Nutrible - Artificially Intelligent Social Workers

What makes your solution innovative?

Our platform represents a significant improvement in the way families engage with and access healthcare and social resources, bringing innovation to this space in several key ways:

Success Rates: In a 2023 study conducted by CMS, which involved more than 160,633 patients, it was discovered that "navigation [and referrals] did not increase beneficiaries' connection to community services or facilitate the resolution of Health-Related Social Needs." While there have been programs aimed at simplifying the process of sending the same referrals between organizations, CMS's data reveals that these referrals have a success rate of less than 20%. However, AI Social Workers have the potential to enroll individuals into programs with a success rate of up to 100%, all while costing significantly less.

Catalysing Current Initiatives: Our innovative approach has the potential to catalyze broader positive impacts within the healthcare and social services space because all of our data is intended to be delivered back into current operational systems and not to replace them. 

Universal Common Application: One of our groundbreaking features is the introduction of what feels like a universal common application for social and health services nationwide. AI’s conversational question approach allows families to answer a single set of straightforward questions, streamlining the enrollment process for every government program they qualify for. This approach simplifies and standardizes a previously fragmented and complicated process, making it easier for families to access essential resources. On the backend, applications arrive to the various agencies in their current format, so agencies do not need to change their processes.

Empowering Patients: Traditionally, patients seeking community-based referrals rely on external sources such as community organizations, government agencies, or healthcare providers to connect them to necessary services. With AI Social Workers, we empower 100 million individuals to take control of their referrals. Patients can initiate and manage their referrals directly to organizations within their communities, enhancing their autonomy and ensuring their specific needs are addressed promptly.

Resource Efficiency: Many organizations serving low-income families struggle with limited resources and budgets, making it challenging to provide adequate support. Our AI Social Workers offer a solution that allows these organizations to support more families efficiently, without the need to hire additional staff. This innovation extends the reach of vital services and maximizes the impact of existing resources.

Addressing Healthcare Disparities: Historical systemic racism in healthcare has created mistrust among African American and Latino families, leading to delayed or avoided interactions with healthcare systems. Our AI Social Workers bridge this gap by providing support for the social services that matter most to these communities while integrating quality measures proven to enhance patient lives. By combining social determinants of health with quality healthcare, we address healthcare disparities head-on.

Overall, our platform has the potential to change the market by influencing the way healthcare and social services are accessed, delivered, and experienced. It represents a step towards a more equitable, efficient, and patient-centered system that benefits all members of our communities.

How does your solution address or plan to address UN Sustainable Development Goal 3 for Good Health and Well-Being?

Our solution directly addresses UN Sustainable Development Goal 3 for Good Health and Well-Being by focusing on two critical aspects: improving access to essential health services and addressing health disparities.

1. Improving Access to Essential Health Services: Our platform enhances access to vital healthcare services by simplifying the process of enrolling individuals into healthcare programs and services. Through AI Social Workers, we enable patients to easily access healthcare resources, schedule wellness visits, vaccinations, and undergo healthcare screenings. This approach ensures that individuals, especially those in underserved communities, can receive essential healthcare services promptly and without financial hardship.

2. Addressing Health Disparities: Health disparities, including those caused by environmental and commercial factors, are a significant concern in achieving the goal of "Health for All." Our platform is designed to address these disparities by providing a user-friendly interface that caters to diverse populations, including those with limited literacy skills. By offering culturally competent and multilingual interactions, we prioritize inclusivity and aim to bridge the gap in accessing healthcare resources.

Through our commitment to simplifying the enrollment process and making it accessible to all, we contribute to the overarching objective of achieving universal health coverage. We empower individuals, especially those in vulnerable populations, to access healthcare services without financial obstacles, aligning with the goal of ensuring that everyone can access quality health services.

Furthermore, our platform's focus on addressing social determinants of health, such as housing and food insecurity, aligns with the broader goal of improving people's overall well-being. By offering support for these critical social needs, we contribute to the creation of healthier communities and individuals.

