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What can you do with an MD? Are there non-clinical careers for doctors? What is the next big thing in health care technology? What do investors look for in health care startups?
Discussing health care startups and innovative ideas for health care businesses with Chris Stock, MD, a managing director for Health2047. AMA Chief Experience Officer Todd Unger hosts.
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Speaker
- Chris Stock, MD, managing director, Health2047
Transcript
Dr. Stock: We are attempting to transform health care from the inside out, the inside being the doctor-patient relationship.
Unger: Hello and welcome to the AMA Update video and podcast. Today we're talking about how Health2047 brings the voice of physicians to Silicon Valley to create technology that truly works for doctors. Joining us in our studio is a managing director for Health2047, Dr. Chris Stock, who's asked me to call her Chris today. I'm Todd Unger, AMA's chief experience officer. Welcome, Chris.
Dr. Stock: Thank you. Delighted to be here.
Unger: It is great to have you in our studio today, and I'm looking forward to learning more about your role at Health2047. But before we get started, I'm sure a lot of people out there are not familiar with Health2047. Will you give us a little background on it?
Dr. Stock: Sure. So, about 10 years ago, Dr. Jim Madara, the AMA CEO, realized that there were commercializable solutions that could transform health care. But he also knew that the AMA really couldn't work with those companies, because of their not-for-profit status. So, under his direction, the AMA formed Health2047. It's a wholly owned subsidiary of the AMA.
It is for profit, and it is, as a venture studio, charged to found and fund companies likely to transform health care by midcentury, midcentury being 2047, the 200th birthday of the AMA. Health2047 is going to have its 10th anniversary later this year. We now have 10 portfolio companies, and several of which are out for Series A funding this coming year. And you can see all of our portfolio companies at health2047.com.
Unger: Excellent. Well, question for you—how does an anesthesiologist find herself at a venture firm?
Dr. Stock: So I practiced medicine for almost 40 years and learned a thing or two. And as an anesthesiologist in particular, because we touch everything that goes on in medicine, everything from fetuses to older people, all kinds of diseases, anything that comes to us, either in the operating room or in the ICU or the pain clinic, people have all these other diseases. So we basically touch everything that goes on in operations, in terms of disease, and so I have a breadth of experience.
And I use that at Health2047 to, as you say, bring the voice of the physician to the opportunities that we evaluate, always asking, how is this innovation going to improve the lot of the physician? And two other questions that I also bring to the table as a physician is the problem that the opportunity or the startup is trying to solve. Is it a real problem for physicians, or physicians? And is it going to increase the burden of practicing medicine at all?
Unger: Well, that's really interesting because I don't think that those questions were asked, maybe, with previous medical technology advances, like EHR. So it's refreshing to hear that the focus is on, is this technology going to help physicians and patient care? So how does your experience—you say you've touched all the aspects of medicine through your role as a physician. How does that operate, then day-to-day, as you're considering companies for investment or working with portfolio companies?
Dr. Stock: So, of the companies that come to us as potential portfolio companies looking for investment, anything that has to do with clinical medicine or physician-patient interaction, I touch and get involved with. We work in teams, and so anything that has those clinical aspects—I become part of the evaluation team. And we go through a process of derisking that involves everything from, is it consistent with AMA strategies and missions, to, does it have a reasonable business plan and all of the things you would expect?
But then, also, the four things that we know from AMA research and our observations at Health2047. The physician users want to know, is it going to work? Is it going to goof up my workflow and my workplace? Am I going to get paid? And am I liable? So we take those questions, in addition to all of the business and marketing and the other things you think about when you think about a startup, very seriously because, as Jim would say, we are attempting to transform health care from the inside out, the inside being the doctor-patient relationship.
Unger: Absolutely. I'm curious. People come in and make a presentation. Are they used to having a physician sitting in the room and evaluating it from that perspective?
Dr. Stock: Not often. But I think that, increasingly, there is more attention to involving the end user in the product, particularly if it has to do with actual clinical practice. And I don't know everything, so we have other advisors that help us with things that—like radiology, for example.
Unger: When you're talking to a potential company to invest in, what are some of the key things you're really looking for in presentations, and what are maybe some of the things that you see over and over again that people miss?
Dr. Stock: So I think, of those four attributes that physicians want to see, the two that most often are missed—or maybe not overlooked, but are absent in their presentations—are the issue about workflow. And surprisingly, does it work? And I think it's not because people overlook "does it work," but the companies come to us in various degrees of maturity.
So if they're in ideation and they have a great idea, but they don't have a minimum viable product, they don't have proof of concept, we don't know if it works. And so, for us, that's not part of our investment thesis. We would give them the best advice we could about how to get to efficacy, and then invite them to return to us again to re-pitch.
The other one is workflow. And since you mentioned the EHR, I think the issue with workflow is less that it's overlooked, and more that there's workarounds to overcome some of the problems with already existing technologies, like the EHR. So if you take the example of a remote monitoring company, where you would expect the blood pressure and heart rate to go from the monitors, or from the company's platform, into the EHR and go to vital signs, that's really hard, and there are very few EHRs that will allow that kind of integration.
