Health Innovators
Health Innovators

Episode · 2 years ago

How to Avoid Pilot Purgatory in Healthcare Innovation w/Dr. Joseph Kvedar, VP of Connected Health with Partners HealthCare

ABOUT THIS EPISODE

The commercialization process in healthcare is very complex, and it’s impacted by a multitude of factors and circumstances. Why is commercialization so much harder in the healthcare industry? What are the biggest mistakes innovators are making, and how do these mistakes make growth impossible? What do we need to be mindful of when trying to get into a delivery network or hospital system?

 

On this episode, I’m joined by Dr. Joseph Kvedar, VP of Connected Health with Partners HealthCare. Dr. Kvedar is a pioneer, early adopter, and influencer in the field of connected health. We talk about overcoming the commercialization difficulties in healthcare that so many innovators face.

 

3 Things We Learned

  • What makes it so challenging to commercialize an innovation in healthcare
  • Why having the most advanced/superior innovation is meaningless
  • How to successfully get into a delivery network or health hospital system

 

When healthcare innovations are still small, just starting to garner entry level interest, is when they are most vulnerable to facing issues that impede commercialization. Whether it’s losing a key team member, or encountering changes in the market, that randomness is inherent in bringing innovations to market. There are ways to mitigate this, however.

 

It’s critical to settle the “people issues” early on and understand your product-market fit. Raise only the right amount of money, and spend it thoughtfully. Line everything up to present the best business case possible.

Welcome to Coiq and first of its kindvideo program about health, innovators earlier doctors and influencers, andthey are stories about writing the roller coaster of health care andovation. I'm your host Dotor Roxy, founder of Legacy, DNA marketing groupand it's time to raise our COIQ on to tha. I show we're going to talkwith one of health, cares: Pioneers early, adoptors and top influences inthe field of connected health and, frankly, somebody that I admire most inthis industry. Dr Joseph Caveder, the vice president of connected health atpartners, health care is going to share with us why some health care divationsfail to commercialize and why some succeed he's also going to share withus some of the biggest challenges health innovators will face in twothousand and nineteen and how to overcome them. Welcome to the show I'mdelighted to be with you rocks you thanks for inviting me that, so I thinkthat you've been leading the way in this field for for decades. So most of the people that arelistening to the show are probably already know who you are, but just incase we have a few people that don't maybe we can just start off theconversation by you sharing a little bit about your background and what youdo. I'm delighted to do that. I don't think I'm so very popular thatintroduce myself for sure I am a dermatologist by training faculty or Professor Actually atHarvard Medical School and really that's my roots as a Clinitian, butabout twenty five years ago. I got intrigued frankly obsessed with a concept thatwhy is it that we demand that healthcare happens when two people aretogether in the same room and that's the only way you can get health careand actually today, as we speak, the adoption of any other type which willget into terminology, I'm sure is still only about twelve percent among doctors,twelve to fifteen percent. So, twenty five years later, we've made a dent,Bhan ways to go, and- and so I still keep hammering away at that concept and-and so that took me to this land that we now call digital health in thebeginning, we call it tela medicine and we just kept jinning up programsillustrate that concept. Some of it was interest of our parent institution. Iwas, I am a Clinishon at the Massachusetts Seneral Hospital inBoston, so they wanted to do a lot of workoverseas with second opinion. So we put that program together. We also gotinterested in chronic illness manjn, because it's a big problem- and Ishould mention also because we're talking about successive innovation-that one of the things I did early on was to launch beyond dermatology and asmuch as I'm passionate and love my clinical work. It is a very small partof healthcare. I just felt like if I was going to make a difference in thisnew care model that I really had to get begein dermatology, which is whychronic illness management online second opinions. All all of these otherthings that we do and so that that was the start and thenwe went. We went through some lean years for sure I was taying mentioning to someoneyesterday that in about two thousand and five we got, we thought we, the Tellamedicine was was no more so we abandoned that name and we invented incornected health, and we really did it because nobody wanted to talk aboutTela Medicine, wow, the RESOO. You know we're going to we're going to create anew word, so people will actually ask us what it means and we can talk tothem, and that was what we did. We saidconnected health sounds novel. Let's talk about that and sure enough! Oh,what's that how ies that work- and it...

