Real-world Innovations to Reduce Maternal and Child Health Disparities

Real-world Innovations to Reduce Maternal and Child Health Disparities

Sarah England, PhD

Meet Sarah England, PhD, the
Alan A. and Edith L. Wolfe professor of medicine and vice-chair of research at Washington University School of Medicine’s Department of Obstetrics and Gynecology.

podcast available

Dr. England has devoted her academic research career to maternal and child health, with the goal of reducing disparities and poor outcomes across affected communities. She has been a champion of simple and elegant solutions that, at scale, are poised to make a big impact. Partnering with digital health leaders on innovative solutions can have a global reach and feed into a system where the benefit can be felt across generations.

Maternal and child health disparities today

MDisrupt: Can you describe the current state of health disparities for maternal and child health in the US?

Sarah England: Women of color are not faring well in terms of maternal health outcomes compared to white women. Pregnancy-related death is defined as the death of a woman during pregnancy or within one year of the end of pregnancy; a complication of that pregnancy; or a chain of events initiated by the pregnancy. The statistics are staggering. Black, American Indian, and Alaska Native women are two to three times more likely to die from pregnancy-related causes than white women, according to the Centers for Disease Control and Prevention.

It’s a significant issue and it’s about time that we address it. Many people think it’s due to socioeconomic status, but this is not true. Black women with at least a college degree are still 5.2 times more likely to face these consequences compared to their white counterparts.

Building momentum for change

MDisrupt: How are maternal and child disparities being addressed by the health system and government entities?

Sarah England: Most pregnancy-related deaths are preventable and many of the causes of death can be addressed. Women of color face higher rates of stress associated with situational experiences of racial discrimination in the health system. A well-known example is Serena Williams. She knew that she had a complication from her pregnancy and was not believed by the medical professionals that were caring for her. This happens to Black women more commonly than it does to white women. This is something that we can really address by listening to women during their pregnancy.

And healthcare professionals have to be more cognizant of listening to women of color. Medical schools are developing curricula bringing more attention to issues of this nature. The federal government, especially funding agencies, are realizing that we need to address health disparities more than we have in the past. So the tides are changing. We are realizing that this is not good for the future: In order to reduce the trends in maternal and child health, we have to be much more aware of how we treat patients, how we study them epidemiologically and have a greater focus on those that are carrying the burden of disease.

In summary, we must implement standardized protocols in quality improvement initiatives, especially among facilities that serve disproportionately affected communities We need to identify and address implicit bias in healthcare that would improve patient-provider interactions, health communication, and health outcomes, and there needs to be a greater focus by funding agencies to address racial disparities.

A call to action for digital health leaders

MDisrupt: Many in the MDisrupt audience are entrepreneurs who have access to capital, technology, and engineers to build solutions. How can we help?

Sarah England: There is no shortage of good ideas, but often existing ideas remain stuck in “innovation bottlenecks” as they struggle for attention, funding, or the means of implementation. Healthtech founders can help lift us out of the bottleneck and bridge that gap from academia to commercial.

Fortunately, many digital health entrepreneurs are not only highly innovative but also have a desire to make a social impact. And solutions can be pretty simple. For example, we know that the twelve weeks after childbirth (fourth trimester) is a key window of opportunity to provide healthcare to mothers and babies. However, we often do not focus on the immediate post-pregnancy period. My colleagues and I have talked about getting a mobile unit that could go to underserved or remote areas and check in on new mothers. We could provide women access to services to help their emotional well-being, provide contraception and talk to them about birth spacing, ensure they are getting enough sleep, provide help with medications, and prevent substance abuse, and make sure they have physically recovered from childbirth. This relatively easy solution could make exceptional strides in maternal and child health, especially during this critical fourth trimester period.

Building better and more effective information-gathering systems that connect across all parts of our country is also an area where tech solutions are vital. Many people in remote and underserved communities are routinely left behind. And not all states collect information on race, ethnicity, income, and health insurance status because there are no national standards for data collection and reporting of maternal mortality statistics. Such data are critical for recognizing and understanding disparities, and without them, there has been insufficient accountability for maternal mortality.

Motivating for change

MDisrupt: How do you motivate healthtech entrepreneurs to innovate in maternal and child health?

Sarah England: Investors are interested in companies with broad portfolios and a message around social good. It’s a great time to go into maternal child health for this reason because improving maternal health improves child health and ultimately family health. It’s a feed-forward system that has long-term gains.

