Posts Tagged ‘health technology’
As the new year slips into higher gear, and our national focus shifts from politics to policymaking, we need to take a fresh look at how innovation can give the economy a boost.
While President Obama’s second inauguration speech mentions the need for new technology (harnessing new ideas and technologies to remake, revamp, reform and empower various sectors of society), I find myself asking: what kind of innovation? How could digital health play a role?
Harvard professor and innovation pioneer Clayton Christensen calls for a better mix of the three main types of innovations: empowering, sustaining and efficiency. He observes that empowering innovations, which create jobs by transforming complex and expensive products into simpler, cheaper products, are in unusually short supply. Meanwhile, sustaining innovations, which replace old products with new models (that nonetheless operate the same way), and efficiency innovations, which reduce costs of existing products, are abundant, but don’t help jump-start an economy as much. Today, he says, efficiency innovations are just being reinvested back into more efficiency innovations.
Digital health entrepreneurs pursue all three innovation types. I believe, however, that the overall economic impact of digital health comes from empowering innovations. Christensen cites the Model T Ford, IBM personal computers, and cloud computing as such empowering innovations. In my opinion, the remote monitors and sensors, healthcare apps, and biomarker/companion diagnostic tests now being developed are likewise transforming complex and expensive care paradigms, but also are transforming an equally complex, costly healthcare industry. In fact, mobile devices (today’s “personal computers”) and cloud computing are significant contributors to today’s digital health revolution.
Nonetheless, despite the potential to drive significant process and efficiency improvements, many digital health innovators still face challenges in raising capital. Here at Popper and Co., we’re interested in helping you strengthen your business plan to make it attractive to prospective financial and strategic investors and to identify those that may be most receptive to hearing more about your business. Follow us on Twitter, sign up to receive our e-newsletter or reach out to me directly to learn more.
Tags: digital health, digital health innovation, health technology, healthcare policy, U.S. economy
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I attended the Consumer Electronics Show (#CES2013) in Las Vegas earlier this month. While this was my second year at the Digital Health Summit portion, it was the first year that Qualcomm delivered the keynote address for the entire show. While there, I found myself building upon the “Born Mobile” theme of Qualcomm’s keynote show—which unfortunately came across as parody, as seen in this piece in The Verge—in pointing out that we are experiencing a digital revolution, of which mobile wireless devices and networks are just two subcomponents.
Digital Health is the convergence of the digital revolution with health. “Health” is writ large in this context, and includes sports, fitness, and wellness, plus medicine and healthcare. At CES, we could see the convergence of the following key digital elements:
- Wireless Sensors and Devices
- Social Networking
- Mobile Connectivity and Bandwidth
- Health Information Systems
- The Internet
- Computing Power and the Data Universe (Big & Cheap Data)
I was gladdened to see all of the activity-tracking devices at the show. There were also “soft silos,” where players like Withings and Fitbit had what I’d call consumer digital health solution-sets on display: wrist-worn activity trackers, weight scales, and health dashboards. I thought this Cambrian-esque explosion was great, since it drives a virtuous circle/positive feedback loop in the ecosystem; increasing consumer awareness and demand accelerates product innovation and improvements which, in turn, further drives consumer demand for improved solutions.
Digital Health was prominent at CES (here’s iHealthBeat’s take on “What the 2013 Consumer Electronics Show Means for Health Care IT”) and even people I talked to who were outside of the health sector really seemed to get it. I also loved that Arianna Huffington, who spoke in a super session, wrote a piece explicitly talking about the “Digital Health Revolution.”
Do you think the digital health revolution is experiencing a “Cambrian” explosion of innovation? Could a post-Cambrian “die-off” be somewhere on the horizon? What other new inventions could fill this space? What does this all mean for the healthcare consumer? What about for life science or digital technology companies? We welcome your thoughts.
Tags: CES 2013, Consumer Electronics Show 2013, digital health, digital revolution, health technology, healthcare consumer
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In a previous blog post reporting in after the 2012 AusMedTech (Australia Medical Technology) conference, we discussed the need for healthcare technology companies to quickly demonstrate how their innovations add value.
My presentation at AusMedTech stressed four important elements that are driving the industry now, and that will continue to do so over the next decade. We believe that addressing each of these areas – as outlined below by me and my colleague Ken Walz – will be vitally important as healthcare innovators seek to demonstrate the value of their technologies.
Imperative of operational efficiency
Caroline: Cost constraints in both developed and developing countries are making efficient operations a requirement. Emerging markets and non-healthcare industries like manufacturing or hospitality are more quickly embracing methods that enhance efficiency; we could learn much from them.
