Inside AI-Healthcare Startup Forward’s Demise

The healthcare startup Forward bet the future of its business on a spaceshiplike mall kiosk in Roseville, California.

Launched in 2017 by several high-profile executives from Google and Uber, Forward set out to disrupt primary care with tech-enabled, ultramodern clinics. In mid-2023, it shifted its attention to a new offering: an AI-powered doctor-in-a-box.

Replete with ultraviolet lighting and floor-to-ceiling screens, the metallic “CarePods” let patients get a doctor visit sans the doctor — directing patients to take their own blood, sequence their DNA, and test for diseases like COVID-19, all without speaking with another human.

“If Elon has the self-driving car, well, this is the autonomous doctor’s office,” Forward CEO Adrian Aoun told Axios in late 2023.

Today, Forward’s first CarePod is gone. Where the kiosk used to sit in the center of the Roseville Galleria mall, two strips of blue painter’s tape lie stuck to the shiny marble floor.

The startup announced Tuesday it would close its doors, just a year after raising $100 million in a Series E funding round to power its CarePods rollout. That fundraise took its total funding to over $650 million.

Forward sent a late-night email to its patients on Tuesday, obtained by Business Insider, announcing it would immediately shutter all its locations, cancel scheduled visits, and cut off access to its mobile app. The startup said its clinical team would be available by email until December 13 for remaining patient support.

Eleven former Forward employees spoke with BI before the closure on the condition of anonymity to avoid retribution from the company. They painted a picture of a startup that bet the house on its bold, new healthcare technology, with little to show for it a year later.

Fewer patients than the company had hoped jumped at the chance to try out the CarePods, six former employees said. Logistical challenges in setting up the kiosks forced Forward to delay core parts of its strategy, like launching CarePods in big markets such as Chicago and New York City.

Meanwhile, the technical problems mounted. Automated blood draws routinely failed. Lab test offerings were withdrawn. And patients kept getting trapped inside the CarePods.

Forward said in November 2023 it planned to scale to launch 3,200 CarePods in a year — 12 months later, it said it had launched five. Immediately prior to its closure, only two CarePod locations were listed on its website.

Facing sluggish growth, Forward laid off a significant portion of its staff in March, seven former employees said. Two former employees told BI that, at that time, the startup was set to run out of money in less than a year.

The startup’s abrupt closure points to the perils of its high-growth ambitions and dogged “tech-first” approach to the notoriously complex healthcare industry — a case of AI-fueled style over substance.

Forward did not respond to multiple requests for comment.

Adrian Aoun originally made his name at Google as Larry Page’s right-hand man, leading special projects for the tech giant after the company bought his first AI startup, newsgathering platform Wavii, in 2013.

When he launched Forward in 2017, Aoun positioned the startup’s health clinics as a doctor’s office crossed with an Apple Store. The startup began with a membership model that offered patients complete primary care for $150 a month. (The company never accepted insurance.)

Upon entering a clinic, subscribers faced a Star Trek-teleporter-esque full-body scanner, a platform Forward said takes a patient’s vitals and runs them through its proprietary artificial intelligence to detect symptoms.

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While the scanners helped attract new patients to the clinics, the flashy tech simply took basic vitals that clinicians could easily measure manually — for instance, the scanners take a patient’s temperature by using infrared-thermal-energy mapping, rather than with a thermometer. Three former employees said the scanners often recorded incorrect data, which forced clinicians to retake information like a patient’s blood pressure or heart rate.

“The aesthetics drew people in and kept them there,” one of those former employees said. “But the scanners don’t actually do much.”

Forward operated more than a dozen of these healthcare clinics across the US prior to its closure. BI visited two, in Washington, DC, and San Francisco, in the weeks leading up to it shutting down. The clinics were sleek and glossy, with iPads built into the wall, a shiny white body scanner awaiting its next patient, and no front desk.

Both locations were eerily empty in the past few months. BI went to Forward’s Washington location once and its San Francisco location twice and glimpsed one patient in all. The Washington clinic was silent; after about 10 minutes, a medical assistant emerged to greet the reporter who was wandering the halls and calling out for an employee. The clinicians at both locations declined to speak with BI.

Forward hadn’t opened any new clinics in the past year. Four former employees said the startup closed at least two clinics since the CarePods launch: in Dallas and Bellevue, Washington.

