Episode: 351 |
Kian Beyzavi:
Digital Health:


Kian Beyzavi

Digital Health

Show Notes

Kian Beyzavi, a Venture Partner at Cota Capital, is a seasoned leader in the life sciences. After several years of consulting at McKinsey & Company, a couple of stints as a venture investor and a software entrepreneur, she worked in senior leadership positions at medical device and pharma companies for 10 years.

Her recent consulting work is mainly focused on innovation in life sciences, leveraging digital health, patient engagement, services, devices, and diagnostics. Kian holds a PhD in electrical engineering/applied physics from Princeton University, and she has worked Asia, the UK, Europe, and the Middle East.

Today she provides insight into the digital health industry, what it is, what it offers, where it’s going and how it is changing the interaction between patient, doctor, and health information. Kian can be contacted through LinkedIn.

Key points include:

  • 02:02: How people interact with digital health through wearables
  • 05:23: Technology to monitor neurodegenerative disease
  • 10:19: The various categories of digital health
  • 15:06: The main three drivers in digital health
  • 22:57: How regulation is changing
  • 24:26: Kian’s background
  • 33:03: Investing in the digital health industry

Kian Beyzavi on LinkedIn: https://www.linkedin.com/in/kian-beyzavi-phd-36b1b5/

One weekly email with bonus materials and summaries of each new episode:

Will Bachman 00:01
Hello, and welcome to unleashed the show that explores how to thrive as an independent professional. I’m your host Will Bachman, and I’m here today with Umbrex member Kian Beyzavi. Kian, welcome to the show.

Kian Beyzavi 00:16
Thank you,Will, it’s good to be here.

Will Bachman 00:18
So, Kian, I’d like to explore today. What is digital health? Let’s just start there.

Kian Beyzavi 00:27
Yeah, so that’s a really good question. And different people mean different things by it. My personal definition is — any health related tool that captures data? That is categorized as digital health. You know, some people say, Oh, it’s anything that has an electrical currents going through it, some people say, well, it’s anything that requires some kind of a sensor or variable. But, I think at the end of the day, the ability that we have now to collect data, and then be able to apply advanced analytics, to provide some insights that either weren’t available before, or we are able to provide them in a more efficient way, or being able to provide sort of a holistic way of looking at the health of an individual or a population, those categories for me as digital health.

Will Bachman 01:37
Okay, good. So that’s a helpful kind of broad definition. Within that, you mentioned a few different types. And some people would get more specific in their definition, like you said, wearables within the category of digital health, what would the typical sub categories be?

Kian Beyzavi 02:02
So you could either sub categorize based on the use case, or based on the technology that’s required. For example, one way you could think about it is when you go through the patient journey, or a consumer journey, right? You could think about it as well, a healthy individual, how do they interact with digital health? Most likely, their interaction is going to be either with wellness apps or wearables to just track their health, or it could be for routine telemedicine interactions, checkups and whatnot, with a provider, or it could be with filling their medications, if they’re taking supplements, taking the medications, they be online pharmacies. So that’s kind of the starting from upstream, then you go to a chronic patient, for example, that has diabetes. So, they are monitoring their blood sugar, either through an episodic blood glucose monitor or through a continuous monitor. And that monitor is providing them with some kind of a feedback or insight about their behavior or their diet that needs to be modified. And then you kind of take it further to a patient that has an acute illness, such as somebody who is going through cancer treatment, or somebody who is undergoing neurodegenerative, disease treatment. So, you could think about monitoring them as they are taking a medication to better understand how they are responding. And there’s data that through monitoring someone’s activity, you can actually tell whether they are responding well to a given drug, even if it’s not a neuromuscular drug. So, that’s one way to think about it or monitoring the patient’s compliance and adherence to the drug. So, this is kind of a consumer or patient centered view. Another view is to break it up by technology to say, Okay, we have sensors and hardware elements. So, we categorize that as one bucket. Then we have telemedicine and mobile health, we kind of categorize that as a different one. And then we have…

Will Bachman 05:05
Let me just pause there. So, back up a little bit. So sensors. So, break that up for me a little bit. So that would be so we’re not talking just about my mobile phone, which might be a sensor, but also might be mobile health. When you say sensors, like what, sorts of sensors are we talking about?

