In June of this year, the American data think tank CB Insights released a research report summarizing the recent strategic deployments of tech giants such as Amazon, Google, Microsoft, and NVIDIA in the healthcare sector.

Looking at acquisitions, partnerships, licensing agreements, and investments among the companies, from January 1, 2021, to May 21, 2024, NVIDIA has concluded over 801 collaborations, Google has over 352, Amazon has over 222, and Microsoft has over 100.

In terms of investment or financial commitment, currently, NVIDIA's direct and indirect revenue in the healthcare industry has already surpassed $1 billion and could potentially reach tens of billions in the future. In 2022, Microsoft invested $19.7 billion in the acquisition of the intelligent voice company Nuance, whose technology is used by most hospitals and doctors in the United States. Additionally, tech giants like Apple, Amazon, and Google have cumulatively invested at least several billion dollars in the healthcare field over the years.

The enterprises that have shaped countless legends in the technology and internet sectors over the past three decades are now attempting to use their expertise in cloud computing, AI, and hardware development to transform the healthcare industry. These tech giants are actively penetrating the healthcare sector through strategic investments, establishing cooperative relationships, and product development, aiming to capture this new market high ground.

In 2022, the total healthcare expenditure in the United States reached $4.46 trillion, accounting for 17.3% of GDP, and provided 11% of employment opportunities in the country, indicating a vast market potential.

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In addition to the actively deploying American tech companies, SoftBank Group has also been attracted by the healthcare market and has invested in numerous healthcare enterprises in recent years. In June of this year, SoftBank and the American AI precision medicine company Tempus AI jointly established a joint venture, Pegasos, in Japan, offering clinical sequencing, patient data management, and data-based medical services. Recently, according to media reports, SoftBank has invested another $10 billion in AI-related projects.

For tech giants, the healthcare industry represents a vast market waiting to be explored, filled with opportunities and challenges. The giants, who have been competing in the internet and IT sectors for many years, are unwilling to fall behind in this new arena.

NVIDIA: Betting Big on AI + Healthcare

On June 28, NVIDIA CEO Jen-Hsun Huang conducted an interview with Chris Gibson, the co-founder and CEO of the American biotechnology company Recursion, discussing NVIDIA's positioning in the healthcare sector.

During the interview, Huang pointed out that NVIDIA's goal is to support and empower other companies and researchers by providing advanced technology to promote the development of the healthcare industry, especially in drug discovery and personalized medicine.Recursion is one of the many AI pharmaceutical companies invested in by NVIDIA. In 2023, NVIDIA made a significant push into the field of AI pharmaceuticals, investing in 10 AI pharmaceutical companies within a year, with the highest investment amount reaching $273 million. Jen-Hsun Huang has pointed out on more than one occasion that "AI+Pharmaceuticals" will become the next "golden track."

AI pharmaceuticals is just one of the many focal points for NVIDIA's entry into healthcare. Observing NVIDIA's investment events since 2023, in addition to AI pharmaceuticals, which account for the largest proportion, there are also deployments in areas such as surgical robots, medical imaging, and health management platforms.

In the winter when the frequency of investment in healthcare plummeted and investment institutions were pulling back, NVIDIA was advancing vigorously, continuously improving its own technological ecosystem through investment and expanding its business map in the healthcare field.

As a supplier of basic hardware equipment, NVIDIA needs to continuously explore more downstream industries that require continuous strong computational power support to sustain their upstream business volume. In the field of AI+healthcare, many scenarios are worth exploring. With NVIDIA's increasing penetration rate in the industry, what lies ahead is a huge market of tens of billions or even hundreds of billions of dollars.

Taking NVIDIA's investment in Recursion as an example, at the same time as the investment news was released, there was also a cooperation between the two companies: Recursion plans to use NVIDIA's vast proprietary biological and chemical datasets (over 23 petabytes and 3 trillion searchable gene and compound relationships) to accelerate the training of foundational models on NVIDIA DGX Cloud, in order to obtain possible commercial licenses/releases on NVIDIA's cloud service BioNeMo.

