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Help turn a substantial intellectual foundation into publication assets, a limited demonstration, and a sponsor-ready pilot.
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Better Engagement.
A New Direction for
Healthcare Spending.
A math-grounded patient-engagement platform in development—connecting serialized health-entertainment, gamification, and preventive care to help people stay engaged between clinical encounters.
What if preventive-maintenance mathematics and the pull of stories and games could work together to sustain healthier behavior—and open a more relevant channel for Rx communication?
Patent pendingDelaware public benefit corporationFounded by a Hertz Fellow
Larry J. Pipes, Ph.D. · Founder and CEO · From preventive-maintenance mathematics to pilot validation
Test a fit for your population
Co-design a focused evaluation around a real engagement, navigation, or adherence challenge.
See what a pilot involves →Bring expertise or access
Contribute publishing, evaluation, technical, clinical, or commercialization expertise—or a useful introduction.
Find a role in the next stage →The economic challenge
More spending is not the same as better health.
Excess and avoidable healthcare spending competes with wages, business investment, public priorities, and household security. Addressing it is both a healthcare opportunity and an economic-security imperative.
$5.3T
Annual U.S. spending
National health expenditures in 2024, according to CMS.
18.0%
Share of U.S. GDP
Healthcare’s share of the economy in the same year.
10th of 10
Overall system performance
U.S. ranking in the Commonwealth Fund’s 2024 comparison of ten high-income countries—not a ranking of every clinical service.
One spending challenge. Six national trajectories.
Healthcare spending as a share of GDP, 1990–2024. The U.S. remains well above these five selected high-income peers.
United StatesCanadaFranceGermanyJapanUnited Kingdom
Sources: CMS, 2024 National Health Expenditures; Commonwealth Fund, Mirror, Mirror 2024. The reports use different measures and reference periods.
Our thesis: excess and avoidable healthcare spending is America’s largest addressable economic inefficiency. The opportunity is the remediable portion of spending—not healthcare spending as a whole, and not a claim that e-Live-Health can capture all of it.
Payment and risk-sharing reforms matter. Their potential depends in part on what people do between clinical encounters: follow through on care, manage risks, and participate in timely prevention and treatment.
Manage the hospital episode—and help avoid the next one.
Diagnosis-related groups tie hospital payment to a discharge category. That structure encourages resource management within an episode. The payment rule alone does not supply sustained patient participation before admission or after discharge.
The proposed addition: repeated engagement and partner-directed follow-through designed to limit avoidable deterioration.
Connect the incentive to everyday action.
Prospective payment can support prevention and care management. But a financial incentive alone does not ensure that patients participate consistently. e-Live-Health is designed to complement the engagement programs partners already operate.
The proposed addition: serialized health entertainment, gamification, and outreach that help people return, participate, and complete appropriate next steps.
Payment structures: CMS inpatient prospective payment; CMS capitation and prepayment. The participation gap is e-Live-Health’s proposed opportunity, not a claim that these reforms excluded prevention or engagement.
Sustained, effective participation is essential to the pathway we propose for improving health and bending the spending trajectory. The pilots will test whether e-Live-Health can deliver that participation and measurable benefits economically.
The cost of waiting
What does waiting cost?
An illustration of scale—not an e-Live-Health forecast
A 1% improvement. A $53 billion annual difference.
If proven improvements reduced U.S. healthcare spending by 1% without compromising care, postponing their full implementation would defer about $53 billion in gross savings per year at 2024 spending levels.
Illustrative cumulative gross savings deferred by length of delay:
Calculation: CMS’s $5.3 trillion in 2024 spending × a hypothetical 1% × months ÷ 12. Assumes the full reduction is achievable and sustained, with a constant spending baseline and benefits spread evenly over time. Excludes implementation costs, ramp-up, and spending growth. This is not an estimate of e-Live-Health’s achievable savings.
For e-Live-Health, the immediate cost of delay is also delayed learning. Postponing a well-designed pilot postpones evidence about engagement, operational fit, and economics—and the decision to improve, scale, or stop. The next step is to test the opportunity.
The approach
Make the next healthy action easier to take—and easier to measure.
From aircraft maintenance to maintaining health
Aircraft are complex systems. Their components deteriorate, and information about condition and failure risk helps determine when and how to maintain them. Human health also changes over time; effective care must account for behavior, preferences, and social circumstances as well as clinical needs.
In his 1975 UCLA dissertation, Maintenance Approaches to Evaluating Health Care Delivery Systems, Dr. Pipes applied maintenance mathematics to health-state changes and the timing of preventive, diagnostic, and restorative services. The objective was more time in a well state, subject to constraints.
e-Live-Health extends that practical question: how can we sustain participation in appropriate health-maintenance activities, measure the resulting balance of restoration and deterioration, and test its relationship to spending change?
The proposed platform combines engaging stories and games, personalized prompts, appropriate incentives, and partner-directed navigation. Its purpose is to strengthen the connection between a care plan and what happens in everyday life.
