Last Month In Digital Health (May 2019)

An action packed last month, with some interesting developments in Digital Mental Health, and across a host of other therapy areas. Enjoy the short summary with links to original articles.

Digital Mental Health

Virtual Reality> A pilot for mental wellbeing, using immersive VR as part of a validated clinical trial, is launched as a Hong Kong & UK partnership. Another company HypnoVR claim ‘promising’ clinical trial results in pain and anxiety. Researchers at UCLA are exploring if VR can boost positive feelings in patients with depression.

Artificial Intelligence> A number of Startups are attempting to use AI to treat depression. And an Israeli – UK tie up, is claiming AI can successfully find the best antidepressant for a patient.

Voice> Has significant potential in mental health. Things are accelerating in this area, Amazon Alexa is now compliant with US healthcare data privacy rules. Sonde health are using biomarkers to detect depression and other conditions.

Other> Ulster University is pioneering research into chatbot technology to support people living with mental illness health & the UK is rolling is out mental health trials in schools, including mindfulness training.

Other Digital Health News 

Dementia> The worlds first AI trial measuring pain in dementia patients using facial recognition has been launched. Imperial College opens £20m centre to develop dementia-friendly homes.

ADHD> FDA approves digital health treatment for children living with ADHD, The mHealth device delivers directed doses of energy to the brain through a wearable patch while the child is sleeping. 

COPD> New wearables trial allows patients’ to be monitored at home

Parkinsons> Pilot program will provide motion tracking wearables to UK patients. And european researchers & pharma team up on gait detecting sensor (potentially useful in other neurological conditions)

Wearables> The value of these devices are often questioned. It is true they are often not integrated into the care pathway. But encouraging results; a new study finds link between mHealth wearables and medication adherence. Wearables also improve post-op recovery. Those who took > 1000 daily steps had a 63% reduced chance of a prolonged hospital stay.

Genes> CRISPR Research moves out of labs and into clinics around the world. Gene therapy cures infant suffering from ‘bubble boy’ immune disease.

The NHS> Is continuing to focus on tech solutions, such as expanding use of robot technology for medicine dispensing, rolling out a digital portal for care home vacancies to cut delays, and expanding their ‘digital health hubs’ across England. But questions remain if this is really joined up and centered around the patient or just lots of shiny tech stuff. Alarm has been raised over tripling in cancelled NHS appointments and a report warns the NHS needs to do more to inform public on AI benefits.

NICE> launches online resource to help development and adoption of new health technologies in the UK ‘Health Tech Connect’

WHO> World Health Organization releases 10 guidelines for digital health adoption to improve patient care.

Out-There Innovations

Scientists pull speech directly from the brain.

Israeli researchers print 3D heart using patient’s own cells.

Doctors use electrical implant to aid brain-damaged woman 

How artificial intelligence is helping to prevent blindness

Funding News

Ro, the direct-to-consumer online pharmacy, reaches $500M valuation with an $85M Series B round

Brooklyn health startup Cityblock, raises $65M for tech-driven community care

Sonde Health nabs $16M to commercialize Vocal Biomarker Device to diagnose diseases

Finnish Digital Mental Health Startup Meru Health raises $4.1M in seed funding 

Sword Health gets $8M from Khosla for digital physical therapy

London-based Medbelle raises €6M to build the world’s first digital hospital 

Last Month In Digital Health (April 2019)

Are Health Apps Just Data Sucking Parasites?

One study showed that 79% of health apps share our data with minimum transparency and another study of Mental Health Apps showed that only 14% have any evidence of clinical efficacy 🤔

Is Apple as accurate AF when it comes to monitoring your heart?

The huge study of 419,093 participants showed 0.5% received an irregular heartbeat notification. Some hailed the results as a great success while others questioned the accuracy,

Is Tech the Enemy or Savior of our Mental Health?

