Technology
Value-Based Oncology at Scale: Inside Thyme Care
In this episode, Vinita Agarwala and Jay Rugani engage with Thyme Care founders Robin Shaw, Bobby Green MD, and Brad D. Byse MD to explore the innovative approaches Thyme Care is implementing to enhan...
Value-Based Oncology at Scale: Inside Thyme Care
Technology •
0:00 / 0:00
Interactive Transcript
spk_0
One of your observations through your life working in cancer care is that the
spk_0
one frustration you still had was that the system is not designed for people
spk_0
with cancer. The early diagnosis journey which is do you have cancer is such a
spk_0
fearful vulnerable time in anyone's life and there's just a lot of areas where
spk_0
the system can break down for you. The mantra you always hear with
spk_0
engineer is like use AI to make yourself the best engineer and I think that is
spk_0
absolutely going to be true in medicine in general and then in oncology specific.
spk_0
We support 83,000 active literature to cancer patients today. We anticipate that
spk_0
to grow significantly in 2026 and it's just a testament to the need. Cancer
spk_0
care in the US costs over 200 billion per year. Almost two million Americans
spk_0
receive a new diagnosis annually. Yet for too many patients the journey still
spk_0
begins with silence. No one calls, no one explains, no one helps them take the
spk_0
next step. Today, Vinita Agarwala and Jay Rugani talk with time care
spk_0
founders and leaders, Robin Shaw, Bobby Green MD, and Brad D. Byse MD about how
spk_0
they're trying to do just that. From building a value based on college model that
spk_0
works with patients, providers and payers to deploy technology and AI in ways
spk_0
that extend, not replace the human touch.
spk_0
Welcome to the 16 Z pod pleasure to have you guys on here. And this is kind of
spk_0
special one, huh? We've known each other for a lot longer than most people know
spk_0
their investors. I always think back to karaoke in 2015 in New York when we were
spk_0
all at Flatiron and had no kids. What are your favorite moments? Just thinking
spk_0
back. I do remember in a sort of full circle story, like the first four months I
spk_0
was at Flatiron, I was trying to fear what the hell I like had done with my life
spk_0
and what I was doing, right? I like left practice and showed up at a small
spk_0
health tech startup in New York. And I spent a lot of time my first, I don't know,
spk_0
month or two months there with a very young early engineer building multiple
spk_0
myeloma data models. And it was actually quite cool because it was sort of my
spk_0
first example and understanding of like how much cool stuff could be done
spk_0
when you put clinicians and tech people together. And then in the full circle
spk_0
moment, I won't reveal who that is. But as you guys all know, that person in
spk_0
about three weeks is going to be joining a timecare for a super impactful role.
spk_0
So we're super excited about that too. Amazing.
spk_0
Amy and story reminds me of one of the things we focus on a lot of time care,
spk_0
which is that medical oncologists are great medical oncologists and often need
spk_0
support on internal medicine decisions. And so I'm glad that Bobby, you continue
spk_0
to help us demonstrate that. Well, Robin, I distinctly remember the early days
spk_0
of you putting the time care idea together. And I remember you saying that one
spk_0
of your observations through your life working in cancer care and certainly your
spk_0
experiences at Flatiron is that the one frustration you still had was that the
spk_0
system is not designed for people with cancer. Yeah. I'm curious for folks to
spk_0
understand what you meant by that and why that was the North star for you
spk_0
starting this company. Yeah, I've been working in oncology for 18 years now,
spk_0
but I actually really grew up in it. My father's a medical oncologist. And the way
spk_0
he practiced medicine to me is just very inspiring, which is he felt like the
spk_0
patient in front of him was the most important thing in all the records in the
spk_0
background for later. And growing up, a lot of his patients would actually come
spk_0
over to our house and I would meet them and their families. And you just sort of
spk_0
see that connection that a cancer patient gets with their oncologist fast forward
spk_0
to having that be my professional career. I just get phone calls from people all
spk_0
across the country still to the state. And the system fails people when they
spk_0
can't get someone to actually truly empathize with what's going on. And that
spk_0
starts with the early diagnosis journey, which is do you have cancer? And it is
spk_0
such a fearful vulnerable time in anyone's life. And there's just a lot of
spk_0
areas where the system can break down for you, meaning there are results out
spk_0
there. But no one's calling you to give you those results to tell you what's
spk_0
going on. So what was the impetus to starting time care was as a single case
spk_0
at the end of 2019 where a friend's mother was told she may have paid
spk_0
credit cancer and the academic institution was going to see her said they'll
spk_0
see her in five weeks. And as all of us know on the call here, like that's just
spk_0
not acceptable. And when I heard that in that instance, I called my father, he
spk_0
saw my friend's mother got her on treatment and got all her testing and
spk_0
scanning done within 72 hours. And she ended up living a good life after that. I
spk_0
called Bobby in a bunch of former flat iron folks. And this is the exciting
spk_0
story about time care is I probably called 10 or 12 people, the two of you,
spk_0
Jay and Javier included, and said, Hey, like we've got to solve for this
spk_0
problem. And everybody jumped in. I think the story is probably well documented.
