Not Just Patients

Co-Creating HealthTech Solutions | Cécile Tardy-Srinivasan

• Caitlin and Clarinda • Episode 21

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Join us for an insightful conversation with Cécile Tardy-Srinivasan, EUPATI Fellow, patient advocate, and leader of the DayOne Accelerator, as we explore what it takes to bring meaningful patient and stakeholder involvement to health tech innovation.

With over 20 years of cross-sector experience bridging pharma, healthcare technology, and patient advocacy, Cecile draws upon her own journey as a rare disease patient to share unique perspectives on connecting patients, clinicians, innovators, and industry. As a mentor, advocate, and innovation accelerator, she is dedicated to breaking down barriers and enabling collaboration for patient-centred solutions.

In this episode, we dive into the vast and evolving landscape of health tech—what it encompasses, how patient voices can shape technology, and why thoughtful patient involvement is critical from design to implementation. Cécile shares her story, examines key challenges for start-ups, highlights real examples of patient-led solutions, and offers practical advice for both innovators and patients seeking to drive change in healthcare.

Chapters

  • 0:00 - Introductions and episode overview
  • 1:52 - Defining health tech
  • 8:42 - Cécile's story and journey into innovation
  • 11:34 - The evolution and challenges of health tech
  • 19:42 - The DayOne Accelerator Programme
  • 25:52 - Patient involvement in health tech
  • 37:04 - Cecile’s vision for the future of health tech
  • 40:04 - Advice for health tech innovators and patients
  • 45:08 - Reflections with Caitlin and Clarinda

Resources and Abbreviations

Have feedback or suggestions for us? We'd love to hear from you!
Website: notjustpatients.com
LinkedIn: Not Just Patients
Email: info@notjustpatients.com

Cécile: 00:00
And that's where, I mean, to your point, I think that's where also you see only the tip of the iceberg very often when you're a patient or the normal citizen, because there are so many possibilities, right? So it really depends. That's what is making it exciting, and that's also what the potential because there are a few things which are already getting in place and used by a lot of people, but we are far from having explored and used all possibilities.

Caitlin: 00:26
Hi, I'm Caitlin. 

Clarinda: 00:28
And I'm Clarinda. 

Caitlin: 00:29
And this is Not Just Patients. 

Clarinda: 00:32
A podcast where we break barriers to meaningful patients involvement in healthcare.

Caitlin: 00:37
Thanks so much for tuning in today. Our guest on today's episode is Cécile Tardy-Srinivasan, and we're going to be talking about patient involvement in health tech.

Clarinda: 00:46
Drawing on a career background spanning finance strategy and healthcare innovation across sectors, Cécile brings over 20 years of experience at the intersection of Pharma HealthTech and patient advocacy. She currently leads the Day One Accelerator in Basel and supports international high potential early stage ventures at the intersection of health tech with pharma RD. Her mission is to build bridges between patients, clinicians, innovators, and the pharmaceutical industry to advance healthcare together. As a EUPATI Fellow and rare disease patient living with an auto-inflammatory condition for 26 years, Cecile brings a deeply personal perspective to her work. Beyond her leadership role, Cecile is an active mentor, keynote speaker, and advocate for patient voices in innovation. Welcome Cecile. It's so lovely to have you here today. Thank you for joining us.

Cécile: 01:45
Well, thank you for the invitation and lovely to discuss with you today about health tech innovation.

Clarinda: 01:50
You are one of our fellow fellows in our EUPATI cohort. So it's great to share this platform with you. Maybe we can just start by defining the term health tech. We hear terms like digital health, med tech, health-tech. Are they all synonymous or how do they overlap and differ?

Cécile: 02:10
I think maybe we can start to explain what health tech stands for, right? Because it depends on the audience how close to the topic you are. And health tech stands for healthcare technology. And I would say broadly it's any technology that aims to improve health and healthcare delivery. So to your question, Clarinda, so digital health, usually we we speak about data health for software, apps, data platforms, and medtech is usually more uh for devices, equipment, diagnostics tools as well. I mean, here it's very broad, right? And health tech, so it's a kind of umbrella term that blends both together. So that's uh health tech, then data health, med tech coming together.

Clarinda: 02:54
Right. So I guess if you imagined Venn diagram, then you might have an overlap between digital health and and med tech, would you say? But health tech would be like a superset.

Cécile: 03:06
Yes, yeah, yeah, yeah.

Clarinda: 03:08
That's an interesting way to look at it. And what would you say the scope of health tech might be? So, for example, there would be solutions for different stakeholders within the health continuum. So doctors, patients, clinical researchers, regulators, I suppose, and various stakeholders across the spectrum. And then when you talk about patients as well, there might be products that talk to them at different stages of their journey from diagnosis, etc. So, can you talk a little bit about that scope?

