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Live Life Love | Volume Thirty-Nine

Hi Everyone,

I hope your summer is off to a great start and you are finding your way to having tons of fun. I am starting to really enjoy further deconstructing the topic of fun. Seneca said, “we suffer more in imagination than in reality,” which is likely true. However, I believe we can make a case that we enjoy more contentment in imagination than in reality, too. So, if it is true that contentment is subjective (academics acknowledge this by measuring happiness through subjective well-being instruments), then a strong case can be made for the benefits of architecting a life through positional economics and taking measures to increase one’s prospects to engage in fun opportunities. In an attempt to practice what I preach, the family and I have made the decision to move from California to North Carolina — freeing up some resources for more life experience and (hopefully) more fun. Time will tell if we feel like the reward (opportunities for fun) outweighed the risk (loss of existing support systems).

More on that in future editions; for now, here are some more great interviews with two modern pioneers in digital health.

Business, Innovation and Entrepreneurship: This quarter, we look at the entrepreneurial side of digital health with Ryan Tarzy. Ryan is the current director of the Incubation Studio at CoverMyMeds. Before this position, he served as SVP of Business Development for PokitDok and has co-founded two companies, Medikeeper and Playful Bee. The interview with Ryan Tarzy about digital health can be found here.

Health and Wellness: This quarter’s health and wellness interview is with Daniel Freedman about virtual fitness. Daniel originally co-founded CyecureBox, a successful cyber security tool. He has since gone on to focus his efforts on the development of his new company BurnAlong — a virtual fitness startup that aims to help people find the time to exercise. The interview with Daniel Freedman about virtual fitness can be found here.

Life Experience: This quarter, I got to experience Lightning in a Bottle. It is an unbelievable festival with stunning art, good music, and lots of great educational sessions. I got to meet and learn from Dr. Jack Kreindler (@drjackUK) and Dr. Adam Gazzaley (@adamgazz) while partaking in some shenanigans with good friends and enjoying the scenic setting of California’s Central Coast.

Lighting in a Bottle | Bradley, CA

Contribution: I was able to donate time, as well as money, this quarter. Through TECHquality, I helped improve the gender gap in digital health by mentoring a co-founder of the company Cleanopy. I also donated to former interviewee Jeff Atkinson’s son during his Tour de Pier effort, as well as donated a car to the East Bay SPCA.

It is the anniversary of my brother’s passing. Brian left a legacy through amazing memories with quality friends — a testament to the value of making time to enjoy and experience life. I believe he would be proud of the direction I have taken this endeavor and the directive to focus on fun for a while. His life is certainly a reminder to make the most of the time we have. My hope is to honor him by making sure I maximize people’s ability to have fun with the short time we have been given. The next edition will mark 10 years of this project. It has been quite a journey so far, and I look forward to it being a lot more fun as we continue on. I’m grateful that you are a part of it.

In health,
Dr. Rucker

P.S. I was featured in the Wall Street Journal this month; good piece about fitness technology for those interested: Your Gym’s Tech Wants to Know You Better
P.S.S. I plan to be in Portland in July for the World Domination Summit. If you are going too, please let me know … I’d love to meet up.

Interview with Daniel Freedman about Virtual Fitness

Daniel Freedman graduated from the London School of Economics (LSE). He started his career as a journalist and worked for several publications, including the Wall Street Journal and Forbes. He contributed to the bestseller “The Black Banners,” a book about Sept. 11 and the United States’ war with al-Qaeda that was published in 2012. Freedman later shifted his interest to the technology sector, working at tech startup Apploi and co-founding CyecureBox, a cyber security tool. After transitioning from Manhattan to Baltimore, he has been focusing on the development of BurnAlong, a startup that aims to help people find the time to exercise. During his eclectic career, Freedman has also held posts at the United Nations and the U.S. Senate.


1) What currently excites you about virtual fitness? How have things evolved from the days of Jane Fonda VHS tapes to the virtual fitness experience a user can consume today?

I think what’s really changed today is virtual fitness is allowing people to bridge the online and the offline fitness experience. New ways of delivering virtual fitness can finally bring people the “real” experience that they want, as opposed to having disconnected, lonely experiences with static content.

If you look at video games, the virtual world bridges that divide. If I go back to when I was a kid, if I wanted to play video games with a friend, I had to travel to their home. Today, my nieces can play with one another and/or their friends online, from their respective homes in different cities. They can see and speak to each other no matter where they are in the world. It’s the same in the business world where work tools like Skype and Google Hangouts have connected us.

