Using Tech to Navigate Well-Being – Jeff Arnold, CEO of Sharecare

Shiv Gaglani: Hi, I'm Shiv Gaglani. I'm delighted to welcome Jeff Arnold to Raise Line today. Jeff is a pioneer in digital information with decades of success creating and leading companies that leverage technology to provide easy access to knowledge, including WebMD and HowStuffWorks. Since 2010, he's been Chairman and CEO of Sharecare, a company whose founding investors include the likes of Oprah Winfrey, Sony Pictures Television, and Discovery Communications. 

Sharecare is a leading health and wellness engagement platform that provides people with personalized information, programs, and resources to improve their health, whether they download the Sharecare app themselves or access its platform through a self-insured employer health plan or, coming soon, health system. It has experienced significant success throughout the pandemic, and it's just about to go public and begin trading on the NASDAQ exchange. I'm really looking forward to asking Jeff about Sharecare's pandemic experience, role in the digital health landscape, and where he sees Sharecare and digital health going in the next decade. So, Jeff, it's an honor to meet you. Thanks so much for being with us today. 

Jeff Arnold: Great. Thanks for having me. It's nice to meet you as well. 

Shiv Gaglani: So I'd like to start by learning more about your background and what led to your interest, first in digital media and information and then in the healthcare space.

Jeff Arnold: Sure. So I went to the University of Georgia, and my senior year, my sister called me and said, "I can get you a job selling pharmaceuticals." And I left school early. Didn't really know yet quite what I wanted to do, and flew out west, got trained, became a pharmaceutical rep. My girlfriend at the time was going to Emory Nursing School, and I used to go have breakfast with her in the morning as she was getting off the graveyard shift, and met a doctor. The doctor started talking about people that have transient heart symptoms, and was describing it to me it's like taking your car to the mechanic and you tell the mechanic your car's making a noise and it doesn't happen at the shop. And then you drive a few miles away and you hear it again. I started going over to his house. He taught me how to read EKGs and I remember still the book was by Dale Dubin. It was like "EKG for Dummies" or something. But I learned how to read EKGs. 

I quit the pharmaceutical company and I got on a plane -- I'd never been out of the country before -- flew over to Tel Aviv, and got somebody to make me a heart monitor that was the size of an American Express card. You would put it up to your heart and it would record the EKG and transmit it through the phone line. So it was like kind of the early days of telemedicine or remote patient monitoring, and that's what got me into healthcare. That was the early 90s, and kind of never looked back.

Shiv Gaglani: That's pretty incredible. I didn't know that background about you. When I was first getting into medical school, AliveCor came out and this was the early 2010s. What you were just describing is basically what Dr. Dave Albert and AliveCor created, but 20 years earlier.

Jeff Arnold: Sure. There was a company that was called Cardiomedix in Tel Aviv that was awesome. It was hard to capture the EKG during symptoms, and so you just pull it out of your purse or wallet, you put it up to your heart and put the phone on top of it, and then we had a bank of nurses and you would see the EKG. You could print it out and put what the person was feeling and what they were doing at the time. This is 1998. We grew it up to 60,000 patients a year. Then the internet comes roaring along and we think to ourselves, man, we should stop sending out all these faxes, and we should create a homepage for health. That's how we started WebMD. 

Shiv Gaglani: That's pretty incredible. We've gone through some of the WebMD story. We had John Whyte on the podcast who is their current chief medical officer, and before this interview started, we talked about the Godfather of Osmosis, Peter Frischauf, who started Medscape who obviously you all at WebMD acquired. I do want to get to know more about WebMD and HowStuffWorks, but you're about to list publicly for Sharecare. So, take us back to 2010 when you started it, tell us about the value prop then and how it's evolved over the past decade in terms of differentiating from those other sites you helped build.

