FAMGA Bet On Healthcare: But Where Do They Go?

Published in

The Startup

9 min readApr 22, 2019

Got the sniffles? Chances are you’ll search the web for advice before consulting your doc. If it turns out you do end up in a waiting room for a diagnosis, scrolling on your phone will pass the time. These are small examples of how technology has primed us to demand efficiency and value. You might even say technology has set to disrupt healthcare since it entered our lives. This priming isn’t unreciprocated. FAMGA — Facebook, Amazon, Microsoft, Google, and Amazon have been making strides to shake up healthcare. Their efforts are even more impressive efforts in recent years. Along with other big tech companies, they’re primed to step up further.

The rise of FAMGA is the result of strategy. This formula is different for each player, but generally, it means some blend of:

● Building internal capabilities

● Acquiring companies to enlarge their portfolio of services and products.

● Investing in companies directly or through their venture arm.

Since 2012, FAMGA has played an interesting role in the healthcare sector. They’ve been able to take part in at least 209 healthcare financing deals and spent more than $4.7 billion on an average of 25 healthcare acquisitions. In 2018 alone, big tech managed to participate in 27 funding rounds around the world and aimed for 41 funding rounds by the end of the year.

The most interesting question is: where do all these investments land now? Because by knowing where FAMGA and big tech are placing their bets, the most pivotal topics of healthcare present and future emerge. Within these areas are likely advancements within the system, benefiting patients and physicians.

Take these categories with a spoonful of sugar due to the emergence of new categories — hello, software as a medical device — and evolution within sectors.

Big Data and AI In Healthcare Bring Value-Based Care

If big tech is going to shake things up and improve healthcare, it needs to build a fresh foundation. This means new infrastructure mainstays, like artificial intelligence (AI) to improve efficiency. But AI algorithms and other heavy streams of healthcare data need a home. Enter big data and blockchain systems for security and accessibility. This is showing up in several ways throughout sectors.

Blockchain in Healthcare — We’re Set

Consider blockchain a dependable friend on hold. It’s being developed and tested in other industries such as banking, at the ready to grow along with electronic healthcare records (EHR). Reflecting this, Apple two years after their acquisition of Gliimpse to extract the AI health data platform’s capability to put data control in the hands of patients. Now known as Health Records, it’s beta run is gaining traction with a short but growing list of providers.

Facebook sees the potential for data from their 2.3 billion monthly active users to improve healthcare globally. The vision is to match Facebook profile information with patient data to help providers create care plans. Of course, blockchain would need to be in place for this data to be secure. Facebook reached out to hospitals and organizations, but this effort seems to be on hold. Instead, there are clues they’re laying the groundwork with an in-house Blockchain team. Their data scientist job listing expresses their goal of helping billions of people gain access to things they don’t have now — including healthcare.

AI in Healthcare is On High

AI is coming in hot. Here’s where FAMGA bets are settling and what they look like in action.

● Google DeepMind has proven 94% accuracy in eye disease detection — that’s equal to the accuracy of the world’s leading doctors. The current testing process for eye disease requires a scan, then analysis. Time to complete this process can mean the loss of sight in some patients. DeepMind not only detects the presence of disease in seconds but determines the need for urgent intervention.

● Google Ventures’ wager on Owkin contributes to cancer centers and pharmaceutical companies in the US and Europe. Their AI algorithms and “proprietary privacy-preserving transfer” of data. Owkin is working toward advancement in biomarker pattern recognition, drug design, clinical trials, and patient treatment plans.

● Facebook Artificial Intelligence Research (FAIR) has contributed efforts to MRI imaging, making the technology faster and accessible to more people. FAIR has also innovated AI suicide prevention by analyzing user content for patterns that indicate distress, then alerting a response team. Facebook has reported this allows them to alert authorities twice as quickly.

● Apple created ResearchKit and CareKit to allow data collection from apps. The apps use AI to document and report data to clinical trials. This is an improvement in the traditional clinical trial model which was inefficient for the research team and the patient. More efficient trials mean more solutions, faster.

● Amazon is now expanding its expertise toward new horizons. The Alexa ecosystem, which connects people with the devices around them, is anticipated to be used in healthcare. Voice recognition software and applications are becoming popular in hospitals and clinical settings. Alexa would be a likely hit in the industry.

● GE Ventures contributed to HealthReveal. Their mission: “Save lives and reduce costs through practical applications of AI and machine learning for the chronically ill.” Utilizing data from patient records, wearables, and medical devices, HealthReveal is able to provide real-time updates and risk assessment to patients and their care team. This means more accurate monitoring of outpatient care.

Pharmaceuticals and Biotechnology

PillPack Delivers Medications By Mail and Uncertainty

Amazon has a track record disrupting how we shop for apparel, home goods, and even groceries. It should come as no surprise that Amazon is applying its convenience factor to prescription medications. Predictions of how Amazon’s acquisition of online pharmacy service PillPack will affect the market range from complete disruption to minor shake-up. Though drugstores have already caught on to the demand for delivery, Amazon is poised to dominate with a seamless process for the consumer. This could sway the market to take advantage of home delivery.