The money NVIDIA invested in Recursion came back to its own hands in the form of data fees and service fees.

At the same time, NVIDIA is also continuously expanding its service content in the healthcare field. In addition to the previously launched open-source AI drug discovery tool application store BioNemo and the medical device AI computing platform NVIDIA Clara® Holoscan, at the NVIDIA 2024 GTC conference held in March, NVIDIA launched 25 microservices for medical scenarios (NIM), covering drug discovery, medical technology (MedTech), and digital health, among other fields.

The layout of NVIDIA's smart hospital technology platform is gradually taking shape, with products such as AI-assisted diagnostic imaging, AI robotic minimally invasive surgery, and patient home care software and equipment already integrated, and it has also invested in an AI hospital, Artisight.

Kimberly Powell, Vice President of Healthcare at NVIDIA, pointed out at the NVIDIA 2024 GTC conference that there are significant growth opportunities in three areas: drug discovery, medical technology, and the next generation of digital health. Currently, NVIDIA's direct and indirect revenue in the healthcare industry has exceeded $1 billion, and it may reach tens of billions of dollars in the future. Many leading companies in the healthcare field, such as Novo Nordisk, Johnson & Johnson Medical, and GE Healthcare, are using NVIDIA's AI services.

In the conversation with Recursion in June, when Huang Renxun talked about NVIDIA's overall strategy for healthcare, he said: "NVIDIA does not have and does not seek to have expertise in a specific field, but can become an excellent partner for companies in that specific field." As Huang Renxun said, NVIDIA is becoming more and more favored by medical companies.Google: Medical Business Has Stumbled Several Times, Exploring the "Penicillin" of AI in the Health Field

At the HLTH Europe 2024 conference held in June this year, Google's Chief Health Officer Karen DeSalvo shared with reporters Google's latest layout - it is developing a digital platform, establishing cooperation with medical service providers, and promoting disease prevention. Among them, generative artificial intelligence (AI) models are a key part of this work.

DeSalvo stated at the conference that although innovative technology brings hope, "I don't want people to think that by simply building a generative AI model, we can cure all health problems and diseases." Generative AI models are just one of many tools.

Google is one of the earliest technology companies to lay out in the medical field. As early as 2006, it established the Google Health department, initially aimed at personal health record services to connect doctors, hospitals, and pharmacies. Due to the market expansion not meeting expectations, the project was discontinued in 2012.

In 2018, Google re-established the health department, Google Health, integrating the medical segments of search, cloud, Google Brain, and other businesses, the health department of DeepMind, and the Steamers team into Google Health. In addition, it also integrated Calico's anti-aging technology. David Feinberg was parachuted in as CEO to oversee the reorganization.

When Karen DeSalvo joined Google as Chief Health Officer in 2019, she reported to David Feinberg. However, just three years later, David Feinberg resigned, and Google Health was disbanded again.

After the second dissolution of Google Health, Google's layout in the medical and health field continues.

On the one hand, Google bets on biotechnology through its venture capital department Google Ventures (GV), investing in companies such as XtalPi, LifeMine Therapeutics, Seismic Therapeutic, and others, covering drug discovery, clinical research, health management, and many other directions, to expand the company's influence in the medical field.

On the other hand, Google has launched several generative AI products aimed at medical scenarios, including generative AI electronic health record (EHR) documents, medical contract management, radiology AI image enhancement, gene therapy, inpatient monitoring, and other scenarios.

In the medical field, Google's cloud platform carries a very core task. Google has established an independent supplier ecosystem on its cloud platform. The above-mentioned various generative AI products are all launched on this basis, providing medical and health-related services for governments, medical systems, and scientists.In addition, Google's consumer products such as its search engine and YouTube also provide health information education to individual users. According to Dr. Michael Howell, Google's Chief Clinical Officer, billions of people watch health videos on YouTube every year.

