Who’s Hacking Healthcare?media.mmm-online.com/documents/180/who's_hacking... · the Hackathon Kool-Aid Mandira Singh, athenahealth senior manager, business development, More Disruption

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SkillSets

Who’s Hacking Healthcare?

Expert insights, observations and practical advicefrom a half-day conference on November 10, 2015

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Keynote: Hacking Pharma Business Models—A View from the MIT Hacking Medicine InstituteZen Chu, co-founder, MIT Hacking Medicine Institute

Skills in 30: Case Study—Tapping into the Hacking Community to Improve Support for Patients with GlioblastomaChris Iafolla, head of digital & social strategy, inVentiv Health PR Group

Tracy Hanover, director of business operations and communications, Novocure

Skills in 30: Executing a HackathonPanel Discussion: How DIY Has Changed Everything in Healthcare Moderator: Sara Holoubek, CEO and founder, Luminary Labs Panelists: Aman Bhandari, executive director, data science & insights, Merck Naomi Fried, former chief innovation officer, Boston Children’s Hospital Gokul Krishnan, SciPlay research fellow, NY Hall of Science

Panel Discussion: What Will the Future Pharma Hackathon Look Like?Moderator: Marc Iskowitz, Editor in Chief, MM&M

Panelists: Chris Iafolla, head of digital & social strategy, inVentiv Health PR Group Mandira Singh, athenahealth senior manager, business development, More Disruption Please (MDP)

Skills in 30: How Not to Drink the Hackathon Kool-AidMandira Singh, athenahealth senior manager, business development, More Disruption Please (MDP)

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Who’s Hacking Healthcare: Expert Insights, Observations and

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“How do we keep the teachable spirit while allowing sponsorships?”—Zen Chu, MIT Hacking Medicine Institute

Keynote: Hacking Pharma Business Models—A View from the MIT Hacking Medicine Institute Zen Chu, co-founder, MIT Hacking Medicine Institute

Hackathons serve as the front end of innova-tion, Chu explained in the opening moments of the keynote presentation, but they don’t

solve all problems. In his estimation, hacking is a clever solution sorely needed to propel the health-care industry forward.

As the faculty director and co-founder of MIT Hacking Medicine, Chu is well versed in the utility of hackathons as well as MIT’s long history of hacking. Seismic shifts in the healthcare industry have left gaps that large companies cannot fill. That’s where hack-athons come in: to fill the gaps (read: opportunities).

Chu believes there is no time like the present for healthcare entrepreneurs, engineers and other stake-holders to muscle their way into the landscape to cre-ate solutions to improve healthcare quality and man-age skyrocketing costs. He has faith in digital health to deliver convenience, capacity and trust in healthcare to patients and providers. “There is more noise and hype in digital healthcare than ever before, so how do we cut through the BS?” Chu asked.

A good place to begin, according to Chu, is measur-ing its impact. He insists there are good results amid the noise, with some 1,000 companies vying for atten-tion in the digital health space. For Chu, an equation is the logical way to estimate the impact of a digital health solution and he thus suggested: impact = inven-tion × commercialization. He qualified that the effort

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requires entrepreneurship because if the commercial-ization aspect is zero, the impact will also be zero.

The rise of digiceuticals is coming face-to-face with a greater need to measure effectiveness and demon-strate clinical value. Mobile diabetes apps, according to Chu, are being reimbursed and proving in some cases to have more efficacy than molecules. He be-lieves prescribable apps are the future of healthcare but wonders whether pharma will perceive them as a threat or an opportunity.

Chu believes that open hackathons are the best way to gain new solutions to healthcare’s woes. It’s going to take more than the input of traditional stakeholders to cut through the digital health noise and hype, and hackathons attract just the right mix of people.

Legal, reimbursement, regulation and script plat-form issues all accompany app development. “Those developing apps are naïve about the complexities of healthcare,” Chu stated. “The key is to provide real help in healthcare while engaging patients.”

