Digital Health Archives - Recon Strategy

What’s so special about One Medical in the eyes of Amazon? A few quick thoughts

Tory Wolff and Thomas Uhler July 27, 2022

There isn’t a bricks-and-mortar primary care acquisition out there that is beyond Amazon’s financial reach. While the announcement regarding One Medical has provoked fresh rounds of speculation about what Amazon might do broadly in primary care (e.g., push Pillpack),[1] our interest here is in why Amazon seems to think One Medical specifically is the right move right now. Below are some quick thoughts: Compatible business models One Medical’s legacy commercial business and Amazon (Prime) both operate a fixed annual membership fee plus charge-per-transaction business model. The membership fee provides customers

Advances in AI for Health in 2021: An Analysis of the Clinicaltrials.gov Registry

Irina Ahmad June 2, 2022

The role of artificial intelligence (AI) and machine learning (ML) in healthcare spans a vast range of potential applications. A view of AI development on clinicaltrials.gov helps to focus this landscape, giving a sense of trends and near-term applications. Following last year’s review of AI development, we have updated our analysis to include registered studies starting in 2021.[1] The analysis revealed continued strong growth of studies across the field, especially in patient engagement and research. Within patient engagement, the tools studied (mostly chatbots) have increased in complexity, tracking with advancements

The Puzzling Future of Healthcare

Nikhil Bhojwani October 10, 2021

This post is from a talk at the 2021 Link Ventures CEO summit. Original talk: Transcript: The practice of medicine has always been an information problem. Clinicians seek to diagnose an ailment and to prescribe a cure based on an incomplete understanding of what’s happening in a patient’s body as it relates to an incomplete set of knowledge about diagnoses and treatments. This aspect of medicine has remained the same for centuries even as our collective understanding of medicine has gone through three major phases. Until the 18th century, much

A tale of two cities: Referral networks of orthopedic surgeons in Miami and Seattle

Max Holle October 22, 2020

Summary: We conducted a comparative analysis of the referral networks of orthopedic surgeons in King County (the area around Seattle, WA) and Miami-Dade County. Similarities Bigger systems are better at keeping referrals internal So, the level of fragmentation in the referral base is associated with the level of fragmentation in the specialty market structure Despite this, a consolidated referral base does not necessarily mean that systems are able to keep orthopedics referrals internal Miami-Dade Independent physicians make a significant proportion of referrals (9.4%) So, independent surgeons receive a significant

AI in healthcare III: COVID-19 applications and implications

Sophie Ranen and Nikhil Bhojwani June 5, 2020

COVID-19 has accelerated the adoption of AI in healthcare. AI based tools and solutions can work quickly, be deployed at scale, and respond to the dynamic nature of the crisis. Use-cases span all facets of responding to the pandemic, from diagnosis and triage, to treatment and combating new transmission. A wide range of players—including startups, established companies, universities, and more—are bringing their capabilities and perspectives to the table. Startups like Current Health, a UK-based remote-monitoring company supporting Mayo Clinic and Baptist Health with their COVID-19 response, are benefitting the industry’s

Strategy in the Time of Covid

Nikhil Bhojwani April 15, 2020

Preamble A recent post from Recon Strategy outlined the longer-term strategic implications of Covid-19 on 12 healthcare sectors. This post highlights the opportunity to redeploy corporate strategy assets to focus on the most important short-term strategy imperatives to not only ensure organizational resilience but to set up for success coming out of this crisis. Corporate strategy teams have tremendous analytical, creative, and operationally savvy resources that are accustomed to jumping into new situations, getting quickly up-to-speed, and delivering value. Leaders should proactively point these resources towards these areas of greatest

The day after: Implications for hospitals, payers, biotech and more…

Nikhil Bhojwani April 6, 2020

Even as our priority today is dealing with the Covid crisis, healthcare organizations would do well to start thinking about the longer-term implications for their strategies. In some instances the marketplace will revert to the prior dynamic, but in many others the changes wrought during this crisis are likely to persist in a way that will call for new strategy or will produce unpredictable outcomes that will require scenario planning. Sectors will be impacted in very different ways and there will be winners and losers in each. In this short

Choosing your customers wisely: are hospitals the right place to engineer the future of healthcare (and the software services to support it)?

