reminders of bills about to come due, pretty color-coded charts illustrating the user’s progress toward financial goals, and personalized advice on ways to save money. He says he figured that if he could get users to enter some of their own health data, while grabbing the rest from pharmacy and medical lab databases, he could build a kind of health dashboard for average consumers.
Google opened up the service to great acclaim in 2008. But while it generated a lot of discussion in the healthcare industry, it never collected enough users to make it an interesting business. “It became clear to me at Google that nobody would want this,” Bosworth says. “There was nothing actionable in it. You pull the data together and you just feel confused and stupid.”
And there was another problem with Google Health: co-founder Larry Page, now the company’s CEO, didn’t like the idea. “At Google, you are free to build something Larry wants, or to leave,” Bosworth remarks. He hastens to add, however, that Page is “an extraordinarily smart guy, and in all fairness he turned out to be correct.” (Google announced this summer that it will pull the plug on Google Health on Jan. 1.)
Bosworth left Google in late 2007 and started thinking about how he could improve on Google Health. At the time, he was still enamored with the Mint.com approach to personalized data visualization. And he was absolutely convinced that Web-delivered health advice could help blunt long-brewing public health crises around conditions like obesity, diabetes, heart disease, and depression.
“Back in 1985 there was no state in this nation which had more than 10 percent obesity,” he notes. “As of 2005 there was no state that had less than 20 percent, and many that had more than 30 percent. If you want to understand why we have twice the healthcare costs of other industrialized nations, some of it is due to inefficiencies and inequities in how we deliver care, but most of it is just due to the fact that we are fatter than anyone else.”
Bosworth co-founded Keas in 2008 with George Kassabgi, the former CEO of Boston-based security software firm Bit9. With funding from Atlas and Ignition, they set out to build a system that would send consumers Mint-like text messages and e-mails containing reminders and advice tailored to their personal health goals, such as controlling high blood pressure, cholesterol, weight, stress, or diabetes. The company lined up healthcare providers such as the Joslin Diabetes Center to help design the care plans, and it built an elaborate software back end—“this huge platform with APIs and tools and all sorts of mission-critical control and deployment models”—to serve them up, Bosworth says.
Keas rolled out the technology in October 2009. But within months, a couple of big problems became apparent. First, consumers weren’t willing to pay for the care plans. To get around that problem, Keas began marketing the technology to employers—especially big, self-insured companies with a vested interest in improving the health of their workforce and thus lowering healthcare costs over the long term. Pharmaceutical giant Pfizer was one of the first to buy in.
But the second problem was more vexing: employee participation in the plans would start off high and then drop drastically. To illustrate the point, Bosworth grabbed a marker during our interview and drew a cliff-like curve on the conference room whiteboard. “It became clear we were not going to
