Why startups have an edge over tech giants with AI in healthcare

Alphabet, Microsoft, Amazon, and Apple have all dominated many sectors of technology. Aside from tech, these four companies have one thing in common. They have all entered additional markets vastly different from the ones from which they started.

Such markets include oil, transportation, and food and beverage. Something else these four companies have in common is that they seem to prevail effortlessly time and again as leaders in these new distinct industries. Given these trends, it only seems likely that they would also be the predominant companies when it comes to AI in healthcare.

However, unlike the oil, transportation, food and beverage industries, etc., the medical field requires far more prudence. In order to be successful in this sphere, a profuse amount of patient data is needed. This data can be received from places such as hospitals, urgent care, primary care, EHR/EMR companies, and nursing homes. Given how large the above mentioned tech companies already are, it will be difficult for them to prevail in a field that requires so much trust and transparency from the consumer. They will face far more challenges than startups when it comes to AI in healthcare due to this consumer barrier.

In an article in MedCity News, “The Goliath strategy: How healthcare enterprises can compete with startup innovation,” the title states how enterprises can compete with startups, not the other way around. When it comes to AI in healthcare, the startups are the dominant players.We have already seen that consumers are hesitant to share their medical data with these tech giants. Large enterprises have been around for many years, and along with their longevity and broad consumer network come scandals.

One of the best examples was from the lack of trust that arose when an article in the Wall Street Journal surfaced on November 11, 2019 about Google’s surreptitious behavior with regard to individuals’ protected health information (PHI). This article reported on a partnership—code-named ‘Project Nightingale’—between Ascension (one of the largest health-care systems in the nation) and Alphabet (the umbrella company for Google). Google was receiving medical data from Ascension hospitals, doctor’s offices and senior care centers. This patient data was then stored in the Project Nightingale system, all of this taking place without the patients’ and doctors’ knowledge or consent. Although Google is said to have acted in accordance with HIPAA and other legal regulations, their behavior is considered scandalous due to the company’s covertness and lack of transparency. Had Google asked patients for consent before accessing their medical data from Ascension, trust would have likely been kept intact and patients may not be as skeptical of the tech giants today.

As Copeland wrote, “The health data-gathering efforts of other tech giants such as Amazon and IBM face skepticism from physician and patient advocates.” If these tech giants can’t be trusted with their health data by physicians, patients, and hospitals, then these companies will never be able to succeed in a market that fully depends on the ability to acquire this data. Another consumer concern and reason for the lack of support for these tech giants is due to their already vast control and huge access to personal data. In our society today, knowledge is power. Data is valued as one of the most important pieces of knowledge, yet it is not accredited with the same value as that of a material good. Many are worried that by giving these tech giants even more data, they will end up with a monopolization over everything—from where and when you got your morning coffee to the number of genetic predispositions to health risks you may have.

An example of this becoming problematic can be seen in what occurred between Google and the University of Chicago’s UChicago Medicine. Google made a partnership with UChicago Medicine to receive de-identified medical records. The dates were included in the medical data provided by UChicago Medicine. This alone was not necessarily a violation of HIPAA. However, due to the vast amount of data that Google has on every individual outside of medical reports—in this case location data from Android software, Google Maps and Waze—the UChicago Medicine data could become re-identifiable.

While this vast control of data outside of personal health data becomes problematic for the big tech companies, this is not an issue that healthcare startups have to deal with. Not only does the consumers’ lack of trust in these big tech companies leave these enterprises at a disadvantage, but the tech giants’ ability to succeed in this area is also hindered due to their lack of adaptability. Unlike startups, large tech companies face greater obstacles in their ability to pivot or modify their current business practices.

As discussed in an article in the Harvard Business Review, this inability to adjust is largely due to the “hierarchical structures and fixed routines [which] lack the diversity and flexibility needed for rapid learning and change.” While this may not be a hindrance for large companies when entering already established fields, it is a large impediment for an area as new and metamorphosing as medical AI. However, the ability for startups to easily innovate and readjust will give them a huge advantage in this rapidly progressing and ever-changing field of AI in healthcare.

There are many hurdles that the large tech companies will have to overcome in order to dominate the field of AI in healthcare. To begin with, they need to start by gaining access to the medical data. However, with consumer fears due to lack of trust and transparency and even greater monopolizations—as well as the tech giants’ inability to easily adapt and pivot—these large tech companies may never be granted access to enough medical data to succeed.

This is where startups, like Segmed, come into play. They have a huge leg up over the tech giants due to their less corporate and more human nature, their flexibility, and their transparency. These traits will take startups working with AI in healthcare a long way.