Jack Barrette
WEGO Health
CEO and founder

Not long ago, the term patient influencers was an oxymoron. Determined to change that and give patients the power to drive conversations about care and treatment, WEGO enlisted an entire army of opinion makers. It has since connected more than 100,000 of the most influential bloggers, tweeters and pinners, not to mention users of health-specific (and WEGO-backed) platforms Truvio and CureClick.Barrette expects that sum to double within a year. “While many companies have been talking about being patient-centric, there was no good way to do that before,” he says. “To take the friction out of the space, we built a mobile platform with the technology to make these instant interactions easier.” In return, these patients provide insights for groups ranging from regulatory agencies to pharmaceutical companies. Barrette admiringly describes WEGO users as a “glowing power source. They’re passionate, articulate and experienced—and driving healthcare change and innovation. They are seen not as an audience, but as partners.”   —Sarah Mahoney

David Blair
Head of industry, health

While some within the healthcare loop may have tired of the endless accolades heaped upon Google, it’s hard to overestimate the influence of the world’s biggest brand on health. Indeed, health—and attempting to solve some of the most vexing problems associated therewith—ranks high on Google’s list of priorities, according to Blair. “The real tipping point for us has been the intersection of wearables and wireless Internet and the velocity of mobile technology. It’s moving us from point-of-care to care-everywhere,” he explains, adding that Google believes that the country is experiencing “macro changes” across the entire healthcare system. “Seeking health information is now the third-most-logged consumer activity on the Web, after email and search. People are on a huge quest.”Google has endured a setback or two in the health space. The company pulled the plug on Google Health, a platform intended to collect and store all of an individual’s medical information in a single place, at the start of 2013. Unbowed, several months ago it introduced Google Fit, which focuses on fitness and nutrition rather than information from healthcare providers.It goes without saying that Google is monitoring all aspects of, well, monitoring. That includes fitness wearables, of course, but also the activities of organizations like Teddy the Guardian, an Eastern European company that manufactures a plush teddy bear with heat sensors that can track children’s vital signs in pediatric hospitals. It also includes Google’s collaboration with Novartis on contact lenses that act as glucose monitors for diabetes patients. “We’re seeing changes in all walks of everyday life. We’re working across the spectrum,” Blair says.Google’s multiple health endeavors share one thing in common: They’re driven by the pervasiveness of Wi-Fi, biometrics and smart phones/devices. “We’re trying to help everyone realize the velocity of the changes that are taking place in communication technology and interaction across devices,” Blair adds. “It’s not in the future. It’s already here.” —Sarah Mahoney

Faruk Capan
Intouch Solutions

It says something about Capan’s record of transformation and disruption that his work growing Intouch Solutions into one of the industry’s biggest and most highly regarded agencies might not rank first on his list of career innovations. Way back in the 1990s, Capan founded MSWatch.com, the healthcare industry’s first community portal. He downplays the achievement—“if I showed it to you now, you’d ask, ‘Why didn’t you build Facebook instead?’ ”—but the point remains: When everybody else was attempting to wrap their heads around this crazy newfangled Internet thing, Capan had already envisioned its future. At Intouch, he’s used that same intuition to convince wary clients to contemporize their marketing. “I don’t think pharma has figured out mobile yet, but mobile and all the data that will be generated is what’s most interesting. It’s about the marriage of big data and behavioral science. There’s so much value in this for patients and doctors—it’s just a matter of convincing clients to go there with us.” —Larry Dobrow

Steve Cashman
Founder and CEO

It takes a certain degree of chutzpah to tell Walmart, Walgreen and other mega-retailers that have taken a dive into healthcare services that, well, they’re doing it all wrong. But when Cashman makes these proclamations—in the interest of prompting retailers to take a look at, and perhaps devote some floor space to, his teleconnected HealthSpot healthcare delivery kiosks—he does so because he truly believes that his way is better for consumers. “When was the last time you heard anybody say something nice about a healthcare experience?” he asks rhetorically. 

At the same time, Cashman believes the HealthSpot model is an equally good fit for the doctors who will tend to those consumers. The company takes care of the scheduling, connectivity and insurance; all the doctor has to do is tele-see the patient. “There was skepticism at first. Now it’s just a matter of getting more people and physicians to see us in action. They get it right away,” Cashman says. —Larry Dobrow

Michael Coffey
Consumer experience team lead

Of all the individuals on this list, Coffey faces one of the most daunting challenges on a day-in, day-out basis: His role is to make living with diabetes a positive experience for the 21 million Americans suffering from the disease. And while “positive experience” is highly subjective, several of Coffey’s patient-centric innovations have resonated with his target audience. Most notably, Coffey and his team have surprised customers with the monthly delivery of Accu-Check To, a box filled with both the essentials for monitoring glucose levels and treats like popcorn and aroma candles. “The challenge is understanding where our ability to walk alongside the customer truly is and to break out of the commoditized world we live in,” he says. Along those lines, Coffey believes that it’s important to look beyond healthcare to delight consumers; he finds inspiration in the world of discovery retail (wine clubs, Birch Box). 

The Accu-Check program has been a part of Coffey’s efforts to build a much richer relationship with customers—even to generate some enthusiasm around the treatment of their condition. “Can we get them excited about testing? Can we get them to share it socially?” he asks. “If we can make that happen, it would open up the door for them to talk about diabetes as part of their lifestyle in a positive way. We approach them as people, not patients.” —Sarah Mahoney

Kevin Conroy
Exact Sciences

It is one of the most preventable forms of cancer, but colon cancer still kills some 50,000 Americans a year, primarily because half the people who should get screened don’t. But while at-risk individuals continue to duck colonoscopies, DNA analysis has improved. In the process, it has paved the way for Exact Sciences’ Cologuard, the first (and so far only) FDA-approved noninvasive screening. “We offer a test people can use in the privacy of their own home with an accuracy rate of 92% in detecting colorectal cancers,” Conroy claims. 

