Podcast

#101 – How the world is changing the healthcare & prescription process (Varun Boriah & Chris Jones)

Episode introduction

Show Notes

Consumers are the driving force behind changes to healthcare. They are getting accustomed to better access, faster service and transparent data. Levels Head of Member Experience Chris Jones sat down with Varun Boriah, SVP and GM of Diagnostics at Truepill, an online B2B pharmacy delivery service. They talked about how Truepill works, what’s broken about the traditional patient experience today and the future of consumer healthcare.

Key Takeaways

03:50 – The future of consumer healthcare

Truepill partners with consumer wellness companies and healthcare providers to build solutions that make healthcare easier, faster and better for patients.

The way I think about Truepill is we’re powering the future of consumer healthcare. So, we connect telehealth, pharmacy, diagnostics, infrastructure together [to] build innovative solutions to help companies like Levels bring their products and solutions to market. We’re a B2B organization, so we don’t go direct-to-patient or direct-to-consumer with our offerings, but instead partner with other organizations to help build out their consumer health for consumer wellness experiences. So, the way to think about us is we have a bag of Legos that allow you to do a bunch of stuff within telehealth, pharmacy, and diagnostics. And we work [with] our partners to put those Legos together to help build out their experiences.

05:40 – Creating a white-label experience

By working with Truepill, Levels is able to deliver a custom-branded experienced, which builds brand loyalty with consumers.

So 100% of what we do is white label. So, it’s always our partner’s brand. So, it’s the level of brand, whether that’s the online experience or the physical offline experience, that’s fully branded with our customers, colors, logos copy. Truepill is often not on any sort of material that a consumer would see unless they’re regulatory requirements for it and that’s our intention. We don’t want anyone to know that Truepill is powering these experiences. We just want to support our customers in helping deliver their solutions to market more scalably and more quickly. And so, that’s our core business at Truepill.

07:13 – Working across a wide spectrum

Truepill’s services work well for a lean startup team, such as Levels, or for a large established healthcare organization.

Truepill serves customers all the way from 10, 20-person startups to healthcare organizations that have hundreds of thousands of employees and manage tens of millions of life. So, we do span the spectrum in terms of types of companies and the size of companies we service. Our approach or what we offer varies across those segments. So, when we’re working with a smaller startup that’s maybe building a consumer wellness business, they really want to control all the patient or the customer-facing assets or the experiences. And so, oftentimes they build out anything that is consumer-facing, use our APIs to connect into our core infrastructure and that’s how we would work with a smaller consumer brand. Whereas on the other end of the spectrum when we’re working with the incumbents and really large healthcare organizations that are starting to think about what is consumerization of healthcare mean, they really don’t have the internal experience or expertise to build out consumers experiences. So, they may come to us and say, “Hey, just build everything for me because you have more experience in the space than we do.” And so, for those examples, we’ll build out the entire member-facing experience branded with our customers’ branding and logos, colors, fonts, all of that, but we’ll do the end to end rather than just using our APIs.

09:50 – Prioritizing patient confidentiality

Regulatory compliance and consumer privacy are a top priority when working in the healthcare and technology fields.

If you go back to our values, one of them is patient confidentiality. And we take that very seriously where a healthcare organization at our center, we started as a pharmacy. And so, we take PHI and PII as very important in our business. And so, that’s a cultural value that we have where we’re obviously HIPAA compliant and meet the regulations there. We’re doing another certification with HITRUST. And so, I think we’re continuously on this journey of how do we ensure we protect any of the information that we’re privileged to have access to through our customers and ensure we’re not at fault for any information getting out of the public that should not be in the public domain.

12:13 – Consumers are changing healthcare

Prescription deliveries and at-home test kits during the pandemic contributed to the demand for more accessible healthcare.

You think about in-person appointments now going online, you think about going to a Quest or Labcorp to get blood work done. Now you do a COVID test at home going into a Walgreens or a CVS to get your medication. Now medication is being delivered at home. So, people have sort of gotten the taste of all of those, or at least some set of those over the last two years and realized that’s an easy experience. It’s not that hard to swab your nose and do a test at home. And I think that’s just opening the eyes for consumers to say, “Why should I take a half day off to go see my doctor and get some blood work done when I can see a doctor online? They send a phlebotomist to my home and it’s a five minute encounter and I have the results delivered on my phone.” So, I think consumers are sort of driving the incumbent healthcare system to rethink how healthcare is being delivered.

18:18 – Learning through collaboration

The partnership between Levels and Truepill opens up opportunities for feedback and growth for both products.

It’s been a great collaboration, a great partnership. And I think what I have really respected in this relationship is we’re learning from each other. We’re going into this saying, “Hey, some of the things we’re doing are things we’ve done for years and years and years and we know it the back of our hand and there are other things where it’s new to triple as well and let’s learn about this together.” And I recall when we did our first pilot with the mobile phlebotomy experience and having phlebotomists go in was just blown away by the level of detail and feedback that came back from the Levels team. I was like, “I’m on all these Notion pages with everyone putting in comments. This is amazing.” And sort of just speaks to how using iterations to improve a product is so valuable when you’re first getting started with a new program.

24:10 – Fixing a broken experience

The patient experience of visiting multiple doctor offices, getting referrals, finding separate lab test locations, booking separate appointments and coordinating test results puts the burden on the patient when all those touchpoints could be automated and digitized.

Another area that’s been really interesting is you see a provider online for a symptom that you’re experiencing. Now today, the experience is fairly broken. You are sent to a Quest, you have to figure out how to get up there, how to get a result back. How do I get it to my doctor now? Maybe it’s a week before I get an appointment. They write a prescription. I go to Walgreens, I have to wait, pick it up and that’s like a really broken experience. And so, we’re thinking about how can all this be done digitally in a seamless way. You see a doctor online, you have a test delivered to your home or mobile phlebotomy shows up the next day. Results automatically go back into your patient record. And if the physician thinks it’s appropriate, writes a prescription without necessarily even talking to you and medication gets delivered to you the next day.

25:07 – The next wave of consumer health

Varun said the next step in virtual care as diagnostic testing for conditions that can be managed virtually.

Rewind a couple of years, we were treating hair loss, ED, birth control over telehealth and that was because all those conditions can be assessed through clinical presentation. You don’t need any diagnostic work. I think the next wave that we’re going to see in consumer health world is conditions that can still be managed virtually but need a diagnostic test. And so, think about thyroid management, fertility testing, hormone panels. Those that I think the next wave of things we’ll see in terms of how healthcare is delivered virtually.

