OR_Sempre Health Podcast_ Liam McMorrow: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Rich Prest:
Hello everyone, and welcome to the Sempre Health Outcomes Rocket Podcast. This is where we talk with healthcare leaders on the state of the industry, patient engagement, and technology innovation. I’m your host, Rich Prest, and today, we’re fortunate to be speaking with Liam McMorrow, who is a leader in digital health at Novo Nordisk. Liam got an early start as an entrepreneur in digital health, so I’m keen to see what lessons he can share with us today about that. Liam, welcome to the podcast today.
Liam McMorrow:
Hi Rich, thanks for having me.
Rich Prest:
You bet, so maybe, Liam, just to kick things off and to help our audience get to know you a little better, maybe you can share if you had a dream career when you were growing up?
Liam McMorrow:
Yeah, but not in healthcare. First off, … The dream, I didn’t really think too deeply after that. It was, I wanted a job in an office that paid me well. That was kind of the bulk of it. Yeah, pretty, pretty simple.
Rich Prest:
So how does a Scottish lad end up working, living, and working in Copenhagen? What’s the, what was the path that led you to your current role? Yeah.
Liam McMorrow:
Yeah, so before coming to Copenhagen, I had a startup for a few years and we won one of these innovation challenges with Novo Nordisk, … a global Danish pharma company, and then just through contacts there, when it was kind of falling apart, I was having a few conversations, and one of them said, if you want to come and work in Novo Nordisk, we can find you a position. So I jumped at the opportunity and moved to Copenhagen.
Rich Prest:
Awesome, and so I know your early days of a career, but in terms of accomplishments or favorite roles, are there any things in particular to speak out from, to you from what you’ve done? Yeah.
Liam McMorrow:
Yeah, I definitely miss the startup world. I think the kind of, having one thing to focus on and few stakeholders to manage is a nice way to work. Corporate’s definitely more complex in terms of just stakeholder management and the pace of things. So yeah, being a founder in a startup I think was my favorite role. And then in terms of accomplishments, I think, I don’t want this to sound cheesy, but because it actually did mean a lot, but we were trying to encourage people to check their blood sugar. And one mother emailed me once and said how her kid was finally checking their blood sugars at school using the app that we built. So that was a pretty cool email to receive.
Rich Prest:
That’s awesome, yeah. So yeah, I know it makes a ton of difference to us. We see these texts coming in from patients and just every time you feel like you’ve helped someone, it just, it’s a really rewarding thing. So yeah, very cool to have that experience. Cool, and then as you sort of look forward to your career, like is there something that you’d love to achieve or accomplish or to be remembered for? And yeah.
Liam McMorrow:
Yeah, I think so. I live with type one diabetes, so I’m very much into like diabetes technologies and the advancements in the field right now in terms of continuous glucose monitors, insulin pumps, connected pens, it’s just going to be completely different to when I was diagnosed 20 years ago and you had to prick your finger and inject four or five times a day. So somehow getting involved in that and either improving access to these technologies or contributing to that design, I think it’s, people diagnosed with type one diabetes today are going to look back at 20 years ago like we do with needles and syringes that are like couple of inches long and stuff. So getting involved there fascinates me, and then and then maybe even taking it like one step ahead where you’ve got companies like Prevention Bio with an almost like a vaccine almost for diabetes. And we have an internal cell therapy unit and you’ve got companies like Vertex doing really exciting stuff as well to cure type one diabetes. So I’m not sure how exactly, but somewhere along that lines would be awesome to get involved in.
Rich Prest:
Yeah, it’s amazing to think that this sort of age of engineering biology is just beginning and we’re starting to see a few cures come through, and that really will revolutionize lives. If we can see science continue to do amazing things with more disease states, very cool. So maybe we can now sort of pivot to talking about the industry today. Is there something that you can think of where perhaps people just don’t understand an aspect of healthcare that you think industry insiders maybe have a better understanding of than perhaps the general public?
Liam McMorrow:
I think, so I have a background in health economics, so I kind of, starting point is just to understand how the money flows. And I think a lot of people might get frustrated with healthcare or have just complaints, but once you understand how the money flows, a lot of it makes a lot of sense. Now in the US, the money flows in a lot more complex ways than in Europe, I think, but it still sheds a lot of light on behaviors and systems and why things might not be easy to access. And so yeah, I think just dig into who pays who and why and for what, and then you slowly start to make sense of a lot of complexity.
Rich Prest:
Yeah, I think that’s absolutely right, as that’s usually a strong driver for why things are the way they are. So yeah, definitely a good place to look if something doesn’t quite make sense at face value. Yeah, absolutely, so then if you could change anything overnight in healthcare, what do you think that would be? What would be a focus area?
