Industry Life Cycles for Startups


lifecycle-product-overview

In a recent report on Stryker, a leading medical device manufacturer, its marketing team reported that it was entering the year “on the cusp of new product cycles” and it sales grew 18% by the 4th Q and experienced 11.7% international growth. And the term, life cycle, hit my memory cells that recalled my first year marketing class.

Virtually all companies, including startups, need to concern themselves about these cycles. Businesses, old and new, face increasing competition.  Verizon, a 100 year plus old PSTN provider, sees its revenues declining just this last Q in 2016.  It struggles to look for new products to prop up its revenues.  Dropbox, a new generational digital company, is facing competition from Amazon, Google which build and manage data centers that will undercut Dropbox’s pricing. Unless Dropbox finds new products, it will also suffer revenue declines.

On the other hand, Stryker follows the textbook marketing lesson – -always get new products when the lifecycle or competition reduces the market share and product pricing. That is why Stryker is enjoying double digit growth. And, when I myself work on 3-5 year business plans, I have to think, how can I expand the list of products before initial revenues from my first product get hit? Then one has to consider the speed at which potential competitors can enter the same market. That is what Dropbox confronts today.

What is the industry life cycle?  The graph is self explanatory. And one adds the other product must be timed when the product sales dip or, to use a mathematical term, when the second derivative reaches zero.

Then, one includes a new product or a product extension.  In a medical device project I am currently drafting, I consider the new product extensions or lines to begin to be introduced within 24 months of the first product. The company must diversify products to reduce the risks to loss in its revenues when competition enters.

Somehow, in Silicon Valley, many entrepreneurs and patent attorneys all believe that their products don’t require immediate extensions or innovations since the patents provide them with a virtual monopoly. In a perfect world that would be true.  But today’s world is filled with many patent lawyers, many competitors, and fast moving markets that contribute to a new innovation paranoia – to paraphrase Grove’s oft quoted remark on survival. Even Intel with its treasure troves of patents, knows that competitive concerns are paramount to financial success – even with patents. It builds huge new factories for innovative products to compete. Innovation and new product cycles are key.

So, if the company is a startup or an established company, innovation must be introduced every few years. It needs to be thought early, even when putting together an initial business plan. Investors do not want the one trick pony.  And that is what you want to avoid being – a short demonstration of one product line.

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The New Wave of Entrepreneurship by Matt Swanson, Managing Partner of Silicon Valley Software Group – Toptal


There is a multi-trillion dollar economy opening up to technology faster than ever. It has been driven by trends that have changed the nature of how entrepreneurs will be characterized going forward; specifically, industry executives will be the next wave of in-demand startup CEOs.

new wave of entrepreneurship

In April of 2007, Apple changed everything with the launch of the iPhone. It is hard to imagine that it has only been 8 years since the release of the first truly pervasive smartphone, but there is no denying its impact has been world-changing. Beyond the creation of a new dimension of industry-driven, by location-based, services (and with it, a myriad of billion dollar companies), an equally significant phenomenon emerged. By creating technology that was intuitive to the consumer masses, every person around the world started to embrace technology as more than just a work tool. Lawyers, doctors, car mechanics and people from every sector of the economy not only had a tool for productivity, but a piece of technology in their pocket they embraced as an intimate part of their lives.

Furthermore, these new consumers could now point to a standard for usable technology. Cumbersome, enterprise legal software that won’t allow a lawyer to search cases from outside the office is no longer acceptable. For those outside of the Silicon Valley silo, conversations can be heard from construction workers sitting on a lunch break saying “Wouldn’t it be nice if there was an app to …”. Unfortunately, these conversations are often too far away from Silicon Valley’s ears, which are still dominated by the talk of what will be the next WhatsApp or Instagram. Even so, a new breed of entrepreneur is emerging who see firsthand the challenges in their industry, and with that the opportunity to make a world-changing impact, and these entrepreneurs do not fit the founder archetype that many Silicon Valley investors look for.

new breed of entrepreneur

Photos from http://www.ablogtowatch.com, http://securityaffairs.co, http://geniusapp.com, and http://www.rakenapp.com

Previous decades saw similar shifts in entrepreneur characterizations. The late 90s were about Harvard MBAs applying traditional management techniques to leverage brand new Internet technologies. The “aughts” brought on the “22 year-old Stanford Computer Science” graduate applying technology to a low hanging industry. Now, in this decade, we are seeing a new wave of entrepreneurship driven by industry executives with deep product backgrounds leveraging technology to disrupt a traditionally non-tech industry.

