The Intersection of AI and Healthcare: Challenges, Innovations, and Investment. Digital Health Interviews: Ankit Jain

In this special episode, we have a unique format with two interviewers and one guest. Sergei Polevikov, who was recently interviewed on the podcast, joins Alex Koshykov as a co-interviewer. Our guest today is Ankit Jain, the founder and company lead at Infinitus. He shares his journey through the tech landscape, discusses the challenges and opportunities in healthcare, the importance of APIs, and how AI can transform patient experiences.

Ankit Jain’s Background and Journey

Ankit Jain introduces himself as the founder of Infinitus, a San Francisco-based startup focused on automating tedious back-office operations in healthcare using AI. He shares his journey, starting with his move to the Bay Area 28 years ago, inspired by his father’s career in network security and startup ecosystem.

After studying linear algebra on multi-core machines at UC Berkeley, Ankit joined a search engine startup working on natural language understanding. The company was later acquired by Google, where Ankit became part of the Android team. There, he was instrumental in launching Google Play, developing its search engine, recommendation engine, and personalization platform.

Ankit’s experience at Google led him to recognize the power of mobile device data. Observing the poor state of mobile advertising in 2012, he left Google to start a company focused on understanding users through their devices. This venture evolved into a competitive intelligence company with data from 250 million phones worldwide, which was eventually acquired by a larger competitor.

Following this, Ankit returned to Google to help start their AI venture fund. In this role, he invested in early-stage AI companies, both vertical full application companies and horizontal platform companies. This experience gave him a front-row seat to the emerging possibilities in AI technology, especially with the release of the Transformers paper in 2017.

The Genesis of Infinitus

Ankit’s journey into healthcare technology began with an unexpected insight from his wife. After witnessing Google’s Duplex demonstration at Google I/O 2018, Ankit was excited about the AI’s capabilities in natural conversation. However, his wife challenged the application’s significance.

She pointed out that in healthcare, there are hundreds, if not thousands of people making phone calls just to keep the system running. These are individuals who joined healthcare to serve patients and be empathetic, but instead spend their time on hold checking claim statuses or prior authorizations.

This revelation sparked the idea for Infinitus. Ankit realized there was a massive opportunity to drive efficiency in healthcare, not just in terms of reducing administrative costs, but also in improving time to therapy for patients. The delays caused by these manual processes were impacting patient care, and Ankit saw the potential for AI to make a real difference.

Challenges in Healthcare Communication

When Ankit first approached the problem, he questioned why there weren’t APIs in place for these communications. It seemed logical that insurance companies with clear patient plans should be able to provide information about coinsurance or prior authorization requirements through an API.

However, the reality in healthcare is far more complex. Ankit explains, “There are thousands upon thousands of entities that need to coordinate with each other. So whether it’s coordinate to agree on a standard, in terms of how data should exchange hands or agree on the timeline on which something should be implemented, everything gets distilled down to the least common denominator.”

While some APIs and EDI rails do exist, they’re very basic and don’t work in many areas of healthcare, particularly in specialty care. Ankit provides an example: “I don’t think anybody makes a phone call to figure out what someone’s copay for an x-ray is or for a PCP visit is. But the second someone needs to be told they need to get on Prolia, which is a specialty drug by Amgen, which costs tens of thousands of dollars for osteoporosis. No API tells you the prior auth requirements or the step therapy requirements or the copays or coinsurances.”

The Importance of APIs in Healthcare

Ankit highlights the growing importance of APIs in healthcare communication. As Infinitus has conducted millions of phone calls on behalf of providers, they’ve encountered a surprising reaction from insurance companies and PBMs. “We’re calling the insurance companies, the PBMs thousands upon thousands of times a day, if not a month. And they go, that’s my people spending time talking to your machine. And I said they don’t have to be. If you give me the data digitally, I’ll get rid of the phone call. This situation has created a network effect, incentivizing the development of APIs. The more calls we do, the more incentive and value prop there is for the other side, whoever that might be, to create the APIs, which moves the ecosystem forward.”

