Entrepeneur Rx_Uli Chettipally: Audio automatically transcribed by Sonix

Entrepeneur Rx_Uli Chettipally: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

John Shufeldt:
Hello everybody, and welcome to another edition of Entrepreneur Rx, where we help healthcare professionals own their future.

John Shufeldt:
Hey everybody, welcome back to Entrepreneurs Rx. Today, I have the real honor and pleasure of talking to somebody I've gotten to know over the last couple of years. His name is Uli Chettipally. He is a physician. He has his master's in public health. He's an emergency medicine physician, even better, and he has these couple of really cool gigs that we're going to talk about today. Uli, welcome to this.

Uli Chettipally:
Thank you very much, John. It's a pleasure to be with you and it's an honor to be on your podcast.

John Shufeldt:
Thanks. Well, this will be fun because I've got a lot to learn from you, so this will be really cool. Okay, so just for background, because I always say there's ... a lot of people, myself included, who say when I grow up, I want to be you. Give us your background in healthcare first.

Uli Chettipally:
Sure, so I started off in emergency medicine, trained in Los Angeles, and while I was doing a research fellowship before that, my mentor offered to pay for a master's degree in public health, and that was at UCLA. I said, Yeah, sure, I'll take it. And that got me a little bit interested in the population side of health. So when I joined Kaiser Permanente, it was my first and last job. When I joined Kaiser, they said, Oh, you know, you have this additional qualification. So when they put me on the administration track and then I ran the department for several years as the chairman of the department. But yeah, that's how I got started. And I got more and more interested on the business side and the research side and the technology side as time went on.

John Shufeldt:
So when did you finish your EM residency? What year?

Uli Chettipally:
Oh, God. 1992.

John Shufeldt:
'92. Okay, so I've had a couple of years on you. I was '89, so not a lot of years, but a couple of years. Alright, so you did that and then you did your MPH in a research fellowship after that?

Uli Chettipally:
Before that.

John Shufeldt:
Alright, and then, so you went right to Kaiser. How long were you at Kaiser for?

Uli Chettipally:
I was at Kaiser for 27 years.

John Shufeldt:
Holy cow. Did you you just recently?

Uli Chettipally:
Yes.

John Shufeldt:
Not long ago.

Uli Chettipally:
Yeah, so, but, you know, it was not a straight career at Kaiser. So first thing is, I was the administration track managing the department. I did that for several years and got to be a little boring after a while. And so what I did was I took a sabbatical and since I was living in Silicon Valley, this was the dot-com boom time. And so I said, okay, I'm going to do a startup and raised half a million dollars and worked on the startup, built the product, and then went for the second round of funding. That's when the market crashed. And so I got back to my job at Kaiser because the one year was over and I said, I want to do something else. And one of the things I did next was a project where I started a call center for Kaiser in Pasadena, Southern California. I did that for several years and got bored with that. And then I started a research network called Crest Network, which was, I think, my most significant contribution there. You know, I was the technology lead for the group and it was, you know, a few of us got together and said, hey, you know, now that all the charts are up and running and we have four or five years' worth of data, hey, let's look at that and see what we can do with that, and that's how it started.

John Shufeldt:
What was your undergrad degree in?

Uli Chettipally:
Well, undergrad, I went to medical school in India. So it's biology and chemistry and physics. That's basically it, so it's a very generic one. But I got more interested because of the startup I did here in Silicon Valley.

John Shufeldt:
What was the startup?

Uli Chettipally:
So the startup was a virtual office online, and this was before, before video, before anything. How can you run a clinician's office online? Mainly, we had personal health records, prescriptions, messaging, and billing. So those are the four things that we did. It was called Clinic America.

John Shufeldt:
And the patients were being seen virtually?

Uli Chettipally:
Yeah.

John Shufeldt:
What year?

Uli Chettipally:
1999, 2000, we were like 20 years too ahead of our time, I guess.

John Shufeldt:
Wow, because, you know, I did MeMD in 2010, and that seemed like an uphill slog against like, you know, people were like, wait, you're doing what, online? You were ten years ahead of me, holy cow.

Uli Chettipally:
So, yeah, so I realized that, well, you know, the market is not ready. You can do anything.

John Shufeldt:
That is amazing. So you did that for a year. It didn't quite get much take-off because the world wasn't quite ready for that yet. That was, you know, Amazon was relatively new then, and like Priceline had just come out, as I recall also. So, yeah, you were, holy cow, you were early. God, you went from Amazon to taking ...

