Bryan Arkwright, VP of Innovation at SCP Health, Craig Lipset, Former Head of Clinical Innovation at Pfizer, and Paul Sterling, VP of Emerging Products at United Healthcare at Converge2Xcelerate Conference (Boston, MA)
- By 2022, worldwide spending on blockchain solutions will reach $11.7 billion
- United Healthcare covers approx. 45 million individuals worldwide
- Goal of blockchain in healthcare is to reduce uncertainty between doctors and patients
Bryan Arkwright – VP of Innovation, SCP Health: 00:00
I’m especially excited because right before I took the panel I went into a new role, which is vice president of innovation for SCP health. So very excited to be alongside these two esteemed individuals in innovation. So our topic today is patient impact and the bottom line with digital health. I am your moderator Brian Arkwright as I mentioned vice president of innovation for SCP health. We’re a large position staffing company. I’m also chief research officer of Cromford Health which is a research and advisory group that collaborates with digital health organizations. And then also adjunct faculty with Wake Forest University school of law where I teach a telehealth overview course. So very excited to have these gentlemen here. I’m going to first let Paul Sterling introduce himself.
Paul Sterling – VP of Emerging Products, United Healthcare: 00:57
Yeah, absolutely. So, thank you for having me. Pleasure to be here. I’m Paul Sterling. I’m the vice president of emerging products at United Healthcare. I’ve been with United Healthcare total about 14 years. My role is really focused on the convergence of innovation in the healthcare space, just broadly defined. So that’s in care delivery, that’s an administration. It’s an everything in between and traditional health benefit products. So that’s what we do at United Healthcare. And so my focus is on how can we improve these benefit products, these benefit designs with emerging solutions coming from, primarily my focus is outside the four walls of our enterprise. So taking, cutting edge innovation, combining with, you know, what you would consider traditional benefit design and delivering a product and, or a service that moves the needle forward for our members as well as our enterprise.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 02:00
And I’m Craig Lipset. Up until this summer I ran innovation and medicine development at Pfizer down in New York. And so the scope there was very much around our portfolio of investigational medicines across therapeutic areas, across phases of development. And how do we bring in innovative new approaches to engaging patients to leveraging digital tools that can help us to measure the efficacy and safety of new medicines faster and more efficiently. Today I’m mostly working as an advisor with a number of venture and startup in tech that are all leaned in around medicine development, clinical trials how to still achieve many of those same goals and objectives.
Bryan Arkwright – VP of Innovation, SCP Health: 02:44
Excellent. Let’s kind of start off, we collaborated on different questions that we feel would be valuable. First up, you know, this is a telehealth track reimbursement for telehealth is, is quite the kind of patchwork quilt across the country in terms of state and federal requirements. How does, specifically at your organizations, in the work that you’re doing with innovation, how does reimbursement for telehealth and digital health factor into your innovation work for pilots?
Paul Sterling – VP of Emerging Products, United Healthcare: 03:19
Yeah, so I think in a number of ways. So I think, you know, the first thing I’ll tell you is that you think about, so, you know, from at least where I’ve sit in my experience, United Healthcare was, and this will not be a commercial for United Healthcare, trust me. But we think about kind of pushing the boundary forward in terms of digital health and telehealth and United Healthcare was a groundbreaker in that regard. You know, 10 plus years ago in terms of commercial reimbursement for telehealth services. So, I use that as an example to say it to illustrate the point that we’re always looking for better ways to deliver care to those who need it, period. And we’re very aggressive about that. Digital health tele-health, new applications of telehealth beyond simple primary care. So, we’re always looking for and pushing the boundary in that regard.
