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What will healthcare look like in the
coming decades?
Healthcare in
2025, 2035
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#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
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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
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The future is very easy to predict
Predictions about the year 2000
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We can think of the future in terms of different
shifts
1 0
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3 1
Demographic Shifts
Technological Shifts
Societal + Cultural Shifts
Table Of Contents
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Demographic
Shifts
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CIA World Factbook
A large wave of
the US population
will hit age 65+
within the next 20
years.
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Different countries vary in their aging dynamics
CIA World Factbook
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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?
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Health Affairs
We're going to
have to manage
diseases in the
population,
especially
chronic and
lifestyle-based
conditions.
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Will there be enough doctors?
World Health Organization
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What skills will doctors need to have?
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What new healthcare jobs will emerge?
Health coaches
Genetic counselors
Patient concierges
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Technological
Shifts
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The cost to sequence is dropping, and more
genomic information is becoming available
NIH, National Human Genome Research Institute/ARK Investment Management
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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
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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.
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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
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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?
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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
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Will we have more devices inside of us?
Ingestible sensors
Implanted intraocular
device
Artificial pancreas
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AI in healthcare is taking off
Funding activity for AI + healthcare companies, 2013 - 2017
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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
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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
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Blockchain + healthcare hype is real, but reality
is TBD
CB Insights Trends Tool
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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?
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Societal +
Cultural Shifts
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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
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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
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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
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Apple
Google
Health Insurance
(average)
NPS Scores
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Healthcare is coming to more everyday places
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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.
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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.
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China creates new drug regulator in biggest
government overhaul in years
March 13, 2018
What regulatory changes will happen?
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Who knows what the
administration will look like?
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"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
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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
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Questions?
Twitter: @nikillinit
nkrishnan@cbinsights.com
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