Engineering an AI-powered doctor’s office with Forward CEO Adrian Aoun | E1848

SPEAKER_02: I used to think that I was a big thinker. And I don't think I was a big thinker until I really worked for for Larry. I'll tell you Larry told me something once he's like, you know, and I'm going to paraphrase but he's like, it's just, it's just as hard to work on easy things as it is to work on hard things. He's like, pretend you want to build the world's best spoon. What are you gonna do? You're gonna raise a couple million bucks, get 20 people in a room work on it, come out with a product a year later. Let's say you want to I don't know go to Mars, you're gonna get raised a couple million bucks, you know, get 20 people come out with a product a year later, like at some point you realize like, your first steps are always kind of the same, you might as well work on something that's enormous, right? Like, at least like, look, what we're working on it for it's really damn hard. Like I don't have any pretense about it. Like we know that our probability of getting health care to a billion people is a rounding error to zero. But you know what, man, we get to wake up every day and be like, Yeah, but you know what, if it works, like look at the world we live in. Yeah. And to me, that's the ballgame. This week in startups SPEAKER_00: is brought to you by dot tech domains has a new program called startups.tech where you can get your company featured on this week in startups. Go to startups.tech slash Jason to find out how Vanta compliance and security shouldn't be a deal breaker for startups to win new business. Vanta makes it easy for companies to get a sock to report fast twist listeners can get $1,000 off for a limited time. advantage.com slash twist and Arising Ventures is a holding company that acquires tech startups facing setbacks. Arising Ventures knows what founders care about, because they aren't bankers. They're tech founders themselves. Go to Arising Ventures comm slash twist today to learn more and connect with the team. Hey SPEAKER_03: everybody, welcome back to this week in startups today you're in for a treat because we have somebody who's an angel investor in a lot of notable companies, including ones I've invested in like Robin Hood and Uber, but also Kota I love Kota open door air and BB bunch of great companies also worked for Larry Page at Google did some work for President Obama related to science and technology. But most importantly, he's working on a company called forward which you can go see at go forward.com which is setting the goal to make healthcare more preventative and basically revolutionize the space. His name is Adrian own and he is the CEO of forward welcome to the program Adrian. Not at all. Thanks for SPEAKER_02: having me get semen. Good to see you. We we see each other all over the world. We were SPEAKER_03: just talking about it recently we ran into each other in Riyadh at fi very interesting, which is funny when we don't run into each other in San Francisco, but we do in Riyadh. SPEAKER_02: You know that, you know, there's definitely something happening over there. It does seem SPEAKER_03: to me like the whole region I just you know, I've only been to Riyadh once I've been to Abu Dhabi, Dubai, Doha. I think that's it actually. But it does seem like they have come to participate meaningfully in the technology and capital allocation business. And the reforms over there and how the society has changed has been very dramatic in Riyadh and obviously Dubai's been on a 20 year journey. Which are what do you think founders and capital allocation should know about that region and their intent? What they're trying to get out of this relationship? SPEAKER_02: Well I think one of the most interesting parts about them is they're they're particularly intelligent and realizing that they are flush with cash and not flush with other industries aside from oil. And so they're they're very strategic in that they're not just going to deploy the capital but they're getting really wise it like we're going to deploy capital to help our region and some of that just means diversifying you know your sources of wealth and income. Okay great. The more interesting thing is the amount that they want to partner. And you know when you live in the US one of the things that kind of is always top of mind is democracy democracy democracy is fantastic and democracy I'm like I'm a fan of democracy but democracy has its pros and cons and the thing about rulers is that they can get done really really fast pardon my language but they can and so when you have good rulers wow and do things happen over there and we have bad rulers obviously things go south really really quickly but one of the interesting things for startups is they kind of run their country much more like startups right somebody somebody at the top says this is gonna happen and quite honestly it happens whether you like it or not and sometimes it's good sometimes that's bad but if you can align your interests with the region I think it's an incredibly interesting place to to work yeah the Gulf SPEAKER_03: monarchies are really interested in participating in the creation of the future and having a seat at the table and they're going to so then the question becomes for people who are operating businesses or you know geopolitically which is beyond the scope of this weekend startups obviously are you going to participate or not are you going to talk to them and do business with them or not are you going to you know try to build businesses together and while I don't have any announcements to make yet you know I'm thinking about doing a series of episodes of this week in startups maybe my founder university from over there and I've been talking to a bunch of people there I think building businesses together is like a really great peace dividend and a way to move society forward and culture forward yeah if nothing else I think just learning the culture SPEAKER_02: and learning kind of the pros and cons on both sides and what we can learn from each other is definitely there is there's something there right there's a there there for sure yeah and SPEAKER_03: it was interesting when we both ran into each other there how business is so different like here yeah everything's very transactional oh you have a deal I have a deal let me look at your deal okay you got these two deals okay I'll take this one I'll take a and c you want d okay we'll do d great send the paperwork we're done um and then hey maybe we'll hang out or not you know we'll develop over there it's all relationship building relationship building relationship building maybe a deal happens maybe it doesn't but the relationship portion is uh the predicate the 80 percent it's 80 percent yeah by the time you come around to saying here's the deal you kind of know SPEAKER_02: it's already going to happen because you're close to the person and again I think there's some pros and cons to this like everything but the pro is you're probably going you're going into business for the long term with people who you really know as opposed to us where it's like hi I just did my road show I'm about to get in bed with Sequoia I've known them for three minutes they've known me for three minutes and yet they're going to sit on my board and be able to fire me for the next 10 years and all of a sudden you're like whoa that's that's it yeah you know like that's a pretty serious relationship you know what I mean and they're theirs is obviously you know again pros and