For the past 2 years I’ve had the opportunity to see this shift firsthand as the managing partner of Silicon Valley Software Group (SVSG), a firm of CTOs focused on helping companies with their technology strategy. SVSG has seen entrepreneurs ranging from movie producers, lead singers of platinum album rock bands, travel executives, and hedge fund managers all trying to figure out how to leverage their domain expertise through technology. After a number of similar engagements, a few observations have emerged:

  • In each venture, a product-focused entrepreneur saw the adoption of technology among their peers in a particular industry and, with that, the opportunity to create a product focused on that industry.

  • None of these entrepreneurs had notable tech experience.

  • Hardly ANY of these high profile individuals had relevant connections with the Silicon Valley community.

This last observation is of particular importance!

As tunnel-visioned as Silicon Valley might be, there is a reason that it has produced so many world-changing companies.

https://platform.twitter.com/widgets/tweet_button.21a54035d226e6309ff10dbaaff7ca1f.en.html#dnt=true&id=twitter-widget-0&lang=en&original_referer=https%3A%2F%2Fwww.toptal.com%2Fit%2Fthe-new-wave-of-entrepreneurship&size=m&text=As%20tunnel-visioned%20as%20Silicon%20Valley%20might%20%20be%2C%20there%20is%20a%20reason%20that%20it%20has%20produced%20so%20many%20world-changing%20companies.&time=1484144269897&type=share&url=https%3A%2F%2Fwww.toptal.com%2Fit%2Fthe-new-wave-of-entrepreneurship&via=toptal

The combination of growth capital, multidisciplinary talent, and mentors sharing best practices around how to create hyper-growth businesses are often taken for granted by those who are part of the ecosystem. However, the disconnect between Silicon Valley natives and outsiders is shocking. Many of the companies SVSG has come across have no ability to raise strategic capital at first because their businesses are too risky when considering common pitfalls they are more likely to fall into compared with their Valley peers. Concepts as commonplace as the lean startup methodology are welcomed as sage insight to these new entrepreneurs.

What is missing for these new founders is a bridge into Silicon Valley. To date, this has been stymied by a narrow mindset from the Silicon Valley community. However, the forces of capitalism will eventually prevail and these new entrepreneurs will find their own community to center around. Keen investors will lead the herd and take advantage of existing markets ripe for change. Incubators and accelerators will emerge with a focus on entrepreneurs with deep industry experience. We are in a tech boom right now and there are countless ways to apply technology to industries that haven’t changed in decades. For those sitting in the corner office, the time has come to venture out, there are markets to disrupt

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Is it worthwhile to do an IPO during an era where Private Equity can invest considerably in the later rounds?


Is it worthwhile to do an IPO during an era where Private Equity can invest considerably in the later rounds?

The business channel, Bloomberg, broadcasted a dispute of the advantages/disadvantages of IPbloomberg-chartsO (Mark Cuban) vs. Silicon Valley (Andrew Romans) in today’s markets. Since I have witnessed first-hand the IPO process as corporate counsel, I feel that I can throw my 2 cents in.

Cuban stated that the advantage of the IPO is the liquidity afforded by the marketplace. Romans felt that there is enough liquidity in the VC world, even to the point that equity is exchanged among the Silicon Valley firms.

