2017 will be recorded as the year of “resilience” – a year that illustrated more than any in recent memory our human capacity to endure. To survive the unexpected, to adapt and to rebuild after recurring setbacks. A year where the world began to search for new sources of leadership. A world where iconic institutions that were seemingly unshakable began to prove disruptable.
A year when the massive behemoths of online, have landed into storefront retail to secure even deeper connections with customers, and their grocery lists, e.g., Amazon acquires Whole Foods. A year in which the behemoths of retail healthcare have taken bold moves into the coffers of data/evidence, e.g., CVS to acquire Aetna.
Beneath the seismic shifts caused by the “big players” is a curated list I build each year that highlights the most remarkable advances being made on the frontlines of innovation, by the fast and fearless, and the small. I keep my daily list of all that I’ve encountered over the course of a year, then in December, boil them down to what I call my “thrilling three” – the three most thought-provoking ideas, products or trends I’ve encountered. Though diverse, each has caused me to pause and say, “Really? Wow! That’s impactful. That could change everything.”
In 2016, we zoomed into blockchain and its immutable ledger. One year later, blockchain is becoming a household name. Beyond the blitz of newer cryptocurrencies, we now see more and more applications coming online. The World Economic Forum has just proclaimed that “10% of the world’s GDP will be stored on a blockchain by 2025.” That is a big number and a really short time horizon – blockchain has arrived.
In 2016, we reminded ourselves just how unsettling it is to be “a patient.” To be told you have a medical condition that requires treatment is challenging enough, but paying for treatment can add to the burden of disease. Enter Iodine, an early stage company developing a platform with which patients could potentially track precisely how their medications are performing and catalogue what might be the negative attributes. If successful, patients could also see how well they are trending compared to everyone else. And, they could also use this real-world evidence platform to see how large treatment populations look before they even elect to take the medicine. Across 2017, two words – price and evidence – have dominated so much of the healthcare narrative. Although Iodine might not be able to help with the former, it could certainly be an important contributor to the latter. Healthcare of our future will be all about “evidence” – patient-level proof – of how well treatments are actually working.
Within our photo archives, to open our newest phones or even in the movies we watch, at this point “face recognition” almost seems old school. Last year, we took a look at Affectiva, another impressive startup. And although there are other expert systems for recognizing our faces, Affectiva takes the game to a completely different level. To not just “knowing who we are” but to “knowing how we feel.” One year (and now over six million faces studied) later, Affectiva is pushing into whole new spaces. Bringing artificial intelligence, emotional mapping and ethics into a mashup that seeks to help machines “understand” us in ways previously thought impossible. Bold new relationships await. When our machines understand us in ways better than our spouses, where does that take us?
So, for 2017 here they are:
MoBike – “Start-up Nation” is a 2009 book by Dan Senor and Saul Singer that chronicles how Israel, a 60-year-old nation with a population of only 7.1 million, has an economy largely driven by fast growing start-ups. The book has been clearly well read in China and few companies represent how rapidly a business can scale when focused on a true customer need more than MoBike.
During China’s rapid rise from a largely rural agriculture and textile economy to clusters of megacities and a rapidly growing middle class, one icon of China has almost vanished from sight with little notice – the bicycle. For decades, China was a country that relied on bicycles for transportation. With increases in wealth, the demographic shift to cities, and the upsurge in cars and freeways, lost were the bikes and born was the “first and last mile” dilemma – the urban challenge of getting millions of citizens into public transportation and then to their final destinations, to work and back home.
Enter Mobike. Launched in Beijing in 2015, the Mobike team took a lesson from mistakes of others and embarked on a collaborative approach with local urban planning officials – first in China and now across the world. They took the “let’s ask for permission, rather than forgiveness” approach. It paid off. Within 18 months, they built and deployed their Internet of Things (IoT)-inspired bikes and fully station-less bike system across 180 Chinese cities then swiftly expanded overseas to another 20 cities including Japan, Britain, Thailand, U.S., South Korea and Singapore. In seemingly a blink of an eye, Mobike reports that it has built a customer base of over 200 million users around the world, which clock an average of about 30 million trips per day. The latest statistics from Mobike indicate that to date they have built and distributed eight million bikes across the world and their users have cycled more than 11.3 billion miles, preventing 4.4 million tons of carbon dioxide emissions, equivalent to taking 1.24 million cars off the road for a year. Across the world, Mobike faces substantial competition but by remaining focused on precisely what customers need – extreme proximity, reliability, and a seamless and simplified experience – MoBike has built a loyal community and a unique, mobile phone centric channel. Where they will take their customer-focused approach next will be interesting to follow. But by coupling authentication-to-exercise, they have a unique opportunity to enable their customers to demonstrate (i.e., prove) and be rewarded for their daily physical activity – a new emerging currency with employers, healthcare providers and insurers.