...worked so it became a term of art inthe industry and, I think, still is to a great extent, although ver recently,probably surmounted by the term digital health,which is which is certainly all encompassing. So that leads us to thepresent, where I have system level oversighted our delivery system fortell health programs. I still have a a strong foothold in our innovationgroup, which was recently rebranded as pivot labs, so they're helping it's through a lot of corporatepartnerships, create the future of digital health and I have the privilege of doingthings external departners, which I love, such as, and maybe we'll comeback to this, but cocharing the AMAS committee on digital payment reform, working with a double AMC, advisingsome a number of companies. So it's it's a really fun job and you can tell hi'm delighted to talkabout it and, let's just talk a little bit aboutthe conference, because that's how we met and there's that right, so oyeah fififteen. Sixteen years ago now I've kind of lost track. My colleague JoeTrenello had this idea of bringing people together convening and it grewover the years in Twenty fifteen two thousand and sixteen wecombined it with the personal connected of Allince at Hymns and theyreconnected ofth conference. So it's now hym's event. It occurs every October. Iam privileged to be program chair, so it's my job to lineup the content, which I do with a very, very capable group of people at my side,and I think again, as you were talking about innovation and therole of convening it's amazing to me. I was recently at a because anotherinterest of mine is technology and aging, and I was recently at a meetingthat the dean of Harvard Medical School conbeined, a number of people in the inthe area and just the rich tapestry that we build on moving when we meetNew People. A similar interestus is very special, so these these eventsthat we all go to know and there and when we started the the conference, there were aboutprobably four or five four or five a week, and everyone has to sort of split theirtime and choose wisely. But but the value is so much in the networking andthe sharing of ideas, and I think that's an innovation feeder as well. I like to say that you were doing itbefore it was cool people in the beginning and again thisis this, is you know we're talking about success in innovation, but peoplethought I had lost my mind rigtruly they did because I was in the lab g taround here in the Harvard teaching hospitals.That's the path Y, you open a lab, you do basic research, you get promotedObester, you become a chair and a dean, and that's thing, and I just thatwasn't for me, so they really thought I had kind of abandoned ship stuff and in the in the early days itwas a little bit of rough sailing, but we got by that yeah and look at it tonow. So you know a big part of the reasonwhy I even started this show. Is this stat that I've been so passionate aboutand spent like the last six years? kind of I would say being married to isthat over ninety five percent of health care devations brought to market, failto generate a profit or reach any acceptable level of customer acceptance,and- and- and so I would love to get your feedback, and I know that thelisteners would as well. Why do you think that some health care innovationsfail and some succeed? Well, of course, there are multiplemultiple reasons. I could tell a story...

