For too long, the healthcare industry’s silos and dispersed data have created numerous pain points, with problems so large that the prognosis has been poor, at best.

Today, however, the model may be shifting – offering many opportunities. Building on the models put forward by EY (“When the human body is the biggest data platform, who will capture value?”) and elsewhere, the Healthcare 1.0 model was a traditional pipeline value chain, focused on creating blockbuster products and optimizing R&D productivity. Healthcare 2.0 saw the emergence of healthcare networks as consolidation intensified – a model based on Team-based-care and a cross-disciplinary approach. Emerging technologies created more opportunities for scalability and collaboration – but pain points engendered by a fragmented approach remained. Healthcare 3.0 saw a shift towards patient centricity, the emergence of value-based models due to cost pressures, and, as a result, newly diversified portfolios which served different segments of the market, leading in many cases to complex portfolios and brand architectures.

Healthcare 4.0 Takes Shape

Now the pace is accelerating toward Healthcare 4.0 – a future driven by data, collaboration, and new value creation models. In this model, the value creation method is fundamentally changed – it is no longer based on optimizing transactions (e.g. a new drug developed, marketed and sold to providers and end users). Instead, it relies on the power of data to enhance every step of the process so that the value creation model is not based on transactions anymore, but on interactions that generate data and therefore allow the creation of shared value across the ecosystem. This model is what Erich Joachimsthaler calls an Interaction Field.

At its core, an interaction field is dependent on key interactions within the context of the healthcare industry — including, for instance, patients and healthcare providers, exchanging data in the course of these interactions. This is what we call the Nucleus of the interaction field – the first step towards creating an ecosystem.  

An Ecosystem then gets built around this core, which might include health tech companies, medical device manufacturers, pharmaceutical companies, insurance companies, hospital systems, professional associations, and other groups. Beyond that, Market Makers will enable velocity in the field by exerting influence. These could include government agencies, equipment suppliers, educational institutions, and foundations or nonprofit organizations. Over time, as the field expands, it creates more shared value.  

According to EY: “To create value now and in the future, life sciences companies should consider participating in data-centric platforms of care that improve individual health outcomes and reduce costs. In this environment, platforms provide a framework to create future value that is based on individualized outcomes, and is amplified by the ability to connect, combine and share data.”

Going forward, data can be used to both create universal standards of care, and to offer more personalized treatment and help deliver precision medicine – in particular in the context of blockchain and Web3 where data can be controlled not just by institutions but by patients themselves, ultimately breaking the barriers that exist to sharing it. 

Harnessing the power of data produced by interactions across the ecosystem, interaction fields have the ability to address and solve new, emerging or previously unsolved problems. This is because problems of this magnitude require collaboration from players across the ecosystem, enabled by data. No one player, company, technology or system has the ability to tackle these problems on their own.  

McKinsey acknowledges, “Today’s connected health technology landscape includes a wide array of apps and a dispersed set of data sources, but to fully exploit the benefits, the provision of solutions and the collection and application of data need to shift from fragmented ‘silos’ to an integrated ‘ecosystem’ of players.” (“Capturing Value From Connected Health”)

Why Healthcare is Ripe for Disruption by Interaction Fields 

A siloed industry, with disconnected sources of data, leading to a disjointed patient experience, healthcare is ripe for disruption by interaction fields. In research that Vivaldi conducted among health care providers (HCPs), they shared feeling isolated, not just when faced with complex patient cases, but also in adapting to evolving requirements and changing models.  

Scattered patient data, a disconnection from outcomes, and one-size-fits-all treatments — all these factors create the opportunity for a sea change.  

There are several criteria that make an industry particularly well-suited for an interaction field, and healthcare presents a number of these. These criteria were examined in the BCG article “Do You Need a Business Ecosystem?”

