Michael Eisenberg:

The story of Healthy.io actually starts with your mom. 

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Yonatan Adiri:

That's true. 

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Yonatan Adiri:

How and why did Healthy.io get started? 

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Yonatan Adiri: 

My parents were at the point where my dad was kind of already figuring out how to close shop, and they were in China. We get a call, actually my oldest brother, which again, it's a hierarchical family–my oldest brother, he gets the call from my dad, that's how things are done–my mom fell, she was pretty badly injured, lost consciousness for quite some time. They're now hospitalized, he feels everything is fine. They want to fly them out to Hong Kong in a couple of days. And they think she broke a couple of ribs, but he kind of feels that's not the case. So, having worked with Peres, we always had trauma doctors with us.

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So I had on my speed dial some of the best trauma doctors in Israel. When my brother told us the story, I said, “Put Dad on the line immediately, I want to hear from Dad.” And he said he has CT scans. Luckily, by the way, they bought an iPhone 4, their first smartphone, before leaving. So I said, do you have your iPhone 4 with you?

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“Yes.” “Just take pictures of CT scans and send it by email.” And I send it out to a couple of those trauma doctors, who are like, “Oh yeah, that's very clear. She has, you know, a punctured lung. And so she can't fly for the next few days, definitely on a medical flight, because when they take off, her lungs can collapse. Like she could literally die.” 

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I was like, “No, she's flying. She’s supposed to fly the next day, like on a commercial flight to Hong Kong.” They’re like, “No way. She's not flying.” Hang up the phone. Obviously, we take care of it and whatnot. And suddenly, I'm like, wow. Is it possible that between the smartphone camera, the CT scan, knowing some people who are kind of–by fluke, right?

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So if you kind of remove one of these things from the equation–no camera on the phone, no phone, no bandwidth–she may have died, right? Like, this could have been, like, a horrible outcome. And that got me thinking, and I started kind of plotting. You saw that deck. This was later called, by the economists when they wrote about us, ‘the people who dreamt and created the medical selfie,’ right?

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So, you know, in a way, that was kind of the vision. 

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Michael Eisenberg:

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Your mom invented the medical selfie. 

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Yonatan Adiri:

My mom invented the medical selfie, for sure. 

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Michael Eisenberg: 

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Today, I'm really excited. I'm here with Yonatan Adiri, who's the founder and CEO ofHealthy. io and most importantly, he's married to Maureen. We here at Aleph are investors in Healthy.io. And I would love for you, Yonatan, just to give your brief, one second background on who you are, and then I'll dig in some more. 

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Yonatan Adiri: 

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So I think you started off with the most important thing. So I'm married to Maureen. It's been now, 15 years. And she made “aliya” from Switzerland. We have four kids, so a father of four.

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I'm also the youngest of four. But in my case, it's only boys, the youngest of four boys. Born and raised here in Israel, grew up outside of Tel Aviv, and then joined a school in a certain program that allowed for us to take our undergrad while we were in high school. So I never graduated high school, left that piece behind me, had a very unique military service for about five years.

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And then–

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Michael Eisenberg: 

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What did you do in the military? 

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Yonatan Adiri: 

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So this was a very interesting period–I grew up in the late 90s, you know, those were the Oslo years, delegations of Palestinians, the disengagement from Lebanon, where two of my older brother's friends died when we were there for 18 years.

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So we were thinking we were the peace generation, and then we ended up with five years of a very difficult period, suicide bombings and so on. So I joined the army in the end of 2000, and was given a very unique task of being the Chief Negotiator for the army and the Red Cross. This was a period where three angles–like, international law was being rewritten around, kind of, modern warfare.

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Israel was deploying so much tech into trying to figure out what to do with suicide bombers. And so this was like, watching life on speed, right? And the third was that the entire diplomatic space around what can and cannot be done was also affected by 9/11. And so five years, really, at the forefront of those three fields.

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I then spent a couple of years in the US on research of this specific topic, and then was very fortunate to come back and this was, you know, for me, the pinnacle of my career in the public service, was to serve as a CTO or the diplomatic advisor to the president of Israel. 

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Michael Eisenberg: 

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Who was that?

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Yonatan Adiri: 

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Shimon Peres. 

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Michael Eisenberg: 

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Shimon Peres. 

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Yonatan Adiri: 

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Which is true. You're right. I mean, it's not just a president. It was a privilege to work with a person–I had some White House counterparts who said, “This is like, you're like working with William Jefferson,” which is true, right? Like it was a very, it was a true privilege.

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He was 86, I was 26 when I joined. So 60 years between us, but I can say, you know, and things pertain to sort of, you know, our conversations about tech and where it's going. The guy was 86 years old, never opened a computer in the modern era, right? Facebook, Twitter. But in ‘09, his vision of where the second decade of the 21st century is going to go in terms of exponential growth of tech, what it's going to do to politics, what it's going to do to society, to our conscience, I mean, even in hindsight was so accurate, in ways that many other leaders who we've met worldwide, who were more, I would say, tech savvy, lost touch with the arc of what tech is going to do to the world. 

