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

Episode Date: November 15, 2023

This Week in Startups is brought to you by… .Tech Domains has a new program called startups.tech, where you can get your startup featured on This Week in Startups. Go to startups.tech/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 SOC 2 report fast. TWiST listeners can get $1,000 off for a limited time at vanta.com/twist 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 are tech founders themselves! Go to ⁠http://arisingventures.com/TWIST Today’s show: Forward CEO Adrian Aoun joins Jason to discuss how his startup creating the first AI doctor's office (13:55)! The two dive into how Forward's AI technology operates (15:55), the challenges with modern healthcare (9:52), and how Forward plans to revolutionize the healthcare service (40:36). * Time stamps: (0:00) Forward CEO Adrian Aoun joins Jason. (1:46) VC in the Middle East and the lack of diligence in the last boom and bust cycle (8:51) .Tech Domains - Apply to get your startup featured on This Week in Startups at https://startups.tech/jason (9:52) Challenges in healthcare and Adrian’s journey to Forward (13:55) The Forward “Care Pod”, an AI-powered doctor's office providing scans, monitoring, blood tests and more (15:55) Adrian demos Forward’s product (23:44) Vanta - Get $1000 off your SOC 2 at https://vanta.com/twist (24:50) Forward’s business model and target customer (28:08) Figuring out how to make healthcare scalable (30:29) Reactions to the Care Pod and thoughts on wearables (34:51) The role of a doctor in Forward’s ecosystem (37:28) Forward’s rollout strategy (39:35) Arising Ventures - head to http://arisingventures.com/TWIST to learn more and connect with the team (40:36) AI’s role in Forward’s technology (43:27) The size of the company and plans for expansion * Check out Forward: https://goforward.com/ Follow Adrian: https://twitter.com/adrianaoun https://www.linkedin.com/in/adrianaoun/ * Great 2023 interviews: Steve Huffman, Brian Chesky, Aaron Levie, Sophia Amoruso, Reid Hoffman, Frank Slootman, Billy McFarland Check out Jason’s suite of newsletters: https://substack.com/@calacanis * Follow Jason: Twitter: https://twitter.com/jason Instagram: https://www.instagram.com/jason LinkedIn: https://www.linkedin.com/in/jasoncalacanis * Follow TWiST: Substack: https://twistartups.substack.com Twitter: https://twitter.com/TWiStartups YouTube: https://www.youtube.com/thisweekin * Subscribe to the Founder University Podcast: https://www.founder.university/podcast

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 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 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 going to do? You're going to 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 going to raise a couple million bucks, you know, get 20 people, come out with a product a year later. 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 at Ford'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 is brought to you by dottech domains has a new program called Startups. Tech, where you can get your company featured on this week in startups. Go to startups.comptops.com 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 SOC2 report fast. Twist listeners can get $1,000 off for a limited time at vanta.com slash twist. And a rising ventures is a holding company that acquires tech startups facing setbacks. A rising ventures knows what founders care about because they aren't bankers, they're tech founders themselves. Go to a rising ventures.com slash twist today to learn more and connect with the team. Hey 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 Koda. I love Koda, open door, Aaron B, B, a 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 GoForgorg.com, which is setting the goal to make health care more preventative and basically revolutionized the space. His name is Adrian Aoun, and he is the CEO of Forward. Welcome to the program, Adrian. Not at all. Thanks for having me get to see men. Good to see you.

We see each other all over the world who are just talking about. Recently, we ran into each other in Riyadh at FII. Very interesting. Which is funny when we don't run into each other in San Francisco, but we do in Riyadh. You know there's definitely something happening over there. It does seem to me like the whole region. I just, you know, I've only been to Riyadh once. I've been to Abu Dhabi, Dubai, 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. What do you think founders and capital allocations should know about that region and their intent? What they're trying to get out of this relationship? Well, I think one of the most interesting parts about them is, is they're particularly intelligent at realizing that they are flush with cash and not flush

with other industries aside from oil. And so they're very strategic in that they're not just going to deploy the capital, but they're getting really wise that 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 U.S., one of the things that kind of is always top of mind is democracy, democracy, democracy is fantastic. And democracy, look, 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, do things happen over there? And when you're 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 at the top says, this is going to happen.

