Excerpt: “What keeps me up is not what we’re innovating, but how we’re innovating. Are we working on research that have the greatest impact on vascular health, vs. satisfying intellectual curiosity, or worse just because it’s easier ROI? And how much of the patients’ voice is influencing the R&D agenda?”

Interview & Writing by Emmy Award-winning Journalist, Kym McNicholas, The Way To My Heart

As part of our ongoing Vascular Innovation Series in conjunction with The Way To My Heart, journalist Kym McNicholas interviewed Vascular Cures Chairman, Ed Yu. As a former Principal of PwC’s Health Industries Advisory practice focused on health convergence, Ed brings a unique perspective and creativity to aligning values across vascular healthcare players for the benefit of patients.

It is an exciting time of healthcare innovation with investors doubling down this year. According to Startup Health, total healthcare funding is up nearly 19% from the same period a year ago to $9.1 billion. Will all of this investment in innovation translate into better patient outcomes? Vascular Cures Chairman Ed Yu is committed to turning innovation into a conversation that puts patients before profits to create a sustainable long-term impact on global health. Yu has spent his entire career in management consulting focusing on engineering and the healthcare ecosystem. He learned a lot about what works and doesn’t. Now, a retired partner of PwC, Yu is taking his knowledge and experience to where it matters most to him, saving life & limb.

As you read Yu’s comments below, take note of some very important questions Yu poses to all stakeholders innovating around the prevention, diagnosis, treatment, and long-term management of vascular diseases – and become a part of the conversation around innovation to help create the change we all want to see, which is better patient outcomes. Write your thoughts in the comment section of this blog or of the video interview with Chairman Ed Yu posted at the bottom.

“What keeps me up is not what we’re innovating, but how we’re innovating. Are we working on research that have the greatest impact on vascular health, vs. satisfying intellectual curiosity, or worse just because it’s easier ROI? And how much of the patients’ voice is influencing the R&D agenda?”

Why are you passionate about innovation around prevention, diagnosis, and vascular cures?

Ed Yu: I am passionate about results that matter. A lifetime of learning about innovation in every sector of the health ecosystem – what works, what’s broken – has prepared me to undertake the opportunity to drive better health systemically. I am lucky to be at a point in life where I can focus on this complex problem without material self-interest. What’s better than to do this from a health research and advocacy organization that is trusted, and patient-centered?

One of my first action areas is solving a complex system problem in silos. More innovative payment models, new disease prevention apps, novel diagnostic technology and biopharmaceutical discoveries, are all great point solutions, but in and of themselves aren’t sufficient to creating sustained, improved health outcomes. We have to solve for complex problems with clarity and alignment around vision, strategy, and execution. Most important, we have to involve diverse stakeholders from all silos, especially the unempowered patients.

Question from Yu: Who are the trusted stewards for this problem-solving process?

Where does capitalism break down in our current healthcare system that’s failing vascular disease patients?

The breakdown is in the imbalance in two major ways. One imbalance is productivity vs. distribution, i.e., that while capitalism has fueled R&D leading to availability of breakthrough treatments and therapies, we don’t have an equally effective mechanism to ‘distribute’ the treatments to everyone who needs it. This is typically the role of government, but we don’t have a good balance between capitalism and legislation. The second imbalance is that health consumers are not customers, i.e., patients are not the the direct payers in the healthcare marketplace. So while all other industries design innovations around what customers want, patients don’t pay directly and therefore are not directly influencing the design of products and services to meet their needs. They are designed by and for all other paying stakeholders (payers, providers, pharma LS, etc.).

A classic example of this is fall detection devices for the elderly. While the technology works, the packaging is designed by young ‘tech bros’ that are guided by their perception of what grandma would wear – a lanyard. The result is that the usage rate is low and falls still happen in spite of innovative tech that works.

Question from Yu: How do we institute customer/patient-inspired design in healthcare?

How do we build the right healthcare system from where we are now that will best serve patients with vascular diseases?

We start with having more multi-stakeholder dialog inclusive of patients (as customers). And the first topic of discussion should be on the consensus definition of good health outcomes in vascular disease treatment. This definition would define the north star for the desired outcomes so all health sectors can work backwards to next generation treatments, therapies and technology that achieve that patient-defined outcome.

