Digital Health 2024: 7 Predictions & 50 Names You Don't Want to Miss

2023 was the year of digital health 'parasites.' Digital health has become the parasite of the tech industry. Digital health startups patiently wait on the sidelines until new tech hype takes over.

🎉🥳🥂🎇🎊 Happy New Year! 🍾🎆🌟✨🍸

2023 is over 😔, which means it's time for the 2023 conclusions and the 2024 predictions. 😉

2023 was the year of digital health 'parasites.' Digital health has become the parasite of the tech industry. Digital health startups patiently wait on the sidelines until new tech hype takes over. Then, like piranhas, they swarm in, numbering in the hundreds and thousands, adept at repackaging innovations developed by others and claiming them as their own. This 'tech parasite' trend is set to continue into 2024 and beyond. There has never been an innovative startup in digital health. Ever. Yet, I remain an optimist. A handful of startups in the digital health arena are genuinely striving to make a difference. In this article, I shed light on all of them - the good, the bad, and, more often than not, the ugly.

Let's dive into potential winners and losers of digital health in 2024. Translation? It's time to make some enemies and call someone's bullshit. When you're a lone wolf, unshackled by sponsors or allegiances, speaking your unvarnished truth, you're bound to step on some toes. And that's a badge of honor. Picking up a few adversaries along the way? It signals I'm hitting the mark, cutting through the noise, unearthing the hard truths. That's the sweet spot, right there. It's proof that I'm adeptly navigating and fleshing out the truth in the tangled web of digital health.

After meticulously scrutinizing the following 50 digital health companies, which span the spectrum from impressive to mediocre, and, let's be real, some that are just abysmal, I've formulated seven predictions for 2024. Here's the thing: pretending to pinpoint the timeline in healthcare is a fool's errand. Healthcare is hard. So, these predictions are not just for 2024 but more realistically for the next 3-5 years. Now let’s get them out of the way.

1️⃣ Digital health failures are expected to persist, mirroring the trend seen in 2023. The underlying reason for this crisis is the entrenchment of health insurance, PBM (Pharmacy Benefit Manager), and EHR (Electronic Health Record) monopolies. These multi-billion dollar conglomerates are deeply embedded in lobbying and politics, blacking any, even remote, potential for innovation in healthcare. Lina Khan's FTC chairmanship is not expected to break up these monopolies. Consequently, startups in the digital health sector, even those who secure funding from venture capitalists (VCs) and general partners (GPs), are likely to squander their resources very quickly. This pattern of financial mismanagement is attributed to a "champagne and cocaine" mentality, which was prevalent in 2023.

2️⃣ The trend of "tech parasites" and tech copycats will continue as seen in 2023. This trend involves new digital health startups involved in an unethical practice of repackaging existing technologies rather than innovating. These startups are influenced by bad examples such as Carbon Health, Infermedica, and Suki. They are led to believe that success can be achieved by riding on the coattails of existing technologies like GPT-4, GPT-5, or other emerging AI concepts, rather than developing original ideas. I see this trend is seen as extremely dangerous. It is obviously encouraged by incumbent monopolies in the healthcare industry to maintain their status quo.

3️⃣ I predict venture capital in the digital health sector to continue facing significant losses in 2024. This trend is due to a lack of due diligence and competence within the venture capital community. The digital health industry has already seen substantial failures in 2023 with companies like Babylon Health, Olive AI, and Bright Healthcare, which resulted in billions in financial losses for investors. The pattern of investing in startups run by bullshit “visionaries” is expected to persist. VCs have a short-term memory. This one was the easiest prediction to make.

4️⃣ The year 2024 and beyond are likely to witness significant product consolidation in the digital health industry. Areas like Telehealth and Medical Transcription, along with other AI-driven medical fields, will continue their decline as standalone products. The expected winners in this evolving landscape will be companies that can offer comprehensive, convenient digital solutions for patients. This process of product consolidation and shift towards integrated solutions began in 2023. (Note to myself: A startup idea - a telehealth platform that employs only local doctors. That's so simple. Why hasn't anyone come up with this? I'm a genius! 💡)

5️⃣ The LLMs (Large Language Models) that captivated the world in 2023 were not even an innovation. Their idea dates back to at least the early 1980s, with subsequent developments primarily leveraging brute force and massive amount of compute. The emergence of LLMs was somewhat inevitable over time. My hope for 2024 is that the current hype surrounding LLMs will subside, paving the way for truly revolutionary inventions that rely on elegant math rather than brute force. Forget ChatGPT. Such a development would represent a genuine breakthrough.

