Join us as we explore how Raju Joshi, CCO and Co-founder of Cogensus, is leveraging digital innovation to address loneliness as a critical social determinant of health. Raju brings 30+ years of healthcare expertise to discuss how AI-powered conversations capture patient sentiments, provide valuable clinical context, and preserve personal legacies. This session examines the intersection of technology, social health, and the Surgeon General's focus on loneliness as a public health priority.
Raju Joshi, Co-Founder, Chief Clinical Officer, Member Board of Directors, Cogensus
Megan Antonelli, Chief Executive Officer, HealthIMPACT
Welcome 0:00 Welcome to Digital Health talks. Each week we meet with healthcare leaders making an immeasurable difference in equity, access and quality. Hear about what tech is worth investing in and what isn't. As we focus on the innovations that deliver. Join Megan Antonelli, Janae sharp and Shahid Shah for a weekly no BS, deep dive on what's really making an impact in healthcare.
Megan Antonelli 0:19 Hi everyone. Welcome to Digital Health talks. This is Megan Antonelli, and I'm excited to introduce Raju Joshi, a healthcare leader with over three decades of experience spanning academic research, healthcare system delivery, biotech and digital health innovation. She is an entrepreneur currently focused on condenses a pioneering platform that addresses social determinants of health by alleviating loneliness and preserving legacy through AI powered conversations. Her personal experience with family members in 2024 has brought a unique perspective today's discussion, and I'm excited to talk to you. Hi, Raju, how are you?
Raju Joshi 1:02 I'm great, Megan, thanks for having me on your show. I'm really excited about talking to you.
Megan Antonelli 1:07 Yeah, so great to meet you. I do, you know, I feel like we've had a similar background, you know, I think going, you know, sort of the payer experience, PBMs, health plans and then pharmacide. I you know, my trajectory has been similar, and then I started in academic research. Worked in, you know, events for payers, the payer side. Worked at Kaiser on the payer side for a bit, and then did Pharma. So I am sure our paths have crossed through that. But tell our audience a little bit about your background and how you came to cogents, yeah,
Raju Joshi 1:41 thanks, and thanks for that intro. I have been in the healthcare space for over 30 years. Have a background in biomedical science and epidemiology and Health Administration. Worked in a variety of different sectors within the industry. I have experience in academic research. As you mentioned, the payer sector. Was with Deloitte healthcare consulting for about six and a half years, went to Medtronic and Amgen was at a startup. Had started my own startup and joined cogensis About a year ago, kind of serendipitously, to be honest with you, because I was going through my family, I should say, was going through a lot of change. We We unfortunately lost two senior members of our family and and just at that time, I was introduced to cogensis, because cogensis was working on a platform to address elder care and allow aging in place with dignity, which was very important to me, because I had just experienced that for my with my mother in law, whom we lost in February of 2024, and trying to care for my grieving father in law, who had lost his wife of 60 years, and then two months later, my father fell ill, and my we lost my dad on Father's Day. And my mother was not prepared, nor was I prepared for any of that. So it was at times chaotic, more often than not, we were just sad and trying to figure all of this out. My daughter was applying for law school. I was working. I mean, there's just so much going on, right? So cogensis just felt like the right place to be, because it's addressing a topic I think that not only I would have benefited from, but I actually may be a user of at some point in time, in the future, and sharing this story with you know, a lot of my friends, as I was going through my own grieving process, seemed to be more common than the not we're all in our 50s and we're all in that sandwich of caring for aging parents and raising our children. So anyways, that's how, that's how I came about. Yeah,
Megan Antonelli 4:24 well, I think it is. It's such, you know, I've always felt as we kind of go through our lives and our experiences, and we are, we become different patients in in those cases and and certainly supporting different patients. And we see where the gaps of the system exist, and certainly both grieving and aging and that loneliness piece you know is such a is such a big gap. So you know, I'm sorry that you went through that, but I appreciate your the. Desire and drive to then solve, solve some, solve for some of that. Tell me a little bit about what consensus does and, and how, what the vision for that and, and how it will, will support you in that space. Yeah
Raju Joshi 5:13 Thanks. So cogens, this is an AI enabled platform that aims to increase, you know, communication across the care team as well as with caregivers. It in intends to increase agency that a patient has about their own lives and their care, and it increases connectedness with the patient in a in effort to solve loneliness, so or reduce loneliness, we're not always going to be able to solve it, because that's a, you know, loneliness is a a like feeling that a patient has about how lonely they feel. You know, whether they feel connected to someone or not, even if they are physically not alone. You know, they may not be isolated physically, but they may certainly feel lonely. So we hope to give them agency through an AI enabled platform that enables them to speak about their perceptions, attitudes, anything really, that we want to, that they want to talk about, and then provide that information to their care team and to their caregivers, so that the care team can make more informed decisions about their treatment, and that caregivers can care for their loved ones in a In a more meaningful way.
