The Longevity

Want to Test Your Digital Health Product? Perhaps Consider Dubai

In the last year or two, says Forbes contributing writer Suparna Dutt D'Cunha, Dubai has become a hotbed for digital health innovation, boasting not only the entrepreneurs and capital necessary but also the infrastructure.

“The digital health startup scene has gained immense momentum in Dubai over the past year, as the city’s vision and drive towards innovation is creating interest in both the public and private sector to explore new technologies,” says Roland Daher, head of health tech accelerator Dubai 100.

Last month, aiming to be the next FitBit, young health tech startups from China, Germany, Nigeria, Singapore, the U.K. and U.S. pitched their tech-driven solutions to investors and industry leaders, as part of the Dubai 100 program.

The unique features of the wealthy, international city make it especially suited for testing out new products.

To transform the way patients seek medical help, global digital health entrepreneurs are leveraging Dubai as a “test bed” to validate new concepts and futuristic technologies, says Daher. “It is partly due to the multicultural industry here, combined with a culture of embracing new ideas and a will to make ‘the impossible possible’.”

Over the past 18 months, drawing on the collective expertise of leaders and investors in healthcare, Dubai 100 and Dubai Future Accelerators (DFA) have been facilitating this access to validations and connections, adding to the growing momentum of digital health industry in the UAE.

“I recently sat with the founder of an innovative motion detection company for digital rehab, taking part in the DFA program. In less than two months, he had the opportunity to secure a pilot covering hundreds of patients with the Dubai Health Authority (DHA),” says Daher. DFA invites entrepreneurs from around the world to submit proposals on cutting edge products or new technologies, and the winners are then flown to Dubai and given access to state-of-the-art prototyping labs and engagement with the government leaders.

Dubai has leapfrogged its way to some of the most technologically connected healthcare in the world.

No wonder then that the UAE’s healthcare sector is expected to grow over $28 billion in 2021. In 2016, UAE came out on top of Philips’ Future Health Index report, which measures accessibility and integration of healthcare systems and the adoption of connected healthcare.

Over a dozen health tech innovations have been implemented in the country. For instance, the UAE uses the Wareed system in the public hospitals and clinics, providing advanced integrated administrative and clinical systems. In Dubai, DHA has digitized health records, launched a number of apps to connect people to healthcare, including Tummy Fish to encourage children to drink water, and will soon implement a robotic dispensing system to reduce the public's waiting period to receive medicines.

In addition to attracting foreign startups, UAE is also fostering an innovation community of its own.

"There are many homegrown and regional startups such as Altibbi and HeyDoc, both focusing on telemedicine, and Ver2, which is disrupting medical education in emerging markets."

Based in Dubai, health tech startup AlemHealth enables physicians to collaborate across borders ensuring patients receive world-class care at reasonable prices.

New Brunswick Launches Canada’s First Innovation Hub to Support Tech Solutions for Aging

The Canadian province of New Brunswick recently launched the country's first innovation hub focused on tech solutions for the aging.

The New Brunswick Health Research Foundation (NBHRF), in collaboration with the AGE–WELL Network of Centres of Excellence (NCE), is launching Advancing Policies and Practices in Technology and Aging (APPTA), an innovation hub dedicated to building tech that supports healthy aging.

AGE-WELL NCE said the APPTA hub, which officially opened on May 16 in Fredericton, will focus mainly on developing technologies and solutions for policy, program, and service challenges in the field of technology and aging. The hub is meant to allow Canadians to benefit from emerging technologies that foster independent living and improve the quality of life for aging adults.

The goal is to help entrepreneurs get to market with their products and services designed to support healthy aging.

Lisa Harris, New Brunswick’s minister of seniors and long-term care [said], “We are delighted to be the host province for a hub that will be a national resource for policymakers, researchers, clinicians, and others working to implement novel technologies that will improve the health and wellbeing of older Canadians and their caregivers.”

The APPTA hub will help entrepreneurs take their ideas to market by connecting them to end users, policymakers, and service providers. AGE-WELL NCE said it will also bring training opportunities for graduate students and post-doctoral fellows from the field of technology and aging. AGE-WELL and NBHRF will jointly fund the salaries of four individuals annually.