1. A high proportion of information to value creation. Traditionally, the diagnostic model relied on unstructured data – the judgment call of an HCP. New technologies and analysis tools – such as AI-guided imaging – require the use of databases where this data can be stored and analyzed, typically dissociated from EHR because patient data needs to be de-identified. In an aggregate form, data allows the extraction of patterns – identifying how a patient condition presents itself, spotting patterns, increasingly with the help of AI – and matching treatment options in a way that allows the measuring and weighing of risk of different courses of action. In turn, pattern identification tools and AI can develop learning effects, optimizing future interactions. More data leads to smarter insights, improved pattern identification, and ultimately better outcomes for patients. As a result, an increasing proportion of value is derived from data rather than assets such as equipment and technology. This is evidenced, for instance, in the imaging market where the value of imaging equipment is increasingly enhanced by AI that guides usage and interpretation. One example among many is GE’s decision to acquire BK medical, providing AI-guided surgery – its largest acquisition in years.  

2. Unpredictability. Healthcare has been undergoing rapid market evolution – and yet there is also substantial inertia across the system. The interplay between these two factors creates unpredictability, another pre-condition of the rise of interaction fields. The swift pace of technology development and adoption creates new opportunities for participants in the healthcare ecosystem, and even accommodates different paces of change.  

3. Malleability. Utilizing healthcare data requires a customizable approach. Ultimately, the opportunity is in defining personalized paths based on patterns identified through aggregated patient data – something that is already being explored in genomics and will be further enabled by AI.  

4. High modularity. A high degree of modularity is an intrinsic characteristic of a fragmented industry – disparate steps of the process that create a disjointed patient experience. An interaction field has the ability to bring together different aspects of care or steps of the value chain – in a network rather than hierarchical model.  

5. Intrinsic need for collaboration. The healthcare ecosystem requires that various participants work together – something that glaringly does not happen today. Systematic issues cannot be resolved by any one entity, but require cooperation from the likes of healthcare providers, hospitals, health tech companies, insurance companies, medical device manufacturers, and patients themselves. Beyond that, further collaboration is needed from educational institutions, equipment suppliers, foundations and nonprofits, government entities and regulatory agencies. 

This model of collaboration can solve complex problems that no single entity could resolve, as well as create new market opportunities and spaces for innovation. Interaction fields are well suited for industries that have a high need for coordinated components. Enhancing collaboration can lead to improved outcomes for patients and better processes. 

Types of Emerging Interaction Fields  

For the various sets of interactions, different types of interaction fields are already emerging. There are four key types that are currently developing: 

1. Real World Data and Health Data Companies: These companies are collaborating to revolutionize how patient data is shared and turned into insights. This data might include electronic health records and doctors’ notes. The Real World Evidence (RWE) Alliance, for instance, is a group of healthcare companies that are working to make real world data and evidence more accessible so that more informed care decisions and regulatory policies are possible. Another company, Datavant, also looks to aggregate vast amounts of patient data to develop smarter insights. Datavant brings fragmented data together across thousands of organizations to create a complete picture of patient health, but, as expected, still has some limitations on access to data.  

2. Personalized and Relevant Solutions: Organizations in this type are leveraging their capabilities and insights to produce smarter patient solutions in real time at a lower cost. For example, Aetion has a platform that analyzes data from real world evidence, which can be used by providers to develop better patient solutions, and during the height of the Covid crisis, helped provide solutions directly to the FDA.

3. Foster Collaboration Amongst Care Teams: This type of interaction field can bring care teams closer together, regardless of geography. The company Owkin is aggregating data to produce insights for drug discovery and development. Through cloud capabilities compliant with patient privacy measures, they are able to work with numerous hospitals, universities, and life science companies to accelerate drug development, optimize clinical trials, and identify patient populations of interest.

4. Foster Collaboration Amongst Patients: With access to aggregated data, patients themselves can connect through online forums or other platforms to discuss conditions and treatments, provide support, and enable others to utilize health systems in a way that delivers more positive patient connections and outcomes. PatientsLikeMe is one such forum. Based on aggregated data, patients are brought together with others who have similar problems or conditions, enabling them to seek solutions in a smarter way, and allowing health systems to get more positive patient connections and outcomes as a result.

