Health Innovators
Health Innovators

Episode · 3 years ago

3 Vital Techniques Every Innovation Leader Needs to Include in Their Commercialization Plan w/John Sharp

ABOUT THIS EPISODE

Healthcare is a complex industry, and a lot of innovators and founders underestimate the process of bringing an innovation through the regulatory process to commercialization. How can you avoid “death by pilot”? What are the biggest potential failure points to be prepared for in the commercialization process? Why is it so important to include real patients in the development process, and what are the potential pitfalls you might deal with?

 

On this episode, we're joined by John Sharp, the senior manager of PCHA, the Personal Connected Health Alliance of HIMSS. We talk about why some healthcare innovations fail to commercialize while others succeed. John shares what’s unique about commercializing an innovation in healthcare versus other industries. And, he reveals three vital tactics that every health innovator needs to include in their commercialization plan.

 

3 Things You'll Learn

  • The difference between the healthcare industry and the innovation of startups
  • How to avoid "death by pilot"
  • Why you need healthcare organization partnership 

 

Healthcare innovators have a lot of passion for the problem they are trying to solve, but that passion won’t compensate for a lack of understanding the industry and how it actually functions. Healthcare and startups are industries with fundamental differences, and unless innovators are prepared for that, they are doomed to fail.

You have to make sure your funding is able last through the process of regulation and the education of healthcare professionals. Involve real patients in your development. You must understand the complexity of the healthcare system and know what your niche will be in that system.

Welcome to Coiq, and first of its kind video program about health innovators, early adoptors and influencers and their stories about writing the roller coaster of healthcare innovation. I'm your host, Dr Roxy, founder of Legacy DNA marketing group, and it's time to raise our COIQ. On today's show, we're going to talk about why some healthcare innovations fail to commercialize and went why some succeed. John Sharp is with us today. He's the senior manager for PCCHA, the personal connected Health Alliance of Hymns, and he's going to share why it's so difficult and so unique to commercialize and innovation and healthcare compared to other industries. He's also going to reveal three vital tactics that every health innovator needs to include in their commercialization plan. So, John, let's start off the conversation by you just telling us a little bit about your background and what you do. Okay, thanks, glad to be here today. Well, as you said, currently I'm senior manager and I'm in charge of leadership for the personal connected health alliance and we're the part of hymns that's focused on consumer facing health it whereas most of him's, if you're familiar with it, is more focused on providers and insurers and harm in other areas. So really, really focused in on the APPS and devices that patients and consumers use. My background is that I've always been interested in patient engagement. My first career, which lasted a good long time, was actually as a hospital social worker, but then I swish with the coming of all things Internet to health I and most recently, before I joined hymns about five years ago, as at the Cleveland Clinic in research in formatics, I've interested in research as well as patient engagement and APPS and devices. Gotcha. Great, what a wonderful background. So I'm going to start off, you know, the conversation a little bit by talking about this stat that really is kind of like the foundation for the reason why we even have this show. So Ninety five percent of innovations that are brought to the market failed to commercialize, and so I'd like you to share some insights on why do you think some fail in some succeed? Well, I think there are a lot of reason and I think one aspect that may be beginning to change is that investors and founders of startup companies don't as understand the complexity of the health care industry. I think investors are getting a little smarter and realistic about that, which is encouraging. So I think that percentage hopefully will go down as a result, but there's still a lot of money available, a lot of people willing to invest, so that danger is still there. I think the IT might be extreme to say naivete of a lot of founders in this area and people involved in developing new absent devices is not understanding their market. There there's a lot of passion, as in any successful industry, with startups, where the founders are very passionate about what they're trying to build,...

