We continue our exploration mission into the American healthcare system, and today’s guest is going to bring more insights into how technological innovations are being adopted here. So we’re happy to introduce Yatin Patil — CEO of Doctors for Health Innovation.
Yatin Patil: “I came to the US from India in 2005. I did some research here before working at GBMC — Greater Baltimore Medical Center. Then I began my career in hospital medicine with Apogee Physicians — it’s a nationwide hospitalist group. In 2013 I moved to New Jersey (where my future wife lived) continuing to work with Apogee, and then later on I transitioned to their travel team as an implementing program director: I helped them launch new hospice programs or turn around existing hospitalist ones. I did that for another five years, but when COVID happened it was difficult to travel so much. So I switched to working with a local group, which was a traditional dental medicine practice. Then I also started working as a physician advisor with one of the project hospitals in South Philadelphia, so I did that for a couple of years. At the end of last year, I transitioned to working as a remote physician advisor for Sound Physicians. My work with healthcare startups started a while ago.”
Originally Yatin used to invest in startups outside of healthcare as well. He used to go to different conferences, and there were a lot of cool healthcare startups with good solutions that got him excited as a clinician, who was facing all kinds of different problems day in day. But two or three years later those solutions weren’t in practice, and it was very frustrating to him. With his colleagues, they started getting involved in supporting some companies and their services as an angel investing group. They created a chat on WhatsApp, which has grown to almost 50 physicians. Coordinating with so many people in such a way was a little difficult. Yatin suggested having a more structured way of doing the interaction between physicians and healthcare startups. And that’s how the concept of “Doctors for Health Innovation” came about.
Yatin Patil: “We started with the venture capital fund. After that experience with the WhatsApp group, it was difficult for clinicians to have much time to understand the opportunity. With the VC fund, it’s a lot easier: they just have to decide if they want to invest in the fund or not — and then we take care of the investing part. They can choose how involved they want to be: if they want to be hands-on, get involved with the company, try out the product, help to develop the product, or work in an advisory role there. One of the things we realized was a big barrier to entry for most physicians into the VC world. The traditional VC funds require you to put down somewhere between 250 to 500,000 per limited partner, and that’s a big amount of money for most family physicians — they make some money but not that kind of. We did a micro VC fund and kept our minimums at 25,000, which is much more doable for most physicians. If they want to invest more, they are always welcome to invest at a later point. The whole goal for us was to lower the barriers for physicians to get involved in this process. Clinicians mustn’t be just limited to physicians, and we have some non-physician-limited partners as well. People within healthcare must get involved in supporting these companies and these innovations. Otherwise a lot of times there are good companies, and good solutions out there, but either for lack of adoption or eventually, for lack of funding, they don’t make it. I look at it as impact investing for physicians or healthcare people, because this is something that will impact the lives of your patients, it will also impact your own personal and professional lives.”
Describing the US healthcare system as adopting technology, Yatin says it’s slow. A lot of HealthTech companies are started by people who have more of a technical background rather than a healthcare one. The system has certainly a lot of complexities.
Yatin Patil: “If you are in any other part of this world, it’s very easy to figure out who is going to be paying and who your customer is. Here it can be quite complex even to understand that piece, and even if you know that, it is a little bit of a challenge to get them to pay. It’s not as easy as showing that this is helping patients. It’s not enough: so many things need to be done. I’d say it’s not conducive in some ways: a lot of companies don’t make it because of the complexity of the system we have. Nonetheless, there’s still a lot of innovation happening. When I went to the recent HIMSS conference, almost 40,000 people were attending (that’s like a small city). The challenging question is also who you support and what innovation makes sense. That’s why it’s important to have people within healthcare involved when you’re developing these solutions to make sure they are meaningful and bringing real value to healthcare.”
In Alex’s opinion, hospitals in the US are not interested in adopting technology as opposed to insurance companies and patients, but Yatin thinks it’s just challenging for them. There’s little motivation on their part to be changing things around. The other thing is they have to be careful not to make changes that are not sound: “You want to make sure whatever technology you’re integrating is secure, HIPAA-compliant, you need to understand what they are going to do with the patient data, that’s another concern. Beyond that you have to do a lot of training, you may have to change even some of your hardware components if you’re integrating new technology. Then you have to invest resources not just time but money. Sometimes when you change EMR, for example, you have to train the entire staff, everyone needs to get trained on that system. That’s a huge undertaking for a lot of healthcare systems.”
