Health Care Medicine

INDUSTRY Health Care & Medicine

Detailed analysis of the emerging

tech and science trends influencing
healthcare and medicine, with
spotlights on AI-first drug discovery,
the future of hospitals and
technology-assisted patient care.
2 © 2023 Future Today Institute

TABLE OF
CONTENTS 35
35
36
Bionic Noses
Brain-to-Brain Communication
Observing the Brain in Real Time
43
43
43
Emerging Prosthetics
Synthetic Skin
Assistive Exoskeletons
49
49
Rings
Smart Gloves
51 Scenarios
36 Consumer Brain-Computer 43 Tattoos and Electronic Skins 51 What if you could get paid
Interface Products in your sleep?
44 Emerging Implants
04 Letter from FTI’s CEO 21 Direct-to-Consumer
36 Neurorights Campaigns 52 What if hospitals had specialized
Health Care Models 44 Dissolving Bioelectronics
05 How to Use the Trend Report patient experience teams?
36 Companies Sunsetting
22 Patient Access to Medical Data 46 Wearables
06 State of Health Care & Medicine Implant Support 54 How to Prepare
in 2023 23 Automatic Medical Transcribing 46 Wearables and Biointerfaces
37 Patient-Generated Health Data 55 Key Questions
09 Key Insights 24 Remote Patient Monitoring 47 Emerging Wearables
38 Cognitive and Neural 57 Selected Sources
10 Ones to Watch 25 Telemedicine Optimization 47 Augmented Reality Glasses
59 Author & Contributors
12 Health Care & Medicine Trends 26 Big Tech Disrupts Health Care 39 Digital Fitness and Health Tech 47 Ultrasound Stickers
60 2023 Tech Trend Reports
12 Medical Deepfakes 28 How Soon Will Amazon Disrupt 40 Frontier Technologies 47 In-Ear EEG Devices
62 About FTI
Your Business?
13 Synthetic Health Data 41 Emerging Treatments 47 Connected Fabrics and Apparel
63 Methodology
31 Prescription Digital Therapeutics
14 Full Genome Exams 41 DNA Robots 47 Smart Biohazard Wearables
64 Disclaimer
32 Medical Misinformation
15 In-Womb Treatments 41 Telerobotics 48 Commercial Full-Body
and Disinformation 65 Using and Sharing the Report
Exoskeletons
16 Xenotransplantation 41 Medically Assistive Nanobots
33 Medical Extended Reality
48 Wearable Air Conditioners
17 Healthy Towns 41 Nerve Coolers
34 Brain Machine Interfaces,
48 Skinput Systems
18 Chief Medical Officers Brain-Computer Interfaces, 42 Emerging Diagnostics
and Neuroprosthetics 49 Mature Wearables
19 Doctorless Exams 42 Smart Materials
35 Neural Engineering 49 Hearing Devices
20 At-Home Medical 42 Diagnostic Beds
Laboratory Tests 35 Brain-Computer Interfaces 49 Watches
42 Illness-Detecting Sensors

THIS YEAR REQUIRES FOCUS

In August 2017, a rare explosive event known Now more than ever, it’s important to carefully Trends on their own cannot predict the future.
as GW17817 took place in space. Two stars track new trends as they emerge. But that isn’t Rather, future-focused organizations use them to
collided, unleashing a blast energetic enough easy, given the rapid pace of change. For that deeply reflect on the tension between long-term
to form an incalculable number of new stellar reason, the theme of our 2023 Tech Trends report and short-term goals and to reduce uncertainty.
bits that continue to travel through interstellar is Focus. It is crucial to focus when new signals By understanding the trends and changes shap-
space. Over time, this stardust will combine into are forming because some may be lasting and ing the landscape, executives can make informed
small objects, evolve into large rocks, fuse with develop into impactful trends, while others might decisions and capitalize on new opportunities in
even more material, and form into planets. One burn out and fade away. In an increasingly com- the year ahead.
incredibly violent disruption will someday lead plex and fast-paced world, leaders who focus
We invite you to join us in observing how the star-
to the formation of a new corner of the universe. on the trends that matter and adapt to changing
dust settles into new signals and trends.
This is how our own sun and Earth, and all of circumstances make better decisions and see
Share your feedback with us at
human existence, came into being. improved outcomes. Trends enable them to antic-
[email protected].
ipate near-term change, understand the factors
Lately it’s as if we’ve been living through the
influencing their industries, and develop a point of
aftermath of cataclysmic explosions: the
view on the future.
release of generative artificial intelligence
systems like ChatGPT and Midjourney, a fusion Our research is presented in 14 in-depth reports
breakthrough that could someday generate that reveal the current state of play, a list of influ- Amy Webb
zero-carbon energy, Russia’s ongoing invasion encers to watch, key trends, detailed examples, Chief Executive Officer
into Ukraine, deep uncertainty about a global expert perspectives and recommendations de- Future Today Institute
recession, and AlphaFold’s protein-folding al- signed to help executives and their teams devel-
gorithms that predicted structures for nearly all op their strategic positioning. Some of the trends
cataloged proteins known to science, to name are new advancements on mature technologies,
a few. These and other forces of change are while others represent frontier technologies and
colliding, going supernovae, and resulting in an areas of science. When we look at them collec-
unfathomable amount of new signals—bits of tively, new centers of gravity come into focus, and
change that, over time, result in the trends that we can glimpse the impacts they will have on
shape society. every sector.

HOW TO USE THE TREND REPORT
Our framework organizes nearly 700

trends into 14 clear categories, which
are being published as separate reports.
Each report includes specific use cases 1 3 4
and recommendations for leaders and
their teams.
1. Years on the List

We track longitudinal tech and science trends. This
measurement indicates how long we have followed
the trend and its progression. 2
2. What it is
Concise description of this trend that can be easily
understood and repeated to others.
3. How it Works
Real-world use cases, some of
which should be familiar to you.
4. Why it Matters
The implications of this trend on your business,
government, or society.

Migrating to the Cloud

While there is consensus that cloud technologies could unlock enormous value for hospitals and
health care systems—think automation, streamlined workflows, patient insights, improving the pa-
tient experience, and data analytics—many companies have not yet completed their journey to the
cloud. Health care system leaders view the near-term investment as too large, and the immediate
payoff too small. Executive leader sponsorship is needed to champion a cloud strategy, develop a
compelling business case, and execute on a longer-term plan to sustain growth.
An emerging Internet of Medical Things (IoMT) will eventually connect the infrastructure of patient
wearables, diagnostic tools, and hospital systems, and result in new efficiencies. The benefits to
patients can be profound: By using connected wearable devices, they could recuperate at home
while being monitored remotely by a health care professional. As technology improves, hospital
and patient costs will become more affordable, potentially increasing health equity.
Growth Through Virtual Services

Remote patient monitoring and telehealth, which gained regulatory approval during the pandemic,
forced providers to pivot quickly, and soon more than half of Medicare primary care visits were
being conducted via telehealth services. A 2022 survey of physicians offering virtual visits revealed
that 85% believe such services resulted in timelier care, and 70% intend to increase their use of
telehealth technologies. Such adoption could lead to health care systems realizing expanded of-
ferings for patients and reducing overhead. They also represent a new opportunity for health care
A constellation of forces is aligning, and executives to reimagine growth beyond their physical walls. As the technology improves, hospi-
promising to result in a transformation of tal-at-home systems could result in new revenue streams for traditional players, as well as oppor-
tunities to invest in or partner with startups.
every aspect of health care: operational,
Hospitals now use telemedicine to tap into the expertise of external specialists. During the pan-
clinical, financial, and patient care itself. demic, hospitals with tele-ICU services reduced their volumes of COVID-19 patient transfers to
larger hospitals for specialized care. Telemedicine is becoming more full-service, and telehealth
startups keep expanding into new areas of care.

STATE OF HEALTH CARE & MEDICINE IN 2023

Workarounds for Proprietary Electronic Security for health care systems is no longer cused cloud systems, regulatory changes, and the US surgeon general’s office forecasts a
Health Records just about safeguarding patient privacy where hundreds of new digital technologies. shortage of 3 million low-wage health care
In many countries, electronic health records regulations already exist. Hospitals must ensure workers, owing to burnout. And the Associ-
that their digital systems, and the devices they Achieving Value-Based Care ation of American Medical Colleges projects
(EHRs) are housed in proprietary, inoperable
systems, which makes the data challenging to use to care for their patients, are secure from The health care industry will shift from fee-for- that physician demand will continue to grow
access. While EHRs protect patient confidential- outside threats. However, the US has yet to pass service models to value-based care, where faster than supply, leading to a shortage of up
ity and privacy, they also limit valuable insights legislation on cybersecurity requirements for reimbursement is tied to quality of care, and vol- to 139,000 physicians by 2033. There simply
that could be gleaned about community health. medical devices and hospital systems. ume-based care, which incentivizes the quantity won’t be enough physicians, nurses, com-
One emerging workaround: Synthetic patient of interactions, tests, and procedures. As it does, munity and public health workers, or nurse
A bipartisan bill that would have created look for emerging technologies to play a ben- aides—which will challenge the operations of
data, which have statistical properties that rep- baseline cybersecurity requirements for device
resent the original patient but don’t reveal any eficial role. Value-based care seeks to provide health care systems. These looming shortages,
manufacturers seeking FDA approval failed in better care for individuals, improve public health if ignored today, will translate into escalating
personal information. Some hospitals in Israel 2022. Its language also required the develop-
and Finland are starting to use synthetic patient management strategies, and reduce health care costs for hospital systems. But leaders can
ment of plans to monitor, identify, and address costs; as it moves medicine toward those goals, meet this challenge now by exploring technol-
data and AI models to better understand the postmarket cybersecurity vulnerabilities in the
spread of Covid, study the brain, and learn more modern technologies’ ability to create efficien- ogies that target the patient experience. Tech
IMoT. Without a regulatory push, some industry cies will be crucial. For instance, automated isn’t a replacement for human health workers,
about health overall. players might delay investing in robust cyber- medical transcription and artificial intelligence of course, but automated systems will mitigate
Shoring Up Privacy, Security, and Safety security capabilities, and also put off making will act as a force multiplier during patient visits: the impending workforce shortage. Technolo-
continued investment to upgrade such capabili- With them, providers can fully engage with their gy can also lighten the burden on the existing
In the past few years, health care systems have ties regularly. patients and gain better insights that could lead workforce, and by doing so, improve retention.
been plagued by cyberattacks. Because such
systems offer critical services, threat actors are to longer-term, healthy outcomes.
Emerging Opportunities Improving Patient Outcomes
continuously seeking out vulnerabilities and Managing the Impending Workforce
targeting systems with malware, ransomware, Studies have shown that wearable devices, re-
A constellation of forces is aligning, and promis- Shortage
and distributed denial of services attacks, which mote patient monitoring, and hospital-at-home
ing to result in a transformation of every aspect
severely disrupt facilities’ ability to care for In 2022, nearly half a million nurses retired—or programs are effective in preventing hospital
of health care: operational, clinical, financial, and
patients. For example, on a single day in Octo- chose to leave the field by retiring early—re- readmissions after discharge. They also help to
patient care itself. Among them: groundbreaking
ber 2022, a sophisticated ransomware attack sulting in an immediate need for a staggering reduce the development of chronic conditions,
advancements in medical science, increased use
effectively shut down 140 hospitals in one health number of newly registered nurses. There aren’t and the myriad related challenges that come
of data and analytics, an emerging consumer de-
system, forcing surgeries, appointments, and nearly enough people enrolled in training pro- with them, in otherwise healthy patients.
mand for wellness services, expanded health-fo-
visits to be postponed. grams to meet that need. In the next five years,