Jeff Arnold: So, we had sold a company called HowStuffWorks to Discovery Channel and I went to Discovery as their global Chief Digital Strategy Officer, which means nobody reports to you. One day the CEO called me and said, "We're doing the Oprah Winfrey Network, and she wants to brainstorm with Dr. Oz Digital Health." I got on the call and got asked the question, "If you could do WebMD over, a decade later, how would you do it?" I went to the Wayback Machine -- I don't know if you've ever been to that website -- and I typed in WebMD and I was looking at the site and thinking to myself that it still felt very similar to what it was a decade earlier. It was providing great quality information, but hadn't evolved past that. I felt what had changed was now everybody had the smartphone. But the idea of WebMD -- of health having a homepage -- was such a big idea because healthcare is really fragmented, and wouldn't it be great if there was a destination that patients and providers and payers and employers could collaborate on behalf of the person. In 2012, while I was still basically at Discovery Channel, said, "Let's go pursue this dream. Let's try to use these enabling technologies to connect the ecosystem on behalf of the person." So we've been pursuing that for the last nine years.

Shiv Gaglani: Obviously, a lot has changed over those nine years. Smartphones are ubiquitous, digital health is having quite the moment. We were just talking about how another one of the companies we work with -- 23andMe -- just went public on a SPAC. Can you talk about some of the changes you've seen over the past decade and the ultimate hope that you have for Sharecare, in terms of what it will do for patients, consumers, and health systems at large?

Jeff Arnold: I think what we've seen over the last decade is there's a lot of fragmentation, still. There are all these amazing point solutions out there...great companies that can help you with your diabetes, or can help you do telemedicine or give you a transparency tool, and the list goes on and on. But what has yet to emerge is a true platform. A platform that is interoperable with the data so that it truly talks to each other; a platform that's user friendly, so if you gave it to your mom or your kids, they would know what to do; a platform that's affordable for all. So what we've been trying to do at Sharecare is evolve from health having a homepage to what we call "all together better". And what we mean by all together better is we're all together better when you can bring the ecosystem to the palm of the person's hand. So instead of having a sea of apps on your phone, how could you have one app that could connect you to your doctor, your health plan and your employer, and other point solutions? And then how do you go from a point solution to a platform that in itself is all together better? And then lastly, how do you go from "my" health to "our" health or individual transformation to community transformation. So the business that we've been building is what we like to call a category of one. The reason we think it's a category of one business is it's very comprehensive. We've acquired over 15 companies that we've built this one platform off of. It's very diversified. We sell Sharecare's services and platforms to health plans, employers, government, health systems, and life science companies. It's very innovative. We think that's usually important...that if you're choosing to adopt Sharecare as a platform, then we have to be your innovation partner and then build a business that can scale so that we can continue to invest in the user experience and, and getting results for our clients and users.

Shiv Gaglani: Absolutely. I love especially the transition from individual care to communal care. To be innovative, you guys obviously are investing in data and I believe artificial intelligence. We've had people like Eric Topol and Dan Kraft, who are leaders in AI and digital health, on the podcast as well. Do you mind talking a bit about how you see that evolving -- having all this data -- not just with how you can use it for AI, but then also privacy and security concerns which often come up in those conversations?

Jeff Arnold: How do you put data to work, and use data to drive insights and insights to drive action? For us, there's kind of three data pillars that we work on. One is all around the environment. So how does the environment affect your health in the same way your lifestyle or your genetics do? So we have invested over $80 million building a Community Wellbeing Index where we look at every zip code in America and in real-time assess what's their physical health, what's their mental health, what's their financial health, what's their sense of purpose and their sense of community, what do the social determinants of health look like, so that we can almost give like a FICA score on every zip code. So that's one thing that's really important to Sharecare. 

Then in the middle, what has come out of the pandemic is what we're calling the emergence of health security. How do you tech-enable best practices to make sure that your environment is safe? In the same way cybersecurity protects infrastructure against the virus, how does health security help protect people against this threat and future threats? So we've built this really interesting Sharecare Verification Platform that has now been adopted in 75 countries. 

