There’s a lot going on in Healthcare Tech

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.

Macro-Trends

  • 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
  • Biotech

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
  • Nanotechnology
  • Biotech
  • Insurance
  • Gene Therapy
  • Health and Wellness
  • Digital Health
  • Health IT

In Health IT software:

Care Coordination: Patientping, HealthLoop
Payer Management: Oration
Data Analytics: Medivo, BeneStream
EMRs: Elation

In Digital Health we see:

“Communities” like:

  • Health coaches (eating, personal trainers, etc)
  • Community for X
  • Competition
  • 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.

Virtual Agents, ChatBots, Invisible Apps and Conversation Commerce

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:

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.

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.

Microsoft is also pushing hard in this area by providing a Developer Framework called BotBuilder. And Facebook’s Messenger Platform of course.

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.

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.

Using Trigger Lists in Product Management

I’m a big fan of “trigger lists”. The exercise of building them and the value they bring to a Mind Mapping or Design process have proved beneficial to me over the years. One of my favorites is David Allen’s GTD Incompletion Trigger List.

Recently, I transitioned from obsessing over providing Developers with APIs that would help them build amazing things with AI to obsessing about Healthcare and how AI can provide better care while lowering costs.

I pounded a Doppio and spent an hour brainstorming this trigger list to help me empathize with Users and better understand Actors in the crazy ecosystem that is today’s Healthcare tech.

I am a…

Healthy person
Cancer survivor
Farmer
Factory Floor Worker
CRO Administrator
CIO
CFO
CEO
Developer
Product Manager
Auditor
Patient
Physician
Nurse
RN
PA
Administrator
Researcher
Daughter
Son
Parent
Community Oncology Clinic
Hospital CEO
CMS Employee
FDA Committee Member

And I have…

Outcome data
Clinical trials
Drug databases
Medical journals
App Store Reviews
Medical Devices
Demographics
Avatars
Full Contact API data
Clinical Trial Participants
Patient data
Lab results
Population data
Reimbursement data
Patent filings
Hunches
Students
Research and Health kit data
Hospital trends
Emails
Tweets
Blog posts
Survey results
Internet searches
Essays
Product reviews
X-rays
Photos
Instagram searches
A list of questions

And I want to…

Find Patterns
Organize my data
Filter my data
Search my data
Understand social media
Build an Android app
Surface correlations
Have access to information

So I can…

Comply with regulations
Stay up-to-date
Collaborate with a Physician
Track my progress
Get credit for a course
Be reminded of an appointment
Find cost savings
Sell an app
Make people healthier
Prove a point
Get reimbursed
Understand health trends
Track my Clinical Trial
Find a Hospital
Research and buy my medication
Predict outcomes
Make more money
Connect data together
Build a treatment plan
Find a Clinical Trial
Predict the Future
Support Meaningful Use
Make evidence-based clinical decisions
Analyze adverse events
Provide better treatment “in the field”

For those familiar with Agile, you’ll recognize the “As a User I want” format of this trigger list.

We all have so much stuck in our heads, try creating one of these trigger lists for something in your world and you’ll be surprised at how it can help.

Getting Started With AlchemyAPI

AlchemyAPI is a collection of APIs that help you understand text and images.

Here are three links to checkout before moving on:

Get your free API key
API Documentation
API Demos

Alright, now that you have your API key, you can continue on with these examples. Simply replace your API key and copy into a browser tab.

Working with Text:

Using the “combined” call, you can extract a large amount of meta data from any document or URL including entities, relations, concepts, sentiment, taxonomy and more.


