Healthcare Innovation Clusters: Solving Healthcare’s Most Complex Challenges | LSI Europe '22

Transcription

Nadine Hachach-Haram  0:05  

Good morning, everyone. And I know this is just the probably last session before lunch. So everyone's really thinking about what to kind of have at the buffet. But I appreciate all of you that are in the room today. Appreciate all those that are also watching us online. I'm really delighted to be moderating this panel because I get to sit with some of my favorite people in the sector, who I'll get the pleasure of introducing in a minute. But what I hope today we'll be able to get out of this panel is really how we're looking at collaboration between health systems, physicians, early stage innovators, but also strategics and investors to really join forces to address some of our most complex challenges. We know healthcare is complex. We know this time and this reimagination is going to take every effort possible to succeed. And so today we're very fortunate to have Lawrence talent who stepped away from a very busy hospital in London. He's a Deputy Chief Exec of guidance in Thomas's hospital. Lawrence, if you want to come up a bit of background about Lawrence he was appointed as the deputy chief exec in March of 2020. As some of you know, guises and Thomas's is one of the largest if not the largest hospital trusts in the UK. And he's the SRO for the merger between guidance and Thomas's and the Royal Brompton Hospital in Harefield. This was completed successfully despite many challenges with the COVID 19 pandemic. Thanks to his efforts. He also holds board board responsibility for strategy, organizational change, communications improvements and innovation and established one of the leading centers really in the country that's called the Center for Innovation transformation and improvement. And as a board member of QHP ventures. This is the trust joint venture company that's really focusing on commercializing technological innovations across our sector. Prior to guidance in Thomas's he was the Director of Strategy and Planning and Performance at the University Hospitals, Birmingham NHS Trusts. And Lawrence has held a wide range of health care leadership roles both in the UK and abroad, working with the UK Department of Health, and the offices of both Secretary of State and the NHS chief exec and was previously Managing Director of the Shelford group, which is a conglomerate of some of the biggest trusts in the country. Thank you, Lawrence. I know it's very busy at the hospital this week. And you've made time to come all the way to the grove. So appreciate it. so honored to be here. Thanks, Dean. We're also very fortunate to have a good friend of mine, Chris Bishop, who's the Managing Director at General catalyst. I'm sure general catalyst isn't an unknown to many of you, you're all aware of it, but it is for those who don't know, a venture capital firm that partners with founders from seed stage all the way through growth stages and beyond to build companies that endure. He's based in London and Leeds, GCS Global Healthcare investment practice responsible for delivering on the promise of health assurance, the health industry's evolution from a sick care system, to a resilient and proactive health assurance system designed to help people stay well bend the cost curve, and make the quality care more affordable and accessible to all, which I know is something we all want to achieve. Prior TGC he was a senior investment director at Kinnevik. And also before that worked, leading head he was the head of European media and internet at Goldman Sachs. He's led many investments in category defining companies, many of which I'm sure you will be familiar with, such as a dark, a veto Babylon, devoted health Livongo sword health, just to name a few. And so it's a pleasure to have both of them here with us today. This is an unusual type of panel where you have a venture fund and a hospital institution, within the NHS sitting together to explore and talk about complex challenges in healthcare. So I hope you'll enjoy as much as I look forward to. So first of all, I thought we'd kick off by just asking you both. I wanted to ask you about your experience in innovating in healthcare. What have you found to be the biggest challenge? Maybe starting with you, Lawrence?