Ken: There’s been a greater scrutiny of inefficiencies in healthcare in the past few years. This has led equally intense efforts to develop disruptive innovations in healthcare (for example, smartphone monitoring, or a consumer healthcare ranking system). What’s encouraging is that more life science and healthcare organizations are working to develop and incorporate these disruptive innovations into their operations.
Importance of the consumer
Caroline: Consumer power is only going to grow, fueled by smartphones and more widespread internet access. Consumers are demanding more transparency and they are comparison shopping. This will encourage more consumer-oriented companies to enter the healthcare market; new methods of reaching, educating, and retaining consumers will be crucial to success.
Ken: We have focused on the issue of growing consumer power in previous posts, such as a recent entry by Caroline chronicling the demystification and democratization of healthcare. Consumers will be less willing to accept inefficient healthcare delivery, especially as their other consumer experiences become more efficient and convenient.
New biological insights
Caroline: Genomic sequencing and other new tools have helped us understand biology like never before. Genomics, in particular, opened the door to personalized treatments. Understanding proteins and cellular functions is also providing critical insights. The lightning-fast pace of discovery in this area is showing no signs of slowing down; hence our significant focus on and interest in this area.
Caroline: Information technology makes healthcare information delivery possible—it also enhances services and is the bedrock of the consumer power revolutionizing healthcare. Technology that was developed for other industries has become incorporated into healthcare. This is what led us to add Paul Sonnier to our team as head of Popper and Company digital health strategy.
Ken: This application of technologies from other industries goes hand in hand with business models, also borrowed from other industries, which are now applied to healthcare. Leveraging these ideas and technologies can maximize return on investment, which goes back to improving operational efficiency.
Do you think these four points are the key healthcare technology drivers today? Are there others? How willing is the industry to accept “outside” technologies and ideas? Share your thoughts with us.
Tags: ausmedtech, biological insights, health innovation, health innovation drivers, health technology, healthcare innovation, importance of the consumer, operational efficiency
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Washington, DC, is an impressive city. But too many times, one leaves our nation’s capital scratching one’s head. Understanding how large, complex agencies deal with equally large, complex issues is puzzling enough, but issues that change on an almost-daily basis—such as optimizing the potential of advances in digital health—call for much faster solutions than our bureaucratic system is designed to address.
To discuss ways to resolve the puzzles inherent in regulating digital health opportunities, Paul Sonnier and I met with Keith Studdard, the Legislative Director to U.S. Representative Marsha Blackburn (R-Tenn), who has been advocating a clearer, more streamlined regulatory approach to new developments in digital health. What was our reaction coming home? Instead of scratching our heads, we were pleasantly surprised by the level of engagement and dedication we found.
Our meeting included an acknowledgement that the Republicans in the U.S. House needed to address digital health regulations in a way that involved Democrats. Despite persistent accusations of partisan gridlock in Congress, I came away sensing a high degree of sincerity, at least judging from the candid remarks coming from Blackburn’s office. One of the biggest problems to legislators and regulators in digital health is uncertainty within the industry, a point Studdard reinforced by citing the old maxim that, while “no” is often an answer that people don’t want to hear, “maybe” is worse, particularly in terms of its impact on business planning. And at the moment, digital health’s regulatory future is replete with “maybes.”
Blackburn has been involved in regulating digital health for at least two years, when a Memorandum of Understanding (MOU) was signed between the Food and Drug Administration (FDA) and the Federal Communications Commission (FCC) to help eliminate the “maybes” and coordinate regulations of mobile health apps, devices and other innovations in digital health. The FDA and FCC agreed that wireless and digital health is a brave new world and admitted they were not equipped to deal with this fast-moving area. The agencies admitted that no policies that existed in 2010 could be written in such a way that comprehends what the mobile health space would mean for consumers or patients. The MOU promised to focus on this.
Blackburn was one of six members of Congress who recently crafted a letter asking for a progress report from the FDA and FCC on this MOU. What should be regulated? How should they determine what gets regulated? What regulations would apply? What’s happened since the signing of the MOU in 2010?
Certainly, patient safety, medical record security, and consumer protection are very important areas to consider from a regulatory perspective. But how much regulation is necessary? And how can these regulations provide safeguards without slowing innovation? What types of regulations do you think are necessary in this area? And how would they keep up with the ever-changing digital health world? Let us know, and we commit to continue engaging with those – like Mr. Studdard – who can help make a difference!
