In the Ecosystm Predicts: The Top 5 Healthcare Trends in 2022we have said that 2022 will be the year when we start seeing the second-order impacts of the pandemic and we will see healthcare providers address these impacts. This means an increase in tech adoption and a greater (and in some cases, renewed) interest in tech providers to focus on the Healthcare industry.
Last month, we saw announcements of Francisco Partners acquiring the healthcare data and analytics assets from the IBM Watson Health business unit. This was neither unexpected nor an isolated news – it follows a series of significant Healthcare tech news from last year.
Here are some announcements from 2021 that I feel give us an indication of where the Healthcare tech market is headed.
Oracle’s acquisition of Cerner
Microsoft’s continued focus on Healthcare with the Nuance acquisition
The acquisition of athenahealth by private equity firms
Examples of the focus on mental health such as the creation of Headspace Health
The interest of consumer apps in Healthcare as witnessed by Peloton’s corporate wellness programme.
Read on to find out more about these announcements. And let me know what you think is the most interesting Healthcare tech announcement in the last year.
Here are the 3 key emerging trends in the data centre market:
#1 Top cloud providers drive webscale investment but are not alone
The webscale sector’s big cloud providers have accounted for much of the recent CapEx surge. AWS, Google, and Microsoft have been building larger facilities, expanding existing campuses and clusters, and broadening their cloud region footprint into smaller markets. These three account for just under 60% of global webscale tech CapEx over the last four quarters. Alibaba and Tencent have been reinforcing their footprints in China and expanding overseas, usually with partners. Numerous smaller cloud providers – notably Oracle and IBM – are also expanding their cloud services offerings and coverage.
Facebook and Apple, while they don’t provide cloud services, also continue to invest aggressively in networks to support large volumes of customer traffic. If we look at Facebook, the reason becomes clear: as of early 2021, they needed to support 65 billion WhatsApp messages per day, over 2 billion minutes of voice and video calls per day, and on a monthly basis their Messenger platform carries 81 billion messages.
The facilities these webscale players are building can be immense. For instance, Microsoft was scheduled to start construction this month on two new data centres in Des Moines Iowa, each of which costs over USD 1 billion and measures over 167 thousand square metres. And Microsoft is not alone in building these large facilities.
#2 Building it all alone is not an option for even the biggest players
The largest webscalers – Google, AWS, Facebook and Microsoft – clearly prefer to design and operate their own facilities. Each of them spends heavily on both external procurement and internal design for the technology that goes into their data centres. Custom silicon and the highest speed, most advanced optical interconnect solutions are key. As utility costs are a huge element of running a data centre, webscalers also seek out the lowest cost (and, increasingly, greenest) power solutions, often investing in new power sources directly. Webscalers aim to deploy facilities that are on the bleeding edge of technology. Nonetheless, in order to reach the far corners of the earth, they have to also rely on other providers’ network infrastructure. Most importantly, this means renting out space in data centres owned by carrier-neutral network operators (CNNOs) in which to install their gear.
The Big 4 webscalers do this as little as possible. For many smaller webscalers though, piggybacking on other networks is the norm. Of course, they want some of their own data centres – usually the largest ones closest to their main concentrations of customers and traffic generators. But leasing space – and functionalities like cloud on-ramps – in third-party facilities helps enormously with time to market.
Oracle is a case in point. They have expanded their cloud services business dramatically in the last few years and attracted some marquee names to their client list, including Zoom, FedEx and Cisco. To ramp up, Oracle reported a rise in CapEx, growing to USD 2.1 billion in the 12 months ended June 2021, which represents a 31% increase from the previous year. However, when compared to Microsoft’s spending this appears modest. Microsoft reported having spent USD 20.6 billion in the 12 months ended June 2021 – a 33% increase over the previous year – to help drive the growth of their Azure cloud service.
One reason behind Oracle’s more modest spending is how heavily the company has relied on colocation partners for their cloud buildouts. Oracle partners with Equinix, Digital Realty, and other providers of neutral data centre space to speed their cloud time to market. Oracle rents space in 29 Digital Realty locations, for instance, and while Equinix doesn’t quantify its partnership with Oracle, Oracle’s cloud regions across the globe access the Oracle Cloud Infrastructure (OCI) via the Equinix Cloud Exchange Fabric. Oracle also works with telecom providers; their Dubai cloud region, launched in October 2020, is hosted out of an Etisalat owned data centre.