Then our guest deals with some examples of tech solutions that are now widely used in healthcare throughout the country that weren’t there 5 or 10 years ago. The quality of EMRs has become better in some respects, they also have increased in complexity. One of the other things is an acceleration in the adoption of telehealth. Before COVID it wasn’t so widespread. Even patients were kind of leery of doing telemedicine. The same thing with physicians: it was a sort of an unknown. With COVID, there was no alternative, so both patients and physicians adopted this technology; now a lot of people have realized that it’s quite convenient, but there are still bad problems with access to care in rural areas with bad Wi-Fi connections.
The whole movement of providing care at home has also taken off with a hospital-at-home model and home-based primary care where physicians are doing home visits. Can it become a new normal for some percentage of patients? Yatin thinks so, particularly for the patients who find it very challenging to do in-person visits. It’s not unheard of, even before COVID happened. A lot of patients cannot walk or get around, they may have amputations, wounds, strokes, and all kinds of complications. It may get very complicated and risky to move the person, put them in a different environment, and have them travel back and forth. To some extent, it may be unnecessary: “Sometimes you have to see the person in real life, you have to examine things and that’s completely fine. In those situations, I think it will make a real impact having the ability to see the person at home so you’re doing an in-person visit, but beyond that even understanding their home environment is crucial, and that’s the real change. There’s been a focus on social determinants of health: it’s not just enough to prescribe a medication or prescribe a treatment and assume that that’s gonna just go smoothly because that’s not what happens. You could give a patient a prescription, they go home and then somehow they still don’t take the medication and there’s plenty of reasons that might happen. Maybe they don’t have family members or a support system. It might be someone who has dementia. When you go to the home, you understand what the individual’s challenges are. And that’s very difficult to gauge from sitting in a clinic or in a hospital never stepping into their environment.”
Returning to Doctors for Health Innovation, they’ve invested in four medical device companies. One of the device companies they’ve invested in is a mobile device called CardioScreen: it’s in use in 18-plus countries across the world with partnerships with major players within the device industry. They got FDA clearance in 2020 so Yatin is working with them as a medical director helping with go-to-market strategy. One of the other devices is a pre-FDA-staged handheld EEG pen. Another device is actually EEG-based but it’s to detect large vessel occlusion stroke in the field and it will impact greatly the care provided to the patients. Another company is the obesity treatment platform: they’ve been pitching to academic institutions and recently got a contract with the Connecticut state government.
The whole idea of Doctors to Health Innovation wasn’t to invest but to work with the companies and support them in any manner: “I love making connections, helping them, introducing them to other people or companies that might be relevant. Investing in a certain amount of companies is just a small section but if you want to change the bigger picture you need to have a wider impact beyond just the investment, especially in healthcare. You need at least one healthcare person there to give you some insight on what might be the challenges and what are the things you should look for as you’re developing the solution and going to market. It’s really important!”
Here are some other recommendations to startup founders in digital health and MedTech: “One of the most crucial is to have people within healthcare involved right from the get-go, whatever device, service, or product you’re developing. Once you’ve developed the product, it’s a lot more difficult to go back and have to change things. The other crucial thing to understand is figuring out who your customer is. Just because someone is using the product doesn’t mean that that’s the person you’re going to sell the product to. From my perspective, especially if I’m looking at it as an investment, the question is if you’re bringing real value and if you’re somehow lowering the cost of care. If it’s something that is going to add a cost or if it’s just something that adds more demands on people who are already overworked, they don’t need one other step to add to their daily lives or a few more clicks. I think to be successful in this complex system it’s really important to have that insight from the get-go and then develop the product accordingly fully understanding who your customer is going to be, how you’re going to get paid, and what value you’re bringing to the system. If you can do those things, I think you have already a leg up on your competitors.”
Our previous episode was with Austin Lee Chiang: The Double Life: From Hospital Wards to Corporate Meetings
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