a16z Podcast - a16z Podcast: Tackling Senior Care with Help from Technology

Episode Date: April 10, 2015

It is something we all face -- the prospect of taking care of a parent (or two) when they can't quite take care of themselves. For Seth Sternberg, part of the founding team of messaging service Meebo (bought by Google) a trip in the car with his mother reinforced the inevitability of her aging. Today it was her driving, but soon how would she manage everything else? For Sternberg, the answer to that question lay in part with technology. How could technology be brought to bear so that his mother -- and other seniors -- might stay in their homes longer and live not just physically satisfying lives, but lives that addressed their emotional well-being as well? The founding Meebo team got back together to build that technology, the backbone of their new company Honor. In this segment of the pod Sternberg and co-founder Sandy Jen discuss how technology needs to disappear into a human experience -- becoming something that isn't about the shiny and new, and more about human interaction. Also, after such a successful run at Meebo why torture themselves with building some new? The answer is exactly what you would hope.

Welcome to the A16Z podcast on Michael Copeland, and we are here in San Francisco in the World Headquarters of Honor with Seth Sternberg, CEO and Sandy Jen, head of engineering, one of the heads of engineering, I should say. So welcome, guys. Thank you. Thanks. You guys just came out of stealth mode, you know, a matter of a week or two ago. So explain for us at the high level what Honor is and what Honor is doing. Sure. So, Honor is reinventing in home care for seniors. So I went for a drive with my mother back in Connecticut, maybe a year and a half ago now. And I just noticed that my mother wasn't quite as good a driver as she used to be. And that just got my brain thinking about, like, wow, like what happens in five years or in 10 years when, you know, my mom who lives in Connecticut, which is a six-hour plane flight from me, needs help to be able to stay in her home. And my mom loves her home, right? So I started looking for ways to make sure that I never, had to have the conversation with my mom that was, sorry, Mom, it's time to sell your home and move into assisted living. And what I found is that there are no good ways today to really help my mom stay in her home. I'd be scared, frankly, to help my mom, or to have my mom use the current set of services that are out there for her. You know, at best I'd have to fly

to Connecticut and interview 20 care providers and pick one and have no idea. I'd be in the dark in California having no idea what kind of care my mom was actually getting. So we're completely reinventing in home care by both creating a way for seniors and care professionals to be matched, right? So a way to find the best care professional for the needs of your parent. And then making it really easy for you to get, you know, have that care delivered. So things from having the parent know who's coming to their home and when they're going to get there by putting a device in their home. Me is the kid having a app on my phone that tells me, hey, you know, Jeanette spent two hours with your mom today. Here's what she did with your mom and here's a note about your, you know, what

happened with your mom. And then also, you know, empowering the care professionals to be the professionals that they really are. You know, giving them client information, letting them choose their hours, letting them choose who they do and don't work for, you know, paying them in a much higher rate, right? Their earnings potential right out the gate with honor will be in the Bay Area for our Pioneer is $17 an hour, and we're creating a floor of $15 for the company. And that's a huge deal when the average earnings for care providers today are $9.50 an hour. When you think about, oh, I don't want to have that conversation with my mom. And your reaction is sort of like, well, I'm going to have to go search and find the best people I possibly can

and take all this time and maybe move back to Connecticut for a couple of months or go back there all the time to just make sure it's working. How does technology sort of take all those things that we do in a very ad hoc way now and make it better? So I think at the heart of what Honor is, you know, even though we're using technology to enable, you know, a wonderful service, we're a services company. Like at the end of the day, if you feel much better about who's coming to your mom's home, you feel like your mom's seeking care of, you feel like there's a sort of a peace of mind, that's the success goal. And it's not. about what is the app that powers that particular interaction and so we use we

see technology as an enabler it's how do we create technology that creates a wonderful human experience rather than you know having the technology be front and center showcase and I think you know these days in the Valley you know there are a ton of these services you know Uber Montreal these sort of you know food delivery which is great but you know I think people see it more as an app or technology rather than well you know what is the quality of service that my mom can get on home care situation. And we really need to sort of think about that angle rather than,

well, what is the fancy and new shiny iOS that I'm going to get with the service? That's so exactly right. I mean, you know, the technology does stuff like letting you pick between, you know, thousands of care professionals to make sure that your mom gets the best person for her specific needs. Or the technology makes sure that, hey, if the care professional who normally serves your mom is sick today, very quickly we're able to find a replacement who's the best next match for your mom. for your mom. So it does things to create a much better service or even just visibility, right? Like knowing who was in your mom's home, getting that in-app notification that tells you

Jeanette was there. She spent two hours with your mom. But fundamentally, it's humans, right? It's about providing the best care possible for your mom. And we're all about enabling the care professionals to provide amazing service to the seniors and to their families. So we build technology that makes it incredibly easy for the care professionals to do their jobs extremely well for the families. So it sounds to me, and this is I'm channeling my Jeff Jordan kind of marketplace's view of the world, it's a marketplace. But what are the then, is it a two-sided marketplace, a three-sided marketplace?

