START Summit 2019 Insights About HealthTech

When in 1895 Wilhelm Conrad Roentgen invented the X-Ray, it was considered to be the most disruptive technological breakthrough in medicine at the time. Since then, we have come a long way, with technologies such as Blockchain, Augmented Reality, Virtual Reality, Artificial Intelligence, and 3D Printing finding their way into the medical sphere. However, there is even more to come.

What are some of the developments we can expect in this field in the coming years? How will regulation affect technological progress, and is there currently any transatlantic cooperation to promote human health? These questions were discussed this year at the START Summit St.Gallen as part of the panel discussion on “Emerging Trends for Healthcare”. One of our Health-Trends co-initiators, Matthias Mettler, was invited to this discussion. Below we have summarized the most important questions to our co-initiator and Matthias answers for you.

(START Summit) As a hobby, you publish the so-called “Swiss Digital Health Map”. In your opinion, what are the most important trends you have observed over the past two years?

For some years now, our healthcare systems have been experiencing a fundamental change, driven by several trends. These trends have different causes and can be technological, societal, or political in nature. However, what is especially interesting is the increasing speed of adopting new technologies in healthcare during the last two to three years. So, there are many technological trends I could highlight here, let me give you three examples for the Swiss healthcare system:

• First, I would like to highlight blockchain, which is still accelerating in Swiss healthcare. We observe many new startups in this field, e.g., in the area of health data market places or supply chain solutions. Moreover, incumbents, like the Swiss post company, start to explore blockchain in healthcare.
• Second, since we create lots of health data based on electronic patient records, wearables, or health apps, artificial intelligence is definitely on the move in Swiss healthcare as well. There are many different fields of application, e.g., the analysis and evaluation of medical data which are driving new ways of better medical diagnoses. I think in 5 to 10 years AI-based algorithms will make better diagnoses than doctors.
• Third, I would like to outline genomics and based on this the accelerated discussion on personalized medicine and value-based care. Currently, this topic is still at an early stage in Switzerland in terms of debate in the market. Nevertheless, people start to explore the different application fields, and I’m convinced that genomics will drive significant change in healthcare during the next ten years.

To summarize this: Thanks to new technologies like blockchain, genomics, and the application of artificial intelligence, we can better understand and influence the development of diseases and ageing processes. In other words, in the near future, it will no longer be primarily a question of treating diseases, but of preventing them.

(START Summit) What are the driving forces behind those trends?

In general, I’m working as a management consultant in the Swiss and U.S. healthcare system for more than five years. Compared to my start five years ago, we observe a significant change in the mindset of the people and stakeholders in the market. So, for example, five years ago, we almost saw no partnership activities between different players like a payer and a hospital. Nowadays, the mindset of the people changed; they begin to explore new partnerships with other players in the market, start to jointly test end explore new technologies to tackle significant challenges in the market.

Why do they do this? If we look in our healthcare systems, we still see different significant challenges like the extraordinary rise of healthcare-related costs, the increasing amount of people with chronical diseases, lack of patient-related data and therefore lack of collaboration between medical players. So these are only a few examples, but important ones because they raise the pressure on the existing stakeholders in the market and, in the meantime, also enhance the attractiveness for new competitors. Therefore, the current players in the healthcare system now begin to innovate their business models, their processes and IT systems and, their ways of collaboration between each other. Moreover, last but not least, they slowly but steadily accept that there is a so-called patient empowerment movement in the market. Patients expect, for example, that their doctors become more efficient and more cost- and service-oriented when they treat diseases. Therefore, stakeholders in healthcare start to think from an end-customer perspective when innovating the business models.

(START Summit) What role do regulations play in the sector of HealthTech with specific regard to Switzerland? Do you believe there is a discrepancy between Switzerland and the USA?

I see a difference between the U.S. and Swiss regulatory activities. In the U.S., for example, the Food and Drug Administration (FDA) is much more improvement-oriented for HealthTech innovations. They are more eager to test new technologies and are willing to pilot more HealtTech solutions. In comparison, in Switzerland, regulation is more conservative, which forces companies to wait and learn from other markets before launching their solutions.

Let me give you another example. In the U.S., the Health Insurance Portability and Accountability Act (HIPAA) is the established regulatory standard for electronic exchanges and privacy and security of health information. This act provides a framework for U.S. companies to innovate around. In Switzerland, however, they first brought up the topic of a national e-health strategy ten years ago and only now, are we seeing the country begin to implement that strategy. This slow pace and hesitant implementation of innovation in the healthcare sector can be observed not only in Switzerland but also in other European countries such as Germany.

In general, Europe is not necessarily in a good position concerning digitization, and that worries me. Even now, the three largest internet companies in the U.S. are worth more than all DAX companies combined. I’m also worried when I see how long it takes, for example, in Switzerland, for an electronic patient file to be prepared and how little is being invested in digital technologies at the same time. If we do not soon shift up to three gears in Europe, open up the healthcare market and enter into many more collaborations, we will miss important opportunities. In the future, we will no longer be able to separate research from digital services, because those who do not have access to large data pools will not be able to carry out significant medical research. This lack of access could result in dependencies in the future that we cannot even imagine today.

In summary, I hope for the future that the Swiss regulatory authority will not only play a purely regulatory role, but will also act more actively as an innovator and promote new healthcare solutions for the benefit of end customers.

(START Summit) If you could choose one particular technological innovation of HealthTech which exists today to have been available ten years ago, which would it be and why? What is its main advantage over other technologies?

As already mentioned earlier, I think genomics and, personalized medicine will have a significant impact. The costs for a full genome sequencing have decreased extremely fast in the last years. Today, 88% of the human genome can be sequenced for around CHF 2500. This is a “Once-in-a-Lifetime-Invest”, and the insights that result are enormous. If, for example, a patient has his genome analyzed, numerous conclusions could be drawn about personal medication, a better and adapted diet and ultimately better medical results and more quality in everyday life. The potential for health prevention is enormous, and it can already be said today that genomics can influence people’s lifestyles to such an extent that it can save or at least reduce possible future medical costs due to prevented chronic diseases (e.g. diabetes, cardiovascular diseases). However, there are also some negative aspects, e.g. in the area of access control and secure storage of genome-based data. Finally, this topic also has a strong ethical component that should not be underestimated. Using genome sequencing, people are also able to gain profound insights into their health. This would probably provide information about possible future diseases that people personally prefer to prevent.

About START Summit: START Summit is Switzerland’s leading conference for entrepreneurship and technology. The conference focuses on creating an environment of inspiration and idea-sharing for a brighter, more innovative future. START Summit 2019 brought together 2’500 leaders, visionaries and young minds for a thought-provoking event.