Getting Physicians Involved in Digital Health

Getting Physicians Involved in Digital Health

Ben Schwartz, MD

Meet Ben Schwartz, MD, an orthopedic surgeon who’s dived into digital health.

podcast available

Dr. Schwartz is a board-certified orthopedic surgeon specializing in surgical and non-surgical treatment of hip and knee arthritis. He has extensive experience in digital health and serves as a chief innovation officer for Healent, an early-stage healthcare technology company. He also holds mentorship positions with incubators and accelerators, as well as advisory roles. He’s a prominent voice on LinkedIn and other social media platforms.

The Promise of Technology

MDisrupt: What got you interested in digital health?

Ben Schwartz: I had a pretty traditional practice for the first 10 years of my career. I’ve always been fascinated by computers and gadgets and new ways of doing things. About two or three years ago, I became aware of this whole world of digital health, which was maturing. We have this healthcare system that doesn’t work in a lot of ways. We have technology that works in other aspects of our lives, but we’re not really utilizing it well in healthcare. How do we adopt technology in healthcare to make things better?

MDisrupt: You’re a top voice on LinkedIn and your posts really get the conversation started. What impact do you think you’ve had?

Ben Schwartz: When I started to become interested in this, I was your traditional orthopedic private practice surgeon outside of a major metropolitan area. I didn’t necessarily come across people in digital health. LinkedIn became a great way to open doors.

MDisrupt: You wrote, “Big tech doesn’t need healthcare. Does healthcare need big tech?” What’s your answer?

Ben Schwartz: I don’t think healthcare necessarily needs big tech. We know healthcare needs to do a better job incorporating technology, because we lag behind other industries. I do think big tech has the potential to address a lot of issues in healthcare, from an access as well as a technological standpoint. You’re talking about some of the biggest, most resource-rich companies in the world and one of the biggest problems we’re facing, not just in this country, but in the entire world. 

Google and Apple have shown interest in healthcare. Whether that persists I don’t know. The clinics that Apple supposedly was trying to open up were really fascinating—it’s disappointing to hear that maybe that didn’t work. Amazon is doing their typical approach of starting slowly and testing use cases and gradually building. 

“Digital health tools are coming”

MDisrupt: What kind of trends are you seeing among your colleagues around innovation in healthcare?

Ben Schwartz: There are definitely pockets of physicians who are very innovation-minded. And then you have more traditional physicians who are just so busy that when they hear about technology and innovation, they roll their eyes and equate it with the EMR that’s just going to make their lives more complicated. Or they think that it’s hard to prove the use case or the value. But more and more we’re seeing physicians who are entrepreneurial who are either going to come up with their own solutions or work with companies who embrace solutions. I think that’s going to become the norm.

And if you are a physician who’s resistant to technology or innovation, now is the time to reconsider. Because artificial intelligence is coming, these health tools are coming. Patients are going to want them, health systems are going to start embracing them. The future may belong to physicians who are more innovative and entrepreneurial and embrace these things.

Consult clinicians early and often

MDisrupt: Say you were at dinner with a digital health entrepreneur, and they ask, “What do I need to consider to get my product to market?” What would you tell them?

Ben Schwartz: It’s a matter of addressing true pain points. If you don’t have experience in real-world healthcare, you may say, “Oh, I have this great product that addresses this pain point.” But if you don’t understand how healthcare is actually delivered, there are barriers you may not have considered. It’s important to make sure your solution really can be incorporated into a workflow. And how do you prove return on investment? How do you monetize it?

These are the things you want to figure out early on. A great way to do that is incorporate people who have real-world experience early on in the process. Start building your clinical team early on so you don’t get too far down the road in the wrong direction and have to start over.

MDisrupt: Bridging that gap can be pretty difficult.

Ben Schwartz: It’s a challenge. Most physicians are not on an island where they can make unilateral decisions. So how do you incorporate it into a hospital, or a health system, a physician practice, and get everybody on board? If there’s one person who puts up resistance, that can table the whole thing. There’s not an easy answer. It’s a challenge that digital health companies face and that’s why often they go to an employer or a payer, because it’s easier to make traction there.

We need physicians involved and using these products. At the end of the day, a lot of times physicians or patients are the end users, but they’re not necessarily seen as the way forward for these ideas to really gain traction and be viable.

The growing network of physician innovators

MDisrupt: Can you describe the doctor innovator phenotype?

