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HealthXL Digital Health Success Stories Report Part One

Circulation is a digital health company that coordinates non-emergency medical transportation (NEMT) for patients through partnerships with transportation companies like Uber and Lyft. By streamlining NEMT, Circulation has helped reduce no-show rates for medical appointments from 20-25% industry average to only 8% for partner hospitals. Circulation also saves those hospitals up to 70% on transportation costs and ensures 95% of patients arrive on time for their appointments. The company works with over 1000 health facilities across 44 US states.

1 of 29
Connecting The Dots To Promote Health Innovation
HealthXL | December 2017
1
Digital Health Success
Stories (and Failures)
About HealthXL:
The Leading
Platform For
Collaboration
The HealthXL Community brings together
key market stakeholders in digital health
and empowers them to collaborate and
learn from each other.
(see list of some of our members on the
right).
2
CONTENTS
3
Navigating the Space
Success Stories
Fail Better
Expert Perspectives
What Next?
Section 1:
Section 2:
Section 3:
Section 4:
Section 5:
Hanna Phelan
Head of Clinical Engagement
Dr Chandana Fitzgerald
Medical Lead
Michael Garrow
Head of Innovator Relations
Navigating the Space
Where Are We Now?
4
Here’s The Problem
5
INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND
MANAGING DIRECTOR
GE VENTURES
Lisa Suennen
Lisa Suennen is Managing Director
at GE Ventures focused on early-late
stage healthcare investments
across health IT, health services and
medical devices. Lisa also leads
Venture Valkyrie LLC, a publishing
and business advisory firm and is a
founder of CSweetener, a not-for-
profit company focused on
matching women in and nearing
the healthcare C-Suite with mentors
who have been there and wish to
give back. Lisa is a member of the
faculty at the UC Berkeley Haas
School of Business, where she
teaches classes on venture capital
and the changing healthcare
economy.
6
“Digital health success cannot be defined by investment statistics. It
must be measured by the impact of these products and services on people –
the patients and providers and scientists using them to make material
changes in the healthcare system.
We must see evidence of efficacy, both clinical and financial, in order to
declare a company a possible success. And in the end, these companies will
have to produce material returns for their investors - given the amount of
money that has poured into the sector, we have yet to see more than
handful of superior financial outcomes.
It’s still early in the marketplace, but aspiring healthcare players need to
play the healthcare game, meaning evidence to justify adoption,
reimbursement and sustainable long-term business success.
We will know we have succeeded when we stop talking about “digital”
health and start talking about solutions that payers, providers, and
patients can’t live without. Digital should not be a novelty, but a feature of
a solution, as it has become in other industries.”
EXPERT PERSPECTIVE

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HealthXL Digital Health Success Stories Report Part One

  • 1. Connecting The Dots To Promote Health Innovation HealthXL | December 2017 1 Digital Health Success Stories (and Failures)
  • 2. About HealthXL: The Leading Platform For Collaboration The HealthXL Community brings together key market stakeholders in digital health and empowers them to collaborate and learn from each other. (see list of some of our members on the right). 2
  • 3. CONTENTS 3 Navigating the Space Success Stories Fail Better Expert Perspectives What Next? Section 1: Section 2: Section 3: Section 4: Section 5: Hanna Phelan Head of Clinical Engagement Dr Chandana Fitzgerald Medical Lead Michael Garrow Head of Innovator Relations
  • 6. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND MANAGING DIRECTOR GE VENTURES Lisa Suennen Lisa Suennen is Managing Director at GE Ventures focused on early-late stage healthcare investments across health IT, health services and medical devices. Lisa also leads Venture Valkyrie LLC, a publishing and business advisory firm and is a founder of CSweetener, a not-for- profit company focused on matching women in and nearing the healthcare C-Suite with mentors who have been there and wish to give back. Lisa is a member of the faculty at the UC Berkeley Haas School of Business, where she teaches classes on venture capital and the changing healthcare economy. 6 “Digital health success cannot be defined by investment statistics. It must be measured by the impact of these products and services on people – the patients and providers and scientists using them to make material changes in the healthcare system. We must see evidence of efficacy, both clinical and financial, in order to declare a company a possible success. And in the end, these companies will have to produce material returns for their investors - given the amount of money that has poured into the sector, we have yet to see more than handful of superior financial outcomes. It’s still early in the marketplace, but aspiring healthcare players need to play the healthcare game, meaning evidence to justify adoption, reimbursement and sustainable long-term business success. We will know we have succeeded when we stop talking about “digital” health and start talking about solutions that payers, providers, and patients can’t live without. Digital should not be a novelty, but a feature of a solution, as it has become in other industries.” EXPERT PERSPECTIVE