Lawrence Tallon  3:54  

Sure. Okay. Thanks again. So let me just start off with with I think why it's so important that we innovate fundamentally and at scale. And I'm going to particularly give some examples from the UK. But a lot of these are actually applicable across across many developed systems, which is that we face a very fundamental problem of sustainability in terms of providing high quality care to our populations. Largely because healthcare is consuming a growing proportion of national wealth. And I think in this country, we probably reached a point where the consensus is it's, it's, it's consuming the maximum that it can in terms of public funds GDP. And so we need to find ways to continue to innovate, to bring in new technologies, new ways of doing things to provide ever better, higher quality, more timely care, but without consuming an ever growing part of the National Pie. And most fundamentally, that means pivoting from a heavily people intensive industry to one that will always be Very much a people industry that will take far greater use of technology automation of both simple and complex tasks. And that's already now possible. But health systems in this country and other countries are quite conservative in their uptake of innovation generally and new technologies. And the the main barriers that we experienced our regulatory barriers are hyper, a hyper conservative approach, often to regulation. Now, it's absolutely right, we should have low risk tolerance for certain things we do in healthcare, first in man drug trials, for example, but many of the new technologies that when are now available to us, we can adopt a different level of risk appetite. Payment systems are often misaligned. organizational systems and structures are often misaligned. And I think there is a real short termism, often driven by political priorities. If we're going to innovate at scale, we need to be able to look much longer term. So I think those are some of the main barriers I see and barriers that we can overcome. But it will take long term partnerships with the type we're going to talk about today to do that.

Chris Bischoff  6:12  

Yeah, and add to that, that a lot of people come to healthcare thinking innovation will be like in other sectors, and that you can go built in technology in your garage and just put it out there and people will buy it. And so I think innovation requires entrepreneurs, and a lot of entrepreneurs in other sectors, our product and user experience lead, why innovation and health care needs to be also clinically led, there's the risk that you know, that Lauren's talked about, and so blending that risk appetite of conventional entrepreneurs, but that risk caution of clinical folks, and really focus on the patient is challenging. You know, certainly when we look at it, that's the reason why we're so encouraged about partnering with health systems to drive innovation, innovation in the wild rent work in healthcare, as it might in other industries, in terms of other areas of complexity that we see is the funding environment, not just from governments, but also from the traditional industries that fund innovation tends to be a 18 month runway to go fund a business and the deans are entrepreneurship. So she knows this all too well. And if you try to look at things from an 18 month perspective, it's very, very hard to build for the long term. And so any entrepreneur building a business always has that short term versus long term trade off. But I think that's particularly acute in healthcare, where the sales cycles are extremely long. And so you know, that that adds an additional degree of complexity.

Nadine Hachach-Haram  7:45  

I think and you know, from our perspective to the innovators in the room as well, I think it's encouraging to hear both from the institution that's trying to be more creative and more bold and saying there are certain things we need to be careful about, but there's certain areas where we can really just be a bit more bold and ambitious and kind of push the envelope a bit. But equally, you know, fun thinking about let's think beyond 18 months, because I agree with the sales cycles. And all those delays that we've been seeing now with the markets, the the incentives are not aligned, that it becomes very hard to sort of drive a business for scale. Of course, one of the exciting things I'm very encouraged about is an announcement today, that guidance and Thomas's and general catalysts are partnering. I don't want to steal your thunder, I'm sure there's there'll be it'll be in the press as well. But one of the key components that these two groups are coming together to really help evolve and accelerate the Innovation Cluster in London. I'd love to start with you, Chris, how do you see this partnership, helping or hopefully giving us a better chance of addressing some of the challenges, both for this population? Of course in London, but beyond as well.

