HLTH Europe 2024: AI, Patients, Women's health, and more

[00:00:00] Dear listeners, welcome to Faces of Digital Health, a podcast about digital health and how healthcare systems around the world adopt technology. With me, Tjasa Zajc. If you ever want to go to a healthcare innovation conference that doesn't shy away from potentially controversial topics,

[00:00:24] Health or HLTH is your place to go. In June 2024, the conference which attracts 12,000 people in the US came to Europe for the first time. One of the panels on the main stage was focused on the state of psychedelics in medicine in Europe.

[00:00:44] At the center of the exhibition hall stood the heart stage, focused on topics related to women's health. Around it were the exhibitor booths and other stages, each designed with a different theme, each like a theater setup that made speakers feel like stars.

[00:01:04] Why do people love going to health? Because it's focused on the experience of the attendees in a quote-unquote a little extra way. The ticket includes meals, music, there were a massage and a hair salon in the middle of the exhibition floor.

[00:01:23] There were lots of evening networking events from more formal but still unusual ones such as the Phillips reception in a museum to the closing evening that also included a concert by the Libertines. When the experience is good and festival-like, it attracts people.

[00:01:43] And when people come, you very quickly attract VIPs from the industry who many hope to meet and do business with. In this episode, you will hear impressions and insights from speakers and attendees of the first Health Europe event.

[00:02:00] You will hear about partnerships and investment in Europe, women's health, how to access the German market, what companies don't understand about patient engagement and where we currently are with AI in healthcare.

[00:02:16] Enjoy the show and if you haven't yet, make sure to subscribe to the podcast and also our newsletter which you can find at fodh.substack.com. The summary of health insights will also be available there. Now let's dive in.

[00:02:38] Since it's the hottest topic at the moment, let's start with AI in healthcare. The hype around generative AI is settling down in 2024 but AI more broadly is still the key topic. For example, Mayo Clinic in the US uses around 250 algorithms.

[00:03:14] These are the use cases as explained by John Halemka, president of the Mayo Clinic platform. About half are administrative in nature. Supply chain, revenue cycle, workflow enhancement, staff augmentation. Then we go into fields like cardiology, early diagnosis of disease, prediction of cancer, assessment of neurology

[00:03:36] like Parkinsonism or other neuromuscular diseases, radiation oncology, planning treatment. So you've got a whole variety of clinical use cases but that's predictive AI. In the world of generative AI, such things as summarizing a record, writing a discharge summary, helping with nursing notes,

[00:03:56] helping interpret genomes and one speculative early project is can we predict a patient's journey? Looking at hundreds of millions of patients and every event in their lives, what's next for you? Do you need a lab test, a visit, a surgery? We're just starting on that journey.

[00:04:17] At the end of 2023, the quick question around generative AI was how can we best regulate technology which produces different outputs which each prompt. By June 2024, ITS are on the horizon. GDPR is not a restriction to the secondary use of data. It tells us how.

[00:04:39] The EUA law doesn't prohibit the use of AI. It gives us guardrails and guidelines. So I would say certainly Europe is moving fast. The US is innovating quickly with technology and there have been several regulatory and non-regulatory approaches to building guidance around AI

[00:05:00] like the Coalition for Help AI. I think our job, because no one has the right answer, is to just work together. If anything, my job is about building the togetherness.

[00:05:13] You often emphasize or I heard you say at Health in Las Vegas that when it comes to generative AI which has been all the hype in the last 12 months, the challenge is that when the output is different every time,

[00:05:26] how do you actually regulate that? What's new in this field? So in the field of figuring out what's the best way to regulate and regulate generative AI in healthcare. Right, well two approaches. First we know it's going to have hallucinations, it's going to have...

[00:05:43] some answer is not so good. So what's the risk? So imagine that we decide on a use case. The summary of your historical record so I can read it more easily. Okay, if it's inaccurate, it's probably not going to do a huge amount of harm.

[00:05:58] If on the other hand we say generative AI, decide on your treatment plan, that could do real harm. So first issue is look at the risks of every use case and go forward with those administrative low risk high yield use cases

[00:06:12] and that's happening now. Second, we're going to need a credibility score because it may very well be as we said one moment the answer is brilliant, the next moment the answer is horrible.

[00:06:23] So you need to assign a numeric credibility score because if the answer is bad then another prompt might be in order and companies are starting to build credibility measures, quality measures for generative AI. By the end of 2023 2% of all digital health ventures were using generative AI.

