Telehealth 2030: Infrastructure, AI, and the Future of Digital Health

Hey everyone. Welcome to the venture capital podcast with Peter Harrison and me today. Our co hosts are Ryan Morley, he is a partner at springtide and John Lenstein, he is the co founder and CEO of Open Loop, a telehealth company. They are leaders in the telehealth space between either investing it or running very complex infrastructure companies. The space I think is fairly interesting. It's estimated to be about a 200 billion plus company global market by 2030. Drastic utilization or I think where the, where the space became really interesting to the venture capital market is, you know, during the COVID and post Covid market when telehealth became very normal, other companies like hims that took kind of taboo topics have made it more mainstream and so telehealth is shifting from a novelty to I think a very major part of the, the, of the, of our medical care. So Ryan, do you want to discuss your background first just briefly?

Yeah, happy to. Thanks John and Peter. My background is foundationally as an entrepreneur. I helped lead three different organizations. My last was a digital health company that was acquired by Teladoc. I helped lead care delivery innovation at a payer provider health system and from a public policy perspective I was the deputy finance director for Governor Romney during his presidential run and then helped establish a public private partnership to accelerate innovation in a state based model. So take those facets foundational as an entrepreneur, health system innovation and public policy to my work as an early stage investing health technology. We as a at springtide we have 39 portfolio companies over three funds and really seek to shape the future of healthcare and we think that digital health is a big part of it. And John Lensing being a great illustration of that happening.

Awesome, thanks for joining us Ryan. John, do you want to give us a quick background?

Yeah. I don't have quite the storied career that Ryan does but you know when I was young I enjoyed science, math, working with my hands and so I decided that I wanted to go into the field of medicine pretty early on and ended up doing that. Went to the University of Iowa for medical school, you know, matched in for reconstructive surgery for residency, was headed down that path. But then I had started Open Loop as a passion project really to address a lot of the accessibility issues we were witnessing within rural America. Given my upbringing in small town Iowa, my co founder's upbringing in small town Midwest, that was sort of our core focus. But original idea was something completely different. It was tech enabled staffing meant for these rural communities and their healthcare centers. But Then because of COVID as you so, you know, aptly pointed out there, John, that Covid just drove it, you know, headfirst into the digital health space and we haven't looked back.

Awesome. Well, thanks for joining us. One quick disclosure. None of this show is meant to be investment or financial advice. This is just us having a discussion about trends that we're seeing in the venture capital space, especially around telehealth. And I think for disclosure, I think. Ryan, you're an investor in Open Loop, right?

Yes.

Got it. Peter, are you an investor?

I am not. Although I wish I was, based on the great things I've been hearing about John. So appreciate you guys being on the call.

Let's kick off and talk about, like, why Open Loop? Why now?

Ryan, you want to go or you want me to take it?

I think you should go first, John, and I'll share after you.

Yeah. Why open the white. Why now? Fundamentally, we know that health care is broken, and a lot of people have varying opinions on why health care is broken. But for us, we view traditional health care as the health care that's delivered in hospitals and clinics. And we think it's broken for no other reason other than it's just highly inconvenient to patients. It takes time out of their day, they gotta drive there, they gotta come back, and so it's just inconvenient. Instead, we think that the next generation of healthcare should be done at places of high convenience. And so then the question is, where are those places of high convenience? And to, you know, for us, we look at where do all four of us exist on a daily basis? And that is, you know, where we live, it's where we work, it's where we go shop, it's where we go work out at. It's on our phones. But then even on our phones, more in particular, it's what apps are we interacting with and spending hours a day with on our phones? Those all, like any companies, brands, organizations along that spectrum, represent an area to interject healthcare, make it more convenient, meet people exactly where they're at. So Open Loop is set up to be the infrastructure, this operating system, if you will, that can enable all those different types of entities to become healthcare delivery epicenters. Right? So what would it look like if your dating app now also offered sexual reproductive healthcare services to their monthly active users? Your profile's already there, your credit card's already hooked up there. It's easy. Well, what would it look like if your gym now started offering a obesity or weight management program? For you to actually help accelerate and get to your goals quicker. Or your grocery store chain if they, you know, you could get all your common cold and flu medicine picked up right there at the counter, but have the visit done while you're walking down the aisles or your employer place to work. All of those different places open loop enables them to, to turn that on.

So, so is your thought I can go to my gym and then walk out and have a testosterone prescription?