Let’s look at the different resources for transparency provided by VCs versus investment banks.  First, the level of due diligence by a Wall Street investment bank overwhelms whatever I have seen in Silicon Valley. Some months ago, I visited a VC firm in Palo Alto that occupied a quarter of a floor of a small, nondescript building. It had no receptionist. And the meeting was populated by 2 personnel – one director and one analyst. Several months later that VC fund disbanded.  The main entrance space, where the receptionist and waiting room would have been located, was populated by younger personnel, about 3, with their computer terminals.

The one director, I believed, was not qualified to understand medical devices, as his life experience was focused on semiconductors. During my presentation, I felt that they had not read carefully the materials sent earlier.  So, maybe because of limited time, they never bother reading the complexities of the technology.

Now, let’s look at a Wall Street investment firm. In one meeting in a large conference room with a floor high screen, I counted over 9 analysts besides the managing director.  One had a Ph.D. in finance from Harvard.  All others attended top tiered business schools.  True, a Wall Street engagement letter requires a retainer exceeding $50k a month to cover the due diligence process. But you see every penny being spent on high quality support.  This bank has teams of writers, researchers, and PowerPoint experts that produce in less than a week a well drafted “Teaser” document with illustrations, statistics, not found in the business plan I had produced.

Moreover, they also bring in the top tiered accounting and law firms. The law firms’ production requests cover virtually every document needed. Accounting firms review every aspect of the company as well as the senior managers. Indeed, I actually noted that a CEO decided to move the company’s operations to Spain when the accounting firm needed to review his financial filings and taxes. As everyone knows, Spain has no extradition treaty with the U.S.

With the substantial vetting of any potential IPO, one has to conclude that their analysis and work really reflect the fact that they are avoiding any potential securities violations.  Once a stock is public, there are litigious vultures waiting to see any “blood” or mistake to swoop upon.

What does Silicon Valley offer?  A small club of investors protecting each other. Let’s take Yahoo, run by a local veteran from Google and Stanford.  Over the course of her leadership in 4 years, she has single handedly lost the company over $20 billion, more than the GDP of some countries.  Yet the small club mind set kept her on board while she laid off over 20% of her staff and she enriched herself last year with a $40 million payday.

Since by nature, all VC firms are thinly staffed, they are incapable of vetting the validity of a business plan outside of their comfort zone.  And I have met virtually all of these firms and I noticed that all know each other’s activities and deals.  There is a clubby atmosphere where each managing director knows each other, eat at the same restaurants, share the same innumerable panels.  And they still lose in about 70% of their deals.  One would be better off just flipping a coin to determine whether the investments will be successful. So the focus has been the inveterate leaders such as Uber, creating the mega-investments with the sobriquet, Unicorns. Yet, more money pursuing the same money has its limits.  Sooner or later they need to diversify and sell some of that equity to someone else to share that risk.  And this came out from Romans interview – the trading of equity among the VC “clubs, waiting for the right time to exit without an IPO.  He admitted this fact to Cuban (putting his foot in his mouth), who commented that this intra-trading should undergo regulatory scrutiny.  So now the clubby atmosphere is sharing more than golf game tees and the like.

So this Silicon Valley trend underscores what Cuban was addressing – the preference to use the IPO for liquidity where all transactions are transparent and small time investors can have access to equity that has been made squeaky clean by the SEC rules and regulations. Why is this important? Prior to the promulgation of securities laws, public trading was a wild, wild West show where the individual investors were burnt by stock manipulation and fraud. One such manipulator was the patrician, Joe Kennedy, a master at manipulating stock.  When stock transactions are not so transparent and held by few, then those transactions can be subject to manipulation.  What seems to confirm that observation is the fact that many Silicon Valley “highly valued” companies have been trading underwater since their IPOs.

The suggestion is that these companies were initially overvalued by the private firms, going for their exit strategy after the IPO, and that stock settled to its true value as determined by the analysts and performance, while providing the insiders the right to sell immediately after the IPO, and letting the unknowing investors to buy the overpriced equity.  Mary Jo White, SEC Chairperson, has recently warned the public about this Unicorn excessive valuations.

