Validating Digital Health: Interview with Deborah Kilpatrick, PhD

By Neil Rens

Dr. Kilpatrick is the Chief Executive Officer of Evidation Health, a new company that is focused on demonstrating value in digital health. Among her many accolades, Dr. Kilpatrick was named one of the �100 Women of Influence in Silicon Valley� by the Silicon Valley Business Journal and one of the �Top Women in Biotech� by FierceBiotech. Co-founder of the MedtechVision Conference held annually in Silicon Valley, she also serves on the Georgia Tech Advisory Board and is a Fellow of the American Institute of Medical and Biological Engineering.

After earning BS, MS, and PhD degrees in mechanical engineering with a bioengineering focus at Georgia Tech, she worked in biomechanics at Exponent, Inc. Later, Dr. Kilpatrick held roles as Research Fellow, Director of R&D, and Director of New Ventures at Guidant in the Vascular Intervention Division. More recently, she served as the Chief Commercial Officer of genomic diagnostics company CardioDx.


Can you briefly explain to our readers what �Digital Health� is? Why is it important?

Most definitions I hear of Digital Health reference the confluence of digital technologies and the transformation of our health care system. A simple example of digital health that everyone recognizes is using the web or a smart phone to deliver virtual physician visits. Other examples of digital health are enterprise platforms that coordinate complex patient care, sensors that monitor risk of in-hospital complications like pressure sores, or smartphone-based apps for coaching patients through chronic disease management. A few years from now we won�t refer to �digital health,� we�ll just be referring to health care again�i.e., as Rowan Chapman at GE Ventures says, no one refers to digital music or digital banking anymore. It�s just music and banking.

I do think the importance of what is happening in digital health today cannot be overstated. Aside from the reality that healthcare delivery is morphing right in front of us (and not just in the U.S.), the financial impact of this sector on new company creation is pretty amazing. Over $4B was invested last year alone and at the current investment rate the number looks to be significantly more this year in the U.S.


What do you think healthcare will look like ten years from now?

I think there are some pretty fundamental things that have changed already, and those trajectories will continue. But I think some of the most interesting changes will relate to how patient behavioral insights will impact development and commercialization of new diagnostics and therapeutics. Because of the ubiquity of digital technologies in all our lives, we have insight into patient behavior outside of the walls of a hospital or clinic. For example, suppose a new biotech injectable was known to have disproportionate clinical and/or economic benefit in a given subset of its on-label population�but that you needed both traditional biomarkers and digital biomarkers to identify those patients. You can start to imagine how our historical approach to new drug development will change substantially.


Where does Evidation Health fit into the picture?

Our business and our expertise sits squarely at the intersection of digital health solutions and the demonstration of health outcomes. To me, �digital health solutions� can be interventions themselves, but they can also refer to digital tools that identify the right patient and the right time for a given traditional intervention like a pill or a device. This can enable precision medicine. But the key is that those solutions need to be validated. To be relevant, the digital health solutions need proof of clinical or economic benefit to the patient, the payer, and/or the provider system. We partner with different healthcare stakeholders to demonstrate that evidence. In that sense, I like to think of Evidation Health as ultimately enabling precision digital medicine.


Can you give some examples of projects that Evidation is undertaking?

With provider systems like Stanford Healthcare, we are partnering with digital health startup companies on prospective validation studies to demonstrate their clinical and economic value in the Stanford population. With payers or pharma companies we can use our digital tools and analytics engine to understand how patient behavior in specific situations may be important to health outcomes in the future.

One interesting example of the efficiency of our capabilities happened recently after the FitBit S-1 filing; Buzzfeed called the tech team at Evidation Health to see if we could validate the user engagement data that appeared in the filing. Within 48 hours, we deployed a multi-armed study into tens of thousands of users with study endpoints aligned to test what FitBit was reporting. In short, our study findings validated what is reported in the FitBit S-1. Though the vast majority of our work is focused on clinical outcome validation of digital health solutions, this example just shows you how fast you can move and test things in the digital realm. For some people, technology like the Fitbit encourages people to stay on top of their health, especially as there is the ability to monitor progress. There are even options through sites like Mobile Mob to switch up the Fitbit band, just to switch things up a little. Keeping fit doesn’t have to be boring.


Clearly it is crucial to rigorously evaluate these new technologies before they can be successfully integrated into the healthcare system. What other barriers do you anticipate to widespread adoption of digital health?

I think the workflow and interoperability hurdles are both deep and broad in certain geographies and in certain provider systems. So those are very real adoption hurdles to digital health solutions in the broadest, global sense. But these are not �if� questions, they are �when� questions�they will get solved, it will just take time.


How did you come to be CEO of Evidation?

Evidation Health was started by GE Ventures and Stanford Healthcare. I have known some of the leadership at GE Ventures for a number of years, as several of us spent time in the genomic medicine/molecular diagnostic space in our prior lives. So when I was looking for my next challenge after leaving my last operating role in 2014, I approached them and discovered they were planning to start what would become Evidation Health. Then several planets aligned, and here we are.


Do you have any advice for young entrepreneurs entering the digital health space who are trying to start their own companies?

Don�t make claims of clinical or economic benefit of your solution to our health care system without the evidence to back them up. Invest in studies, invest in proving what your product is capable of delivering. The alternative shortcuts may get you a �pilot� demo, but without this kind of trial evidence in relevant patient populations, you won�t get paid for the value you are delivering in the long run.


What digital technology most excites you?

I won�t name specific companies or products in the context of our work at Evidation Health, but I will say that I am personally quite excited and intrigued about digital health products that will focus on �aging at home� issues. For the first time in our history, the aging population�including our parents, our grandparents, and eventually ourselves�is becoming more visible to the health care system via digital technologies. And I think this can have profound, lasting impact on health outcomes in the Medicare population in coming years.



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