From Design Thinking to $1 Billion Healthcare IPO: Omada’s Sean Duffy + His Former Boss

I mean, there was this one woman where we're like showing her the prototype and she was just imploring us to build it. She was like, you have to build this. Go build this. Please build this. It needs to exist. And we're like, yes, ma'am. We're gonna go build it for you.

Welcome to Leap Forward, a show about founders and the people who believed in them before anyone else. On today's episode,

I'm Sean Duffy. I'm the co-founder and CEO of Omada Health.

When Sean was a medical student, he took an internship at the legendary design thinking firm IDEO that would put him face to face with one of America's overwhelming systemic health problems.

You know, we interviewed patients, you know, people that had prediabetes obesity and asked them, well, what was offered to you? It was like they got a pamphlet and a prescription and then asked to come back in six months.

He knew right away that this could be his life's work, but how to turn the idea into a solution and a company, that took a lot longer. To learn more about how that happened, I also talked to Sean's boss at IDEO, David Webster.

We put Sean and Adrian on it. They're like, I think we can probably do better than see you next year.

And now, Sean Duffy. Why don't we start at the top? Just what, you know, where did you grow up? What did your parents do for a living?

Yeah, sure. So I grew up in Colorado Springs, a little bit south of Denver. Um my dad uh was an electrical engineer. So uh, you know, life with dad was all about engineering, and then my mom was a nurse. And I think I was kind of drawn to healthcare because it felt like a good, just a good thing for the world, you know, neat way to contribute. So um uh, you know, I think some of her stories as a nurse really did kind of awaken me to the power of healthcare. So um uh, you know, I think even from day one it was somewhat of a mix of both.

How would you describe yourself as a kid? What kind of kid were you? What kind of things were you interested in?

Uh I was a little bit of a late bloomer. I mean, I think um, uh my God, I think I hit puberty like junior year in high school. So I'm more oriented toward the Dungeons and Dragons table than uh than you know, the cool kids table. Uh, but uh I was interested in a lot of things. I think fundamentally I like to build things. I loved computers. Any new bit of technology that came out, I wanted to, you know, play with it, you know, lived and breathed roller coaster tycoon, the computer with the turbo button that you know you'd always leave on. Um, and I just uh you know loved creation.

And so let's talk about going from kind of high school off to college. How did you decide what to pursue in school and where to go?

I I went here, I did my undergrad at Columbia and studied neuroscience and behavior. I first thought I would be an engineer, but just realized there could be a world where I combined science and this you know slight interest in health. And at night, throughout my undergrad, I wasn't cracking open my biochem textbook. I was like reading Slashdot, you know, which was obviously yesterday's hacker news. And so um, when I graduated, I got a little cold feet about going straight to medical school. I had done my pre-medrex, but I felt like this tech itch needed to be scratched. So I found this random role at Google and I was like, all right, I'm gonna do this. I'm gonna spend a couple of years there, feel it out, and either pick tech or healthcare. It was it was kind of the strategy.

So I mean, but still at that time you kind of felt like you had to choose tech or healthcare. You didn't kind of see something that did both.

Well, you know, it was kind of lucky. It was a moment where Google was dabbling in healthcare, poking, you know, at the fringes on what software could do in healthcare. And I was never involved in any of that. But the fact that that was happening led me to think interesting, maybe there are software and technology applications in healthcare, you know, that could blend both. And so um, that actually left me like more comfortable in going to medical school.

Yeah, so let's talk about that. So you're kind of at Google and then you decide to go to med school. Walk us through that decision and you know, where you decide to go.

Yeah, so I was only interested in MDMBA programs because I wanted to do something tech meets healthcare. Uh so got into the program at Harvard. There weren't too many people interested in entrepreneurship. It was me and like four other people, basically.

Yeah, that's really interesting. I mean, a lot of times, whether in startups or you know, even in science, you know, the greatest opportunities are the intersection of two different disciplines. Like, was that something that you actively thought about, or is that just something that just came, you know, natural to you?

No, I think it just happened, but yeah, I totally agree with the sentiment. The the things that create product or services experience or value that hits at that level of 10x that's needed to really punch through, you know, tend to be in intersections, which I think they're they're more likely to happen now than before, which is good. Uh so the program at Harvard, you know, they have this funny ask that as you go through it, you're supposed to take somewhat of an internship that blends business and medicine. Usually they'd set you up at a hospital, but uh, I had known some folks at IDEO just from my time in the valley and um asked if I could do my internship there.

So yeah, let's, I mean, let's talk about you know, IDEO, which is kind of really the start of a motto. But do you remember when you decided to apply to IDEO, what kind of like what your application looked like?

Yeah, it was a crazy story. I, for no other reason than I was just like interested in it, started writing for this medical technology blog, just as a side hustle while I was at Google. Uh, and they asked me to cover this conference, TEDMED, which was like the spin-off of TED that was focused on healthcare. And while covering that in the shrimp cocktail line, you know, started talking to the person in front of me. It happened to be the guy, Dennis Boyle, one of the um early founders of IDEO. Fast forward when I needed the internship, and I emailed him and I didn't hear back. And like weeks later, I emailed him again and you know, it's being pretty persistent. And then I get this random email from someone that's not him at IDEO saying, I don't know who you are, but I found your resume on the copy room floor. Like, why is a medical student interested in IDEO? I don't know why this person, Michael Moskowitz, chose to email me, but I emailed him and he emailed back. He's like, I just talked to Dennis, like, we're totally interested. And yeah, the rest is history.