Another aspect around innovation is this concept of academia and companies working together to solve big problems. When I started my career, it was really important to be independent and have your own ideas and solutions. Now it’s really gone to “team science” and working with others to move your ideas forward. Also, women are pursuing technological fields. Oftentimes, they have children and raise awareness of this issue and push for robust solutions. There is going to be great innovation in this space in the years to come.

Passion-forward

MDisrupt: What advice can you give to women on their career and personal journeys?

Sarah England: It’s about following your passion. My original career path was cardiovascular sciences, not women’s health. Then I read a paper about preterm birth and felt compelled to connect with people in the field and find out more. I ended up going into a neonatal intensive care unit (NICU) with a friend of mine who was an NICU nurse. I saw a baby who had been born at six months and was being kept alive by multiple machines. It was heart-wrenching. I talked to the mother of the child and she blamed herself, even though the medical professionals didn’t know why she delivered the baby early. It made me realize that we don’t have all the answers, and you need innovative, creative minds in this space. So my advice is to follow opportunities because they may end up changing your course in life and opening up a chance to follow your interests and passions.

For women interested in connecting with other women in health, there’s a group that I’m part of called the Women’s Health Collaborative. The goal of this group is to support women in the field by networking and finding others to connect with who can help you move your ideas forward. You just have to be fearless and be ok not knowing everything. It’s very rewarding when you get to where you want to be.

Parting wisdom

MDisrupt: What parting wisdom can you give digital health entrepreneurs?

Sarah England: First and foremost, we need to raise awareness that maternal health is key for child health, and often the health of the entire family. Addressing maternal health issues has long-lasting health benefits across many generations. Second, you can partner with reproductive health researchers and clinicians. For example, we are partnering with engineers to develop devices needed for the care of women during pregnancy. We are very interested in partnering with other innovators with a sincere desire to improve maternal/child health.

At MDisrupt we believe that the most impactful health products should make it to market quickly. We help make this happen by connecting digital health innovators to the healthcare industry experts and scientists they need to responsibly accelerate product development, commercialization, adoption, and scale.

Our expert consultants span the healthcare continuum and can assist with all stages of health product development: This includes regulatory, clinical studies and evidence generation, payor strategies, commercialization, and channel strategies. If you are building a health product, talk to us.

How Health Economists Add Value to Digital Health

How Health Economists Add Value to Digital Health

Ragan Hart

Ragan Hart, MS (public health genetics), PhD (health economics), is a co-founder of MDisrupt and its director of operations. Previously, she served as entrepreneur-in-residence at F-Prime Capital. Ragan recently celebrated her one-year anniversary with MDisrupt, and sat down for an interview to talk about the career path that brought her from science to startup.

Bringing innovation to the clinic

MDisrupt: Why did you choose to study health economics?

Ragan Hart: I was an exercise science major doing lab work in the genetics of diabetes, and I wanted to better understand genomics tools and sequencing. That led to an interdisciplinary graduate program in public health genetics. I was very interested in biostatistics and how to get these technologies to the clinic.

With colleagues who were physicians, research scientists, genetic counselors and others in an academic medical center focused on genetic testing, I kept hearing, “Payers don’t want to pay for this.” And so I asked, “What type of evidence do the payers need? Are we having conversations with payers?” And the response was, “No, we haven’t been engaging payers.”

That was pivotal. I said, I need to train in applied health economics to understand payer decision making. Economics and business are two things I wish had been introduced to sooner.

MDisrupt: What did you envision for yourself in terms of a career?  

Ragan Hart: I definitely knew I wanted to work in industry. I didn’t know the term commercialization at that point, but I was absolutely trying to find my way into commercialization. I knew I had an understanding of startups in the genomics diagnostics space. So I started following the market of early stage venture capital into a set of these companies. I really started to understand the different levers at play for health tech adoption.

MDisrupt: Why did you decide to join MDisrupt?  

Ragan Hart: Because I absolutely understood the mission that MDisrupt was founded to serve—getting the most impactful health products to market faster and more responsibly—and I wanted to be part of that. I wanted to have a role in connecting scientists and health experts to digital health founders. I pride myself on being able to appreciate new ideas; I value a lot of lessons learned from the tech sector and I want to be part of figuring out how we can bring this into health care.

How health economists add value 

MDisrupt: How do you see health economists as helpful to digital health companies?