Tags: cyber health, digital health, digital technology and health, health technology, Keith Studdard, Marsha Blackburn, U.S. Congress
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In a previous blog post for Popper and Co, I discussed how telehealth can be a life-saving tool in rural and urban settings. As devices get more versatile and affordable, we will start seeing additional efficiencies in health care delivery. Moreover, patients will (if they aren’t already) start demanding it. But does telehealth work in every situation? And how should telehealth systems developers adapt to an individual practice’s needs?
The Center for Telehealth and Cybermedicine Research found that while enthusiasm for telehealth was high among patients and (some) caregivers, not every clinic could perceive a benefit. It is very easy, for example, to lose the advantages of this technology without first doing some preliminary research on your particular center and patients. Telehealth must be needs-driven, filling gaps in health services that are not effectively met.
In some cases, demand for telehealth may not be very high. If patients can find care at other facilities or may be reluctant to seek care for certain diseases, then telehealth may not be helpful. Similarly, if practitioners are reluctant to use telehealth tools, this reluctance may place such a system in jeopardy.
Electronic health record (EHR) integration can be one obstacle to telehealth (at least among practitioners). Aside from data security and confidentiality issues, practitioners perceive converting records to electronic format as a burden. However, conversion is becoming easier, and improvements in remote devices are allowing us to integrate many records and data of patient vital statistics into the system, including blood pressure, weight, oxygen saturation, etc. If developed correctly, EHR adoption, remote monitoring, and health information exchange (HIE) systems can be complementary to telehealth and improve efficiencies in provision of care, improve health outcomes, and reduce costs.
Reimbursement is another issue. A project conducted by our ophthalmology division screened patients with diabetes who were at risk for retinopathy. An eye specialist looked at retinal images with a camera that didn’t require eye drops (therefore, a highly skilled caregiver wasn’t needed at the patient’s location). Two hundred patients were scanned, and approximately 40 percent of them needed referrals. Of those referrals, 5 percent were in danger of going blind without immediate treatment. Here, telehealth provided better access, improved patient health, and reduced costs of care. Yet Medicare would not cover these types of diagnostic image interpretations (called “Store and Forward”) and related referral services, because it only covers that type of Store and Forward remote services in Alaska and Hawaii. On an optimistic note: Coverage requirements can change (in fact, Medicare has already changed coverage rules for some services)!
Other obstacles to telehealth success include:
- Not thinking about sustainability. Your program may have started out with a grant, but it needs to continue operating after the grant expires. Controlling technology costs is key, as is finding out which technology is most appropriate.
- What’s the best technology? It’s always changing, making it hard to know where to turn. And often, the latest tool isn’t the best solution for a specific practice or facility. At the Center, we are always helping end-users develop the right technology mix. Often, the right mix may have to be invented.
- Telehealth may not immediately fit into a practice’s workflow. If you only have one patient using your conferencing facility, that’s a problem. Reasonable volume is key to providing adequate return on investment, as is making telehealth systems scalable to incorporate other health services. You’ll need to develop a business operating plan stating how telehealth encounters will be scheduled, how to document each encounter, what you need to build and design, how many staff you need, and what your upfront and operating costs are.
- Lack of data. Make sure you document your encounters, and analyze whether your programs are successful. How many more patients did you see? What were the outcomes? What’s the impact on costs? This data also is crucial for systems developers to create the right solutions for telehealth.
Telehealth and information technologies are needed for healthcare reform in this country. It’s going to be an interesting time, getting people connected to care. But it’s the way we do it that’s going to make the biggest difference.
Do you work for a technology company that aims to make a difference in how telehealth is practiced? Are you a health care provider who believes telehealth can make a significant impact to your practice? What, if any, are its limitations? Please tell us what you think.
Tags: cybermedicine, health technology, medical technology, telehealth system developers, telehealth systems, teleheath, telemedicine
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In a recent Forbes article on the last FutureMed meeting in California, writer David Shaywitz expressed his concern that technology developers are more focused on their technology than with how it may be accepted by health care practitioners. But he also expressed hope that, soon, technology and the practice of health care might experience a meeting of minds (and possibly even hearts).
At Popper and Co., we make an effort to search for technology solutions that can truly make a difference in health care, and often we’ve been skeptical of the “latest shiny new thing.” While I believe that sometimes technology apps appear to be solutions in search of a problem, we are arriving at a point in time when a happy merger between health care and health technology may be feasible. Why?
- Because we (the scientific and technology community) now understand enough about biology to adapt technology to address real clinical problems. Our knowledge of genetics alone allows us to design targeted (i.e., “personalized”) therapeutic solutions.
- Because cost and resource constraints have led to patients being more engaged in the price and quality of their health care.
- Because consumer power has forced many practitioners (and technologists) to consider the “might” of this market.
- Because new technologies facilitate fundamental health service innovation for providers as well as patients.