spk_0
But when we started time care, I think there was a total of eight to 10 former
spk_0
flat iron colleagues, whether investors, board members, or amongst the
spk_0
management team. And every single one of them are still here. But we think we're
spk_0
the type of the iceberg in regards to just sort of changing the experience
spk_0
for cancer patients throughout the country. And same more about the three of
spk_0
you, you all bring really different lenses and expertise across clinical,
spk_0
go to market, operational, financial, how did your tripod sort of shape the
spk_0
way you designed a time care is model? And what did you bring from your prior
spk_0
environments, Brad, you're at CMMI Robin. You started one oncology between
spk_0
flat iron and time care. Bobby, you were at both Flat Iron and Foundation
spk_0
medicine. Like, what do you want to do differently at time care?
spk_0
I think when we started time care, one of the core things that I knew was
spk_0
important is I wanted to build and solve a problem with people that I not only
spk_0
deeply cared about, but I knew we're deeply connected to the mission.
spk_0
And so Nate Brown, Rob Rocky, Scott Boy, Ashley Patton,
spk_0
Monica Allen, Berg, just a bunch of people that we worked with that all at Flat
spk_0
Iron had that same mission of impacting the cancer journey. And so when I
spk_0
called Bobby, it was very simple. But when we met Brad, we knew like from
spk_0
day one that he was one of us. And so although he didn't work at Flat
spk_0
Iron, he is no different internally or than the rest of us that have been
spk_0
doing this for 10 years together.
spk_0
I'll be for everyone to understand for someone newly diagnosed with cancer.
spk_0
What does the journey look like today? If you map out the full arc from diagnosis
spk_0
to treatment, to survivorship, to palliative care, where is the system most
spk_0
likely to fail people and help us understand why time care needs to exist?
spk_0
Well, I'll share an anecdote that happened to me, I don't know, two weeks ago,
spk_0
or three weeks ago. This is outside the time care ecosystem. But I think
spk_0
it's a great example of friend's sister.
spk_0
Abnormal mammogram gets a biopsy done on a Friday calls me.
spk_0
We go look in the portal on Monday. There's a breast cancer diagnosis in the portal.
spk_0
I walk through with her what it means. You know, it's breast cancer, if there are
spk_0
early stage breast cancer, you are probably going to be fine, right? So like
spk_0
a leave a lot of the concern. Set her up through a connection with an
spk_0
oncologist surgeon radiation oncologist gets the appointments to see all them.
spk_0
So the biopsy was on a Friday. Now we're at the next Friday.
spk_0
And it occurs to me, I say to her, did you ever get a notification from the place that
spk_0
actually did your biopsy that you have breast cancer? And the answer was nope.
spk_0
And she ended up getting it later that afternoon a week later. So imagine,
spk_0
and this happens to people all the time. And this is a very well connected,
spk_0
smart person looking in the portal and seeing a breast cancer diagnosis and not
spk_0
having an oncologist that you happen to know to have the conversation with.
spk_0
And so those types of things break down not once in a while, but consistently across the
spk_0
cancer journey, right? So from the time that you get diagnosed to the time that you are getting
spk_0
put on chemotherapy and maybe your oncologist did a great job of explaining the information,
spk_0
but you forgot to bring a friend or a caregiver with you to actually take notes or you don't have
spk_0
technology to help you take notes during the visit. So you actually don't remember what the
spk_0
side effects of your chemotherapy are going to be or you're confused about what does it mean that
spk_0
my oncologist told me I was curable or not curable. And then getting treatment, not understanding the
spk_0
side effects, not knowing when to call your doctor, calling your doctor and not being able to get
spk_0
through. I mean, Jay, we could spend an hour here going through this, but it is at every step
spk_0
where things break down and it breaks down at the best health systems at the best oncology practices.
