Fireside Chat with Sean Duffy

Bio Eats World is now Raising Health! On this first episode of Raising Health, Sean Duffy, cofounder and CEO of Omada Health, joins Vijay Pande, founding partner of Bio + Health. Sean and Vijay discuss the building and growth of Omada, from the early days to now. As the cofounder of one of the original digital health companies, Sean has unique insight into the growth of both the digital health field and the changing venture capital environment. They also talk about the future of AI, how Omada is leveraging AI, and the challenges that might arise with using a technology in a caregiving environment.

• 0:00Speaker 1

  So welcome to raising health. The news for 2024 is that BioEats World is getting an upgrade. We're rebranding as raising health. And as our very first uh guest on raising health, it's my pleasure to welcome Sean Duffy, uh CEO and co-founder of Mata Health. So Sean, thank you so much for joining me. Yeah, VJ, thank you. And thanks for uh thanks for allowing me to be the first. What an honor. This starts with actually that um email that you sent me, or I think that's actually maybe even a tweet that I saw that Omata hit a million uh uh patients. That's right. And and so that was a huge deal. And I think that made us very sentimental about like all the whole path that you've been through and the path that we've been through together.

• 0:38Speaker 0

  Oh, for sure. No, I mean a million, uh, you know, we're really proud of it. I'm proud of it, I'm proud of the team. Uh, you know, I think it's a it's a lot of people, it's big impact. Um, and I think if you pull up, uh, I think it is a statement on where digital health has come from uh and that it's possible. Um, admittedly, uh, you know, I feel two ways about it. I think the the positives are my gosh, it took you know so many years of toil to even get to the couple of thousand. But then if you compare the million to the task at hand of actually impacting epidemiology and and really, you know, doing what we need to do for the business. Um, we haven't really really made a dent yet, kind of told our teams, let's celebrate for 30 seconds and let's go try to get it to 10, 20, 50 uh and beyond. Well, that you

• 1:18Speaker 1

  make a great point because a million is hitting scale, but uh in principle, you could get to tens, hundreds of millions and even beyond. Like how do you view the next steps? Like how do you um how do you get to that type

• 1:31Speaker 0

  of scale? Uh well, well, I think you're at a million, you're on strong foundations. As long as as long as you're serving your members well and you're serving your customers well, what it does become uh, you know, slightly easier because we're in a new state in digital health where it's a little bit more accepted. Um, you know, there's a little bit more trust. We now have you know, published trials, you know, data, et cetera. So we're uh we're staying hungry as possible. And I think it just shows that the space, uh, though it has progressed a lot, it's still relatively nascent relative to having a you know the impact that it can and and will. Yeah. Well, so before we get too far ahead of ourselves, actually, I'd

• 2:00Speaker 1

  love to take us back to the beginning. Sure. So it's a CSS Age, I guess it's 2011, right? That's right. And when you started Omada, obviously there were zero patients then, you know, what did that zero to one part of the startup uh look like? What was that like?

• 2:13Speaker 0

  Yeah. So first just uh I mean, I'm you know, I'm here in the you know, in recent offices, kind of, you know, speaking with someone who probably isn't in the same camp, but I've always been pulled between technology uh and and science uh in healthcare. Originally I thought I had to choose. I had to pick, okay, tel tech or healthcare. Um, so after undergrad, um, even though I did my pre-med rec, I worked at Google for a couple of years. Uh, went off to medical school. I was enrolled in Harvard's MD MBA, and then, you know, through that came up with the idea for Omada. And really, the the key reflection was kind of a you know, a statement of where the market was at at the time. I'd be with my tech friends from Google and oh my gosh, these like Fitbits are gonna change healthcare. My medical school classmates were like, well, where the level one evidence, what diseasers are you targeting? And so, you know, the idea for Omato was to build a convergence company, one that didn't didn't sacrifice on technology and you know, design, um, but tried to, you know, do so in such a way where it earned earned the trust of the existing healthcare market.

• 3:06Speaker 0

  So that led to the business and and zero to one. Um, it was a it was a journey. I mean, we were we're a little ahead of our times. I think we um when we founded the company, um, the world kind of didn't know what to do with us. So yeah,

• 3:17Speaker 1

  tell us more. Like they you were a tech company, but you're also a healthcare company.

