Daily Archives: December 23, 2021

Earlier this week enterprise software giant Oracle shocked the healthcare IT world when it announced its plans to buy one of the leading EHR systems Cerner for $28.3 billion. Thenews puts Oracle on the map as a potential major player in the health technology world.

This was a deal that no one saw coming. Beyond that, I would say it puts Oracle quietly in the healthcare tech space for the first time, Paddy Padmanabhan, CEO of Damo Consulting, told HIMSSTV.

Oracle has a presence through its ER pay products and its database offerings, and so on, but this is the first time they are getting into the clinical software space.And they are doing that with the biggest acquisition by far that they have done, but also the biggest acquisition of this year in tech, and in general one of the biggest acquisitions weve seen in the tech space in sometime.

Its not the first time big tech has entered the healthcare arena. Over the last several years the FANNG companies have invested in the space. For example, Google developed an EHR search tool called Care Studios, Amazon began to offervirtual care services and Appledeveloped an FDA-clearedECG algorithm for its Watch.

There is a new player in town, and that player has announced their presence in a very loud and compelling way. But lets also not forget that big tech has had its own set of challenges in the last year.

"A couple of them actually took a step back, and the most obvious one is Google, where David Feinberg used to work before taking on the role of CEO at Cerner.And Google effectively shut down its healthcare business.There isnt a healthcare business. Apple also had some setbacks in the primary care business they were launching, Padmanabhan said.

"Amazon is pressing forward.They seem to have consolidated all of their healthcare initiatives under one leader. They are getting directly into the primary care space, which is something that other tech firms have avoided. That is getting into the healthcare business, because selling healthcare technology and selling healthcare services are two entirely different things. Microsoft has had the most steady growth, if you look at all of these tech firms.

The news also brings to mind another major big tech acquisition of a healthcare company.

It has already happened and will continue. Microsofts acquisition of Nuance is one example, Lee Shapiro, cofounder and managing partner at 7wireVentures, wrote in an email to MobiHealthNews.

Electronic health records and billing systems are pervasive in the industry, so the next frontier will be on leveraging the data that comes from these systems to improve health. Oracle, with its experience in life sciences, is well situated to help drive some of these learnings. There are other big-tech players that have also made progress in healthcare that I expect will also be on the acquisition trail.

There is also a question of this acquisition making Oracle a competitor to Nuance, a voice recognition and artificial intelligence technology. In the acquisition announcement, Larry Ellison, Oracles chief technology officer, brought up potential new capabilities in voice recognition.

With this acquisition, Oracles corporate mission expands to assume the responsibility to provide our overworked medical professionals with a new generation of easier-to-use digital tools that enable access to information via a hands-free voice interface to secure cloud applications, Ellison said in the press release announcing the news.

This new generation of medical information systems promises to lower the administrative workload burdening our medical professionals, improve patient privacy and outcomes, and lower overall healthcare costs.

However, voice recognition isnt something often associated with Oracle.

When we talk about voice recognition technology, Oracle is not the first name that comes to mind. There will be many questions that come up in the months to unfold, Padmanabhan said.

There are still a lot of unknowns about what the acquisition will mean for the industry, but in the meantime the other major tech players will be watching.

Now they are going to have to contend with this really big player, and one that has quite a dominant position through just one single transaction, Padmanabhan said. So it is going to put everyone on notice to say the least.

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What Oracle's acquisition of Cerner could mean for big tech in health - Mobihealth News

Sam Bankman-Fried, CEO of cryptocurrency exchange FTX, at the Bitcoin 2021 conference in Miami, Florida, on June 5, 2021.

Eva Marie Uzcategui | Bloomberg | Getty Images

Cryptocurrencies have had yet another wild year.

Bitcoin, the world's largest digital asset, has seen a roughly 65% gain since January with some ten to twenty percent swings in between. It brought in a crop of new, individual investors along the way as payment giants like PayPal started letting users trade crypto. More billionaires and institutional investors dove in to help legitimize the asset class.

The industry now sprawls well beyond bitcoin. NFTs, blockchain-based videogames and "Web3" are top of executives' minds heading into next year. Regulation remains as the biggest uncertainty.

Here's a look at what some of the industry's most influential executives had to say.

The 29-year-old founder and CEO told CNBC he doesn't expect legislative action to be the immediate answer for "regulatory clarity." Especially since it's "pretty hard right now to get things through Congress."

It's just as likely to be cobbled together from a series of statements, enforcement actions, and "other indications" to set the guardrails," Bankman-Fried said.