In response to a related article by David Shaywitz, Popper and Co. strategic advisor Paul Sonnier had this to say:
While we need to be cautious about broad generalizations when it comes to digital health (which includes non-FDA-regulated consumer solutions) and the business sectors where it is having a direct impact, drug development – an area of focus in Mr. Shaywitz’s Forbes piece – is certainly seeing the integration of wireless technologies in a beneficial way. For example, new, “virtual clinical trials” enabled by smartphones and other apps allow patients to register and participate in drug trials without visiting a clinical site. Moreover, monitoring clinical trial participant compliance and relevant vital signs via wireless health devices can provide a greater level of detail and confidence in study data and conclusions, which is also of benefit in obtaining FDA clearance. DNA sequencing, too, which has been described as “bio-digital health,” allows for more targeted clinical trial participant selection and a movement away from population-based medicine. These examples alone illustrate digital health’s potential to improve biopharma’s bottom line and, ultimately, create better, more individualized health care.
Finally, here are some thoughts on the topic from Popper and Co. co-founder Ken Walz:
Many new emerging technologies have disruptive potential; including smart phones for clinical trials, remote diagnosis and data interpretation, for example. And there are some areas of health care in which patients and practitioners may be more amenable to adopting new technology. But not every part of medical practice is welcoming technology with open arms. It’s important to note that many of the areas that aren’t as accepting happen to be the more challenging areas of medicine. To assess the fate of all technology based on its current lack of proven utility in specific niches of health care may be setting the bar needlessly high.
In fact, targeting areas that are less “sexy,” but nonetheless important—e.g., process workflow improvement, better use of sensors, remote monitoring of patient compliance, and online appointment scheduling and lab result access—could deliver a great deal of value through new technology adoption.
Where do you see the most ideal matches between technology and health care? What challenging areas of medicine might be better postponing marriages with technology for another day? Do you have specific questions about the convergence of technology and health care that you’d like to pose to us? Share with us here.
Tags: bio-digital health, cyber health, digital health, digital technology and health, health technology, healthcare technology, telemedicine
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Wireless technology is evolving in positive ways. It’s now more affordable, more accessible (thanks to broadband capacity), and more portable (via devices such as tablets and smartphones). And it is no exaggeration to say that this technology has made a life-saving difference for many patients who otherwise would not get care.
At the Center for Telehealth and Cybermedicine Research at the University of New Mexico, we studied the ability of telehealth tools (e.g., video connections, conference calling, electronic record sharing) to improve access and outcomes of rural New Mexicans suffering from a variety of health problems. In that role, we have been the incubator for several applications of telehealth designed to integrate the technologies that address important healthcare needs and gaps in access. One example was hepatitis C. While this disease is curable, multiple treatments are required and patients must be monitored for adverse effects. Project ECHO (Extension for Community Healthcare Outcomes) was initially incubated in our Center under the leadership of Dr. Sanjeev Arora. That project was recently published in the New England Journal of Medicine demonstrating how the program provided community healthcare providers with the expertise and tools they needed to treat hundreds, if not thousands, of people who previously were receiving no care for hepatitis C. In addition, outcomes of these remote patients were as good as outcomes of patients who traveled (often hundreds of miles) to the University’s medical center in Albuquerque.
This model was successful enough that it is now being expanded into other treatment areas, such as cardiology, rheumatology, and even adolescent psychiatry. For example, adolescents on Indian reservations, who have very high rates of suicide, are benefitting from counseling. Once the patient and practitioner are familiar with the technology, online counseling sessions are very similar to face-to-face encounters.
In addition to improving patient outcomes and access to care, telehealth can reduce costs in the clinic. At the University of New Mexico, our head of neurosurgery worked with The Center to set up a system where surgeons could view patient CT scans through a secure web portal. Because of this system, 44 percent of risky patient transfers were avoided, simply by looking at the scans remotely before surgery.
In rural New Mexico, the access improvements of telehealth appear obvious (though telehealth doesn’t work in every situation, an issue I’ll discuss in a future post). But the technology can also work in urban areas, bypassing transportation and traffic congestion problems by bringing virtual care to the patient. This is health care where it’s needed, when it’s needed.
One effect of health care reform that isn’t making headlines is that increased demand for services will be placed on a limited resource: existing health care providers. But telehealth systems will help meet this new demand by providing services to nearly everyone. For example, Dr. Arora, one of the few liver specialists in New Mexico, stated as we helped start his project that he couldn’t personally treat the 30,000 New Mexicans with hepatitis C at that time. But with the help of specialists—such as Dr. Arora and his team—at the touch of a button or the click of a mouse, community practitioners can readily access experts.
