Digital Charisma: Using AI to Improve Health Behaviors with Ravi Komatireddy, Founder and CEO of Motive Health Inc.: Audio automatically transcribed by Sonix

Digital Charisma: Using AI to Improve Health Behaviors with Ravi Komatireddy, Founder and CEO of Motive Health Inc.: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Saul Marquez:
Hey everybody, Saul Marquez here with the Outcomes Rockets, and welcome back to the podcast. Today, I have the privilege of hosting Dr. Ravi Komatireddy. He’s a digital health entrepreneur who is currently the Founder and CEO of Motiv Health Inc., a startup passionately focused on using human and AI coaches for health behavior change. He is an Internal Medicine Physician who trained at Dartmouth Hitchcock Medical Center and the University of California, San Diego. Additionally, he was the first NIH wireless digital health scholar at the Scripps Translational Science Institute and West Health Institute, where he earned a Master’s in Clinical Translation Investigation. Previously, he co-founded and served as the Chief Medical Officer of two funded digital health startups, Lumiata Inc., A big data, a health care company focused on creating the world’s largest medical graph database, which is eventually acquired by Google and Reflexion Health Inc., a digital medicine avatar led gamified virtual physical therapy solution using motion-tracking cameras in the home. He also received the first grant from NASA Flight Opportunities Program to advance research in digital health and human spaceflight. That’s pretty cool and the work that he’s doing is really cool at Motiv Health, so I’m excited to have him on the podcast. Welcome, Ravi.

Ravi Komatireddy:
Thanks, Saul. Thanks so much for having me. You know, when you list that stuff off, it sounds like a lot. I think about it like, wow, that is a lot. I don’t have time for all that.

Saul Marquez:
Well, you know, a lot of people that do great things are usually the ones that the majority of them. That’s why I say if you want something done, give it to the busiest person you know.

Ravi Komatireddy:
That’s true. That’s definitely a lifestyle that has adopted. Well, thank you very much for having me on. Be glad to talk about whatever you want to talk about.

Saul Marquez:
Absolutely. So before we go there, Ravi, I definitely want to learn about Motiv Health and the listeners want to definitely learn about it. Talk to us a little bit about what inspires your work and health care.

Ravi Komatireddy:
Honestly, I can tell you the line about, you know, we should make everyone feel better and not be sick and stuff like that. But if I had to drill it down to what really inspires me about it, because those things are true. But the truth is, it’s about human performance. I’m just fascinated by what people can achieve when they work together on things. And I’m talking let’s just if we just zoom out for a second and go to like everything from pyramids to highways to vaccines to landing on the moon, right? This is like, aliens didn’t build that stuff, right? This is people. So it’s like people coming together, rallying around a common goal is a pretty amazing thing. And you can get some amazing things done with that, you can explore the universe. You can figure out how to solve really complicated problems. So that’s only possible when you have people healthy. And that’s like the initial gateways to getting those problems solved. So health is such a fundamental part of human performance. If you want to be the best version of yourself or have a society be the best version of itself, you really need to prioritize how people feel about themselves and the things that they’re doing to make themselves healthy and how we collectively view that culturally. So to me, it’s about human performance and it’s like there’s no upper limit to human performance that I’m aware of, right? But I just don’t know how we’re going to get there unless we start prioritizing how we feel and how we run these machines that we have in human bodies.

Saul Marquez:
Yeah, well said. I love that and I love the approach. Ultimately, performance is so important. If we’re going to have success if we could say the success, the wealth is the health of our country and of our people. And so I love that you’ve focused us there, Ravi. Talk to us about Motiv Health. What are you guys doing? How are you adding value to the ecosystem?

Ravi Komatireddy:
Yeah, it’s an interesting question. So Motiv Health was born out of frustration. All good ideas usually are right. So the thing with motive is we’re working on using humans and machines to help improve health behaviors. The reason we’re doing that is because when I take a look at the things that we’re mostly going to die from and are going to suffer from, they’re mostly reversible, they’re mostly treatable, and a lot of them are preventable. So these are all cardiometabolic diseases. If you look at what we die from, a paper just came out, I think in I believe it was drama last week about the top 10 or top 15 causes of death.