...of a company that we launched out of ourcenter intwo thousand a ten calledhealthrageous, and it was. It was an early play on remotemonitoring for chronic illness, but but in the in the corporate corporatebenefit space. U and the reason I tell that story isn't totell that the details of that company, but to illustrate one point, which iswe were doing really well. We had four majorhealth plans, piloting the solution and they weregiving really good feedback and then all those affordable, careact exchangas happened and every single one of those within aweek set we're not going to continue working with you, because we have tofocus on the exchanges. So those are kind of you know when you're, whenyou're small and you have entry level interest in what you'redoing you're so vulnerable to the way the wind blows or anything else right.The executive, that', your champion leaves the company and nobody elseseems to want to pick up the contract, and so that randomness is inherent in bringinginnovations to market, and sometimes there are quite legitimatereasons that companies fail like from a product perspective, there's notabout a Acke, said Yep and there's a there's a founder often- and this isn'tmeant to be a slander, but it is, it is, I think, accurate, often someone from technologyor engineering who is passionate about a technology and feels like that's going. No do the thing, and, and so and one ruleI would say that we must all follow us that technology should never lead. Itshould always follow a business problem. So so that's one thing that you see alot of. I think we're talking about this the other dayhow it's become fashionable to raise a lot of venture money. People seem to measure theirentrepreneurial success by the amount of venture money they can raise. Isuspect part of the reason, for that is right. Now it's there's a lot of mentamoney out there, and so people can raise tens of millions ofventure fun, but what you do with it, of course, iscritical D, and if you don't have the mindset to use capital efficientlyand thoughtfully, you can see companies go south very quickly that way as well,and then I think again, thereare, probably I'mforgetting or not mentioning ten times as many as I'm mentioning here, but theother, the other one that I see a lot of is. Unfortunately, people problems it. You spoke about being married to aconcept when you form a company you're married to your fellow executives, and if, if an because it's brutal th,the pith is breashtaking building any business, I'm sure youfeel that way. Building Your Business, but if you don't get along with thosepeople or if there's early like you, didn't, have the conversationabout equity that you should have with your that can ruin a company five, five orsix or ten months into it when there's a real feeling, a negative feeling ormisunderstanding, because those are the times when you can't stop and repair it, because Ifly out tomorrow to see a customer that you didn't know you're going to fly outto see because they're either going to sign a contract or they having aproblem. It just gets to be...

...breathtaking, so I think settling thepeople issues a early on understanding and really really beinghumble about product market sit eraising only the right amount of money,not the Mostcan, raise and then spending it softfully. The other thingwhich is related to that that I definitely see is people who don'tbring on now. Not every startup needs o CFLright away, but you need a controller. You need someone who can keep the books,because sloppy use of finances is a big potential problem, so those are a fewthoughts. Probably, as I said, there's ten times more than I didn't mention.No, I think that's great insight. You know just kind of going back to one ofthe things that you said. I see it all the time with innovators, you know tthe innovation then becomes their baby and they love their baby. So everyoneelse is going to love their baby, and you know most people won't tell you thetruth. Theyl just say I love your baby too. Nobody wants to tell you that youhave an ugly baby or unless, unless you're you're the person, theyre ore they'reasking you to pay money for it right right, yeah, that's true! Absolutelyone of my other favorite. I I subscribe to a newsletter from aninvestment banker, and part of the reason is that it's an area of business that I don't fully understandso I'm eager to learn, but he is a this guy is a very simple and that's one ofthe reasons I read his stuff is because it's Hute it's like plain English andhe always hays. What are you doing that people careenough about? What is the problem you're solving that people care enoughabout to pay you to solve M, and will they pay you enough that you can make aProt, absolutely simple questions, and andyet, and this especially in this economy, where people are buildingbusinesses based on aggregating and then monetizing later and all that kindof stuff in very kind of opaque, fairly quickly yeah, you know, that's so true a lot oftimes. There might be real problem that the innovation cansolve. But if it's the last on the priority list, you know, then it'sreally pointless, and so I see a lot of health inovadors spending a lot of timearm twisting trying to convince the target audience that they have aproblem that they need to solve yeah another fun, something I see withwith startups and maybe again f. If this is the direction you want to takeit, otherwise you can shut me up and move on, but but when you ask them about competition andthey'll say well, no one's really doing what we're doing right. I say, butthat's not what I asked, because people are solving the problem that you'retrying to solve somehow and in my own case, having pobeen, been a an advocate, anevangelist for a New Care Model for twenty five years now, every single day I wind up in front ofsomeone who's quite happy with the old car model. Thank you very much, andeven though I can logically tell them about what I'm want to do and why Imakes sense, they don't need to change they're solving that problem anotherway and it suits them. Just fine, so I think that's a big dos reality thatentrepreneurs need to take as well as is the competition may not be someones.Who's got your tech innovation, but maybe maybe someone's doing it with penand paper and they're doing just fine. They don't need your system, absolutelyjust ta substitute of status, Clo rigt yeah yea, so you know...