Understanding Healthcare’s Unique Dynamics

When asked about any surprising realizations about healthcare compared to other industries, Ankit’s response underscores the sector’s complexity and vast potential: “You know, it’s interesting you asked that. I think there are many moments. The biggest one is I’ve not had a moment to think about how it would work in a different industry. The number of times someone comes to me and says, ‘Hey, can you do this for FinTech?’ Or ‘Can you do this for real estate?’ And I’m like, no, I don’t have enough time. There’s so much to do in healthcare.”

The Role of Security in AI Development

Ankit emphasizes the critical importance of security and data privacy in AI development, especially in healthcare. He highlights how his company’s proactive approach to security has been a significant advantage: “When we went through and got our SOC two type two or when we go through all those third-party risk assessments or information security assessments from prospective customers, things that other people trip over or say, oh, we’ll get back to you in six months when we have done that, we always could say, ‘Oh yeah, we’re already doing that.’ And that’s made it a lot easier for us to build our business.”

This approach has been particularly valuable in the rapidly evolving world of large language models. Ankit notes that while many companies struggled with the sudden demand for AI solutions and the associated security concerns, his team was prepared: “Credit goes to my co-founder and our security team for being way ahead of that and saying, before we put this into our environments, let’s design the right guardrails so that our customers who rightfully want to make sure data is protected, want to make sure the correct information makes it to the right person at the right time, has that comfort going that, yes, this is a new tool in our toolkit that we use it to drive efficiency, but in the right way.”

Impact on Jobs: Automation vs. Employment

When asked about the potential impact of automation on jobs, particularly in back-office administrative roles, Ankit offers a nuanced perspective. He acknowledges that it’s a concern they actively consider, but points out that so far, their technology hasn’t led to job losses among their customers: “So far, we haven’t seen a single major customer of ours let go of people as they’ve adopted our technology. And I think that’s because of a couple of trends that are kind of tailwinds to this industry.”

Ankit explains that the increasing use of specialty drugs is driving up the need for support staff. The number of patients who need these high-cost specialty medication therapies is increasing. So the number of support staff needed for the entire patient lifecycle is increasing. This trend is helping to offset potential job losses from automation.

The Gap Between Providers: Old vs. New

Ankit Jain highlights the increasing divide between healthcare providers who have embraced advanced solutions and those who haven’t, but he stresses that the gap is more complex than it first appears.

“There are two kinds of scheduling,” he explains. “There’s very simple scheduling and there’s very complicated scheduling. For people who are sick, when they enter the healthcare system, their day is packed. They go in for blood work in the morning, see Specialist #1, then head for another test. Afterward, they meet with Specialist #2 to review the blood work, and then there are a couple of other procedures.”

Coordinating all of these moving parts is not something that simple scheduling systems can handle. Jain continues, “It’s like solving a jigsaw puzzle — factoring in travel time and aligning all the pieces. This is one of those things in healthcare where, from an outsider’s perspective, many tasks seem straightforward. But the moment you integrate them into the workflow of a healthcare entity and mix in the complexity of human life, suddenly something simple becomes very complicated.”

The Complexity of Scheduling in Healthcare

Ankit Jain explores the intricate challenges of healthcare scheduling and the hurdles of implementing new technologies in this space.

“Getting that right is crucial,” he emphasizes, “because otherwise, we’re not going to make forward progress on that person’s health or that family’s journey in what is probably an anxiety-driven process in their life.”

Traditionally, the solution to these challenges has been people — case managers or patient navigators whose sole job is to guide patients through the complexities of the system. However, startups often begin with a point solution that gains initial traction with early adopters. But to achieve widespread use, they need to integrate into the existing workflow, making it more seamless. Jain points out that it’s not enough to build the right technology — “How does it fit in from a data perspective? How does it fit from a workflow perspective? How do you train the staff in change management?”

