For making primary care affordable and convenient
To identify the many ways that a doctor’s office can be improved, One Medical founder and CEO Tom X. Lee, an internist, spent the company’s early days serving in a variety of roles, from physician to accountant. He hit on a membership model that adds tech-enabled services to a high-tech foundation—allowing him to cut the administrative costs of traditional care by two-thirds, he says. One Medical now has 54 offices around the U.S., a 46% bump over 2015, and its model offers a template for a health care system in flux. “We’re doing more for less,” says Lee, “and always reengineering our processes.”
For mining data to build health apps
Apple became the world’s most valuable company by being its preeminent maker of computing devices, from those you stick on a desk (Macs) to ones you strap to your wrist (the Apple Watch). So when people talk about the company as a creative force, they tend to assess its newest devices and judge how strikingly they improve on their predecessors. That’s why there was heated debate in 2016 about matters such as whether the iPhone 7 was a disappointment because its industrial design stuck close to that of the iPhone 6s, and whether the Touch Bar on the new MacBook Pros was an adequately radical rethink of what a modern laptop should offer.
But creativity is more than skin deep—and Apple’s approach to the hardware and software engineering that creates its experiences has never been more ambitious. Other makers of phones and tablets buy the same off-the-shelf chips as their competitors. Apple, by contrast, designs its own chips—so an iPhone packs a processor designed specifically optimized for Apple’s operating system, apps, display, camera, and touch sensor. The company has gotten so good at chip design that the A10 Fusion inside the iPhone 7 trounces rival processors in independent speed benchmarks.
Apple has also made major inroads in artificial intelligence, an area where the competition from companies such as Google couldn’t be any more daunting. For instance, it uses AI techniques to wring as much life as possible out of the iPhone’s battery. Because of Apple’s privacy-driven decision to limit the amount of information it aggregates and analyzes in the cloud, it also does much of its AI right on the devices rather than using massive server farms. When it calls machines such as the iPad Pro “supercomputers,” it isn’t exaggerating.
The company has been expanding beyond its traditional consumer electronics roots and is growing an entertainment business with Apple Music and Apple TV. In March 2016, Apple announced CareKit, an open-source platform that makes it easier for developers to aggregate and share patients’ medical information with their caregivers—all with consent. Since its launch, CareKit has already been used to make apps to help patients manage diabetes (One Drop), monitor depression (Iodine), track reproductive health (Glow), and record asthma symptoms (Cleveland Clinic). Apple’s approach to health is to operate behind the scenes by helping researchers, patients, and developers to make use of the health data they’re collecting via a smartphone.
Cofounded in 1976 by the revered tech entrepreneur and inventor Steve Jobs and engineer Steve Wozniak in Cupertino, California, Apple has continually revolutionized the consumer electronics industry. The company helped usher in the age of the personal computer in the 1980s with the sleek, affordable Macintosh; bolstered the age of digital-music listening with the iPod and iTunes in 2001; and laid the groundwork for the current smartphone landscape with 2007’s iPhone and iOS operating system. Under Jobs’s purview as Apple’s CEO from 1997 until shortly before his death in 2011, the company became known for its intense focus on design. The British designer Jony Ive, who was hired in 1992 and later became Apple’s chief design officer, is largely responsible for much of the company’s iconic visual appeal: sleek (often white) minimalism and an emphasis on unparalleled user experience.
For mobilizing hearth monitoring
AliveCor developed the first smartphone-connected electrocardiogram, or EKG, called Kardia, which detects abnormal heart rhythms on a phone in much the same way that an EKG in a hospital records the electrical activity of the heart. What this means is that patients can check their heart health regularly and find out within 30 seconds whether their results are normal or they should seek medical attention. That’s particularly important for millions of Americans at risk for arrhythmias, which may be symptomless and can result in potentially fatal outcomes like heart failure and stroke. In 2016, the company announced a new version of its electrocardiogram for the Apple Watch, called Kardia Band, and it is the first to have an FDA-cleared blood pressure monitor and EKG in a single app. By November 2016, Kardia had recorded some 11 million EKGs, up from 2 million in March 2015. Also in 2016, AliveCor announced a collaboration with Mayo Clinic to use machine learning technology to better understand some of the hidden health indicators in all of the EKG readings it is collecting.
For reducing pain points at health care facillities
GE Healthcare works with partners ranging from the University of California San Francisco to Johns Hopkins to develop both hardware and software technologies that solve some of the most pressing problems in health care. Some are drawn from health systems; for example, UCSF needed a partner to develop machine learning algorithms for medical imaging, and Johns Hopkins needed a NASA-style command center to better manage patient flow in and around the hospital. Early results from Johns Hopkins have been promising: The hospital has reported a 60% improvement in the ability to accept patients with complex medical conditions from other hospitals around the region and country; its ambulances are able to get dispatched 63 minutes sooner to patients at outside hospitals; and its emergency department is assigning patients to beds 30% faster.