Cécile: 03:42
Maybe we can start with the different kind of categories because uh in software apps platform, what does it mean and for whom, right? So, like you were mentioning, that can be patient-facing apps, uh, typically for understanding their patient journey or helping, you know, maintain the regimen of treatment or noting some side effects, or you know, the context in which daily life is also influencing their disease or treatment. This can be also helping healthcare professionals, doctors, nurses, and so in terms of uh clinical decision support. So, what do you notice in terms of trend pattern and when do you intervene, for example, to change uh regimen of treatment, or how do you intervene, for example, when you see a diagnostic, for example, in radiology, you look at uh the x-ray and you have AI tools to help the clinician with the diagnostic. Can be research platforms as well. So, here typically you also hear a lot these days about AI-aided drug discovery in the pharma industry. So that can be also in uh health stack. It can also help with uh hospital operation, and here we are really talking about operational uh not excellence, because very often it's about how do you digitize your workflow or how do you optimize them or where do you have digital intervention to help with the operation, can be simply an appointment, can be a scribe, or you know, a voice capture of uh patient and doctor discussion, or can be diagnostic devices as well, here to help in the patient journey, but diagnosing patients much earlier. And it can be available, like everybody has seen these days, quite you know, the the smartwatches and how can you integrate this uh together with over source of data in the health care patient file. I think one good point you made when you introduced the kind of solution and scope, it's not only for patients. Of course, what has is not just patients. I think one of the key things when we we talk about health tech, people think about you know, patient app to improve adherence. But that's not only this, right? That's also in the previous example I gave tools to have doctors, nurses, researchers, even regulators or payers, looking at, in the case of payers, what is value brought by a specific treatment to determine the condition for reimbursement, or you know, when they have agreement with the pharma companies to demonstrate that the molecule is actually really working for the patient. Coming back to patients, I think it starts with uh tools for prevention, diagnosis, treatment, management, follow-up, community support as well. I think that's also one of the key things among patients. You don't necessarily belong to a patient organization, it really depends on your condition, your personal circumstances. And here that's also where a lot of patients find support through digital tools.

Caitlin: 06:31
So to conclude, the scope is absolutely massive. I think you know, when people talk about health tech, I think a certain thing might come to mind. So for myself in particular, I think when people mention sort of digital health solutions, I'm thinking about more of those patient-facing apps. So they're helping patients with reminding them when to take their medicines, you know, using a diary to log their symptoms, or maybe using it to order medications, make appointments, speak to their doctor. But actually, there's so many different applications for technology within the healthcare spectrum and different stakeholders. So you mentioned clinical applications, you mentioned logistical applications, maybe even administrative, scientific applications in terms of drug discovery. So yeah, I guess it almost is as simple as any technology that is used in a health sector, can count as health tech. But the other thing I wanted to pick up on is not just the scope in terms of application, but in terms of the type of technology that people can use. So anything from an app or a watch, as you mentioned, up to really scientific devices. And then what's really cutting-edge technology, such as you mentioned AI, artificial intelligence, and using it for really sort of highly technical scientific discovery. So the scope is absolutely huge. And I suppose as technology is evolving, there's an element of trying to find applications for that technology in the healthcare space.

Cécile: 08:01
And that's where I mean, to your point, I think that's where also you see only the tip of the iceberg very often when you're a patient or a normal citizen, because there are so many possibilities, right? So it's really dependent. That's what is making it exciting, and that's also what the potential because there are a few things which are already getting in place and used by a lot of people, but we are far from having explored and used all the possibilities.

Caitlin: 08:28
Yeah, I mean, as you just said, I think we could spend the whole hour just talking about what the different applications are, and that's fantastic. But we're gonna delve later a little bit into the more patient angle of that and how patients can get involved in health tech, not just for tech for patients, but also tech on that sort of wider scope of things. But just firstly, Cecile, I think it'd be really interesting to hear a little bit about your journey and how you came to work in this space and come to lead the day one accelerator program.

Cécile: 09:02
But like you explained in the intro, right? I moved from finance to pharma and people like, but how did you land in innovations? Like, well, that's a long story, but I will try to make it short. I think the motivation started with the fact that I was diagnosed I was uh 19 years old when I got really sick suddenly and and landed in uh tropical and infectious disease for unexplained long uh long-term fever and different symptoms. I mean, we we didn't have a clue how it started in the first place, and we still don't know. And then it was really a differential diagnosis. So you try what is the most probable, and then no, not this, not that. So where I got lucky is that within six months I was diagnosed actually, which is pretty rapid for rare disease. And still, even more than 20 years later, we still don't know if the diagnosis is exact, but I have a treatment which is working for me, right? So that's already a good part. But the technology was also not that uh advanced at that time, right? And if you have already something working for you, people in the hospital don't try to rerun through plenty of new uh exams, unfortunately. I think the genomic could bring a lot of answers, but yeah, that was the main motivation for me to see okay, what do we do, right? Because of course I was lucky that I got diagnosed quickly. I was lucky that honestly I had a rheumatologist who was also very open to bring me on board to listen to my journey as well. So that was really great. That's what brought me also to the industry because I realized that okay, I got lucky, but not every doctor would listen to patients. Being a patient is also what led me to leave the industry uh a few years ago, at least finance in the industry because I wanted to be closer to patients, right? I mean, it would not happen easily inside the corporate, then I took a longer route. I said, okay, I was motivated. I was like, I'm gonna make it happen. I'm gonna go out, still keep a foot in the industry because I really want to find a way to you know to build this bridge. And if I cannot change it from inside, I will try to do it from outside. And that's how yeah, I went into freelancing and patient advocacy, and that's what brought me to healthcare innovation and later to health tech. And I mean, that's also how through my journey I got to know several facets, you know, the patient experience, the corporate, the startup side, and that's what's motivated me also to train as a U Party Fellow two years ago and uh how we met.