[00:06:43] Much more were using some form of AI. The analytics company Gallon Growth presented the current trends in partnerships and focus of digital health ventures across the globe. This is Sarah Schmachstenberg, digital health venture expert and head of data and analytics for Europe and USA at Gallon Growth

[00:07:03] talking about these trends. Telemedicine is being a lot driven by the development of AI and the more acceptance and the trust being built between physicians health systems and AI and bring that actually into their telemedicine practices.

[00:07:20] But as well the health management systems right this is where we see a lot of money going into ventures in health management systems for EHR purposes, clinical note taking and there's going to be a saturation at some point of the partnership

[00:07:33] so it'll be interesting to follow in 2024 the health management solutions and if we see that plateau or not and that money then going into what you mentioned telemedicine.

[00:07:41] What's your kind of expert observation or opinion about the trends that you see in Europe in terms of the investments of health care systems? For example a lot of money has been put into health care digitalization as part of the EU resilience funding

[00:07:56] but now that funding is going to run out so some experts in the field are wondering how are health care systems or just health care providers going to embed funding for digital innovation in their existing budgets?

[00:08:10] That's a very good question because we do see a lot more activity in the European health systems going into the research and medical diagnostics and not actually into the healthcare management systems right the EHR systems.

[00:08:24] That money does run out then they're going to have to really scramble we heard from the NHS that they were having problems with the implementation of such systems just because the incentives are different in Europe than they are in the US.

[00:08:35] So definitely something to keep in mind and to look into 2024 what happens there. We do see is just there's a difference in the attitudes and what where the AI is being implemented especially in Europe

[00:08:48] and that's really medical diagnostics. Europe is known to be a very, very let's say strong in medical diagnostics and areas that require a lot of clinical evidence and a lot of research. Fantastic but leads to questions when it comes to health management solutions and those types of areas.

[00:09:04] Where do you see AI at the moment? What are your observations in this regard? Yeah, that 2% is Gen AI. When you look at AI you're close to half I think it's 56%.

[00:09:15] Absolutely we're hopefully we're over the high perv of Gen AI because last year everyone wanted to talk about it right.

[00:09:22] There's a lot of incredible potential in that area. It's still very small people have to build confidence and they have to use it in wise ways in responsible ways as well.

[00:09:33] Let's see the future it will continue to grow right obviously and the tech companies big tech coming into digital health that will as well help to develop the ecosystem a lot

[00:09:44] and there's a really big difference in Europe. There aren't that many big tech companies in Europe right. All the big companies to big tech companies are Asia Pacific and the US

[00:09:52] so there we see a big gap in Europe as to where who do these European ventures partner with right. AWS web services or cloud services are a different story but when you're talking about actual partnerships for algorithms and stuff like that

[00:10:06] it'll be interesting to see who the big European tech champion will be for that area. For Simon Philip Roth chief marketing officer at GE Healthcare insightful topics at the event included patient engagement and what healthcare can learn from industries such as FinTech.

[00:10:27] From here big topic here has been around patient engagement all of these things like patient portals even using gamification to get more patient centric at the end.

[00:10:38] One of the biggest things that I didn't hear so much in the last conferences. The second big thing is generally I'm Jennifer I now our case computer vision is a big one to help to increase quality at the end

[00:10:49] and make more informed decisions. A second one especially for Jennifer I is taking out the redundant tasks reporting there will be likely a big play for that. I think it will ultimately help healthcare professionals to go from customization to personalization.

[00:11:05] I was in a session about what we can learn from the FinTech sector as a healthcare sector and their big takeaways that they are way better in personalizing the offer at the end to the customer and this we can surely take over also in the healthcare sector.

[00:11:23] When it comes to patient feedback the best thing to do is ask patients for opinion and ask them early says Jen Horonjev Phd founder and CEO of Savvy cooperative. Too often companies come to patients when the tools and digital solutions are already finalized and changes aren't possible anymore.

[00:11:45] This is what Jen and Ronny Sharpie co-founder and CEO at Savvy cooperative advice to innovators. And what we unfortunately still sometimes see is a fully baked product or idea or service that can be changed.

[00:12:00] And so when they come to patients and they say what do you think do you like this and patient say no this doesn't work for me we can't change it now it's too late.