Ben Schwartz: They are people who aren’t satisfied with the status quo. But rather than just decrying the challenges or feeling burnt out, they think, “There’s a problem, let’s figure out a way to solve it. Maybe I can design my own solution, maybe I can partner with somebody who’s developing a solution.” Those people are out there—on Twitter, on LinkedIn, at hackathons. They’re doing advisory work and they’re joining digital health companies.

MDisrupt: Is that phenotype fostered in medical school?

Ben Schwartz: The current generation of doctors in medical school are very tech savvy. They are learning about this stuff in medical school. I get so many young medical students or residents who reach out to me and say, I have an interest in this, how do I get involved? Which is great to see because that’s really going to help adoption. You’re going to have people who are innately willing to embrace this, with the medical background to guide the development of these solutions.

What’s essential to a health innovation?

MDisrupt: When you look at a new health product, how do you evaluate what’s important?

Ben Schwartz: Number one, does the health product really bring something new to the table? Does it solve a problem? Does it bring something that’s clinically relevant, clinically validated? Is it something that can be easily incorporated into a workflow, as opposed to a piece of technology that’s making things more complicated? To me, the best technology is elegant, it works in the background, or it integrates very seamlessly into what you’re already doing. And then it really makes meaningful change. 

And again, unfortunately with the reality of our system, there’s got to be some eye towards return on investment and how do you make sure that this is something you can incorporate and it’s not cost-prohibitive or bring something to the table from a value standpoint.

MDisrupt: Do you see a lot of positive headlines around the pandemic having helped to bolster digital health? 

Ben Schwartz: My concern is that as we—hopefully—move to a post-pandemic environment, [we examine] Did we go too far towards telehealth? I worry that there’s an overcorrection. There are certain things that telehealth or virtual solutions aren’t going to be able to address. And some patients really do want that traditional doctor-patient relationship. It doesn’t have to be for everything, and maybe healthcare technology and digital health can replace some of the inefficient, expensive things we’re doing. But at the end of the day, the doctor-patient relationship is at the core of healthcare. 

Top innovative US health systems leading the way

MDisrupt: You wrote, “If you’re developing a tech-enabled healthcare solution and counting on physicians to embrace it, this issue should be front and center in your product design and go-to-market strategy.” MDisrupt is connecting innovators with clinical experts. Do you see health innovators trying to get clinical early adopters to use the technology before it’s out there?

Ben Schwartz: You have to find the individuals willing to embrace it. And there is, as far as I know, no central resource of a list of hospitals, health systems, physicians that are open to this kind of thing. And there are so many companies out there—the same people can’t be trying to adopt 50 different tools because they’re known as more forward-thinking. So I think it’s coming, I think it’s slow. I think hospitals and health systems are realizing that they have to get on board with healthcare technology and innovation. I don’t think they know exactly yet how best to do that. Some of the more innovative health systems like Stanford, Intermountain Healthcare, Cleveland Clinic, Mayo Clinic will really be the leaders on that. And then it will diffuse out to the rest of the system.

Digital tools supporting traditional healthcare

MDisrupt: What is your dream digital health tool for orthopedics?

Ben Schwartz: Orthopedics is procedure-focused. A lot of the innovation happens [around] surgical robots, or tools and equipment that we can use in the operating room. We’re seeing a shift towards value-based care. Hip and knee replacements are so commonplace and cost, particularly Medicare, a lot of money. We’re understanding that we have to do a better job of preparing patients for surgery, making sure they’re healthy enough for surgery, and making sure they understand the process of recovery. I think we are going to see educational tools like we’re trying to build with Healent. I think we’re going to see post-operative remote patient monitoring tools so that we can keep a close enough eye on patients to identify a problem and intervene earlier.

I think we will see more innovation outside the operating room in orthopedics as we see more adoption of value-based care. It’s about preparing people for treatment and also supporting them afterward. Digital health can fill that void.

MDisrupt: What does a doctor-patient relationship look like today? And what will it look like in the future?

Ben Schwartz: It gets frustrating sometimes to hear about how so-called traditional physicians are really bad at their job.  If you’re outside that system, it’s easy to throw stones. But there are people on the front lines fighting these battles and doing the best they can within the system.

The doctor-patient relationship has been eroded over the last 20 years by things like EMRs, increasing administrative hoops to jump through, declining reimbursement, and increasing overhead. That doesn’t get enough attention from digital health—can we build tools to [bolster] that doctor-patient relationship? Whether it’s through documentation, natural language processing, or a better EMR, it would be great to see more of those tools come to light. Let’s build tools that really support what works about traditional healthcare, restore that doctor-patient relationship and focus on those physicians that are willing to evolve and be agents of change.

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

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

And check out our blog and services!

