Day 05 — Kicking Off the Lean Process

When I turned 18, I was your pretty typical college kid — I was living in the dorms, meeting lots of new friends, and choosing fun over good decisions.

I was legally considered an adult, but I promise you I was anything but...

Which is why when I was diagnosed with type 1 diabetes as a freshman in college, I was entirely unprepared for the baggage that comes with adult life with a chronic health issue. The initial challenges of dosing insulin and checking glucose soon gave way to much bigger, annoying problems like: dealing with the mental ups and downs of type 1 diabetes, navigating health insurance, managing prescription refills, and scheduling doctor’s appointments.

This first lean canvas attempts to break down some of the challenges of growing up as a kid with a chronic health issue, specifically:

How might we teach kids with a chronic health issue the skills to live a safe and happy life?

Building kid superpowers

Song of the Day:

If you insert the word “startup” before life in this song, that’s pretty much what it’s been like starting Invincible: the highs are higher and the lows are lower, but that’s all part of (startup) life.

Putting the Lean Canvas to Work

This theme of independence is something I heard throughout the past 2 years of talking to kids, families, school nurses, and healthcare providers. When a kid is diagnosed with a chronic health issue, it quickly becomes a part of everyday life. For me, taking insulin has become as routine as brushing my teeth — I wouldn’t describe it as fun, but it’s a necessary part of me now.

The result is below. Ash Maurya mentions spending 15 minutes on filling out the lean canvas. Well, I didn’t do that. With each problem identified I couldn’t resist the urge to dive in and learn more. What I ended up with was a pretty fat “lean” canvas of problems:

The first iteration of the “Lean” Canvas

So far, I found it to be an extremely worthwhile activity that forced a lot of thought from a simple exercise.

Here are my biggest insights so far.

Insight #1 — A LOT of kids rely on Medicaid for Health Insurance

It’s hard to talk about healthcare without considering health insurance. This number blew me away:

37.5% of all kids in the US are on Medicaid

For kids, it’s known as CHIP, or the Children’s Health Insurance Program. Each state pays for CHIP through a mix of state and federal funding:

State-by-State CHIP Coverage

But CHIP is for kids…so what happens when kids become legal adults? So far as I can tell, they lose CHIP coverage the day they turn 19 (private insurance usually allows kids to remain on their parents plan until 25). Imagine turning 19 and suddenly you have to get your own insurance coverage, find a new doctor, AND figure out how to navigate probably the most complex healthcare system in the world (oh, and by the way you still have a daily health need you need to constantly manage).

Honestly, it makes me sad and angry. Sad for the kids that have to go through it and angry at the system we’ve created that enables it to happen.

Insight #2 — Kids are learning, whether or not it’s intentional

Kids are super perceptive — and I found the perceptions the adults around them have toward their care usually get reflected in their own. In the best cases, kids are taught skills and confidence in bite-sized chunks from their healthcare providers, parents, and school nurses as they grow up (e.g., at their daily lunch check-in with the school nurse).

Any solution helping kids become independent must utilize help from the adults in their lives.

Insight #3— Kids Are Kids, especially those with a health condition

Through interviews with ~35 kids so far on the Invincible Kids Network, I’ve learned that kids with type 1 diabetes are still just kids.

Some like sports, others like dance — ALL are inspiring. Oh, and most like Fortnite and the Floss.

However we choose to build independence must acknowledge kids for what they are — kids.

Insight #4 — Milestones for building care independence are more predictable than we realize

Through our work, I’ve learned there are several age-based expectations / milestones for kids living with type 1 diabetes.

  • Elementary-aged kids are almost completely dependent on those around them for care — and rightfully so. 5 and 6 year olds hate needles (who doesn’t) and kids become WAY more proficient in math than they deserve to be for their age (comes with the territory of counting carbs every day).
  • By middle school, kids are expected by schools to become “independent”. This is more practical than anything: in the schools we’ve worked with, there just aren’t enough health staff to ensure consistent care at school in middle school.
  • By high school, kids usually know what to do ,but many don’t do it — high school is hard enough without dealing with a chronic health issue.
  • By college, kids take an even bigger leap of faith and have to add insurance and medication to the crazy mix.

Parents I’ve talked with have described the initial diagnosis as “bringing home a newborn.” Only with babies, we’ve established methods, milestones, and training for young parents. For kids managing a chronic health issue, few such programs exist, and instead we leave kids and their families largely to fend for themselves. What if we could develop a milestone-based structure to deliver targeted interventions based on each child’s need? Does such a program already exist?

Insight #5 — All kids have a story to tell

Just because they’re little doesn’t mean they haven’t been through a lot. Kids are so perceptive and are constantly learning. We all could learn a lot from their perspective. What if could help kids learn skills from other kids who know exactly what it’s like?

What Now?

Well, there’s still a lot to unpack here and lots more questions to answer, but I’m really excited about refining this model, creatively exploring solutions, and experimenting on potential risk areas.

This challenge is definitely massive and we’ve got our work cut out for us, but I think we’re more than up for the task. Only time and experimenting will help us know for sure.

See ya tomorrow.

My goals for writing this series are to 👇:

For the next 6 months, I plan to start building Invincible in public. What’s in it for you? Hopefully, mistakes you can avoid mixed with some good ideas and tools that can be useful to you. And for me? Getting back some accountability you lose when you become your own boss.

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Bob Weishar

Bob Weishar

Startup founder surviving in his parent’s basement.