Google, Apple, Amazon — Who Will Win the Race for Med-tech?

Considering which of the ‘horsemen’ companies is the most likely to make a bid for healthcare-tech supremacy in the 2020s

If you’re at all familiar with the work of Scott Galloway, then you’re probably closely and passionately familiar with the work of Scott Galloway. Even if you’re not, and you have an interest in keeping generally abreast of developments in tech news, you may be on nodding terms with the ‘four horsemen’ idea. As Professor Galloway has it, in our time, the four horsemen we need to worry about are not (necessarily) named war, famine, pestilence and death. The horsemen we need to worry about are named Google, Apple, Amazon and Facebook.

Whether or not you have any discrete interest in developments in technology, you may also have heard that the 2020s will be a decade of medical technology, or med-tech. There are considerable grounds for belief that these two quantities will come to interact over the next ten years.

But who, then, of the big bad horsemen looks most likely to lead the charge when the scramble for med-tech begins? We threw the question around among the Wonk Bridge Newsroom, along with a couple of the Bridge’s good friends and collaborators, and thought through the possibilities. The group’s answers to the question “Who Will Win the Race for Med-tech?” were, predictably, extraordinarily broad and ranging.

Karin — Google

Karin Flieswasser is a Data Privacy expert and philosopher in all things AI and cyber based in Israël, and a long-time friend of Wonk Bridge. Her diverse experience working in China, Israel and the United States shines through her engagement with the Wonk Bridge community.

Google currently leads the pack in investment into artificial intelligence for human-centric purposes and organises its organisational structure to accomplish so. Its multitude divisions, subsidiaries and M&A portfolio have demonstrated so.

The most obvious point of reference is the acquisition of DeepMind, specifically, its dedication to developing high-quality AI for healthcare via new deep learning approaches which have proven promising to handle the problems found in the healthcare arena.

In its leadership orientation, Google Head of AI Jeff Dean — a legend in the field — has long stated his desire to break into the Healthcare space.

Besides the direct application of AI and machine-learning approaches to Healthcare, there are indirect ways in which Google can make an entry. Google has already played a major role in the Healthcare industry with coordination of the data scientist and healthcare professional community during the COVID-19 pandemic. Google Cloud Solutions and its affiliates (such as Kaggle) are leading the way in coordinating and connecting data and data science to solve some of healthcare’s toughest issues. I can expect Google to continue leading the way in preventing and managing public health issues such as epidemics and pandemics.

Yuji — Amazon

Yuji Develle is Wonk Bridge’s Co-Founder

Most of the population is getting older and this is placing a greater strain on healthcare systems. The Life Sciences and Healthcare industries are in dire need of solutions, to both manage the economics and logistics driving 21st century healthcare. Why is Amazon best placed to become the tech provider of choice for patients and other Healthcare industry stakeholders?

Amazon’s ecosystem is hospitable to many existing players in the Healthcare ecosystem. It provides a value-added to virtually every player. Big Pharma needs a data-broker to better target their products to consumer segments. Healthcare providers are looking for ways to lower the overall cost of drugs that affect the extent to which citizens can access life-saving medication. Patients (or customers) are looking for an easier and cheaper way to stay healthy. Pharmacies are ripe for disruption, as one of the last brick-and-mortar shops on the high-street that hasn’t reinvented itself for the online era. In fact, on that last note, the lack of digital delivery solution has forced many industrialised countries to keep Pharmacies open during the COVID-19 lockdowns. Amazon has proven competency in increasing product reach (for Pharmaceuticals) while simultaneously lowering costs to the end-user (for Patients), by radically improving the efficiency of the market (for Pharmacies and Healthcare providers).

Amazon has an unparalleled ability to track consumer behaviour and does so in a way that other Big Tech organisations do not. They can provide an immediate return on investment to customers through the discounts and bundled offerings of Amazon Prime. Furthermore, it has already launched a multi-suite Health & Wellbeing Insurance service called the “Employee Health Initiative” with the 1.2m employees of Amazon, Berkshire Hathaway and JP Morgan; This pilot is a laboratory for the kaleidoscopic vision of Amazon — cheaper healthy foods and gym discounts for those willing to subscribe to the pilot and receive an attractive suite of discounts/premiums.

Yes, it has suffered from privacy allegations similar to those of its Big Tech rivals, especially relative to its more “avant-garde” data-collecting (e.g. Alexa’s cough detection). However, in countries where purchasing-power keeps declining and where health insurance can be seen as a luxury, the choice is an easier one.

