Last weekend we attended the Stanford Medicine X conference that brought together a variety of people involved in every aspect of health care. Even a few investors were present, but none more famous than Robert Herjavec. He’s the “nice guy” on Shark Tank, the TV show where entrepreneurs pitch their businesses to wealthy investors. His fortune comes from building Herjavec Group, Canada’s largest cybersecurity provider. He was invited to help judge the finals of the Astellas Oncology C3 Prize, a contest designed to help foster technologies that can improve cancer care. We were offered an opportunity to sit down with Robert to discuss challenges he faced while taking care of his mother, who had ovarian cancer, and how technology can improve these and other issues in oncology patient care.
Gene Ostrovsky, Medgadget: I heard your mother passed away from cancer. What was it like? What was the most difficult aspect of taking care of her?
Robert Herjavec: Yes, years ago. I think it was eight years. She had ovarian cancer and passed away. It is very interesting, you know… I think anybody who goes through cancer experiences a process, especially depending on their background. I am a business person; I have built companies. So my first reaction was – “it is no big deal, I will be able to fix it.” And what we learned very quickly (we are going back to eight years ago) was how little technology has caught up to the medical field. I just assumed that there are all sorts of innovation, new information and services that I will be able to find. And you quickly learn that cancer is a catch-all for a very large world. And that every type of treatment is different, that getting information was difficult, getting services was difficult. So that was the first thing that really hit me – the lack of innovation in cancer treatment field.
Gene: Do you have an idea of why that is? Where is it coming from?
Robert: You know, I think it all stems from the natural way that medicine is designed. You have a natural conflict between the people who are trying to take care of the patient’s records, and doctors who want to innovate and move quickly, researchers, and advocacy groups. And especially, I think, in the last few years you have seen a tremendous spurt in innovation and growth. And part of it is the Internet of Things, you know, what doctor does not want to use his iPad to access electronic records? One of the great things about getting involved was Astellas and the C3 Prize. Because any time you can talk about innovation and shine a light on that, it is good. If you look at this program, they had over a hundred applications for the finalists and there were people from all over the world: people from Australia, people from Canada, people from Africa….
Gene: How did you get involved with this prize?
Robert: Well, they contacted me and we have an opportunity to look at a lot of different things, we are pretty busy, so we tend to pretty quickly only work with things that we have a personal connection with. And it is such a privilege to have a platform like Shark Tank to bring light to certain things.
Gene: Any specifics, when you were helping your mother… when you thought “this should change right now, this is clear that there should not be any barrier to this?
Robert: Yeah, I think… You know for me it became very quickly two tracks. One was the actual medical aspect of a disease, which I cannot really control and there is a pace to it. But then there was a patient care aspect of it, which I really did not understand. Things… Everything from transportation to depression and fatigue. I did not know any of that. I knew that she was sick, that she needed chemo, that there is medicine. I did not expect all the other stuff that goes around it, and it was a real learning experience. Again, it is a great thing if you look at the five finalists here: we have somebody who is dealing with fatigue here from patient care perspective, we have somebody who is creating an environment online for prostate cancer patients to get information, and we have somebody who is doing something as relatively simple as transporting patients to treatment.
Gene: Now, regarding the prize. How are you going to judge? What is your criteria?
Robert: Well, I think my criteria is innovation and patient care aspect of it. Because great innovation in cancer does not always come from the for-profit sector. Even some of the finalists. One of them is a non-for-profit. Another one is an advocacy group. But, you know, for me it is really about innovation, not about the profit aspect of it. But there is no point in having innovation if you cannot reach a wider audience. You know, somebody creates something that affects a small group of people and nobody ever hears about it, I am not sure it is effective. So I think it is innovation married with effectiveness.
Gene: How important do you think is innovation?
Robert: I think it is really critical. You look at the tech industry and how the tech industry has grown, I mean we live in the tech industry that is very narrow, very complicated, very niche. But you have big shows and gatherings from universities, trade groups, things like RSA, and things like Comdex, where it really ignites discussion. I think that things like this, like Medicine X are great platforms for people to come together and it is always great to have a prize, like C3 prize, where you can get people talking about it and give them a bit of an incentive. People not only get the prize (we are giving away $100,000, which is $50,000 to the finalist, and two other people get $25,000), they also get involved in a program called “Matter” which is a tech incubator for medicine.
