A conversation with Vasant Kumar Ramaswamy

We publish our conversations with inspirational individuals in the healthcare industry to promote the innovation discourse and support framework. We spoke with Vasant Kumar Ramaswamy, Founder and CEO of Scriplogix. 

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Scriplogix offers strategy, market research, and data analytics services to companies across the healthcare industry. Mr. Kumar’s work has been published in the Harvard Business Review.Mr. Kumar explains the findings from his research on the gap in education-innovation, discusses the importance of personalizing care navigation pathways, and offers insight into the blooming areas of healthcare. A transcript of our conversation is below.

Mr. Kumar: You guys are working on innovation in health care. That’s great.

Healthcare Innovators: Yes, we’re trying to learn how we can innovate as students. I came across your article in the Harvard Business Review. I really liked your article and wanted to ask a few questions about you and your motivations.

We have noticed that as students, we are encouraged to innovate but we do not know how. We are hoping to speak to influential CEOs and powerful thought leaders in the industry to learn what steps we can take as students.

Mr. Kumar: Right. In fact, that’s what our studies showed. The [work] that we did for Harvard became an innovation conference. All CEOs said there’s a need for building bricks for innovation in health care; however, when it came to schools, schools were not making students innovation-ready in the sense that they could hit the ground running. It took companies time to train them and orient them towards innovation and that was always a delta they had to add to academic training.

Healthcare Innovators: Right. You can imagine our surprise when we came across your article and noticed how similar the missions were. The reason that we exist is because there’s still a disconnect from the student perspective, as in students connecting to professionals themselves. It is easy to have faculty members bring CEOs to discuss innovation. It’s a different learning process altogether when students reach out. We think that’s more fulfilling on an educational and motivational level. It also gives us a great opportunity for us to speak with very influential leaders with whom we may never have connected otherwise.

You have a very fascinating background yourself. Would you mind telling us your story?

Mr. Kumar: I did all my education in India. I did a degree in mathematics, a degree in economics, and a degree in business from the Faculty of Management Studies in New Delhi. Then I worked at a consulting firm and joined the World Bank in economic policy; macroeconomics and policy. I also looked at health care from a policy environment.

I moved into microeconomics and strategy with Ranbaxy. At that time, Ranbaxy Pharmaceuticals was a company that was growing at breakneck speed out of India as one of the world’s largest genetic pharmaceutical companies, in the top ten. When I joined them, they were a small company, about $200 million in size and when I left them, they were about $1 billion in size. They grew 5 times in 5 years.

I was heading strategy and technology for the company. I was the CIO of the company and also the Chief Strategy Officer globally. I was going from policy and macroeconomics at the World Bank to strategy and microeconomics with pharma. This is what caused me to set up Scriplogix about ten years ago out of New York and now we are in New York, Princeton, and Chicago with a knowledge center back in India.

Healthcare Innovators: Amazing! I know you offer lots of different avenues to research. Can you describe what those are?

Mr. Kumar: We do three things at Scriplogix. One is strategy consulting, which also includes primary research with industry capitalists and CEOs of large health care organizations. It is mostly research in strategy and research that informs strategy for US clients. That allows us to interact with physicians, physician leaders, CEOs of large health care companies, pharmaceutical companies, diagnostic companies, and so forth. That’s one line of business.

The second [line of business] is analytics. We do a lot of analytical modeling and quantitative analytics, including predictive and prospective analytics. All of this is within the realm of health care.

Finally, we work on behavior shaping and computational behavior, which is understanding patient and physician behavior and how it applies to health care outcomes. These are the three things we do at Scriplogix.

I know you’re interested in innovation. Our trust is in personalizing care navigation pathways for patients. As an example, there are two diabetics. If we went to the same physician, [the physician is] bound to tell both four things. He’s bound to say, control your diet and your carbs in terms of intake, increase your physical exercise and activity levels, reduce your stress levels, and then he’d put them on a prescription medication.

It will be the same treatment because medicine takes the one-size-fits-all approach. However, what if I said you can control my diet anyway you want and I can pop any pill that you want me to, but I’m not going to be physically active. The other patient says I would do all the exercise in the world but I won’t be restrictive about my diet.

This does not mean that both of us can’t get to the right blood glucose levels. We can both get there but we’d be getting there through very different paths. Those different paths depend on our own beliefs, propensities of behavior, and our own attitudes.

There is a third behavior type. For example, my father is skeptical of medicine and physicians. That attitude will mean that if you treat that patient with the best medical regimen, you’re not going to get the best outcomes because you’re not factoring for his beliefs and attitudes.

How do you craft personal care navigation pathways for each patient that responds to the patient’s own situation, condition, behaviors, beliefs, attitudes, and motivations?

That, I believe, is where much of health care is headed, particularly because of the reform in health care where patients are required to take more responsibility for their health. There are a whole host of startups and innovative companies that are addressing this opportunity of how to make this happen.

The ACO, Accountable Care Organization, for example is one of the steps in the direction where government regulation is being used. The government is saying that if you have more readmissions, it will reduce the rate of reimbursements. These are incentives for beginning to think of patient-centered care in more fundamental ways instead of the one-size-fits-all approach.