STATE OF HEALTH CARE & MEDICINE IN 2023
Emerging Risks to adapt deepfake tools for medical purposes. Semiconductor Chips Supply products, and wellness home technology will
Diagnostic imagery can be deepfaked to falsely Chain Disruption mean that wealthy people could endlessly op-
Advancements in diagnostic tools, patient en- show, or intentionally erase, cancerous tumors. Modern health care depends on semiconductor timize their health, ongoing gaps in broadband
gagement systems, and workforce automation Once a hospital is breached, it will be challeng- chips, which are used in everything from imag- coverage will prevent many low-income families
are coming fast. Health care organizations must ing to determine which images were real and ing and diagnostic machines to robotic surgical from accessing basic telehealth services. Health
adapt, but that’s easier said than done. which had been faked, and make it difficult to systems to patient monitoring devices. But we’re care leaders will need to address ethical ques-
trust future diagnostic images. Health care ex- in the middle of a global chip shortage, one that’s tions about democratizing use, and they will
Government and Insurers Lag ecutives must be vigilant, by looking outside the need to align their organization’s point of view
expected to extend into 2024. Some of the short-
Government entities and insurance companies industry to anticipate emerging threats, and also age has to do with an imbalance in production with the realities of emerging technology.
move significantly slower than technology. This be prepared to continually reevaluate where due to Covid. There are now unprecedented lead
affects the financial and operational compo- there might be new (and previously unconsid- Why health care and medicine trends
times from suppliers, huge price increases, and a matter to your organization
nents of health care. Emerging products and ered) attack surfaces. semiconductor supply chain that’s unpredictable
services may be wildly beneficial for patients and messy. The result could be an equipment Whether you lead a health care organization or
and providers—but in the US, without certain Disrupting Traditional Labs a medtech startup, or you are positioned outside
shortage: As diagnostic imaging machines break
approvals, their costs won’t be reimbursed. In- Health monitoring and testing will be seamlessly down and require service, there may not be any the industry, your ability to thrive relies on your
surers have been slow to update their actuarial integrated into patients’ daily lives. Whether this replacement parts to install. Hospital systems workforce. In 2023, leaders will need to make
models and reimbursement codes, and insurers’ looks like using a connected toilet in a home could struggle to do financial planning, and decisions about employee wellness, insurance
regulators haven’t set a clear, long-term vision bathroom, wearing a continuous monitoring planned equipment purchases may have to be benefits, and the use of personal health devices
for health care. This uncertainty could make sticker, or ordering a direct-to-consumer blood postponed without a definitive timeline, making (such as fitness trackers that wirelessly transmit
executives wary about big capital investments, test, the traditional lab model will be seriously budgeting a challenge. data over local networks) while at work, to name
which would create significant downstream challenged. Patients want agency in requesting a few. Future Today Institute research suggests
consequences on everything from cybersecurity their own tests without a prescription or doctor’s Ethics that value will be created within the health care
to advanced therapeutics. visit, especially for routine checks that require As you’ll read in this report, breathtaking health industry as related technologies advance—
immediate treatment, such as yeast infections or care advancements are visible on the horizon: think: artificial intelligence, robotics, synthetic
New Cyberthreats shingles. Amazon and a number of startups are biology, cloud computing, and 5G. In order to
new opportunities to grow life-saving human or-
Ransomware attacks, while devastating, are already offering compelling services for patients. gans in genetically engineered animals; genetic remain competitive, leaders must develop a
commonplace now. As the tools used by cy- These could pose a serious risk to companies surgery that can be performed while a fetus is long-term point of view on emerging opportuni-
bercriminals improve, health care systems and like LabCorp and Quest Diagnostics, and the still growing; ways to create an always-on data ties and threats and develop a strategic plan to
hospitals will need additional layers of protec- hospital systems that rely on their rent. pipeline between patients and providers. While take advantage of technological progress.
tion. Already, bad actors have figured out how a dazzling array of wearable devices, fitness

Amazon is health care’s most ambitious disruptor, and its every acquisition or new service announcement moves markets. In
January 2023, the company announced RxPass, a $5-per-month subscription service for unlimited prescriptions. In the future,
look for Amazon to execute on a broad strategy that aims at nothing less than reworking the entire US health care ecosystem.
Venture capitalists now target rural Breakthroughs in sensors and artificial intelligence are expanding the
communities, which traditionally possibilities for remote diagnosis. Data captured by clinical-grade sensors
KEY
lack access to health care, with is triaged by algorithms, thereby reducing the time from insights to action.
medical startups. In order for bio-
and health tech-focused startups
Brain-computer interfaces will begin
to find footings in the market, they
clinical trials in 2023.
need real-world applications. This
INSIGHTS
means getting a foot in the door of
health care systems, which is what Medical misinformation will continue
investors are doing as they launch to pose significant risks. In addition
partnerships to create pilot sites for to disinformation campaigns about
the startups in their portfolios. viruses and vaccines, a new breed of
medical deepfakes in diagnostic imagery
maliciously adds—or removes—tumors
and other conditions.
Membership-based services and health tech startups are creating new direct-to-consumer
(D2C) models that better fit the needs and lifestyles of younger, digitally savvy generations.
Whole-genome sequencing, to screen babies for genetic
Since the start of the pandemic, consumer adoption diseases, could become a routine part of wellness exams in
Americans can now legally obtain their medical data, though the near-future. Emerging therapies are allowing doctors to
of digital fitness technologies has skyrocketed. Health
existing systems make it difficult to access most of it. That will treat genetic disorders in utero.
and fitness apps, connected fitness equipment, and
change starting in 2023, thanks to new policy changes, which
health-focused wearables are up 13%, 15%, and
will create new opportunities and operational challenges for
16%, respectively, since early 2020. The next wave of Researchers are developing genetically engineered organs
health providers.
fitness and health-focused technology growth will in animals for xenotransplantation, or transplantation into
focus on scaling meditation, sleep, and mental health human patients. This could unlock a new type of medical
technologies so they are more affordable—and more agribusiness—and, of course, a whole host of ethical
accessible—for the mass market. concerns.

ONES TO WATCH
AION Labs, a new partnership between Amazon Isomorphic Labs leadership, including Dr. Mark Cuban, serial entrepreneur and TV Paul Muret, general manager of Google Health
Web Services, Pfizer, AstraZeneca, and other Demis Hassabis (CEO), Dr. Miles Congreve personality, for partnering with Dr. Alex Oshmyansky Care Studio, for developing a new product line to
pharmacy and biotech leaders, for using AI in new (chief scientific officer), Dr. Sergei Yakneen (chief to create the Cost Plus Drug Co. to make it easier funnel fragmented health information from multiple
drug development. technology officer), and Dr. Max Jaderberg and cheaper for hospitals to get the medications systems into a single comprehensive view of the
(managing director of machine learning), for their most vulnerable to shortages, and for patients to get patient.
Amira Barger, head of health communications work on AI and machine learning methods to medications at steep discounts.
and DEI advisory at Edelman, for researching accelerate and improve the drug discovery process. Dr. Ricky Bloomfield, clinical and health
systemic medical racism and working with the Melissa Hanna and Linda Hanna, cofounders informatics lead at Apple, for developing software
pharma industry to get the COVID-19 vaccine to Dr. Jacob Becraft, founder of Strand of Mahmee, for aiming to prevent deaths during and products to help people monitor their health.
underserved communities. Therapeutics, for advancing messenger RNA as a childbirth by creating a new type of comprehensive
technology to fight cancer. health record for every pregnant person that can be Shruti Kothari, director of industry initiatives and
Blake Wu, partner at New Enterprise Associates, accessed by their care team. health care reform at Blue Shield of California, for
for finding and supporting projects that bring Dr. Jacqueline Shreibati, senior clinical lead for driving innovation in data sharing, getting legislation
health care up to speed with more technologically consumer health devices and services at Google, for Dr. Neil Wagle, chief medical officer at Devoted passed to enable the exchange of health care data
advanced industries. advancing health research and wearables. Health, for charting a path to fix health care by between organizations and patients, and cajoling
expanding value-based models. insurers to agree to a common strategy on how they
Dr. Elenoe Smith, director of molecular and cell Dr. Jim Weinstein, senior vice president will pay for primary care.
biology at Vertex, for exploring new ways to treat at Microsoft Healthcare, for leading strategy, Olive AI, which designs software for health care
sickle cell disease. innovation, and health equity, and developing the systems for improving operations and enhancing Dr. Taha Kass-Hout, chief medical officer at
company’s strategic vision in health care. patient care. Amazon, for overseeing the company’s push into AI
Ellen DaSilva, founder and CEO of Summer and health care.
Health, for reimagining pediatric care to include a Johnson & Johnson MedTech, for developing Michael Dowling, president and CEO of
telehealth messaging platform that answers nervous robotics, virtual platforms, and surgical training Northwell Health, for innovative approaches Tiffany Gibson, founder of New Nursing
parents’ questions within a few minutes. content. throughout the pandemic, such as developing Academy, for developing a curriculum that aims to
3D-printed nasal swabs and running a validation better care for patients through health care diversity,
Florian Brand, co-founder and CEO of Atai Life Dr. Karen DeSalvo, chief health officer at study of a Fitbit algorithm for detecting Covid before equity, and inclusion, and emotional intelligence.
Sciences, for leading development of a biotech Google, for her work on patient-centered care and symptoms started to show.
platform that helps scientists create psychedelic interoperability. Dr. Toby Cosgrove, executive advisor to Google
and nonpsychedelic compounds for various mental Patty Maysent, CEO of UC San Diego Health, Cloud Healthcare and Life Sciences team, for his
health conditions. Kelsey Mellard, founder and CEO of startup Sitka, for establishing an innovation center focused on role in how the company uses data and technology
for providing virtual specialist consults to primary improving virtual visit experiences for patients and to improve the patient experience.
The Ichan School of Medicine at Mount care physicians so that they can keep patients integrating remote monitoring technologies within
Sinai, which launched a new department focused in their clinics and patients don’t have to seek treatment plans. Dr. Vivian Lee, president of the Verily Health
on advancing AI use in health care. out additional appointments and out-of-pocket Platform, for leading the development of technology
payments. to improve health outcomes.

HEALTH CARE &

MEDICINE
TRENDS

1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS
MEDICAL DEEPFAKES Researchers at Ben-Gurion University and the

Soroka University Medical Center demonstrat-
Bad actors could deploy medical deepfakes
to achieve many horrifying ends. Individuals
ed that tumors could be added or removed could be targeted: Their MRI image could
from CT images—and the deepfakes were be edited to show cancerous tumors, which
good enough that radiologists didn’t realize would result in them undergoing chemother-
they were altered. After the radiologists were apy. Malware deployed to a hospital system
told that some of the scans had been edited, could intercept and deepfake CT scans before
they misdiagnosed 60% of the AI-generated they were uploaded to a patient’s records,
tumors and 87% of the tumors that had been which would mean that images would need
edited out. In a study from Oslo Metropolitan to be retaken and interpreted again. Venture
University, researchers used artificial intelli- capitalists, evaluating a startup’s new imaging
WHAT IT IS gence to generate fake electrocardiograms, technology, could be duped into believing that
which visualize aspects of a human heartbeat. a new type of imaging machine worked and
Deepfakes are digitally manipulated content intended could scale. Think Theranos, but this time with
deepfaked visual evidence that the system
to deceive another person into believing they are real. performed as promised.
Medical deepfakes result in diagnostic imagery that

maliciously adds—or removes—tumors and other
conditions. Cybercriminals are developing novel medical
deepfake attacks intended to bring chaos to hospital
systems and diagnostic centers.

SYNTHETIC HEALTH DATA In the US and Europe, privacy regulations pro-

tect health information from being viewed by
Approximating real-world data will speed
innovation without compromising patient
third parties. This means a patient’s cholesterol privacy. Synthea is an open-source tool that
levels, prescription medications, and mental can generate populations of patients without
health cannot be shared—but a pool of fake needing to rely on actual medical records. In
patients, created by algorithms, could accu- an effort to build and grow the system, the US
rately reflect different segments of the popula- Department of Health and Human Services of-
tion, and enable a new flow of R&D. In the ear- fered $100,000 in cash prizes for improving the
ly days of the pandemic, Israel-based Sheba tech or developing new use cases for the data
Medical Center used MDClone, a local startup Synthea generates. Researchers in Finland
that creates synthetic data from medical are developing new types of synthetic data to
WHAT IT IS records, to generate data from its COVID-19 study the human brain, which is notoriously
patients. That enabled Israel’s research com- difficult to anonymize because MRI images are
Artificially generated (or synthetic) data can convincingly munity to study the development of the virus,
which led to an algorithm that assisted doctors
unique to every person. More health systems,
medical schools, and government agencies
represent patient data sets for use in research, training, in making decisions about prioritizing patients will use synthetic health care data to study and
for the ICU. Synthetic data allows health care improve outcomes in the years ahead.
or other applications. administrators, public health officials, and
insurance companies to test hypotheses, run
simulations, and make determinations, without
going through the lengthy process of request-
ing and safeguarding real data.

