6 ms·

The road to healthcare tech is littered with bodies of failed efforts from all kinds of companies. Seems like a particularly hard segment to break into. I'm not

by gundmc 5y ago

The road to healthcare tech is littered with bodies of failed efforts from all kinds of companies. Seems like a particularly hard segment to break into. I'm not exactly sure what the biggest reason for that is. Regulations? Social relationships/politics? Difficult to understand processes and landscape? Resistance to change? Maybe a mix of all of these?

kirykl 5y ago
It’s that Insurance (private or gov) is always going to cap the market. Opportunity cost is too great when returns elsewhere is uncapped
leovander 5y ago
Money and all of the above.
outside1234 5y ago
All of them - plus long long long timeframes to get anything done.
gopher_space 5y ago
I've seen people do well by targeting specific processes around an illness. IMHO the landscape is so fragmented that a holistic approach would never make sense except as a government initiative.
- wolverine876 5y ago
  Is that obstacle removed in countries with national healthcare programs of some sort?
crazygringo 5y ago
It's very similar to education. Neither health care nor education function anything like a "free market" so the normal business strategies don't apply. And it's so many things -- it's regulation, it's slow-moving, it's hyper-local and non-uniform, it's privacy concerns, it's vested interests, it's interoperability, it's political. Both health care and education have huge amounts of money poured into them -- the money spent on a child's education per-year is orders of magnitude greater than a Netflix or Spotify subscription. Same with your monthly health insurance costs. So despite all the challenges I listed above (and more), it still seems like if you can pull it off, it's a bet worth making. But that doesn't stop it from being really, really hard.
tlogan 5y ago
I think the problem is that we try to simplify healthcare - like it is vertical. Healthcare is more like world on it own. The only way get into “healthcare world” is to attack a very specific niche but the niche is too small for big companies. So the companies decide to “boil the ocean” - which always fails.
lotsofpulp 5y ago
>I'm not exactly sure what the biggest reason for that is I suspect healthcare in the US (and probably elsewhere) has to deal with a lot of liability, and so processes that fly in other situations do not fare well in healthcare. Everything i has to be dotted and every t crossed to make sure you do not end up with any part of the culpability for an adverse healthcare outcome, as well as liabilities from laws such has HIPAA.
Telemakhos 5y ago
Apple is dismantling an internal project for tracking employee health that was likely an incubator for future health projects. https://appleinsider.com/articles/21/08/19/apple-health-division-faces-reduction-after-internal-initiatives-scale-back https://appleinsider.com/articles/21/08/19/apple-health-divi... If Apple and Google are both ditching health projects simultaneously, I wonder if that suggests that they have advance warning of some change to the regulatory climate.
- kQq9oHeAz6wLLS 5y ago
  No, they probably just aren't making headway against the established players like Epic
  - nradov 5y ago
    Apple never really tried to compete directly against Epic. There is only a very small overlap in the PHR space, which doesn't generate much revenue for either company.
ChuckMcM 5y ago
These are questions that are worth delving into more deeply. In my brief period at IBM I was adjacent to the Watson Health folks and the challenge, to my unsophisticated eye, was greed. Basically the "Health Care System" in the US appears to be completely corrupt[1]. Thus any proposed change the is presented based on how it will "Improve the system" is immediately suspect by those for whom the unimproved system is paying them a hefty paycheck. In the two (and be aware there were thousands so this is an anecodtal sized sample set) engagements I had visibility into with Watson Health teams, the one that went in with "This will improve patient outcomes" got shut out, and the one that went in with "This will increase your net margins" was welcomed with open arms. I'm not sure how one unties that particular knot. [1] Corruption here being that the primary mission is the collection of monies and health outcomes are a tolerated side effect of that.
- deadmutex 5y ago
  > Thus any proposed change the is presented based on how it will "Improve the system" is immediately suspect by those for whom the unimproved system is paying them a hefty paycheck Sadly, my observation is that this is the rule (and not the exception) in many industries.
  - pphysch 5y ago
    In my view it's not a problem specific to any industry or domain, but a fundamental problem of social organizations: the clash between individual (employee) interests and organization interests.
    - sul_tasto 5y ago
      This also seems to be the problem of government.
      - pphysch 5y ago
        Government is an organization
brap 5y ago
1. Regulation 2. Regulation 3. Regulation
nradov 5y ago
All of the legal and compliance requirements make it extremely expensive to build new healthcare software. Vendors have to meet a long and growing list of mandatory requirements before they can even start writing new business or clinical functionality. Customers have been burned so many times by new vendors which failed to deliver that they're hesitant to take a risk on start-ups. But I think there is a growing opportunity for innovation in the new SMART on FHIR app stores run by several major EHR vendors. They're copying the Apple / Google app store model by allowing ISVs to use their platform in exchange for a cut of the revenue. In theory you can write an app once, then deploy to any standards compliant EHR (reality is a little more complex). So the platform handles all the compliance stuff and you can focus on innovation. I expect we'll see a wave of start-ups targeting that platform over the next few years.

