Listen in as co-host Carrie Nixon chats with René Quashie, VP of Digital Health at the Consumer Technology Association. The two discuss digital health innovations as “consumer technology.”

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In this episode you’ll discover:

• How the Consumer Technology Association supports Digital Health innovators.

• The most important issues CTA is focusing on in the Digital Health space

• What we can look forward to at CTA’s Consumer Electronics Show in January 2022

Read the transcript:

René Quashie (00:00):

We believe a value-based system, income for outcome, as one of my colleagues calls, it is the best way to incorporate, I think, promising digital health solutions into our healthcare delivery system.

Speaker 2 (00:13):

You're listening to Decoding Healthcare Innovation with Carrie Nixon and Rebecca Gwilt, A podcast for novel and destructive healthcare business leaders seeking to transform how we receive and experience healthcare.

Carrie Nixon (00:26):

Hi everyone. This is Carrie Nixon with another episode of Decoding Healthcare Innovation. I am thrilled to be here today with René Quashie, who is the Vice President of Policy and Regulatory Affairs, affairs for digital health at the Consumer Technology Association. René, thank you so much for joining us.

René Quashie (00:46):

Thanks for having me. I really appreciate it.

Carrie Nixon (00:49):

So tell me a little bit about the mission and role of the digital health division of the Consumer Technology Association. I suspect that digital health is not sort of the first thing people's minds go to when they think about consumer technology, but it's still a very important piece. So tell us a little bit about what you do.

René Quashie (01:10):

Sure and I think you're exactly right. If we've been having this conversation, say five years ago, health was a component of what CTA did, but over time it's become increasingly important both on the CTA side and on the CES side as well. So at the moment, I think if you were to boil down what our mission is, I think it's really to increase the use of technology, enable value-based care to do two things obviously, to reduce healthcare costs, and the most important part is to better health outcomes. I mean, if you look at the state of US health, as I like to call it compared to other industrialized countries, it's not very good. It's not very good news at all. If you look at chronic disease burden, health issues, substance use disorder issues, plus you add on top of that the costs of health in the United States, we probably spend probably a little bit more than two times per capita, other industrialized countries spend yet with the health outcomes we have. So CTA, we believe technology can play an important role, not the only role, but an important role in trying to reverse some of these trends we've seen in the last three decades.

Carrie Nixon (02:25):

Absolutely. And of course, that has only been underscored by the Covid Pandemic. I'm sure that that has sort of elevated everyone's attention to digital health. Are you all with CTA doing anything in particular that is focused on efforts around covid?

René Quashie (02:44):

Yeah, so a lot of our member companies all had their own individual strategies to deal with covid, a lot of them having to do with healthcare and a lot of them having direct impacts on the COVID response. From an association perspective, we really launched two initiatives that were directly related to covid. One was our public health tech initiative, which was really looking at ways in which health technology in particular can play a larger role in preparing and planning for future public health emergencies. And so we put together a number of organizations, both within CTA and outside CTA to really look at those issues, look at the lessons learned from covid, what can we apply to future public health emergencies. And then the next initiative is what we call HEAL or Health Equity and Access Leadership Coalition, which we put together with the Connected Health Initiative. And that was looking at how health technology can advance health equity. Obviously, one of the things that was a byproduct of the pandemic has been really underscoring and highlighting the incredible health disparities that exists within the US healthcare system. And I think it's engendered some very productive and significant conversations, and we think technology has a role to play in advancing health.

Carrie Nixon (04:09):

What you just described is what I have come to view CTA as a convener of thought leaders really around very important issues like this. So you just mentioned a couple of very important issues that became particularly salient during covid. I know that you have also, I believe that you've also focused on value-based care in particular. Can you talk a little bit about the role that you see digital health playing in shifting more from a fee-for-service model to a value-based care model?

