Top Healthcare Trends of 2023

Early on in the pandemic, organ transplants fell almost more than ever before–not because people didn’t need organs, but because fatal traffic collisions–a leading supply source for organs–were also down.

It turns out that motor vehicle crashes and fatal injuries account for the largest share of organ transplant supply – nearly 1/3th of donations. And as self-driving cars become more ubiquitous, and the roads become safer, this same dynamic –the one that played out during the start of the pandemic– will play out again. This time though, it could permanently disrupt the supply chain for organ donations.

Demand for artificial and/or animal organs will then likely grow. While there are currently public companies that aim to do this in the future, like Organovo (ONVO), the technology is not yet there.

When it comes to other forms of bodily replacement, like limb prosthetics, there’s already growing demand and it’s expected to rise: More than 1/4th of limb amputations are due to diabetes, and diabetes is not only growing in prevalence but it also affects such a large number of people: 8.2% of the US population in 2018 had diabetes. 

It’s a tough market to break into, through. Pharma companies often earn more revenue providing a lifetime of treatment as opposed to a single corrective surgery or device. Despite this, a number of companies, like Unlimited Tomorrow, are building more functional and affordable limb prosthetics for this growing market.

Patient portals, online portals where patients can check their medical records, usually after a doctors' visit, are growing in popularity though there's some asymmetry in this growth.

The percent of healthcare providers who offer patient portals is growing quickly - nearly 90% as of this year. However, uptake on the consumer side has been more gradual.

Because the portal is used mostly after infrequent doctors' visits, like an annual checkup, engagement frequency is low so it's rare that logging in turns into a habit. As patient portals expand beyond infrequent doctors' visits and start to include more tools for visibility into daily health data, engagement may rise and usage may become more second nature. 

A portion of consumers also avoid using the portals because they want to talk directly with their doctor. Stemming from a desire for comfort, this will start to change, as we've seen happen in the telemedicine industry where consumers are becoming increasingly comfortable with virtual visits to the doctor.

The pandemic has caused an unprecedented bifurcation in the healthcare industry. Elective procedures, where hospitals make most of their margin, are down, and emergency procedures are up. With spikes in demand for certain healthcare roles, alongside furloughs and layoffs for others, there’s a dislocation in the healthcare job market that is well served by staffing agencies like Clipboard Health, which focuses on temporary healthcare workers.

The spread of the virus in different areas at different rates also makes just-in-time labor deployment more important than ever. And even after the pandemic, just-in-time labor is growing increasingly realistic as public health prediction improves. Meanwhile, the number of medical operations available keeps rising as new technologies get invented and as awareness of existing procedures grows.

Certain demographic trends are also particularly favorable for staffing agencies. Some towns age much faster than average, as young people leave, so their hospitals end up short-staffed even as demand rises. Every day, 10,000 Americans retire, and start spending less on nearly everything except healthcare where the average spend for the 75+ demographic is almost 2.5x that of the 45-54 demographic.

Housecalls used to be one of the most common ways people interacted with the healthcare system, representing 40% of all doctor's visits in the early 1930s. They've nearly vanished since then, as doctors' rising compensation meant that it wasn't economical for them to spend so much time traveling from one appointment to another, and as patients’ direct payments as a share of healthcare costs (rather than through insurance) declined from 67% in 1960 to 11% in recent years.

DispatchHealth is working to bring back the housecall, through a combination of cost savings and the same scale economics that drive performance for ride-sharing, food delivery, and Amazon's e-commerce operations. DispatchHealth is not just a convenience, though: by reducing the barriers to preventive health, it aims to drive down avoidable and costly emergency room visits.

In fact, the U.S. government provides free smartphones to many Americans on Medicaid through the federal Lifeline Assistance Program. This is done, in part, to encourage communication with primary care doctors on a regular basis, helping to avoid costly visits to the emergency room.

Healthcare costs are skewed to a small number of people who need more care than average. According to some studies, roughly 1% of patients represent 30% of all healthcare costs. In some cases, this is unavoidably expensive, but in other cases early intervention can radically lower the cost. Services like DispatchHealth, which visit patients at home, help in two ways: first, they reduce the inconvenience of medical care, which makes people more likely to seek help. Second, they can examine the home environment and identify health risks that might lead to emergencies later. One example of the latter is that when DispatchHealth workers started to notice more patients facing food insecurity, they began bringing along healthy foods.

DispatchHealth is able to make their service economical by sending a nurse practitioner or physician assistant, as well as a medical technician, instead of a doctor. Because they're operating in specific locations, they can increase their utilization rate over time. DispatchHealth markets itself to doctors as a way to serve patients on nights and weekends, and it pitches itself directly to consumers with ads on hyper-local NextDoor.

In communities like Reddit’s 34,000-member strong sleep apnea subreddit, which is growing at 40% each year, members commonly trade tips on the best way to get a specific diagnosis that optimizes for insurance coverage.

A growing trend, health companies have inverted the typical medical model by essentially offering prescriptions as a service. Rather than doctors making diagnoses then suggesting a treatment, consumers are increasingly doing their own research and using doctors largely as gatekeepers. Some have termed the trend “restaurant-menu medicine”.

Navigating the US healthcare system is partly a process of understanding symptoms and treatments, and partly a process of getting insurance companies to pay. At-home sleep studies are a growing trend that leans into the reversal of the traditional process for getting medical treatment.

Sleep studies typically take place in a lab, where study participants have sensors attached that monitor their sleep overnight to measure breathing and see how many times they wake up. These can be inconvenient, uncomfortable, and expensive. But perhaps more importantly, sleep labs are able to choose two different ways of scoring the same data, one of which results in much higher rates of sleep apnea diagnosis. While patients might be reluctant to ask a clinician about scoring in-person, or suggest a different scoring metric, they can find an at-home study that scores using the criteria more likely to get them the diagnosis they want.

With the ideal diagnosis in hand, patients can then legally buy devices like CPAP machines. CPAP accessories on Amazon have racked up millions of sales, but the devices themselves are nowhere to be found on the world’s most popular ecommerce site, as the prescription is needed.

A growing number of companies are looking to lean into this market dislocation in order to drive business. Lofta, a popular CPAP provider, sells a sleep test specifically designed to help customers get the sleep apnea diagnosis, then funnels them to purchase a CPAP sold by Lofta.

Other industries are also increasingly using free tests to hook consumers before going in for the main sell – from internet speed tests for selling routers to online hearing tests for selling hearing aids, website speed tests for selling developer tools, and GPU stress tests for selling computer components.

Technology deployment follows commercial incentives, which leads to a strange paradox: it’s easier to use someone’s smartphone location data to send them an ad than it is to send them an ambulance.

RapidSOS is fixing this, by building an API to let apps summon 911 emergency services when needed. RapidSOS’s product isn’t generally sold to end users. Instead, it’s integrated into products. Apple recently made headlines when an Apple Watch automatically called an ambulance because the wearer was having a heart attack; this ambulance call was powered by RapidSOS.

RapidSOS is part of a growing category of companies: middleware between businesses that move slowly (government, healthcare, banking, transportation) and industries that move quickly (software, consumer electronics). This often means they build the messy interface that allows new technology to interact with legacy systems as if those systems had been designed with modern use cases in mind.

One common customer for RapidSOS is life insurance companies, which subsidize user access to health monitoring hardware. There are long standing precedents for this: the Hartford Steam Boiler Insurance Company discovered, in the 19th century, that a simple safety feature made boilers much less likely to explode. By only underwriting the boilers that used it, they made it standard. RapidSOS makes that standardization a service that insurance companies and others can buy off-the-shelf.