Modern Health

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Modern Health | Fortune

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You're all doing really, really cool things. I wanna start with you, Frank. But I have to mention this OBE cuz you were awarded the Order of the British Empire. And I asked you last night if this meant I had to call you Sir Frank and you said no, no, no, no, no. That's a different Order of the British Empire, something like that. So what exactly is the Order of the British Empire? What mainly does is it gets me room upgrades now. Okay, really it hotels. It's an award from the country. We worked with the NHS for 20 years. That's our health care service. And it was mainly because we joined up doctors talking to doctors and that hadn't been done before. That's an amazing thing. Getting doctors to talk to doctors get you a knighthood that should tell you so much about the health care system and how dysfunctional it is. But Sir Frank and that's the only time I played that. But you began as a software architect in the financial sector, an industry that's actually been very consumer directed. From mobile banking, everybody on their phone can go and check out their bank balance and do whatever they want now, when's that gonna happen to health care? Yeah, I think we've all seen the revolution with the FinTech and the travel agencies. Yeah. It hasn't quite happened yet with healthcare, although I think the me will tell you different, lots of good things are happening. But we haven't quit had the revolution and I think that's because at the moment You still need a doctor or a nurse. It's very labor intensive. But I think some things are coming along a lot of the electronics. We know we're going to talk about AI in a while. Yeah, That's that's a big initiative. But mobility I mean, the same, the same smartphones that we have that every one of us has, then we're doing A thousand different applications a day on. I mean, we can start to use that as well, right? Yeah. But the moment you've still got to connect with the one doctor. Yeah. It's kind of good. You can do it from home. That's really, [ INAUDIBLE ] Knows more about this than me, but But you're still at the moment talking to the one dots, but I think the revolution will come, we can amplify the voices of the doctors and nurses. So I do wanna come right to you now and in order to talk a little bit about part of the challenges in this healthcare system and one of them is represented here in China. The Chinese population over age 60 will be 324 million by 2027. That's just seven years away, essentially a doubling of this cohort of people over 60 in the next seven years, and you've spent much of your professional life anticipating the challenges that this demographic shift brings to health care. What new tools will we have to deal with this to figure out how to keep costs down in particular, but make get better care to the seniors? Sure, I think most people think about the huge number of people beyond a certain age, and think that's That's the main course of the challenge, and think diseases our main enemies. I would, at another dimension, to health as we all expect to live much longer in our next 50 or 100 years, which is Function. Our physical and mental function ability actually determines much more how well we live beyond a certain age. So in China, I think there are two unique challenges that can be turned into opportunities. One is how we could actually better predict and prevent care dependency. So instead of thinking, how are we going to care for this 300 million people, beyond a certain age or hundreds of millions of people who are dependent and needing care, why can't we think How can we reduce peoples period of care dependency or disability and enable more people to live better, healthier, more active life until the very end of their lives? So predict and prevent, that's something we all know. Technology could enable. Right. And the second thing is to actually have the capacity to deliver care services for those who are then in need of care. And we're talking about shortage of nurses, shortage of physicians and all sorts of healthcare workforce. Right. And to empower more people to be able to provide Comprehensive and integrated care. That's again something AI and technology could do very well. So all the things you said were absolutely true and they all had a little subtext to them called cost. And so I just wanna follow up on that because Rate healthcare spending is going up everywhere. But here in China, it's been growing at a clip of 20 % a year since 2003. That's kind of a staggering growth rate and 35 % of that is out of pocket. So how are we, I know that you've been looking at companies to invest in reducing these costs and there are a number of examples About trying to sort of bring the doctor in a different way to consumers that's much cheaper, and outside of the hospital. You talk a little bit about how we deal with some of these costs? Well, that's, I mean Healthcare becomes a much a burden not only to the population, but also to the government as well. Used to be the healthcare expenditure covered mostly by all the pocket and secure Social Security Fund. Commercial healthcare insurance right now this year is less than 7 % of our expenditure. In order to reduce the cost, I think the demand is there. How we can increase efficiencies is the critical key. leveraging our mobility, leveraging artificial intelligence and leveraging on the on the infrastructures. One of the companies as example is that a company we invest as a major who we know in China used to be, there's a system called the bill for doctors. There's More than 1. 