DUOS is a digital health start-up with the mission to reimagine freedom at any age. DUOS forms trusted relationships with older adults by pairing them with personal assistants. Through a combination of technology and community, DUOS offers holistic, personalized support to allow older adults to age independently in their homes. In June, DUOS raised $6M in seed funding from Redesign Health and Forerunner Ventures. Pulse Writer Lauren Gardanier sat down with co-founder and Chief Product Officer, Kristen Lynch, to learn more about how DUOS is building their business to fulfill the needs of the expanding older adult population.

Kristen Lynch, DUOS Co-Founder & Chief Product Officer

The Pulse: Can you give an overview of your career path, and what led you to where you are today as co-founder and Chief Product Officer at DUOS?

Lynch: In mid-2020, living through a global pandemic and observing the chaos and impact it had on people’s lives, I asked myself whether I was living my values to the best of my ability. For me that meant two things: 1) my experience as a caregiver for my mom, navigating the healthcare system and the lack of connectedness between episodes of care and 2) the engagement that I get being at the early stages of building a product and launching it to market. I am a builder. I love to build things and test them out. I wanted to find a space where I could connect my passion for caregiving with early stage product building. 

I was incredibly lucky to connect with one of my co-founders Anne Marie Aponte, our COO. She led a duct tape test of our product in the market; she launched with almost no tech whatsoever and had completed early validation of product-market fit. I was impressed both with the caliber of Anne Marie as a person as well as with the results of this test, which suggested we could put caregiving at the center of our product and make it a viable business. 

Prior to DUOS, I led product development at the chronic disease management company Onduo, which is now a part of Alphabet’s Verily Life Sciences. I was there from inception through post-acquisition, so I experienced the exciting changes and challenges at each phase of growth. Prior to Onduo, I worked in interoperability product development at athenahealth. We were solving for the fact that when we go to the doctor we fill out the same paperwork each time. Yet, we can go to any ATM in the world and somehow get money. Clearly there are secure ways to exchange information, and it should not be harder for us to access healthcare than it is to get dollars out of the bank. Before athenahealth, I spent time on the provider side as well as in the community health center space. 

The Pulse: Can you tell us more about what products and services DUOS offers today, and how you are serving your members? 

Lynch: At DUOS, it’s our mission to reimagine freedom at any age. By this, we mean both supporting the older adults we serve but also reimagining what caregiving as a career path means for people. We are truly reimagining freedom in a two-sided marketplace. We pair older adults, or in some cases their caregivers, with personal assistants who support them on their journey to aging independently. We learn from experiences of members we serve and build that learning into the platform. Each of us are individually going through life just once, but across a population we are able to understand which things are most meaningful for helping people to live fulfilling and independent lives.

The Pulse: Are you connecting members with different services they need at different times? Is it just healthcare or also other areas of members’ lives? Transportation, groceries, etc.

Lynch: We think of our product as offering ‘guided independence’. At every phase, we are proactive in supporting an individual. We ask people clinically validated questions or questions we’ve tested and refined to help uncover their needs. Then we prioritize those needs in a set of personalized recommendations, work with an individual to identify what to work on first. Finally, we actually close the loop to get them the support and services they need. Transportation is the most common need we support members with. It’s crucial to get around or get to medical appointments, and products and services that exist in the world haven’t always been built with an older adult in mind. Another significant activity we enable is groceries. When we learn that someone may be struggling with food or nutrition, whether it be transportation to the grocery store, carrying groceries, or preparing meals, we will support them in addressing that need. 

The Pulse: As you’ve been thinking about go-to-market strategy and the target person being older in age, how do you think about customer acquisition?

Lynch: Our primary go to market channel is Medicare Advantage. We sell to Medicare Advantage plans who are eager and excited to support their members with social determinants of aging. Additionally, we have a small but mighty consumer channel. I have a deep belief in the importance of having a product that people pay us for because they value what we are offering. This helps us validate which things are most valuable not just to an enterprise health plan but to an end user. It forces us to stay really close to our users and becomes a virtuous cycle with our enterprise product because we are able to share that data and information on what is most important to the older adults and their caregivers. 

The Pulse: Can you share a bit about the diversity of people DUOS is serving, and how you think about those different personas?

Lynch: There is a wide variety of tech savviness in the older adult population and it’s changing rapidly. We are doing a ton of user research to understand this deeply because of how quickly this demographic is evolving their engagement with technology. We’ve split our end users into 3 groups: 1) There is the group that prefers telephony and is not interested in engaging with technology. The operations arm of our business is prepared to deliver our full support journey with these folks over the phone 2) On the opposite end of the spectrum, the group that is even more excited about technology than our generation. It’s really interesting to watch that demographic because younger generations are starting to become more skeptical of technology, and there is a profile of older adults that are just so excited about the benefits of technology and what it can do. 3) In the middle, we see a group that views keeping up with technology as important to stay young, yet is frustrated that technology products have not been built for them. These folks often have a younger friend to whom they go for tech support, are familiar with other ways of getting tech support, and are eager and looking for education around engaging with technology. DUOS is invested in supporting each of these customer groups.