And quite honestly, it happens, whether you like it or not. Sometimes it's good. Sometimes that's bad. But if you can align your interest with the region, I think it's an incredibly interesting place to work. Yeah, the Gulf 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 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 or maybe my founding 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 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, there's, There's something there, right? There's a there there for sure. Yeah. And it was interesting when we both ran into each other there, how business is so different.

Like here, everything is 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. 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, the predicate. The 80%. It's 80%. By the time you come around to saying, here's the deal, you kind of know 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 there's is obviously, you know, again, pros and cons.

They might spend, I don't know, less time diligently in 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. Given FTX, it sounds like people could have done more diligence and more understanding and relationship building of the person. And we've got a long list of those here from the last. boom and bus cycle, Theranos, FDX.

I mean, there's been a bunch of them. And then before that, obviously, we had Madoff and Enron and we're all calm. And I'm sure, sadly, they'll never stop. We'll always have something. 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 slowing down sometimes

and trying to deeply understand things from first principles. Like one of the kind of things that Silicon Valley is built on is hype, right? 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 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 slowing down to deeply understand. I mean, I think with crypto, I think a lot of people didn't slow down and just ask fundamental questions like, okay, it's an immutable blockchain. Okay, so we'll translate that into a database you can't change. Yeah, yeah, yeah.

And nobody's in charge of. Yeah. When you frame it like that, it's something 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, this sounds incredibly, you know, it was very weird. The whole tech industry is built on, you know, 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, you know? Yeah, we saw that with Theranos, but that's it. Well, we'll get into that later. Okay, we're back with another segment of Pitchit to JCal. Dot Tech domains is giving Twist listeners the chance to show off their startups on this week in startups. Go to Startups.com.com slash Jason to apply. It'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.com.

Handprint.com tech connects companies with environmental projects. How cool. And this helps brands increase their impact while boosting performance by associating with PlanetPont 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.com. 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.com. It's very simple. Go to startups.com slash jason and apply today. That's startups.com 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. 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 with any of those. So look, I didn't want to get into health care.

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 I've got an older brother who lives in New York, and he had a heart attack. And so I kind of went from not paying attention to health care to overnight being super focused on it. And honestly, Jake out, 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 8 billion people on the planet.

Less than 2 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, how do we end up here, right? I'm an engineer. We got smartphones to the whole planet. Why can't we get basic health care there?

And when you kind of just think about it, it's like fundamentally health care is based on doctors and nurses. Doctors are awesome. Like, they're great. But you're never going to scale doctors to build. millions 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 going to 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.

Because, you know what? I, you know, like most startups, you start with this naivetee 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? Well, okay. It's a necessity to have that naivete. Yeah. Oh, yeah.

Because if you did know how hard it was going to be. I know. Wouldn't do it. By the time you're like pot committed, now you're like, oh, now I realize it, but whatever, I'm already in. So, look, here's what we did. We basically, I don't know, 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 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, it's 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 Jake Al 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 at 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 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 will be listening, but... Totally. Okay. I see a blue, beautiful, oversized phone, blue box. Okay, so this is called the forward care pod. And let me kind of describe. 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, Jake, 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, when those apps come up, 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 help. 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 reading, shows you the results in the screen. Again, gives you a treatment plan, et cetera. 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 10%. 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 this is a little what we built. I actually have, I've got like a video we can play and maybe just the first few seconds of it. And you'll get a good sense of what we're building. But in essence, what we're trying to do is we're trying to say like, what would the future look like? 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 pot, 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're 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 the 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 discolourations 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.

Wow. Yeah, it's not bad, right? It's a crazy vision. doctor's office. 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, 400, 800, 600, 100, 16, just imagine that like we're going to 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 healthcare 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, 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 click a button have somebody come clean your house. Uber is testing like Tass 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 and my family, I had a mole remove 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 bigger. And then track it over time, yeah, exactly, yeah. And then I just did proenovo, 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 actually, you know, this sounds really crazy. We do blood in the care pod, and I know this sounds wild, but we actually don't use a phlebotomist.

