The Propell Group - Singapore Futurists - The Future of Health

SINGAPORE FUTURISTS Ÿ Future of Health
12th April 2015 Ÿ Singapore Ÿ The Propell Group
@enquirepropell
#HealthTech
FUTURE OF HEALTH

©2015 by The Propell Group - All rights reserved. Proprietary and Conﬁdential.
•  Digital is disrupting healthcare and its established players
•  Technology is driving a new paradigm to create better health care
•  Developing markets can leapfrog their healthcare infrastructure limitations
•  New opportunities are opening to shape the new paradigm
Healthcare is changing dramatically

The convergence of the digital revolution with
health:
ELEMENTS
Wireless devices
Hardware sensors
Sensing tech
Microprocessors
Integrated circuits
The Internet
Social Networking
Genomics
Personal genetics
What is digital health?
LEXICON
Wireless Health / mHealth
e-Patients / eHealth
Quantiﬁed Self / Self-tracking
Wearable Computing
Telehealth & Telemedicine
Personalized Medicine / QS
Health IT
Connected Health
Big Data / Health Data

Digital health frequently features in the media
Why Digital Health
Will Have Huge
Impact
March 3, 2014
By Todd Hixon
Digital Health has big buzz this year.
For example, it was a hot topic at both
the Consumer Electronics Show
(“CES”) and the more-serious JP
Morgan Healthcare Conference.
(“Digital Health” refers to products and
businesses that apply modern digital
technologies — the web, mobile, the
cloud, miniature sensors — to
healthcare.)
J.P. Morgan health
conference points toward
a hot year in digital
health
January 15, 2015
By Mark Sullivan
The J.P. Morgan event was a very different
scene, of course, and much smaller, but the
same energy for health tech was palpable
there, too. This conference usually focuses on
biotech and medical device companies. But
this year, the number of digital health
companies was decidedly larger and more
visible

Digital health ecosystem: The new paradigm
Doctors
Efficient Healthcare
Better regulations
Insurance
Customize Packages
User specific rates
Enterprise
Faster discovery
Consumer insights
Individuals
Preventative Care
Personalized Care
Government
Efficient Infrastructure
Better Policy
Shared Information Cloud
Outbreak reports
Health tracking
Claims reporting
Insurance cover
Clinical trial data
Consumer reporting
Sensors and Trackers
Wellness reporting
Population Data
Public Awareness

Digital Health Market Landscape

1.  Big Data and Impact on Healthcare
2.  Advances in Wearable Sensors and Devices
3.  Impact on Business Models
4.  Funding Trends
5.  Regulations Implications
Focus: Digital Health Innovation

“Healthcare isn’t a science problem,
it’s an information problem”
— Thomas Goetz —
Author of The Decision Tree: Taking
Control of Your Health in the New Era of
Personalized Medicine
Big Data
in HEALTHCARE
SECTION 1

Big data is processing huge
amounts of data to understand
actionable insights.
What is big data?
“When we talk about areas of large and growing volume
(petabytes), variety (structured vs unstructured) and
high-velocity data; then those things are present in
some combination, we consider that big data.”
— Tom Lawry—
Director, WW Marketing Microsoft
Volume
amount
Variety
type and sources
Velocity
speed
Veracity
quality & trust

6 Ways Big Data is Changing Healthcare
Genomics & Beyond
Next generation sequencing, data
management & analysis
Data Analytics
Transforming Data: working with
and mixing data sets
Public Awareness
Planning and Preventing: Using data
to reduce and prevent disease
Support Providers
Clinical and Non-clinical Intelligence:
Combining a greater variety of data
Support Self-Care
Patient Focused: Increase variety
and frequency of data
Health Eco-system
Collaboration: Pooling data from many
sources for bigger & better results

Cloud-based, collaborative technology platform for
next generation sequencing and analysis tools
Genetic analysis applied to discover which
healthcare methods work, and for whom.
Cloud-based platform that can rapidly analyze and
annotate personal genomes
Personal DNA analysis and interpretation
service for individuals
Genomics & Beyond Next generation sequencing, data management & analysis