FULL GENOME EXAMS The BabySeq Project, led by Brigham and

Women’s Hospital, the Broad Institute, and
Proponents of full genome exams argue
that while newborns are often checked for a
Harvard Medical School, completed a ran- handful of common heritable diseases, such
domized clinical trial designed to measure the as cystic fibrosis and sickle-cell anemia, more
medical, behavioral, and economic outcomes conditions could be managed successfully giv-
of using comprehensive genomic sequencing en early detection and treatment. Whole-ge-
in newborns. It surfaced unanticipated mono- nome sequencing offers the tantalizing pros-
genic disease risks in 11% of newborns who pect of finding potentially thousands of genetic
otherwise appeared healthy. In 2023, at least variants that might show up later in life, and
200,000 babies born in England will have their dramatically broadens the pool of research
genomes sequenced. Genomics England, a data. Some argue that the data results in
WHAT IT IS government program originally designed to probabilities—not predictions—and will force
investigate genetic diseases and cancer in parents to face the decision of what to tell
Screening babies for genetic diseases with a whole- adults, will pilot an initiative to collect a rep-
resentative sample of the country’s newborn
their child, and when. Another concern: some
governments might use full genome exams to
genome sequence could soon become a routine part of DNA. The program will use whole genome harvest data on its youngest citizens.
sequencing to detect genetic variants, in an
wellness exams. effort to identify and treat hundreds of con-
ditions. This is just one of a dozen newborn
sequencing programs now active worldwide.
The GUARDIAN project, helmed by Colum-
bia University, Irving Medical Center, New
York-Presbyterian, and the New York Depart-
ment of Health, aims to sequence 100,000
babies in the next four years.

IN-WOMB TREATMENTS Rather than waiting for a baby to be born,

some doctors are now hoping to treat genetic
Treating genetic disorders in fetuses could lead
to healthy outcomes for babies who might oth-
diseases in the womb. In 2022, researchers erwise suffer the first few months or years of
used enzyme replacement therapy on a baby life—and indeed, absent such therapies, might
in utero who was likely to die from a rare fail to survive. As the technology advances
genetic disorder called Pompe disease, which and more cases result in positive outcomes,
had killed two of her older siblings. Research- researchers will explore additional in-womb
ers at the University of California at San treatments, including genome surgery. This
Francisco and doctors at the Ottawa Hospital points to a pending need for physicians trained
in Canada developed a procedure to inject in fetal therapy, and researchers capable of
therapeutic enzymes into the umbilical vein to developing advanced protocols.
WHAT IT IS reach the fetus. After six prenatal infusions, the
baby was born with no signs of the mutation. (For more information on genome surgery,
see the Bioengineering section of Future Today
Treating genetic disorders in fetuses could mitigate risk Institute’s 2023 Trend Report.)
before babies are born.

XENOTRANSPLANTATION At NYU Langone Health, surgeons success-

fully attached a modified pig kidney to a pair
The remarkable animal-to-human success-
es in 2022 raise hopes that organ shortages
of large blood vessels outside the body of a may soon be distant memories. Still, research
patient on life support. It successfully filtered teams will need to complete more experiments
waste and produced urine. Last year, the first and work toward full clinical trials of xeno-
person to receive a full heart transplant from a transplantation. In the US, the FDA will need to
pig lived for two months after the surgery was approve new research, but currently it appears
performed. University of Maryland research- as though widespread trials could begin as
ers genetically modified a pig so that it grew early as 2024. A xenotransplantation ecosys-
a heart with human genes, hoping it would tem should follow.
be more quickly and easily accepted inside a
WHAT IT IS human body. A few months later, two medically
dead patients connected to ventilators at NYU
Researchers are developing genetically engineered received hearts from Revivicor, a company
that produces genetically modified pigs; those
organs in animals for xenotransplantation—that is, hearts functioned normally for several days.
transplantation into human patients.

HEALTHY TOWNS Last year, venture capital firm Andreessen

Horowitz (A16z) partnered with Bassett
For bio- and health tech-focused startups to
find a market, they need real-world applica-
Healthcare Network, which operates clinics tions, which means gaining entrée into health
and hospitals in rural New York. Often, health care systems. This can be challenging, since
systems serving rural areas lack funding, many of these startups can’t work without
personnel, and access to the latest innovative an ecosystem of adjacent technologies and
tools, especially when compared to hospitals patient data. Health tech is notoriously consol-
in more densely populated areas. The part- idated, with just a handful of large companies
nership’s ambition is to deliver better health managing various aspects of hospital opera-
outcomes by employing advanced technol- tions, diagnostics, and the patient experience.
ogies. Companies in A16z’s Bio + Health A healthy town approach will bring optionality,
WHAT IT IS portfolio will deploy and test emerging tech and, in the very near future, threaten incum-
related to automation, clinical uses of artificial bents. A16z alone counts 47 active bio and
In a move that evokes the company towns of the early intelligence, and home health in 2023. In Phil-
adelphia, Thomas Jefferson University Hospi-
health-focused startups in its portfolio.
1900s—when then high-tech heavyweights like Pullman tals’ Innovation Pillar invites investors to fund
promising new technologies developed within
Co., Colt, and the Mark Steel Co. designed communities its community, and, as long as one Jefferson
with cutting-edge amenities built around factories— member is a member of a company’s team,
invites startups to test their concepts locally.
investors are launching partnerships with some Dozens of companies incubated at Jefferson
have made use of Philadelphia’s vast network
communities’ health care systems to create pilot sites for of doctors and patients.
the startups in their portfolios.

3RD YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS
CHIEF MEDICAL OFFICERS The CMO and CHO roles expanded during the
pandemic or were quickly established early on,
In the past year, financial services, manu-
facturing, and tech companies have created
such as at Delta Air Lines and Royal Caribbean new CMO and CHO positions. In the past two
Cruises. Consumer-facing companies expect years, there has been a 19% increase in new
these officers to set policies for remote work CMO job postings, especially among compa-
and employee well-being, as well as to make nies planning smartly for the future of their
recommendations for employee benefits. As workforce: healthy workers are more produc-
Delta’s chief health and well-being officer, tive. The Association of American Medical
Dr. Henry Ting oversees health, safety, and Colleges launched a certified 15-month lead-
wellness strategy for the airline’s 75,000 em- ership academy to train CMOs. As the visibility
ployees. For companies that collect and make of CMOs and CHOs increases, so will demand
WHAT IT IS use of sensitive data, such as ride-sharers and for skilled leaders, which could soon result in a
fitness trackers, CMOs are developing R&D competitive job market.
Once limited to pharmaceutical companies, hospitals and data handling policies. In January 2022,
Uber hired its first CMO to lead the develop-
systems, and insurance providers, chief medical officers ment of tools for patients, clinicians, and care
coordinators for the Uber Health platform. And
(CMO) and chief health officers (CHOs) are now as more companies develop partnerships with
being recruited by all types of companies that needed health, wellness, biotech, drugstore, and con-
sumer packaged goods companies, CMOs are
additional guidance during and after the pandemic. Job being tasked with spearheading relationships
and fostering growth. Midwestern supermarket
descriptions are expanding beyond pandemic protocols chain Hy-Vee hired Dr. Daniel Fick to be its first
and remote work policies to include other aspects of CMO. Retailer Dollar General named Dr. Albert
Wu as its first CMO when it rolled out prescrip-
employee wellness, such as mental health. tion drug and telehealth services.

DOCTORLESS EXAMS AliveCor’s KardiaMobile 6L is an FDA-cleared

personal ECG device that displays data on a
The expansion of 5G networks and cloud
computing technologies will help sensors and
mobile phone. It can now calculate cardiac QT medical devices transfer significantly more
interval—an early risk indicator for life-threat- data, which means faster analysis. That will
ening arrhythmias—and provide a diagnostic amplify the impact of companies like Califor-
yield comparable to a conventional 14-day am- nia-based Rockley Photonics, which developed
bulatory monitor. The BiovitalHF, a wearable for a set of clinical instruments on a photonic
heart failure patients, received a “breakthrough chip that’s small enough to fit into a wearable.
device designation” from the FDA. Made by Rockley’s “clinic on the wrist” uses infrared
Boston health technology company Biofourmis, spectrophotometers to measure traditional
it merges patient-reported symptoms and lab vitals like temperature and blood pressure, and
WHAT IT IS results to automatically adjust medications. to detect hydration, muscle lactate, alcohol,
In 2022, Apple introduced an update to Apple and glucose levels. Rockley’s largest customer
Breakthroughs in sensors and artificial intelligence watchOS that lets users diagnosed with atrial
fibrillation keep records of their heart rhythm
is Apple, so the Apple Watch may very soon
monitor even more aspects of wellness. By
expand the possibilities for remote diagnosis. Data data, and thereby gain deeper insights into detecting health changes before symptoms
their condition. It’s now medically approved in are felt, continuous health monitoring can cut
captured by clinical-grade sensors is triaged by more than 100 countries. intervention costs and improve outcomes.
algorithms and reduces the interval between insights Insurers, including Blue Cross Blue Shield and
UnitedHealthcare, have started offering free
and action. or discounted devices for their members. As
algorithms improve, we’ll see more accurate
risk predictions. But the future is not entire-
ly optimistic. There already are examples of
biased medical algorithms that exacerbate
inequities in care.

AT-HOME MEDICAL COVID-19 fueled at-home collection and new

platforms that can accurately detect viral infec-
The National Institutes of Health created the
Rapid Acceleration of Diagnostics initiative
LABORATORY TESTS
tion from throat and nose swabs in 15 minutes during the pandemic to accelerate commer-
or less. Early Covid tests required samples cialization of testing technologies. The NIH
to be shipped to a lab, but in April 2021, the expects the changes to lower the cost of
FDA approved home test kits by Cue Health diagnostic testing and expand accessibility for
that processed samples and sent test results at-home testing. Expanding capabilities and
directly to apps for patient review. OutSense product offerings are already threatening clini-
uses sensors in toilets to screen for dehydra- cal laboratory networks like Quest Diagnostics,
tion, infection, and traces of blood. Coprata, which recently started selling tests that can
a startup spun out of Duke University, uses be purchased online—but patients still need to
WHAT IT IS a fingerprint scanner on the toilet handle to show up at a center to process them, and pay
track each individual’s health in multi-person prices that are higher than startup offerings.
Technology is bringing the power of the laboratory into households.
our homes. Smart toilets and mirrors will turn everyday

routines into opportunities to detect early warning
signs of illness. Health monitoring and testing will be
seamlessly integrated into our daily lives.

DIRECT-TO-CONSUMER San Francisco–based Forward, buoyed by

$225 million from investors, expanded across
Direct to consumer care, led by health tech
startups, is starting to spread outside the US.
HEALTH CARE MODELS

the US in 2022. Its preventive health care Canadian company Tia Health specializes in
memberships use technologies to remotely women’s health and offers unlimited messag-
diagnose and treat patients. Initial visits in- ing and same-day appointments. The UK’s
clude biometric body scanning, a blood panel, National Health Service, widely regarded as
genetic analysis, skin screening, and a mental one of the world’s premier publicly funded
health assessment. Similarly, concierge med- health care systems, will face competition from
ical provider MDVIP in Maryland offers com- startups like Nightingale Health, which offers
prehensive screenings and access to virtual D2C tests, apps, and assessments. This next
or in-person visits with physicians in 24 hours. generation of care relies on home diagnostics,
WHAT IT IS One Medical offers 24/7 access to virtual care self-monitoring, and telemedicine. As more
and uses connected devices and wearables to consumers seek out convenient, on-demand
Membership-based services and health tech startups manage existing conditions. health care, the tech-enabled services will
threaten traditional primary care models.
are creating new direct-to-consumer (D2C) models that
better fit the needs and lifestyles of younger, digitally
savvy generations.

