Mary Meeker Bold On Digital Health, But It’s Time to Get More Bold

I have been reading Mary Meeker’s information-packed Internet Trends Report for as a long as I can remember, but with my focus on Excy, I found myself diving in deeper than ever to the section titled: “Healthcare @ Digital Inflection Point.” The first slide breaks down the rapid changes in three simple images showcasing the evolution of healthcare being about physical touch 100 years ago, then about machine assisted devices 25 years ago, and now about technology-enabled digital devices and the data opportunities in wearables. With so much data coming in from these tech-enabled devices, the obvious evolution is using this data to generate healthy outcomes.

The report did a great job capturing some of the opportunities of this data in patient empowerment with solutions like Propeller or Livongo, ways to improve clinic pathways like Flatiron, and preventative health like Omada.

While all kinds of health monitors have been available for quite some time, such as heart rate bands or GPS watches, their adoption remained with sports enthusiasts. The digital health field was established when consumers began mass adoption of health/fitness mobile apps and new cheaper easier-to-use hardware. What I found missing in the report was the opportunity to capture and manage data across all three categories to understand how, when, and wear exercise can be prescribed in specific ways for disease prevention and management, as well as injury prevention and rehabilitation.

A great place to start this conversation is the rapid explosion of Peloton Interactive out of New York, which was not mentioned in the report, but has moved from a Kickstarter campaign four short years ago to a massive tech home cycling company now estimated to be worth over $1.25B. These guys walked in from outside the fitness industry, embraced live streaming and on-demand workouts and in four years are blowing past long standing companies like Nautilus ($850). Sure, Peloton built a great high quality device, but as it relates to data, they proved that there is an opportunity to place sensors on long-standing exercise equipment and create massive consumer adoption with immersive live content.

Peloton’s bike sensors collect data like revolutions per minute, speed, and distance, but also heart rate, which are displayed on a screen. Sure, right now it’s for personal use, to improve the live coaching experience and for a prime position in a leader board, but what if that data was captured in a disease specific way? What if when you created your Peloton user profile, you could opt-in to share a diagnosis if you had Type 1 or 2 diabetes, Parkinson’s, Alzheimer’s, MS, depression, obesity, heart disease, etc. What if that data could then be used to evaluate disease specific data sets, shared with experts, and preventative disease specific live exercise training modules created? I use Peloton for this example, but I’m talking about all exercise equipment similar in quality, whether it’s Peloton, your Precor treadmill, BowFlex Max, an Excy full body training system, or Biodex physical therapy equipment.

Live streaming and content is here to stay, which is why .LIVE is one of the fastest growing new domains being embraced by brands beyond the typical .COM. Surely the longstanding fitness companies like Nautilus will be trying to figure out how Peloton grew so quickly and how to match their content. My hope is that that the conversation doesn’t start with “How do we change our screens” or how do we create better hardware because Peloton is not winning because of their screen or hardware. They are winning because of create an immersive exercise experience based on data. But, what if across all exercise systems, there was an opportunity to create disease or illness specific immersive experiences? We could have live classes, games, and create new virtual realities with unique content created for Parkinson’s patients, MS, diabetes, etc.

As we go through Meeker’s report, some really cool things emerge:

1) Amazon Echo and Google’s Home are reaching human-level accuracy for word recognition. Imagine if all the health data pulled from our wearables and exercise systems were plugged into these systems for coaching in our homes backed by artificial intelligence. If the data can be captured and rated, then coaching could be offered up in very disease specific ways. The screen doesn’t matter. It could be a TV, a smartphone, or an immersive virtual reality experience. If the data is accurate, then the coaching can be too, especially if these systems can use artificial intelligence to listen and respond accordingly.

2) Meeker notes the huge growth opportunity in the gaming industry and again, Peloton has shown us that there is some interest for competition, but also young startups have also show us that there’s a significant opportunity for gaming as an engagement mechanism to help in areas like depression and anxiety. Litesprite, is a Seattle startup that has created a disease-specific immersive experience. Their mobile game, Sinasprite, teaches people evidence-based stress management methods and mindfulness strategies and allows them to reflect on their mood. This is not a competitive game with high stakes. Instead the experience creates a world to help bring more peace or emotional outlets to people when they need it.

3) The report called out that the cloud war to own consumer health data will grow, but how do we get the data into the right hands to ultimately help consumer’s exercise more and eat healthier to prevent disease. The brands called out as being positioned well for digital health included Google, Microsoft, Samsung, Apple, Amazon, Facebook, and IBM because consumers were more likely to share their health data with these companies.

This brings me back to the discussion about fitness players not starting conversations with the screen. Consumers are already addicted to their screen, but things like virtual reality and augmented reality and immersive live training is an absolute amazing place to start to think about innovation. Pokémon Go likely got more people off the couch than any official exercise program or screen last year. I would have loved to see fitness tracking data based on the user’s health history. Did it get Type 2 diabetics moving? Did it get those with heart disease moving? How amazing would that be to know? So, how do we capture disease specific insight into who is moving and how do we get them moving more for greater overall health. How do we think about starting challenges between people living with the same struggles and get them to inspire each other? We are taking the path of user generated live streams, but what are the opportunities for online and offline group challenges, support systems, etc.

With the technologies that will soon be readily available, we are building a world where patients as consumers can receive holistic care and address foundational issues of their disease. They will receive the similar care and support as elite athletes who already know that exercise data is key to their performance. It’s embarrassing that they already don’t!

We need to recognize the value of consumer-drive data behind re-thinking exercise in the real-world that helps improve disease, illness, and injury to improve overall quality of day life and drive down healthcare expenses worldwide. With future iterations, all this data can be uploaded to home-automation devices like Amazon’s Alexa who can step in and offer up personal coaching to eat the right foods or propose live streaming, gaming, or virtual reality exercise content based on the person’s critical health needs and even vitals.

Health systems are now building master dashboards that pull pharmacy, labs, mobile app, and consumer wearable data to provide clinicians a complete view of a patients’ physical health. They will be able to send advance notifications to patients to recommend physical activity to maintain behavioral and physical health. People will need different forms of motivation to get this exercise. For some it will be gaming platforms, for others home exercise equipment, for others in-home personal training and therapy, and a host of other alternatives. There are massive voice applications that will be built for home health. Hospitals are tinkering with Alexa apps for things like safety checklists, but their hands are often tied by the lack of HIPAA compliance. You know that if the data supports the move, Amazon will take it in home health and in the hospital, opening a huge opportunity deliver diseases specific fitness and routine medical information to patients at home.

According to the CDC, regular physical activity is one of the most important things you can do for your health. It can help reduce the risk of cardiovascular disease, reduce the risk of type 2 diabetes, reduce some cancers, and help you live longer. There’s a lot to learn from Peloton’s rapid growth and live streaming approach. There’s a lot of innovation taking in place in sports tech that can also find it’s way into the world of disease management and prevention. The opportunity to incorporate exercise into the conversation of digital health is so vast that it will require a lot of good intentions by the market leaders and bold collaboration. Also, a unique understanding that exercise is often the magic pill that people don’t want to take, but bold thinking just might bring about the necessary changes.