Ravi Komatireddy:
And they’re very predictable. Obviously, in the world, we’re living in now COVID takes up definitely a big slot in that cause of death. But in terms of non-communicable diseases, they’re exactly the things that you would think they are. So the consequences of high blood pressure, obesity, diabetes, et cetera, heart disease, stroke, smoking, cancer. And even cancer has metabolic origins, a lot of it. So these are diseases of lifestyle. So if you want to make the biggest bang for your buck in health care, the first thing we have to think about is improving our lifestyle.

Ravi Komatireddy:
So there’s a role for physicians, there’s a role for pharmaceuticals, there’s a role for medical procedures. But, you know, it’s kind of like if you’re eating McDonald’s four times a week and then taking pills for your diabetes and your high blood pressure, that’s kind of like stepping on the metabolic gas and the brake at the same time. So I think we need to take a cold, hard look at how we view these diseases and how we view our wellness and think about how do we change our behaviors in a way that makes more sense. Because how we eat, sleep, our nutrition in general, our exercise and our mindfulness, and how we train our mindset and deal with mental health makes more of a difference than just any pill or pharmaceutical loan.

Ravi Komatireddy:
So what we’re doing is trying to deconstruct how humans behave when it comes to their health behaviors, how to give people access to coaching so they can slowly, methodically improve their health behaviors over time, so they can reduce their burden of disease or even improve their ability to avoid going down that path in the first place. So we’re really about prevention.

Saul Marquez:
Yeah. And Ravi, I think you’re focused on something that’s so important. And a lot of our health care system is focused on reactive, sick care. You’re focused on let’s stay healthy. And if you’re not there, let’s get you healthy and keep you there, right?

Ravi Komatireddy:
Yeah. I mean, there’s no doubt the health behavior change is hard. We all struggle with this. I personally struggle with it myself. With all gone through. It’s hard, right? If you take a really good look at why is it hard. It’s hard mainly because of four reasons. One is you need more than just information. So education notifications, reminders are not going to cut. You really need to persuade people and motivate people every day to do it to start making these changes. And these changes sometimes can be very small but they all add up over time.

Ravi Komatireddy:
Secondly, so what motivates you is going to be very different from what motivates me, and how I architect my environment is going to be different than yours, and so on. Three, you need every day. It’s like you spend five or twenty-five thousand minutes a year. How many minutes you spend in a physician’s office or talking to somebody like that. It’s just not many. So you need reinforcement every day. And lastly, you need personalized reinforcement where you’re making decisions and that’s at home and work. It’s not in a physician’s office. It’s not even over Doctor Zoom call. So we need to get this level of intervention to people where they live the most. And it’s you know, we have good data on how we know this is very impactful to preventing disease. So that’s where I think Motiv comes in. We’re filling that gap that, like the traditional health care system, hasn’t really been able to deliver. It’s insane. If you look at the health care system in general, what we can do is just our track-level stuff. We use antimatter to probe your body. That’s insane. We can put a stent in a coronary artery within 90 minutes of you getting a heart attack in most places in the United States. That’s great. That’s amazing.

Ravi Komatireddy:
But we can’t get you to go running for three days and that’s a problem. So this is where, like, Motiv comes in to fill that gap, because we can be with people every day where they need the most and spend the time necessary to persuade them to go down the road of prevention.

Saul Marquez:
So, Ravi, great stuff here. So talk to us about how you’re doing this and what makes you different in that way,

Ravi Komatireddy:
Right. So this is really interesting about behavior change is when you take a close look at it, you know, it’s considered in medicine to be the Holy Grail and it’s very difficult to achieve. It’s difficult to achieve if you view it through the lens of a physician who has very limited access to a patient’s life. And like I said before, can’t be with that person outside that the boundaries of a 50-minute visit or a 30-minute visit. We have good data on how to change people’s behavior. In some sense, humans are infinitely adaptable, right, behavior changes what we do. It’s like the number one superpower of humans. This is why you can have people thriving in the Arctic, in freezing temperatures, and thriving in the Sahara.