PATIENT ACCESS TO In 2022, a new rule in the 21st Century Cures

Act mandated that health providers must
As patient advocates continue to push for
easier access to medical records, an old idea
MEDICAL DATA
give patients digital access to their medical is likely to resurface this year: unique patient
data without exorbitant charges, long delays, identifiers. Associating one number with one
or using outdated technologies such as fax patient and all their medical data, UPIs were
machines. This rule is broad and covers all effectively banned in the US in 1998 over
electronically protected information, includ- concerns that the numbers could lead to fraud,
ing medical images. Additional reforms could black market ID sales, and potentially expose
come in 2023. Rep. Bill Foster (D-Ill.) proposed individuals to hacking. UPIs would, in theory,
the Medical Records Access Fairness Act, make it easier for providers to standardize data
which would require providers to give patients and make it interoperable between various
WHAT IT IS easier access to their medical records at least medical records systems—and therefore make
once per calendar year. it easier for patients to gain access whenever
Americans are legally able to access their medical data, they want.
though existing systems make it difficult to access most

of it. Starting this year, that will change, thanks to new
policy changes, which will create new opportunities and
operational challenges for health providers.

4TH YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS
AUTOMATIC MEDICAL Last year Microsoft completed its acquisition

of voice recognition software provider Nuance
As accuracy improves, automatic transcrip-
tion can lighten the documentation burden for
TRANSCRIBING
Communications, which positions the tech providers and potentially stave off burnout.
giant to boost its health care cloud services. Machine learning could also provide sugges-
Nuance’s integrations into such EHR systems tions or alerts to doctors, based on a conversa-
as Epic and Cerner allow providers to dictate tion’s context. As emotion detection algorithms
notes, use their voice to navigate EHR sys- improve, doctors could gain additional insights
tems, and ultimately reduce the time it takes into the patient’s emotional state in real time.
to provide reports to patients. AWS launched Clinical notes increasingly provide data sets
Amazon Transcribe Medical, an automatic for AI training, so improved accuracy may lead
speech recognition service that transcribes to better diagnostic algorithms.
WHAT IT IS medical-related speech during doctor visits. By
using automatic transcription in telehealth vis-
Automatic medical transcription continued to gain its, providers can worry less about note-taking
and focus more on the patient, and by doing so
traction as telemedicine accelerated during the pick up on small cues that might otherwise be
difficult to detect.
pandemic. Transcribing clinical notes requires excellent
sound quality and an understanding of medical
terminology, which have been obstacles to its adoption.
Advances in artificial intelligence are improving accuracy
and speed, as well as providing real-time diagnostic
analysis and physician alerts.

REMOTE PATIENT MONITORING Continuous glucose monitors help diabetes

patients keep track of their numbers, while
RPM should help patients stay in their homes
and cut medical costs. As the technology
physicians can follow their progress. The improves, more health systems will explore
Department of Veterans Affairs plans to spend “hospital-at-home” systems that can reduce
$1 billion to expand its home-based connected the need for patients to recover at the hospi-
care. Researchers are making advances in the tal. Broad adoption continues to be slow, but
technology’s capabilities: The University of investment in the area is growing. We will likely
Alberta created a wearable patch called the continue to see a fragmented field of ser-
ADAMM-RSM that could warn of an asthma vice providers, though telehealth players are
attack and offer personalized treatment away starting to acquire capabilities through smaller
from any doctor’s office. If successful, it could players.
WHAT IT IS be used for other respiratory diseases. Onduo,
from Google’s Verily Life Sciences, is a vir-
Remote patient monitoring (RPM) is used by health tual care system that uses Fitbits to manage
such chronic conditions such as diabetes and
systems to reduce demand for hospital beds, and to hypertension. Carbon Health acquired Alertive
Healthcare, a remote monitoring startup, to
remotely track patients under treatment or at risk for strengthen its home-based chronic care man-
developing severe disease. As the global population agement and preventive diagnostics.
ages, this technology will make it safer for elderly

patients to remain in their homes.

TELEMEDICINE Telehealth accounted for almost 30% of $19

billion in digital health investments made
Telemedicine is becoming more full-service,
with startups expanding into new areas of
during the first half of 2021. And that figure care. New York City–based Ro started in 2017
doesn’t include internal corporate investments as a discreet solution for erectile dysfunction
made by nontraditional players like Ama- and hair loss, but it has since expanded to
zon, which announced a national expansion provide telemedicine, pharmacy distribution,
of its Amazon Care telehealth services, and and an in-home care network for blood draws
Walmart, which acquired telehealth provider and vaccinations. The $5 billion company now
MeMD and plans to provide health care in 37 plans to support remote monitoring of chronic
states. Last year, investors injected $5.4 million conditions. Full-service telehealth threatens
into Juno Medical’s plans to expand its virtu- the long-term survival of traditional primary
WHAT IT IS al services across the US. Telehealth startup care providers, especially now that AI can
Spora Health provides “culture-centered care” triage patients. Telemedicine also lets smaller,
Telemedicine services have increased more than 38x to better meet the needs of people of color
and reduce racial inequities in health care.
rural hospitals coordinate care with outside
specialists. Whether a growth opportunity or a
since the start of the pandemic, and been used by more Hospitals are using telemedicine to tap into disruptive external force, telemedicine is here
the expertise of external specialists. During to stay. As its capabilities expand, it will affect
than half of the Medicare population in the US. However, the pandemic, hospitals with tele-ICU services more aspects of our health system.
existing telehealth waivers may expire even as demand reduced transfers of Covid patients to larger
hospitals for specialized care. In a 2022 poll,
continues to grow, leaving some patients without access 85% of physicians said that telehealth resulted
in improved timeliness of care and 70% said
to their providers. they intend to increase their use of telehealth
technologies going forward.

BIG TECH DISRUPTS Tech giants—think Alphabet, Amazon, Mic-

rosoft, Apple, and Meta—have been quietly
In 2023, Amazon’s health care partnerships will
provide a wide range of testers for its products
HEALTH CARE
spending billions of dollars to disrupt conven- and services, including providing insurance
tional health care. In 2018, Amazon acquired benefits. Amazon Clinic is currently being
the online pharmacy service PillPack, and in tested; it is a message-based care service for
2023 it will operate a nationwide network of 18 conditions, including pink eye and sinusitis,
pharmacy licenses, telemedicine services, as well as for new birth control prescriptions.
and medicine/health care product distribution Amazon Clinic users can also renew pre-
services. Apple’s smartwatch received updates scriptions for additional conditions, including
in 2022, making the watchOS an even more high cholesterol and asthma. Alphabet will
powerful and accurate tracking device. Micro- sharpen its focus on drug- and health-related
WHAT IT IS soft’s list of health offerings built atop its Azure research and products. Its Isomorphic Labs is
platform continues to expand. By June 2022, a stand-alone drug-discovery company formed
Big Tech is doubling down on its bid to muscle into the Alphabet had invested $1.7 billion into various
health-focused startups. One area of particular
to commercialize products made possible by
another Alphabet subsidiary, DeepMind. In the
health care industry, while reorganizing and shifting note: Alphabet’s life sciences division, Calico, past two years, the company has also doubled
is working on rejuvenation technology, which headcount at Verily, a life sciences unit devel-
strategies to take advantage of emerging technology promises to treat age as a pathology, rather oping health-related software. In 2023, Calico
breakthroughs. than an inevitability. aims to bring the neurodegeneration and can-
cer drugs it developed to market. As Big Tech
continues to target the US health care industry,
it is making inroads with data interoperability
and clinical tools. If successful, the compa-
nies could collapse some silos in the industry
and finally bridge the gap between individual
behavior and health impacts. Cloud services
open entry for world-class AI capabilities in an
industry that has long struggled to effectively
use longitudinal patient data.
(See: Amazon’s Health Care Ambitions.)

HOW SOON
WILL AMAZON
DISRUPT
YOUR BUSINESS?
How Soon Will Amazon Disrupt Your Business?
Amazon’s two biggest acquisitions are Whole Foods ($13.7 billion) and the re-
cently closed purchase of MGM ($8.45 billion). The tech behemoth’s latest indus-
try target is health care, which in 2022 included the announced acquisition of
One Medical for $3.9 billion. One Medical’s business model looks a little like Net-
flix: It’s a $199 annual subscription to primary care services at a modern doctor’s
office. (As of this writing, it’s still possible that a government agency may block
the deal.)
But Amazon’s most disruptive health care announcement to date is RxPass, a

$5-a-month subscription service for medications launched in January 2023.
Exclusive to Prime members, the drug subscription will ship 60 common gener-
ic prescription drugs treating allergies, inflammation, high blood pressure, and
other conditions directly to consumers. With RxPass, Prime members get all of
their eligible medications for one flat monthly fee and have them delivered free
of charge.
Alphabet and Apple each have significant ambitions in health care, and retailers
such as Walmart, Walgreens, and CVS seek to expand their presence by provid-
ing care services directly to consumers. But none can match Amazon’s ability to
execute on a broad strategy to disrupt what appears to be the entire US health
care ecosystem.
It’s without question the most ambitious Big Tech entrant into the sector. Its every
acquisition or new service announcement moves markets. Over the past year,
Amazon struck partnerships with hospitals and insurers, and continues to invest
money and focus across seven key areas:
© 2023 Future Today Institute

1 Primary Care 3 Retail Pharmacies

When Amazon closed its all-cash acquisition of One Medical in a deal valued at $3.9 billion In June 2021, Amazon Pharmacy unveiled a Prime program through which members can
(including the company’s net debt), it became a direct competitor to physicians in private buy a six-month supply of many generic prescriptions for as little as $6. The move echoes
practice. Even as Amazon shuttered Amazon Care, which offered virtual and in-home care Walmart’s $4 generic program, and targets common drugs that can be bought in bulk for
to employees and other companies, the One Medical purchase gives the company a much significant discounts. But Walmart might find it difficult to compete with RxPass, Ama-
deeper bench of services and providers operating nationwide. Neil Lindsay, senior vice zon’s flat-rate prescription subscription benefit for Prime members—for $5, the compa-
president of Amazon Health Services, said the deal was just one part of a long-term plan ny will deliver generic versions of medications to customers in all states but those with
to “reinvent” health care. “Booking an appointment, waiting weeks or even months to be specific prescription delivery requirements, such as California, Texas, and Minnesota. With
seen, taking time off work, driving to a clinic, finding a parking spot, waiting in the waiting more than 200 million Prime subscribers worldwide, who now expect fast, free delivery on
room, then the exam room for what is too often a rushed few minutes with a doctor, then just about every product, Amazon is well positioned to challenge (and improve) pharma-
making another trip to a pharmacy—we see lots of opportunity to both improve the quality cies’ on-premise customer experience.
of the experience and give people back valuable time,” Lindsay said. Meanwhile, Amazon
Clinic, which launched November 2022, is a message-based care website designed to 4 Pharmacy Benefit Managers
treat a variety of ailments. It’s a clever triage system. If someone needs care that can be In the US, the pharmaceutical supply chain is quite long. Layers of middlemen gum up
treated with over-the-counter medications, such as seasonal allergies and yeast infections, logistics and delivery, and drive up consumer costs. At each point along that long supply
or a handful of meds that require prescriptions (birth control, erectile dysfunction), they can chain, entities take their cut. Amazon has ample experience disrupting cluttered sup-
conveniently get prescriptions there or make purchases at Amazon.com. Other patients ply chains, and the outdated model for pharmaceutical sales makes it vulnerable to an
who require a physician might soon get referred to care through One Medical. outside disruptor. One key issue: pharmacy benefit managers (PBMs), which sit between
2 Private Equity and Corporate Investors

manufacturers, distributors, and insurance companies, and negotiate prices for bulk
orders. They receive a co-pay from patients, and also get paid by manufacturers to market
For the past 10 years, private equity firms have been snapping up physicians’ practices. their drugs, so major employers use PBMs to negotiate for better rates, even while insur-
And within the time frame of 2019-2021, corporate entities acquired 31,300 practices, which ance providers outsource drug procurement to PBMs. Remove links from that exceedingly
marks an 84% increase in such ownership, according to a study from Physicians Advocacy long supply chain, make it less complicated, and costs to consumers should fall. That’s
Institute and the consulting firm Avalere. Private practices are attractive investments be- the bet Amazon is making. It’s already had success with PillPack by Amazon Pharmacy.
cause efficiencies—and greater margins—can be achieved at scale. When the Amazon deal
closes, One Medical will wind up with an enormous war chest of financial, tech, distribution,
and data resources, making it a formidable competitor. PE firms and corporate investors can
offer cash, but the incentives they can offer are limited when stacked up against Amazon’s.