Kian Beyzavi 05:23
So, that’s a great question. Mobile phones certainly can do a lot. And it’s actually quite surprising how much they can do. But, so just to dive a little bit deeper there, certainly, they can track your movement; there are apps that you can download. And you can actually, as you’re typing from your typing patterns, these apps can determine if there is a neurodegenerative disease onset at play. By monitoring your voice, by monitoring your speech, there is data that says people that are starting to have dementia; they tend to use pronouns a lot more than specific nouns. So there are these very passive, unobtrusive methods that you can monitor activities of daily living and provide a very rich set of data across multiple disease states. But in addition to the phone, we are seeing, there are a lot of variables. One that is quite an elegant device is the eye rhythm, zero patch. So, it’s a very small patch, a little bit bigger than a bandaid that you put on your chest. And by wearing it over two weeks, and bringing the advanced machine learning and AI capabilities, they can actually detect atrial fibrillation, and atrial arrhythmias, cardiac arrhythmias and irregular heartbeat. So originally, I mean, historically, that was done with a halter monitor, which is very awkward and can only work over 24 hours. But this way, having a two-week data set is quite rich. And then there are consumer apps that, consumer variables that can detect your sleep patterns, there is Oura ring, that, it says it’s a very elegant ring. And it can measure your heart rate; it can potentially measure your sleep patterns. And, there are variables that measure your respiration rate, so to help you sleep better, and we are seeing an explosion of these consumer apps. And there’s of course, the Apple Watch. And there is the Google Study watch. So, we are seeing an explosion of these consumer apps. And some interestingly, even though they are not necessarily clinically validated, they just provide such a tremendous volume of data, that now they’re starting to be used in clinical trials as well. For example, we are seeing Apple Watch being used in a heart study with over 150,000 patients.

Will Bachman 08:30
That’s amazing. And I have a family member who has this little device. So, that connects to your mobile phone that can do just as an EKG. And then the phone can sort of use artificial intelligence to read that EKG. And if it looks questionable, you can like email that to your cardiologist. So, like, beyond just the phone itself, what other sorts of sensors are coming out there that consumers are connecting to their phones with Bluetooth or to even expand the sort of sensing that a phone can do?

Kian Beyzavi 09:13
Yeah, so for example, the continuous glucose monitor that was recently commercialized by Abbotts. It’s a very small sensor that you just put on your arm. And then you can use you can download the app on your phone and read your glucose levels. And I have actually worn this device because I was studying an earlier version of it several years ago, and it’s tremendously powerful in the way it can give you insights and helps you control your diet and do more exercise to manage your blood sugar levels.

Will Bachman 09:57
Okay, so this is amazing. So I interrupted you, you were talking about kind of, we went, you went through categories based on the patient journey. And then you were going through categories based on more like device type. So we have these different sensor types. And then what are the other? Keep on going? What are the other sort of categories from that perspective?

Kian Beyzavi 10:19
So there’s mobile health. And so, these are more around apps that are standalone. So for example, for behavioral health, there are a lot of apps, it’s sort of shifts into digital therapeutics. Also, we have companies like Akili, or Pera therapeutics, that have actually received FDA approval for digital therapeutics, and in behavioral, schizophrenia and other types of mental health applications. So, that’s another category. And then the third category is telemedicine, which is basically replacing the traditional face-to-face interactions between a physician and a patient. Ultimately, what I think is the second way that we categorize, digital health with technology is going to not be very clean, because at the end of the day, the most impactful use cases require all three of these components. So for example, there’s a company called Feel, they have a sensor that can determine, it’s for mental health and depression. But they have a sensor that can detect the patient’s activity level and heart rate, then they have a very rich app that can provide feedback to the user; they actually have a life coach that can intervene. So, it’s a whole ecosystem that touches on all of these components that we mentioned. And that’s where you see the biggest impact.

Will Bachman 12:30
Okay, just the last minute or so I’m just pausing here for a second. In the last minute or so your your your voice quality, declined a little bit. It started getting it started getting more broken. I don’t know if you were getting further from your phone, or if you’re getting further from your Wi Fi connection. But it was starting to get a little bit digitally a little bit. So, were you doing anything different?

Kian Beyzavi 12:57
No. But

Will Bachman 12:59
are you on a Bluetooth device or talking directly into the handset?

Kian Beyzavi 13:04
I am on a wired headphone,

Will Bachman 13:06
a wired headphone. Okay. You might try talking directly into the phone instead of talking through it a handset? Sometimes that’s a little bit better sometimes. Yeah. Okay. Just go ahead and just say 1234512345. Yeah, it’s a little bit better. Okay. I don’t know exactly what was causing it. If you were like, walking around in a different part of the apartment or something like that.

Kian Beyzavi 13:33
Yeah, no, no. And will is this am I making sense?