#3 Carrier-neutral data centre investment is surging in concert with webscale/cloud growth
As the webscale sector has raced to expand over the last 2 years, companies that specialise in carrier-neutral data centres have benefited. Industry sources estimate that as much as 50% or more of the cloud sector’s total data centre footprint is actually in these third-party data centres. That is unlikely to change, especially as some CNNOs are explicitly aiming to build out their networks in areas where webscalers have less incentive to devote resources. It’s not just about the webscalers’ need for space; the need for highly responsive, low latency networks is also key, and interconnection closer to the end-user is a driver.
Looking at the biggest publicly traded carrier-neutral providers in the data centre sector shows that their capacity has expanded significantly in the last few years (Figure 1)
Some of this new investment target core facilities in the usual high-traffic clusters, but some also target smaller country markets (e.g. STT’s new Bangkok-based data centre), and the network edge (e.g. EdgeConneX, a portfolio company of private equity fund EQT Infrastructure).
EdgeConneX is a good example of the flexibility required by the market. They build smaller size facilities and deploy infrastructure closer to the edge of the network, including a PoP in Boston’s Prudential Tower. The company offers data centre solutions “ranging from 40kW to 40MW or more.” They have built over 40 data centres in recent years, including both edge data centres and a number of regional and hyperscale facilities across North America, Europe, and South America. Notably, EdgeConneX recently created a joint venture with India’s property group Adani – AdaniConneX – which looks to leverage India’s status of being the current hotspot for carrier-neutral data centre investment.
As enterprises across many vertical markets continue to adopt cloud services, and their requirements grow more stringent, the investment climate for new data centre capacity is likely to remain strong. Webscale providers will provide much of this capacity, but carrier-neutral specialists have an important role to play.
HPE’s recent announcements show customers that GreenLake is an end-to-end solution for managing their IT infrastructure moving forward. It ticks all the boxes: providing flexibility and scalability; the advantage of using both data centre and cloud; and high manageability and security with a full suite of applications.
Examples are the partnership with Azure Stack HCI, to add to earlier ones with leading vendors like SAP, Citrix, and VMware. HPE is building a platform that provides customers with the comfort that they can adopt GreenLake and pretty much have access to any application they may choose to implement – offering full coverage from the Edge to the Cloud. It is extremely interesting that GreenLake allows the option of switching on and switching off processor cores as needed, and the customer pays based on usage. This is surely a first for the industry!
Another example is Lighthouse, which allows the customer to rapidly configure, and provision workloads based on dynamic needs. While all the hyperscalers provide similar services when the workload is on the cloud, Lighthouse allows the same flexibility and speed for cloud services which can be run in the data centre, on-prem, co-located, or even at the Edge.
A third example was the announcement of Project Aurora which will add an additional security layer from validating the input data all the way to verifying the workload at the start and then as it is running. It appears to use an AI/ML system that checks for unexpected behaviours to detect any kind of malware.
It makes good sense for HPE to push GreenLake and move to offering ‘everything-as-a-service’. As one of the incumbent enterprise hardware business leaders, this is a good response rather than to watch one’s business continue to shrink YoY. GreenLake is HPE’s way of futureproofing themselves and making sure they stay relevant in the new cloud world.
Cisco Secures the Hybrid Workplace
Cisco has been active launching Cisco Plus earlier this year, as their bridge to the as-a-service model with a network-as-a-service (NaaS) offering. Somewhat like GreenLake, Cisco Plus offers flexible consumption for compute, storage, and networking. They are committed to offering most of their portfolio as-a-service over time.
Cisco has shown some resilience in terms of revenue but has still been struggling to grow. After a steady growth since 2017, the revenues dropped by 7% in 2020 almost as a direct impact of COVID-19. The post-pandemic world has the potential of being a bigger threat for Cisco. Many estimates show the number of people working from home is likely to go up dramatically and Cisco’s key networking offering could rapidly become redundant. However, at Ecosystm we believe that the hybrid work model will be predominant.