Clarinda: 11:24
Yeah, yeah, that's a fascinating journey. Thanks for sharing, Cecile. So you've been watching this innovation evolve for the last seven years or so, and I think it would be quite an interesting juxtaposition for you to see the pace of innovation and technology versus the pace of development in pharma, for example, and you know, like the pharma cycle, how slow that typically is versus how quickly health tech is evolving. And I thought that it would be quite interesting for you to share how you've seen technology evolve with some examples maybe of what you've seen from when you started versus what you're seeing now and things coming out of the digital space.

Cécile: 12:12
The pace of different stakeholders, I mean you pointed towards the pharma, but I think also it's also the hospital setting versus the patient, right? Exactly. A lot of patients, for example, discovered more like the digital health part with uh smart watches or with uh online scheduling, you know, for appointment during COVID and so on. So that's pushed kind of uh some part of the system to move, but there are still a lot of things which are still done with too many processes and too many forms to fill out, you know, and it depends really on the country. I mean, yeah, you have Estonia, for example, where it's much more advanced, but most of the other countries are still where you would like to do a lot of things online and where you would like to be able to have access to all your um exams and everything in one place. I think the difference of pace is normal because of also the the kind of objective different people and different organizations have, right? So if you think, for example, pharma, their core innovation engine is R&D. So they started with their health innovation a lot in the commercial part, right? With patient-facing apps, with platforms for cell and gene therapies, for example, so that if there is a problem, hospitals and patients and families can have access very quickly to a kind of special desk. The rest of the technology is not part of their core business. So you always have these cycles, and it depends on the pipelines they have in terms of molecules, because for them, for their board, for their shareholders, the core business is the molecules, right? So technology is here to speed up the process. I think that's also why we have seen a shift, and now they are more conscious about where do they need patient solutions, patient app, and so and on the commercial space, because they realize that not every single molecule, not every single brand needs something for the patient which is digital. It's really to make sense in the patient context. But then where investment has accelerated already on the R&D part, to look how do we use AI or even quantum computing to really fast track the way we do research? Because right now it's 12 years on average. I mean, it depends on the publication, but roughly 12 years on average to get a drug to the market, which is huge. I mean, when you think, but still so many unmet needs uh in terms of uh disease, and how can we find new molecules and how do we find the next breakthrough? So that's also where now they're also looking at solutions for AI-aided drug discovery so that the the target profile of the molecule can be much more quicker designed and tested. The same for clinical trials. One of the big challenges to identify the right patients to enroll in the clinical trials. How can you reach out to this patient? How can be aware of the clinical trials they are eligible for? How can you make it also easier? Because if you're living in a rural area or if you have family duties or if you have also over personal constraints, how do you participate in the clinical trials compared to if you're 10-15 minutes away from the university hospital and you have a part-time job and a disease which is also not impacting you so badly that you are able to follow the clinical trial study for a few years usually? So that's where the technology has been really uh tested not only during COVID but also after, you know, how can you shape trial protocol so differently to accommodate the needs of the target population that you want to enroll in the trials and who could benefit after this from the molecules you are trying to develop and put to the market. I mean, technology is evolving super fast. And we see it with the startup, they are always trying also to find different ways. And I think compared to big corporate, that's really great that the corporate are doing big investment to try and see how can we improve and fast track research, how can we also fasten click and trials. But the startup also looking at usually they start from different tech of from different patient needs or clinician needs. So it's here it depends on the background a bit of the funding team, I would say. Where it's still tough is usually for big collaboration to happen, you need to have a startup being as a certain maturity, and that's why it's a bit tough given the current uh funding environment for the past two, three years, where you see, yeah, it's very capital intensive in in health tech compared to some other industries. Because what also takes time is not only the tech but also the clinical validation. And you can imagine how important it is. I mean, we're talking about impacting people's life either directly through clinical trial setting or through molecules being developed in research.

Caitlin: 16:48
Yeah. Well, firstly, it costs a lot of money, right? So, but as you said, the the capital and the investment is a key, maybe not barrier is not the correct word, but it's a key thing that needs to be in place and can slow things down. And then I guess different if you're creating a game on your phone or something. There are more regulatory processes that need to be involved if it's impacting someone's health. And then, of course, from a technology perspective, you have to have the experts in place, the technology, the coding, the manufacturing to actually create the tech as well. So I can imagine that that takes a lot of investment of time and also money, which I guess is a barrier to it happening.

