Borderless Executive Live: The Podcast

The Digital Healthcare Revolution

October 07, 2020 Headhunter Talks Season 1 Episode 6
Borderless Executive Live: The Podcast
The Digital Healthcare Revolution
Show Notes Transcript

Naomi Fried, Ph.D. Founder, and CEO of Health Innovation Strategies looked ahead at the forces driving digital health innovation and brought fresh perspectives to the digital health revolution.

Andrew Kris:

Hello, everyone and welcome to Borderless Live. We're delighted that you're joining us as our audience. And our special guest today is somebody that we really admired for a long time at Borderless Live. Naomi Fried is joining us today. She's Founder and CEO of Health Innovation Strategies. Naomi, although she wouldn't want us to see her blush here, but is truly an innovator. And many think a thought leader in this particular area of digital health. Naomi is going to bring some clarity, I hope, and will certainly provide some fresh perspectives to the digital health revolution, of which we're right in the middle right now. So I'm looking forward to hearing from you. And with that brief introduction over to you Naomi, let's get started. Welcome.

Naomi Fried:

Thank you, Andrew, it's a pleasure to be here.

Andrew Kris:

I know this thought leader thing, it can be a bit a bit embarrassing, even, sometimes. I know you, and if anybody does you deserve that statement, because you've got a whole collection of firsts in your career. Can you tell us about those and what's been the most important thing for you as you navigated this whole scenario?

Naomi Fried:

Well, thank you, and you are right. But first of all, I want to say it's a pleasure to be with you today, around the world, excited to chat with all the Borderless Live audience. So that's actually kind of an interesting question. You know, in terms of thinking over the first and which one was the most important or the most impactful? It's sort of like asking me which of my children do I love the best, and I love them all. But,you know, I've had learnings across all of my experiences. I was the first vice president of innovation at Kaiser Permanente, which is really my entry into the art and science of innovation. I've been working with startups prior to that, and venture capitalists. And I think at Keiser I did a lot of learning and thinking and that's where I actually developed the innovation lifecycle for explaining how innovation happens in large healthcare organizations. As you may know, I then moved on to become the first Chief Innovation Officer of Boston Children's Hospital, it was a chance to work with an academic medical center. And there were a lot of very motivated innovators there. We built a digital health accelerator. We went on to really develop and incubate solutions, that both doctors and nurses wanted for problems that they faced in daily care. And we launched a telehealth program there. From Kaiser, I actually moved, I'm sorry, from Boston Children's, I moved to Biogen, where I became the vice president of innovation and external partnerships and introduced and began to really help them with their innovation beyond the molecule strategy. So thinking about how to take digital health and bring it to a patient to really add value to their experience. And we also explored how digital health can impact the clinical trial experience for the patients. Today, I am running my own company, Health Innovation Strategies, which I founded. And it's really a pleasure for me now to work with very diverse clients on multiple types of projects, doing some writing and speaking like this. And I love the chance to really share what I've learned from working on the front lines and provide guidance and hopefully direction that lets my clients accelerate their developments. And I'd like to think that I'm just continuing to share the things that I had the pleasure and honor of learning so far.

Andrew Kris:

Well, I was gonna say you seem to have worked at all three corners of the digital health strategies, which obviously has given you some good insights from the patient perspective, from a healthcare perspective, as well as the life sciences perspective. So quite a unique experience. Where we're struggling, I noticed that with a lot of people that we've talked to recently on this topic, is finding a way to define what digital health is. Everybody has their own definitions. How do you position digital health? What are those components for you?

Naomi Fried:

Yeah, it's a great question, because digital health is clearly an exploding field. And to your point, there's a lot of things being called digital health that actually aren't. So the definition that I'm working with my clients on that really seems to resonate is that digital health leverages technology - that's hardware and software - to deliver care and information to patients and providers that can be more convenient, more cost-effective and more personalized. And that means that we're talking about digital health using a variety of types of software, whether that can be apps, computer programs, games, virtual reality, chatbots, even, and a whole host of hardware also go into supporting digital health. So phones, cell phones, in particular, computers, but also sensors, wearables, robots, monitors. And I think what's really exciting about digital health is that it has the potential to improve outcomes, decrease costs, improve efficiency, and actually deliver care and information in entirely new ways because it's digital.

