Posts Tagged GI Dynamics

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.
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OneMedForum – San Francisco, 2014


The OneMed forum conference was launched in January of 2008, when economy was showing all signs of progressing to new heights, with an objective to showcase innovation in medtech.  The conference aimed to bring together the companies and investors, during the large influx of healthcare investors and executives, during the JP Morgan Healthcare Conference, in San Franciso.  Fast forward to 2014 and we are perhaps just emerging from one of the worst recessions; a downturn that hit the medtech sector more than any other industry segment.

This year, the location of OneMed Forum was changed and the venue was moved further away from the JP Morgan Conference.  Since the weather in SF was gorgeous, it was not a problem; but if the venue continues to be further away in future, and in the event of cold and rainy weather, it can have an impact and lower the attendance at future OneMed events.  This year also OneMed event seemed to be sparsely attended, although that appearance might also be enhanced because the meeting rooms were spread out on two different floors and there wasn’t a single spill out location for the participants to meet and network – another problem with the venue.

There was also a palpable difference between the JP Morgan conference and the OneMed Forum, this year, in terms of optimism.  While biotech and pharma sector is returning to pre-recession levels with a large number of IPOs and higher numbers of dollars raised, medical technology companies have yet to see significant investment dollars.  On talking with the participants, I heard a note of disappointment regarding low attendance from VCs and other investors, just like in the last few years.

However, despite slow pickup and staggering growth in the medtech sector, it is transforming and the companies are learning to operate more efficiently.  It is also recognized that healthcare is at a critical point and medical innovation will have to address some key challenges.  Various panels and speakers at the OneMed Forum, addressed the changing healthcare landscape and how the future of health and medicine will need to be shaped, in the coming years to address the key issues. 

Major Highlights

Personalized Medicine Panel discussed the promise offered by customized diagnosis and treatments, in lowering the cost and increasing effectiveness.  Panel sessions addressing the JOBS Act and the Affordable Care Act, explored the impact of the legislation on cost of care and access to care.  Companies and solutions that may be poised to offer effective healthcare solutions and may also present interesting investment opportunities were highlighted.  In somewhat grim medtech landscape, digital health is emerging as the hottest new trend, with much potential.  The Digital Health panel discussed the impact of Affordable Care Act in increasing information transparency and empowered consumers taking greater control of their health information.  The changing role of the patients/ consumers will require change in the healthcare delivery and transformation in the business model.

A panel addressing “reimbursement strategy after the affordable care act”, discussed impact of medicare payment rules on medtech and hospital markets.  The panel also discussed trends in coverage and payment for newly emerging molecular diagnostic tests.  One key advice from the panel was that thinking upfront about the reimbursement strategy will be increasingly more important for companies with new, innovative products.  A panelist also suggested that during clinical trials, companies can also think about reimbursement and instead of doing only what may be required by the FDA, if they can also collect reimbursement data then they would come out ahead.  During innovation, the companies should relentlessly focus on disease management, and that would lead to them to appropriate and effective reimbursement strategy, advised the panel.

Financing and IPO issues were addressed in various panels.  One interesting panel on Crowdfunding discussed a handful of portals that are beginning to raise some capital for emerging growth companies.  One investor who was attending the panel, later told me, that it is too early to give an opinion on what kind of success this strategy would yield, but he had some grave concerns.    AdvaMed CEO’s Unplugged Panel featured some of top leaders of the MedTech industry, who shared their insights on key challenges facing the industry.  Stuart Randle, CEO of GI Dynamics advised startups to focus on crucial healthcare issues including obesity.  He also advise companies to pursue capital intensive strategy, and at least initially sell products outside the US.  Scott Brooks, CEO of Regenesis Biomedical, advised startups to get good legal and regulatory counsel early on.  Patrick Daly, CEO of Cohera Medical was optimistic about the future of MedTech.  “IPOs are coming back, M&A is picking up, and dollars are rolling in, big companies have record levels of cash, and I feel positive”, he said.

One of the most prolific financiers, Bill Hambrecht gave a keynote address.  Hambrecht has over 500 IPO’s to his credit that include seed level funding in nascent industries.  Although I did not attend the keynote, I heard some highly positive comments from an attendee.  Steven Burrill, who has been at the helm of innovation in healthcare and shares and who regularly shares his insights through his annual reports, gave a second keynote.  Again, I missed the address but both keynotes were major highlights of the event.  Throughout the conference, over 800 emerging companies gave presentations.  Following the presentations, partnering and breakout sessions gave the opportunity for conference delegates to meet the CEO’s of these companies.

Although it may seem hard to believe, it appears that now the MedTech sector has nowhere to go but up.  The industry has learned some hard lessons, the companies are lean, operating with greater efficiency, spending cash wisely, and instead of hawking next new technology, they are focused on key problems facing the healthcare industry, and on providing effective solutions.  If the healthcare providers are not eager to incorporate some of the solutions, then it will happen out of necessity.  It will become incumbent upon the healthcare industry to implement solutions offering greater ROI in terms of improved health and lower cost.  Healthcare providers will be looking for solutions that provide digital and point of care diagnosis and health monitoring and treatment options and solutions from personalized medicine and genomic health.  Let us stay tuned for some cool innovations from the MedTech sector in 2014.  Senior Analyst at Wells Fargo, Larry Biegelsen has also observed that not only acceleration in healthcare spending is expected in 2014 but there are number of other tailwinds including, “emerging technologies and emerging markets contributing more to growth and a more industry-friendly FDA, which should lead to faster approval times for medical devices”.   

 

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