Investing in Healthcare: Think Exponentially

For 21st Century Healthcare to be….well…21st Century Healthcare, we will need heavy-duty investing activity – and not just in terms of financial capital. We will need a kind of investment thinking which accounts not only for the exponential growth of technology but also for the corresponding ramifications of that growth.

Much of the venture ideas we hear about basically follow this template: We’ve identified this problem and have come up with this solution. Typically, this does work: there are static problems which basically need static solutions. For instance, if you want to decrease nosocomial wound complications, build a better device that’s safer, more effective and cheaper. No need to think too deeply about the variable of time: such a solution won’t necessarily be out-dated in 18 months.

For more complex and dynamic problems, however, whatever solutions that are currently viable may not be so viable in 18 months (or some other length of time in the future).

A good example would be EMR. By definition, these are technologies – specifically technologies which must meet multiple demands within multiple workflows across multiple platforms and so on. It would be economic insanity to build such systems for today. Why? Because the technology alone will be outdated in 18 months. In choosing to invest in EMR, you must think exponentially.

But, as I said earlier, investing in EMR doesn’t just involve thinking about technology and problems conceived as of today: it involves thinking about how the surrounding ecosystem (e.g. clinical collaboration culture, patient values on privacy permissions, etc.) can change exponentially.

Five or more years ago, it would be hard to imagine that patients would share as much health information online as they do today. The relative percentage of patients sharing select medical data openly may still be rather small today. …But: if the trend is extrapolated, what might the percentage be in another five years (or even less)?

What’s more, social features of EMR – at this point – are a must. Which is to say, any investing in EMR *must* account for the exponential increase in adoption of social, mobile and other technologies which will absolutely have to be embedded in the design of EMR. It would simply be either hardly feasible or expensive to add them later.

This, then, makes the problem of successful Healthcare investing especially difficult and…well…more risky. And therein lies the opportunity: risk is effectively a barrier to entry, so those innovators pregnant with either capital or risk-love stand to earn large returns. That’s only fair.

So investment decisions in Healthcare need to move away from a linear conception of time to an exponential conception of it.

This is why all those iphone Healthcare apps aren’t making too much of a ding by themselves. …But they do demonstrate one thing: tiny enhancements in productivity and information gathering can lead to big things.

That’s sort of the principle behind exponential curves – a tiny step to the right, a huge jump upward.

@PhilBaumann – @HealthIsSocial – Newsletter

0 Replies to “Investing in Healthcare: Think Exponentially”

  1. Investing in health care is not for the faint of heart. I’ve seen many of healthcare business plans over the past 10 years that would have died on the vine if funded due to regulatory risk, obsolescence, or ferocious competition.

    It’s a big crap shoot only meant for the keenest minds in investment.

  2. Phil, I’m catching up on comments today as you can tell.
    I’ve been thinking about this post quite a bit and, in a few recent conversations, paraphrasing you. I read this post on the heals of Ray Kurzweil’s Singularity in which Kerzweil builds on Moore’s law and suggests innovation will continue at exponential rates and there are some inevitabilities associated with that growth. The inevitability he is most concerned with is the point known as the Singularity where machines become indistinguishable from humans.

    Regardless of the esoteric details of his work and the supporting and refuting it, there are some similar ideas in your post. Kurzweil has a graph of innovation and technology with is a diagonal line across the XY axis – it is in fact not exponential, but rather logarithmic, with the idea being that each new advancement builds on the one before it.

    Two things that strike me from your post:

    1) there is some inevitability in all this – health IT (including EMRs) will continue to evolve because it must for a great many reasons. There is no reason to hold back on building systems capable of storing, processing and acting on discrete health data. I would argue we are in fact over due. It is entirely reasonable to predict a future of EMRs which interact directly with implanted devices and make autonomous decisions… the sky is the limit.

    2) the innovations will indeed be a diagonal line b/t time and technology and for some reason that is a really hard idea to digest. A quarterback knows to throw the ball ahead of the receiver – I’m not convinced we think the same way about technology decisions as an industry. Certainly, part of the reason is that the systems are still quite immature, despite how much they have advanced. It is hard to picture the future when so many health IT vendors clamored to catch up to MU guidelines (rather than predicting them).

    Great post – really thought provoking!

    1. There are quite a few “laws” which (at least conceptually, if not mathematically accurately) work into what we’re discussing here. Four are

      Moore’s Law – The processing power of a microchip doubles every 18 months.

      Metcalfe’s Law – The value of a network is proportional to the square of the number of nodes; so, as a network grows, the value of being connected to it grows exponentially, while the cost per user remains the same or even reduces.

      Gilder’s Law – The total bandwidth of communication systems triples every 12 months.

      McGuire’s Law (Law of Mobility) – Mobility exponentially
      increases the value of any product. – (pdf)

      When you factor the last of these – the Law of Mobility – we can see how all four can powerfully influence the overall progress of technology – or the gap in it.

      So, if the tech is dolled out appropriately with some forethought, and as health becomes increasingly mobilized, the value of EMR and other products will dramatically increase.

      Cool stuff, huh? 🙂

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