Tory Wolff July 29, 2019

MSFT’s pathbreaking alliances in healthcare services are impressive and well designed to grow adoption of their Azure cloud over the medium term. But if MSFT wants to be at the forefront of change and maintain a robust hold on healthcare cloud share in the long-term, their publicly disclosed partner set seems highly incomplete[1]. The two major alliances announced this year – Walgreens and Providence St. Joseph (PSJ) — are predictable outcomes of the emergence of the UNH, CVS/AET and CI/ESRX triumvirate. Healthcare’s anxious mid-tier services players need enablement partners with

Amazon to startups: stay close to the consumer and let us own the platforms

Sophie Ranen May 22, 2019

Amazon’s healthcare play appears to be heavily focused on platforms rather than specific applications They would prefer startups focus on elements that are truly differentiating for consumers and let Amazon take care of the infrastructure Early-stage companies investing in their own back-end services may find their dollars wasted or their applications incompatible with Amazon The following insights around Amazon’s healthcare strategy rely on comments made by Eliot Menschik, Global Head, Healthcare + Life Science Startups, at Amazon Web Services and other speakers at the recent TiECon East conference. Because of

There’s always a bigger fish: healthcare services giants are looking anxiously over their shoulders

Sophie Ranen February 24, 2019

With the closing of the CVS/AET and CI/ESRX combinations, healthcare services are now led by a triumvirate of vertically-oriented goliaths. And we can anticipate that there will be more care delivery acquisitions and investments to fill out the new vertical platforms—just as the leader UnitedHealth Group (UNH) continues to invest in its care delivery arm (with the pending acquisition of DaVita’s physician group) a decade after it first went into the clinic business. The extent to which the two new combinations have allowed legacy constituents CVS, AET, CI and ESRX

New class of therapeutics calls for new regulations: thoughts on the FDA’s new process for regulating digiceuticals

Tess Niewood November 15, 2018

Interest and investment in digital health has increased rapidly in recent years. Some digital health software is impactful enough that it requires FDA approval, but current regulatory pathways are slow and cumbersome for tech companies. In July 2017 the FDA announced a beta-test of a new pathway, the pre-certification program, which is intended to increase innovation and minimize barriers to market entry for digital health software. While early signs show the program will have these intended consequences, it also may create an uneven playing field for incumbent players relative to

Google’s health insurance apprenticeship: some unicorns (maybe) but no masterpieces

Tory Wolff March 19, 2018

Last month, word got out that Verily is in talks with health plans to “jointly bid” on care management contracts. Medicaid populations might be a reasonable surmised as the target given that (1) managed Medicaid requires bidding, (2) Medicaid contracts typically come in packets of hundreds of thousands of lives (which was the scale mentioned in the press reports) and (3) Verily had been considering (but decided against) bidding on Medicaid contracts using Oscar Health as a partner. It is curious, however, to see an organization seek collaboration with health

Rapid cycling to get medications right: a potential use case for coupling wireless patient monitoring with remote support?

Tory Wolff August 22, 2016

Summary Cheap home devices are starting to generate a flood of high frequency, low latency biometric data, much of it of uncertain clinical value This uncertainty makes designing the service model difficult: high value use cases may get bundled with broader, low value, more speculative ones (e.g. behavior change), reducing overall ROI and uptake Given the patient-generated nature of the data and uncertain accuracy / calibration of the devices, use cases will need specific targeting or depend on subsequent clinical grade investigation to sort signal from noise High value use

Attacking an oligopoly by integrating downstream services: Can Livongo’s closed loop get traction vs. the big glucometer incumbents?

Tory Wolff June 22, 2016

Summary Livongo is marrying a cellular-enabled glucometer and a data cloud with patient engagement services to help manage sugar levels Glucometer incumbents could match Livongo’s technology but will struggle to counter the business model innovation By expanding into services, however, Livongo is expanding its potential competitive set to include incumbent downstream care providers If Livongo’s model demonstrates compelling value, both device and services incumbents could find ways to stitch together competing solutions in collaborative ecosystems Closed loops are great ways to develop value propositions but can be rickety for trying

When is a patient not a patient? More often than you think

Alex Brown May 6, 2016

I have been conducting an informal test for the past year and a half. And while it has not been a full statistically-significant clinical trial with test and control groups, and “double blind” testing methods, the results have been striking… The way this test works is that when I meet someone new or reconnect with someone I have not seen in a long time, I ask them to describe themselves and then listen carefully to the answer. Some clear patterns emerge: It’s most common for people, and particularly my American

Context is King – When to use an Agile corporate strategy?

