Enabling Physician Adoption of new Medical Technologies

Dr. Akhil Saklecha, General Partner at Artiman Ventures talked about understanding the challenges of physician adoption of new technologies and discussed ways of overcoming resistance and enable adoption of new medical and heatlhcare technologies by physicians, at www.bio2devicegroup.org event. (See below, at the end of the article, more info on bio2devicegroup, EPPICon, TiEcon, & HTF conf.)

Entrepreneurs in the health technology sector, must first understand physicians, the environment they work in, and the nature of the work flow.  Physicians have to be patient advocates, they often control the purse strings and make decisions on allocation of scare resources, and there is a potential to impact their adoption of new technologies by exercising influence upon them.  Physicians generally have competitive, type A personalities and they do not want to lag behind in adoption of useful technologies, said Saklecha.

So what are drivers for adoption of new technologies?  Technologies that solve problems that drive doctors crazy, get their attention.  Entrepreneurs with “must have” technology, will find it easier to get it adopted.  Entrepreneurs must focus on solving their problems, said Saklecha.  In addition to understanding physician’s work challenges, it is also important to understand every single stakeholder, in the healthcare setting.  For instance, Saklecha said he has seen some GI tools that solve a smaller problem but take up additional time of the scrub technician, general nurse, and GI nurse.  All this would add to the expenses and if the technology does not offset the cost, it will be rejected.  In fact, there is an early shift towards disposable colonoscopy devices because it saves set up and clean up time.

When it comes to money, “ignore it at your own peril”, said Saklecha.  His advice was that entrepreneurs must map out the flow of money, very early on.  They should get an understanding of where the revenue is generated and who makes the money and who loses the money.  Given the tremendous pressure to save costs, it is extremely important that new technology does not add costs to the system, unless it is a huge value add in terms of quality of health.  Entrepreneurs must know the flow of the money, direct and indirect costs and savings and they should understand CPT codes and reimbursement rules.  Obtaining CPT code does not necessarily translate into reimbursement, warned Saklecha.

Entrepreneurs must focus on enhancing quality and patient safety, said Saklecha.  Quality drives revenues and safety keeps patients alive and providers’ revenues are increasingly tied to performance.  A thorough understanding of work flow and how it impacts all various service providers including nurses, physicians, clerks etc. is very important.

One of the valuable advice Saklecha gave was with regard to timing and specific point of insertion of new technology.  Find a point of least friction for insertion of new techology, said Saklecha.  With regards to timing, it is important to keep in mind that no benefits will be seen during the first month, and instead there may be adverse effects.  Most inefficiencies will dissipate in the following 3-6 months and only then will the benefits begin to appear.  So this may be a time to keenly observe and understand the impact and every little nuance of the new technology on the work flow.  In the past decade, electronic medical records or EMR has been all the rage.  However, data entry and management takes physicians’ time away from patient care.  This is a challenge that is not yet effectively tackled, said Saklecha.   Voice recognition and scribes are used but the both have challenges of cost and errors.

Saklecha gave examples of several medical technologies and how they overcame physician adoption challenge by solving their key pressure point.  For instance, iRhythm cardiac monitoring device allows for remote monitoring of minimally “at risk” patients and it enables ER doctors to read the data and generate revenues.  Insurance companies also like it because instead of sending the patients over for hospital stays, they can be sent home and patients enjoy the convenience.  Minimally invasive blood test offered by Cardio Dx replaces cardiac stress test and it was a great improvement in saving costs.  The company directly marketed it to primary care physicians.  However, they misjudged and found that these doctors were slow to adopt because they were looking for validation from the cardiologists.  That was an important lesson in physician adoption of new technologies.  Now the company has pivoted and changed their marketing strategy and they are finding traction.

Another example is GI Dynamics which has a medical device that targets obesity.  Bariatric surgery is complex and there is high morbidity population.  The company has a fairly simple procedure that was found to simultaneously solve issues around hypertension and diabetes, while treating obesity.  GI physicians loved the technology since it offered them a whole new class of patients.  Just like GI physicians, cardiologists are also a competitive and procedure driven specialty, and they are quickly adopting new technologies in cardiac stents and percutaneous valves.  The talk was highly interactive and generated lot of discussion.
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Please mark 3 great conferences focused on life science, medtech, & healthcare, in the next two months, in San Francisco Bay Area, on your calendar, & see info on life science networking group that meets every week.

www.eppicglobal.org EPPICon annual conference is on March, 29, at Westin, SF and it features a panel on “Neglected & Rare Diseases” http://bit.ly/1c1vvTR, on “Point of Care”, on “Innovations in Clinical Development of Novel Agents” and more. Excellent event to network with VCs, panelists, speakers & other professionals.

www.tiecon.org is on May 16 & 17 at Santa Clara Convention Center.  On day 2, May 17th, it will feature a Life Science track with keynote and a distinguished panel on “Disruptions in Healthcare”. Great to network with entrepreneurs working inside and on the boundaries of various disciplines.

www.healthtechnologyforum.com  annual conference is on May, 20 at Parc 55, Wyndham, SF and it has excellent lineup of speakers and panels with a broad focus on “pathways to sustainable health”. More specific panels will focus on patient engagement, medical ethics, IoT, health apps, building resilient communities and more. Excellent to network with physicians, non profits & other entrepreneurs.

www.bio2devicegroup.org meets every Tuesday & covers a broad range of topics pertaining to biotech, medical device and pharmaceutical industries. On Tuesday, March 22, at 8:30am Johannes Schweizer, Arbor Vita will talk on OncoE6™ Cervical Test that Predicts Development of Cervical Cancer www.bio2devicegroup.org – Free event, all are welcome. Become a member and network with diverse range of life science industry professionals.
           