Chris Bischoff  8:48  

Yeah, so first of all, we're delighted by the partnership. And

Nadine Hachach-Haram  8:51  

maybe you could give the audience a bit more detail about

Chris Bischoff  8:53  

the first such partnership we're making in Europe, with a health system. And obviously, when we thought about it, we've talked to a number of years leading European health systems and the chance to sit down and work with GSTT as they think about their future and transform their business at a strategic level was something that was deeply interesting to us. And we thought we could help obviously GST T is a leader in the UK, serving in in people largely in South London. And, you know, we hope a beachhead or a lighthouse for further work and partnerships that we see that could develop a period of time when we think about these partnerships. And we have a number in the US ranging from Intermountain a big integrated system that many of you may know two to three others that announced and and five more that are in the works. We think about can we add a take a long term perspective on working with them in what they need in terms of delivering change, and be that conduit to to sort of match the if you will of the incumbency, with the innovators without GST T will know better than any, any startup how to deliver care. But as we think about the new modalities of care, as we think about technology and how technology can drive transformation in bringing together the two sides, matching them in an appropriate way and funding them in which we can do, because ultimately we take risk capital, and and put it to work to, to fund new ideas. So we're terrifically excited by this. As I said, this is not our first partnership. So tstt doesn't need to be guinea pig here. It's working in the US. And we have a lot of learning, we already have a number of companies we built with health systems in the US where we've co identified problems. And we can talk about some of those problems, and then found solutions either to build together with them, or invest alongside them, to roll out to populations. And that negates one of the challenges that I mentioned earlier, which is this long sales cycle. And this short term funding horizon that a lot of startups have, if you actually have a system that knows what they want, and you have entrepreneurs prepared to build what the systems need, then everybody can take a little bit more risk in in building the solutions to serve the populations.

Lawrence Tallon  11:21  

Let me just echo Chris's comments as well. We are guidance. Thomas is very, very excited about this partnership, which is really novel and new for an NHS Trust, not not necessarily as novel and new as it is for Chris in the US. But it but this is really groundbreaking for us. We're delighted to partner with GC, it's reached its scale, its reputation, but also the the other partners that are in the health assurance program, this is a terrific network for us to join, we're very proud to have been invited. Seems to me that we don't have a problem with invention. In health innovation, we have a problem with adoption and scale. And one of the things that we believe we can bring to this partnership, that is a complementary capability to those that Chris and his his network have is the ability to be a translational testbed. So we've got loads of products out there and healthcare that can't get into deployment can't get into the market can't get into the public or private markets. Guys, as Thomas's, as the dean said, we are large scale, we provide pretty much the full span of health services to an incredibly diverse population, the dean and I often use the phrase that we have the world's population in South London, huge number of over 100 languages spoken huge number of ethnic groups, great socio economic diversity. So if you can make a product work in South London, there's a very good chance you can make it work anywhere in the world. And including in the, you know, very fast growing markets of Africa and Asia. What we don't have within the public sector in this country is the ability to take to that kind of risk capital. And actually, I hope no one in this room has had to be involved as I have with writing a business case in the National Health Service. And I would counsel you against it, if you if you can ever avoid as much as I love the NHS, there is a there is a mindset that that every pound or every dollar spent has to be accounted for 20 years out, and you'd have to be able to predict exactly what's gonna happen 20 years out. And innovation does not work like that, of course. So the ability to Team venture capital, with a real operational test, but I think is very exciting. But crucially for me, people often say to me, you know, what works in these kinds of industry, public partnerships, I think you've got to have a number of things. Number one, you've got to have shared strategic alignment, you got to be trying to create the right thing. And I talked about just very simply better, faster, fairer health care for our populations near and far. You can't have a transactional type relationship to these things, it's got to be built on partnership, because these things ebb and flow, you have peaks and troughs. And you've got to be in it for the long haul, which I think is crucial. And thirdly, and crucially, you got to have chemistry, you're at the leadership of the different organizations has got to want to work together and stick with it. And I think that's why I'm excited about this partnership, because because I think we have those crucial ingredients.

