HomeHealthcareHealthcare ConsultingA Tri-Zone Extension: Building Upon a16z’s Vision for the Biggest Company in...

A Tri-Zone Extension: Building Upon a16z’s Vision for the Biggest Company in the World

By Brigitte Piniewsk, HealthTech Founder/team advisor, Nex Cubed

Andreessen Horowitz (a16z) put forth a provocative notion of a consumer-obsessed healthcare-native tech company becoming the biggest company in the world. We all long to rectify a system that has for too long been mired in inefficiencies and patient dissatisfaction but without a more detailed explanation of this new paradigm, it will be difficult to build our preferred tomorrow. To this end, the following both highlights and enlarges the a16z blueprint to provide further clarity regarding the necessary elements, including the three zones, critical to delivering our consumer-obsessed health tech behemoth.

First a quick recap:

Clearly any industry that captures 20% of GDP will house some of society’s biggest companies. UnitedHealth Group (UHG), in the top ten, cannot claim to be a tech company nor does it excel in consumer engagement. Apple has figured out consumers but has struggled to offer compelling health tech.

A16z suggests two paths: vertical or horizontal.

Vertical integration: think UHG and Apple combined in some manner. Unfortunately, many core issues would remain unresolved. Here the customer is not the individual patient. The customer remains the payor and thus lacks effective incentives to ensure great consumer engagement. Some efforts have paid off such as Noom, Headspace and Calm but these seem locked within employee wellness with valuations of only $10Billion or less.

One would expect our future colossal health behemoth to be valued over $2Trillion.

Horizontal option: think infrastructure for all the others: an Amazon or Visa

Healthcare stands alone when it comes to financial transactions: patients and doctors do not know how much particular services cost. Patients are confused about what a bill covers or if they need to pay it. Repeat billing for events already paid are not easily reconciled. The list goes on. There is no shortage of repair needed here.

Thus my bet is this second option: “a horizontal path of building a consumer marketplace or infrastructure layer that enables all other care delivery companies”.

Imagine 90% of healthcare is managed in the palm of your hand on your phone. The system is built natively with web3 and AI and you’re off to the races.

The largest company in the world will reward and harness crowdsourced data with cutting-edge AI to achieve unparalleled consumer engagement. In other words, this patient-first paradigm will leverage unprecedented solutions to the following:

  1. Low health intelligence
  2. Low consumer engagement
  3. Low transaction volume

Low Health Intelligence

Given the technology at our disposal, it is unacceptable for us to remain in the shadow of grossly limited health knowledge. Now, more than ever, future generations will be dumb founded to learn that our health system treats everyone as a population. Everyone diagnosed with diabetes this year should expect an average lifespan of a person with diabetes.

Clinical guidelines that dictate care pathways are based on populations. Yet none of us exist as a population. Nor do we want an average outcome. Faced with a serious illness, each of us hope for the best possible outcome, and outlier achievement. Sadly, given current approaches, we can only expect an average outcome as the nuances necessary to deliver an exceptional outcome are not documented in health records, therefore not part of working health intelligence and not available to those making decisions on our behalf. Yet technology today is ready to enable data-driven access to the best achievable outcomes for each of us. We just have to make it happen.

A consumer-obsessed heath-native tech company would provide the web3 infrastructure for each of us to collect the nuances of our daily lives safely and securely.

Together, we would tap into the transformative capabilities of wearables and apps, translating physical health manifestations into dynamic digital assets. This would unravel a wealth of intricate details, propelling individualized health intelligence at an unprecedented rate. With an optimally designed user experience that prioritizes both

security and unmatched privacy, and using a correlations-only AI, we are likely to amplify our current health intelligence by profound orders of magnitude.

Low Consumer Engagement 

Imagine if accessing your emails or photos was akin to requesting special permission from the hosting platform like Google or Apple. The mere thought of waiting days or weeks to revisit a message or share a photo seems unthinkable. Yet, shockingly, this cumbersome process mirrors how we continue to access our health data today. Patients are mere ‘visitors’ to their data that resides in a tangle of bureaucratic procedures.

Enter our consumer-centric colossus. Individuals will find it effortless to integrate medical notes into their personal health chronicles. Need a lab test or an x-ray? The most influential companies on the planet will guide you to the providers that ensure your data seamlessly integrates into your personal homebase (zone I).

Merely possessing personal data isn’t the silver bullet to skyrocketing consumer engagement, just as wearables and apps alone have shown limited sustained interaction. However, our nuanced health data reflecting our well-being fluctuations converged with episodic medical events could be infused with continuous-correlation AI (termed zone II). This combination radically transforms the landscape of value. Together the elements vividly illuminate what’s effective and what falls short in real-time. New insights that can be both profound and hard to ignore. What’s more, each unique contribution to a valuable insight can be tokenized, allowing for traceability as these validated insights ascend into the commercial realm (Zone III)

While we sleep, tokenized data packets authorized to participate in follow-on value creation in the form of new products and services are continuously converted to economic assets. The commercial zone adds scientific rigor to correlations to expose likely causal relations. This lays the groundwork for new products and services that have surfaced by the free-living system and thus product-market-fit is essentially built in.

As personal digital assets transform into tangible economic assets, consumer engagement reaches unprecedented heights. Personal relevant health insights become searchable, and citizens are able to both witness and benefit economically for their portfolio of contributions to global health intelligence. This torrent of authentic insights ushers in a renaissance of in-depth understanding catalyzing an era of profound economic affluence.

Low Transaction Volume 

Today a handful of mega companies are transacting on consumer-generated data. Imagine if the masses began transacting on this data themselves. We’ve seen this before, phone communications soared after operators left, travel volumes exploded as soon as travel agents became obsolete. These examples are trite compared to Open AI which with 99.99% organic (read spontaneous) traffic has moved the transaction volume bar to the stratosphere. Apparently, ChatGTP acquired a million users just five days after launching in November 2022.

No longer will companies wait on industry incumbents to motivate their membership to adopt new behaviors. The adoption pipeline is already primed and is perhaps the forcing function driving us inevitably towards this tri-zone model. Those savvy about AI recognize that our human-AI relationship is early and the options for fatal mistakes are real.

AI is not a tool. Certainly not in the traditional sense of a tool. AI is very different in at least two important ways.

Yuval Noah Harari states this during a Lex Fridman podcast. AI can do two things that traditional tools have never been able to do. First, AI can have ideas. The printing press could print every idea mankind came up with but could not generate one idea on its own. The second important difference is: AI can make decisions. We can build an atomic bomb but the bomb cannot decide when to go off or in what direction. It remains out of operation until operated by a human.

A robust three zone model delivering a firehose of truth to train and course correct AI throughout the decades of our lives is needed now. For more information on the medical necessity of improved intelligence and the three-zone model, please check out my recent book: Wealthcare: Demystifying Web3 and the Rise of Personal Data Economies.

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