We don't talk enough about how hard it actually is to build a healthcare startup. Behind SmarterDx's story, now one of the biggest health AI exits to date, were 18 months without a single customer, a pivot that seemed to make no product sense, and two co-founders who went back to working as hospitalists just to get by.

In this episode, Steve gets the real story from Dr. Michael Gao and Dr. Joshua Geleris about the challenges they faced and what ultimately unlocked real growth and led to their billion+ acquisition by New Mountain Capital.

For our back-to-school episode, we sat down with Stanford University School of Medicine Dean Dr. Lloyd Minor to talk about how AI is already reshaping what future doctors learn and how they're taught, as well as what's still not working in American healthcare.

Every day, roughly 100 Americans die in crashes caused by human drivers. Yet when a self-driving car hesitates at an intersection or makes the news for an unusual mistake, public trust can evaporate. In this special episode, Dr. Jonathan Slotkin reads his latest Noema essay exploring why we demand perfection from machines while accepting human error as inevitable. Drawing on lessons from medicine, psychology, and autonomous vehicles, he argues that the biggest barrier to safer technology is trust.

This week, Halle sits down with Eric Ries, author of Incorruptible, to unpack the rise of shareholder primacy, what it is, and why he believes it's at the root of many of society’s biggest challenges. They discuss the surprising history of corporate governance, the lessons behind Novo Nordisk's century-long success, and what founders can do today to keep their companies aligned with their mission as they grow.

Over the last decade, the number of drug candidates entering development has doubled, yet the number of successful drug approvals remains flat at ~50 per year.

This week, we sit down with Formation Bio founder and CEO Ben Liu. His company has raised more than $600 million to build what he hopes will become the first new enduring pharmaceutical company in decades, powered by AI. Ben explains why he believes clinical development, not drug discovery, is becoming the industry's biggest bottleneck, and how AI could fundamentally change the economics of bringing new medicines to patients.

They built a $1.2 billion healthcare AI company in under three years, but they say the hardest part of healthcare AI isn't the AI.

This week, Halle sits down with Assort Health co-founders and co-CEOs Jeffery Liu and Jon Wang, whose company reached a $1.2 billion valuation in under three years. They discuss why building great healthcare AI takes far more than good models, how they scaled from 15 employees to nearly 250 in a year, and what they've learned from more than 190 million patient interactions. They also share why voice AI is harder than it looks, how they're thinking about building durable moats in the age of foundation models, and why helping patients navigate the healthcare system may be one of AI's biggest opportunities.

Back by popular demand, 3x Heart of Healthcare guest Eric Larsen joins Steve to answer listener questions on healthcare's AI revolution. Drawing on the ideas behind his latest essay, Healthcare's Oppenheimer Moment, Eric argues that healthcare may be approaching a once-in-a-generation inflection point, and discusses what leaders need to understand before it's too late.

Autonomous vehicles may be the closest real-world example of AI operating in life-and-death situations at scale. Justin Norden believes healthcare has a lot to learn from how that industry approached safety, testing, adoption, and trust. 

This week, Michael and Halle sit down with the founder and CEO of Qualified Health, fresh off the company’s $125 million Series B, to discuss why healthcare organizations need to think differently about deploying AI. Justin shares how his experience at Stanford, Apple, Waymo, and in healthcare investing shaped his view that health systems need AI infrastructure, governance, and workforce buy-in, not just another point solution.

Most careers don’t follow a straight line. But few require starting over in full view of the public.

This week, Halle sits down with Lance Armstrong to discuss how he rebuilt his life and career after multiple turning points, including surviving advanced cancer, and how those experiences shape his approach to life. Now he invests in health and wellness companies through his VC firm Next Ventures, backing new approaches to “whole person care”.

AI in healthcare may be entering a new chapter, one where the biggest question is no longer whether the technology works, but who is willing to deploy it, measure it, and take responsibility for the risk.

This week, Steve sits down again with Eric Larsen to revisit his predictions from last year’s Webby-winning episode on generative AI in healthcare. Eric argues that the first wave of AI has been inflationary, reinforcing the old payer-provider payment model, but that the next wave could be deflationary as automation moves into revenue cycle, administrative work, clinical reasoning, and drug development. They discuss why incumbents still have a narrow window to co-develop the future, why clinical AI may move faster outside the US, and why liability may become the deciding factor in who wins.

