Lyfebulb Holdings Inc. (CVS) Earnings Call Transcript & Summary

Welcome, everyone, to the Lyfebulb CVS Kidney Care Innovation Challenge fireside chat. And I'm Karin Hehenberger, I'm the CEO of Lyfebulb. And I'm joined today by 4 incredible individuals, all representing the great talent that we have seen over the past few months during this challenge that we run in the area of kidney care. And just want to set the stage that this innovation challenge was, of course, focused on patients, and how we can improve the treatment, the prevention and the care and hopefully, eventually, really improve the quality of life for those living with chronic kidney disease. But the strong emphasis here was also thinking about everyone who is experiencing kidney disease. And the inequity of the system that is currently present. It is a situation in this country where if you come from a different background than the higher socioeconomic Caucasian background, you have a much higher risk of being treated differently when it comes to your specific disease, meaning that you may have less of a prognosis that is good. This means access to transplant, which is, of course, the gold standard for end-stage kidney disease, but it also has to do with diagnosis of kidney disease upfront. Many people who are living with kidney disease do not know that they are experiencing this disease, and they do not know what to do, how to treat it, how to seek education, how to find that information. We will learn more about these numbers from our key opinion leader here today, and I start by introducing Dr. Jesse Roach, representing years of work in nephrology at various different reputable institutions, and currently with CVS Kidney Care. We're also joined by one of our judges from our challenge, Jennifer Miller, who is an executive within CVS Kidney Care, and is here to talk about why CVS is interested in this space, and especially the home care of individuals living with chronic illness and kidney disease. This is also here as a representative of the wonderful judges that we had. We had 5 judges. And why we picked these 2 individuals who are also here today are winner representing OmniLife is Dalton Shaull, who is here during his honeymoon because he just got married. So we are incredibly fortunate, and thankful to his wife that she is allowing us to have any part of this current time. And a wonderful -- an honorable mention is Sharron Rouse, who represents kindness for kidneys, an incredible movement, as I would call it. That we hope really will bring more equity, and more education and more awareness to kidney warriors all over the country. So with that, thank you so much. And I'm going to first pass the mic, virtually, to Dr. Jesse Roach to talk about the system as it is right now, and why we're so interested in trying to address the inequity in kidney care.

Thanks, Karin. Thanks for having me speak. And thanks for such a great event, and thanks to Dalton and Sharron, and to all the finalists for really giving us a good event and inspiring us and giving us a lot to think about. One of the reasons that we did this is because keeping disease is sort of one of the prime examples of health equity -- or health and equities actually in this country. So -- and you can't really address kidney disease in the United States without addressing the health equity issues. So just to give you a basic run down, African Americans, for instance, make up 12% to 13% of the U.S. population, and make up 30% to 35% of the end-stage renal disease population, Hispanics are 1 to -- 0.3 to 1.5x more likely to develop kidney disease as their white counterparts. Asian Americans are more likely to develop kidney disease than their white counterparts. We also have an issue of once you develop kidney disease, you're much less likely to get treatments. Black patients are 30% to 40% less likely to get a transplant or you get home dialysis than their white counterparts, and the numbers are same for Hispanic patients. And so we basically have a problem of we have a disease that disproportionately affect certain communities, and those same communities aren't able to get the state-of-the-art treatments, and the treatments that will be best for them. So it's a sort of double-edged sword. And that's why we did this. We wanted to, one -- because we think -- we think that some of those inequities are due to social determinants of health, we think of is due to lack of awareness. And we also just think it's due to less access and less technology available. So we try to pick finalists that will address all of those aspects of the problem, people that worked with people to advocate for them once they got a kidney disease. We want to work with people to find people that wanted to find kidney disease before it happened before it became a problem in these communities. And so -- and I think we found a good mix of those. I think that at CVS -- we're put it -- we are coming up with a good strategy to develop a data system, where we try and identify patients and we try and sort of figure out the specific problems with them. And we think once we understand our patients better and come to them where they live, and we can help address inequities. And I think a lot of the finalists will help us with that or have strategies or have plans to could help us with that down the road. And so I just wanted to thank everyone again, and just talk -- and just sort of tell me on why we did this challenge and why it's so important that we address the health equity issues in kidney disease.