Absolutely right. You know, we, we think health care is sort of based on, you know, in psychology there's Maslow's hierarchy of needs. And you only start worrying about those needs once your baseline ones have been met, all the ones prior to that. The same thing is true with health care. So when you think about, you know, know, where, where is the state of healthcare today in the US majority of the population is overweight. So if you start to fix that now, people start to care more and more about their health. You know, everybody signs up for a New Year's resolution at the gym to lose weight and they end up canceling after three months because they don't get to their goal. But now what if you help them medically get to a really healthy weight a lot faster? Now they want to start working out more and more because they have their baseline needs of weight loss methods. Now they actually care about what their labs and biomarkers look like. So they interested in getting their labs and now they're interested in optimizing those labs. The hormone replacement therapy, the testosterone replacement therapy that you just mentioned. Right, but you gotta meet their baseline meets first.

Got it. Where are your largest areas of growth? Is it like university? Is it, is it gyms? Is it existing health practices?

I'd say our core business is we power a lot of the direct to consumer market. So telehealth brands that are out there. But some of the biggest areas that are growing for us are the retail sectors and sort of like social communities.

Okay, what about the MLM direct sales space? Is that a big opportunity for you?

We've looked into it pretty heavily. I think there's a massive opportunity there. Especially, you know, you're from Utah, you know, a number of them, Doterra, young living, I think they're all looking for the next sort of thing. And I think, you know, the One thing that MLMs have done really well is build direct sales forces. They have a massive distribution arm and you know, those same sort of people would be really good at helping deliver healthcare into the hands of people that need it.

Makes sense Peter, as an investor, why do you think the telehealth space is interesting?

Yeah, I think it's a good question. Well, look, I mean Covid really accelerated a lot of adoption of digital services, right? Whether it's telemedicine or lots of other things. So you know, to John's earlier point, like it's just a lot more convenient to be accessing care where you are, when, when you need it, how you need it in the privacy of your own home. In many cases there's a lot of advantages around, you know, people not feeling comfortable going into a doctor's office. And so being able to get that help remotely makes a lot of sense. And then I think the other thing that's really interesting is this idea that all enterprise SaaS eventually becomes FinTech. And I think there's an interesting element there and it seems like that's something that open loop is kind of doing. Right.

I was going to say. I completely agree with what you're saying, John.

If I could just jump in here a little. I think when you talk about the reforming of our kind of existing brick and mortar infrastructure versus de novo models of care, I think there's a really interesting pathway in that second bucket. You know, we have Value based care has been such a driver of innovation and promises in that sphere and it's been very hard to deliver on value based care with our existing infrastructure, a payer provider system. I think what we're seeing in digital health is a restructuring of the way that individuals consume health and that they view health care. Many of you might be familiar with the determinants of wheel of health Wheel, where really only 15% of our health is determined by the health care that we receive and it's actually 85% in other areas such as lifestyle, behavior, environment and others that we. Some that controllable, some that are not. What I think that the topic that John and Peter are talking about really is taking a broader lens of health and also allowing consumers and patients to, to be in charge of it. We spend 85% of our $7 trillion a year spend in health care on chronic disease management. Most of the vast majority of that spend is reactionary. I think this new de novo build of the way that healthcare is consumed is actually putting it from a reactionary to more of a proactive approach and allowing for higher personalization, which I think is, is has a higher promise of, of delivering better outcomes at a more efficient cost structure.

Awesome. How are, how are the three of you looking at AI changing the telehealth space because it's got to have significant impacts.

I think AI has significant impacts all across the board. You know, not just healthcare, but I think healthcare. It's completely blue ocean on what can be done. There's, there's so much data entry, there's so much manual process within the current confines of healthcare. And AI can revolutionize that. You know, even on the provider side alone, we know that there's a huge shortage of doctors and clinical labor. Um, and so that collective brain power is in shortage. But now AI expands that dramatically. Um, I also think, you know, one of the problems with healthcare is that it takes so long to train somebody up. So now will AI actually give us an ability to use, you know, train people less if they're also accompanied with an AI, you know, support system, a medical AI support system. But as of right now, we try to ingrain AI in sort of every facet of our business. And it's most predominant in the operations side right now. So a lot of our patient support, a lot of our communications, a lot of our call center work is all agentic. Our clinical notes and scribes are all agentic. Our clinician documentation time is down 90% from when we implemented AI. AI is actually calling up and, and talking to our patients and doing a lot of the medical intake, a lot of what a nurse used to do early on. You know, the technology is there. We have it already to be able to do fully autonomous, fully agentic visits, yet the regulatory component is just not there. At some point maybe it will be, but it's, it's just drastically accelerated the amount of work that we can get done with our teams. And, you know, it's, it's, it's enabled better diagnoses, quicker diagnoses, workflow optimization. So if patient A comes in for this condition, then based on the protocol, they should get this set of labs, they should get this medication, they should get X, Y, Z in terms of communication to follow up. And AI coordinates and runs, all of that for us. We also use it on the growth side, so, you know, helping better optimize patient conversions. We use it for care coaching, you know, an AI care coach to help with program retention to help patients actually achieve their desired outcomes. So, you know, we, we, we try to permeate every facet of the business with it right now.

