Weekend Must Read: The 10 point pattern of failure of healthcare tech companies

This says it all for startups and early stage companies in the healthcare tech field. We feature today Haverin Consulting’s Stuart Miller, continuing his analysis of the signs that a health tech company, no matter how hot it may seem, is on its way to failure. All four, from startup to spinoff, were name companies that at one point were valued at over $3 to over $4 billion. All failed to deliver their main value propositions while having excellent ‘cover’ for a time. All were either parted out (assets sold) or were total hull losses.

Mr. Miller has drawn out 10 factors from the success, then failure of four companies: Olive AI, IBM Watson Health, Carbon Health, and Babylon Health–this last, one that TTA chronicled as far back as 2014, through the palmy Matt Hancock days, their questionable SPAC, and right to their near-complete dissolution. Back in February, we featured his article analyzing the Carbon Health failure. But all four have been profiled in impressive deep dives, available for subscribers on his Substack account. He does feature extensive free material and definitely is worth the follow.

This is not a long cuppa but very much worth your time and pondering. All This Has Happened Before

Two weekend ‘must reads’: the New Yorker’s Sam Altman/OpenAI exposé–and comments; a further deep dive into Carbon Health’s implosion

Too long to summarize or opine on this week–but a must for your weekend reading. Grab the cuppa for the talk of AI World–a New Yorker dissection of Sam Altman, the CEO of OpenAI (link below). To say it is an exposé worthy, at first glance, of the Old School (ain’t no school like the Old School–Ed.) on probably the most important company of AD 2026 is to undersell it. It’s a long article and you’ll need at least one break.

OpenAI, founded as a non-profit with integrity at its core to “prioritize the safety of humanity over the company’s success, or even its survival”, recapitalized last year as a for-profit corporation with 26% of the shares owned by the OpenAI Foundation. It is now a trillion-dollar company that had no trouble raising a paltry $122 billion last week [TTA 2 April] though arguments are made that at least some of that money are IOUs or contingent. ChatGPT has become almost generic for AI, like Kleenex has become for tissues. The battles over control and direction of the company are now totally controlled by Sam Altman, whom former colleagues are not shy about pointing out his difficulty with the truth and a pattern of deceit, for instance to his board, to employees, and Microsoft. Yet everyone continues to do business with him. The FOMO Factor is very strong.

Mr. Altman makes extremely broad statements on the future of work (most traditional managerial, healthcare, and IT jobs will be taken over by AI, thus most of us will be unemployed), has easy access to President Donald Trump, as well as other world executives, and may, as the headline barks, control our future. Thus, he is a person of consequence.

My read so far of this is that within OpenAI, there is no one to counterbalance Mr. Altman’s immense ambition, his desire to dominate and win, not only with AI but also over all business and everyday life. These are character issues that also show up in aspects of his personal life, detailed in the article. If past results are predictive of the future, this flaw usually curdles into the desire to control countries and a complete disrespect for the rest of us leading our lives. 

Sam Altman May Control Our Future–Can He Be Trusted?

I will offer two LinkedIn comment posts on this article from an AI person I respect, the head of Curiouser.ai, Stephen Klein. Many of his posts on LinkedIn deal with what AI can and cannot do in business. He writes that he is “committed to designing technology that augments people, creates jobs, and elevates humanity. It’s time we all got back to thinking for ourselves.” 7 April, 8 April 

Our second Must Read is from Sergei Polevikov’s AI Health Uncut, a long analysis on the failure of Carbon Health and what it tells us in “this business we have chosen”. “What The Hell Went Wrong?” and its implications need answers–because it’s being repeated again and again. Today’s article (9 April) is Part 1 of 2, sets the stage about the mistakes made (insiders talk) and, with full credit, springboards off Stuart Miller’s (Haverin Consulting) original analysis made at the time of the Chapter 11 reorg. What we called the ‘Ominous Parallels’ was a Must Read here on 12 February.  TTA (as Telecare Aware, our original name) and this article are also mentioned twice (thanks!).

Those who have yet to subscribe for Mr. Polevikov’s analytic, erudite, and revealing (Emperor’s New Clothes!) POVs can read part of this article for free–but seriously, if you’re in this business, the subscription is worth your money. He also podcasts (links are on his Substack, link at lower right sidebar).

An early and scandalous publisher (before he utterly lost it), Matt Drudge, used to say that he ‘went where the stink is’. Mr. Polevikov does the same. The stink is of our broken primary care reimbursement system, the Covid steroids that pumped up the company, flailing management running through money like drugs, and good ideas for patient care buried under incompetence. 

Must Read: an excellent analysis on Carbon Health’s bankruptcy–and the Ominous Parallels

Carbon Health isn’t an outlier. It’s part of a trend that founders and senior managers must beware. This Editor didn’t know much about Carbon Health when news of its bankruptcy made the news [TTA 7 Feb]. It was of interest because of its telehealth roots and its growth into a current combination of bricks-and-mortar primary care with telehealth. The liabilities were king sized but the way out they chose was unusual, a combination of a sale and a reorganization.

In context and by comparison, Carbon Health follows a path of inevitable failure trod by two other companies, Olive AI and IBM Watson Health. 2022, an ‘in the money’ year for some, was the finis year for all these companies.

  • Olive AI started to fall apart in late 2022, was closed or parted out a year later, and was a classic case of a company that was overfunded, all over the healthcare map, and finally ran out of time and money. (It was also funded heavily by General Catalyst, another red flag.)
  • IBM Watson Health was originally a company that everyone wanted to like with playing chess on Jeopardy. As it grew, it became less lovable and, just like Olive AI, started to pursue multiple lines of business without a solid track record on their main lines as it gobbled up smaller companies. It started to go sideways as early as 2020, it repeatedly failed in high profile pilots with major healthcare organizations, parts were sold off, then the remainder sold by IBM by July 2022. Most of it still does business as Merative, maintaining a very low profile.
  • Carbon started to fail in 2022 as the pandemic tide receded, their overextension was revealed, and their growth plans collapsed; despite buckets of cash extended by CVS and other investors, it was well on the road to bankruptcy. Their creation of and practice dependence on a proprietary EHR in retrospect was mind-boggling.

Get the cuppa and settle in. Stuart Miller of Haverin Consulting, writing on Substack (free article), draws the Ominous Parallels among the three companies first on a seven-point comparison grid: peak valuation (always inflated), core promise (always 35,000 feet), growth strategy (always hyper), strategic overreach (always too complex), technology gap (always aggravated by overreach), demand dependency (always a fadeaway), and outcome (inevitably, failure). He then illustrates what your company should avoid. What are the lessons smart founders and funders should be minding? If you’re a potential partner, investor, or a board member, what are the yellow and red flags? The deal breakers? The simple questions the company should be able to answer?

The subscriber version goes into far greater detail and is recommended if you have earnest money or your future at stake in digital health companies.