Monday, April 1, 2019

It May Be TikTok for U.S. Health Tech

Please don't let me write about TikTok.  Please don't let me write about TikTok.  Please don't...oh, all right, I'm going to write about TikTok.

That's the kind of power it has over people.

TikTok, in case you aren't (yet) aware of it, is a new(ish) social media platform, featuring short videos.  Think of a more successful Vine (now defunct), or a maybe Instagram with videos.  Another comparison might have been Musical.ly, but that was acquired by TikTok's owner, ByteDance Ltd., in November 2017 and was merged with TikTok last summer

TikTok makes it easy to create and view short videos, often with music or other sound effects, and to view videos that others have created.  It, too, uses #hashtags to create memes.  The word that is often used -- at least by those not on the app -- for many of these creations is "cringe," and the more cringeworthy, the better.

It is wildly successful, with over 1 billion downloads on Android and iOS -- and that doesn't count all of its downloads on China.  It had more downloads in 2018 than Instagram, if you're keeping track, and last fall its monthly downloads started surpassing not just Instagram but also Facebook, YouTube, and Snapchat, even in the U.S.  By last summer it had already claimed 500 million users across 175 countries. 


If all that isn't impressive enough, ByteDance secured funding last fall that would value it at $75b, which, at the time, was more than Uber was valued at, and I'll bet you've heard of Uber.

Two things attracted my attention to TikTok.  First, the mainstream media is starting to be all over it.  Without much effort, I found recent articles in The New York Times, NBC News, The Conversation, TechCrunch, Rolling StoneBusiness Insider, CNN, and Quartz, among others.  The New York Times discussed "How TikTok Is Rewriting the World," The Conversation described it as "TikTok: the world's most valuable start-up that you've never heard of," and TechCrunch warned "It's time to pay serious attention to TikTok."

TechCrunch was blunt about TikTok's significance:
 Here comes the new new internet, folks. It’s big, dominated by emerging markets, mobile, video, meme-ified, and goes viral both online and off. 
So if you haven’t been paying attention to TikTok, you may want to get started.
Second, ByteDance is a Chinese company, and TikTok began as an app in China (where it is known as Douyin).  China has its own constellation of apps and tech companies that rival any that the U.S. produces, such as WeChat, but most of their success has been in China, where outside competition is often constrained.  TikTok is one of the first to really break through internationally.  Financial Times speculates that it may provide a "roadmap" for such international success. 

TikTok is different than other social media platforms because it is not really built around your social network or celebrities you've chosen to follow.  John Herrman, writing in The New York Times, says TikTok:
has stepped over the midpoint between the familiar self-directed feed and an experience based first on algorithmic observation and inference...It’s full of things that you seem to have demonstrated you want to watch, no matter what you actually say you want to watch.
It is important to note that ByteDance's other main holding is news app Toutiao, which uses A.I. to learn user's preferences and create customized news feeds for them.  It uses similar A.I. algorithms to produce video feeds for TikTok. 

By its own admission, ByteDance is not a social media company, it's an A.I. company.  Facebook and Google may be going there, but ByteDance is starting there. 

TikTok's success hasn't been all smooth sailing.  It's still trying to figure out more Western markets, and earlier this year was hit by the FTC with a "record fine" for violations of the Children's Online Privacy Protection Act (COPPA) due to its its collection of personal data on children younger than 13. 

All that may (or may not) be interesting, but what does it have to do with health or healthcare?  Nothing about TikTok is aimed at our health, our use of healthcare services, or our healthcare system(s).

Yet. 

For example, more recently, Mr. Herrman noted that: "It’s an app that’s unapologetic about wasting your time. It’s also, apparently, a good way to waste some time at work," citing a number of videos done by people in their workplace.  If you don't think there are cringeworthy videos to be done about our healthcare, you haven't been paying attention.  

It may be that the current TikTok users tend to be too young to have much interaction with the healthcare system, but when they do -- and they will -- we can expect that some of them will produce some TikTok content about those interactions.  #ThisIsStupid or #CanYouBelieveThis.  

More importantly, TikTok may just be the trailblazer for other Chinese apps, as Financial Times suggested.  Healthcare is one area where China is investing heavily, and much of that investment revolves around A.I.  A.I. is not constrained by geography or by borders on a map; if you can build it, they can come.

When Baidu or other Chinese leaders in A.I. healthcare become more successful, it will be tempting for them to follow TikTok's lead in venturing overseas.  They may view U.S. regulations about the practice of medicine differently than a U.S.-based corporation might. 

Telemedicine within the U.S. may still be struggling to deal with the many licensing and regulatory barriers that exist, but a Made-in-China A.I. telehealth app may leap them entirely, forcing regulators to try to figure out who should attempt to deal with them how under what existing laws.  It'd be Uber all over again; the game may be up before the regulators realize what is happening.  

It may not be TikTok, but it could be ByteDance, or it could be one of many other Chinese A.I. leaders.   But in a world where we are used to speculating on the healthcare ambitions of U.S. tech giants, it'd be prudent to pay attention to China's ambitions as well.  

TikTok may mean Tick Tock for many U.S. healthcare companies.


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