6️⃣ 2024 will be the year of blockchain. Blockchain is back, baby! Most people don't see the difference between bitcoin and blockchain, and that's a shame. Bitcoin got a bad rep because of the $8 billion FTX fraud and other negative stories. That's why everyone, especially in healthcare, was afraid even to mention blockchain in 2023. But the truth is, no other technology comes close to addressing HIPAA requirements of portability, security, privacy, accountability, auditability, patient ownership, and assigning access permissions like blockchain does. The two main barriers for blockchain startups in healthcare are: 1. Epic hates blockchain, viewing it as direct competition. 2. Adding new medical records to the blockchain is easy, but integrating the old ones onto the blockchain is costly, both legally and logistically. I predict that EHR monopolies will start acquiring blockchain startups in 2024 and beyond. They refrained from doing so in 2023 due to the FTX fraud - the second-largest financial crime in history. At the same time, these monopolies like money but don't like to do anything, leading to a new wave of acquisitions.

7️⃣ EHR companies are set to embark on a massive acquisition spree in 2024, encompassing a wide range of areas such as AI, data, analytics, and telehealth. They will finally realize that clinicians are frustrated with the need to switch between multiple apps and accounts all day (and night) long. The one account you can bet your house they'll consistently use, day in and day out, is their EHR system. Hence, digital health startups that can demonstrate seamless integration into the EHR system will become prime targets for acquisition by these EHR corporations.

Now I want to share with you something I've been working on. As you know, I've been involved in AI for a number of years and in digital health for four years. I've closely followed the trends and companies in this area. This involvement has brought me both friends and enemies. As Taylor Swift, the 2023 Time Magazine's Person of the Year, would say, "Haters gonna hate," so I'm not concerned about them. Nor am I concerned about sponsors, as I don't have any. 🙂 Until I do, my views remain unbiased and reflect my own perspectives. I speak from what I observe and expose the lies prevalent in digital health. Unfortunately, many in the startup universe of digital and AI healthcare are not what they seem.

There are several promising areas in AI for healthcare, but I'm not focusing on them for two reasons. First, I may not be an expert in those areas. Second, my focus has been on primary care in the United States. This sector is riddled with problems, but it's also where significant differences can be made, directly impacting patients. However, I recognize the potential for major brekathougats, as well as profits, in areas like radiology, mammography, dermatology, genomics, treatment, and drug discovery. Hundreds of startups are operating in these areas, but they are not my focus. I'm keen on understanding trends, developments, and potential innovations related to primary care.

In my research, I've identified four specific areas within primary care. Within these areas, I've pinpointed 50 companies that have the potential to make an impact in 2024. This paper will categorize these companies. When researching companies, I start with their websites and press releases. However, I often find this information biased or unreliable. Therefore, I seek information from external sources like articles, white papers, peer-reviewed studies, and the SEC filings. In some cases, I test the products of these companies before forming an opinion.

After conducting my analysis, I have to report that, by and large, there have been no innovations in digital health. Zero. We're operating in an area dominated by hype, dominated by copycats. There are things like people jumping on the latest LLMs, for example, spending literally a couple of hours repackaging that model, making it nice and shiny, and selling it just like that. Hundreds of startups are operating not just on someone else's innovation, but on someone else's idea. I haven't seen any real innovations specifically in digital health. There are innovations in technology outside of healthcare, sure, but that's what startups are using to promote their agendas. This lack of innovation is clearly linked to the crisis in primary care and healthcare overall. We see that the most mediocre companies, those that haven't improved the situation for patients and physicians at all, but are very loud and have connections in Silicon Valley and Washington D.C., are the ones prevailing. This creates a negative example for new startups. They see that companies with venture capital and connections with big insurance companies or the government are prospering, and they follow suit. This sets a dangerous precedent, completely different from other industries where innovations are highly valued.

Innovations in healthcare, or I should say discoveries, since there haven't been any real innovations or inventions, are often minimized or ridiculed by those who may not fully understand the technology behind these ideas. We need to break this cycle. To promote competition and innovation in the long term, we must break up these monopolies. The big insurance companies, the big EHR companies, the PBMs, and everyone in between, are part of this problem. There are thousands of smaller companies catering to these monopolies. Once we dismantle them and make innovation the focus, the community will benefit – patients, nurses, pharmacists, physicians, everyone.

On a side note, this is why I'm a big believer in independent healthcare, concierge services for patients, and direct primary care. These monopolies obviously oppose this. They love to talk about value-based care, but the kind they promote is still dependent on the payer system and the PBMs, and all the other monopoly parasites. We need to eliminate them. I firmly believe digital health and AI should be central in moving to a healthcare system that truly serves patients, providers, and independent pharmacists.

While I strive to be thorough and diligent in my analyses, I do make mistakes. As Michael Jordan said, you miss 100% of the shots you don't take. I take these shots and miss some, hopefully not too many. The worst scenario is when I make an enemy due to my critical reporting, and it turns out I was wrong. I hate that, but it doesn't stop me from doing my work. I own my mistakes and never double down on them, or at least try not to. I prefer to apologize and take responsibility.

