By the year 2060, the number of people in the United States aged 65 and older is projected to more than double from 46 million today to over 98 million. As a result, the cost of healthcare continues rising, as providers and insurance companies try to find ways to care for this aging population. Many have been looking to find solutions to the many issues that we're facing in this space.
Cake, a digital health startup based out of Boston, is hoping to become the leader in the space of end-of-life planning and advance care decisions. Their online platform makes it easy for individuals to make these types of decisions and store them in a secure system. The team understands that for many, it’s often difficult to make these types of plans for people they care about. Through their technology, they create a seamless experience for those hoping to make these important life decisions for themselves or a loved one.
After signing up, users are taken through a streamlined process where they’re asked to answer ‘yes’ or ‘no’ to prompts like ‘I want my funeral to be a celebration of my life’ and ‘I have a living will or advance directive.’ Depending on each answer, the platform helps to identify what types of decisions and services each user should pursue. Choosing end-of-life preferences ahead of time can help prevent financial losses, unwanted medical interventions, and conflict between loved ones.
To date, Cake has worked with some of the largest healthcare networks in Massachusetts, including Harvard Pilgrim and Blue Cross Blue Shield of MA. They also recently raised a $1.35 million seed round, with the hopes of expanding their reach and making end-of-life planning more accessible to all.
I sat down with Suelin Chen, cofounder of Cake, to speak about her motivation and experience in starting this company. She explains that she always had an interest in healthcare but didn’t necessarily want to pursue a career as a clinician. She pursued a Ph.D. at MIT in Engineering and focused her work on medical technologies related to the treatment of prostate cancer.
“That was the first time that I was exposed to the fact that more medical interventions are not necessarily better for the patient, yet our healthcare system is not set up in a way for these types of conversations to happen. Patient’s families have to either be extremely proactive advocates, or you have to get lucky and encounter a clinician that will present your options in a clear way. This got me thinking about how to contribute to healthcare more directly.”
After working as Director of The Lab at Harvard University, she went on to become a consultant and transaction advisor to healthcare companies in Boston. As part of her work, she was tasked with defining the financial value of new therapies.
"I had to evaluate what a therapy was worth if it extended someone’s life for three months or six months. I talked to insurance companies and prescribing physicians all the time, and I just kept coming back to the dysfunctional way we do end of life today, especially in the United States. Incentives are very confusing and misaligned. The whole system is just not set up to support what a person would want.”
Soon after, Chen met her soon-to-be co-founder Mark Zhang at a hackathon, where they bonded over their shared interest in end-of-life care. Zhang, a palliative care physician at Dana-Farber and Brigham and Women’s Hospital, brought on his experience in the healthcare space to the team. “Once I met Mark, we had a clear vision of what was needed to make an impact in this space. We ended up winning first place at that hackathon, and that’s kind of how it all started.”
In the beginning, they explored different options as to what their product could look like. Because end-of-life is such a universal topic, Chen and her team had to think through how to target a particular audience. “We had a lot of interest from different types of companies and users, but we couldn’t serve everyone at once. So figuring out our direction has been important but challenging, because there is so much we want to do.”
In this process, they were also tasked with finding a way to make their approach to this subject accessible. They knew they needed to prioritize lowering the barrier to entry to speak about this topic. “This is a challenging topic for most people. One question we asked ourselves was, where can we meet people so that people feel interested enough start? We thought that it was more important to get people in the door rather than pushing people to be totally comprehensive all at once, especially since it can be such an emotional topic for a lot of us.”
Their current platform has made it simple for people to approach this conversation in a way that is simple and accessible. Their easy-to-use online dashboard is made available through healthcare organizations and on their website and can be used to plan end-of-life preferences for yourself and loved ones.
“The biggest success is all of the feedback we’ve gotten from people saying ‘I always wanted to take care of this, it’s given me so much peace of mind’ or people who feel like they’ve wanted to talk to a parent about this. A lot of our users are people who have experienced loss along the way and feel that it could have gone better, and are now motivated to plan for someone they care about. That’s why we do what we do.”
In our conversation, Chen and I spoke about some of the most important lessons she’s learned about starting a company in this space. For one, she explains that if she could have done things differently, she would have approached fundraising in a more relaxed way.
“I think I would have stressed out less about fundraising. Sometimes that is impossible to do if you don’t have the resources to build the business that you want to build. But, I think it’s perfectly fine to make incremental progress. You hear these stories in the media of companies raising a bunch of money when at times it’s just not that linear. You don’t have to wait to raise that perfect round. Raise a little money, and prove something to get to that next step.”
We also speak about her experience in becoming a mother during the fundraising process. She explains that going through the process of starting a company while pregnant motivated her to become a relentless prioritizer and to have a very clear plan with her team and her family.
“I’m so motivated to do what I do for my daughter. I definitely feel like I’m leading my life as a good role model for her. I want to show her she can create something good for the world. Plus, I truly believe that if you want something to get done, give it to a busy mom. You’re just always getting things done. There is no wasting time.”
In the future, Chen is hoping to make the Cake platform as accessible as possible, and in that process, to help destigmatize the topic of end-of-life. In the end, she believes that it’s inevitable that a tool like this will exist, and that having these critical choices in the cloud is essential.
“There is a lot going on in the news about healthcare, so I think it’s good timing for us. So much of our GDP goes to this--17.9%!--and yet our healthcare outcomes are not very good. There are so many misaligned incentives. We want to be a part of empowering the consumer, making it easier for them, and reducing costs without compromising quality. And as our population ages, it’s something we’ll all have to think about.”
If you are interested in what Cake is working on, check out their website for available opportunities.
