How are technologies improving the quality of healthcare? In early October a diverse set of speakers from academic, commercial, governmental, military, and athletic sectors joined forces at the University of Southern California Center for Body Computing Conference to answer that question.
The USC Center for Body Computing is a leading institution for technology and connected devices in the healthcare space and they have led some ground-breaking pilots on human performance at the highest levels as well as increasing and democratising access to technology amongst disadvantaged populations. Personally, I have been following their work since 2017 when British Healthcare Business Intelligence Association (BHBIA) winter seminar speaker Julie O’Donnell mentioned this conference as the best source for the latest information on mHealth. It caught my attention because I did my undergraduate degree at USC but I had not realised this prowess, but a few clicks away and I was on their mailing list.
One of the themes of the conference was the impact of COVID on the pace of innovation, and in that vein, it was thanks to COVID-19 that I was able to attend the conference – made virtual by the pandemic. I joined more than 1,000 attendees from 180 cities globally watching a webcast of the 2020 conference to hear the latest from these experts.
The conference covered several topics, but three themes stood out that have the greatest relevance for us in pharmaceutical market research:
- The challenges of bringing cool new tech to healthcare. Andrew Thompson and George Savage, MD co-founders of former Proteus Digital Health (company that developed the sensor in a silicone pill casing that would allow oral medication adherence to be digitally tracked) talked about the difficulty of bringing something to market that had the power to so radically disrupt the pharma profit model (in their words, pharma profits from specialty drugs but doesn’t have a scalable model for adherence). In their case, although the use case seemed bulletproof and the tech stood up in trials the industry just wasn’t ready and the Company eventually filed for bankruptcy. Contrastingly Sumbul Desai, MD of Apple talked about discovering the healthcare use cases for the Apple watch by accident: in their case they developed heart rate monitoring technology for exercise and calorie burn measures but then a few cases where continuous heart rate data from the watch led to diagnoses and they realised the market for, as she described it, “[taking] a test done uncomfortably in hospital on the wrist on the same device that they connect with their loved ones”. One thing all speakers agreed on with regards to technological integration is the importance of evidence that the technology is up to the challenge. In this arena, Senator Bill Cassidy of Louisiana and Jeffrey Shuren, MD of the FDA told delegates about their just launched digital centre of excellence which they described as a “hub for developing digital health technologies, partnerships and collaboration”. The important function of this centre will be to not only be a resource for the rest of the FDA but also ensure consistent standards for regulation. These presentations really underscore the importance of holistically assessing the marketplace context with market research prior to launching new products, and understanding the logistical, market access, and stakeholder factors at play.
- The challenges of bringing ‘old’ tech to healthcare. Several presentations talked about the importance of considering the topic and the audience in selecting whether technology is an appropriate intervention. Examples from the military and homecare settings described deliberate choices of where technology was and was not deployed depending on the parameter being monitored. A particularly impressive session was from Sanjay Arora, MD and Josh Banerjee, MD frontline physicians at the Los Angeles County + University of Southern California Medical Center (LAC + USC). In their talk, Drs Arora and Banerjee talked about their experiences serving the underrepresented and underreported Spanish-speaking only population of Los Angeles. At HRW we have conducted studies with this population across the US too and have seen similar challenges to those the speakers described: people treat emergency department as gateway into the system, can’t afford to take time off work, don’t speak the language, don’t feel unwell (e.g. in the case of diabetes), and have culturally constructed health beliefs. Systemically they’re also being failed by appointment availability and often have logistical difficulties to get to appointments (e.g. must take three different buses). The doctors argue that it is precisely this cohort for whom the value of telemedicine is most significant. They launched a programme to help deliver more reliable telemedicine in this population, providing not only the technology but also the support in implementing the technology: teaching how to use apps, aiding access to Wi-Fi, and partnering with Lyft to provide rides to the hospital. They reflected positively on their experience and caution that just because the barriers to healthcare are significant doesn’t mean the willingness isn’t there – they found that many they work with were very keen to take charge of their health, it’s just a capability and access issue. These presentations covered a theme that we often see at HRW, making sure research is conducted with end users or patients to see how to close the gap between service delivery and user access and abilities.
- Impact of COVID-19 in accelerating digital adoption. A recurring theme in many discussions of digital transformation in healthcare, this conference also described the role of the pandemic in speeding uptake of tech. Senator Cassidy and FDA Dr. Shuren (referenced above) were keen to emphasise how Congress granted regulatory flexibility to rapidly approve new monitoring technologies more quickly in January. In the first talk of the day, Robert Ford of Abbott Labs said COVID-19 has created more personalisation, more regionalised offerings, more direct to consumer, and more retailers keen to play a role in COVID testing. Ford described how roadblocks to telemedicine were always regulatory but that during the pandemic this “has been blown wide open”. In an inspiring case study, Raphael Rakowski, Executive Chairman of Medically Home described how over 12 years they set up a scalable model of healthcare delivery in home to make healthcare more comfortable, personal, and even affordable due to the high cost of hospital overheads. His timing was perfect in that his company had just mastered their model and announced a partnership with the Mayo clinic when COVID hit, so patients felt safer receiving care in home and because typical hospital capacity for beds is not flexible, large health systems would be able to use this model to drive more flexibility, using patients homes as sites for care. Industry-wide we’re seeing the acceleration of digital tech due to COVID-19, and it is opening up so much access to new technologies and helping to speed adoption of more technological options that previously caused resistance; this does create more opportunities for genuinely disruptive or paradigm-changing technologies so is a space we’re watching closely.
Some excellent presentations and great food for thought. Although it was a strange circumstance to attend my first USC center for body computing conference, I’m sure it won’t be my last – the photographs of the LA skyline during the coffee breaks as well as the high quality thinking and content have made me hungry for more.
By Katy Irving, HRW Innovation Team