Ragan Hart: Health economists can help digital health companies by identifying:

  • Who are the stakeholders?
  • What are their economic incentives?
  • How do we build a product that can meet those incentives?
  • What evidence do we need to generate?
  • How do we assess how well the product performs in a clinical setting?
  • What’s the added value? For example, is this improving quality of life? Are cost savings being generated?

From a value proposition perspective, the digital health companies may have a really awesome product. But it’s also critical to their success to be able to articulate why their product should displace standard of care. Applied health economists can support economic evaluation for cost effectiveness studies—evaluating the new health technology against whatever is currently being used and comparing cost effectiveness.

Often, costs are going to be increased by investing in new health technology. But we’re getting this gain in the quality outcome or the health outcomes. The next step of data that needs to be generated is, can the purchaser who’s evaluating this technology afford it?

And so applied health economists can generate budget impact data, honing in on the financial consequences for adopting the new health technology. These are things that a health system needs to know, and in an ideal world, maybe the health system would do that kind of analysis. But they don’t necessarily put resources into doing it, so it really has to be done by the digital health company themselves. However, in the healthcare industry’s transition to value-based care, we may start to see more health systems identifying gaps from a cost-benefit perspective.

Integrity as the North Star

MDisrupt: Can you describe a challenge you’ve faced that’s been formative to the way you work now? 

Ragan Hart: In the academic space, something came up where a senior individual was operating without scientific integrity. The challenge was a dilemma for whether or not to say, yes, we’re willing to accept your lack of scientific integrity. There would have been limited consequences for everyone involved. I was really fortunate that my advisor said, look, here are the two options. And this one—to accept the lack of scientific integrity—is not an option. And that forever changed my ability to be able to navigate situations from that perspective. 

MDisrupt: Can you say more about that? 

Ragan Hart: It allowed me to anchor myself in thinking through the competing incentives, and, going back to my economic roots, that everything is about tradeoffs. It was a valuable lesson in what’s the North Star, and, when are we allowing ourselves to veer away from that? At what cost?

Health startups need scientists

MDisrupt: What advice would you give other scientists who might be thinking about working with a health startup?

Ragan Hart: Do it! Startups building health products need individuals who have critical thinking skills and subject matter expertise. They also need to generate data and evidence that their products work and are safe, effective and clinically useful.

Oftentimes, scientists are conflicted and wonder, Well, am I still going to be in an environment that maintains the academic rigor, intellectual curiosity, and stimulation of the academic environment? The answer is yes, tenfold in a startup environment. Because you’re also getting to cultivate new skills on top of contributing domain expertise you already have. It’s incredibly enriching.

Fresh ways to work

MDisrupt: What have you discovered in your role at MDisrupt that’s been fresh and surprising for you? 

Ragan Hart: I’ve been exposed to the value of marketing. And building trust with colleagues and working in a team. Previous environments have been quite siloed and building that bridge and rapport hasn’t been valued as much. It’s so valuable, because we’re trying to build and execute on the same mission. And I’ve learned that it’s OK to depend on others. Necessary, in fact.

MDisrupt: Can you say more about that? 

Ragan Hart: Building off of that trust piece, there are too many critical things that need to be completed to meet the goal, and not one of us can complete them on our own.

MDisrupt: What would you say to scientists who might be interested in joining MDisrupt?

Ragan Hart: It’s an easy way to work with digital health innovators. It’s about being able to apply your scientific skills in a new environment. And the energy and pace are invigorating! You are able to contribute to getting your science placed in the hands of patients or providers or health systems or whoever the intended user is, faster and more responsibly with data. Scientists don’t often have that opportunity.

At MDisrupt we believe that the most impactful health products should make it to market quickly. We help make this happen by connecting digital health innovators to the healthcare industry experts and scientists they need to responsibly accelerate product development, commercialization, adoption, and scale.

Our expert consultants span the healthcare continuum and can assist with all stages of health product development. This includes regulatory, clinical studies and evidence generation, payor strategies, commercialization, and channel strategies. If you are building a health product, talk to us.

How Healthtech Companies Can Avoid “Death by Pilot” When Working With Health Systems

How Healthtech Companies Can Avoid “Death by Pilot” When Working With Health Systems

Collaborations between healthtech startups and healthcare systems are being announced left and right these days. As you embark on the customer journey, you will undoubtedly be asked about the value your product or service adds and, most relevant to this conversation, whether there is a role for a pilot project in demonstrating the value you bring to a health system. Is a pilot just a hoop to jump through on the way to a sale—or can a pilot be a key tool in your mission to bring value to your customers?

