From Alexa to Watson, Boston Children’s Hospital Ups Digital Focus
John Brownstein spends a lot of time thinking about how to build the hospital of the future. One thing the chief innovation officer of Boston Children’s Hospital is sure of: digital technologies will be a cornerstone.
“Brick and mortar will always be incredibly important,” Brownstein says, referring to treating patients within a hospital’s walls. But at the same time, “so much of that interaction’s going to happen virtually,” he says.
That’s due to a mix of coalescing factors: hospitals’ adoption of electronic medical records systems; the proliferation of wearable health-tracking devices; patient demand for online medical information and virtual doctor visits; and the healthcare industry’s shift from a fee-for-service model to value-based care reimbursement.
“So much of the focus is on keeping populations healthy, rather than dealing with illness,” Brownstein says. “Digital is going to play such a huge part of that.”
Boston Children’s Hospital (BCH) is one of the largest pediatric medical centers in the U.S., and it claims the world’s largest research group based at a pediatric hospital. Part of Brownstein’s job is to make sure the organization stays on top of the digital transformation of healthcare—and, ideally, helps lead it.
Brownstein, a Harvard Medical School professor and BCH faculty member for over a decade, was tapped as the hospital’s innovation chief last June. He succeeded Naomi Fried, who was the hospital’s first chief innovation officer and held that position from mid-2010 through late 2014.
Brownstein has focused on striking partnerships with outside companies—including IBM Watson and venture fund Rock Health—while also revamping BCH programs that support in-house innovation, particularly around digital technologies.
“Generally, the innovation program had been focused, in a good way, on building a culture of innovation and forcing the communication about how to think differently about [clinicians’] workflow and new digital tools to improve care,” Brownstein says. “A lot of these projects tend to be piloted, but then die on the vine.”
Still, BCH has churned out some promising digital health startups. It helped launch cloud healthcare software startup Act.md, which raised an $8.4 million Series A funding round last year. Epidemico—a population health data company co-founded by Brownstein and spun out of BCH, Harvard Medical School, and MIT—was acquired in 2014 by Booz Allen Hamilton for an undisclosed price.
Over the past year, Brownstein has worked with Jean Mixer, BCH’s vice president of strategy and digital health, and others to sharpen the hospital’s focus on shepherding promising ideas to the point of licensing the technology or forming a startup. They launched the Innovation and Digital Health Accelerator about three months ago, which is the successor to BCH’s Innovation Acceleration Program that had been around for several years, Brownstein says.
He wouldn’t share the size of the new accelerator’s budget, but he says about 50 BCH employees are involved in the initiative. One of the changes from the predecessor program: bringing in people with business development and strategy backgrounds, as well as software developers, he says.
The accelerator team is “a great mix of all the components” a startup might need, Brownstein says. “We’re helping people think about business plans and markets and competitors and funding strategy. We’re taking it somewhat to the next level.”
BCH is doubling down on in-house innovation at a time when other hospital systems are doing the same, including nearby Partners HealthCare. Partners, which includes Massachusetts General Hospital and Brigham and Women’s Hospital, has an early-stage venture fund that invests across drugs, diagnostics, medical devices, and healthcare software. The fund was created in 2007 with $35 million from Partners, and the system reportedly pumped another $65 million into it this year.
BCH supports startups and projects in its digital accelerator through “in-kind resources,” but is not making equity investments in the companies, Brownstein says. “We’re not quite there yet,” he says of a potential venture fund. “We’re exploring all options when it comes to the future. First we’re testing the model that we can successfully source companies from the inside and grow them.”
At the same time, BCH has signed a flurry of partnerships with outside tech companies in recent months.
Among the deals: BCH is using IBM Watson’s computing capabilities to analyze genomic data to try and find better ways to diagnose and treat rare pediatric diseases. The hospital’s physicians are also delivering medical second opinions online via a partnership with San Francisco-based startup Grand Rounds. And BCH is advising digital health startups that are in Rock Health’s portfolio; the hospital has also agreed to help pilot their technologies if they have applications in pediatric care.
And Brownstein says BCH is planning to announce a project in the next few weeks that will “embed Children’s Hospital know-how” in the Amazon Echo, a voice-controlled speaker that can run apps and is powered by Amazon’s Alexa voice-assistant software. (Brownstein is mum on details for now.)
The partnerships are all aimed at spreading BCH’s expertise beyond its buildings in Boston, and trying to have a wider impact on pediatric care, Brownstein says. Digital technologies help make that possible.
“If we’re going to expand our reach, it’s not necessarily going to be [through] our workforce,” he says. It’s about figuring out “how do we take our know-how and turn it into decision support, so it can be embedded in apps on [electronic medical records systems], or devices, or Web-based tools?”
Of course, implementing new technologies is never simple, especially in a complicated and often slow-moving industry like healthcare. It’s getting easier for digital health startups to integrate their products in hospitals, but there’s still room for improvement, Brownstein says. “Just changing existing workflow [at hospitals and clinics] is always challenging,” he says.
Take wearable devices and health sensors, an emerging sector of digital health. If these technologies end up playing an integral role in patient care, the conversation between a doctor and a patient will move from sharing “huge amounts of information all at once,” during an annual physical, to sending “little pieces of information continuously,” Brownstein says. It’s like going from being a pen pal with your doctor to tweeting at her or him all the time, he says. “That just changes the nature of the relationship.”