[00:12:09] And so we always encourage companies don't use patient engagement for patients feedback as a checkbox for really come into that session or come into patient engagement with an open mind that you could get feedback that is counter to what you already believe and have the ability to iterate

[00:12:28] and actually co-design your solution with patients or that managed product actually being built with them and not just quote for them. I want to pick your brain on something else. The Gallon growth team presented some results about who digital health company is partnered with.

[00:12:44] 26% is with pharma another 20% with healthcare providers or health systems.

[00:12:49] And what I'm observing is that pharma can very quickly give up on digital health solution he doesn't work in a year or two then they give up which is quite different to the drug development which takes 10 or more years.

[00:13:02] How do you see the collaboration between digital health and pharma where do you see the room for improvement and what are the mistakes potentially in the mindset on how fast these solutions can scale.

[00:13:14] When we think about how you're getting patient engagement to inform drug development hopefully it's initially looking at what outcomes at endpoints are most important to patients including those in your clinical trials and then iterating on that patient experience throughout the trial and commercialization.

[00:13:29] When we think about digital health you also want to get feedback on what gap that sort of tool help to support the patient in their journey.

[00:13:38] But this is where that sort of mindset that like doctor knows best or this is best and trying to just then push a tool onto patients.

[00:13:47] We saw a lot of this during the pandemic when the environment and the digital health space blew up and people are just throwing more and more virtual tools at patients. There's no reason during the pandemic but they weren't necessarily co-designed with patients.

[00:13:59] Patients now have a lot of different digital tools are they interacting together if somebody now has to use five separate tools that don't talk to each other.

[00:14:07] That can be really frustrating for a patient that has additional burden to them so it's not just about your tool it's about where does it fit not just with the drug but also with the other types of tools and devices that patients may be using thinking about do they have access to the data.

[00:14:22] That's always something that we hear but we can't give them the data but it's really important that the patients have access to it because a lot of them are tracking using different tools.

[00:14:32] Thinking about sort of the tolerance of how long it takes for these things to develop and the iteration process what's interesting with digital tools is because you can see the data the usage data.

[00:14:43] You can see if it's something that's engaging or not and then people may be more apt to say it doesn't look like people are using it and then drop it off and say this was a failed attempt rather than saying they're not using it how we made it.

[00:14:56] Maybe it's time to now talk to our users and work with them just like other sectors do when they create new products and services. What are we missing here?

[00:15:04] So that's really where we need to think more about how can we iterate on it when with a drug you're not really iterating on the molecules so much but with a digital tool. There's a lot of opportunities.

[00:15:16] Christof Jacquet is an author and professional keynote speaker on how businesses and technology shape a healthier, happier and more sustainable future. As he observes we're in the era of transformation where people expect more from healthcare and businesses.

[00:15:32] To cater these expectations healthcare and businesses should understand and focus on people's life aspirations. He mentions and explains several of them in his new book but in this short statement he explained five. Energy, avoiding stress, nothingness, solidarity and acceptance.

[00:15:57] I look at how people have evolved in recent years and what is that there's an enormous focus on transforming things. By things I mean transforming myself, transforming society, transforming the planets, sustainability things and all that.

[00:16:12] And because of the fact that people are looking for those transformations they are requesting the same thing from businesses, any type of business.

[00:16:20] And definitely also in healthcare is that patients want to have this form of transformations and they're asking from the healthcare industry not just to focus on a solution, a product or a service

[00:16:33] but to go one step beyond and think about experiences and even one step further which is related to transformation. It's the basic business logic of going from product to service to experience the transformations, that's how you create value. How can you move into transformations?

[00:16:50] And for that you need to take into account the aspirations in life. And the aspirations in life of people the way that I describe it it's the level below health and happiness. It's making health and happiness more concrete.

[00:17:03] Because if I ask you what is health and happiness it's very fluffy, right? And so I have 24 different aspirations that can help the healthcare industry to really understand how they can create better value for their patient.

[00:17:16] So one that has always been around and is not going away is energy. So people want to be energetic, they want to have energy. It's one of the most asked questions to pharmacists for example.

[00:17:26] A pharmacist has to deal with patients saying, well people in general not even patients. I don't feel that energetic. Give me something that gives me a little bit more energy. A second one that is very recognizable is avoiding stress.

[00:17:38] Because people have a lot of stress with a lot going on. The third one might be nothingness. It comes in close to having less stress. But the thing is that we're very much overwhelmed with notifications and there's a lot happening around us.