The CEO is still bullish on Solana as an alternative to Ethereum. But it's possible that a new blockchain pops up as the "Holy Grail" that would eventually be able to host a million transactions per second. Right now, he said there are "very few even trying to get that point."

"There will be substantial fleshing out of the crypto regulatory systems over the next few years."

"Most banks have effectively decided internally that they will be entering the crypto ecosystem. But how and when they do it is going to depend a lot on the details of regulatory structure."

"There's enormous worry about stablecoins right now. But it's pretty straightforward to address. You have attestations, or you have an audit from a regulator."

"The thing that people are worried about with stablecoins is are they stable? If you can address that, you've addressed most of the worries about it from a customer protection and a systemic risk perspective. It's not that hard to do. So I'm cautiously optimistic that that's where we're going."

Jeremy Allaire, Co-Founder and CEO, Circle

David A. Grogan | CNBC

The CEO of Circle is calling for more use of dollar-pegged cryptocurrencies, or stablecoins, by e-commerce firms, consumers and financial institutions. Circle, which is set to go public via SPAC, operates its own stablecoin called USDC.

Allaire expects to see more institutional adoption and celebrity trendsetters lending their brands to crypto through NFTs. DAOs, which rely on crowdfunding, may even "challenge venture capital investors on some of the largest and hottest deals in crypto," he said.

The biggest threat? "Incoherent and inconsistent, hastily formed regulations and policy," Allaire said.

"Even in an environment where the Fed raises interest rates, investors and businesses will be hungry for the high-yield opportunities offered through digital assets. So expect to see institutional adoption of digital assets balloon directly, through ETFs, or custom yield-generating products."

"There is bipartisan recognition that blockchain and crypto technologies represent a U.S. competitive advantage, especially if properly regulated, so new legislation and laws will come quicker than many people expect."

"In 2022 stablecoin adoption will continue its upward trajectory. We believe that dollars on the internet will soon be as efficient and widely available as text messages and email."

Brian Brooks, chief executive officer of Bitfury Group Ltd., speaks during a House Financial Services Committee hearing in Washington, D.C., on Wednesday, Dec. 8, 2021.

Stefani Reynolds | Bloomberg | Getty Images

Brian Brooks, the former Acting Comptroller of the Currency, said there's now consensus among lawmakers in Washington that crypto is here to stay. He expects more blockbuster funding rounds after a record 2021, continued mainstream understanding of the crypto space.

For example, not all "crypto" are currencies, or meant to act like currencies, he said.

"Retail adoption is there and will continue to accelerate, but for those established Wall Street firms and other financial services companies that are not already involved in the crypto ecosystem, it is a matter of "when" not "if".

"The need for clear regulatory action that creates a sustainable framework to allow crypto and Web 3 to grow in the United States will reach its tipping point."

"The level of activity and innovation occurring in the space is too great to ignore, as is the risk to American competitiveness in technology and capital markets."

Chad Cascarilla, CEO of Paxos.

Adam Jeffery | CNBC

Paxos is the company powering PayPal's crypto offering behind the scenes. CEO Charles Cascarilla also expects more action in the stablecoin market. His company offers its own dollar-pegged coin, USDP. The CEO is one of many warning that the U.S. has a lot to lose if it gets regulation wrong.

"Big tech and finance players like Venmo, Interactive Brokers and Mercado Libre entered crypto in 2021. There will be even more and bigger players joining the onslaught next year."

"2022 is the year of the stablecoin. Consumer wallets enabled stablecoins for the first time this year. Money is a product and it needs to be updated for how people live today. Regulated stablecoins like USDP are the answer."

"Regulatory clarity, consistency and certainty will foster Safe blockchain innovation in the US. This technology presents many opportunities for American market primacy in the long-term if we get this right, and there are many risks if we get it wrong."

This year marked an industry milestone of the first futures-based bitcoin ETF. But Grayscale and others in the industry are looking to take that a step further.

It's looking to convert the world's largest bitcoin trust, GBTC, into an ETF and CEO Michael Sonnenshein is optimistic for an approval in 2022. He's also seeing investor interest beyond bitcoin, and "tension" between Big Tech and start-ups.

"We're entering into 2022 without a [spot] Bitcoin ETF, but believe that in the coming year the SEC and other regulators will continue to dig in on this issue. We remain optimistic that they will allow for an even playing field -- and give investors the optionality between both spot and futures-based ETF products for getting exposure."