Andrew Kris:

Yes, I just wonder sometimes what the real drivers for digital health are. If it's this economic component or whether it's the enhanced health care component, I guess it's a mixture of all of these with different organizations having different drivers.

Naomi Fried:

I think I think that's exactly right. And I would also just add that, you know, one of the things that's important with digital health innovations is to recognize what the value is, what the driver is. And it's also one of the challenges because digital health often requires new business models, to think about delivering a value in a different way and thinking about who's going to pay for it. And so that's often some of the challenge in getting new digital solutions adopted is recognizing where the value is, who's going to pay for it, and it may be unlike anything you've seen before.

Andrew Kris:

Even, hopefully, substantially costs at the end of that to a level that wasn't known before. These are interesting definitions. And I know you've written quite a bit on this topic. There's an article recently where you said in the next few years, quoting here, our healthcare experience will be radically different. How's that really playing out?

Naomi Fried:

Yeah, so you know, I expect that eventually, healthcare will fully embrace digital health as a safe, effective method for delivering care. I believe it's an inevitable transformation, and it's the direction healthcare has to move. I had been thinking that the adoption of digital health would sort of continue to happen as it has been sort of incrementally. And we'd be constantly inspiring, maybe even pushing people to focus on digital health. I'm continually sort of selling the value and trying to vie for resources to pilot these programs. But things changed a lot in 2020. And you know why. COVID-19 has really been almost a discontinuous radical acceleration in the adoption of a lot of areas of digital health. You know, I was trained as a chemist actually. And, you know, drawing on my days as a chemist, I would say that things are sort of happening in almost a catalytic way. That is, digital health is now happening faster and hotter. And, you know, at lower activation energy barriers. I personally have been advocating for telehealth for 15, more than 15 years, I launched the telehealth strategy at Kaiser Permanente. And today, we are seeing virtual visits being used everywhere. You know, remote monitoring is happening in the hospitals. And the notion of hospitals at home is even finally becoming popular. So all these things that are sort of happening incrementally have been accelerated because of COVID. So, I personally find it exciting and exhilarating to see how digital health is coming into the forefront today. It's my hope that we can sort of hang on to these learnings and that the clock doesn't somehow get turned back when this pandemic ends, and particularly for digital health and telehealth, I feel like the genies out of the bottle and I hope it stays out.

Andrew Kris:

Well, that's certainly the view of people we've been speaking to on this topic. It's too late to turn back and clearly, benefits start to show through. Certainly one of the questions already coming up and I can see we've got a pretty excited audience here. This individual said, will conditional health simply be also a solution facing the lack of health care providers versus a population, no? It's very clear that that is a wonderful reason for having a good health solution.

Naomi Fried:

Yeah, telehealth, in particular provides new and improved access to care delivery, its care at a distance. And so you know, we've seen in the US slowly a growing interest in telehealth in areas where people were living very far from care centers, particularly in rural areas, and we have a lot of very large states - Texas, Alaska, California, even Georgia and this has been a great solution. I think now people are just recognizing this tremendous benefit.

Andrew Kris:

And hopefully there's no way back. I think everybody agrees that this is a really good way to provide better health care. But I mean, we've been hearing a lot about this topic. Almost inundated with it on a daily basis right now. But how does that all fit in with, you know, digital health as opposed to the broader concept?

Naomi Fried:

Yeah. So, you know, I've been thinking about digital health for a while. And I think that is actually a way to sort of structure or organize at least the patient facing components of digital health. And I think, actually, that it's the patient care piece that really holds the greatest promise to improve health care, to transform it. So I think there's four major categories when thinking about patient facing digital health, and I'd be happy to share those with you. So the first one, and these aren't in any particular order, but the first one that comes to mind is sort of diagnosis and evaluation, where providers use sort of clinical grade digital information that's generated to evaluate and make decisions about patient care. And this digital health data is collected from, or about, a patient and then acted on by a physician. And I think doctors can really look forward to using just a whole trove of new and highly specific data generated from digital tools to help manage their patients. And we'll see more digital tools that help provide cognitive testing or measure gait for patients with neurodegenerative diseases. There's really a lot going on in this area. The second area is one that we've been sort of talking about. Do you have a question about that?

Andrew Kris:

No, I was gonna ask you can cite anything, any specific example?