...and a lot of that comes out of an either personal experience with a diagnosis or life surrending condition or going through the healthcare experience with a family member and as a result that they think, because of their technical background and business background, that they can fix this and then after two years into it and they're running out of money, they don't understand what happened, but they didn't understand the industry in the first place. And the other there a couple other various I'll mentioned briefly. One is provider organizations are traditionally very cautious and conservative. So you come even a lot of of them are allergic to the term disruption right, which is in total contrast to the startup world where, you know, break things fail fast and so on, and positions and other health care providers can are all about safety and not being sued. So you have these contrasting industries. Now that's changed. And another thing that's changing because you have a lot of large healthcare organizations that even now higher physicians, based on entrepreneurship and have their own innovation centers and are funding startup companies and partnering with Start Companies. So that then enables them to give an education to those startups. That may seem left right ideas, but how does it fit into a specific need? I was talking to one startup originally in Chicago at the health box studio, which is a week long advising session for I think twenty startups at a time, and talk to this one and nicely it was a also a female founder, which is still somewhat rare, becoming less rare, and she had a fantastic idea about remote monitoring. The concern was, you know, is everybody already doing that? There are also reinvolved and had a good artificial intelligence background. Then I talked to her maybe four months later in Cleveland, that a plug and play event, and she said that they had really shifted as they talked to provider organizations and provider organizations were focusing in on a specific need they had and they could see how what they were developing, this startup, would fit that need. So the that's a successful example. I think we're a lot of startupscale is engaging provide organization or multiple provide organizations on a need at that organization has, rather than just saying this is the greatest thing in the world, you should buy it, you should implement it at scale, which is unrealistic. So and then the other thing is, I mean that's the story, about getting your foot in the door right least. Then maybe doing a pilot study. The other problem of courses death by pilot and which a lot of people talk about, and part of the reason that...

...occurs is again the different cultures. So if a startup has enough funding, venture funding, Angel Funding, maybe for a year or two years if they're lucky. Provide organizations don't move that fast. Yet some are be getting moved faster in this area, but by the time they do a study, go through all the regulatory stuff through the Institutional Review Board, and I know that space. I I was UN an institutional review ord at one time and it's a very be again a conservative the liberative group and the other provocourses. A lot of the research folks like on the institutional re board that would understand digital health and how it can benefit patients. So they're they understand drugs and device medical devices. So they need an education to about don't create unrealistic barriers for these companies that may have something very useful and need to study it. So I think if you can get past some of those barriers with the right partner who has a need that you're going to fulfill, even if you have to pivot. They may not pivot a hundred eighty, but pivots somewhat, then I think you can be successful, and that in getting into a provider organization. So that's really more APPs for provide that providers they implement with their patients. So it's more of a was that be to BTC. So what do you what do you recommend for health and invaders who are in the trenches and you know, maybe have funding to last them, you know, another year, another eighteen months, and that in itself is really like a win right. So, you know, what do you say to that coals of leaders that have about not, you know, twelve to eighteen months worth of funding left and that they're in the pilot phase? Any recommendations that you have? Yeah, getting from pilot to scale, even within one organization and with your own limited resources, is the real challenge. Not even talking about the next stage, which would be either acquisition or, you know, commercialized commercialization. I think I think the key would be having a partner who would you know, a provider, organization that's willing to help them accelerate the process. So instead of continuing to knock on more doors and getting doors slammed in your face, find if you already have somebody who's going to pilot with you. I think Targal of them. You know, if this is successful, how are we going to scale it? How we going to make this successful as a partnership to get beyond forty patients? You know, if you have you know, and it may be it may be being able to speak the language of population health as well. So if we're doing a pilot study of diabetics, but you're then asks that position. You're working with. Well, how many...

...diabetics does your organization currently see and do you think this too would benefit ten percent, twenty percent, fifty percent of them in the long run? And so and be of a population health program or apped around that or risk sharing. So the next step would be houses. is going to be paid for, and there're couple routes there. One would be some value of these care bundle payments, like I think it was an example of what's now called Virtual Rehab or digital rehab, and there are a lot of organizations right now that are moving into the area of bundled payment. For me and I replacement. Well, if a digital rehab program or Virtual Rehab Program where you actually interact with patient remotely, so there have to come in for those Rehab appointments and they can do exercise as well at home, how much money could I say and what better outcomes could you get for a population like that? So you have to begin to think about you know, in the long run, is going to get paid for either out of a bundle of payment or value based program or in some cases there there do cpt codes for reimbursement on her medicure for remote patient monitoring. So that's treatment, but it's a modern monitoring site. So you really have to become savvay on how is this going to be paid for, and that's how it's going to scale. Yeah, we can had some compsations with health innovators about, you know, not just getting really excited about a pilot and, you know, wessing any terms, but you know, negotiating that pilot agreement to make sure that they have funding that, you know, if they achieve certain benchmarks, they're you know, willing to actually purchase something on a much bigger scale going forward if they have a successful pilot. Yeah, yeah, I only heard of one company, I think is a Canary Health has a guarantee, outcomes guarantee, so they, you get the tool free as a prior organization if they don't meet their outcome targets for chronic illness. But I think they're the only ones trying to do that. It's very risky, but it's taking on the risk really of the that's the provider would usually get stuck with. So that's a very innovative business model and we'll see if it works. But yeah, but the other. Well, this may get to our too far down the road to what we'll talk about later, but I think one in if you look at successful company, says, you know, the thing too, as a startup, is who really has made it and is going either as been acquired or has gotten financial success just based on going from pilot to larger studies to scale. And if you look at those companies, they're the ones that have on their website a tab, and I don't think usually website tabs me very much. Not. They have a tab that says evidence or outcomes. MMM, and then you look at that and you give you get to see. You can see their pilot studies. They can see studies that men go up too, hundred fifty...