“This hub will promote knowledge-sharing and effective transfer of needed technologies right across Canada," [said] Bruno Battistini, president, CEO, and scientific director of NBHRF and a co-sponsor of the hub.

Pew Study: Tech Adoption Among Older Adults is Skyrocketing

Axios' Sara Fischer summarized some of the key findings of the Pew Research Center's latest survey.

Over 40% of American adults ages 65+ own a smartphone, more than double the amount since 2013, according to the latest survey from Pew Research Center. At the same time, more than two-thirds of seniors use the internet — a 55% increase from 2000. And for the first time, half of seniors have broadband at home.

These skyrocketing numbers do not seem to mean seniors feel comfortable or connected to their increased technology use.

[S]eniors still report feeling disconnected from the internet and digital culture. The study also found that roughly one-third of older internet users say they have little to no confidence in their ability to use electronic devices to perform online tasks, and roughly half of seniors say they usually need someone else to set up a new electronic device for them or show them how to use it. As more aspects of daily life become dependent on technology, particularly health care, senior adoption of new technologies will become increasingly important. 

The study also found that broadband access [varied widely and] was dependent on household income and education levels.

One Year After Launch, Israeli Digital Health Incubator has First Portfolio Company

A year ago, at MedCity INVEST, their national healthcare investing conference, eHealth ventures announced that it had secured a tender from the Office of the Chief Scientist in Israel to run a digital health incubator. Now, the incubator has invested in its first portfolio business.

Tom Sudow, director of business development with Cleveland Clinic Innovations, which is a partner in the fund...gave an update on the venture in a phone interview with MedCity News.

TikTalk2Me is a digital health company taking on speech therapy. Its approach combines gaming with speech therapy and voice recognition technology, according to a brief description of the business emailed by Sudow.

The Israeli incubator is also reviewing two more companies for investment, following their selection in its startup competition.

Pending a due diligence review, it is considering a company focused on food allergies and another with a connected cap for insulin pens.

AllerGuard is an early stage company that claims it is developing a matchbox-sized personal allergen hazard sensor to help people with strong food allergies. It can detect the chemical properties of the allergy-inducing compounds and alert users, according to a description of the company on the F6S website.

Insulog is developing a connected insulin pen cap for disposable insulin pens to support adherence. It is designed to detect and count the insulin units injected and enable that information to be tracked by users.

These tenders from the Office of the Chief Scientist, which last eight years, have sparked some other interesting collaborations in digital health.

In 2015, Medtronic and IBM won a grant to set up a digital medicine incubator in Haifa with Pitango Venture Capital and Rambam Hospital. Although it was initially called Health 02, it launched last year as MindUp. The digital health incubator has one portfolio company to date — Hemonitor Medical. The company develops an autonomous, continuous, non-invasive ultrasound device for patient monitoring, according to MindUp’s website.

Johnson & Johnson opened a biotech accelerator with OrbiMed Israel and Takeda Pharmaceuticals called FutuRx and has built a portfolio of nine companies spanning pre-clinical treatments for cancer to Orphan diseases such as Wiskott-Aldrich syndrome and X-linked thrombocytopenia.

Teva and Philips’ Sanara Ventures has six companies in its portfolio such as home monitoring business spirCare and telehealth business My HomeDoc.

With a goal of making Israeli companies competitive in the U.S. market, the incubators all follow the same structure dictated by the grant.

As part of the program, incubators are given budgets ranging from $500,000 to $800,000 and 85 percent of that comes from the government through a grant — the rest is financed by the incubators. Each early stage company in the program pays the government 3 percent to 5 percent of royalties from the revenue they generate until the full amount of the grant, including interest, is repaid, according to a website for the program.

Forbes Speculates on How People 50+ Will Live in the Future

PBS' Next Avenue, a service journalism project dedicated the 50+ consumer, recently turned five, and in honor of that birthday, they decided to look at the future of aging in America--and make some predictions. Contributing writer Shayla Stern's piece--posted by Forbes--focused on elements of "living" for the 50+. Not surprisingly, technology plays a large role in her vision.

