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 CIQ and first of itskind video program about health innovators, earlier doctors and influencers and their stories aboutwriting 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.Welcome back to IQ listeners. On today's show we have with us Dr AshishaTreya, and he is the chief innovation officer from Mount Sinai the founder ofthe sin I APP lab and the founder, you know what, he is foundedso many different businesses and he's got his hands into so many different things. I'm just going to hand it over to him. Welcome to the show, Dr a Treia. Go for it. Tell us a little bit about yourbackground and what you do. Thank you. Thank you, I wouldsay. I would start by saying that my wife calls me twenty person doctor, because I we got that pactice twenty person of my time. Rest ofthe time I'm very lucky to spend an innovation so as a chef innovation opposetin medicine at Montsa and I I lead innovation, especially in digital health technologies, and I've been a position in chromaticist for the last twenty years. Aftermy den see I got in Chromatics Training Board thirty five but last six yearsis completely focused not on chording formatics, ehr in dramatics, but actually buildingnew technologies. We data scientists, with APP designers, with you, Xui, completely new field, what we call is digital medicine, and I thinkthat has really that is even bigger potential to transform healthcare than what Ejos did, you know, for the last twenty years. So so our APPS arenow in fifteen countries. We have done projects from cancer care to heartcare toGi care. And three years ago, I think bulk of power focus,which is right now, is we call it a fut journey. We movedfrom innovation alone to transformation. And how do we put all the different innovationthat's happening, all the different startups, all the different ferent APPS, butmaking it much more coheasy than much more structured, so a health system canunify that and allowed to be transformed. You know, I work with alot of health innovators who are, you know, having different amounts of successwith penetrating the market. And so Kudos to you for having your technology andfifteen different countries. So you know what's the secret? Is it? Isit the brand name of Mount Sinai behind you? Is it? Is itsomething else? Is it that technology? Help US understand how you've been sosuccessful? Yeah, I think our journey is continuing. I wouldn't call itit's super successful. It just, you know, we just enjoy every singleday and build technologies. I think everyone says that, but I think thereality is technology is a part of it and and it's not just one person'sa team, right, which enables that and it becomes robist over a periodof time. But also I think it's a collaboration, because I haven't goneto sixteen different countries. Because of collaborations, the partners are able to take thingsfurther. So I think left learning about what technology can do, buildingnew things which have not been there before, creating a unique value and then drivingdown and finding partners which can extend that value and disseminate the value andtransform that value is kind of the core strategy part which I'm involved in.Without that you can't scale things. Of course technology has to be scalable,but but they many technologies which are scalable which don't get scaled because we don'tfind meaningful partnerships, collaborations to make these HMM, absolutely, collaboration is definitelykey. Or do you find that these partnership alliances are coming to you oryou going out and seeking the best ones...

...that are fit for what you're lookingfor? That's a great quesion. I think when we started off it wasmostly we looking out to say what's out there, because we want to learnfrom the wider landscape and see what is missing. Has the stems need todo as well. Right within the MONTSANA, within our APP lab, we don'tbuild anything that's been built before. We try to build new things,you know. So we want to have a very good external landscape. Youin that. As we have grown, and I think we have also startedseeing people or technologies actually are startups, reaching out to us directly and andthey are saying, Hey, you're doing this, you have a platform approachat mount sign and multiple other health systems which you can describe apps and youcan connect all those apps together. What do you think of this APP weare building in this space and this is pretty novel. So I think sothat is actually very exciting part where it creates an efficiency which was not there. Before efficient to go out and find the right things, but it's moreefficient if people come to you. So I think we were lucky to havethat kind of a model evolving in that Creda. So Do you have moresuccess penetrating your innovations within the Mount Sinai hospital system that you work in,or do you have more success commercialize in it outside of the system? That'sboth. Both are in here. Both have their own inherent challenges. Thatis absolutely true, right, and you know it's very easy to say,Hey, you're within a health system and you're building technology. is you're probablyevery person in that health system patient is using your technology. But you know, nothing is smart than truth, all right. So I think what happensis health systems have more challenges adopting technology which are inherent to how they're structured, and that is irrespective of technologies within that health system or coming from outside. Those structural challenges remain. And I gave a very simple example and I'ma gastro introlity so I talk about