Tech Tonics

Since March 23, 2020, Dr. Patrick Hines, physician, scientist and entrepreneur has spent most of his time between the Detroit Children’s Hospital and a nearby hotel room, where he stays to minimize COVID-19 risk to his family. He occasionally drops by to participate in movie night from a backyard chair while his wife and kids stay inside on the sofa. But Patrick is undaunted by this, saying that helping people is in his DNA. From very humble beginnings in North Carolina, Patrick watched his parents, both teachers, mentor poor rural kids at school and at home; it inspired in him the desire to give back.

Patrick’s dad, a classically-trained baritone, accomplished singer, and choir director at the local college, was also his musical role model. Patrick made his way through college on a music scholarship, playing French horn and trumpet. But all the while, he was drawn to science. Having majored in chemistry at Hampton University, a historically black college in Virginia, Patrick set off to get his PhD but soon realized that research wasn’t enough of a people profession to satisfy his desire to serve. So off he went to medical school at UNC Chapel Hill, where he had the good fortune to meet his clinical mentor and learn about the vastly undeserved clinical needs of people with sickle cell disease.

Patrick, now a PhD and MD, ultimately trained to become a pediatric intensive care physician. He worked first at Children’s Hospital of Philadephia (CHoP) and later at Detroit Children’s Hospital, but he also founded Functional Fluidics, a company that focuses on red blood cell health generally and sickle cell anemia diagnostics specifically. The idea for the company came from his recognition that therapeutics to treat the condition kept failing clinical trials because there was no surrogate endpoint and that he could bring a solution to this problem and to patients who had so few treatment options.

Patrick is now in the process of transitioning out of his regular ICU role to dedicate himself full-time to his young, growing company. Patrick speaks on the podcast about his difficulty raising money as a black founder and how these experiences were even more challenging than some of the prejudice he has faced as a black physician. Given our current discourse on race in America, it is an eye-opening first person account of how someone with significant intellect, experience, and education can come up against the limitations of others’ small thinking. But despite those that have told him his efforts were less than, Patrick has made it pretty clear that he is not giving up – he sees his work as a lifeline to people and intends to live out the helping gene passed on from his parents. Says Patrick, “It is my responsibility to be sure people with sickle cell matter and to get them the medical resources they need.”

Patrick has also returned to music, singing publicly with his dad for the very first time last year. As an avid jazz enthusiast (see below for his favorite song) he is excited to be back around music. And he is especially glad to be leaving his pandemic-driven hotel stay and returning to his family for the everyday hugs, skirmishes and all of the things that were once annoying and are now a joy to experience. Welcome home Patrick and thanks for being on the show!

We are grateful to Manatt Health for sponsoring today’s episode of Tech Tonics. Manatt Health integrates strategic business consulting, public policy acumen, legal excellence and deep analytics capabilities to better serve the complex needs of clients across America’s healthcare system. Together with it’s parent company, Manatt, Phelps & Phillips, the firm’s multidisciplinary team is dedicated to helping clients across all industries grow and prosper.

As a boy, Craig Lipset thought he wanted to become a doctor – but over time, he came to appreciate that his real interest was, as he put it, engaging in the spirit of medicine at the population level – a pursuit that ultimately brought him to the forefront of digital health at Pfizer, establishing a capability long before most pharmas even recognized they needed it.

Craig grew up in the distinct cultural milieu that is the North Shore of Long Island. A middle child with an interest in music and medicine, he attended Brandeis, where he majored in music, took pre-med classes, and worked for an EMS service in Waltham, MA. In 1992 he returned to New York, and obtained an MPH at Columbia, and discovered he loved thinking about populations, and wanted to learn more about the organizations helping to study them.

After graduation in 1998, he considered consulting, but instead joined a contract research organization, Parexel and worked closely with Dr. Mark Goldberg, who would go on to become the President and COO. He eventually left Parexel to join a VC-backed company in Waltham that was ultimately acquired by Bristol Myers Squibb.

