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How the Business of Healthcare is Evolving
Episode 386

Luba Greenwood, J.D., Healthcare and Tech Executive, Google, Verily

How the Business of Healthcare is Evolving

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How the Business of Healthcare is Evolving

Episode 386

Recommended Book:

Thinking, Fast and Slow

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How the Business of Healthcare is Evolving with Luba Greenwood, J.D., Healthcare and Tech Executive, Google, Verily transcript powered by Sonix—the best audio to text transcription service

How the Business of Healthcare is Evolving with Luba Greenwood, J.D., Healthcare and Tech Executive, Google, Verily was automatically transcribed by Sonix with the latest audio-to-text algorithms. This transcript may contain errors. Sonix is the best way to convert your audio to text in 2019.

Welcome to the Outcomes Rocket podcast where we inspire collaborative thinking, improved outcomes and business success with today's most successful and inspiring health care leaders and influencers. And now your host, Saul Marquez.

Saul Marquez:
Welcome back to the podcast. Today I have the privilege of hosting Luba Greenwood. She's the Head of Strategic Business Development and Corporate Ventures at Verily, an alphabet company. Luba brings to Google pharmaceutical biotechnology and digital health industry experience and expertise in building and investing in innovative technology companies and providing strategic counsel to global corporations. Previously Luba has served as vice president of global business development and mergers and acquisitions at Roche where she also established and led the East Coast innovation hub for the diagnostics division. Luba is on the board of Massbio and Brooklyn immuno therapeutics and serves as advisor to the Dana Farber Cancer Institute as part of its business development council. Luba is a thought leader for the New England Journal of Medicine, Catalyst, founder of the pharma digital health roundtable and a lecturer at Boston University Law School and School of Management where she has taught courses in Life Sciences, business law, innovation and entrepreneurship since 2014. Her career has spanned leadership roles in venture investing, business development, mergers and acquisitions law and operations with companies like Venture Partner at Colt ventures BD and strategy for Exelon health a flagship Ventures Company. She's also did some work with Pfizer and started her career at a leading national law firm Wilmer Cutler Pickering Hale and Dorr where she represented clients in securities IP, regulatory, corporate and litigation matters. Many many awards have also been given to her including the science club for girls Catalyst Award for her commitment to advocating for women in science and tech. Lewis served as nonprofit board member of Longwood Symphony Orchestra executive coach for mass next gen. Among many other outstanding appointments. With that I just want to say I'm super excited to have her here on a podcast with us and thrilled to be diving into her thoughts on what's next in healthcare revenue generation and making things actionable and health care so Luba, thanks so much for joining me.

Luba Greenwood:
Saul, thank you for having me.

Saul Marquez:
So Luba. What is it that got you into the health care sector?

Luba Greenwood:
Well I have always been interested and fascinated by biology and science. I've actually, yes I'm a lawyer but it was more by accident that I went into the legal profession. I actually started out in science and have been very interested in not just science but in medicine and people and patient and just very curious about people's journey in life and in health. Actually when I was in an undergrad I did major in science but I also debate through school I became an EMT and just loved it even more and wanted to know and contribute more to medicine and specifically innovation. A lot of what I saw and granted this was from the point of view of an EMT was that there was still a lot of a lot of care that really could be given to patients and so a lot of innovation that could be done. So I remember I came to my biochemistry thesis advisor and I told him I want to go and innovate and come up with new medicines and therapies for patients. Then he said Well innovation if you are interested in that in life sciences is really a lot. So that was that was an interesting take from somebody that teaches biochemistry and but then again this was this is about 20 years ago when more than 20 years ago when you didn't win the Kendall Square didn't look the way that it looks now and it didn't have as much innovation really going on and happening here in Boston. So I wanted to I went into law and it was actually not my strength, my strength has always been in the sciences and math and I was actually not the best writer and English is not my first language and I came from a very different legal system but I loved it. I actually very much enjoyed the legal profession and I think that it really set me up for what became later. I think quite successful investing and both investing in company building because it gave me a real appreciation for intellectual property and regulatory environment that even if you have the greatest innovation you still have to go through all the regulatory hurdles and it takes a lot of time and takes a lot of money.