Liam McMorrow:
Like, so being in Europe, I think access to care, like, looking at the US system it’s still a big issue and almost an issue that we don’t think about that much because a lot of the public health systems in Europe enable very good access. But then being more specific, it would be the access to diabetes technology. That’s what I like, I think about, you can see the benefits in these devices and these algorithms and the companies are now starting to launch their own closed-loop systems. So this is where the insulin pump talks directly to the continuous glucose monitor, and they make insulin adjustments every couple of minutes.
Rich Prest:
Wow, that’s really cool because that’s always been a problem, right? Is this sort of pendulum where you get into a blood sugar problem and then you put some insulin in and you swing to the other end of the pendulum, and it’s always been very challenging for diabetics, I understand, to get that insulin levels right. And so hopefully that closed loop system has more chance of dialing that in, yeah.
Liam McMorrow:
Exactly, and it just does it every few minutes and it does it with smaller adjustments. So it’s just easier for it to self-correct, because that’s like, so many things affect blood sugars and it’s very difficult to predict, but if you just have an algorithm checking it every couple of minutes, you can just make these adjustments. And so yeah, as these devices get launched, there will be an additional cost, I’m sure, and I think they can be life-changing. So enabling access to those kinds of technologies, I think will, could make a big difference in healthcare.
Rich Prest:
Yeah, that would be amazing. Yeah, eliminating that sort of bullwhip effect. Yeah, very cool. Excellent, so I think we’ve chatted a few times in the past about some of the challenges sort of introducing and scaling innovations, and I’d love it if you could share what some of your experiences have been in terms of the challenges you see and in any lessons you’ve learned from that.
Liam McMorrow:
Yeah, so within a big pharma company, I think the first thing is that even though a lot of people are keen to make it happen, the digital side of things isn’t core yet to the offering like it’s a … therapy, it’s not a digital therapeutic, and so what that means is that the entire organization is kind of designed to bring a pharmacotherapy to market and to promote and to sell it and to make sure that it delivers the benefits that we’re showing in clinical studies. And the digital component of that is, even though I think people want to change this and have it more closely integrated, it’s really difficult to do when the organization by design has been set up to bring a molecule to market. And so from the get-go, that’s always a challenge I think, because at the end of the day you’re trying to promote something that isn’t on everyone’s priority list.
Rich Prest:
Right.
Liam McMorrow:
And then if you do manage to find that kind of project, that that is going to kind of tick everyone’s boxes yet letting everyone know that this is what you’re doing, and this is how you want to do it, and this is why it’s the best way to do it is also very challenging. And … the stakeholder management aspect is huge and it, you really do need to kind of go slowly to get everyone on board or it would be, there would be blockers and, for right or wrong reasons, and I haven’t figured this out. It’s, it just makes it very difficult to get it going, I think, and then if you do have something going and you’re into that sort of like scaling aspect of things, you’re back to the organizational structure. Like if you’ve got a successful digital product on the market, you’re kind of dealing with the commercial side of the organization, not so much the development side. And so, it’s very challenging to, I think, get the necessary resources, maybe to scale something, when you’re in a more sort of business-focused aspect of the organization and people have targets to reach and short-term targets. And so yeah, that may be three of the big challenges I see every day.
Rich Prest:
Yeah, yeah, yeah. So that’s an interesting point. So in addition to like every step of the way, you’re going to have different set of stakeholders and you’re going to need to give them all of an opportunity to come on board. And then you’re also going to have this transition from sort of product development to sort of commercial, and, you know, whether that’s devices or digital or traditional sort of prescription medicines, it’s the same sort of challenge, the clinical and the commercial looks at different, have different time scales and different incentives and metrics, and so yeah, understanding those transitions is key to navigating the path and helping to continue to keep that innovation alive and scaling. So yeah, good point. In terms of, we’ve chatted a little bit about some of the exciting stuff happening with diabetes technologies, but are there any other sort of key trends or developments you’re watching that you think are going to have a significant impact on the industry as it goes forward?
Liam McMorrow:
Yeah, definitely, so Novo Nordisk is a diabetes company and I’m very much interested in diabetes, but my day work now is mostly focused on obesity. And what we’re seeing, and this isn’t in obesity only, but these verticals in healthcare, I think are really interesting where you’ve got basically an entire vertical pop up overnight that can recruit new patients, can give them access to a doctor, can issue prescriptions, and then can provide them that patient support to provide that follow-up care and do it in a sort of a technology-enabled environment where it’s text messages and video calls, it’s not 2 hours in a waiting room every three or four months. Yeah, they’re popping up in all sorts of areas of healthcare, and the one that I’m looking more closely into would be obesity. And then the way they operate as well is really fascinating because they’re definitely challenging assumptions. So even in some markets, they define what constitutes a doctor-patient relationship. So some markets see it as you have to have had that face-to-face consultation. You need to meet them in person, but like we’ve never met in person, but we’ve spoken.
