Health Innovators
Health Innovators

Episode · 2 years ago

Digital Medicine, Messaging Strategies & Improving the Efficiency of Adoption w/Dr. Ashish Atreja


Health systems have inherent challenges when adopting technology because of how they are structured. How does this impact the ability to commercialize innovations? Why is collaboration such a key ingredient to finding success when selling innovations to hospital systems? What challenges are innovators facing and what can they do to solve them?

On this episode, I’m joined by Dr. Ashish Atreja, the Chief Innovation Officer of Medicine at Icahn School of Medicine at Mount Sinai, co-founder of Rx.Health, and co-founder of Node.Health. He shares his experience with commercializing innovations within a health system and as an entrepreneur.


3 Things You'll Learn

  • How to find success selling to a hospital system
  • Why financial success or ROI is a must-have for effective messaging
  • How getting doctors to prescribe your mobile health app is critical for consumer adoption

To successfully commercialize your innovation, there are three key things every innovator needs to consider: how to create unique value, how technology can improve efficiency in the health system, and how to find partners who can extend the value nationally and globally. 


Never underestimate what partnering with the right people can do. There are many scalable innovations in the market, but they don’t go anywhere because they don’t find meaningful partnerships to collaborate with. The greatest thing about healthcare is, if you’re bent on creating efficiency, there are so many ways to do it. You just need to have the right people and messaging in your corner to achieve it.

Welcome to Coiq and first of its kindvideo program about health, innovators earlier doctors and influencers andtheyar stories about writing the roller coaster of health care and ovation. I'myour host Dotor Roxy, founder of Legacy, DNA marketing group and it's time toraise our COIQ welcome back to Ouiq listeners ontoday's show. We have with US DOR Ashishatrea, and he is the chiefinnovation officer from Mout Siani, the founder of the CYANI AP lab and thefounder. You know what he's founded so many differentbusinesses and he's got his hands into so many different things. I'm justgoing to hand it over to him. Welcome to the show doctor Atrea go for it tellus a little bit about your background, a d what Chugyou kind you thank you Iwould say. I will start by saying that my wife calls me twenty percent doctor,because I, because I practice twenty person of my time rest of the time I'mvery lucky to spend in innovation, so has a chef, enevation, opsin Medisonthat Mounsan I I lead innovation, especially inDisigal, health technologies and I've been no position in fromadisist. Forthe last twenty years after my Igency, I got infromatic straining boatcertified, but last six years is completely focused, not UNQO,infomatics, EHR intraumatics, but actually building new technologies. WeDida scientists with AB designers with ouxui completely new field. What wecall is visital medicine iting that has really that is even bigger potential totransform healthcare than what yea chance did. You know for the lasttwenty years, so so our APPS are now into teeme countries. We have done projects from cancerkar tohard care to gikre and three years ago. I think bulk of hour focus which isright now is we call it a FRIDG journey? We moved from innovation alone totransformation wit. How do we put all the different innovation? That'shappening, all the different startups, all the different different APPS, butmaking it much more cohesive and much more structured. So a health system canunify that and allowed to be transformed. You know I work with a lot of healthinnovators who are you know, having different amounts of success withpenetrating the market and so Kudos to you for having your technology andfifteen different countries. So you know: What's the secret? Is it? Is it the brand name of Mount Sinibehind you? Is it? Is it something else? Is it that technology help usunderstand what how you've been so successful? Yeah? I think our journey, it'scontinuing. I wouldn't call it it's super successful it just you know wejust enjoy every single day and build technology. I think everyone says that,but I think the reality is technology is a part of it and then it's not just one person as atheme right which elabels that and it becomes roberst toble period of time, but but also, I think, it's acollaboration, because I haven't gone to sixteendifferent countries because of collaborations the partners are able totake things further, so I think llearning about what technology can do,building new things which have not been there before, creating a unique valueand then driving down and filing partners which can extend that valueand dissaminate the value and transform that value is kind of the cold strategy, O artwhich Im involved in. Without that you can't scare things. Of course technolity has to bescaleable, but but there many technologies which are scalable whichdon't get skilled because we don't find meaningful partnerships coraborationsto make the HM absolutely collaboration is definitelykey. Do you find that these partnershipalliances are coming to you? Are you...