Cécile: 17:31
Yes. Yeah, that's actually how I also joined the day one accelerator in the first place. Because uh for me, I was always clear. I mean, even within Big Pharma, I was always the kind of person uh going across the division or the function, because I was like, we need to have a holistic approach. Because I don't think you can do it alone, especially in innovation. Yes, there are things that you can uh develop in-house, but very often you do a lot of things by partnering with others who have a tech. That's why we see also partnership between big pharma and tech companies and sometimes some of the startups as well, because that's also where you are connecting different worlds and bringing knowledge and know-how from different organizations. Yeah, that's how joined the Day One Accelerator. Uh, first, actually, in as a more member of a community of day one uh in the early days, and then I got involved in the section committee for accelerator from the second year onwards as a patient representative because I was interested in the tech, but I was also interested in bringing the patient voice and say, look, guys, it's nice to have plenty of technology, but do you check with patients what they need, right? Because otherwise you're gonna land with something where you burned a lot of cash, you developed a fantastic tool in maybe tech-wise, but is it usable and is it patient-friendly? And is it something that they actually need, or is it just gonna be another gadget which is landed in the app cemetery on the Apple Store, or you know? And yeah, five years ago, that's when I took over the accelerator. And we saw the trend happening, right? I mean, initially the focus was really much about the typical digital health uh patient-fencing platform devices, and then we saw the trend happening in the industry as well, and like, oh, AI, everybody was talking about AI, GEI, and like, yeah, but we need to apply it to something concrete and pragmatic, right? So, where can we make a difference in the ecosystem? Of course, being based in Basel, that's a huge cluster of not only big pharma, but uh also biotech, health tech companies, uh CROs, and so and uh and the past three years we have been focusing on a pharma RD because that's where also we see uh impact could be the biggest, where the startup also needs the biggest help.

Caitlin: 19:40
So you've mentioned a few times there, Cecile, the day one accelerator program. So wondering just for our listeners, if you could tell us a little bit about the program, what it is, and what it's aiming to do.

Cécile: 19:52
Sure. So the program is a hybrid acceleration program for early stage startup, international, because I mean uh pharma you know doesn't know borders and what is innovative can come from any countries. Yeah, and and here we focus more specifically on tech bios or the research part and has tech uh startup who are trying to shift the way RD is done and to reduce time, to reduce effort, and to reduce the money it's costing to also improve outcome for patients in the end, right? So, what we do is we scout startup also across the globe and we have an open call for application every year, and then we go through different selection stage, you know, to see who are the most promising early stage startups, and where can we help them to fast-track also their journey as startup? But really, I mean, this is a very complex and time-consuming journey. So we also want them to be realistic about the expectation they are setting, about the use case they are trying to bring, something which can be great from their perspective might actually not have a real use case for a pharma company or for patients. And that's also where we get them immersed in the pharma world by bringing different experts and speakers to explain different parts of the pharma industry, RD, how the big companies typically partner with startup, and then in parallel, they have also mentoring from experts and veterans from the industry to help them really work on their specific uh solution. And of course, then everybody's coming to Basel at the end for innovation showcase because innovation in closed doors doesn't happen, right? Yeah, the whole point is that innovation should be also shared and showcased to the world so that people know what's happening, and it's also spreading the innovation and building further bridges so that the the collaboration happened and is faster than if they were trying by themselves.

Clarinda: 21:47
Yeah, that sounds really interesting. So I wanted to understand these uh startups that you nurture through your program. How do they get adopted, if that's the right word, by a farmer after that? Or is the point for them to get more visibility through the program? And then after that, they're open to collaboration, or is pharma also part of this process at, for example, the innovations showcase uh do you have pharma in the audience? Is there like a matchmaking process that happens or something like that?

Cécile: 22:24
So don't forget we're uh in the early stage phase, right? Of startup. Right. So usually we need to develop fair solutions. Oh, yeah. But we think that the earlier we do it, the more chance they have, right? So, and to your point, innovation showcase, of course, has pharma and investors because don't forget that without investment, then the startup cannot go further. But the whole point is for us to help them think beforehand what would be your business model, how could you collaborate, and how do you already embed different milestones that there is your solution together with farmer companies, and how also do you embed the scalability of your solution from very early stage, right? Because very often they start in their home country, they might have expanded to one or two more markets, but the stage where we accelerate them, they need already to have this end in mind so that they set up the organization and they focus on the right thing and yeah, don't burn too much cash to increase the probability of success.

Caitlin: 23:27
And just out of curiosity, Cecile, these people who are early stage startups, do they tend to be like sort of tech experts who have discovered that they can apply their tech solution to health? Or are they health experts who have come up with a tech solution to a health problem? Or is it a mix?

Cécile: 23:46
So that's really always super interesting. It really depends. So a lot of them come from the tech side because they have seen a technology that could be applied to certain use cases and situations that they have encountered or they have heard of through their network. Then we have also another group of founders who usually come more from the healthcare system and they were frustrated with something, and they're like, Yeah, as a clinician, I face this and I could not have a solution. So then we are like building a team around this to develop a solution to solve the issue they they faced, or some you know, were in the industry and they could not develop further because it was not a priority for the company where they were. So you have a different profiles, but that's also why it's always nice to hear the story behind the theme.

Clarinda: 24:34
Yeah, I mean, I can only imagine that some techies, well, I'm sure that they've done a lot of research by the time they reach the day one accelerator program. But I'm sure that when they start working in the pharma space, coming from a tech space, they might be quite overwhelmed by probably the complexity of how things work in pharma, the regulations, the pace, and things like that, and also perhaps the lack of user involvement, maybe. And that that's something that I'd love to talk about as well, which is patient involvement.