In summary, our solution aligns with UN Sustainable Development Goal 3 by enhancing access to healthcare services, addressing health disparities, and focusing on the holistic well-being of individuals and communities. Through our innovative approach, we aim to catalyze positive impacts not only in healthcare but also in the broader space of social determinants of health. By providing a model for simplifying access to vital resources, we hope to inspire others to take decisive actions to ensure health equity for all.

Describe the AI components and underlying data that powers your solution.

Our solution is powered by a robust combination of AI components and meticulously curated data sources to ensure its effectiveness in connecting patients with essential resources. Here is a detailed breakdown of our AI and data components:

1. Novel Government Program Dataset: We have created a unique dataset that catalogs relevant federal, state, and county government programs specifically designed to benefit underserved patient populations. This dataset serves as a critical resource, providing details on high-impact programs that are instrumental in improving the well-being of our target demographic. Through our pilot programs, we have observed that this dataset results in an average of $400 in resources per patient. This data repository eliminates the need for healthcare professionals to manually search for programs, saving time and ensuring patients receive the assistance they need. Government programs typically undergo infrequent changes, and when updates occur, there is a considerable lead time, allowing us to keep our database current.

2. Community CauseIQ Database: For non-governmental referral sources, we leverage the CauseIQ database, configured with settings tailored to our patient population's needs. CauseIQ is a trusted source for nonprofit organization information, making it an invaluable resource for identifying relevant referral options. Our platform employs filters to prioritize larger organizations, which often have greater capacity to assist patients. Additionally, we offer the flexibility for our customers to add organizations of their choice, and our AI social workers adapt to navigate patients accordingly.

3. Novel Co-Curated Database: We work closely with our health system customers and community partners to incorporate their preferred referral partners and programs into our platform. By doing so, we ensure that each patient has access to the exact same resources they would if they consulted with one of the health system's employees. This collaboration allows us to align our solution with the specific needs and preferences of our partner health systems.

4. Novel Cultural Competence AWS Machine Learning and Natural Language Processing Tools: Our platform is built using AWS machine learning tools and conversational AI, utilizing AWS's natural language processing tools. This technology stack enables us to create a unique conversational AI experience for our users. What sets us apart is our culturally competent approach to natural language processing. Our diverse team, composed of individuals from African American, Latino, Asian, and other backgrounds, leverages their personal experiences in low-income communities to train the natural language processing tools. These tools will recognize colloquial verbiage and respond in a culturally sensitive manner. This approach enhances patient engagement and ensures that our platform is relatable for the communities that we serve.

In summary, our solution leverages a novel government program dataset, CauseIQ database, collaborative partnerships with health systems, and AWS machine learning and natural language processing tools to deliver a comprehensive and culturally competent AI-driven platform. Our commitment to continuously update and expand our data sources ensures that patients receive the most relevant and timely assistance, contributing to improved health outcomes and overall well-being.

How are you ensuring ethical and responsible use of AI in your work? How are you addressing or mitigating potential risks in your solution?

We are committed to ensuring the ethical and responsible use of AI in our work by implementing rigorous measures to address potential risks and concerns. Here's how we approach this important aspect of our solution:

Privacy and Data Security:

- Data Encryption: We prioritize data security by implementing robust encryption protocols to safeguard all patient information and interactions within our platform.

- Strict Access Controls: Access to sensitive patient data is restricted to authorized personnel only, and we enforce strict access controls to prevent unauthorized access.

- Compliance: We adhere to all relevant data privacy regulations, including HIPAA and GDPR, to ensure the protection of patient data.

Ethical Considerations:

- Cultural Competency: Our AI is only trained to interact with patients in a culturally competent manner that we have extensively vetted from individuals based on lived experience. We do this to ensure that we respect individual values, beliefs, and preferences. For communities that we have not completed a vetting process, we maintain basic communication to ensure that it does not communicate in an offensive manner.