Thank you. Thank you so much. And I just want to reiterate 1 component of this challenge, which is quite different than other innovation challenges is that the leaders of each company is personally associated with kidney disease. So everyone who is applying to an innovation challenge that is partnered with Lyfebulb, needs to either be a patient or a care partner of a patient. So that personal commitment is so very strong and that passion and motivation, I think, shined through. And Jennifer, from your perspective, as both a judge and someone who is seeing new technology all the time at CVS, what drove you to pick these 2? Before we introduce them before we allow them to speak, what drove you to pick them?

I'm very excited to talk about that. And I'll say first, though, echoing Jesse's comment, thank you for the opportunity to join you all here today, and congratulations to our honorees and to all our finalists because to answer your question, it was not an easy task for the judges. I think we went over our time limit because we were having such a robust conversation. We had 10 wonderful finalists. And I think what was really exciting, too, is that the solutions that were presented were all very diverse in addressing different problems along the patient journey. So we had preventative diagnostic different ways to provide care or treatment. And so there's a lot of diversity there as well in what was coming forward. But as we know that the focus was on improving health equity and outcomes, and we were guided by the criteria around how does this address an unmet need. What is the impact on lives of people who are affected by chronic kidney disease? And what is the market feasibility? And what we discussed as a jury was, where did we see a really strong patient connection, as you just mentioned, as well as where did we see an idea or a solution that actually had some proof-of-concept already in the market and have demonstrated some success. And I think we saw that with both of our winners here as well. And then Dalton, as our overall winner from the event, we were really just impressed with how your solution helps improve access and removed by this, that will help improve outcomes. And I'm sure we'll get to hear you speak a little bit more about that. But we could see that in action, and we're very excited about that.

I guess that gives the floor to Dalton. The winner of this challenge, the overall winner from a business perspective, from an impact perspective, we have various criteria, and I think Jennifer is worth noting that you follow those criteria pretty carefully. And also as we together brought out the 10. They all were assessed based on those criteria. But Dalton, you were the winner. So here's your opportunity. What -- first, your personal connection briefly, but then what is your business too, what is OmniLife is about?

Yes. So thank you, Karin. Jennifer, Jesse, Dr. Roach. My name is Dalton Shaull. I'm the CEO, Co-Founder of OmniLife. And OmniLife is a care provider centric collaboration tools, so care collaboration and communication tool. That's always been a provider-centric lauding providers to collaborate to improve patient care across the continuum of transplantation, but now also organ failure. And we've been exploring, and looking at ways that we can take and leverage our provider network to bring increased access to transplantation for the patients. And we do that in 2 important ways. One is on our care collaboration platform. We've got a clinical decision support tool that assesses and addresses analysis, how surgeons and centers are making and evaluating patients for transplantation whether that be on the patient evaluation and listing side, where there occurs -- where there's a lot of bias that occurs on whether or not to list the patient as well as when they're actually receiving an organ offer for a patient, and being able to make a clinical decision. And then we also focus on patient referral as streamlining that process as a care coordination tool, really trying to increase access -- mobile access, and allow patients to track where they're at in their transplant journey. And so really excited to partner with several companies. I mean if we look at just the finalists that were there, there were several specifically in patient education that offer an attractive opportunity for partnership, and also telemedicine and ways that we can bring more and leverage more of our provider network to increase access to transplantation for patients. So that is a little bit about the company, and our vision for our continued growth into this field and to this industry, specifically addressing patient equity -- and an inequity. And for my personal connection, outside of my -- I had a nerve transplantation, but also my uncle is a transplant surgeon, and several family members and close friends with CKD and Stage 1 disease that as I learn more about the organ failure market and ecosystem as well as transplantation itself. I really started to see how many people around me were affected by this disease.

It is an interesting community that doesn't really -- hasn't really existed as a community, the organ transplant community. And speaking about having an organ transplant you're on, you're a kidney transplant recipient, and you've created this movement of kidney warriors. Tell us a little bit more about it.

