This Startup Is Automating America's Biggest Hospitals
TL;DR
Lumini is turning hospital fax chaos into AI-driven triage — Keshav says large systems like Cleveland Clinic still receive critical patient referrals by fax, and Lumini now acts as the first-pass “inbox agent” that classifies urgency, extracts data into the EHR, routes to the right department, and kicks off scheduling.
The pitch is enormous administrative waste, not flashy diagnostics — Lumini is focused on operational workflows where “people, process, and paper” still dominate, targeting the roughly 30% of U.S. healthcare spend tied to admin waste, which Keshav puts at over $1 trillion.
Keshav’s founder edge came from obsessive, measurable practice long before startups — Growing up in India, he spent 7 to 8 hours a day for seven years on Rubik’s Cube speedsolving, broke world records, captained the international team, and even learned from Andrej Karpathy’s YouTube videos.
He effectively survived Silicon Valley by gaming hackathons with customer feedback loops — After arriving in the U.S. at 19, he and friends won roughly $40,000 to $45,000 across five or six hackathons by building what organizers actually wanted, checking in every two hours until the judges were rooting for them.
Enterprise sales worked because he sold a person, not a hospital — Keshav argues you’re never really selling “the Cleveland Clinic”; you’re selling a forward-leaning internal champion, often found through warm intros, relentless networking, personal story, and even red-eye flights to show up in person.
Lumini’s real growth came after narrowing down, not staying horizontal — Even after reaching many millions in revenue, the company realized a generalized automation platform hurt credibility, so it went all-in on healthcare after seeing more than 80% of customers were already in that market.
The Breakdown
The fax machine is still the front door to elite healthcare
Keshav opens with a brutally specific picture of American healthcare: even world-class systems like Cleveland Clinic, with more than 16 million patient encounters last year, still receive many patient referrals by fax. Lumini sits in front of that mess like an AI triage desk, figuring out whether an incoming fax is spam, a thank-you note, or a high-risk cancer patient who needs attention now.
From “bad at school” to world-class at something measurable
He says he wasn’t strong academically growing up in India, and in that environment it made him feel sorted into a lesser bucket early. Rubik’s Cube changed that: he practiced 7 to 8 hours a day for seven years, found a community where only performance mattered, and became good enough that older PhDs and doctors started asking an 11-year-old for advice.
Why Rubik’s Cube became his first meritocracy
What hooked him wasn’t just the puzzle — it was the fairness and feedback loop. In his telling, speedcubing was intoxicating because the target was exact, improvement was measurable every day, and the social hierarchy reset around one simple question: can you solve fast?
The Silk Road bike ride and the decision not to go back
Trying to get noticed by U.S. colleges, Keshav helped organize a bike trip from Turkey to China, backed by institutions, while studying at United World College on a full ride. A foundation eventually flew him to Silicon Valley, and after landing in sunny Palo Alto, meeting founders, and walking Stanford’s campus, he decided he had to find a way to stay.
Winning hackathons as a survival strategy
Once in the Bay Area on a tourist visa and without a safety net, he realized hackathons could literally fund food and rent. His playbook was simple and sharp: don’t just code for 48 hours — identify what the organizers actually care about, show progress in the first two hours, gather feedback over and over, and by the end you’ve basically built what the judges want; the group won around $40,000 to $45,000 total.
YC took the founder before it bought the first idea
Lumini didn’t start as healthcare automation at all — the team first applied to YC with an engineering documentation startup. Ryan says four companies pitched the same thing that day, but Keshav’s background — world records, biking the Silk Road, surviving on hackathon money — signaled unusual founder behavior, and YC backed him even while warning the idea itself probably wasn’t great.
The pivot to healthcare was emotional and methodical
Keshav pushes back on the idea that pivots are pure chaos: for B2B, he thinks it’s closer to science than art. A serious family health event made healthcare feel deeply personal, and as he spoke with enterprises, he saw the same pattern everywhere — operational teams drowning in manual work — which clicked with his lifelong instinct to cut unnecessary steps, like optimizing a Rubik’s Cube solve.
Selling hospitals at 20 by making it personal
His biggest sales insight is that you don’t sell “an enterprise,” you sell one internal champion willing to bet on you. That meant warm intros over cold emails, scraping LinkedIn through investor and network connections, flying anywhere for in-person meetings, leading with personal story, and eventually narrowing Lumini from a horizontal automation platform to a healthcare specialist after realizing more than 80% of customers were already there.
End on ambition, then a 10.58-second flex
Asked what he’d tell his 19-year-old self, Keshav says the right level of ambition is probably 100 to 1,000 times bigger than most people allow themselves. Then, after talking about a mission that now feels multi-decade, he closes by solving a scrambled Rubik’s Cube in 10.58 seconds — a neat little reminder that the obsession is still very much alive.