5 Pharmaceutical Companies 7 Fitness Wearables

When Amazon acquired PillPack for roughly $750 million in 2018, it entered a consolidated Halo, Amazon’s health-monitoring wristband and app, can assess functional fitness using
market with a new promise: If patients upload all their prescriptions to PillPack, they’ll a smartphone camera and cloud-based AI. Its service, Movement Health, guides users
get a real-time dashboard to manage their health. Amazon automatically coordinates through an assessment and scores how they perform in areas like mobility and stability.
prescriptions and sends prepackaged sets of medications; if patients need something ur- The Halo app then offers a personalized set of exercises to address any weaknesses. The
gently, it’ll arrive the same or next day (in locations where PillPack operates). The service Halo band can also share live heart rate data with third-party exercise equipment and
tells consumers when their prescriptions are about to expire and makes it easy for them fitness apps. Halo View, an updated version of Amazon’s wearable, includes a blood oxy-
to renew. Prime members get discounts. And now that Amazon’s voice assistant Alexa gen sensor, bringing its health tracking capabilities to par with Fitbits and other trackers.
won HIPAA designation, patients can use it to both check on their prescriptions and to get Amazon also rolled out two new services in the fall as part of the Halo membership: Halo
verbal reminders. All of which is to say that Amazon is building a massive pool of health Fitness, an interactive fitness platform that will compete with Apple Fitness+, and Halo
and pharmacological data, which could position the company to someday make diagno- Nutrition, which offers personalized meal planning and a recipe library. Here’s where this
ses, or in the further future even delve into precision medications and holistic treatment could get interesting: What if Halo becomes integrated into Amazon’s other health care ini-
plans—with recommended vitamins and supplements, exercise equipment, and therapeu- tiatives, acting as an interoperable, umbilical cord that tethers consumers to the company?
tic goods all available for purchase on Amazon.com.
6 Diagnostic Labs
The pandemic drew Amazon into the clinical laboratory diagnostics space. The company
developed a Covid test for its own workers, and eventually sold its Amazon COVID-19
Test Collection Kit DTC tests on Amazon.com for $39.99. Many expect Amazon to expand
into in-home testing for respiratory and sexually transmitted infections. Amazon now sells
hundreds of at-home medical tests (a mix of Amazon-branded and kits from other com-
panies) including the OraQuick In-Home HIV Test and the Second Generation FIT (Fecal
Immunochemical Test) for Colorectal Cancer; the results of both can be read without a
clinician.

PRESCRIPTION DIGITAL Boston-based Akili Interactive received FDA

approval for its prescription game, AKL-T01
Prescription digital therapeutics are still novel.
They have yet to gain market traction, and no
THERAPEUTICS
(marketed in the US as EndeavorRx) in 2020. established workflow exists for physicians to
The game is the first example of an approved prescribe them. But such therapeutic games
prescription digital therapeutic. In August generate detailed patient data, and algorithms
2022, Akili began a phase 3 trial version of can automatically adjust treatment, ultimately
SDT-001, which follows the game’s original lowering costs. Once commercialized, they
concept but has been adapted for Japan. It could serve as the backbone for telemedicine
also received certification from the Europe- for people suffering from chronic illnesses. Re-
an Union, opening the door to trials across imbursement will remain an issue, as insurers
Europe. While the game is intended to treat look for more evidence of efficacy, and devel-
WHAT IT IS ADHD in children, new data published last opers still must work with physicians to over-
summer from the National Jewish Health and come the challenges inherent with prescribing
The FDA approved the first prescription-only video game the University of Colorado School of Medicine
found that EndeavorRx also improved motor
an entirely new modality of treatment. Still,
an aging global population—and more people
as a treatment for attention deficit disorder in 2020. speed in people diagnosed with lupus. suffering from cognitive impairment—could
build momentum for the sector as companies
Akili and Australian medtech TALi Digital demonstrate effectiveness in treating neurode-
are working to get FDA clearance for TALi’s generative diseases.
Detect and Train software, which screens for
and treats inattention in children. Neuroglee
Therapeutics is also seeking FDA approval for
its game-based therapy to treat mild cognitive
impairment. Swiss developer MindMaze—
valued at $1.5 billion—uses games to rebuild
strength and mobility in patients recovering
from strokes and traumatic brain injuries and
has partnered with Mount Sinai’s tele-neurore-
habilitation program.

2ND YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS
MEDICAL The American Medical Association has blamed medical disinformation

for worsening the impact of Covid. In June 2022, it adopted a new policy
Is intentionally spreading dangerous misinfor-
mation about health and medicine protected
MISINFORMATION
aimed at empowering state licensing boards to discipline health profes- speech? This year, we may find out. In 2022,
sionals for spreading misinformation. The Federation of State Medical California Governor Gavin Newsom signed into
Boards approved a policy on medical disinformation, which defines law a bill making it illegal for local doctors to
AND DISINFORMATION “misinformation” and “disinformation” as they pertain to the practice of
medicine, and sets standards for professionalism.
spread false information about Covid vaccines
and treatments. The first of its kind in the US,
the law took effect on January 1, 2023. But it
Patients are particularly susceptible to harmful medical misinformation faces legal challenges. Some doctors, backed
when they are vulnerable, suffering from an illness, or caring for a loved by the Northern California branch of the
one who’s sick. Given that, the growing distrust of institutions, and the American Civil Liberties Union, argue the law
politicization of topics like vaccines and masking, the Covid era brought a infringes on their right to free speech. If the law
WHAT IT IS
wave of false or misleading ideas about health, medicine, and science. A stands, doctors found spreading false or mis-
2022 study from GoodRx found that more than 70% of Americans sur-
Medical misinformation and veyed were exposed to medical misinformation. Half were unable to dis-
leading information would be subject to fines,
and their medical licenses could be suspended
disinformation aren’t new, but the tinguish accurate information from false, which underscores the dearth of or revoked. Texas and Florida have moved in
patient health literacy. the other direction, by passing laws to compel
pandemic dramatically deepened social media platforms to allow all speech,
While YouTube is home to many Covid falsehoods, a networking site for
the problem. So much so that state medical professionals, Doximity, is also experiencing a rise in conspir- including misleading or incorrect posts related
acy theories. After Elon Musk acquired Twitter in late 2022, previous to health and medicine.
medical boards and local governments efforts to limit the spread of medical misinformation on the platform were
are stepping in to halt the spread of overturned. Even after Facebook promised to limit the reach of anti-vax
content, related groups and pages still proliferate. Misinformation and
misstatements from physicians. disinformation generate ad revenue for social media platforms. And while
the accelerated adoption of telemedicine improved access to health care,
it also drove traffic to sites like SpeakWithAnMD.com, which promises to
provide and fill prescriptions for “miracle cures” for Covid.

2ND YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS
MEDICAL EXTENDED REALITY In 2020, Johns Hopkins Medicine research-

ers found that VR games reduced anxiety
Despite its promise, VR systems often lack
randomized, controlled clinical trials. Many VR
and pain in pediatric patients during medical benefits have been based on small studies that
procedures. Boston-based Rendever won a lacked blinded controls. That could change
$2 million grant from the National Institutes of starting in 2023, as VR starts to scale in health
Health to further study whether VR experienc- care, which could help VR therapeutics over-
es improve quality of life for socially isolated come another challenge: insurance coverage.
seniors. AppliedVR’s EaseVRx—one of the first If these challenges are overcome, VR platforms
VR therapies to receive a “breakthrough device could become an important option for tele-
designation” from the FDA—showed “clinically medicine and home-based care.
meaningful” improvement in lower back pain
WHAT IT IS in a randomized controlled trial. San Francis-
co–based Osso VR, boosted by a $27 million
From treatment of mental disorders to pain management, Series B round, is expanding its VR surgical
training and assessment platform to include
virtual reality is gaining traction in medicine. Augmented additional specialties and procedures. Pixee
Medical’s FDA-cleared Knee+ system uses AR
reality (AR) and VR are also being used to train surgeons glasses to help surgeons judge joint alignment
and provide real-time surgical guidance. The technology during knee replacements.
could disrupt medical education and expand the

capabilities of telemedicine.

6TH YEAR ON THE LIST
BRAIN MACHINE INTERFACES,

BRAIN-COMPUTER INTERFACES,
AND NEUROPROSTHETICS
WHAT IT IS
While Elon Musk’s brain-machine interface (BMI)

company Neuralink grabs all the mainstream’s attention,
many other innovative research and commercial
initiatives continue to accelerate the union of technology
and the human brain. From a breakthrough device
allowing doctors to observe brains in real time, to bionic
noses that give Covid survivors the ability to smell again,
the near future will bring a host of once-fantastical
options.

NEURAL ENGINEERING
BRAIN-COMPUTER INTERFACES much more invasive implant: Part of the pa- The human nose houses more than 400 types BRAIN-TO-BRAIN COMMUNICATION
In June 2022, doctors at Mount Sinai West in tient’s skull needs to be removed. (The FDA has of receptors that detect odor molecules and It’s now possible to remotely control fruit flies
New York wired a patient’s brain with a 1.5-inch yet to approve Neuralink for human trials.) To be send signals up to the brain for interpretation, with a computer and command them to make
long implant created by Synchron, a brain-com- sure, Synchron’s less invasive method means and scientists estimate that there are roughly specific movements. A team of genetic engi-
puter interface (BCI) startup. The hope: enabling the device is placed inside a blood vessel, which 1 trillion possible different scents. Outfitting a neering, nanotechnology, and electrical engi-
an ALS patient, who lost the ability to move means that its electrodes aren’t as close to the computer chip with 400 sensors wasn’t possi- neering researchers at Rice University genet-
and speak, to communicate again simply by brain’s neurons as would be ideal. But future ble—until recently, when researchers at Virginia ically modified fruit flies to express a specific
thinking. To implant the device, which is called iterations of stentrodes could entail placing Commonwealth University (VCU) figured out heat-sensitive ion channel that, when activated,
a stentrode (picture a column of wire mesh), several devices in the brain and feeding signals how to embed them in a pair of smart glasses. caused the insects to spread their wings. Then,
surgeons made a tiny incision in the patient’s back to an external device. Meanwhile, the Uni- A sensor on the frame detects molecules and they implanted magnetic iron oxide nanoparti-
neck and threaded it using a catheter running versity of Pittsburgh’s Rehab Neural Engineering sends a signal to a processor in the temple cles, which heat up when magnetically charged.
through the jugular vein into the motor cortex. Labs developed two-way communication with a of the glasses, which wirelessly transmits the With a magnetic field turned on, researchers
Once implanted, the stentrode is connected to BCI to mimic tactile sensations, a development information to a neural implant near the olfac- warmed the nanoparticles, and the flies (invol-
a computing device implanted in the patient’s that could provide crucial feedback for improv- tory hub. An electrode array simulates a pattern untarily) spread their wings. While still merely
chest, and eventually to a smartphone via ing the control of prosthetics. Brown University corresponding to the original smell. Initially, the proof of concept, this is an alternative, minimally
Bluetooth. The entire procedure takes less than researchers are placing microscale neural sen- device didn’t allow patients to access all trillion invasive approach to brain machine interface
an hour. As of December 2022, Synchron’s BCI sors, called neurograins, on the outer layer of possible smells, but in early trials people report- systems. The project, called MOANA (magnetic,
had been implanted in four Australian patients, the brain to study alternative BCI options. ed perceiving “onionlike,” fruity, and antiseptic optical and acoustic neural access), is funded in
where laws are less stringent than the US. These smells. The VCU team has taken steps to gain part by DARPA, which hopes to create wireless
BIONIC NOSES FDA approval for a medical implant device.
very early US and Australian trials have so far headsets that could facilitate brain-to-brain
been successful: Patients have sent WhatsApp Neuroprosthetics exist for vision and hearing Similar work is underway in the EU, with a communication. In the future, human soldiers
messages and made online purchases. This loss, but until recently there wasn’t a solution project called Restoring Odorant Detection and might be able to transfer information between
technology is still in a very nascent stage of for the loss of other senses. Cochlear implants Recognition in Smell Deficits (ROSE for short), two or more brains by thinking. A more dysto-
development, so that researchers can learn for the hearing impaired have now been fitted that includes seven research institutions. They pian outcome: Rather than forcing prisoners to
how to adjust the technology to be activated by into 700,000 patients, while retinal implants help hope to have a commercial product in the next talk, a bad actor might instead forcibly down-
brain signals. But the trials and approach put blind people regain their sight. Smell and taste decade. load what they’re thinking.
Synchron ahead of Neuralink, which requires a have long been considered too challenging.