  • 7. Overview DIFFERING VISIONS OF SUCCESS The ‘digital health’ arena has brought together a multitude of stakeholders, from healthcare systems to pharmaceutical companies and start-ups. It’s no secret that success looks very different to each of these players. This report provides a bird's-eye view of key digital health successes to date, along with a selection of case studies, companies and thought- leaders who have been involved in moving the needle so far - closely considering reference points from the availability of scientific backing to engagement in commercial and research partnerships, investment and adoption. THERE IS NO SILVER BULLET If you’re looking for a quick fix look away now. There is no one silver bullet or success story that is replicable but it is possible to identify multiple common threads that will help the community deliver the improved health outcomes and reduced costs that the digital healthcare revolution has the potential to deliver. 7 NAVIGATING KEY INDICATORS
  • 8. ● 2001 Proteus Digital Health Solutions Founded ● 2002 Kaiser Selects EPIC for HealthConnect ● 2002 Cygnus launches the GlucoWatch and continuous, non-invasive digital glucose monitoring becomes commercially available ● 2004 First eHealth action plan launched by the EU Member States ● 2004 Khosla Ventures founded. Joins NEA, Sequoia Capital, Venrock and others as active in the digital healthcare space ● 2005 WellDoc founded ● 2005 PatientsLikeMe Founded ● 2006 Outcome Health Founded ● 2006 23andMe Founded ● 2007 Fitbit Founded ● 2009 US adopts the HITECH (Health Information Technology for Economic and Clinical Health) Act ● 2010 HistoRx launches the first commercial automated quantitative tissue pathology analysis software algorithm for cancer assessment ● 2014 Venture capital investments in digital health start-ups exceed $3 billion ● 2014 The UK publishes Personalized Health and Care 2020 outlining a new national health data strategy ● 2015 IBM Watson Health Cloud Launched ● 2015 37 acquisitions including Fossil Group acquisition of Misfit for $260 million and IBM buys Explory’s and Merge ● 2016 HoloLens, Microsoft’s augmented reality (AR) viewer went on sale for developers ● 2016 Theranos Scandal ● 2016 Foundation Medicine First FDA-Approved Companion Diagnostic Digital Health Activity Timeline Highlights: 2001-2016
  • 9. And then there was 2017 and its Milestones OCTOBER 2017MARCH 2017 NOVEMBER 2017 $$$$$ By the first half of 2017 over $3.5B had been invested in 188 digital health companies - a new record in terms of number of companies funded and total amount invested. The Food and Drug Administration (FDA) approves the first ever digital drug-tracking tool hybrid for the U.S. market - Otsuka Pharmaceutical Co Ltd’s Abilify MyCite powered by Proteus Digital Health. Coined as opportunity to address $300B in wasted medical spend. So what have we achieved and what can we learn? SOURCE: http://bit.ly/2tG6o3L SOURCE: http://for.tn/2zFl34u The one that really caused shockwaves. In October Amazon announced its potential disruption of the pharmaceutical industry by selling prescription drugs online. Following this CVS, the largest pharmacy chain in the U.S., reached a deal to buy insurance giant Aetna for $69 billion. Another step towards democratized healthcare? Or just more cash plays? SOURCE: http://bit.ly/2AD8B3r
  • 10. 10 Digital Health Successes Improved Health Outcomes & Financial Returns
  • 11. Core Themes of Digital Health Success Stories Evidence-Based Advances With thousands of digital health solutions on the market, clinical and economic proof is vital for companies to prove validity and efficacy. Purpose-Built Business Models Innovative business models are going outside of the norm to penetrate a tightly-regulated healthcare industry to produce real outcomes and provide precedent for future disruptors looking for guidance. Widespread Adoption Are we too quick to term a solution being ‘adopted’ a success? There is still only a small handful of digital health companies that are making an impact worldwide. Notable Acquisitions The increasing pace of mergers and acquisitions in digital health signal the growing maturity of the space and the opportunity for success that lies ahead given the involvement of key industry players. Acquisition WidespreadAdoption PurposeBuiltBusiness Models Evidence of Efficacy MARKERS FOR DIGITAL HEALTH SUCCESS
  • 12. The Rising Success of Evidence-Based Solutions Why is this a success? The world's first FDA-cleared EKG with artificial intelligence for Apple Watch Research Partnerships: ● Heart Rhythm Society Clinical Trials: ● iPhone Helping Evaluate Atrial Fibrillation Rhythm Through Technology (iHEART) Publications ● Detection of Recurrent Atrial Fibrillation Utilizing Novel Technology Why is this a success? Proven clinical outcomes and cost-reduction through online behaviour change plans. Partnerships: ● Aetna ● BlueCross BlueShield ● Premera ● Horizon Publications: ● A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management ● Leveraging remote behavioral health interventions to improve medical outcomes and reduce costs See More Evidence Based HealthXL Verified Companies Here Why is this a success? Delivering an outcome-based health program to prevent the further development of chronic disease. Research Partnerships: ● American Medical Association ● Intermountain Health ● Kaiser Permanente ● Blue Cross Blue Shield of Louisiana Clinical Trials: ● Preventing Diabetes With Digital Health and Coaching (PREDICTS) Publications: ● Long-term outcomes of a Web-based diabetes prevention program: 2-year results of a single-arm longitudinal study.