So in the end, it seems that Cuban was correct that the IPO provides the best liquidity for secondary investors.

 

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How will the new Trump Administration impact International technology deals?


aixtronIn a Silicon Valley pitch investment meeting hosted by Chinese investors, an audience member asked the presenter whether CFiUS had approved or would approve the potential investment of the NorCal sensor company.  The presenter replied in the affirmative.  I actually knew that his comment wasn’t true. For any review by CFiUS, which is populated by a committee from about 15 different governmental agencies, the review process has to start by approaching them first and waiting for several months to get a reply after multiple meetings and discussions. I was impressed that the Chinese inquirer knew about CFiUS.  What concerned me, if CFiUS had gotten wind of this sensor deal, it could have objected to the transaction.  Given the Trump Administration currency stance against mainland China, I anticipate international technology transfers to be part of the trade wars between both nations. http://www.newsweek.com/2016/12/16/issue.html. Why, pray tell? http://www.law360.com/articles/867136/potential-increased-cfius-scrutiny-under-trump. http://www.law360.com/articles/823678/us-china-panel-queries-investment-accord-s-economic-upside.

Currently, China imports approximately 80% of the advanced technologies embedded in their export products.  The Chinese government has allocated about US$150 million to accelerate its technology development within its borders regarding semiconductors and sensors.  And that money is not simply for greenfield projects but also for M&A to accelerate technology adoption.  If the Chinese government acknowledges that, if it can produce the very same technologies being imported, that technology chasm is bridged and improves the profit margins that provides this nation greater trade balance in their favor. Since Trump fears that the U.S.-China current trade imbalance is not politically supportable, this administration is certainly going to object to any technology transfers that broadens further that trade imbalance.

Why is China needs to pursue its M&A in technologies? Some of the foreign technology in semiconductors and sensors is superior to those developed within China. In the case of many sensors, the U.S. and European sensors are smaller and more efficient than those home grown.  By acquiring superior foreign technologies, China can get a head start of its own.

But this battle is no longer between the U.S. and China.  CFiUS has expanded its reach beyond the U.S. Recently, a German company’s acquisition by Chinese investors has been blocked by CFiUS. http://www.wsj.com/articles/cfius-again-objects-to-a-china-europe-deal-1479667577.  That means that all of the costs, about 3%-5% of the deal value, associated with the M&A came to no avail. Not only is seller has to swallow its M&A costs but might lose “face” in further dealings with the Chinese.

How can the Trump Administration can expand its reviews of any deal that can impact “national security”?  One recent Chinese wind farm acquisition was nixed by CFiUS in northwest America.  Was it because of the wind farm technology that somehow or another impact U.S. security interests?  We all criticize China’s environmental policies so such an acquisition might benefit the environment. Actually, the answer there is no.   The approach here was more oblique: CFiUS claimed that the windmill farm overlooked a U.S. military complex for objecting the deal, although lost in appeal. http://www.defensenews.com/story/defense/policy-budget/industry/2016/02/22/cfius-chinese-interest-us-firms-case-surge-watchdog-panel/80777288/

From this example, one can conclude that CFiUS will investigate any angle that will lead it conclude that it might impact “national security”.  I foresee an expansion of the oversight. For example, if the target company has contracts with DARPA, that might block the deal. Is the company manufactures ANY ingredient or product used by the military, then that fuels sufficient impetus to block that deal.

Note that CFiUS is another tool that impacts the transfer of international technology.  In one of my earlier blogs, I even recite various other governmental tools that restricts certain activities or sale of products to certain countries. So the governmental oversight to control international transfer of technologies covers a) M&A, b) product sales, and c) behavior or business protocols (FCPA).  Then you ask so what? What are my risks?

I enjoy using this actual example as to the bottom line impact – the $300 million dollar email.  An aerospace engineer from a military contractor was sent an email from China’s aerospace program to determine why their rockets where blowing up.  The U.S. engineer suggested by email for them to smooth out the external rivets in one email. The result?  $300 million costs to deal with the U.S. government’s investigations and the full time employment of an ombudsman overseer.

