A Caution for Would-be Digital Health Entrepreneurs
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She was previously with Reuters, covering digital health and Apple and before that, she reported for Venture Beat. Christina was born and raised in London and has graduate degrees from University of London and the Stanford School of Journalism. Farr’s work has appeared in a variety of publications, including the New York Times, the Daily Telegraph, the Bay Citizen and SFGate.com. She has appeared as a featured expert on NBC, ABC and Reuters TV, among others, and frequently speaks at health and technology conferences. She is also co-founder of Ladies Who Vino, a networking group for women in technology and business.","avatar":"https://secure.gravatar.com/avatar/22c63869a7901c61c15e204391c1261d?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"futureofyou","roles":["administrator"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Christina Farr | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/22c63869a7901c61c15e204391c1261d?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/22c63869a7901c61c15e204391c1261d?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/cfarr"},"halletecco":{"type":"authors","id":"8619","meta":{"index":"authors_1591205172","id":"8619","found":true},"name":"Halle 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FM","link":"/"}},"futureofyou_18627":{"type":"posts","id":"futureofyou_18627","meta":{"index":"posts_1591205157","site":"futureofyou","id":"18627","score":null,"sort":[1438358401000]},"guestAuthors":[],"slug":"inside-dr-eric-topols-modern-black-bag","title":"Inside Dr. Eric Topol's 'Modern Black Bag'","publishDate":1438358401,"format":"audio","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>\u003cstrong>Listen to the talk:\u003c/strong>\u003cbr>\nhttp://www.kqed.org/.stream/anon/radio/science/2015/07/Topoltalk.mp3\u003c/p>\n\u003cp>In the not-so-distant past, it was the fashion for doctors to carry black bags filled with stethoscopes, blood pressure cuffs and other gadgets.\u003c/p>\n\u003cp>Eric Topol, a cardiologist and chief academic officer at Scripps Health is one of the few doctors whose black bag isn't gathering dust. But Topol's black bag is no relic of the past: It contains an assortment of the latest wearable devices and gizmos. He describes it as \"exponentially more powerful\" than an equivalent bag from a century ago.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">I met with Topol at a KQED event in San Francisco hosted by \u003ca href=\"https://rockhealth.com/\">\u003cspan class=\"s2\">Rock Health\u003c/span>\u003c/a>, an early-stage venture firm that invests in digital health. Topol is a cardiologist and geneticist who has written several books about how technology — and the smartphone, in particular — is changing medicine.\u003c/span>\u003c/p>\n\u003cp>Within minutes, Topol granted me a peek inside his black bag and described its contents: A heart health monitor from \u003ca href=\"alivecor.com\">AliveCor\u003c/a> that attaches to an iPhone; a miniature scanning device called the \u003ca href=\"https://www.scanadu.com/scout/\">Scanadu Scout\u003c/a> that measures body temperature and blood pressure in a matter of seconds, a coin-shaped sensor that tracks blood sugar levels, and an early-stage prototype of a wristwatch that monitors blood pressure.\u003c/p>\n\u003cfigure id=\"attachment_18646\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-18646\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-2-800x600.jpg\" alt='Dr. Eric Topol shows me his \"modern black bag\" ' width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1400x1050.jpg 1400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Eric Topol opens up his\"modern black bag\" \u003ccite>(Christina Farr / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Topol is no ordinary doctor. \u003ca href=\"http://www.nytimes.com/2015/02/15/books/review/the-patient-will-see-you-now-by-eric-topol.html?_r=0\">The New York Times described him\u003c/a> as a \"digital geek\" with an \"enthusiasm for all things wireless [that] would make any Wired subscriber proud.\" While many of his physician colleagues are skeptical about all this new medical technology, he is already recommending that his patients use some of the new tools to monitor their vitals between visits. In Topol's view, that's the basis for a new kind of dialogue between doctor and patient: One where you and I can take a far more active role.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Here are some of the highlights from our talk. Note: The conversation was recorded for broadcast and will air on KQED on September 23rd at 8pm PT.\u003c/p>\n\u003cp>\u003cstrong>On The Hype and Promise of Digital Health \u003c/strong>\u003c/p>\n\u003cp>Five years ago, few people saw potential in digital health. But in 2014, \u003ca href=\"http://rockhealth.com/2015/01/digital-health-funding-tops-4-1b-2014-year-review/\">investment in the space topped $4.1 billion\u003c/a> as technology entered health care in a big way.\u003c/p>\n\u003cp>Topol was one of the earliest physicians to publicly praise the new medical technology, and try it out in his own practice. One of the key benefits, he says, is the ability to keep an eye on patients once they've left the hospital. Patients with cardiac issues, for instance, can pickup an \u003ca href=\"alivecor.com\">Alivecor\u003c/a> mobile electrocardiogram, which fits onto a smartphone, and regularly check their heart function for signs of distress.