Yes. So I just want to thank you, Dr. Roach, Jennifer, Dr. Hehenberger, Lyfebulb team, CVS. This event was amazing, and changed my life. I learned so much, and I look forward to staying connected with the finalists and everyone there. So yes, I am a transplant recipient. Former hemodialysis and peritoneal dialysis warrior before receiving the gift of life from my sister. And so for me, the day I walked into a dialysis facility, my life changed forever. Here, I was in my 30s, I was a young mom, and I'm walking into a facility for dialysis treatment. It just didn't -- it didn't register to me. Like how is this my life right now? How is this happening to me? And it ended up being a rare kidney disease, but the day I sat down for treatment. My life changed, and I looked around and I saw the people sitting in the chairs, and I'm thinking, why didn't I know that this was going on. Why didn't I know that this was the lives of people? And I know you're young. You're in your 30s. You're newly married child. So usually, that's not in the forefront of our minds. But for whatever reason, this was my story, and this was my luck. And so I did on that day that I would not let my journey be in vain. That something had to be done. People need to know what goes on in these facilities. And of course, with my experiences, I experienced a lot of different things, and that's what drove me to kind of for kidneys. I used to sit in the dialysis share like what could I do to help people like -- and most of the people I will say look like me, they were African-Americans. We had a few other races there, but majority of the people that were on dialysis with me were African-American. And so it just bothered me that we weren't having conversations with our family members. Some were second, third-generation dialysis warriors. And so it's like we've got to put it into this. And so I found it kind is for kidneys on our fifth kidney anniversary. My sister and I celebrated our fifth anniversary by launching Kindness for Kidneys. And our goals were: one, to provide education because I feel like that's an area that -- we need a little more understanding with. So there's a plethora of resources out there but how we take these resources and apply it to our everyday lives, I didn't feel that, that was there. That connection wasn't there. On the encouragement, when you're sitting in a dialysis chair and even before that, when you get a kidney disease diagnosis, it really is a dramatic event. And so you really need that encouragement from your care partners and your family members to really make it through the journey. I know there were days that I just -- I didn't think I could do it anymore, but my will, it showed up in a strong way, and then empowerment, empowering people to be a part of their own rescue. One thing that I say to patients all the time is that we are in this together. It's not up to the doctors to decide your fate. This is a partnership. And the only way you can do that is by getting that empowerment, connecting with other warriors, being educated so that you can speak and make informed decisions for yourself, and then also having that encouragement with your [ will ] because, God forbid, if someone else goes through this in your family, we hope that they would be in a better position than maybe you are right now. And so that's where Kindness for Kidneys was formed, and developed and we've been able to start support group. So just 3 years old, so we're very new to this space. But we've been able to start support groups, and we also do Christmas [ caring ] during the holiday. That was important for me because I remember what it was like sitting in a dialysis chair during the holiday. And we're excited to launch the development of our kidney patient education program. And I could talk all day so I will...

This is fantastic. And what you did out of a very bad situation was create something very good. And that's -- I love the name Kindness for Kidneys. Someone needs to be kind to the kidneys. That's great. So Dalton, just back to you. You won an award here as well, a monetary award in -- what are you going to do with that focuses on the specific task, which is in equity of the system?

Yes. So we have a focus of releasing a new patient referral app. We are trying to add more transparency to the 2 sections I talked about before for the patient, particularly the organ review process. So knowing when there's an organ offer being reviewed for you, what decisions were made and why, how many offers were received. So adding more transparency, and that was something important that came out in the single...

Just for our audience, Dalton. Who makes those decisions Who gets the organ offer and...

Yes. Yes. So this is a process of the overall kind of for the care continuum that it doesn't receive a lot of -- I don't know how many -- how much patients know about the details of what happens. We studied this process for a long time, trying to understand how decisions are made on organ offers, who makes those decisions, what information impacts and, in some cases, creates a bias for those decisions. And so at different hospitals, for the most part, there's an initial intake service or a team that reviews organ offers and triages those 2 surgeons or physicians. For kidneys, it's usually the kidney surgeon. And they may consult the transplant nephrologists, but it's usually a kidney surgeon making the decision. And there's a number of variables that they have to weigh in real time, oftentimes at 3:00 a.m. in the morning laying in their bed. That is a life-changing and life-impacting decision. And so we sought out to figure out how can we use data, artificial intelligence and access to information to make and assist the surgeon making the best decision possible for a patient. And the other area that we want to add transparency to is the transplant evaluation and referral listing process. There's a lot of centers that cherry pick patients, and always list the best patients that they know are going to have the best outcomes. And so how can we add transparency to that process and hold centers accountable to listening to patients that need a transplant the most. So that's another area of the process that is kind of a black box for patients that we want to open up.

So Dalton, that's a really good segue back to Sharron Because you think about the listing process -- and Jennifer and Dr. Roach just feel free to step in whenever you want. But that listing process of actually getting on the waiting list for an organ, meaning that you're moving from this end-stage renal disease to a situation where you have a new kidney or a transplant that kidney. Many -- as Dr. Roach stated in the beginning, that's where a lot of inequity happens, right, because you don't get on the list if you are not eligible to be on the list. And that eligibility can be a lack of education. Because hospital may deem you not going to be adherent to a drug regimen. Any comment on that, Dr. Roach before Sharron can address maybe however Kindness for Kidneys can help elevate that level?

