Health Innovators
Health Innovators

Episode 121 · 1 month ago

How certifying your digital health tech may drive adoption w/ Lloyd Humphreys


Healthcare has always been slow to change, and adoption of digital health solutions has been no different.

When it comes to advances in technology and digital solutions, we sometimes tend to put the cart before the horse - that is, we go in with a solution, without first asking the questions.

A digital health solution can phel drive adoption, support, guide or even act as a network. It’s not a one-size-fits-all solution.

Dr. Lloyd Hymphreys is an expert on digital health, and he’s here to explain why digital health is not a one-size-fits-all solution and how, when we make assumptions, we end up trying to solve problems that don’t exist. And that can be a big problem when commercializing.

Assumptions are like windows - if we don’t scrub them off every once in a while, the sun will never come in - and Dr. Humphreys is here to put his expertise to work and help clean those windows.

Here are the show highlights:

  • Things to do (or not do) when commercializing (1:31)
  • Key differences in Quality Initiatives (6:09)
  • Are you trying to solve a problem that doesn’t exist? (10:10)
  • When looking at the opportunities with digital health, don’t forget the risks (13:15)
  • Digital health is not a “one-size-fits-all” solution (18:56)
  • Digital health should not be treated as a separate healthcare pathway (24:50)

Guest Bio

Dr. Lloyd Humphreys is the Managing Director at ORCHA, a company that assesses and distributes quality assured digital health solutions.

A proven, highly regarded business and sector leader in digital health, Dr. Humphreys has a passion for helping others scale their digital health solutions.

In addition to being a trained clinical psychologist, Dr. Humphreys also completed an Executive MBA at the European School of Management and Technology (ESMT) in Berlin.

If you want more information about ORCHA, visit their website at, or if you wish to reach out to Dr. Humphreys, you can find him on LinkedIn @Dr Lloyd Humphreys

You're listening to health innovators, a podcast and video show about the leaders, influencers and early adopters who are shaping the future of healthcare. I'm your host, Dr Roxy Movie. Welcome back to the show health innovators. On today's episode I'm sitting down with Dr Lloyd Humphreys, WHO's the managing director for Orca. Welcome to the show. Thank you very much for having me, Roxy. Dr Lloyd, month Freees, no doubt. Uh. So, let's start off the episode by just telling our audience a little bit about your background and what you've been innovating these days. So, as as you said, I'm the managing director here at Orca, so I'm helping to lead the organization with the founders. But by background, I'm actually a clinical psychologist by training. Um, I worked in the National Health Service here in the UK, work for the complex trauma. Left the NHS because I felt that things could be done in a more innovative way. So I then set up my own clinical psychology services with another psychologist. Took that scale and then realized that the number of people we could help was always going to be correlated to the number of people we could hire. So we turned to technology as a real great multiplier effect. And so right in the early days, I think this was around the time of the the iphone being launched. So this is how long ago it is and I've shown my age. Um I co created one of the first online treatment programs for addiction, took its scale sorted on and then since then I've helped other technology companies to scale their solutions Um so, and this is it's been fantastic to join Auka and the founders on this journey. So, before we dig into Orca, just kind of looking back on all of the commercialization UM businesses that you've been a part of in healthcare, what are some of the things that you've seen, lessons that you've learned of things to do or in things to not do? Yeah, I think for for me, I've been saying it's quite quite a few times today. I think for digital technologies it changes so fast and sometimes you have to kind of react to those market changes, but sometimes you have to kind of stay the course. So so for me it's about always kind of creating core repeatable business with your technologies rather than reinventing a technology to fit kind of the Wim at the moment, because we see healthcare go through these constant kind of evolution cycles and that can kind of kill a company reacting because when you do react, you're always behind that that reaction Um. So so for us it's about being able to to work and predict the market and guide the market and created as well as react to it. So I think that's kind of one of the key lessons here. And secondly, have the best commercial model you can. I can see really great ideas and and they kind of die on the commercial floor...