After the long running debate on how much screen time is too much a study implicated Social Media in Youth Depression. Yet technology is being used as a solution, video games are being touted as a way of alleviating depression and anxiety, with an increasing evidence base. 1.3% of one chatbot’s users expressed suicidal thoughts, showing that it is sometimes easier to speak to a non-human without stigma. Companies are working to provide empathy in virtual coaching and counseling. Artificial Intelligence is helping human therapists provide better treatment. Technology platforms are being increasingly used to support workplace metal health

Is the FDA being NICE to Pharma?

A PwC report highlighted 4 potential opportunities for Pharma and Medical Device companies, in the FDA’s evolving digital health guidance. NICE (UK) updated its evidence standards for implementing digital health technology in the NHS and gaining reimbursement

Is Healthcare in the Workplace Evolving?

In a growing trend Walmart cut out the health insurers. Funding activity shows an increase focus on workplace mental health

Other Health Tech News:

Start Ups

Pharma

Last Month In Digital Health (March 2019)

Following Google to the Emergency Room

A study has shown health related Google searches double the week before a patient visits an emergency room and 50% would be willing to share search history with providers. This could lead to predictive and preemptive care, directing patients to the right treatment earlier.

Voice Applications are getting Louder in Healthcare

Cedars-Sinai are testing Alexa, allowing patients to make requests, e.g. turn out lights or control their TV.  Mayo Clinic are expanding voice capabilities across 50 health related topics to help patients better manage disease

Technology attempts to put the Black Dog of Depression on a leash

A study has found ‘Brain Training Apps’ could help depression patients.  And mood predicting tech may be able to stop depressed moods before they arise. Researchers are talking about bringing clinical grade brain-stimulation for depression into the home. And consumer devices are also in development

An Anti-Viral Shot for the Anti-Vaxxers 

After sustained public pressure, major social media platforms, including Facebook, Instagram, You Tube & Pinterest, have taken steps to reduce the visibility of anti-vaccination content. This hazardous spread of ignorance has been linked to low vaccination rates and subsequent disease outbreaks  

The Road to Recovery Now Has a Map – Google are to show opioid disposal sites in map searches and (Verily) are building a rehab campus to combat opioid addiction

Apples and Gravity

Johnson & Johnson CEO predicted their Apple Watch collaboration will save lives. Hyperbole? Well in other news the Apple Watch fall detection feature saves the life of a man in Norway

Blindness in the Sights of Digital Health

Implantable tech is fighting blindness. An Australian collaboration is working on a less surgically invasive system to restore sight to people with genetic blindness. And a British woman is the worlds 1st to undergo gene therapy for the most common form of blindness  

We Love Tech….but not Tech Companies

More consumers are using digital health to manage complex health conditions according to a Rock Health survey. But only 11% of consumers willing to share data with tech companies, Google the best of a bad bunch and Facebook perhaps unsurprisingly towards the bottom of the league

Going off Half-Hancocked? 

UK health secretary Matt Hancock was labelled dumb for a knee jerk call to ditch ‘archaic’ pagers.  Pagers save lives where mobile phones can’t go, e.g. zero reception spots.  This ‘aversion’ to old stuff is just as bad as the ‘craving’ for the shiny new.  But focusing on tech grabs headlines rather than boring stuff like er… the patient and their entire journey

A Data Dump for your Heart – How about monitoring your heart health, with toilet seat sensors? 

And finally…

What the UK NHS needs to do in Digital Health, from the Eric Topol report

Facebook receives sensitive personal health data from apps 

23andMe wants to become a drug company, it has 13 drugs in its pipeline 

Great advice for healthcare entrepreneurs – via Elizabeth Holmes

***This blog post is not actually ironic, but somewhat out of date.  Although I cringe when I read it, in its gushing praise of Elizabeth Holmes, it is a reminder of the charm she had, that certainly helped unlock the purses of billionaire to invest in her fake empire***

It was a privilege to see Elizabeth Holmes, CEO of Theranos, being interviewed this week, at the Cleveland Clinic Medical Innovations Summit.  

It was an enchanting 40 minutes of Q&A,  the interviewer was Toby Cosgrove CEO of Cleveland Clinic. It was particularly fascinating as Ms Holmes has been battling intense media criticism of her company in the last 2 weeks.  She gave a robust defense of her company but that is not what I want to share.

