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Hosain Rahman

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112
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2018-09-26
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2018-09-26
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  1. I can handle it. I can handle it Why should we give silicone? That's a hard word, Jerry. Right So look, I think everybody deserves an opportunity to kind of continue.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  2. I'm using as a proxy for all of Silicon Valley. I'm sorry to do that, but sometimes it's like, why should we give? I can handle it. I can handle it. All you people a second chance. You know what I mean? You've broken a lot of stuff. I'm not giving you the Facebook responsibility. You didn't break democracy. But why should we give Silicon? That's a hard word. Right now there's a tech lash. Why should we give you all a second chance? There's this new thing that Julie England's doing, the markup to, you know, like there's a lot of like, what the hell?

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  3. Look, number one, I actually think when you go through these things, it makes you a million percent smarter, right? It makes you a million percent more humble. It makes you a million percent more thoughtful. And so, frankly, I think we're better tooled now given all of the fire that we had to walk through. It was not easy, Kare. A lot of people were just like, walk away, go do something else. Like it would have been a lot easier, right? And also. But we stuck with you.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  4. Proud look, I'm so proud of what we did, and I'm proud that other people stood on our shoulders. I feel like a little bit of the godfather of a bunch of these different things.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  5. I don't know. Look, to be totally candid, it hasn't been easy. And I think that it's hard to get a second chance. I mean, we were fortunate. We created a lot of things that no one had ever done before. Now they're sort of leading. Let me think about what's hot right now. Everybody else is benefiting.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  6. I think everybody should get a second chance. I don't care if you're black, white, Muslim, right, Jewish. But most people don't.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  7. Yeah, no. I worry about people execution, making sure it's tight. All the ingredients that we have for this service have been proven now. It's very different from you build a device, you put it on a package, on a boat, put it on a shelf, hold your breath. Is it going to sell? Now we're rolling it out 100 users at a time. We make sure it works. Are we achieving it? Then we get the next set. And then the next set. So it's a different kind of scalar model. It's slower, but it's a lot more foundationally sound. So we're really excited because now we've gone to a point where it's clinically validated. We have third-party results. We're publishing all that data. It's a different sort of channel structure. It's a subscription model. And we're just taking our time to sort of tune it, get it right.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  8. Companies will do it or insurance companies will recommend it. And there's a lot of these, like I said. What is your worry right now? You've certainly raised significantly less money, so that's not, you don't have to deal with a device or people sweating on it. Yeah, no.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  9. It's a system, so we will use other wearables. The reason we made our own wearables is so that we had really accurate data. Right, I got that. I got it.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  10. The service on the UP device we had an application that we ran that did all this stuff automated. So we've built the new one off of the foundations that we learned from that, but we've added in all this human doctors and this whole new service that we built is completely new from scratch. Mexico.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  11. Yeah, okay. Right. Make smarter decisions. So you've pulled out the choice bit from all these different devices, like the choice bit, which is this service, correct? Because that was part of your up device.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  12. Color is a partner. Yeah. Right. So we integrate the genetic data. There's different people who've tried to do AI, but when you have the continuous raw information that lets you build better models, some people are doing the human component, but not the human component combined with the automated component. So it's the entire stack. And what's cool is that HealthCloud allows us to pull it all together and allows doctors and healthcare professionals to make smarter decisions.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  13. Well, you don't like people telling you to do something. No, no, no, that's true. That's a fair point. It's another entrepreneurial trait, Kara. No, so look, you combine all that machine automation with this early detection, and like the results have been staggering in terms of what we've been able to catch people. And the whole notion is catch it early when you can treat it. It saves a bunch of money for your company, for your insurance, for the government.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  14. I remember was irritating. Look, it worked at scale, over $13 million. No, I get it. And so combining that, I don't even like when Apple Watch tells me to get up, but I don't, that's why I don't. Well, you don't like people telling you to do something. No, no, that's true. That's a fair point.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  15. Well, it was way beyond that. It was sort of personalized and it was like tools to coach you. I remember doing that. Go ahead. Look, it worked at scale. Over 13 million users, the results were staggering. No, I get it. I agree. And so combining that

