"Big Data, AI, Deep Medicine, DTx – Are data taking over and do humans take benefits?" - Part 2 of a panel discussion at Data Natives 2019

Part 2: Big Data & Commercialization

Panelists: Roman Rittweger (CEO at ottonova health insurance), Carina Walter (Data Scientist at Boehringer Ingelheim Pharma), Nicole Büttner (CEO and Co-Founder at MerantixLabs) Moderator: Thilo K?lzer, CEO at antwerpes & COO at DocCheck

Thilo Koelzer (TK): That’s a good point. But lets say data and digitization promise to automate diagnosis, and make it easier and automate care. And at first glance it seems to be obvious to replace humanity by technology. But what do you think when it comes to concrete patient care and the last mile, meaning it the talk between physician and patient, meaning the human interaction in the end. Should that remain analogue or do you see a chance to digitize it? How important is the human touch in the end?

"How important is the human touch?"

Thilo K?lzer

Carina Walter (CW): I think the personal interaction in patient care is necessary and even in times of digitization; it always has to be there. However, you can use all the data and the digital transformation in a first step, to be able to generate a more precise and holistic picture of patients. Based on the complete information, the physician is able to support and accompany patients in a more targeted way, considering all patient needs. Because of the entire digitalized world and all the data which is available you can get an insightful picture of disease patterns and a more focussed view on what patients need. In my opinion, the physical interaction has to be there, but using all the data and analysis, we are able to support HCPs to treat patients more precisely and on an individual basis.

TK: What does a pharmaceutical company like Boehringer (BI) do to empower the physician to get these concrete data and to get the big picture to handle a patient?

CW: We at BI try to support HCPs in getting precise and accurate information about disease patterns, he or she actually is interested in, without losing valuable time by searching through lots of websites. The benefit is: HCPs have more time for treating patients and they get more relevant information faster.

"We at Boehringer try to get precise and accurate information about disease patterns and support HCPs."

Carina Walter

 TK: So your aim is to empower HCPs to work with you therapies.

 CW: Yes, that’s right.

TK: Nicole, at Merantix you’ve developed an image recognition software called Vara which helps radiologists to diagnose breast cancer at a very early stage. What’s your promise regarding Vara?

Nicole Büttner (NB): One of the challenges is (luckily!) low incidence. Just to give you a few numbers on breast cancer: From one thousand women who go into breast cancer screening, under five per cent have to go to a second screening. And about six to seven are diagnosed with actual breast cancer. 20-30% of breast cancers are overlooked, so not diagnosed in either of those two screenings. That’s why the goal and the mission are to empower radiologists to help addressing this problem. And we think this is due to different facts. At times, physicians are under time pressure, given on average about 40-60 seconds per mammography case. Additionally, we know that some cancers are ‘occult’ and not even visible to the human eye at the time of screening. We believe the major challenge is the low incident setting though. The software product Vara that Merantix Healthcare has developed is basically a workflow automation tool for radiologists. It is a smart classification system that looks at mammograms and automatically classifies all the ones that are cancer free. The rationale is to really empower radiologists and the issue with low incidence of breast cancer is: When you don’t see things often, you often don’t see things, right? So Vara shows the radiologists substantially less cancer free mammograms, which increases relative incidence in the remaining mammograms. Currently, 40% of cases can be automatically classified with Vara in this way. Vara pre-fills the medical reports for those, which the radiologist only has to proofread and send off. That’s a huge time saving for the radiologist and he or she can focus on those cases where it might be more ambiguous. So that’s the promise. And we obviously hope that we will be able to increase this number successively over the next years.

TK: So for the moment, Vara focuses on breast cancer screenings. Do we have other indications in that area that could be interesting for Vara in the future?

NB: My understanding is that my colleagues at Merantix Healthcare want to master this task very well. From 40%, which already adds a lot of value, there is still room to improve. I think their first priority is to really deepen the performance on breast cancer cases. So, fully understanding breast cancer with different diagnostic tools, before moving to other medical imaging cases like chest- or head-CT-scans. But what the exact roadmap looks like is a question for Jonas Muff and his team. And remember, it’s only just been CE-certified which means it can only now commercialise this product and roll it out clinically.

TK: All right, so you’re certified and you’re already on the market with Vara?

NB: Now Vara can be commercialized, yes. The process of certification took one and a half years first for Merantix Healthcare to become a certified medical device manufacturer and then to certify the medical product.

TK: So Vara is a medical device. Roman, as you’re the CEO of ottonova, what’s your opinion about these digital medical devices, which have come up? It’s certified, so your members can use it.

Roman Rittweger (RR): I think we’re drilling the tunnel from two sides of the mountain. We’re coming from the payer side and we’re starting in the first step by giving our members digital access to specific knowledge to find out which kind of preventative care is the right thing for me right now. And when they go and have this preventative care we give them a checklist of things a physician should do. So basically we try to make it easier for the physician, so no extra work, but also make sure he does all the right things. And we also have a digital physician visit, so you can just video call from your phone and get a sick note. For instance, my son the other week got one so we didn’t have to go to the physician and sit in the waiting room. You know, all of our insured lives send their bills to us via their smartphone and we have the data right away. So in the long run, we’ll be able to see from the data that would be right for whom and what kind of measure. We could invite them to take digital visit of some kind and we could also pay for that. And we could have an additional payment if it works well and we see that the insured person is staying well afterwards. So we have the infrastructure and place for this but we’re just starting with baby steps on our side.

TK: So you’re ready to support doctors that use software tools like Vara or other apps for example, right?

"A normal health insurance has a problem: They do not know what the patient needs at what time."

Roman Rittweger

RR: Yes. We could even funnel patients to them. Usually that’s the problem that a normal health insurance has. They don’t know what the patient needs at what time. They just wait for the bills. But we have the data and we could actually send the messages and say, “You should be in line for this preventative treatment now and that’s how you can get it”.

NB: And I think, if I may just jump in here, this is fairly critical when we look at deploying these technologies in the healthcare sector. Because there will be some sort of tech-dividend or digital-dividend and sense of a benefit that’s created, right? I think we’re all working hard for this to be to the benefit of the physician who’s treating and the patient to have a better, more meaningful interaction and better quality of treatment. And of course, at the same time, we’re all looking at how high our healthcare expenses as economies are and can we help reduce them while improving quality of care. In my personal opinion those are two factors to weigh and I think for us, to be successful, and maybe potentially for all of you, we have to keep this balance in a good place so that the patients feel that this does not only cut costs for some hospital or insurance company, but also improves their health outcome and their healthcare.

RR: We always need a win-win-win. The patient needs to win, the physician needs to win and the health insurance needs to win because in the end, that’s what the patients will have to pay for in the future.

TK: So coming back to the data aggregation-part from the beginning. I think you as an insurance company are in a good position to be a dig data aggregator and to use this data for the members.

RR: We think that we’re the paying layer of the healthcare system. We pay for the party. We’re also getting most of the data, especially as a private health insurance because we get all the bills. It’s more difficult with GKV in Germany (statutory health insurance), so we are in a great position to do this. And we’re also acting in the interest of the patients. 

TK: Will you do this or are you already doing this?

RR: We’re setting the basis for this and we’re even selling part of our software to other health insurances so that will also be able to do that. We’re growing so fast that we can cover all of Germany in ten years.

---------- The third and final part of the panel is available here ----------

Part 1, "Introduction & Big Data", can be found here.

Btw.: Roman Rittweger will act as a keynote speaker at MESH, a one-day-conference on "Advanced Tech and Digital Transformation in Healthcare Marketing" on June 18th 2020 in Berlin. All speakers and tickets: https://mesh-camp.com/