Using Digital Health Tools to Strengthen the Doctor-Patient Relationship

Using Digital Health Tools to Strengthen the Doctor-Patient Relationship

Arti Thangudu

Meet Arti Thangudu, MD, an endocrinologist pioneering a new model of patient care.

podcast available

Dr. Thangudu is a triple board-certified physician and endocrinology, diabetes, and thyroid specialist at Complete Medicine. She takes an evidence-based approach to care, focusing on the patient and their lifestyle, and uses a membership-based model of practice.

Putting the doctor-patient relationship first

MDisrupt: Tell us how you turned from practicing physician to physician-entrepreneur.

Arti Thangudu: I completed my endocrinology fellowship at the University of Pittsburgh Medical Center. When I graduated, I landed my dream job as an attending physician at the largest endocrinology private practice in the world. I had tons of patients and was seeing more than 30 a day.

I came into medicine to take care of people, and I chose endocrinology because it’s very relationship-based. But with 30-plus patients a day, that relationship is broken down. I thought, “Is this what I see myself doing for the rest of my life?”

In this fee-for-service model, doctors get rewarded for seeing more patients. The quality of care does not get rewarded. Better-quality care takes more time. And it’s not what the healthcare system wants us to do. The incentives are for us to see more patients and order more tests because that brings more money into the system.

I just wasn’t about that. And so I started my practice, Complete Medicine, which strives to break down the barriers to healthcare that I saw in the insurance-based model.

MDisrupt: What is your clinic trying to solve?

Arti Thangudu: The breakdown of the relationship between physician and patient and the lack of pricing transparency. For example, you go to a doctor and you have no idea how much you’re going to pay or how much your insurance is going to cover. And you get a bill two weeks later, another bill two months later, another bill three months later. And they’re all way higher than you expected. My practice is membership-based. Patients have unlimited visits. They can call me, they can text me, they can email me between visits. We can do virtual visits, we can do phone visits.

And our prices are transparent. The patient knows on day one how much they’re going to pay. We have negotiated cash pricing on labs and imaging. Patients can use insurance if they want to, but our prices are usually about one-tenth of what they would be with insurance. And there are no surprise bills.

The patients have better outcomes when they’re working with a physician they can trust and lean on and reach out to when they’re having trouble. So with my diabetes patients, we’ve had stellar outcomes—lots of patients coming off insulin, reducing their need for medication, just getting overall healthier, because good care delivers good outcomes.

Lifestyle medicine: caring for the whole patient

MDisrupt: What is lifestyle medicine?

Arti Thangudu: Lifestyle medicine integrates evidence-based nutrition, exercise, management of stress, sleep hygiene, cessation of bad habits. When I was in private practice, I noticed that people weren’t getting better. As an endocrinologist, I knew that nutrition and diabetes go hand in hand. During my endocrinology fellowship, nutritional training, for me, was 30 minutes with the dietician. That is insufficient for any doctor, especially somebody trying to call themselves a diabetes expert.

I realized that if I was going to create a more patient-centered practice, nutrition had to play a big part. And so I got certified in nutrition. And I also got board-certified in lifestyle medicine. These are all such important things that are bypassed by traditional medical training. When you can teach a patient why they should make lifestyle changes, and can be there to support them, they’re much more likely to make the changes and get themselves to better health.

A life-changing digital health tool

MDisrupt: How do you incorporate digital health tools into lifestyle medicine for your patients?

Arti Thangudu: The majority of my patients have diabetes. We use continuous glucose monitoring (CGM). And it has been fantastic. With these CGM devices, we can see the patient’s blood sugar in real time. So I can see exactly what their blood sugars have been doing all day, and they can too. And they don’t have to use a fingerstick anymore.

Studies have shown the more times a patient takes a blood sugar, the better control they have, but more importantly, the better quality of life they have. And so now with these CGM systems, they can input what they ate. You can see exactly how foods, exercise, and sleep affect them and the patient gets real-time feedback.

I have informally studied my own patients. This is not a randomized controlled study. But I did a small study on patients whose intervention was continuous glucose monitoring and lifestyle coaching. And those patients dropped their hemoglobin A1c by 2% after three months. That’s like a 50% reduction in their risk of complications from diabetes. It’s also cost-effective. Every 2% somebody decreases their A1c, it saves the healthcare system at least $4,000 per year—although it could be much more than that. And in that little study, 75% of my patients who were taking insulin were off of insulin by the end.

It’s a huge improvement in quality of life, health, and cost. Can you imagine using this little tool, and then you go from four shots of insulin a day to none, just by changing your lifestyle? That’s really motivating.