Chu presented PillPack, a full-service pharmacy promising a simpler experience for consumers, as a

Biopharma and med-tech outfits are deepening digital health investments to breathe new life into exist-ing products and add value to impending launches. In an effort to bring fresh perspectives to services, technology and data, pharma is opening up the brainstorming stage of ideation to include entrepre-

neurs, software developers, engineers and other key stakeholders.Hackathons, conceived in Silicon Valley to chip away at certain areas of everyday business that stifle indus-

try, finally arrived on the healthcare scene in 2010. Still gaining traction (as pharma and healthcare in general are historically resistant to rapid change), hackathons are a salve of sorts for the roadblocks that keep industry leaders up at night.

Boston, the epicenter of inventiveness and entrepreneurship, seemed the logical location for MM&M’s Skill-Sets Live series on how pharma is leveraging the hacker approach to transform R&D and marketing campaigns.


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“The external landscape is changing so quickly that we need to change how we think about it.”—Chris Iafolla, inVentiv Health PR Group

recent disruptive force in healthcare and a prime ex-ample of the ingenuity that can come out of a hack-athon. PillPack is intent on changing the patient expe-rience, making it easier to track and take medications.

“Medication adherence is one of the knottiest problems in healthcare,” Chu explained. “Patients no longer need to fill Grandma’s old pill box.”

The crowd-sourced diagnosis platform Figure 1, informally dubbed Instagram for Doctors, was a crowd-pleaser at MM&M’s SkillSets Live. The fast-growing app features teachable images for clinicians in the moment. Case in point? Two hours after post-ing a photo of an 18-month-old patient with indis-cernible symptoms, a physician nailed down a rare-disease diagnosis based on 19 comments posted by various healthcare professionals on Figure 1. “The app is changing the face of diagnosis,” Chu said.

“Diagnoses are happening through rapid feedback.”Figure 1’s developers are open to collaborating with

pharma. “This is next-generation medical CE,” Chu observed. “But how do we keep the teachable spirit while allowing sponsorships?”

Chu believes big pharma, mid-tier companies and early-adopter biotechs all have the potential to take risks with digital transformation. “There is a readiness, but it’s on a product-to-product basis,” he mentioned. “There is no one pharma leader that will break out.”

MIT hackathons range from intimate private events held at companies to large-scale conferences with 700 attendees. The events bring together pharma execu-tives, clinicians, entrepreneurs, engineers and other stakeholders. “Hackathons are the intersection of multiple ecosystems,” Chu explained. “We’re rein-venting the doctor’s bag—which is medieval.”

Skills in 30: Case Study—Tapping into the Hacking Community to Improve Support for Patients with GlioblastomaChris Iafolla, head of digital & social strategy, inVentiv Health PR Group

Tracy Hanover, director of business operations and communications, Novocure

I nnovation no longer happens only in the lab,” Iafolla told the MM&M SkillSets Live audience. “It can happen anywhere and from anyone.” This

is precisely the premise of a hackathon: Gather a bunch of people from a variety of backgrounds at an off-site location and start brainstorming.

Hackathons are on the rise in the pharma sector and the timing couldn’t be more perfect. With access to new technologies and the means to access an end-less amount of information, patients are demanding more from their healthcare outlets. “Patients expect healthcare to behave like CPG companies,” Iafolla shared with the audience.

He outlined three steps to unlocking innovation. First, real inspiration and multiple perspectives are necessities. As a marketing person, Iafolla said he’s comfortable with ideas coming to fruition on a blank white board but admits that the approach lends itself to a rather-limited perspective. Hackathons attract outside perspectives and fresh, inventive views of and

insights about age-old and newly identified problems.Second, he suggested adapting ideas from other

technologies and industries. Iafolla prodded the audi-ence to consider the evolution of the taxicab indus-try. In a pre-Uber world, we saw incremental changes, right? He pointed to the arrival of the maddening backseat screen of endless news and then the abil-ity (or inability, as he noted how rarely the machine cooperated) to swipe a credit card. Uber, an industry outsider, brought innovation to transportation.

Third, Iafolla recommended scanning the external landscape and seeking input from others to make meaningful change. “The external landscape is chang-ing so quickly that we need to change how we think about it,” he said.

To illustrate this last point, he turned the micro-phone over to Tracy Hanover to discuss a hackathon


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“Doctors had ideas about how to enhance care but didn’t have the tech background to apply them.”—Naomi Fried, Boston Children’s Hospital

held by Novocure, an oncology company with a medi-cal device for patients with glioblastoma (GBM). About 10,000 people in the United States have the most prevalent form of brain cancer. Patients diag-nosed with the aggressive disease have a poor prog-nosis—typically 18 months—due to limited treatment options. Hanover said the patients and caregivers who comprise the GBM community inspire the company and her personally.