Nadine Hachach-Haram  14:18  

I mean, I think it's hugely exciting. Also with my entrepreneur hat on I mean, that's often been that kind of the missing of the trifecta, you know, you want to have the capital, you want to have the entrepreneurs that are willing to innovate and do those sort of hard miles to get their cup their solution into healthcare. But then you need to have that kind of health system that testbed the the scalable system that enables you to really test it because doing a pilot is one thing. And you can have you know, pilot itis or whatever other words people use, but being able to then translate that into a system that is treating 5 million patients that's got the diversity, the the operational friction, sometimes that can happen within those is really key. And so by bringing these three together, we hope we'll sort of Unlock and remove some of that friction and enable us to really co develop solutions that are going to address the fundamental challenges that we face day in day out in healthcare. So, it's exciting to see how this develops. And I'm sure we'll come back next year to LSI. And let them know how we've done if Scott will have us back next year. One thing I know, you know, I love to sort of get into some examples. And I think maybe Chris, it'd be really good to bring this to life to talk about some of the verticals where you see this cluster initially focusing, you know, we've talked about patient monitoring, remote care, ambulatory and maybe that you want might want to give us some examples from the states that have succeeded that you could imagine translating well here, or just for some of the discussions you've been having with GCT and the NHS? Absolutely.

Chris Bischoff  15:44  

Look locally, you can see that there's some issues around access to hospital care. And there's also been this development of virtual worlds, the UK has half the number of hospital beds per capita, to the OECD, and the quarter that of a country like Germany. So clearly, we have a shortage of beds. And as we all know, we have lots of patients that need care, right. So thinking through taking health care and making healthcare add any address, including your home, is a really interesting idea. Now it's really complex, right? And, and it could only ever be achieved in a partnership structure. It's not like a innovator consider standalone build that because the flow of the patient's needs to come primarily through the hospital son through the EDI, but also, you know, hopefully, in a future world, the preventative side, to stop them even getting close to the hospital, but you need software, you need clinical skills, you need customer service, you need logistics, these are very, very complex operational businesses, but could go hand in hand with, with the care delivered in the hospital. And so that's, I think, a really interesting opportunity. Again, it goes beyond technology, it's technology plus services. That's powerful. We certainly looked at CRM. And you know, there's obviously a number of solutions already in the UK. But in the US, I think a lot of hospital systems, increasingly getting compensated by CMS in terms of the NPS of the system. And you know, there's lots of pros to NPS, but it's actually a pretty interesting perspective, you know, what is the patient actually feel about the care they've been delivered? Aside from the clinical aspect of that. So how can we reimagine CRM, and take a lot of the burden of the minister Depart of CRM, away from the nurses and the like, so they can focus on the core clinical skills they were trained to deploy? So I think that's very interesting. On the you mentioned, AI, that's, you know, we're excited about the opportunity, both on the sort of back end infrastructure side, you know, we know there's just countless dollars, or pound sterling caught up in, in effectively billing, coding administrative layers, in hospitals, if we could cut that budget that nobody actually wants to do. That is inefficient, that that will create enormous opportunity, I think, for capital be redeployed elsewhere. But I think we're also interested on the clinical side, we've seen AI being used in computer vision, a lot in radiology, and, you know, a little bit in cardiology, but, you know, as we look at the future, there's a way to take that beyond those two other books that, you know, to put some pathologies that not really covered and also help hospital systems think around? Well, look, is there a kind of common enterprise level AI solution here, rather than a point solution for this a point solution for that a point solution for the other? And where, you know, given Ai? Am I sure about, you know, the data integrity, I'm unsure about the data, equity in terms of, you know, looking at people, you know, having a large enough sample set. So, you know, we're very excited around those two areas, or three areas, as an example. But, you know, frankly, we are most focused on delivering solutions that the systems need, we're not going to go build stuff that's just not needed. We have to help identify what are those strategic long term goals? And can we embed innovation to deliver them?