Megan Antonelli 6:40 Yeah, that's amazing. I mean, it sounds like it's both, you know, kind of tackling loneliness from that, you know, mental health element of it, where we've heard so much about the, you know, the detriments of loneliness as we age, and how that can impact our health. Certainly, the Surgeon General has talked about that, and there's been a lot been a lot of research on that, but then also engaging with the care team to make sure that there's a connectedness there that can be hard, perhaps for some elderly, or some elements of, you know, in in terms of social determinants, in terms of social places that they are that can be harder, whether it's rural or, you know, less connected places. So tell me a little bit about that and the research that you guys are doing in that space. Yeah,
Raju Joshi 7:28 so, so social connectedness, social isolation and loneliness, is something that we are really focusing on. Loneliness in particular, we are a product that is in development, and so our intention is to work with providers and with patients to capture using validated instruments, capture information about how lonely a person feels, and we hope to address that by encouraging engagement with this AI platform, sometimes patients who live alone are people who live alone, and that's about 25% of the the the, you know, population over the age of 65 who's living alone is only interacting with their care team. That's their whole interaction. And so their whole life is centered around like my medication and my next appointment, and, you know, things like that. What we are trying to study is, how will loneliness affect your mood? How can it affect some of the cognitive health, or, you know, some cognition and cognitive health issues that you may be encountering. So it could be any some memory recall, it could be some verbal semantics and acoustics, types of of parameters and or issues. And so we're trying to to study that in in patients who are currently lonely or at risk of loneliness, and we will build on that as we go through our product development cycle.
Megan Antonelli 9:09 Great. And as as you're looking at kind of where this is going to fit in to the care path, as well as sort of who your customer is, what you know, what are you looking at from that perspective? Yeah, no,
Raju Joshi 9:23 it's a good question. And so you know, again, as we this will evolve as we continue to study how the product is engaging patients who's using this product, and how they're using this product. But initially, our intention is to go work with the clinical teams at provider groups and or hospitals and or senior care facilities, and work with patients who may be at risk of loneliness. We think that this is a. Solution that can help solve a lot of identified problems, but we're going to take a step wise approach to that. And so we'll start with the elder, start with patients who are at risk of loneliness, for loneliness, and then move on. Move on. From there,
Megan Antonelli 10:14 right, right. And then, you know, in terms of kind of the technology of it, what? Does it look like? What? How does it interact with other applications, other systems, obviously, the EHR, yes.
Raju Joshi 10:26 So we are an early stage product design at the moment. Our intention is to build a product that will be mobile enabled, tablet enabled and computer enabled. A patient would interact with it, or a person would interact with the product by speaking into the AI platform. Initially, there will be a series of questions just to kind of get to know the patient a little bit more, better understand what's important to them, what their life events were like, what their preferences are, and then through a series of conversations. And of course, the more you engage with the tool, the more refined the the the algorithm becomes, and it gets to know you better. The patient would interact with that product, with the product, and then the care team would be provided insights around topics. So your the topics of conversations would be transcribed, but again, coming back to some of those patterns on mood, memory and verbal communication, we would be providing some analytics around that, oh, this person has recorded or has expressed, you know, feeling down. They may not use the word depressed. They may or they may not, and we're certainly not focused on depression and anxiety, but they might use some of these words, and I think that it's important to highlight that to a care team so that the care team can come in in a contemporaneous manner and address it.