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Michael Eisenberg: 

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How do you explain that? 

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Yonatan Adiri: 

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Well, I think he was always, and he kind of, his history is the same way. And for me, the most fascinating decision-making process he went through, the defining episode in his life was not Oslo, was not the nuclear facility, all those things you read about in books.

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And I spent many hours with him on what he did in ‘85, where the country was at 410% inflation 6 weeks ahead of a default on its debt. And he redefined–he's one of, for me, the kind of, most impressive heads of state of the 21st, or the 20th century, that is, in terms of the ability to see a crisis coming, and using it to redefine the core, kind of, values of how the state is built. People think it was an economic restructuring. It was far more profound. And so, in everything he did, he managed to kind of see the noise. And, you know, there's a lot of technical things you got to fix. But he always was looking for the Archimedean point, right?

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What is the one or two things I can do? Knowing that political capital is very scarce, right? So if you have political capital, don't spend it on, like a 20 percent reform incremental–just go and hit, kind of, the nail on the head. And he had the same vision with regards to tech, I think also, when you're a curious person, the way that he was naturally, and you'd lived through the 50s, you know, what happened in aviation and then what happened in space, you kind of, and you co-founded the State of Israel, you're like, you know, everything is possible.

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So there was no limitation to his imagination. 

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Michael Eisenberg: 

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What was more profound about the reform in 1985? For those who don't know, Yonatan mentioned that there was 400 plus percent inflation in Israel. You literally walked in with a stack of bills to go buy milk and it wasn't enough. And, in addition to that, it's a year after a big bank fraud crisis here.

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It was called the North American Bank in Israel and a bunch of unstable governments as well. So what was more profound about the change from a systemic level? 

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Yonatan Adiri: 

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So I think what he identified as an opportunity to go back to the basic level and rewrite, like, the force of the magnitude of the crisis was so profound that he did not want to waste the political capital on, and I think what he identified, and, you know, we've had many hours of conversations around that, was a transformative process. It was worldwide. Remember, this is a couple of years after Thatcher in the UK, kind of–”Well, we've had 30 years post World War II. This isn't working. We're not a British empire.

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We're not going to make small reforms because they're not going to do, we're going to go to the core,” right? Same with Reagan, Volcker, end of the ‘70s, same with Deng Xiaoping in China. So, Peres was inspired by that. He saw the imminent collapse of the Soviet Union. This is 1985, right? And the peace with Egypt that happened a few years earlier kind of got him to the recognition that the operating system, if you will, of Israel, 1947 throughout 79, 80, it's just not working anymore. The paradigm, you know, we're at the tail end, the 1985 crisis was not an economic crisis, it was a crisis of an old paradigm, a couple of numbers and figures, right? The Israeli economy was–75 percent of the GDP was publicly owned in 1985, right? 

Michael Eisenberg:

Yeah, publicly owned, government owned companies, the public sector.

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Yonatan Adiri: 

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Yeah, the public sector basically, right, owned 75 percent of the economy right? As we said, 410 percent inflation ended up kind of as a result of that.

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Michael Eisenberg: 

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Just to say, state the obvious is that, part of the reason is that all the government wages were linked and all these individuals linked. So they had unionized–you tripped one person's salary, and you tripped the whole system's salary up to the top. 

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Yonatan Adiri: 

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My father had a truck electricity garage for 50 years. He was one of the, he was one of the quarter of the population who was entrepreneurial, and kind of a self made man. He immigrated here from Iran in the early 50s. And it was very peculiar to him, in hindsight, when I had conversations with him, he–you know, ‘Soleil Boneh,’ one of the biggest construction companies in Israel, was publicly owned.

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So every employee at Soleil Boneh– 

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Michael Eisenberg: 

‍

Publicly owned does not mean IPO, like, public markets owned. It was owned by the government. 

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Yonatan Adiri: 

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Owned by the state. State owned, I should say. Right, state owned. State owned. And so, drivers of trucks would come in for like, you know, months and months. And he would be like, “Oh, the prices went up,” and they wouldn't care. And at some point he's like, “My supply chain is going up, I'm trying to figure all this out,” right. And you know, he didn't have more than basic education. You didn't go to university, didn't have that privilege, how to figure out, you know, PnL, and how do I plan and so on?

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And he's talking to people and they're like, “I don't care. My, you know, my salary is linked to the CPI, right? So I don't really care.” And by the way, a couple of his really good friends, one of them committed suicide because his business collapsed because he just couldn't handle, you know, the changes in supply chain and so on and so forth.

