WHY HACKING MEDICINE?WHY NOW?WHY INDIA?

ZEN CHUMIT HEALTHCARE VENTURES

INNOVATOR CONCLAVE FOR MED TECHVELLORE INSTITUTE OF TECHNOLOGY

CHRISTIAN MEDICAL COLLEGEMASSACHUSETTS GENERAL HOSPITAL

MARCH 15, 2013

© ZEN CHU 2010

WHY NOW?

• HEALTHCARE CRISIS

• ALTRUISM INSUFFICIENT

• GLOBAL CLINICAL INNOVATION

• MACRO TECHNOLOGY TRENDS

• SUSTAINABLE VENTURES

• ENTREPRENEURS CRITICAL

© ZEN CHU 2010

WHY INDIA?

• UNIQUE NEEDS

• DEMOGRAPHICS

• NEW CLINICAL INNOVATION

• RACIAL/REGIONAL DIFFERENCES

• EMERGING MIDDLE CLASS

© ZEN CHU 2010

• CLEVER SOLUTIONS

• IDEAS ARE CHEAP

• PROVE OR FAIL FAST

• LEAN STARTUPS + DESIGN THINKING

• ACCELERATE DATA + PROOF

• ENTREPRENEURSHIP + MISSION

H@CKING MEDICINE

© ZEN CHU 2010

WHAT DOES A MEDICAL HACKATHON

LOOK LIKE?

The birth of one of the first HackingMedicine venture-backed companies…Amazing things happen in 36 hours!

H@ckMed Sessions on Top Floor of the MIT Media Lab

Craig Lipset, Director of Clinical Innovation, PfizerFaster, Better, Cheaper Data Generation = Central to Pharma Productivity

Joe Smith, Chief Med Officer of West Health Institute & MIT/HST AlumDemonstrating disconnect between health spending and quality outcomes

The Pitch as central vehicle to test & hone mission, solution, business model

TEAM + SHARED MISSION

ONLY REQUIREMENTS: PAPER + COFFEE + DIVERSE TEAM

VISUALIZE & PROTOTYPE ON PAPER

MEDICAL DEVICE RAPID PROTOTYPING

GINGER.IO + VINOD KHOSLA

FRESH EYES ON PROBLEMSFROM OUTSIDE HEALTHCARE

MENTORS VS. EXPERTS“The problem with experts is that they do not know what they do not know…

The problem is that we like to have maps–and seem to prefer to have the wrong map of reality to no map at all.

~ Nassim Nicholas Taleb

The Black Swan

SURROUND TEAMS WITH MENTORSPULL EXPERTS IN LATER, BUT START WITH NEEDS

© ZEN CHU 2010

HEALTHCARE METRICS

CHEAP IS NOT ENOUGH!

FASTERCHEAPER

BETTER

© ZEN CHU 2010

HEALTHCARE METRICS

CAPACITY

TRUST + WORKFLOW ESSENTIAL

CONVENIENCE

TRUST

FASTERCHEAPER

BETTER

© ZEN CHU 2010

HEALTHCARE FRAMEWORK

PREVENTION

EDUCATION

MONITORING

EFFECTIVE TREATMENTS

DIAGNOSTICS

SYSTEMS &

TECH FO

R

ROUTING &

TRIA

GE

TECH ENABLES SCALABLE MEDICINE© ZEN CHU 2010

WHICH RISKS TO PRIORITIZE?TYPICAL ORDER OF UNIVERSITY SPIN-OUT

Value

Market RiskPayment

Physician & Patient AdoptionPackaged Whole Solutions

Regulatory RiskSafety & Efficacy

Management Risk

Technology IP Risk

Time

1

2

3

4

© ZEN CHU 2010

Value

Time

Market RiskPayment

Physician & Patient AdoptionPackaged Whole Solutions

Regulatory RiskSafety & Efficacy

Management Risk

Technology IP Risk

ATTACK FIRST!

CHOOSE BASED ON COST/PERFORMANCEREQUIREMENTS

WHICH RISKS TO PRIORITIZE?BEST ENTREPRENEURS + INVESTORS PRIORITIZE IN REVERSE

© ZEN CHU 2010

LET’S GET HACKING!

