Healthcare's Changing Marketplace

Healthcare's Changing Marketplace

"I'm passionate about my work - it's all about helping transform patient care through innovation." —Nancy Bullock

It's an exciting time to be in the healthcare business. Spurred by technological advances, demographic changes, and product innovation, the healthcare technology and services industry is booming. Not surprisingly, WPI alumni are leaders in this field, helping bring innovative healthcare solutions to market in a changing world. Nancy Bullock '91, '92 (MBA), Vera Tice '86 (MS), and Steve Rusckowski '79 are three such alumni.

As a student in WPI's undergraduate biotechnology program, Nancy Bullock loved her hours in the biotechnology lab. But she wanted to get the same hands-on feel for the business of biotech, which was just beginning to boom. In her junior year, after being accepted into WPI's dual-degree bachelor's MBA program, Bullock began her graduate business studies as an overlay to her undergraduate work.

To complement her studies, she landed a business development role with Genica Corporation (now part of Thermo Fisher Scientific), one of Worcester's first biotech start-ups. She completed her MQP through a project for this provider of neurological diagnostic testing services. "This early role was pivotal in enabling me to experience how I could marry the business with the science," she says. In fact, she's made a successful career at that intersection of science and business.

For 18 years, Bullock led business development and marketing initiatives at various biotech and medical technology companies, from start-ups to major players in the healthcare space like Medtronic and Johnson & Johnson. She helped develop and launch cutting-edge medical implants, instruments, and capital equipment for neurological conditions, minimally invasive cardiovascular surgery, and pain management. She also identified the best opportunities for expansion—in new products and services, and in established and emerging global markets. Now, as principal of her own consultancy, Breakthrough Healthcare Solutions, Bullock does the same for her clients.

"An incredible amount of innovation comes from startup companies who have a great concept, but who aren’t sure how to develop a sound business plan to bring the product to market," she says. Those firms, and their larger multinational brethren, all face similar challenges, from figuring out what their products should look like to identifying the most lucrative geographic markets for them.

They are also riding many of the same trends, such as the transfer of patient care from hospitals to outpatient clinics, physicians' offices, and even home - a shift that is being propelled in part by the development of smarter, less invasive technology and the drive to improve patient quality of life while reducing the cost to provide the associated care.

"Over the past 20 years, we’ve completely transformed the way surgery is done. Many procedures that previously could be done only in a hospital operating room now are safely, effectively, and economically performed in more accessible settings," Bullock says. "We're doing procedures less invasively, using instruments designed to provide access into the body through smaller incisions. For many procedures, surgeons no longer need to make a large incision. Instead, they’re able to operate through natural orifices or openings the diameter of a nickel." All of this can make for greater safety, faster recovery, and lower costs. It does not, however, make the process of capitalizing on these innovations any simpler.

Recently, Bullock consulted for a Minnesota-based startup that had developed an innovative device used to maintain long-term vascular access for chronic hemodialysis patients. With an early successful track record in the United States, the company wanted to expand internationally but didn’t know where to start. So she researched what the group might face when entering markets across Europe and the developing world, from regulatory hurdles to economic barriers to local infrastructure limitations. She then used that information to prepare a global go-to-market plan, recommending where the company should focus first and how it should approach market entry. This plan enabled the start-up to seek the necessary funding from its investors.

Interestingly, Bullock points out that not all of the innovation in the healthcare market takes the form of new technology. Some of it has to do with the way in which businesses are structured and services delivered.

While working for Medtronic, for example, Bullock helped change the way the company delivered its deep brain stimulation solutions, which center around accurately implanting one or two electrical wires the size of a human hair that are then connected to a pacemaker-like implant to stimulate the brain and alleviate symptoms of neurological disorders such as Parkinson’s disease. Previously, hospitals had to spend upwards of $1.5 million in capital, often waiting a full year to purchase, install, and train on all of the necessary technology. Bullock led the shift to a fee-for-service model that depended in part on technological improvements, but that was really about changing the way the procedure was delivered and paid for.

