Back to the Future: Digital Deloreans Take Flight
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Speakers: Chris Bergstrom, Associate Director - Digital Health, The Boston Consulting Group The Digital Health Summit, produced by Living in Digital Times, convenes one of the broadest spectrum of health care and technology audiences in the world. The Summit features innovations and advancements in genomics, diagnostics, wearables, telehealth and more in the mobile health market which is expected to reach $26 billion by 2017. This is a must see event each year that takes place at the International Consumer Electronics Show (CES) in Las Vegas. Website: Http://www.digitalhealthsummit.com Twitter: http://www.twitter.com/dhsummit Hashtags: #digitalhealthces #ces2016 Photos: https://www.flickr.com/digitalhealthsummit
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Back to the Future: Digital Deloreans Take Flight
- 1. 1 | 1:15 PM - 1:25 PM Back to the Future: Digital Deloreans Take Flight PRESENTER Chris Bergstrom Associate Director Digital Health The Boston Consulting Group @BCG #DigitalHealthCES
- 2. Chris Bergstrom, MBA BCG Associate Director, Digital Health @ChrisJBergstrom Digital Health Where are we going? FRI DEC 8 15
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- 5. Google Trends “mHealth” search interest 2009 2010 2011 2012 2013 2014 2015 05
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- 7. What changed in the last 5 years? Technology Reimbursement Regulatory Investment New Entrants to Healthcare 07
- 8. 8
- 9. 9 Cumulative AppStore Downloads 1 Billion 100 Billion
- 11. New Products & Services Covered Meaningful Use Value Based - Quality, Satisfaction, Outcomes • Telemedicine • Chronic Care Management • Mobile Prescription Therapy • Activity Trackers Reimbursement What’s New? 011 • +$30B Incentives Paid • Penalties rising to 5% • Alternate models • Bundled Payments • Pay-for-Use
- 12. Regulatory Guidance Becoming Clear 01 2 2013 (updated 2015) 20152015 2015 FDA Objectives: Innovation, Patient Safety, Patient Engagement MMA “Mobile Medical Apps” MDDS “Medical Devices Data Systems” Draft General Wellness Draft Accessories
- 13. $5Bper year Investment Rapidly Rising Notable Strategic Sources $400M/yr Google Ventures (40% Health) $100M Qualcomm $100M Qualcomm+Novartis $500M Merck GHI $100M McKesson 13
- 14. 14 Starting to See Evidence of… Outcomes Adoption &/or Revenue
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- 17. 17 Walgreens Connect Members can earn up to 20 points per day for glucose testing. +500,000 connected devices now feeding the app
- 18. Engines & Feeds Distribution Platforms & Interfaces 18
- 20. Acquisition Roll-ups Partnerships IPO 20
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- 22. 22 Global Adaption & Impact Language Culture Clinical Technical Regulatory Distribution Billing
- 24. Thank you Chris Bergstrom, MBA BCG Associate Director, Digital Health @ChrisJBergstrom FRI DEC 8 15
Editor's Notes
- Remember 2009, the year before the iPad? Today, there are more tablets sold than PC’s. My kids have them my 95yr old Grandma just got one. It’s just hard to remember there was a life before tablets. I’ll propose Digital Health is essentially just as old, but it’s not yet impossible to remember healthcare without Digital Health. So, lets reflect on where we’ve come in Digital Health’s short history and talk about where we are going. Going to cover 3 things: What’s changing Examples Case Study
- We’ve begun the 2nd 5yr period, so lets take a look Back in time, then return to the present and then look to the future. I’d put for the the 1st was about ideas, 2nd Scaling, 3rd the promised land It’s important to understand where we are in the cycle for planning purposes… they always say if you are 5yrs ahead then you are ....
- So, lets start with the first 5 years… roughtly 2009-2014 Why do I say that...
- Why do I say we are just more than 5yrs into Digital Health? Well barring some very early entrants… 5 years ago mHealth didn’t exist, literally. I know, I remember trying to write a press release then and wondering what to call it. We owe a lot of credit to the NIH and Dr. Collins who were well upstream in seeing the potential of mHealth and creating the first major conference . (1st one in 2009 was a rag tag bunch – 2nd one in 2010 We had Gates, Chopra, and thousands of people). So lets start there ~5yrs ago.
