What does the future of healthcare look like?

Steven Loeb · November 23, 2016 · Short URL: https://vator.tv/n/4854

Top VCs and enteprenuers from the healthcare space tell me what's hot and what's coming

Editor's note: Our Splash Health, Wellness and Wearables event is coming up on March 23 in San Francisco. We'll have Steve Jurvetson (Draper Fisher Jurvetson), J. Craig Venter (Human Longevity), Patrick Chung (XFund), Risa Stack (GE Ventures), Paul Willard (Subtraction Capital), Julie Papanek (Canaan Partners) and more. Check out the full lineup and register for tickets before they jump! If you’re a healthcare startup and you’re interested in being part of our competition, learn more and register here.

Even as venture funding has slowed down this year, healthcare has remained one of the top spaces for companies to raise money. In the first quarter of this year, even as funding sunk to a two-year low, healthcare accounted for nearly a third of all venture capital investments, with $4.1 billion across 191 deals.

As of the beginning of this month, the healthcare space had raised $13.1 billion, according to data provided to VatorNews by Pitchbook, which has been spread across in 1,287 deals.

Obviously there's a lot of innovation happening, so what's hot in healthcare right now, and what does the future of the space look like?

I reached out to some of the top VCs and CEOs in the space to find out. 

Halle Tecco, Founder of Rock Health,  a seed fund investing in digital health startups

 "Six categories represent almost half, 44 percent, of all venture money raised this year. Buoyed heavily by Human Longevity’s massive $220 million round, the genomics category shot up dramatically, appearing in top categories for the first time. Other example companies in this space: Color Genomics, Helix, Veritas, and 23andMe.

Reproductive health is a space that nobody is paying attention to, but they should be. I spoke to Bloomberg about this over the summer. From fertility (which is mostly out of pocket, making it ideal for D2C companies) to pregnancy, one of the largest expenses for employers, this space has historically been under-funded. I'm personally keeping a close eye on this space! 

(Danielle McGuinness, who manages marketing endeavors and digital communications at Rock Health,  is planning a webinar to discuss this topic)

With Trump being elected President, and potentially dismantling the ACA, entrepreneurs and investors seem to be taking a "wait and see" approach. Trump spoke so vocally about repealing the ACA broadly, but said so little about what the replacement would look like. Depending on what exactly happens with the policy, new opportunities could arise while others dismantle. 

It's hard to say which spaces would becoming more prominent if that happened. If the only change is to allow health plans to sell across state lines, then perhaps increased competition will encourage health plans to innovate even more to differentiate their plans."

Rana el Kaliouby, Co-founder and CEO at Affectiva, a developer of emotion-recognition software

"My prediction is that quantifiable emotional and mental health technology will come to the forefront.

Doctors today have mastered the measurement of physical health conditions. For instance, when you walk into a doctor’s office, they don’t need to ask you about your blood pressure, because they can easily measure it. However, mental health is still subject to self-reporting. The healthcare community recognizes that mental health and emotions play a significant role in overall well-being, but there’s a gap when it comes to effectively measuring it.

With this in mind, we expect emotion recognition technology to play a key role in health-tech in 2017 and beyond. Companies have begun to develop these types of technologies, such as Emotion Artificial Intelligence (AI) and facial emotion recognition platforms."

Meng Li, CEO  and Co-founder of MOOV, a wearable fitness tracker

"The next big thing in healthtech is going to be proactivity with intelligence. Greater accuracy is hot now, but the next generation of wearables will go beyond passive tracking in order to deliver real results. Consumers want actionable coaching, “Tell me what to do, instead of just tracking numbers.” Actionable coaching enabled by wearables and artificial intelligence is going to make passive fitness trackers outdated and useless."

Paul Willard, General Partner at Subtraction Capital, an early stage enterprise software fund

"First, data. As most health data is still not digital much less normalized, the places that data exists are the richest places where chips can be most leveraged.  For instance, businesses that can be built on top of (Subtraction Capital family company and Vator Splash Health winner) Pokitdok have more wind at their back because the data is already digital AND normalized.

"Next, value based payments. It will be interesting to see if Trump maintains this reform sector.  As a citizen and taxpayer I hope it stays around.  And there are businesses like (again Subtraction Capital family company) Healthloop positioned to provide better care that is also more cost effective in a market based value model or agent based.

I also see blockchain health as coming trend. While I sometimes worry that hyperbole about Bitcoin and Blockchain are larger than their potential, some areas of health tech can clearly benefit greatly from a distributed ledger maintained by a trusted inside network.  This will create some big winners among the companies that steward this ledger.

Finally, artificial intelligence. AI is perhaps even more overhyped at the moment than Bitcoin and Blockchain, but the fact is that computing power has made deep layered neural networks (commonly synonymous with AI) coupled with digitized and sometimes normalized data, highly accessible.  And time and time again we have seen machines outperform humans in routine mundane tasks, especially when they require scrutiny of voluminous data, as well as objective discernment of statistical outliers. 

