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VISHAL GULATI Twitter: @vgul
HEALTHCARE EVOLUTION:
WHAT IS DIFFERENT THIS TIME
DR VISHAL GULATI: HEALTHTECH VC, DRAPER ESPRIT
VISHAL GULATI Twitter: @vgul
VISHAL GULATI Twitter: @vgul
Draper Esprit Facts
VISHAL GULATI Twitter: @vgul
Digital Health: What & Why
ATTRACTIVE STAGE OF SECTOR
• US market growing rapidly, EU market about
to takeoff
• Global application of technologies
• Attractive valuations – potential arbitrage
opportunities
DEFINITION: Products and platforms exploiting connectivity, data aggregation
and/or analytics to improve disease outcome and or patient experience
DIVERSE OPPORTUNITY LANDSCAPE
• Wide range of opportunities, portfolio opportunity
• B2C side expands later stage investor universe to
help value creation
• Surrounded by acquisitive industries
UNDERPINNED BY TECH CHANGES
• Rising global smartphone penetration
• Exponential tech bringing costs down (DNA
sequencing)
• Data analytics/security technologies maturing
FAVOURABLE MACRO-TRENDS
• Unaffordable healthcare costs
• Aging population
• Baby-boomers driven by quality of life & willing
to pay for better outcome and experiences
VISHAL GULATI Twitter: @vgul
Private and confidential draft for
discussion
952
1,431 1,465
2,355
5,172
5,744
160
292
415
626
737
889
0
100
200
300
400
500
600
700
800
900
1000
0
1000
2000
3000
4000
5000
6000
7000
2010 2011 2012 2013 2014 2015
Funding (USD mio) Deals (#)
In in less than 5 years, digital health has outstripped total investments in medical devices & diagnostics
Notable digital health investments (USD mio raised 1)Digital health funding
313
226
66
77
DealsFunding (USD mio)
18
25
26
9
(1) Rounded figures
Source: CB Insights, January 2016; CrunchBase
Digital Health: Venture Investing
VISHAL GULATI Twitter: @vgul
Digital Health: TRACTION
•$ 2.5b worth of M&A
in 2014 (av. $210m)
•Outperformed
biotech & device M&A
M&A
•8 venture backed IPOs
since 2009
•Include Veeva,
MediData but not all
have performed well
IPOs
•Guidance on major
issues
•27 digital health
products approved
FDA
•Guidance on data
protection since 2013
•Further guidance in
2015
EMEA
•Recongnised role of
software in disease
management
•Omada Health’s
diabetes software first
product
CDC
•Announced Digital
Health Roadmap in
2013. Pt. access in ’15
•Launched accelerator
& test-beds in 2015
NHS
•Leading US health
systems rapidly going
digital (Kaiser)
organically as well as
inorganically
Payers
•Major investments by
Qualcomm, Bluecross,
Google, Novartis
•Big data traction
(Biogen, Roche)
Corporates
•Apple Inc: HealthKit
(EPIC), ResearchKit
•Android
•IBM Watson: Apple,
J&J, Medtronic
Lateral
VISHAL GULATI Twitter: @vgul
Digital health – Matrix of deals
Technological Innovation
Business Model Innovation
B2BB2C
Telemedicine
Consumer Genetics
Neuro enhancement
“Tripadvisor”
Precision Medicine
Remote Pt. MonitoringWearables
Data Security
Workflow Tools
Premarket Access
Ecommerce Clinical Trial Recruitment
DTC Medical Device
Stratification & Triage
Data Generation
Training & Edu
Source: Internal
Online Tx
VISHAL GULATI Twitter: @vgul
Portfolio
VISHAL GULATI Twitter: @vgul
Portfolio Map:
Technological Innovation
Business Model Innovation
B2BB2C
Telemedicine
Consumer Genetics
Neuro enhancement
“Tripadvisor”
Precision Medicine
Remote Pt. MonitoringWearables
Data Security
Workflow Tools
Premarket Access
Ecommerce Clinical Trial Recruitment
DTC Medical Device
Stratification & Triage
Data Generation
Training & Edu
Source: Internal
Online Tx
VISHAL GULATI Twitter: @vgul
Life is Good 1.0
VISHAL GULATI Twitter: @vgul
Life is Good 2.O
VISHAL GULATI Twitter: @vgul
Not so Good: Death is Still Very Common
VISHAL GULATI Twitter: @vgul
So Where are We?
A B
C
VISHAL GULATI Twitter: @vgul
What is different now?
