medical school_Higher Education_ChristensenInstitute

Innovators Worth Watching: Osmosis

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Sep 11, 2018

Welcome to our “Innovators Worth Watching” series, spotlighting interesting and potentially disruptive players across a spectrum of industries.

Getting into medical school is brutal. Getting through medical school is even worse. The lectures alone…well, the lectures actually aren’t a big deal for a lot of students. A full 40% of them only barely or occasionally attend in the first place.

Why would students rather use outside, online study tools instead of attending the lectures they’re paying exorbitant amounts for? Part of it could be ease and convenience, but an important piece of the puzzle is that when it comes to preparing for the all-important licensing examinations—especially the dreaded USMLE Step 1 exam—future clinicians are increasingly putting more trust in tools like Osmosis to get them across the finish line.

Osmosis is a web- and mobile-learning platform designed to help medical students and allied health professionals organize, absorb, and apply the knowledge they will need as clinicians. By subscribing to Osmosis Prime, students can access a library of animated video content, flashcards, links to popular third-party resources, licensing exam-style questions, and a customizable study scheduling tool. Osmosis also shares a portion of its video library for free on YouTube, where patients and their family members can learn more about a number of medical conditions.

“Our vision is that everyone who cares for someone will learn by Osmosis,” explained Osmosis co-founder and CEO Shiv Gaglani. “If you think about it, that applies to all 7.5 billion of us in some way.”

In addition to directly reaching individual users, Osmosis is implemented by over 20 medical schools around the world, as well as PA, nursing, and dental programs. The platform tracks user engagement and gives schools ways of supplementing, or even supplanting, their curricula.

Osmosis is finding powerful ways to commoditize and deliver medical knowledge, to the tune of 53 million video views and, according to an early 2016 study, a jump from 50th to 85th percentile in median Step 1 scores. Could Osmosis expand its offering and be disruptive to US medical schools? We put them to the test with six questions for identifying disruption.

1. Does it target people whose only alternative is to buy nothing at all (nonconsumers) or who are overserved by existing offerings in the market?

Yes. US medical school students are paying very high tuition for access to lectures that they don’t seem to need or want. Osmosis is tailor-made for students’ needs during the preclinical portion of their training.

The company also provides complimentary Osmosis Prime access to several medical schools and individual students in Syria, Namibia, and other countries with restricted access to medical training. Approximately 75% of their video views come from outside the US. That said, all this free access is heavily subsidized by paying subscribers.

2. Is the offering not as good as existing offerings as judged by historical measures of performance?

Yes. Osmosis is not accredited and does not confer degrees, meaning one cannot become a medical practitioner in the US solely using the Osmosis platform. Further, Osmosis is not currently able to offer a good proxy for the hands-on clinical portion of medical training.

3. Is the innovation simpler to use, more convenient, or more affordable than existing offerings?

Yes. Students can watch short, pre-recorded, animated videos at their convenience and at their own pace. The Osmosis platform generates a study schedule, suggesting to students when they should learn or review specific topics, referencing Osmosis videos and materials from external providers. Students could theoretically learn two years’ worth of curriculum in less than one year for about $200, based on current pricing. One year of medical school costs tens of thousands of dollars.

4. Does the offering have a technology that enables it to improve and move upmarket?

Yes. In this case, moving upmarket entails offering a growing portion of medical schools’ core competencies, including more advanced content and hands-on clinical training.

The Osmosis platform uses adaptive learning algorithms to provide users with the learning and assessment materials they need in the moment, based on how well they answer questions as they progress. Further, Osmosis has developed proprietary software to help increase video production rates fivefold, improving the library’s breadth and scope. Several medical schools have shown a willingness to outsource at least a portion of their knowledge delivery function. More advanced content will likely follow.

Further, VR and AR capabilities are improving. The technology is already good enough to simulate biology labs at ASU. When the technology is available, Osmosis hopes to offer virtual clinical and surgical training.

5. Is the technology paired with an innovative business model that allows it to be sustainable?

TBD. Osmosis allows access to many of its videos for free, and employs a subscription model for access to premium content. According to Gaglani, video production costs have been the largest expense, but per-video production costs are decreasing. Further, subscription revenues, predominantly from within the US, have kept pace with these costs, even as the number of videos Osmosis creates expands. Osmosis is also actively working to convert users outside the US to paying customers.

6. Are existing providers motivated to ignore the new innovation and not feel threatened by it at the outset?

Yes. Medical schools do not see Osmosis as a direct threat. There is high demand for medical education—whether MD, DO, PA, nursing, or other—and the space is highly regulated. These institutions are more likely to partner with Osmosis than to compete with it.

In Disruption Theory, we refer to this dynamic as asymmetric motivation. Some medical schools are sacrificing preclinical knowledge delivery, letting companies like Osmosis handle it, to focus on their perceived core competencies of critical thinking skills and clinical training. As Osmosis develops the ability to also tackle those core competencies, will schools follow in the footsteps of Dell, which got disrupted by eventually outsourcing everything to a company that initially only provided smaller components?

Osmosis has created a platform that presents it with many possible routes forward. The most disruptive ones require either finding a business model that is self-sustaining in resource-restricted settings, or tackling additional medical school core competencies to leverage asymmetric motivation.

In the meantime, Osmosis is impacting learners here and abroad. “Our team gets so excited when patients in Somalia or students in Syria learn by Osmosis,” said Gaglani. “That is even more meaningful to us than a ten-point increase in a licensing exam score.” Osmosis users—nonconsumers and lecture skippers alike—are gladly doing both.

As a research assistant on the Christensen Institute's higher education team, Richard helps investigate novel business models in postsecondary education, professional development, and lifelong learning.