3 million of doctors. We are very trained but they are licensed as a doctor and they do not have any technology support. So what the company do is providing them with the cloud- based platform, which enable them in three ways. One is the clinical disease diagnosis supporting system help the doctor to better Train them with the knowledge and practice to see the patients. The second is that we provide them with the electronic medical record. And the third is that we provide the supply chain of pharmaceutical products to them in order the Increased efficiency have better diagnostics of the patients. And we provide them with very cheap doctors compared to before they are in the very bottom of the value chain. So in the sense we increased efficiency and Decreased the cause in the same time by leverage of technology. When I hear a lot of that all the disrupted technology and health care; so much of it, the really important stuff is the unsexy stuff. Right? It, s just making the trains go faster, it's helping with logistics, it's connecting the dots. There's so much of that and in fact, Just now off stage we had a quick converstation with Samone who mentioned that even in genomics in the sequencing about 40 % of that is AI or some sort of type of learning. You know how do we do this how do we make the electronic health records that were supposed to be so effective Frank. And I know you spend a lot of time on, how do we make, how do we fix those? Well, I think some of it is just crewing it and trusting, you know, doctors are very conserve adaption. You don't want to get to adapt, so, it's like, yippe ki yay, you know, you want a very, very careful doctor and that's what we want. The same time, the challenge is that we want to go forward and advance But simple stuff just sharing the record. So the doctor doesn't ask you the same questions over and over again. It's not a it's just quite simply being connected. Um, you know the London a in a in your own car Conscious, the doctor might have minutes to save your life, and really, really simple boring stuff. [ LAUGH ] But in terms of getting the information that we need so doctors, don't have to spend their time on a tablet, or a system. And here we've got, I've got my now fitbit, or I should call it my Google bit. Yeah. I guess, but. [ LAUGH ] You know we've all got our devices are wearable, are we going to start to see in this transformation, wearable turn to embedded and vegetables to translate, but. I think where we're heading when I grew like many of us, the doctor I went to was like half a mile a mile from my house. Yeah, but now we're connected all over the world. And now we can do so much as you said with the watch. There's so many tests you can do. The hospital is a bit of an old constructs. Yeah. And I think as we're going forward. I might want my diabetes managed by a doctor in Beijing using traditional Chinese medicine but my depression managed by somebody in LA who's very good at dealing with that kind of thing. And I think we will see it become much more global. And [ UNKNOWN ] I think China is in many ways taking the lead in the ability to sort of go outside of the box in some of these cases. Absolutely. Talk a little bit about what you're seeing here. Yeah, I think what I observed over the years is people in tech stop saying we are going to replace You replace doctors, replace nurses, replace hospitals, and they are in love with their products or technology. Rather than actually talking on a day to day basis to people who are already in healthcare, understand where the needs are, for example, in terms of lack for prevention We know four is a big risk for people of certain age to get injured and even mortality. Used to be that people all think we need to ask them to wear something to detect their risk of falling. But what about thinking out of the box not just with your product, but think how much more naturally it could be to just have like a censored flooring at home or in public places to track people's gate, like how they walk, are they having imbalances or are they having abnormal patterns. And then be able to predict Without having them were things that feel unnatural to them. Yeah. Just one small example and other things can be done. If we use the same mentality can we think of not disrupting their existing way of living or working in healthcare, but trying to find subtle ways to. Disrupt or the inefficiency and cost effectiveness. So Ray is is there a business model and putting these sensors everywhere ? Do you see this as an opportunity, like your as an investor saying? Yeah I will definitely invest in that company that's investing in censored Kate sensor you know. Well Ithink there's a 22 from the prostitutes. The different segments why is what we call. For the consumer. Yeah. The wearables which like weekend, the Fitbit kind of stuff that fit into that category, but as a serious healthcare investor, we are still looking for something that we call the vital signal that the signals that can help the doctors and the doctors that have the set of proven standard, that doctors correctness. They can use it. That's the real diagnostics and the ones I think one of the breakthroughs is the one of the monitoring for the glucose that is becoming reality. And so long as we have the breakthrough in those kind of wearable and embedded diagnostic tools. Again, I want to emphasize some vital signal the signals, And we know how important that is like the ability to detect atrial fibrillation which is a dangerous heart rhythm using your Fitbit or your Apple Watch. But the challenges is that you know Fitbit, their stock was, In the tank for a long time to the point were Google just scoop it up. My colleague Adam Lashinsky who somewhere in this room wrote years about a company called Job [ UNKNOWN ] that actually made where the first of the smart watches. And that didn't go very far And we've seen a lot of these companies other than Apple, big one, but you know they're not actually making a living doing this. It doesn't seem like it's that good of business model to investors yet. Frank? Take it begins. Yeah. Well, I am curious about because I mean, if you really look into some of the companies mostly like I mean 50 comes with the consumer company but the right real innovation happens is behind. Maybe sometimes. The companies that get into the real into this space could be the computer like a hallway or computer like Apple, they have a huge like consumer basis to start with. They don't have to do anything. The marginal acquisition or consumers have literally zero for that. And they can have a lot of cash on the back to really get into real technology innovations. And I'm hoping something happening within those big consumer jeans, electronic genes that have the healthcare Break through into the vital signal monetary And it's not the device much as the data that they get from it right data is cash in this world, right data is that currency that everybody in Healthcare's wants and they can learn from that. Need. Talk a little bit about the challenges of that. Who owns the data in this new world? Is it the consumer How we storing this unbelievable reams and reams of data that are coming with, a single image from an MRI or X ray. It's just an unbelievable amount of data. So how are we gonna deal with that? I think it has to start with what the data is used for. Yeah. In most people think home house, which is the sector. I mean, it's very much labor or talent intensive. So you need a lot of people to do the work, but