AI-Driven Behavior Change Could Transform Health Care

On the eve of the launch of Thrive AI Health, the company the OpenAI Startup Fund and Thrive Global are jointly funding to build a customized hyper-personalized AI health coach, Sam Altman and I wrote a piece for TIME explaining the vision that led to the launch of the company.

Nearly 130 million Americans have at least one major chronic disease — and 90% of our $4.1 trillion in annual health care spending goes toward treating these physical and mental-health conditions. That financial and personal toll is only projected to grow .

We know this is unsustainable. But there are solutions, because health outcomes are shaped by more than just medical care or genes. Behavior change can be a miracle drug, both for preventing disease and for optimizing the treatment of disease.

Yes, behavior change is hard. But through hyper-personalization, it’s also something that AI is uniquely positioned to solve.

AI is already greatly accelerating the rate of scientific progress in medicine — offering breakthroughs in drug development, diagnoses, and increasing the rate of scientific progress around diseases like cancer.

But humans are more than medical profiles. Every aspect of our health is deeply influenced by the five foundational daily behaviors of sleep, food, movement, stress management, and social connection. And AI, by using the power of hyper-personalization, can significantly improve these behaviors.

These are the ideas behind Thrive AI Health. The AI Health Coach will be trained on the best peer-reviewed science as well as Thrive’s behavior change methodology — including Microsteps , which are tiny daily acts that cumulatively lead to healthier habits. And it will also be trained on the personal biometric, lab, and other medical data you’ve chosen to share with it. It will learn your preferences and patterns across the five behaviors: what conditions allow you to get quality sleep; which foods you love and don’t love; how and when you’re most likely to walk, move, and stretch; and the most effective ways you can reduce stress. Combine that with a superhuman long-term memory, and you have a fully integrated personal AI coach that offers real-time nudges and recommendations unique to you that allows you to take action on your daily behaviors to improve your health.

Right now, most health recommendations are generic: your patient portal might send you an automated reminder to get a flu shot or mammogram, or your smartwatch may ping you to breathe or stand. The AI health coach will make possible very precise recommendations tailored to each person: swap your third afternoon soda with water and lemon; go on a 10-minute walk with your child after you pick them up from school at 3:15 p.m.; start your wind-down routine at 10 p.m. since you have to get up at 6 a.m. the next morning to make your flight.

Using AI in this way would also scale and democratize the life-saving benefits of improving daily habits and address growing health inequities. Those with more resources are already in on the power of behavior change, with access to trainers, chefs, and life coaches. But since chronic diseases — like diabetes and cardiovascular disease — are distributed unequally across demographics, a hyper-personalized AI health coach would help make healthy behavior changes easier and more accessible. For instance, it might recommend a healthy, inexpensive recipe that can be quickly made with few ingredients to replace a fast-food dinner.

Health is also what happens between doctor visits. In the same way the New Deal built out physical infrastructure to transform the country, AI will serve as part of the critical infrastructure of a much more effective health care system that supports everyday people’s health in an ongoing way.

This would have an impact not just on our physical health, but on our mental and emotional health as well. When we’re depleted and stressed, we’re more likely to choose options like endless scrolling or emotional eating that might give us a quick dopamine hit, but won’t make us healthy or happy in the long run. With personalized nudges and real-time recommendations across all five behaviors — helping us improve our sleep, reduce sugar and ultra-processed foods, get more movement in our day, lower stress, and increase connection — AI could help us be in a stronger position to make better choices that nourish our mental health. It could also use our health information to make recommendations based on what motivates and inspires us. So much of the conversation around AI has been about how much time it will save us and how productive it will make us. But AI could go well beyond efficiency and optimization to something much more fundamental: improving both our health spans and our lifespans .

How our behaviors can be used to nurture our health and our full humanity is a topic that’s long been of interest to both of us. Arianna has written several books on the subject. Throughout his career, and while building OpenAI, Sam learned the value of prioritizing these five foundational behaviors, including getting enough sleep, eating well, exercising, spending time in nature, and meditating. This has helped him deal with his stress and anxiety and be more able to stay in the eye of the hurricane. By focusing AI on healthy behavior promotion and taking advantage of its ability to process potentially several billion data points, we put in our hands a powerful tool for positive change, ensuring technology works for our well-being rather than against it. Incentives are superpowers. And so far, they’ve mostly been used to tap into outrage and increase stress. But by creating new incentives, Thrive AI Health can make it possible for the users’ personal data to be used for their own benefit, helping us all make better decisions and lead healthier lives.

With AI-driven personalized behavior change, we have the chance to finally reverse the trend lines on chronic diseases, benefiting millions of people around the world.