Amazon has a track record of using its wide-reach as a way to lighten the burden of high initial cost structures and regulatory complexity, to build cost-effective large-scale infrastructure. It’s done so in a big way in the Food Retail space, which requires costly same-day “fresh-produce delivery” as well as stringent food safety standards. The Food industry is very similar to the Pharmaceutical industry in these ways, and Amazon can benefit from its additional experience working with its regulators: the Food and Drug Administration.

Max — Apple

Max Gorynski is Wonk Bridge’s Head Digital Humanist and Co-Founder

At times, when considering questions like this, a slight excess of emphasis is placed on the infrastructural capabilities of the candidates, and not enough is placed on looking at the question from an end-user’s perspective. The horsemen-and-medtech question will, in my estimation, primarily be answered through consideration of the data handling involved in such an operation.

Worries about the indiscriminate usage of our private data by large companies constitutes, in the main, a new set of concerns native to the 2010s. We didn’t have a great deal to worry about, in that sense, before the Early Digital period. However, a kind of benignly paranoid protectiveness over the security of our private medical information predated this general concern about data privacy by an indefinite length of time. It has more or less always been understood that this health-related information is extraordinarily precious, and that it represents a deep ethical compromise for it to be handled carelessly or misused.

You’ll see these two complimentary public concerns hybridised in the instance that any of the horsemen makes a scramble towards a medtech hegemony — these companies have, to their varying respective extents, earned the distrust of the public.

Which of the four of them has the best reputation for handling data? Apple. They are the only one of these main candidates I can imagine being able to sustain that extremely fragile trust to the degree that will make large volumes of people feel comfortable handing over their private medical information to them. They already hold a good deal of ambient lifestyle information as regards their users. Furthermore, theirs will be a primarily hardware-oriented approach to a hypothetical med-tech rush.

People trust hardware. They can grasp its limits, or rather they nurse the prejudice that they can grasp said limits more easily. They trust software less.

Supriya — Apple

Supriya Rai, the Co-Founder of SwitcherooGlobal, is a newly connected friend of Wonk Bridge’s — she’ll shortly be appearing in the maiden installment of our “Portraits of Young Co-Founders” News Series — and we’re delighted to welcome her to our humble mess.

Apple and Google are very much into this space, and are either trying to acquire technologies or create technologies that might help them go further into the healthcare industry. While a company like Google has developed superior infrastructural ability in terms of machine learning, and with respect to having their own cloud and data pipelines, Apple is yet to catch up. General expectation (in the industry) is that Apple will come to provide healthcare solutions more effectively, probably using Google’s infrastructure.

Mainly, it’s the willingness to pay for healthcare solutions that people have with Apple that will make the difference. There’s research to back this up — I interviewed 267 people, asking this very question for my MSc thesis and looked at the patents filed by the different major players in the healthcare space. Even forgetting that research — if you think about a smartwatch or a wearable, for example, people automatically think of the Apple Watch. It’s not about who is accurately processing the data or picking up data — it’s about the perception of who is accurate. Then other differentiating factors are marketing and design; again data shows that Apple knows their consumers very well.

Dominic — Amazon

Dominic Jukes is Wonk Bridge’s Head of Business Operations.

When the term med-tech is discussed in relation to the 2020s, many people tend to think about how technologies such as AI or machine learning will play a pivotal role in transforming the healthcare industry in this decade. Personally, I believe that although these high-tech possibilities have an exciting long term future, the emphasis in the immediate future should actually be placed on lower-tech alternatives.

In the developing world, the key problems in healthcare can often still be traced back to the lack of adequate infrastructure. The FT recently highlighted how governments in low-income countries spent just $23 per person in 2016, compared to the $4,000 per person spent by the governments in OECD countries. As a result, the medical staff in developing countries find themselves constantly fighting an uphill battle due to this lack of investment in basic infrastructure.

Which is why I have chosen Amazon as the ‘horseman’ that I am willing to place my bet on for med-tech supremacy in the 2020s. Amazon is a company that has built its success on its ability to master logistics. It is a company specialised in getting products to consumers in remote locations around the world. Most importantly, it keeps making this supply chain better by improving coverage, reducing lead times and cutting costs. In the space of healthcare infrastructure, I see Amazon being able to use this advantage to help alleviate the problem of the enormous physical distances involved. A current factor that often prevents sick people from seeking the medical attention that they require.