...going out and seeking the best onesthat are fit for what you're? Looking for? That's a great question, I thinkwhen we started up it was mostly we looking out to say what's out there,because WEU want to learn from the wider landscape and see what is missinghas hetems need to do as well right within H, Mon Chana within our haveplab, we don't build anything, that's been built before we try to build newthings. You know so we want to have a very good external landshape you andthat, as we have grown, and I think we have also started seeingpeople or technologies actually ar startups reaching out to us directly and- and they are saying, hey you'redoing this- you have a platform approach at Mounsan and multiple otherhealth systems which you can describe apps and you can connect all those appstogether. What do you think of this ab? We arebuilding in this space and this is pretty novel, so I think so that isactually a very exciting pard, where it creates an afficiency which is notthere before iieffitient to go out and find the right thing, but it's moreefficient. If people come to you, so I think we were lucky to have that kindof a model evolving in that Egan. So do you have more success, penetrating your innovations within theMount Sini hospital system that you work in or do you have more success?Commercializing it outside of the system. That's both both are inheren both havetheir own inherent challenges. That is absolutelytul right, and you know it'svery easy to say: Hey you're within a health system and you're buildingtechnologies, you're, probably every person in that house system patient isusing your technology, but you know nothing is farther than truth all right.So I think what happens? Is Health Systems have more challenges,adopting technology which are inherent to how theyre structured and met? I Arespective of technologies within that herl system or coming from outsidethose structural challenges remain, and I gave a very simple example and I'mAgastan polly. So I talk about shit all the time. So, if you allow me, I cantalk about the examle of that, so we so the platmom we bilt to CollaSola Tocal, the UNIFORL thes technology got spined off into commercial antitycallise Arex House, which is a Monsanas Peno and Aric Stothel, had built more thingson top of the platform and they build how they can stitch differenttechnologiy together, call arex stitch and then one small facility in Arizonareasens out to them to say hey. We have such a big problem with colonascopy patients, because we have one INPOCOL, annouse, Cobi, pations, wo apoor, bawl prap and we give them a paper, and one in for people forget the paperwhere theyre cat amonly Botit arexs health worked with them to create anengine completely like abot engine four petry proceded pericohascopy thatbecame superhead when they meagured they were able to reduce their bodedsprocages by half ninety two person paciens wanted to readly. You know, useit for next procedures that Americangastontrall, the assessation, our national assisition, actually nowpartnered with the arlexhelt to make it nationally available. Well as the bestpractice now, Mountana is now coming up and Shink. This is a cool thing. Weneed to do that and now we're bringing it to MountShana. So sometimes I think you bring it externally, and you know, and alsoas a pen oppendity, they can go much more faster than we can go internallyright, but they are able to find U scases and to somethings. We learn fromthem and bring back tos, usecase sure, just an example how it can come.Wdecusion of innovation. Can spread not only inside out but outside end, so so there are so many health innovators that are out thereright now in the trenches, with just incredible innovations that solve youknow, challenges that are like our most pressing issues and theyre. Overall, Ihear that they're really struggling to...

...kind of get in front of the keydecision makers and to be able to even have a chance to pitch their innovationand even when they do get in you know the inherent challenges and barriers tothe to the structure. Do you have any recommendations for audience some best practices, some strategiesfor having success with being able to sell to a hospital system yeah, youknow, there's there's a famous saying ow they if you want to go fast, goalone. If you want to go far, you know go together, so I think I've seen many startups whostruggle with getting keeco system. You knowkind of partners and the keythinkers for decision maker are just solo scientists. They may nothave a position in the team. They may not have any car person, so they arecompletely about outside Lance, but I think my m, my ManorRocommendations to them is get some. You know thought laders get somepatients also miimations get physicians, get researchers as advisors as consultants as whateveryou can creat a role for medical role. That way you have a knowledge becauseit's not about they can't get into a decision maker. It's very caugh o knowwho the decision tnaker is yes right, and then someone who partners with them,who is part of the heallh system, can say hey what your building is actuallymore for Qualridy, and this is inpatient quality socef medical officerwill be the right person. You don't need to go to see io for that Fori, youfor sure you don't need to go yo for that, and never ll see a fo for that IA,so right and then best thing which Youre building is actually forpopulation. Have you know to find who is managing the population heals inthis place right? So I think so. If you get into the front of theright person, then it's much more likely. Things will either be yes ornow, but an decision making a be faster, but a lot of the time. The challengeswe touch, someone at the very free and that person takes its own sweith time,then introduce to some other person, and you can kind of have this game.That's getting played and and not because of anyone is insance here. It'sjust that it's incredibatly complex to navigate. So if you have a person,who's navigated, a bat before it just makes it I much more easier yeah, it'sinteresting. So you know when you think about selling there's all of thesedifferent types of decision makers, wrighe, the gatekeeper, the decisionmaker, the influencer, and I recommend that clients find their Trojan horse.And so this is someone that's in the organization that has no influencethey're, not the gatekeeper they're, definitely not the decision maker, butthey are the ones that know everything. That's going on right, they're, theones that can pick up the phone and call you and tell you your competitorjust walked in you need to get back in here. So I think everybody needs tohave a Trojan horse too. You know that's a great idea. You knowI'm never torght of that, but I can see that can potentially work. You need.You need people who wouch for you advorkate for you who believe in you.You know whether it's Trojan horse or nor they may just do it in a goodspirit, because they really trust you and the Welrigt yeah and have takentime to do that, because many time decision maker don't even have time toto find tha trust. But but I think that someone who trust Hamd believein you issuper imponded. So what what innovations? And maybe it'sthe RX health? But what innovations have you successfully commercialized outside of Mout Sin? I so my myjoney started in Cleon Kinneck. So were my first thing, which I, whichwas actually most of what I do, is actually base onproblem centric approach, but is a...