Entering 2024, Google's healthcare business has made many new advancements. In April, Google partnered with Bayer to develop medical imaging AI software products using Google's generative AI and other technologies. In May, they launched the protein structure prediction model AlphaFold 3 and the multimodal medical large model Med-Gemini. Recently, Google has fine-tuned a large language model for personal health, PH-LLM, based on the Gemini model, to provide medical consultation services to individual users.

Karen DeSalvo once stated that AI in the health sector could change the global medical landscape as significantly as the discovery of penicillin in 1928.

To break into the healthcare field, Google has adjusted its strategic direction multiple times over nearly two decades, investing billions of dollars across various directions, but still faces fierce competition.

Previously, Google developed projects such as a glucose-sensing contact lens, a cancer-detection pill, Google Glass for surgery, and a series of projects that have now entered the "Google Graveyard" (referring to projects that Google has discontinued), none of which were ultimately successful. This has raised concerns within the industry about the longevity of Google's healthcare projects.

Now, Google is in urgent need of a victory to break through in the healthcare industry. Can AI be the sharp blade?

Amazon: Pharmacy business grows rapidly, with losses expected to narrow.

On July 30th, media disclosed an internal document from Amazon, which indicated that Amazon expects its healthcare business to lose $1.08 billion in 2024, an improvement from the $1.28 billion loss in 2023, aligning with Amazon's previous goal of reducing costs in the medical department by $100 million.

At the same time, the revenue growth of the healthcare business is very rapid. According to Amazon's forecast data in December last year, the company's overall healthcare revenue is expected to grow by 28% in 2024, reaching $3.16 billion, mainly thanks to Amazon Pharmacy, which is expected to achieve sales of $1.81 billion. Neil Lindsay, Senior Vice President of Amazon Health Services, pointed out during the earnings call for the fourth quarter of last year that the growth of Amazon Pharmacy's business is very fast.

Amazon, which started as an e-commerce company, has long been planning to enter the pharmacy business. As early as 2000, it tried to enter the pharmaceutical e-commerce track. At that time, Amazon planned to expand its business into the pharmacy field by investing in the American online pharmacy retailer Drugstore.com, but due to regulatory issues, it was not successful, and then there was a twenty-year standstill.It wasn't until more than a decade later that Amazon entered the pharmaceutical e-commerce and medical service sectors through two significant acquisitions—acquiring the online pharmacy PillPack in 2018 and the healthcare service company One Medical in 2022.

By acquiring PillPack, Amazon obtained assets such as mail-order pharmacy licenses in 50 U.S. states, pharmacy software, and distribution centers, and on this basis, launched its own online pharmacy, AmazonPharmacy, providing customers with prescription drug ordering and home delivery services.

After investing $3.9 billion in the acquisition of One Medical, Amazon began to vigorously promote the integration of offline medical services with online internet healthcare.

At the same time, Amazon also began to combine medical services with its membership system. First, it introduced the RxPass service for Amazon Prime members through AmazonPharmacy, allowing Prime members to receive more than 50 generic drugs for more than 80 common diseases regularly for an additional $5 per month. By the end of last year, One Medical's medical services were also made available to Prime members at a price of $9 per month or $99 per year, providing them with online consultation services.

In June of this year, Amazon announced the merger of its telemedicine platform, Amazon Clinic, into One Medical, making it a simplified platform under One Medical.

In the insurance business, Amazon had joined forces with JPMorgan Chase and Berkshire Hathaway to establish the health insurance company Haven. However, due to issues such as a single source of customers, the company announced its closure after only three years of poor management.

Continued investment in the healthcare sector has also put pressure on Amazon's costs. In 2023, Amazon's healthcare business suffered a loss of $1.28 billion. According to Amazon's forecast in December 2023, its two core businesses, One Medical and Amazon Pharmacy, will continue to lose money in 2024, with estimated losses of $506 million and $420 million, respectively.

