We need to drastically lower the cost and risk of technology development through lowering of regulatory and reimbursement burden. While regulations in healthcare are absolutely critical to ensure patient safety and efficacy, burdens for regulatory approval that is misaligned to inherent risk raises the cost for all technology development. We must create a more development friendly regulatory construct so the best technology that will drive efficiency and better patient care can come to market more quickly.
Ihad the pleasure to interview Ben Hwang. Ben is a digital health entrepreneur and CEO of Profusa. Ben has seen first-hand the transformative impact that science and technology have to change our world, from his early exposure as an undergraduate research fellow at the lab of Leroy Hood at Caltech, where the automated DNA sequencer was developed, to bringing cutting edge life sciences tools to the market at Life Technologies Corp. (acquired by Thermo Fisher Scientific, Inc.). Ben, who dropped out of high school and started college as a freshman at the ripe old age of 23, earned his M.A. and Ph.D. in Biology from The Johns Hopkins University.
Can you tell us a story about what brought you to this specific career path?
When I was a student at Pasadena City College in the early 1990’s, I was looking for a summer job to help pay the bills. As Caltech was just a couple of blocks away from the PCC campus, I went onto the campus of this iconic institution looking for any opportunities that might be available to keep me busy during the summer. After knocking on a few doors, I was fortunate to be selected as a member of a summer undergraduate fellowship program in the lab of Dr. Leroy Hood. I recall vividly a scientific poster outside of one of Dr. Hood’s laboratories describing the workings of the first capillary electrophoresis DNA sequencer. This is the instrument that enabled the, at that time, rapid sequencing of DNA and was instrumental in the completion of the Human Genome Project. As I was a very inexperienced student just beginning my science education at the time, I did not appreciate fully the magnitude of the opportunity in working in Dr. Hood’s lab, nor did I realize how that instrument would fundamentally open a field of science that would change the landscape of healthcare for mankind. What that experience did ultimately showed me how technology can drive fundamental advancement in science, and it provided me with the foundation and passion for my current endeavors.
What advice would you give to other healthcare leaders to help their team to thrive?
I think it is critical to be unwavering in your focus on the patient and user of the technology. As we all know, creating solutions for the healthcare environment is difficult. The regulatory burden is rightfully high, and the path to revenue generation is long and arduous. And, for a growth phase company not yet into profitability, one must layer on top of this context the need to raise capital to sustain development and growth. It is easy, and often tempting, to create a company where the mission is to drive value and economic creation for the purposes of gaining regulatory approval or fund-raising success. Often, in the zeal of achieving regulatory approval or raising additional financing, the mission of the product strays away from the fundamental premise of helping patients. I think all of us need to take a moment to make sure we constantly ensure we have alignment of our work with the outcome we desire for patients and users of our technologies.
Ok, thank you for that. Let’s jump to the main focus of our interview. According to this study cited by Newsweek, the US healthcare system is ranked as the worst among high income nations. This seems shocking. Can you share with us 3–5 reasons why you think the US is ranked so poorly?
I agree that we shouldn’t expect the US healthcare system to be ranked so low among high income nations. I do think there are a few reasons why this is the case:
First, the cost of innovation is borne by US systems disproportionally. Fundamentally, the issue with the current state of the US healthcare system is one where the resources spent is not efficiently aligned with value-added clinical activities of patient care. The high cost of drug and device innovation and development borne by US companies by necessity need to be passed along to the end-users in the form of pricing. Controlling the cost (and/or sharing the regulatory and administrative burden) required for innovation are necessary steps to ensure there is economic flexibility in the system to bring down costs overall.
Second, current access to care is cumbersome and inefficient. Our access to goods and services for most aspects of our lives are based on multitude of choices and individuals can make decisions that align their needs with the potential cost and time impact of those choices. Yet, the healthcare system as it is currently constructed creates barriers and process for access that is often misaligned with the needs of the patients, leading to significant user dissatisfaction and often higher burden and cost than necessary.