• 3:21Speaker 0

  Yeah, no, and I mean it's in the in the early days of Omada, for instance, you you'd say hi to you know, health plan and say, I want to contract, you know, as a as a provider, and like, okay, great. Well, where are your clinics? Like, we don't have any, like, excuse me, where where are your clinics? Okay. No, no, no, no, we're provider, we don't have offices. They're like,

• 3:39Speaker 1

  well, you can't contract with our network team. It's like a hotel chain without hotels.

• 3:43Speaker 0

  Yeah, exactly. And so to be honest, I mean, the last 10 years has been um, you know, that scene from Apollo 13 with like the square CO2 cartridge and round hole where you just try to like somehow pull it off with the parts on the ship before your, you know, your oxygen depletes, which is your bank account, uh, you know, in startup language.

• 3:57Speaker 1

  Yeah, well, and I made that analogy to the hotel company without hotels.

• 4:01Speaker 0

  Yes, and then

• 4:02Speaker 1

  it's Airbnb. And then there's, you know, total fleets without cars and so on. Yep. So it makes sense in that zero to one time. Uh, you know, there was probably some surprises. I don't know where if there's any no surprises that that um, you know, that makes sense to recount.

• 4:17Speaker 0

  I quickly realized how hard it was to sell into enterprise healthcare. It was a surprise to me. Now it's not a surprise at all. And I'll kind of relay that to any tech founder. It's like the the key thing was that it was not sexy to be a startup. This was this was kind of a moment in time where, you know, it's like, oh my gosh, the zeitgeist was that 20 something founder that goes off and builds like a 10 billion dollar company. And you'd be with these health plans. I'm like, I've never called ourselves a startup. So we were, I mean, we were we were three people and Omada was a digital health company. Right. You had to quickly try to, you know, frame yourself as a you know a measured thoughtful business in order to have uh, you know, success. When you were

• 4:52Speaker 1

  raising, you were raising probably from tech VCs primarily. And now there are sort of uh uh examples of tech bio VCs or or uh health tech VCs that are sort of doing both. Um and actually, you know, it's worth noting that actually um uh ACS and disease investment in OMADA predates the biofund itself. You know,

• 5:11Speaker 0

  how has a statement on what you just said? Yeah, how has the sort of investor landscape changed for you? I mean it's not it's nine-day different. It's we were the first major healthcare investment from injury, but there were very few conversions funds. Yeah. And you'd be on the, you know, in the healthcare kind of fund track. And they're like, well, excuse me, like where specifically is your monopolistic IP and and it's gonna be just so easy for any health plan to build software.

• 5:35Speaker 1

  Right.

• 5:35Speaker 0

  Software, you just that's what that's what they're known for, right? Yeah. And you know, you go to the tech side and they're like, how about that budget item for that you know, million-dollar peer-reviewed study in the RCT you're thinking about running? I don't think we need that. Right. And so there, you know, and and um you you'd work to kind of you know, explain and

• 5:52Speaker 1

  I think that was very much sort of in our mind for launching the biofund, you know, which came after the investment on model that realizing that you were a tech company and there are other tech companies that happen to be in life sciences or in healthcare, but were being built like tech companies, and that was the opportunity. Yeah, 100%.

• 6:07Speaker 0

  Yeah.

• 6:07Speaker 1

  Yeah. So any other changes that you've seen to the space. You're very much a pioneer of digital health. Um, that's probably changed over this decade as well. Yeah,

• 6:14Speaker 0

  I mean, well, so we talked about the investment landscape. I think uh, you know, equally you've seen drastic differences in both the go-to-market, you know, landscape and the talent landscape. Yeah, we shouldn't take each in turn. Yeah, yeah. Yeah. So I mean, the go-to-market, it's very different. I think there are like more plays. There's still there's still kind of things to be learned. I think if you use Omada as an example, we started targeting self-insured employers that can turn into business with plans. And there's a little bit of emotion now that is slightly more codified. Now, now, albeit it's still very, you know, difficult, very capital intensive, but it's more of a known thing. And there's been examples. Well,

• 6:46Speaker 1

  so what makes it difficult?