cons they they might spend I don't know less time diligently seeing a company and understanding it but more time understanding the person and we like to say this is a people business maybe their idea is like not that bad actually um given FTX it sounds like people could SPEAKER_03: have done more diligence and more understanding and relationship building of the person and and we've got a long list of those here from the last boom and bust cycle Theranos FTX I mean there's there's been a bunch of them and then before that obviously we had Madoff and Enron and world and I'm sure they'll I'm sure sadly they'll never stop we'll always have something SPEAKER_03: you know but it does seem like we forget some lessons right like diligence governance that was a very weird moment I also think that the one that's that we forget almost the most is just SPEAKER_02: slowing down sometimes and trying to deeply understand things from first principles like one of the one of the kind of things that Silicon Valley is built on is hype right um and the whole thing of hype is it just engages this FOMO reaction and whether that's the party whether that's the deal whether that's the hot startup to join etc and the reality is that the most valuable things in the world didn't happen in a in a day right like they happened over the course of years and years and a lot of hard work from a lot of people yeah and so it's just worth kind of getting to know like you know whether it's the business the people but like slowing down to particularly understand yeah I mean I think with crypto I think a lot of people didn't slow down and just SPEAKER_03: ask fundamental questions like okay it's an immutable blockchain okay so we'll translate that into a database you can't change yeah nobody's in charge of yeah okay when you frame it like that and it's pretty freaking dangerous to me that I can put a bunch of stolen information into an immutable database that and not get it out yeah and not be able to take it down it's like well I guess we could find the servers and then demand people take them down I guess but maybe not and maybe there's a technology to make it not immutable I'm like yeah this sounds incredibly SPEAKER_02: the whole tech industry is built on you know this this this kind of age-old like move fast and break things and honestly in some places that makes a lot of sense but you know look at me I'm in healthcare like you don't want to move fast and break things as things are humans don't move them SPEAKER_03: you know yeah we saw that with Theranos but that's it that well we'll get into that later okay we're back with another segment of pitch it to JCal. Dot Tech Domains is giving Twist listeners the chance to show off their startups on This Week in Startups. Go to startups.tech slash jason to apply there's only one rule you need to have a dot tech domain to get featured in this ad this week I'm going to tell you about Handprint.Tech. Handprint.Tech connects companies with environmental projects how cool and this helps brands increase their impact while boosting performance by associating with planet positive projects here's an example you ever go to one of those websites and you see a counter ticking up how many trees have been planted from purchases well that's Handprint.Tech it's really simple companies select their impact campaign then they can track and display their progress in public just a win win win the company wins they hit their goals the customer wins they feel great and the environment wins obviously if you want to be featured on This Week in Startups like Handprint.Tech it's very simple go to startups.tech slash jason and apply today that startups.tech slash jason and fill out the form to apply so when did you decide you wanted to get into healthcare because in venture capital in our industry there's a couple of industries that you really want to steer clear of yeah healthcare the music industry and education are three industries where startups go to die because they're regulated they move slowly and they sometimes are resistant to change so when did you decide yeah and I'm not sure I disagree SPEAKER_02: with any of those so look I didn't want to get into healthcare I didn't wake up one morning to be like healthcare is my thing you know I was at google you mentioned this I was working for Larry I was building a bunch of the alphabet companies like think of what my life was like I was literally a kid in a damn candy store every idea I'd have pitch Larry get a few billion dollars go build it before that I was building a bunch of the AI stuff at google like I was literally like living the dream honestly and then um I've got an older brother who lives in New York and he had a heart attack and so I kind of went from like not paying attention to healthcare to overnight being super focused on it and honestly Jacob like think of my experience right on a Monday I'm like at google trying to solve AI and on a Tuesday I'm like you know in my brother's exam room standing over him with like like there's doctors standing over him with like post-it notes in their hand and I'm just sitting here and I'm like are you kidding me but like like what the hell like how'd we end up here right like where's the AI yeah and you quickly realize honestly that healthcare is just a pile of crap but what's worse it's not even an evenly distributed pile of crap right there's eight billion people on the planet less than two billion of them have access to anything you and I would call like a real form of care okay so I'm sitting here and I'm like just trying to figure this out I'm like like how do we end up here right I'm an engineer we got we got smartphones to the whole planet why can't we get basic healthcare there and when you kind of just think about it it's like fundamentally healthcare is based on doctors and nurses doctors are awesome like they're great but you're never going to scale doctors to billions of people like there's not enough of them you know they cost too much so at some point you realize you need some other solution and you know being a tech guy like I'm sitting here and I'm like well we build products healthcare is a service but we build products so then you kind of have to click and say well wait a minute maybe healthcare could be a product not a service maybe we can take every single thing that kind of the doctors and nurses are doing and just kind of migrate it over to hardware and software because if you can look it's hard but if you can like oh my god like you can scale healthcare to the whole planet you can apply all the AI you want it's gonna be it's gonna be absolutely awesome now you said well hold on like startups startups in the healthcare space are really hard and like yeah that's the understatement of the day um because you know what I uh you know like most startups you start with this naivete of like oh it can't be that difficult I'll just go solve it it'll take me a year and I'll be done right it's kind of it's a necessity to have that naivete SPEAKER_03: because if you did know how hard it was going to be I know wouldn't do it by the time you're like SPEAKER_02: pot committed now you're like oh now I realize it but whatever I'm already in so so look here's what we did we we basically I don't know when when you want to boil the ocean you got to start somewhere right Elon starts at the model s and goes to the model 3 so you ask a little like well what's our model s our model s is basically that we um we built a high-tech doctor's office I think you've seen