Showing posts with label Mobile Health Tools. Show all posts
Showing posts with label Mobile Health Tools. Show all posts

Saturday, November 15, 2014

The eleventh commandment: Share thy health data

You know you've got one compelling business plan when your investor starts promoting your wares even before you hit production. Like I've said here earlier, at the base of Google's healthcare ambitions is the health data of its users & now one of their earliest believers is bearing the torch to its data quest & how!
Beth Seidenberg, a partner at Kleiner Perkins Caufield & Byers (@KPCB) that famously invested 25mio USD (along with Sequoia) for a 20% stake in Google way back in 1999, in a recent blog piece of her's exhorts the users saying "You Should Share Your Health Data: Its Value Outweighs the Privacy Risk". Beth of course invests in digital health start-ups and hence could be speaking for those too, but it's anybody's guess which of KPCB's investments this would help the most.
Not that people need to be pressurized much these days to voluntarily part with their data, health or otherwise, but this dictat by the good doctor will surely makes 'em feel good about the 'why' part of it.
Update: 15th Nov 2014
allrighty...... now Accel's Rich Wong is going bullish on Android platform over IOS for investments in mobile health technologies. From making appeals of voluntary data disclosure to enabling automated data recovery through internet of things, the (investing) universe is truly conspiring to give it all to Larry & Sergei :-))

Thursday, September 12, 2013

Ambrosia for food, Palm-top engagement, Iterative decision making – A preview into evolving expectations of the healthcare consumer

Understanding consumer preferences has always been of paramount importance in most product segments. Within the pharmaceutical domain however even as there’s a constant ideation, speculation on future of healthcare; outlook on disease incidence, burden and pharmaceutical consumption patterns, this particular aspect has not been focused on, possibly owing to the prescriptive nature of the medicine where decision-making seldom lies with the patient & the power to influence product development lies more with the medical professionals & payers. To an extent this disengagement of consumer does justify the disinterest of Industry to understanding the consumer as against understanding the prescriber & the payer/ insurer.

Having said that, a number of disorders these days are getting close to being categorized as lifestyle-diseases & with early detection, diagnosis and routine monitoring getting simpler, it’s only imminent that the insurer will increasingly resort to rationalizing what treatment-regimens can be covered thus significantly shifting the onus of payment to consumer. Then again, owing to the abundance of open-source information and availability of validated healthcare gamification apps, the consumer is getting more knowledgeable & hence empowered. Seen together, these trends indicate that the average pharmaceutical consumer is well poised to be the key decision-maker on therapeutic choices, particularly on maintenance therapies that form a predominant portion (vis-à-vis’ the curative therapies) of all pharmaceutical revenues.

It also hence would not be overtly speculative to state that the hitherto quintessential practitioner-dependent healthcare consumer is evolving quick & is looking at an iterative role for her/ him-self rather than merely wanting to being ‘prescribed health’, literally & figuratively. Continued negligence of factoring-in consumer behaviour in the product development process can thus be a serious lapse of judgement in an industry that’s been groping around for the next paradigm shift for a few years now.

The Health 2025 survey I floated in early July is a token attempt to gain some basic perspective into the altering behaviour of an ‘aware pharmaceutical consumer’ which I hope either in its promise OR in its inadequacy will instigate more such studies in-depth and at a larger scale. While I can’t claim to have gotten a great number of responses, I fortunately received quality responses (& some incidental endorsement*) as indicated by consistency of the trend that was showing up right from early stages to till plateauing of response flow.

Even as I was compiling the final results I came across this rather well received fund raising pitch of Stefan Broda (Founder/CEO of BeforeWeDo) at the end of which one particular GP lauded the Consumer Iteration built into the business model which is worth emulating by other healthcare start-ups! – If not a sign from the heavens, a sweet coincidence nonetheless.


I chose the sample population of pharmaceutical professionals who I believe are very representative of the above breed of ‘aware pharmaceutical consumers’ & to whom I have ready access through the Pharmaceutical Discussion Group I founded and manage on Linkedin & Groupsite.

