The Signal: Nearly half (44%) of employers ranked musculoskeletal issues as the No. 1 condition impacting their healthcare costs, according to a 2019 study of nearly 150 large employers, while 85% said musculoskeletal issues were in the top 3. Half of Americans report back and joint pain, costing employers $100B+ annually. With many of these workers in crucial supply chain roles (factories, farming, package delivery, etc.), the potential cost of a breakdown is higher than ever before as countries navigate the COVID-19 pandemic.
To address the issue at scale, companies are turning to digital musculoskeletal (MSK) solutions. Similar to mental wellness apps, digital MSKs offer a combination of education, guided practice, and telehealth services, making care more convenient and affordable for employees.
The Opportunity: Despite the high cost of inaction, less than 23% of employers currently offer a digital MSK solution, according to the Business Group on Health, which conducted the 2019 survey of large companies. That number is expected to more than double in the coming years, with an additional 38% of employers considering offering one by 2022. The companies surveyed managed a total of 15m employees, meaning millions of users in the US alone.
This multibillion-dollar market is still largely up for grabs, with just a few notable competitors:
What to Build: The two biggest problems musculoskeletal rehab faces are convenience (enabling employees to do rehab on their schedule) and adherence (making sure they stick with the program). Technology -- such as smartphone apps -- offers the most interesting solutions to these problems, using new tools to give patients access to rehab from anywhere, and creating accountability by tracking their progress.
While some MSK apps already exist, a look at their reviews offers a few early ideas on how to stand out. Some reviewers request different language settings (e.g., Spanish), while others indicate that aging parents are using the apps, suggesting more need for products that suit an elderly population.
You could also create an app designed to treat specific injuries. Kiio, for example, focuses on the lower back.
One study of 8m annual operating-room procedures found that 5 of the 7 most common types involved the musculoskeletal system -- including knee arthroplasty (700k); laminectomy, removal of part of the spine (468k); hip replacement (468k); spinal fusion (451k); and partial excision of bone (338k).
Each of these could potentially be the focus of an MSK app.
How to Build It: The most fundamental part of physical rehab is being able to observe and judge someone’s range of motion. That’s still best handled by a trained therapist. But digital solutions that use motion-tracking technology to track your progress can help patients and therapists collaborate remotely.
You don’t have to create motion-tracking software from scratch. There are lots of off-the-shelf options which can make your job easier, one motion-tracking expert told us. The major differences lie in the speed and accuracy of tracking, and the one you choose depends on your budget and need for precision. Suggestions for starters:
- This demo shows how to do “pose estimation” using a webcam.
- OpenPose is free software that offers 2D and 3D motion tracking for use in non-commercial research projects.
- Wrnch allows you to buy motion-tracking services, rather than developing them.
How to Sell It: For advice on how to approach prospective clients in this space, we talked to people Gloria Chan Packer. Packer has built her company, Recalibrate, around delivering employee wellbeing to employers. She offered 2 key questions founders need to answer before approaching prospective clients:
- What demographic needs your solution most? This will help you identify potential clients.
- How will clients measure the ROI of your program?
“Companies know [employee wellbeing] is valuable, but are increasingly leery of new wellness benefits, just because there are so many of them popping up,” she said, referring to the broad spectrum of employee wellness programs available. The key to getting in the door is to get clear and concise on the benefit you provide, and find alignment between what you offer and the type of client you approach.
Alisa Avelar, an HR professional who’s passionate about employee benefits, offered additional thoughts on how to sell to HR teams:
- Know the Business: “Know enough about my business to know what’s relevant,” she says. You should understand the actual needs of employees, as well as the unique policies companies in your target industry use to manage time off and medical leave.
- Make it Easy to Use: “Cost is not always the primary driver in adopting or dropping a benefit,” Avelar said. She cares more about making sure her employees can actually use a service. “If it’s not easy for my employees to use,” she says, “forget it.”
- Make it Easy to Buy: A simple fee structure that’s not a burden on employees makes an app compelling. A straight employer cost, with no co-pay for employees, is ideal. Avelar points to HealthiestYou as a favorite for its simple cost structure and ease of use.
Getting to Market: Even with the head start that off-the-shelf tools offer, building an app takes time -- time that’s always in short supply as your startup battles for funding and financial runway. In order to make it to market, one motion-tracking expert suggested that rather than building a medical-grade product out of the gate, founders start by identifying and solving a simpler problem that demands less precision, allowing them to build and refine the technology without needing 100% accuracy. Custom SnapChat filters, for example, are in-demand and are built on some of the same underlying computer vision technology as digital MSKs like Reflexion. But the stakes for users aren’t as high if the initial motion-tracking isn’t perfect.
“If you solve a simple problem and find a forgiving market,” our app expert told us, “you might have the runway to then get better and target more complex use cases.”
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