30:07 – From Jupiter to healthcare

Varun said he wanted to find more practical problems to solve after working on fluid dynamics on the Great Red Spot on Jupiter, which is how he ended up in healthcare technology.

Let’s see, if I start at the beginning, I’m a mechanical engineer and I moved from India to California after grad school at Cal. I remember landing here and I was trying to figure out where do I do my thesis? The project that popped out was doing fluid dynamics on the Great Red Spot on Jupiter, and I was like, “Oh my God, what have I just landed in, and why am I studying the Great Red Spot?” And so, I quickly started looking around for something that was a little more tangible and practical and ended up at the bioengineering department and found a lab that was doing a lot around microfluidics and diagnostics, and was really interested by sort of this concept of the unknowns of biology versus the knowns of the mechanical system. So, mechanical systems are very definable, you know exactly what’s happening. Whereas with biology, I always felt like it’s always an experiment. You push A, and then you’re like, “Let’s see what comes out the other end.” And it was just like intellectually really, really fascinating. And so, that’s sort of what got me into healthcare generally. As an interesting tie back to Levels, my first job out of grad school was technology that I got licensed out my grad school lab to develop CGMs. And I remember us dreaming of the day when CGMs would be used by nondiabetics to figure out how they’re doing and the value that it would have, and the fact that it was so expensive and inaccessible that no one could do it unless it was a prescription.

44:39 – The consumerization of diagnostics

With consumers more interested in monitoring their personal health, diagnostics are becoming more consumer-friendly.

I think the consumerization of diagnostics is here. When Robert Ford was at CES presenting about Abbot Lingo system, I would’ve never imagined seeing a medical device CEO at CES presenting. It’s starting to say like diagnostics traditionally has been restricted to a physician’s office or a lab, but now it’s coming into the home, it’s coming to the end consumer of that test. And we’re past the hurdle of, ”Do people know how to use it? Do people know what to do with the data?” I think we’re passed some of those initial hurdles. So, we’ll start to see more and more of the traditional large medical device companies come out with more consumer-facing products. So, that’s an industry trend I see. And with CGM specifically, one there’s sort of, yeah Abbot’s announcement around Lingo and bringing sort of a non-CGM not intense or diabetics, but the general population. I think we’ll see more of that over time.

Episode Transcript

Varun Boriah (00:06):

So, you think about in-person appointments now going online. Now you do a COVID test at home, going into a Walgreens or a CVS to get your medication. Now, medication is being delivered at home. So, people have gotten the taste of all of those, or at least some set of those over the last two years and realize that’s an easy experience. And I think that’s just opening the eyes of consumers to say, “Why should I take a half day off to go see my doctor and get some blood work done when I can see a doctor online? They send a phlebotomist to my home and it’s a five minute encounter and I have the results delivered on my phone.” So, I think consumers are sort of driving the incumbent healthcare system to rethink how healthcare is being delivered.

Ben Grynol (01:04):

I’m Ben Grynol, part of the early startup team here at Levels. We’re building tech that helps people to understand their metabolic health. And this is your front row seat to everything you do. This is a whole new level.

Ben Grynol (01:30):

From the outside, Levels is very much a brand focused on metabolic health or software company that builds tech, builds a product on top of hardware, that being continuous glucose monitors. And in the US, there’s actually a prescription process that people go through to get their CGM. There’s fulfillment, there’s actually shipping people to CGMs. Well, these are things that we as a company don’t actually own as part of the stack, the distribution and logistics, while they’re controlled by a company called Truepill. Truepill is an online cloud based pharmacy, a healthcare provider that provides all of these health services across the US. So, Chris Jones, head of member experience deals with a lot of our supply chain stuff through Truepill and Varun Boriah, SVP and GM of diagnostics at Truepill. The two of them sat down and discussed all these ideas around supply chain infrastructure and how Truepill is integrated into the Levels ecosystem. No need to wait. Here’s Jones with the intro.

Chris Jones (02:35):

Awesome. So, let’s get after it. For those of you that follow Levels, you’d like to know how we really enjoy building in public and openly share a lot of our learnings, our best practices, how we work, the types of tools we use and who we work with. I’m Chris Jones, I’m the head of member experience at Levels and I’ll be your host today as we dive deep on one of our key partners, which is Truepill. I’m super excited to have Varun Boriah with us today. Varun is the SVP and GM of their diagnostics division within Truepill. He’s been in the health and wellness space, I don’t want to say the years because that’s unfair. I don’t want to date him, but let’s just say he’s had a lot of experience in both lot in big companies and small. So, I’m super excited to get his learnings of both Truepill and his journey. So, with that, I just want a big welcome to Varun. Great to have you on the show with us today.

Varun Boriah (03:26):

Thanks Chris. I’m happy to be here and excited to have this conversation.

Chris Jones (03:31):

Awesome. Cool. So, I’m sure a lot of the listeners who are listening and may not even be familiar with what Truepill is and what they do. Can you talk a little bit around the company, the services you provide and how you help enable companies like Levels and specifically why that matters to members? In the end, why do they care?

Varun Boriah (03:49):

Yeah, sure thing. So, the way I think about Truepill is we’re powering the future of consumer healthcare. So, we connect telehealth, pharmacy, diagnostics, infrastructure, together build innovative solutions to help companies like Levels, bring their products and solutions to market. We’re a B2B organization, so we don’t go direct to patient or direct to consumer with our offerings, but instead partner with other organizations to help build out their consumer health for consumer wellness experiences. So, the way to think about us is we have a bag of Legos that allow you to do a bunch of stuff within telehealth, pharmacy, and diagnostics. And we work our partners to put those Legos together to help build out their experiences.

Chris Jones (04:38):

That’s awesome. So, I’m going to give my example of how I envision this, and let me know if I kind of get this analogy correct.

Varun Boriah (04:44):

Yeah.

Chris Jones (04:45):

So, as a Levels member, to some degree, you may never know that we use Truepill behind the scenes. And correct me if I’m wrong, but that’s intentional. That’s kind of, you really want to be more like you’re empowering companies like, “Hey, we want to have a Levels branded experience. We want a box that looks like ours and to a degree we can control the messaging, the emails who it’s from.” And you just want to say, “Hey, we’re, to your point, the infrastructure, the Legos of what do you want to do to get up and running faster?” We don’t need to have this brand awareness. And to some degree that’s actually like you almost don’t want members to know Truepill.