one of them we built one in sf it did pretty well we've scaled it up to I don't know 20 cities or so and so that's really awesome but obviously you're like okay Adrian but a high-tech doctor's office is never going to scale to billions of people never bring about your AI future but in essence it kind of has because what we're doing is just looking at what's happening inside of those clinics and like you come in you sit in the exam chair and you talk to your doctor about the flu and I go wait a minute why J. Cal come in let's just build that into the mobile app next guy talks to the doctor about skin issues I build a skin scanner next guy talks to the doctor about heart issues I build a body scanner and slowly but surely what I've been doing is just migrating every single thing from kind of doctor and nurse to hardware and software until what you realize is that the limit we are only building hardware and software like we don't even believe the doctor's office should exist we kind of think that's a thing of the past and that's kind of what we're that's kind of the the thing that we're announcing now so I just shared my screen with you I think you can probably see this beautiful yeah we have to describe this because majority people SPEAKER_03: will be listening but totally okay I see a blue beautiful oversized so this is called the forward SPEAKER_02: care pod and let me kind of describe so so here's the way to think about it if Elon has like the self-driving car well this is the autonomous doctor's office and if you're you're trying to imagine the aesthetics here's all you need to know I was a huge nerd as a kid I watched a lot of star trek and so if you remember the med bay I'm basically just trying to build the damn med bay right love it so so it's awesome you walk up to it you unlock it with your phone it's super futuristic it's like hello Jay Cal welcome to forward and as you as you step inside it basically just loads it's got this huge screen on the wall and it basically loads a bunch of different apps for you to play with and so when uh when those apps come up you can you can choose whichever one you want let's say you choose the body scan app this is cool like please stand still and then it rotates you in a circle takes a whole bunch of readings shows you the results on the screen explains them to you and then again like helps you with whatever treatment you need maybe you need a prescription maybe you need some other plan let's say you choose heart health this one's awesome it actually opens a tray and hands you a sensor it's pretty cool you hold that sensor against your heart it shows you how takes the readings shows you the results in the screen again gives you a treatment plan etc like probably the best way to think about it is almost the same way that you think about like an atm and by that what I mean is an atm doesn't do everything that a bank does it does maybe 90 95 you know you lose your credit card you can still call the teller well for us the same thing we still have doctors but now the doctors they're not doing the 100 of the care they're just there for kind of that final five or ten percent like the complex or or frankly you just want to kind of talk to the doctor you got some weird exception things like that right and so so this is a little what we built I actually have I've got like a video we could play and maybe just the first few seconds of it and you'll get a get a good sense of uh of what we're building but um but in essence what we're trying to do is we're trying to say like what would the future look like SPEAKER_01: this is not a doctor's office it's forward beautiful the world's first ai doctor's office it all starts with the care pod an entirely new approach to health care with prevention at its core with health apps in every category to choose from we're here to treat the issues of today and prevent the issues of tomorrow we'll start by establishing a baseline of your health diving deep into all aspects of your health past health history current health state future wellness goals body scan biometric monitoring blood testing genetics and more it's all about understanding where you are today where you want to be and how to get there after establishing a baseline of your health you are able to personalize your care with health apps curated for you like our heart health app proven to lower blood pressure in 90 days powered by in-person and remote biometric monitoring you'll be able to detect murmurs and other irregularities and lower your risk of a heart attack or stroke with a focus on keeping you healthy you and your care team will be equipped to make the right decisions for your long-term health or our skin cancer scan app to track and monitor things like mole growth skin lesions and discolorations over time or our mental health app to monitor anxiety and depression with ongoing guidance and support whether it's weight management diabetes screening or everyday care like a routine blood draw covid-19 testing or kidney and liver health there's something for everyone because health isn't just about seeing a doctor when you're sick it's about continuous comprehensive care that addresses your health concerns today and prevents those of tomorrow SPEAKER_02: wow yeah it's not bad right it's a crazy vision so so so take a step back right and just like think about why this is so profound when you go in this direction right like i told you earlier that we have oh i don't know about 20 locations and you're like okay that's real but like obviously that's because you're thinking of construction not hardware right if i told you i had 20 25 iphones you'd be like whatever like you know you bought that at the apple store 10 minutes ago well you've seen how hardware goes right you launch 25 then you launch 50 then you launch 100 200 400 800 1600 just just imagine that like we're gonna put more health care on this planet than the world's ever seen it'll just be like all around us right and then obviously you've seen you've seen how a world of apps goes right you just over time open it up so that anybody can build apps on top of you so the same way that apple ushered in a mobile computing revolution what we want to do is usher in the health care computing revolution like we want to power the new wave of health care so that starts to give you kind of hopefully a decent sense of what we're going after yeah feels like a super app with a physical manifestation of it so SPEAKER_03: you know with uber you can order food or you can get a ride and then there's other things that have been added to it or if you use some of the super apps kareem in the middle east you can totally click a button have somebody come clean your house uber is testing like tas rabbit kind of assistant you get the idea so here if i really want to check my heart rate you give them that piece of hardware you're making that if i want to do my skin which i have the mole issue now that i'm 50 and i get checked because i had skin cancer in my family i had a mole removed that wasn't cancerous but it was just you know gotten it had grown that doesn't require like reinventing the wheel this is a very basic simple thing you need to take a picture of it and then you have to monitor if it gets big track it over time yeah exactly over time and then i just did prunovo and then i've been doing blood tests so some of these like you're going to need a phlebotomist to do the blood test so so actually you know this sounds really crazy we do blood in the care pod SPEAKER_02: and i