Wednesday, June 3, 2015

WLSA Convergence Summit 2015


A report on The 10th Annual Wireless Life Sciences Alliance Convergence Summit, held at the Omni Hotel, San Diego, CA, U.S.A., May 26th-28th, 2015.

Meeting Report

Graphic listeners, virtual iPhone screens on your forearm, and Apple Watches, these were just a few of the highlights of the 10th Annual Convergence Summit. As Robert McCray, J.D. (Wireless Sciences Alliances, U.S.A.) opened with comments on how we were in a phase of digital health where only the most committed companies were involved to create better solutions to bigger healthcare problems. He also highlighted the importance of having no emotional connections to healthcare, analogizing his point with John Waters’ work in rock and roll music. Eric Topol, M.D. (Scripps Translational Science Institute) highlighted the advent of an iPhone hologram on your forearm that had all of the functionalities of an actual iPhone. The only piece of hardware that was required to use it was a miniature wristband. He closed his keynote with a comment on how doctors were losing a fighting battle for hospital control to nurse practitioners. The 10th Convergence Summit integrated issues in regulation, partnerships with Scandinavians, and connected health care’s role in hospitals to update the community on the current state of the Digital Health Industry.

Digital Diagnostic and Therapeutic Platforms
Lisa Suennen (Venture Valkyrie Consulting, U.S.A.) moderated the first panel of the Summit. She brought attention to the problem of clinicians diagnosing patients with diseases for which there were no treatments – Parkinson’s Disease and Alzheimer’s Disease. Ron Gutman (HealthTap, U.S.A.) took to the stage with comments on crowdsourced medicine and how wearables were re-defining the “SOAP’ing” process clinicians used to evaluate the medical profiles of their patients. Moreover, HealthTap is standardizing medicine by providing access to the clinical advice of tens of thousands of doctors.
Brian Otis, Ph.D. (Google, U.S.A.) urged the digital health community to have an unrelenting respect for the regulatory process. Continuing on, Euan Thomson (Khosla Ventures, U.S.A.), iterated that if we had Uber in medicine, medicine would be simplified.
Dr. Topol exemplified how Switzerland had a health bank for each of their citizens and that other countries needed to follow suit.
He closed with a comment on the ability to monetize patient data was a valuable skill. The problem was making sure you did not violate patients’ rights to access said data.

Making Consumer Driven Healthcare a Reality – The Opportunity and Regulatory Realities
Up next was Ralph Simon leading a discussion on how to overcome regulatory issues holding consumer driven healthcare from becoming a reality. In the panel included Douglas McClure (FitLinxx, U.S.A.), Rob McCray, Kim Tyrrell-Knott (Epstein Becker & Green, P.C., U.S.A.), and Harry Wang (Parks Associates, U.S.A.). In terms of regulatory affairs, Ms. Tyrrell-Knott discussed the difficulties of defining the fine line between a regulated medical device and an unregulated hi-tech device. Rob called for a move toward implementation of digital health technologies in automobiles. Moreover, he made a notion that patient engagement techniques needed to be incorporated into the design of medical products. Harry highlighted his firm had seen a 24% increase in device adoption over the previous six quarters. The panel closed with a comment on how more effective digital solutions needed to be done in the mental health space. Overall, the panel agreed that in a consumer-driven healthcare system, the healthcare community needed to shift from a fee-for-service based system to a value-based system.

