Executive Study with Stephen Johnston

The Executive Study series is a forum to connect with industry thought leaders on a range of thought-provoking topics. These are not interviews. They are conversations to stimulate the ideas and collaboration required to solve some of the industry’s biggest challenges.

In the fourth installment of the Executive Study series, we sat down with Stephen Johnston, Co-Founder and CEO of Aging2.0. Founded in 2012 by Stephen Johnston and Katy Fike, Aging2.0 supports innovators taking on the biggest challenges and opportunities in aging. Aging2.0 is international, interdisciplinary and intergenerational - focused on changing the conversation from 1.0 (focused on local, clinical, siloed approaches) to 2.0 (collaborative, lifestyle oriented, opportunity driven) - hence the name: Aging2.0.

Stephen and Patrick had a fascinating discussion and covered a lot of ground. They discussed how Aging2.0 began, what Stephen has learned along the way and what to expect from technology in the future.


Patrick: It would be helpful to set the context for our conversation if you could tell us a bit about how you got started with Aging2.0?

Stephen: I’m from the UK and have a background in the technology and mobile business. After business school I worked at Nokia in Finland, England and then the US. In 2010, after working on projects around mobile apps in Africa (it was still early!), I became interested in healthcare as it was clear mobile technology could make a big difference in people’s lives. I began consulting with a number of large healthcare companies and started working on a startup with a dermatologist from New York. A wealthy client was diagnosed with dementia while we were working together. I then worked with the family for a couple of years and one day had a “light bulb moment” when one of the family members complained that there were no products or services to help them. I realized that there was a huge gap and wondered how we could bring the mobile, tech and innovation world that I knew together with the aging world to help people. I began interviewing experts and putting together a blog and local events. It became quite clear that there was a community of passionate people who felt the same way, but there was nowhere for them to go. One of the people I interviewed was Katy Fike, and we had a real meeting of the minds, Katie then joined Aging2.0 as a co-founder. That was in 2012. We began to create chapter networks in different cities and these networks have since evolved into over 50 chapters in about 20 different countries. These chapters are the core ‘DNA’ for Aging 2.0, a community of innovative people with a fascination for the topic of aging and innovation and a desire to see change happen.

Patrick: It's amazing what you have been able to accomplish in that short of a time frame, I’m sure it hasn't felt short to you...

Stephen: Within five years, we have established a small world of innovation, in terms of getting some really good partners who are excited about what we are doing. We have probably had 350 events in this time and they are more coming each month.

Patrick: What has surprised you in the last 5 years?

Stephen: What was particularly surprising to me, was how much passion and latent excitement existed. I was surprised at how big the silos were that prevented people from communicating. It was probably one of the most disconnected groups that we could pull from, the 20 somethings from Silicon Valley, older adults with dementia, caregivers, and then the healthcare industry. The other thing I would say, is that there was this paradox that we became aware of despite the good work done by organizations such as AARP and Brookdale, yet there are few well-known brands and still fewer thriving technology businesses. It is important that we make the point that the healthcare world and the aging world are connected, but not the same. We are really the only organization that I have come across that takes a person-centered approach. Healthcare is part of what people do, but people do not want to be defined by their healthcare. Other people have different hopes and challenges, we focus on all of the necessary ideas that are required to help the older adults in their lives.

Patrick: You often reference William Gibson’s quote, “The future is already here, it’s just not evenly distributed”. I love that. Why is that such a powerful quote and give me some color behind it?

Stephen: It’s one of my favorite quotes. It comes back to the paradox that I mentioned before. There is so much potential, there is so much technology available, but it is not being applied. The way we interpret the Gibson quote is that we need to have a global conversation. Everything we do at Aging 2.0 is international, interdisciplinary, and intergenerational. We can shortcut the process by going direct to the source with some of those ideas. We referenced that phrase in the report we just released that was supported by the Robert Wood Johnson Foundation, where we looked at the hundreds of startups who  had applied to our Global Startup Search from 25 countries to see what U.S innovators in healthcare can learn from what is happening around the world.

Patrick: I was at the Google Next conference last week, Marc Andreessen was doing a fireside chat. He elaborated on the confluence of autonomous cars and where Uber is headed. Then he took it one step further to apply machine learning to predict demand. It's not a stretch really to think that in 5 years time, certainly 10, you will have a whole fleet of autonomous cars floating around where you and I don't necessarily need a car especially in an urban setting. It is just crazy to me, and it certainly ties back into William Gibson’s quote. Most of this technology is readily available, we just need to harness it and work collaboratively.

Stephen: Absolutely. This is where I think we can get people like Marc Andreessen excited. We can engage these people in this broader conversation, which is fundamentally changing the shape of society. Transportation is just one area. Cities are going to be changing, as self-driving cars will reduce the need for parking garages and on-street parking take up vast amounts of real estate. Many US cities are optimized for cars not people, and least of all, older people. This will give us a whole new sense of how we get around a city and makes it easier for older adults to integrate with society. These changes should be made while taking the older population’s requirements into account, as designing with their needs in mind makes things work better for all. Up until now, people in the technology world and people in the senior housing world haven’t had these conversations.

Patrick: I agree. While our primary motivation is to figure out a way in which we can impact senior care, it’s interesting to consider the broader implications related to health care costs or even the environmental impacts. Imagine what that could do to reduce our carbon footprint. I think this is a good opportunity to segue into innovation. Talk to me about how Aging2.0 is metaphorically becoming the bridge. What are some of these new opportunities that you are offering to your network and how that is changing that landscape and filling the so-called void?