Paul Sterling – VP of Emerging Products, United Healthcare: 04:09
And reimbursement’s a big deal obviously in that respect. And our medical policy tends to be very upfront and very aggressive to support that. The other side of that I’d say, you know, think about you know, we think a lot about efficacy and safety in terms of telehealth services. So, you know, first and foremost, you know, there’s a lot of good innovation and telehealth, a lot of good innovation, digital health, you can do a lot of things. You know, but at the end of the day, you got to ensure that you are truly advancing in furthering somebodies health in terms of safety. And that the solution really has a demonstrated output you know, something based in, research and evidence that there’s efficacy in the solution itself. So you kind of combine those two things with the mindset of kind of moving the boundary forward. Produce a good scenario.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 05:09
So my lens is a little different. So I think I said among the many different use cases that leverage tools like telemedicine and adjacent areas and what’s nice there is we can represent incremental revenue for companies as they’re figuring out their reimbursement strategies. Now I’ll share what I mean by that. I put together at Pfizer the first fully virtual remote clinical trial for an investigational new medicine under an FDA, Zion D. And so we were leveraging telemedicine and other tools in the context of our interventional clinical trials in our medicine development portfolio. So reimbursement was less of an issue for us because we’re the paying for it. We are the payer where the sponsor of a given research study now to a venture that’s a supporting telemedicine that is nowhere near as interesting revenue as it would be when their solutions get full reimbursement and they have, you know, solution either for a particular market or even, you know, in a multi-state level. But as companies are growing, I think this represents an important channel for them to be able to get more incremental near-term revenue while they’re figuring out their longer-term reimbursement.
Bryan Arkwright – VP of Innovation, SCP Health: 06:31
Two very different lenses, but great answers. Thank you. Do you both have kind of your own business model for innovation and if yes, could you elaborate on it?
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 06:44
So, I would often get asked even, you know, what are you defining as innovation? Right? We all have ideas in a big company like Pfizer, if you have a 100,000 employees who’ve got, I hope at least a hundred thousand ideas out there. And so the definition that I would subscribe to is an idea from which we derive value. Now I worked in a cost center, right? R&D is not a revenue generating part of the business. We we’re a cost to the business. And so we don’t often think about that innovation that we’re using to support our medicine development efforts as a where the value is revenue. Our budget is a fixed cost and we want to try and get as much done under that as possible. And so by using a definition of an idea and you want to derive value from it, what that value is that you’re looking to achieve is going to vary.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 07:42
And for where I sat, that value didn’t mean how much revenue would it bring in in a business. In most cases it meant how did it either remove risk, accelerate or otherwise impact quality or cost of the medicine development efforts that we would have underway. And certainly as we would look at platforms like telemedicine for us that might mean how can we recruit patients faster by improving access for patients for more diverse geographies. How can we reduce attrition in our studies and reduce the need to have to repopulate studies with more patients because patients are able to stay and participate in studies because of burden being reduced and access barriers being limited.
Paul Sterling – VP of Emerging Products, United Healthcare: 08:30
So, you know, United Health group’s perspective. So what’s unique about United health group is we touch pretty much every facet of healthcare period. And so when you talk about business models for innovation in digital health and telehealth yeah, I wouldn’t say it’s an easy thing to respond to, but you know, I would say that you think about care delivery, you think about administration of benefits, you think about operations and administration behind, you think about payment cycle and revenue buzzers. We touch every different area of the healthcare space. And so, there’s not one business model that drives innovation within our enterprise because we can find, we were fortunate frankly, if we find an innovation that will drive a business model of one of our customers, that may be a small practice. It may be a hospital system, a large integrated delivery network. You know, and across the board. So, you know, we’re fortunate in the fact that we can look for we can look for innovation, we can develop, we can find innovation and then match it to somebody on the other side within our book of his, when our customer set. So we’re not restricted our encumbered by, you know, this is our business model and this is interesting, but it doesn’t fit. It won’t take out costs of the to drive revenue. You know, we can really find the innovation first and then find a spot where it fits and then bring that out to the market.