Connected Health Care for Hospitals
Don Jones moderated the following panel consisting of Marty Miller (Advanced ICU Care, U.S.A.) and Yulun Wang (InTouch Health, U.S.A.). Mr. Jones opened with a story on how nurses were the only healthcare professionals allowed to operate a robotic neurosurgeon at Walter Reed Medical Center. Moreover, a lot of digital health work in the hospital was being devoted to improving coordinated care teams. Yulun gave some eye-opening statistics he learned as the American Telemedicine Association President. 500,000 patients were taken care of by a tele-ICU physician. 125,000 were taken care of by a tele-stroke physician. 800,000 online consultations were done in the previous year. Mr. Wang wanted to make it clear that a tele-health physician consult was not necessarily a complete physician consult. Continuing on, Mr. Miller put the $2.5 billion market of serving the ICU into perspective by stating that statistic. He closed with a comment on how advanced practice practitioners covered multiple hospitals.
The Investor Panel
Julie Papenek (Canaan Partners, U.S.A.) led the next panel consisting of Casper de Clerq (Norwest Venture Partners, U.S.A.), M. Wainwright Fishburn (Cooley, LLP, U.S.A.), Lucian Iancovici, M.D. (Qualcomm Ventures, U.S.A.), and Maxwell Kahn (Merck GHI Fund, U.S.A.). Wainwright Fishburn opened with a comment on how digital health was a battle of the game: “Survival of the fittest.” Also, venture capital companies in the past avoided consumer-centric companies due to how fickle the consumer was. 
The concept of having patients more engaged in their own health is not financially helpful to all consumer-centric digital health companies. Dr. Iancovici added his input around the notion that more companies would build technology around drugs in the future. On investing, he mentioned the importance of focusing on companies involved in population health management. Mr. Kahn’s take on population health management was also focused on drugs. He purported that managing hepatitis C virus patients on triple therapies was more difficult than Diabetic patients on monotherapy. 
Moreover, Dr. Iancovici made a point that it was actually good to invest in entrepreneurs that take investors’ advice only 20% of the time. Lucian closed his contributions with a generalization to what was holding back digital health companies from succeeding: traditional hi tech companies did not understand the traditional healthcare business models. On cost-extraction, the panel believed population health management was universally beneficial to all of the stakeholders.
The panel closed with a joke on how they had all underestimated how successful FitBit was going to be.

Daniel Kraft Keynote
Daniel Kraft, M.D. (Singularity University, U.S.A.) ended Day 1 with an excellent keynote covering a wide array of topics summarizing the state of the healthcare innovation space. Dr. Kraft highlighted the use of a diaper for infants that sent messages whenever the child has soiled the diaper. He also focused part of his talk on the use of brain-computer interfaces. Moreover, he opined that gaming could be powerful in improving cognitive disabilities with multi-tasking. He also predicted the advent of robotic anesthesiologists and the prevalence of augmented intelligence in healthcare. Continuing on, he reported on people diagnosing their own brain tumors with the help of 3D printing.

The Digital Life Sciences
The second day of the Convergence Summit started off with Don Jones leading a panel composed of Rena Rosenberg, Ph.D. (Pharma & Medical Products Practice, U.S.A.), Jordan VanLare, M.D., Healthcare Systems and Services Practice, U.S.A.), Mike Doherty (Hoffmann-La Roche Ltd., C.H.E.), Romain Marmot (Voluntis, F.R.A.), and Andrew Obenshain (Sanofi, F.R.A.). Mr. Jones also wanted to highlight the importance of the Scripps Translational Science Institute’s Digital Medicine Group, led by Steven Steinhubl, M.D., and how he was heavily investing in its growth. Drs. Rosenberg and VanLare wanted to highlight 5 fundamental trends in the digital life sciences today: 1) Patient Behavior was changing 2) Government agencies were moving quickly 3) Trial data was necessary 4) Competition was faster and fiercer 5) Care was changing. On improving the negative image that pharmaceutical companies had, Dr. VanLare claimed that image would have improved if Big Pharma involved engaged patients in the design process of their novel technologies. Dr. Rosenberg closed with a notion that device design (like those from Medtronic) tended to be disconnected from the payor system, leaving patients and providers to suffer the expense. Mr. Doherty made comments about how data analysis was unaddressed by regulators today. For example, there was little regulation in the $60 million deal made between 23AndMe and Genentech’s 3000 patient’s genetic profiles. Romain highlighted an important problem amongst his one million insulin users: 50% did not reach their blood glucose goal and 25% stopped using their insulin. Moreover, if pharmaceutical companies were going to invest in solutions that supported the discussion of health outcomes based payments, accountable care organizations would only be a temporary solution. Mr. Obenshain highlighted how Sanofi was making more efforts to provide integrated care.

