By Sonia K. González, DrPH, MPH
Joseph Schneier is a serial entrepreneur and exited two companies in EdTech. In 2013, he co-founded Cognotion–a company solving the talent shortage of healthcare workers. In 2018, Mr. Schneier founded Trusty.care, a company focused healthcare navigation and price transparency. Mr. Schneier has spoken at TedMed, Lake Nona, JP Morgan Healthcare and is a mentor at New York University, Wharton, Cornell, CUNY, and Columbia. Mr. Schneier sits on the board of Superbia Credit Union, a LGBTQ credit union, and the advisory board of Stonewall Community Development Corporation, a non-profit focused on LGBTQ senior housing.
For the last 25 years, I have been either running startups or conducting research in coordination with governments and non-profits around the world. The core thread in all of this has been a focus on how you can motivate people to change a behavior over the course of an extended period of time. I have been lucky to have applied this in many types of locations from rural India to New York City, with the U.S. military and department of state to high end hotel chains and advertising agencies. We have explored all sorts of mediums using technology like artificial intelligence, virtual reality and immersive cinema.
In 2013, I launched a company with my co-founder Jonathan Dariyanani that was focused on solving the talent shortage of healthcare workers that care for aging populations (big problem). Again, we were looking at how we could motivate people who didn’t think of themselves as healthcare workers to pursue a new type of work. This work brought me all over the country into health settings like nursing homes and the more I traveled the more stories I heard about how challenging it was for people to navigate the healthcare system. We began to see the fallout of people’s lack of information and the lack of transparency in healthcare costs and how it affected people from every walk of life. In 2016, I had a personal event that made all of these stories hit home. My younger brother was in a car accident and he didn’t have insurance. I was in the hospital with him looking at his many surgeries and all the many interventions that were taking place and all I could think was, “how much is this going to cost?” We were able to get him signed up for Medicaid but it was a really scary time and I decided that I needed to devote my time to trying to solve the horrifying reality that healthcare costs are your biggest financial risk area.
In 2018, my CTO and I decided to start Trusty.care with the express purpose of looking at how we could apply all of the behavioral work we had done to solve the problem of getting people to understand how to reduce their healthcare costs and to actually act on it. We knew it was going to take all of our knowledge of government, healthcare, motivational change and regulations to succeed…but thankfully that was all we had been doing for 20+ years!
We are building a suite of tools that you access online that help solve your most pressing healthcare decisions. We learn everything we can about you as fast as possible and then our system recommends different ways for you to reduce your costs. So, let’s say you get prescribed a medication, we may tell you that you need to switch pharmacies to one down the street that is much cheaper than the one you currently go to. Let’s say you need to get a hip replacement, our system will automatically review the quality and price in the area compared to your insurance plan and will match you with the best most cost-effective provider. Our goal is to take the stress out of figuring out the complexity of healthcare choices. The technology we are using is artificial intelligence, machine learning, and a robust set of algorithms that match you to personalized options to meet your health needs.
When we launched the company we had interviewed upwards of a thousand people and we knew there were a whole host of problems that people are facing with healthcare. What we didn’t know was where to begin. So we launched a two-sided marketplace where we offered about 40 different options of solutions and then observed what areas of our site were getting the most traction. By far, the most traction was on Medicare cost and care navigation. That process took us about four months and then we began to really build our product. Our first version took a few months and our second version took about six months. We are now a little over a year in and have paying companies and our first two products are in the market.
AI has been hyped up for years but we are now starting to see a lot of very pragmatic use cases around diagnostics, personalized and precision healthcare and in recommendation engines like the one Trusty is building.
A mentor of mine, Esther Dyson, once told me something that stuck with me, she said “Too many people are going around calling themselves entrepreneurs. What I want to know is what problem are you solving?”. I don’t see any major difference between the research work I have done in the human rights field or around medication adherence or in running a startup. We start with a hypothesis of a problem we want to address and we test out solutions until we find something that works. So at a fundamental level I look at these as just different vehicles with different benchmarks for success but both are about solving problems. The hardest part for me is that some areas of research will allow you to spend a much more extended period of time focused on very specific areas of research that may have no monetary value. In business, we have to always remember that the core of what success looks like is tied in some way to making our investors a return on their investment and this can sometimes mean you forgo interesting areas to explore and focus on the areas that will lead to a higher financial return.
Our company operates at the epicenter of insuretech, health tech, and fintech. In my opinion there is no better place for us to be than NYC to accomplish addressing each of these areas. The proximity to Hartford, DC, Boston and Baltimore and then the real growth of fintech in New York has made this an ideal spot for our company. The right kind of talent that is interested in our core values but that has the experience that we need has also been really helpful. I think in New York there is more of an appetite for working in complex regulated markets and there is capital willing to back those types of companies, whether or not they are health tech, insuretech or fintech.
Health tech traditionally has been behind many other industries in terms of technology adoption but there has recently been a real shift of data made available for startups to work with and it is opening up a ton of opportunities for companies that want to work with democratizing health data, breaking down data silos and empowering consumers of health. We have only scratched the surface on how we can take everything we are learning about social determinants of health, adherence, disease prevention, addiction and use that data to create personalized health care experiences that can meaningfully improve the lives of millions of Americans. That said, it seems clear to me that there are going to be a lot of challenges around data privacy, the ethics of incentivizing behavioral change, and how much companies and insurance companies can require individuals to submit data on themselves with an increasing frequency. We have this tremendous opportunity to make health personal and this real responsibility to not become Big Brother in the process.
Health tech has both the responsibility and the opportunity to serve marginalized communities. I have been lucky to be able to build solutions that increased medication adherence among HIV positive economically challenged populations, tools to increase health literacy among immigrant populations, tools to get benefits in the hands of eligible populations and most recently we are building a toolkit to help LGBTQ communities get connected with care providers who have adequate training. As costs decrease in tech, the possibilities of bringing this tech to public health increase and it is one of the more exciting parts of this time of health tech.
Don’t try to be someone you are not. Know what you are good at and who you are and hire people that can complement your skills.
Running a startup is like walking on a knife’s edge: on one hand, you have wild success and on the other, total failure and your goal is to just keep your eyes looking ahead and not to fall to the right or left.