Have you seen these kind of like self-served blood draw things? No. I got to show you this. Okay, hold on. I'm going to take my jacket off and I'm going to 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 at 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 him is like the freestyle Libre continuous glucose monitor. Yeah, I've tried that. Yeah. We have an investment in a company called Nutrisense that okay. Yeah, awesome. And awesome. And there's, there's a bunch of these companies now. 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, their 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 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, it's like, you know, but if you've ever had a hicky, like, this is kind of what a hicky is or okay. If you've ever done the like cupping thing. Yeah, okay.

Well, you know, maybe you should have more fun in life. 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? No, but I've seen Gwen Paltrow do it. Okay. Yeah.

Yeah. I actually haven't had, or sorry, no, I did 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, yeah, totally. So you can get a little mini blood draw through this device that you just self-administer. It's not that mini. You'll get about 500 micro-liter's. I'm going to stop this merely because honestly, I demo this a lot and I don't like my blood kind of, you know, fully leaving. But you can kind of see like, you know. Yeah. Wow. So that's

the future. Yeah, that's, well, maybe it's not the future. Maybe it's the present, my man. So like, but But the point is, you can do that. You can just pop it right back in that tray and then forward will process it for you, right? So this is kind of the point. The point is when you look like there's a lot of technology that actually exists, sorry, I'm just putting a Band-Aid on. There's a lot of technology that exists for the purpose of providing better health. But that tech doesn't really make it to you today as a consumer, mostly because,

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 the next year. They're like, oh, now let's add 3G and 5G and LiDR and GPS and gyroscope. Well, for us. 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,

per Nuvo, a 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 healthcare 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 healthcare operating system that needs to exist. And to us, that's pretty exciting. If you're a SaaS or Services company that stores customer data in the cloud, then you need to be, uh, SOC2 compliant. You knew that from a third party. And you need that third party.

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You're sought to. So how do you make money from this? has become a long-term sustainable business. Yeah, totally. So we charge consumers. It's this age-old, very confusing thing in the world of healthcare, but you pay us and we deliver you better health. It's a good deal.

So we charge $99 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, et cetera. 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, we're just going to keep going. It's the classic Moore's law, right?

just going to kind of keep lowering our price to 79, 59, 49, 49, 39. And like, 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, for people who are insured, 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, $4,000 a year. for the average American? I think it's more, but honestly, I don't know the exact number. I'll go with five.

We'll say five dollars from that American. So let's say out of that care, they use up some percentage of that, like 80% of it with actual care? I don't know, because it's got to be some profit margin there. But, okay, so let's say we're back down to $4,000 to spend per person

in the healthcare 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. Because it does seem like a lot of the visits I do are complete utter waste of time.

Yeah. That I could have just filled out an online forum. I could have just answered a text message. But yet, I have to go into my doctor, my doctor, my dentist. Everybody wants me to come see them for a stupid prescription. That's how they get paid. That's how they get paid. It's so infuriating.

I know. To waste of their time, waste of my time, waste of office space. So of the 4,000, if we were going to say that, how much would we, yeah. Yeah, it's a good question. So, like, if you think about it, we, 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 the frequent parts of cardiology. We don't do all of 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? 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 do you talk about? I paid for my health care. But not really because you've got a deductible. And we're cheaper than you're 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 pods are the next manifestation, I guess. Yeah, that's right. Cheaper and easier to deploy because you got it. Storefront.

Yeah, you got it. Exactly. Like, our whole thing is we're just like, how can we make like healthcare super damn scalable and super good? Just increase the quality. Like, you were talking about Uber earlier. Well, 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 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 company working on just that.

You have a rash $20 billion company. You want to prevent breast cancer, $100 billion 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 at, like, understanding and solving each and every problem.

And, you know, I'm not a healthcare guy. I'm much more of your standard Silicon Valley tech nerd, right? So I can't come up with what is the next healthcare 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 we're trying to do. There is a nice part of this, which was a silver lining of COVID, was we 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. There's a bunch of these.

