Live at the Yale Innovation Summit 2025

Howard Forman: Welcome to Health & Veritas live from the Innovation Summit at the beautiful Evans Hall at the Yale School of Management in downtown New Haven. I’m Howie Forman.‌

Megan Ranney: And I am not Harlan Krumholz, but I’m going to do my very best to sub in for him, shorten my hair and change gender and all that stuff. My name is Megan Ranney. I am the dean of the Yale School of Public Health.‌

Howard Forman: And we are physicians and professors at Yale University, and we’re always trying to get closer to the truth about health and healthcare. We have a very special episode planned here in Room 2200, Evans Hall, with four special guests stopping by to visit with us and a room full of eager attendees and presenters. But I wanted to start off by asking you, Megan, about why this particular event, the Innovation Summit, which has gone on for several years right now, but why is it so special to you?‌

Megan Ranney: So I’ll actually say this was the very first event that I engaged with at Yale after I was named as dean. I came to the Innovation Summit before my term as dean had even started because this is why I care about public health, because I think that we are in a moment where systems change is deeply needed and we need to bring an innovative and entrepreneurial mindset to everything that we do in health and healthcare. And this Innovation Summit is a really unique place and space to do that. I have heard from multiple people across the last two days, but also the last two years, around how this summit is different from other innovation summits at other institutions, universities, entrepreneurial settings. It is only here that we bring together health, public health, management or business school folks, artists and architects, people who are advocating for change in a wide variety of communities. That’s of course part of the lifeblood of what we do here at Yale, but it’s really neat to have this space where we bring people together from outside of our scholarly community, as well as those inside, to help drive change.‌

Howard Forman: And I just want to point out for our listeners, Yale is very unique in the sense that you can actually walk back and forth between different schools with great ease. And I’m curious to hear, you’ve been at other institutions as well, what do you think about that as being part of the recipe for our success and being able to work together and collaborate so well?‌

Megan Ranney: I frequently say that this is, to my knowledge, one of the few schools of public health that is not separated off on a different campus that’s a 20-minute or hour-long journey in between that and the rest of campus. I think it’s a huge part of what makes Yale Yale and what brought me here. And Howie, I think that you serve as an exemplar in so many ways of that.‌

Howard Forman: Because I walk.‌

Megan Ranney: Yes. But you have appointments at, what, three different schools and you mentor people across the entire university, not just at the schools where you have appointments. I think that’s a pretty unique thing.‌

Howard Forman: And I will say, if you think about the way Yale operates right now, we have people at the School of Management with appointments in the School of Public Health. We have people in the School of Public Health with appointments in the School of Management. Nursing gets in there, Medical School gets in there, the Law School gets in there. And I look at it, this audience—and many of you I know, and you are graduates, you’re current staff, you’re current students from all walks of life, and many of you hold more than one of those titles there. So it really is a very special situation for us and it brings us I think to our first guest. So I’m going to let you do that introduction there.‌

Megan Ranney: Wonderful. I have the absolute pleasure of welcoming K.P. Yelpaala to our podcast episode. K.P., For those who don’t know him, is the faculty director of InnovateHealth Yale and a senior fellow and lecturer at the very own Yale School of Public Health. He was previously co-founder and CEO of InOn Health, a digital health communications company that connected multicultural populations to healthcare services using digital communication channels and consumer insights. He was also founder and CEO of access.mobile international, a global digital health company that partnered with healthcare systems in 13 African countries. And interestingly, K.P. and I got to know each other because he received his BA in econ and public health from Brown University, where I used to be. So he and I got connected as an alum of Brown. And then lo and behold, he also has his MPH from Yale. So when I made the journey here, I was very excited to reconnect with him as an alum of another school that I was quite excited about being part of. So K.P., welcome to the podcast.‌

Kaakpema Yelpaala: Thank you so much.‌

Megan Ranney: So you and I have spent a lot of time together over the last few years, and one of the things that I deeply appreciate you is that you bring that innovator’s or entrepreneurial lens to public health, to scholarship, to education, and you have dived in two feet into this Yale innovation ecosystem. I would love for you to share a little bit about that work within the Yale innovation ecosystem and particularly the health innovation track here at the Innovation Summit.‌

Kaakpema Yelpaala: Amazing. When I was a student at YSPH, none of this was here. So I think it’s incredible to see not just this summit and this type of cross-sector convening but the entrepreneurial energy. So I think when I was at Yale, Yale has produced all kinds of entrepreneurs in many spaces, but we didn’t really have a connected ecosystem, in my view, at the time. And so coming back now, thanks to you pulling me back in, she didn’t have to twist my arm. Megan’s a very easy leader to follow, so I was very enthusiastic to come back. The energy now is very different. And I’m hearing that from so many people here. Even at the School of Public Health, we have so many entrepreneurs thinking about social innovation, thinking about data, thinking about all these fundamental things that will really drive systems change.‌