Ravi Komatireddy:
It’s what we do. Our brains are neuroplastic. So once you realize that, then you think about like even in our current lives, we are surrounded by digital technologies that change our behavior. Right. Spotify makes me click on songs I didn’t know I like. Amazon makes me buy stuff with that one-click button they don’t know that I need and Netflix makes me watch things or my way, you know, something called Bridgerton, which we keep. So it’s like we are able to surround ourselves and create machines that do this for us. We know the science of behavior change. So really what we’re doing is applying those principles to health care. So we’re kind of combining four different elements here.

Ravi Komatireddy:
What we’re doing is bringing the science of behavior change, the science of you based on data from your life, your wearables, where you’re starting from, what actions you take, your personality type and what motivates you, and the gamification strategies that would work for you. We’re combining that with positive technology and the expertise in health coaching and personal training and a machine learning aspect to this, where we can see patterns and find and help our health coaches make better decisions about what strategies would work for you, specifically based on a larger data set. So we’re bundling all that up and putting it through an app that gives you personalized communications and motivates you to make a change.

Ravi Komatireddy:
So just expand on that just a little bit. The real piece de resistance here is that personalization. Everyone is persuaded differently and we are really good at doing is figuring out enough data about you to know what levers to pull so that we can slowly and methodically get you to adopt better eating, better sleep, better exercise over the course of months. And that’s the thing, too, that this is not an overnight hack. You know, this isn’t something about Mary’s eight-minute abs in seven minutes. It takes time to do this and it takes dedication. But once people commit to it or earn the place in their life where they can do it, they’re successful. We’re seeing amazing results, right and people wherever they were starting from are getting better. So what makes us different?

Ravi Komatireddy:
I mean, if you think about it from the standpoint of doctors, well, doctors aren’t set up to do this all the time. You know, personal trainers, super effective. If you go to a personal trainer and you can stick with that person or nutritionist, you’ll get results. But they’re expensive, they’re really expensive, and they’re hard to access. So then that leaves kind of there are competitors, people doing health coaching and again, I think we’re at the very beginning of this whole movement to bring health coaching straight to people.

Ravi Komatireddy:
And so I’m glad they’re competitors. I’m glad we’re starting to move in this direction. But what we do best is that personalization, that personalization that creates a very unique profile for each individual based on the data about their life.

Saul Marquez:
But yeah, I was recently in a clubhouse and they were talking about passive data. And it’s that data that you don’t actually input yourself, right? You go to Dunkin Donuts or geodata. Like there’s a lot of data out there that we can leverage to help people. How are you guys doing that? I mean, is that the type of stuff you’re incorporating into this? Like, I would love to learn more about personalization.

Ravi Komatireddy:
Ok, so this is the part where behavior change, I was saying is actually pretty linear. Right. So if you just follow the protocols, do you take the time to do it? It actually can yield some great results. So what’s the secret sauce thing is what you’re getting at. So let me just say it’s essentially answering the questions to giving the answers to three specific questions. So we take a week to personalize a plan for each person takes that much time to get the data and for us to apply coaching expertise to that individual to figure out what they need to do and how to do it. So those are some of the questions. So let me just start at the beginning.