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  16. There's going to be a monthly subscription fee that ranges up monitors your health and then say remote monitoring would like. Yeah, and so look, in our clinical trials, this is what other people. One third of the people that went through our clinical trials in the US found a disease, a major one that they didn't know they had before. It was shocking to us. In our international trials, we had crazy results. 60% of the people nearly that went through it didn't know that they had high blood pressure. 30% did know they had full-blown diabetes. I mean, crazy stuff. And so you catch it early. We had built out a whole kind of proprietary automated behavior change system in the original smart coach. Yeah. Well, it's suggestions that moved your behavior. And we scrub that with

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  17. Well, it's interesting. They've built this health cloud solution. And he said, look, we can power this whole part of what you're doing, where all of our data plus your health record, it's all HIPAA compliant. Doctors can get in there and manage the patients, message them. So we were building that and we saw what Health Cloud had done. We said, great, let's use that to power our platform. And HealthCloud has become this great tool for us where you have all the HIPAA compliance, so the data is super protected. You have all of the electronic health record integrated. You have all of our lifestyle context. So doctors in our system can look at all this information and make determinations and they take care of it. Doing a service now. And the service is part automated.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  18. Well, so the whole, as I was explaining it, the whole thing, so I went to see Mark Benny off about what we were doing and I showed him this whole thing where we're grabbing all this data, continuously monitoring.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  19. All right. But it's to get the services. And then alongside Dubai, a number of folks came in as well. Right. Some of our old investors are

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  20. We haven't been saying But it's enough to fund the Operation Ghost of Clinical Trials and get going. Tens of thousands of people.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  21. No, they got, I mean, they got some stuff. There was a litigation with Fitbit and a bunch of those other things that were assets in the old company, and then that all got sold off. It wasn't a return of capital to debtors and it didn't cross the debt so that shareholders got paid back. And then we've been focused on...

