Predicting the Future: A Health Moonshot Revolution on a Global Scale
Digital health trends poised to transform the industry in 2018 and beyond
At StartUp Health, we work with hundreds of Health Transformers, entrepreneurs and innovators every year — from founders bootstrapping their way to success, to moonshot visionaries reshaping the future, to CEOs of the world’s largest companies trying to figure out how to keep pace with a dynamic landscape.
It’s a unique perspective seeing in real-time what’s working in one part of the world and what’s not catching on in another.
Two years ago in a column for Forbes I shared 13 health innovation predictions that would take shape in the near-term. Twelve of those predictions have already come true. And I think the thirteenth is just a matter of time.
As we enter 2018, I’ve decided to revisit these predictions to review the progress being made and offer new insights on where these trends will go.
Looking back at the crystal ball — a new look at the progress
A second wave of digital health innovation — Two years ago, I forecasted a “second wave” of digital health transformation, and today we’ve seen massive adoption of wearable health devices, a huge injection of capital into digital health startups, formal FDA guidance and support for digital health applications, the entrance of tech giants like Apple, Amazon, and Facebook, and unexpected mega-deals like CVS/Aetna. The industry has leaped forward in every way imaginable, across the globe.
What’s coming — While the healthcare industry (and government) focuses on the antiquated and elusive EHR, more than a billion people will get CHRs — what I call consumerized health records that are useful and accessible. It will happen automatically as they go about their daily routines and as they use their watches, credit cards, cars, kitchens and bathrooms. Prediction: Apple, Amazon, Google, Microsoft, or someone else smart with a warchest, buys EPIC as a trojan horse into the industry.
Also the same way the quantified-self movement caught the imagination of a legion of creators, and helped spawn rapid adoption of activity trackers in digital health’s First Wave, a more mainstream and impactful generation of consumer wellness-hacking tools will come to market empowering people to rewire, reset and re-energize their mind, body, and spirit. Think of it as Headspace 2.0 — as brain-hacking goes mainstream helping those with addiction, stress, PTSD, and mental and behavioral health needs.
Most importantly, impact will be a baseline requirement for any health solution wanting to break through. And those with measurable outcomes and health moonshot visions will lead to our first Uber-sized success stories over the next decade.
Less logjams, more moonshots — A few years ago we were only on the cusp of a new mindset around bold thinking in health — too few pushed the boundaries toward moonshot-style investments with grand visions for reinventing health. Now we have VP Joe Biden’s well-recognized Cancer Moonshot (the Biden Cancer Initiative) and massive commitments declared by the Chan Zuckerberg Initiative and Silicon Valley leader Sean Parker. Big vision companies like Human Longevity Inc. (disclosure: a StartUp Health company), Verily, and Proteus are betting big on the future of prevention. And hundreds of new companies are organizing around StartUp Health’s quest to achieve 10 global health moonshots aimed at improving the wellbeing of everyone on the planet.
What’s coming — Now that the power of health moonshot thinking is becoming ingrained in public consciousness, there will be a new generation of entrepreneurs, investors, industry leaders and governments who start dreaming of bigger and bolder missions to reimagine what’s possible. This trend will continue to grow, as communities and individuals who care about health rally around these moonshots, and as the era of point-solutions shift to platform-based models with the ability to impact billions of people.
Rise of the “Maker Movement” will customize health — The home-grown “maker movement” is transforming the industry with customized solutions. Mostly, this has taken the form of 3D printed products, such as personalized medical devices and homemade pills. We’ve already seen the first FDA clearances of 3D-printed complex medical products including spines and hands.
What’s coming — This area won’t be without challenges as regulators try to work out how to monitor and control the manufacturing of home-grown medicines and devices, but a robust ecosystem is emerging. Expect wild experimentation, new conferences for early adopters, and niche networks to serve these important conversations. Also watch for specialized investors, dedicated funds, and a rise in crowd-funding focused on the maker-movement for health.
Artificial intelligence (AI) finds purpose in healthcare — In 2015, I described how AI would make a big impact in healthcare. While bots won’t replace your doctor just yet as Venrock VC Bob Kocher also predicts, the industry has moved beyond IBM Watson. It’s already a major sub-sector and one of the most active areas of digital health investment. Numerous companies are receiving funding to focus on solutions dedicated to applying this technology to diagnosis, radiology, automation, and other aspects of medicine. In fact, StartUp Health Insights is tracking over 125 companies focused on AI.
What’s coming — The machine learning capabilities of these solutions are reaching a tipping point and starting to make a real difference in care instead of just being theoretical. Other advancing trends including home-based devices (Alexa, Siri, Home), IoT, and clinical grade wearables for consumers, combined with machine learning capabilities will only speed up the effectiveness of these emerging platforms and opportunities to impact behavior change and health outcomes.
Digital health = health — Now, virtually every sector of healthcare is thinking about, or already leveraging digital. From biotech and life science, to med devices, insurance, clinics, and consumer health — every sector of health has a digital layer.