And so the workaround is for the company to turn it into a PDF and then import the PDF into the EHR. It goes into—
Unger: That sounds easy.
Dr. Stock: Well, that's easy.
Unger: I'm just joking.
Dr. Stock: It goes into External Documents tab. So when the doctor is looking at the patient's record, they have to go into the External Documents tab and then find it with all the other external documents, which sounds almost trivial, those three to six clicks extra, or times. But if it's time and time again, and day after day, and patient after patient, it is not only annoying. It's a burden.
Unger: Yeah, it's not practical. And you're right, it's just another burden on top of 50 other things that are in the same class.
Dr. Stock: And it's a workaround for the EHRs because they are poorly made, and they don't have data interoperability. And that is a huge burden for the entire United States health care system.
Unger: Well, we know that remains a source of burnout and the burdens that you talked about, so really important that those things are considered. Let's talk about a startup that you've looked at recently that checks the boxes that you've laid out. What can you tell us about that?
Dr. Stock: I would actually love to tell you about one of our portfolio companies named Phenomix Sciences. About 10 years ago, two Mayo Clinic physician scientists discovered that there were four phenotypes for obesity. And that means there are four types of obesity that are determined by the person's own genetics and environment.
And not only are there four types of obesity. Each of those types of obesity are responsive to some treatments and not others. And so, in 2021, they, along with Health2047, founded Phenomix Sciences. And they developed a test they call my MyPhenome that was easy.
So talk about workflow? Easy. Buccal smear in the doctor's office or at home by mail. The test goes to the lab, and the lab reports back not only the phenome for that particular patient, but also a list of the probability with which each of the different types of therapy for obesity will work on that particular patient. So it's precision medicine for obesity.
Unger: Is this in practice right now?
Dr. Stock: They are gathering up steam for their Series A round.
Unger: Wow.
Dr. Stock: And yes, it's out. It's in use right now.
Unger: Very, very interesting. Wow, and quite timely, given everything that's going on.
Dr. Stock: Especially with the rise of GLP-1's, because they only really work in about a third of the patients well, another third sort of OK, and then a third not at all.
Unger: Wow, that's very interesting.
Dr. Stock: So you could do the test and then not prescribe it if it's not going to work.
Unger: We talked about issues of burnout and just using technology to avoid adding more burden, administrative burden, on physicians. What technologies are you seeing out there that have the potential to minimize, erase, get rid of a lot of these burdens on physicians?
Dr. Stock: So, right now, most of the opportunities that we see are leveraging large language models and augmented intelligence. And so, as we think about using those tools inside solutions for health care, for medicine, I think of them in four buckets. The first one is the least risky. It's basically intelligent automation of administrative processes, scheduling revenue cycle, prior authorization. And I think the group of physicians most likely to be helped by those types of solutions are the doctors who are in independent practice because they don't have the large back-end support that employed physicians would have to do those functions.
The next bucket are—I think of as—things that reduce the burden of documentation, so transcription services, having ambient AI in the exam room that can then generate a progress note. That does require a human in the loop. The doctor does need to read what the platform writes, composes and edit it to make sure it's correct. But the physicians that are using applications like that find that it just totally decreases the amount of time, keystrokes.
Unger: I've experienced that myself, just what a different appointment, so to speak.
Dr. Stock: Exactly. And so that, I think, does—any physician has to do documentation, so all doctors, I think, can benefit from that. Third bucket is my favorite. And I think, not only is it going to relieve burden in terms of time, but also intellectual burden, because doctors just cannot know everything, every time. Can't do it.
So decision support tools that have evidence-based information, data, probabilities that can inform the physician to make an evidence-based decision—to be clear, the physician makes the decision, human in the loop—are so intellectually unburdening. It's amazing. And the types of those tools that I've used are pretty, pretty impressive. Phenomix Sciences is a good example of a decision support tool.
And then the last bucket I don't think is being used in medicine, at least not to my knowledge, but I find high-risk and very scary. And that's autonomous decision-making tools. So the platform itself would make the diagnosis, would prescribe the drug, would interpret the image. Pretty scary. And all I have to say is, I hope that the medical and technology communities will use their native intelligence to think hard about what should be used, in terms of autonomous decisions in the practice of medicine.
Unger: Well, there's a lot to think about there, and hopefully, we have a lot of work in the first three that you laid out, where it's really about augmenting capabilities. I think we're, hopefully, a long way away from number four.
Dr. Stock: I hope so, too. I am almost of the opinion that—to ask the question, should we go there? But it's going to happen, so we should probably think about what to do.
Unger: All right. Well, Dr. Stock, it's been so great to talk to you and hear your insights. And again, for people to learn more about Health2047, where should they go?
Dr. Stock: To health 2-0-4-7—the numbers—dot com. It's our website.
Unger: Well, thank you so much, Dr. Stock, for being here today.
Dr. Stock: My pleasure.
Unger: It's so incredible to hear your insights and think about the work that's going on that will really drive the future of medicine. Making technology work for physicians is a top priority for the AMA. And to support that work, we encourage you to become an AMA member at ama-assn.org/joinnow.
That wraps up today's episode. We'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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