...because they haven't got the kind of right commercial model. So it's really important that that those those two things are kind of established. Yeah, you know, my heart goes out to some of these innovators that I've seen where they literally have their technology APP built. You can go to the APP store today and downloaded, and they still don't know exactly what their business model is. Yeah, and and, and the problem with this is is that often what happens, particularly in digital health, you have someone in a clinical background and they've got a really great idea to solve a particular pain point, but they don't understand the technology side of the equation and so they kind of stumbled that or you get the technologist that says, Hey, this is kind of a great idea from a technical perspective, but then don't understand how it's going to be kind of used in practical, kind of real terms, and how it's going to help that person on the ground, you know, in terms of seeing patients or helping people. And so it's the magic really happens when you you bring those two types of people together. Yeah, I was talking to someone earlier today and they were saying that you've got to find someone that's going to eat the dog food. And so, yeah, who's going to buy it? WHO's going to eat the dog food? Yeah, absolutely, and if we're eating doctor quick, please make it taste nicer. That's head right now. Exactly. Uh Um. So let's dig into Orca a little bit. So what is Orca? What is Orca, and you know, what's the mission and purpose behind what you guys are doing? Well, the reason that we exist is when we look to digital health, we kind of know that there's about three hingering sixty five thousand technologies on the market, but only twenty of those technologies reach any sort of baseline criteria for quality. So eight of technologies out there right at the minute are at best ineffective and at worst dangerous. So how are we expecting healthcare professionals to know which wants to use, which wants to buy, which wants to condition? How expecting organizations to know which wants to reimburse all patients, which ones they're they're expecting to use and benefit them? And so there's this whole kind of risk associated with digital health right now and this whole wild west. You know, when we consider there's nearly two and fifty new technologies coming on to market every single day, means whilst we're talking, at least ten new products will be kind of coming to market somewhere in the world. How do we kind of help, you know, in terms of making safe decisions? In every other part of kind of healthcare, we have lots of infrastructure to help with making safe decisions. You know, when we look to medicines, we have like the F da to approve and licensed drugs. We have organizations like iser to look at the effectiveness and impact. We have the orange book to know when to prescribe and when not to and we have wonderfully prescribing platforms. So you get kind of your your your prescription delivered to your door. None of this exists with digital..., and so this is kind of why Awka exists, is we are the global leader in terms of assessment of high quality digital health products and also in terms of assessment, accreditation and distribution as well. So so we assess and accredit technologies and we also helped distribute them through digital fomueris. So so how is this different than say, anything like? You named some of those quality organizations, let's say like in C Q, a Um or even your ack Um, just for folks in our audience. What would be the differences between what you're doing and what are those quality initiatives already doing in the marketplace? There's one lots of wonderful kind of organizations like the ones you've mentioned, actually, that I really do and what they do is they focus on on things like software as a medical devices, medical devices and things like that. And the FDA is doing this, and we can see this with five, one zero case, the Break Devices Program, Prescription Digital Therapeutics, Um and that's absolutely kind of wonderful, that absolutely kind of needed. But when we look to the market, medical devices and software as a medical device accounts for just five to ten percent of those technologies. What about the other eight? Um there's no one out there helping to to really kind of define what good looks like with those. And whilst digital therapeutics are absolutely kind of essential, you know, not everyone needs a digital therapeutic. Sometimes we need information, signposting, guidance support, sometimes we need that kind of network, you know, medication support, things like that. So so for me, you know, we need to be able to cover the entire market if we're really going to truly embrace digital health. We shouldn't just be kind of specializing in one area, and that's kind of where all comes in. So part of what has been done historically with those innovators is really do in either some type of clinical trial or some type of piloting program with their target customers and right so they're trying to build that evidence, build that clinical evidence that establishes that it's safe and that it's effective through pilots. So is this something that replaces piloting or is this something that augments it? How do those might work together? So what we've done? We we've tried to where we've worked with twelve countries right across the world or well in twelve countries we've helped kind of design assess or credit scheme. So, for example, we've worked in New Zealand kind of help with health navigator to to define what digital health looks like. There Israel, the Netherlands, the Nordic nations with the Nordic Baseline Review, you know, and the UK. So so ORCA helped assess products for the NHS APPs library, for example. So it's not a replacement for those but it's a it's the ability for those technologies to kind of say yes, we reach the quality criteria along a number of different mentions and absolutely clinical evidence is one,...