Howard Forman: Megan, let me just say, you’re absolutely right. If I go back 10 or 12 years and people ask me about entrepreneurship at Yale, I would often say, Sharon Oster, social enterprise…we had a couple of people at School of Management, did a little bit of entrepreneurship, but there was no center of gravity. Now you have the Tsai Center, you have Kyle Jensen’s group with a myriad number of courses and mentorship opportunities. You, with InnovateHealth, the Thorne Prize. I was wondering if you can speak to what you see from your seat at the School of Public Health about how you are able to work with other schools, other students.‌

Kaakpema Yelpaala: Right. So I think part of my journey as a public health innovator is about the lens through which we think of problems. So I think when people are trained in a business school pedagogy, you usually start with dollars and cents first. And it makes sense, that’s how you’re trained. You look for strategic opportunities where you can capture value in a very clear economical way. As a public health innovator, I think a lot of the people that I work with and how I looked at problems when I started was to say, what is the big public health problem we’re looking to solve and how do we think about and measure impact? Lead with that. Then we come to business models and I think that creates a tension and you see that tension often in terms of which direction we’re going.‌

And so a lot of what I like to do with innovators now is to say, “You could start with dollars and cents and then work your way through how you build sustainability and impact, or you could start with impact and then come to dollars and cents. Just know that there are strategic implications based on the direction you go.” And I think at the summit, we’re seeing innovators that are looking at these problems through all those different lenses. But I feel like as public health practitioners, our orientation is anything we do needs to improve outcomes, needs to measurably have impact at a population level. And if you start with those principles, to me the question is, innovation to what end? And I think as public health practitioners we’re always thinking about public health impact.‌

Megan Ranney: Can you actually talk a little more about that? I know you’ve been working a bunch on a new version of case studies that marries or that openly addresses that tension. Can you share a little bit about the case series?‌

Kaakpema Yelpaala: Yeah, so when Megan and I were thinking about as a practitioner, what were some scholarly areas I could explore, I got really excited about the case study method as a way to do a deep dive on how organizations face certain types of dilemmas. And so I’m working on a number of different cases, and the body of casework covers for-profit companies, nonprofit companies or organizations, and then hybrid models. And really what I hope to do is to help students be exposed to the fact that there are trade-offs with any model. So to me it’s not sufficient to say, “Oh, capitalism is bad, and if you’re seeking profits, that’s a bad thing.” That’s not sufficient. Really, the thing is or the issue is what models are best suited to drive the impact you’re looking for.‌

So we’ve done a case study on cityblock, tremendous value-based model, significant scale, it’s become a unicorn. I’m doing a case on an organization called Girl Effect, the chief creative and technology officer’s here, they’re using AI in large language models in different languages across India, South Africa, Kenya to improve access to services for young girls. So there are all kinds of use cases. They’re a nonprofit. So I think it’s important we expose students deeply to the dilemmas and trade-offs so that they’re prepared when they go out in the world.‌

Howard Forman: Last question. When you look out at the landscape of conferences like this, and by the way, there aren’t that many across the entire country, when you look at it, is there any other one that has a public health emphasis the way this one does?‌

Kaakpema Yelpaala: I have not seen one. And I’ve also been getting that feedback from people that are here. And I think in the panels and conversations we’ve had, we’re covering everything from the policy side. We had a wonderful keynote, fireside chat with the dean and secretary Azar because the policy influences innovation. We’re having conversations about AI. We’re having conversations about data. It’s very cross-disciplinary. I think that’s something unique that Yale brings, having experts from so many different disciplines come together.‌

Howard Forman: I think it’s something unique you bring also, and we really appreciate everything you’ve been able to do to make this a great summit and for just being here with Yale and Yale School of Public Health.‌

Kaakpema Yelpaala: Thank you.‌

Howard Forman: Thank you so much.‌

Megan Ranney: Go K.P. Thank you.‌

Kaakpema Yelpaala: Thank you.‌

Howard Forman: So our next guest is Dr. Basmah Safdar. She is the newly appointed director of Women’s Health Research at Yale, WHRY, and a professor of emergency medicine at Yale. She also serves as director of the emergency department Chest Pain Center at Yale New Haven Hospital. She’s also vice chair, Faculty Affairs and Development for the Department of Emergency Medicine and leads the Yale Coronary Microvascular Dysfunction Registry. She’s an internationally recognized scholar in sex and gender-specific research, particularly in microvascular health, and has led numerous clinical trials on microvascular dysfunction. Dr. Safdar completed her MD at Aga Khan University in Pakistan, her master’s degree at Harvard, and her residency in emergency medicine at Yale, which is when I first met her. So please come join us up here.‌

