Author: Samidha Visai

The Future of American Healthcare

Diabetes. Heart disease. Obesity.

These are terms that are as ubiquitous as their marketing counterparts: “Fat Free,” “Low Sugar,” “Heart Healthy.” While many people may feel desensitized to the names of these diseases, the reality is that overcoming these chronic illnesses is one of the greatest challenges faced by Americans today.

Where We Are Headed

Diabetes is a slow killer.  Afflicted patients experience skyrocketing healthcare costs. Medical costs for people with diabetes are twice as high as for people without diabetes. Just a handful of the complications of diabetes include blindness, kidney failure, stroke, amputations of the legs or feet, and heart disease, the leading cause of death in the United States.

Currently, more than 1 in 3 Americans are pre-diabetic. Without weight loss and moderate physical activity, 2 in 5 Americans are expected to develop type 2 diabetes within 5 years.

The percentage of children with obesity aged just 6-11 years old more than doubled from 7% in 1980 to almost 18% in 2012. Teenagers aged 12-19 experienced an even greater increase in obesity rates during the same period, starting at only 5% and jumping to 21%.

Obese youth have greatly increased risk for cardiovascular disease, diabetes, and even many types of cancer.

Where We Are Now

Departments and organizations are planning major initiatives to work towards bettering our citizens’ health. For example, the National Diabetes Prevention Program run by the Centers for Disease Control and Prevention is “an evidence-based lifestyle change program….that stresses education, dietary changes, coping skills, and group activities to help participants lose a moderate amount of weight and get at least 150 minutes a week of physical activity.”

Another program is Let’s Move, U.S. First Lady Michelle Obama’s personal campaign to “Raise a Healthier Generation of Kids.” Let’s Move provides educational resources hoping to promoting disease preventing lifestyle choices.

U.S. First Lady Michelle Obama delivers a speech on the first anniversary of "Lets Move!", a campaign to combat childhood obesity, at North Point Community Church in Alpharetta, Georgia, February 9, 2011.    REUTERS/Tami Chappell (UNITED STATES - Tags: POLITICS EDUCATION)

U.S. First Lady Michelle Obama delivers a speech on the first anniversary of “Lets Move!” REUTERS/Tami Chappell

Programs like these have their place in our efforts to combat chronic illness. However, take for example, the description from the CDC of its program as a “collaboration between federal agencies, community organizations, employers, insurers, health care professionals, academia, and other stakeholders.”

The reality is that many of the current programs involving large organizations and government agencies are hindered by inefficiency and their efforts are diluted by the interests of the many organizations involved.

Changing Our Trajectory

The best way to get effective healthcare and lifestyle education to individuals is not through bureaucratic programs.

The best way is through something many Americans are already extremely familiar with: web and mobile applications.

Web and mobile apps allow individuals extremely personalized, accessible, and reliable programs to make significant lifestyle changes. These applications pose substantial benefits over other programs because they have much broader access to users and better data collection, leading to increased customization and more effective results.

The validity of user applications in helping solve chronic illnesses is shown by the increasing number of startups in this space, often called “telehealth.”

For example, Omada Health provides an extremely interactive 16 week digital health program to help people develop and maintain healthy lifestyles. Their program utilizes technology and online communication to engage with its users in a very familiar way.


Omada Health Mission Statement Inside Their San Francisco Office

Omada’s key to success is an understanding that lifestyle changes made during the 16 week period are not sufficient for disease prevention; it’s crucial that these lifestyle are adopted for life.  The program provides continued support after the 16 week period.

Another example is Kurbo Health. Similar to Omada Health, Kurbo focuses on weight loss specifically for kids and teenagers.


Kurbo provides personalized health coaching and a mobile app targeting younger audiences with a simple and fun method to tracking diet. Kurbo reinforces long lasting health habits by avoiding restrictive calorie counting and promotes engagement with games and videos. Both factors are essential for younger users to adopt and maintain healthy lifestyle habits.


With their accessibility, usability, and familiarity, web and mobile applications are no doubt inextricably linked with the future of American health and wellness. 7 out of 10 deaths and the majority of health spending yearly for Americans is the result of chronic disease that is largely preventable by lifestyle factors such as diet and physical activity. While that is a grim statistic, if we continue to encourage innovation, growth, and success for startups disrupting healthcare, the future is nothing but sweet.