René Quashie (04:43):

Yeah, I think this really sort of where the rubber hits the road is when you think about all digital health solutions, health technology solutions that exist, it's really hard to incorporate into the healthcare system if the current fee for service payment methodology continues. These things have costs associated with them, they have investments associated with them, and people are not going to use them if our current payment system does not somehow count for the use of these digital health technology. So we believe a value-based system, income for outcome, as one of my colleagues calls it, is the best way to incorporate, I think, promising digital health solutions into our healthcare delivery system. In other words a value-based system where you're really incentivizing patient outcomes along with other quality metrics, would incentivize clinicians of others to use all the solutions at their disposal to treat, diagnose, and deal with consumers, patients, which is not the case today.

Carrie Nixon (05:53):

Yeah, I think that's absolutely right, and we're starting, I think, to see that the government is paying more attention to the role of digital health in value-based payment and delivery models. Earlier this year, they introduced some amendments, some changes to the fraud and abuse landscape that make it a little bit easier for digital health companies to actually participate in a value-based payment and delivery ecosystem in a way that they had not been able to before. And I think that's a tremendous opportunity for digital health companies. Some of them have more resources than perhaps that they can bring to bear as an initial matter than the members of the health ecosystem and can really play a role in improving outcomes and reducing costs.

René Quashie (06:52):

I think that's exactly right, but I do think there's a fundamental or foundational issue you have to deal with, which is I think a lot of payers just have trouble fully evaluating efficacy and effectiveness of digital health solutions. I think there is sometimes a lack of understanding of regarding what these solutions do, what they are, aren't a lot of hype that needs to be separated from the reality of these solutions. So I think even before we get there, I think there needs to be an educational component where there's a lot of education about what these tools are and that they aren't. I think that's a missing piece, quite frankly, when we talk about value based, that we talk about all these interesting models that exist that I think at bottom, a lot of policy makers, a lot of payers don't have fundamental understanding of what these solutions actually are.

Carrie Nixon (07:47):

I think that's exactly right. Part of that, maybe because there are so many innovations out there, so it's a little bit, I can imagine it might be daunting for payers, for example, and providers as well, to sort of separate the wheat from the chaff, as you said, what is hype and what is reality about what these technologies can actually do? Do you have any thoughts or experience around how you can separate out a digital health technology that is effective, the rubber, does heat meet the road and is not just hype? How can you figure that out?

René Quashie (08:31):

The one way that we at CTA believe that can occur is through standards. So CTA is an accredited standards development organization. So we've developed all kinds of standards. If you think about, for example, close captioning on your tv, that's a CTA standard. If you look at your phone and you see airplane mode, that's a CTA standard. And over the last half decade, we've developed a number of health related standards related to step count, heart rate measurement and AI. And you've got upcoming standards on digital therapeutics and mental health technology, cardiac devices. So as one of my colleagues always says, it's standardization for innovation. Let's figure out what these things are. Let's define them. Let's build a taxonomy. What are the characteristics of the solution we're talking about? And then bring together a very diverse deep cross-sector group of organizations together to build standards. I think that's what builds trust in these digital health solutions. It builds certain awareness and knowledge particularly because you're involving all kinds of stakeholders within the ecosystem. So our belief is that standards are one incredibly effective component to doing exactly what you were talking about.

Carrie Nixon (09:51):

Yeah, I think that's right. I actually remember partici, I think in fact, I think it's when we first met participating in a standard session on AI that you all were convening probably in conjunction with the Connected Health Initiative. And I thought that that was a really valuable discussion. You all did a terrific job of convening some key players. How do you go about communicating the standards that evolve from those types of conversations to regulators and policymakers?