Predictive analysis to recognize health patterns and
reduce re-admission
Free health records platform which aggregates
population health data across multiple sites
•  Founded in the US – now launched in the UK
Uses natural language processing to turn data into
insights about compliance, revenue cycle, etc
Cloud-based platform focused on standardizing
health record management across providers
Data Analytics Transforming Data: working with and mixing data sets

Big global data sets available to help guide policy
decisions and improve population health
Scans social media to forecast and track
outbreaks of disease
Identify counterfeit drugs and enable pharmaceutical
companies to track drug distribution
Real-time surveillance for emerging public health
threats by scanning informal sources
Public Awareness Planning and Preventing: Using data to reduce and prevent disease

Cloud-based platform to improve cancer by
organizing the world's real-world oncology data
Cloud-based computing platform to aggregate data
from many disparate sources
Deep analysis and evidence-based reasoning for
more precise diagnosis and clinical decision making.
Lumiata applies big data-driven medical science to
patient data to optimize health care interactions
Support Providers Clinical and Non-clinical Intelligence: Combining a greater variety of data

Diabetes management solution for patients, health
systems, and payer groups
Asia founded remote monitoring for physicians
to manage chronic patients
Collects data and organizes feedback to help
patients better manage asthma
Creates innovative and cost-eﬀective online behavior-
change programs for chronic diseases
CDC Recognised
Support Self-Care Patient Focused: Increase variety and frequency of data

Health Eco-system Collaboration: Pooling data from many sources for bigger & better results
Global wireless health connectivity platform to bring
new and old healthcare data together in new ways
Consolidation and analysis of personal sleep,
wellness and ﬁtness data on one platform
Allows apps that provide health and ﬁtness services
to share data with the Health app & with each other

The Value of Big Data in Digital Health
$40-70 B
Right
Innovation
$300B
$450B
Healthcare Savings
due to Big Data
Right Value Right
Provider
Right Care Right Living
$50-100 B
$50-70 B
$90-110 B
$70-100 B •  Targeted disease
prevention
•  Data-enabled
adherence programs
•  Alignment around proven pathways
•  Coordinated care across providers
•  Shifting volume to right care setting
•  Reducing ER rates
•  Payment innovation & alignment
•  Provider-performance transparency
•  Accelerating discovery in R&D
•  Improving trial operations
$300B to
$450B in
reduced
healthcare
spend

“Technology may replace up
to 80% of what doctors do”
— Vinod Khosla —
Founder at Khosla Ventures
SECTION 2
Wearable
SENSORS & DEVICES

Wearable ecosystem: Biosensing Wearables
Activity
Trackers
e.g. Fitbit, Misﬁt
Smart
Watches
e.g. Garmin, Apple
Smart
Clothing
e.g. Athos
Patches &
Tattoos
e.g. Zio, MC10
Ingestibles &
Smart Implants
e.g. Proteus
BioSensors
Devices that convert a
biological element into a
signal output
Wearables
Are on- or in-body devices
that enable user
experience

•  Create a wealth of data in real time
•  Measure physiological parameters easily
•  Relate trends, behaviors and environments to health and wellness
•  Analyze trends to understand the health ecosystem
Why do wearable and sensors matter?

Wearable and Sensors Life Cycle & Common Uses
Cloud Processing & storage
Community & Comparison
Feedback
Personal Results
Sensor(s)
Records Data
Weight
Under 20%: Acid Reﬂux or Indigestion, Digestive Health
40% 65%
Vital Signs
37% 58%
Sleep Patterns
30% 54%
Calories / Fat Intake
32% 37%
Blood Sugar
21% 61%
Exercise / Physical Activity
24% 36%
Common Wearable Uses
Consumers Physicians

Wearable and Sensors Market Landscape
WELLNESS DIAGNOSTIC CHRONIC MONITORING

Athos LumoGarminWatch
APPLE WATCH
Smart-watch with activity accelerometer
and HR monitor
ATHOS
Clothing with integrated wearable
technology capable of tracking heart
rates, breathing levels, and more
GARMIN 920XT
Triathlon training smart-watch with GPS,
HR monitor & activity accelerometer
LUMOBACK
Measures posture, steps, how long you
sit, and how you sleep
Wellness Lifestyle monitor, intended to increase wellness