...what I also see very often is. Even so,even if someone has a product, an innovation that is technically orfunctionally superior to what's available in the marketplace, which isbasically what you just brought up, it doesn't necessarily gaarantee success. You know this cold commercializationprocess is very complex, especially in health care e. What what do you thinkmakes it even more complex to commercialize an innovation andhealthcare, maybe compared to other industries? Well, I reluctantly answer thatquestion because I wish it wasn't so it is so I quite agree with you, but Ifeel bad about that and again, I think it discourages some very entrepreneurlpeople from getting near health careese they feel like sale cycles are long and- and they are I mean, selling anythingto my health system is a multi frankly year process in mostcases, and you have to get so many different people, whether it's thefinance people, the clinical people, etceter tpete, the regulatory people,maybe Gotg, to throw in it privacy and security t the listseems to go on and on, and so I think there is that duality about what we dothat there's always a clinical voice. One of the things I don't care, youknow- and we don't always agree with our friends in the payer industry inthe pharmaciutical indsty, but we all are obligated not to hurt you, you, the patient. We are obligated todo the thing that doesn't hurt you, so we are inherently more or less risk averse or more. We are inherently more risk coverse andI think that that that's that runs through and through. That's why longsale cycles? That's why multiple eyeballs look at things! That's why youhave to convince the Clinical Committee, not just the CFO and on and on and on so I think, that's the main reason:it's just it's: fragmented sales and and Theyre. The other thing is that,unlike many other and I'm speaking, molt mostly about theprovider side now, although I I certainly translates te payer, I'm notas sure about Farmar but Noyou, know tha. We used to we used tothe the way we would phrase it and I would say joke, but it's not a joke. Isthat if there's a tableful of people making a decision, one person can say no and the answers,no, even if the rest of the table says yes, so it's that kind of sort of consensus,driven decision making process that makes it. I think, a challenge forpeople to make sales and, as I alluded to earlier, they're alltrying to display something. We do now one of the things that I think you knowso that nobody starts crying and turning you off and doesn't want tohear it. One of the things I could say that Ithink is positive and I have I have an example of it is the bright people will look at it n inthe first best business case is how to makesomeone money, but you bring in something that helpsmake them money the second best and it can be seckond best by all longshot. It's not like right up there, because it's a harder thing to sell ishow to make them more efficient, save them money and and most digitalhealth innovations fallin that second category and it's just hard becauseyou're making the you're promising the sales target. PayMe a dollar now and I'll save you ten next week and the person writing thechecks feels like they're, going to lose their dollar and then mayor Ma notsee that ten...