Now, we’re looking at how you can treat each person in ways that resonate with their persona. There, we combine the use of large data, big data analytics, behavioral economics, and the whole host of nudging that’s driven by technology and artificial intelligence.

Healthcare Innovators: How long have you been working on this? Is it relatively recent?

Mr. Kumar: Yes, we have been working on this now for a year and a half. We’ve built the platform because this platform combines three things, which are different. It needs to have the ability to mine a patient’s reality; the ability to take large data sets that stream from any patient. It might come from the EMRs, claims, wearables.

How do you immersively track the patient, either at the individual level or at some population level? How do you get all the signals from around the patient?

These are very large data sets that might be buying habits, exercising habits, consumption, visits to a physicians, prescription drug your on, pretty much anything about you or people like you. That’s the whole data stream story. You need the ability to handle really large data sets, turn it around instantly, the ability to segment it, and to apply analytics at a sophisticated level. That’s the first thing [you need to get signals].

The second thing you need is an understanding of behavioral economics and psychology because you need to understand the motives of the patient, the ability of the patient and, what triggers behavior in that patient or that patient group. A physician understands what I’m saying like all diabetics are not created equal. It’s not the physicians that don’t understand it; they simply don’t have the time it takes to sit there, understand individual histories, and carve something that is custom made for you and me. In order to algorithmize those things, you need a solid understanding of behavioral economics and psychology. You need to understand computational behavior. That’s the second discipline that you need.

The third is all about technology assisted triggering or nudging. It is about being able to nudge the patient towards choices that deliver superior health outcomes without deceit, or persuasive technologies. This means the understanding of machine learning, artificial intelligence, and cloud-based delivery. Most of this is about creating unique experiences rather than technology, where technology becomes almost transparent. The patient is really looking at the impact of technology. I use the example of my father at 90+. How do I make sure he keeps within a certain weight range without being intrusive? How do I use technology to surround him in a way that’s ubiquitous but that’s not interfering in his life? Therefore, technology to design user experiences is the third thing.

From a talent perspective, I think each of these three things [are important] for students in the future of health care. I think the ability to handle really large data streams with a strong understanding of health care in itself is a competency that’s going to be applied in a variety of ways; the ability to handle large data, to draw insights from large data sets, to be able to support decision making from large data at the population level, at the sub population level, and then at the individual level.

The second point about behavioral economics and psychology is in itself an independent set of competencies that students can develop because the future is going to be punctuated with all of that.

Lastly, the nudging, persuasive technologies where machine learning is a subset of artificial intelligence but also a whole host of wearables and technologies that are personal that will constantly be streaming data. For example, we’re working on technologies that are driven through algorithms to prevent falls. Fall prevention is a big deal in health care particularly when a patient is discharged. Some of the biggest problems occur when a patient trips and falls. When a fall happens, they tend to stay 4 to 5 times longer; length of stay goes up.

How do you predict and prevent falls? How do you combine that with the Internet of Things so that devices can help you predict falls based on changes in gait? We’re working on how to detect Parkinson’s Disease from changes in vocal chord resonance, so from voice. How do use some of these large data technologies to create experiences for the patient to either prevent events that are adverse or to promote events that will improve health outcomes?

These are three areas that will have an explosive demand for talent. There will be an explosion of innovation in each of these. We’re seeing this already. We’re seeing a whole host of startups. At Scriplogix, we want to build this platform which combines a bit of all of this. Individually from your perspective as a student who is trying to draw attention to opportunities that can be led to innovation in health care, I think each one of them is a pillar on it’s own.

Healthcare Innovators: That’s amazing, really great to know. I had one last question. You mentioned where students can participate now. If you were in our shoes, what would you do different than what you did when you were in your undergraduate studies?

Mr. Kumar: I think a whole lot. The other way to look at it is, what I would advise my son. He’s an undergrad at the University of Chicago studying economics from there. What would I tell him? I think the future is in the whole area of large data. I hate to use the cliché term “big data analytics” but the problem is there’s such an influx of data while large health care institutions are still struggling for insights and the ability to build models.

You need not wait for perfection. You need not be 100% accurate. Good enough is invaluable right now, but you need to be able to deliver those insights at the point of action. As students, if you were to focus on not handling large data but bringing into it some intuition from the domain will be invaluable. Much of the future will be interdisciplinary. Your ability to combine behavioral economics with data science. Your ability to combine sensor technologies with the ability to build data models on the fly. Most of the future in health care will be about combinatorial skills, not just one skill, but you pick up two or three skills that confluence because there’s lots of interesting convergences happening.

My advice to students would be to pick two or three such areas that you’re seeing convergence, like behavioral psychology and data science. Be combinatorial in your approaches. You’re going to find the confluence of two or three streams of competencies.

Healthcare Innovators: Fantastic, amazing advice. Thank you so much for your time.

Mr. Kumar: My pleasure. If I can help in anyway, I am happy too.

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