Chris Jones (05:18):

If I think of an example, if I go buy a pair of shoes, that partner may use Amazon fulfillment and the whole time I’m getting Amazon emails that gets an Amazon box and the whole time I’m like maybe Amazon made these shoes.

Varun Boriah (05:29):

Yeah.

Chris Jones (05:30):

I mean, if I view you, you’re doing the exact opposite. You’re like we actually want to be behind the scenes and actually let our clients shine in their brand and help deliver that. Is that a fair assessment?

Varun Boriah (05:40):

Yeah, exactly. So, a 100% of what we do is white label. So, it’s always our partners brand. So, it’s the level of brand, whether that’s the online experience or the physical offline experience, that’s fully branded with our customers, colors, logos copy. Truepill is often not on any sort of material that a consumer would see unless they’re regulatory requirements for it and that’s our intention. We don’t want anyone to know that Truepill is powering these experiences. We just want to support our customers in helping deliver their solutions to market more scalably and more quickly. And so, that’s our core business at Truepill.

Chris Jones (06:24):

Awesome. Really it’s an exciting space. I mean, it’s really new, the concept of telehealth and a lot of the things you’re enabling, like a lot of companies are trying to pop up all over to you really change healthcare and how it’s delivered and have people rethink it. You mentioned something earlier around you helping small companies, particular startups. So, if I’m a startup, is there a point in time if I’m in a journey, if I’m in the health and wellness space, that it makes sense to engage with someone like Truepill or is it like the flip side of, at some scale you actually might say, “Hey, maybe you actually bring that in house.” Or it’s like, “Hey, you can be five people. You can be 5,000 people and Truepill can scale with you and your needs.” Is there a size or a sweet spot of clients that would really benefit from your services versus at some point you’re too early or you’re too mature?

Varun Boriah (07:13):

Yeah. I think Truepill serves customers all the way from 10, 20 person startups to healthcare organizations that have hundreds of thousands of employees and manage tens of millions of life. So, we do span the spectrum in terms of types of companies and the size of companies we service. Our approach or what we offer varies across those segments. So, when we’re working with a smaller startup that’s maybe building a consumer wellness business, they really want to control all the patient or the customer facing assets or the experiences. And so, oftentimes they build out anything that is consumer facing, use our APIs to connect into our core infrastructure and that’s how we would work with a smaller consumer brand. Whereas on the other end of the spectrum when we’re working with the incumbents and really large healthcare organizations that are starting to think about what is consumerization of healthcare mean, they really don’t have the internal experience or expertise to build out consumers experiences.

Varun Boriah (08:20):

So, they may come to us and say, “Hey, just build everything for me because you have more experience in the space than we do.” And so, for those examples, we’ll build out the entire member facing experience branded with our customers branding and logos, colors, fonts, all of that, but we’ll do the end to end rather than just using our APIs.

Chris Jones (08:43):

Got it. You mentioned API and all of a sudden the engineer in me starts perking up of like, so having been in large companies and even now kind of on the health space, privacy and security and people like, “Oh, well, it’s one thing for me to share you what websites I’m on or what thing I’m clicking on on Facebook and targeting ads and that upsets enough people.” But now if you’re talking about my health data, both from a regulatory standpoint and a consumer bar in of what people are willing to share, and when you have partners to deliver, talk to me a little a bit around how you help companies, one, the technology that enables that type of security or HIPAA compliance or make sure you’re compliant, but also then how do you message that to the end customers to say that, “Hey, if I’m using a company that’s leveraging Truepill, my data is safe, it’s secure, it’s not being used to target Facebook ads.” Help me understand that kind of where the offerings today, or even just how you help educate the clients and customers.

Varun Boriah (09:47):

Yeah. So, there are couple of ways I think about that, so first is our values. So, if you go back to our values, one of them is patient confidentiality. And we take that very seriously where a healthcare organization at our center, we started as a pharmacy. And so, we take PHI and PII as very important in our business. And so, that’s a cultural value that we have where we’re obviously HIPAA compliant and meet the regulations there. We’re doing another certification with HITRUST. And so, I think we’re continuously on this journey of how do we ensure we protect any of the information that we’re privileged to have access to through our customers and ensure we’re not at fault for any information getting out of the public that should not be in the public domain.

Varun Boriah (10:35):

And oftentimes we do work with our customers or our partners to help them understand what best practices may look like, what security assessment should look like, so that we’re able to sort of help up level the entire industry rather than just saying, “Hey, that’s not my problem. That’s yours.” That’s sort of the approach that we’ve been taking as a business.

Chris Jones (10:59):

I mean, obviously with COVID the adoption of things like telehealth just grew hugely. So, to what degree did COVID really kind of help you because now you had a lot of companies coming up saying, “Oh, I see, I need someone who’s really good at this.” Or did it impact you guys like a lot of other companies like, “Oh, wow, like I don’t maybe have the money or I can’t be expanding right now because of certain unknown.” Was COVID an accelerant for you just given the space of telehealth?

Varun Boriah (11:27):

Yeah. I think COVID was definitely accelerant for our business in many different ways. I think it was an accelerant of the modalities that people used to access care and I’ll talk about that in a minute. It was also an accelerant in terms of incumbent healthcare companies thinking about consumers at the center of their experience. And if you follow the narrative shift three years ago, none of the top healthcare organizations talked about the patient or the consumer, and now every earnings call is about how they’re going to be a consumer centered organization. And so, I think that’s a big theme that’s been an outcome of COVID, but going back to my first point around care delivery changing. So, you think about in-person appointments now going online, you think about going to a Quest or Labcorp to get blood work done. Now you do a COVID test at home going into a Walgreens or a CVS to get your medication.

Varun Boriah (12:27):

Now medication is being delivered at home. So, people have sort of gotten the taste of all of those, or at least some set of those over the last two years and realized that’s an easy experience. It’s not that hard to swab your nose and do a test at home. And I think that’s just opening the eyes for consumers to say, “Why should I take a half day off to go see my doctor and get some blood work done when I can see a doctor online? They send a phlebotomist to my home and it’s a five minute encounter and I have the results delivered on my phone.” So, I think consumers are sort of driving the incumbent healthcare system to rethink how healthcare is being delivered.

Chris Jones (13:12):

I remember my personal journey of when I first signed up with One Medical years ago in Palo Alto and the two things that I would pay, whatever amount of money that they wanted me to pay to join them was I could book my appointment online either with the doctor I wanted or first available, just as easy as like booking a hair appointment and I could email them, “Hey, I’ve got this rash. Let me take a photo of it and email it into a secure way. Do I need to take work off to come to you?” And him being like, “No, put some ointment on it and be fine.” I’d be like, it blew my mind from the old mindset of like, “Oh, this is going to be painful. I’m going to have to go in, have several appointments. No, one’s going to know what to do.” And the amount of anxiety, when you walk into that hospital lobby, what are they going to find? What’s wrong with me?