We had a cohort of interns who we did quite a diligent selection process on, and it was uh maybe less rigorous for Sean. That's where the Sean story starts. It gets kind of interesting, and I can tell you the story of that if you like. Yeah, go ahead. This is a rather entertaining story because um there was a colleague, amazing guy called Michael Moskowitz, and there was one day that he came to me and he was like, David, you gotta see this. And he had literally, I kid you not, picked up this piece of paper from the copy room floor, and it was Sean's resume that had fallen off the printer. Somebody was doing the diligence and all the intern applications, and Sean's had fallen onto the floor, and it caught Michael's eye because it said Sean had the world record for crawling, and it said a bunch of other amazing stuff about Sean, like he got into Harvard to do a joint degree and uh all of this kind of stuff. But the thing that caught Michael's eye and caused him to bring it to me was the crawling thing, and I was like, Oh, yeah, he sounds like one of us already, you know. Um that got him on a radar, and then of course, you know, you have processes for these things, and when we came out the other end of that, the crawling guy was still in the running, no pun intended. I love it.

That's yeah, that that actually happened. I don't know if you've ever heard that story before. No, I haven't heard it from him. That's awesome. Yeah, but I mean it's it's one of those funny things like life is pretty random that you just dream big enough an opportunity finds you, but it's kind of one of those luck things. Like the resume actually just fell on the floor. It could have just stayed in the stack.

And you know, while we're on the topic, like tell us a little bit about this. Are you still in the Guinness Book of World Records for crawling?

No, somebody broke it about like six months after I broke that record, but I was in, I was in for a period of time.

What I mean, what motivated you?

Why? Uh just a joke. I mean, I was at Columbia to just get some extra money, worked in the lab, and I was in this like neuroendocrinology lab. And, you know, my professor, who I really liked, ended up getting a professor job at Berkeley. And so he left the university, and so I lost my job. And I had like so much free time. I mean, it was like 20 hours in a week. Um, and I was just on the phone with a buddy from high school, and I was like, I should like do something with this. Maybe we should like raise money for charity or something. And um, Columbia had a pretty tight relationship with the Elizabeth Glazer Pediatric AIDS Foundation. And so we're like, well, let's come up with a gimmick. We're like, maybe we like break a world record. And we're like, well, what world record would like match that foundation? We're like, oh, crawling. We're crawling so kids can crawl. You know, we didn't know how hard it would be, but the uh the record we had to beat, I think it was like 31 miles. We did just under 33. But I wouldn't recommend it to anybody. It was absolutely putting one of the worst physical experiences, but uh we, you know, we got the job done, which was fun.

How long did it take you? And like, what was the worst moment? Was it like mile 30? Or was there a time where you're just like, I don't think, I don't think we could do this?

Yeah, I mean, it was uh there were so many bad moments. I mean, it was it was uh it took just over 48 hours and you can't sleep. You know, the rules you have to keep one knee in contact with the ground at all points in time, and that includes you know, little bathroom tent. And so the worst moments, probably two. One was like we're out there and all of a sudden we had a hail storm, and like we're just being pelted, like huge hail, just like getting wrecked. And we're doing it around a track, and then we're soaking wet and freezing. So we're like shivering and shaking. This is probably mile like 25. Like, we have a ways to go still. And then you wouldn't think this would happen, but we both got motion sick, me especially. Oh, wow. Um, because your head is down, it kind of screws with your orientation or perception, and that you know, the ground is moving differently in front of you. And so you just got sick. And so I'm like every lap like throwing up, trying to get water down. I feel horrible. But I mean, at you know, at some point you're like, well, I'm I'm so close, like I'm not gonna stop. You know, and and that's where this is why, like, the you know, I think in entrepreneurship it's helpful to obviously have to have a co-founder. I mean, my buddy and I were in it together, like he was feeling horrible too. And we're just like side by side crawling next to each other and like, let's just do this, man. And so we just kept going. Uh so going back to IDEO, I mean, do you remember the first time that you met David Webster? Yeah, I do. So, David Webster, the first time I met him, I think it was in a super senior-level client meeting. I remember just uh feeling him bust into the room with these C-level executives, just like the Kool-Aid man. The guy is just incredibly gregarious. And it was this cool moment for me, you know, as I was developing my sense of what leadership looked like, because what I realized was like you didn't have to put on a veneer. Like David was David with me, David was David with the person who cleaned the bathrooms at IDO, David was David, you know, with the C-level executive. And so that really quickly gravitated to him as an incredible role model, but still to this day he's a you know close friend.

Do you remember the first day that you met him?