\u003c/p>\n\u003cfigure id=\"attachment_18953\" class=\"wp-caption alignright\" style=\"max-width: 348px\">\u003cimg class=\" wp-image-18953\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-1-450x600.jpg\" alt=\"Eric Topol at the Rock Health offices in San Francisco \" width=\"348\" height=\"464\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-885x1180.jpg 885w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1920x2560.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-960x1280.jpg 960w\" sizes=\"(max-width: 348px) 100vw, 348px\">\u003cfigcaption class=\"wp-caption-text\">Eric Topol at the Rock Health offices in San Francisco \u003ccite>(Christina Farr / KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Throughout our conversation, Topol shared stories of patients who were able to avoid a deadly outcome by using a mobile medical tool. \u003ca href=\"http://medcitynews.com/2015/07/topol-apple-watch-helps-colleagues-patient-self-diagnose-heart-condition/\">One of his patients \u003c/a>came into his office and requested to be fit with a pacemaker. This patient said he had been feeling dizzy with a fluctuating heart rate, which he was monitoring with his Apple Watch. After performing a Google search of these symptoms, the patient guessed that it might be sick sinus syndrome That diagnosis proved to be accurate.\u003c/p>\n\u003cp>That's all well and good, but it's still early days for mobile health. What are the potential drawbacks of using these tools?\u003c/p>\n\u003cp>For one thing, not every digital health company takes patient privacy all that seriously. Unlike Apple, many companies make money by selling your data to third parties, including pharmaceutical companies, advertisers and marketers.\u003c/p>\n\u003cp>Moreover, many of the new systems that store your data are not secure. Topol recently shared a graphic on Twitter showing that a patient in the U.S. is five times more likely to have their medical record hacked than to access it at all. (In July, just a few months after he shared that stat, hackers broke into UCLA and accessed computers with medical records of 4.5 million people.)\u003c/p>\n\u003cp>https://twitter.com/EricTopol/status/617325499094708224\u003c/p>\n\u003cp>One of the limitations of his latest book, \"The Patient Will See You Now,\" is that it doesn't grapple with the issue of whether some patients will misinterpret the data and diagnose themselves with all manner of ills. Topol does concede that mobile health isn't for everyone -- he refers to those who are addicted to Google searching symptoms as \"anxious and wired\" and \"cyber-chondriacs.\" But he thinks that \"most people will do well,\" and use these tools in moderation.\u003c/p>\n\u003cp>\u003cb>On Medical Paternalism\u003c/b>\u003c/p>\n\u003cp>Topol has observed that many doctors today maintain the view that patients shouldn't have much of a voice. \u003ca href=\"http://www.goodhousekeeping.com/health/wellness/news/a31841/doctors-not-telling-patients-alzheimers/\">In the 1960s, many doctors wouldn't tell their patients they had cancer\u003c/a>, fearing they would get too distressed. It wasn't until the 1980s that the AMA and other groups included the notion of \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion808.page?\">\"informed consent\"\u003c/a> in their code of ethics.\u003c/p>\n\u003cp>https://twitter.com/rvaughnmd/status/440225195131826176\u003c/p>\n\u003cp>In 2012, three medical institutions agreed to conduct an experimen\u003ca href=\"http://www.healthcareitnews.com/news/opennotes-not-software-package-movement\">t called \"Open Notes,\" \u003c/a>which involved doctors sharing their notes with patients. According to Topol, some physicians feared that patients would be horrified to see \"obese\" scrawled in their notes, or they might misinterpret medical jargon like \"SOB.\" But the experiment proved to be a success. Despite these positive results, more recent surveys show that many doctors are still reluctant to share their notes with patients.\u003c/p>\n\u003cp>\u003cstrong>On That Time He Gave Stephen Colbert an Ear Exam\u003c/strong>\u003c/p>\n\u003cp>Many doctors across the country are still tentative about digital health. But Topol is one of its most avid and earliest supporters. In 2013, he showed off the armory of mobile medical devices in his black bag on the Colbert Show. On live television, he examined Stephen Colbert's heart and \u003ca href=\"http://medcitynews.com/2013/03/eric-topol-gives-stephen-colbert-ear-exam-heart-attack-ringtones-and-other-colbert-highlights/\">performed an ear exam \u003c/a>using a mobile otoscope from CellScope.\u003c/p>\n\u003cp>\"The best part was using a handheld device to examine his [Colbert's] heart -- he had to bare his chest on TV. I told Colbert he had an aortic aneurysm to have some fun. Unfortunately, much of that was edited out,\" Topol said.\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=-4iZQYlygno]\u003c/p>\n\u003cp>\u003cstrong>On the Reign of the Quitbits \u003c/strong>\u003c/p>\n\u003cp>The market is flooded with devices that serve the \"worried well,\" meaning those who are perfectly healthy but are constantly unnerved about getting sick. This set might rush to adopt new devices, such as the Fitbit (which Topol refers to as a \"Quitbit\"), \u003ca href=\"http://www.fool.com/investing/general/2015/06/24/1-red-flag-that-fitbit-inc-investors-cant-ignore.aspx\">but they don't use them for long\u003c/a>. Topol hopes that Silicon Valley will divert its attention away from building tools for the worried well and instead focus on \"devices that are giving clinically relevant information.