In early February 2024, Amazon initiated a new round of layoffs, cutting hundreds of employees from the AmazonPharmacy and One Medical departments.

In addition to C-end businesses such as pharmaceutical e-commerce and online consultations, Amazon Web Services (AWS) also has its own deployments in fields such as biopharmaceuticals, gene sequencing, and healthcare, launching solutions such as natural language processing (NLP) services and medical imaging services, competing with Google Cloud. Companies like Philips, the U.S. NIH, and Chinese companies such as Hejian Technology and New Century Healthcare are all customers of Amazon Web Services.

Similarly, as e-commerce companies, it is not difficult to see similarities in the development paths of Amazon and domestic companies like Alibaba and JD.com in the healthcare field. For example, they all started with pharmaceutical e-commerce business and then expanded into internet medical services. Under the different medical service systems and social security systems of China and the United States, the internet medical businesses of these companies have also taken different directions.Microsoft: Focused on B2B, Cloud Computing, AI, and Medical Data Integration

At the HIMSS24 conference held in March this year, Microsoft announced a new initiative: a collaboration with 16 renowned U.S. healthcare systems, including Duke Health, Johns Hopkins Medicine, and Massachusetts General Hospital, to launch a program called "TRAIN" aimed at enhancing the quality and trustworthiness of new AI capabilities in the healthcare sector.

Microsoft's Global Chief Medical Officer, David Rhew, stated that through this partnership, the TRAIN members aim to establish best practices for responsible AI operations, helping to improve patient treatment outcomes and safety while fostering trust in healthcare AI.

Among the international tech giants that have expanded into healthcare, Microsoft is not the most well-known. Compared to Amazon and Google, which have numerous consumer-facing healthcare services, and NVIDIA, which has been making waves in healthcare investments in recent years, Microsoft's strategy is somewhat more understated.

As early as 1999, Microsoft entered the healthcare field by investing in the health information website WebMD, and subsequently acquired companies such as medical database software Azyxxi, health information search engine Medstory, and healthcare software vendor Sentillion.

Entering the AI era, Microsoft introduced Healthcare NExT, led by Microsoft's Corporate Vice President Peter Lee, attempting to accelerate healthcare industry innovation through artificial intelligence and cloud computing, empowering groundbreaking research and product development, and helping global healthcare providers, biotech companies, and organizations to innovate using AI and the cloud.

With this, Microsoft established a broad direction to leverage the company's strengths in AI and cloud to take a leading position in the industry.

However, among many strategic moves, the most widely noticed is the acquisition of the intelligent voice company Nuance for $19.7 billion in 2022, which translates to over ten billion yuan in Chinese currency. This was Microsoft's second-largest acquisition at the time, just behind the $26 billion acquisition of LinkedIn.

Nuance had provided AI support for Apple's iPhone voice assistant Siri and later shifted to offering voice recognition technology support for specific markets such as healthcare. For example, by using AI to intelligently recognize conversations between doctors and patients, and then inputting the data into electronic medical records to automatically create clinical records, thereby enhancing the diagnostic efficiency of doctors.

In the year prior to being acquired by Microsoft, Nuance's healthcare business grew by 37%. At that time, more than 55% of doctors, 75% of radiologists, and 77% of hospitals in the United States were using Nuance technology.An analyst at the American consulting firm Gartner, Gregg Pessin, stated that the acquisition provided Microsoft with "an entry point into the healthcare industry, as well as a vast customer base already using such products."

Today, Nuance's AI solutions are utilized by 77% of hospitals worldwide and 10,000 healthcare organizations, reaching 300 million patients annually.

Microsoft's healthcare strategy has primarily focused on the business-to-business (B2B) sector. Even before the advent of ChatGPT in 2019, Microsoft partnered with the then-little-known OpenAI, with the deal value subsequently increasing to tens of billions of dollars.