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So a really tough period. And I think going back to sort of where Peres goes, he kind of understands there are fundamental areas that really shifted from the last paradigm definition in the late forties. And I think he kind of assigns three fundamental working assumptions for Israel, which kind of worked really well until, call it a decade ago, right?

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We are kind of at the tail end of that. One, he identified this again, the imminent collapse of the Soviet Union as sort of, we won, we bet on the right horse, our relationship with the US with sort of the West–because remember Ben Gurion founded this country in a sort of schizophrenia, right–like, we're semi Soviet, socialist, we have a great relationship, you know, with that part of the world. And we're liberal, western democracy, so on and so forth. And he kind of tried to, also diplomatically, live in that space. Peres identified that that  has to stop. And that was one. 

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The second piece was a complete, I would say, liberalization of the economy and the fact that he was considering the fact that we had peace with Egypt–and by the way, if you kind of think in hindsight, it made a lot of sense, at least was the only army that kind of had the magnitude to threaten Israel–no existential threat, right? So a lot of decisions coming out, like, he fired 15,000 state employees in one week. That's the depth and breadth of that reform.

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And the third was what we can learn from the peace with Egypt is that, you know, land for peace works. So let's try to exercise this formula with, you know, the West Bank and in Gaza. So I think, you know, what he put in place in ‘85, yes, it was an economic reform, dollarization, for sure. But he actually used it as an opportunity to spend the political capital on the fundamental operating system and put in place a paradigm, for the first time since ‘47, which I think really served Israel incredibly well for 35 years–we're now at the tail end of that. 

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Michael Eisenberg: 

Right. We'll come back to that in a second. I just want to ask you one last question. What's the one thing you took away from your time with Shimon Peres?

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Yonatan Adiri: 

You know, he just, you know–when I thought I dreamed, I had a radical dream, it wasn't radical enough. 

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Michael Eisenberg: 

‍

He always dreamed bigger. Yeah, that’s the name of his book, by the way, “No Dream is Too Small.” 

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Yonatan Adiri: 

Right, No Dream is Too Small. Yeah. Like, I think, like, for me, the main learning from, from Peres was radical changes, they do happen. And not only that they happen, you can make them happen.

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And, you know, he was such a, in his age, sort of after that illustrious career, Nobel prize, whatever–he was a very subtle man to work with, very easy to work with. We had a great trust. And he was–so you could kind of see this, this famous Shimon Peres, 60s, 70s, 80s, like, you know, grit things that made him who you, who he was as a brand, right?

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But in conversations, when you would go in hindsight, you would, you would really realize like some of those processes–it's not only that he had an imagination, he literally made it happen. And part of the reason why he was such a hated politician is, when you go down to that level of the working assumptions of the system and you try to instill a new paradigm, it's painful, right?

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Thatcher was hated for many years, Reagan was hated for many years, and Peres was hated for many, many years. Because he went down into that fundamental level of, what is it that we're trying to get done here. And when you're touching that level, people dislike you. 

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Michael Eisenberg: 

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Some would also, I guess, argue that the land for peace paradigm in particular, you know, it, it affected a lot of people in this country. But we'll come back to that maybe afterwards. 

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Tell me about your parents. 

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Yonatan Adiri: 

‍

The best in the world. You know I'm very fortunate to have had parents who kind of, first of all, connected very well, intimately, in 50 plus years. And they still love each other, you know, kind of very dearly. And there was something very old school about the way they built their relationship and what they modeled for us, which was a sense of like, division of labor and parity at the same time, right?

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It was very clear who does what for us as kids. It was very clear, sort of who has, you know–my dad, you know, would wake up at 6:15, at 6:30 he made his sandwiches for work, at like 6:42 he would go out. I remember I used to joke with him when I would join him to go to the garage, he would, you know–this was before Waze–he would know, like, where traffic would hit, and he would kind of tag himself, so that he would change the radio. These were like old dials. He would change the radio from music, like GalGalatz, to Reshet Bet, to like talk radio at 7 a.m. sharp, and that would be like seven minutes before he opens the garage gate. Like, it was amazing. 

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He was a very kind of meticulous, routine, hard worker. He had a lot, like, you know, now he's almost 80 and we have a lot of, kind of, adult conversations. I realize how hard it was for him. The burden he took on himself to get out of the immigration camp, which is where he came from, coming from Tehran, one of the biggest cities in the world during that time, in the Middle East for sure.

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Yonatan Adiri: 

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What year did he immigrate to Israel? 

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‘51. 

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Michael Eisenberg: 

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‘51? 

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Yonatan Adiri: 

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Yeah. This is the Shah and Mosaddegh, you know, the big, you know, and 4,000 year history. And he ends up in a tent, you know, kind of town, shanty town in a way, right, near Ramat Hasharon for seven years. And he leaves, he leaves when he's about 14, 15, understanding, “No one's going to help me. Like I gotta, I gotta do something to pave a better future for my kids.”

