Monday, 26 June 2017

#DigitalHealth at an Inflection point by Mary Meeker, @kpcb reviewed by Manish Sharma @msharmas





Please note the above slides have been extracted from the Mary Meeker, Internet report 2017 purely for the purposes of this article. The statistics mentioned in this Blog have been taken from the Mary Meeker Internet Report 2017, relevant for DigitalHealth. For more details please view the complete report here  

While reviewing the Mary Meeker, Internet Report 2017 I found came across the statement "DigitalHealth at an Inflection point". So in this article (as also the slide deck above) I have tried to review the Digital Health specific updates and provide a correlation to them by linking it up with the India Internet section that has also been highlighted in the report.


We are seeing a great many startups bringing the healthcare services by deploying Digital platforms, I think it will be an interesting exercise by the incumbents as well as new innovators, to view these two sections of the Mary Meeker report while preparing to expand their digital footprint or while trying to bring in new services to the market. Do we see a new category of Digital Health startups that can leverage the customer segmentation and growth in the customers with access to mobiles and internet penetration.

We start with the India Internet growth story, and proceed to the Digital Health story. 

The India Internet Story

There are some interesting insights related to the India Internet Story. These are:
  1. With 355 MM users, India is second to china in the number of Internet Users. A 40% Y/Y growth and 29% penetration. This presents a large customer base for the Digital Health Startups providing services online
  2. India is number 1 in terms of the number of Android apps downloaded, greater than the US. So an obvious first choice of platform on mobiles
  3. India has been recording a steady growth in the smartphone shipments, at 15% Y/Y
  4. There has been a reduction in the cost of 1GB of data from $3.15/ 1GB to about $2/ 1GB. Including Jio, the cost comes down to $0.33/ 1GB
  5. There has been a push from the Government towards "Digital" services as can be seen from the following initiatives: Jan Dhan, Digital India, Skill India, Startup India. Government’s Policies rolled out with speed and scope
  6. India identity via Aadhar + eKYC, Digital authentication of 1B+ people, 82% of the population have aadhar, has the potential to enable services with speed, scale and scope (e.g., SIM card activation from 1-3 days to 15 minutes)
  7. 46% of Internet users primarily consume local language content. 6 Languages spoken by > 50MM users (excluding english)
  8. Young India: 64 % of the population, 72% of the Internet users less than 35 years of age
  9. 27% increase in the Consumption Class (income levels at which consumers start to have the ability to spend beyond basic necessities). 
  10. India consumption is focused on basics, i.e. 54% of personal consumption expenditure

The India Healthcare Story

  1. India Healthcare has a high and rising out of pocket spend, <20% insurance penetration (a potential area for disruption?)
  2. India Healthcare reimagined: Increasingly accessible via mobile and affordable via online aggregation and price transparency. Savings on Services like Online pharmacy (20-30%), lab tests ordering (40-50%).

The Digital Health at an Inflection Point

There are some interesting insights related to the Digital Health being at an Inflection point. These are:
  1. 100 years ago: human touch; 25 years ago: machine assisted/ analog; Today: technology enabled/ digital
  2. 4 trends highlight the current Digitisation of Healthcare and the Virtuous Cycle of Innovation: Data Inputs, Data Accumulation, Data Insights, Translation. Together these trends are helping measure Outcomes and rapidly iterate to enable compression of Innovation Cycle times.
  3. The earlier analog medical technology is increasingly being replaced with Digital Technology, and is (continuously being) connected
  4. Diagnostics Technology: increase in the number of measured / monitored data attributes
  5. Increasing adoption in the use of wearables, for health and wellness. For health, heart rate and temperature
  6. Leading technology brands are well positioned to participate in the Digital Health wave, with the customers stating in a Rock Health survey they will be most willing to share healthcare data with the likes of Google, Microsoft, Samsung, Apple, Amazon, Facebook and IBM (in that order)
  7. Data Accumulation enabling the proliferation of Digitally native healthcare related datasets
  8. Proliferation of health apps, with a 5% Y/Y growth in the US and 15% Y/Y growth in rest of the world
  9. EHR adoption is leading to a broad and centralised accumulation of data with various types of patient data elements in a native digital dataset , e.g., clinical results, scanned images, vital signs, problems, medications, allergies, etc
  10. In the US there has been an increase in the number of hospitals allowing for the patients digital access to the healthcare information
  11. There has been an increasing digitisation of inputs fueling a 48% Y/Y growth in healthcare data
  12. Data Accumulation: a typical 500-bed hospital generates 50 petabytes of data (1 petabyte = 1 mm gigabytes).
  13. Rise in inputs + increase in digital healthcare data = medical research and knowledge is doubling every 3.5 years
Now that you have these data points available to you, what are the Digital Health business categories can you think of? Digitisation = Democratisation. 

How can we make use of the various natively digital datasets available to deliver better and improved healthcare services to the customers. How can the hospitals adopt Digitisation to improve service delivery. More so what is the shape of a Digitally enabled hospital? Your thoughts? 

Stay tuned to our list of Startup Categories that you can consider for your next startup.

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Manish Sharma
Founder HCITExpert.com, Digital Health Entrepreneur

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