The EconomistFebruary 3rd 2018 53
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1
T
HE past decade has seen the smart-
phone become a portal for managing
daily life. Consumers use their pocket com-
puters to bank, buy and befriend. Now this
array of activities is expanding into an
even more vital sphere. Apple has spent
three years preparing its devices and soft-
ware to process medical data, offering pro-
ducts to researchers and clinical-care
teams. On January 24th it announced the
result. The next big software update for its
iPhone will include a feature, Health Re-
cords, to allow users to view, manage and
share their medical records. Embedded in
Apple’s Health app, the new feature will
bring together medical data from partici-
pating hospitals and clinics, as well as from
the iPhone itself, giving millions of Ameri-
cans direct digital control of their own
health information for the first time.
Apple’s fellow tech giants are also on
the march into medical services. On Janu-
ary 30th Amazon announced a partner-
ship with Berkshire Hathaway and JPMor-
gan Chase to create a not-for-profit
health-care company for their own em-
ployees that promises to employ technol-
ogy to provide cheaper care than conven-
tional health insurers offer. For the past
year, the e-commerce giant has also been
exploring a venture to use its logistical pro-
wess to start selling drugs online.
Alphabet, Google’s parent, has just
launched a third health-care firm, City-
block Health, to operate alongside Verily, a
$178bn respectively in 2016. That is more
than any tech firm except Apple. Shares in
the two insurers fell by 4% on the news of
the new Amazon-led health venture.
Apple and Alphabet, however, are like-
ly to have the biggest impact in the near
term. Amazon’s three-headed health-care
venture will cover roughly 1m employees
in the first instance, whereas Apple and Al-
phabet have the potential to generate or
enable valuable health insights for hun-
dreds of millions of users, collecting a
small slice of that value in return.
There are two broad routes into health
care. The first is doing business with hospi-
tals and health-care companies in the exist-
ing system. Alphabetprovides software
services to hospitals, for example; Apple
sells smartphones, tablet computers and
wearables to medical professionals and
hospitals. A second route is for tech firms to
use their variousplatforms to create entire-
ly new channels through which medical
care can be delivered to patients. Such
channels include watches that use mach-
ine-learning algorithms to monitor the
wearer’s health, phones through which
clinical trials can be run and apps that pro-
vide medical-grade care to people manag-
ing chronic conditions such as diabetes.
Deploying bedside manner
Start with the existing system. Alphabet’s
business here comes through Verily and
DeepMind, and has focused on Britain’s
National Health Service, which offers a sin-
gle, standardised market. DeepMind has
partnerships with four large hospital
groups, to which it provides an app called
Streams. This usesthe hospitals’ data to
generate alerts that draw doctors’ attention
to the potential deterioration of patients.
In May, meanwhile, Verily switched on
data processingfor a hospital—the NHS
Heywood, Middleton and Rochdale Clini-
subsidiary based in San Francisco, and
DeepMind Health, an arm of its London-
based artificial-intelligence (AI) firm (a
fourth company, Calico, is working to ex-
tend human lifespans, but does not pro-
vide health-care services). Alphabet al-
ready claims to be able to use AIto predict
possible deaths of hospitalised patients
two days earlier than current methods, for
instance, allowing more time for doctors to
intervene. Facebook and Microsoft are pre-
paring to add health care to their core busi-
nesses of social networking and software.
Until now the tech giants’ foray into
health care has not gone much beyond
wearable devices to track fitness or the pro-
vision of cloud-computing services to in-
cumbent providers. In future they aim to
deliver real medical services that directly
affect individual patients. All five firms
have secretive health-care skunk works,
are hiring medical talent and are buying or
backing external health-care startups. Un-
deterred by recent claims that their own
products may be harmful to mental health,
they want not only to be indispensable in
customers’ lives but to prolong them, too.
The revenues ofthe industries they
could disrupt are enormous. Health-care
costs make up about a tenth of any coun-
try’sGDPon average, worth in total $7trn
in 2015, according to Deloitte, a consultan-
cy. Two insurers, UnitedHealth Group and
CVSHealth, are among America’s largest
firms by revenue, bringing in $185bn and
Digital health (1)
Surgical intervention
The world’s biggest technology firms are poised to transform health care. That
could mean empowered patients, better diagnoses and lower costs
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