Gene: So, yesterday we heard talks about security, medical device security, open source, and related issues. I was wondering, you running an IT security company, do you have any thoughts about these issues? I wonder what is the approach to take because these issues can threaten patient lives?
Robert: Fundamentally it is the growth of the internet of things. The amount of connected devices in the world is growing at a rate we cannot even imagine. Currently, there are about 3 billion people online with something like five to six billion IP addresses. By 2020, there will be 5 billion people connected and hundreds of trillions of devices that are connected. And nowhere we will see a greater impact of that than we will in healthcare. We are going to see doctors, we are going to see pacemakers connected, we are going to see diagnostics machines connected, everything in a hospital is going to be connected because it just has to go that way. So for me the cybersecurity will become a big part of it. The issue right now is not so much about shutting down pacemakers (not to be mean about it, but it is a very individual thing). What we are seeing now is ransomware, that is the thing… And it is growth of data as a weapon that is affecting healthcare because their systems are so old. It is just about innovation. It is not that different than C3 prize and what Astellas is doing. We are just trying to create innovation about it. And hospitals and IT are really a few years behind.
Gene: Let me ask you a question on another topic. As an immigrant, having lived in Canada and America over the years, how has the potential changed for entrepreneurs?
Robert: I grew up in Yugoslavia, Croatia. I live half the time in Canada, half in LA. It is the easiest time in the history of humankind to start a business, by and far. Having said that, it is also the most competitive time in the history of business to start a business. For example, when I started my first business, I needed a computer, I needed a server. A server cost $15,000. I did not have $15,000, so I spent the first six months selling stuff so I can make enough money to buy a server. And I was competing against eight companies that had thousands of servers. So there was a real barrier to entry. That has gone away. Cloud computing, infrastructure, open source have really leveled the field in terms of the capital required to start a business. But it really comes down to this issue: if you can really add value – that is what it really is about. But because everybody else can get into business with you, you have to add the most amount of value. You know, it is just like C3 prize and Astellas, we are trying to find the people who are doing the most innovative things quickly and shine a light on them.
Gene: Do you think technology will be the main driver of change in healthcare? Or policies, politics?
Robert: I think technology is the enabler. Technology is a tool. And it will have a leap-frogging effect on hospitals and everything. I think the game changer is going to be innovation. We have to innovate the way that patient care in oncology is being done today. The technology will just enable us to do it faster.
Gene: What are your thoughts on the gap in medical care between the poorer and wealthier places of the world. Is it narrowing or widening?
Robert: I would actually say that the gap is getting closer. I would think that … Look for example at the access to the internet in Africa. Africa has the fastest growing rate of people coming online. And the gap is the biggest there today but it is closing the fastest… A lot of the technologies today are very expensive in medical care. And look what happened recently with some injection device, but you are seeing those prices come down. Technology, innovation, things like this forum, which brings really smart people together to talk about things, things like the C3 prize and Astellas, are all driving some of that stuff and you know it is kind of like knowledge that cannot be stopped and knowledge is the greatest equalizer of all time. And you know why Communism has fallen? Because you can keep people in the dark only for so long. And I think the same thing is going to happen in healthcare. I think that a lot of people have not focused on the technology as an enabler.
Gene: Do you invest in medical technology?
Robert: We invest a lot in cyber security and our fastest growing segment is healthcare. We were just at the Department of Homeland Security two weeks ago, meeting with them about what they are seeing in United States in terms of terrorism, ransomware. And that one thing that they told us that we can share is that one area is healthcare.
Gene: Have you heard of the St Jude’s cardiac implant security story that was recently in the news?
Robert: I have not heard a lot of details about it. There was some story …. Anything that is connected can be hacked. Full stop.
Gene: So would you get a wireless pacemaker these days if you had to?
Robert: It is the same as I just got a Tesla. You know, you live in California and you get a Tesla. I have had it for about a week. And what I have realized is that it is just a big server. It is really not a car, it is a big server on four wheels, it is kind of cool. And absolutely it can be hacked. Anything can be hacked.
Gene: But the benefits outweigh that possibility?
Robert: Absolutely. I think you always have a natural risk where technology is involved, but I am very optimistic about it, especially in the healthcare area.