Ravi Komatireddy:
The first question and the most important one for each person is why? This is a very specific type of why. When you talk to people about why they want to change their behavior, they’ll initially give you things like, well, I want to lose weight and I want to look better. I want to…and then you can fill in the blanks of some very superficial type things like these external motivators. The goal of a motive is to push past that and to find functional goals. For a lot of people things like your blood pressure number and the weight on the scale are indicators, but really are essentially side effects of something deeper. What does weight loss mean to you? What is it that you’re going to be able to do in life by being thinner? Why do you want to get off your meds? Why don’t you just think of diabetes as something you can just live with like a chronic illness? And once you start asking these people questions like that, then the real truth comes out and what those real truths we call functional goals, like what are these things you want in life. What does your dad help your bad habits and getting in the way of? Let me give you an example. One of our first clients was a young bank teller, a single mom, and so she was eating poorly and so was prediabetic. Now, when we really pushed through to ask, like, what the reasons were for her to lose weight after a while, after using motivational interviewing techniques, and so on, what came out, she felt like she had been a bad mom. She was eating poorly, and she had her son, who’s super smart, who’s noticing her eating all these things and like, who wants to be a bad mom? She’s like, I know I’m setting a bad example. I don’t want to set this kid up for a bad life of diabetes. And like, I want to change myself. I’ll see. That is such a more important reason to lose weight and to get into shape, trying to tell her that, like, hey, you’re going to have a life full of needles. Then you’re like 50 and 60 years old. It’s a horrible thing to say. It’s not relevant to her. So those are the kind of reasons that come out when you interview people in this way. So that’s the why. Everybody has these. And if you look closely at yourself, you’ll notice that everyone’s whys are different. These are the things that are captivating reasons that move people. And this is important because it’s what we use in the motivation strategy going for.

Ravi Komatireddy:
The second question is the what? So what is it you actually need to do? So like everyone starts in a different place. So some people actually most people in United States don’t do any physical activity. Ninety-five percent of people, according to HHS data, don’t even engage in guidelines based on vigorous activity per week. So the number of minutes you need, according to our best guidelines on that. So. Ninety-five percent. And some of us are just trying to kind of do our best. We’re not consistent with our exercise. So like there are baselines for everybody in the current nutrition, their current exercise, whether they meditating or using mindfulness or not as a strategy, and how they’re sleeping. And so what we go is what do you need to do to get to level up? What is leveling up for you? What are your three-month goals? We can get that from just looking at some of the data. But this is where the digital health ecosystem really helps us, is we can use your phone data, like you said, do the geofencing. Where are you eating? Take a picture of like food you’re eating. Take a picture of the receipts from the grocery store. Give us your wearable data.

Speaker3:
What is your health data at baseline? What is your A1c? What is your blood pressure numbers? What are your lipids look like? Now we can use those to help craft that plan to tell you what to do and those what to do’s actually coming to categories when it comes to behavior change. One is you want to change your behavior, so you have to change your environment. You can’t make every single choice, one that is hard to make, make good choices easier. And a lot of the times that means just changing your environment so that, like, you are going to make better-eating choices, for example, than not.

Ravi Komatireddy:
Right. So put the M&M’S in a container that isn’t glass or clear so you don’t look at it, keep it in the house, almost those choice architecture interventions that we can do to make a difference. The other things that were intentional things, it’s making the time in your schedule to think about food prep. All those things that go in that line of intentional choices that people make, those are the kind of choices that are made by people who can maintain weight loss and maintain fitness. We all have friends who do that, and we know kind of how crazy they get sometimes and very picky about what they put in their mouths and the kind of activities they do. That’s the what? Those are the kinds of choices we want them to make.

Ravi Komatireddy:
And then the last is the how. So like, how do we connect these wines that our users have given us with the actions that they’re doing now, with the actions that they want to do? So let me give you an example of an interaction that we would send over text that would do this.

Saul Marquez:
OK.

Ravi Komatireddy:
Think about that same example of that, that twenty-three-year-old. We have the Whys. We know she needs to, let’s say, increase her physical activity. And we know that’s like our goal. Let’s say we want her to start running 15 minutes, maybe just start with walking in a week. And we wanted to get to that like 15 minutes for like three days a week. And we also know her psych profile well enough to know that she’s very high competitiveness like she’s a very competitive person. She’s ambitious, she’s competitive. I can use that to send one of two messages. One is a boring one that, like most kinds of apps and Fitbit and stuff, said, now, you know what’s really important, to walk 15 minutes, several times a week, full stop. That’s the kind of message that just isn’t persuasive.

Saul Marquez:
Yeah, like I get this brief message from my Apple Watch and I don’t really I mean, I just do it on my own, but like, I’m like, Ok, yeah. Tap gone.