  • 13. FOUNDER & CEO Brenda Schmidt 13 “As a preventive benefits manager, Solera Health works closely with its network of digital solution providers to increase enrollment and sustainable revenue through Solera’s health plan and employer contracts. Solera’s business model was purpose-designed to help digital therapeutics providers gain access to qualified patients, enhance engagement by matching patients to specific programs, and facilitating payments for sustained engagement and outcomes. For digital providers, they can access the appropriate patients for a low acquisition cost without the long lead time to contract with a payer. For payers, health plans and employers contract with Solera to access a dynamic national network of high-performing digital solution providers that offer a variety of options for diverse populations. Solera’s approach of matching patients with the digital program provider that meets their unique needs and preferences drives industry leading sustained engagement and outcomes. Solera monitors and benchmarks satisfaction and quality metrics and is only paid for performance. Solera’s unique model aligns incentives between the payer and digital provider and increases the likelihood of success for the digital providers in their network. We have enrolled tens of thousands of patients in digital programs that are improving patient health.” Purpose-Built Business Models
  • 14. Company Acquisitions Funding Round Amount Date Approximate Investor ROI Seed $750k Nov 2011 >25x Series A $7.6m April 2012 >3x Series B $15.2m Dec 2013 >2x Series C $40m Dec 2014 >1x Total Raised $63.5 m Acquired Nov 2015 $260m Funding Round Amount Date Approximate Investor ROI Angel $450k Jan 2012 >15x Seed $1m March 2014 >12x Series A $4.8m March 2015 5x Total Raised $6.2 m Acquired Jun 2017 $74m Funding Round Amount Date Approximat e Investor ROI Seed $1m Feb 2015 >65x Total Raised $1m Acquired Aug 2016 $200m Notable Company Acquisitions SOURCE: crunchbase.com All investments performed whereby the earliest investors got a higher percentage return for their risk, whilst the later investments had a lower percentage return, but the highest absolute return, with a relatively short period between investment and exit.