Forward had also been cutting costs at its clinics for months. Forward started declining to pay for any lab tests it couldn’t do in-house, according to documents viewed by BI — meaning a wide variety of tests previously available to members, including several STI tests and key hormonal measures like thyroid tests, are no longer covered by the startup.

Last year, the startup stopped paying for genetic tests through 23andMe, a service it had touted since its inception. It cut smaller services from at least some of its clinics, too, like skin-tag and mole removal using too-expensive liquid nitrogen, three former employees said.

Those former employees said Forward leadership told them the startup was closing its clinics, at least partly, so Forward could focus on the CarePod.

When Forward launched its first CarePod in November 2023, Aoun suggested he wanted to replace the type of care he’d spent the past six years building his business on.

“I don’t even believe a doctor’s office should exist,” he told The Information.

Eleven former employees told BI that Forward went all in on its CarePods, pivoting nearly all of its marketing materials and resources away from its clinics.

After Forward launched its first CarePod in Roseville, just outside Sacramento, in summer 2023, it announced its second later the same year, this one in Chandler, Arizona. The startup began offering a CarePod-only membership, without access to its clinics, for $100 a month.

The CarePods came with many financial and logistical challenges, former employees told BI.

Each CarePod, with its state-of-the-art technology, was extremely expensive to manufacture, six former employees told BI. Four former employees said the earliest two CarePods cost the startup more than $1 million each to produce.

And CarePods were a hard sell to landlords. The miniature free-standing clinics were still subject to building codes, but they lacked the scale or customer base to prove they’re worth placing in a mall or office building.

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The biggest CarePod launch Forward promised, in Chicago’s Willis Tower, never materialized. Two former employees said the startup faced logistical challenges with the building, which forced Forward to halt the rollout indefinitely.

The five CarePods Forward launched are a far cry from the 25 the startup sought in its initial launch, let alone the 3,200 CarePods Forward hoped to scale to in a year, per TechCrunch.

While Forward’s $100 million Series E funding round and CarePods launch drew plenty of headlines, some former employees said patients rarely expressed the same enthusiasm.

“I would get people saying it looks like something from ‘Black Mirror,'” one former employee said.

Three former employees said patients would frequently get stuck inside the CarePods, especially in 2023 and early 2024.

Former employees also said some of the CarePods’ self-service offerings, like its blood draws, didn’t work as advertised.

Forward’s blood draws, which the startup said could be used for tests such as cholesterol measures that necessitate a smaller amount of blood, directed patients to place a device on their arm that the startup said could painlessly break the skin and extract blood. But those blood draws were routinely failing to collect even the small amount of blood necessary for those tests through the first half of this year, the three former employees said.

While clinicians are trained to draw blood precisely to get the right amount, one of the former employees said patients would often place the autonomous device on a part of their skin where it couldn’t draw enough blood. That former employee estimated that self-service blood draws were failing well over half the time.

Forward’s messaging during the CarePods rollout left some of the startup’s employees feeling frustrated, too. Four former employees said they felt Aoun’s suggestions that doctors are inefficient and replaceable in the wake of the CarePods launch were disrespectful to the medical professionals who work in Forward’s clinics.

After the public’s initial fascination with CarePods wore off, three former employees, including two former sales staffers, said the CarePods teams struggled to draw new customers and rarely hit their sales targets. In March, four months after the CarePods’ public launch, Forward slashed its workforce, seven former employees said.

As Forward burned through cash, the startup faced a challenging fundraising environment, with many investors leaning away from late-stage investments and countless generalist investors stepping back from healthcare deals. Aoun always eschewed the idea of selling Forward to another company, former employees said.

It’s unclear when Forward officially decided to shutter. As recently as Tuesday morning, Forward was still sending marketing emails to prospective customers offering discount rates to sign up for its services, per emails reviewed by BI.

Most former employees BI spoke with said they still believed in Forward’s mission. Many said they were drawn to the startup explicitly because they wanted to expand access to quality healthcare under Aoun’s direction. Several employees told BI that the CarePod felt “ahead of its time.”

In the Roseville Galleria, there’s no longer any sign that Forward’s first CarePod ever stood in the mall’s atrium, surrounded by stores like Pandora, Uniqlo, and Kids Foot Locker.

An employee at a neighboring pretzel stand remembered the “AI doctor thing,” which he said closed around September.

Businesses that set up shop in that atrium don’t typically stay long, he added. The mall plans to build a playground in the CarePod’s place.