Got it. When do the three of you think that the FDA clearance component will, will dam or break? Because it seems like that's a major turning point in healthcare.

I, I think we're still years out from That I think probably seven to ten years unfortunately.

Yeah, work at the, at the end, healthcare is the most human intensive industry in in, in our country, in our, in the globally. AI is not a, a want to have, it's a need to have. Especially as we face physician shortages of 30 to 80,000 by the end of the decade. And I think that there are thousands of approved AI diagnostics and treatments available right now. It's a really exciting time to be able to see how AI comes in and maximizes the human workforce, augments it and really I think is the unlock really is the personalization of care and that's something that human limitations are are just have a boundary that's being pushed out in a big way to be able to allow for that personalization. I would also say that when we talk about digital health and telehealth and so on, that is the most rich environment to be able to get data points, to be able to maximize and unlock the power of AI in a, in a clinical setting. So I think it's just a great forum and modality for that.

Peter and Ryan, where do you see the investment opportunities arising in the telehealth space?

I think the opportunities is not necessarily in just thinking about it as a video visit. I think the broader view of digital health as a channel. Mark Andreasen famously said software is eating the world. I think digital health is eating brick and mortar. And I think that there is opportunities for digital health to, to expand the scope in a place that you're delivering more efficient care less from, with less costs and more from, with greater access. And I think that there's going to be an expansion of, of the scope that a traditional telehealth of 2020 is, is not going to be the, the, the digital health version in 2030. I think companies like Open Loop are really pioneering the infrastructure that allows those clinical activities to take place. I think there's going to be a lot more infrastructure companies that from a both a payment perspective and a delivery perspective that that really unlock the value that of digital health and also just an unlock of the products and the services that exist. And then fourth being the taking that care to where people live, eat and breathe and making that more accessible and effective. In the end a lot of behavior change is a lot of health care is behavior change. And I think that that's, that's really important scope of digital health.

Got it. Peter, where do you see the investment opportunities?

Yeah, I think it's a good question. I think, I think there's a lot of Opportunities around this dynamic of everybody's kind of moving. You know, it's like we, we talked about on our prior podcast with Max at Superpower, right? And it's this idea of it's not that healthcare is becoming consumerized, but rather that, that consumers are becoming like, more aware of their health, they're like, healthified. Right. And that they're, they're taking it more seriously, they're taking a more proactive role in their health. We now have like, more data about our health, our fitness, all of those things than we've ever had before. And so I think there's a lot of interesting opportunities of now taking that data, pairing it with doctors, clinicians and others that can help make very personalized, interesting recommendations, prescriptions and other things to really drive better health outcomes. And not just health outcomes from like, avoiding getting sick, but actually expanding the longevity. Right. The health span of people, the degree to which they're able to actually enjoy their lives for longer, even if, like, ultimate life expectancy doesn't increase the amount that people are able to enjoy their life. And so I think there's a tremendous amount of opportunities, particularly in telemedicine, around this idea of longevity and helping people better access different services, prescriptions, coaching. Right. All kinds of different things.

Got it. John, what's your contrarian view to the VC view of your space right now? Do you think they have it nailed or do you think there's major gaps that haven't been exposed yet?