...problem? That's happening rater thansolution Centry, but we can buid KSO. I got a page from higher up in cleveandclinic, but I never received that page. This is two thousand five hthousand ndsix, because I was hundred miles two hundred miles away from pople. So thenI realize that pages are, you know, noteof fool proofs like the batteriesgo die and you lose a casion massages. So we committed the first webbatepaging system act, Leeand CLARNIC. We will archive all the pageon message.You can audimmitally forward to someone else if you're going outside thatbecame so super successful. It's still actually used across Gen Teni heaththesystem yeah by the name of my paging yeah is just phenomenal. That's hi SSMiye when I went there for Grand One and I haw that being used. So this islike may Bac Technology, but this is one of the first ones and Thad God licensed out to Americanmessaging, the Secin bigous pagour company in the US. So I had someexperience before I came to Suni and its SANA. I think when, when webuild this platform to prescribe APPs connected with Mr, we started getting so much request fromother heath systems and ther pars as well and within Sani. We couldn'tsupport other HOUTH systems. We don't have team big enough to actually go andsoport and do integration and all those so an so so it was very natural. Ourmounts and inomation partners out tech transfer team head greate spin of Callese arec start help, so we licensedthis platform to Presciribe APPs and Digal K pathways at that time. This isaround two years ago. We also licetenseout technology for remotemonitoring, so for so, patients can keep track howthey are doing and that was plugged on top of the platform as well. SISTON AREX has has built so muchthings on top of it. They built a stitch engine where they can connectdigital rules together and they ave a whole clinical team which is makingclinical rules around every fily operative Care Around Radiology, andthey have partnership with Amirican College of Cardiogy to play the CaudioRascula Tokit and with Aga for Gi to kits and ene. The key things they arefinding is there's so much need for information before an after procedures and those are very expensive procedures. So, for example, wealgy alone there's aten PERCON, no show rate for average redeolgy procedure, cuonosco pe oneinfor patients, you know sometimes Hav poball drap. So if we provide them,information of the right time doesn't have to be downoaded that it could beabout. You know a voice kind of ful thing, Vice Rus, but if you get themthrough the journey with a needbase journey, you can certainly make thewhole health care much more efficient and it can lead to image it Ri withinthe same three months to pr. So I think part of our learning has been. We are able to find not just whereroutinely you can quit Levil Roi for a hospital which everyone can ar complexdises and pop helt sore. Actually things which are so mundaine people,don't even think you can pait value, but but then you look at hundred use.casses you can create is just help. Cary such an interesting feel where, ifyou just are bent upon creating efficiency, you will find thousand waysto create efficiency and and even see ia would never have thought of that.That is so. So we talk a lot about messaging with clients, and you know on the show-and you know everybody kind of has a different perspective. You know somefolks are like you've got to have the rli story FOC. Some other folks arelike you know, there's there's a real problem and it's a little bit more ofthe ultruistic. You know goals of like patient care and then you've gotefficiencies and your experience is it. You know, what's what's reallyimportant for the messaging strategy? Is it all of those? Is it one inparticular yeah? So I think the reality is. Healthsystems are really starved, ofr...