...but it's not always necessarily going to be appropriate for every type of technology. Again, thinking about an administrative tool, I don't know, a patient booking system, you don't necessarily need clinical evidence in terms of the effectiveness of the patient booking system. Um, you need to know that it's efficient. So how do you kind of prove that? You don't need a randomized control trial necessarily? Or for an information or support website, you just need content verification. So it's about making sure and we assess across for ossensible buckets. So firstly, data and security. Um, sorry, data and privacy, to making sure that it conforms to things like kind of hipper here in Europe, GDP, are you know, etcetera. Um. What's its security? So is it kind of high tech? Does it kind of form to nest here? It's kind of cybersentials, etcetera. Um. And then we look at accessibility. Does it kind of fulfill people in terms of the those with impairments? What's the user experience like? And then last is that clinical evidence or professional guidance? Was it created by someone who has a professional kind of qualification in that area? Does it have randomized control trials? And each of those four areas you do need to kind of have a proportional approach to the assessment based on the type of technology that it has and the intended use of that technology. Yeah, you know, just kind of pausing. There's so much to unpack in what you just said, but one that really strikes me is just the the user experience. You know, I think way back when, ten twelve years ago, we had, you know, everybody was launching patient portals, provider portals, and there was this kind of sense of patients and providers don't want portals, and it's kind of been kind of like stigmatized in what we've seen is, though, is that the reality is that most of those weren't effective, they weren't useful or they just had really clunky, clunky user experiences. So it wasn't that the pace. So the providers didn't want those tools. They just needed a higher quality tool in order for it to actually be useful for them. Um, and it sounds like part of what you'll be doing is helping to elevate that. We'll figure out the problem you're trying to solve. and was that the problem or were they looking at the solution first? Um, so, so ask the right question before you get to the answer. Sometimes we start with the answer because we assume what the question is, and so so often that's the case, or we're trying to solve a problem that doesn't exist. So it's really important that you unpack you know why you're doing what you're doing in that way. And we do know, we just run a survey here and we do know that that patients absolutely embrace digital health. In fact, six people in the UK believe that digital health will help alleviate the pressure on the health care system, and over half not hard just up to half of people have actually used digital health APP... the last year and any three percent of them found it help their health. So people want it, people embrace it and people use it and it benefits them. So it's about making sure that we provide the right solutions at the right time. So, who are your customers? M So. So we work with developers to help them to demonstrate the high quality solutions that they've developed. So so developers like to work with us because they want to show the differentiation. They want to show that, you know, they have got a high quality solution. We work with governments and organizations to help them define what good looks like for them. Um, and so we help them digital health assessment frameworks and we've done that in the US, working with the American Telementis and Association American College of Physicians to create the US digital health assessment framework. Um, that's been launched. That was launched a couple of months ago and now that's getting a large number of developers through through that framework because they want to demonstrate the quality of their solutions. So working with organizations to do that, and then we work with both pairs and providers to help kind of distribute those high quality innovations. So being able to provide digital formulais so that healthcare professionals can recommend directly to patients, but also apple libraries where patients can self serve find those over the counter technologies that can help them with their day to day health as well. So where are we with the with the maturity of the market? Do you find Um and it may vary from different customer segment as you just described. Do we are we are kind of like in a pre awareness stage to where we're having to persuade some customer segments that quality is a problem, it's kind of the wild wild west with digital health and so that we need to establish those standards. Or are we working with maybe a little bit more maturity where people are actually seeking out these frameworks and these methodologies that you're bringing to market because they've been stung by either the danger or the ineffectiveness of some of these tools out there? It's it's it's kind of an interesting question. I think different countries around the world are of different stages of recognition. I think it's it's really it's only recently that we started to recognize that there might be some risk associated with digital health. The opportunity is clear and COVID has brought that into start focusing the fact that actually traditional care, you know, wasn't able to be delivered. We had to turn to digital health to maintain some level of healthcare delivery. So so digital health, the opportunity is there and it's here to stay, Um, but what we haven't really focused on is not just the opportunity but the risk that comes with that. We wouldn't kind of expect, you know, a nurse to prescribe a drug to someone just because they might have tried it last week and it helped them. And yet there's people over waiving their phones going hey, you...

