Even before the global pandemic, 2020 was poised to be a year of great change in the worlds of consumer and clinical health – in fact, the two are continually blending further into a single system of health and wellness in which consumers continue to take more dominant roles in driving decisions about their care. The urgency with which many consumers sought to avoid becoming infected with the COVID-19 virus was a boon for preventative solutions, from hand-washing reminders to contact tracing and management software. The pandemic also shifted consumer and regulator appetites for remote and digitally enabled solutions. Teladoc's acquisition of Livongo for $18 billion paints the consolidation underway in the telehealth space in sharp relief, and clients should expect telehealth solutions to continue to consolidate.
With most of the developed world isolated in individual homes and lacking social interaction, mental health and personalized care were key focus areas for 2020 as well, with big leaps forward in each of three major areas: diagnostics made better by digital business models, digital therapeutics, and digital biomarkers. The year was a significant foundation-building phase for the development of clinical decision-making tools based on data gathered remotely. We expect groundbreaking commercial successes to follow in the coming years, but in 2020, the biggest progress made was in developing devices to gather or capture the data needed to build or deliver these digital solutions. Companies from across the health spectrum should be working actively here, one key strategy being working with digitally savvy partners to identify the data streams you already have access to in order to quickly and efficiently build the digital biomarkers that will be most useful for your business.
Reflecting on 2020, we take a look back at some of the most important developments that occurred in the evolution of prevention and personalization in health:
- The Singapore government rolled out a contact tracing app that rapidly identifies and prevents further community spread of COVID-19, and Apple and Google partnered for a COVID-19 contact tracing app. Contact tracing apps for COVID-19 change consumer relationships with personal healthcare data, privacy, and public health. While the tools didn't receive the hoped-for traction, they set the groundwork for consumers to begin to understand what these digital tools can deliver.
- The Swiss Federal Institute of Technology Lausanne is developing a digital biomarker for COVID-19 based on cough sounds. The Embedded Systems Laboratory is developing a digital biomarker to be used for the diagnosis of COVID-19 based on cough sounds collected from a smartphone speaker. Cough sounds have long been used in diagnosing respiratory diseases, and more recently, the use of computer vision coupled with sensors in mobile devices has allowed for the development of digital endpoints for clinical trials. Clients should be looking to invest in this technology as an accompaniment to current digital health offerings like wearables, digital therapeutics, and telehealth services.
- Teladoc Health acquired Livongo Health for $18.5 billion. This is an enormous deal in terms of both money and the market context of telehealth. It brings juggernaut digital therapeutic Livongo Health into the fold of Teladoc, critically augmenting the more traditional video conferencing approach where Teladoc has been a market leader with remote monitoring and mHealth capabilities. The acquisition all but ensures Teladoc Health's primacy in the telehealth space.
- U.S. regulators proposed making telehealth expansion rules permanent but will not reimburse providers. There are two potential consequences from the decision not to reimburse: 1) Telehealth use by providers will drop precipitously, and 2) costs will be put on the consumer directly, which will either cause current advancements to fizzle or drive the creation of a more price-sensitive market. A lack of reimbursement stymies growth, but reimbursement parity with in-person visits undermines the promise of reduced healthcare costs.
- Amwell filed for IPO, and Google invested $100 million; it will need to invest in remote monitoring to succeed. This move by telehealth company Amwell (formerly American Well) is riding a wave of unprecedented legislative and funding support for telehealth, but clients should be aware that the company is predominantly focused on video conferencing software despite last year's launch of a hospital-based remote patient monitoring cart. Google is likely seeing Amwell as a strong player as one of the three biggest telehealth companies in the U.S., but it should be wary. In order to survive against competitors, Amwell will need a consumer-facing remote monitoring solution to compete with rival Teladoc.
- Fitbit declares wearers "ready for work" with a symptom checker and vital signs data. The vital signs monitoring is of particular interest because early evidence suggests that changes in heart rate variability and sleep may indicate an oncoming immune response due to a viral pathogen. Any digital biomarkers used to make recommendations are either from an earlier study based on the flu or are extremely preliminary data, without the scientific review necessary to make recommendations yet, laying foundations for future stand-alone predictive solutions.
- The U.S. National Basketball Association used Oura rings to monitor for COVID-19. Oura is using its vital signs monitoring capabilities to identify digital biomarkers that indicate the likelihood that a player has COVID-19 and make recommendations as to whether the player can work. While this approach needed to be backed up with clinical diagnostic testing, it is a step in the direction of a truly preventative, digitally enabled solution for remote health monitoring.
- Health & Her launched a fully integrated digital symptom management platform for the menopause supplement marketplace. The use of a digitally integrated platform to help women select, purchase, and use supplements to combat common menopause symptoms is a powerful way to foster stickiness in a product line. By integrating a digital experience, the company is supporting the customer as a "trusted partner" rather than just a "marketplace" and is collecting a significant amount of user data to further refine supplement offerings; this last aspect is the most important for success in monetizing digital solutions.
Additionally, the Lux Agrifood and Health team curated the following "Analysts' Choice" for further reading on the evolution of prevention & personalization in health:
- "What are digital biomarkers?" It is worth noting that digital biomarkers get defined not via the act of how the data is collected (which does not intrinsically add more or less value to a biomarker) but rather through the key differentiator of the act of analyzing the data streams to extract novel insights. As one of the most prominent thematic areas in the ongoing evolution of health and wellness, all companies should be actively monitoring the space and planning engagement.
- "Innovation Digest: The Lux Take on the Future of Digital Biomarkers." In addition to being educated on the nature of digital biomarkers, companies need to strategize on the future of this technology area. This report explores the readiness of digital biomarkers for entry to market, identifying opportunities in this space.
- "Innovating Healthcare: Surprising Business Opportunities in a Rapidly Aging Global Population." Virtually every country in the world is experiencing growth in the number and proportion of older persons in its population. This webinar provides actionable recommendations for capitalizing on aging-related trends and highlights areas of opportunity across industries in a market that is only growing along with disposable income as more and more individuals advance into their golden years.
- Getting back to work post-COVID-19. As the world heads toward 2021, eyes are turning to the future and to moving beyond the COVID-adapted temporary situations many organizations have been operating within. Understanding how to use technology to help your teams get back online and potentially get back to in-person operations will be critical. Please also read this update to the full report.
This blog is part of the Lux Agrifood and Health Team's Year in Review series examining the highlights and key developments of the energy industry in 2020. For an overview of the other storylines in Emerging Ecosystem of Agrifood and Health program, be sure to subscribe to our agrifood newsletter.