What to Expect in Digital Health in 2023? Digital Health Interviews: Aline Noizet

In our new episode of Digital Health Interviews, we had a significant chance to speak with Aline Noizet. If you’ve ever been to a conference or a meeting with Aline, this woman knows everyone and is great at making connections to progress digital health in Europe and beyond.

Introduction:

Aline Noizet: a digital health connector, passionate about innovation and connecting the right people to have an impact on patients’ lives and support healthcare professionals. She has strong international experience working with startups and helping them scale up. Her specialties are business development, innovations & trends scouting, and community building. She is a regular reviewer and judge for programs like EIT Health, SXSW pitch competitions, etc. Aline has a particular interest in DTx, personalized medicine, microbiome, and genomics.

Aline Noizet: “I define myself as a digital health connector. That’s what I do and that’s the name I gave to my company. Basically, I connect different actors in the digital health ecosystem. I worked for startups, pharma companies, investors, and vendor regulators. My focus is on startups: to help them to grow, to connect with the right actors in the ecosystem, and to make magic happen to put the innovations to the market. I believe that innovation coming from small companies can really impact a healthcare system. That’s my mission in life”

After a warm introduction especially for those who were not yet familiar with our guest, we decided to ask her about the main drivers of digital health innovations: “It really helps people to access healthcare. You can see it from different points of view. From the patients’ one, it gives access to treatment for those who wouldn’t have it otherwise. It helps people to manage their disease better. Coming to healthcare professionals, digital health solutions give them tools to establish a diagnosis sufficiently. And if we think about prevention, we have much more solutions that go where the patient is. That’s really revolutionizing! Concerning terms of education, I spoke with my friend Rafael Grossmann; he was mentioning the example of a company using AR/VR to train nurses. Instead of 3 years, they are making it in 18 months! That’s a big improvement where technologies have a great impact.”

We asked Aline to recall some vivid examples of startups, which, as she thought, had huge potential, but it never worked out for them: “There was one startup here in Spain: the team needed to do clinical validation to get some investments. But they would only gain investment after getting the clinical validation done. Investment is an issue for sure, and many companies died because of that. Sometimes companies think they have a great product. Then they go to the market — and realize they never validated their solution with actual users.” And what about no-chance startups, which eventually became successful? “When I started in digital health, I was working for a company called Doctoralia based in Spain. A few years the Doctorlib company started in France. When I saw them coming on the market I was very curious: the founders' team came from the business of booking restaurants online. During that time in Doctoralia, I was working with a French market to test if doctors will be willing to use our platform. My conclusion was that France was not ready for changes. And Doctorlib just proposed to call an operator to book an appointment for different doctors. For me, it was too new and unclear, but Doctorlib is a unicorn today. They have done a great job and educated healthcare professionals using their knowledge and expertise in booking systems to enter the new ecosystem for them.”

After that, we spoke about the main reasons startups fail in digital health. Here is the list of them with Aline’s comments.

1. Lack of feedback from potential users/patients: “It’s validating and co-creating the solution. Make sure you involve healthcare professionals and patients in the process as early as you can. We still see many companies failing because of this reason.”

2. Recruiting CMO: “I know that especially from the investment side that’s very important for an investor when he looks at the company. In my opinion, in the early days when your team is small, you should have healthcare professionals, CMOs, or psychologists (if your solution is for mental health) as a part of an advisory board. A CEO-presenter should have an important role, but may not be an actual part of your core team.”

3. Refactoring some of the outdated software: “It’s highly necessary to keep sure that you always control today’s day because technologies are going very fast. You need to be at the top of what’s happening if you want to stay competitive in the market. You also need to enhance your solution, so it can benefit from the latest technologies.”

4. Raising a round of investments: “I always advise startups: if you can bootstrap or get money on your own, it’s better than going to an investor. When you have investors on board, you lose some shares and have someone always interfering in the decision you’re making. You can resort to FFF, for example; some companies are doing some consultations on the side, and it brings them some revenues that they can use to feed the company.”

5. Promoting the solution: “First, I should be sure that I have a solution unspoken to the right people, potential customers, and patients. Once I have it, then I would worry more about the promotion of the solution.”

Then we raised a topic about Spain and Barcelona specifically for a moment and the ecosystem of digital health here: “It’s very dynamic and growing. We have two digital health hubs, so it really shows that there’s an interest. Physical hubs are really helpful to bring people together, create these energies between different actors, and attract people from the outside. When the investors are coming to town, they can just go to these two sides and meet different actors that are part of this ecosystem. There are also many different reputed hospitals, and they all have innovation centers, so many things are happening there.”