spk_0
It's not a people problem. It's not oncologists are bad. It's a systematic problem that we don't
spk_0
have the system is not set up to adequately resource all the things that people need to prevent
spk_0
these things from happening. So cancer is like this huge medical problem that everybody knows about
spk_0
has experienced in some way through a friend or a family member. We spend like $250 billion on cancer
spk_0
care just in America alone. We've had a moonshot. As a country, we've really tried to address cancer
spk_0
care and figure out how to make that journey. You just described better. But how come no major tech
spk_0
company exists yet that has taken on the job of serving cancer patients with technology? How come
spk_0
I think so much of it is that the way to set that up and the way to make that sustainable business
spk_0
requires not just technology, but requires an understanding of the healthcare ecosystem and
spk_0
the key thing that we have done at timecare is create a care delivery model, a technology platform
spk_0
that supports members during their cancer care journey. But pair that with a value-based
spk_0
care set of relationships with payers with risk-bearing provider groups that actually creates the
spk_0
incentives and creates the foundation to actually support that. I think it's very easy or but I
spk_0
think it's very easy to think that you can just go build a tech company that is going to solve that.
spk_0
But unless you are addressing some of the underlying incentive issues and creating structures that
spk_0
solve that, you cannot make that a sustainable business. And so our whole thesis at timecare is that
spk_0
we are going to create a new incentive system through our value-based care contracts with our
spk_0
payer partners, with our risk-bearing primary care partners, with our oncology practices that we
spk_0
partner with to effectively flip a lot of the existing incentives that exist on their head.
spk_0
And then all of that supports the development and the sustainability of the technology platform
spk_0
that we've built. I think a lot of people come to the problem say, oh, let's just throw technology
spk_0
at it. You can do that, but you're not going to change those underlying incentives without the payer
spk_0
site. Yeah, and so we've been partners with you on this journey since 2021 and we now
spk_0
star investment in timecare. We said, cancer care will be 10x better thanks to companies like time
spk_0
care. And we thought that would be true, especially because of what you just said that the incentives,
spk_0
the technology, the public policy and reimbursement policy were finally starting to align with one
spk_0
another to create this 10x torpedo effect. And has that played out in real life? We'll get to
spk_0
your series D announcement shortly here. But has that played out in real life? Like did those forces
spk_0
combine in the ways you expected or what was something that was super unexpected?
spk_0
I would say when we announced our series C or A, round with you guys in 2021,
spk_0
we anticipated this 10x growth that we talked about. I will tell you the one thing that we
spk_0
didn't anticipate is the pace of scale. When we announced that with you guys, we were supporting
spk_0
about 1,000 patients across the country, which was so rewarding and amazing for us. We support 83,000
spk_0
active literature to cancer patients today. We anticipate that to grow significantly in 2026.
spk_0
And it's just a testament to the need. You mentioned the system. And I think as timecare has gotten
spk_0
more traction and we'll talk about our series D here in a second. The system is recognizing that
spk_0
a timecare or something like timecare is needed and required for the people in the US who are
spk_0
insured by the major insurance plans. Because those breakdowns in the system not only create a
spk_0
horrible experience for the patient, but ultimately increase the cost for the patient, the plan,
spk_0
and don't have a great experience or outcome for the provider as well. So we are seeing that play out,
spk_0
but a lot faster than we anticipated when we started the company and when we guys early invested.
spk_0
It is crazy, right? Robin, I remember we were standing around a table when we had our first
spk_0
care partner call with a patient, right? And now you think about all the interactions that we've had since
spk_0
in. I think I saw that over the last quarter, I believe we've done 14,000 proactive outreach is to
spk_0
members on structured surveys after their therapy. And like you said, I think we used to
spk_0
follow each one of those individually. And just the scale of our care team impact, we have
spk_0
I think well over 450 care professionals at our team now that are supporting cancer members in
spk_0
one way or another, it's been super cool to see, especially 2025 has been a crazy year for us and
spk_0
has been a amazing rallying cry for our company to figure out how to take all the things that we
spk_0
showed worked in 2023, 2024 and actually replicate that and even do it better, but at a much
spk_0
larger scale. And what Brad's referring to proactive outreach, right? As an example, like these are
spk_0
EPRO's electronic patient reported outcomes, it's something that there's a ton of literature that
spk_0
these things work and are good for patients and most people don't get them. And so the idea that we're
spk_0
able to sort of deliver these things at scale, along with a bunch of other things that patients
spk_0
usually aren't getting is just super exciting. I love that memory of standing around a table for the
spk_0
first care partner call, most tech companies stand around a table and go live and ship a
spk_0
software product. And I love just remembering that our product is actually clinical care.