...know, I tried this great app last week, why don't you give it a go? You know, if that happens, who carries the liability if something goes wrong? Yeah, you know, is it the person who recommended it? Is that the organization that they work for, or is it the patient that has actually kind of taken that advice? You know, we haven't even considered the liability issues around digital health. We haven't considered the risk that actually wants if we get it wrong, Um, and so these are things that are coming into stark focus. You know, some digital formers now are building their digital formers and they're building them based on kind of commercial relationships, you know, rather than actually kind of quality of solution or maybe in terms of voluble market share rather than actually in terms of kind of clinical output. And so for me, we need to kind of have a look at you know, if we're going to have a look at the opportunity, we need to kind of look at the other side of the fence as well and to make sure that we can support great technologies, you know, and help them accelerate, but also provide the voice, the breadth and depth of solutions so that we don't kind of take a one size fits all to digital health, that we can actually kind of serve the entire kind of healthcare community. M Hm. So do you see Orca maybe, Um, you know, I don't want to put words in your mouth, but is it maybe a pathway for accelerated commercialization for innovators because they have been validated? Um, maybe faster? You know, one of the things that I hear all the time when we're working with startups is just the piloting process and you know, so they're already, Um, you know, struggling with funding or, you know right, some of them bootstrap, some of them funded and and just trying to make it these couple of years and then they get stuck in these piloting engagements that take to three years to kind of complete and gather that evidence. Is this potentially a pathway to be able to establish that high quality measure or benchmark much sooner and helping them with the commercial relation? It's it's what. We're never going to be a replacement for all of those things. What we do is we shine a light on on great kind of technologies. You know, we consider ourselves to be an enabler. We consider ourselves to kind of support the market on every side side of the fence in that way. So it's shining and talk. So it's not a replacement for generating that evidence, getting great customers, having those pilots. But what we do is we kind of, you know, light, light that up so that others can see that and so they don't have to say right, well, we've done it over here and need we need to repeat it over here, you know, just because there's lack of awareness. So so we kind of we helped kind of enable that, enable everyone to kind of come together, you know. So so we're the place where people can find demonstrates and then distribute those great technologies and that's really kind of important, you know, and a number of countries are trying to do um this in some ways. So often, you know, Germany is kind of brought up as a good example. They've got something called the digger where they've got a great digital frame work, they've got central...

...reimbursement. But the problem, there's two problems with that. They've got funding, central reimbursement, they've got a framework to show what good looks like, but they've only been able to assess just thirty three products in two years now. If we think about that as a digital pharmacy, the cupboards of bear Um and only seven of those have got final listing, and so we need to kind of be able to accelerate. That's not accelerating that market. That's going to the glacial pace. But this in comparison, we've done over eighteen thousand assessments on seven thousand products and we do about four to six hundred assessments per month on products, and so it's kind of we need to be able to kind of move at that pace and unfortunately, sometimes. You know, agencies kind of tend to kind of move at that slower pace. You know, we, we as a as as an independent organization, can can move at that that sort of acceleration because we're a technology driven company. Yeah, so, so that that's kind of where we so what we consider ourselves an accelerant to the market but, more crucially, an enabler and enabler to kind of reduce risk, improve quality and improve adoption. Hey, it's Dr Roxy here with a quick break from the conversation. Are you trying to figure out what moves you need to make to survive and thrive in the new covid economy? I want every health innovator to find their most viable and profitable pivot strategy, which is why I created the covid proof your business pivot kit. The pivot kit is a step by step framework that helps you find your best pivot strategy. It walks you through six categories you need to examine for a three and sixty degree view of your business. I call them the six critical pivot lenses. As you make your way through this comprehensive kit, you'll be armed with the tools, tips and strategies you need to make sure you can pivot with speed without missing out on critical details and opportunities learn more at legacy, Hyphen DNA, dot com, BA, slash kit. I can see that on the you know, the B Two b side as well, because they are you know, the amount of time that it takes them to sort through all the digital health options that are available in the marketplace and to be able to identify them, to be able to assess which ones are the higher quality. And then the risk of you know, one C I o making that decision and kind of in sometimes putting their whole entire career on the line for whatever that they've recommended for to be invested, UM, without having that third party to help with that validation, uh process. I can imagine that that might go faster. Yeah, it takes years. And what usually happens because of that? Because it takes so long to do that? You have to go through that assessment process, you have to look at all of the things, from financial and commercial viability to quality and, you know, make sure all those regulations and that takes a long time. So usually what happens, because it's such a labor intensive process, you know, a lot of pairs...