I think I do because he was wearing an identical shirt to me, and I thought, oh, this kid's alright, he's got good taste. You know, we're we were in uh I mean it wasn't a particularly good taste shirt. Uh I remember it because it was a blue and white striped that I would put on when I had to be kind of semi-formal because I was going in front of a client, and I think Sean probably had the same thought process going. He's just like, I'll play it safe and go semi-formal because it's my first day at Ideal, and we were wearing the same shirt.

Do you remember if you had any first impressions of him other than the shirt?

I mean, that there's a little mania, a little spark in his eyes. He gets excited about something in a in a very irresistible way. It's almost innocent, it's definitely not trying to be cool, it's a very unfiltered, hey, why wouldn't we get excited about this kind of vibe? And when Sean came to IDEO, I had just changed role to leading our Palo Alto studio, and we had done what we could to express our creative culture in our space. It was really beautifully composed, but also not all pristine and persnickety because we had this ethos of a creative culture being a culture of low inhibition, you know, where you feel okay about externalizing your ideas while they're still half-formed and vulnerable. The only guidance that David, the founder of IDEO, had was you should be able to walk up to any surface in the space with a drill in your hand and drill a hole in it and not feel any inhibition about doing that, and it makes it better.

The Palo Alto office, it's kind of like anchored around the centerpiece of this enormous machine shop where like it had all the equipment needed to like build a rapid prototype of something, a physical object. You had people in there at all times, like making things, and the spirit of IDEO was uh very playful. I mean, they took like design thinking and kind of yes and orientation, you know, very seriously, you know, was messy in a great way.

So let's get to the story of like the idea, how Amada got started. So you start at IDEO. Do you remember the first time that you started talking about it?

Yeah, it's funny. There, like IDEO occasionally would do these phase zero projects where they could turn into like, you know, points of view for the world, occasionally businesses. It was very rare, but they wanted to do one in healthcare. And so the question was like, well, how might one build a more evidence-based digital health company? What are the care areas where digital really mattered? Like, what are the care areas where like the existing system is like actually broken, where fundamentally a different design uh experience was needed? They knew I had an entrepreneur bend, so they like were like, Oh, well, maybe Sean, hey, how about you look at this like brief?

Was it a paper brief that you read? What did someone email you a document?

Uh yeah, it was uh someone emailed me a document. And I remember I just like wrote a ton of feedback on the brief and just wrote, you know, a bunch of like red lines back on like suggestions if Ideo were to pursue this. And they were like, that was incredible feedback. Like, actually, we think you and Adrian should like run this thing, you know, Adrian who ran medical products.

You know, the cool thing about IDEO was we're working across all these different sectors, and it seems like there's an opportunity here at the sort of system level to figure out how to do something when you still can. And we didn't know what it was gonna be. So what we're gonna do is we're gonna set up a project. We'll give it three months and we'll put two of our hotshots on it, and uh we'll see what they come up with. And we put Sean and Adrian on it. Sean being this person that we had very quickly realized was someone who can hang and is really extraordinary on the creative heart and soul side, and is really extraordinary on the pragmatic clarity business, get it done, move it forward side. And Adrian James being this amazing engineer, prototyper, builder, you would have put Adrian in any team. He was just like this easy to get along with the type. And we put those two together and said, Yeah, let's see what you come up with.

And so it was great. I mean, they carved out the time and budget for me and Adrian to like really think about what was wrong in medical care, you know, what the business opportunities could look like. I just started to look at the epidemiology, just digging deep into a clinical area and realizing that the deeper you dig, it was like, I was like, this is bad news. And you look at like where we had come as a country, relative obesity, metabolic disease, diabetes, hypertension, you know, all the subsequent conditions, you know, we're looking at that and we're like, this is bad. It feels like it wasn't even getting the attention it needed. Now we have like 156 million Americans with chronic disease, and you know, very few of them are getting the sort of care that like has any chance to actually help their health. And then you look at, you're like, well, what can fix it? You know, we interviewed patients. We sat in the homes of, you know, people in Georgia and you know, and the Bay Area that had prediabetes obesity and you know, diabetes and asked them, well, what was offered to you? And these individuals all had primary care. And it was like, it was so obvious they weren't getting care. I mean, it was like they got a pamphlet and a prescription and then asked to come back in six months. And like it wasn't working for them.

We had a lot of people who had a lot of insight into different components of the diabetes experience, and they used that to characterize this opportunity that starts with the conversation with a doctor, you're pre-diabetic, you need to change your lifestyle, see you next year. And they're like, I think we can probably do better than see you next year.

And so the it was so obvious that the like model of the existing system actually unfortunately would never meet the need. It was obvious that the like the laws of physics of how both the uh current operations and the finances of our healthcare system is structured just do not fit what is needed for these care areas. And so um realizing that the trajectory that the country was on and the globe, frankly, was so horrible that like if you didn't start now, it's like you didn't have any hope. That like just fired Adrian and I up. And it was clear that there was something in the water with digital health, but equally clear that like there needed to be a little bit more refinement. You had these just remarkably different worlds of technology and healthcare. And so the worlds were too separate. That was a moment in digital health where like step trackers were all the rage. And I'd be with my tech friends and like, oh my gosh, these are going to change healthcare. And then my medical school classmates were like, Well, what are the clinical areas? You know, where's the evidence? What are the endpoints? What are the trials? I mean, you didn't have like VCs that would do healthcare and technology at that point in time. So, you know, that felt like that was doing a disservice to really what society could use.