Shite all the time, so if youallow me, I can talk about examples from that. So we so theplatform we built to cola solid accuty UNIFILE. This technology got spinned off into acommercial entity, college utx health, which is amounts and as we nowand are extort health had built more things on top of the platform and theybuilt how they can stitch different technologies together. Called out extitch. And then onesmall facility in Arizona reaches out to them to say, Hey, wehave such a big problem with colonoscopy patients, because we have one in Pocolon oscopypatients who are poor bowl trap and we give them a paper and onein four people forget the paper. Where they're kept and money, but iton. Ex Health worked with them to create an engine, completely like abought engine, for pretty proceded pery coscopy. That became super head. When theymeasure they were able to reduce the aboorded procedures by half. Ninety twopercent patients wanted to red you know, use it for next procedures. ThatAmerican Gastron told the Association. Our National Association actually now partnered with our excelledto make it nationally available. Well, as the best practice now Mount Sannais now coming up and saying this is a cool thing, we need todo that. And now we're bringing it to mounts on it. So sometimesI think you bring it externally and you know, and I also as aspinoffenity, they can go much more faster than we can go internally. Right, but they are able to find use cases and the sometimes we learn fromthem and bring back those use guess. Sure, just an example how itcan come, how the fusion of innovation can spread not only inside out butoutside end. So so there are so many health innovators that are out thereright now in the trenches with just incredible innovations that solve, you know,challenges that are like our most pressing issues. In their overall I hear that they'rereally struggling to kind of get in...

...front of the key decision makers andto be able to even have a chance to pitch their their innovation. Andeven when they do get in, you know the inherent challenges and barriers tothe to the structure. Do you have any recommendations for audience, some bestpractices, some strategies for having success with being able to sell to a hospitalsystem? Yeah, you know, there's a there's a famous saying out thereif you want to go fast, go alone. If you want to gofar, you know, go together. So I think I've seen many startupswho struggle with getting key ecosystem, you know, kind of partners, andthe key thinkers for decision maker are just solo scientists. They may not havea position in the team, they may not have any care person, sothey are completely heavy outside Lance. But I think my my main recommendations tothem is get some you know, thought leaders, get some patients, also, nations, get physicians, get researchers, as advisors, as consultants, aswhatever you can create a role for medical role. That way you havea knowledge, because it's not about they can't get into a decision maker.It's very careful to know who the decision maker is. Yes, right,and then someone who partners with them, who is part of the health system, can say hey, what's your building? Is actually more for cality and thisis in patient quality. So chief medical officer will be the right person. You don't need to go to CEIO for that. Yeo, for sure, you don't need to go to her for that and never will CFO forthat. Right. So right. And then this thing that you are buildingis actually for population have you need to find who is managing the population healthin this place right. So I think so. If you get into thefront of the right person, then it's much more likely things will either beyes or now. But the decision making really faster. But a lot ofthe time the challenge is we touch someone at the Perry free and that persontakes its own sweet time. Then introduced to some other person and you kindof have this game that's getting played and and not because of anyone is instanchere, it's just that it's incredibly complex to navigate show. If you havea person who's navigated about before, it just makes it much more easier.Yeah, it's interesting. So you know, when you think about selling, there'sall of these different types of decision makers, right, the gatekeeper,the decisionmaker, the influencer, and I I recommend that clients find their Trojanhorse, and so this is someone that's in the organization that has no influence. They're not the gatekeeper, they're definitely not the decisionmaker, but they arethe ones that know everything that's going on. Right they are the ones that canpick up the phone and call you and tell you your competitor just walkedin. You need to get back in here. So I think everybody needsto ever Trojan horse to. You know, that's a great idea. You know, I've never thought of that, but I can see that can potentiallywork. You need you need people who vouch for you, advocate for you, who believe in you. You know, whether it's Trojan Hoarse or not,they may just do it in a good spitted because they really trust you. And the back right. Yeah, and if they can time to dothat, because many time decision maker don't even have time to do find atrust. But but I think that someone who trust and believe in you issuper important. So what? What innovations? And maybe it's the Rx health,but what innovation is have you successfully commercialized outside of Mount Sinai. Somy journey started in Cleveland Clinic. So we're my first thing which I whichwas actually most of what I do, is actually based on problem centric approach. What is the problem that's happening,...