Naomi Fried:

Sure. Yeah, a lot come to mind. One of the ones that I think is very exciting is the diagnosis and tracking of Parkinson's disease. And there's a company here in the US called nQ Medical, that actually monitors and evaluates a person's typing patterns, whether it's on a keyboard or a phone or tablet, and by running in the background can actually diagnose Parkinson's, and then of course, track the disease progression. I know nQ Medical's also looking at using the same concept and type of finely tuned algorithms to look at the evaluation of Alzheimer's, to measure pain, all sorts of interesting things, so there's a lot happening in the diagnosis and evaluation space.

Andrew Kris:

Obviously, working on three finger typing, any idea?

Naomi Fried:

That's a good question. I think, I'm not totally sure, but I think it probably could a hunt in pack.

Andrew Kris:

That's really interesting. And the other area said was virtual patient care.

Naomi Fried:

Oh, yes. Yeah. So we were talking a little bit about that already. This is delivering patient care, virtually, obviously includes telehealth and remote patient monitoring. And I think what's exciting about this is, patients can get care where they are. And this can be at work, at home, at school for kids, and I think it's the convenience of virtual care that people finally are coming to appreciate and that really delights patients. And the third area is one that I think is particularly exciting, and not everyone's heard about, which are digiceuticles. So digiceuticals are digital pharmaceuticals. So they're digital therapeutics that are administered through apps, or games, or software, and they actually treat a patient's condition or disease. So just to give you some examples, you know, today there are apps that can treat depression, attention deficit disorder, insomnia, panic attacks, chronic pain, smoking cessation, the list goes on. You know, I think we're seeing more and more conditions for which we can say, "hey, there's an app for that." And I think this is actually one of the most innovative types of digital health because it's a fundamentally new therapy. And then just to sort of round out, the fourth category is medication compliance. And, again, these are apps, sensors, games, even ingestible, you know, pills you swallow, that are the next generation that remind patients to take medication, and also provide information to doctors or caregivers about a patient's adherence and compliance. And I think this is an area where digital health is going to make a big difference in the adherence to medication regimens. I think it'll be easier, maybe even fun for patients to take their medications.

Andrew Kris:

Yes, that sounds really cool. digiceuticles is not a word that we would have coined, but that certainly gets the meaning across. You know, in recent times, telehealth has been getting a huge amount of publicity in the pandemic, of course, which of these areas do you think will have the greatest impact, as you mentioned?

Naomi Fried:

Yeah, so I think, I agree three digiceuticals are very cool, and telehealth is continuing to be used. But actually, I think that we're going to see that, as someone has been watching digital health for a while, the biggest growth area in digital health will actually be in health diagnostics, the clinical grade digital diagnostics we were talking about a little bit earlier. You know, we are seeing diagnostics for sleep, sleep apnea, for pain, for Parkinson's Disease, which I mentioned earlier, even things like concussions, Prevent Biometrics has a mouth guard, that people who are playing sports, particularly teen athletes wear, and it can instantly detect a concussion and then notifies the coach via an app that this has occurred. Mental health is an area where there's a lot of digital diagnostic work. An example is Sound Health, which has a digital health solution that analyzes a person's voice to evaluate their mental health. And what I want to emphasize is Sound actually focuses on how someone speaks, not what they're saying. So they identify and analyze the digital biomarkers in a person's voice to measure symptoms of depression or mild traumatic brain injury, or concussion. And you know, when it comes to diagnostics, Andrew, and digital health, even cancer is being diagnosed with digital health tools. For example, pancreatic cancer, the digital health app, BiliScreen, uses the smartphone camera to detect pancreatic cancer by measuring the bilirubin levels and the whites of a person's eyes because, you know, with pancreatic cancer, the bilirubin level starts to rise, and the whites of the eyes turn yellow. But by the time this yellowing is visible to the naked eye, the cancer is often quite advanced. But BiliScreen because it's using this camera can detect very low levels of bilirubin and indicate possible disease. And so this is an easier, cheaper way than the traditional blood tests. And what's really important is it can be done before any symptoms start to show. And also speaking of cancer and digital health diagnostics, lung cancer is now being diagnosed digitally, when someone just blows on a chip. Very cool. I just, you know, I think digital health diagnostics are really capable of going beyond diagnosing diseases and even predicting when attacks can occur. So for like epilepsy and asthma, there are now wearables that can detect when these attacks might be coming on. And this is of huge potential value. Because if you can predict an oncoming attack, you may have the opportunity to intervene and prevent, potentially prevent, an attack. So a lot of exciting things. And that's why I think that diagnostics is where we're going to see the most activity.

