Emily Mischel - FlexTogether

[00:00:00] Today I am happy to be joined by Emily Michelle. She's the co-founder and CEO of Flex. Together, a health tech startup delivering virtual pulmonary care with a mission to help 37 million people living with chronic lung disease. Which is a hearty mission and a, a worthy mission. And Emily's so kind to join us, uh, from, from my friend Cass's recommendation.

I thank you Cass. And she's joining us post, uh, two weeks after surgery. So, um, it's sort of ironic, but also perfect that your motto of your company is, breathe stronger or Breathe strong. And I hope you're breathing well, and thanks for joining us. Yeah, thank you so much for having me. Happy to be here.

Yeah, no, I, I feel. Much more able to be strong. Get a side of surgery, get out there, see your ATTs folks. Uh, it'll do you good. But, uh, really happy to be here and talk about our mission and, you know, all the folks struggling with chronic lung [00:01:00] disease and breathlessness overall. Absolutely. I'm excited to dive into all that.

Um, you know, as an SLP and as someone who considered working in then entertainment myself, uh, I always thought about what is the. What is the best way I can make an impact in this world? And first it was like, well, entertainment, maybe that's, you know, if you can get a message on tv, you're reaching more people or through media in some way.

Um, and I know you worked somewhere in entertainment and in finance, and I'm wondering, how did you land on this? Interesting. I. Niche Well and health tech in general, but specifically in pulmonary rehabilitation as your ripple of impact? Yeah, no, it's a great question. I had a, definitely an unconventional journey.

Um, as you mentioned, I was, I was a former theater kid. I was really passionate about the arts. I'm still really passionate about the arts to get people to, I. Be okay with public speaking, taking on leadership roles. Thought that was what I was gonna do. I'm born and raised in LA so you know, I did the whole LA thing.

So worked in casting, video [00:02:00] production, you know, a lot of my friends are actors. Um, and that was great and all, um, but it wasn't really giving me the sort of meaning I wanted in my life. Um, and it didn't hurt that my family is a healthcare family. So my dad's a physician. My mom works in healthcare. My brother was working in healthcare at the time.

Uh, so the joke a little bit is I couldn't stay away from the family business, uh, even if I wanted to. So I did go back to school. I went to USC. They have a program in social entrepreneurship, which is about doing well and doing good. Uh, it's there. I met my co-founder, Benji. And he had a lot of family with severe medical issues.

And of course I had a medical family, so we're like, let's get together, let's try to make some magic happen. And going through the program, we really learned a lot about working with older adults specifically. Um, and our initial idea was really thinking about older adults and old and exercise as a way to connect and thinking about social isolation and loneliness.

Um, we worked with the A A RP Foundation, some other great, um, partners. And unfortunately as we were doing this [00:03:00] exploration, my. Co-founder's father was diagnosed with a chronic lung disease. So you're asking sort of how did we get here? Um, we'd been working in the older adult space. Obviously we are familiar with frailty and breathlessness.

Um, and then when we were looking for opportunities for his father, we learned about pulmonary rehab and there's so much amazing, amazing research. The people who've been working in the space for. 20 years. I mean, it's not a new intervention by any stretch of the imagination. You know, it's reducing hospitalizations.

It's meaningfully improving quality of life, but less than 4% of Medicare patients are actually getting access to this intervention, and we're like. You know, business school, duh. Like big problem, big good solution that already exists. Like, can we make that solution better? Can we add our own touch to it?

And you know, from my end, being an entertaining person, like, can I make it fun and enjoyable? Because the thing about, you know, exercise or any of these things, it doesn't work unless you do it. Um, so making sure it's something that people show up and do, um, is really important to us. And so that's really how we [00:04:00] got to the point about.

Creating pulmonary rehab and thinking about our patients, which a lot of them are home bound. We're like, can we do this in the home? And so that really was our pathway to becoming a virtual pulmonary rehab practice. And then we now do other things as well, but our bread and butter is, is doing that. I'm happy to talk in more detail, but uh, about that as well.

No, that's amazing. I mean, yeah, you personal story is a common theme on this podcast. And then seeing the gap in the sheer numbers, we talk about millions of people and only 3% of them getting coverage. Yeah, 3%, 4%, depending. It's like every year we're like, you look at the new recent and we're like, like picks up like the tedious amount.

