Healthcare Entrepreneurship – The Low Hanging Fruit in Healthcare


The author is a MD/MBA from Harvard Medical School and Harvard Business School who is passionate about entrepreneurship, healthcare technology and healthcare systems improvment. He is the founder and CEO of Aavya Health, a Healthbox/Blue Cross/Blue Shield-backed company. He has experience in healthcare venture capital, hospital quality improvement, and biomedical research with over 7 publications. He blogs regularly at

The litany of broken processes and inconsistencies that plague US healthcare create a seemingly endless array of opportunities for healthtech startups. However some problems are bigger than others, and in the healthcare industry, the magnitude of pain and cost embedded within a problem can spell the difference between success and failure for a startup.

Many startups apply the “wouldn’t it be great if…” that works well in consumer tech to healthcare. We all are consumers of healthcare on some level, and it’s easy to conjure up ideas of how to make a broken system better. Unsurprisingly, many consumer health tech plays originate from this line of thinking. Applications that monitor your exercise, tell you which vitamins to buy, and aggregate your medical records fall within this category. All are everyday healthcare problems that could use solutions.

However, addressing these everyday problems often doesn’t lead us to where the biggest healthcare opportunities lie. Exercise tracking certainly stimulates healthy behaviors, but these sorts of solutions are often “nice-to-haves” for a population that is already quite healthy. The ripest opportunities are linked to real inconvenience for consumers and huge cost for system. We can break these out individually to see some examples in the market today.

Inconvenience for consumers: I emphasize that inconvenience here refers to the way consumersalready use healthcare. ZocDoc is a perfect example of a company that addresses such a need. The primary way nearly everyone engages with their healthcare is through their doctor. A necessary step in this process is scheduling an appointment, and the frustrations of phone scheduling are known to all. ZocDoc’s online scheduling service solves this problem, addressing a pain point that a large number of people are already feeling.

Cost/pain to the system: The mainstream press has recently focused attention on costs in healthcare. A recent expose in the New York Times revealed the outrageous inconsistency in pricing for a colonoscopies, an otherwise standard procedure. There are many ways to reduce cost in the healthcare system, but the most obvious is to expose the costs themselves. Companies like Castlight Health have enjoyed success by solving this problem for large employers, with health plans and other risk-bearing entities in the pipeline.

Some examples of opportunities that lack established players include solutions designed for high-cost patients with multiple chronic diseases (the 5-10% who drive a disproportionate fraction of costs), as well as end-of-life care, which also accounts for a staggering percentage of hospital costs.

None of this is to discount the importance of execution attached to the success of these ideas. There are dozens of companies in both of the above two spaces that have failed to achieve the same success for this very reason.

Nor is this to say that there is no opportunity in consumer health. Companies like Jawbone, FitBit, and RunKeeper have compelling traction that could translate to a massive opportunity someday. But the opportunity is not a healthcare opportunity in the traditional sense. I’ll discuss my thoughts on successful consumer health approaches in a subsequent post.

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