Doing Well by Doing Good: Devoted Health’s Todd and Ed Park on Mission, Culture, and AI

0:00A lot of the reason we wanted to do this is we've always been taken with this idea of like doing well by doing good. How do you sustainably produce better results in the world? And a lot of that did come from the love that our parents had for us growing up.

0:14Unity Stoakes: Good morning, everyone, and welcome to another Startup Health Fireside Chat. My name is Unity Stokes, and today is a particularly special one for me. We're joined by two extraordinary entrepreneurs and really instrumental inspirations for Startup Health. Todd Park and Ed Park, the brothers and co-founders of Devoted Health, one of the most important and ambitious healthcare companies being built today. And really, one, we're incredibly proud to have in the Startup Health portfolio. We were just talking earlier, the last time we did a fireside chat with Todd and Ed together was at the Startup Health Festival in 2018.

1:03Unity Stoakes: I think it was 18 or 19. When you guys were just, I think about a year into Devoted. Many of you know Todd and Ed from their earlier work building companies like Athena Health, one of the pioneering companies in digital health. Todd, of course, you went on to serve as the US CTO under President Obama and Ed. You really scaled Athena from its earliest days into a publicly traded company. You guys have built so many other things as well. But what you guys are building today with devoted health, it's just extraordinary. And I think a really important example of what's possible in health care, as we know, in the industry.

1:48Unity Stoakes: So many companies are trying to innovate. What you guys are demonstrating is that you can grow thoughtfully. You can deliver outstanding clinical outcomes and build a company around a deeply human mission in this age of technology. So we want to talk about that. Some stats, you guys have grown, I think, to more than half a million members already. You're expanding, I think, already more than 30 states. But what I think is really most inspiring, it's not about the growth or the valuation. It's that your mission has remained so remarkably unique and special. Treat the people you serve like family.

2:31Unity Stoakes: So I really want to dig into that. and now how you're using AI and technology in such fascinating ways, not to replace relationships, but to make healthcare more personal, more effective and more humans. We've got a lot to dig into with the innovator community. We're so grateful. So let's go. Todd and Ed, welcome. We're so grateful to have you both here. Thank you so much. It's so great to see all you guys. Number one, Unity, thank you so much for all of your support and the support of the Startup Health community over the years. You guys are absolutely amazing. We love all of you and we're just happy to be here.

3:12Happy to just chat informally with members of the community and we're just totally stoked to be here. But thank you so much and super grateful. Yeah, plus one.

3:21Unity Stoakes: Let's start with you because both of you built extraordinarily extraordinarily successful healthcare companies. What was it about the healthcare system that made you decide you need to start again and build devoted health? Yeah, well, we can start with the background. Some of you guys have heard this, but we'll start from the beginning, right? The very short version, parents came over from Korea in 1969. They came to the US in search of the American dream, a better life for themselves and for their kids. Todd was born in Utah, I was born in Michigan. And then my parents settled down in Ohio, which is where we are today, actually, to raise us among cornfields and bass ponds.

4:00We looked up to folks like John Glenn. We both got to meet him, a legendary astronaut as a kid. And we really grew up with this conception of America as the greatest country on Earth, this shining city on a hill where you could do anything if you just put your mind to it. And so that's how we came up. And so we then shipped out east. We both went to Harvard. Ty graduated in economics. He's a couple of years older than me. And then I graduated in computer science. And we decided that we were going to start a company together. My parents actually weren't too hot on that idea. They were like, one of you should be a doctor and one of you should be a lawyer.

4:36But like, I don't know which one is which, but like one of you guys should go into those professions. And we're like, but we want to pursue our dream, which is to start a company together to help people. My dad had saved$50 ,000, which is all the money he had in the world, to send us to grad school. It turned out we needed about$50 ,000 seed capital to start our business together. So we asked for it from my dad. And he said no. He said no way. But we were persistent. And he finally relented and said, I love you guys. And so go off and pursue your dream together. So we started our first business, Athena Health, which was rooted in this idea that we don't do a good enough job.

5:14in preventing the bad things from happening in healthcare. So the original idea behind Athena was actually women's health. It was with our friend, Jonathan Bush. And the observation that we had had was that if you take better care of moms, especially underserved moms during the pregnancy, you can reduce the number of NICU days that happened on the back end. And that was the entire model that we served. A lot of the reason we wanted to do this is we've always been taken with this idea of like doing well by doing good. How do you sustainably produce better results in the world. And a lot of that did come from the love that our parents had for us growing up.

