Latest / StartUp Health NOW Podcast / #235: Roberto Ascione MD, Healthware

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#235: Roberto Ascione MD, Healthware · StartUp Health NOW Podcast

• 0:01
  [on-hold music] I'm here with Roberto Ascione. Did I pronounce that correctly? Great. All right. Uh, he is the CEO of, of Healthwares, uh, a healthware group in Europe.
• 0:14
  Uh, and he's also one of the leaders of Frontiers Health, uh, a-and has advised health tech in Europe for how long? As Healthware, we have been around for the past 20 years. Okay.
• 0:25
  Uh, and of course, very much into digital health since '10. Okay. Uh, and Frontiers Health is up and running since four years now. Okay.
• 0:33
  So this gives you a unique vantage point to understand the trends of digital health in Europe. So we kind of, we asked you here to, to give us your 10,000 foot view of where digital health is heading in Europe. Yeah.
• 0:45
  I think it's at a c- it's at a great moment. It's clearly maturing. Mm-hmm. Um, there's been a lot of progress over the last three, four years.
• 0:53
  Uh, the key things, um, we reached probably in the cou- last couple of years, a good level of, uh, available funding. Mm-hmm. So I think the early stage is fairly well covered.
• 1:05
  Uh, and we are starting to see also, uh, some more traction. Okay. Uh, I think companies have learned, uh, that Europe, it's, uh, clearly an interesting market to go. Mm-hmm.
• 1:17
  Uh, a few years ago, it was a little bit funny. You had companies that, in the very early stage, starting to get a little bit of traction, were looking to move to the US- Mm... which of course is a much different game.
• 1:28
  Mm. And some made it, but many, many others did not. So I think what's really new is that in Europe we've created the, the conditions for companies to kind of thrive- Okay... in the local markets.
• 1:40
  Um, companies learned, as I was saying before, that Europe can be a viable market. Each country, uh, the main ones are pretty decent healthcare markets.
• 1:50
  Uh, think about the UK, France, Germany, Italy are pretty sizable markets. And I think another key development has been that this company have learned that it's much better to be strong in one market first- Okay...
• 2:03
  and then understand what are other markets that they might, uh, attack. Uh, not just maybe the nearby ones, but more those that from a user dynamic and business model perspective could be more kind of suitable. Mm.
• 2:20
  So I think this kind of general conditions, uh, and this kind of learnings that the founders- Mm... uh, have in some cases learned the hard way- Yeah...
• 2:31
  uh, has created a kind of environment that now it's allowing a few companies, or several companies I should say, to really kind of thrive and scale and raise more funds. Okay. So you've said the conditions have changed.
• 2:44
  What are some specific ways that the conditions have changed so that traction, um... So you've seen the kind of traction that you have? Yeah. So I think the, uh, a, a few different things.
• 2:56
  So on one side, uh, the availability of, uh, uh, early stage funding- Mm... uh, in multiple countries, uh, of course has been important.
• 3:07
  Um, a generation of entrepreneurs that started to cultivate more digital health in a much more kind of wise and organic way- Mm... of course, has been very important. There's much more general attention- Right...
• 3:18
  uh, by the different stakeholders. Why do you think that is? Um, well, I mean, uh, first because the, they've been observing clearly the US dynamics. Okay.
• 3:28
  Uh, so the ecosystem in Europe is probably, uh, I would say roughly, uh, it was at several years behind, has been catching up quite fast, so it's still a bit less developed than over here. Mm-hmm.
• 3:42
  But clearly this kind of, um, kind of mirroring effect has been, uh, playing a role. Um, look at Frontiers.
• 3:50
  When we started four years ago, Frontiers Health as the health vertical of the Frontiers Conference, uh, that has been o- for the past, say, 10 to 12 years in Europe, uh, really talking about innovation.
• 4:01
  Uh, when it, when we did start and they, you know, asked me to lead this as chairman, uh, basically the movement was really in the beginning.