The U.S. has multiple tools: fines, U.S. government contracts ban, and even criminal charges, in their penalty portfolio.  The other costs are those sunk in preparing the deal that will be written off once CFiUS blocks the transaction.  Here, it pays to be pounds-wise.  A $100 million transaction will incur about $3-$5 million fees (3%-5%) charged by both accounting and legal firms.  An earlier investment to screen for CFiUS decisions would be cost effective. White collar defense during criminal indictments is also costly. CFiUS deliberation turnaround times is about several months. Yet is far less expensive than a CFiUS adverse ruling.

I foresee more and more barriers to transfer international technology to targeted countries such as China and all within Trump Administration’s radar zone. It pays to look into these issues diligently when considering acquiring technology companies and transferring that technology offshore.  All CxOs should be aware of the potential calamity that can occur when involved in such transactions. Yet, this crisis can be averted by due diligence and smart political gestures.

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Due Diligence


Due Diligence, thoffice-workat is “doing your homework”, comes in many forms in business transactions.  One applies to M&A or investments where the investor’s team validate the information about the target company.  Legal and financial representatives go about requesting various documents, such as financial statements, tax filings, corporate books, PR announcements, etc.  Sometimes it doesn’t work well. (https://www.linkedin.com/pulse/mark-cuban-shark-tank-got-royally-screwed-howard-marks?trk=hp-feed-article-title-comment, http://www.wsj.com/articles/big-names-take-hit-on-theranos-1480379536) And the other approach to Due Diligence (“DD”) applies to pursuing investors. http://www.garage.com/resources/perfecting-your-pitch/.  But these articles omit that the key elements to these DD are the detailed preparation of business plans, corporate records, competitive analysis, security interest searches, and other DD tools.

Recently, I was asked to participate in the fund raising of a new startup dealing with sensors.  My contact stated that he had one potential investor who would be interested.  But I asked to pause any drum beating until all “T”s are crossed and “I”s dotted. Why? Investors and VCs receive approximately 200 business plans a week requesting capital. Of that group, less than 5% get invited I solely based on the materials that they receive.  In other words, the WRITTEN word and the graphics will get the company into the door.  And whatever content being presented must be consonant with the experience that the audience has had in viewing so many business plans.  Then, after that pitch comes additional DD to determine the final investment.  Yet, since only 8-10 deals are funded annually, the percentage of success is low and can be worst without the right DD!

In my actual experience, I personally advised a NYC fintech team and had them meet the VC fund in Boston.  In the fintech’s presentation, they claimed that they would be able to license 7-8 units in a year.  The Managing Director pointed out that in his 10 years of experience, he has not seen any company license more than 5.  Hence, the fintech company’s numbers were too sanguine and testified to their lack of experience in this space.  In other words, the Fintech team’s DD was lacking and failed to attract the funding.

In other words, part of the company’s DD is to evaluate how the projections meet industry standards. What is the appropriate size of a management team?  Which EBITDA multiples apply to my company? And so forth.

In the Howard Marks’ article we see another form of DD.  Before investing, can everyone validate the quality of the management and truthfulness of the corporate documents?  One M&A transaction had one investigate local county records to confirm no secured filings that compromised the actual physical assets when being purchased. In international transactions, one looks for Apostilled documents since many other countries rely on a formalized documentation to validate contracts.  In other words, if you have a supposed contract, is it enforceable in the foreign jurisdiction?  If not, then the contract is not worth much beyond the piece of paper.  Corporate books must contain the right wording for the various board and shareholder meetings — otherwise, any apparent corporate action can be annulled. And, again, we can go on.

So, quote Yates, many a slip between the cup and the lip. Anything can go wrong in making an investment, to going to the wrong investors, or even putting together a business plan. The purpose of excellent DD is to mitigate those risks.  And, if it cannot be done internally, outsource that skill set.  As an example, I did some DD for a potential Maryland investment in data storage.  When I spoke with the founder, who was foreign born, I knew that the business plan was too well written.  I then confronted the founder and asked, who did author the plan.  And he admitted a professional did and he compensated him.  At least, he admitted to himself that, to attract funding, he did need some help.  And guess what, he did get the funding.