What’s coming — Next, we’ll see “digital health” echo the “mobile health” or “internet” trend and ultimately become less useful as a sub-category. Newer niche sub-sectors will gain increased focus, including blockchain (for health), AI (for health), the maker movement (for health), and IoT (for health).
Growing experimentation with ‘healthbots’ — Now, it’s normal to talk to Amazon’s Alexa in your living room, or explore the idea of finding a ‘smart’ health aid for your aging parent. Consumers are starting to accept the idea that heathbots can be used to automate, improve, and simplify routine tasks that impact our time, lifestyle, and everyday wellbeing.
What’s coming — Moving forward, healthbots will increasingly focus on solving automation problems in healthcare, such as workflow data entry and fraud detection. They will also make significant leaps forward to impact behavior change to help coach us to better health with invisible micro-steps. Unused health apps will fade away and be replaced by invisible services layered into the wearable sensors, home appliances, mobile tools, and cars we live with.
Short-term innovation programs give way to the healthcare marathon — Innovation programs continue to transform as the realities of the ‘healthcare marathon’ endure. After Rock Health killed its accelerator program, the founders of HealthBox, Dreamit and Blueprint Health all left or changed their roles. All these organizations, and many others have evolved to new areas of focus, beyond the short-term (3–6 month) model.
What’s coming — While there are too many health challenges, demo days, and accelerator programs to name, those organizations with a commitment to the long-term who are setting the stage for what’s next. From mega-funds (like the $1 billion Ping An Global Voyager Fund) to sovereign wealth funds are thinking in years and decades vs. weeks and months.
Unlikely marriages in healthcare become the norm — After Novartis and Qualcomm launched a $1 billion partnership in 2015, it became clear that we’d start to see even more collaborations between health, tech, and communications companies. This year, the estimated $66 billion CVS acquisition of Aetna was another pairing that seemed unexpected at first, but makes sense in context of healthcare economics and market need.
What’s coming — These partnerships will become even more common as leading companies start to realize the benefit of breaking down silos, collaboration, and skill sharing. As we move into a cost-conscious, value-based environment, expect to see innovative partnerships that aim to streamline certain aspects of the healthcare experience and/or enterprise. Also, we will see an M&A race for those with the best healthcare assets. It won’t just be companies in similar lines of business acquiring each other like two pharma companies joining forces. It will be tech giants and consumer companies buying health systems, EHRs, med device, pharmacy, and life science companies to give them fast entry into the complexities of the healthcare market. Some of these unions will not end well, but one or two will reshape the industry’s assumptions of how healthcare works.
New entrants stake their claim in healthcare — The line between “consumer” and “healthcare” companies has continued to blur since 2015. A growing number of retailers muscled into the clinic business and ER-lite services usually provided at hospitals, and consumer tech companies began offering healthcare products. As tech giants from Apple to Amazon to Facebook skunkwork their way into healthcare in mysterious ways, other entrants including grocery chains, car companies, clothing manufacturers, and telecoms are also investing in the sector.
What’s coming — This trend is likely to become the norm as tech giants continue buying up healthcare startups and legacy companies. For example, Amazon is moving into the prescription drug market, with others predicting that the tech giant may soon partner with a pharmacy benefit manager.
Silicon Valley gets smart about the FDA — After forging boldly into the healthcare arena with little regulatory expertise, several Silicon-Valley companies have had high-profile clashes with regulators (think: 23andMe and Theranos). With these examples as guides, the smartest innovators aren’t running from the sector, but instead learning to manage the complexities of the industry.
What’s coming — Continued FDA guidance after years of uncertainty will benefit investors and startups alike, and the prodding from companies like Apple, 23andMe, and Google that now have regulatory expertise and relationships with the Agency will speed the process up. We’ll also see more big flame outs from first-generation innovators where hype overcame diligence.
Consumers become the new angel investors — In 2015, we noticed that consumers were becoming the new angel investors of digital health. We’ve seen that transformation take place this year as one of StartUp Health’s companies, Patientory, raised several million from an initial coin offering (ICO) recently. Meanwhile, Kickstarter and Indiegogo continue to thrive with health solutions.
What’s coming — This trend will continue with vigor and expands as a variety of alternative sources of capital make themselves available to startups. From ICOs to global public offerings (GPOs) to sovereign wealth funds and ega-funds there will be more than enough capital to support the best innovation and bet big on health moonshots.
And the prediction I’m still waiting to happen…
The Leapfrog Effect materializes in underserved markets — In 2015, I wrote that by now we’d see transformative “leapfrog solutions” in emerging health markets inspire the US and Europe to replace clunky, siloed, and overcomplicated technology. While we’re starting to see rapid adoption of digital health tech in China and India, the benefits of this innovation have not yet circled back the way I envisioned.
What’s coming — The leapfrog effect may ultimately be a boomerang effect. While we haven’t seen the zenith of this concept yet, trust me: it’s coming and I look forward to seeing what happens in the next three years.
As I think about the progress being made, what’s most illuminating is how health innovation is moving faster than many realize — an important reality that will create many winners and losers — especially for those not upgrading and re-calibrating along the way. What’s inspiring, is that we are finally in a health moonshot era taking shape on a global scale.