Andrew Kris:

That's certainly something to look forward to as a member of the human race. I mean, the whole subject is a very interesting topic, as one of our guests has just said, you know, it's going to be quite an effort for pharma companies to master this. How do pharma companies and devices companies address this topic? Other than talking to you, of course, which is a good idea, we'll leave your address at the end of the session, just in case somebody has an interest. I mean, how do you build a business case here?

Naomi Fried:

Yeah, it's a really great question. And I am a very strong proponent of the importance of the pharmaceutical industry embracing the opportunity around digital health, I think that they can really enhance their patients experience and augment the value that we're delivering beyond just the pharmaceutical to include really a digital health wrapper. I like to talk about sort of drug and digital, or 'DND,' as the future. But it's not the easiest thing for Big Pharma, in particular, to get involved with digital health. There is, in a lot of ways, sort of a mismatch between, you know, the way pharma thinks about business and the way digital health startups in particular approach business. You know, pharma is a little bit more slow moving, cautious, concerned with regulatory requirements in a way that you see a lot of startups that are moving quickly are in a big hurry. It's sort of like, you know, a big aircraft carrier and a speedboat, they're moving at different speeds. But that being said, I think partnership between pharma and these startups is absolutely critical. I don't think that Pharmas really in a position to build all of these solutions themselves. And as we've talked about, there's an exploding market out there, so like, why build what you can buy or partner? So I think the real opportunity is in partnerships between Big Pharma and these startups. And what I would say is really important, though, is understanding that there is a little bit of difference in the language and a little difference in the timing between large companies and small companies. And so having that patience and having open communication is key. But I'm very optimistic that we're gonna see a lot of wonderful partnerships.

Andrew Kris:

No doubt a lot of startups get acquired through this process. And hopefully, are loved by the pharmaceutical guys.

Naomi Fried:

Great for the industry.

Unknown:

One of the things you and I discussed when we spoke was the extent to which it's not digital and Pharma looking at strategies, digital has to be an essential component, whatever drug strategy you might have, or device strategy you might have, really needs to be built in from the start. And when we see that, then we'll see that this whole digital health area will not be something apart, it'll be part of the overall value proposition. Is that what you're experiencing as well in your work?

Naomi Fried:

Well, you're absolutely right, in the ideal world, as people are developing drugs in phase two, phase three, they're actually starting to think about their digital health strategy, and maybe even already started to use some of those tools in the testing that they're doing with the drugs. And then it's a much more natural progression, that once the drug is on the market, it also has a digital wraparound in place. It's a lot harder, as you and I've talked about Andrew, to start developing a digital health strategy after the drug is on market. You've got people very focused on sales and marketing of the drug as-is and then to sort of add, you know, another activity around the digital wraparound can be challenging. So I think we're going to see more success from companies that think about digital health strategies earlier and as an inherent part of drug development.

Andrew Kris:

One of the questions we have coming in here is, "So where in the value chain," as it's referred to by our guest now, "from clinical trials to treatment, compliance or diagnostics, you know, where do you think, which aspect do you suppose will be most impacted?" Do you have a view on that?

Naomi Fried:

So I am a strong proponent of using digital health solutions as part of the clinical trials as a way to evaluate and support the patient. So that could be using a digital diagnostic to, you know, help determine whether a patient qualifies or meets the inclusion criteria for a clinical trial. It could be around using telehealth to support the patients during the clinical trial, when they have questions about side effects. It could be using apps and educational tools, or medication compliance support for the patient, again, while they're in the clinical trial. So I think there's a huge opportunity in phase three, even reaching back into phase two. And by including the solutions at this phase and building them into the trial, the pharmaceutical company comes to understand and appreciate the value. And so it's a very natural transition, when the drug goes out to the market to still continue to use these educational apps, these compliance support tools, even continuing to provide telehealth support to patients in the form of nurses or others that can help them. So, you know, I don't think it's too early, phase two, phase three, for sure.

Andrew Kris:

You are predicting the future here a little bit to some extent. In the article you published, it was before Coronavirus, I remember that. Were you surprised at how fast things have been touched off as a consequence of Corona or the pandemic?