spk_0
And at the beginning, that's what we perfected and crafted and wanted to make just absolutely
spk_0
perfect that when we were patient, it's got to be perfect. Yeah, that care partner is still a time
spk_0
caring leader. We have a picture her name is Teresa with a picture of all of us hovering over her
spk_0
as she made that first phone call. Over the last four years, it's been amazing to see the scale
spk_0
of impact you've had on so many so many people living with cancer. Four years later, you're announcing
spk_0
a series D with five billion under management, national partnerships, real validated savings,
spk_0
and you're back not only by VCs, but by strategic investors that represent various different
spk_0
parts of our healthcare system, CVS, Humana, Texas oncology, Memorial Hermann, JP Morgan's
spk_0
Morgan Health. Why is it so significant that your backers and partners represent the whole oncology
spk_0
ecosystem? Yeah, when we think about this fundraise and the impact that it'll have, the most exciting
spk_0
thing about it is when we talked about it earlier in the conversation, what was so exciting about
spk_0
the launch and our story on time care, which was the people that were so connected to our mission
spk_0
and people that we enjoyed working with. And all of the people that are participating in this fundraise
spk_0
are assigned true value to what we are doing for this population, not only because they see it as
spk_0
a client or a partner, but they care as much as we do. When we see that participation, we also see
spk_0
that all the way through in our partnership meetings with them. In our QBRs, we see the passion
spk_0
that their teams have in making sure that we are collectively successful to deliver more value
spk_0
to their patients and their members. And this fundraise represents all types of clients, partners
spk_0
that support the cancer journey. And we feel like this is a true testament to proving out that this
spk_0
model, this partnership, makes sense for cancer patients across the ecosystem.
spk_0
So you just talked about cancer cares, you know, complex, the patient journey is complex.
spk_0
There's a lot of people involved. What exactly does time care do?
spk_0
So we are a value-based care enabler. We go to health plans or any entities that take
spk_0
risk on the spend of a population. Okay, so like my insurance company, my health insurance company.
spk_0
Your health insurance company. And we go and we talk to them about the unmet needs in a cancer
spk_0
population that are bad for the patient experience, along with which they are well aware of,
spk_0
the rising total cost of care that's due to a variety of factors, including people
spk_0
ending up in the hospital when they don't need to from complications for their treatment
spk_0
and the increase of spend from drugs. And we go with them with a value prop that is really
spk_0
focused on two areas. The first is we're going to deploy our virtual cancer navigation platform
spk_0
across their entire population, irrespective of who they're oncologist is. And that's all focused
spk_0
on filling in the gaps in care that happen. It is very much about how do we improve the patient
spk_0
experience and how do we do things for patients that are going to keep them out of the hospital,
spk_0
keep them out of the ED, make sure that they get care at the end of life that is aligned with
spk_0
their goals, values and preferences. That's good for patients that also reduces the total
spk_0
cost of care. And then at the same time, and again, I think both from Brad and I both as clinicians,
spk_0
Robin with his background as well, very much acknowledging that it's the oncologists who
spk_0
are taking care of the patients, right? And partnering with oncologists to not only make our
spk_0
navigation and the interventions that we're doing better, but also to work with them and set up
spk_0
value-based incentive models that can actually bend the cost curve on drug therapy is another key
spk_0
component model. And the underlying finances of all of this are that we are taking some degree of
spk_0
total cost of care risk on that population, which enables us to do all of these things.
spk_0
So you're coming into Edna and you're delivering this combo win where you're saying,
spk_0
hey, Edna, you manage the care for Venita. You pay for all of her health care.
spk_0
If she gets diagnosed with cancer, I'm going to both make her experience dramatically better.