Bryan Arkwright – VP of Innovation, SCP Health: 10:01
Excellent. Kind of match it. Some good takeaways, Craig as well. Which leads into kind of the next question. Craig, describe it as a fixed cost at times. Are you profitable within innovation and kind of how is that measured, Craig? And maybe talk about former Pfizer and your future current endeavors and very interested in both kind of your takes on that one.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 10:30
Trying to measure the return and a return on investment or return on innovation is a challenge. I think in a lot of large organizations. My father was an accountant. He used to say, figures don’t lie, but liars can figure and it’s always easy to come up with some slide deck that justifies just about whatever idea people can come up with. There are probably some business model people can cook up around that. I think what, what we struggle with is the commitment to drive scale and adoption to realize whatever that return is. And by that, what I mean is it’s one thing that come up and say, here’s my forecast. We’re going to save X dollars. We’re going to accelerate this by Y, but inside of an R&D organization the only way you’re going to get that return is if you get beyond a pilot, get beyond an experiment and actually use whatever that innovative new approaches and a meaningful skill inside of your organization.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 11:32
And that requires change. Those are, these are much less sexy things than going after blockchain or tele-health or some awesome shiny new object. This is just old school change management communications, really boring stuff that loses the attention of a lot of leaders. But without it, you don’t get any of that return that you’re aspiring to. You will never get the ability to generate those metrics that you really change something and shown that return. And I think that that lack of commitment to adopting is a pervasive challenge in a lot of big companies. And quite honestly, stymies a lot of the growth for entrepreneurs and many of the types of startups I work with today, it certainly favors large incumbent service providers that aren’t very interested in change and new approaches. And so, I find myself today working with a lot of large pharma companies that are all stuck in this cycle of pilots and experiments and can’t seem to figure out how they get themselves past it and be able to drive their innovative experiments to scale. And in doing so actually get that return on investment that they sold their board on so many months or years ago.
Paul Sterling – VP of Emerging Products, United Healthcare: 12:56
You know, so I think so you talk about engagement, you know, from where I sit in our perspective it’s almost, you know, maybe it’s a little bit counterintuitive. You think a big enterprise well-structured, you know, there’s, you got to prove out the value on the sexy PowerPoint. It’s counterintuitive a little bit cause it’s almost easier inside our enterprise. You know, we know that that engagement, it’s kind of three areas, right? So there’s engagement. If you can get people, you can get members’ attention and sustain that attention, there’s going to be value at the end of that road near term and long-term period. You know, so we don’t have a lot of, you know, we don’t go through a lot of, just say rigor is not the right word, but it’s not a barrier up front to define in very hard ROI terms.
Paul Sterling – VP of Emerging Products, United Healthcare: 13:47
What’s the value of this initiative? If you can prove that you’re going to get and sustain engagement in whatever solution it is. Telehealth, digital health you know, our enterprise knows and believes that there’s value at the end of that tunnel. There’s the second dimension, clinical and they kind of follow each other in order, right? So engagement, sustained engagement is a number one, critical clinical outcomes, efficacy and safety. As I mentioned before we know there’s value, there’s certainly value for everybody in that dimension and the financials follow that. The hard kind of traditional healthcare financials will follow that, and we believe in, you know, extending access, taking cost out of the system, right? How can you get people, how can you take costs out of the system? The tools and the solutions are there. You have to present those in a way that’s engaging, that’s motivating, that’s compelling, not for six months, not for 12 months, but for the rest of somebody’s life in a lot of scenarios, right? So if you can get and maintain that engagement, the clinicals are going to follow and the financial will follow as well. And we believe that.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 14:52
I was thinking about, you know, when we were getting miked up, we were talking about kids and I was thinking about how when we are putting together pilots or initial experiments inside of large organizations, there’s a huge amount of effort and so much blocking and tackling that internal champions and leaders have to do so that those entrepreneurs in your organization that want to try something new can actually get that pilot done. And I often think that, you know, it’s almost like when, our spouses are pregnant and you’re going through this nine-month period in this journey and there’s all this hard work and it’s painful. But that at the end of that nine months, the really hard work all actually begins, right? Like, if it’s your first, you don’t know, at the very least, hopefully reading a book, you know, and maybe your baby proofing at home and you’re thinking about, you know, my finances and other things.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 15:56
And when we’re doing these pilots, we’re so focused on all the pain and the hard work that’s going on that we have very little energy left to think about the baby proofing and what we’re going to do when that pilot delivers. And at the end of those nine months to then actually be able to adopt and scale and be ready for bringing that pilot home and enabling the change that’s needed in our organizations. And I think that in many of the, at least the pharma companies that I ended up working with, I feel like that tends to be one of the biggest barriers we need to start reading the book what to expect when you’re expecting a pilot to finish and it’d be ready for that change.
