Usually, individuals only undergo lab testing when their doctor is in the process of trying to understand what’s wrong with their patient. In addition, getting data about yourself via consumer lab testing is an antiquated, opaque process. With the consumer health market on the rise, Laila Zemrani created Fitnescity to meet the growing demand. Fitnescity is a consumer health platform that offers a suite of fitness, nutrition and general health lab tests. The startup is based in New York City.
Frederick Daso: What useful kinds of data are consumers missing about their physical health?
Laila Zemrani: As consumers, we live and work in an information-driven world, with our Amazon accounts anticipating what we will order before we’ve even searched for it. However, when it comes to our relationship with our bodies, data is lacking and insights are scarce. For most of us, the human body is still a black box that we are trying to decode with wearables and generalized formulas like body mass index (BMI).
We’ve been conditioned only to look inwards to assess our health once something is wrong. So, aside from an injury, illness, or an annual physical, most people make daily decisions off of limited information and hope for the best. But, what if we treated our bodies like we do our cars? We don’t just guess how much fuel to use. We get a real-time view of our cars’ health, from tire pressure to window washer fluid.
This lack of information has been one of the significant problems in healthcare. As much as 80% of the most common and costly health conditions—such as Type 2 Diabetes and heart disease—are preventable. If consumers could turn on their dashboards and see those warning lights, it would significantly improve our population’s general health and lessen the current burden placed on our healthcare system.
The good news is that the rise of wearable technology, health tracking apps, connected home devices and smart apparel indicates that a new wellness culture is emerging. For a portion of consumers, health is becoming a daily pursuit—self-collected data has been the driver behind this shift. Those above are excellent tools but are limited in terms of data application. We need to go beyond steps and heart rate to derive meaningful insights. We need tools that paint a complete picture: a comprehensive and longitudinal view of our bodies. We imagine a world where everyone has a personal dashboard in their pocket with data on their continuous blood glucose and cholesterol levels, vitamin deficiencies, body fat percentage and metabolic health, along with actionable recommendations.
Daso: Why is lab testing, an avenue to provide this data to interested consumers, outdated? What antiquated methodologies are they using to quantify human health?
Zemrani: If wearables provide a glimpse into how we live our daily lives, lab testing is like a window into our bodies. A simple lab test—coupled with a meaningful analysis of the results—can provide precious insights.
Until now, lab testing has only been used in traditional medicine and as a B2B product, making it challenging to navigate even for the most knowledgeable consumer. In a time when flights and groceries are purchased with the click of a button, consumers expect a level of ease when they’re shopping for anything. But the experience is very different when it comes to lab testing—most consumers don’t know where to go, what number to call or even what test they should take.
Assuming the customer manages to navigate the hurdles of merely finding and completing a test, they’re only halfway there. They still have to figure out what the results—beyond data points and acronyms—mean and, most importantly, understand how to use those results to make meaningful changes in their life.
Unless lab testing is offered like any other tech-enabled consumer product, consumers will never be able to take advantage of its benefits and, therefore, never fully be in control of their health.
Daso: Diving deeper into the space, what is the consumer health-related lab testing market’s size? What is driving its growth?
Zemrani: Wearables, which are relatively limited in terms of data, are a $50B market, and wearable fitness companies, like WHOOP, have recently crossed the billion-dollar valuation mark. Lab testing can be seen as the next generation of fitness tracking, where we move from collecting 3 data points to 30. It’s an enormous white space with the ability to push the consumer health market far beyond its current value of $250 billion.
Besides wearables, companies like 23andme have pioneered the consumer health space, making genomics and biotechnology accessible with direct-to-consumer products. These companies were also responsible for introducing consumers to the narrative of taking health into their own hands. And, in the last year, the COVID-19 pandemic has made telehealth and direct-to-consumer medical testing not just common but instrumental for consumers’ health and safety. The result of which is increased consumer interest in preventative testing.
Previous decades have seen a few cash-rich players rise in the healthcare industry, largely dependent on sickness for revenue. We believe that the next few years will see the rise of a new generation of multi-billion dollar companies instead of focusing on prevention and general wellness.
Daso: How did you decide on the first set of tests to offer to potential customers? What drove your business model and go-to-market strategy in terms of optimizing your reach with this particular initial group?
Zemrani: We are a customer-driven company. While my co-founder Çağatay Demiralp and I started with a big vision of improving healthcare for everyone with our dashboard, we quickly realized that this shift would only happen if consumers drive it. On the demand side, we were revenue-positive since day one, satisfying a need that has quickly guided us towards what tests we should provide.
On the supply side, we worked with our first partner, a large hospital system in New York City, to redesign the experience around their most popular tests. We then made those tests available on our platform, surveying our early adopters as much as possible.
The result is that we ended up focusing on the tests that help customers solve specific problems. We narrowed these core problems down into three categories: (1) managing weight, (2) eating mindfully and (3) improving long-term health. Every test we aggregate needs to solve one of these core problems.
