February 13, 2019
by Priya Gupta
Of the many industries ripe for disruption, healthcare ranks close to the top of the list for many consumers. A bevy of digital products today seeks to enable better medical treatment and give patients more agency over their own health. In a recent Intentional Learning session, we analyzed hundreds of these products and came away excited about a few, worried about others, and in wait-and-see mode on several more.
Accessing your own data. For years, Epic’s MyChart has dominated the personal health record (PHR) realm, making few real changes to improve its utility. Today, Epic finally has competition from startups and tech giants alike. Startup b.well provides access to your health data and recommends personalized next steps for improving your health, like scheduling your next annual preventive health screening. Early positive feedback for Apple Health Records is another indicator that the PHR will become more accessible and easy to use. We’re confident that having a unified place for health data will greatly improve the healthcare experience for many who juggle multiple doctors for either themselves or family members.
Alternatives to pharmaceuticals
Rising drug prices and a raging opioid crisis have some looking to drug alternatives to save lives and costs. Software and hardware innovations can help in two ways:
Because pharmaceutical pain management can be the gateway to opioid addiction, some startups are looking to scale non-drug pain relief methods. Hinge Health and Kaia Health address back and joint pain through digital-delivered exercise therapy and coaching, while Neurometrix’s Quell 2.0 treats chronic pain through neurostimulation.
Treating chronic disease
Lifestyle behaviors such as having a poor diet contribute to the rise in diseases like diabetes. To address this, some digital products offer access to behavioral health programs. “Digital therapeutics” like Livongo help people manage diabetes and hypertension, while Pivot works to prevent the onset of disease by helping people quit smoking. The most promising aspect of these products is the coach, who checks in with users and offers advice and encouragement. Changing a habit or addiction is a huge challenge, made even harder when you don’t have a supportive community. Ready access to a coach can make a big difference.
Taking care of the whole person
The rise of chronic conditions often comes with an increase in medications. Digital treatment could streamline the process, saving costs and more efficiently addressing root causes. Companies like Omada—originally created for pre-diabetics but now helping people with diabetes, hypertension, and depression—are simplifying care for patients with multiple conditions. We’re betting that we will see significant cost savings from these programs that not only coordinate care delivery but also increase the use of non-drug interventions to manage and prevent chronic disease.
At-home lab testing is going to be—without a doubt—a transformative innovation. Some impacts will be positive, saving money on lab infrastructure for healthcare players, saving transportation time and costs for consumers, and offering patients quick guidance about whether to see a doctor or not. However, buying tests online and reviewing results on your own also poses two potentially massive problems. First, when a doctor shares your results with you, they are sharing not just one number, but multiple layers of context that tell you whether or not that number is concerning. Results from company EverlyWell leave you hanging, letting you interpret canned guideline language about what an “out of range” result might mean.
Additionally, most consumers are not educated about what constitutes an accurate or useful medical test, or which labs are reliable. We already see this with the EverlyWell misleading marketing of the Immunoglobulin G test as a “food sensitivity test,” which many doctors say does little to expose any real insights. With no context around health data and few checks for testing quality, some at-home testing products can increase patient stress, drive more people to seek unnecessary care, and increase healthcare costs.
Personalized nutrition advice
Finding the perfect diet that will keep us lean, energetic, and strong is an endless quest for many. As blood, DNA and microbiome testing become cheaper and more accessible direct-to-consumer products, entrepreneurs are jumping at the chance to offer personalized diets and nutrition recommendations. Care/of and Baze offer personalized supplement packs for daily consumption (Baze even tests your blood using an at-home kit). Meanwhile, Viome and Habit have grander goals, claiming to provide consumers with a list of foods to eat more of or avoid based on their microbiome or genetic analyses.
While eliminating a few foods or taking supplements certainly isn’t harmful, a critical question remains—does it help at all? With our understanding of the microbiome still in its infancy, today it’s virtually impossible to know whether changing our consumption of one food will lead to positive outcomes. Science has a long way to go before these types of recommendations can be taken more seriously.
Despite some concerns, our digital healthcare investigation left us with an overall sense of promise and momentum. Millions of people stand to benefit from these trends once products are further refined. Consumers are capable of improving their health through greater access to their health data, but innovators must remember that most patients don’t have the expertise to interpret health data unassisted; a professional with medical knowledge will still be required to guide them. Moving forward, providing appropriate context, support, and coordination will be key principles for building consumer- or patient-facing products that drive positive outcomes.
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