Unknown:

Yeah, so I did write an article in January of this year with some bold predictions. Well, what I thought was gonna happen this year. And obviously the big trend that I missed was that a pandemic was going to happen. But, you know, in looking at sort of what I predicted, I'm happy to check in with you, Andrew, kind of tell you and give myself some scoring about whether things are on track. So, you know, one of my predictions was that pharma would sort of focus and tailor their digital health strategy around therapeutic areas and I think this focus on education, side effect management, and compliance is continuing. Clearly, we're seeing lots of new Pharma activity around COVID-19 focused therapies and vaccines, but overall, I think for their non-COVID business that that prediction is still on track. You know, I also thought there would be, as we've been talking about already a growing emphasis on digital health diagnostics, those clinical grade digital information categories. So COVID-19 has accelerated certain diagnostics and digital diagnostics. One example is ResApp Health. ResApp uses a cell phone microphone to analyze coughing sounds to accurately diagnose pneumonia and other upper respiratory diseases. And obviously, the ability to understand whether a cough is being caused by pneumonia, or potentially Coronavirus, could be huge. So I know they are now working on a differential cough algorithm. And I think it's already in use in Australia. I'm hoping that we'll get it approved in the not too distant future in the US. Also in terms of other digital health diagnostics. So there's a host of new nasal sensor screenings for COVID-19. NanoScent is a startup out of Israel actually, where they are developing a nasal breath test to diagnose Corona in 30 seconds, which, if we could get that in place, I think we might feel more comfortable getting back on airplanes again. So I think that's exciting. In terms of my other predictions, number three was that more startups would seek regulatory approval this year. So that's certainly been happening, digital health companies are continuing on a path to get FDA approval. I think what's changed is the FDA is super busy now with COVID-19. And they have emergency use authorization approval. So I think that things may slow down a little bit for traditional digital health companies trying to get FDA approval. Maybe they'll be bumped farther down because of the crush of really urgent work that's coming to the FDA because of COVID. But we did actually have some good news recently, Andrew, around the FDA, that they announced that they are creating a digital health center of excellence, to build on their experimental pre-certification program for digital health innovations. And I think this means that there's a continued, you know, regulatory support for the FDA around emerging digital health solutions. And I think that the FDA appreciates that digital health is actually a sea of change in care delivery, and warrants its own approval process. So Andrew, just getting back to the predictions. I don't want to wander off topic too much. My last prediction, number four was that pharma innovation challenges would take off in 2020. And as we've been talking about, I think, biopharma is coming to appreciate that digital health is critical to its future. And they've been using innovation challenges to really connect with the digital health community. Big Pharma, like Novo Nordisk, Merck, Eli Lilly, Johnson & Johnson, have all hosted innovation challenges. I think that COVID-19 is actually going to accelerate this focus on innovation and Pharma's needs to partner with the digital health startups in the digital health community. And, you know, when COVID started, Roche Canada actually launched an Innovation Challenge in specifically COVID-19 innovations. And I think also just because we've got fewer conferences and meetups, the challenges that can be run online are going to be even more important. And I think we'll see more and more non-COVID-19 innovation challenges through the rest of this year and next year.

Andrew Kris:

We're getting quite a few questions in concerning the regulators and their work with the health insurance sector, for example. I mean, how do you see that? You've been involved on both sides of that. Do you see that changing as a consequence of what's happening today? In terms of relationship between the insurance and digital health regulators?

Naomi Fried:

So it's a good question. I don't think the payers, the insurance companies, do anything too quickly. I think they're a very measured and thoughtful and careful industry. I think, again, like so many other parts of the healthcare ecosystem, there's been a little bit of an awakening around the opportunity for certain digital health solutions. But I think what we're still seeing pretty consistently with our payers is that they want to see the data, they want to see the value before they're willing to pay for these new ideas. I think unless we see, you know, regulatory change requiring things such as telehealth visits, telehealth is being covered, that we're not going to see a lot of speed and radical changes in the way the payers approach the telehealth and the digital health industry at large. But I do think that with the FDA involved, and as more digital health solutions get regulatory approval, and it's harder for the payer to not embrace these types of solutions. Because remember, in order to get FDA approval, you actually need data. And so these companies that are getting approval have demonstrated data that they have impacted, they're safe, that they're efficacious. And so they really are in a position to work with the payers, because they do have a complete data story. And I think this is one piece of advice that I give a lot of digital health startups is you actually need data too and you're going to need to spend that time doing validation, potentially doing your own clinical trials, it won't be as long or as rigorous as a drug, but you really should have the data. There's not a lot of tolerance now in the industry for sort of hype and fluff, people want solutions that have been demonstrated to deliver value.