Health system pilots can be conducted for free, at a discount, or at full price. They can test proof of concept, validate a technology, or be used as part of a sales strategy. Regardless of the specific type, I would argue that pilots can be an effective mechanism to make the case for your product or service. However, the key is to ensure that the outcomes of the pilot are of value to both the startup and the health system.

Generally, health systems are looking for solutions that solve one of more of the following problems:

  • Does it improve patient health outcomes?
  • Does it reduce healthcare spend?
  • Does it increase access to care?
  • Does It improve the patient and/or physician experience?

So how do you actually deliver a meaningful, valuable pilot? Here are three crucial things to consider:

Are your endpoints convincing enough to lead to a sale?

Here’s an example. Take a company, let’s call it eMD, with an AI tool designed to automate a key process. The eMD team has had positive conversations with a health system customer, “West Care,” and the next step is to do a pilot with one particular team.

As is typical with technology validation pilots, this one is designed to provide evidence that the AI tool does what it sets out to do. The results of the automated process will be compared to the results generated by the West Care human team. If the results are comparable or better, the pilot will be deemed a success. But is that enough to convince West Care decision makers to move forward with a vendor agreement? If not, thinking through how the following questions can help create a better pilot.

What else could you aim to discover, and what will you and your customer learn from the results?

Consider incorporating an endpoint that is of particular value to your health system customer. This, of course, requires you to understand what your customer needs. In particular, you have to identify an outcome that would be so valuable that a customer would actually pay for it.

In the case of eMD and West Care, the pilot is only designed to report on the technology validation endpoint. It may also be important for eMD to do a study comparing the time needed for a human to do the specific task with the time needed by the AI tool. This gives decision-makers a tangible basis for financial decisions.

You want the results of your pilot to lead to deeper conversations around value. For example, could the AI tool capture more revenue by making the process more efficient? If implementing this AI tool measurably frees up staff time, what other revenue-generating activities can those employees be redirected to? If your pilot doesn’t provide evidence to answer value-based questions like these, you haven’t made the most of the opportunity.

What action do the results of the pilot need to lead to, for both you and your customer?

It’s important to have a clear plan of action post-pilot, and that means you need to define when the pilot is over. For eMD, a pilot may consist of two weeks of onboarding and training, followed by two weeks of the AI tool performing the process, then a final week to analyze and present the data. If that was everything, though, the West Care team would likely be left wondering where things would go next.

To guide the outcome toward what you want, you need to set expectations for the presentation of the pilot summary and findings. What is the format and who needs to be present? Do not limit a final presentation to those directly involved with the pilot, as that may exclude key decision makers. Ensure that the person with buying power is in the room, or at least met with separately. Once you know your audience, think through what may be of greatest value in their decision-making and address it in the presentation of the findings.

It’s also a good idea to provide a roadmap to the health system partner outlining a few potential paths forward. The conversation should be driven by the evidence you’ve gathered, but it needs to get people’s wheels spinning about future possibilities. Where could we go from here? What would be required of each of us? What would be lost if we don’t continue this work together? Don’t assume that your audience will have next steps in mind. Instead, take time to explore the possibilities together.

Health systems need to know that a new healthtech solution will add value. Value can be delivered in many different ways, depending on the stage of your company.
Keep in mind that in the pilot phase, regardless of any compensation involved, the health system is investing the time and expertise of its people in testing your product. The outcomes you’re working side-by-side to achieve should be meaningful to both parties involved and lead the way to a value-driven purchase decision.

A pilot can be more than a necessary stepping stone to a bigger sale. If done well, a pilot can lay the foundation for your work with a key customer and demonstrate your commitment to bringing value to their organization.

The MDisrupt community of experts is committed to guiding healthtech entrepreneurs and health systems through the design, execution, and evaluation of impactful pilots. If you are a healthtech founder just embarking on the pilot process, or a seasoned entrepreneur in the midst of the journey, please reach out—we are happy to help.

