Digital health is experiencing explosive growth. Innovators and investors alike see the tremendous potential in technologies that can transform the face of healthcare by leveraging data to improve diagnosis, treatment, outcomes and the overall patient experience. In other words, healthcare is an industry ripe for disruption.
This topic was the focus of a panel at the 2018 VentureClash competition. The discussion was moderated by Sri Muthu, CEO and co-founder of HealthVenture Corporation.
The panel speakers included Matthew Cohen, Vice President of Research and Development for Medtronic’s Minimally Invasive Technologies Group; Erin Hatzikostas, a groundbreaking innovator within Aetna; Harlan Krumholz, MD, renowned cardiologist and Director of the Center for Outcomes Research and Evaluation at Yale-New Haven Hospital; Eric Roscow, CEO of Diameter Health; and Barry Stein, MD, Vice President and Chief Clinical Innovation Officer for Hartford HealthCare.
The following article highlights some of the key perspectives gleaned from this interdisciplinary panel of industry experts. Their thoughts have been consolidated and paraphrased in some cases.
Aspirations for Disruption
The panel was asked to define digital health and what it seeks to accomplish at its core. The consensus of the panelists was that although healthcare has already been transformed to the digital realm, the challenge lies in leveraging the digital data—which none professed to be doing to any great extent in their organizations. Ideally, digital health solutions should facilitate the seamless, frictionless sharing of data among all stakeholders (patients, providers, payers and suppliers), leading to better decisions, improved outcomes and heightened efficiency.
STATE OF THE INDUSTRY
Inferior Consumer Experience
All agreed that the healthcare experience is in desperate need of transformation. Waiting rooms are full, it’s hard to make appointments, information doesn’t flow, duplicate and sometimes unnecessary tests and procedures are performed, and patients can’t readily access their medical records, physician notes, discharge summaries and the like. But the current reality is that patients keep showing up nonetheless. To some extent this is because their choices are limited by their health plans and also by the dominance of certain providers in the market.
When asked to describe the healthcare industry infrastructure that innovators will be required to engage with, one panelist equated it to a mess of tangled Christmas tree lights that you can’t just discard and replace. The others heartily agreed with the analogy.
Today’s truly visionary innovators that recognize the dire need to address the consumer experience can become viable competitors of the much larger players in the market. But there’s the unavoidable issue of a weak infrastructure in the healthcare system. We can bolt many solutions and many technologies onto this infrastructure, but if the Christmas tree light theory holds, we’re attaching to a broken infrastructure that needs to be repaired first. That is challenge number one.
Evolution to Value-Based Healthcare
The move toward value-based care versus fee-for-service should be top of mind for innovators because it will change the healthcare paradigm in a huge way. We’re not quite there yet, but the end game should be around incentivizing providers based on patient health outcomes, not on the number of services provided. The benefits of a such a system in terms of greater efficiency, reduced cost, decreased risk and improved outcomes is an across-the-board win—for patients, providers, payers and suppliers.
OPPORTUNITIES AND CHALLENGES FOR STARTUPS
Understanding the Current State
Startups that succeed will have a deep understanding of the current system. It’s hard to walk into the digital health space without understanding all the moving parts, which is why we have yet to see a Silicon Valley company be truly disruptive in the digital health arena. You have to combine a groundbreaking idea and technology with deep content knowledge of the many illogical facets of our healthcare system that can conspire against innovative practices.
One of the key challenges the panel discussed was the crucial need for interoperability. Any solution must be able to connect data from many different sources—whether it’s CVS or Walgreens, Hartford Hospital or Yale, Aetna or Cigna, Fitbit or Apple—without the benefit of a standardized application programming interface (API). And all that information must be easily aggregated, intelligently delivered, and proactively used to enable the digital health future we’re striving for.
Creating a Viable Business Model in a Complex Industry
The healthcare industry is not for the faint of heart—it takes sheer determination to penetrate. And it’s about as Rubik’s-cube as you can get. You can have the greatest idea of how you can improve things—and digital health is a pathway to do it—but you’ve got to figure out what the business model is. As long as the business model continues to reward bad service, there’s no competitive drive to create solutions. Part of what we have to do is fashion a healthcare system that’s going to reward the kind of innovation that’s going to deliver in a way we haven’t in the past. This will never happen as long as the bottom line is not affected by providing bad service.
WHAT STARTUPS SHOULD DO
Know the Problem You’re Trying to Solve
There’s an enormous amount of technology and talent looking for something to solve. It’s far more important to identify a significant, existing problem—one whose solution will generate substantial value. The greatest such opportunities in the healthcare space will most assuredly be consumer driven. If we craft a solution from the perspective of the consumer lens, there’s a seismic opportunity to transform healthcare.
Know Whom You Can Delight
Ask yourself whose life you’re going to make easier and better—and be able to prove you can make it happen. We can get enamored with the technology. And the technology is crucial. But in the end, it’s really a solid implementation plan that’s going to make a difference.
When you’re approaching a potential strategic partner, you have to understand the problem you propose to solve, but you also have to be confident your solution fits within their business model. You should hit one of their top three priorities. It’s also vital to show that you understand their infrastructure and that you can easily plug into it. It should be obvious why your technology is going to make things better—you shouldn’t have to oversell it—but be sure you have data around all your proof points.
Consider costs and be practical
If the prospect of generating evidence to prove a clinical benefit will be super difficult or expensive, that’s another good litmus test to determine whether you’re on solid ground to advance your idea to the next level. And if you do move forward, you have to always attach to economic value and clinical outcomes.
Demonstrate a scalable market
It’s great to have a problem to solve and the technology to solve it. But if you’re looking to get funded or have investors, you must have a viable business model that’s both scalable and sustainable.
As asserted by one panelist, the medical practice and the healthcare industry will be entirely different a decade from now, in large part due to digital health solutions and how we evolve. But it will be a painful zigzag process due to the legacy systems that make things difficult.
The digital health plays that will make the biggest difference will be the ones that combine a keen sense of technology with a clear and present problem and deep content knowledge of how to navigate a system that’s not always logical. That’s sound advice for any entrepreneur considering entering this space.