
Launch HN: HealthWiz (YC S17) – Navigating health benefits to lower costs - Yertis
Hi HN — My name is Nate Fox. Along with Nate Maslak (Nate^2), I am one of the cofounders of HealthWiz (<a href="https:&#x2F;&#x2F;www.myhealthwiz.com" rel="nofollow">https:&#x2F;&#x2F;www.myhealthwiz.com</a>) in the current YC batch.<p>HealthWiz guides employees to convenient and cost-effective healthcare decisions and lowers healthcare costs by eliminating wasted spend. We help users understand what’s wrong and how to get better quickly and cost-effectively.<p>While lowering costs frequently means taking away benefits, we do the opposite — we bring transparency and information to a messy healthcare system that allows employees to better navigate their benefits, resulting in less wasted spend and a faster return to health.<p>This is personal for us. When Nate Maslak&#x27;s mom needed to find a doctor for joint pain, she went to one physician, then another, then another. Six months and thousands of dollars later, she still wasn’t better and gave up on looking. Nate and I found it ludicrous that despite all the information available to us, healthcare remained opaque and intimidating.<p>Without HealthWiz, we have to scour the web for (often biased) information for what’s wrong and take our best guess at how to find treatment, only to be shocked by the bill. Our goal is to help you triage your symptoms with AI and access the most convenient ways to get better while knowing the cost in advance.<p>We’d love to get your feedback on the product (i.e. would you want your employer to offer this?) and look forward to discussing the nitty-gritty of just how we do all this, if people are interested!
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rcarrigan87
Really like the product and idea. Tools like this are the future of the
internet. For problems/questions where a decent answer requires multiple
inputs from the user, Google doesn't cut it. I think you'll start to see this
AI driven, decision tree logic applied to a ton of complicated questions in
the near future.

Your go to market strategy is exciting also. Health care can be a terribly
frustrating industry to start a business. Best of luck!

~~~
Yertis
Thank you for your kind words!

And agreed on the trickiness of starting a business in healthcare. Many
factors that drive economics/incentives/needs, and requires a lot of thought
toward thinking how to best align many different interests. Definitely helps
to be mission driven!

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anmaslak
Hey everyone - Nate Maslak (Nate #2) here! Excited to get your feedback on the
product and answer any questions you might have.

~~~
Yertis
Definitely not #2!

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vrchen
Cool idea! Went through the "check symptoms" channel and came across a few
things...

(1) Generally slightly more scrolling than I'd like. I'm on a MBPro 13" and if
I have more than 1 symptom then I have to scroll down to see what they are
(should I decide to remove some).

What does help is that the "Possible Matches" button is just high enough for
me to not have to scroll to notice it pop up. Something to keep an eye on if
more things get added to this page since it'll be important for users to know
when the questions they're answering are leading to possible matches.

(2) Clicking "X" to remove my single symptom brings me back to the check
symptoms starting point. This makes sense, but I noticed there's a message on
that page that says "Something went wrong in the browser -- please try again."

Would suggest only having that error message appear if user got there because
of an actual error (seems to be a result of reusing a page for multiple
purposes).

[https://www.myhealthwiz.com/symptoms?status=restart](https://www.myhealthwiz.com/symptoms?status=restart)

(3) Got to this question: "Do your symptoms begin during your period or a few
days before?"

But the options were Yes, No, and Don't Know. Doesn't really match what the
question was asking.

