Vital Signs Highlights

And a New Season Preview

We’ve got a great new season of Vital Signs starting next week with guests like Sarah London, the CEO of Centene, Amy Abernathy, former Principal Deputy Commissioner and Acting CIO of the FDA and CMO at Verily, Mario Schlosser, co-founder of Oscar and Jean-Charles Samuelian-Werve, co-founder of French health tech unicorn Alan. Subscribe on Apple or Spotify so you don’t miss anything. 

As we look forward to next season we wanted to reflect back on our 23 episodes from last year. Here were five of our favorite topics from last year: 

Marta Bralic Kerns, Pomelo Care CEO

We talked with Marta about contracting with payers, building a career in digital health, and challenges with maternity care in the US: 

“There's a really significant gap in the amount of care that we're providing to people, and actually the trend is moving in the wrong direction in that more and more OB practices are shuttering. More and more hospitals and rural hospitals are really under threat, and 150 or so have closed just in the last decade, and that affects L&D capacity, that affects OB capacity. And so we're seeing this problem just get worse and worse in the country, and postpartum care is completely lacking. [...] Then you also have in the US – partially because the access to care challenges – you have a sicker population even at the ages we're talking about. [...] Even when you look at the childbearing age population, we have much higher rates of comorbid conditions in the population than our peer countries. Most common things that actually affect pregnancy outcomes that we see higher rates of are diabetes, high blood pressure, obesity, any behavioral health conditions around depression, anxiety, substance use disorder. [...] The last thing I'll say is all of this compounds on itself.”

Apple: https://apple.co/3G092aK 

Spotify: https://spoti.fi/3SG5HVP 

James Zou, Stanford Professor

Our conversation with James hits on all things AI in healthcare, from the regulatory landscape to promising innovations to the current state of adoption: 

“So currently in the US, there are over 500 AI algorithms that have been already approved by the FDA to be used on patients. So these are algorithms, for example, for segmenting out and diagnosing heart diseases or diagnosing cancer or doing different kinds of decision support. So these are 500 different medical AI devices that have gone through the FDA approval process. And many of these – I think more than half of these – have gone through the approval processes since the last year or two. So the pace of growth is really fast and exponentially increasing. So that's the exciting part. But now, if you actually look at which of these 500 algorithms are really being used in hospitals… So we actually did a survey based on reimbursement patterns from AI algorithms – you can actually see how many of them are getting reimbursed in which hospitals. There's really only about a dozen out of these 500 that are really seeing any reasonable reimbursement signals across the whole country. And among that dozen, it's really only three or four that are getting more than 10,000 users right now across different hospitals. In other words, they're getting reimbursed from over 10,000 patients. So you actually see this huge funnel going from the tens of thousands of research papers to the 500 FDA approvals to the five that are actually being used in healthcare today at a reasonably high throughput.”

Apple: apple.co/42hVyju  

Spotify: https://spoti.fi/3OKwka7  

Naomi Allen, Brightline CEO

Naomi discussed her experiences at Castlight and Livongo, building a pediatric mental health business, and selling to employers: 

“We've seen a fundamental shift in terms of what's on the mind of benefit buyers in the past few years. Brightline has been a beneficiary of that because I do think that no longer do employers think about their employee in the context of the individual. They think about them in the context of the broader family unit. It's not surprising to me that we're seeing the rise of fertility benefits, of caregiving for aging adults if the employee is having to do some caregiving for an aging parent, solutions like Brightline that are focused on full family care. [...] One of the things that benefits executives are always doing with their consultants is looking at trends and what's going on, and the consultants are saying there's these new solutions out there that are doing X, Y, and Z. That's a constant driver of spikes in claims. The other one is frankly just awareness of trends going on. Benefits executives, it's actually a pretty small pool of people. They are real trendsetters. They are real leaders who are influencers. There's the 25 people whose names you hear over and over again if you're an employer-facing salesperson. If one of them, or two of them, or three of them are talking about your solution, then it creates buzz and that trickles down to a lot of other benefits buyers. This idea that if you can get into that cohort into how they're thinking about solutions, then it does have a real impact. There's also just macro trends.”

Apple: https://apple.co/3EPtR8K 

Daphne Koller, insitro CEO

We sat down with Daphne to learn about insitro’s approach to using AI for uncovering biological relationships, the potential and hype of large language models, and current barriers to drug discovery and development: 

“But I felt like if you look at the challenges that the [drug discovery] industry has faced [...] and why things take so long and cost so much, it's because we make some wrong decisions often at the beginning that don't manifest until much later. So, most drugs that fail, fail in Phase 2. Some of them fail in Phase 3 typically because people squinted at the data in Phase 2 and push forward when they probably shouldn't have. And the reason why most of those drugs failed is because they're simply going after the wrong mechanism. It's not because the pharma industry can't make molecules – they're actually pretty good at making molecules. And certainly one can accelerate that and make new kinds of molecules that people hadn't quite figured out how to make before. But that really wasn't the crux of the problem. The crux of the problem was we don't understand biology – we're kind of feeling our way in the dark and latching onto things that just don't make sense biologically. And so I felt like if you were really going to make a difference, that was the place to make a difference.” 

Apple: http://apple.co/43tNqh3 

Spotify: http://spoti.fi/3CrYiAg 

Dr. Jaewon Ryu, Geisinger CEO

Dr. Ryu shared his perspectives on the future of the physician workforce and training, Geisinger’s genome sequencing and SDoH initiatives, and what Geisinger looks for in its partnerships:

“I think it really starts with value creation. We've got to believe, and the partner has to believe and have a clear vision of how value would be created by doing something together. [...] Many times there's a yin to the yang, there's a complementary nature of what we're bringing to the table and what a prospective partner is bringing to the table. And when that happens and we're still aligned in terms of what we're setting out to do and we now have a fair degree of confidence that there's value to be created, I think then there's a potential win-win. [...] I think first and foremost, the model has to make sense. And there are plenty that we see where we're just not sure and it's not worth it because even if we're not paying for a product, let's say, there's still an awful lot of time and energy resources that get deployed to every one of these partnerships. And so we want to be choosy, we want to be selective because we owe it to our employees, we owe it to our patients and members. We owe it to our communities to make sure that we're good stewards of resources and that we're deploying them in areas where we really see potential for huge value.” 

Apple: https://apple.co/3xoHOGC 

We’ve got a lot in store for this coming year, including a new lineup of fantastic guests and synthesis pieces integrating learnings across episodes. Be sure to subscribe so you don’t miss any of it!