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Has “Disruption” Reached Its Sell-by Date? 

BY JEFF GOLDSMITH

If you read the business press, as I do every day, It is impossible to escape the “disruption” meme. Clayton Christiansen’s 1997 Innovator’s Dilemma explored how established businesses are blindsided by lower cost competitors that undermine their core products, and eventually destroy their businesses. Classic examples were the displacement of film-based cameras by digital cameras and then cell phones, the destruction of retail shopping by Amazon and of video rental by streaming video services.

A Civic Religion

Perhaps because Christiansen’s analysis arrived at the peak of the first Internet boom, it generated a high level of anxiety in the corporate world. It did not seem to matter that Christiansen’s analysis was riddled with flaws, meticulously detailed in Harvard colleague Jill Lepore’s takedown in the New Yorker in 2014.

By then, the disruption thesis had become a cornerstone of a kind of civic religion, an article of faith and an indispensable staple of fundraising pitches in the venture and private equity worlds.   No one seemed to be asking how great a trade for the society was, say, tiny Craigslist taking down the newspaper business by drying up its classified ad revenues.   

Disrupting a $4 Trillion Health System

I believe that, twenty five years on, the notion of disruptive innovation has reached its “sell-by” date. At least in healthcare, the field of commerce I follow most closely, it is now doing more harm than good. The healthcare version of the disruption thesis was found in Christiansen’s “Innovator’s Prescription”, written with health industry maverick Dr. Jerome Grossman in 2009. Christiansen and Grossman forecast that innovations such as point-of-care testing, retail clinics, and special purpose surgical hospitals threatened to take down healthcare incumbents. 

A swarm of breathless (and reckless) healthcare disruption forecasts shortly followed. 

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Where’s Our National Health Tech Academy

By KIM BELLARD

It has been said that if your company has a Chief Innovation Officer or an Innovation Department, it’s probably not a very innovative company. To be successful, innovation has to be part of a company’s culture, embraced widely, and practiced constantly.  

Similarly, if your company has a Chief Digital Officer, chances are “digital” is still seen as a novelty, an adjunct to the “real” work of the company. E.g., “digital health” isn’t going to have much effect on the healthcare system, or on the health of those using it, until it’s a seamless part of that system and their lives.

What got me thinking about this, oddly enough, was a report from the U.S. Government Accountability Office (GAO) as to the advisability of a Federal Academy – “similar to the military academies” – to develop digital expertise for government agencies.  As the GAO noted: “A talented and diverse cadre of digital-ready, tech-savvy federal employees is critical to a modern, efficient government.”

Boy, howdy; you could say that about employees in a “modern, efficient” healthcare system too. 

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You Want to 3D Print What

By KIM BELLARD

You know we’re living in the 21st century when people are 3D printing chicken and cooking it with lasers.  They had me at “3D printing chicken.”  

An article in NPJ Science of Food explains how scientists combined additive manufacturing (a.k.a, 3D printing) of food with “precision laser cooking,” which achieves a “higher degree of spatial and temporal control for food processing than conventional cooking methods.”  And, oh, by the way, the color of the laser matters (e.g., red is best for browning).   

Very nice, but wake me when they get to replicators…which they will.  Meanwhile, other people are 3D printing not just individual houses but entire communities.   It reminds me that we’ve still not quite realized how revolutionary 3D printing can and will be, including for healthcare. 

The New York Times profiled the creation of a village in Mexico using “an 11-foot-tall three-dimensional printer.”  The project, being built by New Story, a nonprofit organization focused on providing affordable housing solutions, Échale, a Mexican social housing production company, and Icon, a construction technology company, is building 500 homes.  Each home takes about 24 hours to build; 200 have already been built.

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#Healthin2Point00, Episode 231 | Pager, Ovivia, Meru Health, and NOCD

It’s Telehealth Awareness Week! Today on Health in 2 Point 00, we cover Pager raising $70 million, bringing their total to $132.6 million. German-based company Ovivia gets $80 million, bringing their total to $127 million. Meru Health raises $38 million, and NOCD raises $33 million. —Matthew Holt

Metaverse and Health Care – A View From 50,000 Feet

by MIKE MAGEE

dystopian

[disˈtōpēən]

ADJECTIVE

1. relating to or denoting an imagined state or society where there is great suffering or injustice.

NOUN

1. a person who imagines or foresees a state or society where there is great suffering or injustice.

There are certain words that keep popping up in 2021 whose meanings are uncertain and which deserve both recognition and definition. And so, the offering above – the word “dystopian.” Dystopian as in the sentence “The term was coined by writer Neal Stephenson in the 1992 dystopian novel Snow Crash.”

One word leads to another. For example, the above-mentioned noun, referred to as dystopian by science fiction writer Stephenson three decades ago, was “Metaverse”. He attached this invented word (the prefix “meta” meaning beyond and “universe”) to a vision of how “a virtual reality-based Internet might evolve in the near future.”

“Metaverse” is all the rage today, referenced by the leaders of Facebook, Microsoft, and Apple, but also by many other inhabitors of virtual worlds and augmented reality. The land of imaginary 3D spaces has grown at breakneck speed, and that was before the self-imposed isolation of a worldwide pandemic.