[https://www.myhealthwiz.com/healthwiz_symptom_question?gende...](https://www.myhealthwiz.com/healthwiz_symptom_question?gender=F&age=28&present_symptoms=s_1190%2C&absent_symptoms=%2Cs_1192%2Cs_59&unknown_symptoms=&question_counter=2&null_q_count=2&originals=Back+pain)

\----

Otherwise, great work! Here are a few things I really liked:

\- Being able to see the original symptoms I added and the option to remove
them

\- Seeing potential matches appear as I answer clarifying questions

\- Estimates of options (Online Doctor, Visit, etc.)

~~~
anmaslak
Thank you for going through the product and for the comments, incredibly
helpful! (1) Agree with your feedback (amazing how obvious it is now that you
point it out). We'll make the containers around the inputted symptoms shorter
to give more room at the bottom of the screen; (2) That's just bad UX, sorry
about that! We'll get right on updating that; (3) You're 100% right, that is a
weird question for the tool to ask for Back Pain... we're looking into what
triggered that question and what condition the system was confirming / ruling
out.

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toomuchtodo
Have you considered working with [https://watsi.org](https://watsi.org) to
offer this directly to patients in the third world who might have no other
alternatives (check symptoms/research conditions features)?

~~~
Yertis
We just digged a bit to learn more about them; WOW, what an amazing
organization and mission!

A lot of the tech we've built is focused on integrating with US insurance
plans, but we have been starting to get asks from some of our clients about
offering our solution in other markets as well, so we can definitely see
efforts like ours expanding internationally. In the short term we're focused
on serving US companies who are struggling with rising healthcare costs, but
perhaps there's an opportunity to partner on the tech related to things like
our symptom checker and condition content.

From a mission standpoint of helping _everyone_ get access to better
healthcare, that's something where we definitely align strongly. We'll reach
out to see if they might find any of our technology useful -- would be an
amazing partner!

[edited for grammar + expanding on a point]

~~~
toomuchtodo
Appreciate it!

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shimon
You're working in an area that has tremendous room for improvement. The giant
in this space is Castlight Health.

How do you guys differentiate?

Are you targeting a specific market? (Geographic, specific health plans,
procedures, etc.)

Who do you need? (Payor partners, employer types to test with, ...?)

~~~
anmaslak
Thank you for the smart questions. We are focused on a specific market of
midsize employers (frequently self-insured). Our goal is to help employees of
our clients navigate the full point of healthcare in a way that is scalable.

Many companies in the navigation ecosystem today provide call centers that
members/employees can call to get help. Unfortunately, these models have a
hard time scaling to the midsize market -- our tech solution is able to scale
for this market.

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physcab
This seems like a cool product, but I'm not sure if I'm either
misunderstanding how to use it or it is wildly inaccurate. I started off the
questionnaire for shoulder joint pain, went through about 20 questions. the
only one I answered yes to was "Does the stiffness in your joint feel better
after exercise". The condition results were "Common Cold, Match: Very Low". I
expected that maybe it might give me a list of chiropractors or physical
therapists that specialize in sports medicine in my area, but I was definitely
surprised by this outcome.

~~~
Yertis
That's a poor result on our end -- we're building the feature that you
described so that we're more on point when we have a low match like that. And
the sad part is we actually do have national coverage of physical therapists,
so it was a lost opportunity to get you to that next step.

If you're interested, would love if you tried the next version that we're
working on. Our goal is that it will be able to better handle cases like these
(which happen about 10% of the time right now -- which is a lot and in our
minds leaves a lot of room for improvement.)

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victoriasun
Cool product! I have two bits of UX feedback:

1) in step 2, after you click on Yes/No/Don't Know, there isn't enough
feedback in the product that indicates that you successfully answered the
question. I originally thought that the web request failed to send and didn't
notice that the two questions presented were different.

2) When does a person ever reach step 3? It doesn't appear to be the case for
me, you can circumvent reaching step 3 thru the possible matches. I think this
is misleading and confusing.