5. Sharing Insights with Patients: Analytics are as advanced as ever, and healthcare might allow for providers to have as detailed a look as ever into what may be happening to their bodies and what may be the best course of action to help treat them.  Included Health is an example of a company looking to become a one stop shop in the digital health world to provide these services, as they offer personalized guidance for patients in everyday and urgent care, primary care, behavioral health, and specialty care.  

While the HealthTech market has yet to shake out, large healthcare players are increasingly vying for the interaction field opportunity. Corinne Dive-Reclus, Head of Lab Insights at Roche Information Solutions has said, “With the use of digital healthcare ecosystems, we can, together and right now, innovate to change lives quickly and effectively for all.” And Pfizer’s Chief Digital and Technology Officer, Lidia Fonseca, has referred to health care as a “team sport.”  

To help build health tech innovation pipelines, Novartis introduced the Novartis Biome digital innovation lab, and Merck launched Merck Digital Sciences Studio. Pfizer has been introducing AI-powered tools and apps as part of its Pfizer Digital Companion platform, and has partnered with a robotics company to deliver medications to remote areas via drone. Roche is pursuing a digital ecosystem to better unify data, with the goal of creating more personalized care. And Eli Lilly and Company has been collaborating with technology companies, including Apple, to work on solutions for health diagnoses and management. 

As we move further into this Healthcare 4.0 era, the focus is on data-driven healthcare ecosystems: data, analytics, and insights shared across participants to find, and create, new forms of value. The opportunity for key healthcare players is to assess their role – participate or assume a leading role in shaping the ecosystem. Ultimately, the opportunity is larger than ecosystems within specific areas of healthcare or data aggregation; it is in what is being called the “platform of platforms” or “Interaction Field of Interaction Fields,” bringing together all different ecosystems within healthcare into one meta-ecosystem.  

While it is clear that emerging Interaction Fields will pivot and evolve multiple times, the key questions will be how the future value chain shifts, which players will bring the ecosystem together, and who will be at the center. One can only hope it will ultimately be the patient.

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Founded in 2017 by former Australian army officers, Craig Cowdrey, Peter Burnheim, and Christopher Marr, Sonder is a company focused on providing active care services through its responder network and technology platform. Utilized by Woolworths, PWC, Allianz, Team Global Express and other organizations, Sonder has made an impact across Australia and New Zealand, and it’s working to take its mission global.

Vivaldi spoke with Chris Marr, Sonder’s Chief Commercial Officer, about building a care network, meeting the demands of Gen Z, and the limitations of bots in addressing human challenges.

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Christopher Marr, CCO, Sonder

How would you describe Sonder and the benefits it offers?

We consider Sonder a single entry point for care — and there’s a lot that those few words speak to. It recognizes that the health landscape across safety, medical, and mental health is really disparate. It has typically existed in silos; individual services or point solutions, that may, when aggregated, deal with a broad spectrum of issues, but actually there’s no ecosystem around that. We understand at Sonder that issues don’t exist in isolation, they’re conflated. For example, if you’ve got anxiety, it often doesn’t exist on its own, it exists because there’s an underlying issue. As a single entry point to care, we make it really simple for people to engage with health solutions, increasing access to care, and ultimately making impact on the health of people around the world.

Understanding how all of those things work together might be a differentiator from what else is out there.

If you think of the landscape, it’s all point solutions and it’s really hard to even understand that they exist, let alone understand what’s the best way to access them. Together they present serious hurdles for people to access help, so that’s the problem we’re solving. We’re decluttering this otherwise really complex landscape to make it really simple and highly accessible in order to help people.

Who participates in the Sonder network?

Up front we have the digital interface, it’s an app focused on building earlier intervention pathways and help-seeking behavior. It does that through clinically based wellbeing and mental health assessment tools that enable you to get personalized support for your unique needs.

The mobile interface is also a mechanism to get you through to our care specialists, and that’s where the heart of the business exists. Our doctors, nurses and psychologists are there 24-7 to listen and, because we know that issues get conflated, to try to understand the holistic picture for a person and put together a bespoke care plan.