Third, there is a misalignment of expensive resources to desired outcomes. A vast majority of healthcare services are provided in some of the most expensive assets — clinics, hospitals, emergency rooms — when much of the care can be provided with much lower burden. Tools such as telemedicine, phone consultations, preventative care, are often underutilized for better outcome and lower cost of care.
Fourth, the cost of the administration of healthcare is growing at a faster rate than the actual cost of healthcare delivery. Our healthcare system is so complicated now that the cost of administration and management of services are becoming a much larger portion of the overall healthcare system. Professional salaries and costs of technologies for actual patient care have increased at a much slower rate than those for management and administration. This disconnect need to be corrected.
You are a “healthcare insider.” If you had the power to make a change, can you share 5 changes that need to be made to improve the overall US healthcare system? Please share a story or example for each.
The problems are complicated and work for correction vast. But here are some ideas:
- We need to drastically lower the cost and risk of technology development through lowering of regulatory and reimbursement burden. While regulations in healthcare are absolutely critical to ensure patient safety and efficacy, burdens for regulatory approval that is misaligned to inherent risk raises the cost for all technology development. We must create a more development friendly regulatory construct so the best technology that will drive efficiency and better patient care can come to market more quickly.
- We must invest in technologies that will allow more decisions to be made away from hospitals and clinics, and into the individuals homes at the right time. A visit to a doctor should not be necessary to manage the day-to-day complexities of caring for chronic patients, for example.
- We should simplify the transaction burden to the access of healthcare providers by an individual. Simplify insurance and physician access process, and allow for individuals to be able to make choices of their care provider and make cost/benefit trade-offs.
- Create interoperability of healthcare data and allow an individual to be able to take that data to any provider he/she wishes.
- Create tremendous price transparency and allow individuals to make decisions at the time that it matters with price in mind. Most individuals would be able to make the cost efficiency choice of necessary v. nice-to-have services if pricing transparency allows for the choice to be made with price in mind.
Ok, it’s very nice to suggest changes, but what concrete steps would have to be done to actually manifest these changes? What can a) individuals, b) corporations, c) communities and d) leaders do to help?
- Individuals: be thoughtful on using the resources. Work on prevention and not reactive care
- Corporation: invest in wellness programs. Create large pools of individuals and simplify the process for health care technology access. For corporations in the healthcare arena, invest in innovation that takes burden away from the expensive infrastructures into the home.
- Communities: educate and provide incentives to encourage the right choices and behaviors.
- Leaders: policy changes to simplify regulatory burden for new technology development
Right now we have two parallel tracks mental/behavioral health and general health. What are your thoughts about this status quo? What would you suggest to improve this?
We talk about co-morbidities for physical ailments. We need to speak of the mental/behavioral health in the same vein in many chronic conditions. It is clear that mental state has a direct correlation with the physical well being and process of recovery for many people. As we gain in our knowledge of relationships between disease states, I believe we need to include mental health as part of that holistic equation.
How would you define an “excellent healthcare provider”?
I believe an excellent healthcare provider is an organization that is rooted in making patient outcome and experience the number one priority. This includes not only the clinical aspects of service, but also making sure the entire experience is “delightful” for the patients.
Can you please give us your favorite “Life Lesson Quote”? Can you share how that was relevant to you in your life?
I am a big Dodgers/Jackie Robinson fan. I believe the following quote attributed to Jackie Robinson captures how we should evaluate our lives: “A life is not important except in the impact it has on other lives.” — Jackie Robinson
What are your favorite books, podcasts, or resources that inspire you to be a better healthcare leader? Can you explain why you like them?
I keep track of content from Christina Farr, John Nosta, Chamath Palihapitiya, Eric Topol, Bob Kocher, among others. I think they are smart, insightful, and often able to connect dots between developments from other industries and incorporate into the healthcare arena.
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