Varun Boriah (14:01):

Right.

Chris Jones (14:01):

So, even though it was very little things like, can I email my provider? We weren’t even doing video chats or real what true maybe telehealth, but minor things I’m like, this is completely changing.

Varun Boriah (14:15):

I’d put all of that in the bucket of accessibility, right? You’re just making it easier to seek the care that you want. And whether it’s booking an appointment, whether it’s sending an email or a text to your doctor, all of those things just reduce the barrier of accessing healthcare and get people in the door sooner rather than waiting for that knee pain that’s been bothering you for six months to flare up into a serious issue.

Chris Jones (14:41):

Totally. Maybe to bring it back for people that have been using Levels, we have two main offerings today. One is partnering with to get a CGM or continuous glucose monitor and today because of how it’s regulated, you need a prescription to do that. So, our members, when they sign up for Levels, fill out just like a little simple survey which is a medical consult that really goes to Truepill and you partner with a network of doctors that review that in an asynchronous way. So, to some degree, our members might say, “Yes, your prescription’s been filled and here’s your prescription number,” which then goes to Truepill to say, “I now need to create a Levels box. I need to put some CGMs in it, the instructions, the swabs.” And your fulfillment of actually shipping that out almost like an Amazon warehouse.

Chris Jones (15:29):

And you’re doing that and then with also that prescription and partnering with the network and a lot of people are well coming to support going, “Well, wait a minute, when do I get that consult with the doctor?” And we’re like, “Oh yeah, you already had it. That email you got that said approved, that was it.” And you’re like, “Really? That was so easy.” And then the other offering that we just recently started doing with Truepill is on what we call the metabolic health panel which is really a phlebotomist that comes to your house. So again, scheduling like, again, I don’t even have to leave my house. I’m getting excited. I’m getting this one my own next week. I have it scheduled. And I’m like, all right, I’m all excited to the experiencing of like, they come to your house, maybe takes five or 10 minutes and take a couple vials, bring it back, analyze it to get the diagnostics, send that and then we upload that into the Levels app.

Chris Jones (16:21):

So, you can now see your cholesterol, your lipids, your A1C. And then we also give you guidance from our doctors and panels around not just your number, but how do you feel about it? Not just a, is it good or bad, but is it optimal? Is it normal? Here’s doctors commentary around how you should think about it and the ratio is not just the absolute. So, it’s an area that is newer for us with Truepill but one that’s super exciting because we can learn so much more than what we can collect with just analyzing. I mean, real time glucose is amazing, but it’s just one and signal. I know I’m super excited as we really kind of tap into another one of your pillars to kind of really get the diagnostics.

Chris Jones (17:00):

And you’re probably like, “Yeah, that’s my area. I’m excited as well.” So, maybe if I think about in the diagnostic standpoint, are there things that you get excited that you think that Levels should be thinking more about how to use Truepill, either offering, do you guys have today, or is it more things that you guys are thinking about of like, “Hey, I know kind of where Levels is going. I know what you’re doing. These are things that we’re thinking about doing to actually even really enable you to do a lot more.”

Varun Boriah (17:27):

Yeah. So, just going back a step as you described, like all the ways we’ve worked with Levels over the past couple of years, it’s been really strong relationship that we built starting with just using our pharmacy then Levels was our first telehealth customer when we were doing the asynchronous consultations and stood up that program. And then on the diagnostic side, I recall it was April, about April, May last year, Sam emailed Sid, our CEO saying, “Hey, I read something about diagnostics. What is this? What are you guys doing?” And so, Sid connected Sam and I, and I talked to about what we’re doing diagnostic. He was like, “Great. That’s what I want. How do I set it?”

Chris Jones (18:11):

Yeah. And Sam wants the project live in the following week.

Varun Boriah (18:14):

Yeah, exactly.

Chris Jones (18:15):

Yeah, totally. I can imagine how that conversation went.

Varun Boriah (18:18):

Yeah. But it’s been a great collaboration, a great partnership. And I think what I have really respected in this relationship is we’re learning from each other. We’re going into this saying, “Hey, some of the things we’re doing are things we’ve done for years and years and years and we know it the back of our hand and there are other things where it’s new to triple as well and let’s learn about this together.” And I recall when we did our first pilot with the mobile phlebotomy experience and having phlebotomists go in was just blown away by the level of detail and feedback that came back from the Levels team. I was like, “I’m on all these notion pages with everyone putting in comments. This is amazing.” And sort of just speaks to how using iterations to improve a product is so valuable when you’re first getting started with a new program.

Chris Jones (19:07):

Varun, welcome to the Levels team. When you really pop the hood around, it’s one thing to watch a podcast of how we do it, but when you’re actually in the middle of it of like, “Oh, wow, that went from zero to a 100 quickly.” And I mean, and it seems like as we look to roll out new features, we are really good internally about eating our own dog food or beta test state are using it. And that’s great, but that only gets it so far. We are now trying to say, “How do we get better to roll out these new features, these new services to our members in a controlled way that’s more scalable?” And that’s a problem that I know I’m working on.

Chris Jones (19:44):

It’s not just using AB testing software and put people in a cohort of like red button, blue button, but you’re like, “All right, I want to get a set of users and I want to give them a different experience, whether it’s a different patch that goes over the CGM or whether it’s like, “Hey, what’s the benefit of the phlebotomist coming to your house versus a mail kit of like I want to take this thing myself. I don’t want a stranger in my house.” And I was trying to understanding like, do we offer both? Do we offer one? What’s the difference from the accuracy in terms of how they’re pulling the blood? So, it’s an area that we are all super interested. It’s your point of learning of, as you do this with more clients, you’re like, “All right, are these things comparable?” We can offer them and they’re going to get the same data or is it like, “Well, this was more convenient or cheaper, but we’ve had more risk with A, B and C.”

Chris Jones (20:32):

So yeah. So, they’re learning from each other is an area that I really enjoy. And I mean, I’m much newer to this field. I’m much more like big tech, give me a bunch of data, let me build some pie charts and they’ll let me go to town. And working with the triple team has been, I really enjoyed it. I mean, I think your key is the word partnership is one that rings true. It’s not a vendor around, I don’t think I’ve ever pulled out the contract around like, “All right. Should I be getting reports? What do I need to be doing?”