Cécile: 25:09
The tech, usually they come from academia, right? Right. It's not tech tech, or sometimes they already have entrepreneurial seed in them. So they have done their PhD, their postdoc, and so on, and they want to take it further. But then what is tough is the business side, right? And then you discover a completely new world when you're looking at pharma. So that's always a bit surprising for startups. And actually, the the part of the accelerator is also to help them realize is actually pharma gonna be your partner, or should you be partnering rather with CROs or with biotech? Uh so depending on on the solution they are developing, but that's also why the the program exists, right?

Clarinda: 25:48
Yeah. So I'd like to move on to patient involvement in this whole scenario, which is obviously one of our favorite things to talk about. But the way I see tech work in general when it comes to tech startups, I see them across industries being very user-focused, I see user-centric design thinking, you know, that's the principles on which tech tends to operate. And if you translate that to health tech, I can only assume that the end user for whom they are designing, if it's patients, then I would hope that patients are involved potentially more in health tech development than in other areas. Would you say that's true? And overall, would you like to comment on the scope for patient involvement in all this?

Cécile: 26:36
It depends. Who is involved, not ready? I mean, ideally we should, because to your point, who is the end user? So if it's a facing app, a patient should be involved, and uh ideally not just as a validation point, because this is what we saw in the earlier days. I would say uh like uh 10, 12 years, uh, that's probably what was happening for a lot of solutions where like, okay, can you please uh check this and validate this? Whereas now I think it's more systematic, at least in trying to do this. It's not necessarily done properly because it's also tough, right? I mean, yeah, it's nice to involve patients, especially for a patient facing app and so, but how do you do this, right? There are some companies doing, oh, I send a questionnaire to 500 patients and then I hope they're gonna be filled out, or you do a smaller user experience looking at how patients use in situ app and getting really user feedback on the features and so now there are so many apps that it's very difficult for both patients and doctors to realize what I should use. So that's that's great to see more involvement, but it's also tough. On the R&D part, I think it really depends where it makes sense, right? I mean, for clinical research, some companies do it in the sense that if they want help to prioritize the research areas, they're already kind of getting input from patient communities because they want to make sure that this is actually a molecule that should be developed, right? This is still where the tech is more important than really the people's involvement, I would say, when you design molecules and so on. I think where the the big potential is, and that's where there has been a huge progress over the past decade, I would say, because that's where the patient can really have an active part, is about you know clinical trials. And you don't understand why you can't enroll patients, why the patients are not staying on clinical trials and so, and you realize that well, if you had co-created the clinical trial protocol, maybe have realized that you're asking the patient to come, I don't know, every month or every two months and travel two hours or be away from home two days, and maybe they need a caregiver to accompany them, or maybe it's costing them financially, and you don't have a way of having easily operation, then to refund or to cover for the expense. I mean, it can be as basic as some logistical issue for some patients. I think what will improve definitely in general for health tech is to see patients as people. And this was something very often forgotten. But in clinical development, when you think about recruitment of patients, remote monitoring of patients, real-world evidence collection through wearables or through apps, that's where typically that makes sense to have patients involved because then you can shape better trial design or protocols, you can ensure that the digital tools are usable, you can make also the participation in clinical trials are less burdensome. You know, now we see more and more, for example, digital biomarkers being co-developed. You know, what matters? Yeah, you have your endpoint to validate that your molecule is working, but is there any other so usually it's called the secondary endpoint, and typically the secondary endpoint or the exploratory endpoints are co-designed with patients because that's where. Where you see, okay, which kind of additional information could we get while we are running the trials? And in the end, it's I think it creates a win-win because then the pharma companies get higher quality of data, more relevant data, and you have real life evidence and feedback.

Caitlin: 30:17
Yeah, so from everything you've just said, it's really clear to me that there is a really good place for patients to be involved, and there's clearly value in that in terms of ensuring that actually the end product is really valuable to patients, they actually use it. That early investment as well is something we've heard a lot of times in terms of if you get patients in early enough, then it's not like at the end where you have to validate it and potentially something's wrong or something's not quite right, and then you have to go back and change everything about the product. So, really sort of having that co-creation, that sounding board throughout is clearly really valuable. Yeah, that's something we've heard a lot as well, and that works with health tech and it works with drug development and it works with trials, as you've mentioned. So it's clearly really important. But you also mentioned that there are some barriers to that, and some of it might just be the fact that health tech companies don't have the time, the investment, they maybe don't even know how or when to bring patients in or have those contacts. But what would be really interesting is if you could share with us, therefore, maybe some initiatives that are helping to drive patient involvement in health tech.

