Michael Ackermann explains why technology has failed to transform healthcare despite decades of innovation. The industry's complexity, regulatory requirements, and conservative culture create barriers that software alone cannot overcome.
So logos of our friends and neighbors here in Silicon Valley, right here, we're used to all this technology coming in and completely transforming a marketplace. Right. It's the way that we connect, it's the way that we buy goods, the way that we get around, the way that we interface with the world. And we're used to these big technologies coming in and making a real difference. Right? But here, healthcare, 17.5% of gross domestic product, and none of those logos are a health care company. Right. And it's been very, very slow to be converted by big technology. So why is that the case? Well, there's a few reasons. So one is that there's a very complex network of consumers. So if you're Amazon, it's very clear who your consumer is. It's the person who's buying the goods, right? Well, in healthcare it's a little different. You have the patient is what we typically think about this is someone who is either being diagnosed or being treated, but frankly, a lot of the time they're not even the one who's making the decision as to which product to use. Right. The decision is oftentimes being made or at least heavily influenced by a healthcare practitioner. This is the doctors, the nurses, the technicians. These healthcare providers very typically operate in a hospital or a hospital system. And so that hospital also has tremendous decision making ability over what products are used for the patients and by the practitioners within their system. So yet another decision maker, and frankly, none of these people are actually paying for any of it. Right. So it's all paid for by an insurance company or it's paid for by the federal government, Medicare and Medicaid. So yet another customer has to decide that this is the right technology to use. This is also a highly regulated industry. So you also have to satisfy the fda and they have their own sets of needs and requirements. And it's also an industry that's very heavily influenced by the professional medical societies. So these are societies that provide guidance to the practicing public what's the best practice to use and to not use. And they also have very heavy influence over the payer system as well. So what products actually ultimately end up getting paid for and make the list. So okay, why don't we have Amazon of healthcare? Well, one of the reasons, this very complex network of consumers, why else? Well, it's also a very conservative industry by nature. Right. And that's actually probably justified. So we are talking about people's health. If we make bad decisions, there are very real and bad consequences for it. So every physician before they start practicing, they take the Hippocratic oath and they vow to first do no harm. And that attitude actually pervades not only the physician community, but the FDA and industry as well. So it's everyone wants to make sure that things are safe. Another thing is that medical innovation oftentimes relies on new science and sometimes new science happens a lot slower than new software. So it could be a tough thing to go there. We have a distributed provider system and meaning, as I mentioned before, you go one place for your knee and another place for your eyes, another place for your heart. Same thing with the payer system. All these different payers all over the place. And then also finally both ethical and legal privacy concerns as well. So maybe it's no wonder why we haven't seen this big enormous splash, right? We haven't seen someone come in and just completely transform this healthcare space. But what really excites me and what I think should really excite you, and I'm hoping that a few of you in the audience will want to take a good hard look at healthcare, because frankly, I mean, this is really a once in a career type shift or opportunity. What we are starting to see is a lot of little splashes and we're going to start seeing a heck of a lot more than that. So coming into one disease space at a time, coming in attacking one inefficiency at a time, and this is really going to start snowballing.
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