Dr. Rebecca Rose Payne 0:00

Hi everyone. Today we have a very special guest, Arup Roy Berman. He is a physician, entrepreneur, and healthcare innovator dedicated to helping healthcare teams deliver safe, safer, more consistent care. Drawing on decades of experience in pediatric critical care and health system leadership, he founded Elemento Health to bridge the gap between clinical knowledge and frontline practice, empowering clinicians the tools that they need to improve patient outcomes at scale. Thank you so much for coming on.

Arup Roy- Burman 0:30

Absolutely, my pleasure.

Dr. Rebecca Rose Payne 0:32

It is so great to have you. So to start, can you just tell us actually a little bit about yourself and your company and what that company does, just for everyone listening?

Arup Roy- Burman 0:45

Yeah, so um I'm a physician entrepreneur. I'm former medical director of the pediatric ICU at UCSF Bennyoff Children's Hospital in San Francisco. And there is a director of the ICU, together with my nursing leadership and my tech colleagues, we were like, how do we keep our staff on the same page with constantly changing information in the context of constantly changing staff?

Dr. Rebecca Rose Payne 1:11

Yeah.

Arup Roy- Burman 1:12

And we asked ourselves, why is it in our consumer lives that devices such as this are connecting us to what we need when we need it to help us to be able to be our better selves? And thinking that in empowering us in our consumer workspace or consumer life, how could we do the same in healthcare where the risks and the stakes are so much higher? And so that's what LMN is about is about taking that information that's essential to our operations in healthcare. How we do X, Y, or Z, how we change that dressing, how we access this port, how we set up this equipment specific to my family, my ICU or my OR, my ED with my people and my resources, how do I do that the right way in the moment when I need to do it? And so we take that information and we transform it into bite-sized multimedia job aids, pictures, videos, interactive decision guides that you can pull in the moment when you need it in the flow of work. And important to us is we also understand that every hospital out there, we're all tackling variations of the same problem. Yet we're all stuck within our own four walls.

Dr. Rebecca Rose Payne 2:34

Yeah.

Arup Roy- Burman 2:35

And have a hard time learning from each other. And as, you know, other, as social media has shown us, you know, whether it's in YouTube or Facebook or Instagram, people crave hearing from their peers and learning from their peers. So when we create these little job aids, hospitals are able to put it up on the cloud. Other managers are able to see, ooh, I like how they're tackling that problem. Let me grab that, let me tweak it to my needs and deploy it to my people. So this unlocks knowledge between hospitals and accelerates the spread of information and best practices. And that gets to our mission. It creates an arising tide to lift all boats, to help even those who are the most resource-constrained deliver better care to their patients.

Dr. Rebecca Rose Payne 3:23

That's wonderful. So when did you first kind of notice this problem and decide that you needed to do something about it?

Arup Roy- Burman 3:32

Well, I guess I subconsciously first noted this problem when as a young child I lost my sister to a medical error in the hospital. And that was subconscious inspiration to go into medicine, to go into pediatrics in the ICU and care for children like her. But you know, so many years later, when I started as an adult and working in this field, I had the privilege of working in some of the top-rated hospitals in the United States, working with really excellent teams. But in every one of these hospitals, I continued to see patients dying from preventable mistakes. Those were mistakes made by hardworking, well-intentioned, well-educated staff who simply couldn't pull that information when they needed it. And we would sit in the hospitals on these system-wide, what they call RCA committees, root cause analysis committees, looking at these events, and invariably, as an organization, we knew the right thing to do. But our people had forgotten or didn't know it.

Dr. Rebecca Rose Payne 4:37

Yeah.

Arup Roy- Burman 4:38

And so we would fall back on these archaic, okay, let me go back and teach people about this and cross our fingers that it doesn't happen again. And that was like, there's got to be a better way to do this. And that all dovetailed with, you know, why we created Elemento. First and foremost, it was about how can we as clinicians, when we go into healthcare to help people, you know, to make them better, the last thing we want to do is hurt them. How can we empower our peers so that they can deliver that safer care and they can do the right thing?

Dr. Rebecca Rose Payne 5:10

Yeah. And that that makes so much sense. As somebody who's worked in healthcare myself, I can attest to in the moment, like when it's an emergency, you can't always pull what you wish you could pull. You're kind of, I mean, panic sets in and you're just like, what can I do?

