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

0:00I used to think that I was a big thinker and I don't think I was a big thinker until I really work 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.

0:29Like 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 healthcare to a billion people is a rounding error to zero. But you know what, man, we get to wake up every day and be like, yeah, but you know what, if it works, like look at the world we live in. Yeah. And to me, that's the ball game. This Week in Startups is brought to you by.techdomains has a new program called startups.tech, where you can get your company featured on This Week in Startups.

1:05Go to startups.tech slash Jason to find out how. Vanta. Compliance and security shouldn't be a deal breaker for startups to win new business. Vanta makes it easy for companies to get a SOC 2 report fast. Twist listeners can get$1 ,000 off for a limited time at vanta.com slash twist. and Arising Ventures is a holding company that acquires tech startups facing setbacks. Arising Ventures knows what founders care about because they aren't bankers, they are tech founders themselves. Go to arisingventures.com slash twist today to learn more and connect with the team. Hey everybody, welcome back to this week in startups today.

1:49You'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 coda i love coda open door air and bb bunch of great companies i 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 goforward.com which is setting the goal to make health care more preventative and uh basically revolutionize the space his name is adrian Aoun and he is the CEO of Forward. Welcome to the program, Adrian.

2:28Not at all. Thanks for having me. Good to see you, man. Good to see you. We see each other all over the world. We're just talking about it 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 i've been to riyadh once i've been to abu dhabi dubai doha uh i think that's it actually um 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 this way.

3:17What do you think founders and capital allocators 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 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 at 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.

3:48Okay, great. The more interesting thing is the amount that they want to partner. And, you know, when you live in the US, one of the things that kind of is always top of mind is democracy, democracy, democracy is fantastic. And democracy, I'm 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?

4:19Somebody at the top says, this is going to happen. And quite honestly, it happens whether you like it or not. And sometimes it's good. Sometimes that's bad. But if you can align your interests with the region, I think it's an incredibly interesting place to 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 geopolitically, which is beyond the scope of This Week in Startups, obviously, are you going to participate or not?

4:50Are 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, I'm thinking about doing a series of episodes of This Week in Startups or maybe my founder university from over there. And I've been talking to a bunch of people there. I think building businesses together is like a really great peace dividend and a way to move society forward and culture forward. Yeah, if nothing else, I think just learning the culture and learning kind of the pros and cons on both sides and what we can learn from each other is definitely there is there's something there, right?

5:24There'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's very transactional. Oh, you have a deal. I have a deal. Let me look at your deal. Okay, you got these two deals. Okay, I'll take this one. I'll take A and C. You want D? Okay, we'll do D. Great. Send the paperwork. We're done. And then, hey, maybe we'll hang out or not. 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.

5:54The 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 roadshow. 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.

6:22And 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, there's is obviously, you know, again, pros and cons, they they might spend, I don't know, less time diligencing a company and understanding it but more time understanding the person and we like to say this is a people business maybe their idea is like not that bad actually um given ftx it sounds like people could have done more diligence and more understanding and relationship building of the person and and we've got a long list of those here from the last boom and bust cycle theranos ftx i mean there's there's been a bunch of them and then before that obviously So we had Madoff and Enron and Worldcon.

7:02And 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 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? um and the whole thing of hype is it just engages this fomo reaction and whether that's the party whether that's the deal whether that's the hot startup to join etc and the reality is that the most valuable things in the world didn't happen in a in a day right like they happened over the course of years and years and a lot of hard work from a lot of people yeah and so it's just worth kind of getting to know like you know whether it's the business the people but like slowing down to the technology understand yeah 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 nobody's in charge of yeah okay when you frame it like that and it's pretty freaking dangerous to me that i can put a bunch of stolen information into an immutable database that and not get it out yeah and not be able to take it down it's like well i guess we could find the servers and then demand people take them down i guess but maybe not and maybe there's a technology to make it not immutable i'm like yeah this sounds incredibly you know yeah it's the whole the whole tech industry is built on you know this this this kind of age-old like move fast and break things and honestly in some places that makes a lot of sense but you know look at me i'm in health care like you don't want to move fast and break things those things are humans don't move them you know yeah we we saw that with Theranos, but we'll get into that later.

8:51Okay, we're back with another segment of Pitch It to JCal. .tech domains is giving twist listeners the chance to show off their startups on this week in startups. Go to startups.tech slash Jason to apply. It's only one rule, you need to have a.tech domain to get featured in this ad. This week, I'm going to tell you about handprint.tech. Handprint.tech connects companies with environmental projects. How cool. And this helps brands increase their impact while boosting performance by associating with planet positive projects. Here's an example. You ever go to one of those websites and you see a counter ticking up how many trees have been planted from purchases?