know this sounds wild but we actually don't use a phlebotomist have you seen these kind of like self-serve blood draw things no i gotta show you this okay hold on i'm gonna i'm gonna take my jacket off and i'm gonna show you so this isn't from us but if you think about what we're doing we're just kind of looking out there it's saying like what is the latest technologies that we can kind of bring to bear to consumers and so obviously one of the kind of cool technologies out there that you're probably familiar with in fact you might have used them is like the freestyle libre continuous glucose monitor right i've tried that yeah yeah totally a company called nutrisense SPEAKER_03: that okay yeah awesome yeah and awesome and there's there's a bunch of these companies now SPEAKER_02: well basically you can almost think of like the next generation of that as being something like this and there's a few companies that make these and don't worry they're fda cleared and all that but in essence what i'm going to do is just pop this off this is just double-sided stick tape and then i'm just going to go ahead and you know lift my arm my my nice like farmer's tan farmer's tan arm over here and just pop this on and then this little white chamber this is a vacuum chamber and so what i'm going to do is i'm going to puncture the vacuum chamber i'm not puncturing my skin i am not there's no needle there's no there's no lancet there's nothing cutting me but what it does if you see this little kind of tube down here it now basically has enough suction ability that it can literally like suck the blood out of you which i know sounds ridiculous it's like yeah it's like you know but if you've ever had a hickey like this is kind of what a hickey is or okay if you've ever done the like 15 years old but yeah okay well you know maybe you should have more fun in life um i'm just saying so so in essence what it's doing is it's just sucking the blood maybe you've had cupping have you ever had that weird massage cupping thing SPEAKER_03: no but i've seen gwen paltrow do it okay yeah okay i actually haven't had or sorry no i did SPEAKER_02: have it once i think it's weird but anyway but the point is okay so now do you see how this blood is like filling up right there yeah that is wild yeah yeah yeah totally so you see that a little SPEAKER_03: mini blood draw through this it's actually not that you just self-administer it's not that many SPEAKER_02: you'll get about 500 microliters i'm gonna stop this merely because honestly i demo this a lot and i don't like my blood um kind of you know fully leaving but you can kind of see like you know yeah and so that's the future yeah that's well maybe it's not the future maybe it's the present my man yeah so like but but the point is you can do that you can just pop it right back in that tray and then forward we'll process it for you right so so this is kind of the point the point is when you when you look like there's a lot of technology that actually exists i'm just putting a band-aid on yeah there's a lot of technology that exists for the purpose of of providing better health but that tech doesn't really make it to you today as a consumer mostly because like frankly the insurance company has no incentive to deliver better and better care it just cost them more so we took a slightly different approach and said well there's a bunch of cool stuff out there maybe we can bring it all together under one roof and if you think about what we're doing we almost look a little like the iphone right like they launched the iphone and then next year they're like oh now let's add 3g and 5g and lidar and gps and gyro yeah exactly it's like they add capabilities and then apps get built on top of the capabilities and that's what we're doing we're like great how many capabilities can we add you know pernuvo like caveat i'm an investor in them but like they've got some cool tech like maybe we should be building that in right and so you just look at everything that's out there and say can we build it and then every single kind of like health care provider whether that's a doctor whether that's a startup whether that's a who knows you know an academic they can all sit there and be like i can use all the technologies in essence what you're doing is you're kind of creating the the health care operating system that needs to exist and and to us that's pretty exciting if you're a sas or SPEAKER_03: services company that stores customer data in the cloud then you need to be huh sock2 compliant you knew that from a third party and you need that third party to close big deals and if you want to get compliant easier and faster you need to use vanta v a n t a vanta makes it so easy for you to get and renew your sock to on average vant customers or sock to compliant in just two to four weeks prepare that to three to five months without vanta and vanta can save you hundreds of hours of manual work and up to 85 percent of compliance costs this is a total no-brainer and vanta does more than just sock to compliance they also automate up to 90 compliance for gdpr hippa and more you can't afford to lose out on major customers we all know that listen it's a hard year last year was hard you can't lose those major customers because you don't have your compliance dialed in just work with vanta get your compliance automated and tight and tight is right lock down those big deals here's the best part vanta is going to give you a thousand dollars off that's 10 hundies get one thousand dollars off at vanta.com twist that's vanta.com twist for a thousand dollars off your sock to so how do you make money from this how does this become a long term sustainable business yeah totally so we charge consumers it's this age-old very confusing SPEAKER_02: thing in the world of health care but uh you pay us and we deliver you better health it's a good deal so we charge 99 bucks a month and that includes everything from your blood test to your genetic sequencing to you know chatting with our doctors to all the apps etc and if you think about it like when ford started you know we were 149 a month now we've cut a third of that now we're down to 99 right like and like we're just going to keep going it's the classic moore's law right we're just going to kind of keep lowering our price to 79 59 49 39 and like our our real mission is we want to get health care to as many people as possible so so maybe if we're lucky and we you know and we do the right things maybe one day we can deliver these in the middle of india and rwanda for like pennies on the dollar and like that to me is a pretty cool idea here in america let's just say SPEAKER_03: for people who are insured yeah they're spending on average thousands of dollars a year on insurance i don't know what the exact number is i'm going to pick a number four thousand dollars a year for the average american i think it's more but honestly i don't know the exact number sorry go with five SPEAKER_02: let's say five dollars from the american yeah so let's say out of that care they use up some SPEAKER_03: percentage of that like 80 of it with actual care i don't know because there's got to be some profit margin there but okay so let's say we're back down to four thousand dollars to spend per person in the health care system okay on average what percentage today and by the end of next year let's say somewhere in that range would you with ford be hovering yeah yeah so it seemed like a lot of the visits i do are a complete utter waste of time yeah that i could