Dear Doctor: Indu Subaiya
By: Maya De La Rosa-Cohen
Tags: Healthtech, Healthcare, Entrepreneur, Founder Stories, Dear Doctor

The co-founder and President of Catalyst @ Health 2.0 on entering the healthtech space and what lies ahead for the future of healthcare.

A physician by training, Dr. Indu Subaiya is a visionary leader whose work as co-founder of Health 2.0 and Catalyst @ Health 2.0 has inspired new and vital technologies in healthcare. In 2018, Indu was selected as a fellow of the Aspen Institute’s fourth class of Health Innovators Fellows. She has served as Vice President of the Society for Participatory Medicine and on advisory committees of the Department of Health and Human Services and National Health Data Consortium. Read on to learn more about her transition from medicine into the health tech, and what she believes are the most promising advances in the space.

“In hindsight, going into medicine was a bit of an unexpected decision. During high school and college, I was strongly drawn to the social sciences, communication, and writing. But behind my true motivation toward medicine was the appeal of working with people in a way that would make the world a better place. In some ways, I looked at medicine as a means to entering a system that took care of people. From the very beginning, medicine had a social mission for me. But I don’t know that I put all of the pieces together of what a career in medicine would actually entail. I went to medical school directly after college, and had a very optimistic, wide-eyed perspective of the industry at that time. Soon enough, I learned that there were things that I loved and didn’t love about it, and began to evolve my career accordingly.”

Transitioning from Medical Professional to Startup Entrepreneur

Once I started medical school at Stony Brook, I immediately found myself involved in healthcare reform. I joined the student chapter of the American Medical Women’s Association, and was passionately involved with curriculum changes at the school. For example, teaching doctors how to recognize symptoms of violence, how to properly detect cases of domestic violence, and how to train the profession to triage women appropriately. I was also involved in a group that visited the New York State legislature to lobby for policies that we felt were important for the practice of medicine, including opposing certain medical legal issues that made decision-making as a provider difficult. While entrepreneurship might not have been on my mind right away, the concept of changing a system always was at the forefront.

Toward the end of my fourth year, a friend of mine in the technology industry had started a company focused on advancing the first palm pilots used by doctors in hospital settings. The company was particularly interested in what the concerns would be around HIPAA, and what adoption issues might arise in their user base. So they asked me to do a fourth year research project based on how their technology would be perceived in a clinical setting. This project became my first landscape analysis for new tech. I began talking with different stakeholders to understand the issues and challenges around this new product, and soon became fascinated with the intersection of healthcare and technology. At the time, I had no idea that my interest in that one small piece of technology would lead to a career in healthtech, but it did spark an interest.

Rather than applying to residencies after receiving my MD, I decided to transition to working in the healthcare industry in San Francisco, where a lot of the tech scene was unfolding in the early 2000’s. I got my first job at a consulting firm that was working specifically on how to commercialize novel technologies, both in the biotech and lifescience spaces. My role there was to apply my clinical background to discover what was needed in order to make new technologies adoptable. The firm was a startup led by an entrepreneur, and taught me a lot about startups and how to create something new and get it out into the world. I decided to get my MBA at Berkeley while working in the industry to give me a framework for how to build successful organizations.

During the early days of my healthtech career, I was very motivated to start my own health technology company. At this point in time, around 2003 and 2004, the web was going through its next iteration and it was an extremely exciting time for connected networks and online communities. I thought I was going to start a tech company, but ended up starting Health 2.0, which began as a forum for bringing together entrepreneurs and companies looking to use technology to disrupt healthcare.

Unexpectedly, we ended up growing Health 2.0 into a global community of entrepreneurs, healthcare professionals, and policy makers who thought that healthcare could be more efficient and more patient-centered, and believed technology could help us achieve those goals.

The first conference’s theme was “user-generated healthcare,” centered on the idea that medicine’s end-user is what’s most important, and we need a system that’s focused on patient needs rather than external incentives.

