1 What will healthcare look like in the coming decades? Healthcare in 2025, 2035 2 The presentation will also be sent to you. Feel free to share with colleagues. The resolution of some slides may be suboptimal due to the webinar software. Those slides will look fine in the presentation that we send you. Briefing recording will be distributed http://support.citrixonline.com/en_US/Webinar W I T H I N 2 4 H O U R S 3 @cbinsights @nikillinit #healthcare2025 J O I N T H E C O N V E R S A T I O N O N T W I T T E R 4 W H O W E A R E The technology market intelligence platform. CB Insights software lets you predict, discuss, and communicate emerging technology trends using data in ways that are beyond human cognition. 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LEARN MORE HERE events.cbinsights.com/councils councils@cbinsights.com cbinsights.com 7 Nikhil Krishnan A B O U T T H E A N A L Y S T Nikhil Krishnan is a senior analyst at CB Insights, where he produces data- driven analysis and research reports on trends in digital health, agtech, and construction. He sends the weekly Digital Health Insights newsletter to 45K+ members. His research has been featured in The Economist, New York Times, Wall Street Journal, and more. Prior to joining CB Insights, Nikhil worked at Uber, the Small Business Administration, and Relationship Science. Most popular analyses by Nikhil: Oscar Health Insurance Strategy Teardown Apple In Healthcare @nikillinit | nkrishnan@cbinsights.com Senior Analyst 8 The future is very easy to predict Predictions about the year 2000 9 We can think of the future in terms of different shifts 1 0 18 3 1 Demographic Shifts Technological Shifts Societal + Cultural Shifts Table Of Contents 10 Demographic Shifts 11 CIA World Factbook A large wave of the US population will hit age 65+ within the next 20 years. 12 Different countries vary in their aging dynamics CIA World Factbook 13 Our World In Data But life expectancies keep increasing nearly across the board. Increasing life expectancy changes the cost and health problems of the population depending on what age the average life expectancy is increasing from. Will we see another stepwise jump in life expectancy? 14 Health Affairs We're going to have to manage diseases in the population, especially chronic and lifestyle-based conditions. 15 Will there be enough doctors? World Health Organization 16 What skills will doctors need to have? 17 What new healthcare jobs will emerge? Health coaches Genetic counselors Patient concierges 18 Technological Shifts 19 The cost to sequence is dropping, and more genomic information is becoming available NIH, National Human Genome Research Institute/ARK Investment Management 20 We're slowly learning more about our predispositions and diseases Nature Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression April 26, 2018 Large-scale GWAS identifies multiple loci for hand grip strength providing biological insights into muscular fitness July 12, 2017 21 CRISPR is opening new doors in the therapeutics space CRISPR enables us to turn genes on and off, which could help us address Mendelian hereditary disorders and conduct experiments to understand how different mutations are expressed. 22 CRISPR applications extend to other areas Xenotransplantation: Creating transplantable organs in other animals Population health: Stopping the spread of infectious disease with genetically altered mosquitoes 23 Will healthy people start wearing medical- grade wearables? Apple is working with the FDA to get approval to detect atrial fibrillation through the Apple Watch. Will wearables get more accurate, identify more diseases, and become more widespread? 24 Will monitoring become more passive? Patent: Turning your phone into a monitoring device Patent: Wireless heart rate detection Patent: Optical sensors in your bathroom to monitor blood flow 25 Will we have more devices inside of us? Ingestible sensors Implanted intraocular device Artificial pancreas 26 AI in healthcare is taking off Funding activity for AI + healthcare companies, 2013 - 2017 27 And the algorithms are getting very good "The results show that our algorithm's performance is on-par with that of ophthalmologists." Performance of the algorithm (black curve) and eight ophthalmologists (colored dots) for the presence of referable diabetic retinopathy based on 9,000+ images. Google 28 Good enough for the FDA The FDA approved IDx-DR, an algorithm that's able to detect diabetic retinopathy and doesn't require a clinician to interpret the results. This enables detection for more people and in more settings. FDA 29 Blockchain + healthcare hype is real, but reality is TBD CB Insights Trends Tool 30 The ingenious and 'dystopian' DNA technique police used to hunt the 'Golden State Killer' suspect March 13, 2018 Are we prepared for these new technologies? 31 Societal + Cultural Shifts 32 1. Consumer seeks health services when feeling ill 2. Sorts through different care options 3. Data is then captured to confirm diagnosis 1. Data is captured passively via medical-grade wearables 2. A provider, nurse, or PA reaches out if there is an anomaly 3. Provider already has historical dataset of relevant biomarkers and genetic predispositions Is the patient-doctor relationship going to change? Reactive Health Proactive Health 33 The digital gap in healthcare is expanding. Digital tools change our customer service expectations. Will we eventually demand that same service from healthcare? Will the people who work in healthcare demand tools more comparable to the ones they use in their personal lives? McKinsey 34 NPS Benchmarks Will the entrance of tech companies make customer experience and brand a higher priority? Tech companies have a much higher Net Promoter Score (NPS) than some of the existing players in the health industry, like health insurance companies. 89 50 12 Apple Google Health Insurance (average) NPS Scores 35 Healthcare is coming to more everyday places 36 Market sizes for home healthcare predict growth CB Insights market sizing tool Including in your home Home healthcare is growing and important area, especially for the elderly as evidenced by large acquisitions like Kindred Health. As more data is generated at home via consumer diagnostics, wearables, etc. it might become normal to see more health professionals come to the homes of high-risk individuals. 37 Kaiser Family Foundation Government heath programs will need to better manage cost An expected surge of Medicare costs and cuts to Medicaid are going to force Medicare Advantage carriers, the federal government, and states to implement solutions to manage cost as tightly as possible. 38 China creates new drug regulator in biggest government overhaul in years March 13, 2018 What regulatory changes will happen? 39 Who knows what the administration will look like? 40 "I very frequently get the question: 'What's going to change in the next 10 years?' And that is a very interesting question; it's a very common one. I almost never get the question: 'What's not going to change in the next 10 years?' And I submit to you that that second question is actually the more important of the two because you can build a business strategy around the things that are stable in time." K N O W I N G W H A T W O N ' T C H A N G E I S J U S T A S I M P O R T A N T Jeff Bezos, Amazon CEO 41 What won't change? We'll always want to: Create, capture, and better analyze data from various sources Better identify and create new therapies and treatment options Identify at-risk patients and intervene earlier Move to a value-based, outcome- based model of reimbursement Improve access to care for all 42 Questions? Twitter: @nikillinit nkrishnan@cbinsights.com 43 The CB Insights platform has the underlying data included in this report W H E R E I S A L L T H I S D A T A F R O M ? CLICK HERE TO SIGN UP FOR FREE 44 cbinsights.com @cbinsights