Uli Chettipally:
Yeah, so I got a real taste of not only the entrepreneurship bug but also the technology bug. Wow, you know, what else is possible Using technology? Especially Internet was just booming, and then know, what else can we do? You know, that's what got me started on the research network ..., oh, we have so much data, you know, how can the data help make healthcare better, make patients better, make lives easier? And I guess you can say that you know, we emergency physicians, I know you are one, and we have a different kind of take on medicine. I think we have a much broader view of what happens in healthcare, right? You know, anything that breaks down ends up in the emergency. So you're at the bottom of the funnel.

John Shufeldt:
The bottom feeders.

Uli Chettipally:
Bottom feeders. You know you put some mud in a glass of water, you stir, and what settles down, that's emergency medicine for us.

John Shufeldt:
It's a good way to look at it.

Uli Chettipally:
Yeah, and so we have a different view of healthcare and that's where I got my insight into, Oh, okay, what can we do with data? So with data and that project was where when a person shows up, let's say I'll give you an example, chest pain, right? When a person shows up with chest pain to the emergency, as physicians, we are looking at the patient. We are taking the history. We're looking at the past history of medications and all that risk factors, right? But you know what? What I've seen is that as physicians, we have a tendency to overestimate the risk of that patient because we are risk-averse. We don't want to get sued. We don't want to make bad decisions and bad outcomes, right? But what if you can look at 100,000 patients that came before this patient with the same chief complaint? And if you took that data and analyzed it and compared this patient with that 100,000 patients, and where can you fit this patient's profile into those 100,000 patients? That's exactly what the concept was. And so right now, what happens is when the patient comes in an alert goes to the physician's cell phone saying that, hey, there's a patient in room number 23 that has chest pain and is qualified to be enrolled in this study. So everything is under research so, and then when the patient, when the physician goes and sees the patient and they get a picture, in the background, our system is doing all the analytics and so it is taking the patient's 30 plus variables and comparing with these 100,000 patients that came before this person, and it will give you a specific risk category. So it'll say the chances of this person having a heart attack in the next seven days is 0.003%. So you should do A, B, and C. You should send the patient home, don't admit the patient. Let them follow up with their primary care doctor, that's it. And the physician doesn't have to follow it. But what we have seen is that if they follow, they are on the right path because then there is less chance of missing something significant, but also there's less chance of overdoing stuff. So that's how the system works.

John Shufeldt:
So I love that, so it's basically an AI-driven natural language processing machine learning algorithm that adds that patient into it as well. And in Kaiser, it's probably pretty straightforward because you have all the patient data and those 100,000 patients in the way they are treated become the standard of care. So did you ever have to use that data in your algorithm to defend the care of a patient in real-time? In other words, this patient becomes one of the 0.003 who does have a STEMI and drops dead and then they sue you. Can you hold up that, your algorithm, and say, look, got the data.

Uli Chettipally:
So a correction, I did not use AI yet in that system.

John Shufeldt:
It's kind of AI.

Uli Chettipally:
And that's where it's going, yeah.

John Shufeldt:
It's algorithmic-based.

Uli Chettipally:
Algorithmic-based. So what happens is, you know, as you do these studies, so it is clinical research, right? So what we did was ten medical centers would use the system, the other 11 would be controls, and you do a clinical trial and see what happens. Well, after 10,000 patients, then you can see that in this intervention side, you actually decrease the risk of missing a patient, missing MIs, missing bad outcomes. So your overall risk, let's say it's 1% to 2%, right? Missed MI rate. So here it is, 0.5. And so, yeah, of course, you cannot make a system 100% accurate, but it is more accurate than not using the system.

John Shufeldt:
Right.

Uli Chettipally:
And that's the bottom line.

John Shufeldt:
Yeah, and a lot of cost savings.

Uli Chettipally:
Cost savings, huge cost savings because the length of stay in the ED dropped, the testing dropped, the amount of testing, the observation stays dropped, the admissions dropped, the post-discharge testing dropped, and no major bad outcomes, so, yeah. It's a win-win-win situation.

John Shufeldt:
Are they, you know if Kaiser is still using it?