I will say in full transparency, we’ve known each other for 25-plus years now, and we lived in the same building for several of those and our children played together, so.‌

Basmah Safdar: We’ve been neighbors.‌

Howard Forman: Exactly right. Truly friends and also colleagues.‌

Megan Ranney: Okay, okay, but, but—‌

Howard Forman: But don’t compete.‌

Megan Ranney: ...when we were at a conference last week, someone came up and pulled my hair from behind, thinking I was Basmah.‌

Basmah Safdar: Many days we share the look.‌

Howard Forman: I have to admit no one has ever pulled my hair, at least not recently.‌

First of all, I want to start off and ask you, I don’t remember if you’ve been to the Innovation Summit before, but both in your new role as well as in your expanded roles that you already have, what do you think of the Innovation Summit? What has surprised you the most?‌

Basmah Safdar: So this is my first time that I came and it has been fantastic for all the reasons that Megan pointed out. For me, it captures the essence of academia, like bringing people together from very different backgrounds and looking for bright new ideas that get invigorated just with that conversation, something we kind of lost in COVID. So it’s just wonderful to have... Forums like these energize me. And as an incoming director—I start July 1st—I walked around with the lens of which of the innovations I can bring to my patients? So I’m an emergency physician, and right after this forum I am going to my emergency department shift. So if, say, one of you develops chest pain, which I hope you don’t, you will likely get the advice to come to the emergency department. You will likely show up on my shift.‌

And if you are a man, the tools that we currently have for sure will be very good at making sure that you’re not having a heart attack and you don’t have heart disease. If you’re a woman, we’ll do a very good job of making sure you don’t have heart attack. That is more common in men. If all the tests are negative, you may actually walk out of the ER not knowing if you have ischemia or heart disease. That is more common in women. And I think that’s where the gap is, that’s where the work is.‌

And so if you are an innovator here, I want you to ask that question of how is it different between men and women? And if you’re an investor in the audience, I want you to ask that question. Unless we’re asking a question and looking at it intentionally, we will continue to misdiagnose, mistreat, continue to waste healthcare dollars. So I think that’s where the lens is.‌

Howard Forman: That’s great.‌

Megan Ranney: I love that, and I think it’s a great challenge to all of the innovators in the room. I would love to hear, I stepped into my role almost two years ago now. You’re stepping into a new role on July 1st, I’d love to hear a little bit about besides innovation, what are you most looking forward to in this position as director of the Women’s Health Research Institute Center at Yale? And how are you hoping to guide the center through this uncertain and unstable moment that we’re in in health research?‌

Basmah Safdar: It’s a really good question. I think we’ll have—‌

Megan Ranney: I’m good at easy questions, by the way.‌

Basmah Safdar: Yes, yes. And we’ll have to think about it together. I feel like last 30 years, when the center was first created, the founders of the center and that movement did the first layer of work. The first phase was why are women not being included in the research in the first place and how does it affect people? We’re in the second phase. We actually have been now including some women, we have the data, but we haven’t matched it up and brought it back to the patient bedside. So I think the work is really, continue to build that research community, but also then to translate it back to patients, to populations, the community, whether it is development of precision-based diagnostics, whether it is creating individualized personalized treatments. Unless we’re including everybody, we will not be treating anyone. And so we will leave half of our population empty.‌

And I’m a big proponent that by including men and women, which is what the center is really geared for, we’re not just improving the lives of women, we’re also improving the lives of men. And an example would be in COVID. COVID came; lots of patients die. Till we actually start looking at the sex-specific differences, we didn’t realize that more men were dying in the first phase. And actually, thanks to the research and at Yale we found that was because men have a different immune response to viruses compared to women. And not just COVID. Actually, flu, you know when they call it “man flu”? It’s real.‌

Megan Ranney: Darn it. Don’t say that, my husband is going to listen to this—‌

Basmah Safdar: They actually get sicker. And so we have to look at these things through that lens. And if I would say, if there’s one takeaway for all of you, no matter what field you’re in, it is to actually ask that question, how is it different in men and women?‌

Howard Forman: So gender disparities in health outcomes as well as healthcare have been top of research agenda for now for decades. And we’ve definitely made progress. We’ve definitely identified lots of areas where both variation exists where it shouldn’t, and where outcomes exist where they shouldn’t. I’m wondering, number one, why are we still so far behind on this and what do you expect over the next decade? What are the levers that might be available that might help narrow the gaps that we see?‌

Basmah Safdar: It’s a really good question. It’s something I think about often because if you look at why women were not originally including in research, and for those of you who don’t know the history on it, in 1993 NIH mandated including women in research. And so it’s been decades.‌

Megan Ranney: 1993. I’m sorry, that was not so long ago. Go ahead.‌

Howard Forman: It’s long, but it’s not long. Yeah.‌

Basmah Safdar: It’s been decades, right? So why are we still talking about it as if you’re not doing this?‌