Arup Roy- Burman 5:26

Yeah, one of my favorite stories from one of our clients, so they're a level two emergency room, trauma emergency room. And the manager told me, he said, he goes, Yeah, but I came in this morning and one of my new techs, she's the one who works on night shift, she was sitting outside my office, and I was thinking, like, oh gosh, what went wrong? You know, why is she here? And he got in, opened the door, met with her, and she said, You know, Brian, I just gotta tell you, last night a trauma came in, and the trauma surgeon was like, This patient's bleeding out. We need the rapid infuser. Go get it, turn it on. And she said, I realized he was looking at me. I hadn't done this since orientation, but I was panicked, but I pulled it up here, I saw it, I pulled it out, I did it, and it worked. And she goes, you know, that was like so gratifying that I could actually do it. And as the manager told me, he goes, This is these kind of episodes, you know, you're a psychologist, you feel they kind of make or break you. You put in a stressful situation, and if you can overcome that, it's like, hey, I can do this, I want to stay here. But if you don't have the resources there and you can't, it's so disheartening. And it's it's the type of thing that when people feel that I can't do my job right, what do they do? They leave.

Dr. Rebecca Rose Payne 6:48

Yeah. I mean, and especially something you like haven't done before. I think that particularly if it's like a teaching hospital, things that you've been taught and know how to do, you still are like, oh, I don't know how to do that like for real. I don't want to do that theoretically.

Arup Roy- Burman 7:03

Exactly. Yeah. It's like, you know, it's kind of crazy in medicine. You know, we still have that adage of see one, do one, teach one. But the reality is, is that it shouldn't be that I've seen one and now I'm ready to do one and turn around and teach it. We benefit from a technology now that allows us to see it a million times in the palm of our hand as much as we want before we go to do it. We think about uh one of my favorite analogies is to look at cooking. Once um those recipes started coming online in the videos, my cooking skills they went way up because it was there when I needed it and I could see it as many times as I wanted.

Dr. Rebecca Rose Payne 7:41

Yeah, exactly. I mean, and I've had friends that have gone to medical school describing like in an emergency, pulling up YouTube and just like frantically searching for like how to do this thing and then watching it. And I mean, it just makes so much sense that you would have something that's more systemic than just whatever YouTube throws up at you and like with the ads coming in as you're trying to like save somebody's life.

Arup Roy- Burman 8:03

And exactly. And you know, on YouTube, there is some good content on there, but there's a lot of other noise. And what was really important for us is that we could give people that YouTube or Google-like experience, but with information that was already curated and approved by the subject matter experts in their own organizations. So anything that you do find and you pull up is truly the right way to do it in my organization.

Dr. Rebecca Rose Payne 8:31

Yeah, that makes so much sense. I know both from experience and from hearsay that it can be really frustrating and slow to change things in healthcare. Have you ever reached a point where you questioned whether you want it to keep going or like, is this worth it? How nobody's listening, nobody wants to change anything ever?

Arup Roy- Burman 8:56

So I remember kind of midway through my career before I started this company, I was speaking with the CEO of a major academic health system. And he was asking me, well, what are my goals? You know, what do I want to be able to achieve? And is it about trying to lead a health system or is it about truly trying to change how we deliver care, giving people this information, driving this technology forward? And I told him it was the latter. You know, I wanted to make this bigger impact. This was something that was too important not to scale. And his advice to me was get out of the institution, because he said, we are only going to slow you down. There's so much that we say about academics and so much that we say about, you know, these big, you know, um cutting-edge health systems. But there is so much bureaucracy and there's so many competing interests that it's hard to get new ideas to move. He said, you know, take it out of here, build it out in smaller places, and then bring it back. So I do feel that healthcare is so often, all too often stuck in the status quo.

Dr. Rebecca Rose Payne 10:06

Yeah.

Arup Roy- Burman 10:06

You know, when we look at how fast other industries move, we may be the slowest. Maybe uh legal would be a little bit slower than us. But there's really a need to move. Unfortunately, you know, when we think about healthcare itself, there's the adage of first do no harm. People don't want to disturb things. They don't want to cause mistakes. So instead, they mistakenly stick with the status quo and keep pushing on. That's what makes innovation in healthcare really hard.