Stephen: It is a good metaphor that we try to operate as that bridge. One of the programs that we kicked off, is the Alliance program where we have about 150 partners and they range from the big corporate names to emerging start-ups. A couple of years ago we helped Brookdale create their “Entrepreneurship in (Senior) Residence” program and that is something they have really taken and run with. It’s an opportunity to introduce innovators into the community setting to have a two-way dialogue. Chatting with older adults about tech startups is very different from the usual conversations - it benefits both sides immensely. We’re building the bridge in three phases. First, a dialogue phase, just a “getting to know you” session, so we can understand exactly what people want. This idea of involving older adults, designing with not for, is something that we are focused on. Second, is this interaction between the innovators, the ones that have ideas, and the older adults for piloting, testing and concepting. The third phase comes in terms of distribution & funding, how can we get great talent, products, and services that have the potential to improve lives rolled out into the communities and scaled up. This is “minimal viable product” thinking, using “design thinking” as a way to bring in insights for users as a starting point for innovations.

Patrick: Let’s unpack the landscape a bit. Talk to me about the gaps as well as the opportunities that exist. For example, we are gaining ground in a certain area whereas we haven’t even touched another area.

Stephen: The report I referenced before is structured around the kinds of opportunities that we have been looking at within the four categories of mind, mobility, independence, and care. We took another slice of those and looked at them closer, and then fleshed those out a little bit more. It was interesting to take that approach to say, ok there is a lot of different innovation and potential topics that will have different stakeholders interested, and different points of view. As a result, we are developing a new program centered around 12 “Grand Challenges”, which covers topics such as Engagement, Family Caregiving, Cognitive Impairment, Financial Security and Remote Care Delivery. We are now speaking with our partners with the intention to push for change when it comes to innovation and aging. We need to move from a “technology” conversation to a “solutions” conversation and look at it from a much more integrated angle - not just a startup pitching an idea that may not fly. Right now, I am keeping this sort of vague because we need to sit down with our partners over the next couple of weeks and decide what on this list warrants our focus. We are going to collaborate together as startups, industry, investors, government, academia and older adults themselves to ensure we’re all on the same page. We’ll be benchmarking key metrics to figure out what success looks like in each of these areas over the course of a year.

Patrick: Do you feel like there are certain companies that are, when you think of Clay Christensen's definition of disruptive innovation, that have the potential to completely disrupt the market?

Stephen: Yes, It's interesting because aging is not an industry per say, and that is why it is so challenging - it sits at the intersection of housing, healthcare, technology and consumer goods. You are not going to have one little widget or startup company that solves the problem and disrupts all markets at the same time. There are a few themes that I am quite excited about in terms of moving very quickly right now, one area is the “concierge model” to make life easier for people managing multiple services. If we think about it from a public policy perspective, allowing people to be independent does not mean they just remain in their own houses. It could be that they are living in a senior living community - which can equally be their home. There is an empowerment piece in which they are taking control and have the ability to live the life they want, in the place they choose. We layer in smart homes, healthcare, clinical care, and information, and you've got a lot of touchpoints. You've got this interesting convergence from technology, consumer goods, senior housing and healthcare centered around the individual. We need to provide user-centric services that integrate with each other, and across silos. The other area of opportunity, is going to be in the business model side and we are seeing where we can go with some of these modern technologies and products that require private pay. Many times, what we are seeing, especially when it comes it to the home care market, is a lot of innovation and there is a decent amount of venture funding in home care. However, a number are still finding it slow going because of regulatory and business challenges, in particular the family paying for care that delivers demonstrable value to the healthcare system, but is generally not reimbursed. Integrating healthcare business models and tech / private pay business model will be interesting and help companies scale.

Patrick: I was listening to a podcast on the way into the city this morning. Did you happen to catch the documentary Cowspiracy?

Stephen: No, but it sounds interesting.

Patrick: It is actually very interesting. It illustrates the environmental impacts from the meat industry. The documentarians said their story gained a tremendous amount attention particularly in Europe. They found that European governments were far more receptive to collaborating and trying make changes versus the US. I’m interested in perspective relative to innovation. Do you feel that certain countries embrace change more than others?

Stephen: It's certainly an interesting time to be in the space. I just came back from Europe, and they have a different starting position. They are well ahead of the US in terms of public discussion about the need for change when it comes to the aging population because they have an older demographic. The systems are much more integrated around the single payer or universal coverage and they are starting to integrate the social care and the health care system. I'll say that the Dutch, Danes and Swedes are consistently creating an integrated society for older adults. I think there are discussions in the US at this time around the idea of inequality in terms of societal dysfunction, however, the US remains a hotbed of innovation. We need to connect those dots from around the world and not constantly reinvent the wheel.

Patrick: Give us your perspective regarding what to expect in the next 10 years as it relates to general innovation and how it translates for the betterment of our society.

Stephen: There are a few things that occur to me, we are going to see really big changes in the user experience of aging innovations, we will see changes in business models and also realize the value for data. On the usability side, we will see this idea of disappearing user interfaces, for example, the Amazon Echo or the Myo Gesture, which wasn’t designed to help older people, but it will help them engage more with services without even feeling like technology is there. I think on the business model side, looking forward in 10 years, I really hope that innovative interventions are rewarded by the healthcare system and not just left to stand alone. I think the time has come that the US allows these really great thinkers and practitioners to drive the whole continuum collaboratively. Finally, on the data side, I think we are going to see much more openness in terms of data sharing, and understanding of the value of data - and recognition that the consumer should be in charge of what happens to their data, and who monetizes it. We can look to other industries for inspiration, as they’re in turn looking at the aging space - self driving cars, drones, robots, wearables and even new platforms such as Blockchain. In the future, collaboration will be a business requirement and there will be processes and systems that make it easier to execute and to show the bottom-line value, which is what we need for these new ideas to be scalable and have the kind of impact we all want.