What’s Really Killing Digital Health Startups
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What’s Really Killing Digital Health Startups
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Re: What’s Really Killing Digital Health Startups
#2Articles like this make me wonder about Oscar Health.
Re: What’s Really Killing Digital Health Startups
#3I'm a grant writer and have worked for numerous Federally Qualified Health Centers (FQHCs) and a smaller number of hospitals. From their perspective, EMR and related systems have tended to cost at least as much as they've saved. Some of them have seen the vendor jousting Sung describes and have experienced all sorts of vendor fatigue and vendor lock-in.
At the same time, FQHCs and hospitals are facing CMS requirements that dictate increasing EMR usage. This effort has had... some setbacks, let's just say. And what Executive Directors are willing to say off the record is not pretty: http://seliger.com/2015/10/25/meaningful-use-regulations-cms....
Re: What’s Really Killing Digital Health Startups
#4Digital health is difficult since:
1. [B2B] Providers/enterprises aren't willing (or able) to integrate into legacy systems
2. [B2C] Consumers see their futures selves as strangers [1], and most aren't willing to put in time now to prevent something that may or may not happen in the future (e.g. sickness)
Which is sad, because this is a huge area for tech to have a meaningful impact on lives.
There are definitely some interesting companies in the space. For example, Omada Health [2] sells to companies. Companies like them because their employees' health increases (meaning more time spent working) and insurance companies like them because their loss ratio decreases.
[1] http://www.vox.com/2014/12/18/7414105/procrastination-future... [2] https://omadahealth.com/
Re: What’s Really Killing Digital Health Startups
#5I'm a grant writer and have worked for numerous Federally Qualified Health Centers (FQHCs) and a smaller number of hospitals. From their perspective, EMR and related systems have tended to cost at least as much as they've saved. Some of them have seen the vendor jousting Sung describes and have experienced all sorts of vendor fatigue and vendor lock-in. At the same time, FQHCs and hospitals are facing CMS requirement…
Why doesn't the federal government build an EMR system and require its use as a condition of accepting Medicare payments?
Sure, I'd expect a terrible process and result previously (such as the mess healthcare.gov was when rolled out), but I have a lot more faith with the USDS and 18F in place.
Re: What’s Really Killing Digital Health Startups
#6Also something less talked about is how hospital administrators don't want to share their data for competitive advantages. So, they're more than happy letting the EMR vendors taking the blame for the lack of interoperability while in fact that said lack of interoperability is exactly what they're looking for when partnering up with an EMR.
So, when trying to sell a third-party product to a hospital, administrators forward you to the EMR vendor, while EMR vendor forwards you to the administrators :) Each of those "forwarding" takes a few months.
Re: What’s Really Killing Digital Health Startups
#7Digital health is difficult since: 1. [B2B] Providers/enterprises aren't willing (or able) to integrate into legacy systems 2. [B2C] Consumers see their futures selves as strangers [1], and most aren't willing to put in time now to prevent something that may or may not happen in the future (e.g. sickness) Which is sad, because this is a huge area for tech to have a meaningful impact on lives. There are definitely som…
I wonder if part of the B2C difficulty is that insurance pays for most healthcare but (with a few exceptions) not for the lifestyle choices that would reduce healthcare costs.
If there was more of an emphasis on preventative measures that insurance paid for, I wonder if it would be different.
Re: What’s Really Killing Digital Health Startups
#8Articles like this make me wonder about Oscar Health.
Oscar Health is actually an insurer. They're trying to win by (a) better marketing and (b) using tech (like free fitness tracker) to reduce their loss ratio.
I've heard their innovation was also in pre-paying facilities for services. The collection rate for facilities from insurers is abysmal, so Oscar can negotiate a substantial discount by paying up front. Same idea as if you go to an MRI facility and offer them cash up front - they sometimes give discounts up to 75%. (Note: not 100% sure Oscar does this, I heard from investor and don't have time to research.)
Re: What’s Really Killing Digital Health Startups
#9Digital health is difficult since: 1. [B2B] Providers/enterprises aren't willing (or able) to integrate into legacy systems 2. [B2C] Consumers see their futures selves as strangers [1], and most aren't willing to put in time now to prevent something that may or may not happen in the future (e.g. sickness) Which is sad, because this is a huge area for tech to have a meaningful impact on lives. There are definitely som…
I wonder if part of the B2C difficulty is that insurance pays for most healthcare but (with a few exceptions) not for the lifestyle choices that would reduce healthcare costs. If there was more of an emphasis on preventative measures that insurance paid for, I wonder if it would be different.
This is difficult due to ACA regulations. For example, Pact (formerly GymPact) was trying to give people discounts on Blue Shield of CA health insurance premiums for going to the gym. A provision/update in the ACA made this illegal about a year ago; not sure if it's changed since then.
That said, it seems likely that insurance premiums will eventually be tied to real time health data, like Metromile is doing for car insurance.
Re: What’s Really Killing Digital Health Startups
#10Digital health is difficult since: 1. [B2B] Providers/enterprises aren't willing (or able) to integrate into legacy systems 2. [B2C] Consumers see their futures selves as strangers [1], and most aren't willing to put in time now to prevent something that may or may not happen in the future (e.g. sickness) Which is sad, because this is a huge area for tech to have a meaningful impact on lives. There are definitely som…
I wonder if part of the B2C difficulty is that insurance pays for most healthcare but (with a few exceptions) not for the lifestyle choices that would reduce healthcare costs. If there was more of an emphasis on preventative measures that insurance paid for, I wonder if it would be different.
What lifestyle changes would an insurer pay for--at least without very intrusive lifestyle monitoring? (Which will increasingly be possible to do whether it's done or not.) There are often discounts for gym memberships and the like. And annual physicals are typically paid for.