- Bias Mitigation: We continuously monitor and address biases in our AI models to ensure fairness and equity in our recommendations and interactions. We have standardized eligibility criteria based on unbiased government requirements. These requirements are clear and our platform reads them directly. 

- Human Oversight: Our AI is complemented by human oversight to ensure ethical decision-making, and human experts are always available to intervene when necessary.

Policy Implications:

- Policy Compliance: We stay up-to-date with evolving healthcare policies and regulations to ensure our solution remains compliant and aligns with industry standards.

- Transparency: We maintain transparency in our operations, clearly communicating our processes and data handling practices to patients and stakeholders.

Risk Assessment:

- We conduct regular risk assessments to identify potential ethical, privacy, and security risks associated with our solution.

- We have implemented risk mitigation strategies and contingency plans to address these risks promptly and effectively.

Patient Consent and Control:

- We prioritize patient consent and control, ensuring that patients have full agency over their data and engagement with our platform.

- Patients can choose to opt in or out of specific programs and interactions based on their preferences.

User Education:

- We provide education and resources to patients, helping them understand how their data is used and emphasizing the benefits of engaging with our AI platform.

- We offer clear opt-out mechanisms for patients who wish to discontinue their interactions with our AI.

Continuous Monitoring and Improvement:

- We have established a robust monitoring system to track AI interactions and patient feedback, allowing us to continuously improve our solution.

- Any concerns or issues raised by patients or healthcare providers are promptly addressed, and necessary adjustments are made.

By taking a proactive and holistic approach to ethical and responsible AI usage, we aim to ensure that our solution not only delivers valuable assistance to patients but also maintains the highest standards of privacy, security, and ethical conduct. 

What are your impact goals for the next year and the next five years, and how will you achieve them?

Next Year's Impact Goals (2024):

1. Enroll Families into $5M in Resources: Our immediate goal for the next year is to enroll underserved families into $5M in resources across the United States, helping them access vital healthcare and social resources.

2. Achieve 90% Program Enrollment Success: We aim to achieve a 90% success rate in enrolling individuals into essential programs, ensuring that they receive the support they need.

Next Five Years Impact Goals (2028):

1. Enroll Families into $100B in Resources: Over the next five years, our primary objective is to extend our support into $50B in resources across the United States, effectively transforming their access to essential healthcare and social resources.

2. Enable Universal Access to Programs: We aspire to become a catalyst for change in the healthcare and social services landscape, with the goal of enabling universal access to programs and resources for eligible individuals.

3. Reduce Healthcare Disparities: By 2028, we aim to significantly reduce healthcare disparities among underserved populations, addressing both immediate social determinants of health (SDOH) and long-term health outcomes.

How We Will Achieve These Goals:

1. Scalability: We will scale our operations by adding all government and healthcare programs that are available in the United States. This will enable us to expand our partnerships with healthcare systems, community organizations, and government agencies. This growth will enable us to reach more individuals in need.

2. AI Enhancements: We will invest in continuous improvements to our AI technology, making it even more effective in engaging patients, enrolling them in programs, and providing culturally competent support.

3. Community Engagement: Building on our team's personal experiences and connections in underserved communities, we will strengthen our community engagement efforts. This includes collaborating with community leaders and organizations to raise awareness and ensure that our solution is accessible and culturally sensitive.

4. Data Enhancement: We will enrich our data sets by cataloging additional government programs, nonprofit organizations, and referral sources, ensuring that our platform remains comprehensive and up-to-date.

5. Policy Advocacy: We will actively engage in policy advocacy to promote streamlined enrollment processes and reduce barriers to accessing essential resources. By collaborating with policymakers, we aim to create a more equitable and efficient healthcare and social services system.

6. User Education: Educating patients about the benefits of our platform and how to use it effectively will remain a key focus. This will empower individuals to take control of their healthcare and well-being.