• 4:11
  So the conference itself as a, a, a place for the ecosystem to kind of meet and mingle- Yeah... uh, also probably contribute a little bit. Mm.
• 4:18
  When you look at the conference last November where you guys had like a full, uh, kind of breakout with the sort of mini festival as we said with Unity, uh, European version was really successful.
• 4:32
  It's now a 600 people, you know, event. Uh, all the stakeholders, insurance, uh, pharma, um, so all the life sciences investors, including startups. Uh, when you look at four years after, it's really night and day- Mm...
• 4:47
  uh, because of the size of the companies, the level of maturity, the products, the traction they're gaining on the market. Mm. And in fact, we are also starting to see the first acquisitions.
• 4:56
  Uh, so in Europe we had, uh, uh, now nearly two years ago, the MySugr by Roche. Mm-hmm. Uh, recently we had the Noona Bavarian, uh, just few weeks before the event, and, uh, they were, uh, speaking at the conference.
• 5:10
  Uh, so I think we are also starting to see, uh, we had volunteers doing the IPO- Yeah... in the digital therapeutics space. So I think we are starting to see also some kind of path to value- Mm-hmm...
• 5:22
  and some early exits. Clearly, you know, it's just the beginning- Mm... but I think this is contributing, you know- Mm... to kind of encourage- Mm... all the ecosystem to develop. Mm. Yeah.
• 5:33
  You mentioned this idea of a mirroring effect and the European market being a couple years behind the American market.
• 5:39
  Uh, does that open up an opportunity to, uh, see what has been tried and maybe even leapfrog over mistakes that have been made? Does that actually create a new opportunity? That's...
• 5:50
  I'm very in favor of this, and this is something that I, I think is not only happening in some cases, but I think it should happen as much as possible.
• 5:59
  Now-The markets are different, so it's not that all the learnings can be just kind of, you know, imported, so to speak, i- in Europe because the systems are fairly different.
• 6:10
  But certainly from an entrepreneurial perspective, uh, whether it's on the founder's side, the way you basically work on the capital side, the way you work, especially in the large corporations, uh, there's a lot of learnings that can be kind of mutuated from, from other markets.
• 6:30
  And there's a beauty to be first, I think. Mm. But there's also a beauty if you can... if you know how to play the game, to be a follower. Mm.
• 6:39
  Because you can learn, you know, and kind of, uh, leapfrog a number of mistakes that maybe have been done. So it's not everything because of difference of the systems, but I think there's a lot.
• 6:50
  And, uh, this is also part of what we do, uh, when we work on projects. You know, we have a fairly substantial operation as Healthware also in the United States.
• 7:00
  Uh, and our innovation division, for example, Healthware Labs, which works with the large scale corporates- Mm... and startups to kind of, uh, do innovation management and kind of fast track products. Mm-hmm.
• 7:12
  That was started not by chance in the States. Mm. And then we basically moved back in Europe, even if the company was originally founded in Europe.
• 7:19
  So w- w- I think there's a great value in this, and I believe it will happen the same with Far East, you know? Yeah.
• 7:25
  With China especially, it's very different again as a system, but again, there are a lot of things that can be mutuated.
• 7:33
  As a, as a healthcare consultant, you're under the hood, you're, you know, understanding the, the really the mechanisms that, that make digital health work, and yet with the moonshot approach that we have, it always comes back to this personal motivation or this desire to see change.
• 7:48
  Yeah. You know, we're celebrating moonshots from i- trying to end cancer to rolling out this new, uh, opioid addiction moonshot.
• 7:56
  Is there w- is there a s- a, a moonshot that really speaks to you personally that sort of gives you motivation to do the work that you do? Yeah, I mean, that's, uh, that, that, that, that, that's interesting.
• 8:06
  Um, and I'm very familiar with the moonshot concept since, uh, the i- ignition. Um, I'm very passionate for anything that is able to, uh, increase impact,
• 8:21
  uh, and humanize care through the technology. Mm. So my whole work since I was studying medicine back, uh, more than 20 years ago- Yeah. You're a practicing physician?