This approach has forced us to be disciplined in the products we provide, resulting in a customer acquisition cost close to $0.
Daso: Usually, one would have their doctor order a slate of tests to an idea of their physical fitness. How has Fitnescity made lab testing more accessible to the average person, especially those without a primary care provider or those lacking knowledge about taking care of their bodies?
Zemrani: For half of the world’s population, primary care doctor visits last less than five minutes. That is not enough time to discuss a patient’s most pressing questions, let alone go through critical aspects of their lifestyle such as diet and physical fitness. Most doctors are trained to treat people who are sick. As a result, physical fitness, nutrition and preventative health are rarely the triggers when a doctor orders a set of tests.
With or without a primary care provider, most people have never had these preventative assessments ordered for them by their doctors, so there is not a lot of awareness surrounding these tests in regards to how it works and the results you receive.
The first step, and one of the most critical for us as a company, is working with our partner labs to educate the consumer. Our Customer Growth team, led by Melissa Benkendorf, is primarily focused on driving its efforts in educating consumers through content and personalized communication.
Addressing the current lack of accessibility to testing is our subsequent focus. Often, when consumers decide they want to learn more about or have a lab test performed, they don’t know where to go. The general consumer’s knowledge of the lab testing network—private labs, clinics, hospitals, and universities—is generally low and for a good reason. Labs are difficult to find and even more difficult to contact. We take away that guesswork by giving consumers access to our network of partners that we have already discovered, vetted and partnered with—agreeing upon an upfront price.
The third factor, understanding, is last but not of lesser importance. Most assessments of this type would traditionally finish with a paper printout that contains your data—as important as it is unreadable. A key part of what we do at Fitnescity is taking that data and translating it into understandable and actionable information. We create a personal dashboard that explains what these numbers mean and give people information that empowers them to make positive lifestyle changes. This dashboard is theirs forever, allowing easy access to their information and the ability to compare over time.
Daso: What are the incentives driving leasing labs such as Quest Diagnostics and hospital facilities to partner with Fitnescity in providing these tests?
Zemrani: Our partners are usually the first ones to believe in and champion our vision. However, the larger ones are rarely able to reinvent themselves as consumer companies or as prevention-driven organizations. This creates the perfect environment for a partnership between them and Fitnescity. This is especially the case for large industry leaders such as Quest Diagnostics or big hospital facilities.
For smaller partners such as local imaging centers, universities, wellness and sports medicine clinics, our partnership helps them take advantage of the growing demand for preventative lab testing. Whether they lack the marketing resources or are just unaware of the market segment available to them, we help push customers through their doors. It’s a rare thing to meet a facility that will turn away easy revenue, especially under the strain of the ongoing pandemic.
In some cases, we even educate them on their equipment’s capabilities (and therefore revenue opportunity). In the process of researching and vetting potential partners, our Head of Partnerships & Growth, Jenna Parker, recognized that many imaging centers and clinics are only utilizing their dual-energy x-ray absorptiometry (DEXA) machines—medical equipment for bone mineral density screening—in conjunction with osteoporosis detection. However, most of these expensive DEXA machines are also capable of performing full-body composition scans. By educating those locations on the additional capability of their machines, we are opening them up to a completely new market segment.
Daso: Is there any possibility for U.S. health insurers to provide coverage for ordering these tests as well, considering one could be viewed as lowering their risk profile by being proactive about monitoring their physical health?
We certainly hope so. Our healthcare system continues to evolve, albeit often at a snail’s pace, and has already taken steps towards recognizing the benefits of certain types of preventative and alternative care in some plans. As interest continues to grow at the corporate level—with companies adding alternative care, like Fitnescity, as wellness benefits for their employees—higher-level change will certainly follow.
That being said, one of the benefits of working outside of the insurance system is that it allows us to be fully transparent with our customers about the cost of testing. They never have to worry that they will have to pay more because insurance won’t cover it or that they’ll get a surprise bill in the mail at a later date.
Daso: What’s the most important thing you and your team have learned from your customers?
Zemrani: When building an entirely new product, customers can teach you just about everything. Perhaps the most significant thing we have learned from our customers is that lab testing is just the beginning as insightful as it is. Consumers want our data to inform the rest of their decisions, from their nutrition plan to their supplement intake and exercise habits. Ideally, they would want all of that to co-exist in the same environment.
This has enabled us to broaden our vision as a company. In the long term, we do not view ourselves solely as a lab testing platform but as a new way of approaching wellness. Long-term, we see our platform as an end-to-end brand that provides the tests and integrates with other data sources and powers other offerings, from gym memberships to meal plans and supplement subscriptions. It all comes back to helping customers solve specific problems, but we learned that the data we collect would enable us to be there beyond the tests and throughout the customer’s wellness journey.