...or providers. They will go right, okay, well, what's the best one for depression? What's the best digital because they haven't got time to SS multiple ones, and so they go right, what's the best one for depression, and they shortlist it down and then they go through that big long cycle and they come out with the other end and they go hey, this is the best digital health solution for depression for us. But that kind of flies in the face of how we deliver healthcare and every other walk of life. We don't just have one antidepressant medication, we have a whole sea of them and we prescribe that medication based on the person presenting their problems, you know their history, and we personalize that medication to them. But we're not doing that with digital health because of that inefficiencies in the system, and so we usually have a one size fits all and we expect everyone to respond to that one digital health solution in exactly the same way and positively, and then we kind of sit back and think, well, why isn't everyone benefiting from this? I don't get it, and it's because, you know, we're expecting too much. So it sounds like what you're saying, then, is that you envision that there could be multiple high quality depression APPs using that same example, and some people might have success with some and some people might have success with others, and that doesn't mean that the quality of both is not there. It just means that people are different, just like like you're describing, with the way we engage with medication, medication or over any other part of healthcare, we're going to respond in different like in all parts of our lives, you know, we all kind of have choice and we all respond in different ways, we all learn in different ways, we all kind of face treatment in different ways, and so we need to be able to personalize that. And you're only going to be able to do that is if you have the breadth and depth of solutions available to you. We need to kind of take that sort of medication or of a Healthcare Treatment Paradigm and apply it to digital health, and we haven't been doing that and for for me it kind of, you know, it's kind of really confusing that we haven't taken that approach. Is because we don't have that infrastructure in place to do so. And that's kind of what what Orca does. We we provide that infrastructure to enable that breadth and depth and choice available so you can personalize those digital health and it's strange that when we have digital that can have ai and machine learning and personalize in so many different ways, that we're not kind of taking that at the front end in terms of personalizing and having that choice of solutions. Well, I think part of it is just this fundamental shift to its just how we imagine this healthcare Um that you know still, I think there's so many organizations that speak to all patients the same or all oncology patients one way and then all MS patients another way, but still realizing that all oncology patients aren't the same just because they share this disease, or all MS patients aren't the same. So going even further on the Digital Health Um, you know, thinking about message gene, thinking about Um, you know, education and...

...being able to personalize it at scale is really something I think we still have a lot of opportunity to grow into. There's so much opportunity and so much kind of ways that we can benefit healthcare at the healthcare system. You know, I'm visus to day when we talk about digital health, but we dropped the word digital. It's just health. It's just another modality of delivering care Um and that's kind of where we need to get to. But we're so far off that because we're not learning the lessons from from other part of Health Um, and we need to kind of apply that and we need to accelerate it and not kind of befooled in some of the senses of the GLITZ and Glamor that we've got to have one choice and there's the best kind of APP you know, and because we're often asked, what's the best APP that you come across Walker, you know there isn't you know? There's just one best drug, you know. Yeah, yeah, yeah, I think that. You know, the I think of the pay or formulary is being a great example of that Um of kind of having a framework that patients go through Um, but they try different tiers before they move through that formularity and get to do whatever the solution that's going to be right for them. But in that formerly you've got a breadth and depth, again, to come back to that phrase of solutions, so you can go through that formula. If they don't respond to this one, then you've got a choice available to you. If you look at existing formulas that are on the market. They've got about solutions in there, UM, which means unusually too maybe for for for mental health, or maybe three for behavioral change. Um, you suddenly get to the bottom of the list pretty quickly. So you know. So we need to be able to kind of expand, you know, and we need to be able to drive the efficiencies, and that's where assessments, you know, the ability to kind of have quality digital health marks and things like that are absolutely kind of fundamental. So in some of our conversations before you had mentioned that the way we're looking at care, digital health as being just an offshoot of traditional healthcare. Describe why that's a problem and what we need to be doing going forward. But one of the problems with digital right now is we're seeing it almost as a separate, parallel digital pathway, that we're kind of seeing it as almost a diversionary tactic, that we've got traditional care and then we've got digital and we can push a certain number of patients over to this separate pathway over here. And that doesn't work for me, because you know that patient is going to come around the loop at some point Um, and so for for me it's about making sure that our pathways, that we have our technology enabled, that we embed digital into our existing pathways, not see it as a separate, parallel diversionary pathway where we can push patients too. You know, for some efficiency gains, we need to have a technology enabled.

