Welcome everyone to the Lyfebulb CVS Kidney Care Innovation Challenge Fireside Chat. I'm Karin Hehenberger, I'm the CEO of Lyfebulb, and I'm joined today by four 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. Just wanna set the stage that this innovation challenge was, of course, focused on patients and how we can improve the treatment, the prevention and t he care and hopefully eventually, you know, really improve the quality of life for those living with chronic kidney disease. The strong emphasis here was also thinking about everyone who is experiencing kidney disease and the inequity in the system that is currently present. It is a situation in this country where, if you come from a different background than a 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 transplants, which is of course the gold standard for end-stage kidney disease. It also has to do with diagnosis of kidney disease up front. 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'll 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. She's also here as a representative of the wonderful judges that we had. We had five judges. On why we picked these two individuals who are also here today, our winner, representing OmniLife, is Dalton Shaull, who is here during his honeymoon, 'cause he just got married. We are incredibly fortunate and thankful to his wife that she's allowing us to have any part of his current time. Our wonderful and 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. With that, thank you so much. I'm gonna 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 kidney disease is sort of one of the prime examples of health equity, or health inequities actually, in this country. You can't really address kidney disease in the United States without addressing the health equity issues. So just to give you a basic rundown, African Americans, for instance, make up 12%-13% of the U.S. population and make up 30%-35% of the end-stage renal disease population. Hispanics are 1.3x to 1.5 x 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 are much less likely to get treatment. Black patients are 30%-40% less likely to get a transplant or to get home dialysis than their white counterparts. The numbers are the same for Hispanic patients. We basically have a problem of we have a disease that disproportionately affects certain communities, and those same communities aren't able to get the state-of-the-art treatments and the treatments that'll be best for them. It's a sort of double-edged sword. That's why we did this. We wanted to because we think that some of those inequities are due to social determinants of health. We think that it's due to lack of awareness, and we also just think it's due to less access and less technology available. We tried to pick finalists that would address all of those aspects of the problem. People that worked with people to advocate for them once they got kidney disease. We wanted to work with people to find people that wanted to find kidney disease before it happened and before it became a problem in these communities. I think we found a good mix of those. I think that at CVS we're, w e 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. We think once we understand our patients better and come to them where they live, then we can help address inequities. I think a lot of the finalists will help us with that or have strategies or have plans that could help us with that down the road. I just wanted to thank everyone again and just talk and just sort of tell everyone 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. I just wanna reiterate one component of this challenge, which is quite different than other innovation challenges, is that the leaders of each company, you know, is personally associated with kidney disease. 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. That personal commitment is so very strong, and that passion and motivation, I think, shine through. You know, Jennifer, from your perspective as both a judge and someone who is seeing new technology all the time, you know, at CVS, what drove you to pick these two before we introduced them, before we allowed them to speak? What drove you to pick them? Oh, well. What was fun? I'm very excited to talk about that, and I'll say first, though, echoing Jesse's comments, thank you for the opportunity to join you all here today. 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. We had preventative, diagnostic, different ways to provide care or treatment. There was a lot of diversity there as well in what was coming forward. 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? What we discussed as a jury was, you know, where did we see a really strong patient connection, as you just mentioned, as well as where did we see, you know, an idea or a solution that actually had some proof of concept already in the market and had demonstrated, you know, some success. I think we saw that with both of our winners here as well. You know, Dalton, as our overall winner from the event, we were really just impressed with how your solution helps improve access and remove bias that'll help improve outcomes. 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. You know, the winner of this challenge, the overall winner from a business perspective, from an impact perspective, we had various criteria. I think Jennifer, it was worth noting that you followed those criteria pretty carefully. Also as we together brought out the ten, you know, they all were assessed based on those criteria. Dalton, you are the winner. Here's your opportunity. First, your personal connection briefly, but then what does your business do? What is OmniLife about? Hmm. Yes. Thank you, Karin, Jennifer, Jesse, Dr. Roach. My name is Dalton Shaull. I'm the CEO, Co-Founder of OmniLife. OmniLife is a care provider-centric collaboration tool. Care, collaboration, and communication tool. That's always been provider-centric, allowing providers to collaborate to improve patient care across the continuum of transplantation, but now also organ failure. We've been exploring and looking at ways that we can take and leverage our provider network to bring increased access to transplantation for patients. We do that in two important ways. One is on our care collaboration platform. We've got a clinical decision support tool that assesses and addresses and analyzes how surgeons as and Centers are making and evaluating patients for transplantation, whether that be on the patient evaluation and listing side, 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. 