Based on a guestimate of ~5million pharmaceutical professionals world-wide, I derived my target sample size as 350, using a Confidence level of 95%, which is the mostly used default level & a Confidence interval of 5, which again is the oft-employed default figure. By the time I chose to start the compilation (the survey is still active) I however had only 159 responses which translated amount to a confidence interval of 7.7 while the confidence level remains at 95% - That, I guess is my cue to you for taking the results with a pinch of salt :-)

Finally, I am neither a professional statistician nor a qualified analyst and it’s likely the design of survey may not fully please many out there. I however did consciously try and keep the questionnaire short, the questions specific & the choice of answers broad in order to minimize any chance of a bias setting-in – the trends indicated by the responses, as I see, justify some if not all questions.


The survey is based on ten questions out of which the first three are essentially filters namely age, sex & nationality that enable some level of demographic segmentation of responses. While the charts of responses to individual questions looked very pretty on Surveymonkey dash-board, I agonized nonetheless quite a bit deciding on an ideal approach to presenting the results on my blog without sounding too pedagogic – I hence chose to weave the details around certain KEY OBSERVATIONS and then go about detailing on those further.

Since it may help put things in perspective, I have uploaded the primary results document* to file cabinet on Pharmaceutical Discussion Group – please note that this link opens the document only when you are logged in, (i.e. if not a member already, you will have to join the group)

**I’ll be happy to share the master data file too with anyone interested.


In hindsight I realize some of the questions are pretty skewed & some fairly meaningful, but overall they seemed to fall in two broad categories, one set wherein the standalone overall response is itself strongly indicative of a trend & a second set wherein an interesting picture emerges only when the responses are separated out and compared across demographics. I however will spare the mundane trends and go straight to top observations based on the percentage response towards a trend-indicating response;

Not just food, Ambrosia is what the consumer wants - a huge thumbs-up for Functional Foods!

Quite ironic that the top trend in a health survey is food & not medicine! - A whopping 87% of the respondents see/ want the food in 2025 to be more than nutrition, out of which 46% see a potential for food being a curative!

Women make up the majority of the ‘food as a curative’ advocates (60% as against 30% among men) – which simultaneously underscores & endorses the greater influence of women in the functional food promise.

More Indians (56%) believe in the promise of curative food than the North Americans (40%) or Europeans (44%) – a possible connection to the expectations influenced by prevailing, predominant ethno-cultural dietary practises?

Consumers want to take things into their hands, literally – Mobile Health Tools all set to Rule

At 68%, a clear majority of the respondents are bullish on the role & significance of personal mobile apps in an individual’s health management. (25%, Indispensable & 43%, Very crucial)

Once again this is a trend driven primarily by women, the percentage of women who chose ‘Indispensable’ (40%) being significantly higher than the men, a majority of whom (67%) chose the mildly-tempered but still bullish, ‘Very crucial’ as their answer. This clearly establishes women as the ‘early adaptors of the health mobile tools & apps’ & possibly that mobile apps are more amenable to woman’s health management and finally that factoring-in gender into the development of a mobile healthcare app can be a key determiner of the success of the same.

When the Geography filter is applied, the trend expectedly peaks in North America with an overall bullish-ness at 76% - within which women once again stand-out strongly with 55% responding ‘Indispensable’. The dominant European response is however ‘Very crucial’ (60%) which probably indicates a currently lower penetration of mobile health apps within this geography – this holds good for India too.


They seem to say, keep the Doctor away – Eating an apple isn't the only way

While the question has some unfortunate bias & choice of ‘You’ sounds like a given…, the responses still indicate an increasing role for non-physician health professionals. If the choice of ‘You’ (53%) is ignored, only 12% see the physician playing the single most crucial role towards an individual’s health much below the diagnostician at 18%.

There’s an interesting contrast in choice of physician v/s diagnostician among the female & male respondents’ viz., Female: 7% (P) v/s 21% (D) & Male: 14% (P) v/s 16% (D) – probably again owing to the essential nature of women’s health issues vis-à-vis’ male issues – nonetheless, a potentially important alert to the healthcare industry.