Chris Jones (21:00):

This more like, what’s the best thing for the member and how do we build a great experience and how do we get there quickly and iterate? And that’s been fun. I think it was one of the first things when I joined Levels, [inaudible 00:21:10], my boss who was running kind of that main point of contact with the Levels team is like, “All right, Chris. Here’s Peter, here’s Ben, here’s the Truepill team.” You’re now on the hook for like, do we have enough order of shipments, where are we going? SLA ship times. I’m like, “What, how does this thing even work?” And it’s been great and I really enjoy it. So, it’s been a lot of fun. On the diagnostic sides, how are other customers using Truepill? What are they doing that’s either similar or completely unique?

Varun Boriah (21:39):

I’ll talk about our diagnostic product for a second and then I’ll go to question. So, our approach is we want to be a single point solution for a diagnostic test that matches what the customer most needs, right? And so, that could be a rapid test shipped to your home that you do completely independently and you have the results at home, that could be an at home kit that you just mentioned, where we ship a kit out to you, you collect a specimen and send it back to a lab and you have your results in a couple of days. That could be a mobile phlebotomist coming into your home, collecting a specimen and giving you a results in a day or two. Or we do integrate with the traditional patient service centers like a quest for a Labcorp if you ultimately want go in and our position as an infrastructure company isn’t necessarily to put you down or another path, but relying on our partners to understand the consumer experience that they want to build, and then deciding what modalities or what combination of modalities make sense for their population.

Varun Boriah (22:42):

And so, with Levels, we’ve obviously started with mobile phlebotomy, but an extension in at home kits definitely makes sense when you think about maybe people who live in more rural areas where getting mobile phlebotomist out there maybe-

Chris Jones (22:56):

Decent point. In the middle of Montana, I’m out of service zone.

Varun Boriah (23:00):

Yeah, exactly. So, that’s an example or it maybe someone who’s not comfortable having someone come into their home and would rather do it at their own leisure over the weekend when they have a couple of minutes to complete a specimen collection. So, really thinking about what is the end customer of our product want to do, what is their preference and our role at Truepill is ensuring that’s an option that we can offer them. So, that’s generally how I think about Truepill. In terms of the interesting things we’re seeing, one is with Levels with the CGM, that’s more of a real time indicator of their blood glucose level. So, that’s one measure. That’s a high frequency measure. It changes very quickly and what’s interesting with the metabolic panel is that’s sort of assessing your health at a different frequency, right? It’s looking at your A1Cs and what did that look like over the past three months and maybe your lipid panels and how that’s changing over time.

Varun Boriah (24:01):

So, using different modalities of diagnostics based on what frequency of measurement most makes sense. So, that’s one area that’s been really interesting. Another area that’s been really interesting is you see a provider online for a symptom that you’re experiencing. Now today, the experience is fairly broken. You are sent to a Quest, you have to figure out how to get up there, how to get a result back. How do I get it to my doctor now? Maybe it’s a week before I get an appointment. They write a prescription. I go to Walgreens, I have to wait, pick it up and that’s like a really broken experience. And so, we’re thinking about how can all this be done digitally in a seamless way. You see a doctor online, you have a test delivered to your home or mobile phlebotomy shows up the next day. Results automatically go back into your patient record. And if the physician thinks it’s appropriate, writes a prescription without necessarily even talking to you and medication gets delivered to you-

Chris Jones (25:01):

Love it.

Varun Boriah (25:02):

… the next day.

Chris Jones (25:03):

Sign me up, give me the [inaudible 00:25:06].

Varun Boriah (25:06):

So, we’re seeing a lot more of rewind a couple of years, we were treating hair loss, ED, birth control over telehealth and that was because all those conditions can be assessed through clinical presentation. You don’t need any diagnostic work. I think the next wave that we’re going to see in consumer health world is conditions that can still be managed virtually but need a diagnostic test. And so, think about thyroid management, fertility testing, hormone panels. Those that I think the next wave of things we’ll see in terms of how healthcare is delivered virtually. So, that’s a second interesting area for us in diagnostics.

Chris Jones (25:47):

I can’t wait for that future to come today. I mean, having relocated from the Bay Area to Montana, of course you have to do things like, “Oh, I now have to find a new doctor, a new dentist, a new barber.” And I’m like, “I don’t know where to go.” And I’m having this anxiety around like I had my guy, I had company I liked that was close and convenient and comfortable and served great coffee. And now I’m like, I don’t know where to go and I’m just it’s anxiety around I don’t know where to start.

Varun Boriah (26:15):

Yeah.

Chris Jones (26:15):

So, this one was one what’s interesting to me as well as the Levels team, the recent announcement of you guys partnering with Mark Cuban for the Mark Cuban Cost Plus Drug Company. One, I would be super curious, like what it was, one you might want to explain to people listening what that offering is and the problem it’s solving, but then also just like, what’s it like to work or partner and negotiate with mark Cuban when he’s on the other side? That just seems so cool.

Varun Boriah (26:42):

Yeah. Happy to share some of that. So, the company is the Mark Cuban Cost Plus Drug Company and their core mission is price transparency around drugs. And so, they want to have a great patient experience where you know exactly how much you’re going to pay for the medication that you’re getting and you also understand the costs of that medication. I think today in the healthcare world, there’s a lot of opacity in terms of what a PBM does and what the actual pricing, what the cost is and what the retail price of any medication is. Whereas with the Mark Cuban Cost Plus Drug Company, it’s-

Chris Jones (27:23):

[inaudible 00:27:23] front a tongue [crosstalk 00:27:24].

Varun Boriah (27:24):

Yeah, exactly. It’s like once you get past that, everything is sort of transparent. So, they publish what their manufacturing costs are. There’s a 15% markup on that that they charge you. There’s a $3 dispense fee for the pharmacy and then it ships to you for, I think, $5 via ground. And so, you know exactly who is making how much money and why you are paying the end dollar value. And through that, you are able to improve access because you are making drugs more affordable. So, that’s the value proposition of the organization. And since they launched and Mark Cuban started talking about it publicly, we’ve seen a tremendous amount of interest across the US for people switching over their prescriptions to get medication from [inaudible 00:28:15].

Chris Jones (28:15):

That’s awesome. So, it’s the opposite of pharma boy, where it’s like let’s just see how much the market will bear for this drug.

Varun Boriah (28:23):

Right.