But again, I mean 37 million is just a. Drop the bucket. If you think about long covid, you know, other types of lung diseases, it's around more closer to 53 million. Um, and so it's not a niche space by any stretch of the imagination. And unfortunately, wildfires as well, there's a lot more folks [00:05:00] who are having trouble breathing and accessing, you know, methods to be able to improve that quality of life.

Yeah. What was, um. Like, so you kinda spoke to the gap of the care you saw, and this was in this entrepreneurship program in USC was 2019, right? So right before Covid. So why do you think there was such a gap? I mean, I imagine the gap even got larger and maybe that helped. I. You're the business aspect, for better or for worse.

But you had this tele telepractice angle, which took off during the pandemic 'cause everyone was stuck at home and needed oth other ways to get care. Um, well actually, let's back up. Like for our listeners, I want to know what, what goes into pulmonary rehab and what, what does that care delivery look like typically, and maybe what are some of the gaps that you saw?

Yeah, and I, and I'll just speak to our own program. I mean, the in-person centers are awesome. Great. If you can get in, like you should totally go, that just, there's just not enough of them is really the TLDR on that. [00:06:00] But I can speak to our program and so what we do is we have an interdisciplinary approach.

So we use speech, occupational and physical therapist to really be able to get to the root cause of breathlessness for these folks. So we do an evaluation usually with a physical therapist to understand their frailty fall risks. You know, what are the symptoms they're really struggling with? Because I think the thing that's interesting about pulmonary rehab versus some other types of interventions in the pulmonary space is it's subjective in that it's not like you are looking for a specific number, right?

You're not like, oh, I'm trying to get. My cholesterol below X, Y, Z number, it's really specific to the patient and how they feel in their body. Like one person's 88% on the pulse ox might feel great and someone else's might feel like they're totally like really struggling for breath. So it's really helping that patient.

Feel good in their body and be able to do their ADLs and live in the community the way that they want to. So being able to understand, you know, and for the SLPs [00:07:00] here, you know, donation, you know, um, all that good stuff. And so that's a unique thing that we bring to the table. So usually speech is not part of that discussion.

Um, and we didn't understand why, because the speech folks, you know. Breathing, donation, you know, swallowing. These all seem pretty queued into breathing. So being able to use each rehab specialty skills to really target the different struggles that our patients are having. So each patient usually sees a speech and OTPT twice a week.

That's how it goes. And it's all done on our own platform. Um, and so those are one-on-one sessions that we're able to build for, um, and. I couldn't leave my entertainment part of me behind. And so it's another thing that's unique about our intervention is while that video chat is happening, we actually have prerecorded exercise content.

So our clinicians are not. Demonstrating, looking at patients and taking notes. It's like way too many things to do all at once. We really wanna make this not only a great experience for [00:08:00] patients, but like a great experience for our clinicians so they can do the best work and have the best experience delivering care.

'cause so many folks, especially in the telehealth space, are like, I have all these windows open and I'm writing all these things. And we just did not, we did not want that, uh, to happen. And so we help, uh, folks be able to. Be able to exercise safely, be able to push themselves, but not too much. Because what's really important about pulmonary rehab is you don't wanna overdo it and then, you know, be out the next day or really have those effects.

So it's about being able to. Push yourself, but within a safe understanding, measuring vitals and understanding, you know, how to best get to that goal. So that's the way that we deliver care, is really enabling our clinicians to do what they do best, which is help people breathe and move better, um, and do that for generally around three months, depending on the patient.

Gotcha. Thanks for that overview, and I'm happy that you're including speech pathologist selfishly. Um, but it seems [00:09:00] like, uh, it's a lot of people to coordinate for care. Um, I have a couple different places in my mind goes. One is where, who did you, what clinical field did you start talking to first when you're validating this idea?

I would guess pulmonologists are kind of the head of the, uh, the care team maybe, but um. Yeah, maybe sort of, I mean, what's kind of interesting is so, because I, I'm clinical aware, but not a clinician. I think there was, this is one of the aspects that actually benefited us because what we did is we really approached this from no precon preconceived notions.

Like what would be the best clinical intervention to help these patients if I didn't know anything about anything. Obviously we work with pulmonologists. We presented at the American Thoracic Society. We have a pulmonologist on our team. Um, we, we think that's really important, but a lot of our patients are actually in primary care.