~~~
Yertis
Thank you for the kind words and the helpful feedback! On your points:

1) That's a great point -- we should make that more clear that the user
answered the question (and not seem like its broken if the questions are
similar)

2) The way it currently works is we wait until the symptom checker has reached
high enough confidence to render the results. Sometimes this can take 15+
questions, which we've found to be frustrating to the user. So we've designed
the tool to give the user lots of ways to exit the symptom checker toward
taking action (learning more about a relevant condition, or getting help to
find a doctor, etc). To your point, I think we definitely need to make it
clear that step 3 isn't the goal per say -- that there are multiple ways to
exit the tool, and it's not just only answering enough questions to get to a
high enough level of confidence

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gwintrob
Looks pretty cool! It's hard to know what to trust on WebMD and all of the
other links at the top of search results.

Quick heads up. I tried filling out the example you listed "strep throat" and
got the error "Sorry, we do not have any results for "strep throat""
([https://www.myhealthwiz.com/condition_search?query=strep%20t...](https://www.myhealthwiz.com/condition_search?query=strep%20throat))

~~~
Yertis
Thank you for flagging that! We'll get onto fixing that UI/UX issue.

In the short term, if you click on the autocomplete results or select any of
them, it'll bring you to the content page. (See here:
[http://imgur.com/a/XFdOg](http://imgur.com/a/XFdOg))

Also in the meantime, the link to the Strep Throat article is:
[http://www.myhealthwiz.com/condition_overview/101558](http://www.myhealthwiz.com/condition_overview/101558)

Again, thank you so much for flagging!

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jtwiegele
You guys are going to save so many people from misdiagnosis on webmd! Love the
"check symptoms" feature and a user interface. Would love a little graphic
that shows how far I've gone in the self-diagnosis (so I don't think it's
going to go on forever). Love the product and the UI! Simple/beautiful/sleek.

~~~
jshevek
I agree with the idea of feedback on how far you've progressed - though a
linear graphic might not be possible. I assume we are navigating a tree whose
depth varies greatly with your answers.

After a particular selection you might have tree of max depth 10, but with the
other selection you land on a tree of max depth 5, for example.

Personally, I've love to see a list of the conditions whose probabilities are
increasing and decreasing with each selection. This may not be suitable for
the average consumer, but it would be very educational! And also fun.

~~~
anmaslak
We've gone back and for the with the idea of showing the probabilities across
the matches.

Ultimately, to your point, we learned that at times it can scare users more
than it can help them (e.g., if a condition goes from 0.5% to 1%)... not to
say that we can't do that above a certain threshold.

We'll keep testing this. Is there a certain minimum probability you'd want to
see before seeing a condition (e.g., if something is 1% matching vs 10% vs
70%)?

~~~
Retric
It's a question of risk vs downside. Pulmonary embolism for example is deadly
and can look like a lot of more common things. Which is why it kills a _lot_
of people every year.

~~~
Yertis
This is a great point -- weighing false positives against false negatives/true
positives/false positives is something we think about a lot. It's really
important to get this right.

This is why, at this stage, we have a strong bias towards guiding people
towards the _right_ care provider rather than trying to replace them; it's
more of an aid rather than substitute. One example of this is how some of our
users have used the symptom tool with joint pain, and its helped them figure
out that they should see a rheumatologist, who was then able to guide them
towards the right care to treat their particular version of arthritis.

It's smart care providers like that that can really deal with the nuanced
cases and make sure people minimize the risk that they miss things like a
pulmonary embolism.

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bberenberg
Attention deficit hyperactivity disorder

Bladder infections, also known as Urinary tract infections (UTIs), are common
infections that can affect the bladder, the kidneys and the tubes connected to
them.

[https://www.myhealthwiz.com/condition_overview/100156](https://www.myhealthwiz.com/condition_overview/100156)

:)

~~~
Yertis
Hah! Thank you -- Condition summary string got mis-mapped we're fixing that
now.

~~~
Yertis
Fixed!

"Attention deficit hyperactivity disorder (ADHD) is a group of behavioural
symptoms that include inattentiveness, hyperactivity and impulsiveness."

Just a little bit more on point ;)

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danielamitay
I haven't started a company that needs to provide employee healthcare--does
this have a short-term improvement to insurance rates? What incentivizes a
company to employ HealthWiz--are there insurance providers that reduce rates
as a result?

How do you convince employers that this service is in their best interest?

