John Walls: The world of mHealth health continues to evolve and really exploded in a lot of
respects and at the same time
still looking at fits and starts to really catch on. So, there's an innovation
side and certainly regulatory side here
to consider and with me to talk about all that is Mo Kaushal
who is the
Chief Strategy Officer at West Health
located out here in the San Diego area
Nice to have us in your backyard, thank you Dr. Mo Kaushal: Thanks for having me.
Walls: Chamber of Commerce weather too, so you always produce.
Well let's just talk about...you and I actually spoke about this a couple of years
Kaushal: That's right.
Walls: Where are we from then until now?
What's been going on in this space that gives you
encouragement, or gives you
positive thoughts
hey, we're getting somewhere. Kaushal: Yes, I think some some key learnings
as the years have gone by
things have evolved
i think an important point is that
mobility by itself is not just going to work, it won't get adopted
healthcare is a really complicated, fragmented ecosystem
so, for things to all come together
a bunch of levers have to
move in the right direction and we're seeing that, so the most important thing
first of all is the payment model
classically health care has been paid on a per transaction basis, so if you're a hospital
you get paid for what goes on inside you four walls
that's slowly changing, they're getting paid for what's going on outside
so, that suddenly creates incentives to keep people healthier
stop them from coming into the hospital
so now what we're seeing in the landscape is hospitals are changing their clinical
processes
to optimize around keeping that patient well outside
then once you've got those two in check
then you can think about all the great technologies that you and I know the
mobility, analytics, cloud base computing
and bundle that into all those clinical processes to keep people healthier
Walls: So, let me interrupt, you're saying
you think the payment structure
is kind of the underpinning of all this. Once we get settled as to
who is going to be rewarded or compensated for what
that's a huge step in the right direction.
Kaushal: I completely agree, so if there's one thing I could change
it'll be the payment model. How do we pay for real outcomes versus just volume?
I think paying for volume creates real perverse incentives
not to keep people healthy, but that's changing
Walls: Mobile, you can get outcomes
You can see real outcomes right there on your device, measurements on a day in day out
basis
I would think that's encouraging
to consumers to patients to see that they have control
and they're aware of progress they're making
Kaushal: Absolutely
I think going back to the fundamental economics, things have to change
The US spends around 18% of GDP on health care
we don't get the same outcomes as other countries, so i think there's real hope
given that mismatch
The country will go bankrupt unless we figure out health care
Walls: What about the regulatory burdens here
the FDA has had some
rulings with regard to device
approvals, some general guidelines and what have you, but there's still a lot of
gray it seems like.
It's just not as clear cut as some would like it
Kaushal: Really good point, I think innovation is always going to
out pace policy
So, I could never think of a time where policy was clear-cut around the
regulation of technology. Walls: Don't tell that to a regulator.
Kaushal: It's always going to outpace. The FDA like other regulatory agenceis
have a hard job, so
and especially the FDA
things have to be safe
you can't release products out in the marketplace which could injure patients
you've seen the paper
you've seen the front pages of
national papers outlining those scenarios
so, that can't happen. They've got a tough job. What's the right risk reward balance.
Walls: Then on the patient adoption side
there is probably in some respects, some reluctance.
worries about security
privacy
and then maybe
you know kind of that
you know that's the big brotherism
and a few people that, is that an impediment to some extent?
Kaushal: A very simplistic classification this thing sold directly to
consumers, so you've seen all these wonderful apps, these fit bit devices
consumers don't worry about that, if it creates value for them and they'll buy it
and we see that world growing year on year on year
the stuff which is prescribed
by a physician or hospital. I think there are more concerns about safety and privacy and
security
but I don't think these are huge problems
sensible policy in the right technology embedded
can fix those and is
Walls: How do you and I mean you personally
you're involved in an
industry and certainly a nascent
industry
that has so much
innovation occurring, but yet
it's still a wide open playing field
and there's a lot of opportunity there
it's almost
I guess I wonder about the
the patience factor or persistence factor
trying to push that rock up the hill
You know there's a great payoff
Kaushal : Absolutely
and that's exactly what's going on right now.
post health reform we've seen a lot of changes in the ecosystem yet to be
settled
health reform is pushing through different payment models
we're seeing the pay in hospital systems innovating a great deal in the landscape
and trying using new technologies, seeing what works, what doesn't, lots of
pilots
and that's all undergoing now.
which I think is great. Is there a final answer as to if this is going to work or not?
I don't think we're there as yet.
I don't think we're far away though. Walls: So, we're getting there.
Kaushal: Hopefully, we have to get there
Walls: well again, it seems like the opportunities are immense
and certainly the benefits
that chronic disease management and so on so forth.
Good luck
at West Health. We certainly appreciate all of the work you're doing and thanks for being here with us in the Buzz Zone.
Kaushal: Likewise, thanks for having me.