Meeker 2019: 3 Key Health Takeaways

It’s that time of year again: VC and tech analyst Mary Meeker has just released all 334 slides in her closely-watched annual Internet Trends deck (archive). Don’t have time to view all three-hundred-plus for the health-related bits? Let me outline what she’s saying about health and healthcare this year.

In last year’s deck, Meeker pointed out that the portion of healthcare costs paid by consumers was increasing — while consumers’ expectations for the healthcare experience were also rising, driven by improving UX (convenience, personalization, lower cost) across a wide variety of other parts of their lives. Could this mean that consumers would finally start paying more attention to healthcare costs, and exert downward pricing pressure?

Well, we don’t know: in this year’s deck, Meeker doesn’t provide any data to suggest an overall reduction in consumer health spending. After pointing out the USA’s unfavorable results in terms of costs, efficiency, and health outcomes, she focuses on three big takeaways:

More health data available
Improving the healthcare experience
Big tech moving in

Consumer adoption of digital health tools is soaring

But don’t miss the overarching theme of “consumer experience” — part of a secular shift towards the consumerization of health and healthcare. People want their prescriptions, appointment booking, and health records to all be up to the UX standards of Gmail, Uber, and Hulu — though in many cases these things are stuck in 2005. Major competition to change that.

Details below. And you can view just the health-related slides here.

More and more genomic data is available.

1 - More Health Data Available

Meeker briefly touches on the large amounts of data that are now becoming digital as a result of the advent of EHRs, with penetration nearing 100% (noting that it is still “early innings” for the technology).

She also devotes a slide to genomics; in particular the soaring popularity of consumer testing, and the resulting enormous increase in genomic data (see slide 275 at right).

Her main point here, though, is that the digitization of healthcare is “driven by consumers” (see slide 273 at right). This trend includes digital telemedicine activities going from about 10% penetration in 2015 to more than 30% in 2018, and the use of wearables more than doubling over the same time period.

The increase in data from all this adoption is key to health research, management, and to the increasing use of artificial intelligence.

2 - Improving the Healthcare Experience

Much of what Meeker talks about isn’t related to artificial intelligence, robots replacing doctors, or any of the topics that take up much of the news coverage of healthcare tech. What she really drills down on are the companies that are using technology to tackle the inefficiencies of the healthcare system and make the health experience as easy as the Uber experience or the Facebook experience.

Importantly, and very unlike the majority of electronic health record systems that have had a very bumpy introduction (looking at you Epic and Cerner!), all of these companies run their own software independently, rather than installing it within a health system. This is key in letting them aim for consumer-grade user experiences.

A great example is Zocdoc (@zocdoc), which uses a modern website and mobile app to provide scheduling services for health providers. I’ve used Zocdoc myself to find and book appointments with doctors, and I can tell you that it beats calling and waiting on hold to talk to the receptionist by a mile.

Other conveniences include the ability to fill in health questionnaires (those 300 question long surveys usually provided on paper with a clipboard in the waiting room) online — and then simply edit your answers for subsequent visits (instead of filling out the paper form every year).

Full list of health-related companies in this year’s Internet Trends coming soon.

Another compelling entry, specifically in the “insuretech” space, is Oscar Health (@oscarhealth), which provides simplified health insurance plans, claims, and coverage — along with scheduling and other tools, aiming to use technology to improve the insurance experience. The latest on Oscar.

3 - Big Tech Moving In

Of course it isn’t just startups and smaller companies moving into the health space, and Meeker wraps up the health section of the slides by looking at Apple, Microsoft, Google, Amazon, and their increasing interest in health.

Apple — “Apple = Democratization of Healthcare” — Quoting Tim Cook, Meeker touches on Apple’s Health app, access to EHR records, and the integration of consumer tools like ResearchKit and CareKit into medical research and consumer-provider interaction, respectively. Meanwhile sales of the Apple Watch (not specifically mentioned by Meeker) continue to soar.
Google — “Artificial Intelligence Unlocking Insights for Practitioners” — here Meeker mentions the Streams app created by Deepmind, a formerly independent but soon to be wholly integrated part of Google. Streams is a tool currently in us at the UK’s NHS that aims to increase the efficiency of treatment by better managing patient data, including test results. Streams has gotten high marks, and at the same time courted controversy around data privacy protection, but it’s clear that Google wants to improve Streams, including now by incorporating AI.
Microsoft — “Enabling Healthcare’s Move to the Cloud with AI Solutions” — the focus here is on rolling out cloud services to “more than 168,000 healthcare organizations”, with those services including Microsoft’s AI Healthcare Bot, a set of tools to enable healthcare organization to role out AI-powered chatbots and “virtual health assistants”
Amazon/Pillpack — “Consumer-Centric Approach to Medication Management — Amazon’s medication delivery service, acquired last year, aims to bring consumer-centered UX to prescription medication use. Pillpack has been lauded for its customer-friendly packaging (though just this week it was called on the carpet for alleged user privacy violations), and can be a potent weapon for Amazon against CVS and Walgreens in fighting for the $500 billion prescription drug market.