Rich Prest:
Right.
Liam McMorrow:
So it’s nice to have these rules, I think, for a health system to provide some kind of guidance, but they don’t always make sense. And then the next layer of that then is, you know, diagnosing remotely. Is this okay? Is this safe? Is it possible? And again, for something like obesity, we’re seeing in some markets, it is. They even take it one step further where you can diagnose via an asynchronous consultation. So someone will share that information and then the doctor will review that and then make a diagnosis and the treatment decision. And I think this is awesome because it’s a patient being able to share the information that they see as fit. They don’t the doctor doesn’t have to look at the screen while they’re trying to talk to someone. They don’t feel like they’re pressed for time. They can relax and respond when it’s a good time for them. And of course, there are always, potential for the system to be misused and there needs to be careful checks in place, but having this whole new aspect of care where people can access it on their terms, I think is, is yeah, it’s impressive to see and there’s a lot of companies doing some really cool stuff.
Rich Prest:
Now, thank you for that, Liam. So in terms of future opportunities that you’re excited about, anything you wanted to share there? Yeah.
Liam McMorrow:
Yes, so I think when it comes to the verticals in healthcare and then our work in obesity, we’ve actually just set up a new team which is trying to figure out how a big pharmaceutical company can work with these sort of verticals and other companies in the space to enable more awareness around obesity as a disease and also access to treatment through these sorts of channels that we’re seeing through the consumerization of healthcare. So it’s pretty exciting to be within a big organization doing this because you can definitely feel the interest is growing and we have some internal pilots running with some really strong results. So yes, right now internally our team is growing. So if anyone’s interested, they can reach out. And also if anyone is doing something in the obesity space that they think could be of interest, I’d love to figure out if we can, if and how we could work together because this isn’t something that pharma can do by itself. We need to partner, and how we help these verticals mature, it’s an exciting space and it’s the, one of the most exciting areas of, I think, how pharma and digital health overlap, and we’re seeing some really, really strong business cases develop as well, which makes everything easier to get going.
Rich Prest:
Yeah, makes sense, a strong business case and.
Liam McMorrow:
Exactly, exactly.
Rich Prest:
Awesome, well, that’s really cool to hear about. And yeah, it’s fascinating to watch this sort of consumerization of healthcare and I think this sort of ability to do a search, get connected to a telehealth consult, get a diagnosis, get a prescription, and get it shipped to your home. It’s going to be really interesting to see how far those sorts of approaches can go. And I think we’ve seen a lot of it with generic meds, but I think we’re going to see it spreading into traditional and special, and maybe even specialty meds, yeah.
Liam McMorrow:
Yeah, and that’s it. It’s, I think the verticals that are popping up now, there seems to be like that, they’re being underserved by the health system in some way. There may be like not as urgent, you know, it’s not like there’s an … for emergency care and never should be, but there’s, or maybe there should be if it doesn’t. Yeah, you don’t need to…
Rich Prest:
Yeah! That’s right, if you could get triaged from home rather than waiting 6 hours in the emergency room, then maybe that’d be better for everyone.
Liam McMorrow:
Yeah, yeah. Where, where the, where it gets, where it goes is really exciting. And I think as well, as I can see like in the near future how the traditional healthcare system response will be really interesting too because they’re definitely going to adopt some of these practices. Like in an article from the US where a doctor spoke really favorably about asynchronous consultations because of the time that it saved him and the, we hadn’t, I hadn’t thought about it from a doctor’s perspective before. Yeah, so as traditional healthcare takes aspects of these verticals and you know, can provide a more technology-enabled like healthcare service, I think it’s going to kind of raise the bar all around, which is great.
Rich Prest:
Yeah, absolutely. I think we’ve come to expect many things with sort of Internet commerce and in terms of standards of customer service, and it’s going to be interesting to see if that also drives some changes with healthcare as well. So interesting times, as always. So I think, you know, maybe now just thinking about, for young folks that are thinking about getting started in the industry, would you have any recommendations for them on where to start or what spaces to look at?
Liam McMorrow:
Like, coming from a tech background? Like, I think there’s a cool program running out of Stanford Biodesign and they have this sort of like clinical immersion aspect to the program where you spend the first.
Rich Prest:
Oh, cool!
Liam McMorrow:
In a clinic. Yeah, I don’t know how you do it. Just, like, speak to your friends or your friends of friends who are working in healthcare or, like, just get into a clinic and, like, working at … or something, but I just wouldn’t presume anything, you know? It’s, yeah, that kind of doing that a little bit of kind of.