• 6:48Speaker 0

  Uh I mean, there's a lot of stakeholders. The buying cycles are really long. You're dealing with not just you know, HR leaders, but consultants and their plans and their channels and you know, it's a very multi-state corporal sales process and in still a risk-inverse environment, but but there's a little bit of like a known way to do it. And, you know, when Omada uh, you know, founded, that was far less so. I mean, you'd seen Caslight work towards selling into employers, um, but a little bit and not the way that Omada was doing it. We figured out a way to build through claims. We took our trials to the American Medical Association, got them to issue the first ever digital specific CBT code, just literally for building infrastructure. Now there's many startups that have figured out on the back of that, you know, how to build through claims and contract, you know, as a provider, like what we talked about before. So the the world has evolved. And I if I could make one statement that I think is the most yeah, the most beneficial relative to the go-to-market is buyers better know how to buy.

• 7:38Speaker 0

  So how do you make that happen? Well, it's I mean, it's coming as like Omada that you're like, well, and I remember in the early days, you know, you'd be talking to the network teams and you're like, you know, I'm imagining a world where there's actually specific individuals on a network team focused on your digital provider network. Wow. And you just kind of paint this future that could be, but that's not there yet. And then and then you you just kind of work your way to it. And and a bit of his learning together with your partners, like, how do you implement? You know, what are the claim systems? And then the next one that comes in the door, they're like, oh, we've kind of done this before. And you know, I remember one experience, like it was a uh it was a health plan. And so I get a call from a CEO of another digital health company. I was like, hey, okay, I just want to take five minutes to thank you. Like, well, why? And he's like, I I just we just did this deal with a health plan, you kind of named it.

• 8:24Speaker 0

  And they sent over the papers, the contract, and they just forgot to take Amada's name out of it all.

• 8:30Speaker 1

  It's like, how long did that take you to close? He's like, you know, three months. I was like, well, that took us a year and a half.

• 8:35Speaker 0

  Yeah. And what that means is all right, there are there are plenty of ambitious digitally forward people in enterprise healthcare, but like there's also like laid down processes and infrastructure and ways of buying that are pretty solidified. So it takes a little bit of time to like chip at it, morph it, you know, heat it up, make it a little bit malleable,

• 8:55Speaker 1

  and

• 8:55Speaker 0

  then and then kind of lay new foundations on how to just ingest things like Omada. Yeah, once you've retempered

• 9:00Speaker 1

  that steel thing.

• 9:01Speaker 0

  That's that's correct. Exactly. That's right.

• 9:03Speaker 1

  Is ready to go. And then mention something on the talent side too.

• 9:06Speaker 0

  This changes from everything to current state to kind of the feeder, the feeder world. And I remember in medical school, it was kind of like me and like two other people in my med school class who had an entrepreneur bent. Um, you know, there was a out of what, out of like hundreds? Yeah, like 250. Yeah, yeah. Um, and and it, you know, it's funny. Like I I restarted the Harvard Medical School like entrepreneurship society. It died. It had died. Like literally

• 9:29Speaker 1

  it existed. Yes.

• 9:30Speaker 0

  There was only uh a society of three, and then wither on the vine. And like, so you know, you had to give it CPR and get that thing back going. And uh, and now I think that's different. It's like, you know, today's cursive is JavaScript. So you're not on uh it's not so there's just more uh tech fluidity coming out of the, you know, I think the life sciences, yeah, which speaks to more talent that can appreciate both worlds, which speaks to cultures that can pull the best of both worlds together, which speaks to it's just being easier to build

• 9:58Speaker 1

  a convergence business. Yeah. I'd love to see this a graph of time uh and the fraction of med school students who have taken a CS course. Yeah. No, no, it probably is just like growing uh dramatically. It's growing dramatically. Well, it's key because like if you really weren't sort of sophisticated on the tech side, you wouldn't be able to handle that side of it. It seems like at least a part of the problem early on was there are just so few people that were conversant in both. And

• 10:22Speaker 0

  it's and it's funny, it's both like a vision issue that's super important, but it's also like a hiring issue. Yeah.