"This was certainly a year when we thought people were diversifying beyond Bitcoin and Ether. We're starting to see that investors are going to specific protocols and projects, and an increasing mindshare among investors that the universe of crypto assets is only broadening."

"There will be an expanded conversation around the tension between some of these centralized platforms that are today managed by social media and e-commerce giants, and established tech companies versus some of these up and coming decentralized platforms."

Robinhood started as a stock-trading start-up. But in its second quarter as a public company, it got more than half of total revenue from crypto trades. Of that, more than 60% came from Dogecoin transactions. As the asset class becomes more important to the company's bottom line, executives have said they're moving slowly on adding new assets to the platform, until there's more regulatory clarity.

"2021 was the year crypto went mainstream."

"Whether through NFTs or their token of choice, more people engaged in crypto in what was a breakout year."

"Crypto has long had a HODL mentality, and that extended to NFTs in 2021 where JPGs replaced photos all across social media. The infrastructure investment from 2017 is ready for primetime, with multiple layer L1s and L2 platforms flourishing in 2021. With more crypto enthusiasts to cater to, 2022 will see companies focus more on design and user experience to ease that transition from web 2 to web 3, and we'll continue to see major brands continuing to get involved."

If you've ever perused crypto Twitter, you probably know "Pomp." With more than 1 million followers, the investor is known for his bullish calls on bitcoin and said the asset has transitioned from a contrarian idea, to a "consensus idea on Wall Street in 2021." He expects more adoption next year from legacy companies buying bitcoin for their balance sheets, and eventually building dedicated business units.

Pompliano also highlighted moves in the bitcoin mining industry after China made the activity illegal, bitcoin's potential for global payments, and a "brain drain" underway from Big Tech and Wall Street.

"Bitcoin mining transitioned from a largely international activity to a US-centric activity in 2021. It would not surprise me to see new all-time highs in the bitcoin hash rate in 2022, along with continued market share growth for the US as a whole, along with Texas as a single state."

"We saw a major social media platform, Twitter, embrace the Lightning Network for payments in 2021 via Strike's API (I'm an investor). We also saw a nation state, El Salvador, embrace the Lightning Network for payments. We should expect multiple large Fortune 500 companies to embrace the Lightning Network in 2022 for payments."

"The brain drain from legacy technology and finance industry will continue. Young people, and increasingly the most skilled people, want to focus their talents on the industry where they can have the greatest impact. Crypto has been growing at an incredible rate, both in terms of new jobs, new companies, funding, economic value created, etc. This transition has only begun and will likely accelerate in 2022."

While this was a busy year for the crypto trade association in DC, "2022 is going to be way busier," Bond said. She also expects the SEC to come out with more enforcement actions.

"The Biden administration has been in office for a year. We're now presented with a window where something can get done on a bipartisan basis. And that will advance the industry and it will provide guardrails for market integrity and consumer protection."

"While final legislation may not actually take place, take effect in 2022. I think the direction of travel is going to be clear, and what we're doing in 2022 is setting the stage for 2023, 2024 and beyond."

"The balance is going to be one finding a policy framework in which the industry can flourish and the U.S. can benefit where consumers can also be protected."

The crypto exchange, founded by Tyler and Cameron Winklevoss, climbed to a $7 billion valuation this year and is among the dozens with a bitcoin ETF application in the works. Its COO, Noah Perlman, sees crypto payments going mainstream, more non-tech companies embracing the Metaverse, and more women jumping into a male-dominated market.

"More retail companies with household names will expand their crypto offerings, further legitimizing digital currencies as a form of payment and as an asset. Credit card companies such as Mastercard and Visa that offer crypto rewards will become more prevalent, which will make investing in digital assets as easy as swiping your card at a store."

"It's no surprise to see tech giants Apple, Meta, Snap, Alphabet, and Microsoft build out their Metatverse ecosystem, but we expect this trend will target other industries as we've seen with Nike's acquisition of RTFKT and Adidas launching an NFT collection called "Into the Metaverse".

"The profile of the typical crypto investor will change significantly in 2022. Previously, the typical crypto investor was a man in his 30s making more than $100,000 per year. We already saw some significant demographic shifts in the past year. According to Gemini's 2021 State of the US Crypto Report, 63 percent of U.S. adults are crypto-curious, meaning they don't yet own crypto but report interest in learning more or holding digital assets soon."

"We'll see an approval for a spot bitcoin ETF most likely in H1."

