Digital Health Comes of Age - Awkward Adolescence, Growing Pains and How We Can Get Through This

ANDHealths Summer Summit Summary

Welcome back!

Hope we’re all well-rested and not harbouring a chocolate hangover.

A few weeks ago ANDHealth held their Annual Summer (or farewell summer) Summit, Digital Health Comes of Age, and they were kind enough to have me along.

I found myself glued to the screen and struggling to keep up as we were bombarded with non-stop brilliant presentations, some of the best international experts, and of course, bants.

And now, I can deliver some of the amazing insights direct to you.

I thought long and hard how to capture so many diverse learnings and nuggets of gold in a single article, but I kept coming back to this one simple line that perfectly summarises everything

“It’s not a technology challenge but organisational” ~ Drew Schiller

I’m sure this hits close to home for every operator, doctor, practitioner, founder, professional and advocate in the field.

Australia has never been short on smart people or leading stuff.

It’s not our technology, ideas, capabilities or talent blocking progress - but all the surrounding support systems, knowledge, bureaucracy, pathways (or lack thereof) and assistance for people to access.

Anywho… here are some of the insights into the latest issues, opportunities and practical takeaways for combating this in digital health…

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1) 🇺🇸 US Models & Changes in the Payer Landscape

US Insurance Giant, Anthem, touches 1 in 3 payers in the US and has seen the landscape change drastically in the last year. And their new partnership with ANDHealth is helping accessibility, understanding and commercial pathways for Aussie companies in the giant US market. Kate Merton, Head of Anthem Digital Incubator shed light on the changes and opportunities they’re noting.

The US was seriously shaken in the last 12 months, seeing traditional healthcare models hit hard, and an influx of funds and new operators taking flight.

Also, the previous “Fee for Service” Model (or volume-based) is slowly starting to transition to “Value-Based Care” (or fee for value) to improve quality of care and tackle out of control costs 🤞 Though it’s early days, this is a game-changer for health systems and ahead of Aus on this front. As well as brand new business model opportunities.

Of course, with all these shifts in power dynamics, reimbursement schemes and purchasing power - it’s more important than ever to ensure you support the customer…

But also, ensure you know who that is... the payer, the health provider, or the end-user/patient. It seems simple but too often overlooked and mixed up.

TLDR; Know who your payer, provider and patient are - The classic healthcare trifecta

2) 💰 US Funding, Following the Money & Where to Focus

With funds invested increasing from ~4B in 2014 to ~14B in 2020, the supposed “funding bubble” doesn’t look like it’s going anywhere. That being said, Lisa Suennen of Manatt Ventures dissected how some areas have been infiltrated more than others.

There’s been some >700 Behavioural health companies funded in the past 18 months and “virtual care has been pretty staked out”. But still, lots of opportunity and more attention to be paid on supply chain, integrations, virtual models for clinical trials, diagnostics and hospitals”. Exciting times.

3) 📺 Telehealth’s Take-Off & Optimising Its Use

Nothing new here - except patient uptake has finally happened which is the key. During 2020 Coviu went from a few hundred consults per week to a total of over 3 Million video consults. Wild.

But the preference for phone-based services highlights the importance of User experience, ease of access and comfort levels. Telehealth ultimately is still in its infancy and needs lots of tweaks and trials to create optimal experiences and utilisation for patients, providers and professionals.

Not to mention our systems and regulation are still figuring out where it fits...

Perhaps we need to redesign these for it to be maximised? Don’t try and fit it in the box but create a new one? But the future focus is all about integration with physicians, AI, digital prescribing apps and more.

4) ✅ Playing Regulation Catch Up with Software As A Medical Device (SAMD)

There are two different speeds in the world of healthtech…

The speed of tech development and discoveries, and the speed of regulation.
We need these to be a tad more aligned.

Despite international HIPPA, EU’s GDPR and all other frameworks for security, privacy and data standards - the Aus government has been behind leading to lots of confusion and concerns with no formal regulation hitting until Feb 25th of this year.

There’s still a long way to go carving out the categories and best practice, but the new SAMD regs developed from expert input are up and running with great resources.

Want to know if your software is regulated? Check out this great pres by the TGA to find out

Pro-tip for being approved: Make sure you actually submit. No one will do it for you. Not even Apple is exempt (they learnt the hard way with failing to file their atrial fibrillation ap).

5) 🌏 How to Scale Internationally & Global Investment Trends ft Optum Ventures

Insights from this global fund echoed what we heard earlier about more funding, mass interest in behavioural health, and the growing pains of companies trying to scale and switch between different markets - mostly around fitting regs and knowing routes in.

There was so much this session my fingers couldn’t keep up so here’s a drop of dot point wisdom for those looking to scale internationally:

1) Know your value prop in your home country vs new market before you begin - it’s the business model that doesn't always translate. Ensure you understand the market you’re going after & who you’re selling to

2) If you want to succeed in the US, think about it from day 1

3) Before going international your team should have regulation, data access, interoperability in the bag - or at least properly planned

4) Ask yourself what will it take to be chosen over a homegrown competitor - Why would they pick you over a local? What’s your proof point? Do you have it covered on a clinical, data, reg & market front?