One key to the company’s success, he says, was “a ridiculously large” clinical trial, a partnership with the Mayo Clinic that included more than 10,000 patients. The company is focused on getting the word out about the prescription-only Cologuard, in part via Facebook ads targeting people on their 50th birthdays. Moving forward, look for Exact Sciences to preach the early-detection gospel. —Sarah Mahoney

Ingo Elfering
Chief information officer

Experts have pontificated on the potential of the Apple Watch and similar offerings from Google to turn information aggregated by fitness trackers into something pharma will see as valuable—say, real-world evidence for clinical trials. Elfering, the former VP of disruptive innovation for GlaxoSmithKline, is positioned to turn that potential into reality. While at GSK, he helped steer a demonstration project that involved taking data from mHealth devices, unifying it with a cloud-based app and making the information available for drug-related R&D.
Elfering holds up the pilot, publicized in late 2014, as “a good partnership between our businesspeople, our innovation function in GSK and the external supplier.” GSK and cloud-computing outfit Medidata ran the project at the drugmaker’s Human Performance Lab. Participants were given two wearable devices to continuously measure vital signs, ECG data and activity levels. The project showed that the technology can deliver FDA-compliant data and enhance the trial experience for volunteers.
Shepherding a use case like this was deceptively complicated. Among the different components: making sure all participants had a mobile phone with a data plan and Web coverage, ensuring that sensors and app worked in concert with each other and training patients on how to use their devices. “We had to work through a lot of these things for the first time, and that’s why partnership with the internal business unit is essential. Assessment of regulatory reviews and validation is something you can discuss, but ultimately it’s up to the business unit,” he says.
Elfering hints that more pilots may be announced involving the use of mobile technology for more than conducting clinical trials digitally. A 2011 use case involving GSK and Nigerian health authorities, for instance, showed that Nigerians could leverage SMS to verify that the antibiotic they bought at the pharmacy is not counterfeit. “As mobiles become more dominant around the world, there’s plenty of thinking about where that type of technology could also be used,” Elfering says. —Marc Iskowitz

Derek Flanzraich
Founder and CEO

While people have long been swarming the Internet for information about health and nutrition, Flanzraich never found what he was looking for, even as a kid. “I’m a Millennial and I grew up struggling with my weight,” he recalls. “I wanted someone who was on my side and talking with me, not to me.” His solution? Greatist, a provider of wellness/fitness information for Millennials that self-identifies as “real,” “hilarious” and “legit” and regularly proclaims that “being healthy doesn’t have to suck.” Since its debut in 2011 (as a WordPress blog), the site has cranked out health and lifestyle coverage that, in Flanzraich’s words, helps visitors “define their own idea of healthy.”
With five million monthly unique visitors—65% checking in via mobile devices—Greatist enjoys a unique relationship with 18- to 35-year-olds. They love it for the easy health ideas (“31 portable protein snacks”) and its realistic affirming voice. They also dig the humor (see under: snot-rocket etiquette). Flanzraich says Greatist doesn’t have to work too hard to differentiate itself, given that much of what’s on the Web is unreliable, unverified or just plan middle-aged. “Our ideas are all science-based and run by our panel of experts,” he notes. “Then we write them in a way that is fun and friendly and down-to-earth.” —Sarah Mahoney

Eric Foster
Global marketing director

Inspiration for change can blossom even when things have been quiet for a while. For GlaxoSmithKline, lupus presented an opportunity to shake things up by prompting patients to get more engaged with their condition though an awareness campaign. This may not seem like a big deal—awareness campaigns aren’t exactly on the endangered-species list—but Foster notes that GSK was attempting to create a community around a condition for which there hadn’t been “any new development or treatment” for decades.
The first iteration of the campaign, by Foster’s admission, was basically “if we create it, they will come.” The second attempt —the first was reframed as a “learning”—gave the team a chance to seek out patient needs, like a conversation guide, and create an environment in which they wanted to engage. “Patients are passionate,” he says. “You need to believe that you make a difference and use that motivation to push for the patient.” —Deborah Weinstein

Hamish Franklin
Atlantis Healthcare
Director of research and development

Adherence has long been one of the most baffling problems in healthcare for Franklin, who arrived in the field from the world of direct marketing in the 1990s. “I came to this from loyalty programs for banks and supermarkets, where we were trying to get people to change their behavior by writing emails with interesting headlines and lively copy,” he recalls. It worked, a little. The game didn’t change, however, until Franklin began consulting with a health psychologist—his group now works with 25 of them—on behavioral medicine. “We started to be able not just to predict who wouldn’t adhere to their medications, but also to understand why,” he says.
Franklin has learned that the reasons vary wildly. “People may resist corticosteroids because they think their testicles will shrink, for example, or reject a medication for chronic asthma because they believe their condition is episodic,” he continues. “The cause of nonadherence is different for each of us, as well as for each drug.” Atlantis thus built its business around behavior rather than information alone. The results? “We’ve got published clinical papers now, looking at such conditions as diabetes and hypertension, that show adherence gains of 20% or 30%. We believe it’s because we are addressing the why in patient adherence and doing it in a way that is personal and meaningful.” —Sarah Mahoney

Jay Goldman
Klick Health
Senior vice president, innovation

Judging by its recent growth—40% per year, the agency says—Klick Health is doing an awful lot of things right. The firm has always been quick to embrace those technologies that, according to Goldman, help companies “treat you less as, say, a stomach-cancer patient and more as a person who has stomach cancer—treat you as a whole person, in a more personalized way.” 