\"\u003c/p>\n\u003cp>But there are barriers to entry for those who are developing true medical devices. These entrepreneurs will need to gain clearance from the U.S. Food and Drug Administration. This process can take months, and sometimes years.\u003c/p>\n\u003cp>\u003cstrong>On His Bad Luck on Flights\u003c/strong>\u003c/p>\n\u003cp>\"If you see me getting on your flight, reconsider. I seem to have some bad luck in this regard,\" Topol said. He's only slightly kidding. On three occasions in recent years, he's made an emergency diagnosis in the air. Fortunately, his black bag was on hand.\u003c/p>\n\u003cp>In one case, he used an Alivecor to make a \"very quick diagnosis\" that a patient was having a heart attack. The plane made an emergency landing. In his book, 'The Patient Will See You Now,' he recalls another emergency situation where he checked a patient's ECG in the air, as well as performing a cardiac ultrasound and taking their blood pressure -- and concluded that the patient was fine. He writes that in the future, a doctor's intervention wouldn't be required: \"All that was needed were the tools to collect the data.\" This might be taking it a bit far. I would argue that mobile health will improve the doctor-patient relationship, but it isn't going to replace the doctor anytime.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>https://twitter.com/EricTopol/status/600848164267110400\u003c/p>\n\n","blocks":[],"excerpt":"KQED spoke with Dr. Eric Topol, a cardiologist and author, at an event hosted by Rock Health. Here are some of the highlights from our wide-ranging conversation about how mobile technology is changing health care. ","status":"publish","parent":0,"modified":1477280213,"stats":{"hasAudio":true,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1362},"headData":{"title":"Inside Dr. Eric Topol's 'Modern Black Bag' | KQED","description":"KQED spoke with Dr. Eric Topol, a cardiologist and author, at an event hosted by Rock Health. Here are some of the highlights from our wide-ranging conversation about how mobile technology is changing health care. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Inside Dr. Eric Topol's 'Modern Black Bag'","datePublished":"2015-07-31T16:00:01.000Z","dateModified":"2016-10-24T03:36:53.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"18627 http://ww2.kqed.org/futureofyou/?p=18627","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/07/31/inside-dr-eric-topols-modern-black-bag/","disqusTitle":"Inside Dr. Eric Topol's 'Modern Black Bag'","path":"/futureofyou/18627/inside-dr-eric-topols-modern-black-bag","audioUrl":"http://www.kqed.org/.stream/anon/radio/science/2015/07/Topoltalk.mp3","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>Listen to the talk:\u003c/strong>\u003cbr>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audioLink","attributes":{"named":{"src":"http://www.kqed.org/.stream/anon/radio/science/2015/07/Topoltalk.mp3"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In the not-so-distant past, it was the fashion for doctors to carry black bags filled with stethoscopes, blood pressure cuffs and other gadgets.\u003c/p>\n\u003cp>Eric Topol, a cardiologist and chief academic officer at Scripps Health is one of the few doctors whose black bag isn't gathering dust. But Topol's black bag is no relic of the past: It contains an assortment of the latest wearable devices and gizmos. He describes it as \"exponentially more powerful\" than an equivalent bag from a century ago.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">I met with Topol at a KQED event in San Francisco hosted by \u003ca href=\"https://rockhealth.com/\">\u003cspan class=\"s2\">Rock Health\u003c/span>\u003c/a>, an early-stage venture firm that invests in digital health. Topol is a cardiologist and geneticist who has written several books about how technology — and the smartphone, in particular — is changing medicine.\u003c/span>\u003c/p>\n\u003cp>Within minutes, Topol granted me a peek inside his black bag and described its contents: A heart health monitor from \u003ca href=\"alivecor.com\">AliveCor\u003c/a> that attaches to an iPhone; a miniature scanning device called the \u003ca href=\"https://www.scanadu.com/scout/\">Scanadu Scout\u003c/a> that measures body temperature and blood pressure in a matter of seconds, a coin-shaped sensor that tracks blood sugar levels, and an early-stage prototype of a wristwatch that monitors blood pressure.\u003c/p>\n\u003cfigure id=\"attachment_18646\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-18646\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-2-800x600.jpg\" alt='Dr. Eric Topol shows me his \"modern black bag\" ' width=\"800\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-800x600.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-400x300.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1180x885.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-1400x1050.jpg 1400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-2-960x720.jpg 960w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003cfigcaption class=\"wp-caption-text\">Dr. Eric Topol opens up his\"modern black bag\" \u003ccite>(Christina Farr / KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Topol is no ordinary doctor. \u003ca href=\"http://www.nytimes.com/2015/02/15/books/review/the-patient-will-see-you-now-by-eric-topol.html?