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On April 29, 2017, changeme_43 commented on Augmedix: Humanizing Healthcare Through Google Glass :

Thanks for the post Seanna! I wonder as you mentioned how scalable Augmedix and how difficult it will be to transition the processing from humans to NLP, especially given the complexities and range of doctor speak depending on specialty.

On April 29, 2017, changeme_43 commented on TheWaveVR: A Musical Metaverse :

Interesting post Ian! Would love the opportunity to use this as a fellow music aficionado. I wonder how defensible the technology and company product is – even as a first mover, it seems like companies that have already a much stronger user base could capitalize on this once the value proposition and technology becomes more defined.

On April 29, 2017, changeme_43 commented on Medical Realities: Transforming Medical Training through VR :

Thanks for your interesting post! I wonder how difficult education and adoption will be of VR in healthcare which is historically and presently still a very conservative group when it comes to technology, especially among doctors.

On March 21, 2017, changeme_43 commented on Iodine: the ‘Yelp of Medicine’ :

Great post Sonali! I’m a fan of Iodine. It seems like the value of Iodine is hinged on the breadth of their patient data and reviews – I wonder if platforms like PatientsLikeMe would have an advantage having owned more of the entire patient experience including reviews on drugs (PLM recently formed a partnership with Walgreens on drug adherence). I might think also about how Iodine might partner with healthcare providers, physicians as a way to shuttle in more customers or adding other drug or treatment experience into the platform.

On March 21, 2017, changeme_43 commented on Crowdsourcing Genealogy :

Thanks for your post! How should think about creating stickiness around their platform with competitors like 23andMe that are also focused on ancestry as well as other type of genetic services? Does it make sense to focus on the core ancestry product or branch out into other services such as integration of other activity, DNA, genomics data?

On March 21, 2017, changeme_43 commented on 23andMe: Healing the World through Crowdsourcing :

Thanks for your post Ali! 23andMe announced this past 2016 that they have decided not to focus on next-gen sequencing as a path forward for more holistic sequencing of genes. How do you think this will impact credibility with the scientific community.

In terms of regulation, in the past FDA has raised questions around 23andMe actually got shut down by the FDA – while FDA approves 23andMe’s current product, how will future reiterations on their product be impacted by potential regulations by the FDA?

I’d also like the point out that genomics start-ups were actually the highest funded digital health category of 2016 at $410M – how do you think this will impact competition in the space for 23andMe – especially for companies that are focused on platform based genomics testing (Helix) and other focused on next gen sequencing (ColorGenomics, Arivale, Genospace)?

On March 21, 2017, changeme_43 commented on PatientsLikeMe: Finding Cures for Chronic Diseases :

Thanks for your post! How do you see niche players tapping into patientslikeme’s value proposition by focusing on specific disease conditions? Is the platform sticky enough to retain customers?

On February 28, 2017, changeme_43 commented on SoundCloud Tunes Up the Music Ecosystem :

I am a big fan of soundcloud and when I used to be in a band would post our music on there as well. How do you see soundcloud playing in the realm of larger music streaming incumbents like Apple Music and Spotify that you mentioned? If Spotify was also to allow users and musicians to upload their own music in a similar sharing interface – how would Soundcloud be able to respond / maintain a competitive advantage?

On February 28, 2017, changeme_43 commented on Building an Integrated Digital Travel Platform: TripAdvisor vs. Google :

Does it look like there Airbnb might be a target for acquisition by bigger players like Google? I would be curious to get your sense of whether TripAdvisor “brand” will be sufficient to keep barriers to entry high and multihoming low between different travel platforms.

On February 28, 2017, changeme_43 commented on Honor: the next “Uber for elderly care” :

Thanks Brandon! The elderly care market is expected to grow to $319 billion by 2016. So in terms of a low capital investment market with historically large margins from Medicare reimbursement there a huge opportunity here to improve quality and efficiency from traditional brick and mortar home health agencies. Research has shown that one of the biggest elderly care costs is from in-home care – with costs ranging from $3-$6K a month.

Companies like Honor who can create a scalable and quality tech platform will be key to success in this new disruptive tech approach to elderly care.

On February 28, 2017, changeme_43 commented on Honor: the next “Uber for elderly care” :

As mentioned above – but caregivers on the Honor platform are not only employed but go through a rigorous screening process. In term Honor prides itself on a rigorous application process where the current acceptance rate of caregivers is 5% (see above). In terms of scalability, Honor is differentiated from other similar technology based elderly care platforms with an automated match and pricing service to limit SG&A costs of additional HR / staff to coordinate care. I definitely scalability will be a key challenge to developing a platform that is sustainable.

On February 28, 2017, changeme_43 commented on Honor: the next “Uber for elderly care” :


You’re right – oftentimes the market user of the platform are caregiver’s loved ones rather than the caregiver herself/himself that purchases the services. Honor prides itself on a rigorous application process where the current acceptance rate of caregivers is 5%. Screening criteria include clean courthouse and criminal database records going back 7 years, 60 min interviews including competency and in-person screening as well as registered drug testing. One of the key drivers for the company will be retaining top caregiver talent in a way that preserves quality but that is also scalable.

Beyond just competition in the space, I wonder about widespread sustainability of usage with these apps. How great is the data if you only have disparate pieces of usage? I think the fitbit still has a far reach to establishing credibilty accuracy to be used in the healthcare community (e.g. clinical trials). I think with everyone moving into the healthcare space – the company that is able to show the type of scientific evidence and outcomes that clinical stakeholders are akin to will be the winner in the healthcare market.

On February 3, 2017, changeme_43 commented on One Medical Group: The Potential Uber of Healthcare :

Thanks for your post! I believe on-demand or concierge medicine is on the rise in America with companies like Pager and Heal. I wonder what regulatory challenges on reimbursement for services since care is provided remotely as well as concerns about patient data privacy.

So great to see a post about Omada – I definitely believe that are the leaders of behavioral change in the diabetes space. Besides barriers to entry as Alice mentioned, I would also be curious to see how Omada can scale their model in a way that is profitable and continue to show sustained results. Only time will tell!

On February 3, 2017, changeme_43 commented on Slack: Where You Go to Get Work Done :

I have always been a loyal Slack fan (including trying to unsuccessfully convince my section last year to use Slack instead of GroupMe. Just to note – all RC sections this year are on Slack instead). I will be interested to see how Slack can scale up and support larger enterprises and how it plans to differentiate and retain it’s customers from the incumbents like Microsoft, Google, etc.

Great post Alex! @Alex Mahylis’ comment we had a case on Spotify in SMICI last semester. Roughly 25% of Spotify’s 60M customers in 2015 were paying customers but subscription revenue makes up about 80% of Spotify revenue compared to advertising revenue. Alex – you were spot on that Pandora’s bet on an advertising business model wasn’t sustainable and has pushed them to be a lost leader. I agree with your analysis. In addition, as Ian comments, I don’t believe Pandora has been able to leverage data on it’s customers listening habits as Spotify has done to push out relevant customized content / concerts to it’s users.

On February 3, 2017, changeme_43 commented on Sweat with Kayla – the unstoppable growth of the Virtual Trainer :

Thanks for the blog post! I also am a big fan of Kayla. Besides churn I also wonder about barriers to entry – Kayla isn’t the only app that can create a work out video and none of what they do is proprietary or continue to show results. How will the market handle an influx of similar competitors? and subscribing on and off the platform?