The future of the way people 50 and older live and learn will be increasingly more connected and networked — social networks, cloud-based networks and actual real-live human networks.

For this article, we reached out to leaders and creative thinkers in areas covered in our Living & Learning channel to predict and imagine how we will live and learn in five years, 10 years and way, way down the road — the Jetsons prediction, as we've been calling it internally.

The Five Year Prediction: More Pervasive Home Automation

Scott Moody is the CEO and founder of K4Connect, a tech company that serves older adults and people with disabilities through software platforms that integrate devices, systems and applications into a single system that can work together and be managed as one form of application. Moody believes that in five years there will be a more seamless approach to accessing apps and managing household items — something we currently think about as the “Internet of Things” (IoT), or home automation.

“We’ve seen all these new ideas, products and applications coming out, but look: You can’t put 50,000 apps on your device and live a good life,” he said. "A lot of people talk about IoT and home automation, but it hasn’t really been successful.”

This is because the Internet of Things is not simple enough to use now. Companies like Moody's are working to overcome this.

So what does a "more ideal" smart home look like?

In a perfect IoT system, an older person could stand up in the middle of the night and a light would automatically turn on and potentially prevent a fall. Or if the person missed taking a medication, an alert would come over his or her in-house stereo system. Moody's company is working to assure that doorbells, door locks, motion sensors, streaming music, blood pressure monitors and pill reminders, as well as video chat and photo sharing, are automated through a central platform that can be controlled by a user’s smartphone or tablet.

Will this revolution really happen in the next five years?

[It] is “definitely coming,” [Moody] said, “but is it a few years? Is it five? It might be a little bit more” for a majority of older adults to be able to have such systems involved in their homes or retirement communities.

“It has to be an open system — a very open system, in my opinion — and not this monstrosity of individual things to make home automation really work,” Moody added. “New products and new ideas will have to be able to come out without a complete revamp of a whole system.”

However, Moody points out, we may see an important consideration with older adults in 10 years: income-level changes.

The Ten-Year Prediction: Tech That is Truly For an Aging Population

Americans in the next decade likely will retire with far less savings than their parents did. “The fact of the matter is the population we serve is, in fact, going to be very financially challenged in the future,” Moody said. “People today have pensions and insurance programs, but now people are retiring with maybe $25,000 in a 401(k). It’s going to be financially challenging for them.”

Because of this, tech-based systems for living will have to become not only more seamless, but also more affordable.

Will that affordable solution be lots of robots, to handle everything from housecleaning to caregiving? Moody doesn't think so.

[He says] the lack of humanity (and affordability) of robots makes him believe they will be less prevalent than some predict.

Additionally, Moody hopes that technological development will skew to being created with older adults in mind. “All these products are coming out every day and some of them are pretty neat. They’re all being designed for 25-year-olds, not the people we serve," he said. "Then someone slaps a bigger font on it and says they’ve adapted it for 90-year-olds."

More importantly, older adults do not all see themselves as ill, and even if they are, living in a fulfilling way means they want to address more than just their health issues.

In a recent essay posted on Next Avenue, Joseph F. Coughlin, director of the MIT AgeLab, warned against conflating growing older with health issues, which he said will be an especially important distinction to make for developers and inventors seeking to make innovations in the way we live as we age. "Older people, especially the oldest among us, are more likely to suffer from multiple chronic conditions and require significant care," Coughlin wrote. "But while this may be the story for some older adults, illness and older age are not equivalents. And even elderly patients managing chronic disease want to do things that do not involve their ‘conditions’."

Moody agreed, noting that as a boomer himself, he was especially sensitive to tech innovators treating older people like patients as they consider design.

“Too many people look at you when you turn 65 like you’re a patient and they want to tell you what to do,” he said. “At the end of the day, we all want purpose, and sometimes that purpose is the ability to take some level of care of myself. That whole idea of providing technology so I can live the life I want — that’s what I really want."

The Distant Future...Has Arrived

The piece finished up with a roundup of some more possibilities that may not be so far-fetched as they sound.

The Jetsons, you'll recall, lived in a flying saucer-like apartment building on the tallest stilts you’ve seen, accessible only by space car or jetpack, with a robotic maid and cool contraptions like smartwatches and 3D printers for food that actually exist today.