Alivecor CueZioScout
ALIVECOR
Heart Monitor is a single-channel ECG
recorder that is portable and easy to use
- FDA approved!
SCANADU SCOUT
Sophisticated physical exam:
tracks & trends body vitals
ZIO by iRythm
Micro sensor for long-term monitoring
of cardiac rhythms
CUE
Personal cartridge driven saliva analysis
Diagnostic, Chronic & Monitoring, Intended to aid medical systems and speed diagnosis

APPLE’S HEALTH ECOSYSTEM
•  HealthKit provides a health data clearing house, collecting data from many kinds of devices from smart-watches to hospital
based ECGs
•  FDA-regulated medical devices are able to send information via HealthKit and accompanying apps leading to
breakthroughs in continuous monitoring as well as data analysis and sharing
•  ResearchKit is a platform which enables the constant monitoring of symptoms and reactions to medication from a very
large clinical trial patient sample
•  The current clinical trial approach is to cease the monitoring when the trial is ended to submit the data to the FDA
THE CASE FOR BEST BIOSENSING WEARABLE
•  We all own one
•  We take it everywhere we go
•  It is full of sensors which track our every move
•  A simple app can turn it into a powerful healthcare and wellness tool:
•  Sleep
•  Activity
•  Lifestyle
•  Habits
Mobile Phone The most powerful biosensing wearable available?

Today’s Market: Wearable devices and sensors
Disease management
Preventative health
Remote monitoring & care
Detection & screening
Consumer personalized medicine
Predicting and controlling outbreaks
Barriers
Poor Management
No sustainable business model
Perverse money-driven intentions
Lack of awareness and initiative
Making raw data valuable
Regulatory hurdles
Early Adopters
WELLNESS
Self-initiated health tracking
Quantiﬁed Self
MEDICAL
Doctor-initiated prescribed
health intervention
US $3 BILLION
100 million devices
2014

Today’s Market: Wearable devices and sensors
Less expensive
Over-the-counter
Longer Battery Life
Easier to use
More sensors
Drivers
Better compatibility with existing devices
More public awareness and marketing
Medical community adoption
Improved manufacturing
Better distribution
Mass Adoption
WELLNESS
Self-initiated health tracking
Mass Adoption of
Quantiﬁed Self
MEDICAL
Doctor-initiated prescribed
health intervention
Mass Adoption within
health community
US $12 BILLION
400 million devices
BY 2018

Business
MODELS
“Great products are becoming a
commodity. It's the combination between
great products and a great business
model that is going to keep you ahead of
the competition in the coming decade.”
— Alexander Osterwalder —
Business Model Generation, a global
bestseller on the topic of business model
innovation
SECTION 3

•  Spending is ineﬃcient or non-existent
•  Policies are shifting in mature & developing countries
•  Increasing focus on outcomes, not volumes
•  New business models are forming to address changes
•  76% of Fortune 50 companies are now in healthcare
The healthcare business landscape is shifting

Developing Solutions
Free cloud-based health
records platform which
aggregates population health
data across multiple sites
Supported by advertising
IN ASIA
Using mobile phones and
devices for innovative and
practical solutions for cost
eﬀective healthcare services
Supported by Enterprise
IN ASIA
Employee engagement
platform that drives
productivity and manages cost
though employee wellness
Supported by Employers
IN ASIA
Electronic Health
Records (EHR)
mHealth
(Mobile Health)
Health Insurance /
Employee Wellness

Business Models: B2B vs B2C
USED BY CUSTOMERS
B2B Supported by insurance/pharma
Supported by advertising
Supported by physicians Supported by advertising
Supported by business
Supported by business
Supported by customers
Attracts 80% of Funding
é Higher willingness to pay
é Greater lifetime customer value
ê Longer sales cycles
ê Requires gatekeeper
approval or system integration
B2C
ê Lower willingness to pay
é Quicker product iterations
and user feedback
é Shorter Sales Cycle
ê Crowded Landscape
USED BY BUSINESS
PAIDBYBUSINESSPAIDBYCUSTOMER

•  Targeted research through rational design model
•  Customised clinical trials through pharmaco-genomics
•  Individualised medicine
•  Real World Evidence research
•  Digital marketing, tracking and sales
Rebooting The Life Sciences Industry