5:48Long story short, it turned out to be harder to get paid for that than we thought. A lot of the health plans in the world don't actually reimburse you for preventive care correctly. And so we pivoted the business. The reason it was called Athena Health was because if you're a startup OB clinic, you want to be early in the alphabet and Aardvark Health didn't sound like a good name for a women's health company. So we went with Athena, goddess of wisdom and strength, and we built the business from there. The name Athena stuck. It became a revenue cycle in electronic health record management service where our job was to make sure that doctors could focus on doctoring and we would basically do all the work in the background.

6:28That turned out to be super successful. As you know, we took it public and I ran that company for close to two decades. But I would say the reason we started to vote was because at the end of 2016, when we looked at the system, we still weren't anywhere close to us far down the road of the basic idea that if you take better care of folks with love and with care, that they will live healthy, healthier, happier, longer lives. And the question for us was, why is that still true? Like, why does that whole still exist in the market? And that's why we

7:03Unity Stoakes: started Devoted. Todd, I heard you, I think the first time I heard about Devoted, it came down to one word. It was love. It just kind of emanated from you. So if I'm hearing you guys correctly, it started with mission even earlier companies, several companies ago. And that progression of mission and purpose has transcending through various companies. That's exactly right. Yeah. The mission of Devoted and frankly, the mission of our entire lives has been to dramatically improve health and well-being by caring for every single human being like they are literally family. That's the mission. That's Devode's mission.

7:44We built an entire alternate universe, tech native, AI native, love native healthcare system that embodies that mission. And it's been a mission we've been on since we were small people. Yeah.

7:56Unity Stoakes: Why is that so important for founders to understand this kind of, we're not talking about business model yet. We're not talking about technology yet. We're not talking about how to build your team, but we're really a couple levels up with this North Star that it seems like never needs to change once you know what that is. When you meet other founders and what do you say to them about why that's important? I mean, there are so many reasons, which I think other founders, probably everyone on this call, you could say exactly what we're about to say. But first of all, Every founder is doing what they're doing because of mission, right?

8:36That's why they're doing the insanely difficult, complex thing. That's to build a company or organization or a new organism from scratch, right? You're doing it because, as Steve Jobs said, you can't stand the idea of the world not having what you're building. You know the world needs it to your core. And that is what motivates you at a fundamental level. And that's what keeps you going after you've broken every bone in your body. You pick yourself up and say, okay, I just learned something new and let's go, right? Because I'm incredibly excited to bring this mission come alive, right? Into the world.

9:14And then very, very concretely is that the most important ingredient in Devoted, the most important ingredient in any company organization by far is its culture, right? Culture eats everything else for breakfast, lunch, and dinner. Culture is the soul that then builds and animates and clearly improves the body. And culture at its best and strongest is defined by mission. So if you ask anyone that devoted, any of our 2 ,900 spirits, why are you here? Why are you here at Devoted? They'll all give you the same answer, regardless of their role. They'll say, I'm here to care for every person like they're my own.

9:51And they'll name someone that is incredibly dear to them. That defines the culture of devoted. Our mission does. And that culture has powered the building of our solution and everything that's accomplished in the world and keeps pushing us to be ever better, ever faster for the benefit of each human being we serve. And you hear this, I think, as, you know, earlier in your career, how important it is to start with where you're going and why you're doing it. Like the why is the most important thing and the culture is true. I would say that having now lived this for the better part of two, three decades now, there's nothing that's more true.

10:31And if you actually look at the great institutions that have been built over the last thousand years, they all have this sense of purpose and mission. The church, do unto others as you would have them do unto you. Or the United States of America, life, liberty, and the pursuit of happiness. They all are founded on this idea of a shared belief in something better. And I think that that is where we start. It's the seed kernel, in part because at the end of the day, it's not our mission. We still talk with every single employee who comes on board at Devoted. And we tell them exactly the same thing.

11:08We say, look, this is the reason that you're joining is not because it's our mission. It's because you heard us say it, but it's your mission. Your mission. It's your mission. Our jobs are not to tell you what to do. Our jobs are simply to create an environment in which you can do the best work and most meaningful work of your careers. And for us, I think the mission is everything because that's where you get the energy. That's where you get the mojo. That's where you get the strength to actually take something small and make it big.