The one question and subsequent answer that stood out for me and also electrified the capacious room was this one.

What message would you have for an entrepreneur interested in the field of health care?

I would first understand what you really want to do, what your absolute passion is and why you want to do it

There are a lot of people who make the statement “I want to start a company”

But if you start a company you really have to know why, especially if it is one you want to win with in the long term, because it is really hard.

And in our experience, having done this for 12 years it takes a long time.

So that mission, and it’s a mission that can’t be about you, and it can’t be about any of the great things that can happen along the way, In our experience it has to be about who you are serving and why.

It has to be really really personal.

And when you find that, then you are ready to be able to deal with everything you have to deal with, when you try to change things.

That passion and that absolute obsession with doing something that you would do over and over and over again, even if you got fired, or even if people didn’t pay you, is the answer to being able to build something great.

Elizabeth Holmes October 26th 2015 – Cleveland

Latest Healthcare Innovations

Some recent Health Innovation news

Good examples of patients engaging in mobile health (#mhealth) solutions.  

Diabetes patients have improved outcomes from #mhealth coaching

And this app can apparently prevent heart attacks – at least patients are engaging and demonstrating healthier behaviors as a result

Apple Watch owners seem pretty convinced about #mhealth with 5 out of 6 saying the device contributes to their overall health

We all know about the Proteus ‘microchip’ pill but is Jawbone building a health tracker you can swallow?

Talking of diagnostic stuff, some sweet examples

A smartphone device that can quickly diagnose cancer

An eye-test device on virtual reality screens that could lead to prescription

Turning the Apple Watch into a seizure detector ‪

Outputs from this innovation can flow into the Big Data stream, as Apple expand their Research Kit disease areas to include Epilepsy, Autism and Melanoma (previous disease areas included Diabetes, Asthma, Parkinson’s Disease, and Breast Cancer)

FDA Challenges?

Blood testing outfit Theranos according to the WSJ has FDA and other issues, CEO Elizabeth Holmes hit back last week

Genetic testing company 23andMe Returns with FDA-Approved Genetic Health Tests ‪

Now that is Mobile Health!

Samsung brings its high-tech medicine to the west coast community in  a van 

Advice for Start-Ups #MIS2015

At the Cleveland Clinic Medical Innovations conference

Charlie Lougheed – Chief Strategy Officer at Explorys, acquired by IBM and part of the Watson cloud solution has some great advice for start ups

  • You have to be able to build a team, yes incentives, stock options are important – but there needs to a great mission that they believe in.  They need to believe in you, the CEO
  • Pay attention to companies doing well in the market, what can you learn from them?  And don’t trash them – they may end up acquiring you!
  • Have a support infrastructure available.  Cleveland Clinic were a great support for Explorys and even introduced them to customers
  • Have a good idea, a good one is good enough! Great ideas are usually overrated and distracting
  • On being acquired – is the acquiring company aligned with your mission and a good fit?  If not do your best to keep going and raise more funding

What makes a good client?

I posted this blog about a year ago, it seems to have got lost in a botched wordpress back up

This post relates to the previous post, but from the opposite perspective.  I have not amended it to include the last 14 months I have spent in the US (a separate post is required) but a key observed difference is the business culture here is more straightforward and frank discussions are more welcome.  That can only be a positive in enhancing the client agency relationship.

There is a clear paradox, an agency has to extend a certain amount of respect to clients as without them we no longer exist. Yet if we are too deferential then we move from the role of trusted partner to humble acolyte, which serves neither party in the long run.   So actually candour is very important in the agency-client relationship.

I should stress these are my views; this is less of a disclaimer, more recognition that those in the agency I work for and other agencies are likely to have different opinions and experiences. I will be interested to hear those.

