Can Oura Become the Doctor in Your Pocket? | Oura CEO Tom Hale

The reality of the healthcare industry is there's just simply not enough doctors to go around. If you were to take all the time of all the primary care physicians in the US, say, you might have 500 million hours of care that you could provide. Well, there's 330 million people in the US. So each person's going to get an hour and 20 minutes of care a year. That is just not enough to change someone's behavior. And our belief is that really the foundation of health is actually your behaviors.

Thank you, Steve. Thank you, Michael. It's nice to be here.

Well, I think the answer is it's a little bit of all of those things, but if you were to check the actual registry under which our name is officially launched, it is Oura Health. And I think, you know, to kind of go across the areas, I think we started actually many years ago in 2013 in Finland with this idea that actually we were building a health company. Meaning that we always knew that there was a strategy to say let's build this form factor ring very comfortable, very small, very unobtrusive. Let's make sure we're focused on sleep because by the way if you measure people's bodies at night you get a really clean signal. There's no other confounding factors of daytime activity. You get a really good baseline and you can use that baseline to make predictions about what's going on in their health. And then we always had the vision of having a big impact on the world of health, both preventative health and ultimately kind of monitoring and managing populations, population level health. We always had that vision. So to just to answer your question, yeah, it's a little bit of all the above.

Well, I guess if you're running a company that's a massively successful company, you're going to have to manage all those things and obviously having a great team will do it. But maybe the one way I would answer it is that the way you manage it is you always look through the lens of the user because really at the end of the day, let's say your employer bought you a ring or maybe your insurance company bought you the ring because you're a Medicare Advantage customer. We have Medicare Advantage people who provide the ring. Maybe you bought it yourself. Maybe someone gave it to you as a gift. All of that is great except for the fact that you have to actually solve the need of the user and you have to engage the user and you have to keep them interested and you have to educate them because by the way not everybody knows everything about themselves. We call it giving your body a voice. We give your body a voice but we also educate you about what it's trying to say so that you can listen and that we tell you what the impact of your behaviors are so you can see the impact of your behaviors on your health. We try and do that in a way that's accessible whether you're a runner training for a marathon or you're somebody who has chronic fatigue syndrome or a man or a woman or all these ranges. Now the thing that's sort of maybe embedded in your question a little bit is this idea of like can you be both things? Can you be a consumer company? Can you be a healthcare company? Can you be a consumer company and be an enterprise company? And there are tensions, you know, I don't think we would minimize that at all. I do think though that if you look through the lens of the user and you serve the user and you keep them engaged and you deliver value, the rest of that stuff is really just about tactics and how you go to market. So the product needs to be meeting the user where they are, needs to be delivering value and then the go to market is different. The people who call on insurance companies are different from the people who call on the Department of Defense. You know, the people who call on Department of Defense are different from the people who do the consumer marketing. That's basically the difference.

I'll give you a couple of ideas. We hear stories every day from people like you who said, 'Yeah, I open up this application multiple times a day. It's the first thing I look at in the morning. It tells me how to plan my day.' Or like it's a really profound thing. I think some of the reasons why we've avoided app fatigue is as follows. I think one is that interestingly your health condition is multifaceted. Anybody's health is multifaceted. And by the way, if it's changing, then you know you're going to, if you're a woman and it's changing every 30 days, then that's interesting. And if you're a man and it's changing, you know, not every 30 days, but you're on some kind of journey, a fitness journey, a health journey, maybe you're recovering from an injury, that's interesting. So there's something about that. I think that's a form of solipsism. It's a form of like, hey, I'm the most interesting user-generated content I can look at. It's me. So maybe that's part of it. But I think the really interesting things about it are this one: sleep, turns out, is something that everybody is going to do at least once in a 24-hour period. And so, there's this sort of call it frequency of use that's mechanical because you're going to go to bed and you're going to wake up and we're going to tell you about it. That's the first thing. Second thing, you don't know how you slept. Okay, sure. You know if you slept terribly, you know, if you woke up 40 times, but did you sleep well? Did you sleep? Putting that in terms that are kind of quantifiable and giving some dimension to that is really interesting because it sort of opens up a window on your health that you can't see or you don't feel or you don't experience. There are other elements to it. One of the things that I think happens in medicine, but also in apps, is they start looking down a very narrow telescope and you start to get this kind of very narrow view. You know, in healthcare, the form of this is like, I'm going to put you in a box. You're diabetic. I'm going to put you in a box. You're training for a marathon. I'm going to put you in a box. You've got an injury. We're going to... And that sort of model of interventionist medicine that puts you into a single category and then says, 'What's the right thing to do? What pharmaceutical should I give you? What surgery should I give you?' And one of the things that we do is we actually allow you to move not just in between boxes, but maybe across boxes. So, you can be a woman going through perimenopause who's having issues with sleep and is concerned about her heart health. And we can service all of those dimensions in one app experience and you can be a woman who is in your young age trying to not get pregnant and then you can say, you know what, I'm trying to get pregnant, we can make that transition and then we can take you into pregnancy because one of the things we do is we provide you insights about your body as you go through pregnancy. So it's this notion of change because change makes things interesting and reduces fatigue. The other thing that we do is breadth and you know we talk about this as sleep, stress, heart health, women's health, activity, understanding your metabolic... we integrate with CGMs. So we kind of give you all of these dimensions of your health and then help you make sense of them together.

