The People behind Healthcare Innovation: Interview with Sebastian Gaede, Founder and Managing Director at smartpatient

As part of my work, I have the privilege to speak with many inspiring innovators. However, the business community usually focuses more on companies, pitches and valuations, and less on the innovator. I think it would be interesting to learn a bit more about the people behind healthcare innovation. Therefore, I'm going to share some of my conversations with innovators in condensed form: 6 questions, 6 answers about their experience, their opinions and learnings.

The ninth conversation is with Sebastian Gaede, Founder and Managing Director at smartpatient.

Tobias: What’s your story, how did you become an innovator in healthcare?

Sebastian: In early 2011, my co-founders and I were scanning the US digital health market for exciting trends. The market was already growing strongly; however, the vast majority of offerings were not focusing on where the actual disease burden is, but rather on fitness-related applications. This was when we started exploring the idea of adherence support: why not harness the engagement potential of smartphones to help people take better decisions regarding their medication? We loved the purpose, and to us, improving adherence would only create winners. However, in 2012, not everybody thought that way. We often heard comments like, “The chronically ill are old and will not use an app,” when we initially pitched the idea.

Nevertheless, we quit our day jobs, founded smartpatient, and started building the MyTherapy app. Fast-forward six years and MyTherapy has evolved into one of the (if not the) fastest-growing treatment management apps in the world. We’ve refined the app over hundreds of iterations—it’s now able to support and engage patients extremely well on almost any treatment. Using the MyTherapy platform, we are running offerings for industry partners in more than 25 markets around the globe. Through tailored offerings within the app, they can support their patients’ specific adherence and persistence-related needs while benefitting from our built-in engagement and continuous innovation.

Tobias: Where do you see the field of medication adherence moving in the next ten years?

Sebastian: With the rise of value-based-care, real-world adherence will only become more important. Instead of simple pill reminders, this will require evidence-backed adherence support offerings that are highly tailored to the educational and behavioral needs of specific patient populations and their medications. These offerings will need to be available as globally as the medication they support while complying with local regulatory requirements. 

Tobias: Looking more broadly, what are the biggest opportunities and obstacles you see for innovation in the healthcare environment?

Sebastian: Personally, I believe that digital — and therefore scalable — patient engagement is a huge opportunity in healthcare. During the first year of smartpatient, my co-founders and I were visiting hundreds of doctors to better understand their view of medication adherence. Once the door was closed, they often expressed their frustration, saying things like: “If patients don’t follow my advice, what can I do? I cannot act as their babysitter.” And seriously, how much can you achieve if you see someone for seven minutes once every so many months? On our platform, an average user is active almost three times a day. These kind of engagement levels unlock the opportunity to change patient behavior and thereby achieve better outcomes.

From our experience, one of the big obstacles to innovation is the disconnect between healthcare’s historically national scope and the ambition and need of digital innovators to scale globally. We are working with pharma in more than 25 markets around the globe. Statements like, “I believe this will not work here,” are rather commonplace before launching an offering. Typically, they are a result of the regulatory uncertainty in our space, and in almost all cases, they can be resolved. Today, healthcare simply comes with lots of national specifics—be it around data storage and handling, privacy, pharmacovigilance, or medical device regulation. Creating a digital platform that scales to all those different environments requires know-how around local regulation, and ideally technical platforms that are highly modular and built with regulatory compliance in mind.

Tobias: When you look at the health system as a whole (providers, payers, regulators, doctors, patients) where do you see most/least openness to innovation?

Sebastian: As an entrepreneur, I generally have a positive view of innovation. For many stakeholders in healthcare, innovation is not necessarily a good thing, though, for a whole set of different reasons. In discussions with doctors or pharmacists, they often associate innovation with doing additional things, instead of doing things differently. Therefore, they often cannot imagine adopting innovation without additional reimbursement. Payers, in contrast, do the math but, given their incentives, they too can be tough to convince — saying things like: “For most conditions, improved adherence has a negative bottom-line in year one. My core KPI is bottom-line at this year-end, so I am not willing to invest into adherence.” From our experience, patients are the most open group and will be a key agent of change in healthcare. 

Tobias: What’s the single most important thing that policymakers could do to enable digital transformation of health systems?

Sebastian: The European Union should make it a priority to create a common market for digital health; it should not be more difficult for digital health solutions to reach an EU-wide scale than reaching a national scale in the United States or China. Currently, many European markets have their own standards for e-prescriptions, provider/health record interfaces, security, and many other aspects. This makes it much more difficult and costly to build EU-wide reach compared to the US; for EU citizens to benefit from innovations in digital health as much as possible, this needs to change.

Tobias: What do you know now that you wish you had known when you were starting out as an innovator and entrepreneur? 

Sebastian: In the early years, we often met so-called experts who we had hoped would accelerate us regarding our product, our marketing, or regulatory requirements. In almost all cases, we went away somewhat frustrated, because they thought healthcare from the "old national, siloed paradigm".

In the new world of healthcare, I encourage every innovator to re-think healthcare in a fresh way: Globally, patient-centric, and highly scalable!

For more information, see Sebastian Gaede and https://www.smartpatient.eu/

Disclaimer: The views and opinions expressed in this article are solely those of the author and his guest contributor and do not reflect the views of McKinsey & Company.