Lastly, our core platform is all about resilience. We get data from self-reported ways. 50 million people have taken our real age test. We get the data with your permission through your device...we're tapping your accelerometer, tapping sensors for sleep. We get your claims data if you're a sponsored user from an employer or health plan. I mentioned SDOH data. This year, we'll collect over 5 million medical records where the people can come to Sharecare and with their consent, we'll go collect your medical records from various health systems and structure the data on your behalf. The idea with the data is, how do you build resilience, which strengthens health security, which improves well-being. And that's kind of how those three data pillars work together.

Shiv Gaglani: Wow, that's incredible...the reach that you have when you have sponsored members providing some of that additional data. I like the idea of a credit score for your health and the zip code. So it's actually probably a good way to transition into how you all have adjusted doing COVID. Because one of the main things that has come out of the COVID pandemic is this knowledge that not all zip codes are the same, right? The outcomes and vaccination rates change, and the pandemic today is flaring in certain zip codes and gone way down in other zip codes. So, can you tell us a bit more about how the COVID pandemic has shaped what you've done in Sharecare? 

JeffArnold: Well, I think that what 's come out of the pandemic is people are more than ever self-aware of risk. For digital health, it's become almost like the Superbowl. I mean, if you can't make it now, you'll never be able to make it, is almost my thinking because it's become a C-suite initiative. People from all types of places are super self-aware. We felt that it was our responsibility to have a rapid response to COVID as a digital health leader. We have 400 plus people in product and tech and so we went back to our three data pillars and said, "What are some things that we can do?" 

The first thing we did at the Community Wellbeing Index is we started looking at the domains of wellbeing through the lens of COVID. If we were looking at physical health, it was all about how COVID-19 was affecting people that have comorbidities and other things. If we were talking about looking at financial health, we put it into unemployment and things that were happening in the stock market. In some states, we built out some "go-to" websites, so one that you can go to now is Georgiawellbeing.com. We partnered with the governor and the Department of Health and the National Guard and we said, "Instead of having 25 state websites, let's develop one website that's a go-to website for all the citizens so that they can know where to get tested and all the other important things. 

The second thing is we felt there can't be all this fragmentation on what all these individual places are doing to make sure that they're COVID ready when the world reopens and people feel safe to come back to work, or people feel safe to stay in hotels again. So we built a conversational AI chatbot, and we built a bunch of analytics. There have been over 2,000 hotels across 75 countries in the world that have become Sharecare verified. I saw a stat the other day that it's generated already 3 billion media impressions for us this year through hotels and others putting out press releases saying that they are Sharecare verified. So we thought that was important, and we think -- like cybersecurity -- that'll be here to stay. 

And then from the resilience standpoint, we did a survey early on in COVID...a flattening the curve survey. We had over 100,000 people participate, and what it told us clearly is that people were under tremendous anxiety and stress, physical stress, financial stress. So we started researching what types of digital therapeutics could we deploy to our core platform to help? I got introduced to a TED Talk by a gentleman by the name of Dr. Jud Brewer, and his TED talk was all-around mindfulness and how to deal with anxiety and stress and other things. His company is called MindSciences and he's an MIT neuroscientist who runs the mindfulness lab at Brown University. We acquired his company and he's joined Sharecare. So we started deploying those digital therapeutics for free for our user base to help people deal with the pandemic.

Shiv Gaglani: That's incredible. I've seen that talk and obviously it's been a boon for mental health companies. We had the chief medical officer of Calm, Omar Dawood, on our podcast as well and it's going to be something that lasts for the next few years. If you were to put on your pontification hat or futuristic hat, what do you see as the future for digital health in the next five to 10 years? What's your vision for Sharecare and also digital health as a whole?