• 10:28Speaker 1

  You

• 10:28Speaker 0

  know, at the end of the day, like you need to be able to pull in incredible skill sets in your organization. And if the language you're using like doesn't communicate that you understand the skills that that person is bringing to bear. Oh, sure. And you can't just like, you know, over a beer, like riff on a specific thing in their world, they're not gonna join. So I mean, that's that's one of the reasons why the legacy health services companies have had trouble, you know, hiring talent. They'll they'll put out a role for like, you know, IT engineer in the language and just the appreciation of the skill sets like matter. And it's hard to get that if you don't, if you're if you're not plumbing. And the top talent are not gonna want to. They're not gonna do it. Yeah, not gonna do that. Yeah, they're not doing the same, you know, the same as on the healthcare side. Like if you're I mean, if you're just an amazing tech company, you're trying to hire great healthcare talent, they're like, they don't know. They don't know what

• 11:11Speaker 1

  they're doing. Well, how's it gonna know? Like, how's it hiring uh sort of the latest crop, like on the ML AI side? Specific to that,

• 11:17Speaker 0

  what's neat is we have just an awesome data corpus. Because I mean, you know, at the end of the day, like, you know, these models are more or less commodities. It's what feeds them that's important. And umada has uh operated against our users' preferences, which is asynchronous messaging, large part. So, you know, about 25 million messages that have flown back and forth between our care teams and our members, which you know, I mean, maybe the richest, you know, data asynchronous text data corpus in metabolic care and what you know,

• 11:45Speaker 1

  LLMs are kind of it gave

• 11:47Speaker 0

  it

• 11:47Speaker 1

  a nice time for us. It's like candy store for any kid

• 11:50Speaker 0

  would love. That's right. So that that talent side is fine. Um, but the the neat thing relative to the the last kind of couple minutes of conversation is now there's a crop of folks that have worked in tech and healthcare. Maybe there's a startup that tried to do both, but you know, didn't work out, or maybe they're you know, a company that has scaled and they want to, you know, do something different. So there are um there's there's just actually a richer, you know, crop of talent to pull from. It's no longer, you know, everyone trying to steal from Omada for people that are experienced with both. It's kind of a a broader, a broader set, which is which is great. I think it's a it's a it's an amazing thing. It's a real

• 12:22Speaker 1

  ecosystem. Well, so 10 years uh

• 12:24Speaker 0

  changes all of us. How have you changed? Oh my gosh. I mean, I was extremely green when I founded Omata. I was in an MD MBA program, but hadn't done any of the business side. I didn't have any managerial experience. I didn't know what a venture capitalist was. My goal has always been uh each year I want to look back at last year's Sean and just feel a little bit embarrassed. Wow. Oh, that's a really unique way to frame it. Literally every year. But embarrassed is that being hard on yourself? I mean, maybe it is, but it's it's the truth. So I think I have been a little just a little bit embarrassed about every sh every preceding Sean. So the Sean now is very, very different than the the vintage, the vintage 2011, Sean. And I mean, you, you know, you've been on the board a number of years. I'm sure you've seen it too.

• 13:02Speaker 1

  Yeah, yeah. Well, actually, and now when I think about it after you said that, it's it's the thing that most people get embarrassed about is like when you watch yourself on video or when you listen to yourself, it's actually the fact it's getting embarrassed is not unusual. Is the fact that you're willing to look at that and look at it in its face? I think that is really takes bravery and is most people don't do that.

• 13:25Speaker 0

  The way that I think through it is is to think through decisions or mistakes. Like would would that have happened with today's, you know, Sean, that misstep that we made, would today Sean have, you know, fallen into that trap. And I think it's a good, it's I think it's a good mindset. I think similarly, um, you know, I was always encouraged entrepreneurs to like, especially founders. Um, try to purposely decouple yourself from the founder mind and the CEO mind. Okay, how would you d differentiate those two? Like, like the in fact, sometimes I I purposely ask like, let's just pretend I was a hired gun CEO brought in today. Like, what would I be doing differently? Um, you know, day one, great, you know, just joined Omada, I'm the CEO. Like, what what would be the next play?

• 14:06Speaker 1

  Yeah.

• 14:06Speaker 0

  And then and then you can similarly ask, what do you think the the organization needs from its CEO like next year and beyond? And then that that like becomes your L and D plan. Also, organizations need sometimes things from their founders too, which are unique from what they need from their CEOs, presumably. That's yeah, that's right. You could reverse it too. You could reverse it too. And there have there have been things. I mean, you you know, as the org grows, you have to even as a founder, especially learn how to like work with your organization because your teams, you know, you have so many bright people and they need to like find the energy around a direction and you have to set the strategy. But there are certain things that uh, you know, I think is very helpful with kind of founder orientation, like you that optimism, you know, doesn't always tend to like carry forward with scale. And if there's like new things in the market, like for us, this whole GLP one landscape or even the you know, the generative AI landscape, those new things, like I view it as my job to like just press the organization into into seizing those.