NEURAL ENGINEERING
OBSERVING THE BRAIN IN REAL TIME led by Georgia Institute of Technology demon- ing, or any other technology that might interfere Patients found out the hard way in 2019, when
The brain transmits a form of electrical signals, strated that participants could use its wireless with how people think. This approach, which the startup Second Sight, which developed a
but it’s composed of gelatinous tissue. While brain-machine interface (BMI) system to control effectively categorizes all neurotech as medical retinal implant capable of restoring vision to the
electrodes and MRIs give us an external view virtual reality movements. The researchers devices and strictly limits their use to very nar- blind, nearly went bankrupt. The company pivot-
of how the brain works, close-up, real-time also developed a machine learning model that row cases, could stifle innovation. But a growing ed, merged with a biopharmaceutical company,
observation remains a challenge. A multidisci- improved the system’s accuracy. Availability of number of activists are calling for a thorough and changed its name to Vivani Medical. Users
plinary team of engineers, software developers, wireless BMIs, which don’t require implantation, public debate on the rights to mental privacy, of its original product no longer had technical
neuroscientists, and nanoelectronics research- will likely expand the use of BMIs. and transparency into how the data extracted support, or options for repairs, replacements, or
ers developed a new type of imaging device from users’ brains could be used for commercial upgrades. The brute fact is that while compa-
NEURORIGHTS CAMPAIGNS purposes. In 2022, the US Government Ac- nies must gain regulatory approval to implant
that records the brain’s electrical activity. The
system, called Neuropixels, consists of ultra-thin As neurotech moves from labs into trials, countability Office published policy questions their devices, they aren’t obligated to keep them
silicon probes capable of measuring the activity some countries are banning the collection and for federal offices: As BCIs develop toward com- running, or to seek approval before discontinu-
of hundreds of neurons at the same time. The sale of brain data. Neurotechnology includes mercial and patient use, will they be accessible ing them.
Neuropixels team created a publicly available brain-machine interfaces and implants capable to all, and who will bear the cost? How should
data set in 2022 showing the neural activity of reading and translating electrical signals, BCIs that augment human capabilities be reg-
from 81 mice. and raises ethical, legal, and political concerns. ulated, if at all? What ethical issues might BCIs
The NeuroRights Foundation seeks to establish raise, and what applications might constitute
CONSUMER BRAIN-COMPUTER INTERFACE “neuro-rights” before the technology reaches unethical or controversial use of BCIs? What
PRODUCTS the mainstream. Spain launched a Digital Rights steps might help to mitigate potential security
Meta sponsored research at University of Charter in 2021, and it includes a provision on and privacy risks associated with the acquisition
California, San Francisco, only to later abandon neurorights and protecting citizen data. The of brain signal data?
efforts to turn its BCI—which had the goal of United Nations published an agenda last fall
arguing in favor of reviewing neurotech in the COMPANIES SUNSETTING IMPLANT SUPPORT
allowing mobile device and computer users to
communicate at a speed of at least 100 words context of human rights. BMIs, BCIs, and neural implants offer a tantaliz-
per minute, much faster than anyone can type ing opportunity to regain control of their senses.
Currently, the most aggressive neurotech regu- But this technology will generally come from
on a keyboard—into wearable consumer tech-
lations are in Chile, where a new constitutional a business, and require updates, patches, and
nology. But research into this technology for
amendment prohibits mind control, mind read- upgrades. What if the company goes under?
consumers isn’t dead. A global collaboration

PATIENT-GENERATED Hundreds of devices collect and monitor

patient health data, but health care systems
As consumer devices inch closer to medi-
cal-grade and more connected devices are
HEALTH DATA
have struggled to integrate that data into EHR used to manage chronic disease, look for a
systems. The result: a new market for busi- greater focus on integrating that patient-gen-
nesses focused on interoperability. The Fast erated data into EHR systems. Such integration
Healthcare Interoperability Resources (FHIR) into EHR systems and clinical workflows will
standards for application programming inter- be critical for the success of remote monitoring
faces (APIs) connect data from smart devices and telemedicine services.
and platforms, including Apple HealthKit to
EHRs. Withings, a maker of smart scales and
connected devices, and Redox, a health IT
WHAT IT IS company, are working to make Withings’ Med
Pro Care–connected health devices compat-
As wearables and sensor technology proliferate, so do ible with major EHR systems. In South Korea,
a major digitization project involves creating
floods of patient data that can help health care providers a single app for patients to access their entire
health record. By 2023, that same effort will
assess a person’s overall health. But capturing that data integrate data from wearables and medical
in electronic health record (EHR) systems and making use devices.
of it in a clinical setting has challenged an industry that

lags in digital transformation.

COGNITIVE AND NEURAL Cognitive sports trainer Reflexion partnered

with eSports league Evil Geniuses to build a
While cognitive interventions may show
individuals’ improvements in training pro-
OPTIMIZATION
visual cognitive training program for eSports grams, translating those performance gains in
athletes, one designed to improve peripheral real-world applications has been less certain.
vision, decision-making, reaction time, and But that has not slowed research, given the
hand-eye coordination. NIH is funding re- needs of an aging global population and the
search in cognitive enhancement, including an desire of many to seek any kind of competitive
Alzheimer’s study at the University of South edge. Despite the inconclusive data, athletes
Florida that will explore whether computerized remain curious if these games could improve
games can reduce the risk of cognitive decline cognitive performance. As use of the technol-
in aging adults. Researchers at the University ogy grows and NIH-funded studies add more
WHAT IT IS of California, Riverside and the University of evidence to the discussion, we may see calls
California, Irvine are looking at the gamification for regulation.
Brain training is a controversial multibillion-dollar and personalization of memory training, driven
by the theory that previous studies showed
industry. These interventions resulted in inconsistent inconsistencies because of neural differenc-
es between people’s brains; individualizing
findings in research studies, and their real-life the approach, the thinking contends, could
performance remains largely subjective. Demand is improve results.
fueled by the emerging long-term cognitive impacts of

Covid, and an aging population facing cognitive decline.

DIGITAL FITNESS Digital fitness players are rolling out new offer-
ings with hopes of sustaining pandemic sub-
As the in-home fitness industry scrambles
to retain subscribers, some companies are
AND HEALTH TECH

scription levels, while new entrants are launch- tapping employer and insurer wellness pro-
ing their own products. Smart gym company grams to offer free access. Others are starting
Tonal added live classes that provide real-time to expand into hospitality, by offering connect-
feedback and a “social zone” where users can ed equipment in hotels for business travelers.
interact. Apple Fitness+ also rolled out Share- Traditional gyms and fitness centers, mean-
Play, which allows users to work out “togeth- while, will be forced to upgrade equipment and
er” even when miles apart. Nike and Netflix offerings to stay competitive and relevant in
partnered in 2023 to offer Nike Training Club, the personalized fitness world.
which offers curated workout programs in 10
WHAT IT IS languages via all Netflix subscription plans.
(What’s in it for Nike, which won’t get a cut
Since the start of Covid, consumer adoption of digital of subscription fees? User data and insights,
which it will use to inform its higher-end foot-
fitness technologies has accelerated significantly. wear and apparel products business.)
The use of health and fitness apps, connected fitness Investments have also flowed into the sector.
Investors put $200 million behind WHOOP,
equipment, and health-focused wearables are up 13%, which provides biometric-driven personal
15%, and 16%, respectively, since early 2020, according coaching; $200 million behind Hydrow, a
connected rowing company; and $220 million
to research firm Activate. The next wave of fitness into Tempo, which uses 3D sensors and AI to
and health-focused technology growth will focus on provide real-time feedback for weight training.
meditation, sleep, and mental health.

FRONTIER
TECHNOLOGIES
TRENDS

EMERGING TREATMENTS
DNA ROBOTS TELEROBOTICS sticky tape; they’re controlled with a magnetic
Ohio State University scientists developed soft- You’ve seen them in sci-fi movies: tiny ro- field. They can fold into different shapes, and
ware that can design more complex DNA robots bots that are swallowed or embedded, and can be manipulated to perform various tasks,
and nanodevices in minutes, instead of days. then remotely controlled by doctors. Fiction is such as patching a gastric ulcer. Los Angeles–
Called MagicDNA, the software allows scientists becoming reality thanks to telerobotics, which based startup Bionaut Labs received a special
to simulate operation of the bots. This could lead uses remote bots capable of performing com- designation from the FDA for its BNL-101 device,
to more useful applications, including detecting plex medical tasks. Think: small pills outfitted which treats malignant gliomas in the brain. Be-
a programmed trigger—like a virus in the body— with cameras, sensors, propellers, a battery, cause their nanomaterials can cross the blood-
and responding by releasing a drug, or envelop- and wireless link, which navigate the depths of brain barrier, Bionaut’s nanobots are theoreti-
ing the pathogen. It could also be used in preci- the body like a submarine might in the ocean. cally capable of working on parts of the human
sion drug targeting: imagine a drug is attached The startup Endiatx developed a robot that can brain that would be too dangerous for traditional
to a DNA robot using a protein linkage which zoom around the human digestive track and surgery. Human clinical trials are still a ways off,
can only be cut by an enzyme that only appears allow doctors to experience it using something but we may someday rely on tiny bots to deliver
inside the target cell. Scientists at ETH Zurich akin to virtual reality. These systems are a signif- therapeutic treatments, instead of a full, human
in Switzerland are investigating how acoustic icant upgrade to traditional endoscopes, which surgical team.
waves, like ultrasound or magnetic fields, can can require anesthesia, multiple visits to capture
NERVE COOLERS
help these devices navigate to desired locations. information, and may still not deliver detailed
Similarly, the EU funded the SONOBOTS project enough information to make a diagnosis or In 2022, researchers published a new break-
to develop navigable nanorobotic systems for repair damaged tissue. through in managing pain. A soft, implantable
targeted drug delivery, precision microsurgery cooling device can temporarily block nerve
and biopsies, and diagnostics. Another EU-fund- MEDICALLY ASSISTIVE NANOBOTS conduction, and once the pain has subsided,
ed project, ANGIE, will investigate steerable A team of researchers at the Max Planck Insti- the materials used to create it dissolve. So far,
nanodevices and magnetic navigation systems tute for Intelligent Systems has designed and the bioresorbable coolers have successfully
for localized treatment of blood clots. Up next: built a tiny millipede-like robot that can climb numbed pain in rats. In the future, patients
interventions in multiple chronic diseases. around in the gut to deliver therapeutic drugs. might control their pain without the need for
The nanobots consist of metallic powder and opioids.

