Last 18 months have been brilliant for technology companies in the healthcare space. Macro trends have started to emerge, paving way for possible consolidation in the next four to six quarters. Practo is clearly leading the doctor booking/discovery space, and players like Lybrate with differentiated products are creating their own niches. Companies like NetMed and Ziggy have raised tens of millions in pharmacy delivery. There is also lot of activity in the EHR/data analytics space, but the focus is towards the developed markets.
Here is a brief overview of the market, the problems faced today, and possibly how the future would look like in the next three to five years.
There are three kinds of healthcare markets in the world, and each has its unique set of problems and appetite for disruption.
- Insurance pay
- In countries like US, most people are insured and it is primarily the insurer who pays for healthcare-related expenses and thus commands the buying decisions of the patients. A lot of data analytics-related startups have come up in these markets, tracking healthcare parameters and improving patient care outcomes.
- Government payMost European states have a national health service that provides free/cheap healthcare services to people. Here the government makes the buying decisions like which doctor treats you, which medicine brands are available, and more.
- Self-payMost developing countries including India have a majority of the services that have to be paid for by the people. Since individuals compared to bulk buyers like insurance and government have much less negotiating power, markets like India are rife with inefficiencies and corruption.
Inefficiencies in healthcare market
Most of this inefficiency/corruption is difficult to prove and thus not documented openly. However, anyone wanting to solve major problems in healthcare must be aware about it and account for it in their models.
Most doctors take kickbacks, in either cash or kind, to market all other healthcare-related services – hospitals, pharmaceutical brands, and diagnostic centres. These kickbacks are significant in value and not only add to the overall costs, but adversely affect the quality of treatment by limiting choice.
It is difficult to question the authority of doctor and there is no way of knowing how good or bad their opinion is. User reviews and information displayed in appointment booking portals can only help in determining the customer experience, but they don’t talk about patient care outcomes. A better indicator would be assessing long-term patient care outcomes, cost of treatment for a set of symptoms, and mortality rate among similar cases – compared across doctors.
Possible business/technical innovation in the next three to five years
A) Discovery and information
- Verified information about doctors, hospitals, and diagnostic centres – not just stopping at timings and accreditations but also documenting ultimate patient care outcomes.
- Digital literacy in medical information – helping patients interpret their medical records better.
B) Preventive healthcare
- Gamification-based fitness apps.
- Curated healthcare-related information for patients with specific symptoms and chronic diseases.
Customised preventive health check-ups based on patient history and lifestyle (something we are trying very hard to perfect at Medd).“Instead of just waiting for a doctor — could you get a test every quarter and begin to look at your biomedical data similar to how you look at your credit card data” – Elizibeth Holmes
- Smartwatches and wearable fitness devices – This year saw Apple launch its watch with fitness tracking features with companies like Xiaomi also joining the bandwagon
- Home diagnostics are still far from accurate and very expensive. Researchers this year have made home HIV test.
- Microfluidic-based diagnostics that require smaller blood samples.
- Telemedicine – this can be the real game changer in providing quality healthcare to the urban population.
- Interdisciplinary therapies.
- Virtual trials can significantly reduce time for a drug to hit the market and thus the RnD costs, making medicines more affordable, and innovation possible by startups.
- Robotic interventions – many hospitals have started using robots to assist in complicated surgeries, innovation here can increase predictability of outcomes.
E) Consequences and outcomes
- Artificial intelligence-based clinical decision support systems.
- Redesigned hospital experience with a focus on outcomes.
Health tech is the next frontier for innovation with possibility of real impact happening. It will require far more than individual genius. The ability of the market to find an optimal solution, along with empathy of the policy makers will define our future.