Uli Chettipally:
Yeah, it is still active and there are several modules we built. So chest pain is one, congestive heart failure, atrial fibrillation, head injury, abdominal pain, so all these modules are continuously running. So basically you're running a clinical trial all the time and you're refining the algorithm, refining the system, and then you are kind of streamlining the practice. You're getting the outliers back. Some people may be overly aggressive, some people may be more cavalier, and so you're bringing these people back into where appropriate care should be.

John Shufeldt:
Right, between the two guardrails of disability. That's very cool. So how long ago did you leave Kaiser?

Uli Chettipally:
That was three years ago, I left Kaiser. I had an opportunity for early retirement and I said, okay, I'll take it. I want to see what else is out there.

John Shufeldt:
That's cool. Are you still practicing emergency medicine?

Uli Chettipally:
No, I'm not. Clinically, I'm not doing it.

John Shufeldt:
Very good. Well, I'm, that alone is impressive after 27 years. Okay, so talk to me about, is it Sirica?

Uli Chettipally:
Yeah, so there is, Sirica is my startup, but there's one gap between Sirica and Kaiser. That is InnovatorMD.

John Shufeldt:
Oh, no, we'll get there. Okay, so go ahead, talk about Sirica first because I want to spend a lot of time on InnovatorMD.

Uli Chettipally:
Okay, sure. Sirica is a startup that I started. I have a daughter with autism. So autism is very, I've been looking all my professional life for some solution that I can really put my thought and effort and everything into, and this is what it is. It is a device, it looks like an exercise machine, basically. You know, you're riding a recumbent bicycle, but you can also steer with your arms and you're pedaling with your legs, and then you add a virtual reality to the device so that when a patient is wearing it, you're actually placed in a virtual environment in a video game, basically. And inside the video game, you are riding a vehicle and that is this vehicle that you're riding physically. So if you go faster, you go faster in there. If you hit a road bump, you feel it because this is a robot, right? It'll jump and you're getting the whole haptic feedback. And so the goal is to totally immerse the patient in this virtual environment. So you will forget that you're in a physical environment, you are actually transposed into that environment. And the reason why to do that is that at that time, you can provide a task-oriented therapy. So you have to go from point A to point B and you have to avoid this and you're in this beautiful forest location and you're going on a trail and you have to go over a bridge, you have to climb a hill. All those things come with this game software that you can actually control. And so the idea is that when you engage patients, especially autism patients because it's hard for them to engage in a real-world situation, but here it is very controlled. Everything is personalized to that person. When you put them in a, in that kind of a mode, the idea is that there'll be neuroplasticity that will enhance their perception, that will enhance their focus, and so it'll decrease their anxiety, it'll decrease their behaviors that are not normal in a typical sense. And so what happens is their aggressiveness goes down, their sleep gets better, and they focus better and they learn better, and so that is the hypothesis behind this. So you offer this as a treatment 30 minutes a day, for five days a week, and you do this, and then we expect that that physical activity and the physical challenge, plus the mental challenges, ... that we're trying to create here. And I've seen that in my daughter. We have engaged her in pretty intense physical activities. And we have seen that her anxiety came down, her focus is better and she's sleeping better. And she lost a lot of weight because that anxiety is down. And so I want to transfer that into a device and be able to scale it so the device can be in any clinic and a therapist can monitor it remotely or in person. So that's the idea behind Sirica Therapeutics.

John Shufeldt:
That's really interesting, and I was trying to think of other use cases for, well, TBIs, any sort of cognitive brain impairment benefit from this?

Uli Chettipally:
Yeah, I mean, you know, so this is a platform, right? Now, you know, the company that we partnered with, they're developing it for stroke, rehabilitation, head injury. Brain injury is a good indication, post-op recovery, sports injury recovery or training, dementias and Parkinson's, and all kinds of degenerative and developmental disorders or acquired disorders of the brain.

John Shufeldt:
Right. Now, would you anticipate, what's your, what's does a go-to-market strategy look like? Is that you open up clinics that have this device in it, or can people buy it and use it in their own home?

Uli Chettipally:
So the first go-to-market is we are going to approach the clinics that are already doing other kinds of therapy and to offer this as an adjunct to their therapy, behavioral therapy, speech therapy, and occupational therapy. So they will have these machines in their clinics and then run it, and so it's shared revenue there. But as all technology becomes cheaper and lighter and better as time goes on, and so that's when maybe five years from now, we'll have it in people's homes.