Lawrence Tallon  19:23  

Now, I mean, I agree with all that, Chris. And I mean, just just wondering about the sort of the human behavioral aspects of this. So one of the things that we've got in our organization, 25,000 people, the large majority of those are direct caregivers. They love this stuff, you know, that this actually is why they come to work, it excites them. Because actually, it's quite hard to be constantly doing the same thing day in day out and they they enjoy being involved in this sort of innovation. So one of the things that we've done with KHP ventures the commercial arm that we are that Dean introduced earlier, is that when we're evaluating a product when we're doing our clinical due diligence, we can just call up, you know, leading clinicians from any specialty. And this isn't a hassle for them, this is something they enjoy doing, you know, it's an added value part of working at an academic medical center as opposed to a more of a local hospital. So we've got huge expertise available to us. And the beauty of this partnership is we don't have to put in place an SLA to contract for that, that we just we just use our hospital network to do them. They can also help us identify the real pinch points. So as Chris said, not like other industries, where someone sits in a garage develops a perfect consumer product, but what's actually what are actually the pinch points in the health system. And very, very, largely, they are around increasingly sophisticated diagnostics. So in this country, we have about seven, nearly 7 million people waiting for hospital based care. That is obviously shot up during the pandemic. But actually the trend was growing for a while, a huge amount of that waiting is non value added waiting to get in for diagnostics. And of course, increasingly, the way many medicines practice, we're going up the diagnostic scale, increasingly, we're imaging in more sophisticated ways. That is exactly the kind of thing where AI has real world application actually now, but certainly in the coming years, if we could get over some of the institutional inertia and nervousness about adopting some of these products that are already in the market already validated. And, frankly, in in some cases are more accurate than humans. Now, you may not go the whole hog, and straightaway have a machine read your MRI image, but you may have a first reading and a final read by human rather than two reads at the moment, which is a huge backlog, it will not be long before we're doing that at scale. The other thing about these machines, the beauty of that much as we value our frontline workers, they, they can work all around the clock, they don't need to take a lunch break, they don't need to go on holiday. So actually, we can get through a huge amount more activity. Now I do not ever envisage in healthcare, a scenario where there isn't a huge important role for highly trained clinical professionals. So the example I give you is, you may have a machine read an MRI image, you do not want a machine to tell a person that they've been diagnosed with cancer that's got to be a human to human interaction. But it's that symbiotic relationship that we need to develop. But I see huge opportunities for us to provide better, faster, fairer health care within the near term. You know, I'm talking months and years, I'm not talking decades, if we can break through some of the barriers that we talked about in the in the first question.

Nadine Hachach-Haram  22:37  

I think it's critically important as well as we think about workforce challenges, the friction, the burden, you know, how do we start to lean into automation, RPA AI, all these different components that can just unlock some of that resource and to read diverted into places where it can be more patient focused, more patient centered, you know, as clinical teams, you know, we all know that we spent quite a bit of time doing that more administrative tasks where now we can really be shifting that time spinning it sitting with the patient, giving them the diagnosis, not rushing through that. So it's exciting to see that and I know at JCT, you know, there's a lot of enthusiasm both around rpa, but also around better understanding of federated datasets, and how do we use the very rich data sets that we have to look at that. So it's exciting to see how this develops. And I agree with you kind of months, months, years as opposed to decades. Chris, I wanted to ask, you know, for for here in the UK, this partnership is new, but you said DC has done many of these in the US? Would it be helpful, I think to the audience to give maybe some key insights from that work, you know, what approaches do you think will resonate within the UK context? I mean, some things are obviously translatable across the pond, but what learnings did you take from your work with Intermountain or Jefferson any of those other health systems that we can accelerate our learning through this partnership here in the UK?