So it was during that internship you went into people's homes and sat with them and and talked. Do you remember? Was there any like one or two people that really stood out?

Oh, yeah. I mean, there was this one woman where we're like showing her the prototype, and you know, at the end, she was just imploring us to build it. She was like, you have to build this. Like, go build this. Please build this, it needs to exist. And we're like, Yes, ma'am. We're gonna we're gonna go build it for you.

Do you remember how long it took? Was it like, oh, you know, you probably had that feedback, you go through a cycle of talking about it. Was it like a couple of days? Was it a couple of weeks? Like, how long did it take you to kind of refine that initial idea into what eventually became a Mada?

Uh, I mean, I think it was a couple of months. I think two to three months after kind of three months, we knew we wanted to swing for it.

Was there a first time when you sort of said, Okay, we really need to like move ahead with this?

Uh you know, I think it was on those like trips visiting people's homes. Because that's where you're like, we're not doing it for us. It's like this is for like all these people, where it was just so obvious. You felt like, how the heck like healthcare is fooling itself. Like the observer from the side would look at those people we interviewed and said, Oh, they're under care. They have a primary care doc. They've got a prescription for medicines, they're under care, they're under great care for their diabetes. You sit in their homes and you're like, uh, they're not gonna get healthier. Like there's zero chance without like active support, they felt totally lost. Um, and so that I think was the moment. It was like leaving those trips. It was like, let's do it.

Can you give us kind of just a quick description of what that initial product was?

Yeah. So I mean, fundamentally, the uh like we're a between visit care provider. And so um, you know, the evidence was clearly there that like with the right longitudinal day-to-day support, you could, you know, help people differently with metabolic disease. You know, the goal is to create a different type of care for those 156 million Americans with chronic diseases. Care areas we're in are pre-diabetes obesity, diabetes hypertension, musculoskeletal care. And then the way we deliver care is pretty common across those. You know, first we set people up with hardware that's needed. So we've got like a cellular connected scale, a blood pressure cuff, a glucometer, a continuous glucose meter. So we get your hardware. Then we introduce you your care team. It's folks like certified diabetes care and education specialists, you know, health coaches, it's physical therapists. Then, you know, everything is tied together with a software experience that's you know done with our mobile app. And so there's goal setting, there's content, there's community, there's tracking. Like we built all the pieces, you know, recognizing that like you couldn't just do the great content or just do the great food tracking experience and have it work. You kind of needed to have it all.

Uh so going back to IDEO, I mean, you know, you expect at that point for it to be what, a three or four-month internship. And did you ever feel any pressure like we got to get this done quickly? Or, you know, did you just fully expect to go back to school?

You know, I think actually at that point I had already asked for a year off because I was just having so much fun over the summer. I knew I wanted to at least spend one more year at IDEO. And then the project, I believe, started January 2011. And so um, I think at that point I was like had that look, I need even more time off from med school conversation with the faculty, and they were like, okay. Um, and we incorporated on April, I think April 24th, 2011. So I was probably uh just about to come up on that you need to come back moment when we spun the company out.

So you kind of had both those things converging at the same time, right? You're like, hey, I could go back to school, I could start the company. Like, talk us through that decision. That seems like a little bit uh harrowing.

Well, it's funny, looking back, I don't view it as a decision strangely. Like uh, you know, sometimes like, oh my, you're so bold, you like dropped out of school. I'm like, no, no, no, that gives me way too much credit. I just like slowly phased out. Um, it didn't feel like a choice, really. I was like, well, obviously I'm gonna keep working on this. You know, I mean, you've lived it in your personal experience, I'm sure, with Weebly. Um, it's like you just get started on something and you're like pulled to it, and you like just fall in love with the problem, and you're like, you can't stop. So it wasn't, it didn't even feel like a choice, which is probably honestly the right thing.

For Sean, it didn't seem like a hard decision. He didn't seem tortured by it. By the time he made that decision, he had absolute conviction that the opportunity that they had glimpsed with this early investigation into Amada, he's like, Well, this is my life's work. Why would I go back to school? I found it. Let's go, you know? And so that was his attitude.

When did that kind of feeling come along and when did it click?