  • 15. Fitbit and MyFitnessPal have both respectively opened up an arena for wearables to be adopted at mass. In Q4 2015, Fitbit reported revenue of nearly $700 million, and 8.2 million devices shipped. They have seen a sharp drop in both earnings and devices shipped as Q3 2017 earnings are reported at just $400 million with 3.6 million devices shipped. Under Armour’s acquisition of MapMyFitness, EndoMondo and MyFitnessPal has made them the largest digital health and fitness community in the world. According to Under Armour's CTO Paul Fipps 215 million people have downloaded one of the 3 apps. These two companies are examples of the new school and old school healthcare disruptors that set out to put health information in the laps of consumers. With more than 2 million customers, 23andme hold the largest collection of gene-linked data in the world. After a recent funding round of $250 million, the company eying to expand it’s customer base to 10 million people. Founded in 1996, WebMD has answered health related questions for consumers and medical professionals years. In 2016 they attracted more than 70 million monthly unique users. KKR acquired WebMD in July 2017 for a deal valued at roughly $2.8 billion. Widespread Adoption SOURCE:
  • 16. CASESTUDY-BOSTONCHILDREN'S HOSPITAL:CIRCULATION 16 The Problem Each year, ~3.6 million patients across the USA miss at least one medical appointment due to lack of access to transportation. This trend has been reported for over a decade, as research from the Transportation Research Board reports similar figures from 2005. To date, non-emergency medical transportation (NEMT) has been coordinated through a variety of parties, such as transportation brokers, managed care benefits, and non-preauthorized contractors. Each of these systems operate on a state-by-state basis, with non- preauthorized contractors able to rely on ‘volunteer drivers’ as sufficient means for non-emergency medical transportation. As a result, NEMT systems are fragmented and inefficient. The issues of ​appointment access, as demonstrated by missed appointments, and fragmented transportation systems, as demonstrated by current transportation systems, are addressed by ​Circulation​. John Brownstein, PhD is a global leader in HCIT and, in particular, the emerging fields of informatics and big data analytics. He runs a 50-person multi-disciplinary team focused on digital innovations that span clinicians and consumers. His group is supported by a multi-million dollar budget including grants from NIH, USAID, DoD, IARPA, CDC, Google, Skoll and Gates Foundation. His work has pioneered ‘digital epidemiology’- utilizing diverse digital data sources to understand population health. His work is published in over 150 peer-reviewed papers, all focused on new methods and applications in digital health. This work was recognized by the White House with the Presidential Early Career Award for Scientists and Engineers. John Brownstein Chief Innovation Officer Boston Children’s Hospital INSIDER CASE STUDY
  • 17. 17 The Team The Circulation team is comprised of 20+ individuals from Boston Children’s Hospital and beyond. The founding team includes: ● John Brownstein, PhD (co-founder) ● Jared Hawkins, PhD (CTO, co-founder) ● Robin Heffernan, PhD (CEO, co-founder) Collaborations Circulation collaborates with a variety of partners, including transportation companies, investors, and health systems. ● Transportation Partners include Uber and Lyft. ​ ● Investors include Flare Capital Partners, Providence Service Corporation, Echo Health Ventures, Intermountain Healthcare Innovation Fund, Humana, and NextGen Venture Partners. ● Currently, Circulation services over 1000+ health facilities across the US, in 44 states, including: Boston Children’s Hospital, Mercy Health System, and Nemours Children’s Health System. John Brownstein, PhD is a global leader in HCIT and, in particular, the emerging fields of informatics and big data analytics. He runs a 50-person multi-disciplinary team focused on digital innovations that span clinicians and consumers. His group is supported by a multi-million dollar budget including grants from NIH, USAID, DoD, IARPA, CDC, Google, Skoll and Gates Foundation. His work has pioneered ‘digital epidemiology’- utilizing diverse digital data sources to understand population health. His work is published in over 150 peer-reviewed papers, all focused on new methods and applications in digital health. This work was recognized by the White House with the Presidential Early Career Award for Scientists and Engineers. John Brownstein Chief Innovation Officer Boston Children’s Hospital INSIDER CASE STUDY CASESTUDY-BOSTONCHILDREN'S HOSPITAL:CIRCULATION
  • 18. PATIENT SATISFACTION 4.9/5 AVERAGE RATING COST SAVINGS UP TO 70% SAVINGS ON RIDE COSTS ON-TIME APPOINTMENTS 95% INCLUDING WAITING FOR PATIENTS NO-SHOW 8% COMPARED TO INDUSTRY 20-25% 18 Success Metrics ● Circulation has achieved several key financial metrics. Institutions participating with Circulation see transportation cost savings of up to 70%. ● Similarly, institutions participating with Circulation report an 8% no-show rate, compared to an industry average of 20% - 25%. ● Circulation has also achieved several key health outcomes. 95% of patients arrive to appointments on time to institutions participating with Circulation. John Brownstein, PhD is a global leader in HCIT and, in particular, the emerging fields of informatics and big data analytics. He runs a 50-person multi-disciplinary team focused on digital innovations that span clinicians and consumers. His group is supported by a multi-million dollar budget including grants from NIH, USAID, DoD, IARPA, CDC, Google, Skoll and Gates Foundation. His work has pioneered ‘digital epidemiology’- utilizing diverse digital data sources to understand population health. His work is published in over 150 peer-reviewed papers, all focused on new methods and applications in digital health. This work was recognized by the White House with the Presidential Early Career Award for Scientists and Engineers. John Brownstein Chief Innovation Officer Boston Children’s Hospital INSIDER CASE STUDY CASESTUDY-BOSTONCHILDREN'S HOSPITAL:CIRCULATION