Howard Forman: Right.‌

Basmah Safdar: It came from a sense of protection. We wanted women not to be exposed to all the bad things that new research and new drugs and new science can do. And it’s interesting, especially from my lens as growing up in Pakistan, in a developing country where I experienced growing up that same lens, women are protected. And so to my benefit, I have never had to stand in line, I never had to carry heavy weights because there were always people jumping in to help me. But in that process, I realized, women became invisible part of the society, part of the reason I came here. And so when I came here I found that terminology was different, the statements were different, but in some ways there were similar themes, especially in patient care.‌

So when I was looking at patients, at that time it was just around the time that women were starting to be included and women were included in what I call “bikini medicine.” It was all just about the boobs and the uterus. You couldn’t think about women more than pregnancy. And the big part of centers like Women’s Health Research is that there is... every cell has a sex. That difference lies in every disease, whether it’s heart attack, strokes. FDA came with a big thing about Ambien a few years ago. It took 30 years. For those of you who don’t know, Ambien is medication for sleep. And it took about 30 years for FDA to change the sex-specific dosing because more women were getting impaired driving, and so they actually had to half the dose. So that’s an example often used. But even if you go around here like psychedelics and all those other therapeutics, new therapeutics that are coming, they’re all have different effects between men and women.‌

Megan Ranney: You and I are both emergency physicians, and I think much of the work that we do is inspired by our bedside care, but also by what we’re sending patients back out into. I would love to hear how that emergency medicine mindset is going to inform your work at the Women’s Health Research program at Yale.‌

Basmah Safdar: Yeah. Part of the reason I love being an emergency physician is it allows me to keep my finger on the pulse of society. It really is a melting pot where you actually get to see not just diseases but all the changes and the consequences of our policies that are happening in healthcare. So I hope to use that experience to inform the kind of research, relevant research that we do. And more importantly, even if we do research with the amazing community, we have to bring it back, not let us stay on the shelves but bring it back to the community.‌

Howard Forman: That’s great.‌

Megan Ranney: Thank you. Thank you, Basmah.‌

All right, next up on our quickly turning carousel of podcast guests is the amazing Kayla Wooley. Kayla is a senior care entrepreneur and the founder and CEO of StaffOnTap, a staffing platform that connects senior care facilities with temporary nurses and therapists. She’s also the owner of Swallowing Diagnostics, a bedside swallowing assessment company serving skilled nursing facilities, and is a co-owner of NextGen Wound Care. Kayla is a third-generation member of her family’s senior care business and previously worked as a licensed nursing home administrator. She received her BA from Boston College, her MBA from Cornell, and her MPH in healthcare management from Yale. Welcome back, Kayla. We are so excited.‌

So Kayla, I’m going to start with your journey as an entrepreneur. You and I have had the chance to chat a little bit as one of our school’s alums about why you came into public health and how you took that back to the business and into making patients’ experiences better. I’d love for you to share a little bit about StaffOnTap and what the genesis of it was and how you’ve created it in a way that makes patients’ and families’ lives better.‌

Kayla Wooley: Sure. Thank you for having me. I decided to come to YSPH to pursue my MPH after working in my family business. I’m third-generation nursing home administrator. And I knew I loved senior care, and I wanted to impact seniors’ lives and make the system better in America, but I didn’t know in quite what capacity that was yet. So I went into YSPH with an open mind there and quickly took advantage of the courses like social entrepreneurship and was exposed very quickly to these different paths that I could take. And at that point I started thinking, okay, COVID hit, nursing homes, I think it was... we lost about 13, 14% of our workforce and there already was a nursing shortage. So I thought, “Here’s this massive problem, what can I do to try and mediate it?”‌

And that’s when the gear started turning for the idea on StaffOnTap. I interviewed the, I think it was about... we lost about 250,000 caregivers. So I interviewed as many as I could and asked them, “Why did you leave? What would make you come back? You’re trained in nursing homes, you love caregiving.” And I just got the same answers over and over: “burnt out, low pay, no flexibility.” So then I was like, “Wow, there’s this huge pool of these nurses that know what they’re doing. They care so much about these patients, and they want to come back.” So then I built StaffOnTap’s business model around that. There’s three, so I’ll leave it at StaffOnTap.‌

Howard Forman: No, no, no. I want to stay on that topic for a minute. A lot of people go and get an MBA and are entrepreneurial, a lot of people get an MPH and are entrepreneurial. You literally come from an area of subject matter expertise. This is not just a family business but a well-built family business that you’ve worked in in an operational way. How did that make you a better entrepreneur not just about recognizing a shortage of nursing, but how did that allow you to be a better entrepreneur by having subject matter expertise as well as the verve of an entrepreneur?‌