At around this time, Craig’s life changed dramatically and unexpectedly when he was diagnosed with pulmonary sarcoidosis. He decided to make a life change, so he returned to the New York area and joined Pfizer in 2006, where he would stay for eleven years. Craig built their clinical innovation program from a footnote to a core business capability. Within a year of joining Pfizer, Craig began to apply his personal experience as an e-patient and was designing the industry’s first fully at-home decentralized clinical trial – the Pfizer REMOTE study. During his tenure, Pfizer — along with the rest of the industry –would increasingly begin to appreciate the value of digital and the opportunity for patient-centricity that Craig had been championing so passionately for years.

Today, Craig serves as an independent adviser, sharing his experience, expertise, and learnings with biopharma companies, startups, and investors.

For 20 years, advocates of telemedicine have been trying to break through to common usage. For all of modern human history, those with mental health challenges have held back from seeking treatment due to the stigma associated with doing so. And then, a Chinese bat opened the flood gates. Today we are seeing record usage of telemedicine, especially for mental health needs of all types.

Regular Tech Tonics listeners know our usual approach is in-depth personal interviews with individuals. Today, in light of current events, we decided to take a topical detour into how the coronavirus pandemic has driven vast advances in the use of telemedicine and has brought out into the open the importance of access to mental health treatment. The combination of these things into what we know now as tele-behavioral health, is our topic today. We invited three tele-behavioral health experts serving different populations to join the show and share with us what they are seeing in the new world order; those people are:

• Russell Glass, CEO of Ginger
• Margaret Laws, co-founder of Nod (and CEO of HopeLab)
• Steve Smith, CEO of NOCD

Notably, all three of these organizations are experiencing skyrocketing use of their tele-behavioral health products and have seen some surprising customers enter their system. Interestingly, the pandemic has driven a stunning rise in telemedicine, but also a much greater openness to discussing and acting on the need for mental health care. Un-hampered by lack of reimbursement or physician/provider reluctance, these companies’ digital approaches are gaining in popularity in a way that may be persistent post-crisis. And not only are patients enjoying their experiences; they consistently report that access challenges have been markedly reduced as compared to the pre-pandemic era. Imagine that.

Never has the need for mental health care been more acute. The Kaiser Family Foundation notes that “More than four in ten adults overall (45%) feel that worry and stress related to coronavirus has had a negative impact on their mental health, up from 32% in early March.” If one needed more proof of the mental health crisis we are facing, prescriptions per week for antidepressants, anti-anxiety and anti-insomnia drugs increased by 21% between February 16 and March 15, peaking the week of March 15 when the virus was deemed a pandemic. The largest increase was in anti-anxiety medications, according to the report, which rose by 34.1% over that month, in contrast to double digit drops in the use of some of these medications over the previous five years, according to this Fierce Healthcare article.

We are grateful to our guests for their willingness to do the show and even more so for their commitment tackling the issues that are plaguing so many people today. Whether you are an adult, a child, a teen; whether you are someone with serious mental health issues or more common ones; whether you are alone, with your family, or in any other situation, know that there is help out there for you – you can access mental health services 24-hours a day by telemedicine by accessing these three companies and many others.

We are grateful to Manatt Health for sponsoring today’s episode of Tech Tonics—Manatt Health is a multi-disciplinary professional services firm that integrates a full-service law firm with a broad-based strategic business and policy consulting practice to help our clients grow and prosper. Manatt Health supports the full range of stakeholders in transforming America’s healthcare system.

Show Notes:

Kaiser Family Foundation report on coronavirus impact on mental health

Press Release abou...

A brilliant and creative cardiac surgeon who went on to become the brilliant and creative CEO of the Cleveland Clinic for 14 years, Dr. Toby Cosgrove surprised many when he was invited back to his alma mater, Williams College, to give a convocation address. As his topic he picked: failure. In our latest episode of Tech Tonics, we learn more about Toby’s unusual journey, and why, in reflecting on his exceptional career, he chose to focus on such an improbable theme.

Toby grew up in Watertown, N.Y., in a family that emphasized both academics and sports (all of them, it seems); he attended college at Williams, and told us his experience was “terrible.” He struggled to keep up with the large amounts of reading required, and only later learned that he had dyslexia, a circumscribed defect in “phonological processing,” often seen in the context of exceptional intellect and other talents – the so-called “Sea of Strengths” model. Toby’s described this experience as “terribly dispiriting,” adding “I thought I was dumb.”