• 15:00Speaker 0

  Yeah,

• 15:00Speaker 1

  to really

• 15:01Speaker 0

  sort of almost

• 15:01Speaker 1

  get

• 15:02Speaker 0

  keep that spirit

• 15:02Speaker 1

  that you

• 15:03Speaker 0

  had when you were like 10 people or 30 people, uh, but not to do that scale. You do it at scale, exactly.

• 15:07Speaker 1

  Any advice you'd give to uh Sean towards that?

• 15:11Speaker 0

  That's a good question. I mean, all sorts of tactical stuff. Yeah, yeah. My number one advice is put a ton of thought in how you price and package kind of what what you've what you're buying. That has just so much path dependency. And

• 15:22Speaker 1

  there's all these other tacticals. Yeah, and that sounds like a detail, but that's like the core future of your business in a sense. Yeah,

• 15:29Speaker 0

  no, it's funny. It's never the strategic stuff that tends to matter as much as the tactical things. Yeah, yeah.

• 15:34Speaker 1

  And

• 15:34Speaker 0

  some of them you can read about, and others like it, you know, it is all on the job training. Well, especially if you're creating a

• 15:39Speaker 1

  field, then there you probably wasn't on the job training for digital health. Yeah, yeah. It was newer. Yeah, exactly. Yeah, exactly. Well, okay. So let's let's take us to today. So and and actually you brought up two great topics I want to hit. Um uh AI and GLPs. Yep. Uh and so uh let's start with the AI side. So you already mentioned that Omada has this a huge corpus. Um, you know, what's your take for how AI is gonna change Omada? Where do you go with that? Where do you go from here?

• 16:04Speaker 0

  Yeah, I mean, I think it's it's just so cool. It's um, I mean, the whole team and the engineering team is just giddy with it. Um, you know, I mean, there's yesterday's like AI, which we've been doing, you know, build, you know, build models and ML models and you know, recommend resources. Almost like small uh ML, small AI versus a large foundation

• 16:20Speaker 1

  model.

• 16:20Speaker 0

  Yeah, exactly, versus versus kind of the generative side. I mean, there's hundreds of ideas on how to best leverage our data. So we're still learning and you know, and and growing, but to give you just some specific examples right now, the um, you know, one thing we launched uh is the ability for our care teams to just see, you know, instantly summarized um views of eating history of their members. So what we found is like if they wanted to talk about food, we had a very beautifully structured like view where they could scroll through the meal patterns, looking at the eating patterns, but they're spending about six minutes uh getting the context to be able to craft a message. And so one quick hit was you know, have have the model do that. Right. And then they can take that and craft it and craft a note to the member that allows them to just feel more insightful, uh, you know, just more precise and likely more impactful.

• 17:10Speaker 0

  Yeah.

• 17:10Speaker 1

  And

• 17:10Speaker 0

  more efficient. It's like everybody wins in that one. Maybe even more empathetic sometimes. And more, yeah, absolutely more empathetic. There's like step one for Omada, which is all right, of these hundred ideas, what are the ones where you have high impact, um, you know, low regulatory risk because there are considerations that you need to think through here. We're trying to strike that balance of ensuring that um, you know, at the end of the day, like we people feel the compassion of the Omadas. Yeah, you know, services as well as the intelligence where you, you know, you you've got to have a human to shine through. And so for us right now, we built our care team platform homegrown by scratch. Um, so it's about helping it to enable our care teams to, you know, be authentic humans to come across that way, do it more efficiently and pro your point in you know, many instances with a little tee up, perhaps more empathetically.

• 17:56Speaker 0

  Well,

• 17:56Speaker 1

  it's really interesting because you sort of alluded to the history of uh virtual-based care where it's like not having brick and mortar was like kind of crazy, right? Yep. And now that's actually, especially post-COVID, it's actually been quite routine. I actually many of us prefer it to some degree. Yeah, you know, it's it's it has its own conveniences and so on. Yep. Um now you're almost like a different type of virtual because now you're even like the caregivers themselves. It can't be true. Yeah, it's funny. Uh, how far does that go? Does it are you always gonna have caregivers and you're just massively scaling them? Are there like you know, like take us five years into the future, like maybe even 10 years in the future, like how far does this go?