But really, Klick’s most underrated recent innovation might be its efforts toward changing the way healthcare marketers work, says Goldman, co-author of The Decoded Company. “We’ve inherited so many management tools that were developed when we were a data-poor world—annual planning cycles, memos, you name it.” To replace those “old and broken” management and workflow tools, Klick has founded Sensei Labs. The goal? To help biotech companies execute and evolve faster. “Management tools haven’t kept up, but living in a data-rich world, we can reconsider everything,” Goldman adds. —Sarah Mahoney

Shwen Gwee
Digitas Health LifeBrands
VP, group director of social strategy

Listening to Gwee discuss the intersection of marketing and technology is like listening to a super-thoughtful, hyper-articulate preacher. While he doesn’t gesticulate or raise his voice, Gwee has the passion part down pat. “Disruption—not just falling back on accepted models—is hard, especially in this business,” he explains. “It’s not just about making a case. You have to live it.”
Over the course of his career, Gwee has walked the proverbial walk. In 2010, he organized an event at SxSW that ultimately led to the addition of a formal/health medical programming track. Now back on the agency side of the biz, Gwee is pushing clients—some reluctant, some not—to open their minds. “Pharma went through this big app phase—‘we need an app for every medicine!’ What we’re seeing now is the importance of platforms, whether Google or Apple or whoever. There’s never been a time where we have so many opportunities to connect with patients.” —Larry Dobrow

Mark Hadfield
CEO and founder

Jumping to the very front of the line is the end game for any would-be disrupter, and HelloMD certainly shares that goal—both for itself and for its customers. Initially launched as a provider of telehealth services, the company now helps patients cut the proverbial line for appointments with top medical specialists via video link.
Hadfield says that first iteration of HelloMD revealed to him not just how frustrated doctors are overall—that’s not exactly a secret—but also that doctors are as impatient about seeing patients as patients are about seeing them. HelloMD has disrupted the doctor/patient experience, then, by short-circuiting it. Doctors agree to give HelloMD patients priority scheduling status and patients agree to pay, an arrangement that often means agreeing to set aside health insurer restrictions in exchange for quick access. Hadfield notes that bypassing payers also gives doctors the freedom they crave. “Doctors don’t like to be put in a corner,” he says. —Deborah Weinstein

Allan Halpern, MD
Memorial Sloan Kettering Cancer Center
Chief of dermatology service

Few medical specialties are as visual as dermatology. So to Halpern, using photography to combat melanoma seems the most logical thing in the world. “We’ve been doing it for years,” he shrugs. But MSK is still the only organization using his pioneering approach of three-dimensional full-body photos for the early detection of melanoma. The images establish a baseline so that new and changing moles can be spotted earlier and subtler melanomas can be identified. “We are amassing gazillions of pictures—people come away from Thanksgiving dinner with 50 digital images and two videos,” Halpern says. “It seems inevitable that we’ll find new ways to use digital photography to benefit patients.”
Yes, there’s been some pushback from doctors, who fear premature obsolescence. Still, Halpern counters that “this technology still relies on clinicians to make the evaluation, based on what something used to look like. It should be a lot more desirable to the average dermatologist, who now either has to jot down, dictate or type a paragraph-long description of something they could have photographed in less than a second.”
As to the, ahem, delicate privacy issue regarding full-body naked photos? “There’s no question that having someone’s naked pictures is a very sensitive issue,” Halpern admits. Nonetheless, that will remain a trade-off patients have to make. “We give them their own body photographs in a book and the existence of those books has caused real concerns,” he adds. “In some cases, patients have hidden them so well they can’t find them when it’s time for the next visit.”
Halpern believes that new technology—in dermatology and elsewhere—moves physicians to a higher plane of providing care. He also points to the use of 3D cameras as part of a larger trend of digital imaging finding its way into dermatology. But he adds that it likely won’t be long before patients, either those with melanoma or those at risk, start asking the questions for which technology can provide a fast answer, “like, ‘How has my mole changed? Show me.’ ” —Sarah Mahoney

David Howe
LuminaCare Solutions
CEO and co-founder

We’ve come far in our treatment of infections—yet when an individual contracts a stubborn one, the path to the right medication remains slow. “Patients are still dependent on culture methods, and timing is critical for a serious infection,” Howe says. To decrease that time lapse, improve outcomes and knock down costs, LuminaCare has devised a cloud-based predictive analytics platform that helps practitioners make better, faster decisions. According to Howe, the company’s models help point doctors toward the right antibacterial treatment within 24 hours, a duration that has been shown to reduce hospital stays by at least 40%. 

For now, LuminaCare’s challenge is to bring together all the players—pharmaceutical and diagnostic companies as well as hospitals—to make its model work. But in the years and months ahead, it hopes to expand its therapeutic slate. “We’re hoping to work with tuberculosis patients,” Howe says. “We’re considering ways we can work with pharmaceutical companies to create new antibiotic formulas.” —Sarah Mahoney

Gary Kay
Cognitive Research Corp.
President and co-founder

Studying the ways drugs affect cognition and motor skills has always been costly. But thanks to innovations from Cognitive Research Corp.—specifically, a driving simulator widely regarded as the most realistic of its kind—that process is becoming more efficient and affordable. A niche company that focuses on driving, CRC has developed technologies that can tell whether a drug impairs or improves cognitive function. “It is critically important that prescribers and consumers recognize that drugs, even OTC drugs, can impair their ability to drive, whether or not they feel drowsy,” Kay says.
Sometimes the interactions are unexpected. The company recently asked test subjects to drink two glasses of wine a day after they took a standard dose of an OTC cold medication. “While that’s a legal amount of alcohol, we found they were really impaired,” Kay reports. Of course, social pressures have sparked change, too. “It took us a long time to become aware of the risks of alcohol and driving, and now we are realizing the effects of medications on driving safety. Consumers are demanding that these studies be conducted.” —Sarah Mahoney