So that burden of being a breadwinner was very, I mean, for us as kids, we didn't feel it. Now in hindsight, I kind of understand that he's, you know, it was, it was hard for him. And, you know, we learned work ethics from him.

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We learned, you know, I'll tell you a funny story. I went with him to the garage many, many months when I was, call it, eight, nine years old until 13, 14. And he would never let me do anything beyond running errands. I remember one summer he gave me a task. This is 4 p.m. The garage is about to close. These are big trucks, so there's a lot of, there are a lot of oil spills, right? At the end of every day, you need to clean. It's a safety thing. There's like shreds of paper or wood that you have to put on it so it absorbs it and whatnot. So he tells me, “Go and do it.” I'm, I think I'm 13. I'm so excited. My dad told me I can do something in the garage.

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I go, and I kind of pick it up, and he screams at me from the second floor where he was kind of having tea. “That's not how it's done!” And he comes down, and like, this was, you know, the most mundane simple thing, at least looking at it from the outside. And he tells me, “No, there's a way to do it. Look how you're doing it. Da da da da.” 

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So for him, everything was a profession for him. Everything is, there's a way, a proper way to do things. So I think for me, that was kind of tacit learning. He’s not a man of many words. 

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My mom was just infinite love. Kindergarten teacher. She always kind of gave us this feeling that whatever we do is great.

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Just let's just be good people, and I trust you that whatever you'll choose to do, you'll do great. Just like no pressure, do whatever you want. She makes fun of me, like when I was about five–and again, in hindsight, now having four kids, I have so much admiration for the way they did it, right? This was truly scarcity, and they built themselves up from nothing. I was kind of–she was asked by my kindergarten teacher to have me kind of diagnosed or whatever, right? And there was a young kids curiosity camp kind of thing happening in Tel Aviv University now. For her, at 4 p.m. right, with three other kids, and my dad coming from work at like 6:30, which he had to kind of be at home for–to drive with me, drop me off there, wait for an hour, and then come back, was quite a big thing to do that once a week. So we're going, and it was like an amazing quality time. 

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And then, Chol Hamoed Pesach. And I tell her, “Mom, next week, there's no class.” I'm five years old. She says, “Of course there is.” I'm saying, “Mom, there isn't.” No internet, like whatever. So she takes me there, drops me off. By the way, my kids are there also. And now it's like, it looks very small to me, but as a kid, I remember it being huge. This is like 1988 we didn't, we had like, public phones, pay phones, but we had ‘asimone,’ like a specific–

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Michael Eisenberg: 

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The token. 

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Yonatan Adiri: 

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The token! So I had that token here in my shoelace–

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Michael Eisenberg: 

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For those listening, in America, if you put, like a dime or a quarter, that's how you operate the pay phone. In Israel, it was asimone. It was a little, kind of silvery piece that had a hole in it, like you put them on shoestrings to kind of hold them on. So what Yonatan is describing that he would keep it on his own in his shoelace. 

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Yonatan Adiri: 

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Yeah. So that was my mom's, didn't own smartphones–that was my mom's kind of, if something happens, you know, we had to memorize my dad's garage number because it was always, there was always someone there answering. It was an easy number, 550 5040. Like I still remember it. And, you know, we had a drill. And so I said, “Mom, there is no class today.” She's like, I'll see you in an hour.” And she drives out, right? 

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You know, sure enough, I go in, there is nobody. Chol HaMoed Pesach, like literally nobody. So I walk around looking for someone to kind of help me, you know, call my dad.

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Like, in hindsight, I'm like, I'm totally cool. Like, I'm walking around, and I find someone, she's a very nice woman, I kind of take my shoelace off, and yeah. She gets into the payphone, she calls, I'm too, I’m not even tall enough, right? She says, “Hi, I have your son here, da da da,” and I'm totally cool. I answer my dad, and my dad's, like, impatient, in the garage, like, what's going on?

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So I'm like, “Abba?” “Yes.” And I burst into tears, “I don't know where I am, you have to let me know.” And I think, well, like, within less than 10 minutes he was there, and my mom says that from that point on, I would not–I would sort of guide my own path. And I have to say to her credit, you know, when people look at it, my kind of journey from the outside, it looks like an overachiever kind of thing, pushing, whatever. My parents always kind of, “Oh, that's what you think you should do? Great. So do it. You want to go to this university thing? Sure.” Even at some points, they tried to discourage me from doing those kinds of things. Just, you know, kind of just do the, do things the regular way, right? 

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Michael Eisenberg: 

My mom used to say that at Friday night dinner, that she prayed she would have mediocre children.

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You probably heard this from my mom, because the line between excellent or genius and crazy is really, really thin. 

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Yonatan Adiri:

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My dad, you know, when we joined the army, all of us got the same story from him, like, cause he was in the Yom Kippur War, and he had like dreadful stories. And it was like, you know, when you go to the army, like never volunteer, don't be at the beginning of the line and not like, like–this mediocre, like excellent people in the army get killed.