Claire Kolar

Claire Kolar, PharmD, PhD

Dr. Claire Kolar is an experienced clinician, researcher, and strategy partner with a background in education, infusion and specialty pharmacy, and genomics. She is the Director of Operations at Fairview Ventures, a health system based venture group located in Minneapolis, MN, where she navigates the integration and implementation of new technologies into complex healthcare ecosystems. She also collaborates with health tech startups on business model development that add value to engagements with health system partners

If you are a healthtech company that requires help designing pilots or defining a strategy to work with health systems, MDisrupt can help, please click here

Ascending the Covid-19 Incline—Reform, Reaction and The Long Way Back

Ascending the Covid-19 Incline—Reform, Reaction and The Long Way Back

Confronting the unimaginable: Covid-19, a surmountable challenge

Each day as I get up and go to work, I have to prepare myself mentally in a way that I have never experienced in my 12 years as a UK Doctor. My colleagues and I witness daily, the gravity and devastation that this despicable thief of life has caused—and it is heart-breaking.

Many of us have been personally affected, directly or indirectly by Covid-19 or have lost someone we love and it is nothing short of brutal. There is no doubt in my mind that we will one day all be living in a post-pandemic world that will no longer resemble much of our pre-pandemic one either economically or socially, but I do hold the firm belief that we will once again, reclaim our independent lives, albeit in some alternate form, at the end of this war.

Adapting to the New Normal

Many healthcare professionals share the same concerns and uncertainty as the rest of the public, but in the thick of it as we are now, our primary resolve is to fire-fight our way to global safety.  

Some healthcare professionals also share the cynicism that many members of the public express about the way our various governments have handled certain aspects of this Covid-19 war. It is undeniable that many positive strategic steps have been taken, such as the rapid deployment and reinstatement of retired healthcare workers, the Herculean effort of everyone involved in the development of the UK Nightingale ITU hospitals – massive temporary hospitals put together in a matter of days to help increase capacity where regular hospitals struggle to admit any more patients – and the active campaign to protect the NHS and global health systems aimed at ‘flattening the curve’ through staying at home, to save lives, have all been pivotal and impressive. However, crucial delays in implementing a hard lockdown, PPE shortages for frontline staff, inadequate levels of testing and the procurement of antibody kits which fail to meet trialled standards have all been hot topics of debate amongst health professionals and our society at large. In response to this, I believe we will see some very significant reforms to our post-pandemic healthcare systems, striking changes within our economy and alterations in our social behaviours that are likely to be long-standing.

Lockdown V Liberty 

My colleagues and patients regularly ask my views on our current state of lockdown. The essential  move to severely curb movement amongst the population has been a globally challenging phenomenon, taking its toll financially, physically and emotionally on every individual. It is, however, the only measure that has been shown to reduce the spread of this highly contagious virus as it clearly deprives Covid-19 of the opportunity to pass from person to person. Hard lockdown has been, and still is, a fundamental step in our fight at the coal face of this pandemic but I am not convinced it can continue in its current form until a vaccine or treatment is established. The impact on the physical and mental health of the population and the socio-economic consequences of a long-term hard lockdown would likely be extensive and far-reaching. The evidence requires detailed evaluation in an effort to find a safe and workable balance in the months ahead.

This does not mean lockdown should be lifted at this phase, while death rates continue on an incline, without careful consideration as to how this should happen. If we are too impatient and take action prematurely, this would put us firmly back to square one, if not worse, as saturation points start to be reached within our hospitals. There is an infectivity index (R0), which measures how infective the virus is among people- our aim is to see this become R0 <1, which is what containment and staying at home should achieve and has been successfully reached in many countries. Anything above R0 >1 will result in an exponential growth in case numbers and this would be catastrophic. 

So, what happens after lockdown is slowly lifted? My view is that Covid-19 will continue to exist among us but we will likely step down the ladder from a pandemic state —> epidemic —> virulence levels. We will still be at risk but the probability of contracting this virus will be much lower as the number of cases declines through isolation and social distancing and we would need to exercise sensible limitations to our movements until such a time that the vaccine and treatments emerge.

If the lockdown release is too abrupt, we risk a secondary surge in cases similar to that seen in China last week in its northern borders with Russia – this was thought to be due to an influx of  overseas Covid-19 positive people into China, after which the border was quickly closed and further quarantining was mandated.

I agree with those who express the view that this pandemic will have a permanent effect on general social behaviours.  Personally, I believe there is likely to (or at least should)  be a graded exposure back to mobilising the public to essential activities first, then close family mixing and finally, over time, a more full social interaction.