by gundmc 5y ago

kirykl 5y ago

It’s that Insurance (private or gov) is always going to cap the market. Opportunity cost is too great when returns elsewhere is uncapped

leovander 5y ago

Money and all of the above.

outside1234 5y ago

All of them - plus long long long timeframes to get anything done.

gopher_space 5y ago

I've seen people do well by targeting specific processes around an illness. IMHO the landscape is so fragmented that a holistic approach would never make sense except as a government initiative.

wolverine876 5y ago
Is that obstacle removed in countries with national healthcare programs of some sort?

crazygringo 5y ago

It's very similar to education. Neither health care nor education function anything like a "free market" so the normal business strategies don't apply. And it's so many things -- it's regulation, it's slow-moving, it's hyper-local and non-uniform, it's privacy concerns, it's vested interests, it's interoperability, it's political. Both health care and education have huge amounts of money poured into them -- the money spent on a child's education per-year is orders of magnitude greater than a Netflix or Spotify subscription. Same with your monthly health insurance costs. So despite all the challenges I listed above (and more), it still seems like if you can pull it off, it's a bet worth making. But that doesn't stop it from being really, really hard.

tlogan 5y ago

I think the problem is that we try to simplify healthcare - like it is vertical. Healthcare is more like world on it own. The only way get into “healthcare world” is to attack a very specific niche but the niche is too small for big companies. So the companies decide to “boil the ocean” - which always fails.

lotsofpulp 5y ago

>I'm not exactly sure what the biggest reason for that is I suspect healthcare in the US (and probably elsewhere) has to deal with a lot of liability, and so processes that fly in other situations do not fare well in healthcare. Everything i has to be dotted and every t crossed to make sure you do not end up with any part of the culpability for an adverse healthcare outcome, as well as liabilities from laws such has HIPAA.

Telemakhos 5y ago

Apple is dismantling an internal project for tracking employee health that was likely an incubator for future health projects. https://appleinsider.com/articles/21/08/19/apple-health-division-faces-reduction-after-internal-initiatives-scale-back https://appleinsider.com/articles/21/08/19/apple-health-divi... If Apple and Google are both ditching health projects simultaneously, I wonder if that suggests that they have advance warning of some change to the regulatory climate.

kQq9oHeAz6wLLS 5y ago
No, they probably just aren't making headway against the established players like Epic
- nradov 5y ago
  Apple never really tried to compete directly against Epic. There is only a very small overlap in the PHR space, which doesn't generate much revenue for either company.

ChuckMcM 5y ago

These are questions that are worth delving into more deeply. In my brief period at IBM I was adjacent to the Watson Health folks and the challenge, to my unsophisticated eye, was greed. Basically the "Health Care System" in the US appears to be completely corrupt[1]. Thus any proposed change the is presented based on how it will "Improve the system" is immediately suspect by those for whom the unimproved system is paying them a hefty paycheck. In the two (and be aware there were thousands so this is an anecodtal sized sample set) engagements I had visibility into with Watson Health teams, the one that went in with "This will improve patient outcomes" got shut out, and the one that went in with "This will increase your net margins" was welcomed with open arms. I'm not sure how one unties that particular knot. [1] Corruption here being that the primary mission is the collection of monies and health outcomes are a tolerated side effect of that.

deadmutex 5y ago
> Thus any proposed change the is presented based on how it will "Improve the system" is immediately suspect by those for whom the unimproved system is paying them a hefty paycheck Sadly, my observation is that this is the rule (and not the exception) in many industries.
- pphysch 5y ago
  In my view it's not a problem specific to any industry or domain, but a fundamental problem of social organizations: the clash between individual (employee) interests and organization interests.
  - sul_tasto 5y ago
    This also seems to be the problem of government.
    - pphysch 5y ago
      Government is an organization

brap 5y ago

1. Regulation 2. Regulation 3. Regulation

nradov 5y ago

All of the legal and compliance requirements make it extremely expensive to build new healthcare software. Vendors have to meet a long and growing list of mandatory requirements before they can even start writing new business or clinical functionality. Customers have been burned so many times by new vendors which failed to deliver that they're hesitant to take a risk on start-ups. But I think there is a growing opportunity for innovation in the new SMART on FHIR app stores run by several major EHR vendors. They're copying the Apple / Google app store model by allowing ISVs to use their platform in exchange for a cut of the revenue. In theory you can write an app once, then deploy to any standards compliant EHR (reality is a little more complex). So the platform handles all the compliance stuff and you can focus on innovation. I expect we'll see a wave of start-ups targeting that platform over the next few years.