Will Bachman 13:37
Yeah. No, this is all great. It’s all really good stuff. Very good. interview. Very, no, it’s terrific, terrific content. So it’s just the it’s just the audio quality was was getting a little bit itchy. Okay. I think we’re better now. So, yeah, sometimes just also having the phone, close to your mouth or something you said, I guess you’re on a headset, though. Okay, so let me jump to my next question. Which is, because we had talked through devices, okay. So let me start with a new question here. Okay. So I’m just going to write down the time, and then I’ll, so I’m just going to pause for a second or two, and then I’ll jump to a new question. Okay. So Kion, we’ve talked now about some of what digital health is. And this was super helpful, because I had thought of it maybe more as mostly about apps. And you helped expand my understanding of what we mean by that term. It really covers a lot of different things. Why do you think that digital health is now going to become much, much more prevalent? What’s changing beyond the obvious of COVID? Or maybe talk about that some, but seems like I’ve heard about digital health from a long time, but maybe we’re now on the brink of some big changes. What do you expect to see?

Kian Beyzavi 15:06
Yeah, yeah, so that’s a great question. And I would say there are three main drivers. The first driver are the stakeholder macro trends. The second driver is technology evolution. And the third driver is the response by financial markets, overlaid on top of all of that, of course, is COVID, which is supercharging. The adoption of digital health. So let me just quickly touch on the first point, which is macro trends. So population is aging, you’re seeing a lot more chronic disease. That has been true for a while it’s just accelerating, patients are looking more and more like actual consumers. So whereas before, the patient trusted a doctor, the doctor wrote a prescription, it was the end of that patients now are getting a lot more empowered with greater awareness, greater choice. And also with higher deductible plans and higher out of pocket costs, patients feel like they have a lot more financial skin in the game. And so, they are playing a greater role, and the ecosystem. In addition, patients are having great seamless experiences when it comes to entertainment, to retail, to banking, and finance. And, you can do all of these things through a few touches on your phone. But healthcare is still quite a bit behind, try getting your blood pressure from two years ago on your phone, it’s near impossible. So patients are pulling, they’re kind of creating this demand for innovation. In parallel with that, you’re seeing rising costs and emergence of value-based healthcare. So historically, payers were paying for procedure, now they are more and more paying for outcomes. And that is why providers are a lot more focused on kind of this holistic care, not just pushing a pill or pushing the procedure, but making sure the patient is monitored over a longer term and has better outcome. And we are in parallel with that we are seeing shifts from sick care to wellcare. So kind of shifting the care upstream to preventive care as opposed to acute care. And then on the pharma and metric side, blockbusters are getting less and less common. So patents are expiring, there’s pricing pressure, and payers are really demanding personalization, and real world evidence, like Plavix at $6 a day, but there’s something like 30 or 40% of patients that don’t even respond to it, because of their genetic disposition. So payers are saying, prove to me that your drug is going to work, not just in the control setting of a clinical trial, but also in the real world, and prove to me that this particular patient that you’re targeting is going to respond. And then likewise, the FDA is getting more nuanced and more thoughtful about approving new solutions. So that’s the macro trends; on the health and the health technology front, we are seeing just rapid pace of data generation with genomics, proteomics, liquid biopsy, electronic medical records, all these consumer apps and wearables. There are I think I read somewhere the volume of health data that’s being generated is doubling every couple of years. So, just imagine this deluge of data that gives us so much insights that weren’t available before. And then we also think interoperability. So whereas before, one, EMR was a silo, one Fitbit was a silo, we are seeing emergence of standards like HL7 fire and smart standards that are enabling interoperability and convergence of data. And where is this data going? It’s not being stored on enterprise servers, it’s going into the cloud. So cloud computing is another big enabler, and then advances and analytics and AI, together with, 5G and, and automation and blockchain and 3D printing. So these are all the technology enablers, and then financial markets have really responded well to kind of this perfect storm that’s been the needs of stakeholders on one hand and emerging technologies. On the other hand, so for example, we saw, in 2020, according to the Economist, it was like a billion dollars of investment in the second quarter that went to digital health. So this is all a perfect storm, and then add to that COVID. So COVID probably accelerated many of the trends that had already started by maybe five, maybe 10 years. So whereas before COVID, probably, maybe 10, or 15%, of the population in the US had ever used an online pharmacy. Now we see that number almost double, maybe before they had only used, kind of medical, maybe they have called a nurse, or they had sought spiritual care, that was like less than 5% of the population. Now, that’s almost, 30% of the population. So, we see that, by improvements that we are seeing and connectivity, video quality, 5G, a lot of these technologies are really improving the latency of communication, and therefore setting us up really well for doing a lot of things that we did, in person doing it remotely. You know, like they say, every doctor visit takes two hours; if you think about driving there, waiting in the waiting room, and coming home. Now, you can do that in 15 minutes. So just think about the impact that that’s going to have on preventive care and earlier diagnosis and earlier intervention.