It is hard to imagine that our social landscapes will ever see the dense aggregation of people that we have previously enjoyed and indeed I suspect that concerts, cinemas and even restaurants that can’t maintain safe social distancing may well need to wait for their lockdowns to be lifted until such a time that vaccines and treatments are more established. This all remains uncertain for now and the coming weeks will be telling as government strategists look at ways to safely rehabilitate us back to our functional lives. 

Collateral Damage—the Forgotten Victims of Covid-19

There is a growing concern amongst healthcare professionals that there is a risk of declining health in non-Covid-19 patients who suffer from other chronic conditions which have been eclipsed by this  pandemic. The fear is that there will be significant consequences if these patients cannot access their healthcare providers or are fearful of attending hospitals over prolonged periods of time. Patients shielding (where extremely vulnerable individuals are advised to minimise all interactions with others and stay home while having access to priority food supplies and other vital services), limited access to health services resulting from Covid-19 surges, cancelled procedures and treatments, delayed presentation and non-surveillance of chronic health conditions will all contribute to the mass grave of the Covid-19 era. 

As primary healthcare providers, we are still able to see many patients (albeit mainly virtually) but access to all our patients needs to improve to prevent an increase in non-Covid-19 mortality over time. Primary care has been forced to digitise at an unprecedented speed with the rapid scale-up and introduction of telemedicine through the use of video consulting, electronic prescribing and other digital applications that enable a more flexible remote working capability. What we can see is an enabled primary care provider that can continue to offer access and services virtually so as to minimise the risk to both healthcare professionals and patients during the pandemic The NHS and private sectors have also harmonised in an unprecedented way with private hospitals and clinics committing their facilities, staff and equipment for the use of NHS patients  Together, they have shown some impressive resolve and flexibility, which will hopefully outlive this viral war and improve national healthcare well after it no longer faces such a colossal challenge. 

Reviving the Economy—the healthcare implications

Our economy will need some serious attention in the coming weeks, not least because at a critical point, and once infectivity is R0<1, the non-Covid 19-related morbidity and mortality caused by a long-term and deep financial depression in our country may potentially outweigh the risk of Covid-19 related tragedies at that junction.

This is a veiled outcome for us all to imagine from where we are all at now but there has been considerable modelling based on Wuhan data and other research to identify the most appropriate way back to some socio-economic ‘life’. One study in the Lancet by Prem, Lui et al. highlights a number of approaches that are being trialled to achieve a return to graded social mixing and with the aim of enabling some socio-economic recovery. They acknowledge their modelling needs further research and analysis but their projections suggest that premature and sudden lifting of interventions could lead to an earlier secondary peak, which could be flattened by relaxing the interventions more gradually

So, to avoid the risk of provoking a second wave of the virus spreading, and a subsequent early second peak, we may need to be prepared to accept a relatively slow approach to lifting the lockdown.

The Marathon, not the Sprint—Uniting for the Win

No one knows how Covid-19 behaves in the long term – we just do not have that insight but an immense amount of research is being undertaken globally and each day we are more informed, more empowered and ever closer to overcoming this pandemic. For now, however, it remains an elusive and unpredictable nemesis. 

I know patience is being tested and it feels like nothing will be the same again but we should try to accept that we are in this for the medium term at least and that we may well emerge with a few positive reflections and adjusted ways of living that, while may not be the same, will still enable us to have our capacitated lives back.

In the meantime, I should say that every single health professional, researcher, and key worker I have encountered has been beyond dedicated and committed to helping us all out of this with the least possible number of casualties and, whatever our political or personal views, for now we are fully united in our fight to shepherd our nations up the incline, to the summit and down the other side safely.

Thank you To All Our Healthcare Colleagues on The Front Line

Please know that I, and many of my colleagues are deeply affected by what we are seeing each day at work, horrified at how unrelenting and unkind this criminal virus is and humbled by seeing other colleagues fearlessly approach the most risky of situations without a second thought to their own safety in order to help someone else. I am optimistic and hopeful that if every person does their bit, people stay at home and give us the time we need,  we will be able to emerge from this and hopefully have some answers. 

I want to express deep gratitude to everyone who is fighting the good fight and sympathy for anyone who has been affected directly or indirectly, or who has lost someone they love to the horror of this disease. Every single person who is staying at home for us, is a warrior in this war.