Asif Khan
Founder and CEO

Impossibly ambitious goals don’t get more impossibly ambitious than “we want to change communications in the healthcare system.” And yet Caremerge, with what it calls a cloud-based care-coordination model, is doing just that. Rather than tackling the entire system—the company isn’t that ambitious—Caremerge has trained its sights on what Khan describes as “the most complex demographic”: the aging population. Noting correctly that many seniors are cared for on a daily basis by numerous people—clinicians, caretakers, family members—Khan and his team have devised a solution that allows for all information and communication about an individual’s care to be centralized in a single place.
An example of the type of information captured by Caremerge that often falls through the cracks elsewhere: what Khan describes as “those subtle lifestyle-type conversations, where somebody notices something that might not get to the level of ‘okay, we have to call the doctor now.’ ” The Caremerge platform is HIPPA-compliant, so the privacy worries associated with such a system (a chatty food-service provider, anyone?) cease to be an issue. “Once a clinical event has occurred, it’s too late,” Khan continues. “What we’re trying to do is bring everybody together to avoid clinical events in the first place. —Larry Dobrow

Bong Koh
Venrock Capital

The list of pharma giants in which Venrock Capital was an early investor is an impressive one indeed: Gilead, Biogen Idec, Millennium and Centcor, among others. Then there are the company’s myriad successes in healthcare IT (athenahealth, Illumina) and biotech (Acceleron, Avalanche). In 1978, it invested a few dollars in a little company named Apple; in 1969, it chose Intel as one of its first investments. All of this is to say that Venrock has some tiny morsel of an idea of what it’s talking about when it comes to investing.
So when Koh, the firm’s in-house biotech ace, agrees to field a few questions about the current state of the business, it pays to listen. “There are three reasons why we’ve done well,” he says. “First, we’ve gone after really big problems. Second, we’re really good partners. And third, we’re flexible. We’re not committed or married to anything other than finding really great companies.” If it were really that easy, of course, there’d be any number of investment firms with a track record similar to Venrock’s. But, you know, there aren’t, which speaks to the company’s deep knowledge of and passion for healthcare. “There are many different ways you can build and invest in companies, but you have to have that mind-set of, ‘Hey, let’s not get overcommitted to one field.’ The goal has to be building great companies,” Koh says.
As for the therapeutic areas in which Koh sees potential, gene therapy tops the list. “It’s finally coming of age,” he says animatedly. “You’re finally talking about cures, literally curing patients who couldn’t be cured before. In modern medicine, there really aren’t cures. Mostly you’re just trying to control a disease. With gene therapy, you’re looking for the cure.” Koh is particularly bullish on a company he only identifies as “the gene therapy company,” which he believes “is going to own 40% of all gene therapy” before too long. “Twenty years from now, when Nobel prizes are being awarded, they’re going to be on the receiving end. I honestly believe this.” —Larry Dobrow

John Langhauser
Co-founder and chief technology officer

The cost of medication non-adherence is, in some estimations, a $290-billion problem. To tackle it, at least in a small way, AdhereTech has developed a “smart” pill bottle that runs on a cellular network and beams reminders to a patient’s phone if he or she misses a dose. What elevates the device from a personal accountability lever into a behavior-analysis tool is the real-time adherence data it generates, which provides context that traditional 30-day-fill retrospectives lack. “This data hasn’t been collected—ever,” Langhauser says. The AdhereTech bottle has attracted interest, he adds, from patients, caregivers, drugmakers and organizations like the Walter Reed National Military Center and Weill Cornell Medical College. The first iteration of AdhereTech’s bottles has sold out; for version 2.0, the company is looking toward the wearables market for inspiration. Possible additions include visualization tools, which could help bolster patient engagement and adherence rates alike. —Deborah Weinstein

Monique Levy
Manhattan Research
Vice president, research

Levy’s followers have come to expect her ability to spot industry zigs while most others see zags. So when she goes against the grain with her opinion that pharma companies are doing just fine in the digital space, people listen. “It hasn’t been easy,” she says of Big Pharma’s transition into the digital era. “But there is a knowledge base and many strong digital users in many companies. They know what they’re doing.” She thinks they’ll get better: “Macro pressures are pushing the leaders of these companies to think about commercial innovation. There’s profound potential for disruption.”
Levy currently finds herself in the middle of new research demonstrating just how resilient the heads of those digital teams are. “Even working within constrained environments, they know how to influence others, to stay the course, to work with very sophisticated multidimensional groups,” she reports. “Many times, it is these leadership skills, rather than things like limited budgets or pressure to produce a return on investment, that predict success. —Sarah Mahoney

Melissa Mackey
Associate director, social media strategy

One of the brightest and most articulate voices in pharma social media, Mackey was the brains behind Novartis’s award-winning “Hey MS! Take This!” campaign for Gilenya. Just as important, her success (not to mention the success of the products she has shepherded in the online/digital sphere) has opened the eyes of any number of social-media holdouts. The challenge in crafting effective social media, she says, is communicating with patients and caregivers in a responsible way and with the same attentive level of service they’ve come to expect from CPG companies. “It’s important to try and meet those needs,” she explains. “It’s about them. That’s why we’re here.”
Mackey was also one of the biggest boosters of the company’s acclaimed two-day hackathon: the Novartis mHealth challenge, which assembled more than 200 companies and developers in San Francisco to develop mobile and Web solutions for caregivers looking after loved ones with heart failure. The winning prototype was a medical assistant avatar that lets users remotely monitor a patient. —Kevin McCaffrey