...rather than solution centric what we cando? Yeah, so I got a page from higher up in Cleveland Clinic, but I never received that page. This is two thousand and five,two thousand and six, because I was a hundred miles, two hundred milesaway from them. So then I realized that pagers are, you know,not at all food proof, like the batteries go die and you lose thepage and messages. So we created the first web based paging system at ClevelandClinic. We will archive all the page and message you can automatically forward tosomeone else if you're going outside. That became so super successful it's still actuallyused across them telling health system by the name of my paging. Yeah,it's just phenomenal. That's high. So is nice. When I went therefor grand runs and I saw that being used. So this is like wayback technology, but this is one of the first ones and that got licenseout to American messaging, the second biggest page of company in the US.So I had some experience before I came to Sanai. And it's SANA.I think when when we build this platform to prescribe APPs connected with Mr westarted getting so much request from other health systems and other payers as well,and within Sana we couldn't support other health systems. We don't have team bigenough to actually go and support and do integration in all those sure. Soso it was very natural our mounts and annovation partners out a transfer team healthcreate a spinoff college artext dot help. So we licensed this platform to prescribeAPPs and digital care pathways at that time, this is around two years ago.Yeah, we also licensed out technology for remote monitoring, so for sopatients can keep track how they are doing, and that was plugged on top ofthe platform as well. Since an autos helt has built so much thingson top of it. They built a stitch engine where they can connect digitalrules together and they were whole clinical team which is making clinical rules around everyperioperative care, around radiology, and they have partnership with American College of Cudeologyto play the caudio vascular tool kit and with a g for Gi tool kitand when the key things they are finding is this so much need for informationbefore and after procedures, and those are very expensive procedures. So, forexample, radiology alone there's a ten percent no short rate for average redeology procedure, chronoscopy, one in for patients, you know, sometimes a poor ballwrap. So if we provide them information at the right time, doesn't haveto be downloaded at it could be about here, you know, a voicekind of thing, voice rules, but if you get them through the journeywith the need based journey, you can suddenly make the whole healthcare much moreefficient. HMM, and it can lead to image it Roy within the samethree months period. So I think bought of our learning has been we areable to find not just weird routinely you can create them with Ouroy, fora hospital which everyone can complex disease and pop health. Sure actually things whichare so mundane people don't even think you can paid value. But but thenyou look at hundred use cases you can create it's just health care is suchan interesting field where if you just are bent upon creating efficiency, you willfind thousand ways to create efficiency and and even see if I would never havethought of that. That is so so we talked a lot about messaging withclients and you know on the show, and you know, ever really kindof has a different perspective. You know, some folks are like you've got tohave the Roy Story. So some other folks are like, you know, there's a there's a real problem and it's a little bit more of thealtruistic, you know, goals of like patient care, and then you've gotefficiencies and your experience is it. You know what's what's really important for themessaging strategy. Is it all of those? Is it one in particular? Yeah, so I think the reality is... systems are really stuffed of finances. Hmm, the margin has really degrees. Yeah, if you walk in andshare your patient experience of suce clinical journey without tangible financial success story,it's tough to find someone who will just bet on that. Yeah, peoplewant that, but they wouldn't be able to create resource for that. Well, Li really cannot go very far. So a lot of so we dois we bucked into clinical success and financial success in some pieces, operational success. And for us it's not either. Are Yeps where we can hit allthe three bubbles up on the top of the bad hmm. Yeah, thatmakes sense. So you and I've already talked a little bit and the pastabout this notion of, you know, clinical evidence that the health innovators,you know, have to have in order to have any chance of commercialization,and I know you think you've done quite a bit of work in this space. So just kind of talk about what what that journey was like for youand in creating, you know, resources to kind of help innovators develop theevidence that they need right so I think one of the things it's time intensive, right, something you start up down as as a love yeah, butI think healthcare startups are and need to be different than you know, ntector other startups. Right. We are touching human lives and they put canbe potential unintended Joan see influences either by omission or by commission, right.So, so they needs to be additional later level of trust. So it'sworthwhile to go through additional year or two to create the evidence. So,for