Deloitte is one of the leading innovators in the world focused on value-based care and medical technology. In this emerging world, it is a business imperative for medtech companies to understand, demonstrate, and clearly articulate how their offerings can not only improve patient outcomes but also create value for key health care stakeholders.
Deloitte works with hundreds of provider organizations, helping them navigate the challenges and opportunities emerging technologies currently present. We had the opportunity to speak with Glenn Snyder, Medical Technology Segment Leader at Deloitte, about medtech in health systems, how patients and healthcare workers are being impacted by various types of health tech, AI, and telemedicine, and the future directions of related tech trends.
Alice Ferng, Medgadget: Great to have the opportunity to chat with you Glenn! Can you please tell me about yourself? I read that you started in another field. How did you get involved with medtech?
Glenn Snyder, Deloitte: I’m an engineer by early professional background, and then after getting my MBA, I’ve been consulting for 28 years. After starting consulting career, I consulted more on the healthcare provider side, and this was back in the early 90s. We were doing a lot of what was called a patient-focused redesign of patient-focused care.
Looking around, I really recognized back then, and still today, that the average patient will interact with people of all ages from all various walks of life in the hospital. Everything from a physician to somebody who’s cleaning the patient room. I really kind of cut my teeth in the healthcare industry by just recognizing the challenges of complexity in our healthcare system, and I think that that’s largely shaped my philosophy now. At that point, I then shifted more to focus on those things. Otherwise, my engineering background was on the manufacturing side of the industry.
I started as an oil and gas engineer, but after my engineering degree I did think about getting a medical degree when I was an undergrad. But I ended up getting pulled into an energy company, so I worked as an engineer for an energy company for three and a half years before going back to school. I was consulting in the meanwhile, and happened get staffed on something healthcare related.
You know, I think a lot of it is that you think: “I’ll do this for two years and then I’ll go work for a client”. But after a while, I thought: “I don’t want to go work for a hospital after a couple of years of consulting, but I really got to like the industry.” I did do some projects outside of the industry my first two years in consulting, and I found out that A) healthcare wasn’t really an interest of mine, but B) it has a real mission aspect to it, and C) frankly I really enjoyed working more with the healthcare executives than executives from other industries – I just thought they had a more holistic view about the business that they were in, and it fit more with my personality. Serendipity. But that’s the way it worked out.
Medgadget: What your role in Deloitte, what do you do, and how did you get involved?
Mr. Snyder: I was asked to found and lead our medtech vertical about 6 years ago. As for my role, I’m a consultant, but I also have responsibility for the other functions that Deloitte for medtech.
My philosophy now on medtech is one that involves the many wonderful advances of sensor technology, lowering sensor costs, and the budding opportunities of augmented or artificial intelligence, where there is a tremendous opportunity for medtech to become simpler and to drive simplification in what has become a very complex healthcare system. I think a lot of the complexity has been driven by technology, but also from developments in science and medicine standpoint, everything from genetics, cellular behavior, and the biome. These things have driven complexities to where there is a need now more specialization of tools and more specialized roles to start to simplify complexities.
One of my colleagues said that in a lot of ways, the last decade was the decade of pharma, with a lot of blockbuster drugs that really have suppressed pretty fundamental means– but we think that this next decade will be the decade for medtech . We will start to see some substantial advancements in the parts of the healthcare system particularly around diagnosis and treatment decisions, but also advancements in treatment and procedures themselves.
Medgadget: What are some emerging trends in the whole smart healthcare revolution that can be seen with everything that’s been happening over the last decade?
Mr. Snyder: First off, I’d say there’s a lot of promise, but of course the big impact has to be realized. I was just speaking with a colleague of mine at the Stanford Biodesign program about this. I think a lot of a lot of people have expected some of the digital health opportunities to yield some kind of blockbuster opportunities that we haven’t seen yet.
As I meet with different individual companies and executive forums, reimbursement keeps coming up as one of the fundamental breakthroughs, especially on the CMS (Centers for Medicare & Medicaid Services) side. I think that people believe that private payers are moving the needle more towards innovative reimbursement programs. But CMS is limited in that it has some 30-year-old statutes and rules that kind of guide how they cover the budget, and so it makes it more difficult for them to get creative.
There are some new reimbursement models, but a lot of these solutions are looking more at prevention for some longer-term cost avoidance that traditional reimbursement mechanisms weren’t built to reward. So I think it will take several years for our health care system to evolve to be able to truly reward these types of innovations. I think that progress will be the result of both the innovators themselves aggressively working in new ways to take on risks and to be rewarded, and the evolution of some of the systems both commercial and on the government side of our healthcare system.
There is also a big spectrum of innovation types where you’ve still got very engineering driven innovations that in a lot of cases result in products that have been developed either based on a physician or an engineer saying “gee, this would be nice if we could do this in a slightly better way.” Incremental innovation isn’t going to get rewarded more, and now we need to really be thinking more from an embedding concepts perspective, like human centered design and look through a lens on valued creation for the healthcare system.