There's not that many pulmonologists. There's a lot of folks who aren't making it to pulmonology. Um, part of our more recent endeavors is actually creating more opportunities to have p fts. [00:10:00] So people can actually get diagnosed with lung diseases that they're not sure they have and then be able to get into that line of care.

Um, but you know, our starting team, how we created the program is actually was a physical therapist and a speech pathologist. Um, and physical therapists like cardiovascular, cardiopulmonary is part of their clinical training. Like you take cardio poem. Classes in school. So, you know, we get a lot of questions.

It's like, oh, are they supposed to be doing that? It's like, totally like it is part of the curriculum. There just hasn't been that many jobs, there hasn't been that many opportunities for them, uh, to do that. And then on the speech side. We had a great speech, uh, pathologist and she really took charge on creating a program.

'cause I was like, she was like, you know, we we're usually not here. We usually, you know, obviously we help people with venting and on the sort of ICU critical care aspect, but not on the at home part. And she really took a lot of what she was doing in home health and other things to create a program. And, you know, having the, I don't know if you're familiar with the [00:11:00] breathers, you know, they're like breath trainers.

We use those as well. Oh. Interesting. Okay. Do you, do you do this all, uh, is it all virtual even from the evaluation? Like how do you collect. The data that you need from the breath, I would imagine some of that is, well, maybe pulse ox. I don't know. You tell me. Yeah, no, I was gonna say, it's all virtual. I mean, again, a lot of our patients, I mean, compromised, they're home bound, they don't wanna go out.

It's fine. We, we can, and a lot of our clinicians are really excited to work from home, so we have like a good thing going. Everyone's happy to be, to be at home. Um, but yeah, I mean, obviously, you know. For the clinicians on the call, like six minute walk would be a little tricky. We don't always do that. We can do five times at the stand, for example, in our evaluation.

Um, there's other sort of clinical, you know, methods we can do to get the results we want for that evaluation. Um, but you know, we make it work. We're, we're creative, our clinicians are creative. Um, and obviously we're measuring vitals and. A lot of times it's, you know, put on your pulse ox, let us know what you see.

Um, [00:12:00] we try to make it not super complicated. Um, we're at a stage in our company that obviously, you know, connected devices are awesome and stuff, but if you don't need all that complication, we don't wanna add that again. A lot of our patients tend to be 65 plus. Um, and so it's really important to us to make it as simple and user friendly as possible.

Um, so yeah, it's the good old fashioned, what are you looking at? What am I seeing? Um, and we can get pretty far doing that. Great. Yeah. I'm wondering, was there a lot of education that you needed to sort of get buy-in from, uh, the six, you know, the Medicare population, maybe they're not as tech savvy, do you, do you have to get, uh, maybe their caretakers buy-in first and kind of educate them?

Or was it direct to these, these patients? So obviously we, we accept referrals from clinicians, so that's where a bulk of our patients come from. Um, we obviously, we do do ads and we get direct, uh. Patients self, um, refer as well. Um, but you know, [00:13:00] obviously like any new intervention, like there has to be, you know, some buy-in.

That's what we, why we went to a TS we poster. We showed our, you know, our outcomes, which were similar to an in-person setting, you know, and they looked over our safety protocols, all these things to make sure that it was good to go. And even though we're not the same exactly as traditional pulmonary rehab, we.

You know, A-C-V-P-R, we read all of their guidelines. We went to their conference as well. They're the governing body on cardiac and pulmonary rehab, um, to really, uh, allow us to create the care that's gonna get those outcomes that have already been studied. But we all want, we're not necessarily trying to compete with in-person centers.

We're just trying to have another option for patients. Um, but yeah, I mean, there's some. Most of our patients end up being okay. So the way that we've developed our app, again, we worked with the A RP Foundation when we were getting started. So we've always designed for older adults in mind. It's nothing to download.

We're a website, so you log in, you know, anything that has a camera and a browser is fine. You know, we prefer people see [00:14:00] us on their laptop, but. They don't have one. A tablet or a phone is okay too. Uh, laptops just have the biggest screen, so that seems to be the best. Um, but we do have caregiver involvement at times, you know, with that login process.

That can be a little tricky, but we spent a lot of time trying to make it user friendly. Um, it's been really, really important to us and it was really important to us. Our patients felt. They could do it on their, their own and that they didn't necessarily need assistance every single time to have that sort of autonomy.