Payers, employers, pharmacies, health systems, and life-sciences partners could use it alongside existing care-management and analytics systems. It is not a replacement for clinical judgment, an EHR, or a partner’s risk models.
Five pillars of the proposed platform
Health-entertainment engagement
Serialized stories, games, and practical health missions designed to encourage voluntary, repeated participation.
AI-supported personalization
Proposed content and prompt selection that adapts to engagement patterns, subject to testing and appropriate human oversight.
Preventive monitoring
Partner-approved check-ins and permitted data to help identify missed steps and support timely follow-up.
Condition-relevant Rx communication
A proposed consent-based model for relevant education and appropriately reviewed pharmaceutical communications.
Aligned incentives
Rewards and support designed around participant needs, with clinical, ethical, and regulatory review.
Explore an illustrative participant journey
Choose an example. These are design concepts—not a working clinical platform, medical advice, or observed results. No health information is collected.
From a reminder to a completed next step
A short story and interactive mission help a participant understand a planned follow-up. A check-in identifies a scheduling barrier and offers a connection to the care team.
What a pilot would measure: response, understanding, barrier resolution, and follow-through—not just clicks.
The Pipes Curve: a proposed earlier signal of spending direction
The proposed framework links the balance of restoration and deterioration to the rate of healthcare spending change. The platform seeks to influence that balance through sustained participation; the pilots test both its effects and the indicator’s predictive usefulness.
1 · The spending relationship
dC/dt = −cn p(t)
2 · What drives the indicator
p(t) = R(t) − D(t)
3 · The same model in three dimensions
dC/dt = cn[D(t) − R(t)]
Conceptual illustrations, not measured results or calibrated forecasts. Restoration includes prevention, recovery, adherence, and timely care. The dissertation’s well-state probability is a different quantity from the restoration score used here.
U.S. healthcare spending as a share of GDP
Swipe the chart to see the full graphic.
Illustrative upward pressureDesired bend if validated
Technical foundation and limits
The dissertation supplies the historical maintenance and health-state modeling foundation. The current equation proposes a direct relationship to spending change; the dissertation did not empirically validate that relationship. C(t) must specify the spending measure, population, price basis, and time unit. The positive constant cₙ scales the indicator into that measure’s rate of change.
Mathematical derivation is distinct from empirical validation. Spending also depends on prices, benefit design, technology, demographics, and other factors. Proposed measures must be defined, calibrated, and tested against observed outcomes and existing analytics.
Here, restoration (or renewal) means prevention, recovery, timely care, and sustained engagement—not reversal of biological aging.
A leading-indicator claim requires testing an earlier measurement against later outcomes at a specified interval. The displayed equation alone does not specify that lead time. Existing risk models already predict expenditures; the question is whether this balance adds useful predictive information and helps guide effective intervention.
For an applied-mathematics review, request the supporting explanation covering health-state modeling, intervention timing, score construction, and pilot validation.
Discuss technical review or request supporting material →Where we are now
A substantial foundation. A defined next step.
Intellectual and organizational assets
- Approximately 78,500 words substantially drafted across ten chapters and appendices.
- Manuscript Synopsis, pilot-planning and evaluation materials, and TV/film treatment.
- Delaware public benefit corporation formed; patent application filed.
Publication and pilot readiness
- Professional editing, graphics, rights readiness, and market-launch assets.
- Sponsor-ready protocol, partner workflow, and evaluation plan.
- Participant-experience specification and limited technical demonstration.
Pre-pilot development stage. Clinical effects, predictive performance, cost savings, and the proposed commercial models have not yet been established through e-Live-Health pilot results.
Why book first? The manuscript makes the intellectual and economic case reviewable, builds awareness, and supports partner development while pilot planning advances in parallel. This is one company with a publication-to-pilot commercialization strategy—not separate book and startup projects.
Pilot partnerships
Start with a real problem in a defined population.
A scoped pilot could focus on care follow-through, pharmacy engagement, preventive participation, or clinical-trial navigation. The first conversation identifies your objective, workflow, population, and evidence needs.
What a partner contributes
- An executive sponsor and operating coordinator.
- A suitable population and approved recruitment pathway.
- Workflow input, governance review, and agreed data access.
- A jointly defined scope, budget, and responsibilities.
What the project would deliver
- A co-designed participant journey and implementation plan.
- A limited prototype or intervention suited to the use case.
- An engagement dashboard and agreed evaluation measures.
- Findings, implementation economics, and a scale-up decision.
Relevant data already exist. The pilots turn them into evidence.
Health and hospital systems hold diagnoses, laboratory results, treatment histories, encounters, admissions, and outcomes that can help measure deterioration and restoration. Linked claims or financial records can provide spending measures. Partner agreements will establish which records are available and suitable; platform activity will add measures of participation and follow-through.
Test the platform
Does the intervention improve sustained participation and agreed health or functional outcomes relative to an appropriate comparison? Measure implementation effort and total cost alongside benefits.
Test the indicator
Does the restoration–deterioration balance anticipate later utilization or spending change beyond baseline risk and established predictors? Define scores, forecast intervals, and uncertainty before judging performance.
