The Longevity

FDA Commissioner Announces Pilot for Expediting Approval of Digital Health Products

Just a few weeks into his role as the US Food and Drug (FDA) Commissioner, Scott Gottlieb has announced that providing clear guidance on digital health regulation--and expediting approval for low-risk digital health products and services--is a priority for the agency. (Read his original letter on FDA's blog).

[Late last week], Gottlieb...announced an upcoming pilot program that would create a third-party certification program under which lower-risk digital health products could be marketed without FDA premarket review and higher-risk products could be marketed with a streamlined FDA review.

The pilot, part of a new approach to regulating digital health tools, would help to certify, according to Gottlieb, whether a company "consistently and reliably engages in high quality software design and testing (validation) and ongoing maintenance of its software products. Employing a unique pre-certification program for software as a medical device (SaMD) could reduce the time and cost of market entry for digital health technologies."

This effort to provide clearer guidelines and expedited processes for digital health products is all part of FDA's implementation of the 21st Century CURES Act that was passed in December at the tail end of the Obama Administration. The Cures Act, passed with an overwhelming majority in both the House and the Senate, aims to "boost funding for medical research, ease the development and approval of experimental treatments and reform federal policy on mental health care," according to a Washington Post article at the time.

"...FDA will provide new guidance on other technologies that, although not addressed in the 21st Century Cures Act, present low enough risks that FDA does not intend to subject them to certain pre-market regulatory requirements," Gottlieb wrote in FDA’s Voice Blog.

FDA also will provide guidance clarifying its stance on products that contain multiple software functions and which currently fall outside FDA regulations.

The push into digital health comes as Bakul Patel, ‎associate center director for digital health at FDA, recently told conference attendees that guidance related to software as a medical device, and a new dedicated unit to digital health are coming to FDA’s Center for Devices and Radiological Health (CDRH). 

(See our coverage of FDA's new digital health unit here).

Gottleib also touted the role of a universal method for collecting post-market data on digital health products and using that data in turn to expedite new or evolving product functions.

"For example, product developers could leverage real-world data gathered through the National Evaluation System for health Technology (NEST) to expedite market entry and subsequent expansion of indications more efficiently ... The Medical Device Innovation Consortium (MDIC), a 501(c)(3) public-private partnership, is serving as an independent coordinating center that operates NEST. In the coming weeks, MDIC will announce the establishment of a Governing Committee for the NEST Coordinating Center comprised of stakeholder representatives of the ecosystem, such as patients, health care professionals, health care organizations, payers, industry, and government," Gottlieb wrote.

NEST’s fully operational system is expected to come by the end of 2019.

The Longevity Network’s Guide To Pitching Digital Health & Caregiving Investors

Entrepreneurs are compelling—captivating even—because of their passion, their willingness to take risks, and their backstory of how they came to be so passionate and willing to take risks. So everything you’ve read about 1) making your pitch aspirational; 2) being creative in capturing “the problem” you’re trying to solve and 3) adding a personal story about why you care about this problem—those are all good tips. You want to convey the entrepreneurial persona when you have those few minutes of an investor’s time.

However, the aura is not usually enough, in particular, for investors experienced in the health tech and caregiving space for the 50+ market. This sector is uncommonly complex. To name just a few reasons: we have both public and private payers, enormous variety in providers, convoluted regulations dictating the behavior of payers and providers and a whole slew of shifting dynamics among aging but capable older adults and their paid and unpaid caregivers (the latter of which often bring geographical distance and complicated family dynamics into the picture).

So what else do you need to make sure you convey in a successful pitch? Here's a curated list pulled from real feedback investors gave entrepreneurs after hearing their pitches.

THE BASICS

Even if you’ve successfully conveyed the entrepreneurial aura, your potential investor can still be left wondering about the basics: who is the user and who is the buyer? These fundamentals of your business plan should not be left to clarify during the Q&A, so when practicing your pitch, make sure you clearly convey who benefits and who pays.

THE DETAILS

Time is of the essence when developing your pitch, so the details of the business plan cannot always be included, but make sure you are fully conversant in those details should any questions come up afterwards. For example, here are a few questions coaches asked during AARP’s recent Innovation@50+ LivePitch event in Mountain View, CA.

- What does it cost for consumers now and what will it look like when you add b2b? What problem are b2b customers most interested in solving for?

- How do you provide value back to the payers?

- How many units do you need to sell to be profitable

- What is the lifetime value of a customer?

- What if your user varies their behavior, e.g., doesn’t take their meds at home one day?

- Tell me more about the data integration with your app.

CUSTOMER ACQUISITION & SCALING UP

If you haven’t yet heard of CAC, now is the time to learn about it because every investor worth their salt will be asking. Cost of (Customer) Acquisition is important for every startup but particularly for startups whose product is software and / or if your target customer is a payer or provider because those sales cycles are notoriously long.

