Sundeep Bhan always knew he’d be around medicine. After all, there a lot of doctors in his family and he went into pre-med himself. But the CEO of Prognos, a healthcare AI company, figured he’d have a bigger impact if he got into the business and technology side of healthcare, rather than donning a stethoscope.
Thus one year out of college, Bhan founded Obelisk Interactive, which offered multimedia medical education software on CDROMs. Later, he founded and ran Medsite, also in the medical education space, which ended up getting bought by WedMD in 2006. A few years after that, Bhan and his cousin Jason (a family medicine physician), founded Medivo, later changing the name to Prognos, which leverages AI in an attempt to predict disease at its earlier stages.
The company works with pharma companies and health plans, which use insights that Prognos gleans around disease risk factors, both at an individual and a population level. For pharma companies, Prognos will help them identify useful therapies that will help a certain patient population. For health plans, it will identify patients that are at risk for complex (and costly) diseases.
Bhan recently spoke with Chief Executive about the big tech disruptors in healthcare, challenges he faces on a day-to-day basis, and more. Below are excerpts from the interview.
Why focus on the predictive side of health?
It’s from different perspectives. One is from the patient perspective. Healthcare is something that all of us, directly or indirectly, have been impacted by. Everybody, in their own personal journey, there’s something happens along the way or a loved one gets sick. And every time, if you think about like cancer as a disease, the worst outcomes are always when people say, “Oh they found out and it was too late by the time they found out.”
I think that we know the earlier you know what’s going on, the better your chances of us having a better outcome are, right? From that sort of patient and people perspective, it’s almost like, “Hey, if we could help understand what’s going on with somebody earlier, it would lead to a better outcome.” And then, how early can you go? Can you go as early as being able to predict who could be at high risk for something? And imagine if you know then, that could give you the best chance for having a great outcome.
From the other side of having been in the industry, and when you talk about what are the biggest issues with the healthcare system, it’s that the costs keep rising and the outcomes are not getting any better. So, even as an industry, when we’re making decisions, what do we base that information on? Most of that information is really the big data sets that are out there around medical billings and claims information and medication history. And the problem with that is that those are great for trying to understand what’s happened in the past, but by their nature, they are after the fact. So, you’re looking back at what’s already happened.
If could then work with a data set that can help inform what’s going on earlier, it would lead to better decisions. So, if you’re going to figure out, what drug will work the best on somebody, well it’s better to figure that out before that drug is prescribed.
There’s been a lot of disruption in healthcare from some of the big tech companies, Amazon, Apple, etc., etc. Why do you think that is? And is that a good trend or a bad trend?
I think it’s great and I think it’s about time because healthcare has been limited in how technology has been utilized. When we look at other areas of our lives, you can get recommendations on an e-commerce site based on not only yours, but other people’s buying behavior. And if you can have a great sort of customer service experience, you expect that in all other parts of your life, right? You want the same things from your bank and you should want the same thing from your doctor and your hospital.
Healthcare is very different. It’s highly regulated. You’re dealing with people’s lives. So, you know, obviously there’s more scrutiny around what you can and cannot do. And understandably because, you know, the safety risk, it’s very different. Getting the wrong shipment to your house, if it’s a book or something, while you may not feel great about it, that’s not a matter of life and death vs. getting the wrong medication. So, I think if you think about it, yes, so the bar is higher and regulations are there to make sure that people are safe.
But that does create sort of barriers in the adoption of innovation in healthcare. Once you get through all that, there’s tremendous opportunity because it is the largest segment of our economy and just the largest industry. So I think the big tech companies are looking at where they’ve had success and how they can bring that to the healthcare market. I think they’re looking at how innovation can help sort of scale things in healthcare.
So a lot of what you see is really around like cloud computing and user experience. That’s kind of where most of the noise has been so far. But I also think that they can underestimate the complexity of the healthcare system. So I think their learning curve is really trying to understand how healthcare works. And it’s not like you throw an app out there and you’re going to get all this immediate adoption. If you’re dealing with, like, healthcare organizations, it’s cumbersome, it takes time, the sales cycles are really long. It takes 12 to 18 months to sign a client because you have to go through privacy, HIPAA, security audits, all that stuff. You can shorten this period of time by sending out HIPAA compliant faxes. But having said that, there is a lot of opportunity.
What are some of the big challenges that Prognos and others in this space are facing?
Regulation is definitely one. So, I think we can move a lot faster. The technologies and probably adoption could happen a lot faster but we have to work within the regulatory environment. And as I said before, it’s there for a good reason because it’s to make sure that from a safety perspective, that’s why they’re there. But some of these regulations need to be updated because the world’s changing at a faster and faster pace and I think they need to be updated and more current to where we are today. So, that’s one challenge.
I think the other big challenge is that most of the healthcare workforce, you know, most doctors that are practicing today were trained like 20 years ago. And there’s so much innovation. There are new diagnostic tests coming out, like, every week. And how do you sort of educate the healthcare workforce on the latest technologies that can help patients today? The adoption becomes really slow because you have to re-educate the current workforce to know about sort of how new innovations can really help patients. So, I think that’s kind of another challenge.
The third is just the amount of information, the amount of data in healthcare coming from everything from like finances and transactions, the amount of clinical information with all these genomics and proteomics, and then all the user-generated data and there’s like social and economic data, you know, we’re starting to link all that together to get a better understanding of what’s happening. But just that amount of data is increasing very quickly. And then to be able to link all of that in like a way where there’s privacy protection and all that. And then normalizing and harmonizing all that data so it can talk to each other. Those are another sort of set of challenges.
My last question for you, Sundeep, is what advice do you have to CEOs in healthcare?
The first thing I would say is that it’s a very exciting time to be in healthcare, right? So, like, I think having been in this sector for 20 years…there’s lots of opportunity. So I think, I would say for new companies and innovators, it’s a very exciting time. My advice to the innovators is you have to be patient, things do take longer, plan for everything taking twice as long as you think it’s going to take because it’s healthcare. And like we said, regulations and all that stuff, it takes longer. And so plan for that.
And then for the companies that have been in the market for a long time, I would say that look, there’s going to be a lot of change coming. And I think, be open to the change and the innovation and embrace it because we’re going to see a lot of disruption in the next 5 to 10 years.