This is why we've been creating Um talk it's across certain pathways. Talk its of technology is a short number. You know, about twelve to fifteen um APPs or technologies within a particular chosen pathway, for example in elective care, for say MSK or ophthalmology or dermatology, and you have a certain number at each stage of the pathway that enables it and empowers it um and that might be from waiting well and waiting, unless it might be some pre oppossessment technologies, you know, some for for rehabilitation and post care discharge, and so being able to kind of embed those technologies, not one that goes across the whole pathway, but chosen technologies, with choice at each stage that really kind of then accelerates that pathway and really turbo and charges it. So so we need to kind of think about it in that way rather than this paralleled diversionary approach. So how are we going to get there? What needs to happen? Well, we need to support it, and this is kind of why, you know, I'm really kind of passionate about what Orca does. We need to get there by by being able to support each part of the journey, you know, firstly, by identifying great technologies that are in existence and supporting those those that are coming through, being able to then shine a light and and, you know, have those assessment frameworks where people can demonstrate those products. And then we need to be able to kind of get them into the market and then look at those reimbursement approaches, you know, looking at the different ways and creative ways. You know, we don't just need to kind of have a cpt code or or other. We need to kind of have a look at other ways that we can kind of fund that and obviously kind of reimbursement codes that are kind of fundamental, but are there other novel ways that we can kind of then digital health has so many wonderful kind of commercial models, you know, in terms of look at just look at the iphone, the different ways that you can kind of pay for APPS or not pay for them, etcetera. You know. So, so I think there's lessons that we can learn from other industries that we can apply to that. So firstly, identify assessor credit, then kind of be able to distribute and then be able to kind of look at the outcomes. And therefore, if we can have a look at that, then we can start then be able to look at things like population analytics. We can start to look at preventative so one of the things that we have a look at in our formulas. We're able to look at what people are searching for. We're able to geolocate, so we can have a look at underserved populations. We can see areas of kind of really high growth or high need. We can see whether people are searching for particular particular technologies, so that we can identify this ahead of schedule. So when you start to power the whole system, it kind of then reinforces itself and that's where we're going to get the acceleration. So so, Lloyd, I think you've got such a unique perspective of being, Um, you know, a global company in having already commercialized your solution and very... forms across different countries. Kind of give our audience a little pulse of what are some observations of maybe where we are in different markets, Um, in a way that might be beneficial to people that are determining whether I enter into the US market versus Asia, Um, you know, just kind of getting a pulse of where we are Um, market by market from a digital health standpoint. I mean we we kind of categorize markets in different ways. I mean we have a look at those that are ready for acceleration, that that have got a really great foundation and just ready for for that. Then we have a look at some markets that are at the tipping point, you know that they could go really one way or another. They've got so far and they're at that kind of tipping point, whereas I'm going to go really well or not so well. Then we've got some that are at base camp. They're just getting there, they're they're kind of really on the cusp and base camp just allows. That's quite an interesting place to be because in some senses at Base Camp you've got the foundation and you kind of have leapfrog into the acceleration phase. So those are really interesting places. And then you've got those that are really at the start of the journey. They don't know what they don't know and I think different countries and different regions are at different stages. I think the UK is quite unique. We've got really high adoption and use of digital health here in the UK. Um. It's really fascinating place to be in the NHS. We're really good at innovation, but we're kind of not so good at terms of reimbursement, um, and so it's really difficult. It's it's kind of, you know, the NHS is kind of the world's largest cottage industry. Um, it's kind of full of hundreds of organizations. There isn't one NHS, so it's difficult to sell into. But you can see real great pockets. Um, when you have a look at places like Europe Francis and the cost they're they're kind of, you know, they're at base camp, they're they're looking to what others have done and they're at really exciting place where they could leapfrog. Germany has done some really great work in terms of having a framework and having an assessment process and then having