On September 4th, we brought the HealthXL Global Gathering home to Dublin, Ireland. Together with our partner Novartis Ireland, we invited some of the world's foremost healthcare leaders to the Vista Building in Elm Park. With Ireland emerging quickly as the world’s leading tech economy, it was only fitting to bring back global healthcare leaders to our small green island for an encore after the last get together in 2017.

For those who couldn’t make the gathering and attendees looking to revisit the discussions, we have put together a short roundup.

At this year’s gathering, two key themes dominated the discussions of the day:

• Clinical Trial Optimization: What are the barriers and opportunities?
• How do we sequence evidence generation within the field of digital therapeutics?

After a brief Welcome by Martin Kelly, HealthXL CEO and a recap of the main conclusion from our Digital Health Evidence Report by Chief Medical Officer, Chandana Fitzgerald, the event kicked off with our first session around clinical trial optimization.

Clinical Trial Optimization

Marie Ennis O’Connor (HealthCare Social Media) kicked off the first session with a presentation on the role and potential of social media in clinical trial recruitment. She argued that the scientific community must rethink its designs to be more patient-centric. Marie highlighted how the issue is not a lack of patients who are willing to participate in clinical trials, but rather a lack of awareness among patients on how or when they may be eligible to participate in trials. Less than 0.2% of patients are referred to clinical trials by clinicians; yet, there was a 180% increase in google searches for ongoing clinical trials in the past 12 months. Marie centred her presentation around the potential for patient communities and social media in the future of effective patient recruitment, and urged us all to work towards new frontiers of participatory research; when you look for patients as partners, the perspective changes entirely.  Marie finished up by sharing some food for thought - ‘’We don’t have a choice on whether we DO social media, the question is how well we do it”.

The second speaker, Kuldeep Singh Rajput (CEO, Biofourmis) spoke about how Biofourmis is working with pharma in enabling trial optimization through the use of wearables and sensors to capture passive data. Kuldeep then shared an example of how Biofourmis is working with the FDA to create a framework for running digital trials and working with digital endpoints. Mortality and hospitalization have traditionally been the only end-points being measured in HF patients, and these outcomes could take months and years to happen. New guidelines now recognize patient-centric endpoints like quality of life and function. Biofourmis is working with the FDA to see how their Biovitals program can be used to capture these endpoints and advance research within this space, defining what biomarkers can be used to quantify these endpoints. 

The Clinical Trial Optimisation session was rounded up by a panel discussion with our two speakers joined by Francesca Wuttke (Chief Digital Officer, Almirall) and Tyler Puglsey (VP of Life Sciences, Medable), moderated by Dermot Kenny (Global Head Data Operations, Novartis). 

Dermot challenged the panel with questions on the increased costs and time to run a clinical trial, and what they see as the catalyst for change within big pharma. The panel agreed that as the complexity of the drugs being trialled continues to increase, so too does the complexity of design, the time taken to execute, the cost to run, as well as the regulatory hurdles that must be overcome. The panel also noted that in order to drive change we need to consider how innovation is brought into clinical trials, focus on what patients are already using (i.e BYOD) and what the user experience may be, and the need for interoperability, data aggregation and data returns when introducing technology into clinical trials. 

Digital Therapeutics: What’s next?

Abishek Shah, CEO of Wellthy Therapeutics, opened the second session to educate the group on cultural adaptations of digital solutions for Asia and other emerging markets and offered some critically important insights to build successful solutions for these markets. Wellthy Therapeutics is driven to transform chronic disease management and has developed India’s first prescribable digital therapeutic for Type 2 diabetes. He argued compellingly for hyper-personalization of digital solutions in newer digital markets and explained how the uniqueness of patients and their needs (in terms of access, affordability, urban/rural location), as well as their interactions with the internet, fundamentally determine the format and delivery of healthcare interventions and solutions. He further emphasised that differences in healthcare infrastructure, regulatory advancements and private insurance penetration further influence how digital solutions reach the patient. The combination of these factors ultimately also affects the optimal price points at which solutions are marketed and scaled in these markets. 

