Stakeholders in health care on the lookout for potential disruptors that may Uber their way into the field may want to take their eyes off the horizon and pay closer attention to what’s happening right now at their front door.

Yes, it seems like companies such as Uber and Amazon came out of nowhere to become major players, but in reality they started small and grew to their current size as everyone in their respective industries watched.

So health care leaders should consider if disruption has already begun, possibly in lab testing.

Despite the negative publicity drawn to disruptive lab testing by the crash and possible burn story of Theranos, companies like myLAB Box and Cologuard are finding some success in snagging patients who might normally be served by physicians or lab companies.

MyLAB Box, which initially focused on providing screens of a few sexually transmitted infections through the mail, has served thousands of patients and has recently expanded the types of testing it offers, according to Lora Ivanova, the company's co-founder and chief marketing officer.

“A lot of the reason we’re adding tests is because there’s demand for them,” Ivanova says.

That's not surprising, given that STIs are not something people are eager to discuss with receptionists, intake clinicians or even physicians. And for the uninsured or those in high-deductible plans, the $189 price tag might seem pretty reasonable.

The story is similar for Cologuard, which offers a Food and Drug Administration-approved at-home colon cancer screening service that H&HN has covered previously. Its parent company, Exact Sciences, this month released some numbers on usage of Cologuard:

  • Preliminary revenues are expected to be between $99 million and $99.5 million for 2016, a year-over-year increase of 150 percent.
  • 244,000 Cologuard tests were completed in 2016, a year-over-year increase of 134 percent.
  • 9,500 additional providers ordered Cologuard during the fourth quarter, and insurance coverage expanded by 67 percent during 2016. 

Like myLAB Box, Cologuard has an inherent advantage over the traditional approach: Many people don’t want to go through the hassle of getting a colonoscopy.

This niche markets could get larger. It took a lot of time for people to accept buying personalized products such as shoes or eyeglasses on the internet, but they did. So why shouldn’t it catch on in health care, including lab testing or, perhaps, telemedicine?

“The patterns that we are seeing in our society are clear: Users have moved their shopping habits online; people have moved their dating habits online; we have moved our social habits online,” Ivanova says. “The users have spoken.”

And there’s a lot of untapped potential. “Health care, it’s become clear, is the one standoff industry that has refused to accept those trends or use them for its benefit,” she says.