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. Really excited to partner with several companies. I mean, if we look at just the finalists that were there were several, particularly in patient education, that offer an attractive opportunity for partnership. Also telemedicine and ways that we can bring more and leverage more of our provider network to increase access to transplantation for patients. That is a little bit about the company and our vision for our continued growth into this field, into this industry. Specifically, addressing patient equity and inequity. For my personal connection, outside of my, I had a nerve transplantation, but also my uncle's a transplant surgeon and several family members and close friends with CKD and end-stage renal disease, that as I learned 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. Thank you. It is an interesting community that hasn't really existed as a community, the organ transplant community. You know, speaking about having an organ transplant, Sharron, you're a kidney transplant recipient, and you've created this movement of Kidney Warriors. Tell us a little bit more about it. Yes. I just wanna 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. Yes, I am a transplant recipient, former hemodialysis and peritoneal dialysis warrior before receiving the gift of life from my sister. For me, the day I walked into a dialysis facility, my life changed forever. Here I was in my thirties. I was a young mom, and I'm walking into a facility for a dialysis treatment. It just didn't register to me. Like, how is this my life right now? How is this happening to me? It ended up being a rare kidney disease. 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," you know? I know you're young, you're in your thirties, you're newly married, child, so usually that's not in the, in the forefront of our minds. For whatever reason, this was my story and this was my lot, you know? I vowed 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. Of course, with my experiences, I experienced a lot of different things, and that's what drove me to Kindness for Kidneys. I used to sit in the dialysis chair like, "What could I do to help people?" Like, most of the people, I will say, looked 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, you know? It's like we've gotta put an end to this. I founded Kindness for Kidneys on our fifth kidney anniversary. My sister and I celebrated our fifth anniversary by launching Kindness for Kidneys. Our goals were, one, to provide education, because I feel like that's an area that we need a little more understanding with. 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 was there. That connection wasn't there. Encouragement. When you're sitting in the dialysis chair and even before that, when you get a kidney disease diagnosis, it really is a traumatic event, and 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 didn't think I could do it anymore, but my village showed up in a strong way. Empowerment. Empowering people to be a part of their own rescue. One thing that I say to patients all the time is that we're 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. Then also having that encouragement with your village 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. That's where Kindness for Kidneys was formed and developed, and we've been able to start support groups. We're just three years old, so we're very new to this space. We've been able to start support groups, and we also do Christmas caroling during the holiday. That was important for me because I remember what it was like sitting in a dialysis chair during the holiday. We're excited to launch the development of our kidney patient education program. I could talk all day, so I'll stop here. This is fantastic. What you did out of a very bad situation, you know, was create something very good. I love the name, Kindness for Kidneys. Someone needs to be kind to the kidneys. That's great. Dalton, just back to you. You won an award here as well, a monetary award. What are you gonna do with that that focuses on the specific task, which is inequity of the system? Yeah. We have a focus of releasing a new patient referral app. We are trying to add more transparency to the two sections I talked about before for the patient, particularly the organ review process. Knowing when there's an organ offer being reviewed for you, what decisions were made and why, how many offers were received. Adding more transparency, and that was something important that came out in a recent- Just for our audience, Dalton, who makes those decisions? Who gets the organ offer and- Yeah. 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 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 bias for those decisions. At different hospitals, for the most part, there's an initial intake service or team that reviews organ offers and triages those to surgeons or physicians. For kidneys, it's usually the kidney surgeon. They may consult the transplant nephrologist, but it's usually the kidney surgeon making the decision. There's a number of variables that they have to weigh in real-time. Oftentimes at 3 A.M. in the morning, laying in their bed. That is a life-changing and life-impacting decision. We sought out to figure out how can we use data, artificial intelligence, and access to information to make and assist the surgeon in making the best decision possible for a patient. The other area that we wanna add transparency to is the transplant evaluation, referral, and listing process. There's a lot of centers that cherry-pick patients and always list the best patients that they know are gonna have the best outcomes. How can we add transparency to that process and hold centers accountable to listing the patients that need it, need a transplant the most? That's another area of the process that is kind of a black box for patients that we wanna open up. Dalton, that's a really good way of segue back to Sharron because when you think about the listing process and, you know, Jennifer and Dr. Roach just feel free to step in whenever you want. 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 transplanted kidney. 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 the hospital may deem you're not going to be adherent to a drug regimen. Any comment on that, Dr. Roach, before Sharron can address maybe how her Kindness for Kidneys can help elevate that level? Yes. Yeah. 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 they haven't interacted with the healthcare system or in the past, or because their circumstances make it so that they can't always keep up with care or make appointments and things like that. We should be working with them to sort of address those barriers and address why they haven't interacted with the health system before or had problems in the past, not cut off this. I also think it's also a lot of patients don't advocate for themselves because they haven't been. They haven't seen a lot of this 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. I think we can work on it from both sides of how. That's a very sad statement, right? From both sides. When a patient doesn't deem themselves worthy of a transplant perhaps. Sharron, you know, do you see that in your population that they don't know about the option? Yes. 