
26 segments available
The first thing that comes to mind when treating health problems is the need to take a pill (or other pharmaceutical) of some kind. But could a digital therapeutic -- a software-based intervention -- not only complement, but possibly even replace pills? In this episode of the a16z Podcast, CEO of Omada Health Sean Duffy and a16z bio fund general partner Vijay Pande (in conversation with Malinka Walaliyadde) discuss the potential of digital therapeutics, which use software, design, and other carefully orchestrated elements to change behavior. (Because what is software, really, observes Duffy, but a way of changing behavior?) Of course, digital therapeutics can augment medical treatment and make doctors better -- but what advantages do such methods have over pills? How do we know it’s really working? And what role does digital health have in the continuing push towards value-based care?
In this opening segment, the podcast introduces the concept of digital therapeutics as a potential alternative to traditional pills for treating health issues like diabetes and depression. The hosts question whether society will one day view reliance on pills as outdated and toxic, setting the stage for a discussion on the transformative potential of software-based interventions.
"hi I'm Hannah and welcome to the a 16z podcast our bio fun team often wonders if one day in the future we might be shocked that we once relied only on something as backwards and often toxic as pills f..."
Sean Duffy and Vijay Pande delve into the definition of digital health, exploring how the term has evolved and what it encompasses. They emphasize the importance of software as a primary driver of healthcare solutions, marking a shift from traditional health IT to a new era where software leads the strategy for healthcare improvements.
"episode on digital health includes Omata health CEO Sean Duffy a 16 Z partner Vijay Pandey and is moderated by our own malinka well Elliott a maybe we'll start with what is digital health it's a prett..."
Duffy discusses how software can empower healthcare outcomes in innovative ways, highlighting the potential of digital therapeutics and diagnostics. He contrasts traditional healthcare approaches with the new possibilities that software offers, suggesting that software can be integral to achieving clinical outcomes.
"of software in healthcare where software has to be a solution to make the big change versus kind of a second order of operations to make something real yeah the way I see it especially is that softwar..."
The conversation shifts to the historical context of therapeutics, comparing the rise of digital therapeutics to the earlier acceptance of biologics in medicine. Duffy explains how the industry has adapted to new therapeutic formats and the regulatory frameworks that have emerged to support these innovations.
"new ways as well and in digital adjuncts where it's digital is a complement to something that could be a you know a drug it amplifies the outcome that you're working to achieve I think historically wh..."
Duffy identifies key areas where digital therapeutics can make a significant impact, particularly in behavioral health issues like PTSD, depression, and type 2 diabetes. He argues that these conditions are inherently behavioral and thus well-suited for digital therapeutic interventions.
"accommodate there were a whole host of new you know regulatory pathways that had to be created there is a you know commercialization pathways manufacturing pathways ways to inject and administer the m..."
The discussion highlights the limitations of traditional pharmaceuticals in treating behavioral health issues. Duffy contrasts the straightforward efficacy of antibiotics with the complexities of addressing mental health conditions, emphasizing the need for tailored digital solutions.
"type 2 diabetes these are behavioral problems for which our behavioral solution is very natural you know I can imagine that there will be things for which digital therapy just don't make any sense lik..."
Duffy explains how digital therapeutics can be evaluated for efficacy in the same way as traditional drugs. He shares insights from the diabetes prevention program trial, illustrating how digital interventions can outperform traditional medications in certain contexts.
"to be talking about that and so for behavioral problems of behavioral solution is very natural well yeah I completely agree and it's you know it's I think it's very hard to find someone who doesn't ag..."
The conversation explores the potential future landscape of medicine, where digital therapeutics could be seen as superior to traditional drugs. Duffy speculates on how the understanding of human behavior will shape the development and acceptance of these new therapeutic approaches.
"the part I think that's particularly intriguing is that we can assess efficacy using basically identical metrics have they been head-to-head comparisons against existing pharmaceutical products in the..."
Duffy discusses how technological advancements have changed cultural attitudes towards health engagement. He notes that people are increasingly comfortable interacting through digital platforms, which enhances the effectiveness of digital therapeutics in behavioral medicine.
"oh for sure and you might even imagine that when drugs were commercialized if there's nuances to the medication that require behavioral support you know maybe the pills really big and it tastes bad ma..."
The segment concludes with a discussion on the advantages of digital therapeutics in terms of adaptability and continuous improvement. Duffy emphasizes the ability to personalize and enhance digital health solutions based on real-time data, contrasting this with the static nature of traditional pharmaceuticals.
"this transformative new wave in you know in behavioral medicine it's also intriguing I think culturally people are very comfortable texting and you actually might be much more comfortable texting a st..."
The conversation shifts to the surprising effectiveness of digital health solutions among older adults. Duffy shares findings that show individuals aged 65 and above engage more with digital programs, challenging the assumption that younger users are more adept with technology.
"can do that through measurement yeah I mean you look at what we don't we've amassed about eleven and a half million weight readings it's the largest longitudinal data set of these sorts of programs in..."
Duffy addresses the skepticism from traditional healthcare professionals regarding digital therapeutics. He references a statement from the AMA labeling digital health technologies as 'snake oil,' emphasizing the need for evidence and clinical validation to gain acceptance in the healthcare community.
"them as internal randomized controlled trials where we reduce the latency with which we gave people feedback on the food after they entered it in that section of the program were that's most relevant ..."
The discussion continues on the importance of generating evidence for digital health solutions. Duffy highlights the necessity for digital therapeutics to undergo rigorous testing and validation, similar to traditional medicine, to ensure effectiveness and build trust within the healthcare system.