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That was kind of, and it was for many years, it was kind of his thing. Like just, you know, play it safe. Right. I came out of this like, camp. ‘I, you know, Mom and I are taking care of the education opportunity for you. Get a job. A steady job.’ And this is important because I never thought of myself as a person that would go outside of public service.

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I always thought of myself as kind of having to serve, right? Having a job and having to serve. Ideals. And when my mom was 60, it was like 15 years ago, we sat together and it was like, we were joking because all of us found out that he told all of us the same thing. We never talked about that. And, and we asked our mom, like, “how is it that that was, what dad would verbalize, right? But we all felt that we have to do things in a certain way.” And she said, “You know, what you'll find out as parents,” and she was spot on, “Kids don't listen to you.” 

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Michael Eisenberg: 

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Yeah. 

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Yonatan Adiri:

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“They observe you and what you do, by example, that's what they pick up, right?” 

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Michael Eisenberg: 

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Or they rebel against what you tell them.

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Yonatan Adiri:

Exactly. Yeah. Which is part of that problem. But, you know, so I mean, having known your mom also, like she personifies not a mediocre person, right? So she can wish for– 

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Michael Eisenberg: 

‍

No, my mom is not a mediocre person. 

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Yonatan Adiri:

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That's what I'm saying. So she can wish for–but what she personifies is something different. And that's what kids kind of follow, and I have to say, sort of as an officer in the army, and then as a, as a founder, you lead a lot of people, and you try to kind of get them to cross a chasm, to cross, to close an imagination gap.

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You work with heads of state, or with investors, or with regulators. This notion of nothing comes easy, you know, just to be very diligent and, you got to personify what you believe. Otherwise, you can't fake people's people in large numbers see that. 

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Michael Eisenberg: 

‍

Like, like you said, especially with those very difficult investors, that's–so, the story of Healthy.io actually starts with your mom.

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Yonatan Adiri: 

‍

That's true. 

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Michael Eisenberg: 

So how and why did Healthy.io get started? 

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Yonatan Adiri: 

‍

Well, I think, you know, the real genesis of me even believing I can start a company happens a year into my service for President Peres. There is an experimental teaching experience hosted at NASA Ames in Mountain View called Singularity University, where a group from MIT dedicates about a hundred days over the summer to teach people–this was 2009–that the second decade of the 21st century is going to see Moore's Law all over, right? And after a year of building this idea of tech, diplomacy, whatever, the president asked me to apply to this thing. He’s like, “I think you should go because we can then kind of understand things in a different way and try to build a better diplomatic, technological kind of vision.”

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So obviously, you know, I go there. And I'm blown away, right? Like this idea that comes natural to you as an investor and a man who'd seen a lot of that. The notion of switching from a linear to an exponential mindset was very foreign to me. Profoundly, right? I understood it, like, graphically, but…and in our dorm room, we started a company called Getaround.com. Which was, you know, kind of the pioneer of peer-to-peer car sharing. 

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So while I have no claim to fame in executing on the company, but I was really there when we built the idea and was on, you know, the, the kind of founding team, and then I came back to serve the president and I'd met Maureen, which I still, you know, I knew I wanted to marry her.

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So I think for me, it was very clear, I'm not staying there. I'm coming back. The privilege of serving under Peres was just too big. And knowing that I want to marry Maureen, who made Aliyah, she's not going to want to go to Silicon Valley. Like this is where we're going to build our family. That was, for me, a mindset shift that maybe I, maybe there is a possibility that, you know, I'm not a doctor, I'm not an engineer, I don't write code, you know–I come from the kind of policy space–that I could really change the world. Because if exponential tech is a reality, and the law of accelerated returns, right, like it's going to be cheaper to get things done in a global magnitude, then, like, can I really build a company? Can I really not just be the advisor to or in public service? Can I really get it done? 

‍

So the seeds were planted at Getaround and at NASA. Fast forward, you know, three years later, I decided I'm leaving public service. I decided the decade ahead, since I am committed to, you know, the ongoing beta, which is Israel, right?

‍

I asked myself a question: “How do I serve my country best?” You know, into the third, you know, fourth decade of my life. Do I kind of take the turn and become a young member of parliament? which kind of, I had an interesting couple of opportunities to do that. And kind of, you know, designate myself as a forever political kind of whiz.

‍

Michael Eisenberg:

Hack. 

‍

Yonatan Adiri: 

Hack. Yeah. 

‍

Michael Eisenberg: 

‍

Maybe you'll be a whiz. I think you could have been a hack. 

‍

Yonatan Adiri: 

For sure. Okay. Or do I really take the turn where I can fail and try to go bottom up and build a company? And there's a reason why I ended up in healthcare, which is in hindsight, you know, quite a tough one.

