"The fourth industrial age is here," says Daniel Kraft, a health care futurist and medical doctor. "It's transforming how we get our digital banking done, how we stream movies. But health care is still stuck in the third -- or maybe the second -- industrial age, with fax machines and CD-ROMs."
Specifically, innovations such as artificial intelligence and machine learning have been stubbornly slow to enter the health sector. And the big strides that have been made in data collection -- wearables that monitor your vitals, voice biomarker trackers, and genomic sequencing, to name just a few -- have so far resulted in only a few widely used, truly useful applications.
"Nobody wants more data, they want the actual insights that are useable," says Kraft, who prefers the term now-ist to futurist. "How do we make actionable information that translates to the point of care or the bedside?"
Bob Wachter, chair of the UC San Francisco Department of Medicine and author of The Digital Doctor, remains optimistic that some of these new technologies may still have a significant impact. "Whether you're looking at an X-ray, or trying to predict how many people are going to come to the emergency room next Tuesday, or seeing a patient and being reminded of an alternative diagnosis, A.I. will be useful in all sorts of ways," he says. "I think it's going to all work out. But it's going to take far longer and be far bumpier than anybody anticipates."
Here are five of the companies industry observers say are leading the charge down that bumpy road and reimagining the future of health care.
Youper designed its A.I.-based chatbot to guide users through the process of cognitive-behavioral therapy, supplemented with remote psychiatrists, health coaches, and an online pharmacy. The chatbot looks and feels like a standard text message exchange: patients talk about their thoughts and feelings and the A.I. responds with questions and advice, as programmed by mental health professionals.
"Some people say the chatbot is even better than talking to a human, because you can say how you're truly feeling," says Youper CEO Jose Hamilton. "[You might say,] 'I'm feeling 100 percent angry' or '100 percent depressed.' And then the chatbot will start guiding you toward what's making you feel that way."
Youper does not intend to replace psychiatrists, but instead to allow them to see more patients than before at a lower cost. "We can't just create psychiatrists or therapists in the lab, but we can provide them with technology to augment them," says Hamilton. "Our goal here is to have a therapist overseeing 10 times more patients than a regular provider would, because we have an A.I. to be there when the therapist is not."
Founded in 2016, the company is headquartered in San Francisco, and has plans to expand its clinical team to reach all 50 states in the next month.
TytoCare is developing digital, multiuse testing kits for monitoring vital signs and diagnosing common illnesses. TytoCare's telemedicine equipment, which is being used in thousands of schools in the U.S., can perform ear exams, listen to heart and lung rhythms, and take temperature readings, and then transmit that data to physicians. The device is designed to be easily used by patients, parents, or non-doctor medical personnel.
"Let's be real -- we're not saving lives," says CEO Dedi Gilad. "But we are dealing with the most annoying and basic interaction with health care. When you don't know what to do, when you are anxious or under stress, you want to access a menu of options. Today, the industry doesn't really give you a very good solution." TytoCare's at-home exams provide that menu without the need to visit a doctor's office.
Telemedicine won't be replacing live doctors anytime soon, but technology like TytoCare's offers a chance to triage basic exams, keeping doctor's offices quieter and lowering costs for patients. Founded in 2012, the New York City-based company recently closed a $100 million Series D funding round.
3. Vida Health
One of health care's most promising opportunities is the use of algorithms to collect massive datasets and present them to users in a helpful and intuitive way. Vida Health offers virtual outpatient care for chronic physical and mental illnesses, and syncs data it has collected from patients' IoT devices to provide holistic treatment regimens. The company offers solutions for diabetes management and prevention, weight loss, stress reduction, and sleep health.
Vida Health, founded in 2014, is headquartered in San Francisco and has raised $188 million in funding. CEO Stephanie Tilenius was inspired to start the company after seeing her father struggle with multiple chronic conditions. "I just couldn't imagine that there wasn't a mobile solution for tracking all of his medications, his stress, sleep, nutrition, exercise, and the intersection between these conditions," she says.
4. Osso VR
Osso VR uses interactive virtual reality technology to simulate the experience of performing surgery on patients for training purposes. The patients are highly realistic, and users are free to design their own experimental surgeries in addition to hundreds of preset modules. The San Francisco-based company, founded in 2016, has raised $43 million and is working to add virtual animal surgeries in the near future.
"The calling card of Osso VR, what we're known for, is the fidelity of our experiences," says CEO Justin Barad. The company says it has assembled the world's largest medical illustration team, in concert with graphics artists from major Hollywood studios. The simulated surgeries are so realistic they constitute graphic content on some social-media platforms. "When we put videos up on YouTube, and it gets banned by their algorithm, we view that as a point of pride," Barad says.
Kintsugi uses a machine-learning algorithm to detect signs of depression and anxiety after listening to 20 seconds of a person's speech. Users of the company's app speak into a voice-journaling interface and receive feedback with charts of their depression and anxiety levels over time.
"It's not so much what people are saying, but how they're saying it," says CEO Grace Chang. "The study and space of voice biomarkers have been studied since as early as 1920. And now, a hundred years later, advances in machine learning have made it possible for us to get almost the same accuracy as a psychiatrist."
Founded in 2019, Kintsugi is one of many private companies leveraging big data and machine learning to speed up and improve diagnoses. The startup, headquartered in Berkeley, California, closed an $8 million funding round in August and is extending its API for use by select health providers and employers.