John Shufeldt:
That's really amazing, and your daughter is definitely, it's definitely helped your daughter?

Uli Chettipally:
Yes, yes. We have seen, and the video that is circulating out there is that the first time she tried it and she loved it, she wanted to do more. And so that's where I got the inspiration that, oh, wow, you know, this can be used as a therapeutic device. And so we are planning to run pilot studies, and our first pilot study would be in Stanford, and we already have identified the people and the location and what we're going to test. So it's going to be fun.

John Shufeldt:
Wow, that's really cool. That's really cool, and if it benefits your daughter even better, that's awesome. Alright, I'm sorry about InnovatorMD, this is really fascinating. Can you explain to everybody what InnovatorMD is?

Uli Chettipally:
Sure, so before I got out of clinical practice about five, six years ago, I started a chapter for Society of Physician Entrepreneurs because I wanted to become an entrepreneur when I retire and I got out of practice. So I wanted to learn from people. So what's, the best way is to start something and invite experts like John. You came to InnovatorMD. And so when you organize events like this, you are listening to so many people, you're actually seeing so many things and so your experience really explodes. So the idea behind InnovatorMD is that physicians have, they are on the front line and they see the problems every day, and I'm sure they think a lot about potential solutions, right? And the solutions that physicians think about are unique in the sense. That they're more practical because if they find a solution, they know that they will use it. They know that their colleagues will use it, and they know that it will solve the real problem. It's very different when a technologist comes up with a solution versus a physician comes up with a solution, right? And I've seen that in my practice, and so I said, okay, let's, how can we help physicians bring their ideas, share it with the world, get resources, get people, get money so that the good solutions can come to market. And so that's the idea behind InnovatorMD. How can we support physicians who are innovating and who are getting into entrepreneurship?

John Shufeldt:
So give us an idea of one of your programs. I think people are going to listen to this and want to sign up to attend. And for those out there, I'm biased because I've spoken at a couple of them. The folks there are super interesting and like most things in my life, I learn more than I teach from them, but they're an enthusiastic crowd, to say the least.

Uli Chettipally:
Yeah, so because people are seeking out this knowledge, right? So one of the programs is, we have InnovatorMD University, which is master classes every Thursday, 40 master classes throughout the year. And so we bring in people, experts like you, John, and in several areas in the legal area in how do you protect your intellectual property? How do you start a company? How do you market it? How do you build a product? How do you engage an engineering company? So simple, small things but very important can be crucial. And so we put all this curriculum together so that within a year's time you get a pretty good idea even before you jump into entrepreneurship or innovation. So you're learning, so learning is the first thing that we do. InnovatorMD University, we do two large conferences, one in winter, one in the summer. This one is coming up in August, our next one, where we bring like the last summer conference was, we had 100 speakers, 100 physicians who have done interesting things and they share it with the community. So that's the first program. And of course, we have opportunities on our website and we do, for every program we do CME, we give CME because we want people to take advantage of that. So there is a membership, but also you can join each event and each class, but obviously, membership is much more valuable.

John Shufeldt:
And so you have master classes all year long, you have the two large conferences, and then also you mentioned before that you have an accelerator.

Uli Chettipally:
Yeah, so, and then we do meetups, just casual one-topic type of meetups. So the accelerator is where we were thinking of starting our own accelerator, and then somebody suggested that, hey, you know, there are other companies that are doing this, we need to partner with them, and so we partnered with Founder Institute. Founder Institute is a large company. They've been doing accelerators forever and they have it in 90 countries, 5000 startups started, and a tremendous group. And so we partnered with them and we started this health tech virtual accelerator. And so what you can do is you can join that and then it'll walk you through 13 weeks of classes and mentorship and courses where at the end of the period you graduate, and so you have an idea, a company, that could potentially be funded, that's what you come out with.

John Shufeldt:
Very good, and so we talked a little bit. I'm excited too with they using ... Ventures to start looking at those companies coming out of there. And I think that would be a very cool interplay. Okay, what advice do you have for physicians now who are coming out of residency, whether they're EM or not, on not being using entrepreneurs as a way to hedge against burnout, as a way to hedge against market downturns, where they need to find another source of income, but what's your advice?