Jeff Arnold: Well, what I hope is when you hear the name Sharecare five years from now, what that will stand for is that 'I'm sharing my data with the platform for my insights, but I'm also sharing the data for our insights.' Our version of Operation Warp Speed is how, with all this machine learning and artificial intelligence and all the data that we've been talking about, can we accelerate research to care? Simple things that we're doing now...we just got a patent where I can take a picture of your face, and it'll tell you what your BMI is. I can take a picture of food and it'll tell me, what's the makeup on the plate and what's the caloric intake. But where we hope that goes is that we're training AI models on how to optimize diet, or how to optimize mood. But the idea is we're sharing data together so that we can accelerate research to care. 

The second thing that I think is going to happen is, user interfaces are going to start to look more like Waze. How do I navigate my well-being? We're going to become more self-aware that where I live, work and play matters to my health, and we're going to use these technologies to make the healthy choice, the easy choice. That's one of the things that we're really working hard at is to figure out how we take our well-being index, and how we treat choices as points of interest so that we can help people navigate their well-being. 

The last thing is, I think that the new user interface is going to be no user interface...that you're going to be able to go to platforms and, with a voice command through a voice biomarker, be able to identify Jeff is Jeff and this is the last time I had an eye exam; this is how many steps I took; this is how I refill my prescription or see my doctor, or understand what gout is, or anything else. It's going to be a voice command away, but highly personalized.

Shiv Gaglani: I love that. I think I remember seeing that press release, maybe a year ago now, of your collaboration with Amazon and Alexa and introducing an Alexa Sharecare app. We had Rachel Jiang, the head of Alexa Health and Wellness on the podcast a couple of months back. 

Jeff Arnold: Great. What do you see? What's your prediction? 

Shiv Gaglani: I think you've nailed a couple of those things. The reason we call this podcast Raise Line is everyone talks about flattening the curve, which is clearly what we've done to promote social distancing, get people to wear masks, get people to that get vaccinated. And so certainly anything that gets people more engaged in their own health, not just understanding it, but then taking action is going to be powerful -- which is why like your Waze analogy -- and then providing incentives around that. Whether people can get lower premiums, or some real incentives -- just like GEICO will drop your premium if you do a driving test, or put that device in your car. I think there will be a lot more of a linkage between education and behavior change. 

We know that there will not be enough clinicians and providers in the world, even though we're trying to train as many of them as possible. So it's really incumbent that patients will take care of their own health and become certified as caregivers, or if you have diabetes, you become an expert in your diabetes even more than your endocrinologist in many ways. So that's where we're focused.

Jeff Arnold: I think, too, this opportunity -- as providers go from fee for service to value-based care -- that all of a sudden, they start to adopt the same platform, strategies, and techniques that the big health plans use to manage risk so that they can have more connectivity with the patient. My hopes for all this technology is, in our world, we call it Sharecare-enabled doctors so that when I see the Sharecare logo next to a provider name, that tells me that I can share my data with my doctor and that my doctor can prescribe Sharecare. I think this patient-provider opportunity is another really big one. How do we use technologies to strengthen that bond? While at the same time, we're empowering people like you just described it -- raising the line much higher than it is today -- but that's all viewed as a positive and empowered consumer with a connected doctor as Nirvana.

Shiv Gaglani: I love it. We're big fans of value-based care at Osmosis. We had Christopher Chen of ChenMed and Rushika Fernandopulle of Iora Health on the podcast, who are leading the way in value-based medicine. I'm respectful of your time, but I would love to talk to you about your decision to go public, and especially to do so via a SPAC, and also a big investment you just got from Anthem. So do you mind giving us a bit of an insight into all those decisions?

Jeff Arnold: Real quick, we had a board meeting last year as a lot of companies were going public. And we said, "We're a $400 million company. We're profitable. We're growing 20 plus percent a year. We need to get on the dance floor, too, to have access to capital to build our brand. We were gonna go the traditional IPO route, and SPACs got really hot. We started getting different SPAC offers. I'll be honest -- I didn't even know what a SPAC was a year ago. When I started learning about it, I thought there were some real advantages for Sharecare because we have a really diverse business -- which I personally love because there are lots of ways to win -- but for investors, sometimes they like a single comparison, like, "You do this thing, and I compare that to others like that." When you don't have that clear comp, it's a little more challenging. 