• 18:34Speaker 0

  I mean, there it's gonna be balanced. I think the you, you know, you remember in in peak COVID, it was like virtual care will do everything. And I literally I felt like the crazy one being like, guys, like biopsy is still need to be done. Surgeries, smalls

• 18:44Speaker 1

  need to be removed. So it's um and

• 18:46Speaker 0

  it'll be the same, the same truth here. There's a reason that artificial intelligence is a buzzword and artificial empathy is not. Yeah. Um, and I and I don't think there is any substitute substitute for just the the human accountability. And in fact, I actually think that maybe in this era of like, you know, AI, it maybe actually come more valuable, like human time, you know, handcrafted goods, like, you know, proper human caregivers that may feel more valuable in the same vein, you can leverage not just them, but Tip and augmented support uh, you know, through these models in a way that I think just will transform outcomes and and you know, impact the

• 19:22Speaker 1

  impact the world. Yeah, and you know, we we've talked about scaling and we're talking about the million members. And this is how you get there. Yeah, yeah, yeah. It helps, yeah. Okay. It's such a crazy time because we've got AI, yep, like doing this insane thing. And then generally unrelated to AI, but very related to our monitor. Yeah, exactly. GLP ones. Yeah, like

• 19:43Speaker 0

  how does that play into what you're doing in a monitor? Yeah, I just feel giddy with what's happening here because you've got this two parallel tracks, like just extraordinary technology innovation, extraordinary life sciences innovation, like two different silos. And I mean, similar to like the fact that your convergence investor or mod is a convergence company, they just hit each other. Yeah. Like right now, you know, right at the moment. And I think they're both um uh you know really have knocked on the doors uh you know of of Omada as a skilled provider that you know has not only the data for the generative AI side, but also just enough scale to and enough clinical credibility to capture the opportunity in GLP ones. The way I look at them is incredible, I mean incredible breakthrough. Like, you know, humanity, we should we should pat ourselves on the back that these exist. Yes. Um, you know, in large part, uh since they especially since the the data has borne out in type two diabetes, I think they'll you know generally considered a very safe medicine, and hopefully that continues to to be the viewpoint.

• 20:37Speaker 0

  The challenge is GLPs are great at at quantity. You can and and will lose weight on a GLP without changing anything about the the quality of your calories because it will use the quantity. So you just will lose appetite. That's right. You'll lose appetite. So you're you know, you're you're dropping your caloric intake, but eating exactly the same foods. The the challenge with that is most patients uh tend to not want to be on these medicines for life, even though you know I mean you will find the KOLs that are you know argue that that's the right clinical point of view. Right now, that's counter to the patient preference. Um and then and then the cost profile is making that for for the employers that are covering GLPs for obesity, uh, you know, a challenge as well. There are very few that you know are thinking, well, shoot, I'll cover this for life. So you have this issue where, okay, you've got quantity. Well, what does the quality?

• 21:23Speaker 1

  Uh

• 21:24Speaker 0

  and that's where Omada thinks we can really differentiate. Um if GLPs are quantity, right? OMADA's quality, because you can use these as almost a behavioral catalyst. Help reframe uh someone's psychology around, hey, I can lose weight. This is amazing. And then on that, you're like, well, what are your goals relative to the medicines? Um, you know, they're like do it in a healthy way. Exactly. Well, let's take advantage of this therapeutic window. Yeah. Like, let's figure out some new meals that you can just start to incorporate. Great, you're losing weight. What are some new activities that you could do now, you know, uh that you couldn't do otherwise. Um, and then Omada can address some of the clinical, you know, complexities here. I mean, I think that the next issue that is already starting to bubble up is sarcopenia.

• 22:04Speaker 1

  I

• 22:04Speaker 0

  mean, you're, you know, because what what's happening with these meds, you'll you'll lose fat and muscle mass. If you do regain, you're gonna regain only fat. So there's there's all these complex body comp questions that are going to require new like, you know, physical activity protocols on top and recommendations and diet and intake to make sure that um you know that you're you're addressing this this kind of truth about weight loss

• 22:24Speaker 1

  generally, not specific to the GPS. Yeah, especially if your body muscle mass goes down, then your basal metabolic rate goes down. It makes it it makes it

• 22:32Speaker 0

  more likely you're weighing, you'll feel

• 22:33Speaker 1

  hunger.

• 22:34Speaker 0

  Exactly.