Chris Bischoff  23:55  

Absolutely. So I think what Lauren's mentioned, was really deeply important, and alignment strategically about delivering a new type of health care over a period of time. Because that's important, if you don't have strategic alignment, no punishment is going to work to very senior level buy in. Because ultimately, you know, healthcare systems are hierarchical, and there's only a certain pot of time and money to be deployed. And so when we forge these partnerships, it really is when the buy in is there at a very, very senior level. That's where it's been most effective. Obviously, we need at various levels of the organization to execute. But you really need to have the C suite saying this is part of our journey. And we want to have and build a trusted relationship and so the genesis of these relationships is not in a transactional it's not like a pitch and then and then we go from there even in the case of GSTT I've known the D now for some time and got to know Lawrence over a period of time. So they do just eight, I think we have been most effective are where we can corral different parties to the table, the sort of honest broker, you know, the startups may come in with a perspective on what they want to achieve. The systems may have a different perspective on what they want to achieve. And they're talking past each other. And we can sit down and say, Guys, look, you know, there is a one plus one equals three here, if if we all work together, and I think that has been yet that's been enormously effective, where we've been able to achieve that, you know, going back to the point that we're trying to address is, we know, particularly as a result of the pandemic in the US, there's a proliferation of point solutions. The systems don't want a proliferation of point solutions. They're not effective, then are integrated, they're often not understood. So how do we move beyond that? And we can say, to these startups look, you know, actually, let's think really consciously about who is your customer here? And can we build together for that, and we've been able to start businesses from scratch around areas like CRM, which I mentioned, also hospital at home. We've done a lot around workforce transformation. And we're doing some interesting stuff around, you know, data and personalized data and having this federation of healthcare systems together means that we can, we can share learning. So, Lawrence was mentioning earlier that one of the things he appreciated about this partnership is like, he can learn from others. Yes, the UK is different from the US or another market, but you know, the common that the, the problems are common, how it gets local in so the the regulatory may be different, be able to lean on seller, what works for you, in your system? And how can we move our system forward? And I know, we may disparate some times the UK health system, but actually the US looks to the UK as an innovator in many respects. Right, and certainly a testbed for great, great product, and advancements. So I think those are a couple of things that are really important. But like any partnership, it's not one and done, when you announce it, it's all about working together over a long period of time through the ebbs, you know that the peaks and troughs that Lauren's mentioned, to deliver a common goal, and what we're focused on is how do we ultimately measure this, right? Because one of the things in healthcare, sometimes criticize around innovation is like, is this truly lowering cost? Are you adding incremental spend on top of the existing and folks like, Lawrence have to sort of fly the existing plane and build the new plane at the same time, and that's obviously really, really tricky and costly. So you know, with we're going to work with the system partners to sort of really try and identify impact from a cost perspective, for quality perspective, and then a customer experience perspective.

Nadine Hachach-Haram  27:56  

Takes me on to my next question, I guess, to Lauren, see, as you know, there's a lot of innovators and inventors in the room and kind of watching online. Over the next few days, many of them will be pitching their projects and initiatives here as well. As an NHS clinician, entrepreneur, myself, I know the excitement of kind of setting up a healthcare company, you know, seeing a problem and trying to solve it creating and deploying a solution. But also the frustrations and barriers that can happen when you're trying to deploy within a backhaul system. You're obviously taking steps within the organization to fix that with city with all the kind of cultural shift and behavior change that you describe. But I would ask how do you think this kind of cluster this relationship as well, but also some of the work you're doing internally, will help encourage more clinicians and more innovators to to bear fruit and come forward with their ideas? As they're seeing those challenges firsthand, you kind of talked about early, it's got to be clinically led. How do you even What's your kind of outlook Now given this partnership and also what you're doing internally?

