Mountains versus mole hills: what are the BIG ideas in digital health
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Frank Boermeester Frank Boermeester - August 12 2014

I’m in the Dolomites mountains in Italy as I write this post. From my balcony I see huge edifices of rock arching steeply skyward. Perhaps because I’m Flemish polder dweller, accustomed to flat horizons, these mountains really make an impression. I find them absolutely staggering. Huge, imposing and majestic. You can’t ignore them. In fact, they define this place – the landscape, the weather, the people, the lifestyles.


That marvelous view sparked a question. Where are those giant peaks, those all embracing bulks of rock in the world of digital health? Because in some ways, the digital health scene resembles more a patchwork of mole hills on a typical Flemish meadow.


What are (or what will be) the digital tools that will change forever the way we look after our health and practice medicine? What will be the giants, the staggering mountains, that define the future of healthcare? What will be the tools that every household or every doctor will need (as opposed to simply ‘want’), akin to the home thermometer and doctor’s stethoscope?

Here’s some thoughts on this.

An all-purpose home diagnostics device.

Consumers want simplicity. While today you can buy distinct devices for measuring body temperature, blood pressure, blood glucose, heart rate, body weight and body fat percentage, in the near future one or two devices will suffice to measure, track and interpret all of these. There will be a time soon when you can throw out all those old thermometers.

Companies to watch: Scanadu (developer of the Scanadu Scout, a multi-sensor device with tricorder ambitions), Withings (makes smart scales, activity trackers, sleep trackers, heart products and so on) and don’t ignore the incumbents such as Philips and Siemens.

A cradle-to-grave personal health management tool.

Today some of us use body trackers and a few of us may even make use of a personal health record of some form. Most of that activity is driven by specific health goals (e.g. losing weight), a chronic illness (e.g. medication and symptom tracking) or an atypical interest in self-tracking (Quantified Self advocates).

What’s missing today is a cradle-to-grave health management tool that helps people proactively manage their health and healthcare, encompassing features that are now still scattered among a multitude of different tools, covering health records, scheduling tools, health coaching, body tracking and aggregating/integrating/platform tools to bind it all together.

Interesting companies & concepts:, iChip and Hello Doctor (personal health record services that collect data from doctors and analyses data to provide insight), Dacadoo, Nuffield HealthScore, Higi and One Health Score (tools to track and manage your all-round health using an aggregated health score, Higi is also rolling out a network of health-assessment stations at pharmacies in the US), Validic (middleware platform offering easy connection to a wide range of body monitoring devices), Apple HealthKit and its companion app Apple Health (health dashboard that integrates data from third party devices, fitness apps and health records, also a platform for developers), Microsoft HealthVault (personal health record that connects to third party apps and devices, also serves as a platform for developers to build apps on).

A healthcare system navigator.

Companies like Zocdoc, DocPlanner and Castlight are showing the way here. Finding and buying healthcare services is set to change fundamentally as we gain access to ever more cost, quality and outcomes data. While Zocdoc and others are still pretty local (home market only) and niched in terms of the service they provide (booking a GP) I expect that at some point we will all be navigating the healthcare system, especially specialised services, in a very different way, more akin to how we’re buying travel products, music or books. Another company to watch is HealthTap, which has evolved from a Q&A site where doctors can build their reputations and patients find answers, to a far more ambitious platform incorporating online doctor consultations and health coaching. HealthTap’s model suggests that the distinction between the ‘navigation’ part and the ‘personal health management’ aspects may blur in time too. 

An all-purpose doctor’s application.

Today most doctors rely on a medical record system (ranging from paper-based systems, to desktop-based to SaaS solutions), an appointment system (again, ranging from a paper-based agenda to a web-based calendar application allowing patients to set their own appointments), and a range of other information services and decision support tools (ranging from the classic medical textbook to decision support apps and doctors’ social networks). Looking ahead, telemonitoring dashboards and tele-consultation platforms should become pretty standard too. But ultimately all or most of these currently distinctly services will probably be wrapped in a single platform. Expect a battle of the giants as network effects take hold and synergies between medical records and decision support tools become viable (mining records for insight).

Interesting companies & concepts: PracticeFusion (free cloud EHR for GPs, major Big Data opportunity here, also has a patient portal called PatientFusion), Epic (major EHR supplier to hospitals, claims to cover over 100 million lives, developing mobile apps for providers and patients), InfoBionic (telemonitoring dashboard for doctors), SnapDx and MedX (clinical decision support tools), HealthTap (mentioned above too, it launched an online consultation service built on a vibrant Q&A community).

It’s a useful intellectual exercise. Are you building a mole hill (to be clear, there’s nothing wrong with a niche product) or a giant mountain that will change healthcare forever? Or another way of looking at it, apply the thermometer test: will you product attain total ubiquity? Will it be found in every household (or doctor’s cabinet)?

Any other big ideas out there? Let us know below or pitch them to the HealthStartup community as a project.


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     Shahid Shah ( September 1 2014 23:30 )

    Great ideas, Frank. I think the (coming) tight integration of Bio IT, Pharma IT, and Digital Health is especially interesting. For example, next generation diagnostics and how they integrate with digital health / health IT is cool. Check out my latest blog post on the subject:

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