have just filled out an online form i could have just answered a text message but yet i have to go into my doctor my dentist everybody wants me to come see them for a stupid prescription that's how they get paid that's the problem it's so infuriating i know it's a waste of their time waste of my time waste of office space so of the four thousand if we're going to say that how much would we yeah yeah SPEAKER_02: it's a good question so like if you think about it we we can already do like kind of all the primary care stuff and then we can already do some specialties right so basically what we're doing is to kind of give you the strategy is we're just like watching every time we refer somebody outside of our system and then saying why do we refer them out like why didn't we just do that ourselves and so like we don't do all of cardiology but we do we do the frequent parts of cardiology we don't do all the dermatology but we do the frequent parts of dermatology and so we're kind of just continuing to add right it's like again the first iphone had i don't know 10 apps now there's a million right now it does basically everything except i think my house keys and like my driver's license and even that they're about to get you know like yeah so so the way i think about it is you know every day it's climbing up more and more i'd say today like easily for it is like cheaper and easier than using your literally your own health care plan and you're like what are you talking about i paid for my health care but not really because you've got a deductible and we're cheaper than your deductible almost always so like that's wild for me to think about right we are cheaper than using the thing you already paid for like what the hell and so so you know we're covering like most things you don't need to leave our system too often you know occasionally you do but like we're trying to cut that down every day in the you have physical storefronts now these SPEAKER_03: pods are the next manifestation yeah that's right cheaper and easier to deploy because you got it storefront yeah you got it exactly we're like our whole thing is we're just like how can we make SPEAKER_02: like health care super damn scalable and super good just increase the quality like you were talking about uber earlier well um let's just take a step back and let's ask ourselves like why is the iphone so valuable well it's because every single one of these icons is like a 10 to 100 billion dollar company right like uber at i don't know why they are 50 spotify at 80 like why because there's thousands of people working on each one of those prompts thousands of people at uber working on just transportation thousands of spotify working on just music well now ask yourself the question of like imagine you walk into a carapod and you're like me you got a little hair loss and you're like you know what there's a 10 billion dollar company working on just that you have a rash 20 billion dollar company you want to prevent breast cancer 100 billion dollar company like holy crap like that's an insane world right you'd be excited like no single doctor without a bunch of technology is ever going to compete with that like that's the world that we need to get to where we go super deep like understanding and solving each and every problem and and i you know i'm not a healthcare guy i'm much more your standard silicon valley tech nerd right so i can't i can't come up with what is the next healthcare and you know innovation but i can come up with like tools to help these researchers and doctors go deeper and deeper at solving problems and that's what that's what we're trying to do there is a nice part of this which was a silver lining of covid was we SPEAKER_03: forced remote and we forced kind of self-care to a certain extent where you had to take some directional ownership of your health care and so people would start using what are the online services hymns there's one for women roman totally a bunch of these and so people started doing remote prescriptions a little dangerous i guess it could be abused on the margins but people did realize oh you know it's really kind of awkward for me to get this type of prescription i don't want to talk to anybody i'd rather do it through an app i'd rather chat through an app and so i do think that you know getting a body scan or doing your scanning your moles and stuff like that it's a little invasive i would rather just stop by the pod i would rather just go to the med bay do it myself be anonymous let somebody look at my moles check them out etc i don't mind stripping down and getting my 3d scan in my skivvies or whatever it's cool that's just gonna i think that's gonna be part of the appealing part for young people is there a difference between how young people approaches versus old people how they will look at the pod yeah but you know what it might be actually the total opposite of what you where SPEAKER_02: you intuitively would go so here's the deal like if we look at our customer race today it's a skews a lot older than you'd imagine right because you know what when you you look at this and you're like oh 20 year olds are gonna love this but you know what 20 year olds don't give a shit about their health they give a shit about burritos you know what i mean like you remember when we were 20 like 97 years ago and we were like we're like we're invincible and now we're getting a little older right and now we're like oh god we gotta monitor our health oh god our backs ache you know and like you start your body starts breaking after after a while if you're gonna be totally candid right and so i think what you find is that this notion like oh but the young people adopt tech i mean not really dude like you know everybody's grandparents have iphones at this point you know it's like so yeah it's kind of for everyone interesting yeah and also you know i have SPEAKER_03: to i think what's one of the things that's happening is the last generation that didn't grow up with the internet is almost gone so you know like boomers yeah they're like our parents i guess or they're sadly going to be gone soon um a lot of us are dealing with that 80 year old parents then you go to gen x you know we kind of remember the birth of the video game and the internet so we're like yeah it's normal for us we barely remember not having it i mean we do remember it but you know barely um so yeah maybe it's a moot point everybody kind of likes technology now so we didn't talk about two topics i'll take it in whichever order you like artificial intelligence and wearables yeah i just got this new apple watch um i got it yeah you got the you got the new ultra too i got the ultra two phenomenal like where this is going what they're SPEAKER_02: okay so okay so let's talk about the wearable thing so the wearable thing is awesome and at the same time useless right so let's just take a step back um like if you think about it you remember when we were growing up how there was like what was that like sharper image that store sharper image yeah okay and we would buy all these gadgets we'd use them for like i don't know three weeks a month and then we'd throw the damn gadget away like it turns out the connected toaster was stupid but but in some ways it wasn't stupid because these days i've got the connected lights the connected garage connected everything but what's changed why am i not throwing them away and it's a today all these things connect to my iphones my iphone like kind of turned them into being like valuable