_r=0\">The New York Times described him\u003c/a> as a \"digital geek\" with an \"enthusiasm for all things wireless [that] would make any Wired subscriber proud.\" While many of his physician colleagues are skeptical about all this new medical technology, he is already recommending that his patients use some of the new tools to monitor their vitals between visits. In Topol's view, that's the basis for a new kind of dialogue between doctor and patient: One where you and I can take a far more active role.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Here are some of the highlights from our talk. Note: The conversation was recorded for broadcast and will air on KQED on September 23rd at 8pm PT.\u003c/p>\n\u003cp>\u003cstrong>On The Hype and Promise of Digital Health \u003c/strong>\u003c/p>\n\u003cp>Five years ago, few people saw potential in digital health. But in 2014, \u003ca href=\"http://rockhealth.com/2015/01/digital-health-funding-tops-4-1b-2014-year-review/\">investment in the space topped $4.1 billion\u003c/a> as technology entered health care in a big way.\u003c/p>\n\u003cp>Topol was one of the earliest physicians to publicly praise the new medical technology, and try it out in his own practice. One of the key benefits, he says, is the ability to keep an eye on patients once they've left the hospital. Patients with cardiac issues, for instance, can pickup an \u003ca href=\"alivecor.com\">Alivecor\u003c/a> mobile electrocardiogram, which fits onto a smartphone, and regularly check their heart function for signs of distress.\u003c/p>\n\u003cfigure id=\"attachment_18953\" class=\"wp-caption alignright\" style=\"max-width: 348px\">\u003cimg class=\" wp-image-18953\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/07/topol-1-450x600.jpg\" alt=\"Eric Topol at the Rock Health offices in San Francisco \" width=\"348\" height=\"464\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-885x1180.jpg 885w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1920x2560.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/07/topol-1-960x1280.jpg 960w\" sizes=\"(max-width: 348px) 100vw, 348px\">\u003cfigcaption class=\"wp-caption-text\">Eric Topol at the Rock Health offices in San Francisco \u003ccite>(Christina Farr / KQED )\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Throughout our conversation, Topol shared stories of patients who were able to avoid a deadly outcome by using a mobile medical tool. \u003ca href=\"http://medcitynews.com/2015/07/topol-apple-watch-helps-colleagues-patient-self-diagnose-heart-condition/\">One of his patients \u003c/a>came into his office and requested to be fit with a pacemaker. This patient said he had been feeling dizzy with a fluctuating heart rate, which he was monitoring with his Apple Watch. After performing a Google search of these symptoms, the patient guessed that it might be sick sinus syndrome That diagnosis proved to be accurate.\u003c/p>\n\u003cp>That's all well and good, but it's still early days for mobile health. What are the potential drawbacks of using these tools?\u003c/p>\n\u003cp>For one thing, not every digital health company takes patient privacy all that seriously. Unlike Apple, many companies make money by selling your data to third parties, including pharmaceutical companies, advertisers and marketers.\u003c/p>\n\u003cp>Moreover, many of the new systems that store your data are not secure. Topol recently shared a graphic on Twitter showing that a patient in the U.S. is five times more likely to have their medical record hacked than to access it at all. (In July, just a few months after he shared that stat, hackers broke into UCLA and accessed computers with medical records of 4.5 million people.)\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"617325499094708224"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>One of the limitations of his latest book, \"The Patient Will See You Now,\" is that it doesn't grapple with the issue of whether some patients will misinterpret the data and diagnose themselves with all manner of ills. Topol does concede that mobile health isn't for everyone -- he refers to those who are addicted to Google searching symptoms as \"anxious and wired\" and \"cyber-chondriacs.\" But he thinks that \"most people will do well,\" and use these tools in moderation.\u003c/p>\n\u003cp>\u003cb>On Medical Paternalism\u003c/b>\u003c/p>\n\u003cp>Topol has observed that many doctors today maintain the view that patients shouldn't have much of a voice. \u003ca href=\"http://www.goodhousekeeping.com/health/wellness/news/a31841/doctors-not-telling-patients-alzheimers/\">In the 1960s, many doctors wouldn't tell their patients they had cancer\u003c/a>, fearing they would get too distressed. It wasn't until the 1980s that the AMA and other groups included the notion of \u003ca href=\"http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion808.page?\">\"informed consent\"\u003c/a> in their code of ethics.\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"440225195131826176"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\n\u003cp>In 2012, three medical institutions agreed to conduct an experimen\u003ca href=\"http://www.healthcareitnews.com/news/opennotes-not-software-package-movement\">t called \"Open Notes,\" \u003c/a>which involved doctors sharing their notes with patients. According to Topol, some physicians feared that patients would be horrified to see \"obese\" scrawled in their notes, or they might misinterpret medical jargon like \"SOB.