Jeff Arnold, founder of WebMD and Sharecare, among other innovative companies, could be considered one of the biggest disruptors in the healthcare industry in the last few decades. Arnold delivered the keynote address at Atlanta Business Chronicle’s Healthcare Forum, focusing on the impact technology is having on the industry, on Oct. 25 at Cobb Energy Performing Arts Centre.
Prior to the event, Arnold spoke about his endeavors and his philosophies on the increasing popularity of consumer-driven healthcare.
Have long have you been interested in technology? In the early 1990s, I was working as a pharmaceutical sales rep. My girlfriend, who is my wife now, was at Emory nursing school. I used to go have breakfast with her when she’d get off work at Egleston [Children’s Healthcare of Atlanta]. I met a doctor there who started introducing me to this idea that you could monitor patients’ hearts remotely. For people who have heart symptoms, sometimes it’s like taking your car to be serviced; when you get [to the doctor], it’s not making the noise that you brought it in for, so this is a way for patients to record their symptoms. One of the things he taught me was how to read EKGs. I quit my job, borrowed $25,000 from my girlfriend’s dad and flew to Israel and found somebody who could make me a heart monitor the size of an American Express card. So when you had a symptom, you put [the card] up to your chest, record your EKG [with the monitor] and call a call center. A bank of nurses would answer phone and you hit the send button on the monitor to send the recording. [The nurses then would triage the patient and help him or her get assistance if necessary.] With that company [called Quality Diagnostic Services, which he later sold], I fell in love with the idea of how you use technology to make healthcare more efficient.
Junior Harewood, with United Healthcare.
How did you first conceive of the idea to merge the two industries? I started off in the health services business with the heart company. When I was sending out 60,000 EKG faxes a month, when the Internet came out, we thought, “Wouldn’t it be cool if doctors could see these EKGs at the same time we did?” That’s when we started WebMD. Now it’s moving from how do you use technology for health services to how do you use technology to spread knowledge? With WebMD, the tagline was, “Now health has a homepage.” All these technologies were so fragmented. Wouldn’t it be great to go to one place to manage your health, talk to your doctor, keep track of your records? That grew into a really big company. This was before Google, so people had to know the name WebMD.
How would you say technology has contributed to the healthcare industry? To have an impact in healthcare in large populations, you have to be fluent in four languages. You have to be fluent in healthcare and prescribe first to the notion of “do no harm.” You also have to be efficient in technology as well as in media. People consume media in so many different ways. How can you motivate this person to take control of their health [using media]? Lastly, you have to be an expert in data. In a consumer-driven healthcare world, data used in the right way helps you be more predictive, more participatory with your healthcare team and more preventative. We have seen so many other areas of life be disrupted so quickly. Think what Uber did to transportation, what Air BnB has done to hospitality. The idea is healthcare is being more personalized and powered through a device you touch 2,000 times a day, your phone. The highest level is we go from fee-for-service healthcare to values-based care. We are starting to have financial alignment. If I’m going to take on the risk as a health plan or a doctor, I have to have connectivity with the user, and 99 percent of the time they are away from me. Having that connectivity with the patient becomes extremely important. The challenge is getting this [concept] into the workflow of the provider. Today, if you go see your doctor, when you’re in the exam room, they spend much of their time typing into the computer – they’re documenting things in your record, they’re capturing billing. But through Sharecare, if you’re my doctor, I walk into [the office], you [sign me in] on your phone, I send you infographics on everything I’ve done since you last saw me – my sleep, my care plan, my prescriptions. Then we get those 10 minutes [of computer typing] back for you to look the patient in the eye and strengthen that hugely important bond that technology can make more awkward.
There are a lot of healthcare IT companies today. What has set apart your companies, especially WebMD and now Sharecare? Companies that are starting to focus on healthcare are other consumer brands. For example, Wal-Mart is making the push into healthcare. Everyone has read about Amazon and Warren Buffett’s efforts. Comcast is now talking about taking a role in healthcare technology and Salesforce hired thousands of engineers for [its new venture] Health Cloud. It’s very encouraging as a consumer because they think about people differently than traditional healthcare companies. Simple things like customer service matter. What Sharecare tries to do is we want to be a platform for all of your health in one place, to empower the person to own your own data. You control the permissions of who sees it. We want to organize these complicated stakeholders on your behalf. Instead of you having to download the apps and the health plans, we’re going to bring everyone into the palm of your hand. We take that and say, “Wal-Mart, how can we use this for your employees and your customers?” It’s about being disruptive but not disenfranchised, helping them accelerate their brands through a partnership with Sharecare. Wal-Mart is now using Sharecare for its employees. We’ve had a couple of nice announcements with them; 4,600 stores had a wellness day where 300,000 people got free health screenings in four hours.
