➤ Telehealth companies such as GoodRx, Livongo and Teladoc recorded significant growth in 2020 due to the pandemic.

➤ Point-of-care medical care is going to continue to shift to "point-of-home" care and will keep telehealth companies' valuations high.

➤ The healthcare industry's complexity is keeping big tech from completely transforming the sector, but disruptions could expand as competition evolves.

John Sculley, chairman and chief marketing officer at the pharmacy benefit management company RxAdvance Corp, was the CEO of Apple Inc. from 1983-1993. Sculley spoke with S&P Global Market Intelligence about how he expects the digital health landscape to evolve during the new year and how big tech might disrupt the healthcare industry. What follows is an edited transcript of that interview.

S&P Global Market Intelligence: In 2020 we saw a shift to telehealth. Do you expect this shift to continue through 2021?

John Sculley: It is only the beginning, I think, of what we're going to see [in terms of] the important role of telehealth in the future. As an example, if you look comparatively, in the 1990s when home banking began, there was huge skepticism [about] whether people would trust home banking with their money. Would it be a niche industry or would it become more important than that? Well, we obviously know today that online banking has become the financial service industry. It's fintech, and it's gigantic ... and I think we're going to see something very [comparable] to that with telehealth.

If you look at the Net Promoter scores for healthcare, in general, it's pretty poor: it's around 30%. But if you look at the Net Promoter scores for companies like Apple and Google and Amazon, it's up in the 70s. We're now starting to see in telehealth that Net Promoter scores are up in that same range because people are very happy with the quality of the service.

Could we see more permanent reimbursement regulations for digital tools and telehealth under the Biden administration?

Over the next four years, we're going to see a continuing close-down of hospital beds in hospitals for a very practical reason that more and more procedures don't require people to spend the night in the hospital, and it's not particularly safe in a lot of hospitals to even spend the night in the hospital. So, my sense is that we're going to find that point-of-care more and more is going to be point-of-home. And that's one of the reasons why I believe telehealth is going to continue to expand into a truly giant industry.

The Biden administration is going to put people into important roles in the government who have a much better understanding of the technologies and the possibilities of how government and the private sector can work together, and we haven't had that in the last four years.

Analysts anticipate the Biden administration will push back more on big tech. Will that affect big tech's healthcare ambitions?

I don't think there's any reason why the government would want to slow down the type of innovation that big tech could potentially bring to the healthcare industry. Big tech has not been particularly successful in making a real inroad into the healthtech industry. If you look at the values that have been created in new companies that have gone public: Teladoc Health Inc. and Livongo Health Inc. were each shot to $19 billion market value. (Note: Teladoc's $18.5 billion acquisition of Livongo in 2020 extends the company's lead in the industry. The combined company now has market capitalization of $38.9 billion, according to S&P Global Market Intelligence data).

GoodRx Holdings Inc. got up to $19 billion market value. Amwell got up to about $9 billion market value. And there will be obviously others. So, the real innovation in technology has come from not the big tech companies, but from entrepreneurial companies.

We will see big tech continue to move into healthcare but they haven't moved into it with the same level of success that they have in other industries. The problem is that the healthcare industry, a regulated industry, is incredibly complex ... [but] I think that it's only a matter of time until big tech becomes more knowledgeable about the complexity of the healthcare industry.

Are there any other trends you expect to see in digital health over the next year?

I don't think there is a better place for the high tech industry to add value than in preventative care. Because if you can get people to take better care of themselves, how they eat, how they exercise, how they watch their own health metrics, the consumers are going to take a bigger role in their own wellness. And that's only possible if you get better data. And that's one of the big promises of digital health, which is getting better data into people's hands [and] getting comfortable to know how to establish routines.