Rich Prest:
Exposure to sort of the patient-provider interface and just sort of really understanding how that works is a great, it’s not just about, oh, this is an interesting piece of technology, but it’s really how it’s going to work or fit in with what they do today and what changes would be required. And sometimes just, you’ve got to go into an office or a hospital just to see how things are done. And it’s easy to visualize, but often that visualization is nothing like the reality, so yeah.
Liam McMorrow:
And it’s amazing how someone will explain something to you and you’ll fully understand it. And then until you see it with your own two eyes, you realize you interpret it in a completely different way of what they meant. And yeah, so I think to kind of crack healthcare, you just really need to have that understanding and time spent with doctors and patients to figure out what they need.
Rich Prest:
Go and spend time with whoever is going to be using the technology and get in their shoes as much as you can, because that’s going to really help you to understand what some of the challenges will be with whatever technology you’re trying to help them with.
Liam McMorrow:
Exactly, and lots of people say healthcare is hard and it’s hard because you just always have to take into account multiple perspectives. So like, it’s rare that you have one user or one customer. And shying away from that complexity just, it doesn’t help. You end up building the wrong thing or it might work for, and this is from experience, it might work for some people, but you won’t get that adoption, you won’t get that uptake that actually you’re looking for.
Rich Prest:
No, I think that’s right too, the other key here is, you know, it’s not like if you spoken to one potential user that you understand the scope of potential users. And I think the more you can speak to, the more variety you can see of the settings and the challenges they face then and how their particular organization works, that the more you understand what some of the barriers to adoption will be, rather than if you just assume that everybody’s going to be like the first one you spoke to because we both know that’s not going to be the case.
Liam McMorrow:
Yeah, and the people you speak to first as well are always almost too helpful, yeah.
Rich Prest:
Yeah, yeah.
Liam McMorrow:
Yeah, I think it’s the same advice for any kind of tech startup. I think just the added complexity of just all the different stakeholders and no one’s willing to pay. And you need to find that sweet spot, which, with a consumer product, it’s just I think a little bit more simple. And then we didn’t even get into the regulations part, but.
Rich Prest:
Save that for another conversation. Well, what about, you got any sort of books or podcasts that you’d recommend for the audience to check out?
Liam McMorrow:
In terms of healthcare, I was actually thinking, I don’t know if you’ve read it, there’s a really good blog out there called Out-of-pocket Costs.
Rich Prest:
Oh yeah, Nicole Krishnan, yes. That’s a killer one, really, really good, yeah.
Liam McMorrow:
That kind of, anytime a new one comes in, I always save that in my inbox for a bit of afternoon reading. And then the other thing that I like is, there’s a blog called The Generalists, and the guy goes deep into anything. And I sometimes think maybe I am a bit blinkered because I don’t really know anything outside of healthcare. It’s nice when someone dives into an industry that you just know nothing about, and he just wrote a blog about FC Barcelona.
Rich Prest:
Oh, wow, yeah.
Liam McMorrow:
I haven’t read it yet, but I’m looking forward to it because it’s, yeah, I don’t really know what he’s going to, I know they’ve had a lot of financial trouble, and I kind of seen they’ve got a bit creative with restructuring their debt and stuff. So kind of having that sort of outside perspective is always good to see kind of what’s coming next in healthcare.
Rich Prest:
Yeah, yeah, I think it’s really interesting. In an age of specialization, there’s still a tremendous amount to be learned from looking at other industries and seeing what you can bring in. So I think that sort of scanning across many, many industries and then seeing what you can bring to the vertical you specialize in is, makes a lot of sense.
Liam McMorrow:
And there’s a good chance, I think that like as time goes on these verticals like if they …, they need to grow, and if they’re going to grow, they’re going to grow like other tech companies already have done, like an Uber or something. And then they’re going to have to win certain markets and will there be network effects? And so you can definitely see history repeat itself, but you can see, make predictions, but yeah, it’s fascinating.
Rich Prest:
Indeed, indeed. Well, this is great. So where can listeners find you online and what’s the best way for them to connect with you?
Liam McMorrow:
I think LinkedIn is the easiest. Yeah, I’m not, yeah, I don’t think I’m really anywhere else, maybe there’s a Facebook profile.
Rich Prest:
No, that’s great. Well, thank you so much, Liam. It really, great to catch up as always. And for our audience, thanks so much for tuning in. I hope you got something of value from this episode. And if you did, please don’t forget to review the Sempre Health podcast on your favorite streaming service, it really helps others to find and enjoy the show, so thank you all, and catch you on the next one.
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