Interview – Julia Hu
CEO, Lark Health
Entrepreneur Julia Hu founded Lark Health with the belief that conversational AI technology could transform the way we prevent and manage chronic diseases. Informed by her own experience managing a chronic condition, Julia saw an enormous opportunity for technology to fill many of the gaps left by a health care system designed around acute, episodic care.
After spending nearly a decade in research and development and $100M in R&D, Julia and her team developed the conversational AI-powered Lark platform with the goal of putting a nurse or health coach in everyone’s pocket. Using a Cognitive Behavioral Therapy framework, and paired with connected devices to create a true 24/7 virtual coaching experience, Lark’s technology can also be seamlessly integrated into a health plan’s existing workflow to guide people to the right care, at the right time, boosting overall engagement and improving health outcomes.
The pandemic has emphasized the importance of care that reaches people where they are, and Julia is working to ensure that digital solutions continue to provide an affordable, accessible pathway for chronic disease prevention and management moving forward.
Over the past year, we have focused on finding ways to reduce friction across the health care system by supporting deeper integrations and expanding new partnerships with major health plans.
It’s not really news that healthcare costs have continued to rise, and we’ve seen an unprecedented amount of innovation and investment in technology solutions in an attempt to control these costs, particularly through the pandemic where the system needed to quickly adapt to providing health care in people’s homes. However, all of these new point solutions have led to increased system fragmentation without providing reliable access to care for many chronic disease patients.
Unlike other chronic disease management solutions, we designed Lark to be a true technology partner for health plans, giving them a chronic disease prevention and management platform with proven outcomes. Lark fits into a health plan’s existing care management pathways, rather than directing members to another outside point solution. As part of our integration, we provide payers with data and member-level information to help drive the appropriate care to the right people, and create a more personalized experience for the user.
Plus, because we’re AI-based, we aren’t dependent on limited coaching resources, which often constrain the potential reach of enrollment, engagement, and treatment. Lark can onboard and treat a plan’s entire at-risk population immediately, and our exceptionally low operational costs facilitate program costs approximately 50 percent lower than other solutions, which allows plans the opportunity to engage their entire scope of at-risk members.
Across all four programs in the Lark platform – Prevention (weight management, stress and anxiety management, sleep coaching, and smoking cessation), Diabetes Care, Hypertension Care, and our Diabetes Prevention Program, which received the highest level of clinical recognition, Full Recognition from the Centers for Disease Control and Prevention – our AI collects real-time feedback from members about what impacts their behaviors and feelings on their chronic condition, and iterates on that feedback with real-time coaching to keep users engaged.
Because our programs use AI, we are able to provide unlimited, 24/7, personalized counseling and care delivered right through users’ smartphones in a friendly, easy-to-use text message-like interface. Users receive hyper-customized, dynamic, real-time coaching available when and where they need it.
Our tech also enables us to scale very effectively. Right now, we’re contracted to manage over 30 million lives, and we’re able to manage that population because of our AI, which achieves high enrollment numbers, retains people in our programs, and keeps them engaged long-term.
Lark is also constantly learning and improving in real-time. The platform receives feedback on biometric readings, activity levels, nutrition, sleep, and medication adherence, and then tailors recommendations to each individual’s history and current needs on a recording-by-recording basis. Additionally, Lark implements clinically validated in-app surveys, such as the Patient Health Questionnaire (PHQ-2), a standardized health survey to screen for depression, to identify and escalate those members who may have additional care needs to appropriate resources.
Our vision is to provide anyone managing, or at-risk for, chronic condition care from a virtual nurse/health coach that they can keep in their pocket. We want to create a system where people can manage all their health care interactions using a modality that’s as easy and common as a text message — communicate about changes in their health care situation, monitor symptoms, ask questions, schedule visits, and get referrals to when and where to go for follow-up appointments.
And all of this information will be integrated with both their health plan and their provider — with both notified in a way that gives them actionable and timely information.
Part of the equation is making sure that the interface is familiar and friendly. Our conversational AI provides prompts and recommendations through a text-message like interface, which users understand intuitively.
It’s also very important to be able to meet each user where they are. That includes providing hyper-personalized recommendations tailored to their unique health situation, but also being available to them in moments that matter. Nearly half of interactions in our program happen outside traditional business hours, which shows the need for care beyond what can be provided in the clinic.
