HealthXL’s Martin Kelly: We Care A Lot

HealthXL CEO Martin Kelly talks to Dublin Commissioner for Startups Niamh Bushnell. The Big Read, sponsored by Vodafone.

Founded in Dublin, HealthXL connects digital health entrepreneurs and growth-stage companies with some of the largest corporations in healthcare, to create effective business partnerships. Their corporate partners include IBM, GSK, Novartis, Cleveland Clinic, Silicon Valley Bank, Janssen Healthcare Innovation, Bupa, ICON PLC, Linde Health, Partners HealthCare and ResMed. Earlier this year, their HealthXL Global Gathering saw more than 200 individuals from 17 countries come to Dublin to discuss challenges facing healthcare, and how technology can help to overcome them.

Tell me how HealthXL began…
We’re a spin-out from IBM Ventures. I was a partner there for many years. We started life as an accelerator program because we saw a great opportunity in healthcare for digital technology. We brought companies from all around the world to Dublin, and through that process we learned a lot. We also spotted that there was a much bigger opportunity, to work not only with startups, but with companies that were scaling, and corporate sponsors, bringing them together. Fast forward to today, and HealthXL now has 17 members. There are big pharmaceutical companies like Johnson & Johnson and Novartis, big healthcare systems like Cleveland Clinic and Apollo, the biggest private hospital network in India, plus insurers like Bupa… We’ve got some of the best brands in the world.

How responsive is the healthcare industry when it comes to adopting digital technology?
If you look at how it’s changed other industries, it’s been really slow in healthcare. If you look at all the problems we have, the idea is ‘How do you get the complete ecosystem to focus around particular problems?’ Not starting with technology, but starting with the problems, and then figuring out how we can apply tech-driven solutions. We do this in a couple of different ways.

One of the things you’ve done is create a custom-built platform for your members…
Exactly. Our members tell us what they’re interested in, and then we match them up with other members. The platform is sort of like a dating site between all these individuals. Bupa, for example, will have their top three interests at an institutional level, but then the individuals within Bupa will have different interests of their own, maybe they align, or maybe not. We help them to find each other, and then find advisors, by which we mean investors, clinicians, serial entrepreneurs and subject matter experts. How can you bring together this very broad local ecosystem around topics that people care about? That’s what we do with our platform.

The second thing we do is host quarterly invite-only events, for roughly 100 people, a mix of members, advisors, and companies, focused around specific topics. We just had one in Munich a couple of weeks ago, for example, where we covered aging. Before that, we covered chronic disease management. These are topics that are really important for our members, and we’re looking at how technologies can impact them.

Then there are what HealthXL refer to as ‘challenges’.
That’s the third thing we do. Take this topic of aging, a very big problem, how do you break it into something tangible? We worked with IBM and an organization called Northern Health in Australia, with their Chief Medical Officer and his team of geriatricians, and looked at the types of problems that they were facing on a day-to-day basis. We broke it into three areas: dementia, social isolation, and malnutrition. Within that, we tried to address a specific problem: with dementia, for example, a lot of patients that the hospital would see would sometimes get into a distressed state. So how do you help them regain their composure? One of the proven ways clinically is to show them some images of their past, or play some music, triggers that help them just to calm down.

The big problem was: how do you create something that a senior would want to use that could help trigger some happier memories when they’re in the distressed state? We invited people to come along over a weekend to prototype, brought together a bunch of seniors, the clinical teams, the insurers, designers, developers, the whole ecosystem. They spent the weekend together looking at these problems trying to figure is a solution already there, or do we need to build something from scratch? That was during the summer, and now we’re bringing everybody back together, and we check point. We’re trying to create a continuity, here, not just one-offs.

How important is it that you’re doing all this out of Ireland?
We think Ireland has huge potential, and is only scratching the surface. We have all the big pharma companies here, all the tech companies, and the MedTech companies. We also have a public and a private healthcare system, and the border with Northern Ireland in terms of access to the NHS (UK National Health Service). However, if you look at digital health, it’s all happening in the US. These problems are really global, but nobody’s grabbing that space internationally. I think Ireland has a real opportunity but hasn’t started to grab it yet. We are really keen to try and find more local partners, especially health systems and insurers, because we think this is a great testbed.

Never start with the money. We’ve bootstrapped HealthXL. We think customers are the best form of investment.

Do you think there’s still an opportunity for many more insurers and health care systems in Ireland to engage?
Absolutely. And that’s a critical point, because at the end of the day somebody has to pay for it. A lot of these technologies can improve care, but a lot of them can also keep care at the same level but reduce the cost, which is important for everybody as well. It’s important for us to try and figure out whether it’s the HSE (Irish Health Service Executive) or whether it’s private insurers. How do we include them? The only way we’re going to innovate is by bringing these different groups together. You can’t innovate in isolation. It has to be a really broad group involved. What is exciting about this is that these problems are global. If you look at the pressures that most healthcare systems are under, there’s a lot of commonality.

We’ve already seen some great companies out of Ireland. We’ve invested in some of them, like Nutritics, nutrition is a really interesting space right now. Something we hope to see is more companies started by people coming out of multinationals who feel really passionate about healthcare, and want to apply their technical skills into that area. Right now, we’re trying to show entrepreneurs that there’s a really interesting business model there.

What advice do you have for startups in terms of getting investment?
I always advise people to go looking for advice and the investment will come, rather than the reverse. You never start with the money. We’ve bootstrapped HealthXL. We think customers are the best form of investment. That’s not always possible, but I encourage people to look at that model as well as venture capital. There is a definite shortage of investment across Europe in this area. My advice would be to focus on finding your customers. If you find customers and figure out who’s going to pay for it, then your funding will come. Probably the biggest thing is working at your business model. Even a lot of our members who are big pharma companies, they can see the societal value but there’s always the challenge of who’s going to pay for it.

What’s the best approach for a digital health startup to find partners?
I think the best approach is to find either the patient or clinician directly yourself and not to go to the industry partners, whether they’re pharma, or tech, or MedTech. The great entrepreneurs go straight to the source, build a relationship, and that’s where you get your strength from. Finding those open minded, passionate clinical leaders and patients, that’s the way forward. In many cases, entrepreneurs are the ones who have a personal medical condition themselves, or someone in their family. That’s what motivates them. And the clinicians are the people supporting them through that. They’re the ones who will say, ‘Clinically this works’, and then the third leg of that stool is then the insurer who’s going to say, ‘Economically this makes sense’. If you get those things, the investors and the industry partners will follow you. You’ve got leverage because you have control. You have the insight.

What are the big trends in terms of tech and healthcare that most excite you? The ones that startups should be jumping on?
Like in every industry, big data is huge. Getting actual insights. Then there’s what we call ‘connected health’. That’s everything from mobile devices to sensors to the internet. Also, there’s what we call ‘behaviour change’. That’s the idea of how to empower people and communities where they can regain responsibility for their health, to be proactive, and help look at things like medicine adherence, which is a huge issue, understanding why people who have illnesses in many cases don’t take their medicines, either because the whole system’s been very badly designed or they don’t understand the need to continue.

What needs to happen for the system here to be great?
I think if you look at where we’ve had success it’s where we’ve had engaged, passionate leaders who have some flexibility to work on things beyond just the day-to-day activities and are willing to look at things in new ways. We really believe in the power of that. If you get people together who really care about something, then great things will happen.