...and it's buried in the back. It's alittle bit like the reason that companies like PhilipsGe Etcete are successful, because if we buy at the massachusetten hospitalanother m magnetic residence, imaging setup, there's a lot of people outthere that need MRIs. We know we're going to generate revenue on that. It'sa vengreat forward investment. But if someone comes in and says I have asoftware tweeg that allows the medical technician to be more efficient. That's a much more thoughtful nuancedconversation. Maybe we don't want to lay off medical technicians. Maybe wehave a there's a union problem, there's all kinds of reasons that might not bea good sale, whereas Oll make me money. Sure sign me up right right, one of thecompanies. That's a spin out of our delivery system that I think has done abrilliant job in this and I'll use. That example is a company comle Medumo, and so what what they kind of startedout with was. We know reminding people to come in forappointments. That seems like a noble cause right whowe lot of people, forget appointments and so forth, but it didn't reallycatch on until they figured out the better use case, which is remindingpeople to come in for their screening colonoscopy. And if you think about it, a screeningcolonos could be takes a lot of time. You got Ta prep for it, it's a big dealand the on the other. On the provider side, one of the worst days in in aguastrontrial just life is when people don't show up for the procedure,because they book the time they booked all the staff and there's no way to utilize it. It'svery disruptive, so the guys at Madumo found this interesting niche where youas an individual, don't want to go through all that prepping for nothing. We as people providing the service,don't want you to be a no show and they capitalize on both sides ofthat, and they are doing quite well now they're business possible as we paidthem. But again it's easy for us to justify paying them, because every timesomeone shows up for a Conas be all those resources are used wisely. That's, I think, a good example ofsomeone finding a sweet spot with a technology that in the beginning,because they, of course, a lot of them do and it's fun for me, but they cameto me when it was just reminders and it was kind of a Hohum- show, shrug yourshoulders project, but but they eventually found this sweet spot. Sosohow was that discovered was. was that discovere through dialogue withpospective customers? Is it something that they just stumbled upon? You knowhow did they move from more of Hey we're going to go to market with thisrightd and then kind of that slight nuances? What actually becomes a game?Changer Yeah? Well, I think the the they did have some unfair advantage,ind that they were. The founders were a physician residence training in oursystem, so they had multiple different views, ways that a hospital mihter might notbenefit from from this tool, and I honestly think it was. There wassome randomness to it because they had a lot of different conversationswith their fellow Trainese and so forth, and it fell into someone's head one daythat Oh wow and again it doesn't have to becolonoscy. But but it's something that if you miss that appointment, it's abig hit to me right. So I can, in my world as a Drumtogis, could be mostsurgery where you're coming in for skin cancer. We've got all these resourceslined up, and then you don't show...

...that's probably one of their nextusecases as they'll roll something out for that. So they're going around thehealthcare delivery, Apparis picking out those times when, if you don't showfor an appointment, it's a real pain for brigter and then therefore for usto pay. I don't know what it is. Per Message is not a lot all of a sudden. It makes sense. So so, if you had a health innovationcompany, innovator approaching you, what would you say are the top three orfive things that you're looking for that? They need to be mindful of asthey're trying to get into a delivery network or health cospital system. So I'm going to try to answer that in arelatively generic way. I want to separate out my passion for connectedhealth, because I'm usually looking for like Maduma was,as I said, that the the initial conversation they had with me- I was- Iwas lukewarm at best as text messaging is kind of a yesterday's technology andagain they turned it into a successful thing, so good for them, but it should like, as I said, it should besomething that is going to either enhance our practice delivery or if it's on the efficiency side- andI happen to love efficiency. But but again it's hard. It's a harder cell,the efficiency side. It's to me. It's got to enable and empower patience todo more of their own decision making and inspire them to take better care ofthemselves, because we need that desperately, and so that's a littlepersonal. But I do look for that like there's, so many people out there thatsay we're Goingta, and this is going to sound awful because it's countercultural right now, but we're going to offer you roxy to show your medicalrecord on your iphone. I mean for you because you're, educatedand engaged that might be a good thing, but for a lot of people like, why do Icare right? What what I can't read the darned thing it's written in adifferent language. I don't even know what elhing of the numbers deen. So Ijust talked to a guy yesterday, who's done what he calls a health infographic view of the EHR, and Ihaven't really studied it in great detail. But to me that's kind ofinteresting right. If I could make what came out of the apple APP, that wasyour health record, something that you could look through and digest the highpoints, and it would make sense to you. I think, that's a breakthrough. No forme, that part is really important and then, as I said, the numbers have towork. That's number three. It can't be one of my favorite examples up. As Isaid, I like innovations that touch on aging and one of my favorites was aJapanese, robotic pet called PARO PAROS. It lookslike a seal. You may have seen one they cost sixthousand dollars. No one's buying them yeah. You can't sell them. Hasbro camealong and created something called a joy for all companion pet at a hundredbucks. It's not a sophisticated as PARROL, but they're settling like hotcakes, because the price is right so that eqating about price is reallyimportant. Adand then you know the sort of corrollary to that one is that peoplecome in because they think well, our price is high, but we're going todeliver a lot on Rli and, like I said, that's asking me to makean enormous leap of face M, which I may or may not believe in. So it's hard when you're, when yourstuff's expensive, an out of the gate and some technologies really are andand that's a harder...