Saul Marquez:
Yeah you know what I mean. Such a it's such an interesting journey. I mean you know career you start your career as an EMT you take a detour into law that becomes very beneficial to you now and you know in your in your previous roles that you've played at various companies I mean love your story and so and you paid your way through school. I mean that's such a great story an inspiring one. So you've seen a lot. You've done a lot. What do you think Luba is a hot topic that needs to be on health leaders agenda today and how are you approaching it?

Luba Greenwood:
The hot topic I would say is is making sense of digital health and people talk about it. Some people don't like the term. A lot of discussion is on what that actually means. And we see words like A.I. and block chain and God knows what else is usually used in healthcare. I have to say that now working for a tech company I have yet to seen many very successful A.I. applications really in healthcare and really comes down to what is really the hot topic and that is we have incredible amount of research and innovation that's happening in biotech. We also have a lot more data about patients and when we want to go and if we want to go and we see that many biotech and pharma companies and diagnostic companies are going there if we want to truly go into personalized health we have to figure out what are the right tools on both the discovery, the drug development and therapeutic but as well as diagnostic side that we could go into to capture information that goes beyond let's say genomics that goes into really truly understanding or makes behavioral health, self reported outcomes, environmental factors, social determinants of health and many others such data points and integrate them all so that we can make better therapies for patients.

Saul Marquez:
Yeah. You know it's it's it's definitely something that's on the mind of a lot of leaders and folks listening to this podcast today. Digital health it's everywhere. How do we leverage it rather than just buzzwords and you know these things that you hear at the meetings or in news articles so it'd be interesting to hear from you Luba whether it be maybe the work that you're doing at mass bio or or Dana Farber some examples of how you guys have leveraged these technologies or some ideas that you're taking action on to create results.

Luba Greenwood:
Yes absolutely. So I would say in Dana Farber and has been really quite a real leader in this space and it really comes down if you look into cancer right you have over 70 percent of cancer patients that are actually seen in community hospitals. So there is a big demand for better patient care pathways. There's a lot of demand for for really bringing the psychology expertise of a place like Dana Farber which is really the world's leading cancer institute to the world right into these community hospitals. So some of the work that Dana Farber has been doing is building these very comprehensive and then truly state of the art clinical decision support tools. They're also building ours for example actually just here in Boston and Chapel Hill and new of its kind really clinical workspace for cancer patients and for cancer care that will really redefine how cancer patients receive care in the future. So that has been for me quite rewarding. And this is coming from especially when when I was a Roche some of the acquisitions that we have done if you look at for example flat iron and then as well as later on acquisition of foundation medicine there you understand finally the genomic information and also the clinical trial information. But the issue not just for pharma and for Roche but also for many other biotech companies and some of these startups in this space is that that data is important. However the problem is it's not across the same phenotype. So if you don't have this you know two big data if you don't have the data that's coming out of earmarks. If you have still limited understanding of how an actual individual truly responds to a particular oncology therapy and why some respond and why others don't you're still quite far away from that personalized medicine approach. So the things that Dana Farber is doing right now to really provide the type of data that is going to be important for drug discovery and drug development in oncology is really very exciting. And from that bio, the base there is we try to and we work with by the way and it's really an amazing team. So you know math by leadership if you look at Popoff and Ken O'Connell and that by board members they have really come together and that you know where yes they have. They're the ones that helped build this amazing ecosystem that we have in biotech but they're also recognizing the importance of all of that data that's coming in that's going to be important for digital health. So we have worked with in the last year with Deloitte and have looked and talked to many stakeholders from not just Massachusetts but across the country to understand where their pain points. What is it that they really want? Because if you look at digital health today we see a lot of investment going into a lot of companies. There are two issues with them. Number one those companies are basically solutions in search of a problem. And number two a lot of those companies are actually investing in buying or leveraging that data. So a lot of money there are literally billions of dollars that have been thrown out on that data. So that's why when people say A.I. or ML machine learning I usually really want to understand well exactly what data are the are they really truly using. What kind of data set for their mobile applications. But mobile bio wanted to be that kind of place from Massachusetts and create that ecosystem from Massachusetts will bring in the type of digital health companies and the kind of ecosystem that will actually lead the way for the real convergence of life sciences companies and tech companies. And that is really if you look into well what are those companies. There are really I would say in just four areas right. Number one is discovery. So these are discovery tools computational biology. These are the tools that help you better understand biology of the disease because we still are far away from understanding biology of the disease for some diseases. We're also realizing that we need to map out for example a new system, we need to still map out the brain. The second one is drug development tools. So these are the tools that actually enable to personalized medicine. Some of the work that for example Dana Farber is doing and companies that are helping collect real world evidence, helping virtualize clinical trials and capturing those data reported outcomes and continuously collecting data. And then the third piece are those matters knowledge management tools that are going to truly empower patients and physicians.

