensitive feels like fertility, it's the power to transform how people receive care. But, as Alice emphasized, only if patient needs are central to how we implement solutions. Ovum Health already has over sixty seven thousand users. Just think of all the pregnancies that
have been supported by the platform. And as we just heard, this is only the beginning. It's exciting to see how this new technology will continue to reach people in need. Smart Talks with IBM is produced by Matt Romano, Joey fish Ground and Jacob Goldstein. We're edited by Lydia Jane Kott. Our engineers are Jason Gambrel, Sarah Bruguier, and Ben Tolliday. Theme song by Gramoscope. Special thanks to Andy Kelly, Kathy Callahan, and the Eight Bar and IBM teams, as well as
the Pushkin marketing team. Smart Talks with IBM is a production of Pushkin Industries and Ruby Studio at iHeartMedia. To find more Pushkin podcasts, listen on the iHeartRadio app, Apple Podcasts, or wherever you listen to podcasts. I'm Malcolm glam