3 Founders on the Real Cost of Health Access | Live @ Civic Health Forum

**Rafael Lopez** (0:03)
It sounds cliché, and maybe Elina has also shared some of it, but where the patients are and reaching them in a way that they feel... I mean, we all know that care is about trust, and without trust, you cannot actually build a patient app or a health care system.

**SPEAKER_2** (0:23)
Welcome back to StartUp Health NOW, the podcast where we celebrate the entrepreneurs and innovators who are transforming health.

**Logan Plaster** (0:31)
We're going to talk about catalyzing change through founder-led innovation, something that's very near and dear to my heart, having worked with StartUp Health for many years, supporting hundreds of founders. We have a short amount of time to talk about why Agile founders and Agile startups are mission critical to really changing the system and opening up access. We have an awesome panel here. We have Elina Onitskansky from Ilant.
Who is a former payer exec turned system disruptor, who is now really changing metabolic health and helping folks who are struggling with obesity. We have Rafael Lopez, who is using AI at Diagnostikare to radically open up access to care in Latin America. And we have Dr. Terry Huang, who has a really interesting combination of public health and private sector entrepreneurial know-how that he's leveraging at the Firefly Innovation Center, which is located at CUNY. I wanted to jump right in there with those quick bios so we could spend most of our time just talking. So I want to start, instead of doing bios, I want you to give us a sense of what you're working on and what you're building through the lens of a single patient. I know that you guys just raised $15 million in a Series A, and I congratulate you for that. But I want to pull back from that kind of press release and say, what is Ilant Health? Tell us what you're working on through the story of a single patient.

**Elina Onitskansky** (2:02)
Absolutely. So we treat obesity, and I think one of the challenges is that we haven't considered an obesity a disease until about 10 years ago.
Everyone and their mother, their grandmother, their uncle, aunt, dog, water, her sister-in-law feels that they know how to address obesity. That's why you've actually seen this renaming into kidney, cardio, diabetes, because everyone's trying to say, no, no, it's important. It's not just excess weight, it's like real conditions.
Our thing is if you actually wanted to rename it, you'd have to call it kidney, liver, cardio, diabetes, obstructive sleep apnea, osteoarthritis, mental health, and about 20 other conditions. What do we do? So we really focus on personalizing care, and we do that through a combination of technology and clinical care. And one of our real focus is really understanding how to meet people where they are, both in terms of their personal needs, but also in terms of the acuity of their condition. And one of our focus areas is on high acuity individuals. So I think everyone is aware that about 43 percent of the US today has what is deemed obesity based on BMI.
Ten percent has what is called Class III obesity, which is over 40 BMI. Just to give you a sense, someone with Class III obesity has about eight times the likelihood of developing diabetes as someone at optimal weight. That is actually our fastest growing segment in the US today. And if you subsegment it further, it's people over 60 BMI. So I want to give you a flavor of a member of ours who was in this Class III obesity realm. She was 28 years old and 80 BMI. And because of her obesity, she literally hadn't left her house since she was about 25 years old because she couldn't stand for more than 30 seconds at a time. And if you can't stand for more than 30 seconds at a time, you can't walk out the door. And so when she came to us, you can imagine even though that she was 28 years old, she had just about every condition I just named for you associated with obesity. And she certainly had, as you would expect, anxiety, depression, a whole host of other mental health issues. I would say sort of ironically or incredibly, she was actually doing phenomenally well at work, but she was so high acuity that you literally couldn't do surgery, right? So the evidence-based treatment for her was bariatric surgery. The surgeons refused to operate. She was too high risk for surgery. So what we did with her is helped her lose 100 pounds through medication, got her into surgery, and she's now down close to 300 pounds. But what I want to talk about is the power of hope for someone like that. So about three months in, she was only down 30 pounds. That's not a material amount of weight. But at that point in time, we got her stand time to two minutes. And so she could literally walk out the door for the first time in years and went to dinner with friends. Something so small, but so impactful for her. And that sort of set her off for the rest of the journey, which she capped with a Taylor Swift concert.