example, the technology we spend off, the remote monitoring platform called health promise. It was and I had sponsored trial two years random as control trial. We showed the value in that and then it got spinned off. Thesame with the black form. We were able to show we were able toincrease activation of the patients from six percent. If you just teleport and do downloadan APP, just in conversation like you and I, but if I'ma position I prescribe you and a that lands on your phone. We wereable to increase activation to ninety two percent. The system usability of ninety four percent. Right. So that is huge. I mean that is just really hugebecause, you know, I forget what the last count is but it's, like you somewhere around fifty a hundredzero healthcare APPs on the market. Inmost of them are like crickets and COB webs. Right, there's nothing goingon in there. And that doesn't mean that it wasn't a viable at all. So not only do you have to sell the innovation, but then onceit's sold, you've kind of got to have the strategy for adoption. Soso, yeah, it's just speak to that a little bit more. Ithink that's huge. Yeah, so we here to kind of a road blockthree years ago because a lot of the stuff we were doing war building apps, and that was fairly successful research setting and they were successful because the researchcoordinator was able to walk the patient, you know, kind of handhold thepatient. But but if you really want a scalable transformation, you cannot havea research coordinator or any choice right. Trying that's not time efficient, right. So. So. So then we did a time emotionalysis and we sawpatients, if we recommend them an APP in the routine conversation, like youand I, patients will forget the name, they will miss type the name.Even if they get the right name, they are more than three Fiftyzero APPS. So they forget the activation code in which is the right APP.So so so we knew they were actual customer friction factors for them to getonto that APP. And here we were building all these assets and APPS andAPPS and but no one is using them because there was no platform to deliverit to the right patients. So that led to our one or two yearsafter, just completely building a platform to deliver APPs to patients. Initially westarted out deliving one hundred and two one like patient comes to us in aclinic, we prescribe an APP, they get on boarded. We found ninetytwo person engagement rate with very high usability. When we spend off to our extrathelp. They built a platform for...

...bulk prescribing where they can prescribe twothousands of patients at once, and they did that for Yale New Heaven.But they were able to prescribe twenty fivezero people my chart APP and got,you know, ten to fifteen percent patients converted into my chart. When thatled to what eight people would have taken a year to do, what ableto do in two days using this stability. Now, using API and five isengine, we can actually out of prescribe APPs where if the patient newcode of asthma gets dropped and is asthma APP, it automatically gets dropped describedthe patient without a human touch. So I think a lot of the journeyhas been making it so easy to reduce any burden on the physicians because,yes, I've already created upward. Our goal is a digital medicine, tocreate it in such a way that it is it is in a way invisible. The magic happens behind the scene. The patients get engaged, the patientscome at the appointment, but physicians don't even have to click and anything andthey get the benefit. I think we as a as a provider community,as a care community, deserves a technology which actually works for us. Thenit's sure. Yeah, yeah, absolutely. So you know how has farmer respondedto this idea of prescribing APPs? So it has been actually a verywe have a lot of collaborations with farm are now it's only hats on apple, but artics health also. They made announcement that they have a partnership nowwith five years with rows around IBD to create a national network of tenzero patientswould be on the APP and they Dada will come back right when acting theIBD sectors and their Roche wants to take it to Europe and many of thecountries as well. So I think Farma is looking for solutions to menially engagethe patients. They're not very different than health systems. Even payers want tomeaningfully engage with the patient. Sure, right, they all come with aslightly different perspective, but if you have a platform approach, it's the samething which farmer wants to do, a certain set of things which help systemswants to do. Right, so you find common grounds and then and farmercan sometimes fund those endeavors which helps systems may not have bandwid to fun.Yep, absolutely. So. How does so is? You know, isit open source or open innovation, where, if you know, somebody has anapp they you know for a patient, you know, how do they getaccess to the Rx platform so that way there for APP can be prescribed? Yeah, so I think it's a curation platform between our expert health.So first, anyone who's an appender, can you actually just say, Ay, we building this and there's a very simple online process on boarding process whichit just have to show. Is it evidence based or not. Okay,right, and so so there's a curation process of many apps get blocked ifthey are not of high quality, they do not have the right clinical contentor they do not have the right API for interfaces. Right, but ifthey're the