He recalls a lesson from a colleague: “If you change the screens of the EHR dramatically, you can’t just train everyone in a week. At any given time, thirty percent of the staff might be unavailable due to sabbatical, research leave, PTO, or illness. So when you change the user interface, you have to continually educate over a six to nine-month period, sometimes even longer, to ensure everyone is up to speed.”

Jain highlights that the cost of change management is now something more organizations are considering and factoring into their technology adoption strategies. When evaluating the pros, he notes that businesses are focusing on initiatives with the greatest impact.

“They’re looking at the numbers,” he says. “You might have one person doing scheduling for an office, costing anywhere from forty-five to ninety thousand dollars a year. If you switch to a technology that costs twenty-five thousand on paper, the assumption is you’ll save between twenty and seventy thousand dollars annually. But in reality, you still have to train someone. You can’t immediately cut that headcount. You’ll need to adjust all your systems, and unexpected issues may arise. The cost of change management becomes part of the equation.”

AI’s Role in the Future of Search Engines

Ankit Jain offers his thoughts on the potential impact of AI on search engines, drawing from his rich background in the industry.

“There’s a technology discussion to be had,” he notes, “but there’s also a distribution discussion. So, let’s start with distribution. Google is the default search engine on billions of devices — whether it’s Android, iOS, or even many desktops. That switch isn’t going to happen overnight.”

He reflects on his own experience working at a startup aiming to disrupt Google’s dominance. “We tried to build a Google killer — a search engine to take over Google. In some areas, we were significantly better, but changing people’s behavior is incredibly difficult, especially when that behavior is the default on their primary devices.”

Jain acknowledges the rise of AI-powered models in search, pointing to ChatGPT’s breakout moment in 2022. “ChatGPT stole the spotlight with its large language models, and they just announced SearchGPT, integrating more real-time data. But that doesn’t mean Google’s been idle. Over the last five years— more than two years — Google hasn’t just been sitting around doing nothing.”

He believes many underestimate the role language models already play in Google’s search. “People assume that Google search today still operates with the traditional search approach versus a language model-driven search. But I don’t think that’s accurate. Google has been integrating features like one box that understands the content and provides direct answers, and more and more, we’re seeing conversational, LLM-like answers in Google search as well.”

While Jain uses both platforms regularly, he highlights the different purposes they serve. “I use ChatGPT probably a dozen times a day, but the things I use it for are very different from what I still go to Google for. For example, when I’m trying to search for LinkedIn, I don’t go directly to LinkedIn; I go to Google. It’s the easiest way to find someone’s profile. On the other hand, if I need help crafting a message to my team, I turn to ChatGPT to help me wordsmith it, something Google couldn’t do in the past.”

AI’s Transformational Potential in Healthcare

AI and technology hold immense potential to transform the healthcare journey for patients and their families. Ankit Jain, speaking from personal experience, shares: “When my daughter was born, she had a very rare disease. Healthcare becomes deeply personal to everyone because, at some point, either you, a family member, or a friend goes through the system. During that time, dozens of angelic people helped us, but there were still moments when we felt lost like we were navigating it alone.”

Jain believes AI and technology can serve as essential companions during these difficult times. “Right now, most technology is aimed at the business side of healthcare — the provider, the payer, the pharmacy — because they’re willing to invest in it. But as this technology matures, its real impact will be in becoming a partner to patients and their families, helping them through these profound changes and making them feel more secure and supported.”

Beyond patient care, Jain also underscores the significant role AI could play in drug discovery. “AI is unlocking so many advancements in the drug discovery world — whether it’s through digital twins, the ability to test hypotheses with different reagents, or searching vast amounts of medical literature. All of this helps speed up the path to more effective therapies, which will fundamentally reshape how we approach medicine and drug development.”

He further explains how this could lower the cost of therapies. “The high cost of drugs is largely due to the billions invested in R&D, with ninety-five percent of experiments failing. The success of the five percent has to cover those losses. But if we can reduce the cost of experimentation and improve success rates, it could lead to more affordable therapies. That’s a win for everyone.”