•Healthcare is changing from a data poor science to
a data rich science: Genomics, Data Science,
Handhelds, Personlised Medicine/ Precision
Medicine
•Culture Shift: Privacy, Democratisation,
Accountability, End of exceptionalism
VISHAL GULATI Twitter: @vgul
Technology change….
VISHAL GULATI Twitter: @vgul
Getting Rich…
VISHAL GULATI Twitter: @vgul
Culture Shift: “Public Health”
"You changed my 11-year-old
daughter's summer! She's been so
self-conscious, but since she read
about you and saw this photo, she
cannot wait to wear a bathing suit
tomorrow and show off her insulin
[pump] and have me post a photo
here!"
Miss Idaho Sierra Sandison
VISHAL GULATI Twitter: @vgul
Patients don’t want to share data. Seriously?
VISHAL GULATI Twitter: @vgul
Culture Shift: Participatory Medicine
VISHAL GULATI Twitter: @vgul
Powershifting
VISHAL GULATI Twitter: @vgul
Data Driven Accountability
Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics.
BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2424 (Published 28 May 2013)
VISHAL GULATI Twitter: @vgul
Which is more important?
VISHAL GULATI Twitter: @vgul
1: Volume to Value
Activity Based Payments Value Based Payments
Birth of the analytics for accountability industry
VISHAL GULATI Twitter: @vgul
2: Herd Medicine to Nerd Medicine
One size fits ‘all’ n = ~1
Genomics & other stratification tools become mainstream
VISHAL GULATI Twitter: @vgul
3: Small is the new Big
Mainframe Handheld
Adding a billion new healthcare consumers
VISHAL GULATI Twitter: @vgul
4: ER to CR
Episodic Care Continuous Care
Strong disruptive interactions between industries
VISHAL GULATI Twitter: @vgul
The Digital Health Opportunity
THE FUTURE OF HEALTH WILL ARISE FROM THE JOINT ENERTPRISE OF
PATIENTS AND HEALTH PROFESSIONALS USING DIGITAL TECHNOLOGIES
AND HARNESSING LARGE POOLS OF DATA
BIG DATA GENOMICS CONNECTIVITY A.I.
VISHAL GULATI Twitter: @vgul
• @vgul
• vg@healthtech.vc
VISHAL GULATI Twitter: @vgul
• @vgul
• vg@healthtech.vc

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Digital Health Evolution and Opportunities

  • 1. VISHAL GULATI Twitter: @vgul HEALTHCARE EVOLUTION: WHAT IS DIFFERENT THIS TIME DR VISHAL GULATI: HEALTHTECH VC, DRAPER ESPRIT
  • 3. VISHAL GULATI Twitter: @vgul Draper Esprit Facts
  • 4. VISHAL GULATI Twitter: @vgul Digital Health: What & Why ATTRACTIVE STAGE OF SECTOR • US market growing rapidly, EU market about to takeoff • Global application of technologies • Attractive valuations – potential arbitrage opportunities DEFINITION: Products and platforms exploiting connectivity, data aggregation and/or analytics to improve disease outcome and or patient experience DIVERSE OPPORTUNITY LANDSCAPE • Wide range of opportunities, portfolio opportunity • B2C side expands later stage investor universe to help value creation • Surrounded by acquisitive industries UNDERPINNED BY TECH CHANGES • Rising global smartphone penetration • Exponential tech bringing costs down (DNA sequencing) • Data analytics/security technologies maturing FAVOURABLE MACRO-TRENDS • Unaffordable healthcare costs • Aging population • Baby-boomers driven by quality of life & willing to pay for better outcome and experiences
  • 5. VISHAL GULATI Twitter: @vgul Private and confidential draft for discussion 952 1,431 1,465 2,355 5,172 5,744 160 292 415 626 737 889 0 100 200 300 400 500 600 700 800 900 1000 0 1000 2000 3000 4000 5000 6000 7000 2010 2011 2012 2013 2014 2015 Funding (USD mio) Deals (#) In in less than 5 years, digital health has outstripped total investments in medical devices & diagnostics Notable digital health investments (USD mio raised 1)Digital health funding 313 226 66 77 DealsFunding (USD mio) 18 25 26 9 (1) Rounded figures Source: CB Insights, January 2016; CrunchBase Digital Health: Venture Investing