Cécile: 31:27
Yeah, I think in general, I don't want everybody to rush and say, Oh, I need to involve patients, boom, boom, boom, I tick my boxes, right? Because you need to be mindful of how you do it, when you do it, when does it make sense? Yeah, because the trend we saw in the early days of patient engagement and involvement, so now it's more than a decade, but it's really going better and ramping up nicely across the different organizations, not only the big one, but also mid-size and small organizations. And usually people underestimate the time needed for meaningful engagement, and they just think you're just gonna book people in a room for two hours and then get something validated, or you're gonna send a questionnaire or a form or something, you know, to hundreds of patients. Or the thing is that they are contacting also the most prominent patient organization, and then they get overloaded with requests and they can't answer all the questions. So patients are people and they have limited time and resources, and they have a life, and they just can't uh pay their bill with pro bono work uh to help here and there. And so this has evolved a lot with more structured engagement. On the US side, you have the FDA, for example. I mean, uh, I don't know what's the latest situation because it keeps changing, but the FDA, there is a special committee for data health in involving patient representative, for example. I don't remember if it was a year or two years ago, there was a public call for application where as a patient representative you could apply to be on the committee, the data health solution. Here in Europe, I think the base for patient engagement is health tech, is already the base of patient engagement in general. Here, typically, patient engagement was early on, more on the commercial side, so that you have advisory board and patient insights on specific uh side effects or molecule or patient journey understanding also how the patients were getting diagnosed, how they got the different line of treatment, and so whereas now the patient engagement has shifted much earlier in you know the value chain of pharma and in in the drug development part already. So typically, I mean PFMD initiative in in Europe to involve patients. Uh EUPATI is also doing, of course, the the educational part, not only for patients, because a lot of people think it's only for patients, but also for the industry and for payers. The thing is that Digital Health is still evolving a lot, right? Yeah. So coming back to pharma, they know how to partner with biotech. It's a process well established, I would say, overall. It's still difficult, for example, for health tech. So the same way, uh, because there's nobody has found the perfect way, and digitalization of a healthcare system is still ongoing, you know, in Europe at least. And so, as long as you don't have this base or so, this foundation in the rest of the healthcare system, it's tough to integrate everything and interoperability of solutions is also key. The patient involvement, I think, in health tech and structure to accompany it and so will probably get more mature and be more systematic once you know the health tech part is also more advanced and more part of the daily life of people, so that they don't have to wait to be a patient to realize, oh, what can we use as a digital solution to manage our health, right?

Caitlin: 34:37
Yeah, so obviously you've supported a lot of startups with your accelerator program. And I wondered if there were any examples of startups you've supported that are a really good case study for how well they involved patients or were even maybe driven by patients.

Cécile: 34:52
Yeah, so it was much more in the earlier cohorts because they were more patient-facing solutions. An example, I mean, to your point, companies who went through the accelerator, IBD relief is typically a great example of patient-led innovation. Patient facing some situation and thinking, how can I help patients like me, but also my doctor, you know, to help me get ready for some specific exam, to also help a patient be less stressed about some examination coming, and encouraging the dialogue with the doctors and nurses, and really improving the support the patients get for IBD. And that's really nice because on top we got acquired by a mid-sized pharma in the meantime. So that was really great. Yeah, and Ancora AI, for example, is more patient-facing app, I would say. More if we think about clinical trials. So typically we would have Ancora AI for clinical trials information for a specific cancer patient to access and trial hub. I think you had Maya Zlatanova as a guest on the podcast earlier. Her sister faced a tough situation, and then it pushed her to find a solution and to develop one. So that's always great to see the impact also of the startup. They are not waiting to have a perfect solution, they are like super motivated on making an impact for patients and trying to solve their daily life issues as patients, but also helping them to connect and communicate better with their doctors, with a care team, with their families.

Caitlin: 36:21
Yeah, that sounds great, and thanks for providing those really nice examples, and it's good to see that that kind of thing's happening. And actually, quite a few of those things were led by patients or people who were, you know, friends and families of patients as well. So it's really driven by that kind of passion and need that they know about, which is, I think, really cool, and that's where a lot of the great solutions come from, where it's actually driven by that unmet need. So we've spoken a lot about how health tech has evolved, but looking into the future, what would you say is your long-term dream for health tech? And how would you imagine this space evolving, for example, in the next five years?

Cécile: 37:03
My dream. Let's put the pink heart dream. I mean, health tech would really become embedded into pharma and healthcare in general, right? Not like just an add-on, and we want to test this and we want to try that. Because I think, but it's always a problem when you have something existing which is a bit archaic, right? It's tough to make a big change in healthcare system and in companies where you have so much, for example, IT system legacy. And how do you think also the processes, right? I mean, the world compliance is a big word. So I think, yeah, health tech becoming more embedded, and so it's really ideally uh with interoperability in the system. I think another dream would be that patients don't have to advocate for themselves or caregivers to advocate, you know, like patient voice should be heard as part of the stakeholders' involvement. So for me, it's it's very important to say it's not only about patients, but about hearing about the different voices and bringing at the same level the doctors, the nurses, the caregivers, the patients to see okay, how do we make the best? And we know there is no perfect solution, so it's it's okay, but how do we bring really value to all these stakeholders and not just shift on one or two? Because that's also gonna be part of the ongoing process, you know, after this, whenever you build something new, if it's part of a habit, then it's also becoming easier, and that's also where you see great improvement. And I would say, yeah, not only patient voice, but in general, citizen voice, right? I mean, I think at some point we need to shave uh the healthcare system so that it's not just about when you are sick, but how can you have something more embedded across you know prevention and and uh sick care and so on? The third probably dreams is but we see more cross-border collaboration and shared infrastructure so that you don't have these silos, these are my data, and then cross-border, because I had to face this myself as well. Like, you know, I have medical files uh literally in several countries in Europe, in Switzerland and even in Fiji. So what do I do and how do I bring all this together? That would be nice uh to see a bit uh better collaboration and exchange of data because this is a big friction in the system. Very often, honestly, it's it's still the patient or the family doing this bridging across data silos and stakeholder.