Partnership with Genomics England to mine
information from a government project to decode the
genomes of 100,000 patients from NHS patients with
cancer and rare diseases to discover personalised
medicines
•  Year-long trial announced March 2015Has announced 12 undisclosed partnerships with
academia and corporate:
•  Signed collaboration with Pﬁzer for the study of Crohn’s
disease
•  Signed a $60M deal with Genentech (Roche) for the
study of Parkinson’s Disease
Pharmaco Genomics: The future of drug design
The Past: Molecular screening libraries used by most large drug companies and academic centers
The Future: Identifying the root cause of, or critical aberrant protein associated with a particular disease
and use this template to design the antibody or molecule to block it

Clinical Data: Next generation clinical trials and RWE
Innovative tele-health solutions through interactive health technology
platform that consists of medical devices, application software, mobile
apps, cloud-based web applications focused on CV clinical trials
Open-source platform that empowers researchers to design and
administer app-based health research. Initial focus on breast cancer,
diabetes, Parkinson’s disease, CV and Asthma
Platform and algorithms allow to gather and show data for faster
clinical trials, and to support patients and doctor in the extreme
complexity of the real-world Neurology and Immunology treatments
•  Post launch real-time patient data from extremely large numbers of patients
•  Increasingly important data sets for market access and reimbursement
§  Velcade (J&J) for the treatment of Myeloma ($35,000 p.a.) was initially rejected by NICE
(UK). J&J agreed not charge any patient not deriving beneﬁt. Velcade was approved

“Investments in digital health are having a
positive impact and the momentum is likely
to continue and cause changes throughout
the entire healthcare ecosystem. In
particular, the pharmaceutical industry is
poised to take advantage of digital and
mobile innovation allowing them to “go
beyond the pill”
— Jack Young —
Head – Qualcomm Life Fund
Funding
TRENDS IN DH
SECTION 4

•  Key investment themes taking shape
•  Venture capital funding doubles again
•  Growing number of technology and strategic investors
•  M&A deal ﬂow growing
•  Strong IPO trend
•  7,500+ DH startups across the globe
Signiﬁcant activity in Digital Health funding

Venture funding of digital health continues to outpace other sectors
Health Sector Funding Changes
Based on total funding from 2012 and 2013
2013 vs 2012 2014 vs 2013
All Sectors Digital Health Med DevicesBiotech
9%
61%
29%
127%
10%
29%
-17%
21%

Venture funding of digital health: Key trends
Top Trends of Digital Health Funding
2011 to 2014
Ranking 2011 2012 2013 2014
1
Healthcare Consumer
Engagement
Healthcare Consumer
Engagement
EHR & Clinical Workflow
Analytics & Big Data
Data aggregation & analysis to support a wide range of healthcare use
cases
2 Analytics & Big Data EHR & Clinical Workflow Analytics & Big Data
Healthcare Consumer Engagement
Consumer tools for the purchasing of healthcare services or health
insurance
3 Digital Dx
Personal Health Tools &
Tracking
Digital Medical Devices Digital Medical Devices
Software / hardware designed to treat a specific disease or condition
4 EHR & Clinical Workflow Care Coordination
Population Health
Management
Telemedicine
Delivery of healthcare services through virtual channels
5 Post-acute Solutions Wearables & Biosensing Wearables & Biosensing
Personal Medicine
Software to support the practice of medicine customised to an individual’s
genetics
6 Hospital Administration Telemedicine
Healthcare Consumer
Engagement
Population Health Management
Platforms for managing population health under the shift to risk-based
payment models