Chris Jones (28:23):

You just keep ramping it up in until they say, “I give.” Yeah. I mean, I know when that came out, we were super excited about it and just to, I mean, we also over time, like right now, we’re in close beta, but as we think about as we launch, we really want to try to partner with the brands and the companies and be able to deliver the blood panels to CGMs really as lowest cost as possible. We don’t want to be making money on the test on the hardware. We kind of want to really just be making money on the Levels membership and be like, “Hey, if the right thing for you is to be having a CGM every month and do a blood panel every month because you really want know those points in time, great.

Chris Jones (29:04):

We want to enable that a lowest price that we possibly can. If for you, you might say, “Hey, I want a one blood panel and one month of CGM. And because I kind of eat the same foods all the time and I’ll know right away, like white rice, brown rice cauliflower rice.” And if you’re not learning, then we wouldn’t want to be in the position where we’re trying to give you more products than you don’t need. So, we completely relate it with the whole like, “Well, one let’s be transparent on what the price is and let’s try to get as low as possible not just like what the market will bear.” It resonated. So, now I’m going to switch off of Truepill for a second. And as I looked at your LinkedIn, I mean, one you’ve been in the health and wellness space for most of your career, and you’ve been a CEO, you’ve been a co-founder at several companies.

Chris Jones (29:47):

So, just talk to me a little on your journey around one, why kind of health and wellness and sort of just your learnings or lessons for, again, I’m kind thinking of like for the serial entrepreneurs out there listening around lessons that they can kind of take away so that they think about starting their own company, even if it’s not in the wellness space, but just like your learnings.

Varun Boriah (30:07):

Yeah, sure. Let’s see if I start at the beginning, I’m mechanical engineer and I moved from India to California after grad school at Cal. And I remember landing here and I was trying to figure out where do I do my thesis? And the project that popped out was doing fluid dynamics on the Great Red Spot on Jupiter and I was like-

Chris Jones (30:29):

Naturally, that’s where we all start.

Varun Boriah (30:30):

Yeah, exactly. I’m like, “Oh my God, what have I just landed in and why am I studying the Great Red Spot?” And so, I quickly started looking around for something that was a little more tangible and practical and ended up at the bioengineering department and found a lab that was doing a lot around microfluidics and diagnostics, and was really interested by sort of this concept of the unknowns of biology versus the knowns of the mechanical system. So, mechanical systems are very definable, you know exactly what’s happening. Whereas with biology, I always felt like it’s always an experiment. You push A, and then you’re like, let’s see what comes out the other end, right? And it was just like intellectually really, really fascinating. And so, that’s sort of what got me into healthcare generally. And as an interesting tie back to Levels, my first job out of grad school was technology that I got licensed out my grad school lab to develop CGMs.

Chris Jones (31:29):

I saw that. I was like small world.

Varun Boriah (31:32):

Yeah. And I remember us dreaming of the day when CGMs would be used by nondiabetics to figure out how they’re doing and the value that it would have, and the fact that it was so expensive and inaccessible that no one could do it unless it was a prescription. So anyway, just interesting start. And my journey from there on was I liked the health and wellness space, sort of the impact that you could have on patient lives and really opportunity to help patients live healthier, better lives. And so, that’s what kept me in the healthcare space and still did product development for a number of years doing continued glucose monitors, RF ablation devices, a lot of surgical tools, but really thought there were better engineers than me, engineers who enjoyed it more than I did and was looking for something more interesting to do.

Varun Boriah (32:29):

And so, I went to Stanford to do a program called bio-design, which really opened up my eyes to this idea of needs based innovation and using design thinking to identify unmet needs in the market, and then developing solutions that really meet those or solve those pain points and met a teammate there and ended up co-founding a company called Lully, which was focused on helping children sleep better and took that product through commercialization and ran that business for a couple of years. And through that experience learnt a couple of things. I started out in med tech, which is hardcore product development, seven to 10 years to get any product market, very slow iterations in terms of learning from the market into a space with Lully which was much more of a consumer health product where still backed on clinical evidence, but something you could get to market really quickly, you were talking directly to the end user of the product.

Varun Boriah (33:29):

You were constantly getting feedback from them and improving the product and really like this sort of this intersection of healthcare technology and consumer. And so, ever since I’ve sort of been somewhere in that triangle, trying to find interesting needs to solve, interesting problems to solve.

Chris Jones (33:50):

That’s awesome. I can’t stop thinking about the Big Red Spot on Jupiter now. And I won’t make you pick around like which school you liked better Stanford or Berkeley. It’s you’re like, “Oh, I’m neutral. I’m Switzerland. I live in San Francisco. I don’t pick either one.”

Varun Boriah (34:07):

Yeah, exactly. I wear Cal shorts and Stanford shirts [inaudible 00:34:15] most.

Chris Jones (34:15):

I was looking at the Lully and well, one made an assumption here because it was right before Lully, you were at Y Combinator. So, was Lully the product of kind of your Y Combinator action? And so, such it is like maybe we should talk about your Y Combinator experience because I know a lot of startups as they try to like, “Oh, if I could just get into Y Combinator. I think that’s really going to help me shape my idea. Give me, so talk a little bit around how that type of program helped you in actually developing a product. Was it critical path or was it like, “Yeah, I probably would’ve got there and it was great,” versus like, “Hey, this is really where it helped me with things I didn’t know I didn’t know.”

Varun Boriah (34:52):

Yeah. So, we took Lully through YC in winter of ’15. So, been a while, but-

Chris Jones (34:59):

You said the date, I didn’t say the date. So, [inaudible 00:35:02] record show.

Varun Boriah (35:04):

No, it was a transformational experience for me and for the company. I think coming into bio-design at Stanford, both me and my co-founder came from the traditional medical device world or the medical world and we sort of looked at everything as a medical product. And as we think about Lully, one of the pivotal things that Y Combinator helped us with was thinking through the transition of this is not a medical device, this is a consumer health product and your go-to market is not a medical device go-to market, it’s a consumer health go-to market. And that mental shift, while it seems simple, I think really helps you change your approach in product development [inaudible 00:35:46] market and financing and marketing and all those things. And so, I would say that’s probably the number one thing that YC gave us was so of that mental shift of, we’re not a medical device product, we’re a consumer health product and not talking about the patient, we’re talking about the consumer of our product and just changing the words that you use changed the decisions that you make.

Varun Boriah (36:10):

So, that was one bit that YC definitely added a lot of value with. And then the second was just a great group of people like-minded founders who are there to learn from each other, help each other and who are willing to pay it forward. And I know today, if I go back to the YC network and say, “Hey, I need help with X, Y, and Z.” And I’m pretty sure 10 people will say, “Yeah, I’ve done that before. Give me a call.”

