UCSF’s Tips for Sustaining Your Startup

Optimized-UCSFMedCenterLast week UC San Francisco announced its Center for Digital Health Innovation (CDHI), the university’s cohesive effort to support its community’s entrepreneurial projects. Michael Blum, MD, UCSF’s chief medical information officer will lead CDHI along with a cast of the university’s faculty and staff. Part of the center’s mission is to evaluate the function of digital health products and to help bring new technology to market.

“I think it was a little over a year ago we didn’t really even have mobile health or digital health awards on campus,” said Aenor Sawyer, MD, assistant clinical professor in orthopaedics and member of the CDHI team. Sawyer spoke last week at the UCSF 2013 Fellowship of Fellows Seminar, a meeting that brings together fellows from various disciplines.

Before the formation of CDHI, UCSF faculty, staff and students had been involved with digital health care projects and startups, though their individual efforts had largely been developed in isolation. During her talk, Sawyer suggested that the community look at this early stage of digital health like the early days of surgery. The learning curve is steep, while the context they’re working in is changing rapidly. In order to train a capable force it will take members of the community to see one, do one, teach one, she said.

Also speaking at the Fellowship of Fellows was Ida Sim, MD, co-founder of Open mHealth, whose talk centered around the pitfalls encountered when entering the space, as well as the shortcomings of the products that are currently on the market. She made a case for her colleagues to get involved.

“It’s the private sector that’s innovating, it’s the public sector that has the needs, and it’s those of us in academia who have, I think, the skills and methods to really make sure that we’re learning,” Sim said. From Sawyer’s and Sim’s talks, here are three takeaways:

1. Beware of a low “plateau of productivity”

Looking at the Gartner Hype Graph, it’s inevitable that digital health will reach a peak of inflated expectations. The trough of disillusionment immediately follows. Sim said that neither of those events is really all that important if the last phase, the plateau of productivity, flattens at a truly productive point. It all depends on where that bar is set. “Do we end up where electronic health records are?” Sim asked. “That’s kind of the cautionary tale.”


2. An app is not a drug, and so it shouldn’t be evaluated in the same way 

Sim said apps are complex in two main ways: one, they can run on various devices, and two, they can be adjusted in order to work better for the patient. Because of these complexities, a randomized controlled trial in order to analyze linear cause-and effect relationships isn’t always an effective. A more involved form of analysis, called theory-driven evaluation, should be used to answer the question, “does it work?”

3. Figure out how to make money before your grant funding runs dry 

Grants are extremely helpful when getting started, but great ideas often die when funding runs out. “Whatever you’re doing and whatever you’re collecting, that data holds value to someone,” Sawyer said. Sawyer advised that startups figure out who that is and to make them a part of the company’s revenue-generating plan.

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