Kayla Wooley: Yeah. I think what YSPH allowed me to do with that... So I came in with this nursing home expertise from the other side as an operator, seeing it over the decades, was involved in nursing home associations. But then YSPH gave me critical thinking and other diverse perspectives of public health that then I could couple with this nursing home expertise. So I think a skill that I took out of YSPH was that critical thinking, which nursing homes we all know are broken. They are so convoluted and they’re a mess. No one’s happy, not one stakeholder in the system. And so then I could look at that problem a bit more holistically and from many different perspectives.‌

And something that, I don’t have the answer for this, but I’ve been thinking about today, seeing the trends in nursing homes we see constant regulation changes, payment model changes, nursing homes closing, people buying nursing homes, some people succeeding, some people not. And it makes me question, what’s the goal of nursing homes in the U.S.? It’s a really hard thing to answer and it might be a different answer who you talk to. Part of the reason for that, and this is where the critical thinking comes in, is, okay, what are the types of patients we’re taking care of now? I’ll list a few personas right off the bat, and some of these are more on the extreme side, but they’re people we take.‌

We might have a 50-year-old who has substance abuse issues and needs Suboxone and their friends who are also 50 in the community coming in. We might have a patient that is in prison and the prison can no longer take care of that patient because they need round-the-clock care. We might have a 97-year-old who’s on hospice. We might have a 65-year-old who had a hip replacement and needs two weeks of physical therapy. So then you ask, what’s the goal of a nursing home? And if you were to create one goal that encompassed all those individuals, how could we meet it? I’ve been trying to think about how these nursing homes are broken. And I think we just keep building on a system that is not made for the type of personnel that we’re taking into the nursing homes today.‌

Megan Ranney: I want to follow through on that topic. I think one of my big motivating factors is this belief that the systems as they exist, whether it is nursing homes, emergency departments, our public health communication structure, that all of them are deeply flawed and that we’ve been stuck in incrementalism. And I think you and I have had discussions about how you’ve seen that added on to nursing homes. You do one small regulation and then another. And I know that you’re still at the beginning stages of thinking about this, but as you think about those different personas and as you’ve spent the last 24 hours here at the Innovation Summit, what new ideas are you thinking of about what might a better system look like? Would it be pods for each of those different types of patients? What are the various versions that you’re dreaming of?‌

Kayla Wooley: My brain says, don’t create a solution before I fully understand the problem. But I think what I would do is really dissect every piece of the nursing home and figure out what every problem is and then start from a clean slate. Maybe the word nursing home has to go away. Maybe those five or six different personas I gave are five or six different systems that we take care of patients in. And then I think from there, if you start clean slate, we can build and create a new system because, like you said, this incremental change isn’t working for anyone. And at the end of the day, it’s about the patients and how can we make aging or taking care of people in general, more graceful and what the society wants, not just what works best as a system. And I think that goes back to what’s the goal of the nursing home, which is hard to—‌

Howard Forman: Hinge Health went public I think in the last week or so. It’s a physical therapy platform and it’s tech-based, it’s app-based. What excites me about it, I know nothing about the company and how well it does, but what excites me about it is it disintermediates what physical therapy is and how we deliver it to people. It gives me hope that there is a better future in delivering healthcare. You’re working on Swallowing Diagnostics, NextGen Wound Care. You already talked about how to rethink the nursing home. As you walk through the Innovation Summit, do you see technology, AI or whatever you think, as playing a bigger role in those startups and maybe others that you might have in the future?‌

Kayla Wooley: Yeah, 100%. I think especially around documentation, the NextGen Wound Care, that’s especially the most clinically involved that we do. And we bill insurance, and there’s tons and tons of documentation. And I think that along with just nursing home care, why can’t we have AI that’s, like if we were to create our own nursing homes or system, that’s automatically paid for? The nurse can go in or APRN [advanced practice nurse] can go in, give the care, and there’s a monitor that does all the documentation so it’s accurate, you kind of level the playing field across the different vendors who are doing it or different providers, but that’s just not incentivized as much today in the current way that it’s built. But I see AI as taking away the things that humans don’t need to do so we can focus on care.‌

Howard Forman: That’s great.‌

Megan Ranney: I’d love to switch tracks, which is to talk about some of the things that you’ve learned since your schooling. You’ve now been on this entrepreneurial journey for quite a while. What kind of surprises have you encountered? What things have opened your mind in new ways that maybe you didn’t learn about when you were here at Yale? What pieces of wisdom do you have to share with our audience?‌

Kayla Wooley: Oh, gosh. I think you never stop experiencing firsts. Especially in entrepreneurship I keep thinking, “Okay, I’ve got this. I know what this next step is,” and then I’m completely lost. But that’s where the Yale ties are so special. I call Howie probably every six months to talk about a challenge I’m going through or something new I’m thinking about. So I think the relationships you build at Yale can really help with any hurdles you’re trying to overcome in the future, whether that’s entrepreneurship or another path you go through because you’ll never stop experiencing those firsts.‌