Pillar number three is our care pathways — these might be our medical, safety, or mental health teams, financial or legal support programs, internet-based cognitive behavioral therapy, a whole host of different programs. You don’t just get filtered into one of them, the plan recognizes the depth and significance of the issues, challenges or opportunities that people are facing. It also includes our responder network. Throughout Australia and New Zealand we can be by someone’s side within an hour. That provides huge peace of mind.

The fourth aspect is the data and insights. We’re a healthcare company, so all the records are medically credentialled. It’s completely anonymized, aggregated data, but it allows us to look at population trends. It lets us understand what issues are burgeoning.

Was this idea for aggregating data built in from the beginning?

In order to make sound business decisions, we needed to be data-led. By understanding the data and insights, by understanding the levers we can pull, we can ultimately have the best affect on someone’s health, and the health of a population generally.

You started with a safety focus, why is that one of the core pillars of what you offer?

Safety sits as the foundation for all the higher order needs or requirements. By being a company that has a foundation in providing safety, it gives the stepping stone to explore higher order needs. We give that platform for people to ultimately get to a place where they can have confidence and trust in the solution in order to engage on something more sensitive like mental health conditions, anxiety, depression, perhaps in its most extreme suicidal ideation.

I think many of the legacy providers that are focused on high-grade mental health are supposing that someone can jump through all these steps independently. We just don’t think that that’s how people behave. We don’t think that’s how to build trust, and if we want to make an impact on the problem and help people, then we ultimately need to provide that platform for them to move through that process themselves.

How do you see the future of the health, wellness, and safety space evolving?

We see Active Care as the future, where people have got the power to engage on their own device, in their own time, on demand, and relevant to their specific requirements, rather than a one-size-fits-all approach. We need to have modern solutions that will recognize complexity, and ultimately simplify care programs for people so they can get the results that they need to crack on with life.

Are you seeing the priorities of Gen Z changing how these pieces are integrated into daily life or work life? How are they impacting where things are going?

I think they’re really demanding, and that’s a wonderful thing. The more recent generations have been exposed to some of the most sophisticated technologies. They understand what good design looks like, they understand that their needs and requirements are fundamental to good output. To the Active Care point, Gen Z are going to continue to demand that services are accessible to them on their own device on their own time for their specific requirements, and they want to have a wonderful experience. You won’t be successful without offering a world class experience because there’s just no patience for anything less.

A lot of businesses think about wellness as critical to employee retention — how are you thinking about that during these more challenging or unpredictable economic times? How do you talk about that with businesses or employers?

It’s a really critical discussion because there are so many providers now that say that they can make impact on productivity, on engagement, on staff churn, but it’s very difficult for them to draw a correlation between input on the left and outcome on the right. I think this is why the data and insights from Sonder are so important. By virtue of the program that we’ve built, the Active Care model that has a foundational focus on safety, it ultimately drives activation and utilization to levels that typically exist between 10 and 20 times the legacy providers. That’s a significant impact.

How do you think about delivering care and what makes your method different than using a chatbot or AI tool?

Sonder uses real people. We don’t use bots. The technologies as we understand it are not sophisticated enough to achieve real impact against real human problems. A chatbot ultimately can’t have empathy. Our business is about supporting people, often in their most vulnerable state. I think when it gets down to the fundamentals of the service, human to human interaction is what we’re all craving. It’s a fundamental aspect to our wellbeing.

What can we look forward to next?

Our expansion into the United Kingdom. Sonder has achieved really significant growth and impact in the Australian and New Zealand markets. We are now expanding into the UK and then other global markets. We want to take the lessons we’ve learned in how to engage and motivate and make more productive people around the world.

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Christopher Marr, DSM, is the Co-founder and Chief Commercial Officer of Sonder. He has dedicated his life to serving others, previously serving 20 years as an Australian Army officer, including 10 as a leader and commander in the special forces. His role at Sonder is to lead the commercial strategy and growth of the company, both domestically and internationally. He is committed to addressing the world’s burgeoning health crisis by disrupting the way people get help.

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