And so people started doing remote prescriptions, a little dangerous, I guess. It could be abuse 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

up my moles, check them out, et cetera. I don't mind stripping down and getting my 3D scan and my skivies or whatever. It's cool. That's just going to, I think that's going to be part of the appealing part for young people. So 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 where 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 look at this and you're like, oh, 20-year-olds are going to 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?

Right. 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 got to monitor our health. Oh, God, our back's ache, you know? And like, your body starts breaking after a while if you're going to 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? So, yeah, it's kind of for everyone. That's interesting. Yeah. And also, you know, I have 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, are they're sadly going to be gone soon. Yeah. A lot of us are dealing with that, 80 year old parents. Totally. 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. 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 to whichever order you like, artificial intelligence and wearables. Yeah.

I just got this new Apple Watch. I got it. Yeah, you got the new Ultra 2. I got the Ultra 2. It's pretty phenomenal, like, where this is going, what they're tracking. Okay, so let's talk about the wearables thing. So the wearables 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 in the Brookstone. Yeah, sure. 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 that today, all these things connect to my iPhones. My iPhone.

iPhone, like, kind of turn them into being, like, valuable. But in health care, we haven't done that yet. So, like, I've got 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 need that. What is the iPhone for healthcare? You need it to radio back. So everybody says, great, have a 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 being for it. You have some health coach who's, you're paying thousands of dollars a year to. Yeah, exactly. And that's not scalable. Totally. It's not scalable. Exactly. So then we said, well, maybe we just create the 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 or 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 add servers. Servers allow us to have desktops. Desktop is 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 go on a plane with no internet. You put your laptop away, right? 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 your Apple Watch data? Can 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 somebody 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 med bay and say, hey, you know, great job. Let me ask a couple questions here. There's arguably like three things that doctors kind of are at their core. A doctor is hands, heart and brain, right?

It's the hands, is 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, J-Cal, 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 is the head of engineering of the Model 3 program at Tesla? No,

you take it to a mechanic, right? The mechanic's cheaper, right? So you just get specialists that can do it or you do it yourself. 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 you're, you know, your sister, your brother, your girlfriend, wife, whomever it is can be the one to help you through them. 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,

what the computers aren't good at, 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 affect 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 them better tools. So the doctors could be in some central location and And then servicing pods across a nation, across the border. You got it. And that's how it works. Yeah. Yeah. 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 a lot of these companies are self-insuring, I understand, which I think is a fancy way of saying they just pay for some X amount of health care per person. You nailed it. Yeah. 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. And then 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? 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 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. Like a starbucks. 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 great. What are the insurance companies think about you? The doctors, obviously, 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 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, which actually had some try to buy us in the past. Problem is, I think, like, insurance causes a lot of problems in our health care system, right? 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 month, right? And so we've created an entire healthcare 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, building a startup is really hard and things, oh, they can turn on a dime. You can do everything right. And let's face it, you can still fail. Well, that's where a rising ventures comes in. A rising ventures is a holding company. And they acquire tech startups that are facing setbacks. Let me tell you about one of a rising venture 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, Horizon Ventures knows what founders care about. Because they aren't bankers, they are tech founders themselves. So, So here's your call to action. You can learn more about arising ventures and connect with the team at arisingventures.com slash twist. After submitting your information, you'll hear directly from the founding team within 24 hours. That's arising ventures.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. So clearly we're on the cusp of this could be certainly really helpful for people who don't have a health care system. You mentioned like 70% of the planets doesn't have health care the way we think about it. So for them, it's going to be all upside. Totally.

So where is this all headed? Do you trust it or not? Yeah. So I'm going to tell 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, you know, 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 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 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 kind of, there's a lot of companies in health care that are like 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 of what they're good at and use humans at what they're good at. Uh, so what's success for you? What are this like if, how do you know you've kind of gotten this to where it needs to be? Look, my goal is I want to get health care to billions and billions of people. I want to be the first health care system that scales to a billion users. By the time we've got these carapods in the middle of India and the middle of Rwanda, I'm going to say, okay, 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. You'd 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.

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 hard execution. That's on us. We've got to go execute. How many people do you have at the company now? I know you've raised a couple hundred million for this. This is a big vision, yeah.