...patients, five hundred patients and so on, and then you can see they're really doing it right because they have the evidence showing this works on more and more patients every time they do a study. Yeah, and they tweet their mode to you know, I say, as a scale. Sure, absolutely, learning every step of the way and iterating. HMM. So, so, you know, we had talked about a number of different things or strategies and tactics that health innovators need to include in their commercialization plan. What's free tactics that you suggest that every health innovator has in their plan? I thought about this before and it's always hard to narrow it two three, but I'll try. Okay, but I think one is really understand the complexity of the health care system and what your niche will be in that system. is obviously at a single solution, as it could solve all the problems. So and part of that finding your niche is some using two for this one. I'm cheating. Is I'll give you for not is not not duplicating every anything that's out there. Obviously, at this point in the market, don't even try to build an electronic medical record right that field to saturated. Yep, even tools for diabetics or diabetic prevention programs. That's been saturated by very some very successful company. So we're where you going to insert yourself and be successful. And obviously there's some areas that are going to be need multiple solutions. So anyway, that's one or one and a half. I think also a strong partnership with a physician or some provider and some cases of impe nurses, and I think nurses are under utilized resources in health care innovation, but have a strong partnership with a healthcare organization and not just their innovation center, but have a physician champion, and part of that solves a previous problem that they understand that complete flexity of reimbursement, treatment, liability, chronic care management, and you need to educate yourself about all those things and know enough, because they're all potential failure points if you don't get it. And then a third one is, I would say, usability. And usability is interesting because I think it covers both the provider side and the patient side. So, depending on the tool, a lot of the tools, whether it's something like remote monitoring or prevention program or even Digital Therapeutics of Treatment Program you have, most of them will have some consumer or patient facing element, and that has to be easy to understand, intuitive, and that means also that you need to do testing with real patients and not just build what you think will work or in...

...some of that through iteration, granted, but and then, and I think one of the most valuable things that is underrated or not even sometimes you've ignored, is a health dashboard concept. So if you're doing, for instance, of remote my on a train for a specific condition and there are a lot of good tools for this. And diabetes again and some other areas. Can you see on your dashboard in simple terms, just like you would with the Fitbit, where you stand today, m as a patient, and I think patients are getting used to this idea from activity monitors and it should translate relative easily to remote monitoring tools. And then, if for the physician, so that side the data needs to be integrated and displayed, preferably imbedded into the electronic medical record but, if not, easily reached from there or part of a Tele Medicine Senator Center that's monitoring this population. So I guess that's three. How exactly, how important is it, do you think, to for health innovators to involve patients, real patients, in the product development process? I think it's a well, if it's not the number one success factor, obviously you have that money, but maybe it's number two. I think it's that important because I myself have been through this e spirit, not innovating per se, but talking to a lot of companies, but I went to a conference of people with type one diabetes several years ago in California and Silicon Valley, and these are very tech savvy by the pretty takes savvy group with type one, but I had no idea what they were going through, what it was like to live insulin dependent. And one of the most shocking aspects for me, and I thought I knew a lot about the patient experience. The most shocking thing for me is several people said out right, I realize any night I go to bed I could die. Just you know. It's the most you know, I felt with cancer patient and a lot of others, but to know that because your bluecoats, your blood sure could bottom out at night and you wouldn't even wake up right. Yeah, and there hasn't been a good solution for that, technically or medically, is just shocking. Now they're there are solutions like the closed loop, what's called an artificial pancreas, which is really working for a lot of people now. But you know, those those are the kinds of things you only learn to talk to patients about their day to day experience and how this technology is going to fit into that. HMM. We have a framework, a cocreation framework, that we take health innovators through, kind of giving them a clear path with that. We call it the five codes because it's not just, you know, Co product development, but it's covalidation, Co ideation, code testing different phases of the CO creation or product development process. How do you recommend that health innovators get patients involved in the process, and are there any pitfalls that they need to...