How do you view it? Yeah. We think of it as a three-sided marketplace in the sense that you have the families and then you have the seniors and you have the care professionals, right? And so those are kind of the core constituents for the marketplace. Now, Marketplace is kind of a loaded term because I actually think that the experience of a user whose mom just fell, right, is just getting, you know, discharged from the hospital. The last thing they want is to wade into a marketplace and try to figure out, you know,

I didn't know care providers existed before, and now I have to pick from one of 100. That's terrible, right? So it's a marketplace in the sense that it is a market matching, you know, needs with, you know, capabilities, yeah. But the experience is not that, right? The experience is something that should be much, much easier and more intuitive for people. I mean, it's crazy, and I'll just tell you my own story, is that, you know, we, my mother was just in the hospital, and they send you out of the hospital. They're like, okay, you're out of the hospital, but you're going to need this, this, and this. And you're like, how am I going to do that?

What do I do? Yeah. No, we've seen the printed sheet. We've gotten from the hospitals, the printed sheets, and it's literally a printed piece of paper, right, that they've run off a photocopier, and it has, like, a list of 20, you know, agencies with phone numbers, no email addresses, no websites, right?

It's like, here you go. Right. That's tough. Good luck. You're expected, and part of the panic is that you're expected to become a knowledge expert instantaneously when you have no idea what's going on. Right. And so part of our goal is to have honor be that knowledge expert

so that we're taking all of that burden away from you and putting it on our lap so that when you are in that situation, it's very easy because it's already difficult. So how can we make that as seamless as possible? So you guys are part of the core team that started Meebo, which was wildly popular messaging and kind of community service

where people wild away, wasted, dare I say, lots of time. But what was really interesting about Meebo was like this engagement, people just hung out for hours and hours. In the same way, that engagement and that kind of activity and sort of the messaging and community world, what have you learned from Meebo that in some ways may apply to this? I think one of the really interesting learnings, and we've sort of used that and how we form honor, is that when people are part of a movement or they feel part of the process, they feel much more engaged as if they're part of the team.

And so when creating honor, we really wanted to have that same emotional tie to you know all the constituents in the in the marketplace and also just the audience at large and so having people feel like they're part of the build process of hey look we understand you we want to hear your feedback we want to integrate all that feedback back into our product and our services that was really important and it really worked with me though the very early adopters you know were very instrumental in evangelizing the service you know becoming our tech experts in the forums and so creating that community I

think is really important for us and we're trying to sort of integrate that learning back to honor as well. I think there's another big piece which is, you know, there's a lot of focus in today's world on the physical needs of a senior, right? Like helping them get out of bed, helping them with, you know, breakfast. But there's not enough focus on the social emotional needs of the senior. And a big thing for us is how do we create community for the seniors who are customers of honor, right?

Because that helps solve the isolation issues that seniors often face. And so, you know, Sandy's completely right. One huge part is community around those who are really purchasing from us, right? Like the caregivers, the, you know, sandwich generation that is trying to take care of their parents while they're trying to take care of their kids. And another big piece is community for the seniors themselves. And what might the latter look like, the community for the senior themselves? You know, it's something even as simple as, you know, once we have scale in a given area,

like, you know, scale in a given neighborhood, what if there were a Mashang night? at one of our customers' homes, right? Or what if we made it really easy for seniors to know, you know, what's happening at the local senior center? There's so much that we can do. We've heard a lot of stories where a senior was, you know, living in their home, and they don't really know a lot of people. Maybe they're in plants from a different part of the country or internationally,

and all of a sudden they found someone who spoke the same language. Right. And it opened up so many doors because all of a sudden they could found someone they could talk to and relate to. And so we could sort of form those connections within the honor platform. That would be wonderful. And again, I also, I can imagine that on the sort of child side sharing stories or this work for me or, you know, this was going on and here's how it all played out for me. When it comes to technology, we always think about tablets are better for older people because they're simpler and they can just push, you know, push an app and keep going.