Well, I think uh like the right orientation in building out any business should be to feel that it's gonna be your life's work because it's like it's so hard. I mean, fighting gravity is hard in any sector, it's especially hard in healthcare. I mean, healthcare is like The double black diamond, you know, of enterprise entrepreneurship. And it kind of felt like we saw things that people didn't weren't seeing. Like you talked to the clinical side and they had all these ideas on how to improve diabetes, but they had like zero fluency on product and tech and experiences and connected hardware and like serve different services models. And then the tech side, I'd hear some of the language in entrepreneurs that were like not medical school literate, but like were trying to start tech companies focused on healthcare. I'm like, shoot, that individual could not have a credible conversation with a chief medical officer. So it was one of those things where it's like, you know, it was a good what I say, like founder fit relative to the founder business fit. It was, I was like, well, this is great because like I can speak both languages. Like I know how to credibly hire incredible engineers and designers. Like I know the right words to use to ensure that their skill sets feel appreciated. Like I can have those conversations with the medical leaders because I know how to read a clinical trial. And I had enough medical exposure to like understand like the mental models and healthcare and how it worked and not didn't work. And you know, and I was like, well, this is like a unique thing where it's like, if I don't do it, who does it? Um and that's how me and Adrian started to feel. We're like, well, whatever, let's just like swing at this and uh you abstract yourself from it. You're like, would you want like a company or some people just giving everything possible to this idea? And the answer was an obvious yes. And you're like, well, it may as well be us. And like I do occasionally get the med student emailing me, be like, should I drop out of med school? And the best answer is what obviously Mark and Treason always says, like, no, you shouldn't, you should stay. Because like, if they really should be dropping out, they like will do it anyway, regardless of the advice.

And like, before kind of moving on, I just want to take a second to reflect on that too, because like you said, you get a lot of emails from founders, they're really torn up about is this the right idea, you know, where I want to start a company and I'm trying to think of an idea. You know, in some ways, this was a bit different in the sense that you kind of start as an internship, this idea kind of grew from that. How do you think about how good ideas come along? Is there a process that's usually better, or is it more just about, you know, being receptive to the right idea when it comes along and being prepared for that?

I mean, I think ideas take a ton of work. It's sometimes people are like, well, if you ever founded something new, like what would you do? What would be your idea? Like, I don't know. It would take me like literally like months of work to find the idea. And like the work is literally going down the pathway, like in so many different vectors on like a problem set. It's like you find like the problem, and then you like literally have to like find, especially in healthcare, like go through every single stakeholder. Like, how would this fit into the world of a physician? How would this fit to like a self-insured employer or fully insured plan? Like, it takes a lot of time. We were kind of given that at Ideo. I mean, we had literally three months to do that, and we went in so many different directions, and that led to the conviction. And I think like that's kind of the process. Like, it's a fool's errand to think that, like, oh my gosh, I was dreaming and aha. Because most of those will have already been thought of. In fact, most ideas have already been thought of, but it's the uniqueness of the details on why it's a different take this time around, relative to where the market's at, et cetera, et cetera, that can make it happen. So it's yeah, I guess the misconception that I sometimes feel is like ideas take real work, real work to get there. We'll be right back.

And now, back to the interview. I mean, at some point you clearly decide this should be its own company. When did you realize that? And where'd you go from there?

I think as the project concluded, like Adrian and I were like, we've got that voice in our head from the patients we interviewed saying, Go make this. You know, we were lucky in the time. Like, you know, ID was very supportive, and we had David Webster who was like rooting us on. So we kind of together figured out like how to get the company out, what the right like structure could be that worked for ID or worked for us. And so um did kind of you know some requisite negotiations, of course, and then um we were free.

So at that point, you decide, okay, we're gonna do this as an independent company was a negotiation. To paraphrase a bit, David Webster described that negotiation as the time when he knew it was gonna be big because of the way because of the way you approached it specifically.

They had to get the funding to move the thing forward post-IDO and the VCs being VCs were like, okay, we love the cute kind of provenance story, but we've got to have this thing tidy, and that involves like you guys have got to do the thing that you don't want to do, which is to not have ideal kind of in the mix. And I remember that was kind of a hard and awkward thing for Sean and Adrian to do because they were so you know, they were us, they were our people, this was a success, they were grateful, and they wanted as much connective tissue to ideal as possible. But that moment was a sort of indicative of okay, everyone involved is playing as if this is for real. This is this is gonna be a big thing.

Uh well, I had a different view on what would be like a norm relative to the ownership structure. I didn't have a lot. I mean, I had literally, I'd like no tech background, but it was like there were norms being established in the valley. You know, IDEA had a little bit less fluency with those norms. So we had to find a little bit of a little bit of a be in the middle relative to like getting the thing started. But it wasn't like out of greed or wanting to like have more ownership. It was like literally like if I went to raise a series A on like some of the proposals that were in front of me, I was like, I couldn't. The investor would be like, this thing is dead on arrival relative to the camp. Like, we have to start with a recap, right? It's not gonna work. So, you know, Adrian and I did dig in some heels, but we found a place that really, you know, ended up hopefully working for everybody here, and it worked, I think.

I I think it worked out great. Um, do you remember raising um that first round? Like what those conversations were like? Was it easy to raise that first round? Was it tough?

I mean, it was way harder than I expected. I look at our like seed deck and it's absolutely embarrassing. I mean, I I was just, you know, I was 27. I'd like never hired anybody, I had zero entrepreneurial background.

We love Sean and Adrian, but they're kind of rough around the edges. Like, uh, should we be concerned in terms of how they present? Like Adrian, you know, be in a t-shirt that he'd worn for the last 24 hours eating cornflakes in front of a client, it wouldn't occur to him that he might not want to bring the cornflakes into the client meeting. And Sean was just like super young.

