Healthcare’s a hot topic these days. Few are satisfied with their plans, doctors are being paid less for doing more, and the national government is about to plunge into unprecedented debt in the quest for solutions.
Part of the problem, according to the founder of personal health tracking startup Polka, is an economic misalignment of incentives. It’s in the interest of employers, insurance companies and pharmaceuticals for individuals to be healthy and take steps to avoid things like diabetes, heart failure and other preventative diseases—but the individuals themselves see little of that economic reward, and are left to more traditional motivations for staying in shape. In the age of universal attention deficit disorder, those motivations don’t cut it for many.
The need to align monetary incentives for health resonates with what Venrock VC Brian Ascher told us last week. Venrock is becoming more involved in healthcare IT, and Ascher sees a need to “create financial incentives for the consumers to make better long-term choices for themselves with regards to wellness, and not just fixing the problems after the fact.”
Polka is one attempt to re-align those incentives. It’s a web application that lets users log their health-related actions—taking medication, going for a run, etc—in Twitter-esque 140 character updates. Users can share that information with doctors, emergency contacts, and others on their appointed “team.” The company partners with employers, insurance and pharma companies in the health industry to reward actions taken to improve health, without giving up any individual’s private info. Users can end up getting paid for health actions, and receive special offers based on their habits.
The company presented at SF New Tech on Tuesday, where I grabbed CEO Mike Kirkwood for a quick interview.
MB: So how does Polka work?
MK: Polka offers a personal information platform. The concept is that a person aggregates information about themselves and what they’re doing, the activities they’re completing over time, and by doing so, are building an asset in themselves overtime, especially in regards to their healthstream.
We know there’s such imperfection in the market between somebody being given a diagnosis or having to complete an action and Polka finds and brings that information into the person’s platform, but then tracks the activities that a person performs for their own benefit, and then we marry those patterns to companies in pharma, providers and health plans that want to offer solutions. We enable the person to monetize themselves and become a more powerful asset over time by doing things that they normally do, but logging them and aggregating them—very similar to what you do with Facebook or Twitter, but it being private first, where it’s my stuff about me
MB: Explain monetization—how do I get paid if I’m using this?
What we’ve learned is that the key challenges in the health system are things like Diabetes, heart failure—areas where the person can, by taking action, reduce the cost of them to their employer, reduce the cost of the plan, and make themselves a better client to pharma and other providers. What we’ve learned is that the person, by taking a step forward and say I’m actually willing to log this information in a system that’s not giving up this information but is reporting back, the person actually saves so much money to the system and becomes such a better client that they offer money back.
There are a lot of services that attempt rewards, though they’ve not been successful so far. For example if you go into United Health Care, they’ll offer you $75 to go into a diet program if you’re over weight. We say that $75 is great, but no one’s really interested in going out to this little application out there and logging it in to the provider. We take a part of that $75 instead and reward me for just doing what I’m already doing to make improvements to my health.
MB: So if I sign up for this, log my information, my bank account gets bigger just by being healthy.
MB: What about privacy. It’d be great if my employer can pay me to be healthy, but I don’t want them to know my diagnoses or know everything about my health. How do you get around that issue?
We take the point of view that a person’s asset over time grows by them actually having their information and being the sole source. So even though this is kind of a new idea emerging, the idea is that the personal information platform—my “stuff” is literally my stuff overtime. The aggregation of what these providers know or pretend to know—meaning they are so dysfunctional themselves in sharing my information, that by me being a credentialized, highly available, authorized secure source, I’m actually helping them save money by letting them know what’s actually going on, and I’m able to aggregate the data, but also able to reduce the photo print of what I send out.
For example, instead of sending out my raw exercise stream or my raw blood pressure stream, or my raw diet, instead what I do is I answer questions for them, and we provide a cloak around the person so Polka can in essence let there be just enough of a shield so the person can do what they’re doing without necessarily letting throwing all their information into the system. There are massive benefits, although not immediate at first, to the provider and to pharma. What they want is for me to be more healthy and today, the original Web 1.0 way of doing that is “come into our site an tell us how you’re doing.” It’s a massive demotivator and people are scared of it because in particular of the provider, because if I do that, there’s a good chance that if I fail in that program, I’m actually going downhill; there’s a good chance that I’m either going to get kicked out of the program, I’m going to lose points over time. What we’re trying to do is create a positive emotional state for continuing to take actions for your own health and providing this nice shield for the person over time.
Also, as that shield gets more data and more rich, the ability to share, aggregate and see trends becomes available as well, and Polka can provide that mechanic without having it locked into each individual small provider or each payer. Instead, it’s citizens’ information and citizens can choose to share what they want.
And we’ve learned that we’ve become this opportunity for lead generation. One way we could do it is we could sell your information. But that’s really imperfect, because what we’re trying to do is make the person more strong overtime, not just because we think it’s good for the person, but because it’s good for the business. If I give up all my data once, it’s gone. They have it, they aggregate and they share it. But if I instead answer questions for example, and I start to project what I’m going to do in the future, for example if I say I’m going to exercise weekly, all of a sudden, who’s interested in me exercising weekly? Well, my payer’s happy, my employer might be happy—I’m now at less risk for diabetes and there’s reason to give me direct rewards—but who else is interested? Nike? Others? I mean, I’m exercising weekly, how long before the treads in my shoes need to be replaced? So I can start to look even beyond the intention curve of Google into what’s going to happen with this person?
So it is relatively well known in terms of all the decision trees that happens in the business of the payer and the employer looking at you and what category you fit in: “oh, high-risk diabetes. OK, you’re going to automatically cost us $20,000.” Well, instead what Polka is suggesting is that by taking actions you get rewarded directly for eating well, exercising and putting the dollars behind doing, so that’s where we believe the opportunity is in terms of monetization.