The 21st century presents a seismic opportunity for leapfrog innovation in healthcare.
Care systems are becoming increasingly consumer-driven, which brings with it – if not begs – an urgency for change.
This is underscored by the rapidly accelerating rate at which private and venture money pours into health innovation.
Great opportunity and great risk come with this unprecedented time in health innovation.
It is a delicate balance that Dr. Bill Carson knows well.
The former CEO of Otsuka Pharmaceutical Development & Commercialization, Inc. (OPDC), Carson is a healthcare visionary who has devoted his life to studying and designing health solutions that are patient-first, specifically in mental healthcare.
He is a pharmaceutical leader, data and technology innovator, and also a board-certified psychiatrist who has led a world-leading R&D organization that produced blockbuster drugs like Abilify.
In an exclusive interview, Hurdle Health sat down with Carson to unpack the metanarratives at work in America’s healthcare system, and glean insights into how digital health solutions like Hurdle’s teletherapy can narrow health equity gaps.
Carson: There is a saying that many have put their personal spin on. It essentially says, “We are using 21st-century solutions, for 20th-century problems, in 19th-century institutions.” Machine learning, AI, and other 21st-century solutions are in our hands. They have the capability of solving social problems that are hundreds of years old. But our institutions and systems seem to have been cemented in the 19th century. We need to break the mold. Many of the health equity problems we face need to be addressed differently if our 21st-century technology is to 1) bear relevance, and 2) have a positive, sustainable impact on health outcomes. We must be willing to ask, “Can those who would benefit most from my solution access it? And if not, what is needed to ensure they will be able to utilize my 21st-century solution?”
There is an erroneous tendency to let the numeric definitions of diversity convince us that we are addressing the fallouts of systemic racism in our institutions. When really, we’re just enumerating. Meaning, that diversity is often boiled down to a headcount, a census. “This number of these people have this disorder.” Or, “this number of this group of people gets these treatments.” The statistics are a starting point. It’s the questions we ask pursuant to the numeric data that inform real change and the pursuit of health equity.
In the late 80s, when I was a resident of psychiatry, I published my first clinical paper. It was on the overuse of electroconvulsive therapy (ECT) amongst Black patients. It wasn’t the first time the overuse had been scientifically noted. In my paper, I enumerated. I offered a count and a numeric comparison to draw attention to the overuse of the controversial treatment. I hoped that the data would elevate the deeper, unspoken question of why Black people’s pain – whether physical or emotional – is perceived differently than the mainstream. But, I was not explicit, even if the data was.
We must add a comma and question after the data. As in, “Comma, now what?” Or “comma why?” In truth, many questions should follow any data that reveal health inequities across racial lines. If we aren’t asking how or why then we are simply enumerating rather than problem-solving. We run the risk of perpetuating universal health solutions that don’t work for everyone.
Industry leaders in health innovation must, first and foremost, remain patient-centric.
Pulling from my own experience, fundamentally, everything I’ve done has been to help the patient. When I built an R & D organization to conduct the trials for Abilify, I did so to meet the patient demand, in particular, to meet the FDA pediatric request for the drug. It returned significant revenue to the enterprise by extending the patent by six months. The money gleaned from this was an indicator of the need, not a ploy for financial gain. For those who stand at the intersection of healthcare and venture, my challenge to them would be to remain accountable to the patient. There is a tendency in this space to start innovation with ‘How do I make the most money?” If this is your first question, then you do not have patient wellbeing at the core of your work.
Shaping the Future of the Fourth Industrial Revolution: A Guide to Building A Better World, by World Economic Forum Founder and Executive Chairman Klaus Schwab. In it, he argues that we hold the power of design in our hands, and with it, the responsibility – as individuals, businesses, and institutions – to design compassionately. If we want to live in a future that is ethical, inclusive, sustainable, and prosperous, then we must design it that way from the beginning. If we want to stop hate speech on platforms then we should build it into the platforms.
Things should be done by design, not by default. That is the informative principle of this mindset. Design and innovate to help people.