YC Root AccessThis Startup Is Automating America's Biggest Hospitals
CHAPTERS
- 0:05 – 0:36
Luminai’s mission: AI transformation for hospital operations
Keshav explains Luminai’s role as an AI transformation partner for large US health systems, focused on shifting operational workflows from manual labor to automated systems. The goal is to reduce administrative waste while helping patients access care faster and hospitals run more efficiently.
- •Positioning as an AI transformation partner for health systems
- •Automation of operational (administrative) workflows, not clinical care
- •Moving work “from people to computers” across large hospital systems
- •Link to massive administrative waste in US healthcare
- 0:36 – 2:08
Case study: automating fax-based referrals and triage at major hospitals
Using Cleveland Clinic as an example, Keshav describes how critical patient referrals still arrive via fax and must be manually sorted and routed. Luminai ingests inbound faxes, triages urgency, extracts key data, matches it to records in the EHR, and routes/schedules appropriately.
- •Fax remains a primary referral channel even for elite institutions
- •Manual teams must distinguish spam vs. critical patient cases
- •Luminai becomes the “frontline inbox agent” for fax triage
- •Data extraction, patient/provider matching, routing to the right department, initiating scheduling
- 2:08 – 3:38
From unstructured paper to structured workflows: the platform approach
Keshav broadens the example into Luminai’s platform concept: converting unstructured inputs (like faxes) into structured data, then applying a workflow engine to run specialized agents. He connects this to the scale of administrative waste and the impact on patient access and hospital effectiveness.
- •Data transformation layer: unstructured-to-structured conversion
- •Workflow engine for building verticalized agents per use case
- •Dozens of workflows per health system are still paper/process-heavy
- •Targeting ~30% administrative waste (over $1T) to speed care and improve operations
- 3:38 – 4:37
Growing up in India: finding identity and focus through Rubik’s Cubes
Keshav shares how he struggled academically in India’s merit-driven system and became deeply invested in Rubik’s Cubes instead. The Rubik’s Cube community gave him belonging, clear goals, and a place where performance mattered more than credentials.
- •Not fitting into traditional academic success expectations
- •Rubik’s Cubes as an alternative path to mastery and recognition
- •Community as a level playing field across age and status
- •Obsessive practice becomes a formative discipline
- 4:37 – 8:44
Elite practice habits and competitive feedback loops
He details the intensity of his training—hours daily for years—and the measurable nature of the sport. The constant feedback of timed solves and incremental improvement reinforced a high-performance mindset.
- •7–8 hours/day of practice alongside school for years
- •World records and leadership in international competition
- •Early exposure to the broader “quirky nerd” community (incl. learning from Karpathy videos)
- •Motivation from precise targets, tight feedback loops, and measurable progress
- 8:44 – 11:00
A nontraditional path to the US: UWC, the Silk Road bike trip, and Silicon Valley
Keshav recounts how he aimed to do something bold to get noticed by US schools, including securing funding to bike from Turkey to China. Through foundation support and a visit to Silicon Valley, he became determined to stay and pursue building a company.
- •Skipping a standard college route; aiming for the US through unconventional signaling
- •United World College influence and mission-driven framing
- •Funded cycling journey from Turkey to China as a standout story
- •First exposure to Palo Alto/Stanford and founder networks catalyzes commitment
- 11:00 – 14:07
Surviving solo at 19: “hacking” hackathons for prize money
Staying in the US without a typical support system, Keshav uses hackathons as a way to generate income. He outlines a systematic approach to winning by optimizing for what organizers (often corporate sponsors) actually value.
- •Hackathons as a practical funding source for living expenses
- •Understanding judge incentives: recruiting and API adoption
- •Rapid iteration loops with organizers early and often during the event
- •Winning ~$40–45k across multiple hackathons to survive for months
- 14:07 – 16:41
Getting into YC with the “wrong” idea—and why YC bet on the founder
Keshav describes applying to Y Combinator with an engineering documentation product, an idea they quickly abandoned. Aaron notes multiple teams had the same idea, but Keshav’s outlier background and behavior signaled founder potential beyond the initial concept.
- •YC appeal as merit-based entry without traditional credentials
- •Initial product: tooling to make engineering documentation easier
- •Rapid realization post-acceptance that the idea wasn’t strong
- •Founder-story differentiation and outlier grit as the reason for selection
- 16:41 – 19:24
Pivoting methodically: choosing a mission and validating pain
Keshav argues pivots can be driven with a scientific, methodical process in B2B. He links his healthcare motivation to a family event and connects operational inefficiency to his Rubik’s Cube intuition about reducing steps.
- •Pivoting framed as systematic experimentation rather than pure intuition
- •Two filters: personal mission energy + repeated customer pain signals
- •Healthcare becomes meaningful due to personal/family experience
- •Rubik’s Cube analogy: cut steps in workflows to “get to solved state” faster
- 19:24 – 23:39
Enterprise sales at 20: selling a champion, not the institution
He explains that enterprise deals are won through individuals inside organizations who will champion the product. The team targeted forward-leaning leaders, used networks for warm intros, and relied heavily on personal narrative when there was little brand or proof.
- •Core insight: enterprise sales = winning an internal champion
- •Identifying forward-leaning execs and rapid career risers as targets
- •Using second/third-degree connections to secure meetings
- •Story-driven trust-building when product maturity/social proof is limited
- 23:39 – 26:51
Warm-intro pipeline engineering: scraping networks and climbing the org chart
Keshav details how Luminai avoided cold outbound early on, instead systematically mining investors’ and supporters’ networks to find relevant contacts. They used lightweight intros to get any foothold, then worked up to the true decision-maker over time.
- •Major institutions often require trusted referrals to engage
- •Building network leverage despite starting without a Rolodex
- •LinkedIn scraping/matching script to identify reachable targets
- •Land anywhere in the org, create excitement, then ladder up to the champion
- 26:51 – 29:50
Reinventing the company: from horizontal automation to healthcare focus and clear wedges
After reaching dozens of customers and millions in revenue, Luminai narrowed focus. They committed fully to healthcare (where most demand already was) and shifted from “we can do anything” to concrete, high-value starting use cases that deliver fast ROI.
- •Horizontal platform messaging reduced credibility at larger enterprise scale
- •Data showed >80% of customers were healthcare, driving focus
- •Need for thick, explicit use cases and a clear “what’s possible” narrative
- •Maintaining extensibility while leading with fast-value wedges
- 29:50 – 32:51
Founder advice: scale your ambition—and prove it with intensity
Keshav’s key lesson is that founders can be far more aggressive and ambitious than they think, regardless of background. He frames the current era as unusually level, encourages multi-decade mission thinking, and closes with a Rubik’s Cube solve as a capstone to his story.
- •Ambition/aggression can be 100–1,000x higher than you assume
- •Background and experience matter less than people think (within integrity constraints)
- •Mission becomes multi-decade; intensity compounds over time
- •Closing moment: Rubik’s Cube demonstration and wrap-up