What’s exciting to me in the fitness space is being able to bridge the divide and give everyone access to the experiences they want, when they want them. Fitness is about relationships, purpose and motivation. New advances in virtual fitness now allow us to do that at scale, with your workout buddies wherever they might be.

2) What are the limitations of delivering virtual fitness, and how have you seen this effectively mitigated?

If you go into any gym or studio, anywhere in the world, and ask, “Who is the most popular instructor here?” And then you ask them, “When was the last time someone said they can’t make a class, or was away for the summer, or traveling for work, and so could you film the class?” Odds are the instructor will say it was within the last two to three days. This reflects a massive lost opportunity for gyms and studios, because their members would prefer to choose a virtual experience with their favorite instructor, rather than strangers, if given that option.

BurnAlong does that, bridging that divide, giving people the connection to their favorite instructors/their friends, at a time and/or place convenient for them. And instructors can gain an insight into what people are doing outside of the gym, and help keep them on track.

3) Throughout the process of your product development, what has surprised you about virtual fitness delivery and consumption while building BurnAlong?

One big surprise is the willingness of people to try something different from home, or get started on their fitness journey. We see with companies, that often people have heard about top local instructors, they’re very curious to try them out, they’ve just never had the time, or confidence, or motivation, to actually take the class. But being able to experience it at home, from the comfort of their own home, makes a big difference.

We see this especially with companies and their employees. Right now, for many, five percent of employees participate in wellness programming. What we’ve found is that it’s not that the other 95 percent of the company isn’t interested. On the contrary, there are just a lot of barriers to attend (e.g. schedule, family commitments, aversion to working out with co-workers in an open setting, etc.). We found that virtual fitness is great for those who do not like exercising in front of others (especially colleagues and/or strangers).

For instance, yoga can be intimidating if you do not understand it. Virtual fitness allows someone who wants to be a little more confident before they subject themselves to other peers seeing them engage in activity [to get some practice]. They can get accustomed to movements, gain familiarity before engaging in the activity in a group setting.

For an instructor, this can be quite eye opening. Big personalities can be intimidating. Virtual fitness allows participants to understand the instructor, the class, they get to know the routines — a relationship is built before having to step in an unfamiliar setting. Through this process, a user can take steps to understand group dynamics before leaning in.

Virtual fitness is a great way to onboard new entrants into fitness who would have been too intimidated to ever get started otherwise.

4) Exergaming is a facet of virtual fitness that has had a lot of press but seemingly always falls flat after the initial hype (i.e. Wii Fit, Pokemon Go, etc.). Why do you think gamification has ultimately not lived up to the hype, and do you see this changing in the future?

Anything can get boring, unless it’s changed up. It’s the same limitation of the old way of delivering virtual fitness — where you’ve only got the same 10 options and the expectation is you are meant to keep going through that same 10 classes over and over again. Most people who buy fitness DVDs don’t buy only one; these folks have got piles of them. They want choice and variety. If there were only 10 books that everyone wanted to read, there wouldn’t be a need for Amazon, right? So too for fitness, there’s not just 10 ways of working out; the rise of boutiques reflects the desire for so many different people to work out in so many different ways.

The appeal of attending fitness classes in person with friends is that while the workout may be similar, the instructor will change things up, and your friends will chat about different things. The conversation is going to be different every week. What virtual fitness can now do is bring that variety to you in your home, with your friends, with fresh content from instructors, when you can’t make it in-person.

5) How do you see fitness evolving over the next five to ten years? How will virtual fitness change the way people currently consume fitness?

What we believe in at BurnAlong, and what our product is based on, is that people increasingly want unique experiences. I think virtual fitness has got the power of bringing fitness to people wherever they are — that specific type of experience that they want whenever and wherever they want it. We believe the virtual compliments the in-person experience, rather than replacing it (which most online companies believe).

The virtual can also bring special classes to places where previously people didn’t have that experience. People talk to friends across the country and all over the world about their favorite instructors; now those friends can experience those classes with that friend. Geography no longer needs to be a limitation.

In five years, I might wake up planning to attend my favorite cardio class at eight o’clock in the morning, but I wake up and Amazon’s Alexa or Google Home or another connected device will say to me, “Daniel, your noon meeting has just been moved, and you do not have time to physically attend your eight o’clock class. However, I’ve notified your instructor that you’re going to be joining online rather than in person.”