Will Bachman 22:32
What about, to what degree would you say there’s a fourth lever around, like, regulatory changes and, sort of payer changes a willingness to pay for a telemedicine visit and that sort of thing?

Kian Beyzavi 22:57
Before COVID, there were some state licensing laws that, for example, said the doctor that writes, a lab test has to reside in the same state that a patient is in. And, before COVID, there was sporadic reimbursement for telemedicine consults, some payers, paid for it. Some payers, even as part of the same health plan didn’t, there were some very strict guidelines. So both of those have relaxed quite a bit. And so like the state licensing laws are getting more relaxed, so that an MD sitting in New Hampshire could write a prescription for somebody sitting in California, and many of these changes are going to be irreversible. So even when we come out of the pandemic, hopefully in the next six to 12 months, these changes are going to remain because they just gave such a great benefit in terms of efficiency of the system.

Will Bachman 24:11
I didn’t do a proper intro when we started the discussion. We just kind of jumped right into it. But let’s take the chance right now. Tell us a little bit about your background and about the type of projects that you work on.

Kian Beyzavi 24:26
Yeah, so I was trained as a scientist, I did a PhD in Electrical Engineering and Applied Physics. But I put myself through college working as a research assistant in the biophysics lab of medical school at University of Minnesota. And I was always really intrigued by the interdisciplinary overlap between technology and medicine, and how technologies could really help drive new insights. insights into into human physiology or into natural biology. So when I got to McKinsey after grad school, I quickly gravitated to the healthcare practice, working with biopharma and medtech. clients and strategy, business development, new market entry and new product development. And subsequently, then I was recruited by one of my clients to join a venture firm, where I did investments in biotech and high tech, and then went off and started my own RFID tagging company with a friend. And that was just when RFID was getting more affordable. And we successfully exited that. And then for about 10 years, I was a senior executive at medical device companies, Medtronic, Abbott Diabetes, and Novartis diagnostics. And then I started my own consulting practice about 10 years ago. So my focus is really threefold. One is to do traditional product development and commercialization work with life sciences clients. The bulk of my work, though, is helping healthcare players navigate emerging technologies. So how do we make sense of AI? How do we make sense of digital health? You know, should we, where should we apply these. And then my third focus is working with startups and basically kind of matching, helping, startups and big companies get to know each other and collaborate together. So in terms of my recent work, I have also started as a venture partner with Coda Capital. And we are a multi stage investment company that has been around and has done investments, in like, several life sciences, tools, and therapeutics companies, and I’m helping build up our health tech portfolio.

Will Bachman 27:19
Now, you are, we’re recording this here on January 8, and you told me that you’re attending, quote, unquote, the upcoming JPMorgan healthcare conference, as you’ve done many years in the past, this year, it’s virtual. Tell me a little bit about what that’s like, in terms of setting up meetings at that, like. How is that working to set up discussions with folks, how do you decide who to do it with? And yeah, and how is it working with in the area of in the era of COVID, to attend JPMorgan?

Kian Beyzavi 27:53
So for anyone who has attended JPMorgan in previous years, I don’t think anyone is gonna miss having to squeeze into tiny little coffee shops and pay $20 for a cup of coffee, and running around from seven in the morning till 10 o’clock at night in inevitable rain. So, but I have to say, the organizers of the meeting have done a really good job. So, as an investor, I am getting matched through multiple platforms, there is Rezi, there is Biotech Showcase, and so, and several others that you’re involved in. So, you see a whole slate of startups that are looking for funding, and then they like, I see a whole slate of VCs that are participating. And then you can just contact each other. And if there is interest, you set up a meeting, and there is an automatic scheduling platform that’s available. So it’s been quite efficient, because you don’t have to spend the phone calls and trying to set something up. And also I can schedule meetings every 30 minutes back to back to back, because I don’t have to worry about going from one side of town to the other. So of course, you miss out on the cocktail hours and bumping into people in the hallways, but I have to say in terms of efficiency, and in terms of being able to just accomplish a lot more in a more compact time slot. I’m very excited that it’s going to be a massive improvement over what we have seen in prior years.

Will Bachman 29:47
That is really amazing. So, tell me just a little bit more about these apps. You listed a few of them. It sounds a little bit like Tinder or something swipe right to meet a venture capitalist. Talk to me about the different ones and or did they focus on specific types of companies? Or just tell me a little bit more about that?