So, I’m making more and more enemies, and that's awesome. It means I’m on the right path to uncovering the truth. Haters gonna hate, sometimes rightfully so, but those who truly know me – not from social media or Internet articles, but my family and close friends who've known me over the years – will always stand by my side. That's what keeps me going.

Why it's Nearly Impossible for Healthcare Startups to Survive Amidst Incumbent Monopolies:

The issue with the U.S. healthcare industry is that innovation is stifled early on by incumbents. Startup founders are forced to go "all-in," hoping to gain notice and potentially be acquired, as surviving independently in healthcare is nearly impossible. While monopolies charge exorbitant rents, evident, for instance, in the excessive earnings of the Big-6 health insurance giants, the likelihood of other companies succeeding without being acquired is slim, with the probability being less than 1%. Notably, patients and clinicians are completely absent from this conversation.

Monetization Challenges in Digital Health:

Making money in healthcare tech is tough. Whether it's governments or insurance corporations footing the bill, they aren’t signing a contract unless they are absolutely sure it’s beneficial to them. Babylon's flawed revenue model highlighted this monetization challenge. As 23andMe painfully found out, there’s no monetization in prevention, diagnosis, and medical advice. The most significant monetization in healthcare tech lies in treatment, drug discovery, genomics, radiology, mammography, and dermatology. It’s something new founders should keep in mind as they enter the complex field of digital health.

Zero Innovations in Digital Health:

Unfortunately, we talk about digital health failures and outright frauds all too often. It's a disheartening narrative, but the truth is stark - there have been zero, yes zero, groundbreaking innovations in digital health. Period. What we're witnessing instead is a parade of startups, each one mirroring the last, all borrowing heavily from the tech playbook. Their modus operandi? Sprinting to venture capitalists with pitches that essentially boil down to "Hey, look, I can use ChatGPT to interpret medical notes." It's an uninspired, unoriginal, pathetic landscape. The state of digital health is bleak. Not one – not a single one – of these companies is turning a profit. It's a tough pill to swallow, but the prognosis for digital health is anything but promising. I wish I had better news, but the reality is grim.

Yet, in the face of all this disheartening data, I remain an optimist. I firmly believe that I will witness a significant innovation in digital health, potentially rooted in AI, within my lifetime.

Predicting Product Consolidation in Digital Health:

One prediction that I strongly believe in is the massive product consolidation in the digital health industry. What do I mean by this? I have written extensively about the absurd state of telehealth in this country. Companies, both large and small, are scrambling, claiming to offer exclusive services to patients and providers. In fact, I believe that among the four areas related to primary care and care delivery, there will be significantly fewer of them in one to three years than there are currently. Not in the sense of the demand, which in fact will be very much vibrant, but in the sense of being a standalone product. In that sense, in my opinion, telehealth is going to be dead. I also think that very soon companies focusing on medical record summarization, clinical notes, transcription, and even scribing, will be out of business. We will see massive consolidation of all products into digital platforms, and this is already happening. Companies that recognize the demand for comprehensive solutions will fare much better than others.

Telehealth is Dead as a Standalone Service:

It’s dead. I wrote about it in detail: The Telehealth Masquerade: How Corporate 'Geniuses' Sold Us the 1876 Wine in a New Bottle.

AI Scribing is Dead as as a Standalone Service:

Physicians hated AI-generated scribing even before the DeepScribe AI cheating scandal.

Here's the reality: Very few physicians are excited about adding this product. A significant portion (50-70%) of the medical record is wordy and unnecessary, consisting of words added to records primarily to facilitate billing. Having a machine create a dictation copy, even if filtered, is adding more garbage to garbage. Physicians hate AI scribing.

But, yeah, DeepScribe made it much worse. Frankly, it contributed to tarnishing the reputation of everyone involved in digital health. Those of us in technology have been on thin ice with the medical community even before the DeepScribe scandal. Now, we find ourselves in an even deeper hole.

The problem, of course, is that companies like DeepScribe are making deals with CIOs and CFOs who are super excited by the mere mentioning of 'AI'. However, it’s the physicians who end up (not) using the product. They absolutely hate it. But who cares, as long as the check is signed, right?

Overall, the field of documentation, summarization, clinical note creation, transcription, and voice scribing is set to undergo significant changes and consolidation. The year 2023 marked the advent of major headlines in this sector, such as the proliferation of Large Language Models (LLMs), making it increasingly challenging for new players to alter the established status quo. This domain is likely to be dominated by the largest entities, those possessing the most robust compute, extensive data resources, and advanced multimodal (video, audio, text) machine learning capabilities.