My co-worker Harry who takes the class with me is in London for work, and will be taking the same class virtually since it is his favorite, too. We choose to take the class live together. I log in at eight o’clock, wave to Harry and the instructor, who sees me and says, “Thanks for joining Daniel. Sorry you couldn’t come in person. You know I see your heart rate is already at 140, good run earlier … Daniel, you are already ready to go!”

It’s an experience where, just because you cannot do something in person, you are no longer limited. The virtual world bridges that divide, makes people more efficient, and allows them to use their time more effectively without sacrificing quality. This will only continue to improve in the years ahead

You should never be in a situation where just because you are traveling this week, or just because you can’t get a babysitter, or just because you had to work late … you can’t get the type of fitness experience and expert guidance you value and deserve.

Interview with Ryan Tarzy about Digital Health

Ryan Tarzy received his B.A. in Economics and Applied Mathematics from Northwestern University. Early in his career, he realized that his talents involved combining the role of an entrepreneur with that of an advisor. Since then, Ryan has been passionately working on moving healthcare forward and has founded or led several digital health startups. In 2003, he co-founded MediKeeper, one of the earliest digital health startups. He later served as CEO of Personal Health Labs, a lab focused on R&D in areas such as health gaming and interoperability.  He now serves as Director of the Incubation Studio at CoverMyMeds. Prior to CoverMyMeds, he served as Co-Founder of Playful Bee and SVP of Business Development for PokitDok. He has recently begun to angel invest in digital health startups.


1) Many have attributed the impressive evolution and expansion of digital health to a move towards human-centered design, suggesting that a lot of previous health technology was engineered in a such a way that user experience was an afterthought. In your opinion, to be a success in digital health is user experience more important than utility? And why?

I think it is absolutely accurate that in the past, user-centered design has arguably been an afterthought. However, as we evolve into this next wave of digital health beyond Health 2.0, I think it is unfortunately still true that neither utility nor user-centered design is the most important factor of success. I would say at this point, success relies primarily on a solid business model. You can have fantastic user-centered design, you can have some utility, but if you have not figured out the way you’re going to get reimbursed, the way you’re going to get paid, or have a compelling value proposition for the direct consumer, then you are still going to struggle to be successful in digital health.

That said, I do believe user-centered design is driving some really exciting things coming out of the new wave of companies in digital health. I’m really encouraged by that, and I hope that it continues. I think that it does become a differentiating factor when you compare multiple companies, all of which have the reimbursement model and/or revenue model figured out.

2) As an investor in digital health startups, what do you look for in early stage companies trying to make it in health tech? And, what is a common flaw of new entrants that you feel could be easily avoided?

First and foremost, I look at the founders. Founders, to me, are the No. 1 determinant for success. I look for founders that, if they haven’t done this before, have deep domain expertise. They have dealt with the business problem before, they understand it, and they’re now trying to solve it through their own company.

I also look for founders that have a combination of passion and hustle that makes me confident that they’re going to be able to get past the inevitable roadblocks and hiccups that are going to take place when you’re trying to tackle an industry like health care. Those are the top two things I look for.

Lastly, I look for companies that I feel like I can provide an unfair advantage (while advising them). I want to feel like I can bring a lot more to the table than just monetary value as an investor.

In terms of things that I think are common mistakes … ultimately the sales cycles in health care are just really long. What I see is most new entrants will come in vastly underestimating the sale cycle and struggle. When you have these long sales cycles, what kills you is waiting on those maybes. You really have to aggressively develop process to manage the pipeline and be able to move beyond that first LOI, or unpaid pilot, and get yourself more quickly to a proven revenue model — a robust pipeline that is bringing in recurring revenue.

Another common mistake is a great idea, with a lack of domain expertise. It sounds self-serving as a healthcare investor with deep domain expertise to say this, but it is always good to have someone with healthcare expertise as an investor and/or advisor in the group. You need an advisor with specific knowledge in the area that you’re trying to tackle.

For example, a lot of people lump life science investors in with health IT and digital health investors — these are completely different businesses. One is dealing with long development cycles and a completely different type of regulation. The other is more about reimbursement cycles and enterprise sales and understanding the intricate players in the space. They are just different animals. You need someone, depending on which area you’re tackling, with that specific type of healthcare domain expertise. Very few can do both.