Because, you know, in addition to our live visits, we also offer patients an asynchronous exercise program. So on their off days, they can go through their exercises on their own, um, be able to take surveys or borg, all these different clinical, uh, evaluations so we can see how they're doing. Because like anything else, the more you do it, the better it gets.

Uh, yeah. And we, we wanna help them get those outcomes as quick as possible. Totally. Yeah. Uh, yeah, as a speech therapist, I would think like Telepractice sometimes was harder when we went into the pandemic [00:15:00] because it's harder to keep their attention in some ways. But the pro, it also was more engaging in some ways because it, it was like, um, at least my population where students, so they were used to screens and they're like, okay, this is multimedia.

And the carryover was maybe easier because they're already in the place. Which is outta school where they are most of the time, which is at home. Um, and they're carrying over and I can coach their parents or whoever's around to say like, here's some other things you can do with them. Um, so generalizing that environment makes a lot of sense too.

I. I mean, I mean our patients are awesome. A lot of them are super self-motivated. It's so cool. Uh, you know, I think a lot of telehealth practices have, you know, no shows, um, dropouts and for us, you know, obviously our only real dropouts is when people are too sick to continue. Um, but people love showing up for their appointments.

They feel a lot of comradery with their clinicians. Also, you know, if anyone's listening, if your rehab people are like the [00:16:00] nicest people on this planet Earth. So all of them don't wanna get discharged because they're all friends with their SLPs and their PTs, which I totally get. Um, and so we are had a bit of a unique situation because our population is home bound and older.

Um, that other telehealth companies, just because I know other entrepreneurs are listening to this call, have other challenges or working with students and minors that we didn't necessarily have, uh, with given our population. But you know, it's, it's all about, I think the best interventions are, you know, meeting patients where they are, wherever that is, you know, whether that's at home or at school or, you know, with parents or without Yeah.

Meeting them where they are. And do you have any memorable case studies or patient stories you could share with us? Well, yeah, I do. I mean, the thing I love about rehab is it's so personalized and it's very much. Everything is around those personal, like those patient goals. And those patient goals are so real.

So my favorite is there's one that she wanted to walk up her steps [00:17:00] without taking a pit stop, which is a great goal. Um, and then there's another one that's like, I just wanna walk my dog around the block. And I know these sounds super small, but for our patients, like those are such big milestones and helping them achieve those goals was so amazing.

It's like. Helping them move towards that goal, be able to get stronger each week. And the way that our program works is, you know, unlike Cap Peloton, where you're competing against other people, which is all fair and good, you know, our patients are competing against themselves, right? The bell curve of themselves.

Because they're taking those quizzes. They're taking those evaluations. We're seeing week to week as they're getting better. Obviously adjusting it if it's not the right course of care. But that, I think, why we get such great. Commitment to our program is our patients see that they're getting better, they're seeing those results a little bit surely, and they're putting in the work to do it.

And I think I, myself and my team, you know, worked really hard to make sure that our, the classes we use for instruction now, we do yoga, qigong, [00:18:00] cardio. We use sort of more traditional fitness. Modalities for our clinical interventions. So it makes it a lot of fun. So they continue to show up, but I think our favorite was, you know, being able to get that our patient up the stairs 'cause she was just such a riot, uh, in general.

Yeah, I love that. Yeah, it's like simple things we take for granted a lot. And my full-time job, um, I wasn't speech therapy, I'm still licensed, but now I'm doing marketing for a mental health tech company. And kind of thinking about the future of wearables and how do we gamify. How do we make it incent or how do we incentivize patients to make them feel like they are making progress, even when it feels myopic and that they're not making progress?

And then something as simple as what you mentioned, like the pedometer in your iPhone. Um, let's say you're severely depressed, you're not gonna walk as far out of your house that often, you're probably gonna stay, you know, in your room. So even just telling them, Hey, you [00:19:00] walked, you know, 20 feet. More than you did yesterday, which doesn't sound like a lot, but getting that forward momentum psychologically can make an upward spiral physically and mentally.

So, um, and I think, you know, it, uh, and this is a, we see program. I think like just showing up and doing it is so important. 'cause like for our patients, like if they get a virus or something, the intensity level will, will go down and some people will get depressed about that. But at the end of the day, like just showing up and doing it every day, like.