HACKATHON PROCESS

• START WITH PROBLEMS + JOBS TO DO

• EMPATHY FOR USER

• DIVERSE TEAMS AROUND THEMES

• LOTS OF WILD IDEAS

• DEFER JUDGEMENT

• BUILD ON IDEAS COLLABORATIVELY

• RAPID CLINICAL FEEDBACK

© ZEN CHU 2010

OPEN INNOVATION

• OPEN YOURSELVES TO CRAZY IDEAS

• OPEN UNIVERSITY TO INDUSTRY NEEDS

• SEEK DIVERSE TEAMS

• SEEK CRITICAL FEEDBACK EARLY

• DEFER PATENTING UNTIL LATER INSIGHTS

© ZEN CHU 2010

JUST THE BEGINNING1st WEEKEND ACCELERATES PROCESS

• CHOOSE THE MISSION

• MAXIMIZE COLLISIONS

• MAXIMIZE FEEDBACK

• IDENTIFY CRITICAL EXPERIMENTS

IPDATAPROTOH@CK VENTURE

© ZEN CHU 2010

THANK YOU VIT + MGH!IMAGINATION IS MORE IMPORTANT

THAN KNOWLEDGEALBERT EINSTEIN

AboutMe.com/ZenVen

HackingMedicine.MIT.eduTwitter: #HackingMedicine @hackmedMIT

H@CK VIT - DAY 29 ORDER OF THE DAY

NEW CLINICIANS

10 JUDGING CRITERIA

11 BIG PIVOT PITCHES

MAD LIB PITCH

12 LUNCH

2 FIRST ROUND JUDGING - BREAKOUT ROOMS BY THEME

3 SEMI FINAL JUDGING - MAIN ROOM 412 GALLERY

4:30 JUDGES ANNOUNCE WINNERS

VALUE OF THE PITCH

• 56 PITCHES YESTERDAY!

• LIMIT TO 3 MINUTES + 2 MIN Q&A

• MISSION: WHY SHOULD ANYONE CARE?

• RAPID FEEDBACK

• FORCE CHANGE IN PROBLEM, SOLUTION, TEAM MIX

• ROLE-PLAY AS ENTREPRENEURS

• COMMUNICATE SOLUTION CONCISELY + ELOQUENTLY

• PROVE OR DIS-PROVE VALUE + APPROACH

© ZEN CHU 2010

PIVOT ON YOUR IDEA

• IDEAS GET CEMENTED IN OUR MINDS

• ESPECIALLY AROUND TECHNOLOGY ORIGIN

• SEEK JOBS THAT CANNOT BE DONE TODAY

• START WITH DESCRIBING THE USER EXPERIENCE

• NEW SERVICE, NEW LOCATION, FASTER, CONVENIENCE...

• GET RAPID FEEDBACK FROM INTENDED USERS

WHO LEARNED + PIVOTED?© ZEN CHU 2010

SCALING MEDICINE

• CREATE NEW EXPERIENCE

• INCREASE CAPACITY

• NEW SERVICE / PROVIDER with CAPACITY

• CREATE NEW PLACE FOR SERVICE

• DE-SKILL COMPLEX DIAGNOSTIC / TREATMENT

• PATIENT SELF-SERVICE

© ZEN CHU 2010

WHAT IS NEW SERVICEENABLED BY YOUR TECH?

DESCRIBE THE EXPERIENCE, EXPERIENCE, EXPERIENCE!

© ZEN CHU 2010

WHERE DOES SERVICETAKE PLACE?

SPECIALIZATION  /  INFREQUENCYCITYCONV

ENIENCE

VILLAGE

PATIENT  HOUSE

TRAIN  STATION

CLINICHOSPITAL

MUMBAI

BOSTON

PHARMACY

SCHOOL

© ZEN CHU 2010

FUNDING IS A CRUTCH

• CONSTRAINTS FORCE CREATIVITY

• SEEK JOBS THAT CANNOT BE DONE TODAY

• START WITH DESCRIBING THE USER EXPERIENCE

• NEW SERVICE, NEW LOCATION, FASTER, CONVENIENCE...

• GET RAPID FEEDBACK FROM INTENDED USERS

EXPERIMENT CHEAPLY + QUICKLY© ZEN CHU 2010

JUDGING CRITERIA5+ CASH AWARDS FOR HACKING VALUES

• PROBLEM STATEMENT CLEAR + BRIEF

• DETAILED USER EXPERIENCE DESCRIPTION

• PITCH + SHOWMANSHIP

• WOW FACTOR = UNIQUE SOLUTION

• MOST CLINICAL FEEDBACK

• GENERATED NEW DATA OVER WEEKEND

• PROTOTYPE EXPERIENCE (PAPER, DRAWINGS, ETC.)