You know, I was in medical school and like worked a little bit in technology, but um, it wasn't like the serial entrepreneurs here. We weren't like out of YC or anything. Uh, equally, it was like a healthcare meets tech play, and it made people nervous. You know, you'd go to these tech investors and like, uh, I don't know about like this diabetes prevention program trial you're talking to me about, and like I don't know how that works, and we're more into tech. And then you go to the healthcare people, like, well, it seems like you can't get monopolistic IP here. Like these health plans, they're just gonna build exactly what you have. Like, I don't see any defensibility. So it was this kind of interesting thing that left it like to be pretty hard to raise money, but we got it done. I mean, we you know, we raised, I think, like an you know, 800 or so K seed round. That's when that's when seed rounds were 800 K. Not like the you know, many multiple millions that they are now. But uh yeah, we got it done just through lots of meetings. And I think it took us like four or five months, probably, maybe even more.

Yeah, our first funding round out of YC was 650K on a two million pre. Yeah, exactly. And the lawyers called it a series A.

Yeah, that's awesome. Exactly, exactly.

And I think, you know, if I'm remembering, I think we met around this time. And and you know, kind of as a bit of background, both of our wives went to college together. They were roommates in college. And I think it was sort of right as you were leaving audio in kind of April 2011 timeframe. Um, what was that process like once you raised the first funding round? I mean, did you just go out and get new offices? Did you start to hire people? Like, what was that like?

Well, we knew we needed some sort of proof that the product could work. So that was kind of job number one. I was like our first health coach, if you will, for a first group. Adrian, you know, coached this group in Chicago on like the software that we had built. And we like knew that had to work. So we had um 16 weeks to show that that software plus Adrian could like help these people improve their health, lose a little bit of weight, and give positive feedback and experience. And so that was a real challenge. But thankfully, I mean the results were great. I mean, it you know, it worked, we got positive feedback that helped lead to like some first really, really, really early customers, which you know led us to eventually be able to raise our A.

Was it? I mean, you know, kind of talking about building the product, getting product market fit, you know, scaling things up. Did you have moments of doubt, pivots, you know, challenges?

You know, I think we're a little early to market. Like it probably honestly probably would have been better probably to start a model like a couple years later. We would have had an easier go of it. Like we had more headwinds because you know, you'd go to these payers and they're like, well, where are your clinics? Like, we don't have them. Like, okay, well, but where are your offices where you see your patients? We're like, we don't. It's like, so it was um the actual like buying landscape wasn't particularly evolved. Um, it's a remarkably risk-averse buying market. Remarkably. Like, I never called ourselves a startup, but we were the digital health company from day one. I like we almost banned the use of the word startup. It is not a market that wants to buy from startups. And I mean, I remember like uh, well, our first office was in Adrian's apartment. And then, you know, at some point, once we had enough money, we're like, you know, I think we're in a we work and we're like really trying to close this customer. It was like um, I had the medical director over from this, you know, big health plan, but it would have been a very meaningful customer. And he liked me and he liked the vision, he liked the early data. But I remember him being in our WeWork conference room and he like looks at me and he's like, Sean, like I really like what you're up to here, but like, let's just be real. Like, you probably had to reserve this conference room, would be my guess. Like, it's true. And he's like, And he's like, I'm about to write you into like a five-year contract with one of our biggest customers. What even gives me any confidence you're here in five years?

You know, it's interesting. I mean, a lot of companies insist on calling themselves startups, even once they've gone public, they're still a startup, right? It sounds like for you guys, that was kind of the opposite. I mean, do you think there was a presumably a positive impact on culture to go in that path?

Well, well, I mean, I do, I do think you have to have a slightly different orientation when building uh, you know, a healthcare company, at least one that I think has like the power of durability, because um, you know, I mean, you can like fall into massive regulatory missteps. You want to move fast, but you have to be a little bit less like shoot at the hip.

Yeah. I mean, I I remember the exact moment we blew, you know, when you're a little startup, it's kind of like, hey, move fast and break things, you know, do whatever you want. Um, I remember the first time I had to sit in a in a staff meeting and be like, our goal is to follow all of the laws now.

Exactly. Yeah.

Um, but uh presumably you were kind of that way from day one. Yeah. And so how quickly, you know, past that first phase where it was really a struggle to get the first customers, you know, after that, how quickly did things start to take off? Was it kind of slow and steady growth? What did that look like?

A little bit oriented toward slow and steady, although, like in enterprise healthcare, you usually don't get like that hockey stick, but you can have very great growth rates, you know, that are durable. There's all these benefits, actually, to that that I've actually I didn't really appreciate as much at the time that I've come to like really appreciate just the like a reliability of growth, reliability revenue profile, like no enormous peaks and valleys. But it certainly wasn't a straight line of success. I mean, like so many zigs and zags, and you know, my gosh, like so many near-death moments. Uh, you know, the frequency that you face an existential crisis widens as you grow. Like in the seed stage, it's like every month, like that designer quits. Like, I'm toast. Like the customer falls through, and that's the only customer you could get to like be able to raise. Like, I mean, our Series A, like, uh, you know, all but fell apart. So we're like basic out of cash, like me and Adrian are putting our own money into like the bank account to make payroll. And it was one of those moments. And like, you know, thankfully, we just called some of our seed investors or like, oh yeah, we'll we'll help you here. Do you remember how low the the bank account balance got? Oh, like it's like $7,000 or something, extremely low.

