Health Evolution | September 2, 2020
Julia Hu founded Lark Health — and then spent the next six years fueled by the inspiration that if the team worked smart and hard enough, Lark would one day create an AI-enabled virtual care platform.
Eight years later, Lark’s AI-enabled technology has earned CDC Full Recognition and, working with hundreds of partners, served nearly 2 million people with or at risk of chronic conditions like diabetes and prediabetes.
Health Evolution spoke with Hu about Lark’s origin story, the most difficult challenge the company overcame along the way, and her advice for other innovator CEOs.
With CleanTechOpen and StartX you have a strong background in innovation. So, what is the inspiration fueling Lark? What’s the origin story?
Hu: I’ve always loved startups but the inspiration to jump into health care was that I have been a very large consumer of health care since I was a child. I grew up with a chronic condition that was very painful and undiagnosed for 25 years. My father had to quit his job to be my caretaker. We went to dozens of specialists, but finally found a pediatrician who worked with us once a week for 12 years to identify coping mechanisms. We changed everything to find the solution, how I ate, sleep, medications, exercise and identified patterns to eliminate 95 percent of my attacks. I was so appreciative of that, and also recognize that it is unrealistic for the billion-plus people who have a chronic condition or at high risk to get this kind of care, so we felt we had to bend the curve in a different way. Coming from the tech startup world at MIT and Stanford before that, we knew right away that we had to attempt to apply the burgeoning technologies behind conversational AI to provide that compassionate care at scale. That began my long journey eight years ago.
Health Evolution: How does the Lark AI work? I don’t mean the algorithms but what should a CEO know about it?
Hu: We use conversational AI to make it feel like a quick message with a friend or care team. Instead of a patient calling a coach to set up an appointment or going to the hospital for a Diabetes Prevention Program, they open their phone and start texting. It’s a 4-minute chat back and forth, on average, with a personal coach, and all of the data is already populated in the system, such as ‘I noted you ran 15 minutes more today than yesterday.’ Or, if they’re a diabetic, it will coach about the meal or carb count and chat with them about that. It picks up data from our smart connected devices and escalates care to a telephonic resource for clinical issues like a medication change that’s needed or a series of abnormal blood sugar or blood pressure readings.
Julia Hu, Lark Health
Health Evolution: The diabetes and chronic conditions elephant in the room right now, of course, is Teladoc acquiring Livongo. What does that signal to CEOs about how the digital health market is evolving?
Hu: It’s a big step for the growth of virtual care delivery because it validates the fact that the public markets believe virtual care is here — and here to stay. We need virtual care more than ever, especially amid COVID-19, to accelerate the transformation of care delivery. Chronic conditions make up almost 90 percent of all healthcare costs, so Livongo was a natural target for Teladoc. But our most important take away is that delivering better care doesn’t have to be through a larger company or conglomerate, it should be through better technology and solutions. Many telemedicine services simply pair patients with any available provider, which can lead to disjointed care. There simply aren’t enough physicians, nurses, and coaches in the world to provide that kind of care, whether it’s being delivered in-person or virtually. So we’re really focused on large-scale care system integrations, but doing so in a way that feels natural and not disjointed to the member and which allows the health plan and provider to remain at the center.
Health Evolution: Relative to Lark and the industry at large, what are the considerations around managing chronic conditions that are not perhaps as well understood by CEOs as they should be?
Hu: Virtual care and telehealth are the places to really invest to shape the future. But I would say that scale is the most important aspect. If you find a truly effective delivery system, then scale is more important because it brings access to care and financial accessibility at the same time. The way to deliver virtual care is through better technology because the health care system is just not built for chronic conditions, whether telehealth or in-person care. We need digital-first solutions to manage day-to-day care tasks, and highly personalized chronic care needs these more frequent touch-points.
Health Evolution: What should existing and prospective Lark clients expect in the next 18 months?
Hu: Our clients have always chosen us, first and foremost, because of our technology. It’s the digital and innovation teams coming together with the clinical and product teams to push the future vision. We have always been a tech-first company focused on platform innovation. We are continuing to double down on technology to help manage the epidemics of chronic disease, behavioral health issues and the need for preventative health such as the Diabetes Prevention Program. We have treated close to 2 million patients today and are the largest DPP provider nationally, and our focus remains on serving more people at risk through our with partners and plans. Similarly, we’ve just launched solutions for behavioral health and addiction that sit on top of our platform, and we’re excited to continue expanding to the other chronic conditions that our customers are asking about, that create the most burden on our health care system.
Health Evolution: Looking a little bit further into the future, what’s on your two- to three-year horizon?
Hu: The future of virtual care is the ability for an end user to have a delightful, integrated customer experience. We differentiate with our ability to help people in real time to navigate complicated areas, whether they get escalated to a pharmacist, a telehealth provider, or a doctor or nurse. We see the ability to extend Lark’s platform to serve as a trusted Sherpa to navigate complex care.
Health Evolution: Which accomplishments are you as a CEO and founder most proud of?
Hu: I love our team and am most proud of their belief and fortitude in a pretty crazy idea eight years ago that was: If we worked hard enough we could one day build AI-enabled coaching to extend and add to the army of current nurses and coaches such that millions of people could access the level of personalized care that I had while navigating my own chronic condition. We were guided by the understanding that there are not enough nurses and coaches to do this, and we wanted to provide a platform that achieves the same or similar clinical benefits – outcomes – but at less half the cost. And I’m so proud that we’ve proven it across Diabetes Prevention, Diabetes, and Hypertension management programs, including in peer review journals and at scale with partners. The team was so patient and dedicated – the most brilliant people – as we spent nearly six years in R&D and training the AI on more than one million members — because we were so stubborn and crazy. It was six years of hunkering down and trying to do this. I’m very proud that we have had such believers on our team and among our investors.
Health Evolution: What is the most difficult challenge you have overcome on the road to success?
Hu: I’m very excited to have achieved market acceptance in the health care community. Innovators at plans, at PBMs, and in large, innovative employers, have all supported the potential of conversational AI as a way to provide scalable, effective care and given us a chance. And now, we work with 4 of the largest health plans in the country, and over 300 employers. And we’ve achieved CDC Full Recognition, the highest level of clinical certification, for Diabetes Prevention. I’m proud we’ve maintained the most brilliant talent with the Silicon Valley tech mindset, and been able to marry that with the ability to competently execute within existing care delivery models.
Health Evolution: What advice would you give to other CEOs and founders?
Hu: I once had an amazing chat with a long-time mentor of mine, she’s the richest self-made female Asian entrepreneur in the U.S., and she said to me, “Julia, you have to do something that is exciting enough for you to spend every waking day sacrificing many others things, something you feel passionate enough about to spend the next 15 years of your life building. If the idea isn’t exciting and big enough for you to imagine that, don’t do it.” At the time I thought 15 years was crazy but eight years later I realize it was a really good barometer. There are many easier ways to make money and have a career. Find something you are truly passionate about and stubborn enough to try and go change, and if it’s not enough of a North Star for you, then really think about aiming higher. You are going to fail in so many different ways but if you try for the moon and keep flying you will land somewhere pretty exciting