EMERGING DIAGNOSTICS
SMART MATERIALS DIAGNOSTIC BEDS and electrodermal activity could predict viral
Nanowear’s SimpleSense is an FDA-cleared, Smart beds monitor patients’ breathing, tem- infection and the severity of illness. The Army is
noninvasive undergarment that monitors and perature, pulse, and other vitals through sensor using the same wristband to detect Covid. More
analyzes multiple patient vitals—such as heart chips. Their data is then transferred to devices study is needed to test the system in a more di-
rate and sounds, respiration rate, lung volume, for clinicians to act on. At Baystate Medical Cen- verse population, but the findings could enable
and physical activity—to predict risk of heart ter in Massachusetts, diagnostic beds can de- valuable public health surveillance—and provide
failure or lung disease, among other ailments. tect moisture exposure caused by incontinence. consumers with a nice heads-up that they’re
Researchers at Rice University are developing a Smart bed technology intended for consumers coming down with something.
smart material out of carbon nanotube threads detects heart rate variability, respiration, and
that can be sewn into clothing and withstand restlessness during sleep. Eight Sleep and Ooler
damage from washing, stretching, or sweat. developed smart bed technology that collects
These threads work just like the wires in an sleep data overnight and makes recommenda-
EKG device, which detects heart conditions by tions via an app in the morning.
measuring heart rhythms, and therefore can
be used for health and health care applica- ILLNESS-DETECTING SENSORS
tions. MIT researchers created a washable fiber Several 2020 studies found that wearables, such
that can sense, store, and process data. When as the Oura Ring, Fitbit, and Apple Watch, can
paired with AI, the fiber data could provide you detect early signs of infections. Apple and the
with real-time alerts about potential respiratory University of Washington used the Apple Watch
problems or arrhythmias. MIT is working with to monitor changes in participants’ heart rate
the Army to develop the technology, which and blood oxygenation as a potential predic-
could alert the wearer of critical health data and tor of infection. In a separate Warrior Watch
inform support forces of injuries. Researchers at Study, researchers found that certain heart rate
the Missouri University of Science and Technol- variability metrics detected on Apple Watches
ogy are using smart fibers to develop a helmet pinpointed early signs of Covid. A study led by
that can detect real-time concussions among Duke University found that a wristband that
athletes. monitors heart rate, skin temperature, activity,

EMERGING PROSTHETICS
SYNTHETIC SKIN to manually control motion through apps or residents of assisted living homes, and sleep
Researchers at the University of Tokyo devel- joysticks. Further research will explore improv- monitoring. E-skins are advancing. Think:
oped a new form of synthetic skin designed to ing the assistive wearable’s energy efficiency by thinner, more durable materials that allow
cover robotic prosthetics. A plastic finger was using motion to charge the batteries. people to retain a sense of touch. MIT and the
placed in a soup of collagen and human skin South Korean skin care company Amorepacific
TATTOOS AND ELECTRONIC SKINS developed artificial sweat ducts that let sweat
cells called fibroblasts. Three days later, the
goop formed a dermis layer. Next, the team The University of Texas at Austin is exploring pass through longer-wear e-skins. Samsung
poured in additional skin cells, called kerati- how graphene electronic tattoos can measure Advanced Institute of Technology proved the
nocytes, to create the epidermis, which is the brain waves, heart activity, and muscle activity commercial viability of stretchable e-skins that
outermost layer of skin. The resulting skin was through biopotentials, which are electrical activ- use existing semiconductor processes. These
1.5 millimeters thick, and could stretch, contract, ities naturally occurring in the body. Researchers skins could be used to measure heart rate, oxy-
and wrinkle. Since the synthetic skin lacked received a National Science Foundation grant gen saturation, electromyograms—the electrical
blood vessels, it eventually dried up—but in the for work with the Georgia Institute of Technolo- activity in muscles—and to display blood pres-
future, artificial blood could keep it alive indefi- gy to develop an e-tattoo that remotely monitors sure data on the patch.
nitely. (If you’re suddenly thinking about “West- pneumonia patients and predicts changes in
world,” you’re not alone.) their condition. A clinical trial at Texas Children’s
Hospital will test the e-tattoo’s capability to indi-
ASSISTIVE EXOSKELETONS vidualize patient care and trigger early interven-
Researchers at the University of Waterloo in tions before a patient’s health deteriorates.
Canada are using computer vision and deep
At Northwestern University, researchers are
learning to create more natural movement
investigating soft, flexible, skin-inspired elec-
for disabled persons who wear exoskeletons.
tronics, called electronic skins, or e-skins. They
The ExoNet system automatically adjusts the
created a skin-like device for the throat that
exoskeleton’s motion to mimic the various ways
monitors speech, respiration, heart rate, and
humans adjust their gait to navigate their sur-
other biometrics. It’s intended to be used for
roundings, as with descending stairs or opening
stroke patients, speech and physical therapy,
doors. The functionality eliminates the need

EMERGING IMPLANTS
DISSOLVING BIOELECTRONICS
Researchers at Northwestern and George
Washington universities developed a cardiac
pacing device that is absorbed by the body
over five to seven weeks—ideal for postsurgical
patients whose hearts require temporary pac-
ing. During surgery, doctors adhere the flexible
device to the surface of the patient’s heart. The
device then harvests power from an external
source using near-field communication, which
eliminates the need for batteries or external
leads. This is the second biodegradable device
from the Northwestern lab led by John Rogers:
In 2018, the team demonstrated a biodegradable
implant that accelerates nerve regeneration
post-op.

WEARABLES TRENDS

11TH YEAR ON THE LIST
WEARABLES AND
BIOINTERFACES
We continue to witness incredible growth in wearables. More than 2,000 wearable

sensors are on the market, ranging from smartwatches to advanced fabrics and
materials. Viable implantable technology is beginning to emerge, and new advanc-
es may help detect and track biomarkers, to assist with and enhance healing.
More wearables can now report data and adjust settings independently of a
smartphone or computer. Capabilities go beyond the smartwatch to include clin-
ical-grade health monitors and full-body exoskeletons that give those who wear it
superhuman strength. And once wearables transition to implantables, we will gain
even greater visibility into real-time biological health.
Wearables will not only offer more data in areas where we previously had little
visibility. Once consumers start using new interfaces in entirely new contexts, wear-
ables will change how consumers interact with businesses and communities. And
companies may gain greater understanding of a consumer’s health—potentially
without that consumer even knowing about it—for business insights and marketing.

EMERGING WEARABLES
AUGMENTED REALITY GLASSES ULTRASOUND STICKERS CONNECTED FABRICS AND APPAREL It can capture 85 patient vitals, including blood
Basic smart eyewear that makes use of aug- A new type of flexible patch can provide contin- Smart clothing uses smart threads and small pressure and heart rate, respiration, lung volume
mented reality (AR) is already on the market. It uous ultrasound imaging of internal organs for sensors to capture various physiological data. and fluid levels, and temperature. Nanowear
incorporates technology like voice assistants, two days. The patch, which detects and trans- In 2022, the Manchester City football team has partnered with health systems in New York
touch-control surfaces, video capture, and mits ultrasound waves, is a form of wearable im- launched a smart scarf for fans, outfitted with City to conduct a clinical trial in Covid patients
bone conduction audio, which allows users to aging. At the moment, they aren’t wireless—the biometric sensors that measure heart rate, of its SimpleSense remote diagnostic monitor-
take calls and hear music and voice messages stickers still need to be connected to an external body temperature and emotional responses. ing platform. Redwood City, California, startup
without using headphones or earphones. These source that can translate the waves into read- The team intends to measure fans’ ups and Athos offers apparel that uses electromyogra-
early-generation examples of smart eyewear— able images— but in the near-future doctors will downs and real-time reactions, to gain a better phy—which measures the electrical activity of
including Amazon’s Echo Frames and RayBan’s be able to monitor patients for cardiovascular understanding of their experience during live muscle tissue—to provide athletes with insights
Stories, made in collaboration with Facebook disease or watch a pregnancy. games. Nextiles is making athletic apparel that about training load, muscle activity, and qual-
(now Meta)–are intended to familiarize the monitors motion, pressure, bending, torque, and ity of movement. Remote patient monitoring
public with the devices, and encourage early IN-EAR EEG DEVICES twisting for detailed athletes’ feedback, includ- startup Siren makes connected socks to detect
adopters who don’t otherwise wear glasses to ing warning signs of fatigue. Rice University’s foot ulcers in diabetic patients by monitoring
Researchers at the University of California,
try out frames that have added functionality. George R. Brown School of Engineering is using foot temperature, which can indicate inflamma-
Berkeley are testing in-ear electroencephalo-
But the long-term play will involve smart lenses, soft, flexible nanotube fibers sewn into athletic tion, and sharing the data with their physician.
gram (EEG) technology, which measures elec-
and glasses that serve as a wearable device for shirts to provide continuous electrocardiograph- A sleeve developed by Cipher Skin can track
trical activity in the brain using small electrodes
many purposes, including health and wellness. ic monitoring. Importantly, the shirt remains physical rehabilitation progress by analyzing
attached to the scalp. The technology could be
(Imagine looking at a meal and knowing the im- washable and stretchable. MIT’s Computer arm movement and mobility, oxygen saturation,
a portable brain-computer interface for medical
pact it will have on your body before consuming Science and Artificial Intelligence Laboratory and heart rate.
sleep monitoring and biofeedback. Scientists
it.) In 2022, Google announced that it is working have found various potential applications of in- developed socks, gloves, and a vest with “tactile
SMART BIOHAZARD WEARABLES
on live speech transcription and translation via ear EEG, including measuring employee atten- electronics” that can coach athletes on improv-
AR glasses, which generate and show text using tion in office settings and recognizing focal tem- ing their technique and detect imbalances that Harvard University and MIT developed a face
the lenses as a heads-up display. Apple is work- poral lobe seizures. As the technology matures, could lead to injury, and provide real-time feed- mask that can detect the SARS-CoV-2 virus. The
ing on its own pair of AR glasses. an EEG alert could provide an early warning of a back during physical rehabilitation. Nanowear scientists used synthetic biology to create circuit
seizure and automatically call for help. developed SimpleSense, a sash worn over the systems that send alerts when they’re exposed
chest that’s lined with billions of nanosensors. to pathogens—and potentially identify chemical

EMERGING WEARABLES
or biological threats, too. The masks could be features, automatically adjusts the temperature Soli—its low-energy radar sensor that de-
integrated into personal protective equipment, level based on your surroundings and activity tects motion on a microscopic scale—into the
such as clinical coats or gowns. level. Its software connects to your smartphone Nest Hub and Pixel 4. The sensor can detect
and can be used with any clothing item, using gestures from a finger tap to full-body move-
COMMERCIAL FULL-BODY EXOSKELETONS an accessory that wraps around your neck. ment, thus enabling contactless control of any
Manufacturing and military settings are using Some brands like Descente sell shirts and cloth- devices connected to the hub including smart
exoskeletons to reduce fatigue and risk of injury. ing designed specifically to hold the device. speakers and thermostats.
General Motors and Fiat are testing SuitX’s
In China, Huazhong University of Science and
industrial exoskeletons to assist workers during
Technology developed a fabric to keep you 5
heavy lifts. Salt Lake City–based Sarcos Tech-
degrees Celsius cooler than traditional materials
nology and Robotics’ full-body exoskeleton
like cotton. The material reflects UV and visible
Guardian XO enables wearers to lift 200 pounds
light, while emitting infrared light and optimizing
without any strain—ideal for freight handlers. In
heat dissipation. Duke University researchers
2022, Sarcos will sell its exoskeletons as part of
developed a nanoporous polyethylene textile
a robotics-as-a-service plan, and T-Mobile will
that’s opaque to visible light but facilitates radia-
add 5G capabilities to its Guardian XT robots,
tive cooling that keeps you two degrees (Cel-
which are built on the upper-body section of
sius) cooler. These fabrics may provide clothing
the Guardian XO. In Richmond, California, Ekso
alternatives for people facing rising tempera-
Bionics sells subscription-based access to its
tures amid climate change.
EksoHealth exosuits for stroke rehabilitation
patients, as well as to its EksoWorks industrial
SKINPUT SYSTEMS
vests that support workers during overhead lifts.
Skinput uses human skin as an interface and
WEARABLE AIR CONDITIONERS effectively turns an arm and hand into an input
device. When users tap a finger or a location
In April 2021, Sony introduced a more powerful
on their arm, sensors translate the vibrations
wearable air conditioner called the Reon Pocket
into specific actions, such as skipping a music
2, which is currently available only in Japan. The
track or answering a call. Google has integrated
device, which has both cooling and warming

