9amHealth describes itself on its website as offering “complete cardiometabolic care.” The company further says it takes a “whole-body approach to chronic conditions is the most effective way to get and stay healthy for good” by providing hands-on help for things such as diabetes, weight loss, and heart health. The startup has apps on iOS and Android, and specializes in providing services organizations such as employers and health plans, but also individuals via a $69 per month subscription.
For co-founder and co-CEO Anton Kittelberger, the decision to help start 9amHealth stemmed from a deeply personal place. In an interview with me conducted earlier this month via videoconference, Kittelberger said about his journey coping with diabetes; he was forthright in saying “I honestly do not know a life” without the disease. Throughout his life, he added, he kept his condition a secret because he didn’t want anyone to perceive him as weak. “[Diabetes is] a very annoying and lifelong disease,” he said of coping with the condition all his life. “I’m very much aware of that, but I don’t think it should be something that stops you because you can still achieve everything you want to do in life.”
According to Kittelberger, the impetus for starting 9amHealth originated out of a desire for convenience and accessibility. He told me people lead busy lives, and it can be hard from many to be diligent about seeing the doctor, getting lab work done, and staying on track with any needed medication(s). Not to mention the fact, from an accessibility standpoint, it can be difficult, if not downright impossible, for a disabled person who’s also, say, diabetic to traipse around town getting to and from doctor’s offices and clinics. That “learning and realization” of these extenuating circumstances is what led Kittelberger to start 9amHealth.
Dr. Avantika Waring, 9amHealth’s chief medical officer and a trained physician and endocrinologist, told me in a separate interview she came to the company two years ago to help provide what she described as “what is really the first and only end-to-end virtual cardio metabolic clinic that cares for people virtually who live with diabetes, high blood pressure, high cholesterol, and obesity, as well as pre-diabetes and heart disease prevention.” She went on to say conditions such as diabetes, obesity, and other cardiometabolic conditions “are on a scale right now in the [United States] that we’re just not able to accommodate people with the quality and level of care they need in the traditional [healthcare] system.” Even when people can, and do, access care, they often are seeing a specialist one time and don’t have the kind of outside support needed to prolong the best care. 9amHealth, then, is designed to bring “complete, high quality, almost concierge-like experience of getting the best care for your conditions to anyone anywhere.” Dr. Waring said 9amHealth tries to reach people living in more rural locales and people—like many in the disability community—who can’t necessarily get to and from an outpatient clinic. “In my mind, we know what works [and] we know what makes people well,” she said. “[We thought we could] bring it [care] to them instead of having people piece it all together themselves.”
At the highest level, what both Kittelberger and Dr. Waring expressed about reaching people, and leveraging modern technology to further the company’s mission, speaks to issues faced by so many in the disability community. Not only are chronic conditions indeed disabilities, the reality is the logistical problems with finding care and literally accessing are both big, seemingly unbreakable barriers. Like so many of the other health tech companies that have seen this space’s spotlight over the years, the sheer might of modern technology is the big driver of what makes 9amHealth and its ilk possible. In this context, it’s accessibility in both senses of the word: a disabled people can literally access care while using the most accessible computer they have (usually their smartphone) in doing so. This is not a trivial detail that transcends sheer convenience.
Dr. Waring expounded on the accessibility benefits of telemedicine.
“When you think about accessibility, there’s so many components of that,” she said. “Sometimes it’s geographies, sometimes it’s the physical ability to travel, sometimes it’s financial. We work with a lot of individuals who have shift work schedules, or the types of jobs where missing work has a big financial impact to them. So, [we are] offering care that you can do on your break at work—you can text with your team, you can check your messages [and] we can talk before or after work hours is super important, because so many Americans are not able to [access care]. Everybody wants to be healthy. Nobody doesn’t want to be healthy. But there are a lot of barriers in the way for people to achieve those goals, and we [at 9amHealth] really aim to bring those down.”
In keeping with the accessibility theme, one group 9amHealth is particularly keen to serve is Medicare recipients. The open enrollment period is in full swing right now; it’s a misnomer that Medicare is available only to senior citizens. As a lifelong disabled person, I can confirm my disabilities have made me eligible for Medicare my entire life. For 9amHealth, Dr. Waring said people on Medicare are “often overlooked” in terms of telemedicine, telling me there is a common misconception that older people are afraid of technology, or curmudgeonly about it and refuse to use it. During the pandemic’s apex—or nadir, if you prefer—Dr. Waring said she noticed the number of seniors using virtual care services rise exponentially out of necessity. One thing of particular note is most seniors prefer appointments without a video component, rather preferring secure messaging, phone calls, and the like. Video visits, while accessible in their own right, can be burdensome in terms of having the right ambient space, language barriers, technical setup, and more. Dr. Waring emphasized texting and phone calls are part of telemedicine just as much as video calls. 9am Health is cognizant of these factors, with Dr. Waring telling me the company tries hard to “connect flexibility” with the team and its users. On 9am Health’s Medicare program specifically, Dr. Waring said in part “we are flexible of meeting our members where they’re at and using whatever mode of communication that they’re comfortable with, because that’s how you’re going to get the best outcomes is by having people want to engage and feel comfortable with your care.” To this end, she added 9amHealth has “focused heavily on investing in the technology for the care component, for our algorithms, for our labs and things like that.”
For Kittelberger’s part, he wants help people with chronic conditions access better care by “taking them on a truly enjoyable journey.” To Dr. Waring’s point about meet people where they are instead of the other way around, as is convention, he said the company’s North Star truly is building a first-class user experience by leaning into technology and finding pathways to things like lower costs of prescription medication.
“I want to create a world where healthcare doesn’t feel as much as healthcare anymore and create a new day for people with chronic conditions,” he said.
When asked about feedback about 9am Health’s work, Dr. Waring told me the response is commonly awesome. People are genuinely impressed by what the company is trying to achieve and how they go about it. People also say they know people who would benefit from 9amHealth due to travel concerns and whatnot. Clinically speaking, Dr. Waring noted her colleagues are often impressed because 9am Health’s accessibility often means patients needn’t “wait months and months for appointments.” 9amHealth wants to make healthcare easy for people.
“We definitely get a lot of great feedback when people hear about what we’re doing at 9am,” Dr. Waring said.
Looking towards the future, Dr. Waring said the company’s goal is simple and, in many ways, singular: 9amHealth wants to help more people. Company leadership has all sorts of ideas for doing so, which include expansion and iterating on current products. For Dr. Waring, her goal is to further normalize virtualized healthcare and expand its capabilities—obviously, a large degree of medical care needs to be done in-person—as much as possible. In a nutshell, she wants to “bring the whole experience to the patient as much as possible.”