Yes. So I mean, I think it's a lot of things. I think the doctors don't always think of some patients as suitable candidates just because of internal biases, or just because you haven't interacted with the health care system in the past or because their circumstances make it so that they can't always keep up with care and make appointments and things like that. And we should be working with them to sort of address those barriers, and address why they have to interact with the health system before or had problems in the past, not cut off this. And then I also think it's also a lot of patients don't advocate for themselves because they haven't been -- they haven't seen this in a lot in their community, and they don't think that they're necessarily transplant candidates, and they have seen people get dialysis, but they don't know of everything that's available to them. So I think it's -- we can work on it from both sides of how...

That's a very sad state, right? When a patient doesn't deem themselves worthy of a transplant perhaps. And Sharron, do you see that in your population that they don't know about the option?

Yes. And I think some of the obstacles that you have to go through. So for my sister and I, our transplant date was actually the fifth date that we had. So had we not been like just really forceful in our approach, I would probably still be on the transplant list right now. We were denied several times, and then it took for us going through several processes. My sister had to get 2 bone marrow biopsies to prove that she was a viable candidate because her hemoglobin levels were being questioned throughout the process. And so we -- I saw firsthand how it is very -- it can be very difficult, and I speak to families all the time, they just say forget it. Like if I have to go through all of this, it's -- maybe I'm just supposed to say on dialysis. Because this is a lot -- I keep getting denied. -- wait is an issue in many communities in many hospitals, where one will put a patient on the list but another won't. And so we -- when we work with families, we tell them, go somewhere else. Try other places, don't give up. You do have to be a part of this rescue. You cannot leave it in the hands of the doctors. And so that's been empowering for them because they're like, oh, I didn't know I could go somewhere else. I didn't know I could go and list at another hospital. And so just giving that information alone, we've seen that be paramount in, and some families lives, where a hospital didn't accept them, but they went somewhere else, and they were accepted and put on the list.

That's self-advocacy, right?

Yes.

So Jennifer, from CVS perspective, I mean what do you see here as -- from these 2 candidates? And also if you want to mention anyone else, but what's -- why is this interesting to you as a business, largest health care company in the country?

Yes. Yes. Well, I think from a CVS perspective, we're really focused on putting the patient at the heart of everything we do, and meeting the patient where they are. And I think Sharron and [ Shaull ] one of our other finalists, I'll give a call out. I think we're both very impactful in what they share, both from their live experience as well as thinking about how do we -- we can have the best solutions in the world. But if we actually can't get them into the hands if we can't meet the patient where they are they're going to fall flat. So I think that, that was one thing that really stayed with me after the event. And then -- and I think the other thing that I know we've all talked about before, and we'd love seeing at the event. It was all the connections that were made with the CVS team, which we all -- I know we all enjoy, but I know amongst the finalists as well because I think the big takeaway was no 1 organization is going to solve these complex problems we're talking about. And so I think it really does take different solutions at each of those different steps to have an impact. And so coming away from it. I know our team was just really excited because everything we talked about is very aligned to our purpose and our strategy and our culture at Kidney Care. And I think there's just a lot of relationships that were formed that help us look at all the different things that when you come together, we could really achieve.

That's great. Anything -- Dr. Roach, in your experience as a physician as well, I mean dealing because this -- we talk a lot about patient's self-advocacy and we haven't fully addressed yet the -- what we can do to help doctors. To a certain extent, Dalton is doing that, right? He is helping the physicians automate and make it more transparent. Do you need to educate doctors, and create more diversity in the doctor group as well?

Yes. And I think these 2 work together in terms of, one is to educate -- one, it educates patients and the other one is to help guide physicians to doing the right thing. I think fixing it from the doctor perspective, I think there's 2 ways -- I think there's more than 1 way to go about it. But I think 2 main ways to go about it are one, we need to have diversity in all the ranks. So doctors, nurses, and transplant coordinators, everyone so that they understand all their patients and the patients and they can develop trust with the patients because I think a lot of these things do with developing [ trucks ] between providers and the patients. And so I think making sure that we have health care providers that look like all the patients they serve is very important. And I also just think it's looking at data. So I think that there are inherent biases, but I don't think that -- I think that most people aren't going to work saying that they want to perpetuate by biases. I think that they let their things creep into the back of their head. They don't even know what they're doing. So one of the other things that we are trying to do is to sort of make it plain, know who our patients are, know their rates, their ethnicity, their language, and then also just show how often are these people getting access to transplant. How often are these people getting access to home therapies. And so I think once people see it, and it is clear that they're both there, then in their patient group, I think that goes a long way to get in the way to get it to fixing it, just being aware of the problem. And so I think those are 2 good ways to start. And then we obviously have a lot more work to do, though.