Uli Chettipally:
So unless somebody is offering you a full-time job, I would say stay in medical practice and start learning things. While you're practicing, you go to meetings, you go to conferences, you go, you meet people and as you see things, you will get ideas on, unless you already have an idea for a startup, the best way is to see what other people are doing and sometimes even join them part-time as an advisor or a chief medical officer or as an investor and learn from that experience. And as you learn, as you understand, okay, this is how it's done, this is how. And then you, at some point you'll say, okay, now I'm going to take the plunge full-time, or if you already have an offer somewhere to come and join full-time, just go ahead and do it. Experience is the best teacher, so the more you do it, you'll get better at it.

John Shufeldt:
Totally, and you know, I think the one thing I've seen recently, you know, I have this staffing company called Tribal Health and we have a lot of folks who are you know, they work a week or two a month. They're very well paid, and then they go do whatever else they want to do, which oftentimes is something like this. It always worried me, though, that if you're not at least engaged in some part of patient care, I always worry that once I'm out, I'm out. And so I always want to keep one foot in the stream so I can say, well, I'm still doing three, five shifts a month. When you retired did that thought concern you? That you were like, okay, I'm not going to practice clinically for a few years or maybe ever.

Uli Chettipally:
So yeah, that is always a thought. So when you're practicing, you do it for a few reasons. Obviously, you went into clinical practice because you're passionate and that's your mission to help people. That's a good thing. But what happens is when you are working too many hours after a while, the burnout starts to hit you maybe five years, ten years, twenty years into practice, right? So in order to keep that flame burning, I would say that you should keep that to a manageable portion of your time. So typically the way I would say is that when you're practicing medicine, you're only using a small part of your brain.

John Shufeldt:
That's true.

Uli Chettipally:
Because there's so much more. And imaging physicians are very good at learning things. They're very diligent and they're hardworking and they're smart. And so why limit your brain to such a small area? I mean, I'm calling it small, but obviously, you know what I mean. So when you have other activities happening on the side, that's when you don't burn out because then your brain is fully occupied and you will start to enjoy the practice more than what you did before when you were doing it full time, I'd say, yeah.

John Shufeldt:
Yeah, it's funny. That's my perspective. I've, people always accused me of working too much, but I think my work outside of medicine has really kept me really excited about practicing medicine. And, but for that, I think I would be like, just, shoot me. You know, I'm 32 years now, but doing all this other stuff, I'm like, I'm kind of excited. I'm thinking right now I'm going to go back out and work one of our reservation facilities in another week or so for a decent long stretch. I'm kind of excited to go. I mean, it's like, Oh God, he knows. In the middle, in South Dakota, and in April, but most of me is like, you know, game on. I love this stuff.

Uli Chettipally:
Yeah, yeah, and then the excitement of actually seeing a patient comes back. I would definitely recommend that. And it may not fit everybody, but if you have that feeling that, Oh, is this it? You get that feeling, right? You know, when you're in practice and then say, Oh, okay, maybe you can make a difference in one patient's life. What if you do an innovation or a startup or a device or something? That can affect thousands, millions of patients, right? So you are making, you're scaling your insight and skill and expertise to many more patients. And that's what I, that's what is gratifying about doing entrepreneurship.

John Shufeldt:
Yeah, I agree. It's the ability to touch a lot of people, if not with direct patient care through whatever device, or app, or technique you came up with. I totally agree with you. So Uli, where can people find out more about you and what you're doing in InnovatorMD? Because I'm hoping people will listen to this and do what I did, which was sign up.

Uli Chettipally:
Yeah, the best place is InnovatorMD.com. If you want to connect with me personally, then LinkedIn is the best way, Uli K. Chettipally, and there's not many Uli Chettipallys on LinkedIn, so it should be easy to find me.

John Shufeldt:
It'll be easy, ... I have the same sort of name, only probably not as unique as yours. There's not a lot of John Shufeldts walking around, which is not a bad thing for the world. Well, hey, this has been great, and I certainly look forward to coming out and working with you and your team again. The conferences you put on are very inspiring and I always learn a lot, so thank you for this opportunity. I know we'll be in touch.

Uli Chettipally:
Yeah, thank you for being a mentor, teacher, and a friend. We always love your talks and I really appreciate what you do.

John Shufeldt:
Thanks, it's been my pleasure.

Uli Chettipally:
Thank you.

John Shufeldt:
Thanks for listening to another great edition of Entrepreneur X. To find out how to start a business and help secure your future, go to JohnShufeldtMD.com. Thanks for listening.

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