More after the break. And we're back. Kind of before moving on to scaling the company, I also want to kind of touch on your relationship with David Webster. You know, did did you guys keep in touch? Is it something you kind of went back to him sometimes for advice as you started to scale the company?

Yeah, we're still a super special relationship. Uh, you know, when Janice and I were planning our wedding, we were like thinking like who would we want to have as an officiant? We're like, well, it'd be like the best would be someone where we just like utterly look up to them and their marriage and the way they like they parent and their belief systems. And so I asked David Webster to officiate our wedding, which thankfully he said yes.

I officiated Sean's wedding. It was great. And I remember I like there were there was uh something that was gonna go through my head was along the lines of don't blow it, Webster, this is a really significant moment in a really extraordinary life. You've been given this responsibility, do it justice. I was like this guy's not normal. And he's an absolute ray of sunshine. And to the extent I get to touch that, you don't want to mess it up, you know.

And so that was what was was was going through my mind if I'm being honest. Shifting gears a little bit, I mean, you know, at some point along the way, you know, you have your first kid, and being, you know, a newborn dad and also a startup CEO, I mean, you know, that that couldn't have been easy.

Yeah, no, it wasn't. Uh, I mean, it's never that's that's tough. It's like I used to have hobbies. Um they're coming back as the kids get older, they come back, which is great. So for all of you, you know, parents who were you know soon to be parents. The um, you know, it kind of shifted from like me being able to occasionally like muck around with like hobbies uh, you know, on the the weekend or otherwise to being like mostly like kids and Omara um and be pretty singularly focused. Um, I mean I desperately want to start a business with my kids. I probably talk about entrepreneurship too much with Aletta. Like we did help her uh her realize this lemonade stand vision that she had. But the um uh but it is tough. You know, it's I think it's doable. You just have to simplify. And and and like I don't say yes to any travel or networking event or conference unless I like feel confident that it has material benefit to a Mara. Like I basically pulled myself out of like that scene entirely, not like I was doing a ton of that before, but it's like you just have to be a little bit more selective with what you say yes to.

Totally. So talking kind of quickly about you know the next phase of the company, um, let's talk about GLP ones. You know, it's obviously changing a lot of the way that people are managing their health and chronic disease. Did you anticipate that? Like when when was the first time that that idea was first talked about internally? And then, you know, how much work was there in in working on that idea before launching it?

Well, I mean, I remember seeing the early clinical data from Wagobi, um, you know, Rosempic, again, being like, wow, this is really powerful because the world needs more tools in the metabolic toolkit. And that's how kind of I view these meds. I mean, they're an incredible tool. You know, like everything in life, there's there's not a silver bullet. You know, what I always say is like, look, an injection doesn't get to know you. And so we launched what we call our GLP1 care track in response to customers, you know, that were paying for the meds, recognizing that like the likely path based on the real world data is people take the meds, stop taking them, and regain all the weight. And that's not what they wanted for their employees. Um, so they wanted, you know, longitudinal services support for their employees on the med, just in one of waste spend. The meds are very expensive. So it's a pretty serious economic decision. If you're an employer and choose to put these onto you know, policy, like they're looking at the cost of these and it's a vertical line. Right. And they're like, Omada, if we're gonna do this, like we need to do it in a way that ideally sets people up for long-term success. And equally, what it's done is allowed us to like make the case for just deploying Omada broadly. So that the door may open because of GLPs, but then we can have the broader Omada conversation.

And do you remember? I mean, you know, obviously once a company is a certain size, it could be really hard to introduce new things, to change. Do you think there's something that's key to just staying open and receptive to new ideas as they come along? Because some, you know, there's sometimes never a good time for a transformational idea.

Yeah.

I mean, is that a state of mind? Like, like, how do you think about that?

No, I yeah, I mean, it's I think it's really important because it's like everyone by definition in a growing company is taxed. I mean, your to-do lists are infinity always. And unfortunately, that's just kind of stasis. And so that can be actually an environment where a new idea feels like more work and scary, but you have to purposely like not think that way.

Right.

With our like leadership team, we we always say the core job as a company scales is the leaders need to be thinking about 2027 and 2028. Um, and that's like your operating mandate. And if you have that, then you're more open-minded to like, holy crap, what's happening with these GLPs? Like, we got to do something.

One more moment I want to kind of dive into in the history of the company, but you know, a lot of times you get a company ready to go public for a while and you know, it's kind of hush-hush. It's kind of an internal thing, you know, you don't know exactly when it'll be, you know, based on how the market is. I mean, do you remember that first moment where you're like, all right, green light, you know, we're we're going out.

