Framework for future of medicine — from Health Evolution Partner conference

Last week, David Brailer’s Health Evolution Partners (where I’m currently an Operating Partner) held its annual conference in Laguna Nigel, CA.   What makes this conference really interesting is they get leaders from major companies across the health economy — health delivery system, research, big pharma, payers, tech — and add in a bunch of disruptive, small companies in the same setting which stimulates a diverse variety of interesting dialogs.      Folks are both inspired and enabled to take some concrete actions to either collaborate, do business or simply be smarter for having participated.

The first night had a quick fireside chat with David Agus and then a later panel which had Eric Topol and Bob Galvin on it.   Agus and Topol are leading researchers in genetics — but have a pretty different perspective on where to focus.   It would have been fun to see them on the stage at the same time.      Both have books out (I’ve finisherd Agus’, started Topol’s).    Here are my takeaways:

  • Agus is promoting a ‘systems biology’ approach to understanding and treating health and disease.    Genes are important — but we won’t find the answer by just improving our understanding of the genetic variations.    Our body is a complex system — which has many redundant capabilities and adapts to inputs.   We really don’t know why certain treatments work — but we should follow the evidence even we don’t understand the causal pathway.    I initially learned about ‘systems biology’, P4 Medicine and the challenges of building computational models of our body from Lee Hood in Seattle.   You can watch Agus at the KhanAcademy here.
  • Topol appears to be more firmly in the camp of truly understanding our genes will lead to the ability to treat and prevent disease.    This focus is similar to Frances Collins head of NIH.   In addition, Topol’s focus in his book (and other talks) is that technology convergence and consumerism will necessarily drive medicine through the digitial revolution that will unlock value.   Naturally I share his enthusiasm for consumerism and technology — but so far I’m in the ‘systems biology’ camp as the more likely framework to right.
  • Galvin made a key points about our need to be skeptical about technology as the solution to our cost problem and that we needed to focus on consumer/patient behavior.   He described the need for incentive systems and feedback loops to consumers to drive better outcomes.

Jeff Trent (founder of TGEN and whose team is doing some great work) later characterized the differences between Topol and Agus in a way I found interesting as:

  • Agus believes common sense trumps technology
  • while Topol believes technology will trump common sense.

The discussion matters (one is not right and the other wrong) because it should impact where our research dollars and programs go.    While average citizens don’t get involved in understanding and caring about our research priorities — they should.   In his book, Agus also shows how a ‘systems’ approach really should influence our health regimen and approach TODAY.    I agree.

TEDMED — further thoughts

There was no way I could keep up with the stream of incoming thoughts and people that I experienced at TEDMED.   Plus TEDMED had their own blog — which provides better coverage than I can do — so here is the official blog…which is worth a scan.

I learned a lot from TEDMED — I was particularly interested to learn about my microbiome.   The speaker — Jonathan Eisen — suggested it should be considered an organ, just like our skin.    His blog on the topic is here.

There were many thought-provoking questions:

  • the real impact of bias in the way data is published and shared from clinical trials.
  • the evolutionary future challenge of drug resistant bacteria — and whether it should impact treatment today and how
  • using gaming/crowdsourcing to figure out the right structure for a protein (go U of Washington)

One observation — which is further exemplified by the 20 grand challenges selected out of over 40 choices — is that there are SO MANY worth causes (diseases, fixing science in so many ways, engaging consumers etc) that real progress is on core issues (my definition — like getting a value driven, consumer centered health delivery system) is diminished as folks push their worthy agenda.    As Mike Leavitt said while Sec. of HHS — it is not that we lack political will – it is that there is too much political will that stops progress.

I was also struck by the many ‘chance’ encounters I ended up having with thoughtful, motivated and energized folks.  That is one of the great benefits of working in the health sector — the breadth and depth of the talent tackling the problems.     I hope the community really makes some progress in the coming year.