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The Nutshell:

How Disruption is Taking the Healthcare Industry Off Life Support

By Winnie Sun & Alex Dodds

5 minute read

Digital, data, artificial intelligence and the rise of consumer expectations have been the forces behind disruption in loads of different industries. As we have seen in previous Nutshells, from beer to sports and all the way back to the automotive industry, we see companies tapping into these forces to find new revenue streams, re-invent their supply chain, and ultimately, change the game. 

Medicine has seen an incredible amount of innovation and changes beyond all recognition in short cycles. However despite all these changes, the core structure of stakeholders that support the ecosystem has remained largely intact.

The healthcare ecosystem in most developed nations relies upon 3 key stakeholders that have previously acted as blockers to innovation: 

  1. Governments building the infrastructure 

  2. Private pharma and universities developing drugs

  3. Insurance paying for the cost of treatment, which in many cases also falls upon the government e.g. through the NHS in the UK or Medicare & Medicaid in the US

This is shown by the US’s stagnant division of the healthcare dollar. In 1960, 37 percent went to hospitals, 24 percent to doctors, and 11 percent to drugs; today, those shares remain effectively the same.

But that’s about to change.

Any great leap forward in healthcare has relied upon these 3 stakeholders working in tandem to foster complementary innovation in two key areas: science and delivery. The science to create breakthrough miracles, and the ability of getting that solution in the hands of those who need it.

The smallpox vaccination is a great example. Although the smallpox vaccine was discovered by Dr Edward Jenner in the late 18th century, it was only with the development of a technique in the 1950s that created a heat-stable, freeze dried vaccine that finally eradicated smallpox across the world and saved millions of lives.

It’s been a long time coming but the forces that disrupted other industries have arrived in healthcare and they’re not content to wait around anymore. Let’s dive into some of the exciting new technologies and the use cases that are emerging in science and delivery.


Personalised Medication

Healthcare is finally waking up to positive disruptive force of personalisation over mass production, with the potential to save billions of dollars and, more importantly, lives

    • Navican: A US healthcare company that tailors cancer treatments to individual patients through genomics testing
    • Microsoft’s Project Emma: Named after an early on-set Parkinson’s sufferer called Emma Lawton, it was launched to provide Parkinson’s sufferers greater control of their movement through a personalised wearable device that is worn like a watch

    • Organovo’s 3D printed Liver Tissue: 3D printing is getting in on the act as the San Diego-based Organovo aims to print patches made of personalised human tissue for defunct organs or for entire transplantation

Big Data and AI

How data is helping doctors and healthcare professionals get to more accurate diagnoses, faster

    • Health Data Research UK: The UK’s national institute for health data science aims to ensure that every healthcare interaction is better informed by access to large scale data and advanced analytics. Given that the UK has some of the richest medical data on the planet and is able to make nationwide changes through the NHS, it is at the forefront of using data in healthcare. Also see 100,000 Genomes Project
    • Tempus: This tech company combines genomics testing with centralised patient data to provide doctors with individualised treatment options & patient insights driven by AI and machine learning 
    • Google’s Deepmind partnership with Moorfields Eye Hospital: A great example of Big Tech teaming up with the oldest national health service in the world to bring AI to the frontline of combating eye disease. Through AI they have been able to automatically detect eye conditions in seconds and prioritise treatment


Digital Delivery

With or without an apple a day, digital delivery methods aim to keep the physical doctor away

    • Babylon’s Interactive Symptom Checker: AI’s at it again with Babylon’s innovative interactive tool to analyse patients’ conditions. Created by doctors and scientists, it harnesses deep-learning to offer medical advice based on a patient’s symptoms

    • Teladoc’s Mobile App: With access to 3100 licensed healthcare professionals, Teladoc’s mobile app allows you to schedule a doctor visit, manage your medical history, or even send a prescription to the nearest pharmacy

D2C Models

With growing and ageing populations creating more complex needs, D2C models can offer respite to creaking health services and cut down on travel and waiting times for patients

    • South Africa’s Medical ‘ATMs’: Faced with the challenges of poverty, rural communities and a large population with chronic illnesses (SA has 7.5m people living with HIV - the most in the world), SA is trialling Pharmacy Dispensing Units to help alleviate some of the pressure on the country’s congested medical system

    • Apple’s Clinical Research EcosystemApple has provided two open-source frameworks to help clinical trials recruit patients and monitor their health remotely through iPhones and Apple Watches
    • Amazon’s PillPack: Amazon’s purchase of PillPack in 2018 brought the online juggernaut into the realm of medical subscriptions and with it, access to wholesale pharmacy licences in 50 US states. Time will tell whether this will give the platform to allow Amazon to play to its’ strengths and scale up to dominate the pharmaceutical market

Manifesto Thinks...

Each in their own right, the innovations we mentioned above are making healthcare better, cheaper, and overall more accessible. But as seen in other industries, when rising customer expectations and technology combine they can have an exponential impact on the entire ecosystem, and change the roles of its players. 

On the tech side, the entrance of the big players (e.g. Apple, Google etc.) into this foyer will be closely watched. Are they the benevolent saviours lending their prowess to better humanity or is this just another foray into a profitable industry ripe for disruption?

Coupled with the emergence of popular D2C models, we’ll hear healthcare leaders asking themselves the same question retail execs have been for a while: “Who owns the customer-facing relationship? Who do they trust?” And they just might not be the big players we see today. After all, if the cost of non-basic, non-urgent care becomes extremely low, what would be the role of insurance? 

On the customer side the radical advancements in tech and data threaten to fundamentally change the customer relationship with their healthcare provider, as expectations of what good service and care looks like rapidly shift. 

This potent mix of rising customer expectations and technological change is finally helping new propositions and experiences gain traction and fundamentally disrupt the core ecosystem that has supported the healthcare industry for decades. The changes we’re about to see will have wide ramifications across all aspects of our lives as these innovations go from testing to implementation. We might finally be about to witness the realignment of the healthcare industry around the needs of the customer.

A truly exciting period awaits.