  • 6. VISHAL GULATI Twitter: @vgul Digital Health: TRACTION •$ 2.5b worth of M&A in 2014 (av. $210m) •Outperformed biotech & device M&A M&A •8 venture backed IPOs since 2009 •Include Veeva, MediData but not all have performed well IPOs •Guidance on major issues •27 digital health products approved FDA •Guidance on data protection since 2013 •Further guidance in 2015 EMEA •Recongnised role of software in disease management •Omada Health’s diabetes software first product CDC •Announced Digital Health Roadmap in 2013. Pt. access in ’15 •Launched accelerator & test-beds in 2015 NHS •Leading US health systems rapidly going digital (Kaiser) organically as well as inorganically Payers •Major investments by Qualcomm, Bluecross, Google, Novartis •Big data traction (Biogen, Roche) Corporates •Apple Inc: HealthKit (EPIC), ResearchKit •Android •IBM Watson: Apple, J&J, Medtronic Lateral
  • 7. VISHAL GULATI Twitter: @vgul Digital health – Matrix of deals Technological Innovation Business Model Innovation B2BB2C Telemedicine Consumer Genetics Neuro enhancement “Tripadvisor” Precision Medicine Remote Pt. MonitoringWearables Data Security Workflow Tools Premarket Access Ecommerce Clinical Trial Recruitment DTC Medical Device Stratification & Triage Data Generation Training & Edu Source: Internal Online Tx
  • 8. VISHAL GULATI Twitter: @vgul Portfolio
  • 9. VISHAL GULATI Twitter: @vgul Portfolio Map: Technological Innovation Business Model Innovation B2BB2C Telemedicine Consumer Genetics Neuro enhancement “Tripadvisor” Precision Medicine Remote Pt. MonitoringWearables Data Security Workflow Tools Premarket Access Ecommerce Clinical Trial Recruitment DTC Medical Device Stratification & Triage Data Generation Training & Edu Source: Internal Online Tx
  • 10. VISHAL GULATI Twitter: @vgul Life is Good 1.0
  • 11. VISHAL GULATI Twitter: @vgul Life is Good 2.O
  • 12. VISHAL GULATI Twitter: @vgul Not so Good: Death is Still Very Common
  • 13. VISHAL GULATI Twitter: @vgul So Where are We? A B C
  • 14. VISHAL GULATI Twitter: @vgul What is different now? •Healthcare is changing from a data poor science to a data rich science: Genomics, Data Science, Handhelds, Personlised Medicine/ Precision Medicine •Culture Shift: Privacy, Democratisation, Accountability, End of exceptionalism
  • 15. VISHAL GULATI Twitter: @vgul Technology change….
  • 16. VISHAL GULATI Twitter: @vgul Getting Rich…
  • 17. VISHAL GULATI Twitter: @vgul Culture Shift: “Public Health” "You changed my 11-year-old daughter's summer! She's been so self-conscious, but since she read about you and saw this photo, she cannot wait to wear a bathing suit tomorrow and show off her insulin [pump] and have me post a photo here!" Miss Idaho Sierra Sandison
  • 18. VISHAL GULATI Twitter: @vgul Patients don’t want to share data. Seriously?
  • 19. VISHAL GULATI Twitter: @vgul Culture Shift: Participatory Medicine
  • 20. VISHAL GULATI Twitter: @vgul Powershifting
  • 21. VISHAL GULATI Twitter: @vgul Data Driven Accountability Day of week of procedure and 30 day mortality for elective surgery: retrospective analysis of hospital episode statistics. BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f2424 (Published 28 May 2013)
  • 22. VISHAL GULATI Twitter: @vgul Which is more important?
  • 23. VISHAL GULATI Twitter: @vgul 1: Volume to Value Activity Based Payments Value Based Payments Birth of the analytics for accountability industry
  • 24. VISHAL GULATI Twitter: @vgul 2: Herd Medicine to Nerd Medicine One size fits ‘all’ n = ~1 Genomics & other stratification tools become mainstream
  • 25. VISHAL GULATI Twitter: @vgul 3: Small is the new Big Mainframe Handheld Adding a billion new healthcare consumers
  • 26. VISHAL GULATI Twitter: @vgul 4: ER to CR Episodic Care Continuous Care Strong disruptive interactions between industries
  • 27. VISHAL GULATI Twitter: @vgul The Digital Health Opportunity THE FUTURE OF HEALTH WILL ARISE FROM THE JOINT ENERTPRISE OF PATIENTS AND HEALTH PROFESSIONALS USING DIGITAL TECHNOLOGIES AND HARNESSING LARGE POOLS OF DATA BIG DATA GENOMICS CONNECTIVITY A.I.
  • 28. VISHAL GULATI Twitter: @vgul • @vgul • vg@healthtech.vc
  • 29. VISHAL GULATI Twitter: @vgul • @vgul • vg@healthtech.vc