What are some of the features of Sharecare that you feel are the most innovative? We’ve made 13 acquisitions. We have lots of partners. Our solution set in three key pillars: wellness; illness and lifestyle. Our goal is how to do you bring all those together in one platform so you can move someone from episodic [attention to health] to every day? Today, I only think about healthcare when I’m sick. How do I start to manage those three areas of my life that gets everyone to open the Sharecare platform every day? In wellness, it’s anchored by the real age [test], which uses data-driven dialogue to determine and improve your real age. On the illness side, the idea is that you can come to Sharecare and give your chief complaint. We ask you questions. In less than three minutes, we say what might be the likely cause. Sharecare can geolocate you and triage you, and help you access the right care near you in the fastest amount of time. For lifestyle, what’s exciting is figuring out how to tap all the sensors on your phone to give you more data that generates more information on yourself. It can measure stress in your voice or you can turn on sensors at night and it can measure the quality of your sleep. There is so much data comping from your phone – how does it impact your health? [To create these applications], we have 400 people in our product technology innovation group. There is a lot we do internally, but we are starting to develop into more of a marketplace.
What are your future goals with Sharecare? The big thing we’re working on is trying to build a wellness currency, like a bitcoin for health. There are 13 items that most influence your real age every day, things like stress, diet, activity, sleep. Every day, if you flip eight of the 13 factors [meeting a positive benchmark], you earn a “green day.” We started getting some of our partners to give financial incentives for green days. For example, in Georgia, the governor and commissioner of health pay [employees on the state health plan] $2 per green day. [Participants] can do it twice a year. We’re now working really hard on how to scale that [to other companies and plans]. Georgia is our first customer; we started in March and it’s something we’re really excited about. Another area is voice activation. The new UI [user interface] is no UI. From the website to the app, pretty much it soon will be all voice controlled. You’ll be able to say, “When was the last time I had an eye exam?” or “How many steps have I taken today?” or “Schedule me an appointment.” Anywhere there’s a microphone, you can access your data.
What advice do you give entrepreneurs in the crowded healthcare IT space? Everyone thinks healthcare is so complicated and can’t be fixed, and they’re frustrated. I’m a very hopeful healthcare executive. I believe we are living in a time of change we’ve never seen before in healthcare. That phone we all carry will become greatest healing device ever seen. How do you empower a person to bring the stakeholders right to the palm of their hands? Healthcare technology uses tech to strengthen bridges, not tear them down. I have a really simple methodology. If you’re talking about diabetes or asthma or anything that impacts a person’s health, you want to make sure what you are offering is evidence based and clinically sound. It is the “First, do no harm” theory. If someone [creating healthcare tech] is not a physician, people tend to skip that step. The next box to check is how are you developing the technology? If it’s not for the phone or voice interfaces, then you’re developing down the wrong path. Then I go to the media side. Consumer-driven healthcare is going to take off. The customer is going to be the person, not the health plan or the hospital system. How are you going to get into the person’s living room or the exam room or the workplace, and how are you going to break through the noise to get that consumer to pay attention to your product or service?
How does Sharecare deal with privacy concerns? It’s about transparency with the user, letting them know what we are using the data for, and not trying to hide that in the “terms and conditions.” Second is best practices. We are learning a lot in this area and there are different ways to do it, for example, spreading different pieces of data around in certain ways so if you get one piece of data you couldn’t get the other. There’s also a healthy dose of corporate paranoia. The reality is there are a lot of bad actors out there trying to hack into people’s data. We don’t know if we can build walls high enough to stop that, but with transparency and best practices, we can do everything we can.
What has kept you in Atlanta? Personally, I have four kids and I think Atlanta is the best city to raise kids. It’s family oriented, it feels safe, there are great schools and good family values. Atlanta has worked really well for our family. On the work side, I feel we have a very loyal workforce. If you take all things for granted, our workforce [in Atlanta] is just as smart as in Austin and Silicon Valley, and just as diverse as those places, maybe even moreso. Sharecare has offices in Berlin, Vermont, New York, Nashville, California, all over the place, but Atlanta remains our headquarters. It’s almost become comical when we introduce ourselves in big meetings, [people say] “I’ve worked with Jeff for 16 years,” or “I’ve worked with Jeff for 20 years.” I don’t think it’s unique to companies in Atlanta that people have worked together for a long time. You develop a cadence with each other, a certain level of comfort when you’re working in a high-stress environment. We’re working to change healthcare, which is very high stress, so to have that familiarity is key.