Anmol Madan
CEO and co-founder

To hear Madan tell it, patients with mental and behavioral health conditions have always been “massively undersupported.” To that end, he co-founded Ginger.io to uncover ways to “find the pieces of the puzzle that can improve the quality of care.” After patients install the Ginger.io app, care providers can track behaviors and patterns that signal a change in condition or a heightened risk. The company works with insurance companies, health systems and hospitals around the country to treat problems like depression, one of the country’s commonest chronic illnesses, one often seen with other health issues.
The app gathers patient data passively. “Things like lethargy, isolating yourself, changes in your sleep cycle or the way you socialize are all discoverable, in some form, from your phone,” Madan explains. “And we know that when people are heading into episodes, coaching at the right time can really help.” So rather than asking them to track thousands of patients, Ginger.io helps care providers “focus on the much smaller group—say the 300 or so who might be exhibiting these changes—and possibly reach out to them just when they are needed most.”
Such interventions are critical, since mental-health episodes are often characterized by a reluctance or inability to act. “Patients aren’t likely to call for help even though they need it,” Madan continues. When they receive a call from a care provider, then, “the sense that ‘my nurse really cares about me’ has a big value.”
Ginger.io began with depression (“that’s where we’ve had the biggest demand and the most validation,” Madan says), but partnerships with institutions like Partners HealthCare, Duke University and the University of California, San Francisco have led the company to other conditions, heart disease and diabetes among them. “In the next five years, I see consumers playing a much bigger role in managing their own health,” Madan predicts. “Some of it will be driven by the ACA, but much of it is about our generation. We go to WebMD before we go to the doctor. It’s a fundamental shift in our thinking.” —Sarah Mahoney

Melissa Manice
CEO and co-founder

With 50 million Americans suffering from asthma or COPD, it’s no surprise that so many start-ups have focused attention on the respiratory space. Few, however, have gained as much traction as CoheroHealth, whose hardware (a sensor-enabled spirometer) and software (a gamified app) have generated excitement among patients and physicians well in advance of the company’s commercial debut. “We’ve built the best ‘mousetrap’ for pulmonary,” Manice says.
That “mousetrap” could revolutionize treatment and adherence in the asthma/COPD space. The sensor-enabled spirometer transmits patient data directly to the doctor, who can scan it for signs of an imminent adverse event or identify if a medication is having the desired effect. “Right now, doctors send patients home with medications and a pen-and-paper-based action plan, then you take readings and bring them back to the doctor,” Manice explains. “But we’re at a point where digital technology can make this an automated and engaging experience. There’s no reason to stay data-dumb when the technology allows us to be data-smart.” —Larry Dobrow

Rob Merkel
IBM Watson Group
Healthcare & life sciences leader

Even devoted Jeopardy fans still can’t wrap their brains around the idea that IBM’s Watson is, like, you know, a brain. “It’s called cognitive computing, and the brain is the best analogy,” Merkel says. “As you combine it with what is happening in the healthcare ecosystem— the evolution of care-delivery models, an explosion of information-based data science, this migration to consumerism—we’re able to offer game-changing analytical insights.” It starts with Watson’s knowledge. The volume of medical literature doubles between every two and five years, depending on which study one believes. So with 700,000 new scientific studies published each year, there is no way a sole individual can keep up. Ah, but Watson can.
One current area of focus is consumer engagement. “When Watson receives a request from a physician, it can read through an entire patient case, understand the rationale and compare it to medical policies and compliance and go ahead and approve the request without any human intervention if its confidence is ‘very high,’ ” Merkel explains.
Another focus area for Merkel’s group is R&D-related productivity, which encompasses its work with the Baylor College of Medicine and the study of a protein related to cell proliferation within tumors. “In Medline alone, there are 70,000 articles on this P53 protein and 6,000 to 8,000 new ones enter the system each year,” Merkel reports. Previously, sifting through all that data led Baylor to one target for this protein per year. With Watson, he says, they came up with seven within months.
Merkel has also trained his sights on improving clinical outcomes, including the Watson for Oncology Solutions program with Memorial Sloan Kettering Cancer Center. “Here we are training Watson, ingesting lots of literature and working with the best doctors,” Merkel says, with a trace of awe in his voice. “Now people around the world can have access to this broad talent that before, quite honestly, was limited to the Upper East Side of New York City.” —Sarah Mahoney

Satish Movva
Founder and CEO

There are many instances of children creating great works of art in response to the treatment of—or by—their parents. There are considerably fewer examples of potential billion-dollar companies being fueled by this same impulse. Consider, then, the story of CarePredict, founded by IBM and Interim Healthcare alumnus Satish Movva. When he left Interim in 2013, he found himself spending lots of time with his 86-year-old father and 72-year-old mother and wondering how to monitor their physical condition from afar. “Every time I visited, I’d notice something different. One time my dad was shuffling instead of walking because he had water in his ankles. I asked my mom, ‘Why didn’t you tell me about this?’ The problem was that the changes were so gradual, she didn’t even notice.”
Movva went to work, experimenting with Fitbits (“all they do is count steps”) and GPS-like location tracking. Ultimately he devised a sensor-enabled wristband that looks like a cross between a wristwatch and a piece of jewelry. The wristband interacts with beacons placed throughout the home to give whoever’s monitoring the person in question a more complete look at the monitored person’s activities. “We can track the meaningful activities of daily living and we can put them in context,” Movva reports. “If somebody stops brushing his teeth, that could be the early onset of memory loss. If somebody stops eating, that could be a sign of a depressive phase.” The technology is amazingly user-friendly: It charges and transmits information automatically. “There’s nothing that flummoxes older people who aren’t familiar with technology,” Movva adds.
He stresses that CarePredict is a consumer company and notes that the most interest so far has come from senior-care facilities and managed-care companies. He also notes that the competitive landscape looks barren: “There are five wearables for dogs but none for seniors,” he says disbelievingly. Look for CarePredict to complete its pilots in the first quarter of 2015, then quickly roll out into the marketplace. —Larry Dobrow