\" But the experiment proved to be a success. Despite these positive results, more recent surveys show that many doctors are still reluctant to share their notes with patients.\u003c/p>\n\u003cp>\u003cstrong>On That Time He Gave Stephen Colbert an Ear Exam\u003c/strong>\u003c/p>\n\u003cp>Many doctors across the country are still tentative about digital health. But Topol is one of its most avid and earliest supporters. In 2013, he showed off the armory of mobile medical devices in his black bag on the Colbert Show. On live television, he examined Stephen Colbert's heart and \u003ca href=\"http://medcitynews.com/2013/03/eric-topol-gives-stephen-colbert-ear-exam-heart-attack-ringtones-and-other-colbert-highlights/\">performed an ear exam \u003c/a>using a mobile otoscope from CellScope.\u003c/p>\n\u003cp>\"The best part was using a handheld device to examine his [Colbert's] heart -- he had to bare his chest on TV. I told Colbert he had an aortic aneurysm to have some fun. Unfortunately, much of that was edited out,\" Topol said.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/-4iZQYlygno'\n title='//www.youtube.com/embed/-4iZQYlygno'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003cstrong>On the Reign of the Quitbits \u003c/strong>\u003c/p>\n\u003cp>The market is flooded with devices that serve the \"worried well,\" meaning those who are perfectly healthy but are constantly unnerved about getting sick. This set might rush to adopt new devices, such as the Fitbit (which Topol refers to as a \"Quitbit\"), \u003ca href=\"http://www.fool.com/investing/general/2015/06/24/1-red-flag-that-fitbit-inc-investors-cant-ignore.aspx\">but they don't use them for long\u003c/a>. Topol hopes that Silicon Valley will divert its attention away from building tools for the worried well and instead focus on \"devices that are giving clinically relevant information.\"\u003c/p>\n\u003cp>But there are barriers to entry for those who are developing true medical devices. These entrepreneurs will need to gain clearance from the U.S. Food and Drug Administration. This process can take months, and sometimes years.\u003c/p>\n\u003cp>\u003cstrong>On His Bad Luck on Flights\u003c/strong>\u003c/p>\n\u003cp>\"If you see me getting on your flight, reconsider. I seem to have some bad luck in this regard,\" Topol said. He's only slightly kidding. On three occasions in recent years, he's made an emergency diagnosis in the air. Fortunately, his black bag was on hand.\u003c/p>\n\u003cp>In one case, he used an Alivecor to make a \"very quick diagnosis\" that a patient was having a heart attack. The plane made an emergency landing. In his book, 'The Patient Will See You Now,' he recalls another emergency situation where he checked a patient's ECG in the air, as well as performing a cardiac ultrasound and taking their blood pressure -- and concluded that the patient was fine. He writes that in the future, a doctor's intervention wouldn't be required: \"All that was needed were the tools to collect the data.\" This might be taking it a bit far. I would argue that mobile health will improve the doctor-patient relationship, but it isn't going to replace the doctor anytime.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"singleTwitterStatus","attributes":{"named":{"id":"600848164267110400"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/18627/inside-dr-eric-topols-modern-black-bag","authors":["3252"],"categories":["futureofyou_1060"],"tags":["futureofyou_26","futureofyou_138","futureofyou_80","futureofyou_547","futureofyou_339","futureofyou_25"],"featImg":"futureofyou_18645","label":"futureofyou"},"futureofyou_3027":{"type":"posts","id":"futureofyou_3027","meta":{"index":"posts_1591205157","site":"futureofyou","id":"3027","score":null,"sort":[1432049436000]},"guestAuthors":[],"slug":"a-caution-for-would-be-digital-health-entrepreneurs","title":"A Caution for Would-be Digital Health Entrepreneurs","publishDate":1432049436,"format":"standard","headTitle":"Startup Culture | KQED Future of You | KQED Science","labelTerm":{"term":110,"site":"futureofyou"},"content":"\u003cp>\u003cem>This is a perspective from Halle Tecco, founder and managing director of digital health venture fund \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>One of the biggest mistakes would-be digital health entrepreneurs make is building a product based on what they think needs to be fixed in healthcare, irrespective of what the industry is willing to buy.\u003c/p>\n\u003cp>\u003ca href=\"http://rockhealth.com/2015/01/digital-health-funding-tops-4-1b-2014-year-review/\">Investment in digital health surpassed $4.1 billion\u003c/a> in 2014, nearly the total of the past three years combined. But many of the most promising startups are failing to get off the ground.\u003c/p>\n\u003cp>Too few entrepreneurs have grasped the distinction between a product that a physician would love to use and a product that is so critical to the business that a hospital is willing to pay for it.\u003c/p>\n\u003cp>\u003cstrong>Defining a 'Death by Pilot'\u003c/strong>\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It’s not all that difficult for “nice-to-have” digital health products to land pilots in today’s spaghetti-against-the-wall environment. Pilots are essentially test-runs of a product, for which the potential customer or partner often doesn't pay.