11:39Unity Stoakes: It's one thing to just have a banner and a headline and say what your mission is, but you really need to translate that down to every aspect of your business, your people, starting with your team. And you told me a story the other day about I think you were with an investor and you just picked up the phone and called your own service line. Maybe you could share that story. We pride ourselves on our service levels. The most important people in the entire company are our guides. They're the people who answer the phone and navigate the member through any problem or situation that they might have.

12:11Everyone in the company works for them, the people who actually talk to our members. We answer the phone very fast. It's all in the US. But most importantly, they're imbued with the entire trust of the organization. So we were talking through some numbers and I said, oh, look, I'm just going to go ahead and call these guys, you know, call one of them right now. They picked up and said, hello, how are you? And I said, hi, I'm Ed. can you just tell me what your job is? And she said, my job is I'm a Devote Health Guide. And my job is to help members through their problems and treat every member like family.

12:42And then I asked the question, Hey, well, can you tell us a story of how you helped a member recently? And she said, yeah, like just yesterday, I was on a call with a member who had both of whose kids had just passed away from cancer. And she just needed someone to cry with. And so I just sat with her on the phone and cried for a while. And that was all. That was the whole thing. And it's what they're supposed to do. It's like why we're here. I mean, there's a bunch of stuff that we do that's obviously different from that. But I think the ability to connect with folks in a way that is authentic to the people who talk with our members is actually the most important mark of culture in the organization for us.

13:28It's very deeply meaningful to me and to Todd. It's why we're here. We get strength and joy, inspiration from hearing the stories of how our guides are helping members every day. And I know when you're just getting started, it's so important how you start, how you start to scale.

13:46Unity Stoakes: And maybe you could go back to the early days of how thoughtful you were in not just starting with 50 states and you really wanted to get it right at a small scale before you started going to a big scale. 100%. Yeah, that's totally right. And I suspect, again, that that resonates with every fellow founder on the call, right? So we really want to get the seed crystal right and build it to be scalable from the beginning and then scale it from there, right? And building our own groundbreaking technology and AI platform is key. But just to continue on the theme of what we're describing here in this conversation, building a culture that's scalable and understanding how to scale the culture is also key.

14:35And so you, of course, want to recruit a team of fellow maniacs who all live and breathe the mission. But they're also very practical things that we found were very, very useful. And we got basically, I think, some of our most useful advice from Howard Schultz, who has been a mentor to us since the very beginning. And I remember he told us early on, he said, you've been given two gifts, don't waste them. We said, yes, sir. He said, the first is you have an extraordinary mission. And it's extraordinary for two reasons. One, it's really deeply meaningful, like care for everyone like family, super powerful.

15:10Secondly, he said, it has the property of being unambiguous. Meaning if you tell a human being, what I want you to do in every moment, no matter what, is to care for everyone like family. They, without any further explanation, know what that means, right? They don't need any further guidance. They have the compass they need to steer through any situation. He said, challenge is not going to be explaining the mission to them. Your challenge is going to be, in terms of scaling your culture, causing them to really believe that that's what you really want them to do in every situation, no matter what.

15:40I said, we'd love advice about how to do that. He said, okay. Something I love about how he's just very practical. He said, tomorrow time, what you're going to start doing is telling stories. You're going to capture story after story after story after story of devotees delivering on the mission. Especially, Valiably said, our stories were, wow, that was a lot of energy and a lot of time spent delivering on the mission. And capture these stories and then disseminate them throughout the company through all means available. And he said, every story that you capture and share is a deposit in the bank of trust between devoted and devotees, that what Devote wants each of us to do in every situation, no matter what, is to care for everyone like family.

16:17He said, only make deposits, don't make withdrawals. And so we did that. We basically start every company meeting with a story, every board meeting with a story. Our most popular Slack channel is member stories. And we're telling each other stories all the time, sharing stories from all points of the compass about how devotees are delivering on the mission. And as a result, our culture is actually stronger now than it was at the beginning. And it was very strong at the winning because at the beginning we would tell each other around our basically card table and this unfolding chair stories about how we would eventually care for members that we'd eventually have someday.