The International Discussion
Up next was the highly anticipated panel garnering the opinions of world-renowned international experts. Ralph Simon (Mobilium Global Ltd., U.K.) led the discussion with Peter Cowhey, Ph.D. (U.C.S.D., U.S.A.), Jack Kreindler, M.D. (Sentrian, U.S.A.), Scott Lambert (Ascension Health, U.S.A.), Anne Lidgard, Ph.D. (Vinnoa, S.W.E.), and Jordi Serrano Pons, Ph.D. (World Health Organization, C.H.E.). Mr. Cowhey highlighted how Beijing and Shanghai were fighting to be dominant in the technology sector. However, Shanghai was losing because Beijing was pouring large sums of research & development money indiscriminately. Shanghai tried to take the lead by looking to San Diego for help in the research & development department. On the use of machine learning and biosensors in data analysis, Dr. Kreingler claimed there was a data triangle between the United States of America, the United Kingdom, and the National Health Service in the U.K. Dr. Pons brought to attention the multitude of projects aiding infants in Africa. More specifically, a non-government organization called Zero Mothers Die that provides women with pay phones. Dr. Lidgard talked about her Stockholm based company relocating her in Silicon Valley to take advantage of the ecosystem’s resources. To add to her story, she agreed that Silicon Valley would not be the only innovation-based sector in the United States of America. For example, Chicago and New York were also hot spots.

The Hospital Discussion
The final panel of the Summit closed with Glenn Steele, M.D., Ph.D. (Geisinger Health System, U.S.A.), M. Michael Shabot, M.D. (Memorial Hermann Healthcare System, U.S.A.), P. Martin Paslick (HCA, U.S.A.), and Rosemary Kennedy, Ph.D., R.N., M.B.A. (Sotera Wireless, U.S.A.). Dr. Steele highlighted the factors technology companies needed to consider to change provider behavior: 1) Culture 2) Staffing 3) Data 4) Best Practices 5) Clinical Workflow 6) Clinical Decision Support. Dr. Kennedy brought to attention the fact that 36% of nurses spent time running up and down the hallway. Michael dishearteningly had to reveal that his health system had to block Apple iPhones and its upgrades because HCA’s network died using them. Moreover, he stated that HCA’s system was not mature enough to adopt speech-to-text or relationship extraction programs. Dr. Steele closed on a note stating that unless we were able to change the thinking of nurse practitioners, pharmacists, and physicians, the platform adoption and data analysis innovations hospitals were seeking to attain would never come to fruition. Moreoever, scaling an idea was not the same as innovating.

Breakout Sessions
For the first time in recent years, the Summit held breakout sessions for the attendees to gain expert opinions on contemporary issues facing the digital health industry. Steven Steinhubl, M.D. (Scripps Translational Science Institute, U.S.A.) focused on how to develop the evidence base to drive forwards the dissemination of clinical technologies. Jeff Belk (Velocity Growth, U.S.A.) held a session on crowdfunding. Kim Tyrrell-Knott gave a round table on regulatory issues surrounding clinical decision support. Eric Milch (Cooley, LLP, U.S.A.) gave a talk on innovations in patent law. Moshe Engelberg (Research Works, U.S.A.) talked about his work in providing local companies resources to connect with one another. 
Dr. Steinhubl mentioned that 2/3 of current healthcare professionals would not have recommended a healthcare profession to their children. Moreover, 1/3 of current healthcare professionals wanted to get out of the healthcare profession. In support of Dr. Glen Steele, Dr. Steinhubl agreed that the financial incentives to order unnecessary tests were perverse. For example, he had a patient that underwent a CT Scan, CABG, and a drug eluting stent the patient was not indicated for. Moreover, he had patients ask him to start medications like Xarelto because of an advertisement the patient saw. The moral dilemma? The drug was not the most appropriate choice for that patient. 

Unlike the theme at the 9th Annual WLSA Convergence Summit, the benefits of engaging more patients to utilize connected health devices were controversial among key opinion leaders this year. The rise of international adoption of the digital life sciences was one important takeaway from the 10th Annual Convergence Summit. With JSR from Japan, The Children’s Foundation of California outside of Tijuana, and Nordic Connected Health Start Track in Scandinavia, more international players demonstrated the global impact digital health was having in healthcare. Finally, there was not a clear consensus amongst key opinion leaders on whether patients should have sole ownership of their connected health or genetic data. Digital health was still in its nascent stages, however, some believed we were in a phase where only the most committed companies were still in this field.


Nicholas T. Vu, Pharm.D.

Twitter: @nicholasvu

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