...hilt to climb and then finally, this iskind of going to be consistent with what I said earlier. Tell youknowppresent, as a group of people with integrity present as a group of peoplewho are professional. Have the sophistication understand that,for instance, if you're going to and deploy an IT system, we have to havesome integration. We have to pass a security oud it we can just throw stuffon our network, it's a little bit and and again. This is how do I phrase Tus without soundinglike an old teimer but be acain be respectful and thoughtful?There's a lot of young most of the time they're young entreprenners wo are justa little bit flip about stuff like that and that's kind of a turnoff Sur yeah.So let's talk a little bit about the pilot phase of the innovation processtouched on this just a little bit. You know it can be a real challenge forhealth innovators. You know. Obviously everyone needs the conical evidence toyou know to be able to validate the safety andefficacy of their innovation, but a lot of of companies get stuck in what Icall pilot purgatory. I ISI say it's death by pilot. You knowthese health, innovators that go out of business because it's one pilot afteranother, you know describe your experience with that phenomenon andthen maybe some some recommendations of how innovators can avoid pilotpurgatory. Well, you can you haven't given meanything easy yet. So that's good way to spend an hour to think some of thesethings through with you that that's a really tough one, I think one one firstbit of advice is: Is don't overcustomize the solution for each newcustomer mhh right? So you come in and say: Well, we do blue papers, we foldthem over a red paper and that's our product and we say well, we kind ofwant green and you've never done green and you've got three other customers atars to blue and red just say no just say WT. No, we don't do green. If weever do green will come back, but have the guts to not overcustomize, andespecially when you're in that early phase were getting early. Customers isso critical, it's a real risk and you can't be stubborn enough that youhave this vision that you alluda to this earlier, that no one will buy well.No, I didn't mean that. But but if you have five pilots going in they're allpretty different, that's a problem. Absolutely. I think that that issomething that we just can't stress enough,because it's so easy to get caught up in the you know the hospital system that has all thebrand reputation- and so I feel compelled to just acquiesce toeverything that they want, because that's going to be my path to success, it can be so much to where you don'thave anything viable at the end, I think the other big big, big, big piece of advice is, is to have, I guess, take a lesson from theJapanese. You know the Japanese negotiate for years before they doanything and they do that for a number of reasons, but but before you sign that precious pilotagreement ask a lot of questions about I one ofmy favorite things to do with people just in generals to say: okay, let'spretend that x, what Wer we're talking about is widely successful. Then what and sometimes you sometimes you're the person across the table actuallydoesn't have budget doesn't have spending authority, can't really hireyou even if the pilot successful so you do. You got to do a little bit ofsniffing. Does that that person the one...

