I have never been particularly interested in Government, Civic Tech and Politics with the exception of reading the Sunday NY Times, watching Meet the Press occasionally and being somewhat interested in the Open Data movement.
A year ago I had a conversation with Susannah Fox about AI, Healthcare and Aneesh Chopra’s book “The Innovative State“. I was inspired and began digging deeper into the intersection of Government and Technology. I learned about 18F, Cloud.gov and played around with datasets from data.gov. I watched hearings on the OPEN Data Act and subscribed to newsletters from Think Tanks like the Center for Data Innovation.
As it turns out, there’s an incredible amount of innovation and goodness happening in Government today from the use of open source to data transparency to progressive tech policy.
Susannah connected me with the US Digital Service, a group of Engineers, Designers, Product Managers and Digital Policy Experts that work across the Departments of Homeland Security, Veterans Affairs, Defense, Education, Health and Human Services, and the Small Business Administration to improve websites, access to datasets, user experiences and more. It sounded awesome and I decided to give it a go.
An election, a hiring freeze, a few background checks and many interviews later, I was accepted into the program. My wife, kids and I are relocating from Denver, CO to Washington, D.C. for a year long “tour of duty”.
Most Cities, States and Federal Agencies are working on some type of Open Data initiatives. The most common is an “Open Data Portal” that makes it easy to grab and use datasets:
Civic Leaders working on these initiatives cite promoting transparency in Government, improving performance and providing data for innovation as reasons why Open Data is so important.
As a Product Manager, it’s helpful to be familiar with what’s out there and how you can play around with these datasets to better understand how your product may benefit.
Before you dive into querying APIs, checkout a few of these projects to see the end result of building something with Open Data.
Ok, now let’s dig into some datasets you can play with.
Socrata’s Open Data Network
Socrata hosts over one hundred different data catalogs for governments, non-profits, and NGOs around the world. Checkout their Open Data Network where you can search for datasets.
Namara has organized a bunch of public datasets into a beautiful UI. Create a free account, sign in, create a new project then click Open Data in the left column to search and add datasets to your project. You can view the table data and manipulate it or call the data using their API.
In your project settings, you can generate an API key. Then, in each dataset you can click “API Info” and get the data_set_id and version_id.
You can use ProPublica to request data about Congress such as a list of Recent Bills and Member Voting records.
You’ll need to request an API key by emailing email@example.com then pass that in the X-API-KEY header.
For example, to query Rep. Jared Polis’s voting record:
Open Data and the big IaaS Platforms
Another approach is to checkout Public Datasets baked into AWS, Google Cloud Platform and IBM Bluemix.
This is a great example of using Google BigQuery on NYC Public Datasets.
AWS hosts a bunch of Open Data in S3 buckets.
IBM, as part of the NOAA Big Data Project, has built an easy way to download tons of data.
Here are a few links related to Open Data policy and relevant news.
DATA Act passed in 2014, America’s first open data law. It directs the federal government to transform all spending information into open data.
The OPEN Government Data Act “directs all federal agencies to publish their information as machine-readable data, using searchable, open formats and requires every agency to maintain a centralized Enterprise Data Inventory that lists all data sets, and also mandates a centralized inventory for the whole government (data.gov)”.
Open Data 500 US is an interesting survey results showing what kinds of companies use which agencies’ data.
I have almost all of my strategic thinking, articles I’ve found useful and reference material in Evernote. Their browser extension works great as does their Mac, iPad and iPhone apps. I even have the WSJ integration enabled so I see relevant news with my Notes.
It’s time for Evernote to not only store my information, but really help me be smarter and better at everything I do.
I would happily opt-in to this feature giving them access to learn from my personal data as long as I had a mechanism to “mark Notes private” which would exclude them from Evernote’s Machine Learning activity.
Given a seed list of Notes or a Notebook, I want Evernote to help me:
- Monitor important news and activity from Companies and People I’m interested in
- Show me correlations and visualizations in my Note data so I can better connect the dots and broaden my context
- Suggest actions I should take based on my Note data
Evernote knows the Companies, People and Topics I’m interested in. Their browser extension could contrast my browsing behavior and work style with what I save into Evernote to learn more about me. They know my travel habits based on where I save Notes and all of the travel data I store in Evernote. They know about my kid’s activities because of the receipts I save, they know the gift idea list I’m keep for my upcoming 15th wedding anniversary.