If you aren’t tracking CAC yet, start now and come to any future pitch armed with data.

Here are some versions of the way you may be asked this question:

- How does acquisition happen?

- How do people find you?

- What data do you have on the cost of acquisition—i.e., growth cost versus cost of maintenance?

- How do you integrate into these health systems specifically, i.e., who do you target and how do you locate the decision makers?

Closely related to acquisition cost questions are questions about the costs involved in scaling up? You will want to be conversant how hiring, training, and marketing play into your business.

You may hear, for example:

- Would you need to build a fairly sizable marketing engine to scale?

- Have you calculated how large a sales team you would need to hit target customer numbers?

- What percentage of your scaling up operation is human-driven and what percentage is based on marketing campaigns?

- Do you have any organic referrals happening yet or are you generating all your own leads?

TEAM

This is a brief lesson: investors know that execution of the business plan is one of the top 3 or 4 factors in the success of startup. Being the impassioned, visionary founder is compelling, but don’t forget to highlight the domain expertise, technical abilities or marketing savvy of your fellow team members. Any previous success with a startup venture is particularly good to highlight.

STRATEGIC PARTNERSHIPS

Having a plan in place for building strategic partnerships may be what separates the unicorns (or even reasonable success stories) from the zombies doomed by an unforgivingly high CAC. Every digital health or caregiving tech startup faces an uphill battle, and investors know it. The space is inefficient and the market is enormous—which is to say, ripe for disruption—but breaking in is still tough and many a startup with a great idea and a talented team has run out of cash before achieving that market traction crucial to securing Series A or even sufficient seed funding.

But don’t show up with a vague reference to how you will soon begin developing those strategic partnerships. Have a concrete list in mind of who they might be and, importantly, what it would mean to be “partners”.  Would they be:

- Distribution channels?

- A marketing platform?

- Willing to pay for kind of data you will be collecting or producing as a by-product?

PILOTS

Pilots for digital health and health IT products have become very popular in recent years. Brookdale Senior Living Solutions, one of the largest operators of senior care facilities in the country, has even developed an Entrepreneur-in-Residence program. (See our in-depth exclusive of the program here).

It’s a great idea to highlight any past or current pilots during a pitch, but because they have become so prevalent, make sure you are prepared to provide plenty of detail so it conveys your skillful execution.

Questions you may hear from investors:

- What have been your biggest learnings from consumer-facing pilot?

- What was the number 1 request you received from your customer during your pilot?

And crucially,

- Is there anything in place to roll this pilot into a paying contract automatically, if say, a certain benchmark is achieved?

Investors will love to hear that you have negotiated that conversion to paying customer ahead of time, because they have already seen too many startups die a slow cycle of “death by pilot”.

DIFFERENTIATION FROM COMPETITORS

This key indicator should arguably be at the top, included under “the basics”. Any smart investor will want to know as much as possible about the competitive landscape, and it may be up to you to educate them on it, depending on how niche your product or service is.

Again, this is not a topic to leave for the Q&A—it should be defined and then reinforced during your pitch.

This is particularly true if you are attempting to break into an already crowded field. As one judge from LivePitch told a contestant: “be stone cold on your differentiator and your creativity, because there are a LOT of these on the market”.

Here are a few ways to frame it:

- How do you differentiate from competitors?

- What competitor scares you the most?

- Do you have anything proprietary—patents or trademarks—that would secure your market differentiation?

Pitching has become its own art form, so the competition is stiff. The better prepared you can be shows not just that you value the time and expertise of the investor but also, that you understand your business model from top to bottom. And that—reinforces the entrepreneurial mystique.  

Report: Digital Disruption in Healthcare is $8.7 Trillion Global Juggernaut

This month, Business Insider released a teaser of some of the top findings from its new report on digital disruption in healthcare. Its first finding? This juggernaut is now impossible to stop.

Whether patients and their doctors are ready or not, though, digital disruption in health care will only accelerate in the years ahead.

The scope of the report is comprehensive.

In a new report from BI Intelligence, we analyze digital disruption in health care, looking at clinical operations and the role of electronic medical records. We identify the expanded scope of medical care and how patients will use health devices in their everyday lives, as well as survey the possible impediments to the digitization of health care in regulation, workflow resistance, and privacy concerns.

Here are some highlights from BI Intelligence’s report:

  • Digital is already disrupting health care in a number of sectors; electronic health record use is climbing and will near saturation as third parties figure out new and better ways to link and comb through that data.
  • Companies are developing all sorts of tools and equipment that doctors and nurses will use to gain new and greater insight into their patients, from connected scales to smart beds, and even augmented reality (AR) glasses.
  • There are clear hurdles to disruptive digital technology in health care, including regulation, staff buy-in, and privacy concerns. However, these barriers are starting to fall as the benefits of connected devices grow more apparent. 