9:27Well, that's handprint.tech. It's really simple. Companies select their impact campaign, then they can track and display their progress in public. Just a win-win-win. The company wins, they hit their goals, the customer wins, they feel great, and the environment wins, obviously. If you want to be featured on This Week in Startups like handprint.tech it's very simple go to startups.tech slash jason and apply today that's startups.tech slash jason and fill out the form to apply so when did you decide you wanted to get into healthcare because in venture capital in our industry there's a couple of industries that you really want to steer clear of yeah healthcare the music industry and education are three industries where startups go to die because they're regulated they move slowly and and uh they they sometimes are resistant to change so so when did you decide yeah and i'm not sure i disagree with any of those so so look i didn't want to get into health care i didn't wake up one morning and be like health care is my thing you know i was i was at google you mentioned this i was 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.

10:40Like 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 like not paying attention to healthcare to overnight being super focused on it. And honestly, Jacob, like think of my experience, right? On a Monday, I'm like at Google trying to solve AI. And on a Tuesday, I'm like, you know, in my brother's exam room standing over him with like, like there's doctors standing over him with like post-it notes in their hand and I'm just sitting here and I'm like, are you kidding me? But like, what the hell?

11:09Like, how'd we end up here, right? Like, where's the AI? 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. 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 we got smartphones to the whole planet why can't we get basic healthcare there and when you kind of just think about it it's like fundamentally healthcare is based on doctors and nurses doctors are awesome like they're great but you're never going to scale doctors to billions of people like there's not enough of them you know they cost too much so at some point you realize you need some other solution and you know being a tech guy like i'm sitting here and i'm like well we build products healthcare is a service but we build products so then you kind of have to click and say, well, wait a minute, maybe healthcare could be a product, not a service.

12:03Maybe 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, 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? You know, like most startups, you start with this naivete of like, oh, it can't be that difficult.

12:35I'll just go solve it. It'll take me a year and I'll be done, right? It's a necessity to have that naivete because if you did know how hard it was going to be, I 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.

13:05We built one in SF. It did pretty well. We've scaled it up to, I don't know, 20 cities or so. And so that's really awesome. But obviously, you're like, okay, Adrian, but a high-tech doctor's office is never going to scale to billions of people, never bring about your AI future. But in essence, it kind of has because what we're doing is just looking at what's happening inside of those clinics. And like, you come in, you sit in the exam chair, and you talk to your doctor about the flu. And I go, wait a minute, why JCal 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.

13:34Next 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 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 will be listening but totally okay i see a blue beautiful oversized so this is called the forward care pod and let me kind of describe so so here's the way to think about it if elon has like the self-driving car well this is the autonomous doctor's office and if you're you're trying to imagine the aesthetics here's all you need to know i was a huge nerd as a kid I watched a lot of Star Trek.

14:22And so if you remember the Med Bay, I'm basically just trying to build the damn Med Bay, right? Love it. So it's awesome. You walk up to it, you unlock it with your phone. It's super futuristic. It's like, hello, J-Cow, welcome to Forward. And 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 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.

14:58And then again, like helps you with whatever treatment you need. Maybe you need a prescription, maybe you need some other plan. Let's say you choose heart health. This one's awesome. It actually opens a tray and hands you a sensor. It's pretty cool. You hold that sensor against your heart. It shows you how, takes the readings, shows you the results on the screen again gives you a treatment plan etc like probably the best way to think about it is almost the same way that you think about like an atm and by that what i mean is an atm doesn't do everything that a bank does it does maybe 90 95 you know you lose your credit card you can still call the teller well for us the same thing we still have doctors but now the doctors they're not doing the 100 of the care they're just there for kind of that final five or ten percent like the complex or or frankly you just want to kind of talk to the doctor you got some weird exception, things like that.

15:43And 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 pod an entirely new approach to health care with prevention at its core with health apps in every category to choose from we're here to treat the issues of today and prevent the issues of tomorrow.

16:28We'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.

17:10With a focus on keeping you healthy, you and your care team will be equipped to make the right decisions for your long-term health. Or our Skin Cancer Scan app, to track and monitor things like mole growth, skin lesions, and discolorations over time. Or our mental health app to monitor anxiety and depression with ongoing guidance and support. Whether it's weight management, diabetes screening, or everyday care, like a routine blood draw, COVID-19 testing, or kidney and liver health, there's something for everyone. Because health isn't just about seeing a doctor when you're sick. It's about continuous comprehensive care that addresses your health concerns today and prevents those of tomorrow.