A leading example of this approach is in defining the desired outcomes in the treatment of peripheral artery disease (PAD). The medical device and biopharma industries have achieved a lot of innovative medical therapies to treat occlusions that have devastating impacts, such as lower limb amputation. But when we convene diverse experts to listen to patient stories, we learn that we’re not innovating in the area of awareness, education and prevention. When patients tell experts that they wish they had known sooner about PAD risk, they probably would be living better lives. That inspires patient-centric innovation.

Question from Yu: How do we at Vascular Cures best promote the voice of the patient in the village of experts that are working toward better treatments and care?

We hear lawmakers and medical industry professionals talking about the evolvement of our healthcare system to a more patient-centric model, but how do you view the current effort versus one in which the patient is present at the decision-making table?

Healthcare leaders – in academic medicine, business, government, consumers – agree in principle that we should strive toward value-based care model to guide more efficient and effective use of resources on behalf of patients. And while there is progress (e.g., ACOs), I don’t think we will really get to a satisfactory and sustainable VBC system unless and until we have patients that are an integral part of that value-based care decision process. We don’t have a system in which patients act as the direct customers that have both accountability and authority in their healthcare decisions.

For example, if you’re told by your doctor that you have a blocked artery in your leg and you need to have the limb amputated, you are not likely to challenge that decision. And we are learning that there are unfortunately, unnecessary amputations (especially in underserved populations).

Question from Yu: How do we at Vascular Cures foster sustained and scalable forums for probably solving with patients as well as traditional stakeholders?

What is hindering advancement in innovation around the prevention, diagnosis, treatment, and long-term management of vascular diseases?

We have plenty of scientific and technology innovation. The gating factor to success is we’re lacking business model innovation. It is very hard to pitch cost avoidance as an end goal in spite of how intuitively obvious why prevention is a good thing. America ingenuity is fueled by ROI. Your innovation is the best one as measured by the ROI, its profitability. Products and services addressing prevention, SDH (social determinants of health) have a mountain to climb in order to demonstrate attractive ROI. That mountain includes FDA approval for safety & efficacy and health economic benefit. And that takes capital to fund research and validation. That capital is usually directed at ideas that have a crystal-clear ROI and fast TTM.

For example, supervised walking exercise therapy is a proven therapy to prevent or slow the progression of PAD. In fact, there is a CMS reimbursement code for this preventive therapy. However, few health systems prescribe it because the business model doesn’t work. It’s labor intensive and don’t make enough money, BUT it does benefit patients. So it’s a classic problem where prevention doesn’t pay within the healthcare system. It pays when you are sick.

Question from Yu: How do we incentivize innovation toward making preventive health sustainable from a business perspective?

What is the most critical area (white space) in which innovation is desperately needed to better support vascular patients?

The white space is energizing the early stage innovation marketplace. What are the most critical problems vs. the important or nice-to-have problems in vascular disease? Who gets to weigh in on defining the problems? What is the give-and-get among the myriad of participants so there is mutual value creation? Where does this all take place? Today, it’s very diffuse and exclusive.

In the business of healthcare innovation, capital flows to early stage solutions that have some degree of proof that it works both clinically and from a business model perspective. But until that proof is evident, few investors are willing to take the risk of funding demonstration projects, testing and validation. Health wearables are a prime example of how difficult it is to get from idea to market.

Question from Yu: For Vascular Cures we pontificate the question of our role in helping to energize the early stage vascular innovation marketplace. What can be our role? What should be our role?

What are the questions that keep you awake at night as Doctors, Researchers, and Innovators strive to innovate around the prevention, diagnosis, treatment and long-term management of patients with vascular diseases and help to improve their quality of life?

What keeps me up is not what we’re innovating, but how we’re innovating. Are we working on research that have the greatest impact on vascular health, vs. satisfying intellectual curiosity, or worse just because it’s easier ROI? And how much of the patients’ voice is influencing the R&D agenda?

Join the conversation with your comments below. For more insight and thought provoking questions from Vascular Cures Chairman Ed Yu, watch his video interview.