‍

Because it was very close to public service in a way, right? Like the good we made in the world at Healthy. The million people, that's our benchmark from a couple weeks ago. The million people that used our AI to diagnose early that their kidneys are not working. That's a public good in a way, right?

‍

Like that's a dent in the universe that is meaningful to me. And that sort of served the purpose. And I made a decision, like, sure I can fail. And this may end up, you know, within a couple of years. And, you know, then I'll have to try and pick up the pieces and figure out where I'm headed. But if I really want to serve our–if I really believe genuinely that if, if people want to serve the country, they got to do stuff, they got to fail. They got to put themselves in a place outside of the political sphere, so they can learn business, job creation, technology, the things that really are going to define the 21st century, and they need to do it bottom up. 

‍

Michael Eisenberg: 

‍

Now tell me about your mom. How'd your mom start to help you start the company?

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Yonatan Adiri: 

So I decided to leave, and decided to do that, and was kind of ideating, was looking into things. I guess my parents were at the point where my dad was kind of already figuring out how to close shop. And they were traveling a month every year. And they were in China. Luckily, by the way, they bought an iPhone 4, their first smartphone before, before leaving. And we get a call–actually my oldest brother, which, again, it's a hierarchical family. My oldest brother, he gets a call from my dad. That's how things are done. He gets a call, my mom fell. She was pretty badly injured, lost consciousness for quite some time.

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They're now hospitalized. He feels everything is fine. They want to fly them out to Hong Kong in a couple of days. And they think she broke a couple of ribs, but he kind of feels that's not the case. So, having worked with Peres, we always had trauma doctors with us. It was, again, ‘86, ‘87, ‘88, ‘89. So I had on my speed dial some of the best trauma doctors in Israel.

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And I asked my dad–actually, not true. When my brother told us the story, I said, “Put Dad on the line immediately. I want to hear from Dad.” And he said he has CT scans. So I said, “Do you have your iPhone 4 with you?” “Yes.” “Just take pictures of CT scans and send it by email.” And the joke in the family was that my dad responded, “What is ML? What is this ML I need to do??” Because he was totally outside of, you know, figured out how to send, you know, Gmail, Whatever, he sends it out. And I sent it out to a couple of those trauma doctors, and they were  like, “Oh, yeah, that's very clear. She has, you know, punctured lung. And there's some pretty serious stuff going on there. They didn't do the right process, and so she can't fly for the next few days, definitely on a medical flight. Because when they take off, her lungs can collapse. Like she could literally die on the plane.” I was like, “No, she's flying, supposed to fly the next day, like on a commercial flight to Hong Kong.”

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They’re like, “No way, she's not flying. And one of you guys better fly out to China, spend a few days with her, so that then, you know, we can fly her directly to Israel on a medical flight.” So, we hang up the phone, obviously we take care of it and whatnot, and suddenly I'm like, wow. Is it possible that between the smartphone camera, the CT scan, knowing some people who are kind of–by fluke, right?

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So if you kind of remove one of these things from the equation, no camera on the phone, no phone. No bandwidth. She may have died, right? Like, this could have been, like, a horrible outcome. And that got me thinking, and I started kind of plotting. You saw that deck. I started plotting different areas of exponential behavior around smartphones. And I ended up with about six of them. 

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So one was obviously camera quality. It was clearly exponential. Knee of the curve was somewhere around 2015. It was very clear. This is 2012, 2013. Bandwidth? I mean, you just look at Netflix and you understand this dynamic is going to drive massive explosion of bandwidth, and by the way, we would pay 30 cents a text message in 2012, right?

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2016, it's like infinite bandwidth for zero, basically. Battery quality on the phone, bandwidth’s on the cloud. Like how do we get, you know, storage on the cloud, computation on the cloud, computation on the phone. They all kind of look the same, and they all converged around, if you kind of plot them well, around 2016.

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I was like, blown away, like what we just did in 2013, was a small–with an iPhone 4, you can do exponentially more. Again, going back to Peres, I'm like, dream big. We can go to the FDA. This is not some wellness thing we can do here. We can deploy AI on the phone. 

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Michael Eisenberg: 

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Did you call it AI then? 

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Yonatan Adiri: 

No, I actually called it, basically, computer vision.

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Michael Eisenberg: 

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Right. 

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Yonatan Adiri: 

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That was like the thought, right? State-of-the-art computer vision that would run on the phone, on the computation, on the phone, and would deliver on near zero cost bandwidth, images to the cloud and, you know, kind of decipher for medical grade, clinical grade. This was later called by the economists when they wrote about us, “The people who dreamt and created the medical selfie,” right?

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So, you know, in a way, that was kind of the vision. 

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Michael Eisenberg: 

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Your mom invented the medical selfie! 

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Yonatan Adiri: 

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My mom invented the medical selfie, for sure. No, but like, and you know, it's been a treacherous road, right? First of all, to raise capital was a nightmare because, you know, this was a very odd vision, right? 