Saul Marquez:
Well fascinating thoughts there. And certainly the need to leverage these technologies are there. You said solutions in search of a problem and you know kind of in the back of my mind was like wow you know that's so true. A lot of companies building their widgets and their tools and then trying to apply them versus the the other way around. I know a big topic for startups is revenue generation. And so I'd like to hear from you some thoughts that that the startups listening to this may be able to benefit from.

Luba Greenwood:
So we we still do not not living in a value true value based care system right. We have some areas. So for example Medicare Advantage right. We have some bundling and surgery.

Saul Marquez:
Right.

Luba Greenwood:
So there is certainly if I were a startup and we see many startups actually emerging in exactly the space and tackling the space because the there are actual business models there that you can we can generate revenue. There's many other startups however that are whose goal it is to try to entirely change the incentive system. And I have to say that one of my biggest I would see failures in career was when I was working for pharma company and we wanted to buy a services business in Europe and bring it into the United States. And it was great. It was ahead of its time and it would have made a big difference. It would have made a big difference to patients. It would also have improved outcomes and actually lower costs for the pair. Well I can tell you that company when brought into the U.S. failed pretty quickly. I mean within months and it happened early on in my career and it was helpful to really frame understanding of the health care system and understanding that you can't just overnight change the incentives but you can't change them long term working together and actually bringing true innovation into the system in a way where you can generate revenues today and some of the ways that you can do that is where I actually see the future and where my bio has been working and Dana Farber and many of the people that are involved in Massachusetts have been working on is the area where you will have real exits and real models. So those are the areas as I mentioned number one it's in discovery right. Because again we are trying to pharmaceutical biotech companies are trying to personalize therapies make therapies better and reduce adverse events. So again any tools that are going into the development phase as well. That is an area again where you can actually have an exit and a good area for investment as well. And then the third area is if you look into the diagnostic industry and med device industry which many traditional biotech players actually usually do not invest in but those are the areas where that are going to be and are being disrupted today and they need quite a bit of differentiation. So in the diagnostics for example you see going into a point of care diagnostics going more into the consumer play. This is an area where you do see pretty effective use of A.I. as an example you have some tools that can diagnose the diabetic retinopathy and then in the medical device industry you're right. It's the same you can you can incorporate sensors and others and other things that actually improve the outcomes of the use of the medical device for patient.

Saul Marquez:
Yeah. You know. Wow what a what a great summary. Luba. And for the people listening just thinking to your your business model. Google has provided a great framework here to think discovery drug development. She mentioned knowledge management diagnostics and devices how are you approaching these and entirely changing the incentive system not the way to go. Can't happen overnight but it can happen over time. And but you need to make a business model that works today and I love the tips that you've given the listeners here Luba and you've shared a big learning right that the big mistake that you made early on in your career. What about the other side of the coin tell us about something that you're really proud of that you've been able to accomplish.

Luba Greenwood:
Oh really proud and able to accomplish. You know I think that the the what my most proud moment are actually not even so much on the on the business side. But it's really on the mentorship side. I have been so proud and happy to see many of the brilliant scientists that I have mentored that ended up starting companies and selling companies and becoming my biggest successes. Empowering people that actually three people in my life now that have become more successful than I am which of is is what brings me the most excitement and happiness about what I do.

Saul Marquez:
That's wonderful. I definitely hear the passion in your voice move on and you know just thinking about the things that you're involved in. You know even in your personal life and you know the organizations that make impact. I mean it's it's incredible. So you know I want to give you a lot of kudos for thinking the way you do and giving you know there's a book that I've recommended in the past is called The Go Giver. And on that being a go getter but being a go giver and you seem to be that kind of person to me.