~~~
shimon
In the US, employers ultimately shoulder much of the burden of health care
costs, so a tool that helps employees make cost-saving choices _eventually_
saves money for the employer.

However, that's a very indirect path. Most employers use a separate insurance
carrier (Humana, Blue Cross, Cigna, etc) and adjust costs on a ~yearly basis
by shopping around. HealthWiz would probably love to go to market by
integrating with these insurers, and offering an incentive to employers whose
members make use of the HealthWiz product to save money.

That's a tough way to go to market because you have to convince an insurance
company to trial your thing with their customers. Insurance companies have
deeply risk-averse cultures. Plus you have to actually achieve significant
cost savings for individuals who use HealthWiz, and wide enough usage
throughout the employer, to make the insurer comfortable with offering a
discount for that population.

Two other potential markets are self-insured employers and accountable care
organizations. Self-insured employers are companies (or often, government
agencies) huge enough that rather than paying an insurance carrier, they just
operate their own, and pay for healthcare directly. These folks feel the costs
a little more urgently and may be easier to pilot with.

Accountable care orgs (ACOs) are a relatively newer model, where the ACO
operator (usually a hospital/health system) receives a fixed per-person amount
to address all the health needs of a population. These orgs are probably the
most informed about both cost and medical needs, and are making real strides
in long-term cost saving measures like improving preventive care. But because
they're so different from insurers and employers, they'd probably need a
somewhat different product, likely one that maintains the primacy of their
brand (and maybe doesn't do things like suggest that cheaper hospital a few
miles away).

~~~
anmaslak
That's a great assessment of the space! We're focused on the midsize self-
insured market for that very reason. The incentives are closely aligned.

For example, ERs frequently take in patients hoping to get a UTI treated. Much
of the time, the right treatment is a prescription. But, going to the ER to
get the diagnosis can cost ~$2K (split between the employer and the employee)
and take as long as 12 hours of waiting in the waiting room.

In this case, if a patient uses a telemedicine provider for the same service,
they're likely to get the same diagnosis and prescription but the visit will
cost ~$50.

The nearly $2K in savings would go to both the employee and employer, the
employee saves money and is able to get treatment faster.

------
shazam
I have a neck fracture and after answering 25 questions it said I have a
'thoracic aortic aneurysm'

~~~
Yertis
Unfortunately our tool doesn't get it right 100% of the time. The cases like
this where we miss, we try to encourage the user to find a healthcare provider
when the tool falls short. Fortunately, the models always learning -- but it's
still got a long way to go.

We're releasing a new and improved version of the symptom tool next month --
if you're interested, would love to have you try it once it's ready!

And sincerely sorry to hear about your neck fracture. Best wishes from us that
you're getting great care for an as quick and painless recovery as possible.

[edited]

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bradknowles
Hmm. Doesn't seem to work very well in iOS.

Have you tested this page for mobile users?

~~~
anmaslak
Sorry to hear it didn't work well for you on mobile! We do test on mobile /
iOS but seems like we didn't do a good job on this side - we'd love to learn
more about what wasn't working well so we can work on that.

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JessOpearlo
Can you talk more about what data you used to build you AI

~~~
Yertis
Absolutely! We partner with a few API providers who are experts at building
the logic that drives the symptom checker, and then build our own layer on top
of that to make it as user friendly as possible.

As for how the AI itself specifically works, given the data it has on the
stated symptoms (Fever, Sore Throat, Chills, etc), it has based on prior data
a best guess of the top conditions correlated with those symptoms.

Then, it asks a question that can help inform its calculations, which has
simple boolean answers (True this symptom exists, False it does not exist).
Then, the ranking of conditions updates, and the API responds with the next
symptom it is curious about to drive towards a smarter diagnosis.

[edited for grammar]