So in no particular order:

Be open and transparent

After signing the required paperwork and being a supposed trusted partner I have had some strange experiences where the client in question must have been working for the FBI or MI5. Everything is on a ‘need to know basis’ Other agencies are working on the project / brand, yet what their role is, is made deliberately unclear. Even the project objectives appear top secret. These are extreme cases, however the more a client can open up about their business & personal goals, and overall approach, the more value a good agency can add!

Be honest

I am not accusing clients of lying here. The damning charge I cite is that they are often too nice! If a client has even the slightest concerns about the project delivery, approach, team chemistry or anything seemingly trivial, then it helps immensely to raise this up front before it festers into a bigger issue. As a client I was fairly candid to my agency partners, in hindsight I could have been even more so!

Be bold

A good agency will respond well to a client who has big ideas and is willing to disrupt the ‘usual’ way of doing things. As a client I found most agencies responded positively to being pushed. And if they don’t, give them some sharp feedback, if that still does not work then just fire them.

Be accountable

There will be times when a client screws up, missing key deadlines or actions. The agency is usually easy fodder for the blame even in a public forum. An agency may be prepared to take the ‘bollix bullet’ on behalf of the client but it is likely to be detrimental to the partnership

Be understanding

Agency folk are human, yet they will work with superhuman tenacity when it is required. The challenge back to the client is ‘does this absolutely have to be delivered by 9am in the morning?’. I have seen thankfully only a few cases where clients have demanded something at short notice, as a way of asserting their power over the agency. Often it is an internal miscommunication on the clients side that leads to an agency team working needlessly through the night. Clearly this can lead to some ill feeling.

Be responsive

Ok I used this one in my previous post as an essential agency quality. It applies equally on the other side. As a client, in the throes of business planning the last thing I wanted was to be ‘disturbed’ by my agencies. I have to admit deadlines sometimes suffered as a result of my tunnel vision.

Be clear

I am hoping as we reach #7 that this list does not already smack of pretentiousness. If any one of the number risks being labeled patronising and high-handed, it is this one, yet too many client briefs are either vague, unclear or contradictory.

From the busy perspective of the client side I have seen the pressures of time lead to incomplete briefs (Note: I chose not to use the word skimpy here) with the assumption that a good agency would ‘figure it out’. An agency’s creative talent should be unleashed on a clear brief rather than channeled into second guessing a clients desires.

Good brief + Good agency = Good result.

Hold your agency to account

This is not meant to sound one sided, rather using a mutually agreed metrics framework to assess project and agency success. This will help frame discussions re: point #2 above.

In the unfortunate event that it is not working out after sustained bilateral effort then it is better for both sides to go their separate ways

I hope the above list was useful and did not engender too much client hatred towards me. Any feedback or thoughts from client and agency persons would be most interesting.

What does a client need from an agency partner?

It has been almost 5 years since I left the client side of pharma to move into the role of service provider or as I would prefer to call it client partner.

The below is based on an original post (Oct 2014):

Here are my top 8 qualities (in no particular order) required for a consultancy or agency to best support pharma marketing teams. Despite the passage of time these all feel just as relevant today, however I am interested in any contrary thoughts or indeed qualities I have missed.

1) A partner that is willing to be stretched

A good pharma marketer will contribute ideas and be willing to do things differently, move faster or take a more extreme path in order to be successful. As a client I responded positively when agencies came back to my challenges with fresh ideas and were willing to enhance their offering. I was less positive when agencies came back with the same dogmatic ideas and templated approach that had blatantly been rolled out to previous clients.

2) A partner that attempts to stretch their client

No matter how good you think your idea is as a client, a competent agency should provide fresh thinking and ideas. They should also be prepared to challenge you to take risks in order to make the final product even better. As a client you still need your agency to help minimise these risks and maximise ‘rewards’. The ‘stretching’ clearly needs to be centred on improving the project rather than a self serving ‘upsell’ of more products and services

3) Good collaboration with other agencies

It is rare for 1 agency to do everything for 1 brand. Joint working with other agencies is the norm. As a brand manager it made my life so much easier to have the various agencies working smoothly towards the same goal rather than having to align a bunch of self-entitled primadonnas.