WeDoctor – Across the U.S. and most developed nations, the entry point into the healthcare system is primary care — our family doctors, general practitioners and pediatricians. But in China this is uniquely not so. For example, the Chinese people in rural area relied on the so called barefoot doctors or “pinyin.” These were typically individuals that received basic medical training who then worked in rural villages all across China. Their role was to bring basic healthcare to rural areas when urban-trained doctors were unavailable. In the mass migration to megacities, the delivery of healthcare has been re-centered on hospitals – about 25,000 of them. They are then divided into three tiers I, II, and III (66%, 20%, 8%, respectively) based on their capabilities. But due to concerns about quality, their utilization is completely inverted with 46% of all patients being seen in the small number of (elite) tier III hospitals (40% in tier II, and 14% in tier I). The result is gridlock; with patients and their family members queuing in the predawn hours every day at tier III hospitals and waiting for many, many hours if not longer, with the hopes of being seen by the most trusted physicians.
Enter WeDoctor, a Tencent Holdings-backed online appointment booking, prescription, diagnosis and payment service. The company already has 150 million registered users across China. Using their mobile platform, users can both find the most appropriate doctor to handle their needs but also secure an appointment, have immediate access to their medical test results and pay for their services – all from their mobile phone and without the conventional hours of queueing. From this starting point, WeDoctor has moved to create “uber IoT institutions”, actual “Internet Hospitals” which migrate a large majority of the interactions between physicians and their patients out of bricks-and-mortar facilities into a robust telemedicine and pharmacy-access online platform. It’s an online system that vastly improves the follow-up, revisit and out-patient experience along with big increases in efficiency. Here again, all in the patient’s hand, on their mobile phone. And although mobile interactions are efficient, they still can’t compete with the human-to-human interaction that the practice of medicine relies on. So, to pull more and more patients away from the queues of tier III hospitals, WeDoctor is building a fleet of concierge primary care offices to complement their total offering. The data that will emerge from patient cohorts of this size coupled with Tencent’s deep push into tele-medicine/AI, suggest that WeDoctor could become a new healthcare juggernaut.
Mitobridge – On one thing we can all agree. Power makes the world (and life) as we know it possible. For us carbon-based life forms, we solely rely on a consortium of ancient organelles that “live” within all the cells of our bodies. They are called mitochondria and have been derived from the earliest moments that life began to evolve past the simple prokaryotic bacteria. Along a cascade of specialized mitochondrial membrane spanning complexes, a current of electrons, extracted from the breakdown products of our food, flows. The current is used to power the creation of local electrical potential (and a massive one, similar in charge to what is witnessed in lightning bolts) which is subsequently used to create the high-energy chemical bonds within ATP, the energy storage molecule of life. Our intracellular ATP levels are essentially the batteries on which we survive. What has become increasingly clear is that the “wellness” of mitochondria play a critical role in the physiology of individual cells and then in turn in the functionality of tissues and whole organs.
Enter Mitobridge – Founded by leading experts in the genetics and biology of mitochondria, Mitobridge is developing a collection of products that seek to address medical conditions that result from inborn errors in mitochondria function as well as looking to find methods to maintain mitochondrial fitness in settings associated with aging, inflammation and the host of conditions that result from cellular atrophy. Although still in its early days, it is increasingly clear that many of the conditions that we have considered to be caused by autoimmunity or cellular senescence, generally relate back to the oldest part of our biology – our ancient powerhouses (mitochondria). These microbially-derived organelles have dangerous jobs, and are often damaged in the process of generating energy. Our ability to improve their lot in life, may in fact, add back more life to us all.
Truly yet another “turbulent” yet “thrilling” year. Next up, J.P. Morgan 2018 and reflections on the historical path on which our healthcare innovations have traveled to get us here.
Robert G. Urban, Ph.D. is a serial entrepreneur and current Global Head of Johnson & Johnson – all views are his own.