You're getting stronger, you're getting those outcomes. And you know, I think everyone always assumes that like the next day has to be better than the next day, which has to be better than the next day, which is, at least in our line of work, clinically, that's not what happens. Mm-hmm. Like sometimes you get a lot better and then you go down and you have to work your way back up.

But my mom always says like, you have to be directionally accurate. Which I think is so true when we're talking about interventions like mental health or like pulmonary rehab, that you can't just take a pill and make [00:20:00] it go away. You know, it takes a lot of work, but I think as long as you're moving in the right direction, you're gonna get to where you wanna go.

But it could be hard to see that. And you know, for us on our software, you know, patients can see how many times they've showed up and. There's graphs and you know, all the things you could see, like it's happening visually. Uh, and I think that helps some patients be like, okay, like I, I, I'm doing it. I'm seeing, I'm seeing the progress, I'm seeing where the, the end goal is.

I'm seeing, you know, the Farmville flower start to grow. Exactly. Yeah. The, the measurement based care. The visualization. 'cause it's hard to have insight into that from a day-to-day basis. Yeah. Sometimes until you zoom out. Well, I wanna shift gears, uh, a bit to. You did a great job of outlaying the clinical aspects, but we have some listeners who are interested in entrepreneurship or maybe they're clinicians.

Um, so I wanna ask you, what was the moment? Well, no, what, like how did you I. Uh, validate the idea and know that you wanted to take funding or [00:21:00] navigate bootstrapping. Um, these are tough business decisions, especially in a field like health tech, which is known for red tape and bureaucracy for a good reason to keep people safe.

But it's not an easy field to be an entrepreneur, and I don't think, no, it's not. No, it's not. And yeah, I mean, I. There's no right answer. You know, for us, you know, we worked a lot, we were part of the Cedar-Sinai Accelerator program. Um, and obviously we pivoted our idea a little bit, right? We started in fitness and we ended up in clinical care.

And I think for us, you know, it, the decision was, you know, moving towards something more traditional so people, we could do more incremental innovation versus starting off on a intervention that didn't have a billing code that. Obviously had great research around it, but you know, people aren't instantly spending money on social determinants of health solutions at the time.

I think now probably is different, hopefully is different. Um, so that was our sort of point [00:22:00] of view. I mean, we have a couple amazing angel investors and partners. Um, I think it's been really important for us to make sure that we take mission aligned capital, um, because at the end of the day, whoever you take money like.

At least in my opinion, it's, that's the team you're playing on. And like, I love the team I'm playing for. Like, I want us all to win so, uh, so badly. Um, and I think everybody has the same ideas that, you know, nobody's pushing us to like deprioritize clinical care or, you know, do anything that would get in the way of our mission, which is radically expanding access to care.

Um, and so I think, you know, as you're going through, you know. I think the advice I guess I would give is if there are small ways to prove it that don't involve, you know, so like we did our solution with, in a nonclinical context, like we tested a lot of our software in that fitness journey so that we knew people liked our content, people could use our software before we, you know, went through the pain and suffering of being enrolled in [00:23:00] Medicare and hiring on clinical talent.

And so we. Knew what we were doing was good and we're like, can we make it better? I think that was really key for us. And, and then for us, it be like, Hey, we actually have seen patients. This is our outcomes. You know, this is how we're, you know, really moving the needle on breathlessness. We could take that to further investors would be like, we could do this with money, we could do more.

Um mm-hmm. And being really, uh. Strategic about proving each part of your business with the least amount of legal as possible, which is really hard in healthcare. There's a just a lot of, to your point, regulation and for good reason. Um, but it can get really expensive, um, especially for a smaller company and, you know, use your network, you know, go to events, meet people.

The thing about healthcare is I think people wanna help you. I, we, they want you to succeed. Uh, I can't speak for other industries, but we're all here to help people. Feel better. Uh, generally people are really excited to help you if they can. So, you know, you know, speak [00:24:00] your truth to power. I guess, for lack of a better way of saying it, you know, tell people what you're working on, you know, mention it when you're out with friends and you'd be surprised how many people are like, oh, that's so cool actually.

I know somebody that's doing X or I have a patient who could really use that. So, you know, it's, it's embarrassing. I appreciate it. I struggle with it as well, but the more you talk about what you're doing. Like you might end up being having a friend introduce you to someone and they might get you on a podcast.