but in healthcare we haven't done that yet so like i've got the the aura ring and in some ways i love this ring and in some ways this ring is the dumbest thing ever because it's like i wake up every morning and it's like adrian you slept terribly i'm like no shit i slept terribly i don't know what like you know it's like it's not changing my diet it's not changing my exercise it's not right so what you realize is like like you you need that what is the iphone for healthcare you need it to radio back so everybody says great have it radio back to the doctor it's like really do you think your doctor is going to sit there and watch your metrics all day like that's not what they're big for some health coaches you're paying thousands of dollars a year exactly SPEAKER_03: SPEAKER_03: and that's not scalable it's not scalable exactly so then we said well maybe we just create the SPEAKER_02: healthcare os that everything plugs into we use that data in your apps and now all the apps can use all the capabilities and all the data and that's an awesome world because now some random new developer can come out tomorrow and be like hey that were a ring data we think that data is pretty valuable we actually think it's valuable in helping you with something else i don't know your posture i'm making this up right whatever it happens to be and like that's a pretty cool world so i think that the wearables are almost like before their time by that what i mean is in technology we almost always hub and spoke things we had servers servers allowed us to have desktops desktops allowed us to have laptops which allowed phones which allowed watches which allowed right like wearables but if you forget the chain before like how useful is your laptop without a server pretty damn useless right like going to go on a plane with no internet you put your laptop away right um and what you realize is in healthcare we've forgotten the hub and spoke model we forgot to build like the care pod and instead we went straight to you know the ring and it's like cool but that makes them incredibly limited in what they can do i mean no doctor has said can we have SPEAKER_03: your apple watch data we have your eight sleep data can we have your aura ring data can we have your peloton data like i'm really waiting for the med bay to kind of pull this together and when if i came in and it was like hey by the way take out the app sync it boom would you like you know somebody to review this so then talk to me about what is the role of a doctor in your world are they going to pop up on the screen in the in the yeah so in the med bay and say hey you know great job let me ask a couple questions here there's arguably like three things that SPEAKER_02: doctors um kind of are at their core a doctor is is hands heart and brain right it's the hands as we do physical things it's the heart like we're just a caring empathetic person right when you're in a tough spot you know you probably don't want the screen to be like by the way jcal you've got cancer like that kind of sucks right yes and then it's their brain it's the algorithms well the reality is our brains are not incredible calculators right we should probably let ai do that and on the hands like sometimes you need the doctor but pretty rarely they're actually a really expensive version of hands right you know i don't know if you crash your tesla model 3 do you take it to the i don't know doug field or whoever's the head of engineering of the model 3 program at tesla no you take it to a mechanic right the mechanics cheaper right so you just get specialists that can do it or you do it yourself and then um and then it's this notion of like the heart and i think that's really valuable i'm not sure it needs to be a doctor like if you're going through a tough time maybe maybe your you know your sister your brother your girlfriend wife whomever it is can be the one to help you through them but but the point is that i think that we're almost kind of decomposing what a doctor is into these various constituent parts for us and we have a lot of doctors at ford and we have some of them that are like building out the applications and we can talk about how we use ai there but then we also have some that are just kind of there for the exception case with what the computers aren't good at or or just there to kind of coach people through their tough times right and i think each of those is a valuable thing but the key is you want to rely less and less on doctors on a ratio basis like you're not going to grow a million doctors tomorrow so what you really want to do is make sure that each doctor can serve more and more people they can have more and more impact like look i'm an engineer i was at google i was working on search like i could write code that went out to three billion people later that day like that's wild yeah now ask yourself like you know can a doctor do that can a doctor affects three billion people later today no they affect one at a time that's crazy like they're highly educated they're like let's build better tools could be in some central location and then servicing pods across SPEAKER_03: you got it across the border yeah yeah and and then where do you place these pods in the image you showed it looked like the lobby of an office building so i'm assuming that's that's right these companies are self-insuring i understand which i think is a fancy way of saying they just pay for the some x amount of health care per person you know that yep this would be super affordable to put in the you know on a college campus or in a you know ibm or google campus or facebook campus yeah yeah we have so we've started rolling them out in malls and office buildings um and then SPEAKER_02: we'll go from there we'll go everywhere i want to be in airports sports stadiums i want to be i mean you name it i want to be on cruise ships one day you know every random place you can think of i want to be right um my goal is to get to the middle of india the middle of rwanda right like for us this is just the beginning right and so so yeah we know it's a long journey and we'll we'll work hard to get there but you can just imagine that like when you think of an atm you're kind of like they're just always all around me there's always one somewhere you know within a few minutes of me you can rely on it exactly and that's kind of what you want your health care to be you're like oh i got to deal with something insurance companies think about you the doctors obviously SPEAKER_03: some doctors are going to be drawn to this and think it's amazing other doctors are like i got my own practice okay so i'm sure it's a split decision there i'm correct yeah yeah yeah i SPEAKER_02: think most doctors look at us and say hey this is clearly like you know you're in the right direction i think you know some small number think we're crazy but like mostly once they once they kind of look at it they go okay that's cool but you're right some some want to make the transition into the new world some don't right and that's not going to be easy on everyone i acknowledge that insurance companies it's interesting mostly they've kind of wanted to partner we've actually had some try to buy us in the past um problem is i think like insurance causes a lot of problems in our health care system right the the average persons with their employer for usually about two and a quarter years which means you're with your insurance for about two and a quarter years and so what that means if you think about it is like they're