I want to build a list of Venture firms funding healthcare companies. I know that Mattermark and CB Insights have these by segment, but I want my own list and to apply my own logic. I want to understand all the people that work there and what they are talking about. I want to know about their investments. I want to know when people leave the companies. I want to dig deeper and see trends using visualizations, etc.
I have been to the Evernote conferences, think Phil Libin was a visionary leader (#selfie) there and continue to be a paid user of the product. I’m hoping 2017 is the year that the Evernote team blows my doors off.
My personal philosophy of Government is one that takes a long-term view, provides infrastructure and conditions to enable Citizens, and holds the massive responsibility to self-regulate and optimize itself.
I have read four books recently that have really informed my views and inspired me about the role of our Government in Technology:
- Innovative State (Aneesh Chopra)
- The Industries of the Future (Alec Ross)
- The Clock of the Long Now (Stewart Brand)
- Thank You For Being Late (Thomas Friedman)
I want to see Government continue giving Entrepreneurs Access to:
- Policy Makers and Regulators
- Pilot programs
The Entrepreneurs, Venture Capitalists and Big Tech Giants will build products, fund ideas and get innovation to the people. Government will ultimately set the regulations. Lately, Government has also taken on an increasing role in sponsoring hackathons and innovation challenges (Challenge.gov) to promote adoption of their data sources and generate awareness of their role in the overall tech ecosystem. From the JOBS Act to Patent Reform to Cybersecurity to the Open Data Initiative to the America Invents Act, there are many good examples of progress outlined on Whitehouse.gov.
I also recommend this Recode Decode interview with the U.S. Chief Data Scientist DJ Patil for good examples of how various Government Agencies are using data to iterate on problems.
As I zoom in on Healthcare and Life Sciences I think about:
- HL7, FHIR and data interoperability
- Open Data Initiatives and Data.gov
- FDA regulation, Medical Devices and GxP compliance
- HIPPA compliance
- Cures Act
- Why do we allow drug ads?
- Reproductive rights
- Medicaid, Medicare
- ACA impacts and opportunities
There are incredible examples of Government using their scale to make progress such as the Million Veteran Program (Genome study) in which Veterans volunteer their DNA analysis and health information into a massive database for Researchers. Government is also funding technology pilots and new approaches to improving care such as a Mount Sinai paramedicine pilot in which Paramedics consult via telemedicine with Docs and treat the patient in their home without transporting them to the hospital.
I hope our Government continues to build upon the power of open data, collaborate with Entrepreneurs and view Healthcare as a fundamental right for our society and citizens.
I talk to Product Managers all the time that are considering building products or features that would move them into the Healthcare space. This post is for them.
As you venture into Healthcare, you are embarking on the most TLA filled space imaginable. Talk to other Product Managers that are veterans in the space and you’ll barely be able to follow along. They are not trying to sound smart, it’s simply that the TLAs get ingrained so deep that it takes real effort to not use them.
You’ll also come across a few big topics like:
- How regulation impacts business models
- Selling into large Healthcare organizations
- HIPAA and GxP
- Healthcare and Life Sciences are very different
I began my first 90 days as a PM in Healthcare on a beach in Florida with my wife and kids on Thanksgiving break. I lounged around reading/listening to these 3 books:
- America’s Bitter Pill by Steven Brill
- The Lucky Years by David B. Agus M.D.
- Reinventing American Health Care by Ezekiel Emanuel
Doing this gave me an understanding of the ACA, Pharma and all of the problems especially in the US Healthcare system. I was beginning to understand some of the TLAs.
My next step was to talk with other Product Managers. I had to ask a lot of dumb questions in these conversations but everyone was super nice and helpful. #givefirst These conversations helped me build a list of news, people, podcasts, blogs, etc that now make up my daily healthcare and biotech information pipeline. On a daily basis I found myself reviewing the Healthcare Top 100 and thinking about the business models of these companies. I subscribed to daily healthcare industry news from Becker’s Hospital Review, STAT and Modern Healthcare. I followed Zdogg and David Chase on LinkedIn. I listened to podcasts from Catalyze.io and a16z.
At this point in my first 90 days I was back in the office, still under a nice “you are still new” grace period and learning from everyone I could. The next step was to talk to Techstars Alumni, Denver-based Founders and friends of mine that are running Healthcare Startups. I had 50 conversations in two weeks and summarized most of them in a shared Box folder the team uses. For a handful of the conversations, I summarized and sent an email to entire team to raise awareness. This quickly established me as the expert for our “Healthcare Startup Developer” persona.