Cisco is also betting on a hybrid world. No matter where one works from, there are networking needs. Cisco’s focus, therefore, is on security – this will be on the mind of virtually any enterprise as it chalks out its future strategy. With a hybrid environment, making everything secure becomes more complex while continuing to be vital. Cisco has a heavy emphasis on Secure Access Service Edge (SASE) – the idea that the security envelope now has to be a flexible form that has a presence everywhere that the enterprise needs to be. This will make a lot of sense to most enterprises as they tread the hybrid path.
Cisco will offer a portfolio of tools to make it increasingly easier for customers to use multi-cloud, multi-vendor environments, offering the best of both worlds.
Oracle Incentivises Cloud Migration
Oracle has a different approach because they are trying to solve a different problem. They are competing with the hyperscalers, while fully acknowledging a hybrid world. However, as a company with less legacy in hardware, it makes sense for them to focus on migrating to cloud rather than on hybridisation. Oracle has just announced that they will subsidise existing customers who add cloud workloads with them, by providing discounts on the existing licensing fees that the customer is paying Oracle. This discount appears to be around 25% to 33%. In essence, this means that if a customer spends about USD 100k with Oracle on licensing and decides to start moving workloads to the Oracle Cloud worth somewhere between USD 300-400k, they can potentially write off the entire license fees they are currently paying!
There is a strong effort from every vendor right now to retain and consolidate their customer share and build a vision that convinces the customer that they are the way to go. For the traditional hardware players that vision is of a hybrid world – attractive to today’s large enterprise. For the likes of AWS, Microsoft, Google, and Oracle it is all about moving the customer to their cloud. The assumption of course is that moving someone to your cloud will lead to more of your apps being used by the customer. For the hardware vendors like Cisco and HPE, it is all about moving the customer to their own platforms which empower hybridisation. In all cases, a necessary component is to offer ‘everything-as-a-service’ upending the traditional models of selling.
In my opinion, with time the IaaS portion of the cloud is likely to gradually devolve into something like a utility. There will be a lot of upheavals and market disruption before we get there, but eventually, software and other services are likely to stand separate from the infrastructure provider. All the vendors are therefore depending on capturing the customer at the platform-as-a-service (PaaS) level, but even this is likely to get commoditised over time. Eventually, the winners will be disparate providers of the best applications for different functions. Meanwhile, we are in for an extremely interesting ride as we see all the vendors jockeying for space!
The Need to enable Foundational Shifts. The younger generation is more aware of environmental, social and governance issues that the world continues to face. Many of the countries in the region are emerging economies, where these issues become more apparent. COVID-19 has also inculcated an empathy in people and they are thinking of future success in terms of impact. The desire to enable foundational shifts is giving direction to the transformation journey in the region. The wonderful new paradigm that is the Digital Economy allows us to cut across all segments; and technology and its advancements has immense potential to create a more sustainable and inclusive future for the world.
Realising the Power of Momentum. The pandemic has caused major disruptions in the region. But every crisis also presents an opportunity to perhaps re-imagine a brighter world through a digital lens.The other thing that the pandemic has done is made people and organisations realise that to succeed they need to be open to change – and that momentum is important. As organisations had to pivot fast, they realised what I have been saying for years – we shouldn’t “let perfect get in the way of better”. This adaptability and the readiness to fail fast and learn from the mistakes early for eventual success, is leading to faster and more agile transformation journeys.
Where are we seeing the most impact?
Industries are Transforming. There are industries such as Healthcare and Education that had to transform out of a necessity and urgency brought about by the COVID-19 pandemic. This has led to a greater impetus for change and optimism in these industries. These industries will continue to transform as governments focus significantly on creating “Social Safety Nets” and technology plays a key role in enabling critical services across Health, Education and Food Security. Then there are industries, such as the Financial Services and Retail, that had a strong customer focus and were well on their digital journeys before the pandemic. The pandemic boosted these efforts.
But these are not the only industries that are transforming. There are industries that have been impacted more than others. There are several instances of how organisations in these industries are demonstrating not only resilience but innovation. The Travel & Hospitality industry has had several such instances. As business models evolve the industry will see significant changes in digital channels to market, booking engines, corporate service offerings and others, as the overall Digital Strategy is overhauled.