spk_0
She's going to have a better cancer patient experience. She's going to get better cancer
spk_0
care. She's going to get more timely care. She's going to be happier with her care.
spk_0
And by the way, Edna, I'm going to save you money while I do that. And that's kind of the combo
spk_0
wins that up that you're describing. And you're not coming in to be my oncologist,
spk_0
importantly, because you guys are saying, hey, you know, Venita lives in a place where they're
spk_0
a great oncologist and radiation oncologist and surgical oncologist. And we're not trying to
spk_0
recreate that infrastructure. It exists, but it doesn't show up in all the right ways to take care
spk_0
of Venita when she needs it and do it in the most efficient way for our health care system.
spk_0
Do I get that right? It's bought on to the side. And I think the other key to remember is the sort
spk_0
of the environment that we are in from a payer perspective, right? And if you are, you know,
spk_0
your health insurance carrier or any of the larger, large health insurance carriers right now,
spk_0
they're experiencing both overall increases in total cost of care.
spk_0
Oncology is, if not the largest, but one of the very largest drivers of that increase,
spk_0
they are at the same time. I think there is increasing scrutiny on a lot of the traditional
spk_0
cost control methods that insurance companies put in place prior authorization
spk_0
that type of work. And they are looking for solutions that can both be
spk_0
member-friendly that are supporting their members through their care, while at the same time trying
spk_0
to adjust this, frankly, this cost crisis that they have, particularly in specialty areas.
spk_0
If you were sort of rewind the clock 10 years ago, I think all of the focus in value-based care
spk_0
was very much on primary care. I'm a primary care doc. I believe that to be fundamentally
spk_0
important and how primary care should be the quarterback of care and how we can, if you do value-based
spk_0
primary care, the primary care doc is going to make sure that happens throughout the patient's
spk_0
entire care journey. I think that remains true in most cases, but there are disease areas. I'm
spk_0
going to go to their oncologist. I don't know what's going on in their day-to-day treatment. I
spk_0
don't know the names of half the drugs the patient is on. It really requires a dedicated solution
spk_0
in the oncology space. And I think payers are realizing that they can't do purely primary care-based
spk_0
models and believe that that is going to drive the savings and the improved member experience
spk_0
that they are looking for. And so I think you're seeing this big boom in specialty-focused value-based
spk_0
over the past three to five years that I think will continue growing as payers are looking for
spk_0
solutions that are both better for members and are going to address that cost-graces.
spk_0
So given the problem that we're talking about with cancer care today, and given the fact that
spk_0
there are almost two million people diagnosed with cancer in the United States each year,
spk_0
how do you balance building a care model that feels personalized and tailored to the unique needs
spk_0
of that individual patient while building technology that scales the scope of your offering.
spk_0
So it's available to everyone who needs it.
spk_0
Yeah, I think, you know, Jay, it starts with. And I think that this has always been true of the
spk_0
way we've viewed technology. And even more so, as we think about artificial intelligence and LLMs
spk_0
and all of the potential there, but it's how do you let humans focus on the things that humans do
spk_0
uniquely well around things like trust and empathy. And you know, we consider ourselves very much
spk_0
a people-first business. And I think we view the tech platform is allowing humans to have those
spk_0
empathetic, empathetic those interactions with patients and to just overall make them better
spk_0
at everything that they're doing. And there are just multiple ways that that ultimately happens.
spk_0
And then, you know, automate away all the things that people don't need to be doing.
spk_0
Leverage technology, as I said, to make those people better. And then also meeting people where they
spk_0
are. So we do have a lot of interactions with people through technology. And I think that, you know,
spk_0
making sure that we're not texting people who only have a landline is critically important,
spk_0
obviously. And then, you know, using tech to make sure that you, you know, can identify when people
spk_0
only have a landline, you know, so like using tech to make sure that you can interact best with
spk_0
the people who don't have tech. So when we started timecare and we mentioned this sort of core flat
spk_0
iron team who came from a tech enabled organization. Two of our leaders, Scott Boy, our head of
spk_0
product and Alpon, our head of data science, who came in from Flatiron, had this belief that we
spk_0
needed to build technology from the ground up to power everything in the future. In recent,
spk_0
A16Z powered that for us because we didn't have the revenue or the members on our platform to
spk_0
support that level of build and scalability, we are now seeing the reward of that given 83,000
spk_0
plus patients are going through our platform. And so, you know, with our team on the technical side,
spk_0
and I can't forget our head of engineering, Rob Rocky, we have been able to deliver so much
spk_0
through our technology platform. And this is where we think this will advance us all far into the
spk_0
future of what we can do with our platform as well. And so talk about that for a second. You sort
spk_0
of referenced that you built it in house ground up a full tech stack for oncology care.