Acquisitions: Is this the start of Digital Health sector consolidation?
95 M&A Deals in 2014 - $20B
ACQUIRER TARGET
Flatiron Health Altos Solutions
Teladoc AmeriDoc
Evidera Archimedes
Optum Audax
Roche Bina Technologies
MDLive Breakthrough
Hearst Health CareinSync
Cambia Health ClarusHealth
Merck eCardio
Google Lift Labs
UnitedHealth Group MedSynergies
WellTok MindBloom
HCA PatientKeeper
Facebook ProtoGeo (Moves)
AirStrip Wireless Sense4Baby
MyFitnessPal Sessions
WebMD TheraSim
Covidien Zephyr Technologies
Sector # of M&A deals
Health Tech
Med Device
Payer
Biopharma
Provider
Other
Healthcare
Tech
Other
47
8
6
6
4
4
7
13
ACQUIRER TARGET VALUE
BD CareFusion $12.2B
Cognizant TriZetto $2.7B
Cerner Siemens Health $1.3B
Optum Alere $600M
Aetna bswift $400M
Brighton Health Privia $400M
GE API Healthcare $340M
Emdeon Change Healthcare $185M
Medtronic Corventis $150M
Astra Zeneca Deﬁniens $150M
Intel Basis $100M
Everyday Health Medico.com $100M
Millenium Labs RxAnte $70M
St Jude Medical CardioMEMS $60M
Care.com Citrus Lane $49M
Advisory Board Co. HealthPost $25M
Weight Watchers Wello $9M
Premier Meddius $8M
DISCLOSED UNDISCLOSED

Asia
DIGITAL HEALTH
“We have to link to what the global trends are.
This means looking at the emerging sectors,
verticals like technology, healthcare, and
biotech”
— Teo Ser Luck —
Minister for Trade & Industry, Singapore
SECTION 5

•  Create greater awareness & patient empowerment
•  Facilitate better provision through private sector
•  Provide healthcare services in underserved urban and rural regions
•  Analyze trends to better allocate limited resources
Asia: Leapfrogging its immature infrastructure

Venture funding of digital health: Asia key trends
199 HealthTech Startups in Asia*
Category Total Examples
Big Data & Analytics 8
•  Genequest (JP)
•  Lean Care Solutions (SG)
Consumer Health & Wellness 43
•  BabyMe (VT)
•  Haamor (TH)
Genomics & Precision Medicine 5
•  MyCode (JP)
•  Prenetics (HK)
Healthcare Incubators & Accelerators 3
•  Clearbridge Accelerator (SG)
•  AIA Accelerator (HK)
Navigating The Healthcare System 32
•  Practo (IN)
•  Our Health Mate (SG)
Patient Engagement 45
•  Tanyadok (INDO)
•  HelpingDoc (IN)
Practice Management 29
•  Klinify (SG)
•  Medix (PH)
Sensors & Diagnostics 26
•  Reka Health (SG)
•  Healint (SG)
Telehealth & Remote Monitoring 8
•  MyDoc (SG)
•  Doktor Gratis (INDO)
Note: Not an exhaustive list!
Source: Health Startups Asia!

Venture funding of digital health: Asia key trends
Noteworthy Asia HealthTech Startups
Startup Funding ($M) Stage Principal Investors
Our Health Mate (SG) 1 •  Seed & Pre A •  LeoTech
HealthKart (INDIA) 20 •  Series B
•  Sequoia Capital
•  Intel Capital
DXY (CH) 2 •  Seed & Pre A •  DCM
PICOOC (CH) 25 •  Series B
•  Tencent
•  Gobi Partners
Reka Health (SG) 4 •  Series A •  Tembusu Partners
Practo (INDIA) 24 •  Series B •  Sequoia Capital
Meet You (CH) 50 •  Series C
•  Matrix Partners
•  K2 Ventures
Klinify (SG) 1 •  Seed & Pre A •  Jungle Ventures
Healint (SG) 1 •  Seed & Pre A •  Wavemaker
mClinica (SG) 1 •  Seed & Pre A
•  500StartUps
•  Kickstart Ventures

•  Digital Healthcare is disrupting healthcare and its stakeholders
•  Technology is driving a new paradigm to create better healthcare
•  EM healthcare will be able to leapfrog its infrastructure limitations
•  New opportunities are opening to shape the new paradigm
Healthcare is changing dramatically

Julien
de SALABERRY
Experienced regional head and GM. 15+
years in healthcare with leading brands
including Eli Lilly, Boston Scientific,
Baxter, GSK, Merck & Co. Significant Asia
Pacific Experience.
The Propell Group is a boutique venture
investor and adviser firm focused on
early stage companies in healthcare
technology
aha! is a dedicated health-tech
accelerator focused on Asia 4 Asia
healthcare technology innovation
Co-Author of iDisrupted
Founder & CIO Ÿ The Propell Group
M: +65 9488 7334 Ÿ julien@propellgroup.biz
@enquirepropell

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