...be aware of? Well, I think the way to do it is to find, where considered, patient experts and organizations like we go. Hell Hadrian experts. A lot of these people with advanced degrees who are also maybe another field but are savvy and a tech wise if they understand both their illness and there what technology is really in health the so and there are plenty of people out there. You could also partner with specific organizations, like we in have just partnered with the United Spinal Association, which I had never heard of before, but okay, it's people with spinal court in injuries who are wheelchair bound, very savvy pose in terms of government policy and getting the tools they need to live good lives. So I think that's one. The pitfall is using patients that are to focus or are angry because they've had bad healthcare experiences, which is not helpful. But I think the ones who have and then there's some that are to tech savvy and then don't appreciate what people who are either health or it or both, illiterate and how they would use a specific technology. So I think you need to look at what population you're focusing on and what kinds of patience you need. Sure, so you've written a lot about, you know, the dilemma that we face when it comes to the language that we use. Tell me a little bit in our audience, a little bit about this phenomenon and what are some of the things that we that health innovators need to be mindful of when it comes to their messaging strategy and how they communicate with stakeholders? Depends on the stakehold where we just grob yeah, patients and providers. Yeah, well, with providers again, I think goes back to understanding what it's both what is like to be a provider. There was an article, I think the stand for, where doctor was suggesting if you want to innovate providing innovation for me, you should shadow me for a day see what it's really like, and that might involve more than twelve hours, by the way. So understanding that and now understanding that they don't want the additional burdens. They want things that simplify their work, that make it or effective. So I think that on the provider side it's really understanding them, but also understanding that terminology like population health and bundled the payments, so you understand the financial side as well as the clinical side. It's a real challenge but it's worth every minute of learning that. On the patient side, I think gets. I think you could begin with focus groups perhaps, but you have to ask the right questions and sometimes it's not so much questions is I think again it would go back to tell me about your day. What's a day like with this disease and what challenges do you face every day with this disease and what are your biggest headaches? And do you use do you...

...have a smartphone to use it all the time? Are you used to using APPS? What are the best apps you have on your phone? What actually have on a phone? What do you use all the time? And then you begin to see, okay, this particular group still use flip phones, so I'm in trouble. Smartmone right, they smartphones or they they use tablets. A lot of pretty good elderly I think he's tablets and the thing they use the most is skype so they can talk to the grand children. So I so you know. All right, what do you so those interfaces are good. Well, maybe you'd be good candidate for, tell, a medicine, if that's the case or whatever. So I think it's really sitting in but throughout the product life cycle he may have an advisor group initially, but I think would be helpful just to have a kind of a, if you can afford it, a patient expert as a console throughout the life cycle process is actually at the table. So you're making a product decision or upgrade decision and they say, wait a minute, that's not going to work right, and then you I think that's part of avoiding the failures, having the advice right up front, whether it's a usability issue or something else. Well, in kind of what you're indicating is is that that's better to know throughout the journey instead of once the product is developed and it's out into the marketplace. It can be very expensive and almost life threatening to the company to find out, you know, when you're so far down the road in the development. Yeah, definitely. So you know if you can build the right the first time. Yeah, right, we're about that. Yeah, definitely, less iteration maybe. So, do you know? Do we have any concerns right now? You know there's a lot of conversation in the industry about, you know, peeple, provider centric, patient centric or patients? Patients? Are they people and you know the language that we're using around that speak to them a little bit that it's still a very tough one. I'm shifting my self from just talking about patients. Obviously the term patient engagement has been around for a long time. It's beginning to shift away from that. I think part of the reason is, and I don't remember the exact statistic, but I've heard over and over again that even somebody with a chronic disease, HMM, that's to be your illness, is going to interact with the provider maybe ten or twelve times a year, maybe have one hospitalization, maybe not even that, right, compared to all the other hours. They're really on their own with her illness and don't always have the right tools to manage that or the right knowledge. So calling you can be a patient if you're in the hospital, but you're still a person. So I don't use person enough. In Europe there's a they often use the term citizen, but that's more a European centric socialized medicine concept, maybe more so, but I like it, but it just doesn't make sense here in the US. So I've been using I've been using consumer, patient, consumer first, and a lot of people don't like consumer because it means does that mean everything is commercial right and commercialized?...