While it’s been a long journey, and we certainly haven’t solved everything, when you look at today’s conversations on value-based and patient-centered healthcare, it’s clear that the industry has moved in the direction we highlighted during that first conference and that technology has helped enable this movement.

In 2009, there was a big movement around open data and healthcare that began under Todd Park, the former Chief Technology Officer of Health and Human Services. This movement was very inspiring to those of us in the tech community who understood that open data would enable entrepreneurs to build tools and services to make that data usable for individuals and the larger healthcare community. This movement also inspired me to launch Catalyst @ Health2.0. At the start, we began our work with the federal government on a series of innovation challenges, where datasets would be available to entrepreneurs who would then use that data to build various solutions. We hosted some of the first hackathons in healthtech with Google, and offered competitions to the innovation community to catalyze new solutions in healthcare.

Over the years, Catalyst evolved from running those shorter programs to running longer ones. As the technology got more sophisticated, we began matchmaking between entrepreneurs and large systems that needed the solutions built by these entrepreneurs. We began to administer programs like the digital health marketplace in New York City that over the course of three years connected all of the hospitals in NYC with entrepreneurs. Similar programs have since been replicated in places like India and Brazil. We’ve also kicked off a number of projects with foundations to find better solutions to issues like the opioid epidemic or the social determinants of health.

Today’s Most Promising Innovations

Right now I’m watching the space of the “flipped stack company,” a fascinating development with emerging companies that begin as tech startups, but soon transform into full-on healthcare delivery systems. The diabetes management company, Virta, is a good example. Virta started with a platform–remote monitoring, and new clinical protocols to help manage, and reverse diabetes. But then Virta begins to hire its own doctors, negotiate reimbursement contracts directly with payers, and eventually transform into a fully functional healthcare delivery system, which is no different from a clinic or hospital. This new category of companies cannot separate the tech from the service or from the provider. They’re driven by AI and have high-touch, remote care. But they hire their own clinicians and compete with the more “traditional” healthcare delivery systems.

The Future of Technology in Healthcare

I think we can imagine a system where, in thirty or forty years down the line, we may have a few players that emerge to take on a few different disease areas. We could also begin to see a larger player emerge from an aggregation of some of these best practice technology platforms and services.

On the other hand, we could also imagine that, in thirty years or so, the “traditional” healthcare system really figures out that it needs to reinvent itself in order to survive. We may see today’s version of Cigna, Aetna, Kaiser, or the like become another type of service organization that’s highly automated, personalized, and AI-driven, and that utilizes new technology companies to compete on a level with Amazon. That may be the longer view, but I would argue that that evolution is no different from what we can expect from every other industry in the next thirty or forty years. Of course, the flipside can be terrifying, too, in terms of how far we allow this automation and reliance on data to go forward without some sort of regulation. Though, I am really happy to see the healthcare and tech industries addressing these concerns already.

Vital Signs

Favorite spot in LA? I love the arts district in downtown LA. A happy day for me is walking through Hauser & Wirth and checking out that rapidly changing part of our city.

Next stop on your travel bucket-list? Our son has a very strong interest in history, and I’m hoping to take a trip with him to visit Pearl Harbor to help him understand the context of that important moment in history.

Go-to meal? I’m obsessed with the South Indian fare at DOSA in San Francisco, and I’ve been begging them to come to LA.

How do you de-stress after a tough week? I’ve been meditating for five years, and I’m a strong believer in bodywork and massage. I also believe that spending time with friends and family, whether it’s a family barbeque or attending free Shakespeare in the Park, is one of the easiest and most natural ways to de-stress.

Best question you’ve been asked as an entrepreneur? “How have I responded to very critical setbacks?” I don’t like using the word “failure,” but I believe that zero-ing in on the low points and what you can do to recover is extremely helpful for anyone starting a new venture. The more you can reflect on the inevitable challenges and various possible paths to resilience, the better prepared you’ll be.

You can learn more about Indu Subaiya here.

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