pretty short-term oriented like you ever notice your employer doesn't walk up to you and say hey you know let's sequence your dna to understand the cancer you're going to have in 30 years why would they like they don't want to incur the cost that's the next guy's problem but they do walk up to you and say hey get your flu shot like why well because you might miss work next next month right and so we created an entire health care system that's really focused on keeping you at work not keeping you alive and like i kind of hate that incentive i think it's a pretty rough incentive you know yeah all right SPEAKER_03: building a startup is really hard and things well they can turn on a dime you can do everything right and let's face it you can still fail well that's where Arising Ventures comes in Arising Ventures is a holding company and they acquire tech startups that are facing setbacks let me tell you about one of Arising Ventures success stories Jive is a talent platform that matches retail stores with in-person workers. COVID totally crushed Jive's business and the company was forced to shut down in 2021. Then Arising Ventures bought it out of liquidation they brought back a couple of the key team members and they restarted the business and they went from zero to one million in ARR in just five months now the company is serving some of the world's biggest brands now listen Arising Ventures knows what founders care about because they aren't bankers they are tech founders themselves so here's your call to action you can learn more about Arising Ventures and connect with the team at arisingventures.com twist after submitting your information you'll hear directly from the founding team within 24 hours that's arisingventures.com slash twist and so AI's role in all of this yep people are having an interesting time uploading their blood tests and all kinds of other diagnoses or reports and then saying hey tell me about this sometimes it hallucinates sometimes it finds interesting things yeah clearly we're on the cusp of this could be certainly really helpful for people who don't have a healthcare system you mentioned like 70% of the planets doesn't have healthcare the way we think about it so for them it's going to be all upside totally totally so where is this all headed do you trust it or not yeah so I'm going to tell SPEAKER_02: you something counterintuitive no I don't really trust AI touching consumers yet and so not on something like this where the stakes are really high so what we do is we use AI to give tools to our doctors so let me give you an example like we've got some we've got a cool AI that kind of goes out to the internet looks at like what the latest guidelines and research says about a condition and then extracts that out and kind of helps us build out an app inside the care pod but the first thing it does is it shows that to one of our doctors here and our doctors on our central medical team look at that and they say okay this is right this is wrong I kind of want to you know solidify it test it good now ship it off so we're not one of these companies we're not like hey user just go talk to the LLM because you know right now as you mentioned the accuracy of these LLMs is not high enough for this use case you know what I mean like it'd be be pretty scary so we shouldn't do that maybe one day they'll get there I don't know you know I hope so but um but no we don't do that in fact even when you're in the pod anything that the pod's doing actually we've got a doctor or a nurse practitioner depending on your geography like sitting at home watching the data kind of in real time and being like hey you know what yeah like this is the prescription I want to give this is the diagnosis I want to give so again you really really want to to kind of there's a lot of companies in healthcare that are like pure pure service and there's a lot of companies that are like pure AI and that's great but like actually the best of both worlds is where you want to be so what we do is like use computers and what they're good at and use humans at what they're good at uh so what success for you what are this like if how do you know you've got this to where SPEAKER_03: it needs to be look my goal is I want to get health care to billions and billions of people SPEAKER_02: I want to be the first health care system that uh that scales to a billion users by the time we've got these care pods in the middle of india in the middle of rwanda I'm gonna say okay we we did what we set out to do like that's an awesome world and what's kind of crazy is if I told you like hey I want to go get you know go build kaiser in 50 countries and get them to a billion users you'd look at me like I'm crazy be like good luck once you kind of see this you can kind of just be like okay I kind of get it like I've seen this path there was an 800 iPhone now in the middle of India I can buy a smartphone for 20 bucks like I get it right and so for us it's like the path from here is incredibly well understood and well trodden but it's it's hard execution that's on us we got to go execute how many people do you have at the company now I know you've raised a couple SPEAKER_03: hundred million for this this is a vision yeah oh yeah we're uh we're not small I don't know more SPEAKER_02: probably still less than a thousand but not far from it my friend we got we got a decent amount of people overall yeah incredible and then uh 100,000 tens of thousands of members so far oh SPEAKER_02: it's it's a it's a bigger number than that but uh but we don't give exact numbers but it's it's healthy it's healthy no pun intended it's just an incredible vision and obviously we're all rooting SPEAKER_03: for you to make this super kind super kind so you're this is primarily us right like you just start here us for now but obviously if I want to get to a billion you know as well as I can't stay SPEAKER_02: in the us so so we're we're not gonna you know go go international immediately but we will sooner rather than later yeah I mean there's got to be some countries that have money and a large SPEAKER_03: population and could see this as a very strategic thing I'm thinking like India Pakistan I'm thinking about people with hundreds of millions to and and then need it because they have no solution like SPEAKER_02: what's crazy is you know we complain about our health care in the us but like we have doctors I can show you like 100 square mile areas in in sub-saharan Africa where there's no doctor around and you're like what are you talking about like that's insane you know what I mean so so yeah I get really excited to get to these places that need us most would be incredible if a government SPEAKER_03: actually you know government of India Pakistan I don't know pick some country with hundreds of millions of people who yeah they don't have enough doctors to go around man what a great front line of just and it's got to be a massive cost statement what does a pod cost to make a couple hundred grand we we don't we don't share the number but it's a lot less than most people SPEAKER_02: think it's it's not it's not that much like it's tens of millions I mean it's not tens of millions no no no no are you doing the full are you doing that body scan in there I know we're not so so SPEAKER_02: we're not yet doing the like call it the prenupo cubio style we want to get there the the cost right now that's still pretty high and we're kind of honestly just waiting for those guys to like optimize and lower their costs and as soon as