Physician perspectives: Patricia Salber

In our latest physician perspectives interview, pharmaphorum’s Hannah Blake speaks with Patricia Salber about all things digital, social media and mobile health.

Every month we interview a physician to find out his or her perspective on the relationship between the pharmaceutical industry and physicians, as well as how the rise in social media and digital technologies has affected their way of working.

July’s physician is Patricia Salber, who believes that “this is one of the most exciting times in healthcare” due to the increased level of engagement we are seeing between patients and physicians in the innovation of new drug delivery systems.

We speak with Patricia about the inspiration behind setting up her blog, The Doctor Weighs In. Patricia hopes that in the future we’ll see more of a “breakdown between things considered strictly healthcare and things that we, as people, could try and maintain“. Find out more of her opinions in our interview summary below.

Interview summary

HB: Hello Patricia, thanks for taking part in this series. To start, can you tell us a bit about your background as a physician please?

PS: I trained in internal medicine and did an endocrinology fellowship at the University of California, San Francisco. But when I went into practice I discovered that my real love was emergency medicine, and that’s what I ended up practicing at Kaiser Permanente for about 18 years, and loved every minute of it. Then I had an opportunity to go into administration for the national Kaiser programme, working with large employers, because that was a time when most people in the United States got their health insurance through their employers. And then later I spent six years as a Kaiser Permanente physician executive on loan to General Motors. It was a pretty exciting time.

“…we feel like we know each other even though we initially met through 140 characters.”

HB: What was it that inspired you to set up the blog The Doctor Weighs In and why do you think it’s so popular?

PS: I actually started writing the blog when I had an affiliation with an online weight loss programme, and I discovered that I loved writing about it. I initially wrote mainly about diet and weight loss, and then expanded into other aspects of endocrinology because of my prior training, and then other writers started joining me. I now have about 11 writers who contribute regularly, and another 20 writers who ask that we repost their material on our blog. And I think that accounts for the popularity, because we have high quality writers whose posts are content rich, with no fluff, and we have a lot of variety.

HB: Have you found that the rise in social media has affected your way of working as a physician?

PS: Well I’m not practicing now, so I can’t say that it’s impacted the way that I practice medicine, but it certainly has impacted the way I handle the blog, and my new company, Health Tech Hatch. It is a fantastic way to communicate with people. I’ve met a lot of folks first on Twitter, and then I meet them at conferences – people will often have both their name and their Twitter handle on their badges, and we’re always going, “Oh so you’re the Afternoon Napper,” “Oh so you’re Healthcare Wen,” and we feel like we know each other even though we initially met through 140 characters.

HB: Certainly know that feeling. And you recently founded Health Tech Hatch, which is an online crowd funding resource for health technology entrepreneurs, and what is the aim behind this platform?

PS: When I decided I wanted to start working in the area of digital health, mhealth, whatever you want to call this exciting field, I spent a lot of time going to meetings where I could meet mhealth entrepreneurs. This is because I was trying to figure out where I would fit in this space. I would ask them, “So what do you need, how can I help out?” And they said, not surprisingly, “We need money, and we need access to doctor and patients to get feedback on what we’re developing,” because a lot of these folks come from technology as opposed to healthcare backgrounds. So I said, “Okay I can do that.

We built out the crowd funding site first, which went live at Health 2.0 in October last year, and since then, we have crowd funded a number of projects. We then discovered that if you didn’t have projects that were pre sales of some cool gizmo or gadget, it was really hard without equity crowd funding, currently not possible in the US, to be able to raise much beyond about $10,000 / 15,000. Sometimes you get up to $30,000, but it wasn’t really large sums of money. Plus, the infrastructure for crowd funding can be somewhat daunting and expensive.

“…we built a platform that allows us to connect patients and doctors and caregivers, asynchronously with developers…”

So recently, we decided to partner with a large crowd funding platform, Indiegogo, so we could combine the best of both worlds: the healthcare expertise of Health Tech Hatch and the international reach of Indiegogo. So now when people crowd fund with us they actually are posted on our Indiegogo partner page as well as the Health Tech Hatch page. This will allow people to have a much broader reach in terms of people who see their projects and be encouraged to donate to their projects.

