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Q&A with Julien de Salaberry: Connecting Medical Investors With Promising Startup Solutions

Julien de SalaberryJulien de Salaberry has created the only known database cataloguing health startups in the Asia-Pacific and U.S. regions, as well as major players in Europe. You can follow him on LinkedIn or visit his site GalenGrowth.com.

Tell me about how Galen Growth came to be and what the company does.

Galen Growth is a 4-and-a-half year old company that is headquartered in Singapore, where most of the staff are based, and also has an office in Basel, Switzerland, where I am located right now. It also has coverage in the U.S. and other parts of Europe. It came out of a discussion between health care entrepreneurs about the need for much greater collaboration between corporations, investors and innovators in the Asia-Pacific region.

It has become the global leader in analytics, intelligence and matchmaking for the healthcare industry, including pharmaceutical companies, device makers, insurance companies, banks, and tech companies; and investors, including venture capitalists as well as traditional investors.

At the core of everything we do is the most accurate and complete database in the world of digital health ventures, which includes the regions of Asia-Pacific, the US, and Europe. Clients can navigate the platform and search for the needle in haystack, which could be a hidden gem among all the startups out there that will provide them with the investment opportunity they are searching for.

Right now we have 12 people on staff, and we have grown steadily and organically without external investment, purely based on our success.

What health technologies have been growing fastest in Asia and Europe?

One of the things we do at Galen Growth is to break down the startups we list and figure out what the building blocks are and why we think they will be successful. And 50% of the decision-making for investors is the leadership team of the startup rather than the actual technology it offers.

Technology in digital health has seen a transition from online and ecommerce health web interfaces to more of an AI-based, diagnostic or educational interface that is more sophisticated than the previous models. At the end of the day, though, both the entrepreneurs and the investors are more focused on solving a pain point. Some of these solutions, particularly in developing nations, may have little to do with technology, but will nonetheless be effective on solving the pain point at hand.

Investors do sometimes want to approach their decision-making by looking at technology, but that often isn’t a good indicator of whether a startup will become successful and provide a good value for the investor.

What do you believe has been driving technological advances in health care?

When you look at health care markets, there are three different groupings: mature markets, developing markets, and new frontier markets. These three have very different levels of sophistication for the technologies available today. The disease burden combined with the sophistication level will set the parameters for how technologies can be used and have very different drivers for the solutions used.

Japan is a mature market concentrated more on robotics and keeping the price of healthcare stable for an aging population, while Myanmar is a new frontier market that is in the process of building a primary care infrastructure that may end up resembling other mature markets or may end up leapfrogging existing infrastructures and building something that can reach many more people in a more effective way than current setups would allow.

There is actually a lot of innovation out of China, from bots triaging patients to kiosks on university campuses diagnosing patients on the spot when it’s a simple diagosis and filling prescriptions automatically. The adoption is high, but the disease burden is also high, and these differences are being emphasized by conditions over the last few months with COVID-19.

How has telemedicine grown over the last few months with the coronavirus outbreak?

The pandemic hit Asia some time before Europe and the U.S., so you can see that wave go from East to West. And it has demonstrated that health systems are inadequate to address a pandemic. Not only were they ill-prepared for a pandemic, but they were ill-prepared for the volume of care that would be needed in a short period of time as well.

One thing that has emerged from the pandemic after the healthcare needs have somewhat flattened is the development of track and trace technology to keep track of new outbreaks and be able to figure out where they came from so they can be stopped. These apps have led to new confinement rules that have impacted how a patient or consumer sees their doctor, as many doctors and patients want to limit in person contact right now for safety reasons.

Because of these factors, we have seen a push towards adoption of technology and what we are calling the digital patient journey, a move from awareness of something to diagnosis, and management of that disease. In Asia-Pacific, a number of people are starting to reach out to third-party organizations to get information about whether they need more medical care, and then reaching out to the doctor when they see that the need is there. These technologies are becoming part of the new normal when it comes to the patient’s digital journey, including teleconsultations and even chatbots to determine whether care is needed.

Person on their phone while viewing a graph on their computer.

Are significant numbers of people using telemedicine in the companies you work with/in your experience?

Traffic growth for teleconsultations has grown almost a thousandfold as many physicians have seen the need not to have potentially ill people congregating in waiting rooms and coming into contact with each other during the current pandemic. Until now, physicians have been resistant to teleconsultation, but they have been forced to embrace it, have realized it’s not so bad, and that it actually makes them more efficient.

COVID-19 has accelerated adoption of these technologies because whereas teleconsultation may have been perceived previously as a less effective method than in-person care, it is now seen as preferable to the risks of in-person care in many cases, but also preferable to no care at all, which might be the alternative during a pandemic.

Will the pandemic lead to widespread adoption of telemedicine and digital health technologies?

It will be adopted in a more widespread way as people get used to the technology and begin to realize that it works and is often more convenient for both the patient and the doctor than other ways of delivering the same services.

When it comes to adoption of digital technologies, we at Galen Growth are acutely aware of which digital health startups exist and already provide these services, and we are spending a lot of our time looking at how programs can collaborate to solve problems. Right now, for instance, sales reps for pharmaceutical companies and medical device companies can’t meet with doctors, so they are finding other ways of doing it using digital health, even using a new technique called telesurgery to connect with the surgeon that would use a particular medical device.

“There is an economic slowdown without doubt [because of COVID-19], but I think outside of biotech or medical device hardware, we are not going to see as much of an impact on digital health innovation as you might think.”

What, if anything, is getting in the way of healthcare growth and innovation?

We are currently seeing some shift in regulations in favor of digital health technologies, but that can be a big obstacle at times. Right now, regulations are being suspended in some cases, like in South Korea where telehealth was illegal, but has just become legal. In Japan, filling prescriptions online was illegal, but has now become legal, and in the U.S. teleconsultations across state lines were illegal but are now legal. The FDA has been an early adopter of adjusting regulations, but in other countries where vested interests are in play, regulations have not been so quick to change.

Scaling solutions to provide access is another obstacle to innovation. Generally, health systems have been slow to adopt these technologies, and many had put them on their road map, but not on their near term road map until COVID-19 came along.

And finally, the short-term greediness of investors has been a detriment to digital health. Some of these technologies need a longer period of time to be adopted and produce an investor return. But overall, the business case for innovations is very clear now, and when we step out of pandemic, I think there will be a shift.

What impact will a slowdown have on medical technology advancement and adoption?

There is an economic slowdown without doubt, but I think outside of biotech or medical device hardware, we are not going to see as much of an impact on digital health innovation as you might think. Galen Growth is tracking investment in digital health, and we are already seeing bounce back in China and India as well as other Asia-Pacific countries. Europe and the U.S. are still in the middle of their outbreaks, so it remains to be seen whether the bounce back will be as strong.

The sheer demand from industry for digital health and teleconsultation remains strong and will likely drive the market, although it will take some time and recovery to see growth again in the short term.

That being said, health systems will necessarily come out of COVID with high indebtedness, which will cause them to rethink how they address healthcare needs and look at where they have been proven to be inadequate.

Preparing for a second wave of COVID that may come is going to be important. Health systems should consider where COVID patients can go besides hospitals to get treatment in order to relieve the burden on hospitals and also allow non-COVID care to take place. Systems should have learned a lot of lessons and realized that they need to address pain points created by COVID. Stronger adoption of technology will be needed to do so, and this will impact growth.

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