John Nosta

When it comes to assessing current opportunities to disrupt healthcare as we know it, John Nosta, who runs the proudly contrarian NostaLab think tank, doesn’t know where to begin. “We are at a true inflection point in human history,” he says. Well, how about if we try and compare it to, say, the Industrial Revolution? “We’d be aiming too low,” he responds. It’s no surprise, then, that Nosta believes the fundamental nature of the pharmaceutical industry is changing, moving away from “the drug-development model, with heavy-handed regulation and conservative philosophy” toward “a digital health movement, with collaboration between multiple stakeholders. It’s so much more than people just being more adept with smartphones.”
What comes next, Nosta says, should prove even more exciting, given recent advances in nanotechnology and wearables that are less fitness trackers than “clinically imperative diagnostics.” Increasingly, the industry’s focus will shift to longevity, he predicts. “We’re seeing this already with Google’s Calico, which focuses on aging.” —Sarah Mahoney

Jesús Pérez-Llano

When asked to describe TedCas, the health-tech company he founded to ease access to and handling of medical information in surgical environments, Pérez-Llano has a pat answer in hand. “I tell people, ‘We’re kind of like Minority Report, even though I don’t look much like Tom Cruise,’ ” he says with a laugh. Pérez-Llano is referring to the 2002 Steven Spielberg–helmed sci-fi flick in which Cruise plays a futuristic police officer of some vague sort—and specifically, to the techno-future the film envisions, one in which nearly every door and device can be controlled via swipes of the hand. That is what TedCas brings to the operating room, sort of.
Let Pérez-Llano explain: “What we do is allow doctors to control any kind of computer with voice comments and hand and finger movements through the air. They don’t have to ask any other person to help. They don’t have to scrub out and leave the OR.” As such, the TedCas technology is a natural in any environment in which aseptic conditions are a must. The problem? Operating-room protocols and procedures vary wildly from one hospital or surgical center to the next: A sensor or device that might work for a trauma surgeon might not meet the needs of an ophthalmic surgeon. Given that TedCas has global ambitions, standardizing the technology for use by a wide range of surgeons would appear to be the biggest obstacle to surmount.
Nonetheless, the TedCas technology is already being used in operating rooms in Spain, France, Italy and Germany, plus Pérez-Llano says the company has deployed units to the Surgery Center of Indianapolis and the University of California, San Francisco. The key to future growth, he believes, is getting face time with surgeons and letting them test-drive the technology for themselves. “Once that happens, and once they see how easy it is to use, they’re like, ‘I want it,’ ” he says. “We also have to learn how to speak the right language to the people who are paying for it. Hopefully they’ll see the same thing in us that the surgeons have seen.” —Larry Dobrow

Sally Poblete
Founder and CEO

Of all the players moved to change by the Affordable Care Act, insurance companies are perhaps the most change-resistant. But for Poblete, that’s created huge potential for disruption. “It’s spurred the insurance industry to be a retail industry. And given the availability of health data and all the technology innovations we have, it’s a moment of enormous opportunity,” she says. So after years working for Wellpoint, she launched Wellthie, a software company that helps insurance companies create platforms to better interact with consumers. Needless to say, it’s not easy. “Insurance products are complicated for consumers to understand, and they are already faced with information overload.”
As a result, Wellthie’s strategy is to look at consumers holistically. “When they interact with the insurance company, they don’t think of themselves as a Medicare patient or a Medicaid patient. They just see themselves as consumers,” Poblete explains. “We bring simplicity. In a world that’s complex, we want to make things easy and quick.” The overarching goal is to remove stress from a landscape that—at least right now—remains crowded with pain points. “We’ll help consumers go beyond the question of, ‘What is the best plan for me?’ and help them understand how to seek the best care within their plan.” —Sarah Mahoney

Michele Polz
Biogen Idec
Head, patient insights, global commercial strategy

At Sanofi US, Polz opened up new pipelines for an organization challenged with thinking about the changing pharma model. In 2011, as AVP, patient insights & analytics, US diabetes, she was instrumental in helping Sanofi manage the inaugural run of its Data Design Diabetes Innovation Challenge, a competition to foster innovation and create new products and services for people with the disease. It goes without saying that pharma companies had not been conditioned to look outside their own labs for this kind of thing. “The traditional pharma model, as we recognized it four years ago, was broken, and we needed to think about how best do we approach the new business model,” Polz recalls.
In six weeks—a nearly unheard-of time frame for the pharma industry—Polz and her team, led by then-VP, US Diabetes Dennis Urbaniak (see his write-up, below), launched the first challenge: to use data and design to find the next breakthrough for the millions of patients living with diabetes. “With zero paid media spend—just a website, a blog and a Twitter handle—we actually gained 19 million media impressions,” Polz says, adding that the competition generated more than 100,000 submissions in a one-month period. Judges narrowed them down to five finalists and the $100,000 prize went to Ginger.io, a mobile tool for automated self-monitoring (see Anmol Madan’s write-up, above). The winners also scored a one-month residency to further develop their prototype and put it in front of patients.
The DDD platform not only identified pockets of external innovation for Sanofi in the US, but also proved scalable and sustainable. Conceptualized as “a new way for industry to drive healthcare innovation,” the project has lived up to its billing: The White House heaped praise on Polz’s team, millions in VC money flowed to DDD participants, and other healthcare companies (Novartis, Janssen, Kaiser Permanente and Pfizer) launched similar programs. Look for Polz to bring that same change-management mind-set to Biogen Idec. —Marc Iskowitz