• 22:34Speaker 1

  Exactly.

• 22:35Speaker 0

  Yeah. So

• 22:35Speaker 1

  and if you're only eating, I don't know what is it, 1500 calories, a thousand calories with these things. Whatever

• 22:40Speaker 0

  small number it is. Um, then every calorie counts, right? Exactly. OMAD has made some decisions we're happy about. You know, the the first is to launch this like GLP one care track. Yeah. Um and then we, you know, we've chosen to not initiate people on the medicines, but just, you know, support them regardless of where the script came from. Yeah. So when we work with our partners who are covering GLPs for obesity, it's like, you know, you can uh create kind of a little bit of an all-roads lead to a Mata strategy. We're like, look for for these to be covered. We want to make sure that you have the lifestyle support alongside.

• 23:09Speaker 1

  Yeah,

• 23:09Speaker 0

  that makes sense. So yeah, I mean,

• 23:12Speaker 1

  given all this that's going on, where do you think this gets us to? Like what is uh digital health look like, you know, five, 10 years from now?

• 23:18Speaker 0

  Well, yeah, I mean, for Omada, I hope these innovations uh help us do what, you know, what would always is kind of been the most important, which is to have tomorrow's, you know, epidemiologists notice like bend in disease curve and have us be a part in that. It's been this weird, weird kind of thing where I feel like every couple of years you see this like report on you know diabetes measures, et cetera. And you're like, wow, the nation's gone nowhere. Um was that really true? Have we really gone nowhere or we gone worse than nowhere? Uh it's about uh fact anything's gone the wrong, you know, a worse direction. We're on a poor trajectory as a country to say the least. So no, you know, I think these innovations help us hit, you know, hit a level of scale that matters. And um, this is the most acute labor crisis we've ever had in the US. Yeah, on the provider side. On the provider side. You talk to you talk to the average provider and and the C suite talk, well, what are your challenges?

• 24:05Speaker 0

  They list, you know, 10, one through eight or labor. Um you there are not, you know, we don't have enough practitioners. So not enough doctors and not enough nurses. Yeah, none. And I mean, you're not gonna we're not gonna have 200,000, you know, primary care clinicians like show up on a tanker. So that what what does that mean? A, like even outside of what we do, you have to find technologies that give more leverage to every credential, like inter LLMs. You know, B, what you need is to provide care differently. Like there is no way that a decade from now, the primary care clinician is going to be point on something like longitudinal diabetes care. So Omada can come in as a between visit care provider as an adjunct to primary care and a partner and make it such that you know, you know, really what you need to do is route the person to us and we'll handle that between visit care and and take that off your plate, which uh which I think is gonna

• 24:50Speaker 1

  be required. Yeah. I mean, it's amazing that scaling goes from an aspiration almost to an obligation. There is a silver lining.

• 24:57Speaker 0

  I mean, this is this is just an extraordinary crisis uh, you know, uh, of labor. What what is happening is the everyday provider recognizes that there's not, you know, there's not a solvent. And I mean, you've had providers that like literally have they're like, well, shoot, we've tried almost everything. They've bought nursing schools. Right.

• 25:11Speaker 1

  Right. Like

• 25:12Speaker 0

  gobbled up nursing schools to try to, you know, build, but but um, there's nothing that's gonna be enough. So it's like we have to deliver care differently. What does that look like? Who do we work with to

• 25:21Speaker 1

  do it? Right. And then so the the shortage is one thing. Then the other sort of crisis that we all know about is cost. Yeah. Yeah. So presumably this plays into that as well.

• 25:29Speaker 0

  Oh my gosh, if we just kept the percent of our GDP spent on healthcare constant, but just use the dollars better. Like we've got an embarrassment of of riches to put forward, you know, to the country here, relative to the the it's not like, oh, could it be done more effectively or efficiently? Like look anywhere besides the you know, the US and you find you find ways that you that one could. So but but you kind of need a rock thrown into the lake.

• 25:52Speaker 1

  Yeah.

• 25:52Speaker 0

  And there are enough like pressure points there that I do think that the silver lining will be it's it's it's kind of hit the fulcrum where it's reinventing the system.