18:00Wow. Yeah, it's not bad, right? It's a crazy vision. The world's first AI 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, 800, 1600.

18:33Just imagine that like, we're going to put more healthcare on this planet than the world's ever seen. It'll just be like all around us, right? And then obviously, 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. We want to power the new wave of healthcare. 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.

19:06So 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 task rabbit kind of assistant. You get the idea. So here, if I really want to check my heart rate, you give them that piece of hardware, you're making that. If I want to do my skin, which I have the mole issue now that I'm 50 and I get checked because I had skin cancer in my family, I had a mole removed that wasn't cancerous, but it was just, you know, gotten, it had grown.

19:39that 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 track it over time yeah exactly over time and then i just did pronovo and then i've been doing uh blood tests so some of these like you're going to need a phlebotomist to do the blood test so so actually you know this sounds really crazy we do blood um 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-serve blood draw things no i gotta show you this okay hold on i'm gonna uh i'm gonna take my jacket off and i'm gonna show you so this isn't from us but if you think about what we're doing we're just kind of looking out there and saying like what is the latest technologies that we can kind of bring to bear to consumers and so obviously one of the kind of cool technologies out there that you're probably familiar with in fact you might have used them is like the freestyle libre continuous glucose monitor yeah i've tried that yeah yeah we have an investment company called nutrisense that okay yeah awesome that does this yeah 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 they're fda cleared and all that but in essence what i'm gonna do is just pop this off this is just double-sided stick tape and then i'm just gonna go ahead and you know lift my arm my my nice like farmer's tan uh farmer's tan arm over here and just pop this on.

21:02And 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 hickey, like this is kind of what a hickey is or okay if you've ever done the like 15 years old but yeah okay well you know maybe you should have more fun in life um i'm just saying so so in essence what it's doing is it's just sucking the blood maybe you've had cupping have you ever had that weird massage cupping thing no but i've seen gwen paltrow do it okay yeah yeah okay 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 totally so you get a little mini blood draw through this it's actually not that many self-administer it's not that many you'll get about 500 microliters i'm gonna stop this merely because honestly i demo this a lot and i don't like my blood um kind of you know fully leaving but you can kind of see like you know yeah and so that's the future yeah that's well maybe it's not the future maybe it's the present my man yeah so like but but the point is you can do that you can just pop it right back in that tray and then forward will process it for you right so amazing so this is kind of the point the point is when you when you look like there's a lot of technology that actually exists or i'm just putting a band-aid on yeah there's a lot of technology that exists for the purpose of of providing better health but that tech doesn't really make it to you today as a consumer mostly because like frankly the insurance company has no incentive to deliver better and better care it just cost them more so we took a slightly different approach and said well there's a bunch of cool stuff out there maybe we can bring it all together under one roof and if you think about what we're doing we almost look a little like the iphone right like they launched the iphone in the next year they're like oh now let's add 3g and 5g and lidar and gps and gyroscope 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 pernuvo 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?

23:21And 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 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 SOC 2 compliant you knew that from a third party and you need that third party to close big deals and if you want to get compliant easier and faster you need to use Vanta V-A-N-T-A Vanta makes it so easy for you to get and renew your SOC 2 on average Vanta customers are SOC 2 compliant in just two to four weeks prepare that to three to five months without Vanta and Vanta can save you hundreds of hours of manual work and up to 85 % of compliance costs.

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24:50So how do you make money from this? How does this become a long term sustainable business? Yeah, totally. So we charge consumers. It's this age old, very confusing 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 bucks a month. And that includes everything from your blood test to your genetic sequencing to you know chatting with our doctors to all the apps etc and if you think about it like when ford started you know we were 149 a bunch now we've cut a third of that now we're down to 99 right like and like we're just going to keep going it's the classic moore's law right we're just going to kind of keep lowering our price to 79 59 49 39 and like our 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 yeah they're spending on average thousands of dollars a year on insurance i don't know what the exact number is i'm going to pick a number four thousand dollars a year for the average american i think it's more but honestly i don't know the exact number sorry go with five let's say five thousand american yeah 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 four thousand dollars to spend per person in the health care system okay on average what percentage today and by the end of next year let's say somewhere in that range would you with forward be hovering yeah yeah it does seem like a lot of the visits i do are a complete utter waste of time yeah that i could have just filled out an online form i could have just answered a text message but yet i have to go into my doctor my doctor my dentist everybody wants me to come see them for a stupid prescription that's how they get paid that's the problem it's so infuriating i know the waste of their time waste of my time waste of office space so of the 4 000 if we're going to say that how much would we yeah yeah it's a good question so like if you think about it we we can already do like kind of all the primary care stuff and then we can already do some specialties right so basically what we're doing just 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 did we refer them out like why didn't we just do that ourselves and so like we don't do all of cardiology but we do we do the frequent parts of cardiology we don't do all 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, like, so, so the way I think about it is, you know, every day it's climbing up more and more.