"We took the most essential technology, miniaturized and customized it for the deep brain stimulation procedure, then packaged it together with all the necessary devices, instruments, and one highly trained Medtronic professional, and provided a one-stop shop solution to the hospital on a fee-per-procedure basis," she says. No more large capital expenditures, and no more excessive wait-times for treatment; instead, there was an easier way for the hospital to pay for state-of-the-art technology, and surgeons could provide patients much faster access to this life-changing procedure.

"I'm passionate about my work - it's all about helping transform patient care through innovation. The breakthroughs in healthcare are evolving not only from the products themselves," Bullock says, "but also from the market dynamics and patient care delivery methods."

For the past seven years, Vera Tice has worked primarily with small entrepreneurial companies and healthcare organizations that are attempting to bring new remote healthcare technologies to market.

With over 20 years of experience in the telecommunications and healthcare technology industries and a resume that covers everything from R&D product development to executive management, Vera Tice has the kind of technical savvy, managerial know-how, and sector-specific expertise needed to navigate the telehealth market. Which is good, because her clients sometimes don't. [Telehealth covers anything that involves delivering healthcare services using telecommunication technologies, from conducting remote doctor’s visits via webcam, to monitoring a person’s vital signs using wireless sensors.]

Not long ago, Tice was approached by a start-up founder who envisioned a software system that would allow consumers to manage all aspects of their healthcare, from electronic visits and accessing of test results to online billing. The problem? "He had no experience in either software development or the healthcare industry," she says.

Tice, who takes obvious pleasure in turning ideas into reality, not only reworked parts of the CEO's business plan, she also recruited a team of software developers to prototype elements of the system, giving her client something to show potential investors. "Now he's back on track," she says.

Tice spent 15 years working on networked patientmonitoring devices and healthcare information systems in the medical products group at Hewlett-Packard (now part of Philips Healthcare), and another four years at Nokia, where she led the development of mobile device applications and network security products. As Nokia and its competitors began to explore the possibility of using smartphones and similar mobile gadgets to deliver telehealth, Tice saw an opportunity of her own. For the past seven years, she has worked primarily with small entrepreneurial companies and healthcare organizations that are attempting to bring new remote healthcare technologies to market.

Philips telemonitoring devices support remote patient education and enable healthcare providers to remotely monitor patients with chronic illnesses in their homes. Photo courtesy of Philips Healthcare.

It's a niche that has expanded rapidly over the past few years, as giants like Philips and GE have begun to acquire smaller entrepreneurial companies in order to beef up their telehealth portfolios, and as large healthcare organizations like Partners Healthcare have begun to commercialize the remote healthcare technologies they’ve developed in-house. A growing number of universities are entering the mix, as well. For example, Tice has consulted with Advanced Body Systems, a start-up built around a novel sensor developed by Yitzhak Mendelson and James Duckworth, WPI professors in biomedical engineering and electrical and computer engineering, respectively. Originally developed to monitor soldiers on the battlefield, the sensor could potentially be used to keep tabs on people who work in all sorts of extreme conditions, from firefighters to miners.

Government promotion of electronic health records (EHR) and the federally mandated expansion of health insurance coverage are also giving the industry a boost, as an aging cohort of baby boomers with chronic conditions - and a looming shortage of primary care physicians - makes remote healthcare a more viable means of serving everyone who needs help. In the future, rather than trudging into your general practitioner’s overcrowded waiting room just to see if you need a specialist, you might simply dial into a call center and be triaged with the help of streaming video and remote biometrics, your data automatically entered in an EHR.

Yet government involvement is a double-edged sword. Recently, Tice worked with a home-care product development company that developed a healthcare information system that would allow visiting nurses to record a patient’s medical data and related billing information on a standard PDA, then upload it all to an online database to be accessed at the home-care agency offices. Home-care agencies could pay to use the system on a subscription basis.