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  22. So, what ended up happening when the new company was created ultimately there was no plan for the old company, so they sold off the audio assets, I think whatever proceeds went to the debtors, and then they shut that down.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  23. We have a device on our own. We did that because we needed to show what was possible. The plan is to let other people build on our sensor texture. Well, we're actually going to integrate Apple watches because now that they've gone to a clinical grade level, we can use that information. So we'll never build a smartwatch, for example, right? Apple's doing a great job of that. So our device is to showcase what's possible. And the idea is to let other people build on our sensor technology because we've proven that it's clinical grade.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  24. So, the whole thing is an encapsulated service where we grab the data off, we analyze it, you have a doctor in the system that analyzes it. There's people doing different pieces. No one's pulled the whole thing together. And we're looking at a series of different lifestyle diseases. We have the continuous monitoring piece.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  25. We already started to. So a couple weeks ago, a few weeks ago, we published at the Deep Learning Conference, the KDD conference in London, we published a lot of our deep learning stuff around atrial fibrillation, for example, is the thing that Apple announced. We've got fantastic results there, four nines on positive predictive value, which means that we're 99% accurate at predicting that. That's something we did at UCSF. That has been accepted in the American Heart Association, so we're going to publish there. So it's a very different model where you do this stuff, you publish it, third parties. And the idea of the clinical trials is you have third parties running this data, you correlate it to ground truth against known standards like FDA or other certification bodies. And then you go correlate all of that, and it's then proven out clinically, empirically, in published data that it works, you take all that information. So now you know you have really accurate stuff, and you go run a bunch of machine intelligence on that, and then you have humans look at that.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  26. Tools, and what we realized through the wearables journey is you had to elevate the actual sensor technology to clinical grade level. What does that mean? It means you have to take it through an IRB process of doing clinical trials, which is an institutional review board approved by the NIH. Everybody, you know, the big institutions like Mayo and Stanford.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  27. Yeah, so what Job One Health is building is this personalized subscription service where we take all this continuous health data about you and we combine that with a lot of machine intelligence, so AI plus human doctors, they go analyze all this data and the idea is to catch issues going on with you, health issues, particularly lifestyle disease preventive health, to catch them early when they can be treated and you can improve longevity. Because the problem is like, look, two-thirds of all deaths today are lifestyle disease related, which means it's just bad living, right? But the reality is if you catch that stuff early and you change your behavior or whatnot, you can push out half of those deaths and save 70% of the cost. The problem is we have no information. We don't know where we stand, what's going on with us, right? We have half a million minutes a year in our lives. If you're good, you spend 15 minutes a year with a doctor, maybe four times a year. That's like a very small percentage of the population. So the idea is to give people.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  28. The shareholders are sitting underneath all of that, right? And this is the kind of tough structures there's not flexibility to do stuff. But, anyways, they went to those people, and it was like an arms length transaction. They said, we formed a new company, we want to buy out all the health stuff. You guys can go sell the audio pieces off, but we want to take this thing into a deeper thing. Jobbed Health. And they hired, you know, me and a bunch of the team that we brought over to go do that. So we formed that company in January 2017. And we've been heads down focused on building this new service, which we're going to talk about publicly, the total picture of it for the first time this week.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  29. They need to diversify for sure. But I think that, look, they have a vision for the future, and I think they're willing to invest, and they have been long-term investors in a lot of stuff and things that you'd be surprised to know that they were big, big massive backers and owners of and have been for decades, right? And we had some of those folks in the old Jawbone, and they had introduced us to this group in Dubai, Moros, and they came and saw what we had built, and they were really blown away by a lot of the clinical grade technology that we were working on. They said, look, if you had kind of a fresh start, And ability to.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  30. Tesla SoftBank, and I think they're doing great stuff, and I think they realize look, we can deploy this capital directly into innovative businesses and push the envelope and market make and sort of be a lab to showcase what's possible and bring that to the rest of the world. I actually think it's exciting. And I think that it's frankly a cool alternative narrative for the Middle East versus a lot of what gets out in the other domains around, you know, frankly, like terrorists and political instability and all that stuff. I think deploying capital to further innovation is an awesome part of what they're doing.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  31. I mean, look, the Middle East investors are sovereigns and a lot of these folks are the capital behind the capital, right? And have been since the late 70s. I think it's just something that people don't realize. They're large LPs in all of the big financial institutions in Norway.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  32. 2800, right? We have huge sort of intellectual property war chests at the time. And so the thought was, let's go figure out what it looks like in this deeper health care arena and what, if anything, we can do. And we learned a lot. I mean, it was a crazy journey in 16, and we tried different paths, and ultimately none of them work because we couldn't just get out from underneath this kind of structure that we had this sort of debt structure. There was a group in the Middle East called Maras, which is a Dubai-based group, sort of one of the largest investment groups there.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  33. There was a lot of revenue, but it wasn't profitable and it wasn't yielding the future, right? So we said instead of focusing on that and going to fight that. It takes a lot of time, takes more capital, all those things. We said, let's go. We've got this really interesting stuff. Everyone that sees it is blown away by what we're doing.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  34. A lot of what we were doing in 16, we never talked about it. We turned off all of our retail stuff and said, you know, we want to focus on this deeper health stuff. Stop making devices. Turn off all of our sales in early 16. And we said we're going to go focus on this deeper.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  35. At peak, I think it got to close to 600 That process of going up and down is hard too. I can imagine another podcast. So a new company, what ended up happening is we had this big debt structure. We tried a number of different business plans and different initiatives. And there was a lot of background. What was your last one?

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  36. So we ended up in 2015 doing big debt deal that ultimately the structure of it just made it hard that we didn't have flexibility to sort of shift a new direction. And in 2015, we also realized a lot of the sort of consumer fitness stuff was flatlining, and that wasn't really where the future of wearables was going to go. We had a number of breakthroughs on the technology sensing side, which started to get into deeper clinical measures around vitals and like understanding more of what was going on with people. We had bought a few things, hired to chief medical officer, and just sort of expanded what...