• 8:31
  No, I've been, uh, uh, study medicine, but never practiced- Okay... because I studied with the idea to basically work in this convergence of medicine and digital- Mm... because I was polluted early on with both sides.
• 8:44
  Yeah. Uh, so for me, digital health is really like, uh, very personal to me because in, in, it kind of, uh, nicely marries together my two main life interests. Mm. And the reason behind Healthware itself
• 9:02
  and the work we do with entrepreneurs, um, which, you know, can be physicians, can be nurses, can be, you know, other professionals coming from all different angles, it's really to...
• 9:15
  The overall idea is really that technology as happening in other sectors can democratize healthcare. Mm. That we know a lot of i- we need a lot of that.
• 9:24
  And finally, by removing complexity, uh, by removing, uh, waste of time and data, uh, will allow d- different players to gain back time to have more relationship with patients. So- Mm...
• 9:37
  my whole idea is that tech will at some point start to kind of disappear. Mm-hmm.
• 9:42
  Uh, increase efficiency, improve impact, and making healthcare a lot more human by making it sustainable because as we know, the systems are largely unsustainable, uh, regardless of the country. Yeah. Yeah.
• 9:54
  So that's basically what moves myself, my team, uh, which is now over 150 people, uh, all basically working on these concepts. What do you think are... What do you think is a big misconception about healthcare in Europe?
• 10:09
  A lot of people around the world really put healthcare in Europe on a pedestal and look at the Scandinavian company, uh, countries and the, uh, happiness i- indices, and they, and they see it, uh, as an ideal in terms of how healthcare is handled.
• 10:24
  I know people in the United States who see it that way. Um, are there misconceptions or, uh, things that people should know about European healthcare in general? Yeah.
• 10:33
  Well, that's, that's, that's a broad one, but in an- in essence, yes, healthcare, it's extremely good on average in many European countries. Yeah. And I can even speak for, for Italy.
• 10:45
  So the national health system is turning, uh, 40 years old this year, is universal, uh, provides access to care to everyone that is on, you know, uh, uh, in the country basically for any reason,
• 11:02
  and the average level is incredibly high. Yeah. Life expectancy is, you know, uh, uh, after the first, uh, uh, you know, uh, is among the first in the world, and the system works really well on average.
• 11:15
  The issues with those kind of systems is that, which is probably true in many other systems, is that the quality of the care can vary significantly- Mm...
• 11:25
  from, you know, kind of point to point, which is where I think technology can help for sure. Mm. Mm. And also, there's a general concern about the sustainability of the systems on the medium long term. Mm.
• 11:36
  With the aging population, with a, a absolutely appropriate desire for people to access the best care option possible- Mm... regardless geography or regardless, you know, income,
• 11:50
  uh, which I think it's absolutely correct. The systems w- are under pressure and will be under more pressure. So
• 11:58
  I think Eu- Europe and some countries e- especially are in a unique position to kind of amplify the pockets of excellence they have in the various healthcare systems. Mm. And in that case, I think ideally
• 12:14
  we in Europe should be using technology to kind of level the play field and give, and, and kind of rise the bar of the, you know, care- Mm... to larger population.
• 12:27
  Um, so because the average is good, but it might vary a lot. Yeah. So I think tech can help with that. Yep.
• 12:34
  And will certainly help to control cost because the cost is high, and is it then because a lot is social medicine. Yeah.
• 12:41
  Um, but if we don't, uh, handle costs, uh, that m- will have to change in a very different kind of system. Mm. And I think the hybrid, if not controlled well, might be dangerous. Yeah.
• 12:55
  Uh, so I think this transition to a sustainable system will have to be done, uh, in, in a smart way, and I think, uh, tech driven will be the answer. All right. All right. Thanks for taking the time to talk.
• 13:08
  Thanks for having me. And thanks for the work you're doing.