[00:17:52] And we are not used to doing nothing, seeing nothing, hearing nothing. And more and more in various industries is that people try to provide those nothingness moments. Silent trains, silent caps. You are ready to pay more to have this knock on us.

[00:18:08] I think others are related to solidarity. It's a bit of the reason why the society is so polarized. But what we see is that we try to find groups that have the same interests, the same opinion as we do.

[00:18:21] And I'm finally one that I really like and I'm not quite sure whether it's already growing but it's one that I always say to any healthcare stakeholder is that it's related to accepting.

[00:18:31] Because very often if we talk to patients for example, we tend to speak to them as warriors. You need to bite and you need to survive and you need to whatever. But very often majority of the patients have not even accepted their disease yet.

[00:18:45] So the way that we approach patients and the way that we talk to patients we need to take into account at what phase are they, what is their aspiration in life. Is it really to pights or do you just want to accept the way things are?

[00:18:56] Because otherwise we'll have to deal with patients that we call non-adherent or non-motivated but actually they are perhaps in a certain phase and we don't approach them in the right way. One of the topics that stood out to many people at the conference was women's health.

[00:19:11] This term refers to conditions that affect only women such as menstruation, ovulation, menopause and pregnancy but also conditions that affect women disproportionately such as migraines, dementia 66% of patients with Alzheimer's disease are women or autoimmune diseases 80% of patients with autoimmune diseases are women

[00:19:36] or conditions that affect men and women differently such as cardiovascular diseases As one of the speakers on the main stage said women's health is not a niche topic 55% of the population is not a niche Therefore investing in women's health is not quote unquote a good thing to do

[00:19:59] it's actually a smart thing to do We still have a lot of clarity to bring to the space This is a statement of Dority Maria-Louise Dupfer, deputy head of digital labs and program manager of digital health accelerator at the Berlin Institute of Health at Charité about women's health

[00:20:20] She also chaired a pre-conference session on the German market and shared a few of her insights in this short statement One of the leading women's health from the UK elderly lady shared she's not happy with the focus of women's health

[00:20:36] She said like too much focus is on maternity health and menopause but if you're lucky maternity is nine months or four times nine months that is only a short amount of time in the life of women Why is everything focusing on this and menopause?

[00:20:52] She said it's only a few years Women's health should shift to all the other areas of 80 years of life of women and should get broader You also chaired the session on the German market

[00:21:04] How did that go? What were the key points that you emphasized around the German market and what were the key questions that you got from the audience So it was a very crowded session, the workshop went super well

[00:21:16] Although we as Germans really started laughing because we were like oh my god we are not positive enough we need to advertise our market more but we learned the startups were really embracing that we were so honest that the German market is an interesting market

[00:21:30] but it's not an easy market and we gave them the advice to hire a quota German because you need a German speaker if you would like to reimbursement in the German systems and choose wisely which reimbursement path you want to take because it's not so easy

[00:21:46] I explained again why you need to have German data to make it work on the market and always do your homework, nothing as fast in Germany lots of biocracy but I learned from other countries as well like from the Netherlands for example where everything is much faster

[00:22:02] it's almost the same you need to learn the language or you have to have someone in the team who speaks the language and it's a long path When you say long how would you define that? Is it a few weeks, few months, few years?

[00:22:14] It's a few years, even with the DIGA path which sounds on paper pretty good it takes a while and you need to show preliminary data they need to answer it's nevertheless than one and a half years even for preliminary DIGA

[00:22:27] we tried to tell the insights what we learned, what's working, what's not working about pricing models we talked as well and the startups were quite surprised what they could expect and renegotiating pricing models was for example a question we went into death as well

[00:22:44] How successful are the German companies in renegotiating their prices for DIGAs? So far if they don't have an HTA that is pretty hard but we gave them advice if you think with your data you have it's worse to re-negotiate the price then put effort in

[00:23:04] execute a HTA, health technology assessment show that your technology is superior over the therapy that's already in the market and then they have to consider it because you show more value for the health care system so that was the advice we gave them

[00:23:18] so far we don't know of any but I think it's coming if you show value You've been listening to Faces of Digital Health a proud member of the Health Podcast Network If you enjoyed the show do leave a rating or review wherever you get your podcast

[00:23:34] subscribe to the show or follow us on LinkedIn Additionally check out our newsletter you can find it at fodh.substack.com that's fodh.substack.com Stay tuned!