spk_0
But we're a company timecare that operates in a sea of other technology. There's, you know,
spk_0
an EMR over here. There's a RCM platform over here. All the, there's a lot of tools and technology
spk_0
in oncology. So what does that mean that we built it from the ground up internally for ourselves?
spk_0
Yeah, one thing I just want, you know, I want to flag we because we talk about flat iron in the
spk_0
background here. I do want to acknowledge here that Brad D. Pice is a computer scientist or was
spk_0
at some point in his so long time ago. So Brad is also an art part of the cultural of the technical
spk_0
DNA. I mean, listen, I mean, we built, we have built all of the core products within timecare
spk_0
from sketch from scratch day one. And you know, the whole we really felt that in order to build the
spk_0
care delivery apparatus in a way that was going to be able to scale like we wanted it to. We needed
spk_0
to build that control. Yes, there are going to be other things that we're interacting with the
spk_0
needa, but we needed the control and the optionality around the user experience to interact with all
spk_0
the stakeholders that we that we work with. And you know, I think we have continued to have
spk_0
confidence that this was ultimately right the right decision. We're not we don't get stuck in
spk_0
this never ending vendor selection and integration process. And we really can turn on a dime.
spk_0
And that's never been as true as AI has really become a thing. And you know, it's been incredibly
spk_0
exciting to watch our teams, you know, really over the last six to nine months mobilized to adopt
spk_0
you know, generator, AI solutions into our products all in a way that is really unique to us.
spk_0
And just much faster than than we would have been able to do otherwise.
spk_0
I would say and it's been the most fun that I think I've had professionally has really been in
spk_0
the last six months watching the watching the teams do this. And so to be very specific, our entire
spk_0
care delivery team operates on a care navigation platform not bought off the shelf like a sales
spk_0
was health cloud, but time box natively built by our engineering and product team.
spk_0
I think care has built an extraordinary care team. I've met many of the care team members.
spk_0
And they are amazingly talented people. And yet, there are many more patients in the country who
spk_0
are managing a cancer diagnosis than we could ever have in our care team. And so you mentioned AI
spk_0
is an AI agent or the concept of agentic care already here in some form in time care. How close
spk_0
are we to AI acting like a nurse handling some of the subclinical tasks routine tasks,
spk_0
you know, perhaps triaging symptoms, surfacing next steps so that the human clinician can spend more
spk_0
of their time on the most complex and high value care for the patient.
spk_0
Yeah, I think, Jay, if you look at the things that we are doing now, where the core of sort of
spk_0
where the concrete things that we're doing well, the framework we sort of look at across all of
spk_0
time care is certainly coding. So right, our engineers using AI to code, but also thinking about
spk_0
tools that allow us to sort of create these multi-step manual workflows, like, and I hate to even use
spk_0
the term faxing, but you know, we have a lot of things that need to be faxed to clinicians'
spk_0
offices that we had humans doing and how to use to sort of automate those things. I'm going all
spk_0
the way through sort of summarization. And that's inclusive of, you know, the AI scribes that are
spk_0
out there and that everyone knows about, but we've had a lot of efficiency from having our nursing
spk_0
team use those, but also being able to leverage LLMs to summarize information, Robin reference time
spk_0
box. So the ability for our teams to go in and, you know, these are things that we've recently
spk_0
rolled out asking for our SOPs, like, what am I supposed to do next instead of having to go
spk_0
search for documents, you know, we've been able to utilize a rag to enable them to do that,
spk_0
or queering time box to say what's happened to the patient over the last, you know, two weeks.
