On a Mission: Putting Digital into Healthcare

What is your elevator pitch? What is Healthware International?

Healthware International is a next generation health consultancy, part of Healthware Group, that helps its clients in the areas of health innovation, advisory, communications, media and technology. We were founded 20 years ago on the belief that digital technology and software could be leveraged to have a significant impact on health outcomes. Hence also our name which combines the words “Health” and “Software”.

What is your health mission – what are you doing for the healthier world?

I would say that, despite the tremendous changes in the world of technology, media and health, our mission has remained truly consistent since the day we were founded: to help all healthcare stakeholders significantly increase their ability to deliver better health and better outcomes to people using digital technologies. In the early days of our company, this was done by supporting clinical studies with platforms we built specifically for managing them; then by using a nascent web to help doctors and patients connect with each other, and access reliable and reputable health information, along with helping many pharmaceutical companies make their digital transformation to join the online conversations. As medicine is entering a new age, a notable example being digital therapeutics, Healthware has continued to evolve in our mission to create a healthier world by launching a health innovation practice dedicated to developing and launching digital therapeutic solutions that can dramatically increase the effectiveness of existing therapies, or in some cases replace them altogether.

What would be the key points of your State of the Nation speech on digital healthcare?

The ground to cover in such a speech is truly enormous, and getting bigger by the day! The overall idea is to provide the audience with an overview of what has happened during the last year and what will be key areas of focus for the year ahead. The main points however, remain consistent: the advent of consumer-driven technologies, which allow the capture and tracking of massive amounts of clinical grade data, combined with the analytical power of machine learning, will provide patients and doctors with novel ways to not only track their health conditions, but actually be able to predict impending health events before they happen. The transformation therefore is not only in being able to treat patients better, but actually in being able to enact measures that can stop people from getting sick to begin with. What this will do to the healthcare industry is tremendous. It will move medicine from an acute/observational model to one that is more predictive and preventive one. As a result, the entire financial model surrounding health (fee for service and outcomes driven) will also necessarily need to shift towards a risk management and avoidance one.

What are the biggest challenges, looking forward to 2019? Will any of them be solved?

Some of the biggest challenges, I would say, are the ones that remain in the way of true adoption and the launch of digital health technologies in the day-to-day practice of medicine. This includes a variety of tasks ranging from the need to validate solutions, to the promotion of them to healthcare professionals, through to reaching the level of digital health literacy among consumers that is needed to really unleash the power of digital health solutions in their daily routines. We also need to define a common set of new biometrics based on digital outcomes, which the scientific community at large can agree upon. To this end, Healthware is a founding advisor of the Digital Therapeutics Alliance, whose mission includes bringing this common set of measures to the industry. Thirdly we are starting to see a significant disconnect in the training and education of the new generation of physicians. There is a tremendous need to completely update the curriculum and knowledge transferred to the doctors of tomorrow, who will be entering a world completely different from the one that they have been taught about. I believe that, as the industry is finally catching up this year with the reality of digital therapeutics, to name just one, academia has to step up to the plate and do the same.

In the tech sector we talk a lot about AI. What is your take on its role in healthcare?

As I mentioned earlier, machine learning and AI will be instrumental in analysing massive quantities of health and real world data from multiple sources. When we get to the point of being able to associate certain disease parameters with seemingly unrelated data points, we can then begin to look for disease characteristics long before the actual symptoms manifest themselves to the individual. AI can therefore help us anticipate the timeline towards disease diagnosis, and with this early disease detection, our opportunities to treat the disease sooner increase the chances that the outcome will be better. There are already consumer apps that run on smartphones allowing people to take photographs of their skin and moles, so that they can diagnose melanoma with a great degree of accuracy by analysing the photo against thousands of actual melanoma photographs. When you consider that a trained dermatologist might only see a few cases of melanoma throughout their professional career, having the diagnostic support of an AI agent that will have seen and learned how to recognise thousands of diagnosed cases is certainly a dramatic development. AI will not replace doctors and the human element of medicine, but it adds a very powerful tool to the physicians’ bag. All in all I want to stress that AI in health is a powerful tech but as with all other tech frameworks, it will be a means to an end not a solution for all healthcare problems.

How far are we towards finding the balance between healthcare and selfcare. It seems to me that a lot of digital measuring is still clearly on the non-healthcare side of the equation.

This is something that is changing dramatically as we speak. The latest version of the Apple Watch can, through a combination of digital measurements and AI, alert its wearer if it is exhibiting symptoms of atrial fibrillation (AFib), which can result in devastating strokes or death if left untreated. This is thanks to continuous “non-healthcare” monitoring on the consumer side of devices. Until last year detecting AFib was only possible if, by chance, a person happened to be experiencing symptoms while wired to a 12 lead ECG machine during a yearly medical checkup. Had that visit happened 10 minutes earlier or later there is a good chance that those symptoms would have not been detected as AFib symptoms are intermittent in nature. As more and more digital biomarkers, backed by AI, are integrated into software running on everyday items that are already on the market, be it Alexa voice interfaces or the webcams built into smartphones, consumer-supplied digital measurements will become a natural extension of the entire healthcare ecosystem. The demarcation lines between them are already becoming blurred, and it is only a matter of time before such a distinction will not exist anymore.

Are there any other specific questions you would like to address?

We are often asked how we chose the location for our Healthware Life Hub, which recently opened in an 11th century former monastery at the start of the Amalfi Coast in Italy. Italy is one of the healthiest nations globally, and it is where Healthware was founded over 20 years ago. We wanted a location there where our clients and partners could meet, experiment and connect, away from their daily routines.
We wanted to identify an unusual, surprising location, close to some of the most beautiful places on earth, where we could concentrate on the type of groundbreaking health innovation work that we are conducting during these transformational years. A lot of great work can be done on location, with many of our clients asking to come and work in our offices rather than having us go to them! The exciting and intense work sessions we hold at our Life Hub balance nicely with time for outdoor enjoyments, great weather and great food. So make sure to come visit us soon!