Kian Beyzavi 30:10
Yeah, so the Biotech Showcase has a platform called Partnering One. And basically, it’s an informatics connectivity tool. So you see, like, I can look at a few 100 companies and choose which ones I’m interested in. And then likewise, the company can find me. So, I’ve been getting 10 or 20 emails every day through this platform saying, “Hey, this is a paragraph about us. Are you interested in meeting?” And I have probably selected 20% of the companies that have emailed me. So and then, you say, “Yes, I’m interested.” And I’ve already provided my available schedule. So the system will automatically match their schedule to mine and immediately schedule the call. So, I don’t have to do anything. I just have to say yes. And then boom, next Thursday at 11 to 1130, I have a meeting up.

Will Bachman 31:33
Okay, so you don’t even have to bother picking a time the system will just look for a time that works for both of you, boom, put it on the calendar. That is, that’s amazing. Are there other apps that are also kind of doing the same thing? Do they have different, targets? or?

Kian Beyzavi 31:51
So, Biotech Showcase is mostly biotech companies. And then, with Rezi, it’s across the board. You know, there are diagnostics, there are therapeutics. And so that’s, it’s a similar functionality, the user interface is slightly different. But, but it’s a similar functionality in terms of providing sort of a synopsis to investors and companies and then doing a match, once if you decide this is relevant, then scheduling this for you.

Will Bachman 32:40
Now, as an investor, are there are certain themes that you’re working on? Are you looking just at any sort of, bioinformatics kind of company or are there certain, second areas or niches, tell me a little bit about what you’re what you’re focusing on?

Kian Beyzavi 33:03
So, that’s a great question. Like I was saying, there are all these macro trends happening. And then there is the technology. And then there are, the financial implications. And so I’ve actually spent the past few months trying to define what Coda’s investment strategy is going to be. And I’ve also looked, I’ve read up a lot on how other investors are thinking about this. And the truth of the matter is, it’s very difficult to create things that are mutually exclusive and collectively exhaustive. So there’s going to be a lot of overlap. But some of the interesting trends that we’re interested in are around computational biology. I’ll define these, then there is precision medicine, and then there is telemedicine. So, what I mean by computational biology is trends that we are seeing and AI enabled drug discovery. There’s tremendous work being done now to replace the traditional wet lab, benchtop essays and do a lot of that work using data analytics, and therefore be able to just pour through large volumes of data and come up with targets and then pour through large volumes of compound libraries and come up with drug candidates. So, that’s an area that’s interesting for us. We are also seeing a lot being done in biomaterials and bio engineering. And then, in terms of precision medicine, of course, liquid biopsy and genomics, and proteomics are very interesting. And then we’re also interested in how COVID has accelerated telemedicine, and where we think opportunities are, not things that have already kind of taken off, but where we think the next three years is going to look like.

Will Bachman 35:18
And then I’m curious, how do you just personally manage your personal knowledge base, as you talk to these companies. Do you, take notes and put it in Evernote, or Rome, or some kind of organized fashion so that you can periodically review and look at themes or, how do you think about organizing what you’re learning and the people that you’re meeting and the themes that you’re seeing? And so you can have it digestible and analyzable?

Kian Beyzavi 35:53
Yeah, that’s a really critical question. Because as an investor, I see a lot of deals every day, and being able to just capture what I think the critical points are, and then be able to then remind myself of those later, and based on that kind of identify patterns and connect the dots and then be able to predict trends that essentially kind of requires digesting large volumes of data. So, I have a OneNote file where I take notes; I have a Google Sheet where we collaborate with my colleagues and take notes. And then, I have a habit of every once in a while, if I have a little bit of free time, I just go back through my old notes. And this is a habit I had ever since I started working in a research lab. And you just take notes to capture the moment, but then going back and looking through old notes, that’s kind of how the pattern recognition and connecting the dots starts to happen. And I I make sure that I do that periodically.

Will Bachman 37:13
Kian, if people wanted to follow up with you or learn more about what you have going on, would you like to share any social media or website where can people find out more about you?

Kian Beyzavi 37:29
So LinkedIn is great. And I welcome people to to reach me there. I would just request that rather than sending a blank invitation, if there is something in particular that you’d like to learn, or something that has resonated, or something that you want to discuss, or a deal that you want to send, just be a little bit more specific about what the reason is that you would like to connect. But that is my preferred platform.

Will Bachman 38:04
Okay, fantastic. We’ll include that link in the show notes. Kian, it’s been really interesting speaking with you, I learned a ton about digital health. I feel I have at least some sense of what that world is about now, at least a beginners understanding. So thank you so much for joining today.

Kian Beyzavi 38:23
Thank you Will, I love talking about these topics.

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