Lawrence Tallon  28:54  

Yeah, so I think healthcare is a very interesting industry. I'm not necessarily saying it's unique, but it's, it's interesting in the sense that we have some of our smartest, most dynamic, sometimes our earlier stage career people right on the shop floor on the front line of healthcare. And then the sort of people who occupied the stodgy people occupy the boardroom like me, but the real the real brains are out there, on the on the shop floor with the patients. And I talk to a lot of people, you know, not everyone's quite like Nadine, but some sort of mini versions of Nadine, let me say we've got some fantastic people in our organization, real innovators, but the way I would summarize it is it feels to people like in order to innovate within a public health system, you often feel like you're swimming against the organizational tide. Having to carve out time often working in your own time, not paid time. There's some times in public systems a bit of a suspicion of enterprise and commerce vary, as I've told About very risk averse approaches to change and regulation without looking at the counter balancing risk of inaction. And so our ambition in the Center for Innovation transformation improvement that we've established within geysers and Thomas's is to really turn that tide around and really support our innovators, to get their their to get their ideas delivered, you know, implemented in practice. And then once a proven concept once there's potentially a commercially viable product, we then have our now our new commercial arm, our venture, arm QHP ventures, which Nadine leads that can take them through to the full commercial cycle. So this is quite a novel approach. Now, I should just clarify in case I've given the wrong impression, I am an absolute committed fan of the National Health Service, I've had a lot of my career in it, and I remain committed to it. But I think it's important in any industry that you hold the mirror up, and you look at where you need to improve. And there's no doubt in my mind that if we want to regenerate taxpayer funded health service in this country, to still be the leading edge of health care provision, for the next generation and generations, which I'm absolutely committed to doing, we need to take these bosses we need to innovate, we cannot ossify and so what I my ambition for our organization is to really be the place that that people say when they're coming out of medical training or surgical training, as Nadine did, you want to innovate goats guys and samosas that's the place to go. And by the way, they're part of a international health assurance network led by GC, and you know, really get that buzz going. I don't think we've quite got that yet. But that's the ambition. That's where we want to get to,

Nadine Hachach-Haram  31:38  

I think, as a clinical teams want to see because, you know, we are all, as you said, incredibly passionate about the NHS, we love what it stands for, we love this idea of, you know, care at, you know, that kind of free care, which you don't really see in other parts of it. It's it's a real, it's a jewel in our sort of crown, the NHS, but we need to make sure that we're building the right environment that encourages the right behaviors, retains great people ideas enables them to flourish. And I'm very optimistic that these kinds of partnerships and the work that you're doing Lawrence at JCT with Citi and others, are those paths are gonna help us get there? Have a couple more questions, I've only got about five minutes left. So I'll be one will be really quick. And then a more broader one is, I want to talk about data, because that's always kind of like the elephant in the room. People want to talk about data, they want to talk about data and often unlocks a can of worms. It's always misrepresented. It can be misrepresented in the press. And so perhaps, you know, Lauren's first and then Chris, I'd love your perspective. You know, what do you see the role of data playing within this reimagining? And this future innovation, healthcare? And what should be the message that we should be putting out both to the public and to anyone here in the room today?

Lawrence Tallon  32:46  

Yeah, sure. So I think if we look at some of the innovations that have happened in healthcare, they often get so fine, and they fall into a big pet, often because of errors in how things are done. So I am absolutely clear that we have a fundamental responsibility as a hospital, to protect the confidentiality of our patient data security of our patient data, and for it only to be used for those purposes that patients have consented for. That said, we hear a lot from a very vocal, but very small minority of people who are very much against the use of data for not necessarily research. But for commercially based research. What we don't hear about is from the much larger, silent majority, who actually say to us all the time, the opposite problem, which is, why am I having to tell my story again, why am I having to input this data again? Don't you people speak to each other? Don't you use the data. So actually, you know, the expectations of vast majority of the public is that we are doing much more to maximize the potential of the huge datasets we've got not only for their individual care, but for the collective good of a search and an enterprise. So actually, we have to be mindful of that small minority. I'm not in any way doing that down, we have to be careful of our responsibilities. But there is a much broader push. And we see it, you know, we see it in so many other things, you know, how many times you look at your webmail and you'd mentioned something about washing machine and there's an advert for washing machine. And you know, that's just part of life, you know, you know why that's wash machines come up. Now, healthcare is a bit different, you know, people are sensitive about aspects of the data. But But I guess in my imagination in the future, you would have a system like you have with your social media, where you can check the boxes and control your settings about who you want to share your data with which updates live to, to either cloud storage or wherever the, the secure data environment is. And you can control how your data is used. And you can lock it off to certain things. And I guarantee if we could get to that place securely, the vast majority of patients actually are quite open to their data being used on anonymized basis for the search for enterprise as well as obviously for health planning and so on.