// replace YOUR API KEY
http://access.alchemyapi.com/calls/url/URLGetCombinedData?apikey=YOUR_API_KEY&outputMode=json&knowledgeGraph=1&extract=page-image,image-kw,feed,entity,keyword,title,author,taxonomy,concept,relation,pub-date,doc-sentiment&url=https://www.reddit.com/r/announcements/comments/3djjxw/lets_talk_content_ama/

To get “clean” text from a web page by removing ads and other unnecessary content:


// replace YOUR API KEY

http://access.alchemyapi.com/calls/url/URLGetRawText?apikey=YOUR API KEY&url=http://www.cnn.com/2009/CRIME/01/13/missing.pilot/index.html

Working with Images:

To find objects and text within an image, combine these two AlchemyVision API calls:


// replace YOUR API KEY
http://access.alchemyapi.com/calls/url/URLGetRankedImageSceneText?apikey=YOUR API KEY&outputMode=json&url=http://www.coloradoski.com/uploads/Telluride_Helitrax_brett_schreckengost_logos.jpg
http://access.alchemyapi.com/calls/url/URLGetRankedImageKeywords?apikey=YOUR API KEY&outputMode=json&url=http://www.coloradoski.com/uploads/Telluride_Helitrax_brett_schreckengost_logos.jpg

To find demographics of the people within an image, use the Face call:


// replace YOUR API KEY
http://access.alchemyapi.com/calls/url/URLGetRankedImageFaceTags?apikey=YOUR API KEY&outputMode=json&knowledgeGraph=1&url=https://instagram.com/p/34XsRcxCAR/

Querying the News:

To get news articles about IBM over the past 24 hours:


// replace YOUR API KEY
http://access.alchemyapi.com/calls/data/GetNews?apikey=YOUR API KEY&outputMode=json&start=now-1d&end=now-0d&maxResults=10&q.enriched.url.enrichedTitle.entities.entity=|text=ibm,type=company|&label_format_string=enriched.url.url,enriched.url.title

and to find approximately how many articles were published by the WSJ over the past 30 days grouped by day:


// replace YOUR API KEY
http://access.alchemyapi.com/calls/data/GetNews?apikey=YOUR API KEY&outputMode=json&start=now-30d&end=now&timeSlice=1d&q.enriched.url.url=wsj

About Language Support:
AlchemyAPI provides named entity extraction capabilities in 8 different languages: English, French, German, Italian, Portuguese, Russian, Spanish, and Swedish.  View full Language Support

Why a Product Manager Needs To Wander

Inbox zero, one-on-ones, daily sync calls, daily standups, weekly meetings, roadmap planning, sprint planning, quarterly planning, exec offsites…oh, and…screencasts, wireframes, designs, qa testing, a/b testing, analytics, customer interviews, customer feedback, support tickets, user stories…and on and on it goes.

Whew.

I love to travel for work and always have. I love to hike and ski by myself too. I like doing things like walking my dog, running, riding my bike and riding the bus alone.

I like to wander.

As you walk through the airport, take a moment and observe people and think about their day. Where are they from, how did they start their day, did they drive to the airport or did someone drop them off, what is stressing them out in their life right now? See that annoying person over there? See that pissed off looking person waiting in the security line? How about the friendly looking older couple walking slowly to their gate? What do you think could make their life better? What business are they in? What experience or product do you think significantly impacted their career ten years ago?

Here’s what Brad Feld was thinking about this morning in the San Jose airport.

As a Product Manager, this is one of the most important things I do even though most people don’t get it and ROI can’t be tied to it. Being empathic is often cited as an important trait of a Product Manager. Wandering helps build this muscle. When I wander, I start to see patterns, feature ideas flow and I meet people and have serendipitous interactions about new ideas that aren’t possible in most contexts.

Establishing cadences, rhythms and process is key to succeeding as a PM, especially as your team scales. Just remember to break yourself out of those molds from time to time and go get lost.

Next week I’ll be in NYC visiting the IBM Watson team at Astor Place. My early mornings and late nights won’t be totally packed with meetings and dinners, I will protect that time and wander around. Who knows what I’ll think of.

Can you explain Programmatic Advertising to your friends and parents?

I can’t either and many of the companies I’ve been working with base their businesses on programmatic ad buys.

Basically, programmatic ad buying is when computers buy and sell ads instead of humans.  One in five ads are bought and sold this way today.  The more the computer understands the content on the page you are browsing, the more relevant the ad is that you see.

Here are some terms to know:

Data Management Platform (DMP)
A huge database of customer information that big companies have.

In many of these systems, Marketers can also buy 3rd party data directly from within the system or sell their own data to other systems.

