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Join David Lee Scher, a cardiologist and digital health consultant. We’ll explore the ever-evolving world of digital health, discussing topics such as problem-solving in health care, building credibility in digital health technologies, the power of digital partnerships, long-term growth strategies, and data-driven improvements.

David Lee Scher is a cardiologist and digital health consultant.

He discusses the KevinMD article, “5 things digital health companies need to do to achieve success.”

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Transcript

Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast, and get CME for this episode by clicking on the CME link in the show notes. Today we welcome David Lee Scher. He’s a cardiologist and digital health consultant. Today’s KevinMD article is “5 things digital health companies need to do to achieve success.” David, welcome to the show.

David Lee Scher: Thank you, Kevin.

Kevin Pho: So we’ll talk about your article in a little bit. Let’s start by sharing your story and journey.

David Lee Scher: Sure. So I’m a cardiac electrophysiologist by training, and always had an interest in technology. I never went to any computer science school or anything, but I did have an electronic record that was actually mobile on a Palm Pilot in 1997. And we actually convinced our hospital to get PCs so that we could get our office records in the hospital. It was very backwards, but educational.

And then shortly thereafter I became an investigator for Medtronic in their wireless monitoring of implantable defibrillators. That was in 2000, and that got me very interested in digital health. I wound up doing some pilot studies by incorporating that data into the electronic record a couple of years later, and then started my consultancy in digital health technology.

Kevin Pho: Excellent. So digital health technology, such a fascinating space, where the pace of innovation is always so quick. So interested in hearing your insights between that and health care, of course. So your KevinMD article is “5 things digital health companies need to do to achieve success.” So super relevant, because not every digital health company is successful. So tell us about your article.

David Lee Scher: Well, my article, actually I’ve been writing a blog for over 10 years, and the goal of the blog really was to educate people about digital health from a number of different ways, from the patient perspective, from the industry perspective, et cetera. And that was really more of creating an awareness of digital health back in those days.

So now that it’s been fully out there in the commercial realm, large companies getting into digital health, et cetera, I thought that it was worthwhile to revisit the foundation of the reasons why digital health came about, and the potential benefits of it.

Kevin Pho: Absolutely. So let’s start there. In your definition, what exactly is digital health? Let’s start there.

David Lee Scher: So digital health is really the broad spectrum term that envelops electronic records, telehealth, genomics, anything that is digital, which really includes a lot of things today, imaging, et cetera, mobile technologies, wearables. So really anything that is digital in health care envelops that term.

Kevin Pho: All right, so what separates a successful product or company from something that fails?

David Lee Scher: So the number one thing, in my opinion, is the fact that you have to address a problem that you’re potentially going to solve. That problem doesn’t have to be world hunger or anything huge, it can be just in the way things operate in health care, whether it’s for the administration, the clinician, things that make life easier for people.

The tradeoff, certainly, potentially cybersecurity, confidentiality, these things need to be incorporated into any digital health technology. And the inclusion of clinicians in the development of this technology is crucial. And I would also add the inclusion of patients, such that when you’re developing the technology people have a chance to chime in, so to speak, and give their perspective, because otherwise it’s much costlier down the line.

Kevin Pho: So what are some examples of successful digital health companies or products?

David Lee Scher: I would say the most successful in its planning and execution today is Kardia, which is AliveCor, which you’ve seen television commercials about, how do you take your electrocardiogram with an app. And the reason why I picked that company is because I’ve been following them since the beginning and they’ve done everything right.

And the reason why there’s not a lot of investment in digital health today is that companies do not feel that’s necessary, and this sounds kind of strange, but they don’t feel it’s necessary to prove that their device or technology works with regards to either functionality or outcomes.

And outcomes data are important because health care enterprises want to know what the return of investment is. And that return of investment may not actually be dollars and cents, it can be efficiencies, it can be patient outcomes. And these kind of studies take a bit of time, and companies don’t want to really go through the appropriate channels to do that. The FDA now has a whole arena or department of digital health to make things easier.

So I think that companies really need to take heed of planning things out, of testing early to identify problems, and to also do things right with regards to proving outcomes.

Kevin Pho: So if you’ve seen digital health companies know what has been successful in the past, outcomes data, patient improvement data, why aren’t more doing it, despite the effort and cost it takes?

David Lee Scher: Well, I think cost has a lot to do with it. I mean, health care is a business today in the United States, and so there’s a cost of developing anything in commercialization.

The problem really is finding funding, and that funding can be creative. I mean, if you have a real product that’s going to solve real patient problems, then applying for grants, whether they be on a governmental basis or nonprofit basis, or associating with other entities, hospitals, that kind of thing, are important.

So it’s important to know people and know which door to go to. And that’s another thing that companies don’t sometimes realize, is what internal partners that they can adopt to become champions of their technology.

Kevin Pho: One of the things that you said earlier was the importance of both clinician and patient input when companies develop these digital products. So how common is that, to have that type of input?

David Lee Scher: It’s not common at all. Most digital health companies do not have a clinician on board, they don’t want to invest in that. It’s not that costly. I mean, I certainly work with, I’m not tooting my own horn, but I certainly work with companies, realizing that they’re startups, but they need a clinical perspective.