Build evidence for expansion: assess whether results can be reproduced across populations and sites, with workable staffing, data integration, and cost per participant. The goal is an evidence-based decision about what to improve and when to scale.
Evaluation: an initial 90-day feasibility period can test reach, understanding, sustained engagement, referral progression, participant experience, and staff burden. Demonstrating durable savings or clinical outcomes may require larger samples, comparison groups, and longer follow-up.
A concrete use case: immunology trial access
A developed J&J QuickFire Challenge application proposes a 180-day project with an embedded 90-day feasibility evaluation: English/Spanish education, serialized content, human navigation, barrier resolution, and a partner dashboard for a lupus-focused community-to-trial pathway.
This is an application-stage design, not a J&J award, endorsement, or completed pilot. Authorized investigators and trial sites—not e-Live-Health—would retain responsibility for trial eligibility, screening, consent, enrollment, and clinical care.
Implementation would follow funding, agreements, privacy/security review, and applicable consent and research-governance determinations. This page is for organizational discussions, not patient enrollment.
Explore a pilot partnershipThe commercial opportunity
One integrated company. Multiple routes to value.
The opportunity links the organizations bearing healthcare costs, the partners communicating with patients, and the content that can attract and sustain an audience.
Population-health subscriptions
A proposed per-member-per-month model for employers, payers, and risk-bearing providers. Pilots would test engagement, operational fit, costs, and the evidence needed for purchasing decisions.
Precision Rx communication
A proposed condition-relevant, consent-based alternative to broad-reach advertising, with agreed engagement measures and attribution. Pricing and outcomes-based terms would require partner, data, and regulatory validation.
Health-entertainment IP
Book, television, film, and licensing opportunities designed to build awareness and attract audiences. These complement the engagement platform; adaptation deals and revenues are not assured.
Explore Engine 02 with an illustrative Rx example
These fictional drug and game names illustrate a proposed communication workflow. They are not actual products, treatment recommendations, sponsor endorsements, or measured results. No personal health information is collected by this demo.
Gluvanta · fictional diabetes communication
A consenting participant with partner-confirmed type 2 diabetes chooses Blood Sugar Balance. A condition-relevant educational message could appear alongside that activity, with sponsored content clearly identified.
Illustrative message: Learn about your care plan and questions to discuss with your care team. Any real product communication would require appropriate review and prescribing and safety information.
What a pilot could measure: voluntary return visits, understanding, permitted message interactions, and agreed follow-through. These are candidate measures, not demonstrated effects.
The efficiency question: does condition-relevant communication improve useful engagement compared with broad-reach messaging, at an acceptable cost? Attribution and any outcomes-based commercial terms would require partner agreements and validation.
These are proposed revenue pathways, not booked revenue. Governed longitudinal analytics could support evaluation and future partner services; no patient-data sale is assumed.
What next-stage support would make possible
- Initial readiness
≈90 days after fundingMake the case reviewable and the pilot sponsorable.Advance manuscript and launch assets, technical review, pilot architecture, a limited demonstration, customer/pricing discovery, and legal/IP readiness.
- Pilot validation
Separately scoped & fundedBuild and test with a qualified partner.Finalize governance and agreements, implement the selected use case, and evaluate feasibility, engagement, and economics. Duration depends on the question and design.
- Scale
Evidence-dependentExpand what the evidence supports.Use findings to guide productization, commercial agreements, team development, and subsequent financing.
Readiness funding does not cover full platform build-out or full pilot execution. Publication and third-party schedules may extend beyond the initial period.
Discuss funding or a qualified introductionBeyond capital
The right expertise can move the project forward.
We welcome publishing and editorial partners; applied-mathematics and evaluation reviewers; clinical, technical, privacy, and legal collaborators; and introductions to pilot sponsors or appropriate funding sources.
A useful first step can be small: review the Manuscript Synopsis, assess a focused pilot idea, identify a technical question, or introduce a decision-maker whose objectives align.
Explore how you could contributeThe founder: mathematical roots, operating experience
Larry J. Pipes, Ph.D., is a Hertz Fellow and former RAND Corporation researcher whose UCLA dissertation applied maintenance theory to healthcare. His subsequent work includes HMO development, healthcare management, health-technology ventures, and managed-care consulting.
e-Live-Health brings that analytical and operating experience together in a book-first path toward pilot testing. The Teller anecdote concerns the foundational idea, not an evaluation of today’s platform. Historical affiliations do not imply institutional endorsement of the venture.
Continue the conversation
What would you like to accomplish?
Dr. Pipes welcomes a candid conversation about your objectives—and whether e-Live-Health could complement, strengthen, or extend work already underway.
No endorsement or commitment is expected. Questions and suggested changes are welcome. The first step is to see whether there is a productive fit.
Materials available on request: Manuscript Synopsis; Pilot Outline and Q&A; Pharma, Patient Engagement & Rx Communication Brief; and Publication and Pilot Readiness Financing Brief.
Prefer email? Contact Dr. Pipes directly at ljpipes@yahoo.com.