\u003c/p>\n\u003cp>In fact, entire units are being established at hospitals just to test new startup concepts. Some hospitals even flip the customer relationship and charge the startup cash or equity to conduct a pilot.\u003c/p>\n\u003cp>Many of these startups never scale beyond the initial pilot. Digital health investors often refer to this as \"death by pilot.\"\u003c/p>\n\u003cp>If you're a digital health entrepreneur or thinking of starting a company, here are some questions to ask yourself to avoid falling victim to this scenario:\u003c/p>\n\u003cp>\u003cstrong>Why are you Piloting Your Product?\u003c/strong>\u003c/p>\n\u003cp>A \"proof of concept\" or \"validation\" pilot is a provisional agreement to test the technical capabilities and value proposition of a product in a controlled manner.\u003c/p>\n\u003cp>In academic medical settings, these pilots are often used in research. Some academic medical centers have standard “unfunded research collaboration” agreements, where a Principal Investigator (or \"PI\") at the university agrees to collaborate on a short-term research project with a startup. In exchange for the time and effort of that researcher, he or she is given the rights to publish any findings.\u003c/p>\n\u003cp>A validation pilot is often critical for a company introducing a new technology. Validation pilots reduce the technology risk for investors and future customers. The results of a pilot are sometimes valuable for marketing purposes. But a validation pilot should not be confused for a real customer relationship.\u003c/p>\n\u003cp>\u003cstrong>Do you Really Know Your Customer?\u003c/strong>\u003c/p>\n\u003cp>It's very important to make sure you are working with someone at your target customer organization who is invested in and capable of taking your product as far as possible. I suggest finding a champion who is directly responsible for implementing new technologies which can reduce administrative overhead or improve the patient experience.\u003c/p>\n\u003cp>The ideal person is someone who has business and finance responsibilities, and views pilots as just the first phase of a larger partnership. Try to talk to department-heads or executives, like a chief executive or chief medical officer. Avoid groups that are solely focused on research, IT, or worse yet -- departments with the entire business model to make money off startups.\u003c/p>\n\u003cp>I also recommend asking questions early on about which departmental budget you will be paid from, so there's no confusion later down the line. Realize that you'll be working with slow, bureaucratic organizations. To grow quickly, reduce the number of staff-members that need to sign off on your product.\u003c/p>\n\u003cp>Take\u003ca href=\"http://kitcheck.com/\" target=\"_blank\"> Kit Check\u003c/a>, a digital health company that specializes in helping hospitals manage inventory in an internal pharmacy. Their product has three components: RFID tags for each medication, a scanning machine, and cloud-based software.\u003c/p>\n\u003cp>[Editors' Note: Kit Check is a \u003ca href=\"http://rockhealth.com/\" target=\"_blank\">Rock Health\u003c/a> portfolio company. The author is a cofounder of Rock Health.]\u003c/p>\n\u003cp>Originally, the Kit Check team sold the scanning machine which required the approval and budgets of procurement, IT, and the Head of Pharmacy. They quickly switched to giving the scanning machine away for free and only charging for the RFID tags, which only requires approval from the Head of Pharmacy. By making this shift, Kit Check has been able to scale to almost 200 hospitals in less than three years.\u003c/p>\n\u003cp>\u003cstrong>Are You Getting Paid?\u003c/strong>\u003c/p>\n\u003cp>Only pursue deals where both parties are willing to invest the time and resources to succeed. If a hospital is unwilling to pay, then they are either the wrong customer or you’re selling the wrong product. It’s not sustainable for any company to work on projects without compensation. Additionally, if another potential customer finds out you’ve worked for free, they could demand the same.\u003c/p>\n\u003caside class=\"pullquote alignright\">“If a hospital truly doesn’t have money to compensate your company for a valuable service or product, they are probably not a good target and you should move on.\"\u003c/aside>\n\u003cp>Remind yourself that if the customer really values your product, they should be paying you and not the other way around. At Rock Health, we’ve been seeing more of these so-called pilots, where startups are actually paying organizations to pilot their product. I’d suggest limiting your free pilots to one. If you do a complimentary pilot, make sure you are getting paid in other tangible ways, such as having the rights to use that hospital’s name and validation results on your sales materials, or having them make introductions to other customers and serving as a reference.\u003c/p>\n\u003cp>If a hospital truly doesn’t have money to compensate your company for a valuable service or product, they are probably not a good target and you should move on.\u003c/p>\n\u003cp>\u003cstrong>Is Your Deal an Opt-Out or Opt-In Contract?\u003c/strong>\u003c/p>\n\u003cp>If you have no other option than to offer an unpaid pilot, structure the pilot as part of a multiphase agreement with clearly defined milestones leading to a paid customer agreement.