CellWorks & BioImagene – Successfully bringing IT innovation to Life Sciences

With technology advancement and ability for wider application, interesting things are happening on the boundaries of disciplines, rather than within a given discipline.  Internet and Sofware technology advancement along with fresh “can do” attitude, has infused new energy into Biotech.  CellWorks and BioImagene are two examples, where software stalwarts and serial entrepreneurs like Pradeep Fernandes and Mohan Uttarwar brought innovation to be applied to the healthcare industry.

At www.eppicglobal.org event on August 5, 2013, Fernandes and Uttarwar discussed what motivated them to gravitate towards life sciences, after a career in IT and software, the opportunities and challenges in making this transition, and the lessons learned in the process.  They both said, their ignorance about regulatory challenges was a bliss because had they been previously aware of the regulatory hurdles, they might have doubted the whole enterprise.  Both of them encountered a problem in healthcare and realized there was a hole in the market, in addressing the problem.

Fernandes’s wife got thyroid cancer and while making the rounds of the hospitals and doctors, they came to realize that despite existence of huge amount of big data and large quantities of freely available published data, few people were connecting the dots for efficient diagnosis and treatment. Serendipitous discussions with his good friend and colleague (an engineer) and his wife, a PhD in biology, led them to investigate whether modeling can be used to connect the dots and predict biological effects computationally, bridging two disciplines. R&D costs in big pharma are skyrocketing and it costs about $1to $4 B per drug, before it is available for commercial use.  During the development stage, 40% of drugs fail due to lack of efficiency (that is, they simply do not work), and other 40% fail due to toxicity (bad side effects), said Fernandes.  In the long chain of drug development, Fernandes focused on Biology.  “If the biology is wrong, no amount of chemistry is going to make it safe or potent”, said Fernandes.  The challenge is that despite technology advancement, drug development process remains unchanged and key decisions regarding validation of drugs happen very late in clinical trials.   Bringing the advancement in computational algorithms and informatics, his company, CellWorks extracts information from large data sets and also predicts information through abstraction modeling and simulation.  With an ability to model how pathways interact to represent disease phenotypes, CellWorks has further refined their approach to design therapies with novel mechanism of actions.  Greatly reduced cost and time for drug development has enabled CellWorks to advance their lead candidates for several indications from early design stage to validated animal efficacy studies in very short time period.  CellWorks closed $10M Series B round, at the end of 2012.

Origins of Mohan Uttarwar’s company BioImagene also lie in his keen notice of a problem in the market place that was not addressed.  One of the close family friends had cancer and in accompanying the individual to the medical facilities, he noticed that the medical establishment used glass slides to analyze, store, and share critical information.  This made it costly and challenging to share tissue samples and other information, critical for timely and effective diagnosis and to discuss treatment options.  BioImagene addressed the need by creating a suite of dynamic, image-based technologies that enable image capture, information management, image analysis and virtual sharing of patients’ tissue samples from glass microscope slides.  Their unique software, iScan, enabled viewing, analysis, and managing of tissue images, using a computer.  Emphasizing the need to adapt and change, Uttarwar said, the pivotal moment in the history of the company was when they made the decision to go into hardware.  They built a unique image viewing input device called the iSlide, and a high performance workstation called Crescendo.  Together their products greatly improved workflow efficiency in image archiving and retrieval, remote viewing, and turnaround time and made them an attractive target and the company was acquired for $100M by Roche, in August, 2010.

Both Uttarwar and Fernandes credited their team and EPPIC for their success.  EPPIC was started with a vision to promote networking, entrepreneurship, and mentoring for life science professionals, by a handful of people of Indian origin and has since vastly expanded.  Uttarwar and Fernandes shared about how they received significant coaching and guidance from prominent EPPIC members and veterans like Nagesh Mhatre, at critical periods.  Additionally, through EPPIC, they connected with Artiman Ventures and received funding as well.  With such a strong community to support and energize, “if I can do it, you can do it”, said Uttarwar.  Mohan Uttarwar is the guest speaker on October, 29 at www.bio2devicegroup.org event, in Sunnyvale, and will be speaking about one of his new ventures.   These are free events and all are welcome.

Please note down following dates (September, 18 and October, 26) for upcoming EPPIC events and register at www.eppicglobal.org.