You know, VC's time horizon is always, you know, seven years on average for, for fun life cycle. And so if I try to play out, where does healthcare, what does healthcare look like in seven years? You know, my ideas are that we have now entered a true era of preventative medicine because everything, medicine itself has become passive. And what I mean by that is there's so many good wearables and technologies now. Like, think about the aura rings, the whoop bands, the. Your Fitbits, your Apple watches. But then even more so your, your scale is now wi Fi and Bluetooth. Your fridge, they have Samsung smart fridges. Imagine there's a camera on it, knows exactly what you're taking out. What you're putting away can tell you how good and how healthy you are actually eating. Your eight sleep mattress, now it's on you. How good is your sleep overnight? You actually slept way hotter. You probably have a fever. Let's get you checked out. So there's just so much passive data collection coming around that, you know, imagine what it looks like in seven years. From now your, your TV has cameras on your security system, your ring doorbell, they all have cameras. Imagine if they were also able to start analyzing your gait, how you walk. You have a lymph now in your hip. So you have, you have hip issues. But if you can synthesize all that information, process it with AI now you have this very personalized digital profile of a human, you know, down to you and I to a T. And now instead of tweaking that person's healthcare on an annual basis with your pcp, we can tweak it almost, you know, daily or even hourly at times based on what, what sort of data is coming back in there. And so I think, you know, people that are going to enable that big system wide integrators are important, the AI for all this data processing and actually putting that back into an actual care plan. Those are the areas that I'd be spending a lot of my time.

Okay, Peter, Ryan, do you guys agree? Disagree?

I agree. I think that's a foundational opportunity with digital health. I also feel like a lot of our traditional way that we consume care in the ambulatory setting is extremely inefficient and from both a time perspective, a cost perspective and the human resource perspective, I think there's ways that, that we can introduce. So if someone has congestive heart failure, you have, using the tools John just mentioned, you can have tremendous insight into the disease progression, times of intervention to manage that disease in a lot better model I think than of, you know, 30 minute visit every couple months. And so it's going to be a rethinking and the, rethinking the paradigms for how we, we view care specifically in ambulatory world. And I think that, that there's, that there's going to be an efficiency scale that's going to drive payers to rethink the way that they, they contract and then health systems, the way that they interact with digital health companies so that the person that could be driving and owning the relationship could be the digital health company that tells you when to go into the facility, when it's necessary to do a procedure or inpatient or imaging. But that the paradigm is not that way today. But I see that flow, ownership and knowledge, trusted knowledge, source being flipped in the future.

John, do you, John and Ryan, why do you guys.

Oh, go ahead Peter, go ahead. Sorry. I'm just curious, you know, why is it that from your perspective we don't have some of those solutions already? Like what are the bottlenecks, what are the things that have made it challenging to do that. Because I feel like ever since, you know, EPIC launch, the promise was unified data, more insights, better, better outcomes. And yet here we are today with a zillion different disparate data systems, even within traditional healthcare. Right. We, we still haven't achieved that promise, let alone the, the more consumer side of the data.

It's a really good question. On the system side of things, there's no incentive to share the data, to be honest with you. Right? It is. So it's, it's misaligned financial incentives and infrastructures. EPIC has zero desire to share data with Cerner or anybody else or create a universal one because then that means anybody can go pick any product they want the shelf and utilize it. That's bad for epic's revenue. You know, same thing for everybody else. You know, the, just the overall mantra of like preventative versus reactive medicine. Like I think that's, that's the more fundamental questions like why have we, you know, the country that spends the most on healthc care per capita, not achieved, you know, the, these excellent end outcomes that we all hope to have which would be derived from preventative care. And that's because we as a western culture prefer the magic bullet. Right. We don't have a desire to go quarterly to our PCP as we probably should, because it's inconvenient. We'd rather take the pill to fight off whatever it is that we get diagnosed with. And so, you know, the complete reworking of is like what are, what is the pieces of tech that make care convenient. How do we get all this data? How do we synthesize all this data to provide those real time things to just be tweaking things, behavior change over and over again in the middle of a patient's normal life where they are daily, rather than having to have it be done in a hospital or health system somewhere. Right, right. Like notifications to your phone. Right. How many, how many times have we all had Apple watches and it says you haven't stood up this hour and we just get a little dopamine rush from getting that notification where we stood up again. Or you're, you're 200 steps away from hitting your 10,000 steps, right? I'm going to go walk the dog. Whereas, you know, I normally wouldn't have done that. Think about if you can just extrapolate that across every area of your health. Hey, I noticed you've, you've gone out to McDonald's three or four times this week and you know, you're usually averaging fast food every other week, once every other week. You know, what's up with it. Talk to the AI coach about what you're experiencing. If it's stress, great. Let's do some stress relief techniques right now. Or, hey, we're going to add this supplement into your mix right away because it helps reduce anxiety and stress that's more temporally constrained. You know, different, different things like that.

Yeah, I, I agree. I think, I think you bring up like an interesting.

