By far the most read piece I've written was about the stark choice pharma faces. Most are on a path that looks like what DEC, Wang and others chose. As I outlined, IBM chose a different path that led to tremendous growth for their next decade and a 10x increase in their stock. Since leaving WebMD (following the acquisition and integration of Avado) last year, I've had the privilege to speak to pharma executive teams, participate in patient-fueled ideation workshops and keynote internal innovation events or global meetings in Europe and North America.
Pharma leaders caught wind of the open source Health Rosetta project I catalyzed as well as the 95 Theses for a New Health Ecosystem. They asked me to draw on those insights and the experience of having founded or been a part of the leadership team of two $1 billion new businesses inside of a large corporation (Microsoft) as well as being one of the relatively few digital health exits. Now that I've built an investment thesis around the precepts of the Health Rosetta and 95 Theses in my position as Managing Partner of Healthfundr, these pharma companies may become partners or acquirers of companies we're investing in so they want that perspective as well.
The Health Rosetta is the blueprint for what wise healthcare purchasers should follow to maximize the benefit to their constituents. Whether it's a public entity in the UK or private companies in the U.S., healthcare's $1 trillion disruption is well underway as they are becoming wiser healthcare purchasers. The 95 Theses for the New Health Ecosystem provides the guiding principles for how winning organizations across the entire health ecosystem will approach the overhauled health ecosystem and deliver the components of the Health Rosetta. Contributors to the 95 Theses include household names such as Bill Gates while others are well-known industry figures such as Dr. Eric Topol, Susannah Fox, Jonathan Bush, and Esther Dyson. Others are not broadly known figures yet are doing extraordinary work in their fields. They include people such as Dr. Tom Delbanco, John Wilbanks, Lygeia Ricciardi, John Grohol, Jan Oldenburg, Shannon Brownlee, Dr. Bryan Vartabedian, Dr. Clay Johnston, Dr. Rushika Fernandopulle and many others whose thinking will shape the industry for years to come.
Leonard Kish and I have spent the last 18 months curating thinking from many of the most forward-looking minds in healthcare. We've been flattered that some have compared the 95 Theses for a New Health Ecosystem to the Cluetrain Manifesto. In fact, it was the Cluetrain Manifesto that was our inspiration. For those unfamiliar with the quirkily named Cluetrain Manifesto, it was hugely influential the development of the commercial Internet when it was published in the late 90s. It remains relevant 17 years later.
10 Rules for Success in the Future Health Ecosystem
In The Future Health Ecosystem Today, a post-Copernican view of the health ecosystem was laid out in a new industry taxonomy that puts the individual (aka "patient) at the center of the healthcare universe. I've selected the guiding principles from the 95 Theses that are most applicable to pharma to guide their decisions. There is one section devoted to Life Sciences and Medical Devices, but I've pulled selected theses that aren't pharma-specific but are just as applicable to them as they are to the industry as a whole. I must acknowledge the input we received from the following people on these particular theses:
- Eric Topol, MD, Professor of Genomics, The Scripps Research Institute; Cardiologist, Scripps Health; Chief Academic Officer, Scripps Health; Vice-Chairman West Wireless Health Institute
- Ben Heywood, Co-Founder, President PatientsLikeMe
- John Wilbanks is the Chief Commons Officer at Sage Bionetworks and a Senior Fellow at the Ewing Marion Kauffman Foundation and at FasterCures. He runs the Consent to Research Project.
- John M. Grohol, Psy.D. Founder & CEO, Psych Central.com
- Daniel Kraft, MD, Chair for Medicine at Singularity Univ & Founder & Chair, Exponential Medicine
In the coming weeks, we'll publish the essays from the individuals mentioned above that expand on the individual theses. The section the thesis is associated with is bolded along with any preamble in that section of the 95 Theses.
A New Medical Science
1. A new social, psychological, biological, and information-driven medical science is emerging that will better understand a person’s environmental context and it’s relationship with disease. It’s precision medicine, but more, using sensors and networks to better predict and prevent as well as treat the root causes of disease. No vision of the future of medicine can be complete or even competent if it doesn’t recognize these new sources of information and the power of patient engagement.
5. This new science will arrive at an evidence-based understanding of what works through a great wealth of shared longitudinal health data captured through mobile devices, sensors and health records. It must be mindful of the concept of transforming Data to Information, Knowledge and Wisdom.
6. The new medical science will focus on understanding the personome. “The influence of the unique circumstances of the person — the personome — is just as powerful as the impact of that individual’s genome, proteome, pharmacogenome, metabolome, and epigenome.” Roy Ziegelstein, MD, JAMA, April, 2015
Relationships and Peer to Peer Networks Will Become Central
Relationships are changing quickly due to ubiquitous connectivity, and we’re finding they are related to outcomes.
19. Verifiable but de-identified, opted-in health data will become part of a unified view of healthcare for research and risk assessment. Individuals will have the choice to contribute.
New Choices for Individuals and Care Teams
34. Mental health is an equal component of a person’s overall health. Mental health directly impacts our physical health and our ability to recover from disease or medical interventions. Therefore, mental health needs to be deliberately and systematically integrated into the general health care system.
37. We have defined sick care very well; what happens when things go wrong and how to correct them. We have very little understanding of how to keep things going right, how to get people back on track when they go off the rails, nor how to continually optimize health. Innovations in research are changing this; new entrants will figure out how to enable it.
A New Competition in Life Science & MedTech/Device
Don’t make the same mistake railroad companies made thinking they were in the railroad business (rather than the transportation business). People crave independence and will seek more personal transportation, a more direct route to where they’re headed. It’s limiting to think of a company as a pill or device company. Rather, they are in the prevention and condition management business, and a partner in working with individuals and their data. There is an emerging confluence of pills, devices, technology and biology that will lead to whole knew ways to monitor and treat diseases and conditions.
76. Tomorrow’s leaders will redesign development and trials to capitalize on the aforementioned New Science dynamics and mobile technologies.
77. New and non-obvious partnerships will need to be forged to ensure leadership in the future. Alliances with health tech and consumer health/Internet companies will be as important as alliances with academic medical centers have been in the past.
78. Post-trial relationships with individuals will allow co-creation and insights not possible before. That is a largely untapped opportunity. ResearchKit is just the beginning.
79. The individual’s relationship to a device or therapeutic may be as profound as their relationship to their doctor, or more so. Be available and open to engagement to make improvements.
Upcoming travel/speaking schedule present opportunities to get on Dave's speaking calendar:
- Week of March 28: Washington DC
- Week of April 4: Montreal, Chicago
- Week of April 25: Orlando
- Week of June 13: New York City
- Week of July 4: Toronto
- Week of July 25: Montana
- Week of September 19: Northern Europe