But like there's a, there's often a sort of goal for a gap between the latest technology and sort of seniors using it. one do you believe that's true and do we eventually like you know as you guys get older and somebody's taking care of you this technology just the way you do things and because you grew up with it but do you need to approach sort of the technology that they see and use and engage with differently the population that's somewhat older versus you know you are the caregivers for that matter or the children yeah well I think there's one piece which is you know some of the seniors just won't be able to use what we put in their home period, right? They won't be the eyesight issues or, you know,

just lack of mobility. So one piece is that the technology that we give to the seniors has to be enabler and something that makes their experience better if they're able to use it, but it can't be a requirement. I see. Another piece is kind of like somebody was saying, I think we're in this weird era with technology right now where when you're using technology, you know, technology, you know, digital technology, right, are smartphones and PCs, you feel like you're using this thing called technology, right? And I think that's an era that's going to come to a close pretty soon, right? And I think we're going to go into an era where technology enables experiences.

And it's kind of like using a toaster oven or a microwave. Like, everyone can use a toaster oven in a microwave. They are technology. You don't perceive it to be technology, right? And I think that we're moving to an era where technology just will enable experiences, and that anyone can use, right? So I think we've been in this weird cycle. I think we need to build technology for that next era.

So how does that play out? And maybe you can talk about this, but, you know, technology in the home, are we talking about a house bristling with sensors? And so, A, it knows your parent is there. It knows that it's nighttime and, you know, the lights are still on for some reason, and or this person has gotten up five times in the night. or can't get up in the morning for that matter. What kinds of things does that play out

and how does that then become an experience? I think with one of our strategies is, you know, seniors have been, well, the marketplace has been inundated with hypotheses on what is the best way to care for seniors in their homes. That could be from sensors to devices to the life alert, you know, all these things that they can wear. I've fallen and I can't get up. Yeah, and, you know, like Seth said,

a lot of this has been really focused on physical needs and how do we solve for the, if they fall in, what do we do? But none of these really address the, well, have you asked the senior or the person living in the home, what do they want? And oftentimes you hear, you know, I don't like to be spied on. I don't want control still. And part of aging is also, you know, a process of, you know, honestly losing a little bit of control.

And so what we want to do in honor is to make them more of an active participant, like not just a receiver of the care, but, you know, someone who's really involved in it. And so our strategy is to, create something that's not really invasive, but very subtle. They can choose to use it, they can choose not to use it. And maybe in the future if it becomes more acceptable in the ecosystem and people are more used to it and sensors are less invasive, maybe that's something that we can think about. But from a starting perspective, again, we don't want to make technology

front center. We want to make it enabling of a great human experience. And so for us, I think the best way is still, I think we're still learning about that. And, you know, we're still learning about that. And, you know, honors strategy right now is to create something that's, Seth said, very appliance-like and not scary and technology and new and too slick and interesting, you know, in that sense. So I have to ask, Meebo, you guys, Google bought Meebo after a time, and you guys both went to Google and spent some time at Google. You guys had built something great. Like, why, I really want to know, because we see it all the time, but why build another company? Why go through the sort of torture of doing it again? Yep. So we clearly can still

talk to each other for that. You know, when we, when we sold Meebo to Google, we were tired, right? And, you know, Meebo had high highs and low lows, just like almost any other startup. And it was an awesome run and we assembled an unbelievable team, right? And I think one of the best parts in Mibo was when we had, when we originally launched the, we had a lot of soldiers in Iraq still. And we would get all these emails from soldiers in Iraq, and they would tell us the only way that I'm capable of communicating with my family back home is by Meebo. And from a user perspective, that was my favorite thing about Mibo, because we were like clearly making those people's lives better. And, you know, after you sold one company, right, you kind of have

to ask yourself, how do I want to spend my time? And we had a long list of like, how were we willing to spend our time. Like, what would motivate us to get up in the morning? And number one on the list was we had to look at human in the eyes and know that we're making their lives better. And that's the best way you can possibly spend your time. Like if you have to work on anything, right, work on something that makes humans' lives better. And we also wanted to find something where once we got that going, right, once we got an engine going, that it would be self-sustaining, right? Like, if we could make humans' lives better by creating a real business around it, then we could make so many more humans' lives better.