And patients need to be involved too, because when we talk about technology we talk about usability, how easy it is to use the technology, the interface. I work with a company called SpeechMed which takes anything in health care and translates it into any language. So health literacy, which is another passion of mine, needs to be incorporated into technologies.

Kevin Pho: Now, how can physicians get more involved with the development of digital health products? You’re a cardiac electrophysiologist, and obviously you’re also a consultant with several digital health initiatives. How can practicing physicians today who are interested in hearing what you have to say, how can they get more involved with the development of digital health products?

David Lee Scher: So that’s a great question. The first thing is really to get involved in social media and follow people, become familiar with the background. I love mentoring people, I’ve had mentors, I think that’s extremely important.

And the other thing is, a lot of medical schools and medical institutions now have divisions of technology or innovation, they call them different things. And I think that students or trainees have great opportunities today to submit ideas, to be involved in projects like that. So the way in which we look at research today needs to be expanded into digital technologies, involving patients as well.

Kevin Pho: One of the things that you touched upon in your article was long-term growth strategies of digital health products. So once you get through that initial hurdle of success, how can digital health products sustain themselves long term?

David Lee Scher: So that’s very important. The revenue that comes in needs to be reinvested in the company to really bolster or enhance their technologies, and more importantly to scale. I mean, health care, to be successful you really need to scale it to a significant degree.

One of the best ways to do that is to partner up with other digital health companies, and that really results in an offering that’s much more enhanced than just the single product. And so chief information officers, chief security officers, they have people knocking on their door 500 times a day with offerings. And so if you partner up with somebody who’s already in that institution, it certainly helps. But also if you partner with another company that complements what you’re doing, it really enhances things.

Kevin Pho: Now, what are some key trends when it comes to digital health over the short-term future, say within the next six to 12 months? What do we have to look forward to?

David Lee Scher: I think people are sick of hearing this, but I think artificial intelligence is going to drive a lot of this. There’s a huge amount of artificial intelligence that’s being adopted in the realm of what we think of as personal assistants in health care, and most importantly that’s needed in behavioral health, and I’m glad to see that it’s being developed in those circumstances.

I’m very passionate about something that’s going to become very important in the next few years, which is called the hospital at home, where patients will be treated more at home than in the hospital. And some people may fear that, but I think it’s very important, because of the fact that medical errors occur in the hospital, the fact that most people want to be at home with friends and caregivers rather than in the hospital.

And the other thing that’s extremely important today is, unfortunately, cost. So I don’t want to get into a whole thing about economics and health care, but we have this thing called fee for service now, where physicians and hospitals get paid per procedure or per visit, et cetera. When you have hospital at home, that shift is going to be taking care of the patient with a diagnosis, and it’s called value based care. So that somebody with a post-operative recovery will be treated in a way in which the outcome is really prime, not, how much can we do to get revenue from this diagnosis.

So I think that digital health is really going to become important when the hospital at home becomes more widespread.

Kevin Pho: Now I want to talk about digital health tools specifically, clinician facing digital health tools. How can you get more adoption for clinicians to use these tools? Because as you said, most of us work in a fee for service system and we’re paid by how much we do, and we simply just don’t have a lot of time to evaluate all these tools that bombard us daily with their marketing. So how can a digital health company break through to the clinician audience?

David Lee Scher: Well, let me say a couple of things in that regard. Number one, technology is not always a good thing, and a lot of technology that we have, much of it based in the electronic record, has actually created a lot of stress and burnout for physicians.

And I’m currently on a committee which is from HIMSS, the Healthcare Information and Management Systems Society, on physician burnout. And we’re working on ways to change workflows, to change technologies, to decrease the burden that technology may, as an unintended consequence, bring to clinicians.

There are tools that are as simple as oximeters that we use every day that we don’t realize are digital tools. So those kinds of things help us a lot.

But in general it’s not up to the individual physician to adopt these tools, it’s really up to the hospital administration. However, I think that if a physician knows about a technology and potentially can create awareness or champion this kind of thing, it’ll work. I’ve done that for Kardia in my previous practices and things of that nature. So it’s not really up to the individual physician, but I would say that awareness is a big deal.

Telehealth is something that is digital also, and needs to be, I think, utilized a lot more than it has. The pandemic really brought that into the foray of clinical care. And again, the money comes into the situation, and reimbursement has decreased for that, which has significantly decreased telehealth. But I think that telehealth is going to become a bigger thing in the future.

Kevin Pho: We’re talking to David Lee Scher. He’s a cardiologist and digital health consultant. Today’s KevinMD article is “5 things digital health companies need to do to achieve success.” David, let’s end with some of your take-home messages to the KevinMD audience.

David Lee Scher: So a take-home message for clinicians, a couple of things. Number one, really, if you keep your focus mentally on the patient, then a lot of stress that’s created from the outside, if you will, outside of that physician patient interaction, has less of a negative impact. So I think that’s very important, is to, on a real daily basis if not more frequently, realize how special it is to be a clinician and take care of patients.

And the other thing is to really pursue outside passions, whether they be technology, whether they be music, or anything, to really create a balance in your life, which decreases stress but also improves your own quality of life.

Kevin Pho: David, thank you so much for sharing your perspective and insight, and thanks again for coming on the show.

David Lee Scher: Thank you.