central reimbursement. But the middle pieces is kind of not so great in the sense they've only got thirty three products. So after two years and they haven't really got the distribution done as well as it might Um with I think they've got about forty prescriptions in the last two years, which sounds a lot, but some products do that in a month Um. And then we've got the US, and the US is is I would say they're at this kind of really exciting phase where it could kind of accelerate out the park and could just be the most amazing kind of place in terms of digital Um and we've in some senses that's kind of great and we can see that with the FDA and some of the wonderful work that center for digital health is doing. But that needs to kind of support that. That's kind of supporting software as a medical device. But when we think about software is as a medical device just being about five to ten cent of the market, how do we help the other nine? So I think there's some really interesting things, which is kind of why we've been working in the US to help kind of accelerate things. And then obviously you've always got the age or problem with reimbursement, but I think...'s a really exciting kind of place to be. In the US. There's some really lovely innovation happening right across right across the sector. Um. And then we've got interesting places like Australia. They're just about to kind of release their digital health framework over the next kind of few weeks Um, and I could kind of continue around the world. The nordics is really exciting. Actually the nordics. If anyone's in hymns in Helsinki next week, Um, please, you know, please kind of get in touch. They're about to kind of launch the Nordic Baseline Review. There's some really exciting things there. So the whole kind of world is a buzz with kind of digital health and I think if we brought all of that learning together, Um, there's so much good that can happen. That's awesome. So thank you for that. I think of the audience will really appreciate that getting that update, because some you know, I know that some businesses, for one reason or another, decide to circumvent the US market and have more success with their initial launch and commercialization in other countries and then circle back to the U S Lader and then some of them, you know, just stay in the US. So that's it's really very insightful information. Yeah, I mean the US is tough, you know, because the US is not one country, it's fifty states, which is the size of Europe. So you know, no one goes over to kind of break Europe. They'll go over and you know so. So I think you know how you kind of grow in the US is the more pertinent question, rather than whether it's a great market to enter. It absolutely is. It's just how you do that is and how you operationalize that is absolutely kind of key. And for any listeners who want to get in contact, we help. You know some of those standards right across the world and we're always happy to kind of give advice, you know, and support people. It's it's really important for us to do so. So how can folks get ahold of you after the episode? Yes, so you can either go to our website orcer how dot com. So aucer is O R C H a. Some pronounce it orchard, but Auca stands for the Organization for the review of care and health APPs. So auker actually stands for something. Um So AUCA HEALTH DOT COM. You can go to our website or you can email us at hello at aalker health dot com, very straightforward, or you can go and find us on Linkedin, twitter, etcetera. You'll find us if you look for so one of the questions that I like to end with is this question around legacy. So I firmly believe in that all the actions, in the investments that we make in our life are forming a legacy, whether we know it or not, whether we're being intentional, and so I think a lot of the work that you're doing is really going to reflect the legacy that you live behind. So how do you want to be remembered, whether it's in healthcare or whether it's out yeah, I think for for me, you know, I want Alca to be remembered as improving lives through technology.

You know that that if we've helped and touched every technology choice in health care in some way where, behind the scenes or whatever, I think that's really lasting legacy, whether that's to help them in terms of their growth or help them in terms of shining a light on the great work that they're doing or being able to help get them into the hands of kind of patients. Um, I think if we can improve lives free technology, then then that that would be a wonderful lasting legacy and that's kind of why we are a mission lead values driven organization sounds like a great cause and we need it all around the world. Thank you so much for joining me today. Thank you so much for listening. I know you're busy working to bring your life changing innovation to market and I value your time and attention. To get the latest episodes on your mobile device, automatically subscribe to the show on your favorite podcast APP like apple podcast, spotify and stitcher. Thank you for listening and I appreciate everyone who shared the show with friends and colleagues. See You on the next episode of Health Innovators. H.

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