For instance, a practicing doctor may only see a rare condition once in their career or never.  So it might be more efficient for them to think about conditions they see more frequently.  For a computer however, the incremental processing to cover an edge case is essentially free.  And also since once algorithm can be applied across a very large population, the algorithm might benefit from seeing rare conditions more frequently."

Ali Diab, ‎CEO at Collective Healtha health benefits solution

"As a result of rising deductibles, we’re seeing a lot of employers getting creative in the types of benefits that they’re offering their people to help them stay healthy and not defer care because of the fear of incurring potentially big bills. Two such areas that have gotten a lot of interest are telemedicine and comparison-shopping tools. In fact, the number of U.S. employers offering telemedicine doubled to 60% in the past year because of the opportunity to not only give quicker access to medical care, but to also save money. And in an effort to get employees in the habit of comparison-shopping which can also help them save money, a growing number of employers are giving their people a cut of the savings when they choose more affordable care. Given the response we've seen from employers and their people, I think these types of complementary or alternative services to brick and mortar healthcare will only continue to gain more ground.

Although, to my earlier point, there have been a number of companies (including Collective Health) that have focused on the employer-sponsored market segment, I would argue that ​it is still relatively under-represented when it comes to healthtech innovation and startups​. Thousands of American companies essentially run their own mini-insurance companies through a vehicle called self-funding​, and, as I mentioned earlier, employers ​spend ​$​1.4 trillion dollars per year to cover ​the ​healthcare​ costs​ for 175 million ​Americans​​. Th​o​se employers can move quickly to implement a complete redesign of our healthcare experience from start to finish and I think that we’re likely to see their position increase; potentially even more so in light of recent events. My hope is that companies like ourselves and others will continue to be their partners in helping to make this change which could impact the way everyone -- not just employers and their people -- access healthcare. 

While there's​ still​ a lot to unpack and learn from the new Trump Administration on their specific plans around the ACA, ​the campaign did not ​​m​ake mention of any meaningfully ​change​s to​ the employer-sponsored market, which is the largest ​segment of the market after the federal segment (Medicare and Medicaid). ​Employers cover $1.4​ trillion in healthcare costs ​in our country​ and​, based on what we have heard from the President-Elect and his campaign, ​th​at seems​ unlikely to change​ meaningfully​, ​so I think ​you can expect ​healthtech ​startups t​o continue to focus on this market​, and for companies that are already serving that market -- companies​ like​ Collective Health​, Grand Rounds, Omada and others -- to ​invest even more heavily in their business ​models over the next four years, ​as ​employers continue to look for new ways to ​more ​​effectively manage the healthcare costs and experience ​of their populations​.​

I think that trend will be further supported by what we expect could be significant changes over the next four years in the individual ​and small group ​markets​​, where ​some of the proposed ​changes to the ACA could have a​ profound negative effect on the viability of healthtech companies that recently got started to take advantage of the emergence of those markets​​​​​. That said, I do​n't believe​ the changes​ to those marketplaces​ will be as​ sudden nor as​ sweeping as ​many suspect they will be, ​due to the ​immense ​complexity of what rolling back th​e ACA actually entails in practice."

Dan Chao, CEO at Halo Neuroscience, a developer of neurotechnologies for enhancing brain performance
Drugs are elegant medicine, but when it comes to the brain there is much left to be desired. The future of healthcare for neurologic and psychiatric conditions inspired us to to develop of more precise approaches to the brain, both spatially and temporally. In fact, the use of electricity (the 'language' of the brain) combined with state of the art electronics can serve as the perfect tool to achieve these goals.

I spent ten years at Neuropace, where we developed a closed loop brain stimulation system. We were able to specifically target problem region(s) of the brain responsible for triggering epileptic seizures, and only apply treatment 'on-demand' when the device recognized electrical signatures that are suggestive of a seizure. The efficacy of a device like this are beyond what a patient could expect with drugs alone. The spatial and temporal precision of therapy delivered by a neurostimulator as in the case of Neuropace stands to have far-reaching potential for success in other applications, and I already see the field growing.

The next breakthrough in the field of neurostimulation is to make these treatments non-invasive. A three-hour brain surgery for even a device as efficacious as Neuropace is a big step for patients, and though some treatments will always require surgery, there is a lot we can do to treat the brain without it. I've seen fascinating developments in VR and videogames as therapy for ADHD, memory and mood disorders. Non-invasive neurostimulators will also show their worth in the medical industry soon.

My company, Halo Neuroscience, is running clinical trials on tDCS for stroke recovery because non-invasive neurostimulation shows powerful results in motor rehabilitation."

The next big thing in healthtech is going to be proactivity with intelligence. Greater accuracy is hot now, but the next generation of wearables will go beyond passive tracking in order to deliver real results. Consumers want actionable coaching, “Tell me what to do, instead of just tracking numbers.” Actionable coaching enabled by wearables and artificial intelligence is going to make passive fitness trackers outdated and useless."

(Image source: medicalfuturist.com)

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