Oh, sorry, go ahead, Ryan.

I think that there's three different factors that really prevented us from achieving that state of data transparency and also flexibility. One is our clinical model. It's fantastic at delivering care, but the specialty, subspecialty, the, our clinical model is all around just having areas of specific knowledge and it doesn't necessarily share. I think that's actually a huge opportunity within digital health to be able to provide subspecialty level insights in the moment that matters the most. And then the second thing being the billing infrastructure that we've created, we've codified this as a, as a country where we have very specific rules about how we can be compensated for care. And that's created just very rigid silos in addition to the clinical models that are established. So that's a challenge. And then third is the infrastructure that we built around it, both from a brick and mortar system and also from our epics and cerners and the hundreds and thousands of other resources that supports those silos. So in the end, you created between those three things, this infrastructure that is just not flexible at all. And so that's why I think that there's this opportunity to rethink and build a de novo way of health delivery that's in the digital health world that has all the elements that we're talking about of proactive health data inform and personalization.

All right, so I guess my question was, and maybe this is less of a question, but would love your feedback and reaction, which is I wonder if part of the reason why we haven't achieved these outcomes that we've been looking for is because the patient themselves are not engaging with the data and taking ownership over it to the extent that maybe they should. Because it's like, oh, yeah, I did, did this blood test, but I don't really know, I don't really care and I'm just going to rely on my doctor to tell me what that means. And so they don't, they don't really feel the pain point of, at least not acutely of these Systems not talking to each other and they don't take ownership of it and it just kind of sits in someone else's hands. In the same way that like they don't think about their healthcare costs in a direct way. Right? Because yeah, I had to have this procedure done, but I didn't pay for the whole procedure out of pocket. I paid something to the insurance company and the insurance company paid it. And so there's this like emotional and intellectual disconnect from how we pay for healthcare, how we think about healthcare, how we track our healthcare data, like all those things. Because I would, I would imagine that people that were really invested in this would push the epics and the Cerners of the world to actually talk to each other and improve interoperability. But I don't know, what do you guys think?

I would say that patients are, we've created a payment structure where patients are not shopping transparently even though we've had several rounds of transparency legislation to promote more of transparent shopping and choice. I do think that the core problem is engaging the payers, specifically employers at the table. I think would having. I think there's a really interesting alignment here around digital health and employers being able to come together with solutions that are more driven, that are patient around patient focus. So I think that that collaboration is really important. Thinking about payers and providers in that way, really thinking about de novo think about who's not involved in that equation. It's not a health system in the middle of it, it's not a payer in the middle of it. It's, it's really kind of just trying to figure out how to deliver care in those, those areas. I don't think that Cerner EPIC are going to be necessarily the panacea or, or the silver bullet to, to actually unlock. I feel like that's not as an urgent solution it, as it is trying to figure out the payment and, and the patient needs.

And I think maybe a little contrarian, I actually think we, we sort of, you know, in the next decade see the dissolution and removal of third party payers. The, the payers who are out there who actually don't have any like you know, medical team or the, they're not in the actual business of care delivery. I think, you know, it's adding a middleman into the mix and eventually capitalism wins out and you strip out any extra costs and third party payers are extra costs instead. I think what you get to is, you know, what does the process look like? I think you're going to See a resurgence of cash pay stuff, which you're seeing in telehealth already. And I think it's only going to continue pretty dramatically. You're going to see more employers take on the brunt of stuff. But then more importantly is the remaining piece is the actual care providers, I. E. The telehealth companies, the clinics, the hospitals, they will all have to be, you know, fully integrated and be the insurance provider. Like as a patient I should say, hey, you know, tell me how much I have to pay you annually to manage and make me and keep me healthy. And then it's on the provider to be like, okay, you know, based on all the data that we have from all the patients that I've seen in my panel and the outcomes that I drive, like here's your price, it's going to cost you $1,000 annually for me to manage your care. And we're going to, and I'm going to do it top to bottom like that. Aligns the provider and aligns the patient. Those are the only two people that matter in the equation. That's it. Strip out all the extra noise and people from that. And that's fundamentally what it gets down to. The person delivering the care and the person who's receiving the care. Keep it there. The one thing I'll say is that cash pay on just fee for service won't exist forever. I mean, there'll be certain little pockets every here and there. But fundamentally human nature, we don't like to save. Right. We, we prefer to pay subscriptions out of our pocket that just automatically get withdrawn from us rather than have to save up a bunch of money in our mind for when we actually need it. So that's why like we'll have contracts directly with providers between patients and providers to be like, okay, here it is. Thousand dollars to manage my care. It's coming out of my paycheck every month. I just forget about it. Right. So it'll be interesting. I really do think we're going to witness the downfall of just third party payers here shortly.

