Health Evolution | December 3, 2020
In 2015, after more than a decade developing consumer products, Stephanie Tilenius founded Vida Health to create a continuous care model for people with one or more chronic diseases. Health Evolution interviewed Tilenius about what inspired Vida Health, what she learned at some of Silicon Valley’s most successful companies, how it informs her work at Vida, how COVID-19 is reshaping the health care landscape, the accomplishments she is most proud of, and more.
What is Vida Health’s origin story or the inspiration that fueled you as a founder?
Tilenius: I was a senior technology executive at eBay and PayPal for about a decade running global products and an $8 billion P&L. Five of my 10 years at eBay I spent building PayPal. I was then recruited to go to Google and build Google Wallet and Google Shopping so my background is in consumer products that scale to millions of users. Around this time my dad was sick with multiple chronic conditions, diabetes, COPD, obesity and depression all at the same time. He was in a wheelchair and on oxygen in Ohio. I was trying to manage his health from California and I kept wondering why there was no comprehensive mobile solution like there was for everything else in my life. That’s when I realized how far behind we were in health care and when I committed to creating a solution that focused on a continuous care model covereing both physical and mental health.
How does that background at Google, eBay and PayPal inform your work at Vida?
Tilenius: It really does inform my work. Because I’ve been so product-focused throughout my career, I’ve focused on creating a great service that users love and that drives clinical outcomes. We pride ourselves on a great product experience and it’s paid off with our users who consistently give us a Net Promoter Score in the mid-70s.
We have amazing user stories of people using Vida to lose weight, lower their A1C and go off their medications for diabetes and hypertension, and reduce their depression and anxiety.
I’ve certainly applied some of the lessons I learned when building Vida. One of those lessons is called the Toothbrush Test. [Google founder] Larry Page used to talk about this. “If you can’t build a product people use daily, what’s the point?” The majority of our users use Vida five to seven times a week. So we’re very much a part of their lives. We’re constantly looking at the data, digging into everything our users are doing to understand how they’re managing their diseases, how they’re improving, and how we can help get off their meds and reduce their symptoms. We run predictive analytics against that data and apply the results to continuously improve our product and clinical outcomes — bringing together technology, clinical experts and digital therapeutics. The longitudinal relationship with a real human provider like a coach or a therapist is at the center of the experience and we combine that with remote patient monitoring, social support and great content and daily guidance.
Coming into healthcare from the consumer tech space, what was the most surprising aspect that you encountered?
Tilenius: At a very big picture level, it’s the importance of the human element. Human accountability and knowledge are critical to achieving long-lasting clinical outcomes. Unfortunately, it seems like a lot of virtual care companies are trying to take cost out of the system by replacing real people with AI. Instead, at Vida, we’re using machine learning to enable doctors, coaches, and therapists to practice at the top of their license by automating what can be automated but never using AI to replace that human connection. I think of it as using technology not to replace humans, but to make them superhuman. I’ve also been surprised by how much price, cost and billing are important in health care. You really have to align yourself against those and constantly innovate to reduce costs. Our North Star is really strong outcomes but it’s also important to achieve those at the right costs.
Stephanie Tilenius, Vida Health
How do you strike that balance in navigating toward effective clinical outcomes while also striving to take costs out of the system?
Tilenius: You have to break down the different owners of the different parts of the ecosystem, look at the unit economics, look at the incentives and analyze the situation to figure out how to work within it and also innovate at the same time. There are some hindrances, I would say. In most industries the consumer is the ultimate decision-maker and so consumer choice creates competitive pressure to improve. It forces everyone in the space to do their best job on the product and to deliver at a low cost. What you see in healthcare are so many intermediaries and consumers don’t really understand the cost of the service that they’re using.
What should CEOs know about Vida and how it works?
Tilenius: Using data from claims files, eligibility files, and member onboarding, Vida brings together the right amount of technology and human care in an easy-to-use app. After sharing a bit of info about themselves and their health goals, new members pick a coach or therapist from a selection curated by machine learning. They then have 24/7 access and meet weekly with their provider to get customized guidance and go through machine learning-curated content in between sessions. Vida also syncs automatically with over 100 fitness trackers, blood sugar meters, scales and blood pressure cuffs so that members — and their provider — can track progress in real time. Over time, we’re able to predict outcomes in a population and work with payers to say “this is the cost savings you can expect in this population.” Continuous virtual care is so much more cost-effective than having people go to the emergency room or hospital in a reactive care model. The other important thing I’d want decisionmakers to know is that members actually use it and love it — more than 50% of users use the app 5-7 days per week.
This being 2020, how has the COVID-19 pandemic changed the landscape and Vida Health?
Tilenius: We all know virtual care is exploding and we’ve certainly seen that explosion of growth here at Vida. Before COVID, one in five patients were coded with depression and anxiety. Now, somewhere between 45-60 percent are coming in with those conditions. So we’re seeing a huge jump in the need for help with mental health conditions like depression, anxiety and stress. I do see COVID really changing the mental health landscape. Our large payers are coming to us asking for these solutions knowing that they need to do a much better job managing mental health ailments. So I see a real shift in awareness, stigma, and a desire for employers and payers to manage mental health better.
What should existing and prospective Vida Health clients expect in the next 18-24 months?
Tilenius: More successful outcomes and continued growth. We’re growing very fast. We have 1.9 million covered lives, we sell to large payers, nationals, Blues, Medicare, Medicaid, and we work with individual exchanges and large employers like Boeing and Cisco. We’re going to see another big year of growth in front of us. We’re always working to improve, whether that’s improving outcomes, retention, NPS, predictive analytics or anything else, we’re never finished. I feel like virtual care right now is where the tech space was in the 90s, we’re only just getting started as an industry with big things to come.
What career accomplishment are you most proud of?
Tilenius: I’m most proud of building products and services that help people live better lives and I’m very proud of our outcomes at Vida. So many of the customer testimonials we get are about how Vida truly changes their lives. Seeing their gratitude and knowing that we helped to improve their lives is really extraordinary. It’s just amazing what people have been able to do with the help and encouragement of our Vida practitioners. That really keeps me going when times are tough. There’s an expression a friend of mine constantly uses: “You’re either a bug or the windshield.” In your career you’re going to rotate between being the bug and the windshield, I’ve been fortunate throughout my career to have been the windshield more often than not.
What advice would you offer to other innovators?
Tilenius: For entrepreneurs, if you’re going into health care, read a lot before you start, meet with a lot of people to understand the incentive structures, the gaps in the consumer user experience and where the legislation is going as well. Start to follow CMS. Medicare sets the trend for much of health care.
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