Following the release of GPT-4, Microsoft integrated it into Nuance's Dragon Ambient Intelligence (DAX) platform, which has since been implemented in numerous hospitals across the United States.

Leveraging the acquisition of Nuance and the collaboration with OpenAI, Microsoft has successfully established a strong presence in the AI+healthcare race, with an accelerating layout.

In 2023, Microsoft partnered with Epic Systems, the largest electronic health record provider in the United States, to integrate Microsoft's generative AI technology into Epic Systems' electronic health record software. A few months later, the two companies announced an enhanced collaboration, with Epic integrating the DAX platform into its native Epic Hyperdrive platform and Haiku mobile application, further deepening the integration with Microsoft's cloud services.

Despite several significant transactions in the B2B sector, Microsoft's overall healthcare strategy in recent years has been cautious, with several related projects being discontinued—such as in 2017, when Microsoft ceased production of fitness wearables; and in 2019, when the online personal health record system HealthVault was discontinued.

Now, Microsoft's healthcare layout focuses on cloud computing, AI, and medical data integration, which may usher in new development opportunities in the AI era.

Apple: Committed to To C, Continuous Investment in Wearable Devices

Since the beginning of 2024, Apple Inc. has not had a smooth overall progress, with a significant decline in iPhone sales in the Chinese market, poor overall performance, and a temporary loss of market value to Microsoft. However, in the healthcare sector, Apple has made new progress in the first half of the year.In June of this year, a feature in the Apple Watch that records irregular heart rates received approval from the U.S. Food and Drug Administration (FDA). It was announced that this feature could be used for clinical research to assess the burden of atrial fibrillation. This feature also became the first qualified digital health product in the U.S. FDA's Medical Device Development Tools (MDDT) program.

After decades of competition with Microsoft, Apple chose a completely different path from Microsoft after entering the healthcare field. Microsoft almost gave up on the layout of wearable devices, while Apple continued to invest in the healthcare functions of personal terminals such as the Apple Watch.

Ten years ago, in 2014, when Apple released the first Apple Watch, it was equipped with a sensor for heart rate detection. After several product iterations, the integrated health functions have become more and more perfect, and several models have been approved by the FDA and the National Medical Products Administration of our country. According to Apple, new products released in 2024 will also be equipped with new functions of blood pressure monitoring and sleep apnea detection.

In addition to the Apple Watch, AirPods and iPhone also have health monitoring and data collection functions, allowing users to access them in one stop. Then, through integration with the electronic medical record (EMR) system, these data can be seamlessly shared from Apple devices to EMR for doctors to view, helping users achieve health care.

At the same time, since 2016, Apple has successively acquired several companies engaged in health data management and sleep monitoring devices, continuously deepening its layout in the direction of wearable health devices.

However, Apple's overall pace in the healthcare field is relatively slow, and it has also encountered personnel crises.

Between 2019 and 2021, a large number of employees left Apple's health team, and the director of business development, Warris Bokhari, and the head of AC Wellness, Brian Ellis, also left one after another. According to media reports, the reason may be the differences in the direction of the company's healthcare business among internal employees.

Some members believe that Apple should pursue more ambitious medical projects for a few people, such as medical devices, telemedicine, medical payments, etc. However, Apple's health team has been focusing on functions for the majority of users, such as health and prevention, for many years.

After this personnel turmoil, Apple began to explore projects for a few people as employees expected. First, it revealed that it would launch a health insurance business in 2024, and then released a new medical product, Apple Vision Pro. After being equipped with Siemens' program, this product can help doctors view holographic human figures. This year, there have been two hospitals in China, Jilin University Third Hospital and Peking University People's Hospital, that have applied this product in clinical surgery.

Although Apple entered the medical market later than other technology giants, its ambition in the healthcare field is not weaker than others. Apple CEO Tim Cook once stated at a meeting, "In the future, when people look back, they will say that Apple's greatest contribution to the world is healthcare."