• 25:59Speaker 1

  Well, so let's paint the picture. So like you're dealing with something which is one of the biggest crises. Pre-diabetes, type two diabetes, weight, and it's cold morbidities, you know, hypertension and all musculoskeletal, all the co-oridities. So that's the problem's very clear. And then on top of that, you have the provider problem and the cost problem. Yep. You put in AI and GLPs, it's almost like this wonderful almost day as X machina, like to the rescue. And no technology to the rescue.

• 26:26Speaker 0

  It's that uh literally, I'm like, in absence of that, plus like you know, the OMATA layers to tie the room together.

• 26:31Speaker 1

  Yeah, what happens? It's you know what I mean? It's like well, well, but then so then what keeps us from the future we're describing? Like what's in our way?

• 26:39Speaker 0

  Uh

• 26:40Speaker 1

  you know, I think it I think it's coming.

• 26:41Speaker 0

  I I genuinely do I feel more optimistic that, you know, than ever. In general, I don't think there's an overnight success. I think that's especially true. Yeah. In in healthcare and building a healthcare business. But I I think it's coming. I mean, I

• 26:52Speaker 1

  think well, what do you think about regulations in this space? I mean, that's one of the reasons why it takes a little bit longer. But especially I say additional

• 26:57Speaker 0

  regulations for AIDS. Do you see a role for that? Right now, the the general basis on how to use generative AI says like, look, guide a licensed practitioner. So you you know, we're at that world where it's like, you know, I mean, use you self-driving as an analogy, like it's driver assisted. Like you can turn it on, but you gotta touch the wheel. Well, and there's already Dr. Google in play, you know, and so

• 27:18Speaker 1

  this is amplifying that. Yeah, exactly and practitioners have regulatory uh bodies that govern their their work and so on.

• 27:25Speaker 0

  I think there will be ways to, you know, create kind of targeted, you know, regulatory like pathways for hyperspecific things that have low patient risk.

• 27:33Speaker 1

  Yeah. Um other obstacles. It feels like it the way you're talking, it feels like it's inevitable. Again, I mean, it speaks

• 27:40Speaker 0

  to the three things that have changed. What what what needs to happen for an innovation ecosystem to throw through flourish in a way that wasn't wasn't there before. You need you need new capital partners. There's more folks that understand, you know, tech and healthcare. And there, and there's some proof points that you can make money here. I mean, you know, there are you need that to create kind of a hap healthy capital environment. And then secondly, you know, you you you need like more go-to-market motion models that make it just a little bit easier for the next person. Right. Right. And that's that's critical. And then, and then you need the people. Yeah. And so, you know, I think you've got you've got the three of those. Um, you know, you've got uh macro pressures that are required and not, you know, innovation is not a it's not a, you know, it's not a um not a vitamin, it's a painkiller, right, you know, at this point. So uh I'm very optimistic. Uh I you know, again, I think we're still at the beginning. I think the next, you know, the next two decades are just gonna be, you know, extraordinary.

• 28:27Speaker 0

  And we need to make it happen. Well, it's it's amazing because not only have you co-founded a model basically help

• 28:31Speaker 1

  co-found this whole ecosystem. Right.

• 28:33Speaker 0

  And that's what needed to be done. Very, very generous, you know, you know, um uh you know, and thank you for being a partner and recent for being a partner along the way. Oh no, it's our pleasure. Obviously, you think a ton about healthcare. Like, what do you do for that? Um, so I have two kids. I have a four-year-old and a two-year-old uh gym called lifetime opened up uh near my home. And uh I begged I would have paid any price to sign up because they have child care for two and a half hours. Oh, wow. It's a deal you can't do. So we've been joking, I'm gonna be the best shape of my life. Because um, you know, I mean, you're busy as an entrepreneur and child care is so precious. And and the kids love it. So we um we call it the family fun center. Excellent. Not lifetime gym, but we um uh yeah, I got a push notification from Life Time that said like, congratulations on your, you know, your your 25th visit. Oh wow. And I looked up how long it'd been open. It was like 45 days.

• 29:19Speaker 0

  That's excellent. Excellent. It's funny. I try to be like um similar to Omada, Omada's pragmatic relative to, you know, what fits into your world and what best kind of you know fits into your life and tend to not be overly zealous one way or the other, but just try to, you know, abide by healthy food habits. That makes sense. Well, thank you so much for joining

• 29:35Speaker 1

  us on raising health. Thank you for uh allowing me to be the the first uh guest on this new new instantiation. Oh, thank you. All right, take care of VJ.