René Quashie (10:24):

Yeah, that's a challenge. That's a challenge. I think we've got so many stakeholders involved. They're able to leverage their existing relationship with policymakers to make them aware of whatever standards effort they're involved in, obviously through social media, through individual meetings. But I think the best ways through relationships with the agencies. So for example we've got a good relationship with FDA and indirectly. We've been talking to them about some of our standard, our current standards to get their, take their position, their approach to some of these emerging health tech areas. So I think it's about relationships with the appropriate policy makers and building those relationships. So they're aware of the standard as it's being developed, not after it's been developed, but as it's being, and even better yet, involving some of those agencies directly in the standards effort, I think is incredibly valuable. So that's what we've been trying to do. And obviously we're not the only standards development organization out there are lots of others, but I think this is where digital health sector is going to have to really sort of focus in on if we really want greater acceptance, greater adoption. Because as you say, there's so many solutions out there. There's a lot of hype out there. If you're a clinician, if you're a health system, if you're a purchaser of these solutions, it's really hard to even know where, again, to assess and evaluate what kinds of solutions are effective for your organization.

Carrie Nixon (11:58):

And the relationship aspect is important, right? Because you have to develop credibility with those people that you're interacting with. We know that the role that policy and regulation plays is incredibly important in either facilitating innovation or in hindering innovation, particularly in digital health. I'm wondering if you have any examples of policy and regulation facilitating or hindering digital health.

René Quashie (12:33):

Well, is there time? Where do we even begin, right? There's so many. For example, privacy. Let's take privacy. That's a great one. So I think if you were to look at the privacy ecosystem that exists, the first thing that comes to mind for people's hipaa HIPAA's done well over what this quarter century it's been around, but HIPAA applies only to covered entities and business associates. And you and I both know that there are a ton of stakeholders out there who don't, who're not covered entities. They're not business associates, but nevertheless, store use, disseminate personal health data. So what laws cover them? We've got a patch of state laws. California, Virginia, and Colorado have been very intentional in really looking at building comprehensive state privacy regimes for their states. The FTC has a role to play. There's some other agencies have had to have a role to play.

(13:31):

So privacy's a great example of there's no real sort of one standard that everybody can adhere to, particularly if you're not covered under hip. So that's one example. Medicare policy. I look at telehealth, right? Medicare, telehealth policy pre pandemic was obviously very restrictive. It was only for rural populations. Patients still had to present at a physical facility in order to receive the services. That obviously is a limiting sort of regime for telehealth. And so you're not going to have a lot of adoption when you've got such stringent requirements. I mean, we could go on and on and on, but I think it underscores the importance of understanding policy in order to ensure that your business models, your clinical models actually work. If you've got a model that's based on Medicaid reimbursement for technology, that's probably not going to work given the way Medicaid reimburses. And so policies an incredibly important factor in the success of digital health overall

Carrie Nixon (14:41):

And vice versa. Having policy makers understand where we are from a technology perspective, what these technologies can actually do at this point is critically important as well to sort of keep abreast of the innovation.

René Quashie (14:56):

And I think mean to be perfectly frank. I think industry and folks on our side, I don't think we do a good enough job of educating, of informing of engaging in conversations before we have an ask. And so I think what we often do is great innovations come up and then we go to Capitol Hill or we go to the agency and say, Hey, look, here's this new shiny toy or invention or model. Please cover it. Please facilitate it's adoption. And these folks don't even have the foundational pieces to understand why that's important. That's number one. The second thing I don't think we do is contextualize these innovations within the broader healthcare system. Are these solutions answering a question that's been asked by the system? Are these solutions actually addressing pain points within the system? And so I think there's a, are a lot of foundational pieces we just don't really do well that I think would service well in the long run if we were to pay attention to some of these more basic foundational.

Carrie Nixon (16:10):

Yeah, I mean, I think that's an excellent point. It really shines a light on the need for continuous engagement with these folks to keep them in the note because everything is changing so much all the time. So let's shift for a moment. The Consumer Electronics Show in January is an event that people really look forward to over the course of the year. There's some really exciting announcements that happen there some terrific bright shiny objects that are unveiled, and there's a whole role for digital health. It's consumer electronics show, is that right?