Do you think that is enabled or hastened by the adoption of telemedicine? Kind of bringing it back full circle?

Yeah.

Or what role does telemedicine have to play in that transition?

You know, I've, I've talked with some of the big payers and I tell them exactly what we're doing and they're like great, well are you billing us? And I say no, it's all cash pay. Like you're doing that much revenue in Non traditional healthcare that's not getting built through payers. And I say yeah, and so that's an entire market that they're missing out on and that we're stealing patients and Wallace share into this new model because people pay for convenience. The, the, the third party payers right now don't value convenience, but the patients do. And that's fundamentally what matters because it's their wallet. So you know, telehealth is hastening, you know, shift away from that by, by focusing more cash pay services right now for the convenient aspect of it. How that morphs over time though is as tele becomes more and more dominant, the telehealth players themselves will take on the overall risk of managing that patient indefinitely. So they'll just say hey, you know, instead of paying me, you know, $50 for your birth control every month, like give me $250. I want to manage the totality of.

Your care from now on and bundle.

It, bundle it,ousand percent.

I think there's also some, some federal waves of policy that are really focused around innovation in, in the way that we're constructing plans. Ichra is one, one example where it's more employee choice around and giving them more of optionality with employers and individuals more choice. I think that that is a trend that will only enable this broader personalization of care. And I think digital health being a key component of that. I think the roles of payers and the roles of health systems are going to change and change again to that more of a patient driven focus if we can, if we can solve the payment challenges.

Do you think that the future of healthcare is going to shift to the wearables as the point of entry?

So we see a wearable having a watch for me as a healthy person is not high value cost in the short run, likely from a health spend perspective. But if we, if we think about the overall kind of data capture and environment that's around us and being able to manage prevent chronic disease. But maybe the first part is manage it in better ways to manage it in the short term and prevent it in the long term. I think that is where the unlock is. It becomes a nice to have and into the need to have when we get to like. I think that's the transition that happens because we've talked about a lot of like cash pay consumerism, like all those elements but there that's, it's creating an infrastructure that is allowing the need to have a medicine to, to expand and that, that's really where the heart of, of the spend and unlock is if you go into a primary care physician's office and you charge $250 or something for a visit, call it 200, $250 per visit and you can get the same thing online through with multi specialty inputs and kind of better patient experience accessible longer term. Look back with all your data and so on. Um, and do that at you know, a quarter of the price. I think that that's where it's going to be very interesting where it's like well where should, how much should I pay for primary care visits? What do kind of rethinking that the way that people are accessing it from that perspective. And then you can go through all the specialties and think through like really like what is the most effective thing for the patient again in the need to have categories as that's built on this kind of current consumerism foundation.

Yeah, let me ask my question a different way you don't see it going. Is the point of entry going to shift instead of me calling my doctor to the future of telehealth is through my woo, through my Oura ring, through my, my Apple health device, through my Google Fit device.

I think so. I think it's going to be the digital health is going to have the primary seat potential has the opportunity to have the primary seat that really will help to dictate what other resources are brought in from a health care perspective. But that will be the front door.

I mean that's my big takeaways from what John was saying on this podcast is you know, maybe my doctor in the future is AI by my woo and I'm choosing my, instead of choosing my doctor or my, my doctor based upon my insurance policy, it's the doctor that works through the, the telehealth device, through you know, my, my or my aura ring.

Am I right?

Am I wrong, John?

Ah, that's right, that's right. You know I, I think there'll be all of these data providers, you know the other options like Whoop, Aura, Apple, they all sell this patient level data back to the people who are owning the cares that help them drive down the overall annual cost to manage a patient. The more data I have on a patient, the better I can manage to care and the more cost effective I'm going to be with it. So they can either be connected, be one entity or they can be disparate ones but they're going to have a very tight relationship.

All right, well thanks John and Ryan for joining people. Peter and I today. We enjoyed having you on the the podcast. I know my views on the future of telehealth and telemedicine has significantly shifted. I mean, I'm excited to see what that looks like. So thanks for joining us. You can find both of them either@springtide.com or openloophealth.com correct?

Yes.

Yep. Thanks for having us on. Really appreciate it. All right.

Thank you.