...who's going to implement this system?As I alluded to early, do they need a committee of five to say yes do theyneed to run it by the CFO DI? They need to run it by the board. What is thepath- and you do that through this sort of sacratic approach, where you saywell, I know my pilotis going to besuccessful and you kind of joke. You Know Haha futs, but just let's pretendit is for a minute then, and I think the more crannular you getabout that and what a success mean by the way. Ifso, well it worked, but it didn't save us any money or it worked. But Tenpeople complain. If one patient complain, we can't do it. I mean Yo Al.I wishtold me that right because you know that would have wasted my time. There's this whole other side of itwhich is about, and this is a hard one for for startups,whether you, whether you give the technology away whether you in of course, our group. We have aclinical validation group in pivot, labs and companies, pay us to validatetheir technology. So S, it's a reverse pilot in that way. Yeah. But I wouldsay we're in the minority in that regard, but but again have thatconversation about and- and I guess the other at least in academic centers, MajorPotpole you can run into- is that you're across the table from someonewhose goal and pretty much only goal is to publish a paper usually and theyre they're important,because you then get to take the paper around and say we validated ourtechnology at Hopkins or Mao or Cleveland or wherever you like Hay. Butagain those people are that their career path is about the paper. It'snot about putting you into the system and scaling that pilot. So that's whenyou sort of say: Okay well, if we're successful, who might theoretically pay for this and how big could it get and would thatbe your department Shaire? Would it be? Would it be someone in another sector?Would it be? Hospital leadership depends on the AP or the technology,but I think that's really thego and not that you can avoid pilot purgatory that way, but I thinkwith. If you follow those two rules, you can lessen the chances of it. Ithink that's great wisdom. Thank you so much. I know our audience willappreciate peering that so the last question I have for you before we openit up to live QNA is there? Is this explosion of innovation happening right?So you know twenty years ago, ten years ago, if you had a new innovation, youknow it might be more easy to get in front of people, but one of the thingsthat I hear over and over people are asking me is: How do I rise above thenoise, the target audience that I'm going after you know a thousand fivehundred tenthousand other innovators or trying to get in front of Front of themas well? How do I rise above the noise? Any advice that you have for folksregarding that? Well candarly, it's really more your expertise than mine,but, but so so this is half bake. Compared to what you could offer, I mean it's. I have made a a career frankly out of learning fromother industries, ING those learnings into health care. Part of the reasonthat I started in this space to begin with, because other people were held w hello, rendering serviceswithout having to be in a room together what an idea O, I think, there's a healthcare equivalent tocelebrity endorsements, there's healthcare equivalent togetting buzz on social media right there, the same tools that you woulduse if you had a new perfume or if you...

...got Kendl, Jennito, wear your jewelryor whatever. It's not exactly that. But but thoseare not off the table. Yeah you get get Andrason herwids to investin you. I mean, I know. That's, Oh sure, thankyou, but but but my point is g, a lot of money out there and and choose yourvcs wisely and if they have that kind of star power use it. So I think you know one of my anothercompany that I admire and I'm actually in a discussion with this founder about doing more of themis Lark and they're a chat bought company thathas done a lot of work in chronic illness management. But but one thing I admire about Julia isthe way that she has done exactly what you describe so she's on InstagramYouyou scirld for your in Scram feed. You See ads for Lark, she itter she'sgot you know her slide. Deck has ten different awards that she wont forbeing the Best of something now she's dyned good, but I'm sure there was someengineering behind at least some of those Awar Shol I yeah ato. You knowyou get someone again like yourself, who knows how to create a bit of Buzz and- and I wouldnot wewere talking about earlier aboutspending money wisely. I would not underestimate spending money on PR andmarketing. It's really important. I an Anari'll, tell you the reason. It isbecause if you really have an innovation, if it's really trulydifferent people will be. As I said earlier, people will be solving thatproblem a normal way and they won't even think to invite you to the partyunless they know about you, yeah yeah. Absolutely. I think that has a lot todo. I think that is great, and in you havemarketing insights, maybe that you're not even aware of well. I've hung around folks like youfor a while. I good good folks that surround me that I learne from I'm alifelong learner in any case, so so thank you so much for sharing your timeand your wisdom with us today. How do people get in touch with you or stayconnected with you if they want to follow you? Well, you can certainly I'm actuallypretty good about responding to people, I'm on Linkein Joseph caleter. I thinkat Jacoviter on twitter Instagram, though most of my postare about wineand not health care, my email, j, cveter, a partner stat oryou can find my blog, which is the sea health blog, and we do a podcast aswell called the well connected that all of that stuff is on the websiteconnected health, dop partners, totdor awesome. Thank you so much yeah. Thankyou. What's the difference between launchingand commercializing a health care, Novation, many people will watch a newproduct. Few will commercialize it to learn the difference between watchand commercialization and to watch past episodes of the show head to our videoshow page at Dr Roxycom thanks 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 Roxy untilnext time. LET'S RAISE OUR COIQ.

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