  • 19. 19 Transferable Learnings for Future Successes: Lesson One: ● Consumers want to consume health care. Circulation, which has partnered with Uber and Lyft, reports an average rating of 4.9 out of 5 from extensive user feedback. This is, in large part, a result of the convenience and ease that Circulation brings to healthcare logistics. “Patients and providers expect the same service that they receive outside healthcare – namely convenience, quality, and reliability,” says Robin Heffernan, PhD, Circulation CEO and Co-Founder. Lesson Two: ● Social barriers can inspire healthcare tech. Iora Health, a Circulation client, is scaling the Circulation platform to a national level. “A key way to ensure that older adults can make progress on their health goals is by removing significant social determinant barriers such as reliable transportation,” says Duncan Reece, Senior Vice President and General Manager for Iora Health. ● Lesson Three: Create a track record of success. Circulation recently announced Lyft as a partner. Robin Heffernan, PhD, Circulation CEO and Co-Founder, recognizes Lyft as a “collaborative partner with a track record demonstrating a strong commitment to the healthcare space.” Relationships with strong, successful partners have enabled Circulation to scale rapidly, demonstrated by the 1,000+ healthcare facilities supported by Circulation and the recent closing of a $10.5 million series A round of funding. John Brownstein, PhD is a global leader in HCIT and, in particular, the emerging fields of informatics and big data analytics. He runs a 50-person multi-disciplinary team focused on digital innovations that span clinicians and consumers. His group is supported by a multi-million dollar budget including grants from NIH, USAID, DoD, IARPA, CDC, Google, Skoll and Gates Foundation. His work has pioneered ‘digital epidemiology’- utilizing diverse digital data sources to understand population health. His work is published in over 150 peer-reviewed papers, all focused on new methods and applications in digital health. This work was recognized by the White House with the Presidential Early Career Award for Scientists and Engineers. John Brownstein Chief Innovation Officer Boston Children’s Hospital INSIDER CASE STUDY CASESTUDY-BOSTONCHILDREN'S HOSPITAL:CIRCULATION
  • 20. 20 Expert Perspectives Clinical, Investment, Entrepreneur & Industry Insights
  • 21. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND PARTNER Albion Capital Christoph Ruedig Christoph focuses on investments in healthcare and renewables. He initially practised as a radiologist, before spending 3 years at Bain & Company. In 2006, he joined 3i working for their Healthcare Venture Capital after which he worked for General Electric's healthcare division, where he was responsible for mergers and acquisitions in the medical technology and healthcare IT sectors. He holds a degree in medicine from Ludwig-Maximilians University, Munich and an MBA from INSEAD. 21 “I emphatically agree that there is a lot of investment going into the sector but very few success stories. Our sale of Exco Intouch was one of the very few VC-backed companies to be sold in the sector in Europe. At the heart of the problem in my view is that there is a mismatch between: 1. Expectations of quick and fast returns, partly driven by hype around new technologies incl. AI, partly by investors not familiar with healthcare. 1. The reality of the slow pace of adoption in the healthcare industry. My prediction is that there will be a correction and that only firms that demonstrably deliver improved outcomes at lower cost will be able to thrive and attract capital in the long term. Success in digital health has to mean improved outcomes and lower cost. This is not the drug industry where you only need to show improved outcomes – most clinicians are highly sceptical that tech will deliver improved outcomes, even if a company has demonstrated it, say in a clinical trial. Perhaps that scepticism will decline in the future as more and more data is generated and today's millennials enter medical professions and become the new KOLs. But today, we as investors always want to see the cost curve being bent. If you achieve both improved outcomes and cost, than financial returns should follow, all else being equal.” EXPERT PERSPECTIVE