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This is 2013. A lot of the kind of gaming apps are out there, very nice, you know, risk reward equations for investors. And here's this guy coming, saying, “I'm going to–” You know, there's a risk of creating apps. That's a certain risk. “I'm going to create a medical app without hardware. And I'm going to get you through the FDA.”

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And so nobody believed in that. And so, we went to like gaming and app funds, and people heard the name FDA and were like, “No way.” And then we went to folks dealing with healthcare and they said, “You're not going to get computer vision.” Like, it was hard for them to imagine what I saw happening in 2016, this convergence.

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Nobody believed in that, right? Nobody believed that that would–you can get to clinical grade, no hardware by then. 

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Michael Eisenberg: 

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It's not that there's no hardware, it's more that it's commodity hardware that was getting better on its own because, because of the cell phone, because of Netflix, because there was this kind of–

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Yonatan Adiri:

When I say no hardware, I mean the consumer or the patient does not have to buy or add anything to their phone, right?

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And actually it's a great–you're making a great point. Because at the time in the Valley, not in Israel, it was kind of the emergence of digital healthcare, and there were three kinds of verticals. One was wearables and it made a lot of sense, right? Price of hardware was cheaper, you can create great optics, chips, and so on.

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But, again, one of the things I learned from Peres, and again, we've had infinite conversations about that. When you draw an argument, draw it all the way to the end, right? If your argument is, I can do for 50 million what somebody did for half a billion five years ago, then draw it all the way to the end.

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It means that five years from now, somebody would do it for half a million. So how does that look like? And what do you got to do when, when these guys have, you know, Instagram has an incentive to make cameras better and better and better and better. So who's going to do that better than Apple or Google or, you know, or Samsung?

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So you're effectively saying, “I'm going to compete with these guys.” And you know, now we're north of a decade later, a million patients, north of 50,000 cases of dialysis averted in all the markets that we operate, because what we do is we allow people to test at their speed of life, right? Part of the crisis of healthcare.

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Last year, north of three trillion dollars spent in the U.S. Bigger than the GDP of India. It's the third GDP in the world, basically, healthcare spending in the U.S. bigger than the entire consumption of oil globally. 

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Michael Eisenberg:

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How many people need dialysis every year in the United States?? 

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Yonatan Adiri: 

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It depends. Now it’s about 750,000 people. 

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Michael Eisenberg:

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New people who need dialysis every year.

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Ongoing, right? Ongoing dialysis. Ongoing and growth. This is 135 billion, no 160 billion this year, 135 billion was last year, 160 billion cost to the American taxpayer every year because dialysis ends up–

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Michael Eisenberg: 

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And it's fully avertable, right? With early diagnosis. So to the extent that the smartphone is ubiquitous and it can get into people's hands and you can make it a critical medical device, anybody can pee in a cup.

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Yonatan Adiri: 

Take a picture. Yep. That medical selfie. 

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And beyond that, the drugs are generic. So not only that we have a solution, it's super cost effective. And so this 150, 60 billion could easily be 30 to 35 billion. And so that kind of, when you look back, it now is a clinical reality, but so many things had to happen for that to eventually happen.

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You've been obviously on that journey. 

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Michael Eisenberg: 

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Seven rungs of hell. 

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Yeah. And you know, first of all, I would say four, we've survived, you know, four waves of extinction in the industry, right? The 2016 extinction period one, which is to kind of summarize, Google primarily promising the birth of an AI, by then already AI, with a white robe that would rid us of cancer.

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Google Health and this or that, the other. By the way, it's now almost a decade later, nothing to show for it, and they closed that division, right? And the wellness and hardware, all of that died in 2016. That was wave of extinction–the first wave of extinction. The second, and this is credit to Aleph and to you, right, because you became a partner before, during, and after the Theranos criminal case. For people outside of healthcare, urine testing on the phone sounds a lot like blood testing at home, right? So they kind of draw the parallel and nobody wanted to talk to us. 

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Michael Eisenberg: 

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Yeah, Elizabeth Holmes cast a pall over the entire market.

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Yonatan Adiri:

And I would say even today, even today, there's still a part of that. “Oh, here's another crazy hack, liar, whatnot,” right? And now we know it's criminal and, you know, that court case has been adjudicated. So the second wave of extinction, which was, you know, decimation in many parts of the industry.

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And then came COVID, and that was, in the beginning, kind of cleared out a lot of certain types of companies, but ushered in another era for companies that were kind of like us already established, and had a unique type of service that works, and allows people to test remote and not get to, you know.

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Michael Eisenberg: 

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And all those companies, except for Healthy IO basically pivoted to go off for COVID testing and that then disappeared.