All facts, quotes, and statistics are taken from the Center for Disease Control and Prevention at

Product and Team at First Opinion: An Interview with Rachel Steed

Walk into First Opinion and the first thing you notice is a bright blue board that spans two walls where our engineering team, including myself, work. Labels such as “30,000 Feet”, “Creation”, and “Layers” organize the board into distinct columns filled with dozens of carefully placed sticky notes.

While this board may come off as superfluous – who really needs this level of organization? Can’t we just build new features as they come up? – this board is a representation of a product development methodology that has allowed our company extreme confidence in our product at every stage of development. I sat down with our Product Manager, Rachel Steed, to talk more about this process and how it drives our team.

Rachel Steed


So to get a little bit of background, how did you first get involved with Product Management and First Opinion?

RS: When we first started First Opinion, we launched a beta program and I reached out to each user after their conversations to get their feedback. I really got a strong sense for what our users liked and didn’t like. I started creating training for our doctors based on my observations of how our users wanted to be interacted with. The overwhelming response was that people were not comfortable asking all of their questions to their doctors when they went into the office, and I was convinced we were building an extremely useful product. I developed a strong opinion based on feedback from our users on what we should be building for them. So, this passion for building a product that people actually like and want to use is ultimately what got me involved with Product Management.

Why is First Opinion special to you? What do you see as the biggest impact of the product?

RS: I’ve seen how our doctors touch so many lives on our platform. Users always reach out letting us know how our product has helped them when they didn’t have any other resources providing that help. As a company, we have an incredible team with a culture where no idea is a bad idea. We’re touching so many lives in a unique way that no one has done before, and we are saving our customers’ tons of money and time by answering their health questions or validating their need for a visit to the doctor when necessary.

So, First Opinion has a product development process that I think is special. Tell me a little more about it.

RS: There are three general parts to our process. The first takes into account what our customers are showing interest in, and the second is something that I have worked hard to implement that I mentioned before and that is no idea is a bad idea. Finally, the last step is our process around validating ideas.

It’s very important to me that every team member feels encouraged to share their ideas in solving our problems. The benefit of involving each team member in our process allows me to tap into the skills of each member. By allowing anybody to bring ideas to the table, we can come up with better solutions. There’s always a better solution you may not have thought of. Having our engineers and designers involved in the why of what we are developing has been invaluable in building better products. It also really gets them excited and motivated about what they are building.

There are a lot of visuals — boards, notes, charts — around the office that seem to outline what we are doing at any point.

RS: I try to keep our process visual so that people really understand the steps that the product team is going through to validate ideas, and so they can see where in the process their idea is.

Nobody wants to just be building the highest paid person’s idea. If you don’t have a process outlined for how you validate ideas or how you are going to follow through on them, you develop a process that is based solely on who is the “smartest” person on the team. Truly, this doesn’t bring a lot of innovation to our product. The more people you have thinking about how to improve our product and solve our problems, the better.

The visual board also helps with another aspect of our development. When we thinking about what we’re building next, we always try to build an experience end to end for our user, so that we’re not just focusing on one tiny area of the app. Making our process visual shows us if we are putting too many resources into one area of our app and neglecting others. For example, if I had everything centered around logging in for the next 3 months, I would want to spread out a little more and push some of these tasks for later. This allows us to not just focus on building for the new user as there are also current users we need to take care of.

There’s also a big emphasis on user research at this company. A lot of companies especially smaller ones may not see the value in this. How does user research really impact and drive product development here?

RS: User research is hugely important to us here, we even have a person dedicated to that role, just so that we can gain better insights into what people want. We are doing something totally new and in order to come up with a product better than the current system, we have to understand what’s working for people and what’s not working for people and what their pain points are, and we just have to overall understand everything we can about the user.

What benefits are companies not doing this missing out on?

RS: We put a big emphasis on usability. We can sit here for 10 hours staring at our product, but eventually we are so familiar with it that we don’t notice problems that are there. Talking to someone with a fresh perspective is invaluable. I’d rather test tons of our ideas than spending 2 or 3 months building something and realizing that it’s not what our users wanted or there’s concerns that we didn’t see before.

So to summarize, what do you feel you do differently in terms of your user research and product development that you have seen the most positive impact with?

RS: Having a process that includes everybody, especially our users. We like to know as much as we can before we develop something. It’s a short term additional cost, but the long term benefits have been more than worth it. Continue reading