Medicaid reimbursements are shrinking, providers are pulling back, and vulnerable populations are losing access to care. Akido Labs is betting that AI can expand care capacity fast enough to reverse that trend.

This week, Halle sits down with Prashant Samant, co-founder and CEO of Akido Labs, to discuss what it actually takes to scale care with AI. They explore why Akido built a full-stack healthcare company, how its AI operates inside real clinical workflows, and why the hardest patients are the best place to test whether this model works.

Forty million people use ChatGPT for health-related questions every day, making it one of the most widely used tools for health information in the world. So what is their team doing to maximize impact and minimize harm?

In this full circle episode, Halle Tecco sits down with her Rock Health co-founder Nate Gross, who also co-founded Doximity (DOCS) and is now VP of Health at OpenAI. They discuss the astonishing speed of AI progress, how models are trained for safety and accuracy, and what this technological evolution means for every part of the healthcare system.

Nearly one billion prescriptions are abandoned at the pharmacy counter every year, often because patients are blindsided by the cost.

This week, co-host Halle Tecco is joined by Wendy Barnes, President and CEO of GoodRx, to discuss the chaos of prescription drug pricing, the murky world of Pharmacy Benefit Managers (PBMs), and how digital tools are changing patient affordability. They break down the layered system of manufacturers, payers, and pharmacies that creates inconsistent pricing, and explore the current push for greater transparency.

Pete McCanna, CEO of Baylor Scott & White Health, believes that health systems are built around the wrong objective… and he has an ambitious goal to change that.

This week, Halle sits down with McCanna to unpack how one of the largest and most successful health systems in the country is shifting from a supply-driven model to one built entirely around the customer. They discuss why legacy systems operate like “walled castles,” what it takes to redesign care around real conditions instead of departments, and how Baylor Scott & White is testing a model that prioritizes access, personalization, and long-term trust over short-term profit.

Last year, his independent pharmacy spent $13 million on brand-name drugs for patients processed by the three biggest Pharmacy Benefit Managers (PBMs) which earned a profit margin of 0.01%.

In this episode, Halle speaks with Alec Ginsberg, owner and fourth-generation pharmacist at C.O. Bigelow, the oldest surviving apothecary–pharmacy in the United States. Alec is fighting against the forces squeezing independent pharmacies and charting a course for the future of the pharmacist.

Chris Klomp, Director of Medicare and Deputy Administrator of CMS, and Senior Advisor to HHS Secretary RFK Jr., has big ambitions to reshape how healthcare works in the United States.

This week, ​​Steve sits down with Klomp to discuss how his experience as a digital health entrepreneur is guiding his current role overseeing a roughly $2 trillion department. Klomp shares the government's strategy for restoring trust between providers and payers, driving down costs, and addressing a system where approximately 90% of healthcare dollars are still spent in a fee-for-service arrangement.

This week, Halle and Michael sit down for a special in-person listener Q&A to answer a range of founder questions you submitted.

Breakthrough blood tests that can flag dozens of cancers before symptoms appear are gaining momentum, yet questions remain about accuracy, equity, and how these tools will fit into routine care.

In this episode, Steve talks with Helmy Eltoukhy, co-founder and co-CEO of Guardant Health, a $14 billion publicly-traded precision oncology company. The conversation explores the science behind cell-free DNA, the rise of blood-based cancer screening, and the broader shift toward data-driven diagnostics.

When Eric Lefkofsky’s wife was diagnosed with breast cancer, it exposed how little technology and data were shaping cancer care, pushing the serial entrepreneur to build a different model.

Lefkofsky is the founder and CEO of Tempus, now a $10B publicy traded health tech company, and previously founded Groupon. At Tempus, he’s building a tech-first company applying multimodal data and AI to make diagnostics smarter and treatment decisions more tailored, starting in oncology and expanding across disease areas.

Physicians now face a world where search bars, chat apps, and large AI models are becoming many people’s first stop for health questions, long before they enter a clinic.

Former Google Chief Health Officer and national health IT leader Dr. Karen DeSalvo joins us to unpack what this shift means for clinicians, regulators, and patients, and why 15% of daily Google searches are questions no one has ever asked before.