Clarinda: 39:27
Yeah, yeah, yeah. Thank you, Sassi. That's a bold vision, and I think I'm completely on board with that. You asked me for my dream, right? Yeah, yeah. That is that is a lovely dream to have. I think, as you spoke about, you know, how some of the startups that you've nurtured have involved patients. I wanted to ask for your advice, and we will share some more details about those examples in our notes of this episode as well, for our listeners who don't know those examples that you provided. But what would be your advice for other health tech developers who want to better integrate patient voices into the product development process?

Cécile: 40:08
So I would say don't see patients and caregivers as well, only as end users, you know, also see them as partners, so which means engage with them early and not at the validation stage only. I think this has improved over the past five, six years easily. I have uh much less requests because you know sometimes I'm getting requests through email or messaging, and they're like, Oh, do you have so much time and so for this? I just need this, and it was more like transactional. I was here ping polar, trying to do this as a meaningful engagement, trying to build a mid-to-long-term relationship and partnership. And I would say also invest in relationships, not just feedback session, not just, you know, I need your feedback on this or that, or what do you think about this and that, but really to understand the personal context, the situation, and get as many examples as possible so that your health stack solution reflects really the needs of uh users and key people who will use your solution. It might not be only patients, and I think it's very important to reflect on this because sometimes I have requests like, oh, what are the low-hanging fruits in health tech? I was like, well, well, uh then don't go to healthcare. Well, if you're if your the your goal is to get uh profit as quickly as possible and get a bit of something on the market in a year, forget it, that's not realistic. But I think it's it's good to see a lot of people trying to to change the way health stack is developed.

Caitlin: 41:38
Yeah, yeah, amazing. And I guess on the flip side of that, what would be your advice for patients or other stakeholders, as you mentioned, who could be end users, to better understand and contribute to health tech development?

Cécile: 41:52
I would say, I mean, for patient caregivers, get informed, be curious, you know, open to engage with innovators. I mean, get informed through EUPATI, but not only, you know, they have, of course, developed the training for patients to be more aware and informed about the R&D process and how to get involved in drug development in pharma. But I think your first point could be going to some events where health stack is presented, talking to different people who where you see they are using different solutions, and you read articles about this topic, trying to research in your disease which kind of solution could be available, talking through patients' forum, all these kind of things. And I would say also don't be shy. I mean, I know in a lot of countries it's very tough because when you see your doctor, you already have a very short time, right? But I think okay, when there is no major concern for your health, and when you have a bit of time, try to carve out from this session with your doctor a bit of time to ask if there is any project or initiative you could get involved. We don't know. I mean, sometimes it's about checking your hospital or clinic website and looking if there is anything happening in that area. And of course, you can be also discussing about how to improve the patient diagnosis or access to clinical trials or your treatment. I think it depends also on your areas of interest or your availability. Now you can see so many things on the web for the good and bad, but I think there are a lot of more avenues to try and get involved if you want than uh a few years ago. And I think it's important for people to realize it's not only from a patient perspective, but I think your voice as a person can not only improve the drugs, the medicines being developed, but also how the healthcare system works, right? So having a broader view than just health tech, but you know, in terms of innovation, where can you be useful? You have transferable skills, and maybe that's something you want to do for your community. I mean, your interests can be also changing over time. I think there is no problem to be focused on a few things for a few months or years, and it's still helping to change things hopefully for better.

Clarinda: 44:03
Yeah, or if there's a problem with the system or anything that's bothering you, maybe you're the one who can build that solution.

Cécile: 44:10
Yeah. I would say don't just plunge into health tech for the sake of it. But which kind of challenge do you have as a patient or as a caregiver and you're trying to solve, and then look at what is existing and try maybe a few different solutions and see what fits you best at that time in your life and how it can help you in your journey.

Clarinda: 44:32
Thank you, Cecile. This has been really interesting, and we've loved learning from you today.


Cecile: 44:39
So thank you very much for sharing uh the floor and giving you the opportunity. I think it's also nice that we could, you know, not only connect to specific training and patients' organization, but that we also are super active in our own way uh to shape you know the healthcare system for better and try to see which kind of different solution can we bring for the future generations.

Caitlin: 45:03
Thanks so much, Cecile, and good luck with your next bout of startups as well.

Clarinda: 45:08
So Caitlin, now that it's just the two of us, I thought that we could reflect on that conversation we just had with Cecile. It was a lot that we learned about health tech. Do you want to tell me what stood out for you?