So I don't have a good answer to it. I think the ideal thing would be person, the and you know I do use that to like person with diabetes, person with COPD, rather than, you know, a diabetic or you know other terms which seemed to pigeonhole people. I think so. I think people with our person with a specific condition, and we've had a whole twitter stream now on this term that I was engaged with this week on the term problem list. Even so, why, for me, as a patient, do I have problems? I really have conditions or symptoms? Not, I'm not a problem, and that's a obviously a physician oriented terminology that doesn't translate well or feels insulting potentially. So you know, I think we do need to be careful and you know, the patients board may use different terminology than the physicians Ash Board, and that's okay. We're still talking about the same condition or problems or diagnosis. I think those are great observations and insights that our audience will find valuable. So we have, you know, handful of people that have joined our live show today, innovaders that are in the trenches right now. What are what some of the advice that you have for them? You want three more points or five? I don't know. Such a gap, most of it, I mean most of the being by way of summary. I'll try to think of something that I haven't talked about so far. Well, I think the by way of summary, health care is complex and not easily disruptive and part of it is understanding the financial transition or paying means of payment, transition we're going through from fee for service and you know, I think the worst case scenario that fee for service has forced us into and trying to treat chronic disease is, for incess, you're newly diagnosed with asthma, or here's a prescription for an inhaler, here's some patient education. Material goes in paper. Could luck and I'll see you in a month and you know, call me if you have a problem or go to the emergency room. Those are not good alternatives for helping me manage my disease. You know, that's just a recipe for disaster as far as I'm concerned, and I think what we're shifting to and digital health is more continuous monitoring of a condition so you know how you're doing and treatment. Well, personalized treatment is also the term precision medicine, which is a little more heavy into genomics, which I don't want to get into, but personalized treatment. So if you see princetance, if you have a digital he's going back to as me of a digital inhaler that gives you feedback on how often you're using your regular inhaler versus your rescue inhaler, and you understand and that tells you, you know, the pollution levels when you were using your rescue hell or three...

...times in a row in an hour, and you know, maybe I should avoid that or, you know, think twice about that kind of an environment. And just so you learn, the solution teaches you as a patient how to manage your illness, helps you with it on a dated that day basis. Is True in a lot of coaching APPs as well and then helps you understand how to adjust your medical treatment. And in some cases that might be actually the physician or a nurse or tell medicine center calling saying, you know, we're seeing these monitoring numbers and they may not say it, but our algorithm tells us that you could end up in the emergency room the next two days if we don't change your medication. So that, again it's personalized. Based on continuous monitoring, we can customize your treatment and that's a big difference than ending up in the emergency room and a doctor never saw you before says well, we're going to increase your medicine, we're going to add another medication and good luck, and then you're back in the emergency room within a week because you're not getting good continuity of care or continuous monitoring. So I think in the future my vision is that continuous monitoring, if it's done right and has the right staff thing and has the right user interface that really teaches patient about their illness and the treatment, I have a lot better outcomes and that should be the goal for any body and starting up in this space. How do I get to that point? There a lot of ingredients. Let's make sure recover all the bases, and you know, which doesn't mean you burn through all your cash and six months necessarily, but you do in smart ways to and you get the right advice from the right people and your physician champion and maybe nurse champion and figure this out and patient champion. Yeah, absolutely, it's great insights that you've shared with us, with us today. Thank you so much. And so how can our audience get Ahold of you? What's the best way for them to connect with you? The easiest way is twitter, but and it's just at John Sharp. So it was an early a doctor and seven. So I got my my name. Great. I'm also on Linkedin, also just as John Sharp, and my email is jay sharp at him's Dot Org. And the hymns conferences. Just a couple of weeks they out its story. February eleven in Orlando, in your neighborhood, yea, and at the Orange County Convention Center, and we're expecting forty five thousands or closest friends and a mile, a mile of exhibit space. So we're good shoes. So we're really excited. So connect with John there and I will be there as well, so feel free to reach out and stay connected. And until next time, let's raise our COIQ. What's the difference between launching and commercializing a healthcare in avation? Many people will launch a new product, few will commercialize it. To learn the difference between latch and commercialization...

...and to watch past episodes of the show, head to our video show page at Dr Roxycom. Thanks so much for watching and listening to the show. You can subscribe to the latest episodes on your favorite podcast APP like apple podcasts and spotify, or subscribe to the video episodes on our youtube channel. No matter the platform, just search coiq with Dr Roxy. Until next time, let's raise our COIQ.

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