\u003c/p>\n\u003cp>Multi-phased, definitive sales contracts are up-front agreements that give each partner in the deal the choice to opt-out if certain milestones are not met. These contracts align the business goals of both parties. It’s a larger upfront commitment from the customer, but it also ensures that a startup will get paid if the product works as promised. These agreements also help startups focus on the product and implementation itself, rather than the sales process.\u003c/p>\n\u003cp>I'm optimistic about startups’ ability to get their foot in the door at large hospitals in today’s innovation-positive climate. But entrepreneurs should always consider the long-term sustainability and scalability of pilots before signing on the dotted line. Validation from a top-tier medical center is impressive, but a list of multiple, unpaid pilots on a fundraising deck is a \"death by pilot\" waiting to happen. When going to market and working in the healthcare industry, make sure both sides are aligned and ready to scale.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Thanks to Rock Health entrepreneurs Chris DeNoia, Tim Kress-Spatz, Christine Lemke, and Ian Shakhil for sharing ideas for this article.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Many young and promising digital health startups are falling into the trap of securing 'pilots' -- not paying customers -- and thus, they struggle to get off the ground. ","status":"publish","parent":0,"modified":1434048273,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":31,"wordCount":1178},"headData":{"title":"A Caution for Would-be Digital Health Entrepreneurs | KQED","description":"Many young and promising digital health startups are falling into the trap of securing 'pilots' -- not paying customers -- and thus, they struggle to get off the ground. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Caution for Would-be Digital Health Entrepreneurs","datePublished":"2015-05-19T15:30:36.000Z","dateModified":"2015-06-11T18:44:33.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"3027 http://ww2.kqed.org/futureofyou/?p=3027","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/05/19/a-caution-for-would-be-digital-health-entrepreneurs/","disqusTitle":"A Caution for Would-be Digital Health Entrepreneurs","path":"/futureofyou/3027/a-caution-for-would-be-digital-health-entrepreneurs","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>This is a perspective from Halle Tecco, founder and managing director of digital health venture fund \u003ca href=\"http://rockhealth.com/\">Rock Health\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>One of the biggest mistakes would-be digital health entrepreneurs make is building a product based on what they think needs to be fixed in healthcare, irrespective of what the industry is willing to buy.\u003c/p>\n\u003cp>\u003ca href=\"http://rockhealth.com/2015/01/digital-health-funding-tops-4-1b-2014-year-review/\">Investment in digital health surpassed $4.1 billion\u003c/a> in 2014, nearly the total of the past three years combined. But many of the most promising startups are failing to get off the ground.\u003c/p>\n\u003cp>Too few entrepreneurs have grasped the distinction between a product that a physician would love to use and a product that is so critical to the business that a hospital is willing to pay for it.\u003c/p>\n\u003cp>\u003cstrong>Defining a 'Death by Pilot'\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It’s not all that difficult for “nice-to-have” digital health products to land pilots in today’s spaghetti-against-the-wall environment. Pilots are essentially test-runs of a product, for which the potential customer or partner often doesn't pay.\u003c/p>\n\u003cp>In fact, entire units are being established at hospitals just to test new startup concepts. Some hospitals even flip the customer relationship and charge the startup cash or equity to conduct a pilot.\u003c/p>\n\u003cp>Many of these startups never scale beyond the initial pilot. Digital health investors often refer to this as \"death by pilot.\"\u003c/p>\n\u003cp>If you're a digital health entrepreneur or thinking of starting a company, here are some questions to ask yourself to avoid falling victim to this scenario:\u003c/p>\n\u003cp>\u003cstrong>Why are you Piloting Your Product?\u003c/strong>\u003c/p>\n\u003cp>A \"proof of concept\" or \"validation\" pilot is a provisional agreement to test the technical capabilities and value proposition of a product in a controlled manner.\u003c/p>\n\u003cp>In academic medical settings, these pilots are often used in research. Some academic medical centers have standard “unfunded research collaboration” agreements, where a Principal Investigator (or \"PI\") at the university agrees to collaborate on a short-term research project with a startup. In exchange for the time and effort of that researcher, he or she is given the rights to publish any findings.\u003c/p>\n\u003cp>A validation pilot is often critical for a company introducing a new technology. Validation pilots reduce the technology risk for investors and future customers. The results of a pilot are sometimes valuable for marketing purposes. But a validation pilot should not be confused for a real customer relationship.\u003c/p>\n\u003cp>\u003cstrong>Do you Really Know Your Customer?