3) In 2014, Robert Szczerba wrote an interesting article: If Google Health Failed, Why Will Your Health Portal Company Succeed? We still have not seen a true runaway success in this area. What will it take to finally get there?

This is very personal to me because the first company I co-founded was one of the early personal health record companies. My co-founders and I built the company on the premise that there is this need, this obvious need, for a more central place for individuals to manage their health information. Back then we called it personal health records (PHRs), now you might call it a health portal. It just still feels like something that should exist but, I agree, at this point there has not been a huge success in this space yet.

What’s really interesting about this is there’s information leaking out that both Google and Apple are now attacking this space with new technologies. The ubiquity of smartphones, or even now through smartwatches, might potentially be a new opportunity for this to take hold.

I’ve always believed that the ideal health information exchange is the “HIE of One,” where the individual is the conduit of their own health information. The panacea of interoperability to create a universal portal, whether it’s Google Health or Microsoft HealthVault, is the wrong way to think about it. We need the ability for an individual to easily be able to take control of their health information and have control of the back and forth. Then, consume their data in whatever portal they want. I hope this is where things are going and I’m excited to see Apple coming into the market and Google seemingly retrying to attack this market. I’m really intrigued to see what they come up with.

4) What is your take on the longevity of today’s wearables? There are numerous articles with click-bait titles indicating the smartphone is dead within five years. One could argue that might be the same fate for most wearables today. Where do you see the puck heading for wearables?

I feel like five years is too aggressive to say the smartphone will die, but I may be wrong. I think that I’m much more pessimistic about the future of wearables as they exist today. We are seeing the early stages of these devices; they have passionate followers; they literally have millions of users out there. If you believe that wearables are going to become a more ubiquitous thing — I will say today’s wearables will likely be starkly different five years from now. Looks at Apple’s AirPods, those will change the smartphone and are technically a wearable. Wearables will evolve in ways we cannot predict.

It comes down to, what do you define as a wearable? Staying with the AirPods example, this is a sign that we’ll be utilizing voice for data entry … speech will be integrated into our car, which is integrated into our watch and into our AirPods. And really, the cloud becomes more and more the world we live in versus having our nose in our smartphone.

So although I am pessimistic that devices like the Fitbit will have legs five years from now, I am optimist about the future of computing being more integrated into all parts of our life in a, hopefully, more user-centric way without having to have our nose buried in our smartphone all the time. As voice gets more and more compelling, we will not need to physical interact with devices, limiting the need to “wear” anything.

5) In your opinion, what are two underrated and/or little-known companies right now in digital health that you believe are positioned to make a huge impact (in the future) and why?

1) LeapCure: This is a company that has really cracked the code on recruiting patients for clinical trials. It is fascinating to me that over 60 percent of clinical trials fail due to patient recruitment issues. That’s just staggering to me and just seems like such a big problem that we haven’t been able to crack.

This company has been able to use techniques that have been utilized in other non-health care markets to micro-target individuals — even for very rare diseases. One of their customers specifically specializes in rare diseases for children. So, truly the needle in the haystack kind of problem: how do you find the less than 20 patients in the country that would qualify for this clinic trial?

They are able to do that, and will likely make a huge impact. They are reducing the cost of patient recruitment and increasing the success rate of clinical trials. That could have a far-reaching impact on the industry. So, I’m really bullish on that and what they’re doing and excited to work with their team as an investor and board observer.

2) Paubox:  Sometimes seemingly boring companies on the surface are in the best position to make an impact. Paubox operates in the area of email and disaster recovery. Sounds incredibly boring for healthcare but, what they’ve done is, they have cracked the code of how to deliver HIPAA-secure email — and they do that in a way that is user-friendly. You can finally simply use your Gmail account as a doctor, and they’re able to make that HIPAA secure for communication with patients. All the friction created by email alerts that push you to a portal, only to hassle with additional passwords and clunky communication channels. Paubox solves all that. Finally, you can simply email your doctor … like you email the rest of the world.

 

What is Fun Anyway?

What is Fun? The Oxford English Dictionary (O.E.D) defines fun as “amusement, especially lively or playful.” As an adjective, the word is described as “amusing, entertaining, enjoyable.” “For fun” or “for the fun of it” means “not for a serious purpose.”

What is Fun?

