Hacking Healthcare

In “Illness as Metaphor”, Susan Sontag wrote “Everyone who is born holds dual citizenship in the kingdom of the well and the kingdom of the sick…sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.” 

Even though Sontag’s book was published over forty years ago, the fundamental lesson holds true: we all inevitably spend time in the “kingdom of the sick.” The current healthcare system is imperfect to say the least – issues of cost and access have topped the ranking of America’s most urgent health problems since 2003. Several of our healthcare portfolio companies as well as others in the space are innovating around a shift from a sick care model to a more patient-centric preventative care model. This shift requires behavior change in both the healthcare system and patients but is one we are eager to explore as a powerful unlock of more comprehensive and effective care.

Earlier this year, we held a small virtual event called Hacking Healthcare, modeled after Hacking Education and designed to expand our perspectives on our wellbeing thesis. We gathered a group of practitioners, healthcare founders, investors, and payers around a specific prompt: What will a doctor’s appointment look like in 10 years? 

Here are a few themes and questions that came up in the conversation:

Doctors appointments vs patient care. During the conversation we eventually reframed the question to “What will an interaction involving patient care look like in 10 years?” The role of humans, increasingly supplemented by AI and ML, may involve a care manager, coach, or other care advocate who doesn’t have a MD. Already, nearly half of adults under 30 do not have a primary care physician. What might a broader definition of patient care look like and how could it help address inequities in access? 

Virtual practices. As practices become virtual and no longer bound by geography, consumer relationships are moving away from 1:1 relationships and towards a series of relationships with virtual practices. Gen Z and Millennials are the least likely to have a primary care physician. These consumers might use one platform for mental health, another for a chronic condition, another for dental work, and yet another for prescription delivery and management and interact with many healthcare professionals in the process. How does this new structure of care change the promises brands must make and keep in order to build trust with users?

Health literacy and data sharing. How will the information flow of health data change to meet the expectations of Gen Z and Millennials? As we have seen in education and financial services, this generational shift will likely drive demand for greater ownership and transparency over health information than for previous generations. Health literacy also extends beyond data sharing – the next evolution in this category will involve knowledge and tools to help consumers better understand and contextualize health data to become more informed advocates in their own care.

Out of this conversation and our thesis work, there are two areas we are exploring:

1/ Digital health stack – One way to think of digital health is as applications and infrastructure (or enablement) as we have seen in other internet sectors. Most of USV’s healthcare investments (Clue, Nurx, Modern Fertility) are applications. As healthcare becomes increasingly virtual and distributed, we are interested in the horizontal infrastructure layers needed to enable this new economy – staffing, licensing, billing, communications – and help digital health companies launch and scale.

2/ Consumer EHR 2.0 – we have started to invest in this thesis with companies such as Abridge, but are keen to continue exploring new ways for patients to gain control over their health data and narrative. In keeping with thesis 3.0, we are most interested in networked and direct-to-patient approaches in this category.

We are excited to meet more entrepreneurs building companies in these areas and others as we explore access to wellbeing in thesis 3.0.