Megan Antonelli 12:06 Yeah, no, absolutely. And you mentioned also, you know, being, you know that we're sort of in that sandwich generation, right, where we are both, you know, taking care of and, and, you know, hopefully watching our parents age and if not helping them, you know, grieve. And then on the other side, of course, with our with our children, and sort of, you know, lots of, lots of responsibilities. But what it comes down to is, is, what about the how does the caregiver benefit from this? How do they engage with the congensis tool. Do they have access to did they get notifications? Because I think I, you know, I hear from so many of my friends who are, you know, going and doing everything that they can to make sure that their parents aren't lonely, whether it's through phone conversations or in person visits and all of that. But then there is that, you know, the struggle with how you engage with their both their clinicians, their caregivers, but also, you know, almost a permanent monitoring thing. So is that part of the vision? You know? How do you see it working with with caregivers? Yeah, I
Raju Joshi 13:14mean, the demands that are placed on caregivers is is enormous. I've experienced it firsthand, and I know friends of mine who've experienced it firsthand as well. And so the you know, we just can't be everywhere all at once. And you know, sometimes conversations are missed, depending upon our parents cognitive health. They may have moments of alertness. They may be, you know, sleeping a lot of a lot of the time, and so, you know, we just may not be there physically when, you know, to capture their their their mood, or to capture their frustration, or to capture something that's happening in their life, or a memory that they're recalling. And by the time we speak with them, maybe it's at the end of our day, because that's the only time we've we have as caregivers, is after dinner, perhaps after work, then dinner, you know, etc. We give them a call. How was your day today, mom? And the answer is, always, or more often than not. Oh, yeah, fine. You know nothing new, but we've missed that opportunity to engage them on something that was important to them and may have been relevant from a clinical standpoint. She may have been administering an insulin shot or some medication, and might have expressed, you know, frustration with that, or they may have talked about, Gosh, I am so tired all the time. I am so sleepy, I mean, and that could be a sign of disease progression, or it could be a side effect of a medication that. They're on, but unbeknownst to them, it's a side effect they don't know, you know, they just are doing what their doctor told them to do. And so if there's an opportunity as a caregiver to understand that, then we have an opportunity to then take that information and parlay that to the clinician, right? Or the clinician can hear it directly as well.
Megan Antonelli 15:42 That's great. know, I think there's so many points at which we can be kind of capturing that information. And, you know, from the sort of application of the AI, is the vision that, obviously large language models the conversational part of that. But what about the analytics? Is there some level of report out that comes to the caregiver? Is that? Is that built in? Is that part of the vision?
Raju Joshi 16:03 Yeah, so part of the vision is to have a dashboard for the caregiver to better understand what the patient talked about, what their loved one was talking about in the course of that day. And it could be something from it could be a I know towards towards the end of my dad's life. He kept talking about his childhood, and, you know, that was really interesting, but it and there were stories that I'd not even heard of before, and so that that improved the connection between myself and my father. But if we had had an opportunity to make those connections when he was healthy, that may have enabled us to better understand his attitudes towards his care, it would have given him agency so that you know when you're interacting with the AI platform, the more you talk to it, the more we'll learn about what's going on, and the caregiver will then be notified about hey, you know Dan talked about our dog Tommy. Today, I haven't heard about our dog Tommy. The dog Tommy was our child. My childhood dog. I'm in my 50s. So this is my childhood. I was a long time ago. I haven't heard my dad talk about our dog for ages, you know, but for some reason that was important, and then I can kind of maybe, when I engage him, instead of asking him, Hey, Dad, how was your day today? It would have been something like, Hey, Dad. Remember that time where we took Tommy camping with us, and he jumped into the lake, and we didn't know if he could swim, and we were all worried, or, you know, whatever the story is, but it just it improves the quality of connection. In our opinion,
Megan Antonelli 17:49 absolutely, I can see that for sure, both both of my grandparents and with my parents. You know that the storytelling as continues and grows as they've as they've gotten older. And that's
Raju Joshi 18:05 exactly and that's the whole premise behind cogensis, is to enable storytelling and use that storytelling as a means to improve communication, improve agency, and improve connectedness, and improve the communication with the care team, so that they understand who the person is, you know, and not just what the condition is that they're treating
Megan Antonelli 18:33 Right, right, you know. And that that communication, and that consistency of communication between both the caregiver and the patient is more and one Absolutely. So tell us a little bit about, you know, kind of where you are in the stages of this. Are you guys looking for investors? Are you piloting? Where's the, you know, what? Where are we and, you know, how can, how can our audience help?
Raju Joshi 18:58 Well, we are in a pre product stage. We are in early stages of development. We are raising funds. We are in a $2 million fundraising drive at the moment, and we have raised half of that. So we've raised a million. We're looking for the last million at this point in time. That money will be spent towards product development efforts. We have received letters of interest from folks that are with payers and with providers, so we know that and patients as well. So we know that there's, there's a lot of interest. We have developed our clinical strategy. So we are getting ready to, once the product has been developed, deploy that out into a variety of centers, we have a development team that is ready and waiting to go, and so we are hoping to build and launch this product more, you know, closer to the end of this year. So. Um, we also have plans to expand in Asia at a later time because, and we have a lot of interest there as well, because this, this notion of loneliness in the elderly is affecting a number of different Asian countries, in particular South Korea, and so we are looking to advance this technology there as well.