16:52We wouldn't care for them like family once we were like, and now we have tens of thousands of stories that have been shared. Again, in some ways we're just freeing folks who already know how to take care of folks back to their natural state. That's exactly right. But most of what happens is, for whatever reason, they get the mission beat out of them in all kinds of ways that we've seen. But most of the folks that we have have been around the block, and they know what to do. And they just need the freedom to do it and the platform to do it. So we give them the freedom, the platform, the tools, and the guidance that helps.

17:28And that was the second thing that Howard said. He said, the second gift you've been given is a blank sheet of paper. The second gift you've been given is you have absolutely nothing. He said, most people regard that as a burden. But it's an incredible gift because you have no legacy baggage of any kind of tech, ops, culture, people. So you can actually build exactly what should be to make your mission come alive. And that's everything I just said, right? We recruit the right team that could then self-replicate, right? And then also build the right technology platform, the right product model, the right business model, right?

17:57To support the culture living the mission in a way that then builds upon itself, if that makes sense.

18:03Unity Stoakes: It strikes me that we're 22 minutes into our conversation and the first time we heard the word technology was now. And you guys are in a lot of ways, you're a technology company or certainly powered and super powered by extraordinary technology and AI. But that's not where we're focusing. But could we talk about how you leverage technology, but in a way that creates the opportunity for your culture to be leveled up or superpowered? That's kind of a paradox, it seems. One way to really make a job miserable is to drown people in administrative paperwork and not give them the information they need to do their jobs well.

18:53So we have an industry that is burdened by tremendous regulatory and administrative burden. I think that if we spend more than any other country on earth, as you know, on healthcare, we have among the worst outcomes. And 25 % of our costs are due to admin burdens. It's an incredible amount that we spend on admin every year. And I think it really begins to impact the way that people think about their day-to-day work and their jobs. The way that we think about technology is that there are things that people shouldn't be doing. There's a number of administrative tasks that you don't need gigantic buildings full of people looking at screens and clicking at stuff along the way.

19:37A bunch of that stuff should be automated so that you can spend more time with each member. Furthermore, when you're talking to that member, there's a number of conversations you can have. Everyone's time is precious. And so if you're wrestling with the member through an administrative problem, that's a waste of time. It's a total waste of time, right? On the other hand, if you're also asking the member clinical questions that they've already answered a thousand times, that's also a waste of time for everybody involved. If on the other hand, you knew the member has a favorite cat named Fluffy, you know that they are a caregiver for someone else in their family who has dementia, that they have transportation problems and nutrition problems as well, that they went to the hospital recently for the reason X, Y, and Z, and you can give them very specific guidance on what they can do next to improve their health, that's a good use of time.

20:34And so the way we think about technology is removing a lot of the administrative cruft and then focusing the conversation so that it's not on repeat, but you can take your time cognitively thinking about how do you really connect with someone and what should they do next in their journey to give themselves a healthy and out of harm's way. So for us, technology is a tool to humanize each relationship and make each conversation we have with every member much more deeply meaningful. And that results in, I think, the most important number to me and Tom, the whole company, is this member trust metric, which is after every interaction we have with a member, we ask the question, do you trust devoted to get you the care that you need?

21:28And an astonishing 92 % of our members say yes, and 99 % for the people who actually talk with our medical group. And this is American seniors. You don't really trust anybody. For a good reason. We watch it very, very closely. And for us, technology is an enabler of trust, as opposed to simply sort of some kind of magic wizardry to create AI-enabled talking heads. And so for us, I think it's really, really important. That's an enhancer of the human experience, an enhancer of our relationship with each member.

22:00Unity Stoakes: So in a world where a lot of companies are being told they should replace humans with AI or automated videos, there's this friction or this complexity around how to do things more efficiently or to save money or at scale. where it seems like there's different types of companies emerging, those that are doing what you're describing that are leveraging technology to enable and then another group that's going all in on technology to kind of, that is the whole thing to just replace. Do you think in healthcare, there's a place for both? And maybe it's just at this administrative level we're talking about.

22:44Unity Stoakes: There's also the discovery level where technology is so important. But really what we're talking about are relationships and trust and connections and something that so many clinicians for so long if their time to do that has just been winnowed down so much over the past decades where do you think it's going will it open back up are clinicians still gonna be needed the coast less is AI is gonna replace all doctors and they're not needed anymore it's a complex debate going on right now. Yeah, I think this is why it's so important to really be clear on what your mission is, right? Because technology, no matter how incredible, it's just a tool, right?