MATURE WEARABLES
HEARING DEVICES menstrual cycle tracking that uses heart rate pany that has focused on bands, and it could be
In 2022, the FDA changed its rules and no lon- data to improve accuracy of predictions. Face- a direct competitor to the Oura Ring.
ger requires a medical examination or hearing book is expected to launch its own smartwatch
with fitness features and heart rate monitoring, SMART GLOVES
test for prescription hearing aids, which will like-
ly increase competition in a previously closed and it won’t need to be paired with a smart- Personal protective equipment manufacturer
market. Some consumers are using Bluetooth phone. Researchers at Duke University and the Mechanix Wear and thermal wearables tech-
headphones, such as AirPods, as assistive hear- Stanford University School of Medicine found nology company Clim8 created a smart glove
ing devices. No longer just for listening to music that smartwatch data on heart rate, tempera- that self-regulates temperature to keep hands
or taking a call, these in-ear wearables could ture, and activity could indicate dehydration and comfortable. IED Electronics developed smart
someday soon monitor brain, cardiac, and respi- abnormal blood counts. This research suggests gloves that measure quality and accuracy
ratory function, too. At the University of Illinois at that smartwatches could one day be used for during manufacture and assembly. The system
Urbana-Champaign, researchers are looking at early health intervention, long before a doctor uses machine learning and data captured by an
how smart hearing devices could use acoustic requests a blood test. embedded gyroscope, accelerometers, and a
augmented reality, which help people navigate microphone to indicate whether a user assem-
RINGS bled components correctly. Bioservo Technolo-
with audible commands. Sound mapping shifts
the sound, so that it appears to come from the Scientists from MIT’s Computer Science and gies’ Ironhand 2.0 provides extra grip strength
direction in which the person should walk or Artificial Intelligence Laboratory and Massa- and endurance to the wearer. The glove reduces
turn. Imagine being guided through a morning chusetts General Hospital’s Center for Artificial repetitive strain injuries and tracks ergonomic
run through the woods, on any path you choose, Intelligence created an open-source toolkit that risk through analysis of use data.
without ever getting lost. lets users design and fabricate health-sensing
devices like bracelets that detect distracted driv-
WATCHES ing or bands that provide important data during
Smartwatches are monitoring more than heart physical therapy like muscle motion, strain, and
rates. They’re providing blood pressure and tension. A patent application by Fitbit published
temperature observations, and starting to draw in June 2021 describes a ring that monitors bio-
conclusions about health status. The Apple metrics like blood oxygen levels. This would be
Watch added oxygen saturation metrics, and the first new form factor introduced by the com-

SCENARIOS

WHAT IF YOU COULD GET PAID IN YOUR SLEEP?

Scenario Year: 2029
Consumers are now paid to dream. A new app, NoctEarner, plays ads during sleep,
encoding positive new memories about brands. Dream incubation advertising
is a noninvasive way of shaping nighttime visions during key stages of sleep. The
NoctEarner app nudges consumers to complete activities during the day, such as
watching short videos. At night, they simply put on a comfortable headband and open
the app, which plays soothing soundscapes to encourage a peaceful transition to
sleep. Consumers report having pleasant dreams featuring their chosen brands. With
every successfully completed sleep cycle, points are added to the NoctEarner app,
which can be redeemed for cash, gift certificates and a bevy of consumer electronics.
Brand loyalists receive discounted offers to try out the latest products. Premium
members can choose from enhanced packages that guarantee zero nightmares and
allow personalized dreamscapes featuring celebrities.

WHAT IF HOSPITALS HAD SPECIALIZED

PATIENT EXPERIENCE TEAMS?
Scenario Year: 2033
The Orlando Regional Medical Center recently launched a new Patient Experience (PX) strategy
team to anticipate patient needs and collaborate with internal departments to optimize patient
care. The PX team includes technology usability experts, hospitalists, and data scientists, who
configure a patient’s real-time experience based on their individual well-being profiles and medical
needs. Hospital rooms, redesigned around groundbreaking health-forward technology, are now
considered an essential component of healing. Diminished reality (DR) sensors on windows, walls,
and the doorway mutes intrusive noises, like the worrying beeps from diagnostic machines or
patient groans from adjoining rooms. Built-in augmented reality overlays show ambient colors
proven to reduce stress and inflammation. A generative music system automatically creates
soundscapes to calm patients and spur the release of dopamine. Mattresses and blankets, built with
conduit and water-filled micro tubes, automatically heat or cool the patient to optimal levels.
A PX-centered strategy means faster healing, leading to better patient outcomes.

HOW TO
PREPARE
FOR THE
FUTURE
HOW TO PREPARE What should your organization do now to prepare for these trends?
As emerging Executives and their teams must con- talent pipeline. Which of these will likely
front their cherished beliefs about what impact your enterprise earliest? Which
technologies bring health care has always been—and might take longer to develop, but could
develop new mental models for what have a larger impact on your opera-
the power of the it could be in the future. It would be a tions?
laboratory into our mistake to focus only on three- or five-
Wearable devices are moving from the
year strategic plans, because big tech
homes and AI expands players (Amazon, Meta, Google, Apple) fringe to the mainstream, and consum-
ers are looking for actionable insights.
the possibilities for and well-capitalized startups play a lon-
They are also more health-conscious in
ger game. In the next few years, leaders
remote diagnosis, will need to develop a refined vision for the wake of the pandemic. Additional
factors include the rollout of 5G net-
knock-on effects future growth. We recommend that you
works and relaxed rules on telemed-
evaluate how the technology trends in
will be realized this this report are likely to shape the futures icine and remote patient monitoring.
Longer-range road maps in the health,
decade. Ongoing of health care operations, as well as
medical, and wearable space can bal-
the practice of medicine and the health
disruption is likely. insurance ecosystem. ance near-term expectations with more
aggressive research agendas. Rehears-
Companies seeking to take an active ing the futures of health care using
role in shaping the future of health strategic foresight has never been more
and medicine should be developing a important.
point of view on technology (hardware,
software), data collection, the patient
experience, external partners, and the
54
KEY QUESTIONS FOR YOUR TEAM

1 2 3 4 5 6 7 8
How could home- If direct-to- How might If we source new/ How could How do these Do we have the In a field where
based diagnostic consumer tests emerging more biometric advancements trends change our right knowledge, breakthroughs can’t
systems disrupt our threaten our technology unlock data, could we in some of these perspective on risk? experience, and be scheduled and
business? profitability, can new growth develop new and health and medical talent in place to research can take
we develop new opportunities for deeper insights tech trends make take advantage of a decade or more
products or services our business? about our patients our company these trends? to produce a viable
to compete with and customers? vulnerable? candidate, how can
upstarts? we create a sense
of urgency and take
meaningful action
right now?

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AUTHOR
& CONTRIBUTORS
AMY WEBB Chief Executive Officer
Founder and CEO of Future Today Institute AMY WEBB
Amy Webb pioneered a data-driven fore- Managing Director
sight methodology that is now used within hundreds of organizations. MELANIE SUBIN
She possesses master-level knowledge and insights on the potential
Chief Content Officer
futures for the industries critical to keeping the world moving during
JON FINE
this unparalleled period of disruption in business and society. Webb is
a sought-after advisor to Fortune 100 and Global 1000 companies and Creative Director
provides strategic foresight on the emerging tech and trends that will EMILY CAUFIELD
turn industries on their heads and transform every aspect of our lives. Designer
She was elected a life member of the Council on Foreign Relations, ERICA GRAU
serves on a Stewardship Board at the World Economic Forum, and in
Editors
2022 received an official Mad Scientist proclamation from the US Army.
CAROLE BRADEN
A lifelong science fiction fan, she collaborates closely with writers and
TOM BRADY
producers on films, TV shows and commercials about science, tech-
MEGAN CREYDT
nology, and the future. Webb was named by Forbes as one of the five
TOM FOSTER
women changing the world, listed as the BBC’s 100 Women of 2020,
named one of the most influential business professors in the world by Copy Editor
Poets & Quants, and is ranked on the Thinkers50 list of the 50 most influ- SARAH JOHNSON
ential management thinkers globally.
Director of Operations
CHERYL COONEY

FUTURE TODAY INSTITUTE’S 2023 TECH TREND REPORT

Our 2023 edition includes nearly 700 trends, which are published individually in 14 volumes and as one comprehensive report with all trends included.
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METHODOLOGY
Future Today Institute conducts in-depth qualitative and quantitative

research throughout the year to identify emerging trends. We review
patent and trademark filings, pre-print and published scientific pa-
pers, investment rounds, online search trends, macroeconomic data,
publications from governments worldwide, news mentions, influencer
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of standardized indicators. Qualified trends are further scored for their
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In continuous publication since 2007, Future Today Institute’s annu-

al report includes maturing and emerging trends grouped into two
categories: industry and technology. Industry trends reflect the ways in
which technology is shaping the future of an entire industry. Technology
trends are specific developments within one arena, such as artificial
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Monitored regularly, trends help executives recognize emerging threats

and opportunities in the near-term and enable them to develop per-
spectives, strategies and plans for the future.

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Institute or this report’s authors.
Future Today Institute’s 2023 Tech Trends Report relies on data, analysis,
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INDUSTRY Health Care & Medicine

Detailed analysis of the emerging

2 © 2023 Future Today Institute

3 © 2023 Future Today Institute

THIS YEAR REQUIRES FOCUS

4 © 2023 Future Today Institute

HOW TO USE THE TREND REPORT

Our framework organizes nearly 700

1. Years on the List

5 © 2023 Future Today Institute

Migrating to the Cloud

Growth Through Virtual Services

6 © 2023 Future Today Institute

STATE OF HEALTH CARE & MEDICINE IN 2023

7 © 2023 Future Today Institute

STATE OF HEALTH CARE & MEDICINE IN 2023

8 © 2023 Future Today Institute

9 © 2023 Future Today Institute

10 © 2023 Future Today Institute

HEALTH CARE &

11 © 2023 Future Today Institute

1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

MEDICAL DEEPFAKES Researchers at Ben-Gurion University and the

Medical deepfakes result in diagnostic imagery that

12 © 2023 Future Today Institute

1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

SYNTHETIC HEALTH DATA In the US and Europe, privacy regulations pro-

13 © 2023 Future Today Institute

1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

FULL GENOME EXAMS The BabySeq Project, led by Brigham and

14 © 2023 Future Today Institute

1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

IN-WOMB TREATMENTS Rather than waiting for a baby to be born,

15 © 2023 Future Today Institute

1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

XENOTRANSPLANTATION At NYU Langone Health, surgeons success-

transplantation into human patients.

16 © 2023 Future Today Institute

1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

HEALTHY TOWNS Last year, venture capital firm Andreessen

17 © 2023 Future Today Institute

3RD YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

18 © 2023 Future Today Institute

3RD YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

DOCTORLESS EXAMS AliveCor’s KardiaMobile 6L is an FDA-cleared

19 © 2023 Future Today Institute

3RD YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

AT-HOME MEDICAL COVID-19 fueled at-home collection and new

our homes. Smart toilets and mirrors will turn everyday

20 © 2023 Future Today Institute

3RD YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

DIRECT-TO-CONSUMER San Francisco–based Forward, buoyed by

HEALTH CARE MODELS

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1ST YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS

PATIENT ACCESS TO In 2022, a new rule in the 21st Century Cures

though existing systems make it difficult to access most

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4TH YEAR ON THE LIST HOW IT WORKS WHY IT MATTERS