Dr. Rebecca Rose Payne 10:35

And you're like, what is gonna keep me from getting sued?

Arup Roy- Burman 10:39

Yes, exactly. It's defensive medicine.

Dr. Rebecca Rose Payne 10:42

Yeah.

Arup Roy- Burman 10:43

Defensive medicine, or we see that, you know, when we look at educating frontline staff, many hospitals say, well, we already have education here, right? Yes, but the education that's there in the hospital was designed to satisfy legal and regulatory, to check the box that everybody's done, their HIPAA, their set uh, you know, the sexual harassment and all their various little bits of training and medical training, that you've done it. But that doesn't mean that you're really competent and can do it. You need to have some type of support for you at your fingertips.

Dr. Rebecca Rose Payne 11:15

Yeah.

Arup Roy- Burman 11:16

That can assure that.

Dr. Rebecca Rose Payne 11:17

Absolutely. So is that what you did? You left the big hospital and went and implemented it.

Arup Roy- Burman 11:24

Yeah. So we left the big hospital and then created out a prototype, brought it back into smaller hospitals, showed the value there, did try to, you know, keep things going in the big hospital, which was, I don't know if really the effort was was worth it. Rather that, you know, interesting thing to have seen was that I had assumed early on that when you started sharing this type of information, the information of the best practices. So I had assumed that when we would start a network where we could share best practices, that it would be the large institutions with all the resources whose information everybody wanted. But what we found is that the large institutions were full of bloat. They wanted to give all this information of the who, what, why, where, and when, that the frontline staff were saying, just give me what I need to know. And we found that the smaller hospitals and the mid-sized hospitals, they were much more pragmatic. They were about, we really need to get quickly to the point so our people can get their job done. And as we started doing more of this knowledge sharing, the bigger hospitals started to realize hey, the smaller hospitals are a lot more clear about how they get their message across. I need to learn from them. So that was a wonderful thing to see as we started to doing knowledge sharing. It wasn't just sharing knowledge, but it was sharing how we actually deliver the knowledge and seeing how everybody was learning from each other.

Dr. Rebecca Rose Payne 13:00

That makes a lot of sense. I mean, because I it's counterintuitive. Like you think you're gonna get the best care and the quickest care and stuff from the biggest, most well-regarded hospital, but I think there ends up being a lot of ego involved and I mean the more the bigger it is, the more bureaucracy there is to get absolutely. So what has the experience been like seeing, I think, when you're working in smaller, more underserved hospitals versus larger, like well very like first class hospitals. Have you noticed a difference in how the information is utilized and the information that there is being utilized?

Arup Roy- Burman 13:44

So we like to say that when we are delivering information, we're doing so as a multiplier. We're a force multiplier of the leaders in the organization. And so if you have zero leaders who are able to advance clinical care and operation, we can't help you there. You need to have something. And so for the very most resource-constrained hospitals, it's hard to do anything new because they're just constantly putting out fires. But once you get a little bit above that, by leveraging shared knowledge from the bigger systems or from the greater community, we're able to help those smaller systems move forward really quickly. We're seeing them ending up with, since they're sharing knowledge, their training times for their new staff aren't made shorter because they're instead of having to create all the knowledge or the training themselves de novo, they're able to leverage what other people are doing. So that's been a lot of help there in cutting down time. Cutting down time by augmenting with knowledge from the community. For the bigger health systems who have a lot of infrastructure in place and a lot of people, then it's Elementos giving a way to be able to more elegantly deliver the information they already have, to be able to chop that down and deliver it in bite-sized chunks, and to actually deliver that information with less people than they have. We're driving efficiency either way, is driving efficiency either through giving you a modality through which to deliver information quickly and easily, or to be able to give you the strength of a much larger community of hospitals to support you. You're not alone, so that you can deliver the information you need to do.

Dr. Rebecca Rose Payne 15:33

When you were kind of you said you part of what inspired you to go into medicine was your sister. Did you ever imagine that you would end up having like such a big impact on the medical field and how many lives you would end up saving?