René Quashie (16:52):

Absolutely. In fact, it's it's been an increasing part of the show because people are coming up with all kinds of interesting innovations. We've talked about the digital health revolution. Unfortunately this past year we cannot meet in person for obvious reasons. But CES 2022 which occurs January 5th through eighth, 2022, is going to be a hybrid event. We're going to have an in-person component. We're also going to have a virtual component, and digital health is going to be an incredibly important and significant part of the show. And so they're going to be panels on mental health and AI and digital therapeutics on the future of digital health, post pandemic women's health. So we're really sort of addressing all the sort of important and relevant questions that I think the digital health community and others are wrestling with. And I think the show's committed to being a forum for those kinds of deep discussions, particularly among different sectors, the payer community, the provider community, tech community. I think it's important for those sectors to talk to each other, which I don't think happens as much as we would like.

Carrie Nixon (18:06):

Yeah, totally agree. I mean, I know you're going to have some really exciting innovators there. You mentioned women's health in the femme tech space. I'm really delighted about the role that the new role that women's health and fem tech has found in the digital health space. That's very exciting. So you're going to have founders there, but you'll also have investors there, I suspect. And we've seen a lot of investment in digital health over the past year record investment. How are you seeing that play out?

René Quashie (18:37):

I'm sort of all over the map on this when I think about it. I think on the one hand, so a couple of points to me. So I think on the one hand, I think it's incredible that we've got all this innovation occurring in space number one, and that there's so much interest in this area. I think there's a recognition finally, that technology has to play a much larger role in our healthcare system. We talked about the state of US health earlier, and the status quo is no longer acceptable. And I think digital health is one way we can start to address some of the longstanding complex issues in the US healthcare system. But I'm also concerned that some of the innovations that I talked about before, are they answering the right questions? Are they really addressing some of the important pain points in our system?

(19:27):

And I'm not sure, I don't know. I think it's going to have to be some sorting done over the next few years to figure out what is work and what has. And then the other thing that occurs to me is there's sort of, I can use the term a horse racefication of digital health innovation. We're always worried about valuations and revenues and SPACs and IPOs. And we're not asking the fundamental question, are these solutions good for consumers and patients? And are they good for clinicians? And I think sometimes those sort of considerations get lost in our love of numbers and sort of who's ahead, who's not, and who's being evaluated, how and why. So that also is a concern for me. But I think overall, I think I'm heartened by all the innovation that's occurring in digital health space. All the investment, increased interest in this space. But again, some of the issues I've brought up I think are things we ought to be thinking about second.

Carrie Nixon (20:32):

Yeah. So if you had to pick one thing that you're most excited about in the digital health space, what would it be?

René Quashie (20:40):

All the mental health models and solutions. I see. Okay. I think that's been an area in which for a lot of reasons we haven't fully addressed. We know about the clinician workforce issues in healthcare, but particularly in the mental health space. And I think there are all kinds of fascinating and interesting solutions being introduced in the mental health space. So that's one sector that I pay particular attention to and I think the association does as well. In fact, we've got a big research paper that is going to be released later this year that really looks at mental health technology, how it's being used by consumers payer sentiment around mental health technology, and also clinician sentiment around mental health. So I'm excited about that space. I think it has tremendous potential to really revolutionize the way we think of mental health. And also, by the way, increase access to people who, for a whole number of complex reasons, don't avail themselves of mental health services. This could be a way to increase access for a lot of underserved communities and for people who quite frankly, just don't want to be seen getting these kinds of services.

Carrie Nixon (22:02):

I agree thoroughly. I second that wholeheartedly. Mental health, mental health space and the increased access that digital health technologies have brought forth is absolutely one of the best things that digital health has brought us. And I'm excited. We're going to be having a conversation with Russ Glass, the CEO of Ginger on the podcast coming up and they're doing some really interesting work in that space as well. Well, René, I thank you so much for taking the time to be with us today. I cannot wait to hear what goes on at the Consumer Electronics Show in January. Maybe we'll have you back to talk about some of the neat stuff you saw then.

René Quashie (22:44):

Thank you very much. I appreciate you having.

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Consumer Technology Association: Digital Health