3D printed houses (that can be finished in 8 hours)

Homes with appliances that can look, speak and teach like humans

‘Smart threads’ that can allow fabric on your furniture to change color instantly and frequently

Homes equipped with virtual reality as a means of helping with dementia or distracting from pain

NY’s Governor Cuomo Launches Country’s First Aging Services Mobile App

With the launch of the Aging Services mobile app, announced on May 9th, the Governor of New York has high hopes for his state as a role model in serving older adults.

[It] is part of the Governor’s overall goal to make New York State the healthiest and the first age-friendly state in the nation, in accordance with the eight Age Friendly/Livable Community Domains outlined by the World Health Organization and AARP. Communities that are designed and designated as age-friendly are communities that promote healthy aging for older adults and individuals of any age.

[The] app [will] connect older adults with valuable resources and services in their communities. The New York State Office for the Aging’s Aging Services app will provide New York's more than 3.7 million older adults with easily accessible material about benefits, programs, and services, including information regarding health and wellness, housing, and transportation options. The app is compatible with both iOS and Android platforms.

A primary aim of the app is to help older adults locate the services already available in their neighborhood.

Using the app’s “Near Me” feature, an older adult or caregiver anywhere in New York can immediately obtain address and contact information for local offices for the aging, senior centers, farmers’ markets, caregiver services, Alzheimer’s Association chapters, and more, within the closest proximity to their exact location. 

The Aging Services app also links users with live information and assistance through NY Connects, the state’s “no wrong door” system for community-based long-term services and supports, which is designed to help older adults and those with disabilities remain healthy and independent. Additionally, the app provides timely news and updates about state and federal programs that directly impact the lives of older New Yorkers and their families.

Governor Cuomo's initiative is timely, given the changing technology habits of older adults and their widespread desire to age-in-place.

Older adults are increasingly using technological tools to connect to news and information, health and wellness resources, and social supports. Almost 75 percent of people over age 50 and almost 45 percent of people over age 65 now own a smartphone, and those numbers continue to grow.

Beth Finkel, AARP NY State Director said, “AARP is proud to partner with Governor Cuomo to make New York the first age friendly state. The launching of this app, specifically designed for older New Yorkers and their families, supports many of the principles of age friendly/livable communities. Today’s older adults are becoming increasingly connected to mobile technology via smartphones and other mobile devices, and this new age-friendly mobile app allows people to more easily link to community resources that help them age independently.”

Tom Kamber, Founder and Executive Director of Older Adults Technology Services, said, “We are experiencing a longevity revolution in this country and the role of technology to assist and support our daily activities is paramount. There is an increasing awareness of healthy living and social engagement among today’s older adults, and technology plays a key role in healthy aging. New York State’s new mobile Aging Services app helps older adults remain healthy, active, and engaged in their communities, which in turn leads to a stronger and smarter New York.”

The Aging Services app was developed by the New York State Office for the Aging in collaboration with the New York State Office of Information Technology Services. To explore more of New York State’s official mobile apps, visit www.ny.gov/mobileapps.

Did the Fully Integrated Smart Home Just Get a Whole Lot Closer?

The truly integrated smart home is still primarily a project--and an investment--for gadget-loving early adopters. But this week, the prototype of a new kind of sensor was announced, promising to be that one simple device which could connect everything in the room.

That’s the idea behind Synthetic Sensors, a Carnegie Mellon University project that promises to make creating a smart, context-aware home a snap. The tiny device, unveiled this week at the big ACM CHI computer interaction conference, can capture all of the the environmental data needed to transform a wide variety of ordinary household objects into smart devices. It’s a prototype for now, but as a proof of concept it’s damn impressive.

Plug the module into an electrical outlet and it becomes the eyes and ears of the room, its 10 embedded sensors logging information like sound, humidity, electromagnetic noise, motion, and light (the researchers excluded a camera for privacy reasons). Machine learning algorithms translate that data into context-specific information about what’s happening in the room. Synthetic Sensors can tell you, for example, if you forgot to turn off the oven, how much water your leaky faucet is wasting...