In-line with the number one trend above, the nutritionist polled 10% of the vote. Quite surprisingly, of all respondents who chose Nutritionist, 70% belong to the age group of 35-44 yrs. This read together with the first trend gives a great demographic insight into who could be the prime target demographic segment for promoting functional foods – Women between the age group of 35-44.


Apart from the above three observations, the rest of the observations though interesting aren’t necessarily great insights into the health consumer psyche - the same are listed below in no specific order;

  • 78% of the respondents feel medicines should target cure as against 22% that are okay with maintenance – expectedly, the 78% group is populated majorly with people under 55 years of age.
  • 87% of the respondents prefer oral medications to parenterals – Interestingly though, there’s a strong geographical variation with NA & EU preferring oral medications at 92%, while the Indian respondents still retain some of the cultural trust of ‘injections’ (26%) 
  • 89% of all respondents still believe the necessity of medicines per se’ in-spite or despite the preference of the ambrosial foods – if anything, this seems to showcase the omnipresence of the pills.

While the results may not qualify as astonishing findings, the unmistakable relevance of the trends thrown up by a mere seven-question survey still underscores the value of understanding the health consumer’s perspective and using the knowledge to build, refine the road-map of pharmaceutical product development.

Functional Food for thought! :-)

Sunday, March 17, 2013

IT & ITeS Enterprise in India: an Outsider Perspective based on trends in Investment & Technological Evolution

Why should an outsider perspective matter?
I tend to believe that way too many people have taken Steve Jobs maxim, ‘customers cannot tell you what they need’ at its face-value and in the process probably haven’t realized fully that the very user-experience guidelines Apple Inc., so vigorously pursued, propagated to the developer community made the tech-consumer an integral part of the technological evolution & hence an “insider” for all practical purposes – After all within six months of launching iPhone, Jobs recalled his earlier decree of ‘No third-party apps on iPhone’ :-) - I rest my case here.
Life, tech & the metaphysics of a cyber-quest
The exabytes of sheer information thrown up by an internet-query and the consequent collateral learning at times gives a radically different perspective of the principal quest &/or changes the very course of the search/ research.
That’s precisely what happened when I set-out with an innocuous query ‘Life+Tech’ to check-on how the marriage of life sciences & technology is working out as indicated by the quality of innovation and the investor sentiment towards this emerging IT subset globally and, if India is in-sync with these trends – I strayed off-course quite a bit soaking up some non-serious gyan on gamification, cross-application potential of game mechanics to health & wellness, dallying a while with the first ever ‘drug discovery’ game, Syrum & eventually decided that I’d do good to first understand how the IT & ITeS enterprise is poised in India & then go about speculating on where it could go from here, towards life-tech or some other direction altogether.
The quantitative & the qualitative sojourn

As I looked into the openly available, mostly undifferentiated data** & the trends, I used the following assumptions in order to get as close to reality as possible;
  • Wherever the VC activity has been clubbed under PE, I considered all early-stage & some growth-stage deals as essentially venture deals
  • Where I depended on individual alerts of certain deals, I considered funding up to series-C as venture funding & series-D too if that involved at least one VC 
  • No acquisitions, Mezzanine funding rounds have been considered as Venture capital (which of course wasn’t much)
  • Since I was looking into IT sub-category trends & the only categorization ‘Industry Codes (VEIC)’ by NVCA is surprisingly devoid of some well-understood terms such as “Cloud”, “Apps” etc., I decided to use my own simplistic terminology that’s hopefully self-descriptive
**My primary source for the data was which derives its own info from Venture Intelligence alerts & reports. In addition to this I have also used, primarily for cross-verification of primary category figures, the MoneyTree reports by PWC & NVCA from data provided by Thomson Reuters ……. phew
True to my enlightened detour, the not-so-cursory analysis of the available information on IT & ITeS related investments in India in 2012 drew an interesting picture;

  • Commerce sub-category (B2C e-commerce) hogged the largest share of 45%
  • Services sub-categories (B2B BPO, Cloud, Edutech, IT Services, Telephony) cornered second highest 22%
  • Analytics sub-categories (B2B Internet & Mobile Advertising; web-analytics) that are focused on the increasingly crucial data mining, analysis and consumer demographic profiling gathered 20%
  • Product sub-categories (B2B Mobile apps; PaaS; Software; Health-IT & Gaming) managed only 13% share of investments, helped in a large measure by the Mobile Apps category