Andrew Kris:

Indeed, and when you see the complete reliance on data, in order to develop some of these applications, there's no choice. They really do have to invest in getting that collection data. So a couple of interesting things. There's been, really, hype over the last period of looking at innovation challenges now, and we see a lot coming from the non obvious places, perhaps like alphabet and Microsoft, Amazon, and Apple, all the heavy guys getting involved in this space as well. How do you see the innovation challenges, you know, the big tech giants together with the pharmaceutical industry? How do you see that coming? You mentioned the Eli Lilly as somebody you were thinking about earlier on. How does it all fit together?

Naomi Fried:

Yeah, so great question. I am really excited about the opportunity, the innovation challenges and hackathons generally provide for large organizations to connect with the innovation and startup community. And you know, Andrew, my firm specializes in open innovation challenges and hackathons for the pharmaceutical industry. We help biotech and pharma use challenges to connect with the ecosystem, while maintaining compliance in the unique regulatory environment of these companies. There's a lot of constraints on the drug development industry. And we're actually currently assisting Eli Lilly with their latest innovation challenge, which is to find solutions to enhance the quality of life for people living with atopic dermatitis or eczema. Atopic dermatitis is a pretty unpleasant disease. It's a chronic condition that actually affects 10% of children in the US, and in the US., 16 million adults don't outgrow their pediatric atopic dermatitis. And the thing about it is, you know, the pain, the itch, the discomfort from this inflammatory skin disease can be very disruptive to a person's life. People lose sleep, they don't go to work or school, they can become depressed. And so we are actually honored to be helping Lilly connect with this digital health ecosystem to find digital health innovations, whether it's in the idea, or prototype, or pre commercial stage to address the quality of life challenges that people face with atopic dermatitis. And to sweeten the pot, Lilly is offering $50,000 to the best idea. But what I think is also really exciting is they're also offering a chance to partner with the winner to help them further develop and commercialize the idea. Not a lot of time left, about two weeks, the challenge is closing on the 21st. And I'm excited to see what gets submitted to the pitch event that will be later this year where the winner will be selected.

Andrew Kris:

These things are not always recognized. But there's successes there and some interesting innovation comes. I'm looking back at the whole impact of COVID-19 on the health care systems, you know, what do you see as the innovations are helping us to address the pandemic? What struck you and has come out strongest in that direction?

Naomi Fried:

Yeah, so I think innovation has a really important role to play in helping us address COVID-19 and, you know, Andrew, I have been championing healthcare for a very long time from Kaiser, through Boston Children's, to Biogen. And I frankly believe that innovation is more important now than ever. We are facing an unprecedented threat from this pandemic. And for many of us, this is the first real public health crisis that we're living through that requires not just new solutions, but also new ways of living. And I think that, you know, innovation will ultimately be, will rescue us from this pandemic. We will be able to get back to normal life, whether it's eating and gathering the ways we used to, having meetings and conferences, traveling safely again, because of what innovation is going to bring. And I think that, you know, we need to embrace innovation. It is going to be the path that's going to help us sort of figure out new ways to detect COVID-19, new ways to interact with each other in a safe and socially distant way. And ultimately, innovation is going to provide treatments after COVID-19. And, you know, the much, much wished for vaccine is going to be an innovation. You know, and innovation has been driving change in healthcare. We've talked about telehealth, we talked about delivery tools. But I think one thing I'll say about innovation is, you know, it is the process of trying new things when you don't know if they'll succeed or not. And so it's important for people to realize that innovation also comes with risk. And innovation is actually about taking risk. And there's going to be no reward from innovation, if there's no risk involved. And if you know what you're going to do is going to succeed, then by definition, it's not innovation. So I sort of see, I feel like we're going through a global lesson right now, Andrew, in the appreciation for the power of innovation, and the need to take and be comfortable with risk. I see this as an amazing learning opportunity for the whole world about the value of innovation and what it can bring to our lives. And really, the power that innovation has to change the world for better. So I'm excited and optimistic about the innovation impact.

