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SAN FRANCISCO — Esther Dyson is one of the most active investors in the rapidly emerging health IT sector. But she recently ceased investing to focus her attention on a new challenge, “HICCup.”

At Rock Health’s Innovation Summit, a conference focused on digital health, Dyson offered insight into her ambitious plan to improve healthy living throughout America.

“Investing is not a transaction like sex … it’s like raising children, and I’m trying to raise one whopping child,” said Dyson on stage during her interview.

That whopping child is HICCup, an initiative to set up citywide health intervention programs in five or six communities of 100,000 people or fewer. HICCup’s team of “counselors” will work with community leaders and spokespeople in these cities to make small and everyday changes to improve health, like a Friday night soccer game or new school lunch options.


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The process of fundraising, recruiting cities and building a team of experts for HICCup is still underway.

The program is about preventing diseases, not just finding cures. For Dyson, new consumer technologies and gadgets, like the Fitbit or Jawbone’s UP, are causing people to think more deeply about health and nutrition, which offers the opportunity for entrepreneurs to make a real difference.

Improving health everywhere — not just in Silicon Valley

Over breakfast prior to the keynote, Dyson took one look at the vanilla-flavored yogurt and politely asked for a plain, sugar-free alternative. Most people wouldn’t have the confidence, or even think to ask about, healthier alternatives.

I ask Dyson about her five-year goal for HICCup. “Early promising results,” she said, results that she can use to inspire other communities in America and give people the confidence to demand better.

According to Dyson, the communities selected for HICCup should actively want to be a “better place to live [and for their] children to be healthier,” even if the decks are stacked against them.

HICCup will support these communities in any way it can, including helping them forge partnerships with larger health companies. HICCup will measure over time how some of the new programs are actively making a difference — “‘big data’ up the wazoo,” Dyson puts it.

Ultimately, the community will do the bulk of the work.

“We want to encourage collaboration between local stakeholders, like employers who would like their employees to be at work rather than the clinic, the mayor who’s interested in bringing in new business, and townspeople who are interested in creating a better life for themselves and their families are key,” Dyson explained.

Improving health care in small-town America

Dyson is a frequent visitor to Silicon Valley. She’s on the board of a number of health companies, including personal genomics company 23andme.

She noticed a surging interest in digital health among tech entrepreneurs and venture capitalists. Rock Health gathered data to support this contention — the accelerator recently predicted a record year for digital health investments.

However, while this excitement in digital health is positive, some entrepreneurs are tackling minor problems and building “apps, when they ought to be building companies,” Dyson explained.

“Everyone wants to do the for health care,” said Dyson. “The first three will be acquired, and the next 10 will pivot.” As an investor, she looked for companies that would add value and be sustainable in the long-term.

Dyson fears that many of the early-stage health IT startups are too insulated in Silicon Valley, one of the wealthiest communities. She recommends breaking out of “the bubble,” and having conversations with the “99 percent,” people who are balancing family budgets around healthy food every day.

Wide-open opportunities in digital health?

Still, entrepreneurs are tackling a variety of problems in the health sector, whether it’s patient experience apps, nutrition and wellness, social networking sites for doctors, or cloud and communication services.

Certain problems are not being adequately addressed.

Dyson believes the next big challenge is “noninvasive blood biomarker analysis.”

This may seem like a mouthful, but in practice, it means developing better ways for people to manage and measure their health. It’s more than just tracking daily fluctuations in your weight — it’s about helping diabetics monitor their blood sugar or check cholesterol in real time.

Dyson”The best thing I can do for the digital health ecosystem now is to prove, through these pilots and HICCup, that entrepreneurs can make a real impact,” she said.

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