  • 22. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND 22 “There are few successes in Europe of late. Most are in the pharma IT sector (Zinc being bought by Veeva, Definiens being bought by AstraZeneca, Exco Intouch being bought by ERT, etc.), far fewer on the provider or patient facing side. Our strong view is that as far as provider-facing solutions are concerned, just offering another geeky technology is not going to cut it, for a number of reasons. You need to be delivering a solution and that most often means providing a service in addition to the technology if you want to be able to quickly drive adoption. A lot of the interesting businesses we see have got a well-run service that they make more efficient and effective with the use of technology. The other area where we see strong growth in adoption and businesses scaling quickly is B2C, i.e. a new software or piece of hardware which consumers pay out of pocket. This is overlapping with the wellness space but we focus on the ones which can demonstrate improved clinical outcomes, e.g. by running trials with the consumer data. Completely depends on the area. Pharma IT needs an ability to understand the pharma mindset and a culture sharing the same views, i.e. conservatism, fear of regulators, etc. B2C needs a culture that is marketing-led.” PARTNER Albion Capital Christoph Ruedig Christoph focuses on investments in healthcare and renewables. He initially practised as a radiologist, before spending 3 years at Bain & Company. In 2006, he joined 3i working for their Healthcare Venture Capital after which he worked for General Electric's healthcare division, where he was responsible for mergers and acquisitions in the medical technology and healthcare IT sectors. He holds a degree in medicine from Ludwig-Maximilians University, Munich and an MBA from INSEAD. EXPERT PERSPECTIVE
  • 23. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND 23 Would you define digital health success as delivering positive health outcomes and financial returns? As a clinician working in the NHS, my principle focus is patient care so I am heavily weighted towards looking at positive health outcomes. Having spent time as a commissioner, and also from previous battles on increasing adoption, those paying for healthcare services look for hard evidence on clinical outcomes from trial data over pilot experience. Regarding financial returns, within the NHS this is mostly about reducing net spend. What examples come to mind when you think of digital health successes and failures? What can we learn from these examples?National programme for IT is often cited as a significant digital health failure, and the lessons learned from this are well known. Out of this, some successes did arise, such as the NHS Spine and services such as Summary Care Record, Patient Demographic Service, and eReferrals. The lesson here is that foundation work that allows people to build on top is an important area to deliver on. General Practitioner, Digital Health Consultant and Founder of VR Doctors Dr Keith Grimes Dr Keith Grimes a General Practitioner and Digital Healthcare Consultant. With 20 years’ experience of work within the NHS, he’s led award winning projects including MyLittleOne, a neonatal camera & tablet system, and Brighton & Hove Roving GP service and founded VR Doctoran online community dedicated to exploring Virtual & Augmented Reality in Health & Social Care. EXPERT PERSPECTIVE
  • 24. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND 24 Which segments of digital health do you see as having the greatest potential for positively impacting health outcomes and delivering financial returns and why? “There is much interest in Artificial Intelligence as a way of improving outcomes (through better clinician decision support and early notification of abnormal test results, for example) and reducing costs (by decreasing the need for costly and scarce clinician human resource). It remains to be seen whether this can be delivered, but there is reason to be hopeful in areas such as pathology and radiology. With immersive reality technologies like VR and AR, the hope is that applications such as pain and anxiety reduction, mental health, and education and training will lead to improved access to care and greater numbers of doctors and nurses. Mental health in particular is a difficult area with long waiting lists and growing demand.” In your perspective, what cultural elements are facilitators/impediments to scaling digital health success? “In the UK NHS, the public are not used to paying for any health care services, which is an impediment to going direct to consumer. The NHS is famously difficult to have innovations adopted as well, although the National Innovation Accelerator, the Academic Health & Science Networks, and the tech tariff are beginning to change this. Any products or services that sit on consumer technology, such as smartphones and popular apps and platforms, are more likely to succeed by driving the pressure for service change from the patients or frontline staff. A good example is how whatsapp use between doctors in hospital is growing in the absence of other options. The NHS needs to be better at accepting this into workflow.” General Practitioner, Digital Health Consultant and Founder of VR Doctors Dr Keith Grimes Dr Keith Grimes a General Practitioner and Digital Healthcare Consultant. With 20 years’ experience of work within the NHS, he’s led award winning projects including MyLittleOne, a neonatal camera & tablet system, and Brighton & Hove Roving GP service and founded VR Doctoran online community dedicated to exploring Virtual & Augmented Reality in Health & Social Care. EXPERT PERSPECTIVE