Howard Forman: That’s fantastic. We really appreciate you coming and joining us today.‌

Kayla Wooley: Thank you.‌

Megan Ranney: Thank you, Kayla.‌

Howard Forman: So last but definitely not least, Laurie Jimenez. She is the co-founder and CEO of FulcrumCare, a tech-enabled oral health management system focused on addressing unmet oral health needs of the Medicaid and Medicare populations. At Yale, she founded a student-run oral health club, leads an oral health initiative at the HAVEN Free Clinic. That’s the student-run free clinic. And won the Thorne Prize for Social Innovation at Startup Yale for her work on FulcrumCare. She’s a registered dental hygienist and a rising senior at Yale College where she’s part of the Eli Whitney program for nontraditional-age student. I’m reading that by quote because I don’t judge age. And is pursuing an MPH in health care management through the BA/MPH program. And I have been so fortunate to know you for a few years now, and you are absolutely, when people say a force of nature, you are a force of nature. You are passionate about this topic of dental healthcare.‌

I think our first conversation we even had, I probably told you that you would think that a radiologist would have the least overlap with dental healthcare, but it is literally one of the first things I teach our residents, and that is that you can tell someone socioeconomic status just by looking at their teeth whenever we do a head CT. So I’m completely aligned with you on the fact that this is so critical. Can you tell us a little bit about how you even arrived at the company and arrived at Yale?‌

Laurie Jimenez: Yeah, absolutely. I want to first start by saying thank you so much for having me. I’m really grateful to be here. And also, Professor Forman, that early conversation that we had actually drove me closer into exploring public health as well. So that was actually a really important point for me.‌

So to get started, I’d like to share a bit of my background and that I think informs a lot of the trajectory to FulcrumCare. And so I had an exposure to the dental industry really early on. I started working at a dental office just helping out during my junior and senior year of high school. And I was working with a lot of Medicaid patients because this office I worked at, they actually had a very high percentage of Medicaid patients, which is I found out later on not the norm. This was actually a really meaningful experience for me because I myself as a teenager was enrolled in Medicaid.‌

And so being able to understand the challenges that my family and community experienced when it came to accessing healthcare and the distress that really existed as well with the broader healthcare system, it was important for me to play that role in their own journey of understanding what their options were and how they could go about accessing that care. So that was a really just early start, but it’s what prompted me to decide to go into the dental industry. And I actually really valued the role of the dental hygienist because the role of the dental hygienist is really focused on that relationship with the patient, really focused on finding ways to prevent disease, and really guiding the patient and making the best decisions for themselves.‌

So I went to school, studied dental hygiene, and when I graduated and went off into the workforce, I quickly realized that the things that drove me into the dental industry were not reflected in the broader dental industry. I saw this through my work with patients where it was consistently the same patterns. I had my lower-income patients usually on Medicaid or older patients with complex health needs or patients with disabilities that always had the worst oral health. And statistically, they have two times worse oral health than those that are not on Medicaid or Medicare if we’re speaking about insurance.‌

And so I saw this pattern, and as a practitioner, I didn’t have any tools, any resources at my disposal to really support these patients better. And so after a few years of experiencing that and just understanding that the dental care model, the prevailing dental care model is really geared towards a younger, healthier, more affluent patient population, that’s what it is. And so it caused me to become disillusioned with the dental industry. I decided to go back to school. I was actually on a pre-med track when I ended up here at Yale.‌

And it was in that first semester that I was really wrestling with the decision of whether I was going to continue this pre-med track, I was enrolled in all those classes, or if I was going to try to solve this problem that I recognized, this was a really significant problem. I cared a lot about it, and I felt that maybe I could be the one to do something about it. And so that first winter break after my first semester, I just focused on research. I tried to understand, what does innovation in healthcare look like right now? What does healthcare look or innovation in the dental care space look like right now? And the research that I did during that, that winter break, established the foundation for FulcrumCare.‌

Megan Ranney: That’s terrific. Thank you for sharing that. And thank you for working on this issue. I will say both as an emergency physician and a public health professional, the lack of attention to dental needs is one of the most frustrating things for me. So many folks come to the emergency department looking for us to fix their chronic tooth pain and we send them off with a prescription for pen VK [phenoxymethylpenicillin or “penicillin VK”] and now hydro... Ibuprofen because we’re not prescribing opioids, but not a lot more than that. And so I really appreciate that lens and that dedication to improving this critical part of human health.‌

