From Spice to Drones

Sanjay Mohan

Every industry has shown that there is an exponential relationship between the time it takes to detect a problem and the cost to fix it. The later the problem is found, the more expensive – and sub-optimal – the fix is. Hence, we see the investments in preventive maintenance of machines as well as software across industries. From automobiles, to infrastructure to computers.

Healthcare, however – arguably the most pertinent industry to our lives – still operates on this principle of “break-fix.” We will worry about fixing our health later - when it breaks down, when we get sick. This reactive system was designed when infectious disease and injury constituted the primary burden of healthcare. As the US transitions to a chronic disease burden, however, we need to employ a prevention-focused model. While this stands to reason, sadly the current system continues to resist a preventive approach - as is exhibited by numerous studies and the lack of funding for prevention programs.

Singularity University defines “areas ripe for disruption” as those with complex experiences, broken trust, redundant intermediaries, and limited access. This definition aptly describes the state of the healthcare industry today. The system is plagued with multi-dimensional issues, with quality and cost being the ultimate barriers for consumers and society at large.

According to Dhruv Khullar, a physician and researcher at the Weill Cornell Department of Healthcare Policy and Research, the proportion of Americans who "had great confidence in medical leaders" has dropped from more than

75% in 1966 to just 34% as of 2014. This general lack of trust in the physician also leads to a reduction in healthy behaviors ranging from compliance to medication and adherence to physician’s instructions. Equally importantly, this lack of trust prevents industry-led healthcare innovation to be adopted by the consumer.

Consumer expectations from the system continue to evolve rapidly, perhaps due to the rapid pace of technological evolution in everyday life. However, the ability of the healthcare industry to respond lags behind. A 2016 survey of US healthcare consumers found that over 50% of respondents would likely switch hospitals due to poor electronic communication, for instance. The experience from healthcare continues to be far more complex compared to what the consumer receives - and is now expecting - from any other industry (e.g. retail, banking..) given the pace at which consumer-facing industries have adopted new technology.

While we can argue that the healthcare industry is ripe for disruption, we have to think carefully about what the end-state should look like. I recently attended a talk on disruption that took me through the journey of the Spice Route and the associated trade. At the peak of that business, cloves and nutmeg were more precious than gold. Why? Spices masked the flavor of not-so-fresh food. Empires were created out of the spice trade. Maritime technology innovation accelerated. Worlds were conquered.

Then, in the early 19th century, Frederic Tudor invented an insulated

warehouse and used it to ship blocks of ice around the world. With this new way to keep meat fresh, the spice trade was no longer lucrative. However, with the advent of the refrigerator industry, even Tudor’s enterprise crashed. The human need, after all, had remained the same – fresh food. The demand wasn’t for spice or ice, or even refrigeration. The need was simply to consume fresh food. Today we have the promise of a third wave disruption on the horizon: drones that can deliver fresh food to your home on demand in thirty seconds. Would you still make space for a refrigerator in your kitchen?

In healthcare, the human need – the human right – is to be well and to stay healthy as long as possible. We know the human body is frail and that we need a break-fix system to deliver care when the body needs immediate attention – injuries and crisis events, for example. However, we also need a collaborative healthcare system that proactively aims to prevent those acute events from arising as much as possible. That is to say, we need to heal it before it breaks.

A consumer-driven healthcare revolution is approaching. This revolution is made possible by the exponential growth in technology and technology platforms that can substantially lower the costs of prevention and intervention. This revolution is also driven by the changing consumer expectations of being treated anytime, anywhere, and with adequate transparency of a cost model that doesn’t disproportionally burden the society. This revolution will shift the emphasis of the industry from “sick-care” to true “health-care.”

healthio is building an AI platform for acquiring longitudinal data in those 5000 waking hours per year that we spend away from the healthcare system. This platform aspires to digitize the human body in a way that enables us to combine individual-level data with large population incident data to make healthcare predictive and thus preventive. Learn more at