Dr Rasha Gadelrab

Dr. Rasha Gadelrab

MDisrupt Guest Blogger: Dr. Rasha Gadelrab, MRCGP MBBS BSc (Hons), NHS GP & Chief Medical Relations Officer

Dr. Rasha Gadelrab is a portfolio NHS GP, Quality Improvement Manager and a clinical Covid-19 contingency lead in a North London Practice. She is also the Chief Medical Relations Officer of www.myhealthspecialist.com. Since completing her medical training, she has dedicated her career portfolio to clinical medicine, medical education, digital innovation and healthcare quality improvement activities in order to improve patient care.

If you are a health tech founder looking for guidance on building or growing a healthcare savvy product team, talk to us—we can help.

How Healthcare and Healthtech Should Unite to Combat the COVID-19 Crisis

How Healthcare and Healthtech Should Unite to Combat the COVID-19 Crisis

We’re facing unprecedented times as we gear up to confront the reality of COVID-19, both on the economy and within the healthcare system. As cases continue to rise, sorting through misinformation on the virus has become more vital than ever. Fortunately, the healthtech and healthcare industries have never been ones to stand immobile or on the sidelines when the public’s health is at risk. With each passing day, great steps have been made to better inform the public of actionable recommendations they can make to combat the growing COVID-19 crisis, including a passionate movement to increase efforts on the current and most significant challenge: production and distribution of clinically valid diagnostic tests.

And with the current climate, anxiety and trepidation abound showing an uptick in claims surrounding the coronavirus pathogen. There is no more prevalent time for rapid dissemination of scientifically valid research to help educate and appease the public than now. With more people staying at home and practicing “social distancing,” the market has become a flooded landscape of companies either suffering or taking advantage of nervous individuals. Although there is an opportunity to help stabilize the health market, the greatest potential is in partnering tech with patient care to promote evidence-based information and valid actionable recommendations to the many facing the COVID-19 pandemic. 

The first step is understanding which are some of the most reliable resources available – which include more than constantly refreshing the CDC website – in fact, the CDC provides a variety of webinars to address updates for private sector partners, including frequently asked questions about the virus.

In addition, several credible sites ranging from OSHA to the New York Department of Health are regularly updated, sharing protective tips and FAQs. If you’ve recently reviewed the USDA’s response or visited the WHO’s website, you’ll find similar levels of information. But as the government continues to struggle over the shortage of diagnostic tests and the stresses facing the healthcare system, new opportunities are emerging.

How Healthcare and Healthtech Companies Have Risen to the Challenge

The healthcare and healthtech industries have responded to the call for increased action to combat COVID-19 across various fronts. This has taken the form of amplified production of kits, reagents and supplies, therapies, and preventative-care products. We’ve seen many companies rise to the occasion to address the severity of gaps in COVID-19 preparations. 

Test Kit Suppliers 

Building a health product responsibly takes careful orchestration between medical, commercial and regulatory teams and can often take years for commercialization and scale.  However in response to the crisis, the FDA has expedited the process to approve new COVID-19 kits under the new Emergency Use Authorization (EUA) guidelines. This has allowed a number of health companies to quickly mobilize and create tests that have made it to market in a matter of weeks

The severity of the situation has since been emphasized as the CDC has announced the allowance of commercial testing facilities to develop and distribute COVID-19 tests as of February 29th – with companies like Thermo Fisher offering state-of-the-art pathogen detection kits for both real-time PCR and Applied Biosystems QuantStudio 5 assay systems. As the CDC has repeatedly announced their challenges in improving the availability of tests, Thermo Fisher’s increased production is alleviating the scarcity in kit supplies. 

Several other companies have also  developed current COVID-19 test kits and begun making them more accessible to meet the growing and urgent demand.  Their quick response has steadily reduced kit shortages. This list of companies grows each day and includes: 

In recent weeks, Cepheid has released a COVID-19 test with an analysis 4x faster than standard kits with an improved 45 minute turnaround. Their test, now available, has been primarily distributed to hospitals first. 

Reagent Suppliers

As the COVID-19 crisis has grown, demand for reagents and testing supplies has surged. Fortunately, companies such as Promega manufacturers have answered the call of the CDC in improving access to critical components needed for diagnostic test production. Already, Promega has begun accessing their stored inventory and ramping up production of the key materials and reagents necessary for meeting the demand of diagnostic tests. Their focus has meant fulfilling much-needed orders by adding additional work shifts, paying overtime, and even diverting work on other projects to prioritize COVID-19 efforts. Reagent supplied Qiagen has also joined its ranks, aiming to increase its contribution 4-fold.

