The Future of Healthcare: “We need to optimize payer programs” with Avi Veidman, CEO of Nucleai & Christina D. Warner

…Optimization of payer programs — many studies were performed on how payers should pay providers for procedures that they do. Currently, in most cases, the actual cost of each part of the procedure are not well measured and thus, no real optimization is performed, especially across different providers. Technology can provide unique insights into these processes to […]

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…Optimization of payer programs — many studies were performed on how payers should pay providers for procedures that they do. Currently, in most cases, the actual cost of each part of the procedure are not well measured and thus, no real optimization is performed, especially across different providers. Technology can provide unique insights into these processes to help with their optimization.

Asa part of my interview series with leaders in healthcare, I had the pleasure to interview Avi Veidman, CEO and Founder of Nucleai. Avi Veidman, CEO and Founder, launched Nucleai after a personal experience with a family member led to his discovery of the untapped potential to resolve the cancer diagnosis bottleneck. When his father underwent a biopsy, Avi and his family were left in the lurch for weeks before receiving the all-clear. While the story ends well, he identified the acute need to improve the pathology bottleneck, and established Nucleai as the result. Avi is an expert in artificial intelligence, having served in the IDF’s Technology Unit in the Military Intelligence Corps for over 20 years. He held several leadership positions in machine learning and data science departments. Through deep understanding and familiarity with cutting-edge visual technology imaging, Avi ventured into the field of AI-powered pathology using his expertise and drive to create a positive impact on people’s lives.

Thank you so much for doing this with us! Can you tell us a story about what brought you to this specific career path?

Sure. I have a background in engineering so AI, big data, and machine learning had a major part of my career. I spent most of my formative professional years (20 years) serving in various Technology Units in the Military Intelligence Corps of the Israeli army, and eventually serving as Head of an AI department. In this role, my team and I would work with satellite and aerial images, our aim being to augment the image analysts and detect different objects within those images. After retiring from service three years ago, I knew that I wanted to establish a startup that is impactful to people lives. I didn’t have a specific idea where to go but I knew healthcare or agriculture could be helpful relevant to my big data analysis experience. One thing I started to see is that in healthcare — you don’t need to find the problem, the problem finds you. Around this time, my dad was going through the standard biopsy result process to rule out possible prostate cancer. It took about 30 days (which is the standard in Israel) to receive the result of his biopsy. Luckily it was negative, but I couldn’t help asking myself why this waiting period was so long — causing many sleepless nights and anxiety.

So, I went into different labs and met with various pathologists who explained to me that the role of the physicians and clinicians are very important as they are the only people to set the diagnosis, but that there is more demand for biopsies than the supply of pathologists. I also found out that they were still relying on their human eye and microscopes — technology that hasn’t evolved in more than 100 years. This outdated method mixed with natural capacity for human error shocked me — and that’s when I realized that I had the technology to help.

Can you share the most interesting story that happened to you since you began leading your company?

There were few interesting stories. One of them happened during the early stages of the Nucleai’s fundraising round. We had two leading investors for our seed round: Vertex Ventures and another VC who was brand new and looking to invest in us as their first move. When all of the paperwork and agreements were almost done and signed, the new VC informed me that they couldn’t invest because they were simply not ready yet. It was quite a challenging experience as we were at a critical stage of operation as a company and we really needed the capital to grow.

I remember that day clearly: I gathered my co-founders Eliron Amir and Lotan Chorev, and told them we are going to bring another leading investor on board, and I was quite sure we could do it fast. Luckily, it took only two weeks for Grove Ventures -led by Dov Moran (the inventor of the USB memory stick)- to invest in us. It was a really good lesson about the “roller coaster” nature of startup scene, and the ability to endure and to not give up.

What do you think makes your company stand out? Can you share a story?

Nucleai is unique because of the mix we created in building our core team of experts. As a technologist, I know my limitations and strengths. In creating Nucleai, I could not rely solely on a team of AI experts to develop a product that would answer the needs and core daily problems that clinicians confront day in and day out. That’s why Nucleai’s core team incorporates experts in both industries -AI and healthcare- who are leaders in their field.

Thanks to this unique combination, we are able to provide an offering that we like to term — “Personalized AI”. It is a two-part approach which is personal to the user, and contextual to the working environment. Our research revealed that physicians are afraid of AI — so personalizing it helps gives clinicians a more comfortable feeling in understanding that they can integrate this technology into their workflow, in a tailored way that will improve efficiency and suit their needs. Nucleai will never replace physicians, instead it will adapt into their work flow in the most personal way possible.

The second aspect of ‘Personalized AI refers to the environment in which it functions. We found out that different pathologists and organizations have different ways of determining diagnosis. Whilst we already have a unique technology that is trained by thousands of slides, with an accuracy rate of 97% and higher, the decision makers in labs are free to adapt Nucleai to their methods of diagnosis in their lab.

What advice would you give to other healthcare leaders to help their team to thrive?