23:27So it's just to help you do whatever it is you are intending to do in the first place, right? And so if your mission is to care for everyone like family, and you therefore want to get everyone the best care in the world, and that best care in the world is defined as the right whole person-oriented, to prevention-oriented care delivered up front and throughout with love and true caring that keeps you as healthy and well as possible and out of the very expensive hospital, right? Then what you're going to use AI to do is exactly what Ed said. You're going to basically automate a whole bunch of work that humans, including clinicians, hate doing, right?

24:02You're going to free up the human to do what the human loves doing, which is loving on someone, connecting eye to eye, connecting heart to heart, and exercising their judgment and compassion. You're going to give them superpowers during those dialogues that give them incredibly personalized knowledge of the human being in front of them, right? And sync them with the medical knowledge of the universe as of that point. And you're going to support clinicians and force multiply them in delivering the best care in the world to someone. And teams of clinicians doing that over the longitudinal arc of a human being's life so they can live their best life, a longer, healthier, happier life.

24:40So that's what we use AI to do. Other people use AI to do whatever it is they're seeking to do in the world, right? But we're using it to enhance trust, enhance relationships, deliver dramatically better, dramatically more affordable, more accessible care, and one that is powered by love at the center.

25:00Unity Stoakes: For so many years, I heard, you know, just when we were beginning Startup Health and Todd, you were speaking at South by Southwest. And I believe you were CTO of HHS at the time. You were giving this amazing speech about data liberation. We walked up with you, with Jerry Levin, who's since passed away, was chairman of our board and shared our vision for Startup Health. one of the things that was so inspiring that you said on stage was there's never been a better time to be a builder, to be a creator within healthcare. And I'm wondering what you both think about the moment we're in now, because it's an extraordinary, wild, dynamic, confusing time for the world, but also for innovators, for entrepreneurs.

25:52Unity Stoakes: It seems very exciting from where I'm sitting. I'm here in Berkeley and Bay Area and all this AI stuff. I'm curious what you think about now as a good time or not to be just getting started. You guys are well on your journey of devoted health, but what would you tell to maybe new entrepreneurs and innovators just thinking about, hey, should I do this now? What are your takes, both of you on that? It is the best time in the world to start something. There's two things that we see going on at a very high level, especially in healthcare. So healthcare worldwide is in crisis. Here at the stats, we know what they are.

26:33We've never spent more on healthcare and we've never been sicker. We have an epidemic of mental health. One in four people in the US, one in seven people worldwide have been diagnosed with a mental health condition of some kind. We have epidemics of dementia. 75 % of the people who are age 65 and older are dying of chronic disease, where you can actually see the issues coming from miles away. I think something like 40 % of pediatrics patients, 40 % of the cost is associated with mental health conditions these days. It's just a crisis worldwide that's occurring at this point. I think that part of the question is why there's lots of reasons why.

27:14One of the reasons we see is that the world has for sure gotten more complex, but also we think we have exactly the right healthcare system today for the year 1900. So like back in 1900, like, I don't know, like, you know, if you're in Jane Austen novel, like everyone's dying of consumption, but we're not there anymore because we actually did amazing things over the last century. We built hospitals, we built lifesaving drugs, and we owe our lives to many of these innovations. But as a result, we actually now are the longest lived generation in history. And all of our infrastructure is pointed in the wrong direction.

27:53It's pointed towards these things that we've been working on for the last century. We have a new set of problems. They're actually whole person problems. They're usually not, hey, what's going on with your kidney or what's going on with your pancreas? You need to treat the whole person. You're getting into issues where healthcare and social determinants, all the rest of the stuff. We've been talking about this stuff for the last decade or plus. But the other thing that's happening is that the tool sets to begin to address some of these issues have never been better. Back when I started Athena, I racked my own servers.

28:27I compiled my own Linux kernels. I wrote all my code from scratch. And that was incredibly painful to do. These days, obviously, technology has come so, so far. And so the leverage to technology into thinking has never been greater. So I think that because we have this sort of this set of crises that no one company can solve, it's going to take a lot of companies, an entire generation of companies working together to try to create a better life for our kids. combined with more availability of, I think, technology and business ideas and lessons learned than has ever existed before. It's part of the reason we love startups so much is because we get to share stories.

