Coulter Partners recently talked to Tanja Dowe, Chief Executive Officer of Debiopharm Innovation Fund S.A. about digital disruption and talent in healthcare.
Coulter Partners: Your investments in digital health and smart data are at the intersection of life sciences and technology. Where do these overlap and what are the biggest challenges?
Tanja Dowe: Pure tech companies and those who come from this environment bring incredible capabilities in handling and aggregating data, making it comparable and analysing it. They are expert in the use of Artificial Intelligence, including technologies such as machine learning and neural networks. The next stage, and a natural development, is for Digital Health companies to provide the interface to all this data and its analysis. They either connect to one of the tech players or they use their data engineering systems to analyse and structure the data they have been collecting. They then have to make the connection between the data and AI to the patient and what it means to the patient journey.
The challenge for Digital Health companies is to gain the right level of patient and disease understanding so that they can tackle the problems that need to be solved. They need to understand on some level the clinical processes involved, whether the solution is for drug development, for the patient journey or for patient care. How can they fit their technology solution into the clinical process or into the workflow? At the same time, they also need to recognise that they are breaking down old-fashioned systems and structures and have the courage to do this!
There is an interesting continuum from the highly technological end to the life sciences end and both are needed. Within our portfolio, for instance, BC Platforms is aggregating data and making it available through their incredible technology and architecture, while companies such as Carevive are bringing solutions directly to the patient. At each end of the spectrum it is key that they can combine the health and digital worlds coherently.
CP: To pick up on a recurring theme of this blog series, how important is it to talk to patients or customers when designing digital health solutions?
Tanja: It’s extremely important to understand the end user. A good example is Kaiku Health, recently acquired by Elekta. This started as a university project and they went directly to an oncology clinic. Although they didn’t have a complete product story ready, they asked the clinic how they could serve their patients better. Right at the start of this hospital collaboration they brought in clinicians to their advisory board. This is the best strategy, to tap into the real problems from the very beginning.
CP: There is a lot of discussion about the value of data in digital health and life sciences. What are some of the common misconceptions on data?
Tanja: There are two major misconceptions – firstly, that there are readily available and accessible Big Data ripe for exploitation. Pharma companies are finding that the proliferation of data spread around organisations, projects and cohorts is neither easy to access, nor necessarily comparable because different parameters are in use. It takes a great deal of effort to access and make data analysable.
Secondly, there is huge concern around what commercial businesses will do with an individual’s data. Security, anonymity of data, and control over its use or sale are of course key questions that need to be resolved. But the irony is that pharma companies don’t want an individual’s data. They want to see clear patterns in big data sets – several patients showing certain common patterns of a disease, for instance. That is the aim here, not being able to drill down to individual level. The exception is patient recruitment for clinical trials. But that’s a different story. This is why patient consents exist – there are clear controls and rules in place for this.
CP: Given the possibilities of data, machine learning and AI in this space, what are the biggest barriers to the acceleration of the impact technologies like your investments can have?
Tanja: There are some incredible companies developing data security systems and some comparing data without ever having that data leave their sources. There are many new and interesting technologies helping to protect data and break down the barriers to build for the future. Old regulatory structures, however, need major transformation. The FDA and EMA are trying hard to find new ways to keep pace with multiple new concepts and technological developments but regulatory delays are inevitable.
A study by Decision Resources Group on reimbursement found that in the US 25% of payors cover digital therapies, 25% are interested in covering them, but 35% are still not open to this technology. Of physicians in the US, only 44% are prepared to prescribe a digital therapy. To bring the remainder on board would take a concerted campaign of re-education of users and markets, even though digitalisation is so far advanced in many consumer sectors. In the US and in Europe, where reimbursement is also gradually being worked out, the message has still not sunk in that the cost of digital therapies is a fraction of hands-on therapies.
CP: When bringing talent into your organisations, particularly at CEO level, what do you look for and what are the hallmarks of people who are successful in this cross over (Health / Tech) world?
Tanja: At CEO and C-suite level I look for authenticity, passion and values. Why is passion so important and perhaps more so in healthcare than in other industries? We need individuals who really want to solve some of the biggest societal problems – working together with end-users to improve global patient health. In other segments like finance, I don’t always see importance placed on an ethical motivation or mission. To build the future of healthcare, passion is key.
When we are looking for investments, we sometimes find that an overriding goal of younger entrepreneurs is to create financial value. Of course, we need to make good margins to develop businesses and contribute to a sustainable industry. Nevertheless, most individuals we meet want meaning in their working life – the opportunity to benefit patient health and build this industry’s reputation.
CP: And what are the most critical roles you hire for as your organisations scale?
Tanja: Critical roles for smart data and digital health companies include Chief Medical Officer and people with clinical experience in hospitals. CMO is a key hire early on and we find this role even at Series A more often now. Creative, out-of-the-box thinking together with substantial clinical experience is the ideal we look for. To have a vision of where the future lies and to be able to illustrate the importance of real-world evidence are both key when talking to healthcare providers, payors and pharmaceuticals customers. A recent CMO we hired impressed us with their experience beyond clinical trials into the clinic, and their capacity to bridge their thinking in order to identify where future bottlenecks might occur.
CP: What other challenges do you face?
Tanja: Start-up companies are used to bootstrapping and especially in Europe we find that they are more reluctant to commit money and resource to building a high impact team. The C-level team is often pared back to the minimum of a CEO and a tech specialist. When they see the salary expectations of a Chief Medical Officer, they are inclined to postpone hiring for as long as possible! Building a solid C-suite does takes time and effort, but it is critical. Hiring a great assistant to the CEO early on can also make all the difference, even though this doesn’t seem an obvious step at the Series A stage.
CP: What have been the implications of COVID-19 for Digital?
Tanja: There was perhaps an initial slow down in response to the pandemic, but now everyone is looking again at the bigger picture. Before COVID-19 struck, there were already many early adopters of digital technologies in healthcare, but now the sector is accelerating away, and this will be fantastic for healthcare reform!
For further information about Debiopharm, please visit: debiopharm.com
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