Reid Robison, MD
Tute Genomics
CEO and co-founder

When Robison announces, less than 30 seconds into a phone call, that “genomics is changing healthcare as we know it,” he’s not engaging in shameless self-hype. After all, half the cancer drugs that came to market in 2014 have a molecular target. What this means? Personalized medicine through genetics has arrived in cancer treatment and it’s just a matter of time before other specialties follow suit.
But with the possibilities come a host of challenges, one of them oddly bourgeois in nature: Researchers will soon find themselves awash in genetics data to the extent that they’ll have a tough time managing it and using it to make decisions. Enter Tute, a platform designed to help these and other potential audiences make better and faster sense of the information that will soon be available.
“The $1,000 genome was announced this year,” Robison notes. “That was thought to be the tipping point for widespread adoption of genomics in healthcare and research, so hopefully the timing is right.” Robison comes at his interest in the subject organically. He recalls an instance from his time as a doctor and professor at the University of Utah, where he studied the genetic makeup of autism and other neurodevelopmental disorders. An autistic child and his parents came to the clinic. “He was seven, low IQ, really impaired. I ordered two gene tests and they both came back negative—but the bill to the family was $6,000. I said, ‘Never again will I do one at a time.’ ”
Tute, then, is betting that its software will help doctors and researchers get past the obstacle that is data overload. “It’s been established that if you rapidly sequence the whole genome of a newborn, you can save tens of thousands of dollars—but much more importantly, you can get the kid treatment sooner,” Robison says. “We’re just now starting to see certain healthcare systems become open to implement this type of thing, in part due to this drop in the cost of sequencing and in part due to software like Tute’s gaining trust. You watch—pretty soon every doctor will be a geneticist.” —Larry Dobrow

Lita Sands
Global head, digital transformation

When Sands says that Novartis’s shift toward digital strategies required changing the entire company, she isn’t kidding. It started three years ago, she says, with the CEO’s decision to move from laptops to iPads and, in the process, “bring all customer-facing teams into the future.” The resulting interface, called Launchpad, “is a dashboard as intuitive as a car or a newspaper,” Sands says. It can tell Novartis staffers “what’s trending, what’s wearing out, what combination of messages is working and the best ways to tell a story. It’s transformed how we act in the company, helping to bring the voice of the field force into everything that we do.”
Launchpad has also revolutionized the pharma giant’s approach to customers, extending to a new app for patients with COPD that utilizes internal sensors on mobile phones. And while Novartis continues to examine the potential of wearables, the company is “much more focused on invisibles,” Sands quips. “People are lazy by nature, and these invisibles are medically more accurate and cheaper.” —Sarah Mahoney

Mario Schlosser
Oscar Health

It was impossible to miss the ads. During the open-enrollment period for health insurance at the end of last year, mass-transit riders in the New York/New Jersey corridor found nearly every available flat surface papered with sly spots for Oscar Health (“Get a bright, articulate doctor to call you without having to join a dating site”). The insurance start-up snared 17,000 customers during its launch year and has its sights on far more. The hook? Customer service and readily comprehensible verbiage delivered via the tech devices embraced by younger consumers.
“Oscar was born out of the Affordable Care Act and the frustration people had with the health-insurance industry,” says Schlosser, who co-founded the company with Josh Kushner and Kevin Nazemi. “We opened one of our own insurance bills only to realize we could not make any sense of it. We saw this as an opportunity to simplify this complicated industry, which can so often be overwhelming and unfriendly for consumers.” —Larry Dobrow

Amanda Sheldon
Director of digital marketing and communications

Patients suffering from diabetes were connecting with one another online long before Medtronic entered the social-media realm. At the same time, many communities were rife with misinformation—and given that diabetes is largely a self-managed condition, patient frustration ran high. As a maker of pumps and other devices used by such patients, Medtronic was far from an uninterested observer of these conversations.
But rather than jump screaming into every thread, Sheldon and her team evolved their social-media presence into an extension of the company’s customer-service arm. “We wanted to ensure that the right information about our products was out there, but over time we realized the opportunity to connect people with answers to their questions,” Sheldon recalls. Challenges abounded—to steer clear of regulatory headaches, Medtronic must keep an audit trail of everything that appears on its pages—but the company soon became an avid player of the social-media game. “It’s good for patients and it’s good for us,” Sheldon adds. —Larry Dobrow

Joe Shields
Global director, digital strategy

When pondering the year ahead, most pharma execs set goals like “grow sales by 10%” or “launch product without incident.” Then there’s Shields, who says his goal for 2015 is “to more consistently use ‘systems thinking’—applying a more holistic approach to solving complex problems—to the challenges with which I’m faced.” Such high-minded ambition will come as no surprise to anyone who knows him well, of course. The 18-year healthcare vet has a well-earned rep as one of the industry’s most thoughtful strategists and communicators.
While he describes his current role at AZ as “simply a problem solver,” Shields has looked far and wide for answers to his questions. Discussing his recent exposure to healthcare systems outside the US, he says, “I think our industry needs to continue to adapt to the world around it. If we don’t fundamentally change the way things are done—from the inside—then someone else will.” Thus it should be no surprise that Shields even takes mild issue with the “disruption” premise of this feature. “The word seems to be spouted by every tech start-up seeking funding,” he says. “I think it’s lost its meaning, like ‘innovation.’ ” —Larry Dobrow