Luba Greenwood:
Well thank you. Thank you. I try to do that.

Saul Marquez:
Now for sure. And so tell us about an exciting project you're working on today. What's keeping you up at night and what's making you wake up early?

Luba Greenwood:
So I would say the exciting project actually is working actually with with Dana Farber. And what about them in particular. Like what are you working on now. It's like I can just I have to keep doing this. I going to work on it.

Luba Greenwood:
Yeah. So it's the it's the ability to actually be the first basically the first if you think about it. Well I will. I do want to step back very briefly and this will resonate with probably many of your listeners which is everybody wants at the end of the day when you're going into digital health and you don't even have to go into digital health if you're going into. And you would like more data to understand more information about a patient. The issue that many companies even with many resources and great amazing teams come across is that this data is unstructured. It's very hard to get access to it even if you get access to it. The number of people that you will need to either you to have as consultants or hire internally for yourself or for your partner that you're you're working on the data with is quite substantial. So many barriers to getting the kind of data that will truly help inform the therapeutic the therapy that a patient really needs to be on or inform better drug discovery and better drug development. And if you go to different institutes usually that again the data is there many of them don't have the resources or even understanding of what data they have. So usually the the response is we're not going to give it to you it's highly proprietary and we need millions of dollars until we talk to you. And in a lot of the time I can tell you as a lawyer it comes from it comes a bit from fear of the unknown it also comes from the fact that a lot of it is unstructured and it is quite costly too and it's a lot of it is not actually there. There are huge gaps were there to actually be data that will be useful for really for prey. So the reason why I was excited about a place like well first of all cancer and oncology research is dear to me dear to my heart. So that was very important it is. And finding and working with an institute that actually has incredible treatments for patients and continuous treatment right. So again we you go back to the data it's getting that data not only on genomic data which by the way everyone that goes into Dana Farber gets tumor sequence but it's also understanding on the continuum of care what is actually happening to to a patient. How is the patient treated. What are the other factors. And in the clinical notes of that patient. And of course the therapy that's given in the response. So that type of data is doesn't reside in many places. So working on with Dana Farber on this and creating this basically unique database that is unlike really any other are available so that you can understand not only as the therapeutics company and have access to information that will help you make better therapies but also information for other providers and payers for how they can manage cancer patients better throughout that cancer patient's life. Because as we know thankfully many cancers are managed and they become almost like managing your chronic disease and hoping that patients throughout their lives is something that again that Dana Farber has done an amazing job at and has the data to show how and why and the and the outcomes.

Saul Marquez:
Well it's definitely an exciting time to be involved in something like this and once the data is structured and let's just say you have a structure can that structure be used by somebody else collecting data so that the data that they collect is more useful?

Luba Greenwood:
Oh Absolutely. So that is the goal right.

Saul Marquez:
Gotcha.

Luba Greenwood:
Or that that is that is available for for all. Right. So that. Exactly. Because right now it is hard to get access to that entire continuum of structured data.

Saul Marquez:
Fascinating. Well you know what I definitely am excited to hear the progress that's happening there. And is there a timeline to when something is expected to be available and even commercialized or just you know what's the model there first for them.

Luba Greenwood:
Yes. So first of all I mean the one of the things that is happening right away is there is actually going to be kind of the state of the art high tech, I would say patient hub in Chapel Hill. They're opening this really incredible Center in Tucson which is again very accessible and easier with parking and other things that you need to think about which are important. And and it's going to be high tech and high end and high tech is important because again it enables you to get truly personalized treatment better outcomes and better care. So that's one of the one of the aspects and the second one really on the on the data pieces again trying to make it happen this year.

Saul Marquez:
Wow that's exciting. Well we'll definitely have to stay in touch and update the listeners with with any news there on that front.

Luba Greenwood:
Absolutely. Be happy to.

Saul Marquez:
Love it. Luba, so it's time for The Lightning Round. They've got a couple of questions for you and we're going to follow that by a recommendation of a book to the listeners. You ready.

Luba Greenwood:
Yes.

Saul Marquez:
All right. What's the best way to improve health care outcomes?

Luba Greenwood:
It's to provide a comprehensive treatment for an individual patient given that individual not just genomic profile but environmental and and make and other behavioral data that you can collect from that individual. So really really patient centric therapies but also Patient Power amounts of patients are educated.