Chris Jones (36:33):

Yeah.

Varun Boriah (36:35):

That lives on beyond your time at YC or even the startup [inaudible 00:36:40] YC.

Chris Jones (36:40):

A couple jobs ago, I was at a hardware startup, and we were pitching to YC. And I remember a lot of the questions that they were kind of asking and posing to us. So, our product was basically turned your smartphone into a radio off the grid communication. So, you’re at Coachella, you’re at Outside Lands. I have my smartphone but I don’t have self-service. And basically using the same radio technology for more point to point or on a ski slope. And a lot of the questions they started asking was like, if you are a radio company that is a heavy regulated space in terms of very, you’ve got this much band that’s why there’s 50 different single purpose radios out there for search and rescue for fire or for kids on the Snow Hill or back country ham instead, if you’re focusing what problem you’re trying to solve.

Chris Jones (37:25):

And we’re like, “Oh, we’re trying to solve consumer communication for people that are off the grid. They’re skiing, they’re outdoors where they don’t have to rely on having cell service, they’re in Montana. So, it’s like enabling a lifestyle and they’re like, “Okay, well then forget the technology, focus on how do you solve that and not get tripped up by this heavily regulated space.” So, I totally get that. Changing your mindset around what problem you’re solving and how you approach it really changes your solutions in terms of what you go after versus like, I must go down this path and it’s regulated and I must clear all these hurdles to get there which is hard. So, that’s super interesting. I’m sure a lot of future CEOs are going to be like, “All right, next thing I’m doing is applying to the next Y Combinator test.” So, now maybe if I come back to another where you were, and you mentioned a little bit at Cardiocanary where you were co-founder and that’s where you were also, you’re working like, I’m going to get this right, autonomous blood testing.

Varun Boriah (38:20):

Yeah.

Chris Jones (38:22):

If I think about that, is that like a CGM for blood test or is that more of just like, how do we make it for the humans aren’t involved? How should I think about what that product [inaudible 00:38:32]?

Varun Boriah (38:32):

So yeah, it was the format. So, we were thinking I’d spent three or four years thinking about CGMs and measuring glucose through micro needles and the next logical step was what else can you do with the needles? How else? What other analytes can you start measuring? And so, me and a coworker of ours started to sort of moonlight thinking about that problem statement. And we landed on this interesting space around people will have heart attacks and the fact that a small percentage of heart attacks can be detected with an ECG. A majority of them are normal on ECG and you need to do what’s called a troponin test and look at how your troponin levels change. And that’s what will happen if you go into an ER saying you have chest pain, they’ll do three blood draws. I don’t know if that’s the protocol still, but you would do three blood draws over like nine hours or something like that. And they look for it did you have a spike in your troponin levels?

Chris Jones (39:29):

Sounds fun.

Varun Boriah (39:31):

Yeah, exactly. Sitting in the waiting room and the ER, like getting your blood drawn. And we thought that’s one such a waste of resources for someone to keep coming back and doing blood draws. Can you just put something on the patient and collect troponin over time and as soon as you see an inflection, you know someone has had a heart attack? So, that was the idea there. And reflecting back, it was definitely a fun experience, but it was one of those, the classic camera looking for a nail, we added technology and we were looking for a problem. And now I look back and especially after the bio-design program which is the exact opposite of like, go find the problem, then you can go find technologies to solve it. It just feels like nailing the problem statements you’re trying to solve and having clarity around the problem statements you’re trying to solve is so much better than finding a technology and then going market after market trying to find a way to use that technology.

Chris Jones (40:31):

But that can still be cool of like, let me get in the lab and start soldering stuff together and be like, great this like I’m sure someone’s going to want to pay a lot of money for this thing.

Varun Boriah (40:41):

Yeah, for sure. And that’s, I mean, the engineer on me, that’s what comes to me naturally, right?

Chris Jones (40:45):

Yeah.

Varun Boriah (40:45):

I would rather like, I don’t want to think about all this esoteric ideas. I just want to go build something. Let me get to the building. So, it took a lot of discipline to say, “Okay, we’re not going to solution. We’re only going to define and you sort of force that.”

Chris Jones (40:59):

Yeah. That takes patience. And even doing this data analysis, people be like, “Well, Chris, shouldn’t you ask all your users what business questions they want, what KPI metrics?” I’m like, “Uh-uh (negative), let me add the data and let me just start building. And then I’ll present to them like I found a bunch of interesting stuff. Does any of this resonate?” And then I’ll iterate from there. And they’re like, “Wait, so you didn’t even ask your end users what they want to do?” I’m like, I’m like, “One, because I don’t want to disappoint them.” They might say, “Oh, I want all this data.” I’m like, “Yeah, that data we don’t collect, we don’t have it, doesn’t integrate and I won’t be able to deliver it or at least not anytime soon.” So, I get the builder in me as well of like, just let me add it, let me get my hands dirty and let me see what I can go do.

Varun Boriah (41:39):

Yeah. I think there’s a healthy balance like you want to prototyping is really important, right? You define something, you define a problem statement, you have a hypothesis and then you test that hypothesis through rapid prototyping and then you go update that hypothesis based on what you want. And so, for sure that’s iterative process.

Chris Jones (41:58):

I completely forgot to ask you at the beginning, are you a Levels member? Do you use it or are you like, “You know what? I’ve had CGMs on me for the last decade. I totally get it. I know it. I have all the learnings.”

Varun Boriah (42:08):

Yeah. I’m not a Levels customer right now.

Chris Jones (42:11):

All right. We’re going to stop this call right now. We’re going to hit end. We’re going to hit delete. Start over.

Varun Boriah (42:16):

I’m probably somewhere in the queue although Josh did say he would hook me up. But yeah, I’ve had so many CGMs on me and I joke, I picked my fingers so many time to do comparisons against a CGM with [inaudible 00:42:29] glucose meter. There were days I couldn’t type because I’d picked all my fingers. So, I feel like I understand my blood glucose very, very well.

Chris Jones (42:38):

Yeah. That is an area I have not stooped to. We have lots of members on the team and lots of our, even our members that say, “Hey, my reading is 20 points off versus my finger prick and finger pricks.” I’m like, “I don’t like to stick myself.” So, I’ll put the sensor on and just say, “I care more about the trends and how much it goes up and goes down.” If sensor to sensor moves, that’s not really changing the insight I’m getting. It’s much more around like, “Oh wow, I had that piece of cake or that thin crust pizza versus the thick crust pizza or the potatoes in the fries versus this salad.” It’s the variance that really is my learning.