"was one that was really counterintuitive but it's still very new it's it's difficult for those in the traditional healthcare system to wrap their mind around this they don't completely get it yet what..."
Duffy explores the balance between digital interactions and face-to-face care in healthcare. He argues that modern technology can provide support and care remotely, potentially enhancing patient experiences while addressing concerns about losing personal connections in healthcare.
"sense clinically for the person it just needs to be done in a way that actually delivers a result which increasingly companies are doing traditional medicine had it's a long history of dealing with sn..."
The conversation shifts to the evolving nature of patient interactions with healthcare systems. Duffy suggests that as technology advances, patients can feel supported and cared for through digital means, which may lead to more efficient healthcare delivery.
"on face to face interactions with pcps between PCBs and patients or what do you think about the concern that we're losing something here by by you know reducing the amount of that face to face interac..."
Duffy discusses the potential of AI in digital health, expressing skepticism about fully automated coaching. He emphasizes the importance of human relationships in healthcare while acknowledging the exciting possibilities AI could bring to enhance patient care and engagement.
"there are people who actually would prefer yes type of interaction yeah I agree in addition to creating really rich feel for users you can actually add efficiency and efficacy because you can use data..."
In this discussion, Duffy highlights the challenges of scaling human healthcare providers using technology. He argues that the future of primary care will differ significantly from today, emphasizing the need for a digital approach that integrates with existing healthcare systems. This segment addresses the importance of enhancing human capabilities rather than replacing them with technology.
"sometimes when it's you know so when it's when it's off it doesn't cross the uncanny valley closer to r2d2 exactly close to r2d2 because you can't you've got a like its first principles of like social..."
Duffy shares insights on the importance of startups innovating within the existing healthcare framework rather than operating entirely outside of it. He discusses the need for digital health solutions to align with current systems to effectively serve patients. This segment emphasizes the significance of understanding the complexities of healthcare to drive meaningful change.
"like health system to do that I know this because of a real interesting point what do you think about startups innovating within the existing healthcare system versus being completely outside well it'..."
This segment delves into the transformative potential of AI in primary care. Duffy argues that while AI can enhance diagnostic capabilities, it should not be seen as a replacement for human doctors. He discusses the need for a collaborative approach where AI assists healthcare professionals in making better decisions, ultimately improving patient outcomes.
"accelerating them exactly and having them do so much more I'm pretty sure we'll see that first just like you don't think a word process over the grammar checker it's gonna replace a writer anytime soo..."
Duffy addresses the stark healthcare disparities in countries like India, where the doctor-to-patient ratio is alarming. He discusses how AI and digital health solutions could help bridge these gaps, enabling healthcare providers to reach more patients effectively. This segment highlights the potential for technology to leapfrog traditional healthcare infrastructures in developing regions.
"that we've been talking i think implicitly about a sort of a us or at least first world approach to healthcare and there's a lot more of the globe than just the US and you know when i think about othe..."
In this segment, Duffy emphasizes the importance of enhancing the doctor-patient relationship through technology. He argues that by alleviating administrative burdens, doctors can focus more on patient care, leading to a more fulfilling practice. This discussion underscores the potential of digital health to improve the overall healthcare experience for both providers and patients.
"I think that'll that'll start to happen in certain kind of pockets especially pockets where the current existing healthcare in the u.s. might be just slightly uncomfortable with like how different som..."
Duffy outlines the commercialization challenges faced by companies in the digital health space. He discusses the need for clear communication with healthcare entities to redefine perceptions of digital therapeutics as more than just software vendors. This segment highlights the complexities of integrating digital solutions into traditional healthcare systems and the importance of demonstrating clinical benefits.
"more fulfilling profession yeah absolutely my friends that go into the profession they go there to save people yeah not to do paperwork or not to that make sense so let's maybe let's shift over a litt..."
This segment focuses on the importance of demonstrating a return on investment (ROI) for customers in the digital health space. Duffy emphasizes the need for digital therapeutics to not only improve healthcare quality but also reduce costs, addressing the challenges of a risk-averse market while highlighting the role of clinical evangelists in promoting innovative solutions.
"figure out how to use their existing infrastructure to do this in a different way as a for instance prices on outcomes I think digital companies are better equipped to do that because they're better a..."
Duffy discusses the transition from a reactive healthcare system to one that prioritizes prevention. He acknowledges the complexities of preventive care and the role of software in identifying at-risk populations. The conversation touches on the need for a value-based approach to healthcare that incentivizes preventive measures and improves overall patient outcomes.
"the enterprise healthcare can be tough because it's a very appropriately risk-averse buying market I mean yet they want to make sure to do right by their members their patient's etcetera so the areas ..."
In this forward-looking segment, Duffy speculates on the future of digital health, emphasizing the integration of machine learning and AI into healthcare practices. He envisions a landscape where digital solutions are routinely prescribed by clinicians, driven by the need for evidence-based practices and the potential for significant advancements in patient care.
"that's a little bit of an oversimplification I mean vaccines are preventive you know the US has something called the US Preventive Services Task Force which is one of the most illustrious like positio..."
Duffy concludes with thoughts on how to accelerate the integration of software and technology in healthcare. He highlights the importance of leveraging emergent properties of software to drive change and improve patient outcomes, reflecting on the rapid technological advancements that have transformed everyday life and their potential impact on healthcare.
"bio and software what do you think the next few years look like it'll be a lot of infrastructure building I think the you know more companies are gonna continue to realize that evidence is gonna be im..."