From the above observations it can be inferred that the investor sentiment in India is very strong towards Commerce, strong towards Services & Analytics and weak towards Products. This also could mean that the investment in IT & ITeS in India is driven more by the local than the global potential–while this statement may sound altruistic, the statistics seem to support it;
It’s an irony that my initial interest ‘Health-IT’ is very insignificant at 1% of funding – a cursory review of the ‘mobile apps’ companies also doesn't indicate any healthcare component being pursued – so much for my principal quest!
Takeaways for the investing universe, primarily for the VCs
There’s only as much space to jostle around on the e-com super express
  • The e-commerce opportunity while looks tempting is surely reaching the tipping point wherein differentiation & achieving of critical mass is going to be a huge challenge
  • Compounding this is the fact that the global biggies like Amazon, eBay et al that could’ve offered a superior exit option by way of an acquisition have started to get-in on their own (, – banking on the relative ease of establishing a virtual enterprise
  • It’s also apparent that the likes of Amazon are now gearing up to ‘Walmartify’ their online shopping and go physical to enhance user experience! – If not anything, this points out to the cyclical nature of consumer preference of a buying experience & hence the caution one has to execute in putting too many eggs in one basket.

The Quants will rule and later they won’t & then again they would
  • The monetization of analytics opportunity will surely out-pace e-commerce & services given the eventuality of any business is to understand consumer & maximize the consumers buying impulses.
  • Quite interestingly the innovation quality of Indian companies in this domain seems to be pretty high – probably since analytics combines Math & Jugaad, skills Indians inherently seem to possess.
  • I’d also think it makes business sense for the quant in consumer analytics context to be essentially an ‘insider’ &  hence Indian analytics enterprise could always showcase an edge, a value-add
  •  Eventually, while the ‘insider advantage could work in favour of Indian analytics enterprise in the shorter term, the Math + Jugaad + Semantics combination could open the world to India in a big way, touch wood.

Hop onto the Gravy (app) train early on & dish out by the dime
  • Mobile apps development is essentially a platform (OS specific SDKs et al) based innovation that enables small & Individual pools of expertise to emerge quickly & thus very amenable to garage innovation
  • While building of apps is innovation per se’, it is more ‘applied innovation’  (owing to the afore mentioned platform technologies) & hence India won’t necessarily face a quality-of-innovation prejudice
  • Added to this is the global trend of healthcare going mobile progressively, there’s an open opportunity of cellular network providers tying up with local app developers, for the service & transactional ease they’d bring in.
  • Apps are evolutionary products with a limited shelf-life (before being reinvented in a different version) & hence inherently man-power intensive. Given this context & given the explosion of engineering education making available qualified young (& economical) tech work-force that can think in English, India has the potential to become the ‘China’ of mobile apps – if only the rough edges of campus-to-corporate transition can be smoothened out sooner.
  • Using this & some of the 'local' advantages i mentioned under Analytics, I'd think there's no reason why Indian enterprise shouldn't give an India flavor to its Gaming?, after all, all nationalities like to play by their own rules :-) - this would also expose the average indian youngster to the game mechanics that from whatever I read, is poised to dominate every tangible domain in the years to come.
  • And finally, a domain where VCs can play evangelists, stoke the fires of enterprise & seed the self-sustaining revolution of mobile apps – all with minimal risk & funding :-)

And hey, is Mobile Hardware IT too? – thought NVCA said so…
  • Is it me or wasn't there really any investment into the super accelerating mobile handset Indian enterprise in 2012? Unless this is already reaching saturation which I seriously doubt, there’s still a good open investment opportunity. But of course given the capital intensive nature of these start-ups, the scope for venture funding may be low and only at very early stages, but if successful this could turn into a multi-X return by series-B funding itself.

After Thought:

What’s with financial analysts & their compulsive fetish for quarterly reporting? – I’d agree quarterly trends do matter in consumer markets, but I’m utterly confused about their utility in a long-decision-cycle B2B environment like investing – enlighten me folks, I’m all ears!