What do you see as the limitations of telehealth? Is rural New Mexico a truly unique niche for this technology? In my next post, we’ll discuss the importance of setting up an operating plan, and more cost-cutting benefits of telehealth. In the mean time, if you have any questions about my telehealth study or work, please post them here.
Tags: cybermedicine, health technology, medical technology, teleheath, teleheath study in New Mexico, telemedicine
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In my May 17 blog post, I introduced Dr. Andreas Muehler as one of Popper and Co.’s new strategic advisors. Dr. Muehler brings broad perspectives and business insights, owing in part to his close relationships with established industry leaders in the joint development and commercialization of medical products worldwide. Building upon our last discussion, where I was caught by his enthusiasm as we talked about his past role as CEO for a struggling medical device firm and his experiences positioning products in the global marketplace, I recently talked with Dr. Muehler again to further explore his impressions on the differences between the E.U. and U.S. markets for new life science technologies.
CP: You’ve served within or supported the pharmaceutical and medical device industries in both Europe and the U.S. What do you see as some of the differences?
AM: There are differences in the health care system itself – mainly how you pay for health care delivery, what gets reimbursed, and what control in decision making a physician has in terms of technologies used. For example, the U.S. has good reimbursement for breast biopsies using MRI. In Europe, it’s mainly done with ultrasound because MRI isn’t paid for at all. So in the U.S., technologies are being used when insurance will reimburse for testing and therefore provide a financial benefit to the hospital or physician. In Europe, however, clinical data around a technology is very important in terms of benefit for patient or patient outcome. In Europe, there’s a higher likelihood that good technology, which is backed by good clinical data, will be used when all ducks line up, and the financial benefits to physicians may be less of an overriding issue.
CP: When it comes to launching a new technology, can you tell us more about some of the pros and cons for each geographic locale?
AM: The advantage of Europe for marketing a new technology is that physicians are free (in particular in the hospital setting) to choose their technology if they believe it has a benefit. In Germany, for example, there is a general pricing reimbursement system in hospitals through which the hospitals receive a lump sum payment for a patient with a certain diagnosis but are basically free to use any products and technologies as they see fit. The hurdle to get into market is less as long as you have good clinical data. In the U.S., however, physicians are more open to trying new technology even without clinical data, which can be good for companies. Physicians in the U.S. are also very open to use of electronic patient records (EPR); whereas in Europe, physicians are not as convinced that EPR makes a difference and have more concerns around patient privacy.
CP: What’s different today than five years ago in terms of health technology adoption?
AM: On both sides of the Atlantic, there’s an increase in need for good clinical data for adoption of new devices, in part because of financial pressures on the systems themselves. To successfully market your device, the importance of large-scale clinical data has grown if you want market penetration of your product. In the past, a small clinical observation was sometimes enough to get adoption of your device. Now physicians ask for clinical outcome data and payers and hospitals ask for pharmaco-economic data.
CP: What will be different five years in the future?
AM: The pendulum swings back and forth. The U.S. will realize that a lot of innovation in medical devices will go to Europe because of current restrictions within the FDA’s 510K process. If good examples of important medical breakthrough technologies emerge in Europe that America doesn’t have access to, I believe some new processes will evolve that will allow medical technologies to get approved quicker in the U.S. One such example is hearing implants. Countries like Austria and Germany had in the past instituted mandatory routine hearing tests for babies, and, if needed, paid routinely for hearing implants while the children were still quite young. As a result, most educational facilities for children with hearing disabilities in Austria and Germany actually closed since implanted children undergo an almost normal linguistic development. In the U.S., hearing implants aren’t yet available as widely because they are seen as expensive for the healthcare system and by payers, even if they save more than their share of costs down the road by removing special educational requirements. If this continues, the industry should lobby to politicians and changes may occur in the regulatory process. Then, hearing implants will likely be made more widely available. By the way, the European policy for early hearing tests and hearing implants produced a market leader in hearing implants that is located in Austria.
There are important insights here, especially the need to track the level of clinical research attached to a product as it’s introduced to the E.U. market. It’s also important to note how receptive the European medical community is to new technologies introduced from the U.S. We’ll continue to focus on this important topic, and to share additional insights from Dr. Muehler and our second advisor, Dr. Mills.
We welcome your thoughts on the importance of clinical data in selling medical technologies and how the pendulum of restrictions continues to swing. Where do you think we are now in the U.S. as far as restrictions and our ability to sell in the E.U.? Share your thoughts below.
Tags: Dr. Andreas Muehler, health technology, life science, life science technologies, medical devices
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