Making digital health better

MDisrupt: What are some of the biggest challenges in digital health?

Arti Thangudu: One is the evidence base. There are a lot of at-home lab tests, or testing that you can order online direct-to-consumer. They say they’re evidence-based, but then when somebody who’s a physician or scientist reads that evidence, they can recognize that it’s not at all evidence-based.

A lot of healthtech products are done in a silo and the physician is practicing in a silo. There’s no connection between the patient’s physician and the technology. And physicians don’t know how to interpret the data given to the patient from these tech solutions. If the physician can’t help interpret the data, it makes the patient lose trust.

If there’s a solution that wants to be really big, we need to get the patient’s physicians on board. Or the tech companies need to have a physician that they can send patients to who understands that tech. If we work together as physicians and a digital health team, we can make these products all the more robust and meaningful for patients. Digital health has so much potential—we can’t alienate doctors from it, because it’s the future. We, as physicians, have to get on board, and we have to make these digital tools usable by both patients and physicians. We can do so much together.

MDisrupt: What is your dream digital health tool for lifestyle medicine?

Arti Thangudu: If we could integrate the continuous glucose monitor plus our patients’ dietary and exercise logs, and then create an AI-sourced daily feedback model for them, supported by a health coach or nurse and into the clinical model—with the physician in that same team—that would be amazing for patients with diabetes. I know there are tools getting pretty close to that, but it seems like still there’s a bit of limitation with the physician being part of the team.

Doctors and patients as allies

MDisrupt: What will the doctor-patient relationship look like in 10 years?

Arti Thangudu: My hope is that we, as a community, recognize the value of that relationship. And we as patients and physicians fight to get it back, because doctors and patients are on the same side.

Patients feel frustrated. They’re rushed through their appointment and they blame the doctor because that’s the person in front of them. We need to take a step back and say, “Well, the system is making this doctor have to see 35 patients a day to keep their office open.”

If that same doctor could be in a situation where they saw 12 patients a day, would they be able to deliver better care? The answer, 99.9% of the time is, absolutely. I’ll tell you a story. I consult for a company that takes care of retired police and fire. I have more time to take care of these patients because it is not an insurance-based clinic.

I saw a patient for hypothyroidism and pre-diabetes. After I spent 20 minutes with her, taking a really thorough history, she said, “Doctor, I have to tell you something. You’ve seen me before.” And I was like, “Really? When?” And she said, “In your old clinic. It was really rushed—I must’ve spent three minutes with you. I never went back because the experience was so bad.” I was horrified! I said, “I hope I can make it up to you.” She said, “You already have. I recognize that you were put in a bad situation. Now I’m really excited to be on this journey with you.”

The same doctor can be put in a bad situation or a good situation, and that’s going to affect the care they provide. And so for things to improve in the future, the system really, really needs to change. We as doctors and patients need to recognize that the system isn’t necessarily helping us and maybe move outside of the system until the system decides to catch up. And really be our own advocates.

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

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

And check out our blog and services!

How Precision Medicine Can Transform Healthcare

How Precision Medicine Can Transform Healthcare

Bernard Esquivel

Meet Bernard Esquivel, MD, PhD,
a leader in precision medicine.

podcast available

Dr. Esquivel is a clinical immunologist-allergist and international business leader with expertise in developing new markets in genomics and precision medicine. He’s the founder and president of the Latin American Association of Personalized Medicine, ALAMP.

A passion for precision medicine

MDisrupt: Tell us how you turned your passion for precision medicine into a career.  

Bernard Esquivel: During my medical training, I learned about the role our genetic information can play in influencing disease development. Once I started practicing medicine, I tried to start testing my patients, and understanding their genes, and then find a way to implement that into my workflow.

That’s when I noticed that, number one, it was very hard to find [genetic] tests. Number two, it was very hard to access the information needed to understand and clinically implement decisions based on that information. And number three, my colleagues thought that I was talking about Star Wars or some dark science.

So, facing those barriers, back in 2014 a colleague of mine and I founded the Latin American Association of Personalized Medicine (ALAMP). The aim was to share knowledge to foster the implementation of precision medicine.

I interacted with a lot of key opinion leaders (KOLs) globally from different fields of precision medicine. And I learned how they were implementing precision medicine, pharmacogenomics, cancer molecular testing, health wearables, and so on. Long story short, for the last 12 years I’ve been 100% into precision medicine, to find a way to bring these fantastic new tools closer to the patients.