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  37. Through the trenches, right? I think it's important. I mean, look, we're unpacking a lot of beyond what happened in Jawbone stuff that I think could be interesting lessons, because that's what I hope for now, right?

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  38. and bowed foundational elements, right? But I think that what you need is the ability to be optimistic. Lead a charge because that's what it takes to break new ground and do something new. If you weren't optimistic and just pessimistic, you'd never take these risks and these challenges, right? So you need that, but you also have to be really grounded in the realities of where you are. And that's a hard duplicity, right? And it's hard to sort of move yourself back and forth.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  39. But then, no, but I think everybody is in the dark or when they're by themselves Like way more than people let on And then the balance is, and I don't know who's achieved this well

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  40. It's a balance, right? Because you have to be extremely brutally honest when you look in the mirror and when you look at your organization.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  41. No, no, no, I need to be there too. I think you all get licked up and down. And then it ends up in the worst way, in a Theranos situation where there's actual fraud going on and a lot of hyping. But she's a version of everybody else. Do you know what I mean? Just taking it too far, taking it too far. I think she's a version too salesy to everything's going to be fine, too positive. Like I hate to say that, but it's too positive.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  42. Because you have platforms set up that allow that to happen. Enterprise businesses scale differently. Healthcare businesses completely different cycle. Pharma businesses, biotech, different cycle completely, right? Hardware, different cycles. So I think that there needs to be more rational discussions of like what are reasonable growth rates. But when you have an environment where some things are growing really, really fast, everybody gets caught up in that. You're like, oh, no, no, I need to be there too.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  43. I think we absolutely overreached on sort of valuations and picking the wrong partners and end up agreeing to structures that just weren't right for us. And I think we probably should have taken a step back, slowed down, rebuilt, built a solid foundation. That was sort of better to scale from and gone slower. And I think there's a lot of pressure to move quickly, to grow faster. And I think that one of the things that happens is each business has its own dynamic, right? So consumer internet businesses scale really fast.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  44. To think about what to learn from it, what to do better. And I spent a lot of time now thinking about how can I take those lessons and how can other people learn from my mistakes? And what are the platforms and what are those?

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  45. Well, yeah, it's true, but part of it is your products were very exciting, right? And at the same time, when you're hearing like he didn't pay this person, these investors are mad, maybe they're going to go out of business. It's hard to, this is why I want to talk about this. It's a much more complex issue than it is. And so what you do is you leave behind a lot of people who are angry at you and they're willing to talk about it. And had you sold to Apple the way Beats did, you'd be a genius, right? Right? Like, I'm just saying, that's the thing. If you had sold, nobody would be complaining, right? Or you had.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  46. The way it goes is it's this attack, and then the other side digs in, and it's not like, hey, can you get help? What are the problems? Yeah, but we're not your partner

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  47. Well, you know, when we were, you know, I was tough on your board member Marissa May. I didn't think she was up for the task of that job. I didn't think that Travis was, you know, didn't hang the moon. And I think saying.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  48. Of Silicon Valley. Because I think you all hype it too. Like we're all great, we're all this. What we don't do a good job of is monitoring it during the time. It's like, is it Mark Zuckerberg a genius? I'll use him, not you necessarily. And then now it's clear there's some management problems there, right? There's some decision making problems. There's some wisdom problems there that are clear. And I think when you start to say that, which I think I've been more than most people say they can't do that, people in Silicon Valley don't like it at all. Don't

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  49. Why do you think that is, by the way? I mean, you are. The Queen of Silicon Valley Press. Why is that? Why do they take it up and take it down? Why does that cycle have to be...

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT

  50. Cause stress. One of the other things is you wrote a really positive press wave and then a negative one when the things broke down. That was the first time I remember when there were stories about the problem with the sweating, which I think every company goes through, like Apple's gone through it 20 shots. But with you, it mattered a great more because you were just a small company. Right.

    2018-09-26 · Decoder with Nilay Patel · Recode Decode: Jawbone Health CEO Hosain Rahman · IDENTIFIED FROM THE TRANSCRIPT