Toby persevered, attended medical school at University of Virginia (“the only acceptance out of 13 schools I applied to”), discovered he enjoyed it, and gravitated towards surgery in general, and cardiac surgery in particular. He completed two years of surgical training then served a year at a military hospital in Vietnam during the war, ultimately receiving a Bronze Star for his contributions. He then continued his training in cardiac surgery at Massachusetts General Hospital, where he was helpfully told he was the least talented individual in his residency group and advised not to pursue cardiac surgery – a recommendation he fortunately ignored.

In short order, Toby emerged as an incredibly talented, soon legendary, cardiac surgeon, known for his creative solutions to patients with valvular disease. Toby says he embraced the mechanical ingenuity cardiac surgery required.

Toby’s rapid ascent through the ranks of medicine culminated with his appointment as CEO of the Cleveland Clinic, where he focused on two areas that were in a sense at the opposite ends of the spectrum: careful measurement and transparent metrics, on the one hand, and a deep commitment to essential intangibles, like empathy, on the other.

After fourteen years, Toby stepped down as CEO; today, among other responsibilities, he serves as an advisor to Google Cloud, and discusses with us his perspective on the role of digital and data in healthcare.

We’re grateful our sponsor, Manatt Health—a multi-disciplinary professional services firm that includes a full service law firm and a broad-based strategic business and policy consulting practice to help clients grow and prosper. Manatt Health supports the full range of stakeholders in transforming America’s healthcare system.

Show notes:
Yale panel (with Toby, Ari Emanuel, and others) discussed here.
Profile of Toby on Yale Center for Dyslexia and Creativity website
New, updated edition of Overcoming Dyslexia, the best-selling book written by David’s mom, Sally, and his brother, Jonathan can be found here.
Profile by Katie Hafner in The New York Times of David’s parents, Bennett and Sally, focused on their ongoing career research in dyslexia
Essay on “Failure” written by Toby.

Famous Cleveland Clinic “Empathy” video, an initiative launched by Toby.

A childhood fraught with illness, loss and uncertainty drove Torrie Fields to an adulthood focused on making these experiences better for others. Torrie sincerely believes that we are all here for a reason and that her reason to is help people have more dignified, less painful experiences at the end of their lives.

Having learned early in life that you could take nothing for granted and that you really need to show up when things are going in the right direction. Torrie has parlayed these guiding principles into an accelerated and notable career, culminating in the founding of Votive Health, which she views as a company in the business of making better memories – by that she means, “There is an intimate tie between how you die and how people remember you.” Votive Health is also a company focused on using data and people to help manage the care of patients with serious illnesses. The company, which is now launching, also works firsthand at the intersection of illness, insurance and employment, which is clearly a critical confluence at this currently challenging time of COVID-19. Notably, David and I recorded this show well before we knew what was coming on the plague front. This show seems particularly relevant now.

Torrie’s early career you focused on emergency preparedness and epidemiology with a special focus on systems design. This skill set served her well through her time at McKinsey and then later, when she somewhat randomly applied for an actuarial program at Cambia Health Solutions, the parent of Regence Blue Cross Blue Shield and several other companies. The wonderfully kind and very community-minded CEO of Cambia, Mark Ganz, encouraged employees to seek a special project that was meaningful to them – ultimately this led Torrie to found and ultimately lead Cambia’s palliative care program. She later joined Blue Shield California to start a similar program. She later joined Blue Shield California to start a similar program.

Torrie discusses the challenges at the intersection of palliative care, end of life vs. the traditional medical and insurance systems, where there are no standard definitions of palliative care, few appropriate payment models, bad program packaging and low prioritization. Given the current COVID-19 environment, perhaps we will see some changes in that.

We loved having Torrie on the show, as despite what can be a dark topic, she is a perennial ray of sunshine.

We are grateful to Manatt Health for sponsoring today’s episode of Tech Tonics—Manatt Health is a multi-disciplinary professional services firm that integrates a full-service law firm with a broad-based strategic business and policy consulting practice to help our clients grow and prosper. Manatt Health supports the full range of stakeholders in transforming America’s healthcare system.

Show Notes:

• A useful article about COVID-19-related advanced care planning from the Kaiser Family Foundation can be found HERE
• A prior post by Lisa on end of life is HERE.