Products like NestSen.se, and Notion have brought smart sensors into the home, but the ubiquitous sensor that could track and interpret data from multiple devices--both smart and dumb--has long been a tantalizing and seemingly remote possibilities for designers.

[S]ensors have gotten so small and sophisticated that gathering the data wasn’t hard. The challenge was doing something with it....

Using data captured by the sensor module, the researchers assign each object or action a unique signature. Opening the fridge, for example, produces a wealth of data: You hear the creak, see the light, and feel the movement. To a suite of sensors, it looks and sounds very different from a running faucet, which produces its own data. Laput and his team trained machine learning algorithms to recognize these signatures, building a vast library of senseable objects and actions. The variety of sensors is key. “These are all inferences from the data,” says Irfan Essa, director of Georgia Tech’s Interdisciplinary Research Center for Machine Learning. “If you had just one sensor, it would be much harder to distinguish.”

But while this type of machine learning is very promising and exciting, it must still catch up to the complexity of an ordinary human life.

A truly useful universal sensor must recognize and understand the nuances of constantly changing inputs. For example, it should be able to discern your coffeemaker from your blender, even if you move the appliance from one counter to another. Likewise, adding a new appliance to your kitchen can’t derail the whole system. Ensuring that level of robustness is a matter of improving the machine learning, which could fall to the system’s end user. “The easy solution in the short term is coming up with an interface that makes it easier for users to point out problems and retrain the system,” Rowe says.

For now, the Synthetic Sensors product is all data tracking and interpretation and no user interface.

Laput says he might eventually build an app to control the system, but the bigger idea is to incorporate Synthetic Sensor technology into smart home hubs as a way to capture more fine-grained data without the need for a camera (cough, Alexa). “If you embed more sensors into Alexa, you’ll potentially have a more knowledgable Alexa,” he says, referring to Amazon’s digital assistant. And that, Laput says, is the end goal of a smart home: building an environment that knows more about itself than you do.

Entrepreneurs for the 50+, take note: the possibilities for this kind of universal sensor in the home of those seeking to age-in-place are endless. We look forward to tracking the collaborations.

With Blue Cross Blue Shield Partnership, Lyft Continues to Expand Healthcare Mobility Services

Lyft has been pursuing strategic partnerships in the the patient transportation market with vigor, telling MobiHealthNews recently that they have hundreds of healthcare partners. This week Blue Cross Blue Shield became their largest partnership yet.

“Transportation is a really important piece to have to solve problems of healthcare access, and with over 100 million members, Blue Cross Blue Shield can have a big impact,” Gyre Renwick, Lyft’s head of healthcare partnerships told MobiHealthNews. “An important piece is patients do not need to do anything else to get the benefit of the service. Many people we are transporting today for medical appointments do not have a smartphone or the technical capabilities, so our goal is to remove the barrier to individual consumers even having to call a ride.”

The San Francisco-based ride-sharing company proactively reached out to BCBS, and the service will begin rolling out over the next few months at no cost to patients. Prior to launching the service, BCBS will work to incorporate Lyft’s platform into a yet-to-be-determined delivery model, and it will function as a service carried out on BCBS’s behalf.

Blue Cross Blue Shield joins the ranks of large payers and providers who have recognized healthcare solutions are not always about improving a healthcare service.

"Many Americans live in areas where medical care is beyond the reach of walking, biking or public transportation. As a result, they struggle to access critical health care services, even when they have health insurance," Dr. Trent Haywood, BCBSA chief medical officer and president of the BCBS Institute said in a statement. "We are committed to addressing issues like transportation that are inextricably linked to health outcomes, yet can't be tackled through health care resources alone."

With 106 million BCBS members, the two partners are already discussing how their datasets could be combined to reveal--and ultimately improve--community health.

While Renwick said its too early to say just what that data marriage and analysis will look like, the basic plan is to leverage local data such as transportation, nutrition and environment to understand zip code-level factors that impact individual health.