Chris Bischoff  34:57  

And I think it's one of the great advantages of the NHS. versus they do have lists longitudinal data, right. But there's trillions of gigabytes of data too locked, because people are worried about patient safety. It's trapped in systems that can't talk to each other. And so if we can find a way using the latest technologies, you mentioned federated learning multi sites, where data is not held on site by an intermediary, it's shared, but it's de identified. And there's no risk of transfer of that personal information. I think it can, can do wonders, right? Because we're so early in really the use of data. In healthcare, again, back to the UK, we have better data. In the US it's deeply fragmented. That data and you know, CMS has got 2000 people, there's no way they can, you know, assess all that data on their own, right. But in the UK, you know, we have this most centralized system that is a common public system. So I really do think if we're going to play to our strengths, we got to use them.

Nadine Hachach-Haram  35:59  

I would agree and and just highlight that one of the great things I've seen happen at JCT more recently is just a whole revamping of the data policy, how do we become easier to work with? How do we create sandbox sort of anonymized data sets to give access to smaller companies to test but their technologies in a safe environment, with data being pulled from multiple sensors in a way that really helps these technologies either succeed and hopefully succeed and scale or fail quickly if it's not going to work, but try and figure that out earlier, rather than sort of five years into the journey because you're going around the house is trying to collect bits and bits of data.

Chris Bischoff  36:33  

Right, and then just may just pause GSTT has is very diverse population, some of the biases that you find sometimes finding data in a GSTT can be really interesting in terms of saying, Well look, you know, we are actually covering a huge spectrum of people. And so when identifying, you know, solutions that only fit a very small subset of the population.

Lawrence Tallon  36:50  

That's such an important thing. You know, there are so many products now devices, algorithms, where we now can identify known bias. And actually, if we're going to eliminate that bias for our own populations, but also to scale in the very large emerging markets in Africa and Asia, we need to be able to develop products that are viable and tested on those kinds of populations. And we have that opportunity, this world's population in South London that I like to talk about.

Nadine Hachach-Haram  37:19  

Final I mean, I joined this too much. But final question to both as we have, and then I'll offer to final comments. We've got, obviously industry in the audience today and across the sort of the session. We've got SMEs, we've got investors, we've got all you know, people from all walks of life across health tech, how can you see relationships with Mehta companies, big and small, best interacting with the NHS? And how central is that to the collaboration into the future success of the NHS?

Lawrence Tallon  37:48  

Yeah, so I mean, if I kind of refer back to what I said, at the start, it's pretty clear that the way that the health service is going in this country, we're at something of a inflection point, unless we are able to innovate at scale, we are frankly, running out of people to provide health care in the way we're doing it at the moment. And we see waiting times increasing, we see patient and public satisfaction dropping, dropping quite fast. So we have an absolute imperative to innovate to design, redesign the ways in which we deliver healthcare fit for the mid 21st century. And we can only do that by working with industry. And the kind of principles I talked about earlier for industry partnerships have of strategic alignment trust, you know, there are some that are transactional, but actually the deeper strategic partnership is going to deliver long term gain rather than points solutions are likely to be longer term, not transactional arrangements. So I think I guess what I would like says, as an organization, we want to be very much open to working with industry, particularly through our venture arm, Kings Health Partners ventures, wish you can contact the dean and she'll give you all the details. And we see ourselves as a, we want to become a really good portal into this translational testbed that we have for operational services for a data environment in the National Health Service.

Nadine Hachach-Haram  39:12  

Thank you. Any final comments from both of you? I know we've we've come to time, but 

Chris Bischoff  39:16  

Well, thank you, first of all, for hosting us. It's a pleasure to be here.

Nadine Hachach-Haram  39:20  

Yeah. Thank you both for coming. Thank you. We'll come back next year and you can update us on this partnership. Thank you. Thank you.