spk_0
All things which enable and make the nurses more efficient, that can help them queue up what is
spk_0
the next best thing for them to do in what we, when we're thinking about tasking or next steps for
spk_0
the nurses. What we have not done yet is have the agents ask patients questions, or have the
spk_0
patients directly interact with that. You know, this is something that I would have been skeptical
spk_0
about six months ago. I clearly think it's coming now. I've spent a lot of time playing, you know,
spk_0
with these agents. I don't know if you guys, there was an article in the Journal of Clinical
spk_0
Oncology within the last three weeks out of, I think, Yale and the University of Chicago where they
spk_0
actually use chat GPT to look at how it would triage patient questions and it's like crazy how good
spk_0
that is. I think that is coming. I think that's going to drive a lot of value. But I also think,
spk_0
and I think we are in a really good position to do that, like to deploy that widely and at scale,
spk_0
you have to do it safely, you have to make sure you have the right guardrails. And, you know, the
spk_0
thing that we do that I think is so critical is we are always building these products together
spk_0
with the technical and the clinical and the care delivery team. And, you know, you can sort of watch
spk_0
in our Slack conversations, the interaction and it's really quite fun to, quite fun to watch.
spk_0
Yeah, and those are all tools we can use. They're all tools that are disposal. The reality is,
spk_0
a cancer patient has a myriad number of things that need to happen in person. They need to show up
spk_0
at their clinic. They need to get their labs drawn. They need to get an infusion. They need to get
spk_0
an ultrasound done. They need to get a PET scan done. They need a biopsy, a surgery. And so,
spk_0
there's a lot of in-person touch points that an AI can't fully take over. And so, the best way
spk_0
as you're saying, Bobbie, to deploy AI in cancer care is to wield it as part of the cancer team.
spk_0
And, integrate it deeply, right, with all of the other in-person touch points that a cancer patient,
spk_0
unfortunately, just cannot avoid. Yeah. And it's, you know, it just even thinking, because this
spk_0
this came up recently, an example, like, just there's so much information. And it's not just a medical
spk_0
information. It's information of what's going on with your patient. So, you know, think about
spk_0
a patient who has a history of falls and a fall risk that is buried somewhere in the chart that
spk_0
you don't remember it and someone's about to start on a blood thinner. And, you know, you don't
spk_0
put two and two together. There's just, there are so many things that go wrong because information
spk_0
gets missed. And just, you know, as an example, LLM's and the ability to summarize information and
spk_0
sort of keep track of all these things in ways that people just can't. And just there's like a
spk_0
ton of really exciting things that I think. There was an open AI employee who put in, you know,
spk_0
complicated breast cancer case and asked, you know, ask chat GPT to assemble a virtual, you know,
spk_0
collection of expert views on what the right next treatment steps would be. And it reminded me of
spk_0
a tumor board that most cancer centers and great multi-specialty, multidisciplinary teams have.
spk_0
And I guess the provocative question is like, should everybody have access to an AI version
spk_0
of an oncologist? And what about the places where that tumor board isn't happening? And what about
spk_0
the patients who don't get to benefit from that level of expertise? Will every cancer patient
spk_0
have an AI oncologist? Well, Navinita, you're not trying to put us out of jobs, I hope, right, with that.
spk_0
So I just think you might want an alter ego sitting on your shoulder, that's all I'm saying. Yeah.
spk_0
Listen, I don't think we're going to replace oncologists. But I think you're going to see, you know,
spk_0
the the mantra you always hear with engineer, right, is like use AI to make yourself the best
spk_0
engineer, right? And I think that is absolutely going to be true in medicine in general and then
spk_0
in oncology specific. Like you are like you are going to be crazy not to leverage artificial
spk_0
intelligence to make yourself better as an oncologist. And you know, so you can think of the oncologist
spk_0
as the quarterback orchestrating various agents that, you know, reduce administrative burden, make
spk_0
sure you have all the right information. I think the flip side to that is that the question you ask
spk_0
should all patients have access to it. The reality is that people are right now going out there and
spk_0
querying chat GPT with all sorts of questions. And I think a lot of the time it is gittening them
spk_0
meaningful answers. Sometimes it's misinterpreting information. Sometimes they're not prompting it in
spk_0
the right way. And things are going wrong. And I think one of the things that is really, I think
spk_0
really exciting from a time care perspective is there is an opportunity to build these things,
spk_0
to wrap the GPT, to make sure the GPT has access to the latest NCC and guidelines and to actually
spk_0
do this in a way and to build this, you know, with the right clinical expertise to make sure that
spk_0
the guardrails are there and that it is answering questions that are in a patient-centric way and that
spk_0
it's not misleading patients. So it's just another thing that we're super excited about. I mean,
spk_0
the only other thing I would say and I was going to add this on before if it's useful is I think
spk_0
one of the, you know, Brad was referencing before how we're solving the patient, sorry, the health
spk_0
like the health plans have these problems that we're solving. I think this unique to time care
spk_0
is that we have, we are solving problems for health plans, but we also have relationships with
spk_0
patients and providers and are very patient and provider-centric. And that gives us, I think,
spk_0
touch points to do a lot of things that other people can't do from deploying technology in a way
spk_0
across the ecosystem in ways that other people can to addressing the rising cost of drug pricing
spk_0
in ways, of drug costs in ways that other people can. So I think we are in a really great position
spk_0
to, I mean, I think we've had a lot of impact to date, but to really accelerate that going forward.