right technology is whether it's a APP, whether it'll share decision makingvideo, whether it's a wailable device or, you know, Internet of things,any of those things. As Swat is, it's validated and it's ait's a valued driven thing. It's an open API, which arects. Hehas hand that will open it so it can be prescribed. Okay, soit becomes a market place in that regard. Yeah, so you touched on,you know, 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 thisfor a while and if you think about, you know, where theindustry was in two thousand and five and then where we are today. Man, we you know, I a lot of people you know there's still alot of change that needs to take place, but in some regards we've come along way. So what are the challenges that you think that health innovatorsare still facing today or that are facing... two thousand and nineteen. Alot of challenges, I think still. I think the biggest asset has beentechnology. Right. So what our programming team used to take nine months tobuild an APP, now we can build that biding a week. Right.It's just been amazing from a data science perspective. All the algorithms had tobe written yourself when new room networks and now those are all packaged stuff andyou can can just run those models. Right. So that efficiency has hasbeen created. I think efficiency has not been created in adoption. It hassystems, UH Huh. Right. So those process challenges, those people challenge, is actually remain on. In fact, they maybe worse now because there's somuch technology now that we may be creating barriers of adoption, because whichhorse to bet on becomes a problem for the show systems as well, Ithink. Also, I think because technology has become I would say a littlebit of commodity, it is easier to build things but it is tougher todistinguish and crease something novel. Hmm Right. So so people say hey, thisis great, this is as cleating, but not many normal things come whichare value even as well. So I think part of still the challengeto create novel things, not just what is the platforms which are built ontop of that, but truly unique solutions and truly which can became changers,even if it's a narrowed, vertical Yep, absolutely. So what is you thinkis the biggest driver of success? What it is, you know,if you had one lesson that you've learned in this whole process, kind ofspeaking directly to our audience who are in the trenches right now, you knowwhat? What are some lessons, or at least one thing that you wouldrecommend to them? I think it's believing in yourself and your team and havingresilience. It does come to core human principles. Right, the barriers wouldalways be there. They've been there. Anything that man gun has done right, any scientist does anything for research. As for clinicians, right, forit's the same for innovators as well. But but truly, if you believeyou want to create value, you right and then you believe the path isthe right like you're on the right track. HMM. Just having resilience allows youto take all those barriers, all those challenges in a in a veryneutral manner, because everything is positive. If you're in the right direction,the barriers will just change the speed of a faster to them. Hmmm.But the direction you decide right, and if the direction is right, thenyou're going to reach there where you want to do. And I did thinkthat that's you know. So it's I think I've learned a lot. It'syou know, as a physician, we do things we nearly always have successright. So I see patients, they get better. If they don't getbetter, we always know why they didn't get better. Right. In astartup or innovation is not like that. Right things are never done before,so we don't even know you on the right back or not. So,so you can't just based on external, external things always you're right or wrong, if you have to have internal parameter as well, and your team,you know, which which becomes your multiplier factor in that Adam. Hmm,yeah, absolutely. Well, this is, then, a very valuable conversation.I think you so much for the wisdom that you've shared with our audience. I know that they have learned a lot from you today. And so, as we wrap up here, what is the best way for people toget a hold of you if they have some questions for you and they wantto just kind of follow what you're doing. You way sure. I think twitteris easy. At a TRACTA, ATR EJ is a very easy wayto get hold of me. They can also get hold of me through APPlab. They up contact, so you just go do APP lovedot NYC.They'll be able to get a contact from...

...and get hold of me. Orlaiden. I'm the one being a bow tie. They can find me andjust connect with me. I love the branding of the bow tie. Brilliant. All right. Well, thank you so much, one of us.Thank you so much of pleasure. What's the difference between launching and commercializing ahealthcare in avation? Many people will watch a new product, few will commercializeit. To learn the difference between watch and commercialization and to watch past episodesof the show, head to our video show page at Dr Roxycom. Thanksso much for watching and listening to the show. You can subscribe to thelatest episodes on your favorite podcast APP like apple podcasts and spotify, or subscribeto the video episodes on our youtube channel. No matter the platform, just searchcoiq with Dr Roxy. Until next time, LET'S RAISE OUR COIQ.

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