Andrew Kris:

That's very clear and obviously, you have good reason to be, you're really experienced in that area. And we'd all like to think that there's some more, let's call them mundane areas, things like track and trace. That is clearly not something which is going on in the US for obvious privacy and anti cultural reasons. But it's been tried in many countries. How do you feel about the success of some of these, because it strikes me that some of the people will be involved in that. And I, obviously examples in my homeland, which has been pretty, pretty poor examples of how not to build digital systems in the health care area. But then how do you feel about track and trace in general? How effective is that? Is that something you'd consider innovative?

Naomi Fried:

So again, anything that's new that hasn't been tried is innovative. I think track and trace is a very important tool in combating COVID-19. And as you've said, it's not something that we've been able to really do here in the US because of cultural reasons. So I think that that's one issue that when you come forward with new innovation, it has to actually work in the organization or ecosystem or society that you want to introduce it to. And I can't emphasize enough how important culture is in the successful transformation and leveraging of new innovative ideas. I think that's one sort of lesson we're seeing from track and trace, which could be hugely impactful. And we look at countries like South Korea, where they're using it very effectively and have been able to not close down their restaurants. And people go about their business because they have a very effective track and trace system that actually works for them, but won't work in the US because culturally, people are not comfortable with government having that level of information and being able to follow them. I think the other big lesson, Andrew, from track and trace, and this really connects with what you just alluded to about sort of some of the big failures, when trying to take it to scale immediately is that innovations need to start in the pilot form, they need to start small, you need to test, optimize, improve, before you try to scale. And I think that's one of the problems that was faced when large tech companies, you know, rushed out and tried to immediately, broadly deploy their track and trace problems. You have to get the bugs out, you have to follow the innovation lifecycle, you have to ideate, you know, and then you have to test what you're doing on a smaller scale. And I understand completely that in the face of global pandemic, people want to go to scale immediately. But this is a lesson that innovators learn over and over and over again, test and pilot, and you know, learn from that before you try to operationalize and optimize at scale.

Andrew Kris:

In that same question. One of the questions that came up earlier on from our lively audience, I don't think we've had a session with so many questions, so we're obviously triggering a lot of thinking here. I mean, one of the things that really came up was, is digital health only for developed economies?

Naomi Fried:

Yeah, so I would say absolutely not. And what's been really interesting, even very early on, was to see that in the developing world, where folks don't have a lot of, you know, infrastructure, what many people still have today is a mobile phone. And those mobile phones are gateways to using digital health. And so they are being leveraged to deliver care in remote villages, people are using them for, you know, connecting with doctors, learning more about conditions. So it doesn't take a huge technology infrastructure to have a successful digital health deployment. Again, this goes back to understanding your environment, understanding the ecosystem, understanding the culture, and then building something that fits in that environment. So I think there's the potential for digital health to transform healthcare delivery around the globe in all sorts of different and very exciting

Andrew Kris:

And I think ideally, I think there'll be ways. some parallels, for example, in payment systems where they're most. Do you think that this whole digital health area, this revolution, is going to change the rules of the game for insurance companies, for example?

Naomi Fried:

So I think insurance companies want to, they want to be involved with innovation. And here in the US, certainly we have some that have innovation arms, they've been funding venture groups to try to find more innovation. So I think they are very much engaged in the innovation game. I think, in that sense, they're leading I think, in other areas, they will be brought along, again, as value is demonstrated and digital health solutions are approved by, in the US the FDA, they will come around to supporting those. So I think that they're very much players. And then I think there's also the opportunity around regulation that will drive innovation to the payers. And this is an area where we're happily seeing some change in the US, we're starting to get some regulations on the books that are requiring telehealth support from the payers. Historically, and I've been very involved with this, you know, the payers have, it's been an optional activity whether or not to cover telehealth. Some payers have embraced telehealth, others have taken much more of a 'wait and see' approach. But when it becomes a regulatory requirement that telehealth must be reimbursed or must be provided, then they'll absolutely get in the game. So I think, you know, we see things at all different stages with the payers, we see them active in their own way, we see them watching and waiting and working on what the FDA is requiring. And then we see sort of the areas where they are being pushed and propelled and required to embrace digital health innovation.

Andrew Kris:

A long way to go, still I see, but it's obviously an appropriate reflection going on. A big question underlying all this, and we've got a little bit of an elephant in the room, in terms of data protection and personal data that's going to be flying around the world in digital health. How do you feel about that? Are people tackling that as a component to the work you're doing?