Precision vs. personalized medicine

MDisrupt: How do you define precision medicine, and how do you see it as different from personalized medicine?

Bernard Esquivel: If we use the definition that cancer.gov has for precision medicine, it’s a form of medicine that uses information about a person’s own genes or proteins to prevent, diagnose, or treat diseases. But I think there are missing parts to this definition. One of them is “predict.” That’s where I believe precision medicine is heading: to predict, by using data from patients, subpopulations, larger groups, and N-of-1s, and using new technology such as machine learning, to predict how a patient will respond.

Also, precision medicine is not only about genetic information anymore. For example, there are different “omics”—metabolomics, epigenomics, nutrigenomics, proteomics, and also the social determinants of health that are crucial as well. Personalized medicine is specific to the patient.

Getting precision medicine adopted

MDisrupt: What are some obstacles to a widespread adoption of precision medicine?

Bernard Esquivel: The first barrier is the way we run clinical trials. We need to continue following an evidence-based approach, meaning we need to show clinical validity, clinical utility, clinical actionability, and so on. But precision medicine is unique because you may be talking about a single individual with a lot of data points.

The second barrier is about implementation and clinical actionability. For example, in pharmacogenomics, some genetic variants of CYP450 enzymes may impact how the patient will respond to certain medications. You need to take that to the next level: “What can I do next? Is there any other option for that patient? Are there clinical guidelines to help me to customize the dose for that specific patient?” That’s clinical actionability.

The third barrier is, precision medicine needs to be user-friendly for the provider as part of our day-to-day tools. If we don’t implement precision medicine data sets into the clinical workflow, it’s going to be a hard stop.
And last but not least is cost-effectiveness. We need to show that it makes sense to invest in the molecular testing and technological platforms that we need.

MDisrupt: When do you see us being able to bring all that information together to give an individualized view of the patient?

Bernard Esquivel: Within the next five years. I think we are getting there in terms of connectivity and data management. The milestone for the next five years is going to be about ethics—how those corporations are going to be managing, handling, and protecting your information as a patient.

Pharmacogenomics (PGx) in precision medicine

MDisrupt: What’s the ideal implementation of PGx in the health care delivery model?

Bernard Esquivel: Pharmacogenomics is a fantastic example of how precision medicine has evolved. One of the barriers has been the lack of standardization. We need to be sure that our [variant] coverage is as similar as possible in order to compare apples to apples.

The other one is about how you interpret that data, the phenotyping calls. How are you calling [a particular] genetic variant and what are the clinical implications? Several organizations are doing outstanding work trying to tackle those problems. And I strongly believe that champions of pharmacogenetics are and will continue to be the pharmacists.

PGx success

MDisrupt: Is there an example of a health system that has been successful in implementing a PGx program?

Bernard Esquivel: Yes, several. St Jude’s Hospital has been a pioneer in implementing PGx into the electronic medical record and having expert pharmacists help other providers implement it. Also Mayo Clinic with its center for individualized medicine.

The Netherlands is a fascinating example of a countrywide PGx implementation. They use a single electronic medical record for the entire country. They already have a specific PGx piece that will follow the patient wherever they go. They’re publishing data on how they are saving money countrywide by using pharmacogenomics.

How digital health innovators can improve precision medicine

MDisrupt: When you think about precision medicine, what could digital health innovators do more of and what are they not doing enough of?

Bernard Esquivel: Number one will be having a smooth workflow in terms of integration. Then, once you’ve got all those data sets, how are you going to start organizing that information? You need to allow new technologies such as machine learning to start making predictive models, then [integrate] that information with genomics, microbiome, exposure, behaviors, clinical tests, even patient contributed data. And then find ways to connect all that to clinical information and deliver it to the final user. I know it sounds hard, but many people are working on this right now.

MDisrupt: What advice would you give a founder interested in precision medicine solutions?

Bernard Esquivel: Have the right experts working with you. If you don’t make that investment at the beginning, it’s going to be way more expensive “learning during the flight.”

With the right team on board, I recommend three pillars: Number one, the regulatory landscape—look into the regulatory requirements, talk about your idea with the regulatory agency.

Then, invest in developing the right evidence behind your product. And number three is clinical actionability: You can go-to-market with the minimal viable product, but you need to always be thinking of how this information will trigger action from the clinical standpoint.

Healthcare’s future

MDisrupt: What do you think the health system is going to look like in 10 years?

Bernard Esquivel: We know that the way we are spending money in healthcare is not working. So everything will change into value-based care and precision medicine will play a critical role there.

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.