4) Be a link of continuity for the brand

Brand managers come and go, an incumbent agency can provide great support to a new marketing manager by sharing their knowledge and experience. It is important that this process is two way and the incumbent agency listens to the ideas and needs of the new guy. I unfortunately fell out terminally with one particular agency for persistently pushing their own views in a rather high handed way.

5) Be responsive

An agency can have great ideas and do great work but this is undone if the client can’t reach them. I felt frustrated as a client, when an otherwise good partner would not pick up the phone and was slow to return calls. It can be hard to manage multiple clients but no one wants to feel like they are bottom of the food chain, especially when they are paying for a premium service.

6) Attention to detail

As a marketing guy I have seen what I thought were fantastic pieces of agency work undone by a very small number of typos and grammatical errors. This attention to detail is a ‘hygiene factor’ that if not present at the foundation, will ensure all great concepts and ideas come tumbling down.

7) Meet deadlines

Obvious right? Of course work needs to be planned so it hits clients deadlines with time to spare. As a marketing manager it was embarrassing to announce at a company conference, that I could not present the latest working version of a project, rather just some boring screenshots of what it would eventually look like when the agency got around to finishing it. It is of course a partnership and often client processes can increase the risk of a delay. It is up to the agency to hold the client accountable and highlight when their activities or more likely inactivity is holding things up.

8) Understand my needs before the business needs

All marketing managers should be focused on their customers, i.e. the patients and the doctors and of course what is best for the business. However we are human therefore also have our own personal needs. They could be personal development, developing expertise in an area, a fun approach to working, external and internal recognition or something else entirely. An agency absolutely must know what drives their client on a personal level. The agency can deliver projects that smash every business KPI but if they neglect the clients personal needs then they have failed.

Quantified Self Meetups

I try to get along to as many London Quantified Self Meetups as I can. Most of the presentations are very interesting.  The discussion of peoples unique experience in personal experimentation is usually fascinating (If like me you are interested in that sort of thing!)

What is great, especially if you can’t make a meeting, is that all talks are recorded.  Ok you miss out on the interaction, questions and networking but it is still a great resource.  Thanks to Ken, one of the organisers for making this happen.

The archive of Videos and Presentations can be found here.  I would certainly recommend having a look.

And of course in the true spirit of self promotion I have embedded my recent quantified self video and presentation below 🙂  Of course I hope it is interesting, but if not you have plenty of others to choose from! Maybe see you at the next #QS Meet Up 🙂

 

A Wikipedia Geek

After my previous Wikipedia post I became curious to see what was going on with Pharmaceutical company Wikipedia pages.  I submerged myself in some geeky analysis, using data from Wikipedia.  I confess I rather enjoyed it.

There is a lot of discussion around Wikipedia being used to look at Pharmaceutical products but less so about Pharma corporate pages.   This is clearly understandable from a patient and doctor perspective however there is a significant PR consideration for companies and ‘their’ prominent Wikipedia entries.

I have attached slides below from my analysis that (sadly perhaps) enthralled me, however I hope you at least find them interesting.  Before that a quick summary of the main findings:

  • The bigger companies Wikipedia pages are seen over 1000 times per day
  • GSK has the most edited Wikipedia page however most pharma co’s will have their pages edited every few days
  • The number of Pfizer edits has dropped by 55% in the past year and those for Novartis has increased by 63%
  • Pfizer & GSK have the most ‘watched‘ pages but all Pharma pages will be watched by many hawk-eyed Wikipedians
  • There are a relatively high number of editors but a small kernel has a disproportionate influence
  • The number 1 editor of both the GSK & Pfizer pages has a very high proportion of edits and a very significant individual influence (interestingly he did have, he is now blocked by Wikipedia)
  • All companies have a well optimised owned media presence and opportunity to increase visibility on their corporate sites

Pharma companies have an opportunity to work with the Wikipedia community to correct inaccuracies in the corresponding Wikipedia pages.  They should also ensure their own websites are of sufficient value to attract and retain those who are searching for information about their company

Enjoy the slides!

 

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