Ever since the formation of HCA Healthcare in 1968, Nashville has been and remains one of the largest health care markets in the United States. We play host to four major hospitals downtown, including one of the country’s most forward-thinking research facilities, Vanderbilt University Medical Center. Essentially, if you’re hoping to get a sense of the direction of the U.S. health care industry, it would be prudent to observe Nashville. And at the moment, thanks to its receptivity to free market ideas, the winds are shifting.
It doesn’t take a Master of Public Health degree to identify and recognize the massive problems plaguing this country’s health care systems: staff shortages and abusive scheduling practices which have generated the most attention lately, to say the least. In the next fifty years, the national health care market will face a windfall. Projections suggest that the health care workforce may decrease as much as 75% by 2070, which, as far as the quality and availability of health care is concerned, would be a cataclysmic nightmare.
Thankfully, the market is sensitive to many of these problems and is already starting to propose solutions. The Nashville Entrepreneur Center (NEC) was opened in 2009 for the purpose of connecting and building new enterprises in Middle Tennessee; this, in turn, attracted hundreds of cutting-edge businesses to the region. Between 2015 and 2017, the Center began a separate project meant to attract new health-care specific startups. Called Project Healthcare, it is one part of a slate of ongoing accelerator programs which are taking root here.
Back in April, the NEC held an event to showcase dozens of startups. I attended, and was able to meet three presenters who are presently at the apex of health care research. Most of the companies who presented were specifically focused on data, information technology, and artificial intelligence applications, because, ultimately, that’s the direction health care is going.
The companies' collective goal seems to be mitigating this by revamping existing medical infrastructure and data in order to maximize available knowledge while minimizing the need for human workers. And many of their efforts are impressive.
David Connor is the CEO of the Rare Disease Data Trust, a data analytics company incorporated in 2020. RDDT describes its internal process as the first transformative solution to hit the marketplace that's able to identify rare diseases—meaning those which affect less than 10,000 patients in the United States. “Rare disease” may give you the idea that these conditions are uncommon and somewhat unthreatening to the majority, but there are many thousands of them and, collectively, they affect as many as one in ten Americans. RDDT uses artificial intelligence to search through electronic health records for uncommon biomarkers most doctors won’t notice.
“Because these are rare diseases in health care, people lack experience in recognizing them and the biomarkers for them go unnoticed,” said Connor. “Patients experience a diagnostic odyssey and they’re lost in health care for 5-8 years, misdiagnosed 3 times, mistreated twice, and mis-flagged as psychosomatic, while their genetic disease is advancing. Our health care system is built for volume, not for complex and rare conditions. Health care data is the most valuable in the world, but it's problematic. It’s your and my data, but it's being stored and there’s an obligation to use it, particularly for the benefit of the patient, and we provide that sort of process. Data should be used to serve the most vulnerable and underserved groups in health care.”
Data is, of course, incredibly sensitive, not to mention incredibly at risk to hostile actors. Nashville hospitals have faced recent struggles with data protection vulnerabilities. Back in February, Nashville General Hospital experienced a major hacking incident and required help from the FBI in order to identify its source. No valuable information was stolen but the hack did briefly take down the hospital’s systems. Most of the effort in the health care market goes specifically to health care IT. This is why companies like David Lazerson’s and Guy Tish’s Briya exist, to create data retrieval platforms that are both easy to use and protective against hostile actors seeking vulnerable identity information.
“Why can’t we make data more valuable in health care and make it more accessible?” said Bill Anderson, VP Customers. “The goal is to make sure that data moves around in a secure way. One of the things we do that’s different from most people out there is… we want to make data available by securing it where it is. We support the technology they have and let them share it in a way that doesn’t move it and allows you to see it across different systems.”
Briya was founded in Tel Aviv, but moved its headquarters to Nashville in 2021. The company was started by two former intelligence officers in the Israeli army, data specialists who were trained in pattern recognition and security in a part of the world where data breaches could and often did mean deaths of innocent civilians.
“It’s so exciting to see what’s going on with Nashville,” said Anderson. “It’s really grown up as a hopeful place for health care. It's such a great community with so much synergy. Everything is coming together to make it the right place to be if you want to build out and develop something in health care. We’re looking at different ways to get involved in Nashville. We’re still just trying to figure out how to get our operations going in the United States.”
Some of the most intrusive and potentially radical developments coming out of the enterprising sector, however, are coming from Darvis, an artificial intelligence startup which moved to North Nashville from San Francisco last June. Started by Jan Schlueter and Jan-Philipp Mohr, they’ve already had success deploying some of their technology in foreign and domestic markets from Atlanta to Islamabad.
Darvis develops proprietary software that uses artificial intelligence—what they call a “24/7 compliance employee”—to perform tasks in retail, logistics and identification capacities within a health care setting. They’ve developed uses for this software in fall-prevention, inventory systems management, delivery systems and more.
“They say health care goes through 15-year innovation cycles and I think we’re approaching the year because people are getting more and more frustrated with their real time asset tracking solutions, maintaining it, fixing it and putting new tags on it,” said lead project manager Craig Cartwright.
These three companies—Rare Disease Data Trust, Briya, and Darvis—are still in the early stages of their development, but all have already seen some level of success. They offer very real solutions to ongoing problems in the health industry, and, similar to HCA, who expanded into the largest health care provider in the United States, they could be developing the health care technologies that will go on to define the industry for the next century. Creating more attentive systems for identifying rare diseases, protecting vulnerable health information, and removing tedious manual labor through automation would go a long way to relieving many current issues.
Certainly there are downsides to these concepts—I laid out many of my concerns with A.I. when I spoke to Cartwright, given the lapses in privacy and data that could emerge if the technology isn’t used with care. A.I. and automation are dirty words to many nowadays. They seem to be bywords for “lost jobs”, “displacement”, “industrial collapse” and more, which is why Tucker Carlson and much of the “dissident right” are careful to embrace gains in A.I., deep learning, and the like. Many on the left also lament the corporatization of the marketplace, often commenting on the profit-driven nature of the US health care industry, and the resulting incentivization to cut corners and raise prices, thus putting a burden on the populace. Both contentions are fundamentally true. Ask any American, and he’ll tell you: the health care system is broken and in need of a rehaul. But it remains to be seen if traditionally socialist or populist solutions are responsible and effective.