Untethered Healthcare

San Diego, CA - The BIL:PIL conference this week was essentially an extension of TED:MED, with many speakers speaking at both. The keynoter, Joe Trippi (former Howard Dean campaign manager) says there are 200,000 people who work in biotech and their voices are not being heard in the current healthcare debate. He believes real change happens bottom-up and is starting iambiotech.org to give the biotech community a more visible public voice and forum.

The BIL:PIL talks seemed to center around three general themes: radical improvements in efficiency when moving from closed to open collaboration models for research and development, interesting new technologies emerging from the labs, and new companies leveraging mobile technology and social networking to improve care. If it wasn’t evident before, it surely was this week that the biggest potential disrupters to healthcare are in process changes rather than in new technologies. This aligns with the general understanding among innovation experts that reinventing the business model usually produces far greater ROI from innovation dollars than does a new product or product line. The most interesting talks were about changing how things are done — removing time, duplication and waste.

One of my favorite talks was by Scott Johnson of the Myelin foundation who spoke about his open research model. He is challenging the whole idea of private research, noting that there were 90 billion dollars spent on healthcare research in 2005 (40 in academia, 50 in biopharma) and yet new approvals remain flat. Johnson believes the current private research model is broken. “Biopharma is doing only development,  academia is focused on publishing with 700k publications a year and declining quality. To do great science today you have to be very narrowly focused. The venture community is not investing significantly in biotech. You can’t get a grant to do validation work so most great ideas don’t get to market. It is almost impossible to get funds to build new tools to find new solutions. Brilliant scientists in today’s world have no way to brainstorm with a peer,” says Johnson.

Johnson’s foundation works from the endpoint backwards and overcomes roadblocks with the goal is of taking fifty to seventy percent of the time out of the process. He requires all funded research to be open and share data, process and results.  “When we started people told us new commercial treatments for MS are 15 to 20 years away. We set a goal of doing it in five and so far we are tracking to that. You don’t have to throw a ton of money: it is about how you do things,” says  Johnson.

Other highlights:

Andrew Hessel, fomerly of Amgen, wants to enable personalized, N=1 medicine by open-sourcing cancer drug development using an innovative coop model.

Jason Hwang, MD of the Innosite Institute used the example of the evolution of the computer industry to describe how centralized industries eventually decentralize, leading to greater accessibility, new markets and lower prices. Leaders of centralized industries (mini-computer companies, hospitals) almost never lead the revolution into decentralization and often don’t even survive. Hwang nicely framed three archetypes that define current healthcare business models and described how he believes each can be disrupted. He argues that hospitals are a mashup of three businesses: the full-service solution provider, the value-added processor and the faciliated exchange and in trying to be all things to all, they don’t do any one of these businesses well.