27:31I'd say today, like easily for it is like cheaper and easier than using your literally your own healthcare plan. And you're like, what are you talking about? I paid for my healthcare, but not really because you've got a deductible and we're cheaper than your deductible almost always. So like, that's wild for me to think about, right? We are cheaper than using the thing you already paid for, like what the hell? And so, so, you know, we're covering like most things you don't need to leave our system too often you know occasionally you do but like we're trying to cut that down every day in the you have physical storefronts now these pods are the next manifestation yeah that's right cheaper and easier to deploy because you got a storefront yeah you got it exactly we're 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 um let's just take a step back and let's ask ourselves like why is the iPhone so valuable?

28:24Well, 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 what 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.

28:54Like, 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 in 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, you know, innovation, but I can come up with like tools to help these researchers and doctors go deeper and deeper at solving problems and that's what that's what we're trying to do there is a nice part of this which was a silver lining of covid was we forced remote and we forced kind of self-care to a certain extent where you had to take some directional ownership of your health care and so people would start using what are the online services hymns there's one for women roman totally a bunch of these and so people started doing remote prescriptions a little dangerous i guess it could be 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 my moles check them out etc i don't mind stripping down and getting my 3d scan and my skivvies or whatever it's cool um that's just gonna i think that's gonna be part of the appealing part for young people so is there a difference between how young people approach this versus old people how they will look at the pod yeah but you know what it might be actually the total opposite of what you where you intuitively would go.

30:38So here's the deal. Like if we look at our customer base today, it's a skews a lot older than you'd imagine. Right. Because you know what, when you, you look at this and you're like, Oh, 20 year olds are 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? Like you remember when we were 20, like 97 years ago and we were like, we were 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 backs ache, you know? And like you start, your body starts breaking after, 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 it's like so yeah it's kind of for everyone 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 um 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 and we do remember it but you know barely um so yeah maybe it's a moot point everybody kind of likes technology now so we didn't talk about two topics i'll take it to whichever order you like artificial intelligence and wearables because i just got this new apple watch um i got it yeah you got the you got the new ultra 2 i got the ultra 2 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 Yeah, okay.

32:27And we would buy all these gadgets, we'd use them for like, I don't know, three weeks a month, and then we throw the damn gadget away. Like it turns out the connected toaster was stupid. 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, like kind of turn them into being like valuable. But in healthcare, we haven't done that yet. So like, I've got the the aura ring and in some ways i love this ring in some ways this ring is the dumbest thing ever because it's like i wake up every morning and it's like adrian you slept terribly i'm like no shit i slept terribly i don't know what like you know it's like it's not changing my diet it's not changing my exercise it's not right so what you realize is like like you you need that what is the iphone for health care you need it to radio back so everybody says great have it radio back to the doctor it's like really do you think your doctor is going to sit there and watch your metrics all day like that's not what they're being for some health coach who's you're paying thousands of dollars a year exactly and that'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 aura ring data we think that data is pretty valuable we actually think it's valuable in helping you with something else i don't know your posture i'm making this up right whatever it happens to be and like that's a pretty cool world so i think that the wearables are almost like before their time by that what i mean is in technology we almost always hub and spoke things we had servers servers allowed us to have desktops desktops allowed us to have laptops which allowed phones which allowed watches which allowed right like wearables but if you forget the chain before like how useful is your laptop without a server pretty damn useless right like go on a go on a plane with no internet you put your laptop away right um and what you realize is in healthcare we've forgotten the hub and spoke model we forgot to build like the care pod and instead we went straight to you know the ring and it's like cool but that makes them incredibly limited in what they can do i mean no doctor has said can we have your apple watch data we have your eight sleep data can we have your aura ring data can we have your peloton data like i'm really waiting for the med bay to kind of pull this together and when if I came in and it was like, hey, by the way, take out the app, sync it, boom.

34:48Would you like, you know, somebody to review this? So then talk to me about what is the role of a doctor in your world? Are they going to pop up on the screen in the med bay and say, hey, you know, great job. Let me ask a couple of 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 as we do physical things. It's the heart. We're just a caring, empathetic person. When you're in a tough spot, you probably don't want the screen to be like, by the way, J. Cal, you've got cancer. That kind of sucks. And then it's their brain.