MEMS evolving role in improving care, health, and well- being. Shahin Farshchi, Ph.D

Transcription

1 MEMS evolving role in improving care, health, and well- being Shahin Farshchi, Ph.D

2 Outline Intro to Lux Capital Where are the VC $$$s going? How healthcare is changing OpportuniIes for MEMS- enabled soluions

3 Lux Capital Founded in 2000 Specialize in building energy, healthcare, and IT companies Invested in more than 20 companies over 3 funds Based in NYC and SF

4 How are VCs doing? "&)!(!!!"" %#!" "&%#(!!!"" "&%!(!!!"" "&$#(!!!"" "&$!(!!!"" "&#(!!!"" %!!" $#!" $!!" #!",-./01"234567"894::4.05;" "&'"" %!!*" %!!+" %!$!" %!$$" Though VCs did have a difficult Ime raising money auer the onset of the recession, fundraising has picked up With all the new dry powder, where are VCs looking to invest?!" hwp://

5 Are VCs sill invesing early?!"##"$%&'!",!!!"+!!!"*!!!")!!!"(!!!"'!!!"&!!!"%!!!"$!!!"#!!!! /0123! :7! 403;<! =22>! -$.$$! -%.$$! -&.$$! -'.$$! -$.$%! Yes, but the porion going towards later- stage deals has been increasing Possibly due to early- stage investors not being rewarded for taking early technology risk

6 Are VCs invesing in the core sciences?!"##"$%&'!,#!+#!*#!)#!(#!'#!&#!%#!$#!"# -$.$$# -%.$$# -&.$$# -'.$$# -$.$%# /01#23# A6B58C7B96# 4:69DE# Yes, but much awenion has shiued towards technology- lite mobile/social/internet opportuniies More emphasis on business opportuni,es a technology can enable as a business, rather than raw figures of merit

7 Big opportunity: Rising healthcare costs (&+)!!!$$ (&*)!!!$$ (&')!!!$$ (&!)!!!$$ (,)!!!$$ (+)!!!$$ (*)!!!$$ (')!!!$$ (!$$ '!!%$ '!!+$ '!!-$ '!!,$ '!!.$ '!&!$ '!&&$ '!&'$ '!&/$ '!&*$ '!&%$ '!&+$ '!&-$ '!&,$ '!&.$ '!'!$ '%"!!#$ '!"!!#$ &%"!!#$ 01234$ :$ &!"!!#$ %"!!#$!"!!#$ CombinaIon of our aging populaion and ever- increasing healthcare costs Trend is not sustainable

8 Increasing prevalence of obesity & diabetes

9 Healthcare costs are going up in a major way A porion of healthcare reform addresses the issue of fundamentally controlling the cost of providing care The accountable care organizaion was recommended as a means to save $5B by the end of this decade hwp://

10 Accountable Care OrganizaIons

11 Have ACOs been tried? California hwp:// In 2009, California had 285 physician organizaions, both integrated medical groups and Independent PracIce AssociaIons (IPAs), which have many of the characterisics described in the current naional policy debate. These include primary and specialty care physicians who care for defined populaions of paients, provide or arrange for hospital services, and publicly report data on their clinical and financial performance. Many go beyond the minimum set of ACO aciviies to include prevenive care, chronic care management, and complex case management, ouen supported by clinical informaion technology and financed through parial or global capitaion payment.

12 Profile of the CA s ACO HMO providers hwp:// Integrated Medical Groups: OrganizaIons that employ primary care and specialty physicians - examples include Kaiser, Palo Alto Medical FoundaIon, HealthCare Partners Medical Group, Scripps Clinic, Sharp Rees- Stealy Medical Group, Sansum Santa Barbara Medical FoundaIon and Facey Medical Group Independent Physician Associa,ons: Range from solo medical pracices to midsized groups that operate under an ACO umbrella with whom they operate under contract on a pre- negoiated fee or capitaion basis. The ACO provides the informaion technology for helping manage chronic paients and administer preventaive care - examples include Hill Physicians Medical Group, Monarch HealthCare, Brown and Toland Medical Group, Heritage Provider Network, Primecare, Sante Community Physicians, and Sharp Community Medical Group

