In April, Jeff Hammerbacher looked around Silicon Valley and made an observation to Businessweek that spread like wildfire: “The best minds of my generation are thinking about how to make people click ads,” he said. “That sucks.”
The open innovation challenge was launched yesterday in New York City. GE and a number of venture capitalists are putting $100 million behind the challenge as part of GE’s larger billion-dollar commitment to fund cancer-related R&D over the next five years.
Tim O’Reilly moderated two panels during the launch yesterday that highlighted some of the challenges and opportunities in the fight against breast cancer. Video of the event is embedded below.
[Disclosure: Tim O'Reilly will be one of the judges in GE's investment challenge.]
A moment of convergence
While the Internet is changing healthcare, what happens next is immensely important to everyone.
“I turned to healthcare partly because I saw an immense hunger among the developers that I work with to start working on stuff that matters,” said O’Reilly at the launch.
O’Reilly noted the combination of medical data and data tools is enticing to developers. “As we’ve been hearing, there are new diagnostic technologies that are producing massive amounts of data,” he said. “And of course, crunching data and extracting meaning is something that the big Silicon Valley companies have worked to perfect. We’re at a moment of convergence and I’m fascinated by what is happening as these two worlds come together.”
Bob Kocher of VenRock cited three reasons why “cancer won’t know what happened when we’ve finished”:
- New data — “We are great at making sense out of data and we’re getting better every day,” Kocher said.
- New demand — “Thank God screening will be available to all Americans,” he said. “Hopefully, we will reach them where they are, with technologies that are more sensitive, more reliable, more pleasant, and making it more pervasive. We’ll catch cancer at a point where we can absolutely take care of it.”
- New economics — “Our health system economics are changing in ways that I think actually will foster much better treatment of patients, more reliably, with drugs that work better with fewer side effects,” Kocher said.
What’s required for innovation? Beth Comstock, senior VP and CMO at General Electric, said that a global survey by GE returned three simple truths for what’s needed: collaboration, the role of the creative individual, and profit with a purpose. When it comes to the latter, “there’s nothing more relevant than healthcare.”
Applying that care to where it’s needed most was a point of agreement for all of the panelists. “Open innovation in health doesn’t matter if we can’t get it to the patient and deliver it,” said O’Reilly.
Atul Gawande has written about lowering medical costs by giving the neediest patients better care with a process called “hotspotting.” Give the success of the approach in Camden, New Jersey, similar data-driven measures for providing healthcare in communities may be in our future.
Personalized medicine and molecular biology
Personalized medicine, driven by the ongoing discoveries in molecular biology, is “just what’s next,” said GE chairman and CEO Jeffrey Immelt. To take on the immense challenge that breast cancer presents, it will require systems thinking to address both outcomes and cost over time.
Immelt is not the only executive bullish on the potential of new technologies to help breast cancer patients. “We’ll see more innovation in the next five years in cancer research and development than we saw in the last 50 years,” said Ron Andrews, CEO of Clarient.
Innovation needs partnership to scale, however, said Sue Siegel a general partner at Mohr Davidow. The ideas submitted to the GE challenge need to be open and scalable to have the biggest impact, she noted.
Siegel posited that the road to a cure will be through molecular diagnostics. The challenge is that less than 1% of spending is on diagnostics, said Siegel, in the context of a healthcare industry that represents $2.6 trillion of the U.S. GDP — and yet most clinical decisions are based on diagnostics. In that context, diagnostic data appears to be a significantly undervalued resource.
“We need to value the diagnostic data as much as we do the therapies,” said Risa Stack, a general partner at Kleiner Perkins Caufield & Byers. Stack said that they’re thinking of a “diagnostics registry,” a website that would enable people to know the different kinds of diagnostics available to patients.
“The time for personalized healthcare is now in oncology, said Greg Plowman, senior vice president for research at ImClone Systems, a subsidiary of Eli Lilly. “What’s best for the patient is knowing that this drug is best for them,” he said. According to Plowman, Eli Lilly is investing heavily in new diagnostics and looking for partnerships.
Susan Love of UCLA noted that screening for breast cancer, however, is still one size fits all. Breast cancer for young women is more aggressive and less likely to be picked up by traditional mechanisms, she said. “We need to focus on screening — not just personalized medicine at the end. Do it at the beginning.”