I’m hearing, as you tell that story, I’m going to go back to the interview with K.P. a few minutes ago, that tension between the profit imperative and the health imperative. And I’d love for you to talk a little bit more about that because I think it’s something that is more evident in the dental field perhaps than in other parts of healthcare, although it’s present elsewhere. So can you talk a little bit about how you’re navigating that tension, both from your lived experience as a dental hygienist but also as you’re thinking about creating FulcrumCare? And maybe if you feel comfortable, share a little bit with the group about what FulcrumCare aims to do.‌

Laurie Jimenez: Yeah, absolutely. So I’ll start with that first. So FulcrumCare is a dental care startup. We aim to create a new care model for Medicaid and Medicare patients. And really the care model, we’re looking at the ways that currently Medicaid and Medicare patients aren’t able to access dental care. So there are different limitations that they experience. A big one is provider network. And so a lot of the dental industry actually doesn’t participate with Medicaid. They don’t actually also participate with Medicare Advantage, which is a main source of insurance for a lot of our traditional Medicare patients. They’ll now look at Medicare Advantage plans as a way to get those supplemental benefits. And dental is a big driver for entering into Medicare Advantage with supplemental benefits. And so we are looking at what are the current restrictions to accessing dental care, and we are building a new care model from the ground up to really connect those dots for these patients.‌

And so when it comes to the intersection between public and private, another important statistic I’d like to tell you is that 90% of the current dental workforce is actually in private systems. And so these systems, they mainly contract with commercial insurance. So these are working adults or people who are paying out of pocket for their insurance, and their care model itself is really geared towards them. So a lot of what they’re generating revenue is pushing more cosmetic procedures as well.‌

And so when it came to me trying to understand, “okay, how do we close this gap?” I really had to look at beyond just the clinical space. So my background is that of a practitioner. I was working closely for many years with the patient. I understood care delivery. I understood how to really improve quality of care. That was my focus. But when it came to the broader healthcare system and really what it would take to drive FulcrumCare forward to solve this problem for Medicaid and Medicare patients, I understood that I needed to understand public health. I needed to understand the programs, the policies, and infrastructure in place that are driving innovation and solutions for Medicaid and Medicare patients. And with the support of mentors as well at Yale, I decided to apply to the master’s program here at Yale.‌

And already it’s been very enriching. I’ve had a lot of exposure through classes. I started early. I know I’m officially a grad student in the fall, but I took some classes in health policy, and that was really important for me to understand at a state level, how was innovation introduced, how do we inform policy, and so I’m very grateful that I took that step because I believe that if I’m going to really try to work towards closing this gap for Medicaid and Medicare patients, it’s important to understand this broader healthcare system, the infrastructure that’s in place that we can leverage to now make dental a part of the conversation.‌

Howard Forman: Before we wrap up, I’m just curious to know, are you focusing on Connecticut first since you’re physically here? How do you think about geography in terms of where you’re going to build your model from?‌

Laurie Jimenez: Yeah, so we are currently looking for a clinical partnership. Our first clinical partnership we are looking for ideally to work with value-based primary care practices. And so that’s an ongoing conversation. This summer we’re part of the Tsai CITY Accelerator here at Yale. And the priority there is just entering into these conversations in Connecticut and neighboring states to see who’s willing to start working with us collaboratively to serve the patients.‌

Howard Forman: We have a lot of listeners that are from that space. So you’re welcome to contact us or contact Laurie and get in touch and be a first mover on this.‌

Laurie Jimenez: Yeah, thank you so much.‌

Megan Ranney: It’s so exciting. Laurie, we’re honored to have you as part of the program and really thank you for joining us today in this interview.‌

Howard Forman: Thank you so much.‌

Megan Ranney: Appreciate it.‌

Laurie Jimenez: Thank you so much.‌

Howard Forman: So I will say, even just listening to them, and we both knew of all of them before, when I listened to them, it gives me a tremendous amount of energy about what the opportunity set is like going forward. When you come here, do you think about, okay, what are we going to do next year? And K.P. is back there. Do you think about, “We got to do this extra next year”?‌

Megan Ranney: Oh. I’m already having conversations. Last night, a few of us went out for drinks, and literally the conversation was, how do we bring more minds together to think about what we need in terms of programming, but also how do we create space for all of the extraordinary people in the room to network with each other? I believe that great innovation happens when you put smart, motivated people together who come from very different disciplines. That’s what this provides, and I think that we can supercharge it a bit more next year. And I’m excited to dream of it with you, Howie, but also with others in the room.‌

Howard Forman: I couldn’t agree more. I know I say this a lot on the podcast, and I know it may just sound like I’m just promoting Yale at this point. I’ve got no stake in Yale—they don’t sell shares.‌

Megan Ranney: Maybe we should, I don’t know.‌

Howard Forman: We may have to, just mentioning that now. But I do really get very excited by the opportunity set that exists. All these schools on a very small campus, people that want to work with one another, it’s one of the things that draws people to New Haven. We’re not Boston, we’re not New York, but people come here and they want to interact with one another. We’ve got over a thousand people at the Innovation Summit moving around. They had so many texts yesterday about people that were visiting. It made me really enthusiastic about what the future holds for us. So even at a tough time, it really builds my enthusiasm.‌