Bryan Arkwright – VP of Innovation, SCP Health: 16:40
That’s great. Excellent insights. And it’s nice to hear you guys kind of boil it down to, you know, the engagement, the culture, the change management, the executive champion, you know, all that stuff is critical and you know, change fatigue, all that stuff is real. And when you’re doing innovation it is, you know, all that more important and still just as important. It’s not just a new initiative. Kind of final closing questions. What are your predictions for healthcare over the next two years? And what are the barriers and maybe give us 1-2 strategies to overcome those barriers.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 17:22
What’s great about these questions is we can either deny it in five years and you’ll, you’ll hopefully have no video evidence that we said it or if we get it right, we’ll be out there waving the flag thing I told Yaz, you know, so I think since this is a conference that really focuses very much on healthcare and healthcare delivery and I come from a medicine development and research perspective. I think part of the future I’m going to lean in on here is this convergence around research and healthcare and how technology is enabling that convergence. Because in today’s world you have a patient having an encounter with a provider. And if somebody should happen to decide this is an opportunity for this individual to participate in a clinical trial, everything stops. The patient has to become a participant, the physician has to become an investigator, their EHR gets thrown out and somebody brings in a clunky 1980s electronic data capture system.
Craig Lipset – Former Head of Clinical Innovation, Pfizer: 18:20
You have to sign all different paperwork and restart everything. And what we’re seeing are these opportunities for increasing convergence between research and health care. And in doing so, how can we create more opportunities for access for both patients and physicians by removing the barriers and the burden by leveraging more existing systems, existing data, and taking advantage of the large integrated delivery networks that are proliferating across this country and elsewhere. Because today our mindset in the research side is we think about an investigator and we have databases of investigators as if these physicians are all Marcus Welby and hanging a single a shingle outside of their practice. And that’s not the way any of our providers practice today. And so I think there’s this great shift and I think technology is creating a great enabler for this integration of research and healthcare, which will continue to center around delivery networks, but how we can then leverage telemedicine, visiting nurses and all the other great tools that healthcare is implementing at scale inside of those networks and be able to leverage them in the research setting.
Paul Sterling – VP of Emerging Products, United Healthcare: 19:30
So what I see day in and day out every day in my particular role at this point is, I’m very bullish about our space. You know, we’re a big, very large, you know, incumbent in this space. And what I see every day is the continued proliferation of not only investment but ideas, new ways of putting together the pieces and the parts telehealth, digital health, evolution of traditional care delivery models. I see new innovation every single day coming from the outside, the four walls of our enterprise, which pushes our enterprise. And I think the, the pace of that in the last five years, it’s not exponential. It’s close. And so I’m very excited about that. I’m very bullish about the opportunity to solve some of the big challenges that we’re facing as a system.
Paul Sterling – VP of Emerging Products, United Healthcare: 20:25
And I’m very excited to be able to be part of, see, partner with work with and hopefully scale some of these great ideas that are popping up repeatedly every day. So I think that’s the future I’m going to see. I think we’re going to see an acceleration of not only a digital and tele-health solutions, but you know, just technology enablement of healthcare. And I think it’s going to push big incumbents like us too. You talked about reimbursement to be even more aggressive on that front. To be even more aggressive on some of the things that traditionally kind of stand in the way of the two people in a garage. Their idea getting going. So I’m very bullish about the future, I believe in technology to get us there.
Bryan Arkwright – VP of Innovation, SCP Health: 21:13
Excellent. Well, yes, if it is an exponential is really critical. It is amazing how much it’s been growing and scaling lately. Well, I just want to thank you guys time. This was a pleasure. I hope the audience enjoyed it. We are going to we’ll do two minutes questions. Anybody have any questions? All right, we’re going to keep rolling. I’m trying to button on track. Thank you guys.