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Arguments, Facts and Decisions


A very well-known jurist once distilled how judges reached a decision into a single equation,

Argument + Facts = Decision.algebra

In other words, how well a lawyer couches his argument substantiated with numerous facts, whether by quantity or quality (or both), he or she can persuade the audience – whether a judge or a jury – to rule in favor of that lawyer.   Essentially a lawyer is attempting to influence the decision of the audience, no different than entrepreneur attempting to influence the decision of an investor into his or her company.

There are many similarities between the lawyer and the entrepreneur.  Both have to pitch an idea, a product or a person.  They have limited time in which to achieve their objectives. Both have to win, or lose face.  And both know that time is money, and money is time.

Legal arguments have structure as well as what an entrepreneur delivers the essential 5T’s (in my earlier blogs.) Invariably I receive so called pitchdecks or business plans that dreadfully fail to carry a cohesive message.  A known investor related to me that the most important thing a pitch should state is a persuasive story.  Is the story well armed with the right facts?  Does the story cover every point or remark made by the audience?  (In other words, is the presenter well prepared?)

Let’s take actual examples. A few weeks ago,  I received a 44 page business plan – somewhat lengthy and not the right format to present initially to potential investors.  And this defect is just the beginning of other ones within the document.  In one page, it states that its value is 7 times EBITDA, but it fails to show or prove to me how that value was calculated.  Is that the industry average?  And just like any legal argument, be prepared to show to the audience the source of that fact?  During legal arguments, every lawyer should be prepared to demonstrate to the judge the source of his or her fact.

Now, on the other side of a coin, a potential investor pointed out to me how would I handle the data safe harbor rules for China for a healthcare network. Not only was I able to address the technical approach in handling this IoT issue, I also demonstrated that similar rules exist in Germany, Brazil and several other countries.  That indicated to the audience that I foresaw the legal and technical issues and covered them professionally.

We can go on.  However, that aforementioned algebraic elegant equation shows with utter simplicity on what one does to persuade an audience.  Simple and direct. Pay attention to it.

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Healthcare and Technology – a Recipe to Reduce Medical Costs


patient

In 2016 even Obama Care has not done much in stemming the rising healthcare costs in the United States – the highest healthcare per GDP than any other country. And still the United States is nowhere in the top ten in results: the U.S. has created the most expensive medical care in the world and not as effective as other leading countries’ healthcare systems. Premiums are escalating around 25% in most States. For a few, the premiums will jump even much higher. In the meantime, we know that technology can create savings, from robotics in car manufacture to process efficiencies in finance. We need to focus on the adoption of technologies for early diagnosis and environmental conditions which, in turn, can forestall most of these skyrocketing premiums.

Early Diagnosis

Early detection reduces mortality and treatment costs, but screening is incomplete. Only 35% of the population receive colorectal cancer screening; 79% receive cervical cancer screening, and; 68% receive breast cancer screening. Cancer is responsible for $128.1 billion in lost productivity annually (ACS Cancer Facts and Figures 2007.) The NCQA report states that preventing these cancer cases would have resulted in healthcare savings of hundreds of millions of dollars, if not billions. Medical screening costs for early diagnosis are high for the uninsured or low insured populations or just simply unavailable.  With tacit agreement to these numbers, the NIH now promotes preventive medicine, which emphatically includes “early diagnosis.”

So it behooves the healthcare industry to identify diseases at its earliest stage. But why isn’t done? One gastrointestinal oncological Chilean doctor, in revealing the rate of late stage cancers in Latin America, demonstrated that once the patient had lesions by stage 3 or 4, his chances of recovery were virtually non-existent. To identify stage 1 or 2, however, required yearly visual inspection with endoscopes of the gastro-intestinal linings that was not only expensive, but physically uncomfortable and time consuming for patients.

