Thursday, April 7, 2016

Understanding Technology-Enabled Healthcare Solutions

Questions and Answers With:

Maulik D. Majmudar, M.D.
Associate Director
Healthcare Transformation Lab

Massachusetts General Hospital

By Patricia Stamas-Jacoby


You were recently a panelist on the Wearables: We Can Measure, But Can We Monetize? session at our Medical Technologies: A Frost & Sullivan Executive MindXchange event. Are there any insights you’d like to share? For instance, what business development opportunities do you forsee?

Thank you for the invitation…we had a really diverse group of panelists representing a lot of healthcare stakeholders, including insurance companies, healthcare systems, startup companies, consumer technology organizations, and the federal government. It was really interesting to see the opportunities and challenges from their unique perspectives.

For example, entrepreneurs are eager to find forward-thinking partners among payer and provider organizations to validate and implement their solutions. However, those organizations are getting overwhelmed with the inflow of "novel solutions” from the industry. It becomes obvious that they need a filtering mechanism for selecting promising products to actually test and implement. And the filtering mechanisms they typically use are traction and evidence.

However, without a strong collaboration between industry and healthcare delivery organizations, you get into a Catch-22 situation, where a company can’t build traction without pilots or contracts with their customer, and those customers are unwilling to sign contracts until they see solid proof of ROI via clinical trials. The federal regulatory bodies are also looking at healthcare organizations to test and validate these innovative solutions in an appropriate clinical environment to determine safety and efficacy. I hope the audience members walked away with a good understanding of the various challenges in scaling adoption of novel technology-enabled healthcare solutions, including wearables.

At the same time, the panelists strongly believe that there is a huge opportunity for technology-enabled solutions to disrupt the current model of healthcare delivery for consumers and patients. They key is a systematic and dedicated long-term approach to generating the necessary and relevant evidence base that will drive clinical adoption, regulatory approvals, and coverage decisions by payer organizations. Of course, that will take some time and significant resources. But, for it to happen in a timely and efficient manner, there needs to be a lot more conversation and collaboration around key clinical and administrative challenges faced by the various organizations.

For instance, what are the key pain points or “hair on fire” problems that these organizations are facing? Can they share some real-life examples or real-world data to demonstrate those issues? Could they sponsor open innovation competitions to solve those problems? I think by doing so, all parties will be very well aligned towards the end goal of solving real problems with real clinical or economic consequences and it will be much easier to prove the ROI for new products.

In addition to being a practicing cardiologist, you are also the Associate Director of the Healthcare Transformation Lab, (HTL) dedicated to improving healthcare through collaborative innovation. What projects are you currently working on that you find particularly promising or exciting? Any success stories you care to share?

We launched the Healthcare Transformation Lab in April 2014 with the mission of improving the experience and value of healthcare, for both patients as well as providers, through collaborative innovation. It’s still early, but we are thrilled with the progress and feedback we have received internally, from colleagues in various departments, as well as hospital administration.

The Lab has three major focus areas: open innovation, technology-enabled care delivery innovations, and clinical trials for technology validation. In regard to open innovation, we are really trying to understand and improve the culture of innovation within the organization. Over the past two years, we have organized “open innovation” competitions to engage the workforce (physicians, nurses, administrators, technicians, and researchers) within the MGH Heart Center.

In regard to technology-enabled solutions, we are experimenting with various use cases for telemedicine in subspecialty practices, such as cardiovascular medicine. We are also building a mobile application for patient navigation with the goal of improving the experience of multidisciplinary care visits. And finally, we are actively engaged in industry-sponsored clinical trials, including testing new diagnostic devices for heart failure and testing novel digital platforms for intensive lifestyle intervention for cardiovascular risk reduction.

The homepage of Healthcare Transformation Lab includes the statement “mobile devices need to be designed to integrate with the healthcare system more broadly.” Can you provide more detail on what you'd like to see happen and when you see that happening?

One of the many challenges facing companies developing technology-enabled healthcare solutions targeted at provider organizations is lack of an in-depth understanding of the inner workings of a large hospital system. First, there are a number of existing legacy health IT systems that physicians are using on a daily basis. Second, there are a number of new health IT initiatives that require physicians to spend more time on things that are not very intellectually stimulating or rewarding (such as clinical documentation and billing), as opposed to patient care. Finally, you have to convince the hospital administrators as well as the front-end clinicians of the value proposition (clinical and business) and incentivize each party to change behavior that will drive adoption of “yet another new technology ‘widget’.” I do believe that entrepreneurs and medical device companies are getting savvy about integration, interoperability, and business models.

One of the other founding guidelines of the Healthcare Transformation Lab is providing clinical input early. Why is this so important?

For the same reasons I mentioned above, we can’t have people building healthcare solutions in silos. It is not uncommon to see young, passionate, healthcare entrepreneurs go to conferences or ‘hackathons;’ hear pain points from a select few clinicians, and then go build a prototype product and bring it to a hospital for a pilot. They spend very little time validating the “pain point;” observing and confirming their assumptions and interviewing a diverse set of end-users in a diverse set of environments before landing on the actual need that is worth addressing.

As a practicing M.D., your thoughts on the advantages and possible pitfalls of emerging telehealth models? From a business perspective, your thoughts on the advantages and possible pitfalls of the telehealth model?

I am a strong proponent of new care delivery models; specifically those enabled by technologies that allow for synchronous and asynchronous communication without the need for an in-person visit in a traditional brick and mortar environment. I believe that a significant proportion of routine healthcare can be delivered efficiently and at high-quality using these new mediums (video visits or asynchronous communication via text or email), especially if you can leverage emerging diagnostics. There are a number of companies that are trying to prove out the business case.

What do you see happening in the near future for technology-enabled healthcare innovation?

The industry as a whole, the digital health industry, is maturing and undergoing some growing pains. I think entrepreneurs and investors realize that it’s relatively easy to build a mobile application or a wearable with some sensors, or even a data analytics platform, but trying figure out the exact clinical use case and demonstrate the value proposition that drives adoption by the customer (patient, provider, payer, pharma, etc.) is a lot harder.

Over the next 2-5 years, we will see a significant change in the rigor and maturity of healthcare technology companies. I hope there is a lot more collaboration between industry, academia, and payer-provider organizations to develop sustainable and scalable technology-enabled products and services.

Dr. Maulik Majmudar is a practicing cardiologist and Associate Director of the Healthcare Transformation Lab at Massachusetts General Hospital. He was also a Founding Member and Chief Clinical Officer at Quanttus, Inc., a venture backed startup that is transforming personal health via novel wearable technology that enables continuous physiologic monitoring. 

Dr. Majmudar also advises a number of other start-ups, leveraging his strong clinical training in internal medicine and cardiology. He enjoys teaching and lectures at Massachusetts Institute of Technology in areas of healthcare innovation & entrepreneurship, as well as medical device design and development.

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