That's great. So Sharron and Dalton, just to finish here, what's your biggest wish after this challenge? Because this is only the beginning. And we've said it many times. First of all, all 10 of you were clearly winners, just by being at the event, and speaking to such great mentors from the judges to the executives from the companies and so on. And we have even investors there. And that's a fact. It's hard to raise money. It may be very hard to raise money right now with the economy and the world in such disarray. But what's your goal in the next year if we think about it short term that you would like to accomplish, and hopefully related to this challenge that it could jump start to that goal? We start with Sharron this time.

Wow, that's a little bit question back to Karin. But within 1 year, I definitely want our patient education program to be complete. Our program is 4 patients, 5 patients. And so I think that us banning together is very important. I look forward to 1 thing that I gleaned from the challenge was just some of the different perspectives to approach what we're doing with the program. And even the resources that we can include in our development that I didn't know existed before the challenge. And so I'm very excited to connect with -- it's especially Dalton, and what he's doing I mean is so important. And I'm excited to connect with the finalists as we complete our program because we're still in a development phase as we completed, incorporating some of these things that I've learned and seeing this finish within the next year so that we can start to put it out there in the market. And we've spoken to so many different companies and patients, and they're like, when is this going to be ready? We're ready for this because they also see this as a way of empowering themselves to then bring in their village. And so all impacting our circle of influence, we really can make something great happen.

We'd love to feature your educational program on transplant life, I can tell you that for our patients, and especially in certain groups of patients who may not access to education that we have right now. So consider us a partner. Dalton?

Yes. At OmniLife, we have the technology ready. We, I think, in the next year, would like to execute a pilot in certain demographics in certain areas of the country to patients that need the most and be able to implement, run, prove that our solution provides increased access to transplantation to the patients that need it most. And so working with CVS Health as well as Lyfebulb too, and a great network of patients that you have within your network as you have online to ask the patients, too, as we build out that patient app, what would they like to see. And one of the things and lessons I learned from the CVS Health competition was the patient wire frames, being able to reach out a group of patients, have them draw. What does the app interface look like for you for an app that would be helpful. And then ask why is this button here? Why do you have this here? And I think it's a great opportunity where we can accelerate our learning by being able to talk to a very wide, diverse group of patients in a streamlined way. So those are really leveraging Lyfebulb's network to learn from the patients faster and using large partners like CVS Health and others to be able to run a pilot with our tool, particularly around the patient referral evaluation process. And then looking into some of the data around decision-making. That can not only influence decision-making in the future across the surgical and physician community, but also to think about how that can influence multi-listing strategies, depending on your patient demographic where our centers that historically -- and in particular, surgeons or physicians, in particular, that tend to make good decisions or get transplants to certain patients of color, for example, and being able to leverage that. And I think when you add transparency, others could say a layer of inspection, I think you start to drastically influence behavior in a positive way.

Well, this has been -- we could continue this discussion. It's really -- actually, I'm learning from you all the time. And I think it's just such a privileged set spend time with you, and I want to continue to do so. And Well, I want to really end because CVS has been thanking everyone several times. But we also really have to thank CVS because it is a big bet that you made on this and not every -- every company in the world who's in health care says they're patient-centric, doesn't mean that they are. And I think you're showing it with actions more than just words, and we're grateful for that, and we really see a lot of hope for the future. As you are such a large company, and you're taking this position. So thank you very much to you and the rest of your team. And thank you so much to the finalists, to our winners and to all the patients out there who are well listening, and I'm sure lots of questions. So as we get questions, we hope that we continue to funnel them to you. And we'll continue with these collaborative efforts because it's really valuable to get that user experience and -- in the hands of companies that can develop new technologies, and that's really important. So thank you very much. Have a wonderful rest of the evening, and Dalton, hope you enjoy your new status as a married man.

Yes. Thank you.

And see you very soon.

Awesome. Thank you, everyone.

Bye-bye now.

Thank you.