Arup Roy- Burman 15:50

Yeah. No. I I didn't. And you know, it is not this is an inspiration from one little girl who I felt in many ways otherwise would have just been forgotten as a statistic. And, you know, what she has inspired has helped so many. But that is the inspiration from her. But the actual saving of those lives is from thousands of staff. You know, what's so exciting to me is we're giving a tool, we're giving support so that thousands of these other caregivers can be their best selves, so that they can do what they are here to do, what they want to do. And so that's like, yes, you can think of Shu as a spark to something, and maybe I help to fan that a bit, but the real work that's happening and the impact that's happening are by those people who are actually touching those patients. We're here to support their success.

Dr. Rebecca Rose Payne 16:50

Yeah. Well, we're almost out of time, but I guess I have like two more questions. One is was there a moment in your career that changed the way that you think about leadership?

Arup Roy- Burman 17:01

Yeah. One moment was so I had come, you know, raised in academia. And academia is very much what we call like an old power model. Everything is top-down, very hierarchical. And you listen to those above and you tell to those below. And when I started this company, we were big in trying to make sure that we had a diversity of opinions in there and uh crossing across different age groups in our company. And one new college grad, she was asking me how we were solving a certain problem about how our users should search for information. And she said, Well, why do you always do it that way? Why don't you do it like this? And I was like, they just don't do it that way in healthcare. And she was like, Why not? You know, it's easy, and this is what we're doing in our consumer lives, right? And I was very resistant to her idea. But six months later, I saw the light. I embraced it, and we incorporated that type of search into our technology, and it's been really successful. But it was one that you started to teach me that in academia, it was all about learning from those above and trying to repeat what they're doing. But truly innovation is about listening to everyone around you, around you, above and below, and not just in your silo or in your vertical, but across other verticals and other industries too. Those lines are all blurring. And the more that we are open to listening and learning from each other, the more successful we can all become.

Dr. Rebecca Rose Payne 18:31

Wow, that is so true. And I've never thought about it that way, but that is exactly right. Like in academia, it's one person or like one, you're just getting one source of information and trying to replicate. So yeah, that that makes a ton of sense. Okay, so my last question is if someone in 20 years from now were to describe the impact that you had on healthcare, what would you hope that they would say?

Arup Roy- Burman 18:56

Oh, I would hope to say that this little company inspired a movement through which people were able to share operationalized best practices in a manner that was able to democratize access to best practices all across the globe and to be able to help every caregiver anywhere with one of these devices deliver the best care possible to every life they touch. I want to see a world where, you know, yes, we start in the U.S., we've had a little bit that we've done abroad, but I firmly believe that those ideas of innovation, especially on how to do more with less, come in places that have the most constrained resources. And I would love to see a world where solutions that are developed for delivering care in Central America are being shared with those in Central Africa and learning with those in Central Asia. And that, you know, there is so much innovation, so many solutions that are developed in these isolated places. If we can start to unlock that, we'll find we are more alike than we are different. We can support us all so we can all be our better selves.

Dr. Rebecca Rose Payne 20:18

Yeah. That makes a lot of sense. And like the most brilliant doctors that are living in rural communities and are never gonna necessarily pitch their ideas to a medical board. This gives them a way to kind of share the well.

Arup Roy- Burman 20:34

Well, there's there's the brilliant doctor, but there's so many of the brilliant community healthcare workers or the community, brilliant nurses who have very little equipment or little little resources. And with our limited resources, this is how we manage this wound. Those types of solutions were this is how we how we're best able to deliver nutrition to our patients. It could be anything like that. But those, there's ways that we think about it here in the US that are limited because we are blessed with so many resources. In places with less, they have to do more with less. They'll find solutions. And those solutions, while they may not be what we're going to do in this country, for another place that's resource constrained, it may make a lot of sense. And how do we start to drive that type of sharing? That would be awesome.

Dr. Rebecca Rose Payne 21:23

Yeah, I mean, that would be amazing. Wow. Well, thank you again so much for coming on. This was very interesting. And I'm really excited to see like what else happens with this company. Because I think it really will continue to make a huge impact on healthcare around the world.

Arup Roy- Burman 21:42

Well, I looking forward to that. And just uh give a little background on our name, the elemental. Yes. Comes from our core elements. It is to elevate quality by empowering the front lines with knowledge and engaging us as one interprofessional team.

Dr. Rebecca Rose Payne 21:59

I like it.

Arup Roy- Burman 22:00

So let's make that happen.

Dr. Rebecca Rose Payne 22:03

Perfect.