actually it's data intensive. For every person every once in a while, we get a lot of assessment data and then we use that to feed into an algorithm to tell the first line caregivers what type of integrated care services and then They did. And for every time they actually provide the care, they collect additional data that will give them feedback to how well the algorithm did. And how better it can become. And this data I think If we use it carefully to inform all these providers including hospitals, including other institutions and the other individuals in the system, it can really increase the level of integration and the outcomes that related to people's quality of life. But then if we use it just for the sake of developing some data products that the market or the end- users don't see the benefit, then they are concerned who's profiting from my very private personal data. Yeah. Especially in healthcare, if it abused, it could be mean a lot of risk For individuals and the society. Yeah, that conversation has been happening for years now in the United States. I want to see if there's a question in the audience because we've got this extraordinary panel here. We get the lights up. anybody have a question? We have a question right there in the back. Could you just identify yourself please? [ INAUDIBLE ] Thank you for Gwanto Pharmaceutical companies I myself yes I kind of food supplement and you talk about a company a house issue. And I have some questions for you because you know the general proper link, yes very much in [ UNKNOWN ]. So about to a medical treatment after the algebraic of the disease. For example if I cannot to work the how you can have that patients of get up again and live by themselves. So it has become a global challenge where medical spending keeps growing. And many governments have come under severe pressure. Then my question is, why shouldn't we shift our focus before the outbreak disease? For the TCM traditional Chinese medicine, we focus on the prevention. [ INAUDIBLE ] We listened carefully a lot of cutting edge technologies. We believe it's very fearful. Why couldn't we identify the sources of the disease, from the prevention, and people would pay more attention to the health, and well being, and wellness to change Their excercise method and mental health, physical health, I think is more important than spending huge amount of money to cure and treat the diseases. Because we were talking about longevity issues But now what we were advocating is both longevity and in good health because we cannot stop the steps of aging, but we want to be aged in a healthy way after getting very older 90 years. Great. Sorry, maybe I'm a little bit off track. [ CROSSTALK ] Yeah, please. Because I work in the governmental agencies I made a lot of investments in science, and R & D in house. Three answers to to diversity as a policy change, including R & D change. And a lot of budget being reduced for the cure and treatment of diseases. Instead, we invest a lot of budget to the grassroots and primary levels and to do the prevention work. Second from the commercial business point of view US Why they had so many prevention's because one of the biggest pairs in US is the insurance companies that they know in house economics. They should go to prevention instead of cure and the treatment. So insurance companies intervened and market based approaches. They use economics to resolve the problems, the third aspects we use technologies. **** you said, nutrition and the supplements for the micro bio grams, you know [ UNKNOWN ] making strong breakthroughs if we can have tailor made or individualized this micro organisms to have Tailor made the supplements and nutrition. So maybe it's a very good profession for the stomach diseases, for example, so, both the market base and the technology or the advancement can solve the problems. What I want to add is only one point Because there are a lot of interconnections between the two. The prevention in the public health arena, why not enough attention being paid to the prevention. As we rightly pointed out, it was due to the The budget allocation disbursement the mechanisms because our reimbursement system is made based on the consumption of drugs and also the cure and treatment. If that's still the case, we will not allocate more budget to the prevention, but in US they use the modalities To provide the coordinated interest of the insurance company and the disbursement of the money and they focus more on outcomes. Then they would be more efficient and effective at investment. And the more investment would be shifted to the prevention aspects. The gap between the two is the data Especially in the TCM field, we do not have a strong data supports, evidence- based to provide larger services to the huge populations. Now, we are using information data and AI to link these dots. And we've seen dramatic changes already. And in the future we're going to invest more energies at first into the prevention and prediction work. The question in for those good answers, cuz I think there was an important turn in the story. I only got you frank with one minute left or a little bit less but Tencent is investing here in New York here in China rather and we doctor a telemedicine effort ping on is doing they have a investment called good doctor. And so this idea of telemedicine that's been coming around is a way to sort of get around that challenge that you mentioned right at the outset, which is the doctor is right in the middle and you've got to connect When is that going to start to become a reality for people? Well, I was actually with a doctor in Hangzhou the other week at the International TCM conference, and I think he's gonna to start to see happening now. Yeah. And I think with the AI. And I thought Amy's point was very good. Whenever I say I people think you're gonna replace doctors. Well I use the spelling checker. When I'm writing a Word document, the spelling check, it doesn't replace me. You're also married to a doctor. So that is Yeah, well, that's a whole other story. Yeah. It's something to help the doctors and move the doctors along, and I think the lady's question that was very interesting. We're looking now at getting AI to manage diabetes and we think we can manage it In the way that a doctor will just stop you becoming diabetic. Right. Prevention. And I think you're gonna start to see over the next two years. Okay, we're gonna have to leave it there, thank my guest very much. That was a terrific conversation. [ APPLAUSE ] [ MUSIC ] [ BLANK_AUDIO ]

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