I would advise other healthcare leaders to always keep the purpose in mind. In the same way that the personal experience with my father led to the inception of Nucleai, I recommend always thinking of that personal figure when making any and all decisions in building, developing and sustaining your team. Treating every decision as if it would directly impact a member of your family has been a positive guiding light in my role as CEO of Nucleai so far, and one that I share with my team members.

Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?

  1. Lack of insurance — without a universal health care system, many people -especially underserved communities- are uninsured. Insurance is very costly and often tied to one’s employer, which creates a major gap in healthcare access across the country.
  2. High cost — the US spends more money on healthcare per capita than similar high income countries by a long shot. That’s because they don’t negotiate like most western countries do because the incentives are such that the more money hospitals charge the more money they make. The prices of drugs and wages are also more inflated across the board.
  3. Unhealthy lifestyle- Despite being a developed and rich nation, it’s a pretty sick population in terms of diet and activity. America has the ninth highest rate of obesity in the world with 35% of the adult population classified as dangerously overweight. In addition, the Bloomberg Global Health Index ranked the 25 healthiest countries in 2019 and America does not appear on that list.
  4. Metrics for success in healthcare are not well defined or well measured in a structured or central way, and data is not easily accessible.

You are a “healthcare insider”. If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.

In general, I strongly believe that the introduction of advanced technologies can provide a huge impact on healthcare systems and effect cost savings dramatically. These technologies can impact many aspects:

  1. Patient diagnosis– for example, the AI platform for pathology that we have at Nucleai can significantly increase the accuracy of cancer detection and time taken for diagnosis.
  2. Optimization of payer programs — many studies were performed on how payers should pay providers for procedures that they do. Currently, in most cases, the actual cost of each part of the procedure are not well measured and thus, no real optimization is performed, especially across different providers. Technology can provide unique insights into these processes to help with their optimization.
  3. Drug development — we currently see many interesting examples of how our image analysis capabilities can help with a variety of different processes in drug development, providing deeper insights in much shorter time frames. While looking at processes that leading companies have been doing in over a 10-year period, we clearly see that with some unique tools, these can be shortened to 1 year with a much smaller workforce.
  4. Patient care — we see many areas where patient care is not optimized and is performed by “trial and error” techniques. A strong example would be with oncology drugs that positively effect only a small percentage of people who are treated with these drugs. Today we have the technology to better predict if a certain patient will react well to these drugs or not before prescribing them.

Ok, its very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?

To create these changes, the regulatory and payer environments will need to build the right infrastructure for this to happen. We are already seeing changes in this direction from the US-FDA and some payers, and we hope this trend will continue. Once this happens, we will see healthcare industry adapt to work around this model, and patients will always want the newer and better solutions.

How would you define an “excellent healthcare provider”?

I believe that excellence lies within the service and quality of the product offering. If the healthcare provider can cater both directly and personally to the customer’s needs and to the overall system in which the customer is a part of, then excellence is achieved.

Nucleai is flexible and personal and in tune with the needs not only to the clients, but also to physicians, and the larger evolutionary trends of the industry and system. Nucleai is making the work of pathologists more efficient and more accurate and it manifests through increasing the number of biopsies that they can diagnose, at a higher level of accuracy. Patient waiting time is reduced, pathologists have higher confidence in their diagnosis process and conclusion, and labs and clinics save time and money.

It is also essential as a healthcare provider to use as much information as possible to continually improve your product offering. For this reason, Nucleai is geographically diverse. We have customers in leading hospitals in strategic regions — Israel, the US and Europe.

Lastly, we try to remain flexible to understand the needs of the customer. For example, a private clinic with five pathologists will receive a different pricing offer that that of a team of 60 pathologists which acts as a part of a bigger system.

Are you working on any exciting new projects now? How do you think that will help people?

Definitely. We have been approached by Big Pharma players looking to gain access to the best companies creating diagnostic tools. Personalized medicine is the next big thing and for this, they want to know which drugs are suitable for each individual patient. To know that their tests could use a technology like ours inspires us and make us very excited for what the future holds as we are confident that Nucleai is a key cog in the system of the future.

We are also in the midst of various pilots with slide imagers (the equipment which makes the glass slides uses for biopsy diagnoses digital). Ultimately, our growth lies in our unique strength as a tech company to create a complete offering for hardware and software through exciting strategic partnerships that will impact the lives of millions of people in a deeply profound way.

You are a person of great influence. If you could inspire a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.

One of my big ambitions is to inspire bright young people who are at the beginning of their career paths to choose to be involved in impactful initiatives such as healthcare, agriculture, and more large-scale global problems that need to be solved. It’s incredible to see bright minds work on things that bring value to the world and society. If I could (and I try in many ways) to influence these people to contribute -each and every one in their own way- that would be my biggest achievement.

How can our readers follow you on social media?

Linkedin: Avi Veidman

Thank you so much for these insights! This was so inspiring!

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