\u003c/strong>\u003c/p>\n\u003cp>It's very important to make sure you are working with someone at your target customer organization who is invested in and capable of taking your product as far as possible. I suggest finding a champion who is directly responsible for implementing new technologies which can reduce administrative overhead or improve the patient experience.\u003c/p>\n\u003cp>The ideal person is someone who has business and finance responsibilities, and views pilots as just the first phase of a larger partnership. Try to talk to department-heads or executives, like a chief executive or chief medical officer. Avoid groups that are solely focused on research, IT, or worse yet -- departments with the entire business model to make money off startups.\u003c/p>\n\u003cp>I also recommend asking questions early on about which departmental budget you will be paid from, so there's no confusion later down the line. Realize that you'll be working with slow, bureaucratic organizations. To grow quickly, reduce the number of staff-members that need to sign off on your product.\u003c/p>\n\u003cp>Take\u003ca href=\"http://kitcheck.com/\" target=\"_blank\"> Kit Check\u003c/a>, a digital health company that specializes in helping hospitals manage inventory in an internal pharmacy. Their product has three components: RFID tags for each medication, a scanning machine, and cloud-based software.\u003c/p>\n\u003cp>[Editors' Note: Kit Check is a \u003ca href=\"http://rockhealth.com/\" target=\"_blank\">Rock Health\u003c/a> portfolio company. The author is a cofounder of Rock Health.]\u003c/p>\n\u003cp>Originally, the Kit Check team sold the scanning machine which required the approval and budgets of procurement, IT, and the Head of Pharmacy. They quickly switched to giving the scanning machine away for free and only charging for the RFID tags, which only requires approval from the Head of Pharmacy. By making this shift, Kit Check has been able to scale to almost 200 hospitals in less than three years.\u003c/p>\n\u003cp>\u003cstrong>Are You Getting Paid?\u003c/strong>\u003c/p>\n\u003cp>Only pursue deals where both parties are willing to invest the time and resources to succeed. If a hospital is unwilling to pay, then they are either the wrong customer or you’re selling the wrong product. It’s not sustainable for any company to work on projects without compensation. Additionally, if another potential customer finds out you’ve worked for free, they could demand the same.\u003c/p>\n\u003caside class=\"pullquote alignright\">“If a hospital truly doesn’t have money to compensate your company for a valuable service or product, they are probably not a good target and you should move on.\"\u003c/aside>\n\u003cp>Remind yourself that if the customer really values your product, they should be paying you and not the other way around. At Rock Health, we’ve been seeing more of these so-called pilots, where startups are actually paying organizations to pilot their product. I’d suggest limiting your free pilots to one. If you do a complimentary pilot, make sure you are getting paid in other tangible ways, such as having the rights to use that hospital’s name and validation results on your sales materials, or having them make introductions to other customers and serving as a reference.\u003c/p>\n\u003cp>If a hospital truly doesn’t have money to compensate your company for a valuable service or product, they are probably not a good target and you should move on.\u003c/p>\n\u003cp>\u003cstrong>Is Your Deal an Opt-Out or Opt-In Contract?\u003c/strong>\u003c/p>\n\u003cp>If you have no other option than to offer an unpaid pilot, structure the pilot as part of a multiphase agreement with clearly defined milestones leading to a paid customer agreement.\u003c/p>\n\u003cp>Multi-phased, definitive sales contracts are up-front agreements that give each partner in the deal the choice to opt-out if certain milestones are not met. These contracts align the business goals of both parties. It’s a larger upfront commitment from the customer, but it also ensures that a startup will get paid if the product works as promised. These agreements also help startups focus on the product and implementation itself, rather than the sales process.\u003c/p>\n\u003cp>I'm optimistic about startups’ ability to get their foot in the door at large hospitals in today’s innovation-positive climate. But entrepreneurs should always consider the long-term sustainability and scalability of pilots before signing on the dotted line. Validation from a top-tier medical center is impressive, but a list of multiple, unpaid pilots on a fundraising deck is a \"death by pilot\" waiting to happen. When going to market and working in the healthcare industry, make sure both sides are aligned and ready to scale.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Thanks to Rock Health entrepreneurs Chris DeNoia, Tim Kress-Spatz, Christine Lemke, and Ian Shakhil for sharing ideas for this article.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/3027/a-caution-for-would-be-digital-health-entrepreneurs","authors":["8619"],"series":["futureofyou_172","futureofyou_110"],"categories":["futureofyou_1"],"tags":["futureofyou_333","futureofyou_335","futureofyou_341","futureofyou_334","futureofyou_338","futureofyou_80","futureofyou_337","futureofyou_339","futureofyou_336","futureofyou_340"],"featImg":"futureofyou_3188","label":"futureofyou_110"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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