Speaker3:
Yeah. That brief message is the most insulting right because the one thing you don’t want to do with a digital health app is to induce contempt from your user. Contempts of really it’s a level of product hell that’s really hard to climb out of that. And it’s like, Breathe. You’re like no shit dude. Of course, I know.

Saul Marquez:
Now I will tell you for a second here and say that I like the vision of the democratization of access to these types of things because you called out. You could easily hire somebody that’s going to call you every morning and make sure you’re good and that’s going to be there for your workouts and make sure you’re good. But where’s the seven ninety-nine a month Netflix model for this?

Ravi Komatireddy:
Yeah, that comes with economies of scale and. Yeah. And so, and I think it makes sense. So the example of a message that would work for that person is, you know what, it’s really important for your son to see you walking and see you taking the effort. The top one percent of moms. This is what they do. Come on, let’s make some time today. Fifteen minutes. I’ll carve it out and send you a calendar invite. Let’s get your shoes and socks together and let’s make this happen. That only takes a couple more seconds to say and construct, right? The structure, the message. But that message, the inputs to that are all those things we talked about. The motivations, the captivating reasons, it’s taking advantage of her competitive instinct and what she wants to do. Now, she’s on the receiving end of that. She’s like, oh, yeah, I want to be the top one percent of moms. And this is important to me. So I’m going to make this happen. What do I do? Get socks and shoes. OK, cool.

Ravi Komatireddy:
So you see how messages like that over time are so personalized. It’s funny because like when you talk about methods for people, it’s very different when those messages are coming at you. When you’re on the receiving end of that, it feels personal. It feels like this coach gets me. How do they get me so well. You told us. Right. So that’s an example of how the secret sauce is and we do other things other than those kinds of messages. But you get it now. So how do we scale that? Right. is, I think what we’re kind of getting it. So how do we make this successful for everybody? So our approach right now is we’re selling this as a premium product. We’re trying to approach the market that way.

Saul Marquez:
Are you doing B2C or B2B through employers? What are you doing?

Ravi Komatireddy:
I’m not going to say no to employer conversations, but honestly, my preference is B2C. I just think that we live in a world now where prevention is pretty clear, like people care about their health, Saul. They care very much. Almost 50 percent of us have tried a health app on their phone. A one in five of them track their health or monitor health with their phone right now, with actively with wearable or an app, people care a lot. They’re in they’re spending their own money for it. I think one thing that we’ve seen over COVID-19 is how much people care. For a lot of people, COVID-19 means they put on nineteen pounds of fat, over the last year and they’re struggling. I mean, they want to pay for gym memberships. They miss having advice. They want to shop at Whole Foods.

Ravi Komatireddy:
For the first time a long time, I’m seeing this movement and I think when I want to make a product, I want to make an incredible product to get straight to the person who benefits the most. We keep putting employers and insurance companies in there. And I think that I’m not interested in solving their problems. That’s right. When they’re your customers, you’re solving their problems. I’m not interested in that anymore. I think one of the things that’s the key to this is as physicians, we have to realize something that’s so obvious to normal people, but it’s not obvious to the health care system. So people care like people want to be. Well, you know, we need to disintermediation, take out the middleman, kind of act like Tesla with this Right.. When you buy a Tesla, don’t go to a dealership. There’s no middleman there. Who’s taking a cut. It’s like you want to Tesla, you want a phone or an Apple Iphone or whatever, you make a great product. You let people decide with their wallets whether it’s valid or not. I think we need to think about prevention that way.

Saul Marquez:
Well said. Well said. So what are you most excited about today?

Ravi Komatireddy:
I’m excited about just to recap what I just said, I think I’m very excited about the way the interest that people are taking in their health care. We live in a time now where there’s more education than ever available. YouTube, which is probably one of the best AI curation of engines in the world. In a couple seconds, you can look up every exercise you ever wanted, every recipe you ever wanted and how to sleep.