Unity Stoakes
StartUp Health

While there is no shortage of brilliant ideas to upend existing business models in healthcare, finding the scratch needed to fund them remains a major challenge—and one that Stoakes and fellow StartUp Health co-founder Steve Krein are eagerly embracing. They’re going well beyond that, in fact, providing advice and network connections in addition to seed money. So far, its companies have raised more than $150 million, and three have been acquired. “From our perspective, this is the most exciting time. Every aspect of the industry is being reinvented and redesigned,” Stoakes enthuses.
For now, the biggest hurdles for StartUp’s army of entrepreneurs continue to be how to manage change in an industry that can seem quite change-resistant. That said, change is coming whether the healthcare world likes it or not. “Over the next two or three years, you will see health and wellness designed into virtually every aspect of our lives,” says Stoakes. “It will be in our homes, cars, offices and clothes. It will be a much bigger part of our lives in unexpected and exciting ways.” —Sarah Mahoney

Jeff Tangney

Doctors congregated and networked online before former Epocrates exec Tangney founded Doximity in 2010, but they did so helter-skelter. The first wave of networking sites may have offered many of the features doctors wanted, but they were desktop-first entities—and for practitioners on the go, a more mobile solution was a must. “Lots of doctors don’t have desks. They go from exam room to exam room,” Tangney says. “Easy access from mobile devices was what would make this work.”
Fueled by the mobile-first approach, Doximity quickly became the largest and most admired professional network for physicians—and the one in which physicians feel most protected, owing to the network’s stern authentication protocols. “Our motto now is the same as when we started: physicians first,” Tangney says. “We’ve got six full-time physicians on staff. What’s best for them drives just about all of our product decisions and development.” —Larry Dobrow

Dennis Urbaniak
Accenture Life Sciences
Managing director

Nearly a year into his tenure at Accenture, Urbaniak has already achieved one of his stated goals: building a life sciences consultancy custom-tailored to the demands and realities of the mobile/digital era. He did so by doing what he’s always done during a 20-plus-year career in healthcare, much of it spent at Sanofi: innovating relentlessly and meticulously. “I’ve been fortunate to find another environment in which collaboration and entrepreneurship are really highly valued,” he says. “I don’t take it for granted that every company is like this.”
Shortly after his arrival at Accenture, Urbaniak described his new gig as “the closest thing I’ll get to my own business in a large organization,” and the months since have borne out that characterization. He’s pushed the brand teams with which his practice works to employ more real-world data and analytics, and early results are promising. “People say, ‘Good luck getting anybody in pharma to change,’ but our experience has been nothing like that. The industry is ready to move forward.” —Larry Dobrow

David Wong, MD
Direct Dermatology
Co-founder and CEO

One of healthcare’s biggest challenges is providing patients with timely access to care, so it bothered Wong that some would be forced to wait for months before seeing a dermatologist. “These access problems diminish quality of care,” he says. “Melanoma is deadly and diagnosing it early can be the difference between life and death.” So in the age of smartphones with high-quality cameras, Wong did something about it: He co-founded Direct Dermatology, a telehealth company that taps top-notch dermatologists to treat patients from afar. “We knew we could leverage technology to get accurate diagnosis and treatment recommendations,” he says.
For patients, it means access to the best dermatologists and with a degree of convenience that’s not usually associated with the US healthcare system. While Wong acknowledges that telehealth solutions aren’t new, he believes the field of dermatology was primed for disruption once employers and health plans starting hopping onboard in substantial numbers. And it doesn’t hurt that the Direct Dermatology model works. “We are able to manage more than 92% of our cases completely online,” he reports—and that, too, is good for the dermatology specialty. “As the number of people using telehealth increases, the wait time to see doctors in person will decrease.” —Sarah Mahoney

David Yakimischak
Executive vice president

While some 50% of prescriptions in the US are now written digitally, scripts for opioid painkillers are still mostly written the old-fashioned way. Indeed, the need for tighter controls on such drugs continues to intensify: The US Centers for Disease Control estimates that 100 people die each day from overdosing on these drugs, a rate that has tripled since 2009.
That’s why Yakimischak is quick to tout the security safeguards of Surescripts’ electronic prescribing of controlled substances. “In the world of paper prescriptions, the paper is handed to the patient, who can Photoshop it or give it to someone else,” he says. “Electronically, a legal prescription is bits flying on the wire and there is no opportunity for a patient to fiddle with the bits.” Ultimately, the move toward electronic prescribing will help doctors recognize abuses earlier, Yakimischak says. “Right now, if someone shows up in the ER, it is nearly impossible for that hospital to know if the person has been getting medications from many hospitals. Having an electronic record of the prescriptions can only help.” —Sarah Mahoney

Sam Zebarjadi
Co-founder and CEO

The era of doctors making house calls ended long before most Millennials were born. But for Medicast, the house call is a concept overdue for a comeback. “We thought, ‘If you can tap a button and get groceries, why shouldn’t healthcare be the same way?’ ” Zebarjadi says. In the markets where it operates—certain parts of Florida and Southern California—customers can expect a doctor to arrive within 30 minutes. And for anywhere from $149 to $249 a visit, they can “get an amazing medical experience. Doctors love it and patients love it,” he crows.
The model comes with its challenges, like convincing regulators that everything is on the up-and-up. Additionally, while the cost of Medicast may be covered by some insurance companies, the company doesn’t yet bill insurers directly. This hasn’t tempered Zebarjadi’s plans for growth, however. Look for Medicast to expand in the months and years ahead to home-based I.V.s and mobile X-rays. —Sarah Mahoney