Among a variety of issues faced by GBM patients and their family members are patient financial strains/job loss, caregiver burden and physical changes rang-ing from seizures and memory loss to impaired speech.

According to Hanover, Novocure is interested in identifying gaps in care to better serve its constituents. A survey launched in May 2015 found that an over-whelming 75% of patients wanted more and better-quality resources, including apps, to navigate GBM.

It’s important for patients, Hanover explained, to find information in one place. “They often feel pres-sured when looking for information,” she said, “and

we found a high need for caregiver resources to help take care of their loved ones.”

Novocure assembled advocacy experts, tech gurus, company leaders and others to participate in a hack-athon with one goal in mind: to develop innovative solutions that make the GBM patient journey easier. Teams competed for $17,500 in cash prizes. Accord-ing to Hanover, participants repurposed existing Novocure technologies, such as Optune, which helps to either slow or to stop recurrent glioblastoma cancer cells from dividing.

In response to a question posed by an audience member, Hanover explained that the timing of the hackathon was tied to Brain Cancer Awareness Month (May). Additionally, Novocure partnered with advocacy groups to inform people of the hackathon and attract participants. Company representatives were pleased with the results of the weekend event.

Novocure is currently sorting through the solutions and ideas presented at the hackathon to determine how they will best serve the GBM community.

Skills in 30: Executing a Hackathon

Panel Discussion: How DIY Has Changed Everything in HealthcareModerator: Sara Holoubek, CEO and founder, Luminary Labs

Panelists: Aman Bhandari, executive director, data science & insights, Merck Naomi Fried, PhD, former VP, medical information, innovation and external partnerships, Biogen, and chief innovation officer, Boston Children’s Hospital Gokul Krishnan, PhD, SciPlay research fellow, NY Hall of Science

T he midway point of the MM&M SkillSets Live meeting gathered an impressive set of panelists, each eager to share thoughts on the

hackathon sensation. Holoubek, the capable modera-tor, introduced the panelists and set the tone for the discussion: “The panelists will share what it’s like in the trenches, what they’ve learned, and what they would do differently,” she relayed.

Bhandari provided historical context on the first healthcare hackathon, an event he co-launched in 2010. “The very first hackathon was held by Sun Micro systems in 1999. That’s how behind healthcare is,” he explained.

The first health hackathon, launched as part of a public–private partnership between the US Govern-ment and Health 2.0, yielded a surprising amount of interest. The field has caught up quickly, Bhandari noted to the audience, with more than 200 health-care-related hackathons launched to date. “Hack-athons are the only way to truly bring together many


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“It’s impor-tant to maintain the brand of the organization and keep patient interests at the core.”—Gokul Krishnan, NY Hall of Science


Practical Advice

stakeholders and explore opportunities,” he shared.Fried stepped in to explain how, and in what ways,

large organizations are slowly adopting the hack-athon model. As the former CIO of Boston Children’s Hospital, Fried was involved in two hackathons. Les-sons included the utmost importance of advance prep-aration and providing the correct legal, financial and technological support. But, what happens Monday morning when the successful hackathon ends? That’s where more people need to focus their energy, Fried shared.

During her time at Boston Children’s, Fried devel-oped the FastTrack Innovation in Technology (FIT) award to turn ideas into mobile apps and other ap-plicable technologies that enhance hospital workflow. The goal, Fried explained, was to harness and harvest the doctors’ ideas. “The doctors had ideas about how to enhance care but didn’t have the tech background to apply them,” she explained.

Companies hold hackathons to meet a wide vari-ety of goals since identifying goals before the event is imperative. Merck and inVentiv Health, for example, have each held internal hackathons. “Hackathons are a huge effort and the logistics are complex,” Bhan-dari said. “It’s like having a 72-hour party for a whole bunch of people you don’t know.”

“You need to understand the focus of your own hackathon,” Fried observed. “At Boston Children’s, for example, we wanted to hack the delivery of pedi-atric care and at Biogen, we were focused on stress management for MS patients.”