A few highlights that made news among Lyft's many healthcare partnerships:

In January 2016, Lyft announced a partnership with Medtrans Network in New York City, and a few months later teamed up with appointment scheduling app Everseat. Both Lyft and their primary competitor Uber (which also works with UK statup Cera to give rides to NHS caregivers and patients) partner with health organizations to help get patients to clinical trial sites. Not for-profit-hospital system Ascension tapped Lyft in December 2016 to provide patient rides, and in February of this year, Lyft teamed up with non-emergency medical transportation company LogistiCare to expand access to Medicare, Medicaid and elderly patients.

Apple Acquires ‘Fitbit of Sleep’ Beddit

The Finnish company recently acquired by Apple specializes in tracking sleep quality, heart rate and snoring. It's unknown how the tech giant will incorporate Beddit's capabilities, but it's clear they hope to secure their place in the digital health market.

[With the purchase] Apple  boost[s] its health and fitness services, as it attempts to secure its place in the “quantified self” market.

Beddit, which was founded in 2007 and has been selling its sleep tracker in Apple stores since 2015, confirmed the acquisition with an updated privacy policy...[stating] “Beddit has been acquired by Apple. Your personal data will be collected, used and disclosed in accordance with the Apple privacy policy.”

Terms of the deal were not disclosed, but Beddit had raised $3.5m (£2.7m) in funding since it was founded.

Beddit will expand Apple's health analytics offerings, an area in which it is often perceived as weak.

Beddit has been described as the “Fitbit of sleep” for its easy to use sensor and comprehensive night-time tracking and analytics, an area that Apple is weak. To date Apple has not featured sleep tracking at all within its iPhone or Apple Watch fitness apps.

Third-party sleep tracking apps, including Beddit, have filled the gap using the iPhone, but with its requirement of a nightly charge, sleep has remained the Achilles heel of the Apple Watch’s otherwise fairly comprehensive health-tracking tools.

The £130 Beddit sleep tracker consists of a 1.5mm thick strip of sensors that are placed on top of the mattress and connected to a wall outlet for power. Combined with an Android or iPhone app, the Beddit 3 sleep sensor tracks sleep time and quality, heart rate, breathing rate and snoring. It also acts as an intelligent alarm clock that wakes you up in the lightest sleep phase.

This acquisition is yet another indicator that health and fitness tracking remain the primary reason consumers purchase wearables.

While the initial focus for smartwatches, including Google’s Android Wear watches and the Apple Watch, was around apps and notifications, it quickly became apparent that health and fitness was a driving reason that customers bought the items.

For Apple and any other smartwatch makers, comprehensive fitness and health tracking is essential. Sleep tracking has remained the domain of fitness trackers such as the Beddit, or wrist-worn devices such as the Fitbit Charge, which do not need charging each night to last through the day.

Whether Apple will continue to sell the Beddit sleep sensor remains to be seen. It is likely the technology and sleep analysis behind it will end up in future Apple products, including the Apple Watch.

Might we Finally See a Digital Health Unicorn? Caremerge’s CTO Believes We Will

Co-Founder and CTO of Caremerge, Fahad Aziz, recently published a piece in Forbes on why he believes no digital health startup has yet achieved the "unicorn" status of a billion dollar valuation. Can it ever happen? Aziz believes it can, because some of the chronic limiting factors in the rapid adoption characteristic of unicorns is increasingly likely as the sector matures and offers ways to get around the limitations.

With Caremerge being one of the the fastest growing healthcare startups around, and one that has raised an impressive $20m in investment to date, his perspective is nuanced and insightful. (Please also check out The Longevity Network's own exclusive Entrepreneur of the Week interview with co-founder and CEO of Caremerge, Asif Khan).

Despite the fact that health is a basic need, not one digital health startup has attained unicorn status...There are several reasons as to why digital health startups have failed thus far to build multibillion-dollar businesses.

The First Difficulty: Securing Adequate Capital

No unicorn exists today that didn’t raise a crazy amount of cash in their first few years of growth. Digital health startups don’t have that luxury — which becomes a huge roadblock for them to grow exponentially.

Investors feel (and rightly so) that they don’t have enough leverage to assist a healthcare startup with growth. In addition to extensive government regulations, buyers (hospitals, physician offices, pharmacies or long-term care facilities) are often slow in buying technology. Investors are excited about the space because of the potential for demand but not enough to take on hundreds of millions of dollars of risk.