7. Continuous Monitoring: We will maintain a robust system for monitoring AI interactions, patient feedback, and program outcomes. This data-driven approach will guide our improvements and ensure that we meet our impact goals.

By executing these strategies and collaborating with various stakeholders, we are confident in our ability to achieve our impact goals and drive meaningful change in the lives of underserved individuals and communities. Our commitment to health equity and social well-being is unwavering, and we look forward to making a transformative impact over the coming years.

What type of organization is your solution team?

For-profit, including B-Corp or similar models

How many people work on your solution team?

Full Time - 5

Part Time - 7

How long have you been working on your solution?

5 years

What is your approach to incorporating diversity, equity, and inclusivity into your work?

This platform was built for us by us, and that ethos extends to every aspect of our approach, especially when it comes to diversity, equity, and inclusivity (DEI). Our commitment to DEI is ingrained in our mission, values, and daily operations. To ensure DEI remains at the forefront, we have required training and participation in community programs to ensure our team members are exposed to the various perspectives that our team members and patients share.

Diverse Leadership Team: Our leadership team reflects the communities we serve. We are proud of our diverse leadership, with members representing various racial, ethnic, and socioeconomic backgrounds. Our collective experiences include growing up in low-income households, navigating healthcare disparities, and personally understanding the challenges our target population face including drug abuse, the justice system, and foster system. 

Inclusive Decision-Making: Inclusivity is at the core of our decision-making processes. We actively seek input and perspectives from all team members, ensuring that diverse voices are heard and valued. This practice extends to our product development, where we consider the needs of underserved communities at every stage.

Ongoing Education: We are committed to continuous learning and education on DEI topics. Our team participates in regular training sessions, workshops, and discussions to deepen our understanding of the issues affecting the communities we serve. 

We also require all team members to become Community Health Workers which requires curriculum and experiences that include:

Effective communication with clients, families, and providers

• Ethical considerations for CHWs

• Communication and interpersonal skills

• Motivational interviewing

• Cultural competency in communication

• Health promotion and disease prevention

Common health problems in the community

• Risk factors and protective factors for disease

• Health promotion and disease prevention strategies

• Culturally appropriate health education

• Case management and referral

Assessing client needs

• Developing and implementing care plans

• Referring clients to appropriate resources

• Community organizing and advocacy

• Developing and implementing community health interventions

Volunteer and Community Engagement: We engage with community leaders, organizations, and advocates to understand the specific needs of our target population. By actively listening to their concerns and insights, we can tailor our platform to better serve these communities.

Equitable Access: Ensuring equitable access to our platform is a priority. We partner with healthcare systems and organizations to offer our services at no cost to underserved patients. This removes financial barriers and levels the playing field, allowing everyone to benefit from our solution.

Recruitment and Outreach: We actively recruit talent from diverse backgrounds and communities. Our goal is to build a team that reflects the diversity of the populations we serve. Additionally, we engage in outreach initiatives to foster relationships with organizations and communities that align with our mission.

In summary, diversity, equity, and inclusivity are not just buzzwords for us; they are fundamental principles guiding our work. We recognize that the path to health equity requires a deep commitment to DEI, and we are dedicated to driving meaningful change for underserved populations by addressing the root causes of disparities.

What is your operational model and plan?

Impact:

In our early pilot programs and with volunteer test families, we have achieved remarkable results

• Engaged over 2,000 patients.
• Provided an average of over $400 in resources per patient.
• Achieved an impressive 96% return rate.
• Supported patients with English as a second language, demonstrating our accessibility and inclusivity.

