What We Are Looking to Fund: Technology on our phone that helps us to live healthier lives

The smartphone era has enabled miraculous things. Social connections, everyday photography, urban mobility, workplace communications, and, of course, dating apps, are just a few of the many examples. These advances have driven new types of commerce, and the thousands of businesses built on the backs of smartphones generate more than $20bn a year for developers.

On the other hand, we are just coming to grips with some of the impacts of smartphone ownership including:

• anxiety, insomnia, and depression,
• lack of real community,
• addictive applications, designed to manipulate us for retention, engagement, and advertising potential, and
• reduced attention spans and focus.

It’s still early days for the smartphone, and like many technologies before it, adoption has had its costs. The early days of flight and automobiles had frequent fatalities and accidents. Industrialized farming, despite incredible benefits, came at costs with which we are only now coming to terms.

At Cowboy, we believe there are tremendous opportunities for entrepreneurs to create companies that enable us to use our phones to improve our well-being. We are particularly encouraged that so many smart people who built the first wave of mobile app technology are now looking to build mission driven companies with greater social impact. We are looking for opportunities to invest in this space and have listed below some of the areas in which we have experience and would consider investment.

Healthier device usage:

Apple’s latest iOS included Screen Time, which provides both analysis and user-defined restrictions on device usage. Smartphone users can easily see how much time they spend on each app, and set restrictions by category (e.g. no more than 15 minutes per day on social media). Moment builds software that takes this concept even further by coaching people on effective strategies for using the phone less. As devices become more central to our lives, we believe that there’s an opportunity to build companies that help us to use these devices when they serve us and limit their usage when they don’t.

Improving our diets:

I was fortunate enough to serve as outside counsel to MyFitnessPal and Cowboy made an early investment in Rise, which was sold to One Medical. We’ve seen food tracking applications continue their popularity. Nutrition tracking startups like Zipongo are now attempting market this service as an employee benefit. Another company in the space is Omada, which supports patients build healthy habits to address certain chronic diseases. Another application with traction seems to be Noom, while Aileen is a religious user of CarbManager. One limitation we’ve seen with food trackers is that they have historically required manual logging of information, which can be tedious. With computer vision, we expect to see companies enabling consumers to monitor what they eat by simply taking a photo of the food or perhaps through even more passive data collection, although we are aware that previous efforts to accomplish this have faltered. A second limitation has been the focus on nutrition separate from exercise (and vice versa). We believe that these are generally two sides of the same coin and see an opportunity to address diet and exercise more holistically.

Helping us exercise:

Exercise category has been an incredibly successful category, with standout companies like Runkeeper, Strava, and Peloton. These applications have historically focused on people who already work out. We think there is an opportunity to serve the folks who aren’t currently as physically active. A company that can successfully grow the market of people who exercise will have both a tremendous potential market and a massive societal impact. Cowboy portfolio company Gixo is a good example of a company tapping into this opportunity as it has focused its offering people who are looking for a less intense or more convenient workout than the P-90x crowd. A completely different approach is Sweatcoin, which lets users earn crypto currency for their exercise, which can be redeemed for items or even cash.

We anticipate that applications making use of computer vision will help to coach people to exercise more safely and efficiently. We have seen some companies using this technology that promise a new experience for consumers, and we are extremely interested in the area. We also suspect that there is more power to be found in passively gathered data to provide feedback to help us exercise more effectively.

Mindfulness and emotional regulation:

An entirely new field has opened up to help us improve our inner states as well. Early companies like Calm and Headspace have helped people to learn to meditate and fall asleep. Mindfulness apps have even taken specific focus areas, like Enjoy for parents. We believe it early days for these types of businesses and that next generation wellness applications, like Cowboy portfolio company Aura Health, will be able to help consumers manage their emotions more effectively by providing content tailored to both the person and the mood state s/he is addressing.

Good habits:

A meta theme that surrounds many of these pursuits is the establishment of habits with the goal of effecting behavior change for the better. As seen in Atomic Habits and The Power of Habit, building automatic “loops” is an effective way to change behaviors and outcomes. There are many calendar and to-do list applications, but we believe some whitespace exists for an application that can help implement a range of habit regimes whether for consumers or in the enterprise.

Healthcare delivery:

Smartphones offer opportunities to change and augment healthcare delivery. Plushcare’s video-based interaction with doctors replaces the hassle of in-person doctors’ office visits, while startups like Phil, Nurx, The Pill Club and Hims allow patients to get prescription medication quickly and easily from the convenience of their homes, which is especially powerful in rural communities where access is extremely limited. Bluetooth-linked sensors have enabled even more sophisticated uses of smartphones for healthcare delivery, like Onedrop for diabetes management, or recently acquired Propeller for asthma and COPD. We are particularly interested in ways to help women who are undergoing menopause, as we believe this area has been underserved by the medical community, in part because the industry has been largely made up of dudes.

Supporting aging populations:

While most of today’s applications began with young healthy people as the early adopters, we believe that there’s an opportunity to provide services to help an older generation, who are in many cases managing multiple chronic conditions. Some early examples are medicine reminder app Mango Health, that motivates patients through gamification and rewards and brain training apps like Lumosity that help us all improve our memory and focus throughout our lives. Obviously there are numerous challenges in getting this demographic to use technology, but recent advances in voice interfaces and computer vision create new opportunities to serve a population that has a harder team pecking at a tiny keyboard.

In conclusion:

The advent of mobile phones brought incredible benefits to our society, but those benefits came with some costs. Unfortunately, so much of the critique of these costs is based on the faulty assumption that we can somehow put the genie back in the bottle and undo these impacts. As Kevin Kelly points out, technology change is inevitable. We are not techno-utopians, but we do believe that there are now significant opportunities to build businesses that can ameliorate some of these costs and help us all live healthier lives, while reducing the costs to the overall healthcare system. We are excited about funding this wave of double bottom line entrepreneurs. If you or someone you know is building something like this, we’d love to meet.