In the first 90 days:
- Tell stories to build empathy about the people the product is trying to help.
- Establish yourself as the voice of the customer on your team.
- Show you are passionate and curious about the problems to be solved and the people you are trying to help.
It’s been one year since I began my journey as a Product Manager in Healthcare. I am once again sitting on the beach over Thanksgiving break pondering our Product Roadmap, Industry trends and reading everything I can about AI in Healthcare, Big Data Analytics use cases, Serverless Compute, how the ACA may change in the next Administration, CRISPR and more.
If you want help with your first 90 days, please don’t hesitate to reach out….and good luck!
Photo Credit: https://unsplash.com/@joaosilas
I ended up down a rabbit hole of research on Sapphire Ventures thanks to the Origins (Notation Capital) podcast on my flight home from Boston early this morning. Sapphire invests in Enterprise software companies. I got to thinking, if I were to analyze companies in that space with my Product Manager hat on, what would I look for?
These 5 areas came to mind.
1. How will the Product interoperate?
Ex: Zapier, BI fabric, Hybrid Cloud
Is the team thinking about how to move pieces of data around from their app to other apps, from their app to the Enterprise systems, between their Public Cloud and the Enterprise’s on-prem and Dedicated Clouds?
How will insights and raw data from their product be accessible to the Enterprise’s BI Fabric, Data Scientists, etc? How does that strengthen the value of the offering?
2. Where are Users interacting with the Product?
Ex: Mobile, APIs, Slackbots, Echo
Is their product enabling all types of Users to be engaged anywhere? Is extension of the product easy by a Customer Developer via APIs? Is there potential for an Ecosystem to organically grow around the product? Does it feel like a Platform? Is the pretty Mobile app for the on-the-go Sales person just as well thought out as the Developer API?
3. What are the Combinatorial Effects?
Ex: Exongenous Datasets, Data Network Effects
Is the team thinking about combining datasets together to create something new? Does the product have inherent data network efforts? As more people use this, will the value increase?
What two features used together accomlishing something really powerful?
4. What role does analytics play?
Ex: NLP, Computer Vision, Salesforce Einstein
Enterprise data is flowing through the product. How is that data being mined into features? How are signals being extracted using NLP, Computer Vision, Machine Learning, etc? Does the business analysis get smarter the more people use it? Does AI feel like a foundational part of their approach or do they think of it as gimmicky and a nice-to-have?
5. Talk about the Tech Stack
Ex: Microservices, Serverless
Is the team using technologies like AWS Lambda? Do they talk about Reference Architectures and Blueprints? Are they taking a Microservices-first approach?
A few more articles I came across while writing this post:
- Quora answer to “Which VCs have a stated focus on investing in enterprise software?”
- Werner Vogel’s blog on Serverless Reference Architectures with AWS Lambda
- Stevey’s Google Platforms Rant
- Selling or Funding A Startup? Tips On Surviving Technical Due Diligence
It’s fun to think this stuff through. I remember the days of meeting with investor after investor while in Techstars and how many of those conversations led to strategy and product improvements.
Moving from a background in AI and Developer Tools to Healthcare has required a crash course in healthcare policy, finance, technology and regulations. I’ve always looked to investing trends and analysis to help me better understand a market. Looking at Corporate Venture Capital (CVC) in healthcare and life sciences is a fun exercise.
“over 48% of the top Fortune 100 companies have a corporate VC arm and these corporate VCs have participated in 24% of total deals globally for the past 4 years.” [source]
First, a few basics on Corporate Venture Capital…
Why does the Corporate Venture Group exist?
- Generate financial returns for Limited Partners (LPs) including parent Corporation
- Generate revenue for the Corporation
- M&A channel
- Licensing, Divestiture, Partnerships
- Foster Innovation, Identify Global Market Opportunities, funding initiatives that need to exist outside parent Corporation structure
What do Corporate Venture Groups do?
- Build a Portfolio of Investments that could range from Series A to “evergreen”
- Build an Ecosystem of Strategic Partners
- Generate revenue from revenue share deals and equity positions
- Invest as a Limited Partner (LP) in other Venture firms
So, what’s going on in Healthcare and Life Sciences Corporate Venture funds?
From this CB Insights report, you can see the most active funds include Merck Global Health Innovation Fund, Kaiser Permanente Ventures, Lilly Ventures, Siemens Venture Capital, Pfizer Venture Investments, Novartis Venture Funds, GE Ventures and of course Google Ventures.