Well, it's this funny thing because it's almost like planning a wedding, but you don't actually know the date until like a couple of weeks before. So you're trying to put all the pieces together. Um, we felt it was the right moment for Amada, but it was like a rough couple of years in our sector. I mean, you had like all these high-flying companies uh just fall off absolute cliffs and like overpromise what they could deliver on. And so it was very um, you know, we we had to really invest in like multiple rounds of investor education to make sure that they began to understand why we're different than everything else that they failed. Many had lost a ton of money in our space. So it did take a fair amount of like diligence and work. Because you want to, you you should feel pull into the capital markets. That's the ideal. Like you should never push a business into the capital market. So I think we had felt pull, and then it's a little bit like once you got the fundamentals ready, the actual day, it's kind of like when you choose to have a kid, there's not, there's not going to be a perfect time. So it was like we we got enough ingredients here. Let's go for it.

Do you, you know, I'm sure you remember, but kind of the night before the big day, you know, your head hits the pillow. Like, what's going through your mind? I'm you know, did you get a lot of sleep that night?

I I mean, I I slept okay. So the day is largely ceremonial. Like you actually don't even need to go, you could like go take a company public and never ring the bell, never go to NASDAQ, never go to NYSC, like you, but that's such a key part of the experience. And that's the one that's the most emotionally meaningful. I mean, it feels like the wedding. So the night before, um, it like felt big. I had to be up at five because I was going on squawk box first thing in the morning. So did squawk box, then went over to NASDAQ, like gave a speech to the team. There's a lot, it's very public day for a CEO. Like you gave a speech to the team, then you come down, then you give your bell ringing speech, and then there's all these pictures they bring you out to like, you know, Times Square and you look up at Nasdaq and like all these photo moments, and then you come back in, and then just media, media, media, media, media, media. Back-to-back interviews, a couple live ones, you know, you're on Bloomberg and Yahoo! Finance, kind of, et cetera. Um, and then you have your party that night. So it was it was a very tiring day. It was a very tiring day, but an amazing day. I mean, it was incredibly special.

I remember seeing a photo of you when you ring the bell and you're holding a letter, you know, Jams next to you, your wife, your family's there. I don't know that I've seen a lot of other CEOs do that.

Well, I thought it would be fun. Like Omada was enabled in large part by the support of my family. And you know, equally I thought it'd be a fun experience for the kids. And it's special for me. And why would I want to have a special experience without the most special people in my world? And um Aletta actually pressed the bell. So I've actually never rung the bell, still to this day. Aletta, Aletta was the one who did it, but she got she got that done at a age of five.

Yeah, maybe someday she'll ring it again.

Yeah, yeah, exactly. Yeah, she'll let me ring her bell.

Yeah. The IPO was a moment where I mean, I was just like really excited for the fact that Sean would have some sort of return for him and his family that was commensurate with the fact that he's put his life into this. There's a little bit of me which I I think he's way smarter than this. He doesn't need me worrying about him, but he's utterly selfless. Like, literally, I when he gets up in the morning, he is not thinking what's in this for Sean, he's thinking about how he's gonna make this thing happen. And I was like, I hope Sean takes care of Sean at some point, you know. And that was the biggest thing I felt in in that moment. I was like, Yeah, the crawling guy from the coffee room floor made it happen, you know. And the you know, the the good guys won. You don't you don't see that so often, you know.

Our mission at Armada is to bend the curve, the curve of disease. Success for us is that tomorrow's epidemiologists like look at the conditions and they notice like a bend. And they're like, what the heck is that? Things seem to be improving. And they, you know, they try to like pull back the curtain and figure out what happened. And of course, we won't be the only answer, but we want to be part of it. And so I think like the next decade mission is to bend the curve and like actually, like, actually bend the curve. Let's think about what it would take. Let's think of how big the business would need to be and you know how we do it, and what are the tactics and strategies, and like we've kind of like set the table, and now it's time to like actually pull it off.

This was awesome, Sean. Thanks for coming on.

Oh, yeah, yeah, yeah. Absolute pleasure. Uh, you know, uh David, thanks for uh thanks for having me.

This podcast is brought to you by Leap Forward Ventures, an investor in early stage startups. If you like the show, the number one thing you'll want to do is sign up to get notified when we release new episodes that includes transcripts and key takeaways from each story. Head to leapforward.fm to sign up. I'd also love to hear your feedback on the episode and who you want to hear from next. Just shoot us a text at 415-915-3050 to get in touch. This episode was produced by Theo Balcomb and Kim Nederveen Pieterse. Craig Eley is our engineer. Reece Laudano made our cover art. Music is by Jim Brunberg and Ben Landsverk of Wonderly. I'm David Rusenko, and this is the Leaf Forward Podcast. See you next episode.

Sean was this very unusual both hand. He's like just this kind of open, genuine, for the love of it and the joy of it, creative being, and he's this ultra-action biased make it happen business pragmatist. But usually the thing that catalyzes those two sides is ego and a fundamental motivation that the person is sort of working on the legend of themselves. And there was none of that. Zero of that with Sean. He's utterly selfless. He's openly pulling people into this vortex of following your fascination with gusto in this incredibly unfiltered way. And that's unusual. That's extraordinary.