Saul Marquez:
Love it. What's the biggest mistake or pitfall to avoid?

Luba Greenwood:
Yes. So the biggest one to avoid is refusing to have multiple disciplinary approach. It is very difficult to have software engineers hardware engineers Data Sciences scientists clinicians working together on making a product. Process wise. But that is where you have truly an amazing product for patients. So it's always easier to streamline and make it easier but it all to avoid it is to encourage true collaboration between different disciplines.

Saul Marquez:
How do you stay relevant as an organization despite constant change?

Luba Greenwood:
You have to invest in innovation. And even if it is the kind of innovation that will disrupt even your primary business model is to stay ahead of it and continue to innovate.

Saul Marquez:
Amen to that. And Luba what's one area of focus that drives everything in your work?

Luba Greenwood:
Area of focus is real data and it can be data from scientific or data that you collect it is basically getting real data making sure it's clinically validated and there is a real business model and a real true unmet medical need that's the focus.

Saul Marquez:
And these next two are two to get the audience to get to know you a little bit better. What is your number one health habit?

Luba Greenwood:
I walk a lot. I walk sometimes five, six, seven miles a day. I want to work from work so.

Saul Marquez:
Even in the cold?

Luba Greenwood:
It's a lot of walking. Yes. And actually a health habit that might be strange is I don't go to the gym so I workout based on the weather which is probably only relevant the people that live in places like Boston that have the four seasons. So in the summer and in the winter I walk very slowly like a penguin and I walk briskly.

Saul Marquez:
That's funny. So you say you want to work in a snowstorm?

Luba Greenwood:
And not in it not when the snow is coming down it's but there are some places off the sidewalks are actually.

Saul Marquez:
Paved.

Luba Greenwood:
Yes you do.

Saul Marquez:
Wow. Good for you.

Luba Greenwood:
Yes.

Saul Marquez:
That's a good one. You're you're committed walker.

Luba Greenwood:
I was I was very excited. There was some research that just came out very preliminary that shows that long low impact walking is actually better than for poor cognition cognitive decline than high resistance type of exercise. So I'm sticking to that again very early research, not validated.

Saul Marquez:
I love it. Directionally I love it. And Luba, how about your number one success habit?

Luba Greenwood:
Listening and listening and and that is something I actually learned. I learned that I didn't know how to do very well when I was a litigator because during deposition I remember my first deposition. I thought that I was listening and then I had no idea what the top person was actually saying but it's actually truly listening is is a very tough skill at least it was for me. And that became once I learned how to do that became very important because it's the key to collaboration. The key to learning being key to success is also being very curious and yet to listen in and read for that.

Saul Marquez:
Love that some great habits Luba and what book would you recommend to the listeners.

Luba Greenwood:
I would recommend Thinking Fast and Slow by Daniel Kahneman.

Saul Marquez:
What did you like about it?

Luba Greenwood:
It's actually talking about decision making and he comes from that background of behavioral economics and I do like reading books by behavioral economists. They make me think in a different way and question the way that I think and I always like to think about that.

Saul Marquez:
I love that, it's a great recommendation. Folks for our entire show transcript and the show notes, the quick notes and all the links that are for resources we've discussed including the book go to outcomesrocket.health and in the search bar type in Luba, you'll be able to find all of that there. Luba, tremendously enjoyable discussion with you I'd love if you could just share a closing thought and then the best place for the listeners could continue the conversation with you.

Luba Greenwood:
The closing thoughts keep on innovating and please reach out to me on LinkedIn. I'm also on Twitter and I usually tweet about interesting things that are happening in the life sciences tech world and also what my friends are doing.

Saul Marquez:
I love it. A good mix of personal professional and that's good. I love it. That's good. Well folks there you have it Luba for you. And again the beauty of podcasts you can always hit rewind listen to some of the value that she shared with us today. Luba Greenwood just want to say big thanks for joining us today.

Luba Greenwood:
Thank you. Thank you for having me Saul.

Thanks for listening to the Outcomes Rocket podcast. Be sure to visit us on the web at www.outcomesrocket.com for the show notes, resources, inspiration and so much more.

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