• TEAM DIVERSITY

• GET OUT OF THE BUILDING TO TEST

• SUSTAINABLE ECONOMICS

• WEIGHT: 1/3 PUBLIC HEALTH 1/3 TECH 1/3 BIZ MODEL

© ZEN CHU 2010

MAD LIB PITCH TEMPLATE• I AM A _____________________

• MY GOAL IS TO IMPROVE

• QUALITY OF _________ (CLINICAL METRIC, EXPERIENCE, PAIN…)

• ACCESS TO _________ (SERVICE, SKILL,

• FREQUENCY/RATE OF _________________ (TEST, BEHAVIOR, DX, SURG)

• EFFICIENCY OF _________________ (TEST, DX, EXPERIENCE, SURG…)

• PROFITS OF _____________________ (PHARMACY, DOC, HOSP, FIELD…)

• FIRST TARGET CUSTOMER IS _________ (DESCRIBE SUB-POPULATION)

• THEY SUFFER FROM _________ (DISEASE, EXPERIENCE, PAIN…)

• WE CAN IMPROVE THEIR EXPERIENCE/HEALTH BY _________

• TODAY THEY SOLVE THIS BY _________ BUT THE PROBLEM IS _________

• OUR SOLUTION IS TO ATTACK _________

• STARTING WITH _________ (FOCUSED POPULATION)

• THEY WILL BE EARLY ADOPTERS BECAUSE (HIGHER SUFFERING, PAIN, COST, RISK, FEAR…)

• WE WILL REACH THEM THROUGH _________ (CHANNEL, SPECIALTY, RETAIL, PHARMACIES…)

• BUT WE CAN ALSO ATTACK LARGER MARKET OF _________ (NEXT USER TYPE)

• OUR PRODUCT/SERVICE WILL BE PAID FOR BY _________ BECAUSE THEY VALUE _________ (UNIQUE QUALITY,

© ZEN CHU 2010

THANK YOU VIT + MGH!SEE ONE - DO ONE - TEACH ONE

APPLY HACKING PRINCIPLES TO WHAT YOU OBSERVETO REMAKE THE FUTURE

AboutMe.com/ZenVen

HackingMedicine.MIT.eduTwitter: #HackingMedicine @hackmedMIT

BACKUP

37

CLINICAL INNOVATIONCRITICAL SUCCESS

• DESIRE TO HELP PATIENTS

• RIGOROUS ANALYSIS + DATA

• FOCUSED PLAN TO EARLY PROOF

• CREATIVE TEAM

• ADAPT TO NEW DATA

• EVIDENCE-BASED

• SUSTAINABLE MODEL FOR PRODUCT/SERVICE

© ZEN CHU 2010

INNOVATION RULES• MINIMIZE TIME TO DEMONSTRATION• BUILD SMALLEST POSSIBLE TEAM• DEVELOP ONLY THE BARE MINIMUM• PROVE ONE IDEA / VARIABLE AT A TIME• ITERATE FREQUENTLY BEFORE MANUFACTURING

CONTROLS REQUIRED• NEVER DEVELOP WHAT CAN BE BOUGHT• INSIST ON HIGHEST QUALITY WORKMANSHIP FOR

FINAL PRODUCT

EMPHASIS ON SPEED & PROOF

© ZEN CHU 2010

BUILD TEAM TO EXECUTEValue

Time

Market RiskReimbursement

Physician & Patient AdoptionPackaged Solutions

Regulatory RiskSafety & Efficacy

Management Risk

Technology Risk2) Te

am Exe

cutio

n

1) Plan

in Rev

erse

© ZEN CHU 2010

TIME IS LIFEACCELERANT DECCELERANT

REGULATORY Device 510(k)Euro CE Literature ClaimsPredictive animal models

New materials & claimsUnclear endpoints

CLINICAL Existing human dataReproducible published studiesAcute episodic symptoms

Non-superiorityEntrenched behaviorChronic disease endpoints

REIMBURSEMENT Existing Codes DRGsExisting insurer coverage policiesPrivate-pay, consumer

Cost-Benefit StudiesNew codes required

MARKET Reduce skills neededPhysician buying powerUnambiguous diagnostic

Capital equipment purchase No physician benefit

SALES Focused physician popul.Existing distribution

Learning curvesEntrenched behavior

© ZEN CHU 2010

INCREMENTAL vs BREAKTHROUGHPlenty of Incremental Value, BUT Different Strategy

METRIC INCREMENTAL BREAKTHROUGHFunding $$ $$$$$$

Market Size Varies depending on funding needed

>$100MMNo current therapies

Time NeededAdoption & Exit

ShorterMatch opportunity to strategy

LongerRegulatory path dependent

Value @ Exit Less More

Major Risks Window of opportunityExecution quality & critical pathCompetition

Technical/Clinical unknownsMarket adoption hurdlesReimbursement

Success Factors Focused executionManagement experienceManufacturing economics

Patents, Franchise ValueMarket adoption, Std of CareInvestor expectations

Patent Protection Less More

Competition More Less

© ZEN CHU 2010