Ravi Komatireddy:
So all the knowledge is actually there in the world for basically for free within minutes of searching on your phone and people are using it. So I’m excited to see people get interested. I’m excited for them to stand up for themselves. I’m excited for them to say no, I’m sick of chronic disease. I don’t want to go down that route of diabetes. I want to eat better. I want my family to eat better. I’m seeing the health care bills now for the first time to see how much it costs right to get an intervention or to stay in the hospital for a couple of days. And these are all preventable. I want to be smarter about this. Just show me how a lot of this personal interest is something that we should take and hold very closely, which is why as a physician, I want patients to be involved. I want them to Google their symptoms. It can be annoying for us sometimes and the medical system and I get that. But that’s mostly because we’re not set up to do it. But that’s something we need to change.

Ravi Komatireddy:
But we should cradle and incubate that interest from people. It’s a signal to us that they’re caring about their well-being, and that’s the only future we can really hope for right, Saul. I mean, if you think back, like, what kind of future do you want for your kids? Do you want them to kind of eat whatever they want, not do any activity for 30 or 40 years, and then kind of hit the health care system hard with for chronic diseases and then get prescribed five pills? That just doesn’t seem to be the right way. What you want is something like health coaching to become a core service of a smartphone. When you get your smartphone, when you’re fifteen or sixteen, it automatically comes to Siri, automatically comes with with health coaching. So for the most. Yeah, right. I mean, it’s to be a core service, just like, just like a web browser is or the AI assistant.

Ravi Komatireddy:
And what you want is to spend the next twenty, thirty years for the most part eating well, for the most part sleeping well, for the most part exercising and getting access to mental health resources on demand. You know, when you slip through the cracks and you do end up getting disease despite that, OK, now’s the time to get pharmaceutical management and to see the health care system formally. So I think that’s what I’m excited about, seeing this difference between health and health care. Health care is doctors, pharmaceutical industries, and insurance companies. Health is those things you do every day to keep well. And that’s what I think we should focus a lot more time. And that’s the future I’m trying to build.

Saul Marquez:
I love it, Ravi. And it’s inspiring to be able to to think about that. And I think you’re right. I think more people are willing to spend their own money on health, not health care, health. And really, you know, that separation between us and the health that is provided, I think was a big mistake. I mean, it had to happen back in the days or the 40s or 50s. But today, to your point, we’re seeing definitely a rise of health care consumerism. More of us are doing more for ourselves. And I think there’s a huge opportunity here for living life healthier with approaches like yours. Ravi, really, really appreciate you jumping on before we conclude today, I love if you could just share a closing thought and then where the listeners could learn more about your company and maybe download the app.

Ravi Komatireddy:
You know, I think my closing thought would be one of optimism. I mean, I’m very optimistic that we can make this change, transform our health system into one that focuses on prevention, because we have this is the exact right time. We have a digital health ecosystem in place. We have much more awareness and education at baseline. We are focused on also improving health disparities. We can make things like this accessible to more people in more zip codes. And we can do this. But this is doable. Health behavior change once thought the holy grail of medicine is doable, it just takes us thinking differently. Important thing to remember is that keeping people healthy is a skill. You’re not born knowing how to do it. And like any other skill in your life, like playing soccer, learning tennis or learning pool, or learning how to play a violin, get a coach Right. learn how to do this. You have agency and control over your health destiny. And for those listening, I would just say start being aware and using services like this, our ambition, ambitions to be a leader in the space. But there are others as well and they’re doing amazing. So if you want to help us in our mission or learn more about us, you can reach me by email ravi@motivhealth.io. My LinkedIn and my Twitter, I’m @rkomatireddy my first initial and my last name, and just DM me on Twitter or Instagram. Instagram’s @Ravi0. Yes. So happy to entertain conversations, answer questions. And you know, we’re looking right now to expand the team and kind of get funding to start to close a seed round so we can bring this, we can bring awesome products as many people as we can.

Saul Marquez:
Love it, Ravi.

Saul Marquez:
Rovi really appreciates jumping on with us. It’s been a really great conversation and we appreciate the unique approach. We need it. So I appreciate what you’re doing out there.

Ravi Komatireddy:
Yeah, thanks. I appreciate the opportunity to speak on motive. And let’s keep in touch.

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