Monitoring and Screening 

In an effort to better monitor changes in COVID-19 progression, technology companies such as Alibaba have developed open-source platforms that update in real-time. They’re joined by other platforms supported by Johns Hopkins COVID-19 Global Dashboard and Bing’s COVID-19 Tracker. With the private sector quickly responding to the gaps by the public sector, we’re seeing market-driven innovation that’s improving the general public’s access to reliable information.

For example, a quick review of commonly searched keywords shows an increase in symptom checks, adding to the current pitfalls in amatuer diagnostics. However, leading innovators like Buoy Health have worked to develop a systematic online screening tool that rapidly assesses symptoms related to COVID-19, alongside the Cleveland Clinic’s. Their tool arrived shortly ahead of Apple’s symptom triage tool, featuring a CDC-approved symptom flow within Siri voice assistant

Telemedicine

While historically the healthcare world has been slow to adopt telemedicine, the COVID-19 crisis has shone a light on the benefits of remote medicine during contagious pandemics. Telemedicine has now become a key tool enabling the public to maintain social distancing practices while still accessing healthcare. This has been facilitated by the Trump Administration’s initiative to expand CMS’s telehealth accessibility. For individuals looking for online resources, you can also access Doctor on Demand, featuring an online symptom assessment.

Medical Equipment and Supplies

Health and tech companies have also responded to help with delivering preventative measures.  With healthcare professionals on the frontlines in our hospitals and doctor’s offices, we’re seeing mass shortages of personal protective equipment, or PPE, as large quantities of protective masks have been purchased by the anxious public. Although most low-grade masks work best for those already ill, the N95 respirators and surgical masks shown to protect against airborne particles are in low supply. Earlier this month, Jack Ma of Alibaba has also improved availability and distribution of N95 masks by pledging to send 1.8 million masks to Asia, which has since been expanded to Africa, Europe and the U.S. including protective suits, ventilators and thermometers.  

Additionally, to improve funding, Biogen has also donated $10 Million to non-profit organizations working during the crisis, including donating medical equipment to supplies to Partners HealthCare in Massachusetts and local hospitals.

Clinical Trials and Therapeutic Development

Other government efforts  to develop treatment options for severe cases have teamed up with pharmaceutical company Roche. Currently, their arthritis drug Actemra has already been in use by Chinese authorities to address COVID-19 cases, however the need for establishing clinical validity is pressing. To tackle the feasibility, the FDA has partnered with Roche to initiate a randomized, double-blind, placebo-controlled phase 3 clinical trial to study Actemra for patients hospitalized with severe COVID-19 induced pneumonia. This comes on the heels of Japanese drug Favipravir, used to combat the flu, which has been shown to be effective in treatment in both Japan and China after a series of clinical trials with over 340 patients. However, the Japanese health ministry has stated that its efficacy is reduced in severe cases and would require government approval before it can be used to treat COVID-19 cases.

The greatest challenge for potential treatments remains the time necessary for evidence generation to assess the safety and efficacy – though we’ve seen various pharmaceutical companies announcing breakthroughs in their viral research efforts (such as companies like Regeneron, and drugs such as Chloroquine). During this time it can seem like grasping for straws may give the appearance of progress, but devotion to clinical validity is the only way to halt the progression of the viral pathogen. Various companies, such as Benchling, have donated funds and resources to research labs working to develop diagnostics, vaccines, and treatments. Reify Health has also begun offering funding for companies utilizing clinical trials for COVID-19 therapies and treatments.

Healthcare and Healthtech Can Make A Difference Together.

Desperate times call for more collaboration and uniting industries to bring together skills to solve health problems both quickly and responsibly.  Despite the urgency health companies feel to bring products to market quickly, it’s important not to take shortcuts in evidence generation so that products are proven to work and are safe.  Healthtech companies have the advantage of technology and agility. Healthcare experts understand how to build medically viable products and navigate the regulatory path. The most critical thing a healthtech company can do is engage health industry experts early and often in the process of bringing health products to market. 

At MDisrupt, we have over 50 Health Industry experts many of whom are dedicated to offering their time and skills to assisting companies combating the COVID-19 crisis. These include physicians, regulatory and commercialization experts .  Most notably a number of pathologists in our network have offered to donate their time to provide CLIA lab medical director services to labs who need assistance. Talk to us, we want to partner with you to contribute to building solutions for this crisis together.