Obstacles to innovation in healthcare
For entrepreneurs, there are always obstacles to building any company. It is, however, 100 times harder to be an entrepreneur inside health and wellness, said Steve Krein, co-founder of StartUp Health. “Everything is stacked against you,” he said, from regulations to the patient feedback cycle.
Krein sees an “incredible amount” of people who are interested in the healthcare space but are frustrated by barriers. He emphasized that there are important opportunities for entrepreneurs to seize, particularly in the “gap” between the Internet and a doctor’s visit, where they’re left alone with a search box.
There are two things that take too long, said Kocher: regulations and reimbursement. In his view, the Food and Drug Administration needs to get involved earlier to help startups navigate the system.
In a larger sense, O’Reilly suggested the healthcare industry apply a lesson from Google’s playbook. The search giant solved a problem that Sam Wannamaker famously articulated about advertising: he knew half of ads work but not which half. By applying data-driven approaches to healthcare, there might be huge potential to know more about what’s working and create feedback loops that allow physicians and regulators to iterate quickly.
We now have the ability to move to much more real-time monitoring of what works, O’Reilly said, suggesting that “regulations need to move from a stack of paper to a set of processes for monitoring in real-time.”
That could become particularly important if more health data was voluntarily introduced into the startup ecosystem through the Blue Button, a technical mechanism for enabling citizens to download their personal health information and take it with them. “Once patients have their own data, they’re much more willing to share than the law will allow,” said O’Reilly, but they “will tend to share if they think it will solve their health crisis.”
As entrepreneurs consider how to innovate, O’Reilly said, it’s important to recognize that the “change in business model is often as important as the change in technology.”
A mobile revolution is coming to healthcare
After the forum, O’Reilly tweeted that healthcare is due for a “UI revolution.” He cited a statistic that 1 in 5 physicians now owns an iPad and that by 2014, virtually all physicians are expected to have a tablet.
Over the past five years, said MedHelp CEO John de Souza during the launch event, monthly visitors to MedHelp.com have grown from 1 million to 12 million, and mobile visitors have grown from 3% to 30% of that traffic.
The “mobile phone is becoming a health hub,” said Souza, with the ability to transmit and collect data. The two big impediments to growth are manual entry and data monitoring. Data needs to be automatically collected and sent on to someone else looking at data through tele-monitoring, where they can analyze it and inform a physician.
Krein cited the iPad as one of the most transformative technologies in healthcare because the simplified user experience has opened the door to different thinking. Krein said that when they opened up StartupAcademy and 125 entrepreneurs applied, half of them had some element of mobile health in the proposals that included the use of an iOS or Android device.
The future of healthcare is social
As reported elsewhere, social media is changing healthcare by connecting patients to information and, increasingly, each other.
As the panelists acknowledged, advocates have built huge communities and created seminal change both online and offline.
There is an opportunity for people to share actual outcomes, said O’Reilly. Given that people are using the Internet to share that information, it becomes a useful source for patients and physicians. “We do see people looking for answers in the Internet,” he said. “The key thing in patient’s education is teaching people how to ask better questions.”
Love went beyond peer-to-peer healthcare: we can really educate the public not just about the treatment but about the research too, she said, including how to get it done and how to participate. “That’s the only way to get the cause, not just the cure.”
A personal challenge
I can’t claim to be unbiased about breast cancer. Both my mother and grandmother have had it and survived. Through their experiences, I learned just how many other women are affected. Breast cancer statistics are stark: about 1 in 8 women in the United States will develop invasive breast cancer over the course of their lifetime. More than 200,000 new cases of breast cancer are detected every year in the U.S. alone. Globally, breast cancer is the number one cancer for women in both the developing world and developed world, according to the World Health Organization. Hundreds of thousands of those diagnosed die.
Nancy Brinkler, the founder of the Susan G. Komen Foundation, lost her sister to breast cancer at the age of 36. We’ve moved from a society where breast cancer couldn’t be said on television to one where billions are invested worldwide, she noted at the launch.
“We don’t have the knowledge of how to defeat it but do know more about the biology,” Brinkler said. While relative survival rates have improved for those who have access to early screening and treatment, “where a woman lives or how many resources she has should never determine whether she lives.” To move forward “will require a bridge between science and society.”
If healthcare data and the energy of innovation can be harnessed to create earlier detection and targeted therapies, more women diagnosed with breast cancer will join the millions of survivors.