The full BI Intelligence report promises to:

  • Explain the role of digital technology in medicine, and how it is and will continue to disrupt health care.
  • Provide an overview of disruption in clinical care, the health records space, and care in everyday life.
  • Analyze how the growth of digital health technologies will save time and reduce costs for the health care sector.

The full report can be Purchased & Downloaded or you can learn more about subscribing for an all-access pass to BI Intelligence.

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.

Conversa’s Doctor-to-Patient Platform Gets $8M Round of Funding

San Francisco-based Conversa Health will use the funds to make improvements to the platform and to scale up its operations in Portland, OR.

The Series A round was led by New York-based Northwell Ventures and also included Epic Ventures, Healthgrades, and other existing investors in the company.

Conversa’s Portland office was established in 2012 and works on the company’s technology, engineering, product development/management and operations functions. The company currently has ten employees based there, with plans to grow the office after the recent funding round.

The company's biggest personnel addition to the Portland office comes from Web MD.

Last month, the company added its new VP of Operations, digital health vet Becky James, to the office. James formerly spent twelve years in leadership positions at Web MD’s Portland office, most recently serving as the company’s senior director of client delivery.

The company's goals are familiar: improve patient engagement and health outcomes and lower costs.

Conversa offers more than 50 automated “conversation programs,” platforms that allow care teams to communicate with patients. The platforms are each tailored to different conditions, including asthma, congestive heart failure, diabetes and joint replacement.

SilverRide Offers Mobility Solutions for Bay Area’s Aging, Disabled

San Francisco-based SilverRide was founded in 2007, with a mission to meet the transportation needs of older adults with ambulatory or other limitations.

“When you get a ride from us, it’s a lot more than a ride,” said Jeff Maltz, who launched SilverRide in 2007 after hearing about older adults facing transportation problems. 

Drivers for SilverRide undergo background checks and random drug testing, but they also get training in transporting people with special needs of all kinds, physical and cognitive.

“The truth is, it’s a little easier to help someone in a wheelchair,” Maltz said. “If you’re helping somebody with a cane or walker, there’s a higher risk of fall.” SilverRide calls the service “door-through-door.” Drivers don’t pull up to the curb and wait for the passenger to hop in. Instead they provide a safe escort from indoors to the car and back indoors again at the destination.

Drivers, who get liability insurance coverage from SilverRide, also shuttle customers to and from medical procedures that involve anesthesia, where doctors recommend against patients driving themselves.

SilverRide staff additionally develop the profile of each rider when they sign up, allowing for more individualized service.

[For example, the] company... gathers information about whether there are steps outside clients’ homes, how to reach their emergency contacts, how often a client likes to go out and where he or she likes to go. The company promises to keep those details and preferences on file and confidential.

...For an additional fee, SilverRide drivers will stay with clients who can’t or don’t want to be on their own, accompanying them to games, shows and other events. Those costs range from $45 to $85 an hour. The company says its drivers spend 70 percent of their time in that capacity.

Like most transportation services designed for older adults, SilverRide does not presume smartphone usage.

Riders can summon SilverRide with a phone call or by email, convenient options for those who aren’t adept with smartphones. “We have a [smartphone] app,” Maltz said. “Zero people use it.”

Cities and States across the country are confronting the transportation needs of their aging populations, and many partnerships with startups--or more established companies like Uber or Lyft--are springing up.

“There are lots of models that have aspects of what is offered in SilverRide,” said Virginia Rize, co-director of the National Aging and Disability Transportation Center. “I think we’re in a period where there is tremendous development and enhancement of transportation options.”

The reason for this wave of developments nationally is a growing need that will be challenging to meet. The Americans with Disabilities Act requires local governments to provide rides for anyone who can’t use ordinary public transportation. Often, what’s provided are minibuses that carry multiple people, each to a different destination, while others ride along waiting for their stops. It can be a slow and inconvenient way to get around. In addition, these services are struggling to stretch their capacity for an aging population.

SilverRide hopes to expand into other markets to meet some of this growing demand.

[Founder Maltz] believes accessible transportation can translate into better health for aging people by enabling them to socialize and take part in activities they would otherwise miss. He gave an example by telling a story.

SilverRide got a call from someone whose uncle had been told he had two weeks to live, Maltz said. The uncle wanted to visit a gay bar one more time before he died. After making sure the man was OK to travel, SilverRide drove him to the bar and handed him off safely to the bartender.

“On the way back, the guy asked if we could take him again the next day. We told him we’d take him as many times as he wanted to go,” Maltz recalled. “The guy wound up going to gay bars three to five times a week — for the next five years.”

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.