Read More in TIME: AI-Driven Behavior Change Could Transform Health Care

A Leadership Cautionary Tale

Ever since I started thinking about leadership, I’ve considered “The Emperor’s New Clothes,” the 1837 folktale by Hans Christian Andersen, to be the ultimate leadership manual. As the story goes, swindling tailors make the Emperor a fine outfit that they tell him will be visible only to those who aren’t foolish or incompetent at their jobs.

When the tailors pretend to dress the Emperor in his new clothes, those assembled marvel at how beautiful they are, and the Emperor sets off on a procession through town. Along the way, not wanting to appear foolish, everybody exclaims how “extraordinarily magnificent” the clothes are — until a child blurts out, “But he hasn't got anything on.”

That breaks the spell, and the people repeat, “But he has nothing at all on!” The Emperor, however, soldiers on. “The Emperor was upset,” the story continues, “for he knew that the people were right. However, he thought the procession must go on now! The lords of the bedchamber took greater pains than ever to appear holding up a train, although, in reality, there was no train to hold, and the Emperor walked on in his underwear.”

We see this phenomenon all the time, and in all industries. This summer, we’ve seen it play out in the presidential race, with some Democratic leaders and trusted aides shielding the President from the truth. Until, finally, the spell was broken and the President saw the truth in front of him and did the right thing. As George Orwell, another storyteller who speaks to our current moment, put it: “to see what is in front of one's nose needs a constant struggle.”

Gold, Silver and Bronze

Mindset makes a difference. Not just in winning or losing, but even when we’re winning. As the Olympics go into its last week, Linh Ta reports in Axios on a fascinating study about Olympic medalists in which researchers found that silver medalists were actually less happy than bronze medalists, even though they performed better. It’s because of a phenomenon known as “counterfactual thinking,” which Andrea Luangrath, a professor at the University of Iowa and a study co-author, describes as thinking about “what could have been.” Silver medalists are more apt to use “upward comparison” and judge themselves negatively relative to the gold medal winner. Bronze medalists, on the other hand, are making a “downward comparison,” thinking, as Luangrath put it, “I’m glad I’m on the podium at all.” And it isn’t just athletes who engage in “second-place thoughts,” says Luangrath. “There will always be someone who is faster, smarter, stronger, wealthier. Just revel in the happiness of the moment — and maybe not so much the outcome.”

The study reminded me of a recent paper by Dr. Kevin Volpp and Alisa Camplin-Warner. Dr. Volpp is a renowned behavioral economist at the University of Pennsylvania School of Medicine (and a member of Thrive Global ’s scientific advisory board) and Camplin-Warner is a two-time Olympic medalist in skiing. It’s about how to use the lessons of coaching in elite athletics — like goal setting, purpose, measuring success, and learning from failure — to help people improve their health and their lives. As they write, “While achieving Olympic-level performances is not a realistic goal for most people, we argue that achieving the highest possible level in terms of health and health behavior is both high stakes and attainable. In contrast to high-performance sport, in which there is always a limited number of spots on a team or the podium, each of us can attain elite levels of health without any restriction on how many people can achieve success at once.”

So no matter how we do, where we are on the podium, or whether we’re on it at all, we should celebrate small wins and enjoy the moment. And now back to the Games.

BEFORE YOU GO

Study of the Month

We know doomscrolling is bad for us — the name is something of a tipoff — and now we know why: because it increases feelings of, spoiler alert, doom. Researchers?found ?that doomscrolling is “associated with elevated levels of existential anxiety,” making participants feel distrustful of others and question whether life has meaning. Which isn’t ideal. “When we’re constantly exposed to negative news and information online, it can threaten our beliefs when it comes to our own mortality and the control we have over our own lives,”?says ?lead author of the study Reza Shabahang . “Moreover, doomscrolling can negatively affect how we view the people and world around us.” So next time you’re tempted to doomscroll, do yourself a favor, put the phone down, and tap into a quality that’s pretty much the opposite of doom: joy. Find a joy trigger, like listening to a song you love, reading an actual (non-screen) book, or taking a walk. As Jean-Paul Sartre put it, “If you are lonely when you are alone, you are in bad company.” Or, to paraphrase another Sartre-ism: “hell is other people’s feeds.”

Monkey See, Monkey Don’t

Zoos around the country are sounding the alarm about a new demographic having problems with screen time: gorillas. As Sara Randazzo reports in The Wall Street Journal , visitors to zoos are increasingly showing screens to gorillas and it’s having the same effect on them that it has on their upright cousins: they’re hooked. For instance, Jelani, a gorilla in Louisville, Kentucky, taps his finger on the glass when he’s ready for a visitor to swipe. Zoo officials discourage the practice. After all, for both gorillas and humans, screen addiction is a way to turn great apes into not-so-great apes.

Best,

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