Megan Ranney: And I want to actually lean into that. I think that we are all here because we believe in both the possibility of deeply engaging with an issue but also the possibility of education and practice to create change. And I will say that events like this give me tremendous hope. These types of events are how change happens and how we keep change happening, not just in the U.S. but very much on a global scale. We didn’t talk a lot about global over the last 45 minutes, but as I look around this room, many of you are working both within and outside of the United States. And gosh, we need innovation everywhere to bring things from outside into this place and vice versa. I’m going to be energized by this conference for weeks to come, giving me that light and fire to keep moving forward.‌

Howard Forman: To that final point, I’ll say with global health, I was talking to our EMBA students recently about what our curriculum is in the healthcare track. I was talking about the fact that we were probably the only business school that has a required global health course in our track. And I said, “In today’s day and age, if you don’t think that global health is domestic health also, you cannot appreciate the challenges. If you think global health affects them but not us, it affects all of us. When you follow the news, when you follow the domestic economy, global health is central as well.” So I apologize for not having more global health, and we could have asked more questions of K.P. on that, but we’ll leave them for next year to do that for us.‌

I do want to say during challenging times like this, this summit, this room does amplify health hope, and we have extraordinary talent both at Yale, New Haven, and way beyond New Haven sharing ideas, testing investment theses, as well as challenging societal inertia, which I think right now a lot of us want us to be inert, and this is a great time for us to push back against that. As you’ve already said, it’s very energizing to me.‌

Megan Ranney: Ditto. I’m actually curious, Howie, about what you are going to take, so hope, yes, but what are three things that you’re going to take away from the conversation as you go forwards?‌

Howard Forman: One thing is that I think the university continues to offer an enormous amount, both to current students, communities, graduates, and so on. We can’t ignore the fact that at times like these when the universities are under attack, there’s actually a real merit to it. You can’t convert this to an online format and think that that’s what it is. There are ways to learn, but this is much more than just that. I think number two, I think that Yale in particular brings together skill sets that are unique here. We have Abbe Gluck in the Solomon Center at the Law School. We have you. We have Azita Emami at the nursing school. We have a lot of healthcare people at the School of Management at this point. We have a lot of people at School of Public Health, the med school, and so on. And we have people that might not even think that they’re moving the needle on healthcare, that are moving the needle on healthcare and sociology and so many other departments. ‌

And I think three is that in times of crisis, it’s very often easy to run around with your head cut off or being very angry. And I have experienced all of those over the last few months. But I think that this is a great time for us to be able to interact with one another, learn from one another, pause and hear people, engage with them, learn more about what we personally can do to advance the mission even in times that are challenging. So those are my three things.‌

Megan Ranney: I love that. I agree with all of those. And I think for me, I’m going to add in one more, which is the focus on systems change rather than individual-level change. Something that I’ve heard over and over the past couple days is we have lots of one-off innovation or entrepreneurial ideas. And what I’m starting to hear in this room is ways in which those one-offs are connecting together to fill the whole picture, whether it’s Laurie’s or Kayla’s or Basmah’s or K.P.’s work. But also many of you who I’ve had the privilege to talk with over the last couple of days, you’re thinking about expanding from a single problem or a single solution set into thinking about how you can change the fabric and the foundation of our work.‌

So Howie, I can’t thank you enough for inviting me to fill the very large shoes of Harlan. Yes, he does wear a larger shoe size than me. But Harlan, if you are listening, we wish you safe travels, but also invite me back to fill in for you when you travel next time. This has been really fun.‌

Howard Forman: He worries about that.‌

Megan Ranney: I’ll bet he does. Harlan, I won’t take your place, but I can try to sub. But thanks also to all of our guests, attendees, and the organizers of this absolutely amazing summit, especially Josh Geballe, who is one of the things, he and Yale Ventures are one of the things that attracted me to this institution two and a half years ago. A huge thanks to Josh.‌

Howard Forman: And please join us next week when we return to our usual podcast, Health & Veritas with amazing guests and updates from the world of health, public health, healthcare, and medicine. Thanks to our amazing producer, Miranda Shafer, our research assistants, Tobias Liu, who’s with us in the back this week, and Gloria Beck, and to the staff at SOM and the summit for making this possible.‌

Megan Ranney: Thanks to all of you. See you soon, Howie. Maybe you’ll have me back if I didn’t bomb this.‌

Howard Forman: We will. Thank you sincerely, Megan, for being a beacon of light and truth and for stepping in this week and stepping up always. So thank you.‌

Megan Ranney: Right back at you. Thanks.‌