they do like let's build it in you know SPEAKER_03: right that would be a lot easier and the yeah the uh Daniel Ek is doing his back some yeah I think SPEAKER_02: we're I think we do everything I need to fully confirm this but I'm pretty sure we do everything that his does his is his is much more like the kind of like us the scalable he's doing a body scan like a 360 body scan yeah I think he's just doing like what what I think are just time of SPEAKER_02: flight sensors but honestly I don't want to speak out of turn I could be wrong on this yeah there's SPEAKER_03: are those full body scans helpful or not my doctor was like uh you know you may find stuff that you don't want to check out and it just creates anxiety but you can do it if you want but so cheers yeah so what you're mentioning is a real issue so here let me give you the way to think SPEAKER_02: about it whenever like let's pretend we we looked at every cell in anybody's body and said we're going to go see if you have cancer well I had to break it to you pretty much everyone has some cancerous cells and so you might say well if I know should I remove them well maybe not see some of those cancerous cells are going to become something bad some of them are never going to cause you any harm so actually just removing them is causing you more harm and so the problem is that when we do these full body scans we don't know as an industry like in in the world of health like we don't have good priors good data to say well these are the ones you should remove these are the ones you shouldn't right like and when you don't have that data it kind of means I don't know we might be harming people and so what happens is you know there's this line in in medicine when you go fishing you find fish like you're going to find something and you might harm somebody so the reality is that the people doing it today are kind of actually really helpful because we're all the guinea pigs and I've done it myself like we're all the guinea pigs for the people in the future so that we can go all collect the data and be like this is the one you should remove this is the one you shouldn't have removed you know what I mean and that's that's kind of the reality now generally I'm an engineer so like you know I learned in I think second grade knowledge is power like you know more data can't can't hurt but it's really important that once we get that data we figure out responsibly what what do we do with it and we can't just say oh I have cancer ergo I must do something because you know what maybe you shouldn't maybe there's different grades of cancer maybe there's different levels yeah it's complicated uh it's great to have somebody with a SPEAKER_03: product vision working on this and we saw it up close and personal with uber you know just you can build a global business like this you do get network efficiencies and when like you said you know there are a hundred thousand of these out here and one module gets upgraded and 10 people can visit it a day I mean you got it that means you know every day a million people can benefit and a lot more than 10 can visit yeah I mean now you got it exactly that's the thing hard work and SPEAKER_02: amortize once you turn health care into an infrastructure problem man is it a good world yeah awesome this has been amazing I wish you continued success you're hiring I know that SPEAKER_03: who do you need to work on this crazy vision and help you get on with it honestly anybody who we SPEAKER_02: only look for really two things wicked smart and you care to help others you care to help others so much that you put that in front of yourself if you want to live your life in service of others and you're wicked smart great you don't have either of those maybe not I think that's the SPEAKER_03: thing we all learned about hiring is like there's people who are talented and then there's people who are mission driven and man if you get somebody who's just mission driven and passionate about it and they're talented you got it that's just going to be great for everybody and then talented people who are not mission driven they're okay for a time and then people who are not talented are just you know just yeah so you got it I love it it's like you can kind of go from qua I hate to say it's something yeah yeah yeah go you gotta find your skills yeah there are people who are mildly talented right and then that's always the problem you know like I would rather have sometimes there's people who are just like talented enough there are seven of ten and they're just so much it's like it's nice to have around it's hard it's hard that around somebody's really talented but they're not mission driven they're just a mercenary they're gonna cause chaos at some time yeah something that the truth ain't that the truth at least they mean well at least they mean well what's SPEAKER_02: SPEAKER_03: your favorite moment working for larry page favorite um you got oh my god that you can tell he's a very iconoclastic individual yeah nobody hears from him anymore he's kind of yeah very quiet uh sergei's back involved we know that he is he's engaged nobody knows the extent to which larry page is engaged in in our last in our i have many i'm not sure i should say most but here's SPEAKER_02: what i'll tell you i'll tell you the one yeah the one i'll give you a lesson from larry not a story because that'll get me in trouble i'll give you a lesson in our last in our last two minutes but okay i used to think that i was a big thinker and i don't think i was a big thinker until i really worked for for larry um i'll tell you larry told me something once he's like you know and i'm gonna paraphrase but he's like it's just it's just as hard to work on easy things as it is to work on hard things he's like pretend you want to build the world's best spoon what are you gonna do you're gonna raise a couple million bucks get 20 people in a room work on it come out with a product a year later let's say you wanna i don't know go to mars you're gonna get raise a couple million bucks so you know uh get 20 people come out with a product a year later like at some point you realize like your first steps are always kind of the same you might as well work on something that's enormous right like at least like look what we're working on it for it's really damn hard like i i don't have any pretense about it like we know that our probability of getting health care to a billion people is a rounding error to zero but you know what man we get to wake up every day and be like yeah but you know what if it works like look at the world we live in yeah and to me that's the ball game yeah i mean i think that's the right way to look at start startups is you know what if it SPEAKER_03: works and we saw that with uber we saw with airbnb chances are love success what if it does work if it does work does like man are we happy man are we happy well listen i'm rooting for you everybody SPEAKER_03: uh the domain name is goforward.com a pretty good domain name goforward.com i don't know who's got forward.com but a a 100 year old jewish newspaper that did not want to sell it to us i will tell you SPEAKER_02: that okay respect yeah it's totally hard to argue it was hard to argue yeah hard to argue yeah so SPEAKER_03: goforward.com it's actually it's got more it's more active go yeah that's right that's right everybody check it out go sign up 100 bucks a month and this is the future of health care continued success and we'll see you all next time on this week in service bye-bye