spk_0
Yeah, there was a, there was a provider for whom we saved an estimated 2000 staff hours in a year,
spk_0
like that's a pretty cool statistic, right? Like that provider probably just couldn't hire.
spk_0
That oncology clinic may not have been able to hire the right staff to take care of patients
spk_0
in the way they wanted to and we can come in with technology and make that possible.
spk_0
So Robin, you're one of the few entrepreneurs in health tech and tech more broadly,
spk_0
who has been a part of multiple $2 billion plus outcomes. And yet this time you said to us from
spk_0
the very beginning, you really want to focus on building infrastructure that lasts and that you
spk_0
want to build a generational company that makes an impact on everyone who needs help.
spk_0
And so I'm curious, what does it mean to you to build a generational company in health care?
spk_0
Yeah, for the folks that know me, those headline numbers are irrelevant. And as Bobby mentioned
spk_0
earlier in our discussion, some of the visions we had at Timecare were these crazy ideas that I had
spk_0
when we were at Flatiron. And if you think about the prior two companies, there are all sort of
spk_0
continuations of this vision of transforming the cancer care journey. And there is this crazy
spk_0
world that I always tell Bobby that we all, these all could have been just one company and we never
spk_0
would have transacted. But if I now think about where we are today, what I want and what you see
spk_0
in not only Brad and Bobby, but our entire management team is a company of people that are so
spk_0
passionate about solving such an important problem. And it shouldn't matter. And it doesn't matter
spk_0
who's in the seat. And we have this culture amongst all of us that we're here to win together.
spk_0
And that winning is not on the valuation of the company, but that winning is on driving meaningful
spk_0
impact to people that are going through this cancer journey. And we started this in 2020.
spk_0
We are impacting, as we mentioned, over 80,000 people in 2025. And in 2030, we want this to continue
spk_0
to expand. And in 2040, with or without me and Bobby, we want this mission to continue to deliver
spk_0
a better experience of people, diagnosed with something so complicated and so difficult.
spk_0
All of us are impacted by cancer. And we think that everyone deserves better. And that's that's
spk_0
what's grounded in the core values and mission of all of us here at timecare. And I couldn't be more
spk_0
excited about that. How that has trickled down to everyone below the leadership team as well.
spk_0
And so I feel grateful for the work that we've done over the last 15 years in oncology.
spk_0
But as folks know, I've got a long career ahead of me and a lot of that will be on impacting
spk_0
not only oncology, but the care delivery model itself.
spk_0
What a beautiful place to end. Robin, Bobby, Brad, thank you so much for
spk_0
allowing Venita and I in the full team here to be part of the journey. And I know we're just
spk_0
getting started. So let's go. Yeah. And Jay and Venita, we honestly could not be more grateful
spk_0
for for your belief in us today, but also the bets you've made on us since since day one. And
spk_0
we would not be here without the work from a 16 Z and the two of you. So thank you.
spk_0
Or review and share it with your friends and family.
spk_0
Follow us on X at a 16 Z and subscribe to our sub stack at a 16 Z dot sub stack dot com.
spk_0
Thanks again for listening and I'll see you in the next episode.
spk_0
As a reminder, the content here is for informational purposes only.
spk_0
Should not be taken as legal business, tax or investment advice or be used to evaluate any
spk_0
investment or security and is not directed at any investors or potential investors in any a 16 Z
spk_0
please note that a 16 Z and its affiliates may also maintain investments in the companies
spk_0
discussed in this podcast. For more details, including a link to our investments, please see a 16 Z dot
spk_0
com forward slash disclosures.