Drug Development and Biotechnology Refresh

Before drugs reach the consumer, they have to be formulated, tested and approved. Or, in the case of biotechnology, discovered and approved. Google Ventures (GV) and IBM Watson Group are the key players in drug development and biotech. Both GV and IBM ventures lean into cancer therapy. Backed by GV, Arcus Bioscience and Forty Seven are developing cancer immunotherapies. IBM invested in Petra Pharma’s mission to develop cancer-fighting drugs. Antibiotic resistance is also an area of interest with GV contributing to Spero Therapeutics and IBM to Lodo Therapeutics. Spero Therapeutics is focusing on multi-drug resistant (MDR) bacterial infection treatment. Lodo Therapeutics analyzes soil samples to derive therapies from nature to fight cancer and MDR bacterial infections.

There is potential for a streamlined process and collaboration to create a more savory investment market for drug discovery and development. This bottom line would end funding hold-ups for research and development. More efficiency in drug development ultimately serves the public interest.

Testing and Disease Diagnostics In for the Haul

GE, Google, and Amazon all have their hands in the genomics testing and diagnostics pot. Human Longevity (GE) boasts the largest database of human genomic and phenomic profiles. Genetic testing is a key tool in research to increase lifespan and fight age-related disease at Calico Labs, co-founded by Google. GRAIL (Amazon) is working to collect enough data to develop blood tests that detect cancer early.

AI is assisting testing and diagnostics research to bring answers closer. Even with this edge, considerable disruption might take awhile. Data banks need to grow grow, studies must advance and cost-efficient models need to be developed. Still, increased lifespan and improved cancer screening are worthy motivators.

Healthcare Delivery

The most tangible examples of value-based care for consumers and providers alike is care delivery through devices, software, and insurance. Do remember data and security are on everyone’s minds, making blockchain the hype guard in this arena.

Software As A Medical Device (SaMD)

Leave it to Apple to bring shiny new toys to the healthcare market. Thanks to new FDA breakthrough designations, the Apple Watch 4 has approval as a breakthrough device. This creates a platform for more SaMD to land on the Apple Watch with apps that tap into its capabilities. The Apple Watch 4 boasts optical and electronic sensors that allow for heart monitoring plus constant fall detection. This gives the patient and physician an improved database for treatment decisions. The EpiWatch app, developed by Johns Hopkins University, also uses the sensors for their seizure detection study. The watch is set to replace stand-alone devices, though it’s ECG capabilities are the first of their kind for consumer use.

With software offering solutions, the need for devices is reduced but not eliminated. Verily Life Sciences, a research organization owned by Google’s parent company Alphabet, funds a variety of medical device and device supporting developers. Some of these are clear disruptors such as digital surgery platform innovators Verb Surgical. Other Verily backed devices fill a gap. Lift Labs is making eating easier for those with neurodegenerative hand tremors with a swiveling spoon.

Verily is also investing in sensor development. They’re behind Dexcom’s miniaturized CBG monitor for those with Type 2 diabetes. Wearable sensors have been invading the diabetic management space since their 1999 FDA approval. Microsoft Ventures joined the digital therapeutics movement in 2012 when they invested in Livongo Health, a combination device and coaching platform for diabetes management. Livongo now boasts measurable reductions in the cost of care along with patient’s hemoglobin A1C levels.

Other notable tech-funded device deliverables include:

● Apple-owned Beddit’s sleep monitor device.

● ViSi Mobile System In-patient vital sign monitoring devices, developed by Sotera Wireless, contributed to by Intel Capital.

● Owlet Baby Care’s baby monitoring devices, funded by Amazon with plans to integrate into Alexa.

Affordable Health Insurance — Really

The term insurance poor has taken on a whole new meaning in the US in recent years, making solutions offered by Google Venture funded Oscar Health and Clover Health welcome newcomers on the market. Clover Health enters as a Medicare Advantage PPO. Oscar Health emphasizes telemedicine to reduce cost. These insurance trailblazers are answering cries for pricing transparency and care convenience while providing stability for providers.

Still quite mysterious, Haven is a looming example of care delivery disruption. Amazon, Berkshire Hathaway, and JPMorgan Chase are behind this new healthcare venture. They aim to simplify insurance, improve care access and make prescriptions more affordable. Initially, Haven will serve 1.2 million employees of Amazon, Berkshire, and JPMorgan, though it later plans “to share our innovations and solutions to help others.”

FAMGA Employee Healthcare

It’s unclear whether Amazon’s new primary care clinics for Seattle employees will be an element of Haven, but the clinics mirror a growing trend. Thirty-three percent of companies with 5,000 or more employees offer on-site medical clinics.

In-house care is possible through two avenues. The first is for employers to contract directly with providers. Silicon Valley embraced this option by contracting with start-up Crossover Health. Crossover provides Facebook, Google and Apple employees with medical and holistic wellness services.

Option two is observed in the AC Wellness Network, which emerged as Apple minimized their contract with Crossover. AC Wellness is a subsidiary of Apple and “an independent medical practice”. Sources to CNBC expressed that AC Wellness will use its clinics to test products and services before launching them into the market. It appears innovation has a new playground.

So What?

Clearly, big tech is in healthcare to stay. They’ve entered fiercely in areas where they can play to their strengths. This is seen in Amazon’s foray into prescription delivery and Apple’s ability to make great moves under our fingertips. Even the Alphabet umbrella of investors bets in drug development, diagnostics and insurance mimic the breadth of Google’s entity.

These investments breathe new life into stale healthcare systems around the world. As solutions develop, new opportunities arise for startups and investors. Meanwhile, the bottom line of value-based care is a win for patients.