13 Managing chronic condiions cost providers $$!"#$%&'()*+,()-&!./"$%")-+()& 0+#1"%"-&2"33+%4-& 5")%#3&*+-($*"$-& 67809&#-%:2#& 7%:"$& Percent of Each Population 4.0% 3.0% 2.0% 1.0% 0.0% $10 $100 $1,000 $10,000 $100,000 All Commercial Members Cancer Patients Diabetes Patients Annual Cost (log scale) Diabetes and cancer patients are patients being actively treated or monitored based on claims coding. Source: MedStat 2008, adjusted to MillimanHCG 2009 Standard Commercial Demographics. More than 25% of the ~$T spent on healthcare goes towards chronic disease 22% of all HC expenditures goes towards treaing the 1% of the sickest populaion EffecIve prevenion and treatment depends on improved care through bewer paient monitoring and interacion

14 Medicaid IncenIves for PrevenIon of Chronic Diseases (MIPCD) Cease use of tobacco products Control/reduce weight Lower cholesterol Lower blood pressure Avoid the onset of diabetes, or in the case of a diabeic, improve management of the condiion

15 Providers must keep paients healthy to control their costs Prevalence of Diabetes Macrovascular & Microvascular Complications $10,000 $8,000 $6,000 $4,000 $2,000 $2,848 $541 $0 No Diabetes with Average Complications Rates $8,039 $1,429 Diabetes with Average Complications Rates Annual Per-Capita Healthcare Costs $9,797 $1,566 Diabetes with Diabetic Complication Rates Total Costs Out-of-Pocket Costs Percentage with Complications Heart Attack Chest Pain Coronary Heart Disease 7.9 Congestive Heart Failure Stroke Chronic Kidney Disease Foot Problems Eye Damage 3 Diagnosed Diabetes Normal Blood Sugar Levels American AssociaIon of Clinical Endocrinologists macrovascular microvascular Keep people from developing chronic illness Manage chronic illnesses properly to avoid costly reacive emergency care

16 How can technology help us achieve this goal? Many ACOs are comprised of a mixture of providers within IPAs and IMGs therefore informaion relaing paient histories and behavior needs to be communicated (electronic health records serves as a staring point) Providers operaing under ACOs are more incenivized to engage with paients and reduce the likelihood of obesity & costly chronic disease and complicaions Furthermore, an increasingly social populaion is feeling more posiive towards sharing well- being- related informaion

17 The connected SmartPhone as the interface Smartphone- mounted device that senses volaile organic compounds linked to TB, etc. (Nathan Lewis Caltech) AliveCor - Smartphone case that monitors ECG Medisense: Raman- based glucose monitor for coninuous communicaion via smartphone Scanadu: Smartphone- connected sensor suite aiming to be a tricorder IMEC s low- power sensor for EEG, EMG, and ECG that communicates with a SmartPhone Sleeptrak: Sensor that monitors sleep and communicates with a smartphone via NFC

18 How can this data drive bewer decisions? Modifying rouine exercise and eaing habits ConnecIvity à compeiive behavior to improve health Closely monitoring parameters that could lead to chronic disease and/or complicaions associated with exising condiions Helping healthcare providers make decisions to pre- empt expensive reacive care e.g., ER visits

19 Trend: QuanIfied Self Movement ph tracking for learning about inflammaion, sleep, and mental performance Monitoring and syncing the brain with the heart during sleep to grow focus Tracking and managing breath to reduce stress AugmenIng the ability to predict health & opimizaion

20 How about the value in the data? Big Data push for capturing more informa5on Companies valued for accumulated and curated data MEMS enables pervasive sensing and communicaions - adding a layer of informaion & knowledge above the tweets & likes that can correlate with mood and well- being When coupled with machine learning & recommendaion engines, providers can take pre- empive acion to prevent costly ER visits

21 Today s BioMEMS: enabling delivery and Dx Wireless implantable pressure sensors Protein measurement DNA sequencing PoC diagnosics Hearing aids Drug delivery Visual prostheses Hearing aids

22 Tomorrow s BioMEMS: pervasive sensing & care KB"("(.>'+ 2#3%*%4)5+2#67+ Using moion and posiion sensing to monitor general wellness and acivity levels Chemical sensors to measure ambient condiions, perhaps coupled with genotypical informaion to predict and prevent disease Miniature, connected devices for precise, schedules drug delivery with feedback mechanisms Miniature, portable disease screening tools leveraging miniature, automated qpcr technologies

23 Summary Chronic disease is becoming more prevalent TreaIng paients with chronic disease is expensive Healthcare as a pay- for- service model is becoming less effecive and non- economical The accountable care model has been successfully implemented - though it will take Ime to refine and improve economics for the providers and paient outcomes Payors and ACOs can benefit from pervasive sensing, communicaions, and data interpretaion to keep paients healthy and manage those with chronic disease