...finances, the margin has really degreesyeah. If you walk and and share your spacient experience of ser clinicaljourney without tangible financial success Tory it's tough to find someone who willjust bet on that CEP. People want that, but they wouldn't be able to creatresource for that. Ultimately, ten on do very far so lot of Sur. We do. Is Webuttered into plinical success and financial success in some paseesoperation of success, and for us it's not either or yet, where we can hit allthe three bubbles up on the top of the bad myeah? That makes sense so you- andI have already talked a little bit in the past- about this notion of you-know clinical evidence that the health innovators you know have to have inorder to have any chance of commercialization, and I know thatyou've done quite a bit of work in this space, so just kind of talk about what what that journey was like for youand and creating you know, resources to kind of help.Innovators develop the evidence that they need right. So I think one of thethings it's time indensive right something I start of dones is in loveyeah, but I think healthcare startups are and need to be different than youknow, pintect or other stylups right. We are touching human lives and theyprocam ne potentials on Intelliggan ssequences, either by amation or bycommission right. So so theres needs to be additionallater level of trust, so tit's worthwhile to go through additional ear or to to create itevidence. So, for example, the technology we spend off the remotemoniting plat form call health promise. It was an IAD sponsored trial. Twoyears random is controlle trial. We showed the value in that and then itgol spend out the same. With Ha Platform we were able to show we wereable to increase activivation of the patients from six percent. If you justtell a person to downnald and AV, just in conversation like you and I, but if I'm and Positian I prescribe youand have that lands on your phone, we were able to increase activiation toninety two percent. The system use ability of ninety four percent timeright, so that is huge. I mean that is just really huge, because you know Iforget what the last count is, but it's like you somewhere around fifty ahundred thousand healthcare apps on the market and most of them are likecrickets and cobwebs right, there's nothing going on in there and thatdoesn't mean that it wasn't a viable tool. So not only do you have to sellthe innovation, but then once it's sold you've kind of got to have thisstrategy for adoption. So so yes just speak to that a little bit more, Ithink that's huge yeah, so we hit a kind of a road bock three years ago,because a lot of the stuff we were doing war building aps and there wasfairly successful research setting and they were successful because theresearch coordinator was able to walk the patient. You know kind of handholdthe patient, but but if you really want a scalaber transformation, you cannothave a yses coordinator or any tin right trint. That's not time efficientright. So so so then we dod ou time emotionalysis and we solve patients.They could recommend them an APP in the routing conversation like you and Ipatients will forget the name they'll mistipe, the name, even if they get theright name. They are more than three to tfy thousand APPS, so they focutd theactivation Colin, which is a light that so so so we knew they were actualcustomer fiction factors for them to get into the A, and here we werebuilding all these assets and APPS and APPS, and but no one is using thembecause there's no blackfum to deliver it to the right patience so that led toour one or two years. Effort is completely building a platform toBeliver APPs to patiencs. Initially we started Ou deliving one to one likepatient comes to us in a planic. We prescribe an APP they get on boardedwith Fonr. Ninety twy percent engagement, Rade with very highusability. When we spent off to rextort...

...hell, they build a platform for bulthprescribing, but they can prescribe two thousands of patients at once and theydid that for Yale New Heaven, but they were able to prescribe twenty fivethousand people my Chart AP and God. You know ten to fifteen percentpatients canvoted into my chart when that led to what eight peoplewould have maken an ear to do. What able to do in two days using thisSimila now using API and firebased engine, we can actually Auno prescribeapps where, if the the patient new Cote of asthma gets dobbed and is asthmaHAPP, it automatically gets dropp described the pision without a humantouch. So I think a lot of the journey has been making it so easy to reduceany burden on the physicians, because he isno have already created enoughproblem. Our Goa is a disital medicine to create it in such a way that it is,it is in a way invisible the magic happens behind the same. The patientsget engaged, the patients come wat, their pointment, but physicians don'teven have to click in anything and they get the benefit Ni. Think we, as as aprovider community as a Kare commonityry, deserves a technologywhich actually works for US ther than it so yeah yeah. Absolutely so you knowhow has farmer responded to this idea of prescribing APPs, so it has been actually very. We have alot of collaborations with farmer. Now it's only at Sana, applabut, arichealth. Also, they made announcement that they have a partnership now, withfive years with Rosh around IBD to create a national network of tenthousand pations will be on the APP and the Datat will come back right on Ectin,IBD, seters and therare losones, who take it to Europe and many of thecountries as well. So I think former is looking for solutions to minicallyengage tetations they're, not very diffifferent, then health systems evenpayers want to meaningfully engage with the patient sure right. They all comewith a slightly different perspective. But if you have a platform approach,it's the same thing which farmer wants to do a certain set of things: it HellSystems Wance, you do right, so you find common grounds and, and farmer cansometimes fund those endeavors which helse systems may not have bandwat tofar yep absolutely so how does so is you know? Is it open source or openinnovation? where, if you know somebody has an APP they youknow for a patient, you know how do they get access to the Rx platform sothat way their PERAPP can be prescribed yeah. So I think it's a cuation,blatfom diminarics hard help, suppose anyonene who's, an Appendro, canactually just say Ham wit. Building this and there's a very simple onlineprocess. onboarding process whet ti jus have to show. Is it evidence based ornot, okay, right? And so so there's a curation process of many APPs get log.If theyare not of high quality, they do not have the right CENICA content orthey do not have the right API for interfaces right. But if there's eright technology is whether it's APP whether it is share decision making.Video whelher, it is a varable device or you know, Internet of things, any of those thingsas wall as it's Valli dated, and it's it's a value driven thing: it's an OpenAbi, which ir ex Helf hand that will open it. So it can be described okay,so it becomes a market place in that regard yeah. So you touched on. Youknow this innovation that you were developing in two thousand and five,and now it's two thousand and nineteen, so you've kind of been at this for awhile and if you think about you know where the industry was in two thousandand five and then where we are today, man, we, you know a lot of people. Youknow, there's still a lot of change that needs to take place, but in someregards we've come a long way. So what are the challenges that youthink that health innovators are still facing today or that are facing in twothousand and nineteen?...

