Leveraging the Power of AI to Create a Personal Health Assistant with Bettina Hein, Founder and CEO of Juli: Audio automatically transcribed by Sonix
Leveraging the Power of AI to Create a Personal Health Assistant with Bettina Hein, Founder and CEO of Juli: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Saul Marquez:
Hey everyone. Saul Marquez here and welcome back to the Outcomes Rocket, so glad you tuned back in. Today, I am privileged to host the outstanding Bettina Hein, she is the CEO and co-founder of an amazing company called Juli. They’re an A-powered health app startup that helps people with chronic health conditions, they dive into data tracked passively through your smartphone or also wearables, the environmental data, and also self-reported data, and they use machine learning to pinpoint factors that make your condition worse and also actors that make things better. It’s not her first time around the block, Bettina is a serial software entrepreneur that has built successful technology companies in Europe, and also the U.S. Juli is her third software company, she’s a young global leader at the World Economic Forum as the 2018 Immigrant Entrepreneur of the Year in Massachusetts, she’s blazing trails. I’m super excited to have Bettina here with us and just such a pleasure that you’re here. Bettina, welcome!
Bettina Hein:
Thank you for having me on, Saul.
Saul Marquez:
Yeah. You know, so the world of chronic conditions, how we manage them, I mean, it’s yesterday that we used to just go to the doctor and then 30 to 60 days pass by and nothing happens in between, so I think the work that you guys are doing using machine learning-AI to make a difference is so interesting and I’m excited to dive into that. But before we do, I’d love to know more about you what inspires your work in healthcare?
Bettina Hein:
Well, mostly two things. I actually come from a family of healthcare providers, and I’m the black sheep in the family, so with my third company, I really had to redeem myself. My dad’s a doctor and my mom’s a pharmacist, my aunts and uncles are doctors, my grandma was a pharmacist, so all of my girl cousins are in healthcare, so, you know, I just, my brother became a banker and I became a tech entrepreneur so it’s such a disappointment. So there are two reasons why I got into healthcare. One is that I had to redeem myself because everybody in my family is a healthcare provider and I’m the black sheep. So yeah, my dad’s a doctor, my mom’s a pharmacist, my aunts and uncles are physicians as well, my grandma was a pharmacist, I really needed to show here that I can do something in the family business, and, you know, so that’s one reason. The other is that I have encountered in my life, as a tech entrepreneur I’ve also encountered chronic conditions myself. I came to founding Juli because 10 years ago when my first child was born, I couldn’t sleep, she was born prematurely, I had fallen on my way to work, I had just closed a funding round 10 days earlier, and it was such a shock to my system that I couldn’t sleep for a year and a half. And as you mentioned earlier, you go to the doctor 60 or not every 60 or 90 days and nothing happens in between. Well, I did that twice to my PCP, and all he said was, you’re probably just stressed at work, you’re breastfeeding, I can’t give you anything, and that was really hard because I had to run a very quickly growing startup and I felt like a zombie. So I decided to hack myself back to health or at least try. And I started wearing this sleep monitor headband and tracking the data and figuring out what factors were influencing my sleep, and I finally figured out what to do and became a person again. So since then, I’ve kind of been doing this tracking of personal data. I’ve encountered other health challenges, and it’s very helpful to me. But I could never find an app or solution that took the just enormous task of tracking all this, looking at all the data, finding correlations, I couldn’t find anything like that on the market. And so I decided as the tech entrepreneur that I am to tackle that problem myself, and that’s how Juli came about.
Saul Marquez:
That’s awesome. Well, you know, huge kudos for everything that you’ve gone through. I mean, it’s hard enough running a business, let alone being a mom and then struggling with some of these things and the need for answers is something that we all share, when we’re in a tough spot like that. And so Juli is hyper-focused on chronic conditions and their algorithms, it’s a subset of ways of doing things, it’s available on an app. Can you tell us a little bit about the business and how you guys are adding value to the healthcare ecosystem?
Bettina Hein:
Absolutely. So we’re a pretty new company, we actually started in March of 2020. It’s just, we’re really a pandemic company and are, essentially have people from all over the world that can contribute to our product. What we do is we help people manage their chronic conditions right now, well, we launched six months to go into the App Store and we’ve ramped up to five different conditions. We cover asthma, chronic pain, migraine, depression, and bipolar disorder. We have a system where we can really ramp up this very quickly. And what we do is we bring in, as you mentioned at the beginning, we bring in five different types of data sources and look at those to find patterns. So we bring in data from your smartphone, from connected devices like your scale or your blood pressure cuff, your watch, then we put in environmental data, which is weather, pollen count, humidity, air pollution, all of those kinds of things, and we do that on a very hyper-local level. So it’s going to be the south shore of Boston instead of the whole metro area, for example, or it’s going to be, you know, the east part of Brooklyn versus all of New York City, so we do that, and then we bring in electronic health record data and we tie it all together with patient-reported data because as you said, we want to show more data than you would typically get by having these snapshots when you go to the doctor. We ask you every day a few short questions, and we tie that together with the passively sensed data that we pull in. And by that, we can learn more about you, about the user and or patient, depending on how, what lens you’re looking, the SAT and give you, show the patterns, show you the triggers, give you ideas for what levers to employ to get better. And we have that, so that is the user-facing, patient-facing part of our app. And then we have a B2B-facing part of our app where we collaborate with payers and employers and health systems to deploy that to their populations.