Ex: BlueKai (Oracle)

Demand-Side Platform (DSP)
Software used by Advertisers to purchase ads in an automated way targeted at specific users based on their location and browsing behavior.

Ex: Google’s DoubleClick Bid Manager

Ad Exchange
A Publisher (a big website with lots of traffic) makes ad space available through ad exchanges.

Ex: AppNexus             Here’s a list of the top five exchanges

Hopefully now you an give a quick overview and hang with a conversation about programmatic ad buying!  For further reading, checkout these articles:

WTF is a demand-side platform?
What is an Ad Exchange?

 

Stapletopia

Friends ask me if I like Stapleton and I tell them a story about how I once vowed I would never live there. I wanted to be in a ski town or a loft downtown, never in a lame, boring, family type neighborhood.

Like most things in my life, every few years I look back and realize what an idiot I was just a short time ago. Obviously, I have changed my tune about Stapleton and couldn’t be happier calling the neighborhood my home. With two little kids, my priorities and lifestyle have also significantly changed.

Stapleton is easy livin’. Walking to the pool, cruising around on bikes, going for runs and hikes on trails, bike commuting to downtown….it goes on.

If you’re interested in the neighboorhood or showing your friends around, this map is my recommendation for experiencing Stapleton. Definitely use Zillow to checkout house prices, etc and remember that April and May are when a lot of houses come on to the market in Stapleton. I’m no realtor (talk to Pam Rios for that), so this knowledge is based on anecdotal observations.

stapleton

The Stapleton Tour

1. Stop at Starbucks at fuel up. Yes, Starbucks. I know it’s not hip but everyone is super nice and it’s easy. If you’ve never been to a Starbucks because you are so incredibly hip, order a Clove, it’s like a pour-over.

2. Cruise down 29th ave to get a sense of the mixed architecture styles. You’ll see super modern, townhouses, regular houses, apartments, etc all on the same block. Turn right on Central Park then left on 26th. Checkout the rock climbing park, one of a zillion playgrounds for the kids all around the neighborhood.

3. Continue on 26th and wind around Westerley Creek Elementary. Yes, Stapleton schools are good. The PTA and parent support is super strong for the several middle schools in the neighborhood.

4. Wrap around back to 26th again and cross the Westerley Creek open space. This is a great place to run and ride bikes with the kids.

5. Turn left on Fulton street, you’re now in the East Bridge neighborhood and my stomping ground. Turn right on 28th and drive another block to see a park with a playground and pool. There are several of these around Stapleton.

6. Continue East on 28th and turn left on Iola St then right on 29th. Drive a minute and you’ll see the Bluff Lake Nature Center on your left. Turn into the parking lot, get out of the car and walk around for a few minutes. This is a great place for running or hiking with the kids.

7. Get back in the car, turn right out of the parking lot and wind around, you’re now on MLK blvd again. Drive a minute and look to your right to see the Central Park Rec Center. This is a great gym with yoga classes, lap pool, kid pool, etc.

8. Keep going on MLK another few minutes and look to the right again to see Central Park. This is a great running, sledding, bouldering and kite flying park with a huge playground. You’ll see road races on the weekends and an occasional cyclo-cross race in the fall.

9. Turn left on Unita then right on 29th to see the Bistro and Wine Cellers at Stapleton. This is your amazing lunch or light apps and glass of wine conclusion to time well spent touring Stapleton. In the summer, cruiser bikes and craft beer dot the Stapleton landscape. If it’s Fri or Sat between 4p-7p stop in the Wine Cellers for a free tasting.

10. Turn right on to MLK then left on Central Park Blvd to head towards I-70. You’ll see the old Stapleton tower and a new neighborhood called Central Park North. On the left you’ll see the RTD bus stop and the new light rail station, it’s super easy to get to DIA from Stapleton. Cross the bridge and you’ll see a gigantic outdoor mall called Northfield. That’s where Target, Bass Pro Shop and stuff like that is. (see “Last minute xmas shopping”).

Good Luck in your Stapletopia journey and feel free to reach out with questions.