Exactly. Rain it. Brain is the first time I've actually thought about it because I actually... what I think is really what the company got right was the form factor and linking it to sleep and that you don't take it off like you take off a watch. And I just think that form factor and obviously the battery life, what the amazing stuff you've done there, to me that strikes me as the unlock because we've seen so many wearables beforehand, the OGs like Fitbit and Misfit and then obviously we've got Whoop and others, but what's really unique I think is just the form factor is there.

I mean, that's like saying the sun's going to rise tomorrow. But no, but there's something really powerful about the obvious, which is that it turns out that many times that's the most important factor. I do think the form factor is critical. It's lightweight. It's small. You know, think about the things you don't take off your body. Well, you probably don't take off your wedding ring when you go to bed. Now, that's not true of your earrings or your necklace or if you're, you know, some other... maybe a watch. I think watch is a great example. I mean, I have an Apple Watch. I love it. I love my Apple Watch. You know where it is every night?

It's on my bed table. It's charging because I use it during the day and it has so much utility for the day that it runs out of battery by 6:30. And I'm not perfect. I don't always get it charged for night. So you're right that form factor is good but the thing that the form factor unlocks besides comfort and kind of ease is that nighttime tracking because the power of Oura is that we see overnight small deviations in your baseline and those small deviations are the clues to what's actually going on. So one of the features of Oura that I think people are often both amazed by and then they fall in love with is this thing called symptom radar. And symptom radar basically looks across your temperature, your respiration, your HRV, and your heart rate, a couple other things, and then says, 'Hey, when we start to see a deviation that fits a certain pattern, we're going to kind of tell you that something's going on with your body.' Can't tell you what it is. We can't predict what it is, but we can tell you that you've got, you know, either minor or major symptoms. And the thing is, what that is is predictive because most people are like, 'Oh, well, I don't feel anything. What is that?' And then 3 days later, they're lying on the couch surrounded by Kleenex. And it blows their mind because what we just gave them was a piece of information that was predictive and correct. And I'll tell you how I use it. I travel a lot and one of the things that happens is if I travel for two weeks at the end I start to get pretty run down.

And I can see that my body is like going, 'Oh, you know, you're running out of steam.' And I will literally take an afternoon and be in my hotel room and drink fluids and not drink any coffee and then I will not get sick. And in fact it has changed my life for the better because now when I travel I don't get sick anymore. And that's because I can see it coming before it hits me because by the time it hits me it is too late.

Well, I think the company was founded in Finland and Finland has sort of a great tradition of both simplicity and clarity in design that kind of reducing something down to its essence. I think that's really critical. I think there's also an element to which the frame that people put on this is they call it calm tech which is that it really minimizes the sort of distractions. You know, there's a big kind of principle in Finnish life of like what you really want to do is you want to avoid all the distractions and make sure you're focusing your energy on the important things. And I think in the ring the way that takes shape is there's not a lot of lights and doodads and screens and vibrations and it's not constantly asking... and for a long time we had a debate about should we even have notifications in the app because we're not there to engage you and nag you and make you feel bad or anything like that. It's like we're here to calm and support you and to help you on your health journey in a way that's positive. And that became like both an aesthetic of the hardware, but also very much an aesthetic of the software. The tone of the software is supportive. And this kind of accountability plus support is a really interesting almost like tonality and maybe personality of the product, which by the way is one of the things that people cite that they love about it.

Unintended consequences.