Naomi Fried:

Yeah, so any, you know, smart digital health starter that wants to get going has to be aware of these requirements around privacy. We've been in the US, again, working under the HIPAA regulations for many years in terms of who can access data and who can see information about a patient. So this is, HIPAA, and privacy and data security issues sort of provide guardrails around which any digital health startup needs to be working. I think where there's challenges is if you're a company and you're already up and running, and we're seeing changes in regulations, so you know, the arrival of GDPR, now in California, CCPA. These are new, relatively new, requirements and so, you know, this is causing existing digital health companies to need to re-examine their process. I think by and large, people do go in though thinking that privacy is important, data security is important, and they do try to build their solutions with those needs in mind from the beginning.

Andrew Kris:

And some are majoring on the fact that there's is the most secure solution, in that context. This is wonderful stuff, Naomi, I mean, really just seeing the number of questions coming up during the session, but I would love to hear a little more about your latest venture with Health Innovation Strategies. Being mindful of a little bit of confidentiality of working with your clients, what's keeping you busy there? What are you up to?

Naomi Fried:

Sure. So, thanks for that question. We are working with clients on building digital health programs. And the thing about digital health program, Andrew, is we're talking about fundamentally building an innovation program. And so as with any innovation program, we tried to help our clients sort of establish the key areas they need to set up. And so that means helping them think about innovation, or digital health, as more than just technology. But they actually, they need to think about how will that technology be adopted? And what is the sustainability of the these new innovations? And as I alluded to earlier, culture is also important. And so when you're working on digital health programs, we're really trying to often drive a culture of transformation, in and around that innovation. So we are helping our clients establish programs that, of course, can support the adoption of these new digital health technologies. But we're also finding that we need to assist with the socialization of digital health within large organizations, particularly pharma, but also providers. And that's really to bring people along on this digital health adventure. So it's not just about setting up resources to ensure success of these digital health programs. But it's also around communicating and educating about what these new functions are and why they're so important to these companies. And what I also try to remind people is, when you're building an innovation program, you should also celebrate your successes. So you know, at Health Innovation Strategies, we're focused on the strategy that underlies successful digital health programs, and broader healthcare innovation programs. And then we also are very involved in supporting the execution and reduction to practice of digital health and innovation programs. And also, digital health activities, as I mentioned, such as innovation challenges, and hackathons.

Andrew Kris:

Sounds like you've got your days pretty full.

Naomi Fried:

It's fun work.

Andrew Kris:

Very clearly. We have a couple more minutes to go there. Just one question that was on my mind when listening to talking now. You've had such a wonderful career, and you've got a long, long way to go on Health Innovation Strategies. It's something you would have done differently coming through the last years?

Naomi Fried:

Yeah, that's a great question. So I think, Andrew, that, you know, I didn't realize, I think when I was at Kaiser, or even a Boston Children's Hospital, how important my experiences and learnings were at the time and how much other people would sort of benefit from understanding what it takes to build digital health programs and to drive a culture that adopts and appreciates innovation. So I think what I wish I had done is kept a diary, written down more what was going on, recorded more of those learnings and had sort of that all to sort of share now, as I'm working with, you know, my clients, I'm certainly, you know, I can remember what I can remember, and I'm sharing as much as I can, that I've learned, but I feel like there were even more nuances that looking back I wish I had captured. So this is my advice to innovators, you know, take a minute to record what you're doing. You know, at a minimum, you will enjoy coming back and looking at it but at a maximum, you may be able to share with others. And I do think that sharing is so important for the innovation community and the digital health community at large.

Andrew Kris:

Well, we suddenly all have a lot to learn from the work that you and your clients are doing. And all we can do is to keep our fingers crossed that all of these wonderful innovations they're bringing on are going to be of the benefit that we all hope for, particularly in the current times. I also want to say a very special thank you to Naomi for taking the time to share all this with us. We have a whole bunch of questions and I'm going to give your email address out in a moment to make sure that whoever wants to continue the conversation can do so directly with you. On behalf of Borderless Live, I would like to say a special thank you to you. Thanks to our producer for bringing us here. And thanks to all of you who are a part of our audience, who should continue to progress in your work. And looking forward to seeing you back here again. We have all the details coming on Live. Please come back to us another day on another important topic. In the meantime, special thanks once again to Naomi. Thanks for joining us.

Naomi Fried:

Thank you, Andrew.