Ethereum has had a break-out year but new, alternative blockchains are popping up as platforms to build NFTs and other apps. Avalanche is among the new challengers to Ethereum. The president of Ava Labs, a former hedge fund trader, predicts a shake out of "speculative" assets, and a "brain drain" as software developers leave Big Tech in search of next wave of computing. He also expects bitcoin's market dominance to keep declining.

"We will continue to see inflows into smart contract platforms, DeFi, Gaming and metaverse. The winners will be the ones with strong growth of users, use cases and transaction activity. Speculative assets with no network effects will be the losers."

"BTC still has strong interest from both institutional and retail investors. Let's not forget that it has had a 10 year lead time compared to other platforms so it still has the biggest brand name out there. On the other hand, it's dominance over the crypto market is declining and will continue to do so."

"While these smart contracts platforms do compete with each other for developers, the real competition is with traditional web 2.0 companies like Google and Facebook. We are seeing tremendous interest from web 2.0 developers who want to now build on decentralized systems because they find web 3.0 to be a lot more creative and exciting."

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What the top crypto execs predict for the industry in 2022: Regulation and a Big Tech 'brain drain' - CNBC

We live in an era of big promises but results that fall far short of expectations. Take the failed construction startup Katerra. Founded in 2015, the company claimed it would use the approaches of digital and mass production industries, including glued and laminated mass timber products and modular design, to disrupt the construction industry, long seen as a bastion of backward, inefficient craft labor. Many people enthusiastically bought into this vision. Over six years, the company raised $3 billion, including $2 billion from Japanese telecom and investment giant SoftBank Group.

In 2021, the global construction industry had a market size of about $11.5 trillion. Any company that truly disrupted and claimed a large chunk of such a huge market would be one of the largest winners in industrial history. But Katerra was not to be that company. It failed for many reasons, including because it hubristically underestimated the complexity of construction. It went belly-up in June 2021.

Journalism and popular culture today are full of similarly large promises around a slew of other emerging technologies, including artificial intelligence, self-driving vehicles, the sharing economy and delivery apps, AI for healthcare, fusion energy, nanotechnology, bio-electronics of the Theranos kind, virtual reality, augmented reality, commercial drones, domestic robots, blockchain, the Internet of Things, asteroid mining, and smart homes. Yet, so far at least, the hype around these technologies far outweighs the creation of successful products and services and growing markets for them.

There is plenty of countervailing evidence that should lead us to question the dramatic claims made of these technologies and the health of an economy so deeply and highly invested in the tech sector. Yet the many setbacks and outright failures rarely lead industry leaders and boosters to reflect, instead of merely upping the promises.

Its now very well known among those who follow the economics of technology that the United States and other industrial nations have experienced pronounced low productivity growth since 2004, precisely the period during which we have heard some of the most exaggerated claims about some of the technologies listed above. Moreover, one of us (Funk) has published several articles demonstrating a gap between hype and reality: One such piece, for example, showed that artificial intelligence technologies are unlikely to produce significant productivity changes soon and will more likely give birth to slow incremental improvements over decades. Another showed that annual and cumulative losses for todays startups are far higher than those of previous decades, suggesting big problems in venture capital. If these new technologies are so great, why cant they make money?

More recently, however, we have found that the gap between promises and reality become even clearer when we compare much-hyped technologies of the past decade to new technologies of previous decades that did lead to significant change. To show just how ridiculous recent claims are, we gathered data on the revenues of new technologies from previous decades, with an emphasis on new ones that are purportedly behind the so-called digital transformation of companies, factories, homes, and roads. We find a fairly radical disconnect between newer technologies and what came before.

Most observers would consider 1950s computing and their electronic components, transistors, and integrated circuits to represent the beginning of the digital transformation. Mainframe computers began to have an impact in the 1950s and 1960s, minicomputers and robots in the 1960s and 1970s, and personal computers in the 1970s and 1980s, with packaged software for them not far behind. Behind these new computers were rapid improvements in microprocessors (from the late 1960s), memory (from the early 1970s), and graphic processors (from the early 1980s). These changes developed enormous markets. In 1989, for example, 21 million PCs were sold at an average of about $3,000 each for a total market of $63 billion ($132 billion in 2020 dollars).

Bigger changes began to occur in the 1990s as networking equipment enabled these computers to be connected both within and between companies, largely based on rapid improvements in fiber optics. The commercial internet was born. Construction of the internet accelerated, giving us e-commerce, enterprise software such as customer relationship management and manufacturing resource planning, and widespread use of mobile phones.