  • 25. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND 25 “Digital Health definitions range depending on who you ask so it is important to set an agreed upon definition across the community, granted it may continue to iterate and evolve. The original definition that was put forth by Paul Sonnier “intersection of digital and genomics”. If I look at the health & care market, we will continue “hacking our bodies from within” – meaning while small molecules still here to stay: large molecules, stem cell, RNA, DNA will continue advancing towards much more personalized experience & medicine. At the same time, digital health is also broadly used to incorporate efficiency tools and process improvements, however my personal view is that HealthIT defines that best – leveraging technology to improve existing cumbersome processes across the health & care ecosystem. We then get to what I would now define digital health – which is the science of behavior change leveraging all the hard work the HealthIT community continues doing around data siloes, combined with huge advancements in artificial intelligence to improve healthcare consumer experiences. In addition, the upstream early & preventative diagnostics that enhance the said patient experiences to much more frequently and with accuracy move towards assisted #selfcare” Eugene Borukhovich GLOBAL HEAD OF DIGITAL HEALTH INNOVATION & INCUBATION BAYER Eugene Borukhovich currently serves as a Global Head of Digital Health & Innovation at Bayer. He’s also an Entrepreneur in Residence at Personal Health Solutions (PHS), and a founder of Health 2.0. Together with Yoram Levanon, Chief Scientist Officer at Startup Beyond Verbal he will talk about startups and innovation in digital health. EXPERT PERSPECTIVE
  • 26. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND 26 Which segments of digital health adoption do you see as having the greatest potential for positively impacting health outcomes and delivering financial returns and why? With that definition, laser focus on customer & patient experiences with digital therapeutics at the core of it is what is already showcasing scientific evidence and even generating revenues. What examples come to mind when you think of digital health successes and failures? What can we learn from these examples? Companies like WellDoc, Omada, Voluntis are great examples of early successes. Of Course companies like theranos brought some negativity to the overall space. While early stage, our own G4A recent alum, Oratel Diagnostics that is tackling early diagnostics for woman's fertility issues via a saliva test.. ·In your perspective what cultural elements are facilitators/impediments to scaling digital health success? Culture eats strategy for breakfast, lunch and dinner and the short answer is risk-averseness is the main impediment. Having said that, when one is selling widgets there is not much at risk unlike in health care when people’s lives are at stake and hence that laser focus on evidence is key for all the startups and ecosystem partners pushing the envelope in digital health. Eugene Borukhovich GLOBAL HEAD OF DIGITAL HEALTH INNOVATION & INCUBATION BAYER EXPERT PERSPECTIVE Eugene Borukhovich currently serves as a Global Head of Digital Health & Innovation at Bayer. He’s also an Entrepreneur in Residence at Personal Health Solutions (PHS), and a founder of Health 2.0. Together with Yoram Levanon, Chief Scientist Officer at Startup Beyond Verbal he will talk about startups and innovation in digital health.
  • 27. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND 27 Dr Travis Good MD and CEO at Datica As CEO, Travis leads Datica’s vision. His background in compliance, security, and cloud infrastructure gives him technical expertise that, when paired with his experiences as an MD, allows for a unique view on the challenges of healthcare. “The success of digital health should align with the quadruple aim of better outcomes, lower costs, and improved patient and provider experience. Doing that at scale creates massive success.” What examples come to mind when you think of digital health successes and failures? What can we learn from these examples? “My success examples include Omada and Flatiron. The failures are plentiful, many of which I've never heard about. In my opinion, the biggest failure perhaps is likely Practice Fusion.” Which segments of digital health do you see as having the greatest potential for positively impacting health outcomes and delivering financial returns and why? “I think the hardest nut to crack so to speak, but also the biggest, is going to be the conditions where you need to activate patients or engage patients that aren't already engaged. This is the source of massive societal issues and healthcare costs. I'm thinking of things like obesity and diabetes, which then lead to things like health disease and eventually some sort of cardiovascular episode. EXPERT PERSPECTIVE
  • 28. INVESTMENTANDOUTCOMEDISPARITIES-ATROUBLINGTREND 28 Dr Travis Good MD and CEO at Datica As CEO, Travis leads Datica’s vision. His background in compliance, security, and cloud infrastructure gives him technical expertise that, when paired with his experiences as an MD, allows for a unique view on the challenges of healthcare. [Continued] “These conditions, most commonly, result over time from unhealthy behavior that gets worse and worse in midlife. Finding a way to engage this group and help them to make even very small, incremental improvements could generate massive savings. This is the biggest impact because it affects a large and growing segment of our society. If I was recommending what segments to target that would be much easier, I'd say things where patients are already engaged. Things like cancer and pregnancy. These do have huge impact potential as well.” In your perspective, what cultural elements are facilitators/impediments to scaling digital health success? “The biggest cultural impediments are technology fatigue (EHRs burn out many clinicians and the boards that paid for them) and the frequent disconnect between the builders of digital health and the users (patients and providers) of digital health.” EXPERT PERSPECTIVE
  • 29. Failed Digital Health Efforts What Can We Learn? 29