September 18-20, 2019 Washington, D.C. - Chairman of Kleiner … · 2017-10-31 · G.D.P.,” By...

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John Doerr Chairman of Kleiner Perkins

In our 40 years, we have invested in disruptive & iconic companies built to last

Redefined retail Innovated interactive gaming Connected the world

Made information universally accessible

Simplified finance for small businesses and individuals

Reinvented the home

Pioneered biotech industry

Brought raw computing power to the enterprise

Brought trust and security to the internet

Democratized communication in real-time

Revolutionized web access

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Made transportation as reliable as running-water

Disruptive tech companies have become the most valuable in the world

Rank 2000 2010 October 2017

1 GE ($477M) PetroChina ($329M) Apple ($842B)

2 Cisco ($304M) Exxon ($316M) Alphabet ($709B)

3 Exxon ($286M) Microsoft ($256M) Microsoft ($646B)

4 Pfizer ($263M) China Bank ($246M) Amazon ($528B)

5 Microsoft ($258M) Apple ($213M) Facebook ($516B)

6 Wal-Mart ($250M) BHP ($209M) Berkshire ($463B)

7 Citigroup ($250M) Wal-Mart ($209M) Alibaba ($451B)

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Data from Financial Times (2000, 2005, 2010, 2015) and Google Finance for October 2017

> $3T

Moore’s Law has held strong over the past 45 years, with transistors now doubling every 2.5 years

Apple’s latest iPhone has the A11 chip, which has 6 cores and 4.3 billion transistors

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DISRUPTION #1

Internet has made information free, abundant, and ubiquitous

Data from UN ITC and Internet Live Stats // Icon by Creative Stall and NAS from the Noun Project

49,258 GB of internet traffic

Every second there is...

62,956 Google searches

2.6M emails are sent (67% spam)

71,084 YouTube vids watched

7,784 Tweets sent

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DISRUPTION #2

Access to mobile devices and connectivity is global, faster speeds becoming more available

Average % population with access to a connection

2G 3G 4G

All countries 94% 76% 43%

High income 99% 98% 88%

Upper middle income 97% 82% 49%

Lower middle income 93% 67% 25%

Low income 84% 52% 8%

Data from Internet.org and Facebook, 2016 & Gartner 2016

2.8Bglobal smartphone

install base

Android made up 82% of smartphones sold last

quarter

iPhone made up 18% of smartphones sold last

quarter

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DISRUPTION #3

Cloud computing has put infinite computing and storage in the hands of entrepreneurs globally

$222

$0.06

$0.01

Data from Deloitte (John Hagel from 2014) and industry reports (2017)

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DISRUPTION #4

Machine learning and artificial intelligence is unlocking capabilities that we thought were unthinkable

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Photos: Waymo, Stripe, Cardiogram, PathAI, Google Home Assistant, Siri

Autonomous Vehicles

Security & Fraud

DetectionHealthcare

DISRUPTION #5

Knowledge

19991996 20079

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We have a social and economic imperative to fix our healthcare system in the United States

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Source: CMS Historical Data & U.S. Bureau of Economic Analysis

“If you go back to 1960 or thereabouts, corporate taxes were about 4 percent of G.D.P.,”

By contrast, he said, while tax rates have fallen as a share of GDP, health care costs have ballooned. About 50 years ago, “health care was 5 percent of G.D.P., and now it’s about 17 percent.”

Mr. Buffett said our global competitiveness had fallen largely because our businesses were paying far more for health care — a tax by another name — than those in other countries.

Warren BuffettMay 2017, NYTimes

With over 74 million beneficiaries, it is critical we invest in our country’s health and vital safety net

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FOR MEDICAID

Meaningful Payoffs of Using Data

Personalization How can we be more involved in the daily lives of our beneficiaries?

Predictive How can we identify those at the highest risk?

Platform How can we use data across and within MCOs, states, and CMS to support new applications?

Social Determinants How do we understand and improve health through transportation, education, and nutrition?

Performance How can we transparently measure and agree on the measures that lead to better outcomes?

Privacy & Security How do we ensure privacy and security best practices are followed?

Policy With more insights, what policy improvements can we make?

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The accumulation of clinical and claims data in healthcare is at its peak

Data from Department of Health and Human Services and AHIP

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KEY SHIFT #1

Wearable and sensors are becoming a real part of our everyday lives, generating a wealth of data

~ 25% of Americans

own a wearable

Source: Rock Health 2016 Consumer Survey (12/16), IDC, Collection and Processing of Data from Wrist Wearable Devices in Heterogeneous and Multiple-User Scenarios (9/16), Analysis on 140 wrist wearable devices

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KEY SHIFT #2

Genomic sequencing has reached affordable levels and is being used to actively treat diseases

Today, you can sequence a whole genome for $1,450. The price has dropped from over $9M just 10 years ago.

Collectively, we have sequenced over 400,000 genomes

This collective knowledge and insights translates into genetic tests and personalized therapeutics

Image from Illumina // Cost of Sequencing from Science Exchange & UCLA’s Bioinformatics Center, PloS Biology (7/15), Genetests (5/17), Personalized Medicine Coalition (2017), PubMed, and Helix

5,007 genetic disorders with

diagnostic tests

132 personalized medicines

(from 5 in 2008)

8,904 research articles on PubMed(and skyrocketing)

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KEY SHIFT #3

Drugmakers like Merck, Eli Lily, Amgen, and Novartis all have drugs that have a performance payment

The way healthcare is being paid for is starting to change, but needs to change faster

Digital Therapeutics like Omada Health are only charging if their program is used and is effective

The country’s biggest payer CMS is betting the future of Medicaid and

Medicare on paying for performance

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KEY SHIFT #4

The venture community is optimistic, with more dollars invested than ever before

Top Categories

Consumer Health InformationDigital Gym Equipment

Healthcare Consumer EngagementEHR / Clinical Workflow

Analytics / Big DataDigital Therapies

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KEY SHIFT #5

Lumeris is a proven model for value-based care delivery producing better outcomes across populations

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Forward is radically transforming your relationship with your primary care physician

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Tempus is personalizing cancer care by collecting volumes of genomic and clinical data

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Nuna creates a new data system for Medicaid to move from vault to value

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FOR MEDICAID

45 states are in production

95% of Medicaid lives are covered

By having timely data available for T-MSIS, shifts in policy can be more nimble, agile, and proactive.

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