The Pulse: How is this sector that’s focused on older adults evolving and shifting over time? How do you think about other businesses in this space?

Lynch: It’s no surprise that the older adult space is growing rapidly. We are seeing a dramatic shift not only in the number of older adults in our population but the relative percentage of people who are older adults relative to younger adults. We are going to need to change the way we think about supporting this population. What is really exciting is that the space is absolutely enormous. When I think about other businesses launching in this space, I get really excited about all of them. I think we can all partner with each other and be successful together. I don’t really see other businesses as “competitors”. I just think we haven’t figured out how to partner well yet. 

The Pulse: As you think about future growth, how do you view challenges around caregiver churn or labor shortages? What is your strategy for how you retain caregivers and ensure satisfaction?

Lynch: This is so important and we’ve very intentionally invested in the human side of our business with our personal assistants. One of the parallel global forces that has been happening is massive departure from the workforce, largely for women. Quite frankly, our business has benefited from this. Folks leaving full-time employment are often still very eager and excited to be involved in the workforce in a part-time and flexible way. We’ve been successful at acquiring and retaining very talented, incredibly passionate and wonderful people because we are able to offer primarily remote, flexible, crisply defined work that is meaningful. We also employ our personal assistants, which may be a different model than other folks out there. We have centered that role at the core of our business, which seems to resonate with people. It is not to suggest that we’ll be immune to some of the trends and challenges. We’ve taken a number of steps that position us to be really successful, and I believe we’ll continue to be for some time. 

The Pulse: As we think about health equity, and you think ahead, how do you ensure DUOS is able to enable access to a broader group of members and communities that are underserved and what needs to happen to achieve that?

Lynch: We are eager to expand our offering beyond Medicare Advantage, starting with dual eligibles and then expanding to Medicaid. I expect those challenges will need to go through payer channels rather than direct to consumer. It’s something we are very excited about. We’ve started with Medicare Advantage rather than Medicaid because of regulatory requirements  once you go into the Medicaid space. As an early stage startup, it made more sense to start with Medicare Advantage.

The Pulse: Can you share about the backgrounds of DUOS’ founding team and how your strengths complement one another?

Lynch: Team is the most important thing at an early stage startup for a couple of reasons. 1) You’re spending most of your waking hours with them, so it better be a really strong set of people. 2) As an entrepreneur, one of the most important things that you’re doing early is pitching both to clients to sell your solution as well as to investors. The track record of the early team is crucial for establishing that baseline. You’re using a combination of what you’ve established in the market as well as the backgrounds of the early team. 

My co-founders include Karl Ulfers, our CEO, formerly of Rally Health which was acquired by United Health. Karl has a deep background in building engaging products that can be sold to health plans. Our COO, Anne Marie Aponte, formerly of Accolade, a care management company that has been wildly successful. Her leadership has been a key part of how we’ve centered caregiving and why we’ve been so intentional in building that workforce into our mission. Our co-founding team is rounded out by Jacques Anderson, our Chief of Staff. A former Skadden lawyer, she has worn many hats in the evolution of our organization. Whatever needs to be done, she makes sure it gets done. 

The Pulse: As co-founder and CPO at DUOS, what strategic priorities are top of mind for you right now? What is keeping you up at night and what are you excited to tackle in the future?

Lynch: I think they are the same thing: how do we activate people who are disengaged with their health. We have some early evidence and tricks up our sleeve that we’ve been using to target and engage people who have fallen through the cracks of the healthcare system, sometimes for decades. We’re now at a place where we’re starting to figure out if this will scale. I’m really excited because once we get people engaged with DUOS we tend to keep them engaged and see great outcomes. The hard thing — and not just for us but frankly for every digital health company out there — is finding and activating those hard to reach people. It is both very exciting and certainly the thing that keeps me up at night – figuring out how we continue to do this in a scalable way. 

The Pulse: Reflecting on your career experiences, what is one skill you would encourage more junior folks in the healthcare industry to focus on developing?

Lynch: When I reflect on the thing that education and many jobs don’t do well is asking people to reflect on your strengths. I feel passionately that the one thing I would change about education is to help people better understand what they are best at. I spend a ton of time with my team helping them figure out what they are best at and how they can maximize their time doing things that they are great at. I think this is how you build really strong teams – find people with a diversity of strengths and bring them together. A fundamental understanding of your strengths, where your pointiness is and how that pairs with other people’s pointiness – that’s what builds great companies.

The Pulse: Other closing thoughts?

Lynch: The other thing I would offer as you think about companies in the healthcare space is the importance of a virtuous cycle between product and services. There are companies along the spectrum from primarily tech products to primarily service products. I have a deep and abiding belief that the best products are actually both – they have a tech component and a service component. The key is making sure the feedback loop between those pieces of the business is really strong and focused. It’s really easy to get pulled too much in one direction or the other. When I think about how I look at my role as CPO and how we’re building out DUOS to be successful, it’s really at the intersection of products and services. We are automating those things that are repeatable and don’t make sense for humans to be doing, whereas humans are really building relationships and making sure that we have a super sticky longitudinal relationship with our members. 

Interviewed by Lauren Gardanier, December 2021.