And here are the top 3 European countries by Aline Noizet, where digital health is developed better than others:

1. Finland: “For many years, there’re a lot of firms like startups and innovative solutions development companies. They are very professional concerning regulations: five years ago when we were preparing conferences and sessions about this topic, their companies were already sharing their reimbursement solutions, and they were so far ahead of the other European countries!”

2. UK: “They are keen on DOS-centered systems, really supporting innovation with nice regulations in place, reimbursement, and prescribing solutions.”

3. France: “I’m really impressed with what they are doing, and that’s amazing how they are supporting startups from the governmental side. They are working on the implementation of a DiGA-like certification system. They are also helping healthcare professionals with training and helping them to adopt digital solutions. The secret is that when the central government is pushing and injecting some money to help the companies, it really makes a big difference.”

Aline is a supporter of an idea of a single regulatory framework for the whole European Union: “There’s no interoperability between our different systems. We’re talking about super-DiGA — a harmonization process for them. Someone who receives DiGA in Germany may go to France, and this certification will be working there. When will it happen? I think it will take a lot of time, at least 10 years.”

We’ve talked a bit about current problems in the healthcare industry:

1. Regulations: “I feel it’s really a barrier. Here in Spain a few years ago telemedicine was not recognized as an option to see a patient, so many healthcare professionals weren’t doing it. Regulations will help to make things happen, especially in digital health.”

2. Integration of digital solutions into hospital/medical system: “When you approach a hospital to try to sell your solution, it’s important to show them how your solution will integrate to the system, what it means to the healthcare professionals, what they will need to do, whether it gonna be extra work for them. You should show them that it will be a seamless integration”.

3. Interoperability: “I think we’ve done a long way with that. When I started 12 years ago, we wanted to integrate Doctoralia with different solutions. Each system was in a different coding system. But today most of them are using Agile 7, it’s easier, but still, it can be a barrier.”

4. Security of patient data: “It’s important to protect the patients’ data and follow regulations in your region, but personally I’m more interested in having a solution to my problem than having my data protected. If a specialist can analyze my data so it can give some answers to the questions concerning my disease, just take it.”

5. The high cost of healthcare: “In France, people get used to having everything covered by a system, and here in Spain you need to pay for everything, so you realize the value and the cost of things. One of the issues in the healthcare industry is who will pay. When you enter the hospital, will it be reimbursed by insurance, by the healthcare system, or is it gonna be paid by the patients? That’s also another thing to take into consideration.”

Our conversation turned in the direction of investing. The pandemic gave a huge boost to digital health in terms of investments. In 2022 their number already went down a bit, but what should we expect in the nearest future? “We saw a drop in big rounds, not in small ones. I’ve been talking to many preseed and seed investors across Europe, and they all said the same: business is as usual. B&C rounds in the US were really affected. If your company is good, if the team is strong, and if there’s a solid solution, you will still find the money. Maybe, years like 2022 are ones when you can see actually the best companies are still gonna survive and find the money. From the startup point of view, the processes may take a little bit longer to close the round. But keep in mind that in 2021 and 2022 there were funds that were created to invest in digital health, so there’s a lot of money, and it should be spent! I wouldn’t worry much about digital health startups, because the money is here. You just need to be more patient. It’s possible that the expectations from the investors are gonna be a bit different, but that is what I’m always telling: do your homework, go on the website of these companies, what they are looking for, get to know them, what they expect. Everything will be within a year.”

Aline is also helping startups with creating and updating a pitch deck. So what is the most important thing investors are looking for in the pitch deck? “The team. When you are at an early stage of a startup, the team values you a lot. Make sure that you have a complementary team, diversity is also very important in it. Define well the unmet need: how you can solve the problem, what special is about you and why should I work with you. And there’s something about which the companies always forget: how much are you looking for and what are you gonna use that money for?”

The general expectations for 2023 in digital health, in Aline’s opinion, are the following: “I think Chat GPT was a big turn — there will be a before and an after. We’ll use it for different things and we will see more applications around that. My keyword for 2023 is “experience”: to focus even more on it for consumers and patients. I hope there will be more consolidation in terms of regulations. Hopefully, France will launch its own certification system this year.”

Traditionally, at the end of the interview, our guest gave some recommendations for startup founders in digital health: “Make sure that you choose a real unmet need, and identify it very well.”

Our previous episode was with Azran Osman-Rani: Preventive Care Startups Are Already Here.