because businesses have this nice thing that they're kind of perpetually in motion and perpetually growing as long as they're working in businesses, which means you can have even bigger impact. So, you know, you can go to the beach, you can, you know, go to the desert, you can rock climb all day long or ride bicycles in my case. But I think to us, you know, there's a limit to how much kind of fun you can have before fun becomes boring. And then you search for meaning. And I think for us, meaning is helping other people and making their lives fundamentally better. Sandy, when Seth sort of got back from Connecticut with his driving experience with his mom, did, were you like, okay, let's do it, let's go. Yeah, you know, it's

interesting because helping seniors was actually on our list of possibilities. We were looking at really large, large plays, like what could we fix society, unemployment, childcare issues, health care issues, you know, senior care was on there. And he came back and he was like, senior care seems pretty interesting. I just had this experience with my mom that kind of freaked me out. And so, you know, as being, as sort of, you know, interesting, curious people, we started to dig. And the more we dig, we were like, wow, there's real opportunity here because this is kind of not an awesome space. We don't talk about senior care much in society. We don't, it's generally a very taboo subject.

We don't talk about death. We don't talk about things like, oh, you know, my mother can't go to the bathroom by herself anymore. And these are issues that, you know, a lot of people face, but no one wants to talk about it. No one wants to put it in front and center. no one wants to solve these problems and so we looked at you know many many areas of senior care and you know when we decided hone in on in-home non-medical care it was like wow this there's something special here that we could do and with our skill set and with our resources we thought we could really make a difference and we could really

look someone in the eye and say I could help you and the awesome thing is that this you know when this works and if this works we can use this and we're old right so that's a great you know sort of feeling where you can create something that really lasts so Well, in the way that this is a massive market, and it's also in a way that everybody can immediately be like, oh, God, yeah, this makes sense, where I'm going to have this problem if I don't have it already, there's also kind of probably another part of that where people will look at, you know, you folks from Silicon Valley and say, well, why, you know, why should they solve this problem?

Like, what do they know about this? Like, how do you answer that? How is it that you think, you know, your view of the world, which is a fresh one, I think when it comes to this, is the right, well, we'll see if it's the right one, but it deserves a shot. Yeah. So, you know, one thing we're passionate about solving problems that we experience personally, right? And so, you know, we're people like anyone else, even if we're from Silicon Valley. And this is a problem that we're really, really passionate about. And the biggest thing when you're trying to solve a really big problem, frankly, is starting with an amazing team.

And a lot of times that amazing team is a team that does not. look like you, right? You go out and find people who fill in for your weaknesses. So, you know, we went and found Fadra and Fader joined us and the first 13 years of her career down in San Jose was working with home care workers. You know, we found this woman named Shruti who joined us and Shruti's career to this point was at Kaiser doing national quality for Kaiser's in-home care agencies. So, you know, we went out and then you know someone who's been helping us as we've been doing care professional orientation is someone who was a scheduler and did tons of

care professional screening at a agency so you know we found people who have deep expertise either in working with home care workers or working in the you know in the in home care space to supplement our expertise which are more around a technology platform that can scale and kind of the building of a company. So it's all about putting together an amazing team, and that team has to be diverse, like by definition in order to succeed at solving a problem this big. You mentioned the moment at Meebo when soldiers in Iraq were saying, like, we used Meebo to communicate with our families, and that was, you know, one of the greatest things about Mibo.

As this goes and as it succeeds, what do you think that kind of moment might be for you guys? Is it going to be some... It's kind of already happened a few times, to be honest. It's interesting because the more you talk about this with people, everybody has a personal experience. It's like, oh, I went through this myself, or my grandmother went through this, or my cousin went through this.

Oh, my best friend is going through this right now. Why couldn't you have launched, you know, a year ago when I needed this right now? And so in that sense, it's become very... It's kind of driven us to go faster and work harder because it's so big of a problem right now that you're meeting, like everybody has some sort of touch point with this. And so I think, you know, that in itself is rewarding, but it's also very,

it's just a very driving force. Like you feel like you're kind of trying to solve all the problems as fast as you can just because there's so many people sort of banking on your solution to help them. And so I think that's, it's already happening. Yeah, I mean, I was up in Seattle and I was like, oh my God, I could use this right now. So get there quickly. And you guys are piloting now, I know, I'm more soon. Yeah, soon we'll launch our, so we're already onboarding our first wave of care professionals onto the platform,

and they're in orientation right now, and then we'll be launching our first homes in Contra Costa County later this month. Across the bay from San Francisco. Yeah, that's right. Well, Sandy and Seth, thank you so much, and we'll keep an eye on this, and we'll revisit it, and, you know, I can't wait for it to come to my neck of the woods. Awesome. Thanks, Michael. Thanks. Thanks.