Like what's happening right now. Exactly. Um, so just talk about what you're doing and even if you have another job or other things are happening at the same time, that doesn't negate what you're doing to work on your idea. So just tell people what you're doing and try to prove as much as you can for the least amount of money as possible.

Yeah, I love that. Yeah. And you don't have to quit your full-time job to burn the bridges and go straight into entrepreneurship. Right? You definitely do not. I, yeah, it's, it's hard enough as it is, like you've gotta take care of yourself and your family. Uh, so yeah, there'll [00:25:00] be a moment when you'll leap, but you know, if you can put that off, I think that could be helpful.

Right. So, and in your experience, were you, you were working in finance when you first validated that for, uh, those first fitness oriented customers? Yeah. I mean, I was, I was doing it like I was moonlighting, so I was. Working at my finance job during the day and, you know, the nine to five, five to nine situation for sure.

Yeah. Um, and then, you know, I think once we got into the accelerator was the time that I was like, Hmm, maybe I should, you know, think about doing something full time. Um, but again, I, you know, it's so different for every person. Um, so. That was what I did. Mm-hmm. But that doesn't necessarily mean that that's the right way, the only way to do it.

Sure. There's there's many ways to, to skin a cat and that's not the best analogy there. Yeah, I was gonna say for healthcare, it just takes a long time. It's really does. So. Whatever runway you have in your brain, double it. Yeah. Be patient, but also don't be shy to talk [00:26:00] about your ideas and validate them and start small and don't go straight into Medicare.

But now you, I, I commend you that you did, you, you company, um, supports insurance, right? Which is its own huge. Obstacle was there, what was the biggest learning curve getting into the Medicare market? Like learning CPT codes or No, we have, we have, I mean, 'cause our CPT codes, I mean, we operate as a rehab practice.

Um, so that's not as hard. I think, you know, under, I think. Clinically it can be something difficult. People are like, oh, you're doing pulmonary rehab but you're doing it with rehab People we're like, yes, because in your brain, like they're thinking of the pulmonary rehab code and we're, we don't use those codes.

And that was intentional. 'cause again, we really don't wanna compete with in person. We think that, you know, there's a lifetime limit on Medicare and of those use of that code, we want people to have that opportunity to go in person. So it was intentional that we use different codes, um, and it's intentional that we use different [00:27:00] clinicians.

'cause again. We're doing something different. We're attacking the problem in a new way. Um, but we, you know, we obviously do do CPT stuff, but we also work with ACOs and health systems as a vendor. So it's, it's not one or the other. It's really, you know, what's the best way for us to get to our patients and serve them, and especially when we're working with folks that wanna do pulmonary function tests all through pulmonary rehab, those are more of a vendor relationship, uh, as well.

I see. Yeah. It's just so many, so many different clinicians, so many different touch points. It's amazing to me to, to coordinate and to find the wedge in between all these connecting factors. Yeah. We have, we have an awesome team. Yeah. Yeah. Um, well you mentioned that, uh, I think before we started recording, that you encourage clinicians who want to get into tech or nonclinical jobs to come, either work for you or, or to get into health tech in general.

Do you have any advice or words of wisdom for them? Because I, [00:28:00] you know, I have my own website called SLP Transitions, where I kind of go through my journey and I talk to other clinicians who made the leap to tech. Um, but yeah, there's some people out there who feel pigeonholed. You know, we've got a master's degree or yeah, doctorate.

If you're a physical therapist and it's like, oh man, this is my whole identity and there's so much. Emotional weight to it. Uh, and also just financial and thinking, how can I even use these skills to pivot to something relevant in tech? How can people think about using it? They're impact in a different way.

I. Yeah, so as I mentioned, I'm not a clinician. So from the start, we felt it was really important to have clinician representation on our management team, as well as obviously in clinical care. Like if we're making software for clinicians, clinicians should be part of making that software. So clinicians enjoy it.

Like that just seemed like a no brainer to me. Um, and there's so much amazing talent, uh, in the rehab space. Um, I think, you know. A lot of pushback weekend are like, oh, I don't have any transferable [00:29:00] skills, or like, I haven't done it before. But the reality is, if you work in rehab, if you're a speech language pathologist, physical therapist, like you have customer service skills, like you're doing that, you have problem solving skills, you understand protocol and can execute on it.