Concurrently, the cost of such products is expected to decrease sharply, owing primarily to the availability of open source AI models. This is precisely why I believe that this entire field will become obsolete within a few years. The features I've mentioned are already becoming integral to a comprehensive digital patient experience. In the meantime, the major companies, especially those developing the most potent models like OpenAI supported by Microsoft and Google, are set to dominate this space.

How to Separate the Wheat from the Chaff in Digital Health:

So, I wanted to share with you my observations and my research on, what I believe, 50 key players in healthcare AI and digital health in the following areas of clinical workflow:

1️⃣ Patient engagement / AI Assistant / Diagnostics / Care Delivery / Care Decision Making

2️⃣ AI-assisted EMR/EHR

3️⃣ Documentation / Clinical Notes / Transcription / Scribing / Coding

4️⃣ AI-assisted Telehealth

For me, this was an important and interesting exercise. However, I must admit, I have no idea which of these 50 names will excel in 2024. There are three main reasons for this uncertainty. 

First, let's be real: predicting healthcare trends over a short period, especially in a field where monopolistic incumbents fiercely guard their wealth at the expense of patients and clinicians, is challenging. Second, I believe that at least two of these four areas will become obsolete soon, if not by 2024, then within the next three years. These areas are documentation / clinical notes transcription and telehealth. Why? I believe these two areas haven't seen significant innovation. A company focused solely on these will likely fail. Telehealth and note transcription should be as integral in every practice as a stethoscope or a CAT scan. Any developed technology or platform should seamlessly integrate these technologies. To draw an analogy, it's like saying, "Look, I have a brand-new stethoscope for you." "OK. How is it different from the one I currently use?" "It's shinier and better looking." I'm being facetious, but there's truth in this. The struggles in the telehealth industry attest to its lack of innovation. COVID-19 certainly amplified the importance of telehealth, but a HIPAA-compliant telephone call isn't innovative. Interestingly, I'm drawn to a company in this domain that isn't focused on telehealth at all: Doximity, often called “LinkedIn for medical professionals.” Many physicians turned to Doximity for telehealth simply because they already had an account, eliminating the need for additional paperwork or BAA partnerships.

My third reason for skepticism regarding these 50 names is the flawed U.S. healthcare system. It favors a few monopolies, discouraging innovation and promoting loyalty to these giants. Unless there's a significant change, I'm pessimistic about seeing substantial innovations in digital health in 2024. I argue that there hasn't been any major breakthrough in digital health since the advent of electronic health records 40 years ago. We need to break up these monopolies to allow innovative companies to emerge and thrive. Until this happens, or the regulatory landscape changes, companies that partner with these monopolies, not necessarily those with the best or most innovative products, will likely prevail. This has been the trend for years, and I don't see it changing soon.

In my analysis, I've tried to avoid the so-called 'tech parasites,' startups whose entire business is built on other people's ideas. After ChatGPT was released by OpenAI in November 2022, hundreds of digital health startups mushroomed, positioning themselves as AI disruptors and innovators, but in reality, are just repackaging the ChatGPT API. They prey on physicians and practices who are swayed by the AI hype but perhaps can't distinguish between real innovation and a 'tech parasite'.

However, I do mention a few of these 'tech parasites' below and will clearly identify them. I include them for context and possibly because they've been in the news recently, likely due to a VC investment stemming from yet another VC fund's lack of due diligence. Rest assured, I express my candid opinions about these 'tech parasites'.

So how do I separate the good from the bad? Simply put, I rely on an extensive list of sources for this kind of information. I favor companies heavily invested in research, science, and leadership. I'm quick to call out bullshit on those companies that are all about marketing, especially those selling unoriginal ideas as if they were new. Interestingly, in today's U.S. healthcare industry, it's often these loud companies that succeed. They typically have connections in the VC world and/or with senior management of some industry-controlling monopolies. Often, they're not the idea generators or particularly concerned about the end-users. 

I have a long list of companies to discuss, including a few that have impressed me and a few I consider bullshitters. Companies that have earned my respect include Ada Health, Atropos, Doximity, Kahun, Nabla, and Oscar Health. On the other hand, I'm calling bullshit on companies like Suki, DeepScribe, MayaMD.ai, Carbon Health, and Infermedica. Despite their noise and publicity, I believe people will eventually see through their bullshit.

Here are the 50 names in digital health I’ve analyzed. Whether they turn out to be winners or disappointments, it’s critical to understand what these companies are capable of.

A side note: Sometimes, you'll find a company on my list that may not be classified strictly as a digital health company. Generally, I try not to confine myself to a specific category, but I am keen on analyzing companies that are either doing something interesting in AI or partnering with entities that are making good strides in AI.

Another side note: The companies are listed in alphabetical order in each category.

Yet another side note: While I may criticize companies, their products, and their leaders, it is purely my opinion regarding those entities only, and in no way is a criticism of the employees of the company.

Enjoy the article. 🤘