5) When entering a new market you’ll likely need to rejig your clinical evidence or value prop - Make sure its appealing enough, creating clear incentives to pay & incentive to purchase

6) Create a valuable data strategy & ensure it captures a high-value endpoint - There is no point in capturing data without it being actionable. Single points are rarely useful - make it longitudinal, complete, outcomes. And you can use this to make a competitive moat

7) The key to data = making it usable, actionable & searchable

8) Do you have data rights? - Most don't. Difficult and debatable right now but important

9) Reimbursement isn't the only route to market- It’s good but tricky and needs lots of work, so be open to other options

There’s Also Confusion Around What Defines Series A These Days

In Optums world = Stage of traction. Tech built and proven, clinical validation and signs of people willing to pay. Regulatory approval depends, if it’s before then there must be a route to market or pharma revenue that doesn't require that. HIPPA, ISO27001 & privacy etc is a given.

6) 🏥 Barriers to Virtual Care & Innovation in Our Big Organisations

There’s a lot of challenges with scaling… especially in healthcare… and the ultimate escape room is scaling within a large organisation.

When you’re big, the complexity of every seemingly simple movement is actually crazy complex and hinders a lot of movement. We’re talking processes, procedures, pitches, endless committees, approvals, people and regulation…

If you’re looking at running programs in a big org, getting commitment, or scaling, then this is for you. 

Pilots should be exciting - but in behemoth organisations, it’s often extremely high effort to get off the ground for low challenge

Drew Schiller, CEO of Validic, used a great example about a simple idea from a hospital doctor who wanted to solve the communication and compliance gaps for patients by placing a notepad with pen next to their bed, so they could write down what the health proffesionals told them.

Straight forward right?

They presented it to a committee… they loved it… so then came another committee… and you guessed it… MONTHS later it was still going through the ringer.

This super simple concept which could have been implemented in an hour with $20 became drastically overcomplicated. And is not uncommon.

You can do it yourself, but you won’t get the organisational resources, commitment or traction

So How Do We Get Around This and Keep Innovation Going?

1️⃣ Part 1 - Design With the End in Mind

To maximise for success, experience and outcomes, make sure you have enough resources from the get-go - Including long term funding commitments, clear scalability plans, outcomes and extra resources.

Programs that need to go through multiple budget cycles that aren’t key to the main business model, are never going to see the light of day unless you have that prior commitment.

In health, there is almost always already more than enough work to do before building something else

There are often many point solutions trialled across organisations, resulting in fragmented programs which end and don’t have follow on, providing poor experiences for all involved. To avoid this, it must be properly integrated and planned.

2️⃣ Part 2 - Choose the Right Partners to Scale

Once you’ve got it off the ground, the right help can help you really take flight. Tech, funding, programs… everyone has the thing they’re really good at. Find the right fit and let them do their thing.

The power of collaboration, crossing skills, networks and industries instead of doing it all yourself is unparalleled.

7) 💸Sales, Storytelling & Scrounging Funds - The Capital Gap

There are some abysmal stats put together by ANDHealth about the crazy funding gaps for digital health in Aus. With the vast majority still coming from Family & Friends, and Grants… it’s one of the biggest blockers of growth.

There's plenty of hype and enthusiasm for healthtech with many investors saying they “do healthech”, but we’re yet to see that translate into action.

Everyone knows finding the right investors is like dating. And in a perfect world, it’s important to find ones with aligned values, skills, goals and vision to partner with.

But the reality is a little different… many founders are scrambling and as Charles Cornish, CEO of DoseMeRx, said “beggars can’t be choosers”, especially in the beginning.

At the start your investors want the story - you’re selling them your vision.
And sadly too often this stage does or die for many startups.

Cath Resnick, Founder of Kinship, outlined how simplifying and communicating the business and story is a real hurdle for healthtechs in getting external buy-in and capital from investors who often don’t yet comprehend the environment or industry.

As you mature, your investor needs often change. The further on you get, the more traction, and proof you’ll have, and you’ll find yourself pitching a different story.

In the end, everything is sales and story telling

It seems we need to better educate, connect and communicate with everyone in this area and get more people in the game - government included.

There’s still a long way to go.

8) 💉 Pharma’s Focus On Digital Health

There’s scepticism about how “real” the pharma opportunity is for digital health companies, but the enthusiastic panellists (head nods across the board) made it clear that the opportunity in this space is nothing to be laughed at.

And they’re especially looking at ways organisations can work together to speed this up and maximise outcomes (and $$$).

The goal they say…

“The Tripple Win” - for the patient, system & company

Focus areas for the giants include improving health literacy, powerful partnerships, cleaning up the lack of conjoined data, and combating the confusing and conflicting information currently provided to people and patients.

Other Top Priorities:

• Reducing time and money to drug development

• Create different methods to reach the patient

• Implement hoodies as the uniform for everyone in pharma
  
  (ok, maybe I slightly misconstrued a quote here…but Claire Edgerton did say her prediction was “Pharma will function like a software company. The heroes of tomorrow will wear hoodies and jeans”)
  

It’s not just about “new” but also discovering what we already have and capitalising on this through data mining and connection.

It’s not always about reinventing the wheel, but also using what we have, improving it and making sure it works

And that’s the perfect note to finish on.

We’ve come so far so fast, but now need to go back, make sure the basics are in place, regulation catches up, and that we have the best infrastructure possible to build a brilliant path forward together.

And ANDHealth is doing a top job in leading the way - keep it up, guys.

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For the full lineup and list of speakers, click here

Make sure to check out their upcoming events and keep an eye out for what's sure to be more announcements coming up soon including a Series A Deal flow Day.

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Thoughts? Questions? Did I get something wrong? Just want a chat?
As always I’d love to hear from you

See you soon

👋 Emily