Caitlin: 45:19
Yeah, so I think to start off, it was really helpful to talk about the definition and scope of what we mean by health tech. So Cecile mentioned that that encompasses both digital health, which is online platforms or applications, and med tech, which is more like medical devices that are being used to make treatment decisions. So, for example, you know, that could be diagnostics or various tests, or there could be a crossover with that and digital health, whereby an app measures something and helps you to make medical decisions from that. So the scope is really broad, but that's almost thinking as well from the types of health tech that you can have and the platforms that are used, whereas actually as well, the scope is kind of beyond what I was thinking in terms of use. So when I think of health tech, I was thinking of almost from the patient perspective what I would see. So, for example, an app that I could go on on my phone that helps me to order medications or a device that measures my blood sugar. But actually, health tech can be used by other stakeholders in the system as well to support the health of the nation in some way. So all the stakeholders that we usually talk about in terms of medicines development, but also in terms of the healthcare system, could be using health tech. For example, right from clinical research, teams could be using that to use tech or AI to discover molecules. They could be using it to optimize their research studies, they could be using it to help recruit people for clinical trials. And then also there's the doctor's side of things, so they can be using digital tools to help make treatment decisions or even do administrative tasks like making sure that their patients have done everything required to start on a treatment or to help arrange appointments, to help communicate with other people in the system. And then also, even in situations like in HTA or reimbursement, they could have tools to help them decide which drugs they're going to approve or reimburse as well. So the scope is actually really huge. And that's really exciting, and it's great that the advances in technology that we've had can help improve people's health and people's lives and make those processes to developing medicines more efficient. But actually, it comes with a few challenges as well in terms of the governance and regulations around it is not set in stone yet. And that's because the scope is so wide, and that can actually make it really difficult for people to try and get involved in those processes.

Clarinda: 48:08
Yeah, I think that what struck me was that we went into this conversation thinking that it was about patient involvement in health tech. But one thing that Cecil kept saying was that if the app is meant for patients, then you talk about patient involvement. But essentially it is about user involvement, whoever the user might be. And that is where the scope comes in, right? Because, like you said, it is not just for patients, it could be for so many stakeholders, it could be used at so many levels where it could really have massive benefits and exponential impact, really, if used well.

Speaker 3: 48:52
Yeah.

Clarinda: 48:52
And that is where, like you said, the challenges are also huge. Because my thinking was, and this was one of the questions that I asked Cecile about how tech companies are so proactive in user engagement. Usually, when they're designing products, it's always so user-focused, and you know, they'll conduct user interviews first, and there's so much user research that goes into product thinking. But in health, it might not be as simple because and this ties back to the conversation that we had with Mark more than a year ago now, where we spoke about digital health and health data, and one of the challenges we talked about there was that there's no overall single mode of governance and there's no clear regulations in terms of how stakeholder engagement can happen. So it just means that even if these health tech startup might want to engage users, they a might not know how to go about it in the ethical regulatory way. They might not know the complexity of the system, they might not understand it because they can't directly apply tech principles, you know, that they would apply in building a regular tech solution when it comes to user research and health. So that adds a whole new layer of complexity, I think, when it comes to user or patient involvement in health tech development.

Caitlin: 50:31
Yeah, and I guess the other insight that we got is actually a fair few of the startups that Cecile said she was working with, they've actually come from a background of tech rather than a background of health. So in that case as well, hopefully they'd bring their processes forward about integrating users in that development journey. But actually, in the health space, people might be a bit more reserved about going through with that without the regulations in place. So I can imagine that that causes a bit of a barrier. Friction, yeah, in that case, because it won't just be patients and stakeholders invested in this, there'll be people who actually their speciality is tech and the coding. So that's an interesting dynamic to consider as well. And also on top of that, considering that there will be investors because that this is a heavy sort of upfront investment piece, and they will need to be convinced on the unmet need and the argument. So, in a way, hopefully, at least that sort of insight in terms of what's needed will be there. And you know, hopefully those learnings from the tech industry about bringing the user on that journey are built in, but there certainly are a lot more regulations generally about involving agents, especially if it then becomes a medical device. There will be stricter rules around that.

Clarinda: 52:04
Yeah, yeah, I agree. I think that this whole episode was a lot about collaboration. And like you said, I can imagine that it's almost like a coming together of very different worlds where things are often done in such a traditional and slow way versus a world where things are done super fast and innovation is the norm and constant agility. So I can imagine that these collaborations could, while creating some friction, they could also spark a really exciting working environment. Yeah, I imagine, that could create some really truly meaningful innovation that could revolutionize the way healthcare evolves and the kind of impact that it has could actually really be tremendously beneficial, I think, to so many stakeholders.

Caitlin: 53:02
Yeah, absolutely. And then the question is just how do we integrate that into the system? Because I think that might also be a challenge. You can develop a really cool tech, but actually, how does that fit into, for example, a healthcare system if it's something doctors are using, or how do we push it out to patients if that's something they're using? And then actually there might even be more regulations if it's impacting patient care, or how do we make sure that actually if it's being really efficient in terms of helping to recruit for clinical trials or bind molecules, for example, how can we roll that out on a more global level to make sure that everyone's getting access to this tech that's really making the system more efficient? So I think it's a really exciting area. And as tech continues to develop, there'll be great opportunities, and it's just whether the health environment can move fast enough to keep up.

Clarinda: 54:03
Yeah, it'll be an exciting space to watch for sure.

Caitlin: 54:07
Thanks so much for listening today. This has been not just patience with our guest, Cecile Taladish Rini Melson, and your host that we can just remember the readers and the same thing.


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Caitlin Rich

Co-host
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Clarinda Cerejo

Co-host