A recent graduate of Vanderbilt University’s Pea-body College of Education, Krishnan focused his dis-sertation on designing a mobile makerspace for chil-dren with chronic illnesses. Krishnan, a self-professed storyteller, had the audience rapt with the tale of a chronically ill high schooler who aspires to be an engi-neer. Krishnan related a brief though insightful story about how he gave the patient a mystery box of ran-dom materials found around the hospital: wires, Legos, lightbulbs, etc. In the span of a few hours, the patient designed a bathroom night-light so hospital personnel

could easily empty trash at night without disrupting patients.

The concept evolved into mobile makerspaces for children with medical conditions that confine them to a hospital room. One of the biggest findings, accord-ing to Krishnan, was the program’s impact on physical health. The patients wore wearables that tracked more daily steps when patients were involved in “making” activities.

The common thread among these initiatives is bring-ing the community together to tinker. “Five years ago there was no place to meet and tinker,” Bhandari said. “It’s a profound shift in healthcare to have a place to tinker.”

Krishnan believes that the focus when developing new solutions should always be on the patient. “It’s important to maintain the brand of the organization and keep patient interests at the core,” he explained.

According to Bhandari, you never know who might solve the problem at hand. He recommends having a diverse set of people to access because “who would have thought a kid would identify a need in a hospital and invent a solution?”

The panelists agreed there is no room for fear at a hackathon, and that all goals and activities need to center around fun. In closing, Holoubek quoted Theodore Roosevelt: “Do what you can, with what you have, where you are.”

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“We need to focus on the hairy problems that help end users. We need to bridge the gap between provider and consumer.”—Mandira Singh, athenahealth’s More Disruption Please


Practical Advice

Skills in 30: How Not to Drink the Hackathon Kool-AidMandira Singh, athenahealth senior manager, business development, More Disruption Please (MDP)

A dmittedly standing before the audience to reveal the harsh realities of the hacker ap-proach, Singh joked there is a reason the

word disruption appears in her job title. She first in-structed attendees to take a step back to ask why they were hacking healthcare and ask that means.

To start with, digital health promises affordable, highly efficacious health solutions. “With so many changes in healthcare, this is the right time to disrupt the available diagnosis, treatment or intervention at a fraction of the cost,” Singh stated.

The industry shift from fee-for-service to value-based healthcare models has pigeonholed hackers into innovating for value-based care. There are new avenues and opportunities, and venture capitalists have invested more than $4.5 billion in the space.

The problem, Singh shared, is that 95% of the indus-try is still engrossed in the fee-for-service model. “Is it moving toward value?” she asked. “Yes. So innovate for the future, but bridge for the present.”

Singh feels that companies that are growing solu-tions that only resonate with the value-based 5% are capping their own potential. Innovators need to de-termine what job is being accomplished by each solu-tion as well as who is using it and how. “It’s important to know your end user,” Singh said, relating her point to Krishnan’s sentiment in the previous session that digital health needs to be about the patient. “Are you catering to the consumer or the patient?”

Singh pointed to opportunities supported by legis-lation including the Medicare Telehealth Parity Act of 2015. “It’s efficient medicine and it fulfills the demand for value-based care,” she said. She believes nonre-imbursable events, such as wound care, are the most compelling. “It takes seconds for a provider to check a wound but it’s not reimbursable in the office,” she explained. “This could easily be done via telehealth.”

The problem? To date, people still prefer phone to video when it comes to conversing with a provider outside the office.

The rise of in-home solutions solely operated by patients is also creating problems. Singh pointed to Smart Scales as the type of technology that may pro-

duce inaccurate results if misused by the patient. The premise of Smart Scales is to have patients who are at risk for diabetes, for example, weigh themselves daily. The physician monitors the data to signal major changes. Well, what happens when the patient’s cat or child also “weighs in”? Skewed data.

To illustrate the industry disconnect, Singh dis-played an image of the Grand Canyon with disrupters on one bank and companies on the other. “There is so much need,” she explained. “But where are the inno vators? Making Fitbits.” (Singh noted earlier that Fitbits are used primarily by consumers and not by the chronically ill patients who desperately need digital solutions.)