Technologies are Evolving. Organisations depended on their tech partners to help them make the fast pivot required to survive and succeed in the last year – and tech companies have not disappointed. They have evolved their capabilities and continue to offer innovative solutions that can solve many of the ongoing business challenges that organisations face in their innovation journey. More and more technologies such as AI, machine learning, robotics, and digital twins are getting enmeshed together to offer better options for business growth, process efficiency and customer engagement. And the 5G rollouts will only accelerate that. The initial benefits being realized from early adoption of 5G has been for consumers. But there is a much bigger impact that is waiting to be realised as 5G empowers governments and businesses to make critical decisions at the edge.
Tech Start-ups are Flourishing. There are immense opportunities for technology start-ups to grow their market presence through innovative products and services. To succeed these companies need to have a strong investment roadmap; maintain a strong focus on customer engagement; and offer technology solutions that can fulfil the global needs of their customers. Technologies that promote efficiency and eliminate mundane tasks for humans are the need of the hour. However, as the reliance on technology-led transformation increases, tech vendors are becoming acutely aware that they cannot be best-in-class across the different technologies that an organisation will require to transform. Here is where having a robust partner ecosystem helps. Partnerships are bringing innovation to scale in Asia.
We can expect Asia to emerge as a powerhouse as businesses continue to innovate, embed technology in their product and service offerings – and as tech start-ups continue to support their innovation journeys.
Ecosystm CEO Amit Gupta gets face to face with Garrett Ilg, President Asia Pacific & Japan, Oracle to discuss the rise of the Asia Digital economies, the impact of the growing middle class on consumerism and the spirit of innovation across the region.
The one area where they were impacted most is security. In his report, Cybersecurity Considerations in the COVID-19 Era, Ecosystm Principal Advisor Andrew Milroy says, “The extraordinary growth of Zoom has made it a target for attackers. It has had to work remarkably hard to plug the security gaps, identified by numerous breaches. Many security vulnerabilities have been discovered with Zoom such as, a vulnerability to UNC path injection in the client chat feature, which allows hackers to steal Windows credentials, keeping decryption keys in the cloud which can potentially be accessed by hackers and the ability for trolls to ‘Zoombomb’ open and unprotected meetings.”
“Zoom largely responded to these disclosures quickly and transparently, and it has already patched many of the weaknesses highlighted by the security community. But it continues to receive rigorous stress testing by hackers, exposing more vulnerabilities.”
However, Milroy does not think that this issue is unique to Zoom. “Collaboration platforms tend to tread a fine line between performance and security. Too much security can cause performance and usability to be impacted negatively. Too little security, as we have seen, allows hackers to find vulnerabilities. If data privacy is critical for a meeting, then perhaps collaboration platforms should not be used, or organisations should not share critical information on them.”
Zoom to increase Capacity and Scalability
Zoom is aware that it has to increase its service capacity and scalability of its offerings, if it has to successfully leverage its current market presence, beyond the COVID-19 crisis. Last week Zoom announced that that it had selected Oracle as its cloud Infrastructure provider. One of the reasons cited for the choice is Oracle’s “industry-leading security”. It has been reported that Zoom is transferring more than 7 PB of data through Oracle Cloud Infrastructure servers daily.
In addition to growing their data centres, Zoom has been using AWS and Microsoft Azure as its hosting providers. Milroy says, “It makes sense for Zoom to use another supplier rather than putting ‘all its eggs in one or two baskets’. Zoom has not shared the commercial details, but it is likely that Oracle has offered more predictable pricing. Also, the security offered by the Oracle Cloud Infrastructure deal is likely to have impacted the choice and it is likely that Oracle has also priced its security features very competitively.”
“It must also be borne in mind that Google, Microsoft and Amazon are all competing directly with Zoom. They all offer video collaboration platforms and like Zoom, are seeing huge growth in demand. Zoom may not wish to contribute to the growth of its competitors any more than it needs to.”
Milroy sees another benefit to using Oracle. “Oracle is known to have a presence in the government sector – especially in the US. Working with Oracle might make it easier for Zoom to win large government contracts, to consolidate its market presence.”
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