I love the ability through a SPAC that you could give forecasts, and that you could spend more than 20 minutes on a roadshow with an investor. So you could really dig into, "This is what we mean by an empowered consumer, and this is how it connects to a health plan and to an employer; and then this is how we think about the role of the provider; and let's not forget the environment of where they live, work, and play; and let's talk about brand permission -- can Sharecare have brand permission to help states put vaccines in people's arms, to help Delta employees with their back pain, and be able to help people in all kinds of different ways." 

So that's the route we went, and along the way, we had a really successful PIPE offering, which is one of the ways you raise capital, as you know, during the SPAC. We started talking to the Anthem. Anthem was a customer previously, and we got excited about this idea of really what Sharecare is, in the effort of managing risk, is a digital advocate and could we make additional investments into the platform so that we could be that one-stop-shop for the person for their medical insurance, or dental insurance, vision insurance, but that one-stop for everything with a digital-first lens? They made a $50 million investment into Sharecare in April, alongside the PIPE, and are joining our board of directors. We're doing a lot of co-development together and hoping to bring that vision to life in early 2022.

Shiv Gaglani: That's awesome. I'm sure the SPAC will go really well and I think it's really smart timing because clearly to accomplish that vision of an empowered consumer, having a publicly listed brand that people get behind -- just like Airbnb or Uber -- will be really important. 

As I mentioned, before we started this, we have over 2 million YouTube subscribers and a couple of million registered users. Most of them are early stage healthcare professionals, many of whom will eventually be Sharecare-verified providers. What advice do you have to them about meeting the challenges of the COVID pandemic and beyond?

Jeff Arnold: When I started WebMD, it was slow to adopt. I can remember the early days when I was in digital health...people would rush into the exam room with information they printed off WebMD, and doctors weren't ready for that yet. I think doctors will lead the digital health revolution. They've grown up with the technology, they understand the power of connectivity and social and being on all the time, but in a good way. I honestly think the hospital of the future, as we go from sick care to home care, is going to look more like NASA than it does today with heads in beds. These connected physicians will be able to treat patients in remarkable ways...helping empower them, helping them stay in place. I look forward to that day. I think it's coming soon, and I think this next generation of doctors is going to expect nothing different.

Shiv Gaglani: Totally. I couldn't agree more with that and that's why we like asking this question. We work with over 150 medical, nursing and PA schools, and part of why we launched the podcast is to get the students and schools thinking about what needs to be in their curriculum so that they're able to leverage tools like Sharecare and many other tools out there, and think about the way they will be practicing in a value-based, home-based framework in the future. 

Jeff Arnold: On that, I would say our strategy for medical students is we're investing in building out the Google maps of the human body, and VR. It's already on Oculus if you want to play with the Sharecare VR, but it's an amazing journey through the body. We have all kinds of ideas of how do we introduce Sharecare to providers of tomorrow with super immersive experiences so that they see the quality of the product that Sharecare can produce as they go through their medical school journey.

Shiv Gaglani: That's awesome. I'll have to bust out my Oculus, which is right behind this poster here. Was there anything else you wanted to be able to share with our audience while we have you, Jeff?

Jeff Arnold: I appreciate everything that you guys are doing to drive awareness to all these activities in digital health. I think it's a really important time for healthcare transformation, and you guys getting the word out on what all these great companies are doing, I think it's amazing, and congratulations on all your success.

Shiv Gaglani: Thank you very much, Jeff. And best of luck in this week's SPAC listing. I really hope it goes well. 

Jeff Arnold: Awesome. Well, thank you so much. 

Shiv Gaglani: Thanks. And with that, I'm Shiv Gaglani. Thank you to our audience for checking out today's show, and remember to do your part to flatten the curve and Raise the Line. We're all in this together. Take care.