MDisrupt’s CEO: Lessons from our 2nd Year & Trends for 2022

MDisrupt’s CEO: Lessons from our 2nd Year & Trends for 2022

ruby.gadelrab

MDisrupt is celebrating its second anniversary this week, and we’re speaking with the company’s founder and CEO, Ruby Gadelrab, about what she’s learned and where digital health is headed.

podcast available

Solving the three pain points

MDisrupt: First, tell us about your path to founding MDisrupt.

Ruby Gadelrab: I spent 24 years in healthcare on the commercial side and eventually landed at 23andMe, as VP of commercial marketing. In three years there I really caught the bug for consumerized healthcare and digital health. I left 23andMe to help the growing number of digital health companies that were forming, and consulted for twenty-five of these companies back to back. I learned that these companies, as they bring their products to market, all have the same three pain points.

We built MDisrupt to help them overcome those pain points, which are:

  • How can digital health innovators access trusted health care operators who can help them build and commercialize their products?
  • As soon as a health product gets to market, how does a digital health company find its earliest clinical users? Who are those innovators within the healthcare system that are willing to try products early on?
  • How to quickly generate evidence to convince the variety of stakeholders that need to be convinced?

Our mission is to help the most impactful digital health products get to market quickly and responsibly.

Today, as we embark on our third year, I want to say a huge thank you to everybody who’s been involved in MDisrupt. We’ve built a network of over 200 health industry experts on demand. We’ve worked with over 40 clients already. And we have this network of incredible advisors who have been guiding us every step of the way. I could not be more grateful to the experts in our network, the clients who have trusted us with complex challenges, and the advisors who have guided us every step of the way.

MDisrupt: What are some lessons you’ve learned in growing MDisrupt through its second year?  

Ruby Gadelrab: The top lesson is around trust. A few weeks ago, I interviewed Dr. Shantanu Nundy on Clubhouse and he said, “Healthcare moves at the speed of trust.” It’s all about trust with your clients, your community, your team, and your advisors.

Secondly, you have to build a team that shares your mission and can fill in your knowledge gaps. We’ve built a really incredible team to augment what I know and push the company forward.

The third lesson is the complexities of fundraising, which we started in the last couple of months. We’ve had some amazing interest so far, but fundraising is hard—and it’s really hard as a brown, female, first-time founder. But I’m really optimistic, because we’ve had some great traction and we see ourselves as building a scalable platform that can really help digital health companies accelerate their path to market.

Healthcare innovation is not optional—it’s an absolute necessity. 

MDisrupt: What have you learned from MDisrupt’s health experts that has surprised you?

Ruby Gadelrab: I’ve been marketing and selling to scientists and physicians my whole career. Today, we are at an inflection point. Everybody I speak to is united in saying that innovation in healthcare is not an option anymore. It’s an absolute necessity.

There is a lot of focus on finding solutions around access to health care, improved health outcomes, simplified delivery of services, transparency, and convenience. And one of the challenges is, How do we build these solutions in an evidence-based way?

The incentives for each type of stakeholder are very different. For providers, it’s about maximizing their time, creating solutions that fit into their clinical workflows, and improving their patients’ experience. For payers, it’s about the economics. For patients, it’s about how to access healthcare simply, conveniently, and transparently. And for the digital health companies, it’s about scaling quickly and being the first disrupters in a very complex market.

The big challenge is, How do we create solutions that address the incentives for everybody in that ecosystem? How do we do it cost effectively, responsibly, and in a way that scales? These are the challenges I think we’ll see solved over the next 10 years.

A new breed of clinician

MDisrupt: What are some characteristics of the people who have joined MDisrupt this year? 

Ruby Gadelrab: A lot of the experts who have joined us have experience in building health products. That’s one of the key features of the MDisrupt health expert network—it’s made up of people who have done this before and really understand the challenges.

We’re also seeing a new breed of clinician. These clinicians have been in practice for many years, and see the need for change through innovation. They want to get involved with digital health companies, they want to be medical advisors, and they want to have a say in building products and in how the products are presented to their peers.

These physicians hold the power to change the healthcare system from within. I want to help them understand their power, so they can work with digital health companies so we can get those solutions into healthcare faster.

Secrets of digital health success

MDisrupt: When you look at successful digital health companies, what are they doing right? 

Ruby Gadelrab: First, they engage clinical experts early and often throughout the process of developing a health product.

Second, they take their regulatory and evidence generation very seriously. They don’t skip steps, and they go very deeply into figuring out the appropriate regulatory path and generating the right evidence to convince the various stakeholders.

