Routes for biomedical researchers to collaborate with tech entrepreneurs to spearhead the development of digital health solutions were explored this week in MedCity x TechCity: London’s Winning Duo for Digital Health Start-ups? - an event co-hosted by the Oxbridge Biotech Roundtable (OBR) with Barts and The London School of Medicine and Dentistry

Panelists including MedCity’s acting Chief Operating Officer Sarah Haywood, Paul Jones of Genomics England Enterprises and Vishal Gulati of the Digital Health Forum debated the issues with an audience of over 200 people.

Sybil Wong, a volunteer with Oxbridge Biotech Roundtable, gives an overview of the event.

Establish evidence of product value by outcomes and experience

As raised by Paul Jones, now CEO of Genomics England Enterprises after many years as Director & Leader of Cisco Global Life Sciences, “connectivity” was the buzzword of the evening. To speed up the digital health movement, there is not only the technical challenge of improving data management and interoperability across the NHS, but also the human aspect of communicating this need to patients, clinicians and policymakers.

Dr Vishal Gulati, Venture Partner at DFJ Esprit and Chairman of the Digital Health Forum, recalled that not long ago, the medical community did not believe that software could save lives. The key here is to demonstrate value, both Paul and Vishal emphasised. Automated systems and data analytics are only useful if it allows end-users to take actions that lead to a favourable outcome.

Dr Nasrin Hafezparast, a doctor-turned-entrepreneur who is Co-founder & Technology Lead of Outcomes Based Healthcare, warned entrepreneurs that at the moment, the NHS’s assessment of clinical success is still mostly volume-based (ie the number of patients that were examined/treated) as opposed to outcomes-based (ie improvement of patients’ quality of life).

Outcomes Based Healthcare aims to shift the NHS towards outcomes-based commissioning, and urges digital health entrepreneurs not to lose sight of putting end-user experience first. Dr Kazem Rahimi, Deputy Director of the George Centre for Healthcare Innovation in Oxford, added that this is why entrepreneurs must work closely with clinicians and academics to understand how the current system works at both a local and national level and establish scientific evidence of the value provided by any digital health offering as early as possible.

Consider the density of pioneering research groups, world-leading clinical departments, patient-focused and entrepreneurial meetup groups, venture capitalist offices, start-up co-working spaces and of course policymakers in Greater South East, and especially London. The geographical barriers between MedCity, TechCity and the many stakeholders relevant to any product idea in digital health are not high, yet communication and mutual understanding still seems inadequate. The packed room on Wednesday was testimony to the digital health movement’s urgency and eagerness to establish cross-sector networks.

Understand the disconnected cogs at the national level

What emerged was also a palpable frustration about the lack of clarity in the existing healthcare infrastructure in the UK. In principle, a digital health start-up is no different to any other business. Nasrin reminded us of the mantra: “Don’t create solutions for problems that don’t exist”. Sounds simple enough, but the problem becomes complex when the payer is not the same as the end-user, and the value of a product is not necessarily linked to the utility of the product for the end-user. Add to that the requirement to prove benefit over cost to the payer at scale without standardised guidelines, and the result is essentially, as Vishal alluded to, a death sentence for any healthcare start-up targeting the NHS as a customer, digital or not.

The NHS is not a monolith, but rather a fragmented collection of stakeholders with variable resistance to new ideas and limited indication of their inclinations. Many start-ups have gone down the route of selling to foreign markets with more tractable healthcare systems, or avoiding the clinic altogether by moving into the less strictly regulated areas of wellbeing/fitness products.

Vishal suggested that more widespread procurement guarantees were needed to prevent wasting the entrepreneurial effort put into developing disruptive products for healthcare in the UK. Having worked extensively with the NHS, Paul also remarked that of the many innovations tested in the clinic so far, far too few were subsequently implemented.

Seize the opportunity to change the status quo

MedCity has recently started working with TechCity to learn from their successes and failures, and Sarah Haywood, acting COO of MedCity, emphasised that they will maintain ongoing discussion with entrepreneurs across the life sciences, as well as decision makers in the NHS. Paul also hinted at the opportunity to engage with the NHS via his team. The door for discussion, at least via MedCity and Genomics England Enterprises, is wide open to all those brave enough to speak up.

In the short timeframe of the event on Wednesday, it was not possible to hear recommendations from everybody who attended, so please continue tweeting comments and questions using #DigHealthOBR14, and also get in touch directly with MedCity.

OBR would to thank once again our event sponsor Barts & The London School of Medicine and Dentistry, and our five panellists: Dr Vishal Gulati, Venture Partner, DFJ Esprit & Chairman, Digital Health Forum; Dr Nasrin Hafezparast, Co-founder & Technology Lead, Outcomes Based Healthcare & Co-founder, WWDC; Paul Jones, CEO of Genomics England Enterprises; Dr Kazem Rahimi, Deputy Director of the George Centre for Healthcare Innovation; Sarah Haywood, Acting COO of MedCity.

See more about Oxbridge Biotech Roundtable online and on Twitter @OxbridgeBiotech

Sybil Wong is a final-year PhD student in Biochemistry at Barts Cancer Institute, Queen Mary, University of London, studying the role of a tumour suppressor protein in microRNA-mediated gene regulation. She has been a volunteer for Oxbridge Biotech Roundtable since January 2014 and led the planning of this panel discussion, with the help of volunteers Shirley Tang, Maria Jose Martin, Graham Mills, Hristina Ivanova, Francesca Chiara and Abid Javed. This article does not represent the official views of MedCity or the Oxbridge Biotech Roundtable.