A lot of chararges? I think still, Ithink the biggest asset has been technology right. So what our programMantean used to take nine months to build an APP now we can build thatdoing a week. It's just been amazing from a delato science porspective allthe algolithms had to widit in yourself on the room networks and now those areall packaged stuff and you can just run those models right, Bu that efficiencyhas has been created. I think efficiency has not been createdin adoption in hes systems mm right, so those process challeges those peoplechallenges actually remain on n fact. They may be worse now, because there'sso much technotogy now that we may be creating barriers of adoption becausewhich hards to bet on becomes e problem for the OOAD systems as well. I think also, I think, becausetechnology has become, I would say, a little bit of commolity. It is easier to build things, but it istoughfer to distinguish and create something now, hmm right, so so peoplesay hey. This is great. This is fasttnating, but not many normal thingscome which Ar Valuatwen as well. So I think part of still the challenges tocreate nomel things now, just what is the platforms which are built on top ofthat, but twoly unique solutions and truly which can became changers even ifit's a narrowd Vordical Yep? Absolutely so what you think is the biggest driver ofsuccess, what it it you know if you had one lesson that you've learned in thiswhole process, kind of speaking directly to our audience, who are inthe trenches right now, you know what what are some lessons, or at least onething that you would recommend to them. I think it's believing in yourself andyour team and having resiliencs. If it does come to core human principlesright, the barriers would always be there. They've been there anything thatMandon has done right. Any scinenist does anything for researchersforclonations right for it's the same porint of waiters as well, but buttruly, if you believe you want to create value right and then you believethe pat is a right like you're on the right trie just having resilliansallows you to take all those tarriers all those challenges in a in a veryneutral manner, because everything is positive. If you're in the rightdirection, the barriers will just change the speed of Hor fast tot, but the direction you decide right andif the direction is right, then you' Gong to reach there, where you want tobe- and I di think that that's you know so t's. I think I've learned a lot.It's you know. As a physician, we do things. We nearly always have successright, so I see patience they get better if the dawn get better. Wealways know why they didn't get her right in a startup or innovation I'snot like that right things, ave never done before. So you don't even know youin the right bat or not. So so you can't just base on externalt externalthings, always youre right wrong. You have to have internal parameter as well,and your team, you know which wic becomes your multifladfactor in thatGAM, yeah absolutely well. This has been avery valuable conversation. I think you so much for the wisdom that you'veshared with our audience. I know that they have learned a lot from you todayand so, as we wrap up here, what is the best way for people to get a hold ofyou if they have some questions for you and they want to just kind of followwhat you're doing Sur. I think titter is easy act. Atradecuff, ATR EJ is a very easy way to get hold of me. They can also get holdof me through apflaps Thi. A contact sow just go to AP Ladot NYC, there'sable to get a contact from and got hold...

...of me or Lingen, I'm the one wearing aboth high. They can find me and just connect with me. I love the Brandon, anTe Boti brilliant all right. Well, thank you. So much wonderful. Thank you. So much apleasure: what's the difference between launchingand commercializing a healthcare Novation, many people will watch a newproduct. Few will commercialize it to learn the difference between launchand commercialization and to watch past episodes of the show head to our videoshow page at Dr Roxycom. Thank so much for watching and listening to the showyou can subscribe to the latest episodes on your favorite podcast, APPlike apple podcasts and spotify, or subscribe to the video episodes on ourYoutube Channel, no matter the platform just search Coyq with Dr Roxin untilnext time. LET'S RAISE OUR COIQ.

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