Where Machine Intelligence and Human Ingenuity Achieve the Impossible
By Josh Sullivan and Angela Zutavern.
VICTOR STRECHER, A PROFESSOR AND PUBLIC HEALTH EXPERT at the University of Michigan, recently set out to answer what we would call impossible questions: Can a healthcare start-up sell a service to make people healthier by improving their sense of purpose? Is it possible to sell this service to healthcare providers? Could Strecher do it at a reasonable cost? Could he get enough buyers to make a business out of it?
At first blush, Strecher’s idea lies outside the mainstream of conventional possibility. It’s not within mainstream medicine. Or mainstream technology. Or mainstream business models. Indeed, addressing preventive medicine from the point of view of people’s sense of purpose is so far outside the mainstream that just a few years ago nobody would have even imagined the idea — except perhaps for Strecher.
But with the market for preventive and personalized health expanding by over 15 percent a year, now worth $250 billion, Strecher is on the cusp of doing what a lot of leaders would like to do: disrupt an existing industry model and build a vibrant new line of business.
We know the answers to Strecher’s impossible questions because JOOL Health, his new company, is now licensing its platform to over a dozen companies, including Steelcase, Truven, and Cincinnati Children’s Hospital, at a rate exceeding its projections by over fourfold. When individuals enroll in the service through their health organization, they download a smartphone or web app as the interface and then receive daily guidance in honing their life purpose. The healthcare organizations or employers in turn can see a dashboard of aggregated anonymous data they can use to better manage their population’s wellness.
Strecher’s work reprises an old theme — a solo entrepreneur takes on industry giants with a storm of clever thinking and technology. Over time, if the story works out, the giants become followers of the next big thing. The entrepreneur, meanwhile, makes the leadership mark of a lifetime, in this case shattering thinking constraints, asking impossible questions, using incredible technology, and building a vision for a new mathematical corporation.
Strecher recognized he could depend more on machines to comprehend data, perceive patterns, remember details, and organize information. So he asked the impossible questions about breaking constraints on traditional business models. And he asked impossible questions about breaking free of technological limitations, too; just a couple of years ago, these limits would have precluded the data handling, modeling, and computational speed he needed to build JOOL. By asking the right questions, he made an idea work that never could before. The impossible, by virtue of asking the right questions, became possible.
Here’s how JOOL’s service works: users of the JOOL app score themselves daily on the quality of their sleep, presence, activity, creativity, eating, or other self-chosen goals. They also rate their energy, willpower, and success in fulfilling their personal, work, family, and community purposes. In return, JOOL’s “Aristotle Insight Engine,” an algorithm-based recommendation tool, provides thirty-second tips targeted expressly to helping people to build their energy and willpower and fulfill their purpose. The longer people stick with the app, the better Aristotle’s advice. As the JOOL app helps people improve their health on their own, the aggregated data from the app help buying organizations make changes in care that can improve the health of all of their subscribers.
The Aristotle Engine learns from data on what has worked for other people with similar profiles and tailors recommendations for each individual. (“Looks like your eating hasn’t been as balanced as you’d like. Try this tip…”). After ten days, the Aristotle Engine can analyze the user’s behaviors (sleep, activity, etc.), local environmental data (weather, economic conditions, etc.), temporal data (day of the week and month and even the phases of the moon!), and biometric data collected from fitness trackers and other devices. The engine helps users understand what gives them more energy, willpower, and other outcomes they care about (such as improvement in migraines, blood sugar levels, or even golf). After fifteen days, the Aristotle Engine has enough data to predict the quality of the user’s day and what to do to improve it. (“Your energy forecast for tomorrow is rockin’.”)
So far, Strecher seems to be on the right track, at least as far as getting the user interface right, which makes the rest of the system possible. JOOL ranks among the top sixty apps in the world for usage in the two weeks that follow initial use. Moreover, among health apps, its first-week retention rate is more than 60 percent, over four times the rate for other health apps.
Strecher, of course, didn’t just launch this business to make money but to fulfill a lifelong mission to improve health in the ways targeted by his service. He cites piles of scientific research that show that a sense of purpose is linked to better health in multiple ways: lowering risk of heart attack, stroke, depression, and even leading to better sex, for example. “If you’re aligned with your true self, then you’re happy,” says Strecher. That in turn gives people a better life and lowers healthcare costs.
Finding the right questions is easier said than done, of course. Nobody asks the right questions out of the gate. That’s because you can’t know in advance which gate to start through. Creating winning strategies involves undertaking a quest to break free of the cycle of asking small questions that lead to small answers in order to discover the big questions and answers that count.
Strecher initially set out to build the JOOL app as a personal digital life coach — to “democratize” what formerly only the wealthy could afford. He went on to figure out the most effective dashboard so healthcare organizations and employers could use the data to better population health. The point solution (personal health) expanded to a system solution (preventive health care).
This is the entrepreneurial approach, indeed, a high-tech approach, in which you answer enough questions to put a good product or service on the street and then upgrade it to something great. In other words, as you ask questions and answer them, you raise new questions and answer them until you iterate to an answer that counts — or better yet a blockbuster answer. You then have conceived a vision that people can rally behind and that you can implement and scale up.
Excerpted from The Mathematical Corporation: Where Machine Intelligence and Human Ingenuity Achieve the Impossible by Josh Sullivan and Angela Zutavern. Copyright © 2017. Available from PublicAffairs, an imprint of Perseus Books, LLC, a subsidiary of Hachette Book Group, Inc.