Third, they build balanced teams. Building health products requires careful orchestration between technical, commercial, and clinical teams, and I think some of the best companies we’ve seen have got a great balance between those three areas.

MDisrupt: In our webinar next week, we’re talking about why it can be important, early on, for a digital health company to hire a chief medical or scientific officer. What’s your view on that? 

Ruby Gadelrab: It’s really important. It helps you build the right product from the start, and save a ton of time and money by not making mistakes. For example, we see a lot of companies who have a technology, and they’re trying to back it into a problem—but it doesn’t actually solve a clinical problem. So having people who really understand clinical workflows and what physicians are looking for can add huge value.

Physicians are some of the most skeptical audiences in the world, but they listen to their peers. And I think chief medical officers, chief scientific officers, and medical affairs teams are really the key to communicating with those communities. Even if it’s a part-time role, chief medical officers are worth their weight in gold and can be the difference between success and failure in getting a health product adopted.

The need for standards

MDisrupt: What are some of the biggest challenges you see in the digital health industry as a whole?

Ruby Gadelrab: There was an article out recently from IQVIA that said there are 350,000 digital health apps in the market, and 250 new ones come out every day. How do we, as consumers or providers, know what’s good? There is no systematized way of identifying what the standards are. If you have a choice of five different genetic tests, which one is right for you? So I think there need to be some standards and transparency around the standards. And I think it’s really important that we bring some of the clinicians along with us in that journey around how that data is generated, how they use it in their clinics.

One thing we would like to do over time is to develop the standards for digital health—to organize the world’s digital health products by performance and create transparency, so people can make the right decisions.

The final challenge is around the cost and time it takes to commercialize a health product. In the consumer world, we can build and commercialize and scale a product within five years. In healthcare, it’s different—the evidence generation by itself takes longer, and the amount of time and the cost in convincing the stakeholders to get widespread adoption is much longer. I think it’s important for innovators to be realistic about what it takes to scale a health product.

Looking ahead

MDisrupt: What do you think is in store for digital health in 2022?

Ruby Gadelrab: I wish I wasn’t saying more COVID solutions, but it will be more COVID solutions because we’re not nearly out of the pandemic yet. With the delta variant, there are going to be more options for testing. I hope over the next year or so, we’ll be thinking about some of the back-to-work solutions for COVID. And I see more healthcare from home solutions, whether that be at-home testing, remote patient monitoring, telemedicine. Many chronic conditions are a function of lifestyle and social determinants of health, so I see a lot of solutions coming around mental health, cancer, cardiovascular disease, addiction, and diabetes.

MDisrupt: This time next year, what do you think we’ll be saying about MDisrupt?

Ruby Gadelrab: I think we will have built out our community of experts to be even bigger and broader. We will have served more truth-seeking clients who are bringing game-changing innovations to healthcare. I think we will have raised our first institutional funding and we’ll hopefully be celebrating with our investors at that point. And I think we will have some new solutions for our digital health clients around how they find their earliest clinical adopters and how they generate evidence. I hope we’ll be celebrating all of that!

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.

MDisrupt’s Chief Commercial Officer on Building & Innovation

MDisrupt’s Chief Commercial Officer on Building & Innovation

greg-nagy

Greg Nagy is a seasoned global executive in life science and medical technology, with expertise in go-to-market strategies. Previously, Greg was chief marketing officer at Drawbridge Health and VP of global marketing at Topcon Eyecare, and has held leadership positions at other biotech and medical device companies, including Solta Medical and Amgen. Here, he talks about his path from engineer to healthcare technology commercial expert and what it takes to thrive in a startup.
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Healthcare from the inside out

MDisrupt: What led to your interest in healthcare?

Greg Nagy: Just a pure fascination with the human body, and a genuine interest in helping people.

When I was just a teenager, I got hit by a car while I was walking to the bus stop. I was thrown about 50 feet from the impact and had a major concussion, a fractured hip, fractured shins, and severely injured my knee.

I went to an all-boys Jesuit high school, and our motto was “Men for others.” When the accident happened, it was a lesson in experiencing a traumatic event surrounded by others who lived by that motto and really wanted to help.

Having your life flash before your eyes, your perspective really changes. It makes you value your healthcare support system, and is a reminder that anything can happen at any time to make you or your loved ones the “patient.” That’s part of why I chose healthcare—it’s personally fulfilling and I feel like I can make a real impact on improving people’s quality of life.

Building right, from the beginning

MDisrupt: You call yourself a “recovering engineer.” What brought you to engineering and then into marketing and commercialization?   