These changes also quickly led to large markets. E-commerce, internet hardware, and software, and mobile service revenues had reached $446 billion, $315 billion, $282 billion, and $230 billion respectively by 2000 (1998 for mobile services), all in 2020 dollars to simplify comparisons to subsequent decades. Internet-connected personal computers also likely led to significant economic growth, with a period of high productivity gains between 1994 and 2004 that outpaced both the period from 1970 and 2004 and the period between 2004 and the present.

The 2000s were the beginning of rapid growth for smartphones, cloud computing, online advertising, social networking, and e-books. Cloud computing had global revenues of $127 billion by 2010 (also in 2020 dollars), and online advertising of $81 billion by 2010. Facebook had 550 million users by the end of 2010. (Some of this growth accelerated during the end of the 2000s and thus the quoted figures are for a year after 2010.) The iPhone was introduced in 2007, and the App Store and Android phones followed in 2008. The global revenues for smartphonesreached $293 billion by 2012, pushing more people to mobile web browsing, navigation services, and a smattering of new apps.

We see something shifting in the 2010s, which were a decade of growing markets for existing technologies, but less so for new ones. Although revenues for e-commerce, cloud computing, smartphones, online advertising, and other technologies continued to grow, only one category of new technology had achieved $50 billion in sales by 2020. That was video streaming, which is more applicable to consumers than to corporate digital transformation efforts. (See the table below.) The next closest was big data/algorithms with $46 billion, tablet computers with $40 billion (the iPad introduced in 2010), and OLED displays with $32 billion in revenues; the latter is also not usually considered part of corporate digital transformation efforts.

Artificial intelligence, virtual reality, augmented reality, commercial drones, smart homes, and blockchain have even smaller markets. Even the Internet of Things had only reached 20% of the number of connected devices projected in 2012 for 2020 and most of those devices were smartphones. To add insult to injury, many hyped startups in these sectors, such as Uber, Lyft, Palantir, Airbnb, Bloom Energy, Nutanix, and Snap have cumulative losses of more than $3 billion each, the amount Amazon had at its peak; they are still unprofitable, and their total cumulative losses are $58 billion and rising.

[Market size of large current high-tech categories. Data from assorted market research reports; see links above.]

Again, contrast these market sizes with what came before: E-commerce, which was launched with the commercialized internet in the early 1990s, had reached $446 billion (in 2020 dollars) less than a decade later. Talk of smart homes began in earnest around the year 2000 but the U.S. market is only $20 billion today. OLEDs were first used in phones in 2007, yet their revenues were only $46 billion in 2020 and the first VR headset was released in 1991, yet its revenues are only $16 billion.

Big data and its successor, AI, are particularly disappointing because they are the technologies that were supposed to bring us the productivity improvements necessary for an accelerating digital transformation. Not only are their market sizes still small, but they have been heavily criticized for both impacting low-income and minority groups and for failing to deliver technically. Those concerns indicate that their impact on productivity growth might be even smaller than their market sizes suggest.

Without a strong base of growth in the 2010s, it is unlikely the newest technologies will achieve high market sizes by 2030.

Why is the slow growth in new technologies in the 2010s a problem? Among other reasons, because their future growth depends on the base that was established for them in the 2010s, and this base remains surprisingly weak. E-commerce, enterprise software, online advertising, social networking, and cloud computing now have huge markets because large bases for them were established decades ago in the 1990s and the 2000s, and as a result exponential growth has built from this large base. But without a strong base of growth in the 2010s, it is unlikely the newest technologies will achieve high market sizes by 2030, and thus they cannot have a big impact on productivity by then. This is simply how exponential growth works.

Explaining why the growth in new technologies was slow during the 2010s is a more complex and challenging question, one that must be left to other articles. The point we wish to make here is that digital transformation has not achieved what many had expected by 2020 and thus productivity improvements will likely take much longer to emerge than techno-optimists have thought they would take. Comparing market sizes between newer and older technologies adds to the pile of evidence suggesting that our current tech industry is not what its boosters claim it is. If we want higher productivity growth, we need to develop different ways of thinking, but first and most of all we must come to grips with the bleak realities of our era, with all of its big promises that simply havent delivered.

Jeffrey Funk is a consultant and a former professor at the National University of Singapore and Pennsylvania State University. Lee Vinsel is an assistant professor of science, technology, and society at Virginia Tech University and a cofounder of The Maintainers.

Link:

We're living in an age of big tech promises and small results - Fast Company