The standard definition of fun suggests some overlap with the concept of play. In fact, these two words are often mentioned together (e.g. fun and games). However, play often appears to be the overarching term, where fun is more specific to experiencing enjoyment. For example, when defining play, play researcher Scott Eberle, Ph.D., writes that fun is one of the basic elements of play. He also observes that we play because the act of play promises fun. If there were no fun in play, we would likely not play (Eberle, 2014). This suggests a relationship between the concepts of fun and play, a possible causality perhaps: fun is a natural byproduct of play — fun is intrinsic to play. Eberle also argues that although there are many ways to develop knowledge, self-assurance and vigor, none of them are as fun as play.

Another academic concept that is used when discussing fun is “flow.” When Gayle Privette of the University of West Florida attempted to distinguish between peak experience, peak performance and flow, she defined peak experience as mystic and transpersonal, peak performance as transactive and flow as having fun (Privette, 1983).

Casual and Academic References to Fun

Definitions of fun are generally discussed as a result of an act and/or engaging in activity. Some authors focus on the fun side of things/activities and talk about the hedonic aspects of certain activities. As such, in academic writing, fun is often equated with hedonism. For instance, Barry Babin, William Darden, and Mitch Griffin (1994) took the hedonistic value of shopping (e.g. shopping for fun) and contrasted it with shopping’s utilitarian value, which is more concerned with usefulness and task completion. Utilitarian shopping can almost be regarded as work. Shopping for fun, on the other hand, is personal, subjective to the shopper and often entails playfulness. The participant values the experience itself because the endeavor is entertaining. In short, many activities can be analyzed for their ability to induce fun — emphasizing entertainment and enjoyment of the process rather than its practical value.

When activity is done for fun, it often involves increased arousal, perceived freedom, fantasy fulfillment and escapism (Hirscham, 1983). The saying “time flies when you’re having fun” indicates that the concept is also connected with our perceptions of temporality and can influence the subjective component of time. This popular anecdote is a cultural artifact that further alludes that flow and fun are related social constructs.

People sometimes also talk about “short-term fun” and contrast it with “long-term gains,” suggesting that fun could obliterate the lasting success of an individual. Fun and play often get negative press, especially when adults engage in fun activities excessively. It sometimes gets implied that people’s efficiency and productivity could decline if they overtly prioritized fun. Modern research, however, does not support that negative proposition of fun (e.g. R. Fluegge-Woolf, 2014).

Can Fun Be Universally Defined?

Although fun is often connected with play, few would argue play is the only time we have fun. For instance, for many, work can be fun as well. A task like gardening can be perceived as monotonous to one person while being perceived as fun by another. But, does work cease to be work if we have fun? Actually, fun in the workplace is increasingly being researched. Researchers are exploring strategies that help make our work lives more fun. For instance, there are evolving applications of gamification. Gamifying work involves creating strategic tactics in an attempt to make arduous tasks more fun. New studies have confirmed that a fun work environment creates more productive and creative employees, therefore showing that both parts of the “work hard, play hard” phrase can actually coexist (R. Fluegge-Woolf, 2014).

Your perception of whether something is fun depends on your mindset, ability and skills, the environment as well as those around you (your relationships). For example, taking public transportation can be a tedious, mind-numbing activity. If you’re headed to a concert with a group of friends, though, it can be the ride of a lifetime: spending time together, chatting while excitedly anticipating the show — in laymen terms, “a ton of fun.”

What is clear is that fun is a subjective construct. What seems fun to one person might be perceived differently by somebody else. Therefore, perhaps the most relevant question is: How do you define fun? What is fun to you?

Sources & further reading:

Babin, B. J., Darden, W. R., & Griffin, M. (1994). Work and/or Fun: Measuring Hedonic and Utilitarian Shopping Value. Journal of Consumer Research, (4). 644-656.

Eberle, S. G. (2014). The Elements of Play: Toward a Philosophy and a Definition of Play. American Journal of Play, 6(2), 214-233.

Hirschman, E. (1983). Predictors of self-projection, fantasy fulfillment, and escapism. Journal of Social Psychology, 120(1), 63-76. doi:10.1080/00224545.1983.9712011

Privette, G. (1983). Peak experience, peak performance, and flow: A comparative analysis of positive human experiences. Journal of Personality And Social Psychology, 45(6), 1361-1368. doi:10.1037/0022-3514.45.6.1361

Fluegge-Woolf, E. (2014). Play hard, work hard: Fun at work and job performance. Management Research Review, (8), 682. doi:10.1108/MRR-11-2012-0252