Greg Nagy: I was always interested in science and medicine. When I started college at UC San Diego, they had recently established their program in bioengineering. I found it fascinating to apply engineering tools to clinical applications in biology and medicine. This led me to an opportunity to develop drug discovery automation for a company that was acquired by Vertex Pharmaceuticals, and later a very large-scale global drug discovery operation for Amgen.

After completing my MBA, two things stood out: I really wanted to be a “builder,” which is easier at small companies, where you can build and scale products from the beginning. And I was drawn to the commercial side, because there is a whole lot of strategy involved in bringing healthcare products to market.

I discovered along the way that there were a lot of products that were fantastic, but never made it in the market. And a lot of terrible products made so much money. The difference was about how they entered the market. I wanted to be part of that downstream success story, so I transitioned from engineering into product management. That allowed me to get my feet wet on the commercial side, but still be upstream in product development and connected with the engineers. To be effective commercially, it’s super-impactful to be able to talk to scientists and technologists in their own language.

MDisrupt: What do you like about being part of a startup?  

Greg Nagy: I’m a builder. To me, that’s the most exciting thing—building in a place where there’s a lot of freedom. Some structure is needed, but you’ve got a blank sheet of paper. I’m enticed by that.

At a startup, it’s like there’s a fire behind you—if you slow down you’ll get burned. You don’t experience that in bigger companies because you’re comfortable and there are lots of resources and established processes. And I thrive in that uncomfortable position. It makes me get up every day and have to think hard and strategically about how we do the next thing.

Bringing innovation where it’s needed 

MDisrupt: What attracted you to MDisrupt in particular?

Greg Nagy: I met MDisrupt’s Founder and CEO, Ruby [Gadelrab], when hiring her for a branding project at my previous company, Drawbridge Health. I was super-impressed with the people she surrounded herself with, and by the phenomenal respect for her in the industry. When she said, “Can you help me build MDisrupt?” it was an easy decision to say yes. The fact that there was already a great team in place, with some resources and market traction, was appealing too. I saw this as a chance to make a profound impact in an industry that really needs change.

MDisrupt: Is there anything you’ve learned since coming to MDisrupt that’s surprised you? 

Greg Nagy: I didn’t realize how many folks want to engage in innovation, but just don’t know how to get involved. Despite what you read about doctors being overworked, I don’t think it’s the overworking that bothers them. I commonly hear that they would love the opportunity to be more involved with innovation—not just using products, but guiding their clinical development. We can help them get involved and help them contribute upstream of patient care. And being here gives me a perspective on how much opportunity there is in the digital health market.

Digital health is absolutely exploding right now—record amounts of funding, large IPOs, and an increase in M&A activity. Most importantly, tons of breakthrough healthcare innovations are coming to doctors and their patients to improve quality of life. It is an exciting time for MDisrupt: We have the opportunity to make a real impact, working with some of the brightest minds in healthcare to bring life-changing digital health products to market and ensuring that clinicians and patients have the information they need to choose the best products that are the right ones for them.

Making a difference

MDisrupt: How do you see the role of marketing and commercialization in digital health startups?

Greg Nagy: I think it’s got a tremendous role. Successful companies understand how to get the product to market and to the masses efficiently. It requires a delicate balance to get to commercial scale while preserving precious capital. Quite literally, it’s a race against the clock.

The more we can speak the language of both sides—science/technology and commercial—the more great technologies we can help bring to market. To me, that’s where we can add the most value. There are hundreds of digital health companies starting every month. How do we make sure they actually make a difference for people? I think there’s been a lot of missed opportunity for humankind, because a lot of products get shelved.

MDisrupt: Co-workers say they appreciate your calmness. What helps you be that calm guy? 

Greg Nagy: I’m always surprised to hear that. I think I’m more like a duck—looks calm on the surface, but paddling really hard underneath.

In startups, there are always lots of ideas and changing priorities. You have to be that person who steers straight down the middle: “This guy is not overreacting and he’s confident about what he’s doing.” I think that confidence is important to feel and to project. By tuning into the challenges people at some of these digital health companies are dealing with, I can show them confidence very quickly out of the gate.

Dog joy

MDisrupt: One last question—why’d you get your dog?

Greg Nagy: The dog got me! I’m a “foster fail.” Frida, a Great Dane named after artist Frida Kahlo, was adopted from a rescue group in Southern California. After just a few weeks of fostering, we fell in love with her and she is now part of the family. I didn’t want a dog—didn’t want to give up my freedom—but now we take her everywhere. You forget about everything else when you’re throwing the ball for your dog. It brings so much joy to everyday life.

 

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.