By Stephanie Tilenius, an executive in residence at Kleiner Perkins Caufield & Byers.
With a big assist from technology, Americans are driving a major transformation of the nation’s health care system. Recent years have brought us the passage of the Affordable Care Act, technology advances in sensors and devices, cheaper personal genomics, and the growth of the mobile app market–and all these things are empowering consumers to take control and become CEOs of their own health.
The rapid adoption of connected mobile devices is enabling the shift from a sickcare nation to a preventative care nation – with big potential savings at stake. I believe health insurers before long will cut premiums for consumers who exercise and have a healthy diet, just as they discount auto insurance rate for safe drivers.
This monumental shift in the way Americans approach health care comes just in the nick of time: as a nation, we badly need a kick in the behind. More than two-thirds of American adults are now overweight or obese. According to one forecast, by 2020 more than half of us will be pre-diabetic or diabetic, creating a $500 billion annual drag on the economy.
But solutions are coming. And it starts with your mobile phone.
Apps And Wearables
Let’s take a closer look at the front lines of this coming consumer health revolution.
- By 2017, according to Research and Markets, half of the 3.4 billion smartphone or tablet users worldwide will use mobile health apps.
- I expect that by 2017, at least 30% of American consumers will regularly wear a device to track sleep, food, exercise, heart rate, blood pressure and even glucose passively and non-invasively.
- By 2017, according to ABI, the global market for wearables in health and fitness alone could reach 170 million devices.
Hopefully we will see the emergence of a few killer healthcare apps that get critical mass, meaning they will have more than 60 million users and 20 million monthly active users, similar to popular consumer apps like Spotify and Evernote. There is an epic battle for the wrist with Apple and Samsung entering the market. Apple Insider estimates that the Apple iWatch will sell 63 million units in the first year. If Apple includes health and fitness sensors, this will turbocharge the market.
Personalized and Mobile Medicine
Before long, all of those devices will be sending real-time data about you to your doctors, nutritionists and trainers. Subjective medical findings will be bolstered by cold, hard stats on the continuous state of your health. In short, we’re headed for a world of truly personalized medicine, practiced from a central hub in the cloud.
In the not-to-distant future, we will talk to our doctors more often via a mobile phone than in an office, saving time for patients and doctors alike. The result will be a more efficient system: By some estimates, 25-30% of today’s doctor visits could be replaced by phone, text, and digital check-ins.
Today, mobile apps are already solving health problems and providing personalized advice and communities. It is early days but you can see the potential. Here are some examples:
- HealthTap is creating a mobile “triage” system, where consumers can ask doctors questions and find out the most effective way to get specific care.
- Diabetic? Welldoc recently rolled out BlueStar, a doctor-prescribed app that offers coaching.
- Have asthma? Try the Asthmapolis sensor which passively logs your data via Bluetooth LE and gives you personalized feedback and education on how to control your asthma.
- Having trouble getting pregnant? Glow will help you track your cycle and tell you the exact best time and how to get pregnant increasing your odds of success.
- Kaiser Permanente has a great mobile app for its members to store all their health records, make appointments, email with their doctors, view test results, and fill prescriptions. More than 4 million of Kaiser’s 9 million members are online.
- MyFitnessPal is teaching consumers a new way to track their nutritional intake and lose weight. Personal trainers will tell you nutrition is 80% of the battle in maintaining a healthy lifestyle that can ward off diabetes, heart disease – even cancer. (Disclosure: I worked on the Kleiner Perkins investment in MyFitnessPal and am a personal investor in the company.)
- There are a growing number of wearable devices out there including Fitbit, Jawbone UP, Nike Fuel, Misfit Shine, all of which use a 3-axis accelerometer to track your overall activity and guesstimate calorie burn. They also analyze your sleep patterns. More than 8 million of these devices will be sold in 2013, however today’s devices are just the beginning, we will see a much greater level of accuracy with heart rate and other biometrics included in future versions.
The core of the digital healthcare revolution will be day-to-day tracking of personal stats, also known as the quantified self. Many companies are trying to be this central health and fitness hub, including insurance companies like Aetna’s CarePass.
For example, I use MyFitnessPal to log my food and exercise. MyFitnessPal has over 40 million users and probably the largest global canonical database for food and exercise anywhere. MyFitnessPal rolled out their open API to connect to apps and devices earlier this year. I connect it to my Withings Scale, my Jawbone UP, and other apps like RunKeeper. My RunKeeper stats automatically sync in MyFitnessPal daily log along with my total activity for the day passively logged via an API integration with my Jawbone UP. MyFitnessPal monitors my weight goals and keeps me from overindulging and connects me to friends that keep me motivated.
Gamification will saturate fitness apps and devices, enticing teams of friends or coworkers to compete for points or trophies. You are seeing the beginnings of this movement on Fitocracy and at corporations like Yahoo, where CEO Marissa Mayer challenged her employees to a contest for the most miles walked. Strava members are addicted to getting to the top of the leaderboard for cycling and running and are willing to pay a monthly subscription to compete.
I was checking in at the airport security line the other day. The agent looking at my ID was wearing a Nike Fuel band. He was excited to tell me he had reached 1 million Fuel points and lost over 30 pounds. That’s what a little fun can do for your waistline.
Impressive as they are, today’s apps and devices are only scratching the surface of this consumerized health and fitness movement. It is early days and very few of these apps have more than 20 million users (with the exception of MyFitnessPal and RunKeeper), it is still a very fragmented market with point solutions. These apps will evolve dramatically in the coming years to offer more accuracy, analysis, insights and advice to consumers on a global scale, leveraging data across patient populations. We will be fully empowered and accountable, receiving instant gratification from our healthy lifestyle and instant care via mobile medicine.
The quantified-self movement will evolve from its geeky roots to a more humanized solution as we use data to provide personalized recommendations for behavior change and connect people to supportive communities of patients, doctors and coaches. The human element is required for fundamental social change, people need to be held accountable and they need emotional support. Vinod Khosla has shared his somewhat controversial view that algorithms will replace 80% of doctors. However, I think you will see a blended model with some automated intelligence as well as the ability to connect to the best specialists right from your phone with your biometrics, genomic data and lab results instantly shared. The business models will also evolve to include premium services as well as marketplace models, connecting consumers to experts and services, driving real change and real revenue. We are seeing the beginnings of a real consumer movement that will make us healthier and reduce healthcare costs.
Stephanie Tilenius joined Kleiner Perkins Caufield & Byers as an executive in residence in 2012 and works primarily with its late-stage portfolio companies. Previously, she was vice president of global commerce and payments at Google and senior vice president of eBay.com and global product. Stephanie was a co-founder of PlanetRx.com and she has worked at Intel, AOL, Firefly and Alex. Brown. She currently serves on the board of Coach, Inc. and IronPlanet.com, and is the Chair of the CA Harvard Business School Research Center. She holds a BA and MA from Brandeis University, as well as an MBA from Harvard.