Where should medtech investment be deployed for greatest impact and return? Here are five under-invested innovation areas I have my eye on:

Competing in the digital marathon

The medtech industry is only on mile five of a digital marathon. At mile one, the organizational adrenaline of forming a digital strategy and embarking on the digital journey felt great. Teams were energized and organizational evolutions were initiated, but that race-start adrenaline will wear off. Most organizations have vastly underestimated the investment required for integrating hardware and device platforms into digital ecosystems. Organizations that have purposefully and quietly been investing to complete the digital marathon are going to pull ahead and lead the pack. What are the characteristics of the winners?

• Developed long-term innovation roadmaps with systematic plans for product, platform, and ecosystem integration.
• Integrated next-generation sensing technologies into their current products, and are capturing high value clinical, procedural, workflow and performance data.
• Building and constantly iterating AI-training models enabled by significant clinical, workflow and performance data streams.
• Nurture R&D cultures that embrace agility, while focusing on marrying unmet needs and clinical applications with continuously evolving emerging technologies.
• Double-down on their core capabilities while forging innovation partnerships to extend capabilities and competitive edge.

Platform integration to improve profitability mix

Medtech R&D pipeline success was historically lauded for 510k clearances and product launches. But long-term value creation will rely not just on product launches alone. Revenue and profitability will increasingly be derived from services, outcome-based payment and new business models enabled by intelligent ecosystems of multiple products and platforms working in harmony to treat patients.

Orthopedic surgery is an inspiring example of dramatic innovation evolution from ‘metal to AI’ in just a five-year period. The orthopedic industry was an early adopter of sensor-enabled surgical instruments integrated with robotic platforms, primarily because sensing bony anatomy presented good technical feasibility for first-gen optical and non-optical sensing modalities. First-generation robots enabled pre-operative planning, task automation and verification and implant placement optimization. Second generation robotic platforms are trending towards data capture (visual, position, orientation, physiologic, tissue-balancing, post-op recovering and monitoring).

Early on, most orthopedic organizations struggled to access procedure data from hospitals, lamenting they couldn’t own the data. But over time, companies and hospitals recognized value creation wasn’t in owning data lakes… value is created from generating meaningful insights. More recently hospitals and organizations have partnered closely on sharing de-identified, anonymized, cybersecure data for the benefit of patient outcomes.

I anticipate more rapid changes to shift R&D portfolios toward integration than ever before. We will see more fast-failing, more agile development and a greater appetite for integrating emerging technologies earlier into R&D portfolios. Emerging technologies I’m watching this year include photonic imaging, in-vivo molecular sensing to guide surgery and real-time diagnostics, micro-stimulation to restore nerve function, AI deployment into real-world evidence platforms, digital twins for entire procedures, and direct-to-organ delivery of novel biotech-based therapeutics.

Women’s health

Women’s health remains one of the most under-invested areas of healthcare, yet has enormous potential for patient impact, societal impact, and positive halo effects on children’s health and wellbeing. There are significant unmet needs in maternal care, reproductive health, breast cancer, ovarian cancer, and cardiovascular and orthopedic disease that affect women.

The dearth of funding is the single biggest barrier to innovation and growth for women’s health. Women’s health is a trillion-dollar opportunity, yet only 4% of a total of $26.5 billion in healthcare venture investment in 2023 was focused on women’s health companies.

The World Economic Forum declared women’s health as the ‘world’s best – and most underfinanced – investment’. Every major business publication including Fortune, Fast Company, SVB, HSBC, McKinsey Health Institute and Deloitte has highlighted the lack of women’s health investment. Shining light on this systemic problem is critically important and spurs necessary action.

There are positive signs the investment community has picked up on this disparity and are acting on it. The Gates Foundation has long led the way in funding innovation for women’s health and children’s health, disbursing billions into global initiatives. In 2023, government funding initiatives in the US and UK NHS programs committed hundreds of millions of dollars toward women’s health.

The smart money will find ways to established dedicated investment funds to fuel women’s health innovation. I’m watching closely to see which venture, private equity and corporate venture arms choose to focus and deploy their investment portfolios on this underserved, high growth, high impact space.

Democratizing healthcare globally

85% of the world’s population lives in emerging markets, but most do not have access to high quality medical care. The sheer opportunity for impact is staggering by any metric: patient pools, procedure volume, hospital size, demographic reach, growth potential. Multinationals have been building global strategies to access global markets for the past decade. Most have done so through conventional means: building regional sales force, distribution partnerships, co-marketing with local manufacturers, and generating clinical and voice of customer insights. But emerging markets hospitals embrace innovation much faster than in the US and Europe.

For example, Apollo Hospitals, based in India, is one of the world’s largest integrated hospital systems, and has a successful industry partnering strategy. Alphabet helps Apollo track patient, procedure and health data in hospitals, while Airtel provides 5G to enable Apollo’s telehealth initiatives in Nigeria. Sanofi is a long-time investment partner in Apollo Sugar Clinics – integrated rural centers for diabetes treatment. Meanwhile, Apollo has long collaborated with Medtronic, developing affordable hemodialysis and AI-enabled stroke management, and more recently completing Medtronic’s first robotic procedures in Asia Pacific.

Global markets can be valuable test beds for new business models, digital service models – and build innovation muscle. This global opportunity is substantial enough to share and even direct medtech competitors can mutually benefit from industry collaboration. There are pragmatic collaboration routes, including real-world evidence generation and co-investing in hospital innovation centers. A consortium approach would also help guide global standards on healthcare data to enable numerous companies to access de-identified, anonymized data sets to enable generation of meaningful insights.

Final thoughts: Re-defining medtech’s investment thesis

Wall Street has often perceived medtech as a stable investment, or recession-resilient investment, or part of a barbell strategy to hedge the Magnificent Seven. But our industry has lived into that role for too long. Medtech offers high growth potential at lower investment risk than most other industries. As our industry moves more rapidly towards addressing entire disease care pathways, I anticipate the investment thesis in medtech will evolve.

Wall Street will be looking beyond quarterly product sales and become increasingly interested in how medtech companies drive healthcare value creation to capture trillion-dollar opportunities. Our industry should be playing an active role in redefining medtech’s investment thesis – this will only help to unleash innovation that delivers lifesaving, life-changing impact to patients and their families globally.