Furthermore, Amazon’s experience and expertise in the cloud computing business enables the company to have a big impact on two other infrastructure areas that I see as crucial to healthcare. Namely the establishment of widespread telecommunication networks and the electronic record systems. Both of which are also currently in need of serious improvement in the developing world.

Nika — Facebook

Nika Mahnič is a long-time friend and collaborator of Wonk Bridge’s. Her professional affiliations include Danes Je Nov Dan, Grounded Festival in Ljubljana, and Aksioma.

With predictive analytics becoming ever more prominent in the health arena, I believe that Facebook stands a good chance to become one of the most important players in the med-tech field. Data gathered from Facebook can capture the social determinants of health which the World Health Organization defines as “the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.”

Facebook owns rich behavioural data that shows specifics and can construct granular digital profiles that other companies rarely have access to. In 2019 they unveiled the Preventive Health tool, they already employ a health research division and have demonstrated their interest for providing data from social networks which could be then combined with health records.

Jackson — Apple

Jackson Webster is Wonk Bridge’s America specialist, and is also the grizzled proprietor of Jackson’s Policy Corner at Wonk Bridge.

Health is a deeply personal matter. There’s a reason that medical confidentiality laws are considered among the most sacrosanct data protection regulations, in Europe and North America alike. People trust Apple, as do regulators. They do not trust Facebook. Despite having impressive brand affinity, consumers certainly do not associate Google nor Amazon explicitly with strong security and privacy records.

Apple has repeatedly used product design, business decisions, and even crisis management to demonstrate to consumers that it is intensely focused on privacy. The iPhone 10’s separate chip for FaceID makes it one of the most secure smartphones ever made. Following the 2015 San Bernardino attack, Apple CEO Tim Cook steered the company to take a very public position against the Obama FBI’s request that the company create a backdoor in their device encryption.

It is also the only of the Horsemen whose market logic is not based on a surveillance model. Despite having access to incredibly intimate, detailed data on millions of people, it chooses explicitly not to sell it. This isn’t borne out of some kind of altruism — corporations are amoral actors — but out of a business calculation. Apple understands that it is not a hardware company, rather, as Professor Galloway often points out, a luxury brand. Its margins are closer to Ferrari and LVMH than Dell or HP. Its marketing plays on consumers’ aesthetic sensibilities and sense of belonging to a socially-mobile, progressive creative class.

Medtech is and will continue to be reliant on individuals’ and institutions’ willingness to trust that their sensitive data will be secure and will not be sold for profit. Apple is the Horseman best positioned to win that trust.

Edward — None of the above

Edward Zhang, a.k.a ‘Beast’, is Wonk Bridge’s China specialist and its Marshall, in charge of building the outlet’s international network of collaborators and contributors

Why have I decided to turn to technologies in the East in particular China? The reasons are fundamentally twofold. Firstly, China over the last 30 years has undergone tremendous economic development from an agrarian state to a manufacturing beast with aims to become a technology powerhouse therefore exploring technology development in China is more important than ever. Secondly, in the West not enough attention is paid to technological advancements from China. I wish to bring this to light and raise awareness that the world is more than FAANG or the 4 Horseman.

Amidst the Coronavirus outbreak Chinese tech firms have accelerated their research efforts in the field of health-care technology in areas from cloud computing to artificial intelligence (AI). Leading tech firms: Alibaba, Tencent, Didi, Baidu and Huawei have all developed new health tech features aimed at diagnosing cases and finding a vaccine for the coronavirus.

Alibaba Medical Brain aims to solve the healthcare industry’s core issues by using advanced cloud computing and big data intelligence. Methods includes: healthcare management using analysis of clinical and hospital operation data, combined with medical quality standards, Alibaba Cloud’s intelligent algorithms increase the quality of medical records in turn reduces human error.

Baidu, China’s answer to Google, has also developed AI capabilities, it operates an online doctor consultation platform and the company has made that free for any online medical queries. Baidu said the platform has handled over 15 million inquiries from users and hosts over 100,000 doctors to answer questions.

Finally, Tencent in 2019 entered a strategic partnership with Elsevier to accelerate the dissemination of global health information in China. China’s medical development has undergone tremendous development in recent years it will only get better. The partnership aims to bring Chinese research on the medical field to global audiences and encouraging the exchange of global health and medical information.