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.
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.
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 Timesprofiled 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.
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
1. relating to or denoting an imagined state or society where there is great suffering or injustice.
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.
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.
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.”
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
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…
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.
Listen to them on Itunes or Spotify
Subscribe to our mailing list
Want to Partner with THCB?
View our Advertisement & Sponsorship Prospectus here