Derek Richards, Chief Scientific Officer, Silver Cloud Health, spoke to the audience about the path of turning evidence-informed interventions into evidence-based interventions. SilverCloud Health has the world’s largest comprehensive library of customisable evidence based programs for persons with mental health and comorbid medical conditions, which to date has worked with over 280K patients. Derek started his presentation acknowledging the differential stages of research penetration as SMEs before charting the multitude and diversity of sequentially phased studies his team designed to ultimately establish the effectiveness and impact of SilverCloud health tools. While the entire process took a very long time, Derek highlight the invaluableness of being able to use your own data to establish the significance of your intervention. He concluded his presentation with a comment on the importance of implementation science in order to establish the replicability of programmes or interventions in more diverse real world contexts.

Abhishek and Derek joined ensuing panel discussion between Sahil Kirpekar (Head of Business Development Europe, Otsuka), Jonas Duss (Business Development Manager at Kaia Health), Christoph Ruedig (Partner at Albion Capital) and Brian Flatley, Business Strategy & Engagement Director at S3 Connected Health, as chair. The panel explored the optimal time points for commercializing digital products and the prior evidence base required for doing so. Jonas offered some insights on the advantages gained from early commercialization and how real world data generated through this process is invaluable for product iterations and improvements. The panel also discussed whether having established an evidence base in one geographic area facilitates market entry into markets further afield. The panel also briefly shared their opinions on and experiences of engaging with regulatory bodies, and discussed the extent to which health systems are currently preoccupied with safety of digital therapeutics.

Ask the Investor: Top 5 stories in Digital Health Investments & artnerships 

The third session of the day began with a fireside chat between Lisa Suennen (Group Leader, Digital & Technology, Group & Lead at Manatt Ventures) and Jeremy Sohn (VP, Global Head of Digital Business Development & Licensing at Novartis). Jeremy shared his learnings from his time at MPM Capital, discussing both successful and challenging investments made and the learnings from those. When Lisa asked about his prognosis of the potential for digital to innovate clinical trials, Jeremy proved optimistic and lauded researchers within this space for their innovative approaches.

The event wrapped up with a panel discussion led by our own Martin Kelly (Co-Founder & CEO, HealthXL), who was joined by Robert Garber (Partner, 7Wire Ventures), Bill Taranto (President, Merck Global Health Innovation Fund), as well as Jeremy Sohn. The panel discussed the ever increasing valuations we are seeing within digital health, and whether or not these are realistic and representative of the true potential of digital health companies. Bill Taranto and Robert Garber shared their learnings having been involved in Livongo’s recent IPO, noting the importance of Livongo’s appropriate valuations at each round, as well as their strong business model similar to other successful companies in other markets. The investors cautioned that companies raising extremely large investments must exercise discipline in order to ensure future sustainability. The panel wrapped up with Martin asking each of the panelists what area they are most excited by. While Bill told the audience that he sees a lot of potential in oncology, Jeremy is most excited about ePharmacy and Robert is likely to focus his attention on aging.

What we learned at this year’s HealthXL Global Gathering

• We must redefine the frontiers of participatory research and render clinical trial designs more patient centric
• We must identify new endpoints in order to leverage digital technologies in clinical trials
• Patients are unique and have very specific needs - digital solutions must be hyper-personalized to increase their useability
• Commercialization happens at different points along the evidence generation continuum, but evidence-based interventions are those that start off as being evidence-informed and can ultimately prove their efficacy and impact.
  
  

We are passionate about stimulating, thought-provoking and inspirational conversations at our Global Gatherings. We love connecting healthcare leaders, innovative thinkers and entrepreneurs and encourage them to share their stories - together with Novartis, we accomplished all we set out to do!

Go raibh maith agat!