Adrian Aoun doesn't believe in doctor's offices — at all. For him, the future of healthcare is an AI-powered mall kiosk he’s dubbed the “CarePod.”
Aoun, who cofounded San Francisco-based health tech startup Forward in 2016 and today announced a fresh $100 million in funding to bring 25 of these pods to malls across the country, compares his healthcare approach to what Elon Musk is building at Tesla. The goal, like Musk’s vision of self-driving cars, is to put medicine on autopilot. “Slowly but surely we're just migrating every single thing from doctor and nurse to hardware and software,” Aoun said. “In fact, we don't even believe a doctor's office should exist.”
And yet Forward's business depends on them; the company currently charges people $149 per month to get virtual and in-person primary care at its 17 medical clinics located in nine states and Washington, D.C. “We're going to scale the pods far more,” he said, “but we're keeping the clinics.”
Rather than the more traditional primary care that Forward offers at these clinics, the CarePod is an attempt to fully automate a check-up: A patient approaches the metallic, square 8x8 foot box, which is eight feet by eight feet, and unlocks it with their phone. Once inside, they find a chair and a large screen, where a robotic voice walks them through a body scan or blood pressure reading or finger prick blood draws — all of which they do on their own.
In the United States, only licensed professionals – doctors and certain nurses – are allowed to diagnose and prescribe medications to treat disease. This means Forward’s autonomous robot box has a Wizard of Oz man-behind-the-curtain problem: licensed medical professionals still have to interact with patients via video or chat to interpret the results of their diagnostics. “Behind-the-scenes, it's sending your data to doctors that work for Forward that are kind of 24/7 sitting in front of screens,” said Aoun.
Unlimited access to the pods will cost $99 per month. Forward does not accept insurance and people on the CarePod membership cannot use the in-person clinics (though Aoun said he anticipates there could be a hybrid CarePod in-person offering in the future). He said around 35% of Forward’s current members are uninsured; he declined to share total membership numbers.
Aoun won’t disclose how much it costs to manufacture a CarePod, but he said Forward has raised $100 million to offer its “first batch” of 25 CarePods in office buildings and malls in San Francisco, New York, Chicago and Philadelphia. He said he’s inked deals with major mall owners, including Westfield, Simon and Macerich, and expects the number of pods to start growing exponentially: “We're gonna put more healthcare on this planet than the world's ever seen,” he told Forbes.
“The solution then isn't to go to jukebox medicine.”
Aoun said the round includes equity and around 25% debt. He said it’s a mix of existing and new investors, including Khosla Ventures, Founders Fund, Abu Dhabi Investment Authority and Samsung’s corporate venture arm Samsung Next, among others. Serena Dayal, a partner at SoftBank Vision Fund who sits on Forward’s board, said in a statement she believed “CarePods could entirely reconstruct the way consumers access preventative healthcare while reducing costs.” SoftBank declined to comment on whether the firm invested in this latest round.
David Lee, who leads Samsung Next, said he tested out the CarePod as part of his firm’s investment in Forward and he liked how it was “removing the friction to have a checkup.” He also said he appreciated Aoun’s desire to “control every piece of that user experience.”
Lee believes Forward will appeal to the digitally native younger generations focused on health and wellness. “The way we treat our bodies, and the way we think about care, I think will sort of evolve into almost how we treat our cars,” he said. “If you own your car, you're going to maintain it, you're going to wash it, you're going to make sure you change the oil. And for really bad accidents, obviously, you have your insurance. But people are starting to think that way about their bodies and their health.”
Forward last announced a $225 million Series D round in March 2021 that valued the company at more than $1 billion, according to Reuters. Aoun declined to comment on Forward’s new valuation other than to confirm this “is not” a down round. He also declined to disclose how much funding Forward has raised since its founding but confirmed the company is not profitable. Forbes estimates total funding to be around $450 million.
He said Forward employs more than 100 doctors, but he would not disclose the company’s total headcount. “One of the things that I think we do that's really dumb is we use things like valuations and employee counts as measures of success,” Aoun said of the broader Silicon Valley ethos. “And I don't want to encourage that because I don't think it's a measure of success.”
Aoun sold his first startup Wavii, which extracted data from the internet to create an early version of a news feed, to Google in 2013 for a reported $30 million, according to Reuters. He then worked on AI projects and was a director of special projects reporting to former CEO Larry Page. When his older brother experienced a heart attack, Aoun came face-to-face with what he describes as a “pile of crap” healthcare system with “doctors standing over my brother with post-it notes,” he recalled.
With Forward, he’s aiming to bring his AI background to healthcare. In order to make the visit faster for the patient and the doctor, the company is using large language models, or LLMs, to digest the latest healthcare research and generate protocols in advance. For example, if a patient enters a pod and has a high blood pressure reading, they will be guided through certain steps to collect more information to help the human doctor arrive at a diagnosis or treatment.
Aoun said Forward did not build its own foundation model (like OpenAI’s GPT or Google’s PaLM) but would not disclose what model it runs on. When asked why this required complex AI models instead of a more simple decision tree, Aoun replied: “You could probably say that about any LLM produced thing, which is LLMs are just purely doing what humans could do,” he said. “It just wouldn't be very efficient.”
“We're gonna put more healthcare on this planet than the world's ever seen.”
The AI is supposed to make each visit faster and help cut down on labor costs. “The key limiting factor of a doctor's office, and I say this with all due respect, is the doctors, they're super expensive and there's not many of them,” said Aoun.
Primary care doctors are indeed in short supply in the U.S., where they are some of the lowest paid physicians. The average wait time for a primary care appointment in the U.S. is around 26 days, and the American Association of Medical Colleges predicts a shortage of between 17,800 and 48,000 primary care physicians by 2034.
“Primary care is very tough to get for many people,” said Arthur Caplan, a professor of bioethics at New York University. But he was skeptical of Forward’s approach.
“The solution then isn't to go to jukebox medicine,” said Caplan. Part of the problem, he said, is what gets lost when you take human interaction out of the equation. “Very few people are going to show up at primary care and say, ‘My sex life is crummy, I'm drinking too much, and my marriage is falling apart,” said Caplan. It takes a doctor picking up on cues and going through a “sophisticated interview” to tease out things that patients don’t want to divulge, he said.
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Besides the doctors remotely reviewing diagnostic tests and videoing in to answer questions, the only human on-site at the CarePods will be an assistant who cleans in between uses and services them when needed, Aoun said.
For Aoun, this kind of scalability is what will help Forward reach its stated mission: “the world’s best healthcare for one billion people, for free.” However, Forward remains a business. When asked to explain the contradiction that the startup operates on a cash-pay monthly membership basis, Aoun said he agrees that Forward’s cost “should be $0” and he plans to “keep working to lower” the price.