Digitas Health scales up; Phila healthcare start-up examples

(Update: See also my column in Monday's Inquirer; plus a "sample list" of Phila healthcare startups at the end of this post) As Big Pharma downsized in the last recession, drug advertising tailed off, too. The industry fragmented: long-dominant firms cut back on research, generic drugmakers threatened price cuts, new firms began pushing smartphone apps and sensors to promote innovative therapies and alter the traditional doctor-patient consultation.

In 2011, French public-relations and marketing giant Publicis Groupe cut headcount at its Digitas Health and Razorfish agencies in their high-ceilinged Wanamaker Building headquarters in Philadelphia. The heads of both practices left. Publicis charged managers with winning new business by going after new customers using the new technologies

How's that working? The group has added a net 70 people at its Philadelphia headquarters -- the total is now 450, "the most we've ever been," says Brendan Gallagher, executive vice president for Digitas Health LifeBrands' Connected Health unit.

"I went to Temple, I'm proud that we can have a scaled (growing) practice in Philadelephia, at the intersection of marketing and media and health, in an emerging and vital industry, and be a signficant employer of young people -- we have a lot of people under 30," says Alexandra von Plato, Philadelphia-based President of Publicis' Health Communications Group, which includes Digitas Health.

After years of false starts and uncertainty over federal regulation, insurer and privacy requirements, venture capital money is pouring into "this space we call digital health," said von Plato. Her group has offices in New York, San Francisco and London. She spoke Thursday after flying back from the firm's fourth yearly m.dot conference (particpants included Havard Med, Kleiner Perkins, Ayogo, Gotta Mobilize, One Drop), held this year at Google headquarters in Silicon Valley. "Digitas Health has been a valuable partner to Google," said Ryan Olohan, Google's national industry director for healthcare, in a statement.

The FDA has helped this transformation: As the number of medically-focused smartphone apps seeking FDA approval passed the number of drugs and devices approved, FDA began reviewing licensing requirments. In 2014 new guidelines expanded the categories of app that don't need FDA approval. The result is an "explosion" of patient-data-focused apps, seeking business and marketing plans, Von Plato says.

"Our job as an agency is to help our clients take advantage of this enormous opportunity to connect doctors, patients," drug and device makers, "and use these channels to make the connection," she added. "Mobility has come to the fore. It's become the dominant channel, the thing we can't live without. It's a way for us to put a frame around the many emerging technologies and channels that are affecting healthcare communcations and offering our clients a rich new way to go to market."

"The app is the tip of the spear," Gallagher says. The goal is the "virtual doctor visit," as pioneered by firms like Teledocs and Doctors on Demand, but not yet adopted by middle medical America. "Not a lot of our clients have been creating content and services that meet that reality," he acknowledges.

"There's going to be a need for brands to engage with patients, doctors and caregivers, remotely. It's not the old days of reps walking into a doctor's office and giving them pamphlets. In a lot of cases the physicians won't be meeting with patients at all anymore."

Health insurers like the idea, both because online is cheaper, and because the process can be easily tracked, "showing clinical evidence they are managing patients over time."

"The information prescription meets the virtual visit, organically," says von Plato. "The doctor can say on a screen, 'Look at these two things,' and the links are immediately part of the interface. That's better than a pamphlet you leave on your car seat. All the information, all the companion material, comes together; the app becomes the front door of your relationship with your doctor."

Not just patients, but also young doctors, have grown used to intense communication on the little handlheld screen. "They feel they are getting undivided attention. not the way they feel, waiting in a paper gown, in a doctor's office. And they get written follow-up almost immediately," von Plato added. "That doesn't often happen in a live meeting with a physician."

Isn't this just a way of sugar-coating a growing physical distance between busy doctors and isolated patients? "We worry about disintermediation. But it isn't turning out to be that. The patient does really feel that they are getting undivided attention. The doctor can follow up in a written way that feels more substantial and doesn't feel so strange. Young doctors are less awkward in this format. There are people who grew up on Skype. And the webcams are getting better. It's a really interesting access opportunity for more people to get more and higher quality time."

Won't fear of malpractice lawyers, insurance and employer productivy metrics push doctors to say as little as possible when they know they are being digitally tracked? "Doctors are already pretty well trained as to when they have to be guarded," says Gallagher. "Medical liablilty has taught them demeanor and behavior."

Von Plato says clients are already setting up practices that look like "virtual hospitals," where doctors still meet and work more or less collegially but deal with patients, mostly, remotely. She credits the Affordable Care Act (Obamacare,) which rewards hospitals for remote monitoring that reduces hospital stays.

The medical-device industry is very much on board: "A large part of this is in sensors, that track concussions in mouthguards, that measure glucose and dehydration through your back," said Gallagher.

Isn't this bad news for medical property owners, office supply houses, the many intermediaries of healthcare? "The analogy is the music industry. (Sales are) half what it was ten years ago. But everybody now has access whenever they want it to the best music," Gallagher said. "This is like that: The patient wins." 

ALSO: "Sample list" of Philadelphia healthcare startups, provided by Digitas, with their brief descriptions of each:

• CareCierge – A platform which provides clarity, direction, and assistance to busy professionals caring for their parents as they age. Met with over 70 caregivers who have confirmed they will purchase.

• dbaza health – Clinically validated patient on boarding platform for managing and reducing the costs of chronic diseases like diabetes. At revenue and already used by over 400,000 patients.

• Diagnostic Driving – Combining a simulation-based driving risk assessment with customized interventions to reduce crashes, starting with the over 50% of US F100 companies experiencing more than 10 crashes per day. Team includes global authorities in driver safety and prior creative director for the Virgin Galactic simulator. Trial with one F100 company.

• GraphWear Technologies – The first graphene-based dehydration, glucose, and lactic acid monitor, all from your sweat. Graphene sensor is non-invasive, wearable and pairs to a smartphone. Dehydration pilots in progress and proof of concept for glucose detection is complete. Ongoing discussions with Microsoft, Samsung, Jawbone, and HP Wearables.

• Gray Matter Technologies – Smart mouthguard helps athletes, coaches, and trainers better identify athletes at risk of concussion as well as providing additional athlete performance data. Proofs of concept complete (mouthguard and apps). Positive feedback from athletic trainers and coaches at 6 top colleges and over 10 private & public schools.

• Neutun Labs – Software that tracks chronic and acute health conditions with existing wearables and mobile devices, beginning with epilepsy and scaling to adjacent markets. Value prop to patients, care providers, clinicians, and pharma. 3 planned pilot projects, on-boarding 20k new users.

• Oncora Medical – Enabling data-driven, personalized radiation oncology to improve cancer center efficiency while reducing the incidence of toxic radiation side effects. Collaborations at 3 major US cancer centers, paid pilots launching in Q4 2015, and pipeline of over a dozen US hospitals.

• VisExcell – A personalized breast cancer risk platform for radiologists and their patients, applying machine learning and advanced computer vision to deliver novel and powerful risk models and automate physician annotation. Concept validated with 6 medical institutions representing more than 200k annual mammograms.