The bright spot: that investor confidence is growing.

In 2010, digital health companies received $1 billion in total investment, a drop in the bucket in comparison to others. Six years later, that number jumped 810% to $8.1 billion in 2016, as reported by Novahill Partners in their quarterly report (paywall). Part of this is due to entrepreneurs finding creative ways to generate revenue, lessening their dependence on providers.

The Second Difficulty: Costly Integration with Provider Systems

The fact that a digital health product cannot work in isolation and that it needs data from hospitals or physician offices adds complication and slows down innovation. By the time a startup creates those integrations, it has exhausted its funds and is likely dependent on this investment to work for them. And they usually don’t.

The bright spot: these integrations have become easier and less costly to perform

Major health systems offer out-of-the-box APIs and interfaces that make the integration process quick to build and test. There are also a number of third-party systems like Interfaceware and Mirth that provide built-in connectors to use and consultants who would do the integration for less, thus allowing startups to focus on their core business.

Third Difficulty: The Stakeholders Who Will Pay have Different Objectives Than the Ones Who Will Use

Healthcare regulations and large customers (like hospitals) often dictate the direction of a particular solution, and it becomes very difficult for a digital health startup to focus on optimizing its features to increase user tracking. New features take priority over A/B testing on existing features. Current unicorns in different markets have mastered the art of increasing traction by designing and redesigning the user experience, gamifying engagement, and sending smart notifications. This is only possible when you have one core offering.

The bright spot: many of the more successful startups are figuring out how to navigate this conflict.

More and more digital health startups are now trying to stay focused on their offerings. PatientPing, Amino, ZocDoc and Honor are several examples of digital health startups that have shown high growth while offering one core service.

The Fourth Difficulty: Many Digital Health Solutions Pull Provider Attention Away from Their Patients

Most healthcare technologies are used by care providers at hospitals, doctors’ offices, pharmacies and senior living communities. However, while technology has helped them become efficient, it takes their focus away from what they are trained to do. If you visit your primary doctor, you will notice that while they are talking to you, they are staring at a computer. It’s annoying, and they hate it too, but they have no choice.

This is the biggest challenge for digital health startups. They haven’t made applications that keep their users in mind.

The bright spot: there is a glimmer of hope in voice-activation, AI and other innovations.

Goodbye to clunky electronic medical records...Forward, a Silicon Valley startup, is determined to change that. By using voice recognition, artificial intelligence and connected EHR, they are letting physicians do what they do best: consult and let the technology assist them in a way that’s not a hindrance.

The Fifth Difficulty: B2B Does Not Utilize the Same Viral Consumer Adoption Model as Unicorns in Other Sectors

Most unicorns provide solutions to consumers. There are proven methodologies that allow to exponentially increase a consumer base via user engagement and virtuous loops (aka network effect). This is not as applicable in a B2B setting, but it’s not far-fetched either.

The bright spot: other sectors have demonstrated there is a version of rapid adoption that works in B2B growth

Palantir and Dropbox are two B2B companies that made it to unicorn status while providing solutions for other businesses. The business models were different, but they mastered the art of user engagement to retain and grow users in the system. Once users become the champions of their applications, it leaves decision makers and enterprises with no option to switch. Digital health startups now have these proven examples, and they need to employ them in their own businesses to generate the kind of growth that’s expected from a unicorn.

The Conclusion: any day now, the bright spots will win out over the entrenched difficulties in achieving the market scale of a unicorn in a digital health startup.

These are very exciting times for digital health startups. According to RockHealth, in the first quarter of 2017, there were 71 digital health deals totaling over $1 billion. Most of these investments were second and third rounds, which shows that startups have established traction and wowed their investors. Moreover, digital health startups are looking for creative ways to increase their revenue by signing up technology partners in addition to direct sales. And finally, more entrepreneurs from non-health startups are entering this space. For example, the founders of Vida, Honor, Forward and CloudMedx came from tech giants like Google, Facebook and Microsoft. Based on all of this, there is reason to believe that very soon we will see not just one but several digital health startups transform into unicorns.