Another factor is cost. Lung cancers can be identified with CAT scans.  However, the average cost is $800, below today’s deductibles. And, in many rural regions, such diagnosis is not easily accessible.

Environmental Diseases

Illnesses and conditions caused by external factors from the environment are collectively called environmental diseases. Air pollution, pesticides, chemicals, radiation, and water pollution, are some of the manmade hazards that contribute to human illnesses.  We all have heard of the Love Canal and, recently, Flint, Michigan. Apparently, human population clusters are exposed to environmental attacks from human activity.  One recent NY Times article described how a small town in China has been exposed to fine graphite powder, a major component to lithium batteries.  This graphite, produced by the local factory, is extremely fine, permeating throughout homes, food and clothing – a recipe for pulmonary diseases.

Water and air pollution have a notable health impact. Poor air quality precipitates asthma and more serious pulmonary diseases. Millions die every year from air pollution. We also know that world’s highest asthmatic incidence is found in China, with a rate of 11%, simply because of inferior air quality.  The world’s incidence of asthma average is 8%, with some pockets being slightly higher, such as Africa, Latin America, and Middle East.  Poor water quality produces gastro-intestinal problems, including cancers, found in Latin America.  In the case of Flint, Michigan, we know well that lead contaminants can cause brain damage.

One recent presentation at this year’s Singularity Healthcare conference claimed that the environment causes about 24% of diseases.   Essentially, about one of every four disease can be prevented by monitoring and managing environmental conditions.

Technologies

Technologies can reduce healthcare costs and garner economic efficiencies.   One technology that can monitor air quality is the sensor. Sensors can be designed to monitor every possible air borne contaminant from Ozone to CO2.  The technology has advanced to the point of shrinking such devices into millimeters, and in some cases, nanometers.  The costs to produce them, to communicate and to store the data have dropped tremendously and are affordable to every common household.

There are also sensors being developed that diagnose early stage lung cancer by identifying Volatile Organic Compounds from human breath. These sensors behave very much like trained canines capable of identifying cancers with over 90% accuracy without incurring $800 CAT scans or endoscopy.

There are other new technologies. In photonics, new infrared light technology can scan passively early stage lesions within the gastro-intestinal linings, as a cheaper, more accurate and better alternative to endoscopes that rely on visible light exploration. Water contaminants can also be identified and then treated inexpensively with the new technologies using the Raman effect and miniature lasers.

(Indirectly related: Recently, a retired woman related to me that to have her dental bridge replaced would cost $2,500, a huge sum for someone living off social security.  3D printing should be able to create that bridge for a fraction of that amount.)

Finally, there is telemedicine – remote diagnosis and treatment.  Telecom and the smart phones can become the new doctor.  No patient needs to drive for miles to visit a medical clinic for checkups and identify early symptoms. Technology can take blood samples, measure pulse rates, gauge body temperature — all effectively done with WiFi, cellphones, Bluetooth—as if the patient and doctor were facing each other. Fedex the tool and connect it with the phone.

There is deep chasm between the implementation of these technologies and healthcare costs – outdated regulations, medical insurance reimbursement, legacy systems and hesitant adoption.  “Zero sum” economics would reveal that, by implementing these new technologies, overly paid CEOs of medical insurance processors would lose millions of dollars in salaries (one CEO earned over $1 billion); numerous medical labs would shut down; and others who thrive in this Byzantine system would be sitting on their hands.  But isn’t the purpose of healthcare to improve a patient’s standard of living, not compensate individuals and organizations that leech off the system? It is this peculiar, economic imbalance that is responsible for the overly priced but inefficient healthcare system. I like to see technology that lowers the costs of medical care, not raise them.   Hopefully, the bubble of rising healthcare costs in 2017 should burst and release these technologies to be adopted quickly in mainstream America. The key is to implement the right technologies for environmental prevention and early detection of diseases.  Those technologies currently exist.

 

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