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 two bone marrow biopsies to prove that she was a viable candidate because her hemoglobin levels were being questioned throughout this process. I saw firsthand how, you know, it is very. It can be very difficult. I speak to families all the time that just say, "Forget it. Like, if I have to go through all of this, it's maybe I'm just supposed to stay on dialysis because this is a lot. I keep getting denied. Weight is an issue in many communities, in many hospitals, where one will put a patient on the list but another won't. 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." 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." Just giving that information alone, we've seen that be paramount in 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. What it's about. Jennifer, from a CVS perspective, I mean, what do you see here as, from these two candidates and also if you wanna mention anyone else, but why is this interesting to you as a business? Largest healthcare company in the country. Yes, yes. Well, I think, you know, 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. I think Sharron and Chet, one of our other finalists, I'll give a call-out. I think were both very impactful in what they shared, both from their lived experience, as well as thinking about how 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 gonna fall flat. I think that was one thing that really stayed with me after the event. I think the other thing that I know we've all talked about before and we loved seeing at the event was all the connections that were made with the CVS team, which we all, I know we all enjoyed, but I know amongst the finalists as well, because I think the big takeaway was no one organization is gonna solve these complex problems we're talking about. Mm-hmm. I think it really does take different solutions at each of those different steps to have an impact. 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. 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, you know, in your experience as a physician as well, I mean, we talk a lot about patient 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's helping the physicians automate and make it more transparent. Is there a need to educate doctors and create more diversity in the doctor group as well? Yeah. I think these two work together in terms of one is to educate 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 two ways. I think there's more than one way to go about it, but I think two main ways to go about it are, one, we need to have diversity in all the ranks, so doctors, nurses. Mm-hmm. 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 trust between the providers and the patients. I think making sure that we have healthcare providers that look like all the patients they serve is very important. I also just think it's looking at data. 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 wanna perpetuate biases. I think that they let their things creep into the back of their head, and they don't even know what they're doing. 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 race, their ethnicity, their language. Just show how often are these people getting access to transplants? How often are these people getting access to home therapies? I think once people see it and it is clear that it's there, then in their patient groups, I think that goes a long way to getting to fixing it, just being aware of the problem. I think those are two good ways to start. We obviously have a lot more work to do, though. That's great. 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 10 of you were clearly winners, you know, just by being at the event and speaking to such great you know mentors from the judges to the executives from the companies and so on. We had even investors there. You know, 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. You know, 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 jumpstart that goal? We start with Sharron this time. Wow, that's a loaded question, Dr. Karin. Within one year, I definitely want our patient education program to be complete. Our program is for patients by patients, and so I think that us banding together is very important. One thing that I gleaned from the challenge was just some of the different perspectives to approach what we're doing with the program. Mm-hmm. Even the resources that we can include in our development that I didn't know existed before the challenge. I'm very excited to connect with, especially Dalton and what he's doing is so important. I'm excited to connect with the finalists as we complete our program because we're still in a development phase. As we complete it, 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. We've spoken to so many different companies and patients, and they're like, "When is this gonna be ready? We're ready for this." Because they also see this as a way of empowering themselves to then bring in their village. If we're all impacting our circle of influence, we really can make something great happen. We'd love to feature your educational program on TransplantLyfe, I can tell you that, for our patients, and especially in certain groups of patients who may not access the education that we have right now. 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, that our solution provides increased access to transplantations to the patients that need it most. Working with CVS Health as well as Lyfebulb too, and the 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? One of the things and lessons I learned from the CVS Health competition was the patient wireframes. You know, being able to reach out to a group of patients, have them draw, you know. Yeah. What does the app interface look like for you for an app that would be helpful? Then ask why, you know, why is this button here? Why do you have this here? 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. 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. 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 are 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. 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. Yeah. Well, 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 privilege to have spent time with you and I wanna continue to do so. I wanna really end because CVS has been thanking everyone, you know, several times. We also really have to thank CVS because it is a big bet that you made on this. Not every company in the world who's in healthcare says they're patient-centric. It doesn't mean that they are. I think you're showing it with actions more than just words, and we're grateful for that. We really see a lot of hope for the future, as you are such a large company and you're taking this position. Thank you very much to you and the rest of your team. Thank you so much to the finalists, to our winners and to all the patients out there who are listening, and I'm sure lots of questions. 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 you know, in the hands of companies that can develop new technologies. That's really important. 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. See you very soon. Awesome. Thank you everyone. Bye bye now. Thank you.