Megan Antonelli 20:28 Oh, wow. Well, that's really interesting in terms of the language and translation. I imagine there's a lot involved there as well. Yes,
Raju Joshi 20:38yes. In fact, we are looking to to translate this product into seven languages in and, you know, to operate in California, we we need to do that. And we want to do that because we think that this is, you know, loneliness is, is an issue that disproportionately affects many marginalized communities. And so we think that there's a huge opportunity to really help people that are of, you know, minority and or marginalized communities.
Megan Antonelli 21:10 So we always like to talk about what's good in health care. Sometimes we can talk a lot about the gaps or the missing elements, but we like to always end on a positive note. Lately that's becoming, you know, a little bit more challenging
Raju Joshi 21:27problem solvers, right? So what's
Megan Antonelli 21:29the problem
Raju Joshi 21:31and what can we do to solve it? So when
Megan Antonelli 21:33 you look at kind of the landscape right now, or even, you know, recent developments, what are you most excited about, you know, and it can be about cajensas, or it can be, more broadly, in healthcare, some, some sort of what's good, what's
Raju Joshi 21:50 good, um, you know what? I i love that we get to be a part of an industry that is so focused on benefiting people. I mean, that's my life's purpose. I love it. I want to make some, even small contribution to better lives of my friends, family and society. So there's a lot of good stuff going on out there in in this environment, that is a little, let's, let's just say, tumultuous at the moment, but there are a lot of really, really, really dedicated people that are focused on doing good work. I Yeah. So there's a lot out there. I would say I am particularly, you know, obviously biased, but interested in in what cogens has to offer. I think giving people an opportunity to address social determinants of health is a huge unmet need. I think there are, and I've had the good fortune of working with brilliant scientists and brilliant physician scientists who are out there looking at the next immuno oncology product or the next CNS product, and I have no doubt that they will make great strides in those therapeutic areas. But I think that there is a huge unmet need and an opportunity to address all of the social drivers of health that can impact health outcomes almost as strongly as some of these. You know, biotech and med tech in innovations and interventions?
Megan Antonelli 23:43Yeah, absolutely. I think it's one of the most exciting things and areas of innovation where AI has really been able to kind of move that needle in a really positive way. Because in some ways, it was a it was an area that everybody knew was a problem, but it was hard to fund. It was hard to find, you know, the motivation or the right alignment to make things work. But what AI is doing is making a lot of it a bit less expensive, a little bit easier to manage. Because if you had a person doing all of this, it would be really hard, but you can do a lot more.
Raju Joshi 24:25Yeah, and we really want to augment our teams. We don't, we won't be replacing them, but we really want to make it a little easier for them. I mean, coming out of COVID, our care teams were just exhausted, and they continue to be, you know, positioned for a lot of demand being placed on on their on them, right? So to the extent that we can maybe give them insights to their patients needs in a way that can provide information and not. Just throw data at them. That's really what we want to help focus on. We don't want to just be another data gathering tool. We want to really help provide insights that the care teams can take action on. And it could be something as simple as adjusting a medication. It could be something about as simple as, you know, having an understanding that a patient is not taking their medications because they just don't want to give themselves a shot. What happened to my dad? And, you know, I didn't even know that and it we just couldn't figure out what was happening and, and, of course, we just didn't have a lot of time with him. We just, you know, he got sick, and a month later he passed, and so, so we were just trying to figure out what was going on, but, but there's a lot of good that's coming out of all of the work that we're doing collectively as an industry.
Megan Antonelli 26:03And it is, it's that balance. I mean, obviously the care team, you know, does everything that they can to get that information. But in a world where time constraints exist, resources are unlimited, things are missed, and where there is this ability to capture more, and, you know, collect more and also at the same time, do it with some empathy and do it with some entertainment elements. Or, you know, however it is, you know, it becomes a very powerful tool. So I agree. Well, amazing. Well, thank you, Raju for joining us. I really, I'm excited to see you know how your work at condenses, develops and and the product when it's when it's on the market and available. And I really appreciate you talking about kind of the how the insights for this technology can address the social determinants of health and preserve meaningful kind of patient engagement and information let our audience know a little bit how to contact you and follow up.
Raju Joshi 27:05Yeah, you can reach me on LinkedIn, at Raju, Joshi is, is, is my name that you can find me there. You can reach me through cogensis at raju@cogensis.com, and I would look forward to to hearing from from folks listening.
Megan Antonelli 27:28 Oh yes, thank you. Raju, thank you listeners. For anyone interested in learning more about innovative approaches to healthcare technology and more female founders stories, please join us next week as we continue our exploration of transporting patient care. This has been Megan Antonelli with digital health talks and thanks for being here.
Raju Joshi 27:47 Thank you, Megan, thank you so much.
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