For helping asthma and COPD patients breathe easier
Propeller Health develops technology for patients and physicians to better understand asthma and COPD, which afflict millions of patients in the U.S. alone, with a goal of improving symptoms and reducing hospitalizations and ER visits. The Propeller Health system includes a sensor that attaches to inhaler rescue or controller medications; an app called Cards (launched in 2016) for patients to better manage their conditions; and tools for providers to proactively manage large groups of patients. This system is FDA-approved as a medical device, with eight separate FDA clearances obtained so far.
Propeller Health’s technologies are now used in more than 45 programs across the U.S., including at large health systems like Dignity Health. Propeller has recently completed an analysis of 330 patients showing a 100% reduction in asthma-related hospitalizations and a 60% reduction in asthma-related ER visits over approximately one year. The company also launched the first predictive tool for asthma risk based on environment, using results from a peer-review publication. The company makes money by working with health plans and integrated health systems to help reduce respiratory utilization and cost, as well as pharma companies that are looking for ways to improve medication adherence.
For putting health data to work
Verily, formerly Google Life Sciences, has become an incubator of sorts for a variety of experimental health initiatives, including a smart contact lens that might someday monitor blood sugar levels and a stabilizing spoon for people with Parkinson’s disease. The company, which is a division of Alphabet, describes its unifying mission as “to make the world’s health data useful.” In 2016, Verily announced a variety of projects: a data management platform for people with diabetes called Onduo, in partnership with biotech giant Sanofi; Debug, which aims to alleviate mosquito-borne disease; Galvani, to create bioelectronic medicines with GSK; and Verb Surgical, which focuses on robotic surgery in partnership with Ethicon. One of Verily’s most advanced projects, Liftware, announced a second product alongside its tremor-stabilizing spoon: The Level, which is designed to help people with cerebral palsy and spinal cord injuries eat independently. Liftware’s devices have been used by more than 10,000 people in the past year.
For using technology to treat diabetes
Omada Health is among the first digital health companies to receive reimbursement from the U.S. federal government for its online diabetes prevention program. Omada is aimed at the roughly 86 million Americans with prediabetes. The government support is a big step forward for chronic disease prevention: The Centers for Medicare & Medicaid Services has always reimbursed for screening diabetes, but not for companies and providers that help prevent the progression of the disease altogether. CMS’s decision is also a big deal for other digital therapeutic startups, which essentially take established offline programs and bring them online to make them accessible for more patients.
Omada Health’s program has more than 85,000 users, making it the largest diabetes prevention program in the U.S. The company’s revenue chiefly comes from employers, health plans, and health systems that are looking for ways to reduce their risk of prediabetes progressing to a full-blown disease. The company says it only makes money when patients participate in its program and achieve clinically meaningful weight loss outcomes.
Global Kinetics Corporation
For collecting data from wearables to treat Parkinson’s
Global Kinetics Corporation is the maker of the Personal KinetiGraph, a wearable that tracks movement in Parkinson’s patients. The device remind patients when to take their medications and even helps their doctors make an accurate diagnosis. The FDA-approved device is worn by 14,500 patients in more than 200 clinics around the world. It is intended to be worn for seven days, so physicians can identify important changes and trends. Global Kinetics in 2016 announced a randomized, controlled trial in partnership with the National Parkinson Foundation to study the impact of the device in 400 patients and determine how technology can be used in future clinical care. Going forward, Global Kinetics says its technology can be expanded to other diseases, including Huntington’s disease, Alzheimer’s disease, and epilepsy. The company makes money by partnering with pharmaceutical companies to use the technology in clinical trials for medicines being developed for Parkinson’s, but it also developing a business model based on direct-to-consumer sales.
For cutting down on surgical incisions
For common abdominal surgeries, like gall bladder removals and appendectomies, the holy grail is to minimize incision points and thereby reduce scarring and pain for the patient. Levita Magnetics has developed a new system that uses magnets in a novel way, with a goal of making it possible for surgeons to perform so-called single port surgery. In 2016 the system received FDA clearance in a new category: Magnetic Surgery. Also in 2016, the company published results from a 50-patient clinical trial that demonstrated no adverse effects. Already, Levita’s system has been used by top surgeons at Duke, Stanford, and the Cleveland Clinic for gall bladder removals, with far more surgeries being conducted in CEO Alberto Rodriguez-Navarro’s native Chile. “It’s simple and very innovative,” says Stanford’s director of innovative surgery, Dr. Homero Rivas, one of the first surgeons to work with Levita.