Alex Brown April 1, 2016

“Agile corporate strategy” (as defined in a previous post) is already the established the weapon of choice for small, early-stage innovators trying to re-invent their marketplace, where the product is the company and uncertainty is the hallmark new emerging markets. Startups like agile strategies – often referred to a “Lean Startup” – because they effectively counter the scale advantage of incumbent competitors without requiring massive initial investment. But contrary to the conventional wisdom that firms must abandon agility as they get larger and more complex, in the right market context

Sustainable Agility – Activity Systems for the Agile Competitor

Alex Brown April 1, 2016

The dirty little secret of the booming agile training and coaching industry is that most Agile implementations ultimately fail, meaning that the companies revert back to their previous working methods. Even ones that experience dramatic early success and drive their entire industry to implement similar approaches typically lose momentum after several years or with a change in leadership. It is telling that, of the first wave of companies to implement Scrum in the mid 1990’s, not one is still using the framework today. In light of this, it is tempting

Enterprise Agility as Corporate Strategy

Alex Brown April 1, 2016

In a previous post, I explored Maxwell Health as an example of agile product development strategy in healthcare. For small single-product companies the product strategy is the corporate strategy, but agile principles can yield profound benefits for larger multi-product business units and even entire firms. This blog focuses on Agile Corporate Strategy, and specifically how a subset of companies in the right strategic context could greatly benefit from institutionalizing agility across the entire enterprise. Agile corporate strategy “Agility” is a term that gets thrown around liberally, often in a very

Emails substituting for visits: Evidence points to “yes” but providers need to answer a lot of emails to replace a single visit

Tory Wolff December 30, 2015

Earlier this month, researchers released a study of patient-initiated emails to providers with Northern California Kaiser Permanente (KPNC) in 2011/12 in the JAMC . The study focused on patients with one or more chronic condition (CDC data indicates this would be about 50% of an average population) but otherwise sought a mix of conditions, benefit designs and demographics among its participants. Respondents were asked about their use of email in the previous 12 months. The study found substantial patient initiation of email contacts: Of the 71% in the sample with

Maxwell Health and Agile Healthcare Strategy

Alex Brown December 11, 2015

Maxwell Health LLC is a rapidly growing company that offers a platform to make it easy and intuitive for employees to manage their employer-sponsored benefits. It is at the intersection of several major macro trends currently transforming the Healthcare industry: As a marketplace for employee benefits, it is near the center of a shifting US regulatory landscape for individual and small group insurance exchanges As a “Software as a Service” (SaaS) platform it is a poster child for the growing use of clever software to deliver intuitive, efficient and quality

Category: Digital Health

Recon takes an analytical look behind select developments in healthcare

What’s so special about One Medical in the eyes of Amazon? A few quick thoughts

Advances in AI for Health in 2021: An Analysis of the Clinicaltrials.gov Registry

The Puzzling Future of Healthcare

A tale of two cities: Referral networks of orthopedic surgeons in Miami and Seattle

AI in healthcare III: COVID-19 applications and implications

Strategy in the Time of Covid

The day after: Implications for hospitals, payers, biotech and more…

Choosing your customers wisely: are hospitals the right place to engineer the future of healthcare (and the software services to support it)?

Amazon to startups: stay close to the consumer and let us own the platforms

There’s always a bigger fish: healthcare services giants are looking anxiously over their shoulders

New class of therapeutics calls for new regulations: thoughts on the FDA’s new process for regulating digiceuticals

Google’s health insurance apprenticeship: some unicorns (maybe) but no masterpieces

Rapid cycling to get medications right: a potential use case for coupling wireless patient monitoring with remote support?

Attacking an oligopoly by integrating downstream services: Can Livongo’s closed loop get traction vs. the big glucometer incumbents?

When is a patient not a patient? More often than you think

Context is King – When to use an Agile corporate strategy?

Sustainable Agility – Activity Systems for the Agile Competitor

Enterprise Agility as Corporate Strategy

Emails substituting for visits: Evidence points to “yes” but providers need to answer a lot of emails to replace a single visit

Maxwell Health and Agile Healthcare Strategy

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