Singh noted too many investments in hacking the me-too’s and little interest in taking risks where the greatest needs lie. “We need to focus on the hairy problems that help the end users,” she challenged. “We need more folks to bridge the gap between pro-vider and consumer.”

Arsenal Health’s Smart Scheduling product epito-mizes Singh’s call to action. The digital solution, the product of a hackathon and built entirely on athena-health’s APIs, checks the boxes of moving to value-based care. How? By predicting whether patients will show up for their doctors’ appointments and cutting costs in lost productivity.

Singh identified a marked difference between inno-vating inside and outside healthcare. “There are ob-stacles to onboarding a healthcare app that Snapchat doesn’t have to deal with,” she said. “The Snapchat model doesn’t happen in healthcare.”

“We have to make it easier for entrepreneurs in healthcare,” Singh concluded. “Innovation needs to sit outside giant companies. My advice to big pharma? Stop making unsuccessful apps in house. Analyze the problem and find the right partner to make it happen.”

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“Follow a nurse around to find out where the needs are. Then pick the one that hurts the most.”—Mandira Singh, athenahealth’s More Disruption Please


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Panel Discussion: What Will the Future Pharma Hackathon Look Like?Moderator: Marc Iskowitz, Editor in Chief, MM&M Panelists: Chris Iafolla, head of digital & social strategy, inVentiv Health PR GroupMandira Singh, athenahealth senior manager, business development, More Disruption Please (MDP)

A s healthcare wraps its brain around the hack-ing approach, changes afoot in the future are almost palpable. Think of hackathons as the

elixir to the healthcare industry’s deep-seated aver-sion to collaboration. So what areas are ripe for the next pharma hack?

Iafolla and Singh agreed the unsexy problems that need a voice are the most ripe for disruption. “It’s the big challenges for small patient populations like GBM,” Iafolla shared. “Pharma needs to focus on the day-to-day problems patients are facing.”

How to market and sell their drugs ranks high among issues garnering pharma attention. “Pharma companies tend to focus on their own problems,” Ia-folla explained, “but they would benefit from follow-ing the patient’s lead to opportunity.”

In Singh’s experience, patients do not trust pharma. “So find hacked solutions to break down that barrier of trust,” she recommended. “To me, that would be fascinating.”

Responding to an audience question about how to identify problems that need to be solved, Singh ex-plained transparency is difficult to come by in health-care. “Follow a nurse around for a day to find where the needs are,” she suggested. “And then pick the one that hurts the most.”

Iafolla would like healthcare companies to admit they aren’t inherently privy to all industry challenges. He suggested directly asking consumers and the com-munity to identify problems. “Otherwise, you’re just chasing your own tail,” he said.

So how about the two-day concept of a hackathon: How much can really be accomplished in that time frame? Singh has been impressed by what people can

address and accomplish in 48 hours but confessed there’s not enough time in just 48 hours to build a whole system.

There is evidence that biopharma is trying to drive the hackathon concept forward. “Big companies face hurdles and challenges that don’t fit this process,” Iafolla said. “Smaller pockets within the larger organi-zations understand the value of this approach but they need a stronger foothold.”

Iafolla recognizes that the mind-set needs to change and is confident that it will. Singh believes the indus-try needs to think broadly beyond pharma to make any gains. “Collaborate and partner outside your com-pany,” she urged. “You can hack your problem with athenahealth data, for example.”

The raw data for doing a hackathon, according to Iafolla, comes from insight into a particular thera-peutic area. It’s imperative to understand the broader needs of the therapeutic area and what the patients are facing.

Singh’s favorite example of an organization that opened its mind to innovation occurred during athe-nahealth’s More Disruption Please hackathon in Aus-tin. Members of the healthcare team at Martin’s Point Health Care in Maine traveled to Austin after missing the hackathon in nearby Boston months earlier. The Martin’s Point team wasn’t focused on winning or los-ing in Austin but rather on the process of innovating, Singh recalled. “Innovation extends to the community and our clients,” she observed.

While tangible outputs are great, Iafolla explained, merely participating in these events exposes orga-nizations to a new means of thinking and attacking problems.

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Who’s Hacking Healthcare?media.mmm-online.com/documents/180/who's_hacking... · the Hackathon Kool-Aid Mandira Singh, athenahealth senior manager, business development, More Disruption