Varun Boriah (43:18):

It’s the actionable insights, right? You can throw a bunch of data at people but at the end of the day, the correlation to what can I change about my behavior is more helpful. And so, knowing to eat that salad instead of the slice of pizza.

Chris Jones (43:34):

Well, no, it’s both. It’s the salad before the pizza. You don’t have to give up your pizza. You can still have it. You just need, have a salad then go for a walk afterwards, perfect. So, another one while we’re on the CGM space, given your background and knowledge of it and going back a handful of years, again, I’m trying to be respectful and not tip your hand. There’s been recent announcements. So, Abbot at CS announced they’re kind of introducing more wellness products and came up with four sensors in terms of glucose, ketones, lactate, and alcohol. How do you feel or even like Dexcom getting their G7 which is a much smaller version, much smaller fingerprint or footprint, how do you feel like that industry’s evolved over time? It gives us like, “Hey, it’s they’re making lots of changes,” or it’s like, “Hey, the technology isn’t that much different than what it was 10 years ago.”

Chris Jones (44:28):

And what do you think should be different about it given kind of your knowledge and having been in this space for a while, either as part of your Truepill hat on or your mechanical engineering hat on?

Varun Boriah (44:39):

Yeah. So, a couple of different things that come to mind. One is I think the consumerization of diagnostics is here when Robert Ford was at CES presenting about Abbot Lingo system, I would’ve never imagined seeing a medical device CEO at CES presenting, right? And so, it’s starting to say like diagnostics traditionally has been restrictive to a physician’s office or a lab, but now it’s coming into the home, it’s coming to the end consumer of that test. And we’re past the huddle of do people know how to use it? Do people know what to do with the data? I think what passed some of those initial huddles. So, we’ll start to see more and more of the traditional large medical device companies come out with more consumer facing products. So, that’s an industry trend I see. And with CGM specifically, one there’s sort of, yeah Abbot’s announcement around Lingo and bringing sort of a non CGM not intense or diabetics, but general population.

Varun Boriah (45:40):

I think we’ll see more of that over time. I’d say what I was hoping would’ve happened over the, not to mention number of years, I’ve been at the CGM space. I don’t know for some reason that I’ve aging myself a lot more, that this is reality. But anyway, I would’ve expected, like we would’ve gone away from subcutaneous sensors. So, most of the devices today, there’s still a sensor that those [inaudible 00:46:06] sensor and I thought we would’ve gotten to the microbial sensors that I was working on then or completely non-invasive sensor of some sort, but feels like the technology is still a whiles away from getting there. So, hopefully the continued demand, I think the push towards more consumer use versus true health use will get these organizations to focus on more user friendly CGM products that maybe a less invasive.

Chris Jones (46:35):

I mean, if I believe my Facebook feed, there’s at least 20 companies that have the non evasive glucose monitor that’s in production today. So, I’m like, what did someone crack it? I’m clicking. I’m like, “Dude, no, that’s not [inaudible 00:46:50].” I mean, again, it’s an area of, like I had no idea about this part of the space until I joined Levels. I didn’t know what a CGM was. I didn’t know how many friends and families were either type one, type two or prediabetic. And then as I joined, like I have all these friends are like, “Oh yeah, I’m diabetic. I have a Dexcom, I’ve got an Abbot, I know what that sensor.” Even my sister, who’s a vet, she’s like, “Oh, I prescribe the Abbot Libre to pets all the time.” She’s like, “Which one are you using?” I’m like, “What?” So, for me, that’s been super fun kind of getting in a new space and your point, like learning and taking on new skills and to be an eye opening. But I always come at it from a consumer play of I’m not in the field.

Chris Jones (47:35):

So, I always more, I think of it like my parents of like, would my mom be able to figure this out in terms of like the unboxing of it, the figuring out how to put it on, the what to do with the app, the insights of that’s really where we need to make it super easy. Yeah, if you’re a biohacker, you’re going to figure this stuff out, or you’ve already figured out a way to get an off-label subscription or you’re doing finger pricks all the time. It’s to really crack it where you have to make it super easy, where even if it’s not a built into watch, it has that same type of like, it’s just as easy as using my Fitbit or my Apple watch. It feels kind of seamless and it kind of integrates in my life and it kind of goes to the background.

Chris Jones (48:14):

So, it’s an exciting space, but I mean, it’s hopefully the next X number of years, the innovation in that field, I think to your point from pressure around like, “Hey, there is a market. Consumers do want this. They are willing to some degree, have a device that breaks the skin to get that type of insight because they can’t get in anywhere else. So, hopefully that. I’m looking forward to it but to some degree as long as they treat them as a medically approved device, that cycle is slow and it’s much harder to innovate faster just given the nature of the beast as you’re well aware of when you’re trying to actually think about it as like a medical device, you’re like, this is not meant to be built as a quick rapid iteration hardware type of play one.

Chris Jones (48:56):

Well, I want to be respectful of your time. I realize it’s almost the top of the hour, I guess. Well, one, a couple things, one, thank you so much for your time. I’ve learned a lot. It’s been super interesting. As I thought about your startups, I’m like, “Oh, I have to ask that. I really want to understand what that experience is like.” So, I just really appreciate the transparency sharing your stories both in terms of what Truepill is doing and your own personal journey in terms of going through different startups and Y Combinator to kind of help others. Any final thoughts, things top of mind that you want to kind of leave our listeners with in terms of just the world according to the Varun?

Varun Boriah (49:29):

That’s maybe a little too [inaudible 00:49:35]. But I think so a couple of things, one is like, I think to the entrepreneurs who are listening, there’s going to be ups and downs and you sort of plow through them and that’s what being an entrepreneur means, having grit, having resilience and finding smart people to work with and finding interesting problems to solve and spending enough time on it. I think to sort of all the biohackers and the wellness warriors out there, products like Levels really help provide access to diagnostics information in a more actionable way. You no longer have to buy things off the black market to figure out what your blood glucose is doing. You have a great user experience with actionable insights, with great content coming back and sort of just raw data. And so, I’m excited for products like Levels to come to market and to grow and excited for Levels to grow as well. From a Truepill standpoint where we’re continue to be sort of consumer brand centric. And so, any healthcare brand that’s looking to accelerate their go-to market, we’re here to help the cross pharmacy telehealth and diagnostics.