But most agree that the metaverse remains a future-facing concept that has not yet approached its full potential. As noted, it was born out of science fiction in 1992, then adopted by gamers and academics, simultaneously focusing on studying, applying, and profiting from the creation of alternate realities. But it is gaining ground fast, and igniting a cultural tug of war.

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For Your Eyeballs Only

By KIM BELLARD

There’s so much going on.  There’s the coronavirus: It’s now a pandemic!  China can build an entire hospital to treat coronavirus patients in under two weeks!  Or there’s primary care: One Medical’s IPO boomed!  AmazonHumana and Walmart are testing their versions!  People are flocking away from primary care!  Or, on a completely unrelated note, Tesla wants to disrupt auto insurance too. 

As interesting as all those are, it’s augmented reality (AR) that I want to talk about. 

Stop thinking about Snap Spectacles or Pokémon Go as what you think of when you think about AR.  Stop thinking about the supposed failure of Google Glass.  Start thinking about AR being ingrained in our daily lives.

Facebook CEO Mark Zuckerberg believes “at some point in the 2020s, we will get breakthrough augmented reality glasses that will redefine our relationship with technology.”  He went on to elaborate:

Instead of having devices that take us away from the people around us, the next platform will help us be more present with each other and will help the technology get out of the way. Even though some of the early devices seem clunky, I think these will be the most human and social technology platforms anyone has built yet.

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Concrete Problems: Experts Caution on Construction of Digital Health Superhighway

By MICHAEL MILLENSON

If you’re used to health tech meetings filled with go-go entrepreneurs and the investors who love them, a conference of academic technology experts can be jarring.

Speakers repeatedly pointed to portions of the digital health superhighway that sorely need more concrete – in this case, concrete knowledge. One researcher even used the word “humility.”

The gathering was the annual symposium of the American Medical Informatics Association (AMIA). AMIA’s founders were pioneers. Witness the physician featured in a Wall Street Journal story detailing his use of “advanced machines [in] helping diagnose illness” – way back in 1959.

That history should provide a sobering perspective on the distinction between inevitable and imminent (a difference at least as important to investors as intellectuals), even on hot-button topics such as new data uses involving the electronic health record (EHR). 

I’ve been one of the optimists. Earlier this year, my colleague Adrian Gropper and I wrote about pending federal regulations requiring providers to give patients access to their medical record in a format usable by mobile apps. This, we said, could “decisively disrupt medicine’s clinical and economic power structure.”

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Health in 2 Point 00, Episode 96 | Amazon Care, Echo, OneDrop & more

Today on Health in 2 Point 00, Jess and I catch up on loads of news in health tech. In this episode, Jess asks me about Amazon Care, doing telehealth, house calls, urgent care, drug delivery for their employees—could it change health delivery? Also, Eko raises $20 million for their smart stethoscope; Bayer leads a $40 million round for OneDrop’s blood glucose meter; GoodRx buys telehealth company HeyDoctor; Rock Health investing $10M in InsideRx, and an undisclosed amount to Arine; and Peloton IPO’s today and everyone’s looking at it as a healthcare company (but no, it’s not). We end on some gossip, so tune in. —Matthew Holt

Whole Genome Sequencing Heads for Consumers – Rodrigo Martinez of Veritas Genetics

By JESSICA DaMASSA, WTF HEALTH

DNA testing companies like 23andMe and Ancestry have made DNA testing mainstream, with adoption skyrocketing among consumers. Meanwhile, health tech startups like Veritas Genetics are starting to push the trend even further – from genotyping to whole genome sequencing. What’s the difference? Well, genotyping looks at less than half of 1% of your genome, while whole genome sequencing looks at over 99% of your genome.

Veritas is betting that consumers are ready for what’s revealed by looking at more than 6.4 billion letters of DNA and are promising that the value of that information will only get richer as time goes on and the science that makes sense of our genome achieves new breakthroughs.

In fact, Veritas is positioning their $999 test as “a resource for life” and Rodrigo Martinez, their Chief Marketing & Design Officer who I chat with here, shares a vision for the future that includes asking Alexa to scan your genome before taking medications or risking allergic reactions to foods.

This is fascinating proposition for the future of health (investors are jazzed too, having poured $50M into the company), but ethical questions abound. How do you make this information useful and actionable? How do you handle situations where major health issues are reveled? And what about data privacy? This is about as personal as personal health information can get. Rodrigo weighs in…

What Do Docs Think About Delivering Care via Telehealth? | Teladoc Provider Dr. Chris Dennis

By JESSICA DAMASSA, WTF HEALTH

As more and more patients seek care using telehealth, one has to wonder what it’s like for the docs. Dr. Chris Dennis provides behavioral health services via the Teladoc virtual care platform and dishes on the experience. Is the patient-physician relationship the same? How does he benefit from actually seeing his patients in their ‘natural environments’? Mental health services are one area where virtual care use is quickly gaining acceptance, will the trend last? Listen in to find out.

Filmed at HIMSS 2019 in Orlando, Florida, February 2019

Jessica DaMassa is the host of the WTF Health show & stars in Health in 2 Point 00 with Matthew Holt.

Get a glimpse of the future of healthcare by meeting the people who are going to change it. Find more WTF Health interviews here or check out www.wtf.health

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