Corporate Venture Capital (CVC) in Healthcare
Includes Information Technology, Therapeutics, Diagnostics and Drug Delivery, Diagnostics, Behavioral Health, retail healthcare and rise of consumerism, new provider payment models, delivery of care, implementation of the Affordable Care Act, Data and Analytics.
Vesalius Ventures (Vanguard Ventures, Fremont Ventures and Guidant Corporation)
Corporate Venture Capital (CVC) in Life Sciences
Includes Biotechnology, Biopharma, Medical Devices and Diagnostics, Drug Discovery, Pharmaceutical services, Pharma value chain.
Some additional reading:
Understanding the portfolios of these Healthcare and Life Sciences Corporate Venture Capital funds, the backgrounds of the Partners, where they are based and what companies they invest in help paint a picture for where things are going.
To learn a bit more about Healthcare technology read There’s a lot going on in Healthcare tech right now.
In 2015, venture funding of digital health companies surpassed $4.3B and accounted for 7% of total VC funding in the US. Deal sizes are growing and the percentage of later stage deals is increasing signaling a maturing in healthcare investments.
In my first six months as part of the Watson Health team, I’ve observed a few trends such as:
Google’s Investment in India will impact Healthcare
Google announced they will train 2M Indians on Android OS and promote internet use among rural women by 2019. In India, 5% of the population has health insurance (“cash for care”) and over 70% live in rural areas without access to quality healthcare (source). No doubt Entrepreneurs and Engineers will be creating major innovations in this space. Related: IBM and Manipal announcement
a16z is talking about Digital Therapeutics
Behavioral change is an area Startups/Developers/Apps have and will continue to embrace. A positive signal is a16z’s movement into this space asVijay Pande talks about in this interview. In this class of app, Email/SMS/Push Notifications/Phone calls are the engagement mechanisms.
VC Investing has increased == Startup activity is very hot
A few months ago Rock Health published their 2015 Healthcare Funding report, a must read. Combine this funding data with a review of new Healthcare products on Product Hunt,new Healthcare companies raising capital on AngelList and scanning Dan Primack’s Term Sheet or any other funding source and you will have a good grasp of the pace.
Regulation continues to provide opportunities
Today, major Health IT spend is in certified electronic health record (CEHRT) technology needed to comply with the federal meaningful use (MU) program, better security systems, and ICD-10 conversion software. Coming soon, additional legislation from the Protecting Access to Medicare Act kicks in mandating “that starting January 1, 2017, physicians ordering advanced diagnostic imaging exams (CT, MRI, nuclear medicine and PET) must consult government- approved, evidence-based appropriate-use criteria, namely through a CDS system.” (source)
Another helpful way to look at the Healthcare VC space is to think about the trends and contrast with VC investments.
- The Consumerization of Healthcare
- Consolidation of and competition between Hospitals and Integrated delivery systems
- Strategic Investing (ex: Mayo investing in Helix)
- Monitoring and Prevention
- “Obamacare” disruption
Healthcare Funding Categories
- Health IT Software
- Digital Health
- Medical Devices
- Payer Disruption
For further reading, I recommend checking out the various portfolio companies from Rock Health, Kapor Capital, SafeGuard, Arsenal and GV. Also checkout the Accelerator programs like Techstars Cedars-Sinai andMore Disruption Please to get a feel for the early stage. CB Insights is always publishing great insights such as this Healthcare IoT market map.
Here’s a brief sampling of some investments I’ve seen recently in these areas:
- Patient Engagement
- Prescription Management
- Healthcare Analytics
- Genetic Testing
- Elder Care
- Life Sciences
- Medical Devices
- Gene Therapy
- Health and Wellness
- Digital Health
- Health IT
In Health IT software:
Care Coordination: Patientping, HealthLoop
Payer Management: Oration
Data Analytics: Medivo, BeneStream
In Digital Health we see:
- Health coaches (eating, personal trainers, etc)
- Community for X
- Reviews and Ratings
- Connecting Providers (Patientping), Caregivers to Seniors (Honor)
- Crowdsourcing data (Human Dx)
“Monitoring” is a huge category including:
- “smart devices”, watch, smart phones
- insights, behaviorial analytics
- personal health and nutrition assistants
- DNA and other self testing (23andme, Helix, uBiome)
Health and Wellness Platforms like ShareCare, Welltok and Omada Health.
