Health IT Bubbles

This post was originally featured on HIStalk

Travis and I attended the Health 2.0 conference in Santa Clara. The most prominent trend I observed was that health IT startups are converging on a few big ideas.

Wellness platforms. I walked the exhibit hall and talked to the reps at every booth. There were at least eight vendors selling a platform to employers and payers to manage wellness. They all employed the same business model and there was no discernible difference between any of their products.

Patient engagement. I think "patient engagement" will win the award for most overhyped, under-delivered term of 2013. Fundamentally, engagement is about pushing and pulling data in using the right channel at the right time. The patient engagement startups were pushing and pulling across many spectrums. Many helped providers push information to patients, and many were predicated on patients initiating engagement with providers through data. None at Health 2.0 were particularly memorable.

Medication adherence. I can’t believe how many startups are trying to help patients take their pills on time. Similar to patient engagement startups, they’re trying different push and pull tactics: pill bottles, cloud services, and social contracts. I suspect the winners in this arena will successfully combine characteristics across all channels. Or they’ll take a completely different approach, such as Proteus Digital Health.

This makes me wonder: if we’re spending so much effort to get patients to take their pills, how on earth are we going to "engage" them? Taking pills at the right time requires almost no behavior change. Real engagement, on the other hand, is the holy grail of behavior change. I’m not optimistic.

These waves remind me of EHRs circa 2010. EHR companies were cropping up left and right in 2009 and 2010. By most accounts, most of the newer EHR companies aren’t doing particularly well, though there are standouts. Although many expected consolidation via M&A, they’re mostly just being left to die off. I suspect we’ll see a similar withering in the bubbles identified above.

All of this begs the question: what are the upcoming bubbles? I suspect we’ll see heightened activity in each of these spaces over the next 2-3 years:

Wearables for healthcare. This has already started, though most of the existing wearables track only the simplest data, primarily footsteps and vitals. There’s enormous opportunities to simplify and sex-ify more powerful wearables such as the Zephyr BioHarness. I suspect the most successful mass-market health-focused wearables will be those that can create provider awareness so providers can prescribe their solutions to their patients.

Google Glass apps for healthcare. I’m surprised by the lack of Glass healthcare startups given how many people are talking about Glass for healthcare. The only two that I’m aware of are Augmedix and my startup Pristine. I suspect we haven’t seen that many healthcare-focused Glass startups because: (a) hardware isn’t readily available and founders aren’t willing to start a business around a single unit of hardware; (b) Google won’t disclose a final commercial release date, so it’s hard to get investors on board; and (c)  the native Glass Development Kit isn’t out yet, though it’s supposed to be soon.

Feel free to leave a comment with your thoughts on existing and upcoming bubbles.