- Wild West (image?), no law and order, no roads, lots of gambling. Mostly passionate problem solvers - doctors and patient entreprenuers. A few light houses ahead of their time CardioNet. Big theme was IDEAS. Wasn't investable - tech vs meddev VC's - no Qualcomm Life or Fund, $35M angels. No FDA. No mHealth conference ... n=300-5k, No CES ... n=50 to 4 days of tracks. When we started WellDoc people said... No one has a smart phone, fda, wouldnt work, no one would pay.
- There were MANY major hurdles to define or overcome in the first 5 years to allow us to move past the “idea” stage. I remember when we got started at WellDoc… people said “no one has a smartphone, it will never work, FDA won’t clear, Payers won’t pay, and we had to raise $35M in Angel capital because VC’s didn’t understand it!!!” Wheather these were real or false objections didn’t matter, they had to be addressed and in fact we all did make major progress on them.... Now have FDA. Have evidence. Have $5B/yr investment. Dedicated Funds (McKesson, QCom+Novartis, GHI, active VC's...). Have some business models. Some IPO's, Wearables. New entrants ... Apple, Google, Samsung, IBM.
- This speaks volumes One of the top selling phones from 2009 & 2015
- If that didn’t do it then look at this Cumulative app store downloads 2009 vs 2015 That’s 100x in 5yrs!!
- Lets use a diabetes example
- Timing is really important, in fact it’s been found to be the #1 reason for start-up success or failure. And we are finally at a moment in healthcare where new models are evolving that are better suited for digital health This will take time… more than the next 5 years (40% US HCP’s think telemed is the future, 20% EU)
- Until recently, It was difficult to jump into digital health for companies like yours because the Regulatory pathway was unclear. That’s changed materially in the last year. The FDA has issued 2 rules and 2 guidance documents that took the unkowns out and made things easier Same rules as always… except they won’t regulate general wellness, things like cell phones, networks or app-stores, things that just transfer and display data without manipulation, or accessories have own classification. THE OTHER big change is that reimbursement is starting to emerge… CCM codes, Telemedicine, Bundled payments, PFP…
- This is huge… up from $0 5 years ago. In fact I can tell you first hand it wasn’t investable. At WD we had to raise $35 Angel because you go to a VC... Finally the strategics moved (thx Qualcomm) and VC’s followed.
- So, now what? Well it’s time to start to scale. That’s what much of the next 5 years will be. Why… the Wild West now has infrustructure, organization to the chaos, and less unkown risks... These allow for large entrants and large capital.
- We have some help coming quickly… Those from outside of healthcare are moving in in a big way and they are well positioned to drive scale. This is going to be important for scaling, especially from the persepective of marrying horizontal platforms to Vertical solutions… we’ll return to this in a moment.
- But there are also large healthcare players that have moved aggressively and built fantastic platforms for scaling. One of the first to scale was actually developed mostly in-house of a big healthcare company… today its the #1 pharmacy app #3 most downloaded retail app. And 7M users per week! I think a big reason for their success is they started from the core and built out from there... To become a platform... Meaning they went vertical in refills and photos, but horizontal in almost everything else. strategic partnerships with companies like Qualcomm Life, WebMD, MDLive, and PatientsLikeMe. +16,000 people signed up for the digital coaching program Walgreens launched with WebMD, over 80,000 now access third-party data, like the data from PatientsLikeMe, through their Walgreens.com dashboard, and more than 40 million new patients have gained access to Walgreens prescription refill service via a third party app that uses Walgreens’ API.
- 2015 was the year of the Platform, Vertical Solutions can scale with the help of these Horizontals. Key is to intersect properly, to be able to define and standby your role and core competency. Product from WellDoc near to my heart having launched BlueStar
- Back to the traditional healthcare front, especially biopharma and med tech… What’s special about 2015=6? The first years of the second 5 years? C-Suite is committing, All my meetings are no longer with Innovation teams but with the C-Suite, the true decision makers. And they are committing that digital health must be part of their core business… they just have no idea what that means yet, that’s why I took the job I have now... To help them bridge the gap of knowledge and identify smaller companies to work with. So will see lots of experimenting, dancing (show image of tall guy and short beautiful girl) of big and little companies in 2016, then some marriages, bad breakups... but finally scale (Big theme of #2 is Scale?)
- Already seeing the beginning of this… A: Misfit + Fossil R: Didn’t Merck do something? … Or use UnderArmour example P: Oscar and ??, Google or IBM and just about anyone, Orthopedic examples --- HealthSpot + RiteAid ... Vertical + Horizontal, Dr. OnDemand + Payers IPO: What was that first one? And then FitBit.