The bright orange, yellow and green walls – covered in notes, project progress reports and washable marker scribbles – on the second floor of Froedtert & the Medical College of Wisconsin’s North Hills Health Center in Menomonee Falls more closely resemble a tech startup than the neutral-toned ambience one expects of a health care office.
Its interior design telegraphs the unique role Inception Health LLC – Wauwatosa-based Froedtert & the Medical College of Wisconsin’s innovation arm – plays in the health system: to change a change-resistant industry from within.
From the digital health hub, which has largely operated quietly since it was formed in 2015, homegrown innovations are conceived and external innovations vetted in hopes of solving key health care problems. In the past three years, Inception has implemented more than 30 projects that are now live within the health system, with another 20 in the queue.
“Health care is complicated,” said Mike Anderes, president of Inception. “We know we’re up against a tough starting point because of the regulatory nature of our business. But, even though it’s a little harder, it’s the same as other industries that have already gone through this. They have either changed themselves or have become obsolete. What we’ve been successful doing up to this point is becoming a magnet for people that want that change and giving them a way to do it so we get to the tipping point where it’s just the way we do things.”
Contained within the company are three separate functions: the innovation operation; a clinical arm, from which Inception staff remotely monitor the implementation of digital solutions; and an investment arm, through which Inception executes Froedtert’s corporate venture efforts.
The Inception team meets with Froedtert & MCW clinicians monthly to identify ways in which care delivery could be improved. While Inception’s projects are wide-ranging in nature, they trace back to the same initial question: What’s the problem?
One innovation to have made its way to patients is digital medicine service from Redwood City, California-based Proteus Digital Health Inc., which produces FDA-cleared ingestible sensors that are co-encapsulated with medicine. When swallowed, the sensor is “woken up” by stomach fluid, which communicates with an adhesive patch on the user’s stomach and transmits information to a mobile app. The app tracks information for patients and issues reminders for them to take their medication.
While Inception isn’t invested in Proteus, it has been an early adopter of the technology.
The goal is to “simplify and optimize” a patient’s medication regimen, which can often become burdensomely complex for those taking multiple medications, said Dr. Bradley Crotty, medical director for digital innovation at Inception.
Follow-through on a medication plan is particularly important for those with hepatitis C, high blood pressure, diabetes, and now oral cancer medications.
“In a lot of these cases, from a patient’s perspective, they are hard to take,” Crotty said. “We began to look to a solution: how can we best get data so we can make objective decisions around what medications people take? The solution we’ve found is Proteus.”
Proteus allows care teams and patients to collaborate on their medication regimen over a two- to three-month program.
If a patient were, for example, on three prescriptions for high blood pressure and the levels weren’t getting under control, Proteus would help doctors and patients determine whether it is an issue of dosing or the combination of medications.
Inception has also partnered with Glooko Inc., a Mountain View, California-based startup that has developed a remote monitoring app for diabetes patients. The app syncs with a patient’s glucometer via Bluetooth, which allows the patient to share diabetes data with his or her health care provider in real time. It addresses a common problem in diabetes management: not being able to receive guidance or make adjustments between doctor visits.
“The problem that will happen with diabetes management is there can be a paradigm of, if you’re not at goal, it will get adjusted and then they are told to come back in three to six months,” Crotty said. “People spend most of their time not in the doctor’s office, living life at home, and it’s an artificial thing to try to make a comprehensive plan in a 15-minute visit and have it stick in real life.”
Glooko prompts users to check their blood glucose and take insulin and other medications through automated reminders on their phone. It also has built-in pattern statements, making it easier to identify their glucose trends and improve self-management.
On Froedtert & MCW’s end, the pharmacy-led telehealth service allows patients to work with clinicians over the phone who have real-time access to the diabetes data.
Crotty said nearly all of the hundreds of patients to participate in the program have seen their levels come under control.
These are the kinds of results Inception is after.
“Froedtert Health created Inception Health to drive innovation and successfully collaborate with innovative companies to solve key health care problems, develop new ideas, and scale those solutions across the health network,” said Cathy Jacobson, president and chief executive officer of Froedtert Health. “We enhanced our investment because, in just a few short years, we’ve seen qualitative and quantitative results improving the health of individuals.”
Inception’s existence as its own company – a separate entity from Froedtert & the MCW – allows the system to devote resources to innovation without siphoning from its clinical arm.
“We can protect and nurture that work,” Anderes said. “We’ve intentionally moved it so it doesn’t have to compete. For us, it’s helped with our ability to actually execute. We can get things to implementation phase almost faster than anybody else because we’ve centralized that function here. If things are successful, we already have the DNA of an academic medical center to scale it.”
Inception is overseen by a six-person board, which includes Jacobson and Medical College of Wisconsin School of Medicine dean Joseph Kerschner. Children’s Hospital of Wisconsin recently joined Inception as a partner.
The AVIA Innovator Network, a national consortium of 37 health systems, has played a key role in Inception’s success, leaders said. The Chicago-based consortium works with health systems to determine how digital solutions can support their strategic priorities, identify early-stage companies to work with and – often the most difficult part – support the scaling and adoption of the digital tools.
Froedtert was an early equity investor in AVIA, and is among seven member-owners, including Providence St. Joseph Health and Rush University Medical Center. Advocate Aurora Health, of Milwaukee and Downers Grove, Illinois, is also a member.
Mike Warren, vice president of client engagement with AVIA, said the partnership with Froedtert made sense from the get-go.
“The bet Froedtert and Inception made on AVIA was consistent with what they wanted to do as an organization,” Warren said. “Froedtert & the Medical College of Wisconsin is committed to innovation; they’re committed to forming care at the health system. Cathy Jacobson has been out in front on these topics as a visionary leader, and Mike (Anderes) shares that perspective. What we’re trying to do and what they’re trying to do are incredibly consistent.”
With the promise of new groundbreaking advancements in health care, particularly those driven by artificial intelligence and machine learning, leaders credit AVIA with helping them discern between “vaporware” and what’s actually going to drive change in their health system.
The Inception team has reviewed an average of about 500 projects annually since 2016.
“I have no doubt that machine learning and AI are going to revolutionize part of medicine, but not every early-stage company is going to do it successfully,” Crotty said. “So we have to separate the hype from, ‘What problem are you really solving?’”
In late 2018, Froedtert – through Inception – committed to investing $15 million in early stage companies to further develop digital capabilities across the health network.
To date, Inception has invested in only seven companies. The company is intentionally picky. For one, Inception maintains a rule that, if it invests, it must implement the innovation within the Froedtert system. And it has to offer value beyond financial return, such as the ability to co-develop or have a board seat.
“We try not to use the word ‘pilot’ here, because once we make a decision to implement one of these innovations, we want to see it succeed,” Anderes said. “We’re willing to continue to pivot to make it successful. ‘Pilot’ can imply that we’re just going to see how it goes, but it will go away eventually. We don’t think it’s a good service to those companies or to us.”
The due diligence process is heavy up front, as the team is focused on “de-risking” investments by thoroughly vetting the project’s potential success, specifically within the Froedtert system, according to Anderes.
“We want to see an impact on patient satisfaction, quality, cost, access to technology. It has to have something like that before we invest,” Anderes said. “Other health systems that have venture arms are sometimes more focused on return, thinking of it as another chunk of our balance sheet we can invest. They treat it more as a fund. Our intent is to use it as a tool to improve health in the community.”