Products like monthly food (Birchbox) and care packages (Citrus Lane).
Content like articles, daily emails and health guides (HealthSherpa)
Dev Tools like HIPPA data stores (TrueVault, Aptible, Catalyze.io) and IoT data streaming (Sense360).
In Biotech we see…
Biorepository, Genetic Analysis, Cellular Models, Regenerative Medicine, Bioinformatic Analytics.
Startups are using new techniques to harden defensibility into their business models such as creating Developer Ecosystems and baking in data network effects. A good example of data network effects at work is Recombine, a genetic testing company. They have built a network of partner clinics that administer its tests; with each new test, Recombine gathers more DNA data which (with appropriate consent) it can run machine learning on to improve its tests and nimbly develop new ones (therefore gathering more data). Recombine uses Machine Learning tools to find and learn patterns in historical data and uses these patterns to generate predictions. Recombine is 4 years old and has raised $3.3M.
I hope this post gets your brain spinning on all of the opportunity and innovation that’s happening in healthcare.
Since drafting this blog post in Evernote a few months ago, the ChatBot hype has escalated. You will read about Virtual Agents, ChatBots, Invisible Apps, Conversation Commerce, Conversational UIs, Ambient Computing, Bot Stores, Tay and more. Checkout “The Complete Beginner’s Guide to ChatBots” on Medium for tons of examples.
Messaging apps like Kik, WeChat, WhatsApp, Facebook M, Slack and Telegram are integrating ChatBots into their experiences and building Developer tools. Experiences for Shopping, Booking Travel, Dating, Marketplaces and Healthcare are being built by Developers, Startups and Enterprises.
Over the past year since first learning about “Invisible Apps” and ChatBots I’ve been following the thinking of Chris Messina. Chris is a thought-leader on this subject. I highly recommend checking out these three writings/podcasts/lists from him:
- 2016 will be the year of Conversation Commerce
- Intercom podcast with Chris Messina
- Chris Messina’s Product Hunt Collection
After you checkout Chris’s work and get a sense of what’s happening, read on…
Designing for AI, Bots and Invisible Apps
One of the aspects of this I find fascinating is the psychology behind bot interactions. My wife, 7 yr old and 5 yr old and me all say “Thanks Alexa” after “she” does something like sets a timer or plays a song. I think most of us have had interactions in which we’re not sure if we’re talking with a bot or a human.
These articles and podcasts discuss the design, psychology and product management approaches to designing for this new paradigm.
- Dennis Mortensen, Founder of x.ai
- Stelios Constantinides, UX Designer/Engineer at Truth Labs
- William Peng has a nice piece on thinking about Platform Bots
- Benedict Evans talks about Chat bots, conversation and AI as an interface
Dev Platforms for Bots
Twilio is totally awesome of course and has been around for a while. We also see startups like Chat Fuel, Layer and Button supporting the new bot type development and technologies like IFFT being leveraged.
Why is this important?
On average, people spend the majority of their time in about 5 apps and interact with about 25 each month. Most experts are predicting a trend in which other interactions beyond apps gradually change the app paradigm that has dominated the past 5+ years. Interacting with notifications, SMS, messenger clients, Siri, Google Now, Cortana, Alexa are all examples of this. Of the experts that predict the “death of apps”, there’s the same amount that predict “ChatBots are hype and apps as we know them are here to stay”.
The “Second Smartphone Revolution” predicts people will bank, shop and interact with their doctor as core mobile experiences. With the mobile phone as the primary device for these important day-to-day interactions, you can imagine how conversational commerce and ChatBot type experiences could play a big role.
Even More Reading
Here’s a few more podcasts and articles I recommend on this topic.
- Contextual Runtimes by Fred Wilson
- Re/code podcast with John Borthwick
- Intercom podcast with Paul Abrams
For Me Personally
Some of my favorite user experiences now are coming from apps that interact mostly via SMS including Digit and TripIt.
I feel myself gradually getting very comfortable with alternative UIs like ChatBots and Alexa. I trust the information I’m submitting is being handled correctly, I enjoy interacting outside of a website, email or mobile app and I find myself experimenting with different types of things. A few times a day I have an interaction where I can see how it could and will be improved by a “Invisible App” type experience.
Who knows if ChatBots will be the next best thing since sliced bread, but it’s certainly a cool paradigm that I see as having an important role in our daily lives.