The Current State of Digital Health Innovations

When discussing the current state of digital health innovations compared to other tech sectors, Ankit Jain emphasizes the long-term nature of transformative change: “We’re in this exciting phase where the rails are being built. No one knows exactly how it’s all going to come together, but the foundation is being laid — and that’s what makes it exciting. There will come a moment when we realize, ‘Oh my God, it all came together.’ All that work over twenty or thirty years will pay off.”

He draws a parallel to other innovative industries: “Take Waymo and Google’s self-driving car project. We’ve been hearing about it for fifteen years, but the research behind it goes back twenty-five years before that. It’s a thirty-to-forty-year journey. Digital health is only eight to ten years into its journey. Now we’re seeing the investments come in, but along the way, ninety percent of efforts will fail. And that’s normal.”

Ankit highlights the resilience and innovation culture of Silicon Valley: “One of the things Silicon Valley gets right is that failure is okay. It’s okay to fall, get back up, and try again. Unlike other ecosystems where success and failure are taken to heart, in Silicon Valley, the most successful people keep going. They don’t spiral downward; they get back up and say, ‘The world hasn’t ended — I’ll try again.’”

Despite the challenges, Ankit remains optimistic about the future of digital health: “We’re still in the early stages of digital health. And that’s fine. Let the detractors sit on the sidelines, throwing popcorn and watching — it’s part of the process.”

The Role of Venture Capital in Digital Health

Ankit Jain, drawing on his experience as a former venture capitalist, offers a nuanced view of venture capital’s role in digital health. While some VCs are genuinely driven to change the world, he acknowledges that most are primarily focused on financial returns. “The top ten percent of venture capitalists are truly in it to change the world — they’ve already achieved so much, and now they want to make a difference. But even they still want tremendous financial returns along the way. The other ninety percent are doing their job as capitalists. Let’s be real — their job is to take in a dollar and return significantly more than a dollar.”

He notes that this focus on returns isn’t inherently negative, as it’s central to the venture capital model. However, Ankit aligns with Vinod Khosla’s view that many VCs might unintentionally hinder their portfolio companies from making a genuine impact: “The question is, are you optimizing to make money, or are you optimizing to make an impact? Very few can balance both. It’s important to figure out where you stand on that line.”

Ankit also emphasizes the crucial role of risk and failure in the startup ecosystem: “If eighty to ninety percent of startups fail, that’s probably a good thing. It sounds painful, but if one hundred percent of startups succeed, we’re not taking enough risks. Progress comes from taking risks.”

He addresses the issue of unprofitable companies going public, acknowledging a recent shift in priorities: “In the past couple of years, there’s been more emphasis on understanding the financial health of startups and how they can achieve profitability. In most boardrooms I’m familiar with, the conversation actively centers around how to reach that point of profitability and self-sustainability.”

For digital health startups, Ankit identifies scale as the biggest challenge. While many companies might be profitable on a small scale, it often isn’t enough to satisfy venture capital returns. “If you’re making ten million dollars in profit and growing at five percent year over year, that’s a great business for a founder and perhaps the team — you can dividend it out. But from a venture capital perspective, if you’re investing from a five hundred million or billion-dollar fund, it won’t make a meaningful difference to your fund’s performance.”

Advice for Startup Founders in AI and Healthcare

When asked to provide advice for startup founders in AI and healthcare, Ankit emphasizes the importance of balancing excitement for new technologies with a realistic understanding of their practical applications. He stresses the need for founders to consider how their solutions fit into existing workflows and ecosystems: “It’s important to be optimistic. It’s important to want to change the future, but it’s also important to be realistic and understand how it fits into the workflow and fits into the total ecosystem that this solution has to be a part of.”

Also, Ankit cautions against adding unnecessary complexity to an already complex healthcare system: “I think too many people jump to, I've got another solution, which just adds to the complexity of healthcare rather than simplifies it. And I think we would be doing each other a disservice if we added more complexity to an already over-complex healthcare system. And we should focus on simplifying things to have that long-term impact on healthcare.”

Our previous episode was with Sergei Polevikov: Brutally Honest Interview About Digital Health