Saul Marquez:
That’s fantastic. Yeah, it’s this ability to take multiple sources and provide actionable insights to the user’s/patient, to the caregivers, what would you say, Bettina, makes what Juli does, your technology and the company, different and better than what’s available today?
Bettina Hein:
We’re kind of a next-gen condition management platform. A lot of the current ones don’t have the consumer-grade interface that we have. They don’t scale quickly enough to new conditions. You don’t take in as many data sources, but they also need a much larger human component to keep people engaged and that, they have large call centers, we don’t need that or not as much of that. We’re experimenting with putting little doses of human in there, but we come from the AI-powered side of things and that can save a lot of costs. It can also help allocate resources towards the people that currently have the most need, not the ones that are scheduled to see their provider or scheduled to talk to disease management care team member at that time.
Saul Marquez:
Yeah, that’s where the difference is, right? It’s the scalability of these things. I mean, we’re in this time right now where clinicians are so overwhelmed, the challenges of being understaffed have never been worse, and I think the scalability has become more important than ever. What would you say is kind of a key outcome or several outcomes that you guys have been able to improve? And how have you made business better for a lot of these severely exhausted clinicians?
Bettina Hein:
We’re still in the early stages in terms of outcomes, but what we can already see is that our population sticks with it. So we’ve onboarded about seven thousand people to our app thus far, which for being six months into it.
Saul Marquez:
Yeah, that’s great!
Bettina Hein:
Is pretty good. We can see that we can sustainably improve people’s well-being, which we monitor. We have these standardized questions that we administer to people every two weeks so we can see, you know, we have, for example, the PHQ9 for depression or the Montreal pain scale for chronic pain patients, et cetera, so we can see that, we can also see some non-intuitive triggers that we can then make people aware of. For example, our data has shown that the third most influential factor for depression, in our data, is air pollution. The first one is obviously mood, how you report your mood, the second is activity, but very close on the heels of that is air pollution. And that’s, those are the kinds of things that we can see through our data that others don’t see. And we can tell you then, for example, to not go outside on a certain day if you have asthma and the air pollution is high, right? Or if you have depression and the air pollution is high, that you need to call a friend, that you need to sit in front of your lightbox if you can’t go out, those kinds of things. And that is, you know, this patient empowerment component is really the key to Juli’s success and also to helping healthcare teams not be as overwhelmed.
Saul Marquez:
Totally. Yeah. And we’re all looking for better ways to help get results, you know, and one of the things that you know you hear a lot about is, for example, medication adherence, right? I mean, this problem of only 50 percent of what’s prescribed actually gets taken and even that 50 percent gets taken incorrectly like a percentage of that, and so being able to have these daily reminders, these insights to do from the most basic to, oh wow, I didn’t realize that the air pollution was bad out there, I should just stay in right now and it’ll help me, is a great way to scale care because if you’re listening to this and call it your Chief Medical Officer and you’re looking for ways to really care for the community, the population that you’re responsible for, you know, this is a way that you could drive your care to a broader audience, and I think being able to execute on this, that makes a difference. And that’s kind of where I’d like to ask you, Bettina, on the execution of this, right? I mean, setbacks. I imagine there’s been some there, can you talk to us about that, and maybe key learnings that have come out of it?
Bettina Hein:
So we found that, we found certain levers for retention that we are employing. As you’re saying, medication adherence is a big thing. So one thing that we’ve done is we have essentially just a tap mess notification that you get on your watch, which says, have you taken your meds? Just press taken or press snooze will remind you again. We found ways to gamify our interface so that people feel rewarded when they do these little micro behavioral changes. As a startup, we keep learning more about it. We’re running our first clinical trial right now, and we were seeing that people were dropping off of the trial, not because they didn’t keep using the app, but because they missed a certain checkpoint for a questionnaire. And so they have to answer five questionnaires, and they didn’t answer three, the number three of five one and they completed the rest and they fall out, so we had to figure out what are these engagement things. And sending people messages via different channels, like sending them an email or doing pop-up notifications, doing things in the app, which has then, again, pushed our retention and completion for the trial way up again, snd I think that that’s a very common thing. And there’s no silver bullet, that’s maybe the learning, right? There’s, you have to employ a lot of different techniques rather than having that one answer that solves it all.