Team

• Kwamane Liddell, JD, MHA, BSN - Founder and everyone's favorite co-pilot. Kwamane is a nurse and healthcare lawyer who led Optum's Southern Orange County Market; he supports all workflows.
• Afnan Nadeem - A software engineer and AWS specialist who built Nutrible's AI Social Workers. Afnan was the first team member and has worked with Kwamane on this for more than two years.
• Yesenia Tinoco - With 10 years of experience managing Optum clinics throughout Orange County, Yesenia and Kwamane achieved 5 STAR quality measures and had the best patient experience score in California. Yesenia leads all patient care and health insurance contracting.
• John Wilson, MBA - Former Manager of Strategic Growth at Dell Technologies and a longtime friend of Kwamane. John leads sales and community engagement.
• An incredible supporting team of contractors and interns from Yale, Washington University, and the University of Miami to bring it all to life!

Resources

As we scale, we need two main things: community health workers and individuals with strong data skills.

• Community Health Workers: We recruit the best medical assistants, both in and out of the market, because they already understand patient experience, patient flow, and the various complex referral and insurance processes that our system engages. They are relatively easy to recruit because medical assistant work in doctor's offices can be challenging, and our 100% virtual company offers a more convenient option, especially in California where the commute alone is a significant benefit.
• Data Team: We have been extremely impressed by our interns, and as we continue to grow, we will expand our data team from our intern pools at Washington University, Yale, St. Louis University, and the University of Miami.

Our solution has demonstrated its ability to deliver impact effectively through a well-structured plan and tangible results.

What is your plan for becoming financially sustainable?

Since our launch on June 1st, 2023, we have generated over $300,000 in revenue, a clear indicator of our solution's value, and our proven business model and engagement strategy. 

Engagement Results

• We have contracted with Medicaid plans covering more than 180,000 patients, with plans to extend our reach to a million patients by early next year.

• We are currently in phase 2 of a significant pilot with Atrium Health, the fifth largest health system in the United States.

• Our engagement also extends to addressing health disparities through a partnership with recipients of the Center for Disease Control's Racial and Ethnic Approaches to Community Health (REACH) Grant, where we will deploy AI social workers to clinics in low-income communities throughout St. Louis for the next five years.

Three-Step Engagement Model:

1. Contracting - Our engagement model follows a straightforward "land and expand" strategy. Initially, we either contract directly with health plans as a billable community health worker provider or subcontract with health systems as a billable Care Management provider.

2. Referrals/Implementation - Physician detailing is a critical next step in our engagement process, where we establish contact with the largest referral partners in the area, targeting those with high readmission rates or significant Medicaid populations. Our process is the same as pharmaceutical sales where we take lunch or coffee to providers and educate them on these free resource for their patients. This process is easy and welcomed by provider organizations because this is a common way for them to get free food.

3. Evangelism - Our approach also includes "site-based reviews," where we provide detailed feedback to our referral partners, highlighting the value we have brought to their patients. This feedback includes the programs patients were enrolled in, the monetary value of these programs, and any qualitative feedback or comments from patients regarding their experiences. From our experience leading in the largest health system in the US, we know this sets us apart form all other vendors and is a natural and welcomed way to stay engaged with our referral partners.

Sustainability:

• Our model is designed for sustainability, as community health workers are covered in several states, including California, Indiana, Louisiana, Minnesota, North Dakota, Nevada, Oregon, Rhode Island, and South Dakota.

• Chronic Care Management is covered by every health plan nationwide, providing a solid foundation for the scalability and sustainability of our solution.

What are your current operating costs, and what are your projected operating costs for the next year? Please include human capital estimates.

• Current Expenses

  • Full-Time Staff - $230,000

  • Contractors and Interns - $60,000

  • Travel for Sales & Competitions - $60,000

  • Subscriptions, Legal, and Operations - $60,000

    • Total - $410,000

• 2024 Expenses

  • Full-Time Staff - $350,000

  • Contractors and Interns - $60,000

  • Travel for Sales & Competitions - $60,000

  • Subscriptions & Operations - $20,000

  • Legal - $50,000

  • Electronic Medical Record Integrations - $120,000 

    • Total - $660,000

2024 expenses will only be added if we are able to raise additional funding, otherwise expenses will remain flat.