Oh, yeah. We're not small. I don't know, more, probably still less than a thousand, but not far from it, my friend. We got a decent amount of people over. Yeah. Incredible. And then 100,000,000, tens of that. thousands of members so far? Oh, 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 for you to make this work. You're super kind. So you're, this is primarily U.S., right? Like, you just start here. U.S. for now, but obviously if I want to get to a billion, you know as well as I can't stay in the U.S. So, so we're, we're not going to, 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 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 be a billion. And I need it because they have no solution. Like what's crazy is,

you know, we complain about our health care in the U.S. but like we have doctors. I can show you like hundred 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. It would be incredible if a government 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 dispel. And it's got to be a massive cost. What does the pod cost to make? A couple hundred grand. We don't share the number, but it's a lot less than most people think. It's not that much. It's not tens of millions.

It's not tens of millions. No, no, no, no. But are you doing the full box? Are you doing that body scan in there? No, we're not. So we're not yet doing the like, call it the pernuvo, cubio style. We want to get there.

The cost right now of 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? Right. That would be a lot easier. And the, yeah, the, uh, Daniel Eck is doing his back some. Yeah, I think we're, I think we do everything.

I need to fully confirm this, but I'm pretty sure we do everything that has done. 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 I think are just time of flight sensors. But honestly, I don't want to speak out of turn. I could be wrong on this. Yeah, are those full body scans helpful or not? My doctor was like, 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 you may just create anxiety for them. So what you're mentioning is a real issue. So, here, let me give you the way to think about it. Whenever, like, let's pretend we looked at every cell in anybody's body and said, we're going to go see if you have cancer. Well, I hate to break 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 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? And when you don't have that data, it kind of means, eh, I don't know, we might be harming people. And so what happens is, you know, there's this line 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 have removed, 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 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 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 the you got it. That means, you know, every day a million people can benefit from that. And a lot more than 10 can visit. Yeah, I mean, now you got it. Exactly. That's the thing. Hard work and amortize. Once you turn healthcare into an infrastructure problem, man, is it a good world? Yeah. Awesome. This has been amazing. I wish you could do your success. You're hiring. I know that. Who do you need to work on this crazy vision and help you get over the... Honestly, anybody who, we 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 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, and it'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 useless. So you got it. I love it. It's like you can kind of go from qua, I hate to say it's a brutal. Yeah,

yeah, yeah. You got it. Refine 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 10 and they're just so mission driven. It's like it's nice to have them around. It's hard. You flip that around. Somebody's really talented,

but they're not mission driven. They're just a mercenary. Oh, they're going to cost chaos at some time. Yeah. Ain't that the truth. Hate that the tooth. At least they mean well.

At least they mean well. What's your favorite moment working for Larry Page? Favorite moment? You got to have a great story that you can tell. He's a very iconoclastic individual. Yeah. Nobody hears from him anymore. He's kind of very quiet.

Sergei's back involved. We know that. There he is. He's engaged. Nobody knows the extent to which Larry Page is engaged. In our last, I have many. I'm not sure I should say most,

but here's what I'll tell you. I'll tell you 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 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 Larry. I'll tell you, Larry told me something once. He's like, you know, and I'm in a paraphrase, but he's like, 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 going to do? You're going to 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 going to get a couple million bucks. 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 is 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 era 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 gay. Yeah, I mean, I think that's the right way to look at startups is, you know, what if it works? And we saw that with Uber, we start with Airbnb. Chances are low of success. What if it does work?

If it does work, if it does like, man, are we happy? Man, are we happy? Well, listen, we're rooting for you. Everybody, the domain name is go forward.com. A pretty good domain name. GoFord. I don't know who's got forward.com. A 100-year-old Jewish newspaper that did not want to sell it to us, I will tell you that. Okay. Respect. It's hard to argue. It was hard to argue. It was hard to argue. Yeah. So go forward.com. It's actually, it's got more, it's more active.

Go forward. That's right. That's right. Everybody check it out. Go sign up. 100 bucks a month. And this is the future of healthcare continues success. And we'll see you all next time on this week and start. Bye. Bye.