Saul Marquez:
Yeah, that’s a great call out, Bettina. And today, you know, the environment to be able to make a difference with these types of technologies is big. I understand right now you’re looking for some pilot sites as well, tell us more about that.
Bettina Hein:
Well, so what we’re we’re doing right now is looking to test Juli with different pilots. One thing that we think is very compelling of Juli is that we can cover a lot more conditions than almost anything out there. So right now, what we see with employers, for example, is that they get bombarded with all of these point solutions for all these different conditions. And there’s, there are not enough resources in the world, even if you work for one hundred years to try all that out, so we’re really trying to make it easier. And so we want to prove out in collaboration with employers and payers that this really scales for them and that it’s easy to implement, and that you know, that there’s the patient empowerment metrics are the right ones for them. So if anybody is interested, they can give me a buzz and I’d be happy to talk to them about how we can do a pilot in the box. We have this really easy system to deploy that because we can spin anything up within a short time and turn on and off features of what we have to clinical trials really quickly because our software is built in a modular way where we can do that really quickly and where we have a template for if you need it, RRB approval, we’ve gone through all of that, so that makes it really easy for an institution to work with us.
Saul Marquez:
That’s great, and Bettina, is it Juli, J U L I .C O, where they would go and find more, or you want them to go somewhere else?
Bettina Hein:
Ok, yeah, yeah, go to Juli.co, as you said J U L I . C O, or send me an email at B like the letter in my first name, Bettina, b@juli.co.
Saul Marquez:
Fantastic. So that’s for the pilots. Certainly, some good incentives there that Bettina and her team are providing for pilot partners, so take advantage of that before they become crazy popular and then the bar is higher. So definitely take advantage of that now. You know, one of the things I’m curious about is what are you most excited about as we, you know, take this business to the next level, what are you most excited about?
Bettina Hein:
So I am just a huge data nerd, right? All of my prior companies have taken large sets of data and applied AI and machine learning to them to optimize for certain outcome, and so I’m really excited to apply everything that I’ve learned in my prior companies to this. So one of the things that I saw, my last company was an advertising technology software company and video advertising, and what I learned there is something that I can apply to Juli. My co-founder did a lot of e-commerce, my CTO, and so we can do things like as you probably have seen Amazon customers like you bought. Well for healthcare, we can do patients that are similar to you have found it helpful to do this, right? Or we show you like when we apply sort of dating algorithms to healthcare, right? It’s like you, Tinder gives you matches and they give you mostly really good close matches, but every once in a while they’ll give you a 60 percent match and that keeps it interesting, right?
Saul Marquez:
Yeah.
Bettina Hein:
You’re, usually your type is blonde, bearded, tattooed people, right? Guys. But now you have this every once in a while, get an Asian banker-type looking guy and you’re like, huh, maybe I should, right? So if you do that with recommendations for behavioral modification, you can just keep it fresh and keep it interesting. So maybe you should go to the street food festival that’s in your town, and we’ll recommend that instead of usually, you know, going for a walk in the mall, you can do this, and so just mixing it up will just help people do the right thing for themselves. And I’m super excited to use all of that knowledge and bring it into Juli and bring it to patients so that they can get stable in their condition more quickly.
Saul Marquez:
And have a good lifestyle and have some fun with it, right?
Bettina Hein:
Yeah, yeah. Totally!
Saul Marquez:
Love that. That’s so great. Yeah, well, look, the opportunity is fantastic. And also, man, I am just like floored by the amount of interesting companies out there doing great things, Juli is another one of those companies, so if you’re VC out there, or exploring options, definitely take a look at this one because just the experience of Bettina and her co-founder and the team, I think, is one worth checking out. Again, it’s Juli.co, J U L I.C O. Bettina, this has been a ton of fun, I don’t know if, what closing thought do you have for us here and then we’ll call it a day?
Bettina Hein:
I was just really thrilled to be on, and as I said in our earlier talk, I think, you know, being on here with an OG of Health podcasting is fun, and I always learn a ton from people like you, so, yeah, I hope to come back!
Saul Marquez:
There’s always a warm welcome here for you, Bettina. I appreciate you saying that, and certainly we look forward to having you back in maybe a year or so when you could tell us some more stories, share some more of the research and certainly tell us about the success that you’ll have because I know it’s coming ahead. Thanks for being with us.
Bettina Hein:
I would love to come back. Thank you so much for having me, Saul!
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