Applicants can request and receive funding at a minimum of 50k and maximum of $100k. How much funding are you seeking to continue your work in 2024, and how did you select this number? What would you use this funding for? Funding is limited; please consider carefully the right amount to request.

We are seeking $100,000 in funding for our work in 2024, and we arrived at this amount through careful consideration of our impact goals and expansion plans. Here's how we determined the funding amount and how we plan to utilize it:

Impact Goals: Our primary goal for 2024 is to enroll families in $5 million worth of resources. On average, we enroll families in approximately $400 worth of resources per patient. To achieve this ambitious goal, we need to engage with approximately 12,500 patients throughout the year. The keys to our engagement are 

Current Contracts: We have already secured contracts with Medicaid plans that collectively cover over 180,000 patients. Additionally, we are in the process of contracting with more health plans, which could significantly increase our reach. With these contracts, we anticipate generating between $80 and $100 per patient, potentially resulting in over a million dollars in revenue.

Allocation of Funds: The requested $100,000 will be allocated in three primary ways:

1. Natural language processing (NLP) Culturally Competent Verbal - Our platform is already a game-changer because families can have conversations via text that help them enroll in life-changing programs. However, we aim to revolutionize the industry by enabling families to engage in verbal conversations, removing literacy barriers and increasing engagement. To achieve this, we need to train the platform to have culturally competent conversations and understand colloquialisms.

2. Growth: Health plans require human engagement with patients or patient applications to qualify for reimbursement. This reimbursement is typically three times the cost of the staff involved in the engagement. Therefore, a significant portion of the funding will be used to hire and retain the staff necessary to support over 12,000 patients. Our platform can contact up to 50,000 people in one day.

3. Data Sets: In states like Indiana, Louisiana, Minnesota, North Dakota, Nevada, Oregon, Rhode Island, and South Dakota, Medicaid plans reimburse for Community Health Worker services. We will use a portion of the funding to develop comprehensive data sets that will enable us to enroll patients in various state, federal, county, and community-based organizations, expanding our reach and impact.

Resource Allocation: Approximately 40% of the funding will be allocated to building the NLP Cultural Competent Voice training, 40% to support our current contracts that will help us engage 12,000 patients and provide billable services. The remaining 20% will be allocated to building data sets for our 2025 expansion into new markets.

In summary, we have carefully calculated the funding amount based on our ambitious impact goals, current contracts, and projected revenue generation. This funding will be instrumental in supporting our mission to improve access to vital healthcare and social resources for underserved communities while ensuring the sustainability and scalability of our platform.

The Cure Residency will provide winners with seed funding, mentorship, lab space, mentorship, educational programming, and networking opportunities. How do you imagine this opportunity will help support your work? Which aspects of the Cure Residency would you be most excited about?

The Cure Residency offers a comprehensive package of support, including seed funding, mentorship, lab space, educational programming, and networking opportunities. We believe that this opportunity will significantly contribute to supporting our work, and there are specific aspects of the Cure Residency that we are particularly excited about.

Mentorship: One of the aspects we are most enthusiastic about is the mentorship component. As we are experiencing rapid growth, we recognize the importance of guidance from experienced founders who have navigated similar challenges. Mentorship from successful entrepreneurs will provide valuable insights into scaling our operations, building a strong core team, refining our product, and expanding our customer base. Learning from the experiences and lessons of others can help us avoid common pitfalls and make informed decisions as we continue to grow.

Educational Programming: Additionally, we are eager to participate in the educational programming offered by the Cure Residency. Specifically, we are interested in learning about strategies for raising future rounds of funding. Understanding the intricacies of fundraising, investor relations, and financial planning is essential for our sustained growth and impact. Access to educational resources and workshops focused on these topics will empower us to make informed financial decisions and secure the necessary resources to further our mission.