Systems such as these would allow agencies to replace their dedicated data recorders and databases with commonly available mobile devices and secure hosted data center storage. Cheap cloud storage could follow. Yet they could also run afoul of FDA regulations governing medical devices - a category that includes anything used for diagnostic purposes. While a PDA such as an iPhone might not resemble an EEG cart, with the right app and enough patient data, "it begins to cross the line," says Tice. This past January, the FDA ruled that an iPhone running medical imaging software was indeed a class III medical device, and hence subject to pre-market approval.

Scenarios like this make telehealth companies nervous. And that makes Tice very, very busy.

"We spend $1 billion a year on R&D at Philips Healthcare, but that’s only beneficial if you can demonstrate that you can use the technology you've developed to better diagnose, treat, and manage disease while lowering cost." —Steve Rusckowski

Steve Rusckowski speaks like a physician.

"We've always been focused on the need to understand what healthcare does every day: to care for a person with a health problem," he says.

But Rusckowski is no doctor. He’s the CEO of Philips Healthcare, the medical technology and services arm of Dutch multinational Royal Philips Electronics.

Philips Healthcare is a major provider of high-end imaging equipment and healthcare information systems, and a leading purveyor of high-tech home monitoring devices, with sales of approximately $10 billion and employing 34,000 people globally. In recent years, the company has also developed cutting-edge handheld diagnostic tools that use exotic technologies like magnetic nanoparticles to scan for signs of drug use and heart disease.

Despite all that technical firepower, however, technology actually comes last at Philips, says Rusckowski, whose first job after WPI involved managing the mechanical support team of a chemical factory for Procter & Gamble. (He later served as a production supervisor in the company's soap and detergent division before earning a degree from MIT's Sloan School of Management, and went on to run the medical products group at Hewlett-Packard and the healthcare group of Agilent.)

"We think about the biggest healthcare issues around the world," he says, "and rather than looking at technology, we consider the biggest problems associated with those issues. Then we try to understand the full care cycle that a doctor would go through in diagnosing, treating, and managing that problem over time." Only then, Rusckowski says, do they ask what technological solutions are most likely to improve care while reducing costs.

The answer to that question may depend on factors ranging from biology to geography. Clinics in rural China, for example, might benefit most from inexpensive diagnostic equipment that doesn’t require a lot of skilled technical support, like simple, reliable ultrasound scanners. Developed countries like Japan and the United States, however, might benefit from a more technologically robust approach.

American hospitals, for example, are faced with a growing number of ICU patients and a shortage of specially trained physicians, or "intensivists," to care for them. So Philips acquired Visicu, a Baltimore-based firm that developed an "eICU" system to permit a small group of intensivists in a central station to remotely monitor all of their acute-care patients. Software algorithms sift through reams of patient data to help identify who needs help before complications can arise. That, in turn, cuts down on unnecessary fatalities, reduces the amount of time patients need to stay in intensive care, and lowers overall staffing levels.

AutoAlert is the only pendant-style help button that can automatically place a call for help if it detects a fall and you're unable to push the button yourself. Photo courtesy of Philips Healthcare.

Sometimes, even a simple fix can make a big difference. As populations in the developed world grow ever greyer, more and more people are going to want to spend their remaining years at home, rather than in some kind of elder-care facility. But those people are going to need help if they suffer a fall - and many of them do, leading to serious complications (broken bones, hypothermia) and expensive hospital stays. In this case, Philips came up with the AutoAlert pendant, a tiny gizmo containing an accelerometer and altimeter that automatically calls for help if its wearer takes a spill. With better software, it may one day learn to recognize the behaviors that lead to falls and sound the alarm before they can even occur.

It's hardly a tricorder; but again, the idea is not to aim for the flashiest technological solution, but one that solves a genuine problem and delivers real value.

"We spend $1 billion a year on R&D at Philips Healthcare," says Rusckowski. "But that's only beneficial if you can demonstrate that you can use the technology you’ve developed to better diagnose, treat, and manage disease while lowering cost."

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Last modified: July 14, 2010 07:57:56