Year after year, Lark’s platforms receive consistently high engagement rates, which in turn leads to successful health outcomes. In fact, Lark has exchanged over 505 million messages with patients to date.
Health apps have median participant retention from 2-26 days, with an average of 5.5 days, but 69 percent of our members are still highly engaged at month four.
Lark also implements a robust enrollment strategy to help our partners engage their members and employees. When we recently took over marketing and communication efforts on behalf of one of our partners, we enrolled 5x as many users than their prior monthly average in our first month.
I’m particularly proud of Lark’s work in this area.
In a recent study from our Clinical Research Team published in peer-reviewed journal Frontiers in Digital Health, they found that across all four of our programs, adults over 65 surpassed adults between 35-64 in their engagement with the Lark digital health platform, evidenced by a significantly larger median number of coaching conversations, meals logged, and device measurements across all programs. This evidence counters the perception that older adults struggle to adopt new health technologies, and is encouraging for the future of chronic care innovation.
Most of Lark’s Diabetes Prevention Program (DPP) users reside in federally designated Health Provider Shortage Areas, meaning they lack meaningful access to primary care. Only 7.6 percent of those users would be able to access a traditional in-person DPP in their zip code, and Lark is bridging this gap and making this gold-standard clinical intervention more accessible directly through their smartphones.
For example, in a study of Lark Diabetes Care, our members with a starting A1c of 6.5 or higher saw an average 1.1 percent reduction in A1c over six months. Reducing A1c levels by even one point has demonstrated annual cost savings of $1,200-4,100 per patient, according to a study by NCQA.
As we see it, we need technology that can easily be scaled, because there’s just not enough doctors and nurses in the world to address the chronic care needs in this country. The healthcare system is also currently built for infectious disease treatment and acute care needs, but doesn’t have the infrastructure to handle the more constant, routine care required for chronic conditions.
We have to have AI solutions to manage the day-to-day, repetitive, but hugely important care. That gives people personalized attention, while allowing doctors and nurses to practice to the top of their licenses, handling the acute, time sensitive, or more complicated issues.
To the extent that they can positively impact care coordination, care management, and connect disparate pieces of our currently fragmented health care system, “big tech” players can play an important role in improving the care ecosystem moving forward.
Our key goal is to provide accessible, affordable chronic care to anyone who needs it, so we’re excited about the potential for some of these larger tech entities to support that mission in the future. Just like our work with health plans, we’re interested in finding ways that our scalable chronic condition prevention and management solution can integrate with existing tech infrastructure to streamline the healthcare experience for patients, providers, and plans.
What makes Lark truly innovative is that we accomplish scalable engagement while working seamlessly within the existing technology, infrastructure, and workflows that drive the current healthcare ecosystem. For payers and employers, this creates a frictionless experience they can deliver. Rather than directing people to an outside point solution, Lark reduces fragmentation in care and creates a better experience for users, making it easier for them to take charge of their own health.
Additionally, rather than reserving the data collected from users in an information silo, as part of its integration with health plans and employers, Lark provides them with data and individual-level information to help drive the appropriate care to the right people, and create a more personalized experience for the user.
I also had to learn how to trust in the team that we built. It’s hard to give away some of that control, particularly early on as you’re bringing your idea to life; but it’s so important when you’re building something so big. If you hire talented team members, you have to trust that they’re bringing their best ideas and approaches to the problem-solving table, and in the end that kind of collaboration actually results in a better overall product and design.
I think one trait that helps drive my success is my optimism and belief in the power of technology for improving the health care experience. That has helped carry me through tougher times, and also helped me grow my confidence in myself, which is an important skill to develop as a woman CEO and co-founder in the VC-funded startup space.
For me, centering compassion is also very important to Lark’s mission. Both in terms of the care we deliver to our users and in the culture of our company. As someone with a chronic condition, I understand deeply how much of a difference compassion can make for someone’s healthcare experience. We try to bring that ethos to everything we do – from creating a positive team environment and fulfilling work experience, to delivering meaningful care that can make a difference in our users’ lives.
I truly believe that we should provide unlimited, personal, high-touch chronic care and health counseling to anyone who needs it—regardless of their socioeconomic status or their geographical location, and whenever or wherever they want it. Everyone should be empowered to take charge of their own health journey, but that requires giving them access to the tools and support necessary to change behaviors and stay physically and mentally healthy. I feel very fortunate to be working every day towards that goal, and am excited about future collaborations that will enable us to help more people stay healthy and well.