Deloitte has done some value framework development design that also kind of looks at a new way of looking at innovation to really see how it’s driving healthcare value. This value framework was created both for medical devices and also for diagnostics separately with some variations on that just because diagnostics have some particular unique challenges in today’s healthcare system. We’ll give you a link to this.
Medgadget: Let’s return to our initial topic of emerging trends – where are these innovations coming from?
Mr. Snyder: There’s really 3 different sources of innovation, maybe 4. 1) traditional medtech, 2) startups, 3) the high-tech part of businesses (e.g., Verily/Google); and academia would certainly be an important one.
One thing I’ve seen that’s fascinating from a medtechstandpoint is you have now seen a broader set of innovators. I think even some that have historically been on the high-tech side of the industry that have tried to stay away from regulated products are increasingly getting into the regulated space… or so we think because there’s a lot of secrecy around that too.
Medgadget: Some of the buzzwords lately have definitely been AI and telemedicine. Do you think AI and telemedicine in healthcare lives up to what everybody thinks? How do you think these technologies will actually impact healthcare workers, patients, or clinicians?
Mr. Snyder: It’s an interesting question. I moderated a debate at the Asia-Pacific MedTech Forum in Singapore in November where we discussed the impact of these growing trends. We had two people on the “for” side and two people on the “against” side of “will AI replace the physician”. I had a physician on either side, which is kind of interesting. In the end, all 4 of my panelists felt they could have argued against or for either side. Actually, 3 of 4 of them held firmly that they wanted to be on the against side. I would say the conclusion of that debate was that it is unlikely that AI would ever fully replace the physician.
I have sometimes maybe an overly simplistic way of looking at it, which is informed by as a child watching Star Trek, with the tricorder, and Dr. Collins. Even in that period with all the technology, you still have a physician there. It is a question of though you know, as in Star Trek, can the tricorder and the other technologies that Dr. Collins would use fundamentally simplify the way healthcare was delivered. So both diagnosis and treatment were vastly simplified, and I think a lot of other science fiction movies have pointed to the same. Now the question is okay, where is reality now. We are on a path that actually that leads us in that direction but are still a long way from that reality. But all that said, there are some really great tangible mind-blowing steps being taken towards that reality.
Just flip the trajectory in price performance around technology. You would expect that it won’t be that long before devices like the tricorder that are in the consumer’s hands, where they are able to do a lot of base level diagnoses at home, and once that starts to happen, that will start to fundamentally change the way our healthcare system works. I mean there are examples out, for example, dermatology app on an iPhone that you can use to determine exactly whether a lesion was cancerous or not with a very high degree of accuracy. All these kinds of devices are pushing towards consumer control over their own health, immediacy, and convenience. Consumer demand and consumer power is really driving a lot of this. The only question then becomes reimbursement, so are these things going to be cost effective enough that the consumers won’t spend out of pocket… and/or is there going to be a mechanism for them to be able to get reimbursed for some of this stuff so that they can manage their health better. Certainly, wearables are clearly in that space too.
Medgadget: Let’s talk about wearables – there’s certainly been a lot of hype around many devices that have since died down over the years, often related to “wearable fatigue” and people just not really continuing to use these devices long term. What do you think about this?
Mr. Snyder: The wearable space is a very tangible example of where we are with a highly used space. One of the big challenges with all the great technology is compliance, and you know if you look at wearables, some of our research has shown that most consumers use wearables only for a period of 6 to 10 months.
AARP did a study that showed that people aged above 50 on average wore the trackers for 32 days, and if they were above 70, they quit after 14 days on average. And so my question is if maybe that’s because the utility of the devices hasn’t worked, and therefore, it doesn’t make it valuable enough for people to continue to go through the trouble of wearing the devices and charging them or what have you. And so maybe the technology just has to get better. You know the other thing that I’ve heard people argue is that maybe that’s an argument for implantables instead of wearables. That is, if we could have a device that’s implanted, then frankly the consumer doesn’t have to worry about putting it on themselves or doing much else. You’re going to have a greater amount of compliance, as well as a greater utility out of it too. However, the AI can be the best in the world, but in the end if it doesn’t change behavior, such as the behavior of the physician in terms of the decisions that are made for the patient, or the behavior of the consumer in terms of the daily decisions that they make regarding their health, whether they take their medications, whether they eat, or whether they exercise more, than it’s all for naught.
Articles from Deloitte:
- The hospital of the future: How digital technologies can change hospitals globally.
- Out of the valley of death How can entrepreneurs, corporations, and investors reinvigorate early-stage medtech innovation?
- A Framework for Comprehensive Assessment of Medical Technologies: Defining Value in the New Health Care Ecosystem