Things & Thinks XVII-2020 in Review

I began curating healthcare news around the end of the first quarter of 2020. With sixteen issues released since then, Things & Thinks has started taking a nicer shape than where it was (at least for me!) In this year-end issue, I reflect on the disparate pieces I curated and three common threads that seem to bind them all. I will be back with some new things and newer thoughts in 2021!

Thread 1-Patch-up innovation doesn’t work, especially in healthcare

• One big message from the pandemic mayhem is how complex, interlinked and interdependent our world is and how that reflects in the already hyper-linked healthcare system. My suggestion-

I think the starting point can be just to accept these complexities and linkages before starting to tinker with things we don’t yet know and/or fully understand. In absence of such acceptance, we will continue to add further complexities that will most probably lead to more problems than they solve.

• There was lot of chatter about emphasis on outcomes from healthcare innovation; but small studies, short studies, ill-designed studies did not help build the momentum further. There are many examples-Omada’s digital Diabetes Prevention Program study which compared not-exactly-comparable arms; mental health apps on Google Play and iTunes lacking evidence to back their claims; However there is some good work being done too-Pear Therapeutics looked at user journey data for their iCBT in chronic insomnia and paid particular attention to think about why do patients dropout of their digital intervention and tried predicting dropout rate using patient engagement characteristics.
• Supply chain and logistics used to be treated as the boring parts of the healthcare machinery. Not anymore; case in point, this spy-movie themed story about sourcing PPE kits in the US- it involves camouflage, FBI agents, Department of Homeland Security and calling US Congress!
• Non-linearity in feedback loops, bounded rationality and nested systems are some of the concepts we continue to ignore when we think of healthcare in fragments vs healthcare as a system.
• In the end, even breakthrough innovation can take a while to show ‘overnight success’; take the example of electricity and its impact on manufacturing to illustrate this diffusion-when the electric dynamo was as old as the web is now, factory owners were still attached to steam. The really big changes were only just appearing on the horizon.

The thing about a revolutionary technology is that it changes everything — that’s why we call it revolutionary. And changing everything takes time and imagination and courage — and sometimes just a lot of hard work.

Thread 2-Digital isn’t ‘everything’ but it can be ‘something’

• The line between health-related data and ‘other’ data is blurring. A report by Ada Lovelace Institute points this out, calling it datafication of health.
• Big Tech continues its experiments, partnerships and takeovers in 2020. Amazon HealthLake, Microsoft Cloud for Healthcare program, Google’ ‘Healthcare Interoperability Readiness Program’ all point out to how tech infrastructure for healthcare digitization is being built by big tech.
• Digital sensors and remote monitoring is riding high on the telemedicine wave; Apple’s watch is a new powerhouse of many sensors, but these new capabilities do not equate to better outcomes on their own.
• Incumbent healthcare organizations are not a step behind when it comes to digital adoption-Medtronic launched InPen Device, Takeda’s partnership with real-world platform firm Seqster and Novartis providing sensor-based approach for medication adherence with Propeller Health and so on.
• Some digital health start-ups are on track of having figured the impact model-Akili’s EndeavorRX, in an innovative video-game like setting, received US FDA approval.
• On the Indian front, a ventilator start-up’s journey from lab to market and beyond during COVID times, shows importance of early adopters in the marketplace, risks with pivoting and mitigating them and the tricky business with government procuring.

Thread 3-Never forget the impact empathy and listening can have in healthcare

• Probably the most inspiring healthcare personality in 2020 is Dr Anthony Fauci; his profile inn New Yorker is one of the best things I read during the year. He says being physician is ‘perfect melding of both humanities and classics’; I think this applies to everyone who is passionate about healthcare problems and will keep driving their innovation and impact quotient!

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