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Yonatan Adiri:

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And then that paved the way for the fourth extinction, which was the flawed IPO markets in healthcare. We've seen, there's a company I admire, and it's a shout out to these guys, Q Diagnostics, they call it Nespresso of medical testing. IPOs in the end of ‘21, three and a half billion dollar IPO, Goldman Sachs sponsored, like, you know, kind of–and everybody has their eyes on that and say, “Hey, finally, digital healthcare, right?” And you look at Livongo and–within six months, they were worth a fraction. And today they're worth, depending on the day, south of 50 million. A three and a half billion dollar–so call it mid ‘21, investors don't want to like, they saw already a wave of like, how do we make money of this in large scale and that, you know, kind of–so four of those waves of extinction in which, you know, many stakeholders, the regulators, the reimbursement agencies, the governments, the insurers. They all reset every three years.

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Michael Eisenberg: 

Do you see Healthy.io being able to get rid of dialysis altogether? 

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Yonatan Adiri:

Yeah. 

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Michael Eisenberg: 

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You do? 

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Yonatan Adiri: 

So beyond that, I think Healthy.io 's 2030 vision, if everything works well, every medical process that's done with a clinician's eyes, nurse, or a doctor will happen on the phone. These cameras are going to get–I would say even not cameras, optical sensors–there's a good opportunity that somewhere in 2027 you have a hyperspectral, near hyperspectral capacity on your phone. You can do dental stuff. Like, there's so much you can do, that's done now with optics in the office or with clinicians’ eyes. 

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Michael Eisenberg: 

I should say that Healthy.io already does that with wound care, right? Provide nurses–same single smartphone, different software. Correct. or even the same backend software, the different application, to diagnose people's diabetic wounds. 

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I mean, make them heal faster. 

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Yonatan Adiri:

Correct. Yeah. Again, Michael, to simplify, and again, you've been such a champion for us. So when my imagination was capped, even though I thought I was imagining big enough, for instance, the acquisition of Inui, right?

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We acquired a competitor from Silicon Valley, very uncommon for a company kind of our age at that time. The reason we did that is ultimately–the way to think about Healthy.io is that it has two fundamental engines of technology, right? Heavily patented and very strong. One is what we call color AI–the ability to identify color in clinical grade through the FDA. And by the way, we're so far not only the first, but so far also the only one to get the FDA to clear AI to operate on any phone, including future phones for the purpose of urine testing, and also wound analysis. So that is a hard battle we won through Israeli talent.

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Part of the reason of founding it here is the computer vision talent here is second to none. Really, unbelievable. 

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The other part, which was born throughout the services–we realized at some point that the kit may be great and the smartphone and the ubiquity, but, and we can get to people's homes through color AI and regulatory approvals–but then how do I convince a person to get tested? Some people are afraid to find out. So they would leave the kit, although they can test whatever they want with their smartphone. Other folks, and this has happened to us in some markets, are afraid that their premium will go up. If they do have protein in urine and they enter this kind of preventive care model, right?

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And they would rather know later and save two to three hundred dollars a year between now and whenever the late discovery happens, right? So, kind of nudging people in healthcare is a very unique, I would say, art. And thanks to big data and thanks to what we were able to create back in the day, now, you know, more and more generative AI–identifying when's the right time to nudge you, with what language, and with, you know. Is it kind of risk-driven language, is it, you know, hopeful, is it comfort, convenience, and so on? That's Persuasion OS.

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So between Color AI and Persuasion OS, you now have two engines that, whatever optically can be done by the phone, Healthy.io was the best platform in the world to do that. 

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Michael Eisenberg: 

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So let me summarize this for a second, which is you went through four extinction events. 

You're serving a million patients that you're preventing from ever having to get to dialysis.

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You saw AI coming before just about anybody else did and built it into the phone and into the cloud. There's Persuasion OS, which is AI driven, and now generative AI driven, our persuasiveness for healthcare–Color AI, which is AI for, for analyzing all these machine vision, these incredible samples of dipsticks and urine sticks that you've done–and this company was born out of your mother's injury in China, and you're a decade in. And so you just step down as a CEO? Like, why? 

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********

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We covered so much ground that we decided to split this episode into two parts. In the next episode, we are going to cover his decision to step down as the CEO of Healthy.io.

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Yonatan Adiri: 

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I asked myself a question, am I still the right guy to run the company?

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Michael Eisenberg: 

You met like a lot of candidates, a bunch of candidates for the CEO job along the way. You said to them, “Hey, I'm gonna step down. Did they actually believe you?” 

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Yonatan Adiri: 

No. You really have to be very honest with yourself, right? When I stepped down, you know, you asked me about how I felt about it. Like, how did that feel to you? 

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Michael Eisenberg: 

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How did I feel? I was challenged, because it's always challenging. Change is challenging. 

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Stay tuned for part two, which will be coming out in the next few weeks. We think his lessons of stepping down as CEO are critically important to any entrepreneur.

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