We also have another new service line, which is pretty exciting. In order to meet the needs that the entrepreneurs told us, about increasing access to doctors and patients, we built a platform that allows us to connect patients and doctors and caregivers, asynchronously with developers. Developers come to our site and post their project, and then we activate our tester community. The hope is that by engaging end users early in the development process we can end up with more apps that people actually use. One of the biggest problems in the field of mobile health is that there are thousands of apps that are never downloaded, and if they are they are only used maybe once or twice. It’s not a sustained use. So we’re hoping that by engaging end users in the development we’ll be able to turn that around.

Our first project using this patient co-design idea was with Health and Human Services’ healthfinder.gov mobile app challenge. Also, just two weeks ago, we started working with another part of Health and Human Services, the Office of the National Coordinator, (ONC) to do patient codesign of applications that will help people be able to use their health data that comes to them via the Blue Button, a technology that enables downloading of such data

HB: In your opinion, how do you think the relationship between pharma and physicians can be improved?

PS: Well I’m not sure that the relationship is terrible. There’s a lot of concern about practices in the past, which I think pharma pretty much is not doing or is not able to do anymore, where docs would get goodies or all the way up to fancy vacations, in the hope that they would prescribe their branded medication. There still is some concern around pharma and its use of physician experts, but I think we’re working our way through that.

What I’m hoping for, and this is with my Health Tech Hatch hat on, is that pharma can work with an organisation like us, not around the science, but to address some of the issues relating to patient adherence. An organisation like Hatch could bring in doctors and patients and caregivers and address questions such as “how does the pill look?“. “how does the pill taste?“, “Oh that inhaled insulin delivery system is so huge I’ll never carry it with me,” for example. We think that could be a way to overcome a piece of this very complicated puzzle that is adherence to medication, which is such a huge problem in healthcare.

HB: Finally, what do you think the big trends in pharma will be in the next decade?

PS: That’s interesting. While I’m not a pharmacy expert, I would say that I’m sure pharma’s main issue is to make sure they have a full pipeline of drugs in development.

“…I prescribe you a medication, but I also prescribe you an app that will help you use that medication correctly.”

I think that there is a trend towards more “do it yourself” medicine, that’s my term for it. I really mean more patient-initiated medicine. I think there will be an increasing need for medications that people can purchase over the counter as opposed to requiring prescriptions. I think there is also a huge need to have more medications that can help people with lifestyle issues that are driving so much of the healthcare issues that we have.

But I also think that there is a trend now, maybe pharma won’t want to hear this, but for people to say, “Hey, maybe I need a prescription for something besides the medication.” So in my field, there is a big push for people to develop really powerful mhealth interventions and then to encourage physicians to prescribe a mhealth intervention as opposed to just prescribing a medication. And maybe those things will work in concert, where I prescribe you a medication, but I also prescribe you an app that will help you use that medication correctly.

HB: Brilliant, thank you very much for your time.

About the interviewee:

Dr Patricia Salber is the Founder and CEO of Health Tech Hatch, a resource for healthcare entrepreneurs that provides a platform for crowd funding as well as concept testing by representative end-users (patients, caregivers, clinicians). The site recently served as the co-design platform for HHS’ Healthfinder.gov mobile app Challenge and is currently serving as the platform for HHS’ Blue Button Patient Codesign Challenge. The company was recently chosen to be a delegate to the inaugural TEDMED Hive.

Patricia is a board certified Internist and Emergency Physician with for more than 15 years experience as a physician executive. She has had leadership roles in many different areas of health care including medical groups, health plans, employer groups, and non–profit organizations. She served as the first Physician Director of National Accounts for Kaiser Permanente, Medical Director of the Kaiser Permanente-General Motors Team, and Chief Medical Officer for a Medicare Advantage plan as well as the Center for Practical Health Reform.

Patricia has founded three companies and served on the boards of a number of other healthcare organizations. She also founded and contributes regularly to a popular, widely read healthcare blog, TheDoctorWeighsIn and she is a founding member the Health Innovation Broadcast Consortium (www.hibc.tv), which brings together influential healthcare bloggers, journalists, and social media leaders to provide an independent view of healthcare innovation.

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