29:13A lot of this is like wisdom that we get to share because I think that how you start companies does matter a lot. And that you can see that in the various generations of Silicon Valley companies, companies get better and better and better and better over time in new vintages as they begin to learn from each other and sort of take the ball a little bit farther downfield. But never been a better time to start. Yeah, I would say, building on what Ed's saying, it's both the best time ever to build innovations in healthcare, and there has never been a time when that's more needed in our lifetime than right now.

29:46We're gonna have to invent our way collectively as a species out of the jam that we're in in terms of health and healthcare. And we absolutely can, but only if we all show up. to actually do that with every fiber of our being.

30:00Unity Stoakes: Well, good news. We got some amazing health transformer here who are on their own journeys. And one thing I remember about your early days is you had different regions that seemed completely different parts of the country. And I thought that was really smart because you weren't just solving what you're doing in one type of environment, but they were drastically different types of environments. I thought that was a really good approach. I don't know if that was by design. It's very much by design. One thing that we do that I think is different than some of the larger companies is we stretch our teams across multiple areas.

30:39The way that we actually organize the teams, I think, are different. So most of our market presidents cover multiple disparate markets. And we do that on purpose because we want for them to be able to learn lessons for themselves between the different markets. They have access to all kinds of different care models and different kinds of work. Like we talked about AI a little bit before. We ended up taking our product team and we took half of the product team and pushed them out into different functions so they could actually live in those functions because how you organize with AI is different.

31:15One of the things that we think is very exciting about AI and the way in scaling a business is one of the levers that you have, starting from scratch, is to organize the business according to your goals. Like what are you trying to do and what learning are you trying to maximize? And how do you think about the things that need to get done in the world and execute it against them in the most efficient way possible? From our perspective, I think it's one of the things to think about a lot. We think that the entire nature of R &D needs to change. We're reorganizing our R &D team according to jobs to be done instead in the world.

31:49How do you serve this member as opposed to we have this UX team and we have this data team and we have this product team and then the systems team and then the app team, etc. We're blowing all that stuff up and asking people to stretch across many more boundaries because I think it's super interesting.

32:06Unity Stoakes: That's really interesting. Well, I know this question has come up from different members. I'll just ask, is there a way to are you looking to partner with emerging innovators? Is there a process for doing that? What type of partnerships do you look for that actually matter to what your goals are? I would say a couple of things. Number one, I think first and foremost, your family is our family. I think that the Startup Health family is our family. And as it relates to thinking and advice and whatever it might be the case, we're happy to chat at any time just to talk. You should just consider us to be friends of the family.

32:43So that's sort of piece one, probably the most important thing. And as it relates to growth, we're still early in our journey. There's a bunch of stuff that we have to work through. And so we're always happy to have various folks on our team talk to various folks in the startup health community. Usually there's learnings both ways. Usually the way that we, I like to have those is have a person on my team talk to a friend of the family and we consider them to be simply friend of the family conversations. And sometimes they lead somewhere, sometimes they don't. usually both sides come away having learned something a little bit new.

33:17Sometimes you plant a seed and it comes back around in two, three, four years. And so I think for us, it's the ongoing conversation that's important. And so we would just welcome everyone here as friends of the family.

33:32Unity Stoakes: Ed and Todd, we are so grateful for everything that you do to help not just this ecosystem, but to inspire the larger community of innovators, entrepreneurs, builders, people really who care about transforming people's health and well-being. So thank you. Thank you. Thank you. This was really, really meaningful. We're so grateful. Thank you. Lots of gratitude back at you and everyone on the call and the entire Startup Health community. We're so incredibly proud and great to be part of the Startup Health family. Thank you. Have fun in Cleveland. Thank you so much. All right. God bless. Thanks, everybody.

34:07Unity Stoakes: Bye. Bye. Bye. And finally, an invitation to all of the extraordinary health transformers, whether you are a startup, someone building the future of health, or whether you are an investor, funder, or buyer of the solutions out there in the marketplace, this is an invitation to you to join the Startup Health member community. Learn more at StartupHealth.com. Look forward to hopefully seeing you soon. Thank you.