You know, I think there's a lot of folks that get scared away by the, the different words that are used, uh, in clinical context, in a tech context. But at the end of the day, like. If you've been a clinician, like you could handle a tech job. Like, it's just, it's the ability to time manage is never gonna be better than anyone who's, who's worked in a clinical context.

Because if you're billing, you know, boy, like I remember our first, one of our first invoices from one of our, uh, contractors had like a 0.3 hours on like one of the tasks. I'm like, what? Like the amount of. Understanding of what you're doing every second of the day is unparalleled than any other profession.

But you know, I think promoting sort of what you've been doing in your clinical care like that you've been working with [00:30:00] patients, you can dispel people who are upset, you can problem solve, you could work at a team like these are all the same things that are in the tech space. It's just about telling your story in a way that a tech person would understand.

And I mean, sites like yours are doing that. And I think companies like ours are doing that. And I like to believe that there's other health tech companies that wanna hire folks who have been in the shoes of their clinicians to advise them on how to make better technology, develop, like, you know, software development decisions, um, where to advertise for jobs.

You know, these are all things that if you're actually had worked in that space, are gonna make you a better leader on the management side as well. A hundred percent. Yeah. Well said. It's like sometimes the lingo sounds so opaque, but it's, you're, you're already doing these things like patient experiences, user experience and Yeah.

You know, care coordination is wrangling cats over Excel. I don't know, it's just, they're just different. I, I'll say everything is, you know, compared to [00:31:00] doing clinical care, like there is, it's, everything has to be easier, right? Like, you know, got like 17,000 windows and 17,000 regulations and. Forms to fill out and people to call and all that.

But I, I'll say just because you're a speech person, I have to say that especially those speech folks, they are fearless. Like y'all will call whoever. You have no fear. You're like, I will do therapy with a book. I find the side of the road like I'm unfazed. So for anyone who is thinking about hiring clinicians who isn't, you definitely should.

They are, um. Fallible. Yeah. We, we've worked out of broom closets where like we've gone through, uh, bootcamp. We can, we can, we can work with a rock on the side of the road and make a speech activity out of it. Yeah. So I appreciate that. Well, Emily, as we start to wrap up here, um, I just want to know what do you, what do you see for the future of.

Either flex together or more broadly in, uh, in the field? Like what changes would you want to see in your ideal world? [00:32:00] Well, I mean, I think, you know, it's interesting, uh, you would think having a respiratory pandemic would get more attention on the space. And unfortunately that hasn't really. Been true.

There's not a lot of startups in the, I mean, there are a lot, but compared to there sort of cardiac or diabetes, there's not as many players in the space, especially not on the care delivery side. There's a lot of ations on the pharmaceutical side, the med device side. And I personally feel that the service delivery side of pulmonary care is also really awesome and deserves innovation as well.

So I hope that we'll continue to get more eyes on this problem. You know, get more people diagnosed. You know, I think like 30, only 30% the CDC estimates are actually diagnosed who have COPD, for example. So it's just a lot of opportunity to really get. More understanding and more care in the space. Um, and I think getting more diverse founders, you know, in the space is great too.

You know, whether that's, you know, on an identity side or you're, where you come from, um, the people who [00:33:00] have a different background, like getting clinicians, making the companies that are serving patients, for example, is what I hope for the future. That there's gonna be more of that. Beautiful. Yeah. Well, if you're listening to this, there's many problems to solve and your background is, is useful.

So let's get your voice in there. We need you. We need you, please. Yeah. Well, Emily, thank you. Um, we can, we can all breathe easier knowing people like you are in the world making a difference. And where should people find you or learn more? Yeah, I mean, go find Flex together. We're at flex together.com.

We're on all the socials. You know, Instagram X, I don't know, Twitter, I dunno what it's called these days. We're flex together everywhere. Um, I'm, I'm Michelle. I'm on LinkedIn. You can always reach out to me. I'm happy to chat with folks. Uh, if any this is interesting or you think I could help you, always happy to help other folks.

You know, if you're interested in investing in us or helping us or partnering with us, sending us patients, uh, we absolutely [00:34:00] wanna hear from you because it's a big problem and big problems only get solved if we work together. So, you know, we're happy to collaborate with anyone in the space who, who feels passionate about it.

Well, thank you for your time, Emily, and yes, please reach out to Emily if you have ideas or wanna collaborate. She's doing amazing work. Thanks for your time. Thank you so much. Thank you.