When Will Pharma Really Adopt Digital Health Tools and Not Simply Dabble?

Pharma's role in digital health innovation has been making news lately--from the number of deals and the sheer quantity of dollars flying around to fund startups, launch their pilot projects, and announce early partnerships. Pfizer recently announced its first digital health accelerator and Bayer has a full ground team in Silicon Valley to keep its finger on the pulse of what's new with digital health startups.

But at a recent media roundtable at Veeva System's Global Commercial and Medical Summit, says MedCity News' Stephanie Baum, experts discussed when pharma will move beyond these digital health "experiments" and really adopt its tools.

Digital health is at an interesting point in its evolution. Not only are some providers and payers connecting patients and members with apps and connected devices but also pharma companies are collaborating with startups and growth stage companies to develop applications to address challenges such as medication adherence. But which groups are further along in the adoption of these tools beyond the pilot phase? And how can the data these tools generate be harnessed for the greatest benefit?

Those were some of the questions addressed in a media roundtable at Veeva System’s Global Commerical and Medical Summit with Daniel Gandor, the head of Takeda Digital Accelerator U.S., and Stephen Davies, research director on Gartner’s healthcare team, spoke with Arno Sosa, Veeva vice president of product strategy.

Everyone agrees the potential for widespread change would skyrocket if pharma were to move beyond experimentation and truly adopt some of the these technologies. But what is required for that to happen?

Asked what it would take for digital health to stop being an experiment and get mainstream adoption from pharma companies like Takeda, Gandor responded in an email following the talk.

“For digital health tools to truly become mainstream they must be integrated within the overall patient experience, provide tangible value for customers, and have credible, scientific evidence proving that value,” Gandor said in email after the talk “When these tools are embedded earlier within the R&D process, it creates an opportunity to not only capture this evidence but potentially fundamentally change what the solution for patients might be.

“To see solutions that might result in completely new business models for our industry, I believe the approach has a higher likelihood of being disruptive when considered as early upstream as possible. Digital health tools can also certainly be added onto products on the market, and there are quite successful beyond the pill initiatives out there. Ultimately a balanced and simultaneous approach will help drive digital health tools to become more mainstream over time.”

Integration may sound like a straightforward goal, but the details of how health data is collected and managed in our current disjointed healthcare system mean that we are still a long way from achieving it.

The challenge of products generating lots of data to gain insight into the patient experience, such as measuring the effectiveness of certain drugs and treatment protocols over time, is that it’s tough to integrate and contextualize all that data in one place. Despite the likes of Validic and other companies creating tools to de-silo that data from apps and connected devices, and for all the talk of the benefits of interoperability, health systems, electronic health record vendors and yes, pharma companies, tend to fiercely guard their patient data — de-identified and otherwise.

Davies noted a couple of challenges with the push by pharma, medical device companies, payers and providers to satisfy their hunger for data to produce insights on the patient experience. There’s no one way patients can access this data. It can also be tough for healthcare organizations to take action from the insights they gain.

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.

Seeking Provider Adoption of your Digital Health Service? Then Be Device-Neutral, says Survey

The annual survey, The State of Mobile Communications in Healthcare, was released this week. One of its key findings: the tide is finally turning for mobile communications adoption among hospital staff--but only if they support a BYOD (bring your own device) policy.

90% of physicians at BYOD supporting hospitals participate in the program, according to recent survey of more than 300 U.S. healthcare professionals conducted by Spok.

The survey...reveals that hospitals are making progress in addressing the previously identified infrastructure gaps in order to better support mobile strategies and devices. Wide-area pagers are gradually declining but are still used by 50 percent of respondents. It also illustrates that there is no standard device and hospitals are still trying to figure out what is the most appropriate device for their staff based on their functional roles and requirements. For this reason, Spok recommends that health systems implement communication solutions that are device neutral.

The survey also assesses communications infrastructure and opportunities to improve mobile communications. HIT Consultant summarized eight additional key trends:

1. Forty-five percent of respondents answered that Wi-Fi coverage is a challenge for mobile device users

2. 38 percent cited cellular coverage as problematic

3. Data security as a mobile device challenge dropped from 43 percent to 31 percent

4. Hospital staff still carries a diverse mix of mobile devices to do their jobs

5. Smartphones are the most popular device, with 77 percent of respondents saying their organization supports them, while other tools, including pagers, maintain strong representation

6. In-house pagers dominate as the device of choice for non-clinical staff (48 percent), smartphones rank second (40 percent), and Wi-Fi phones came in third (30 percent)

7. Twenty-one percent of surveyed healthcare professionals said their organization uses encrypted pagers

8. Enhancing patient care team collaboration and using mobile strategies to simplify technology and bring uniformity across hospital system were identified as the biggest opportunities for mobile communication improvements over the next three to five years