Harsh Thakkar (00:03)
All right, so there we are.

All right, thanks for joining in. I'm sure you probably wondered about this, that why isn't healthcare as accessible as your TV streaming services and other services in this country or in any other country that you're living in? today we're gonna be exploring the topic of whether technology, digital health, AI, data, all of these things, are they the answer to...

to fixing the access to healthcare. And I went out to find a person that had tons of information on this topic and I wanted to bring her on and I wanted her to go into all of these topics and help us understand if any of these are going to improve the access of healthcare. So my guest today is

Amy West, she has led digital health strategy at Novo Nordisk, and now she is driving the innovation for women's health tech initiative at Hit Lab. And in addition to that, she's also leading the Hit Lab advisory services, and she's been advocating for health equity and improving access to, improving access to healthcare for underserved communities.

Without further ado, let's go in and chat with Amy. Welcome to the show. Great to have you on, Amy.

Amy West (01:40)
Thanks, Harsh. It's great to be here. And I really appreciate the opportunity to discuss this topic that is so important when we think about health care in general. The fact that right now we are not seeing the outcomes overall and the healthy society that we want based on the amazing health care that we've had to date. But that indicates that there's a challenge there and there's a better way to do it. And that's where I believe that

Harsh Thakkar (01:58)
huh.

Amy West (02:09)
technology, digital data can play a role to really support the gap that we're seeing and really help accelerate the ability to deliver those improved health outcomes.

Harsh Thakkar (02:22)
Yeah, and I know you, based on the stuff I've researched about you and read, I know that you stress a lot on the social determinants of health and why all of these are important. Maybe the audience that's listening or watching this episode doesn't even know what that means. So before we go into too much detail and talk about why they matter, can you set the stage and let our audience know?

What are the different social determinants of health?

Amy West (02:53)
That's a great topic because the social determinants of health, understanding them are critically important in order to really drive the change we need. And so the social determinants of health are the conditions in which people are born, grow, live, work, and age that shape their health. That includes factors like socioeconomic status, your education.

the neighborhood you live in, that physical environment, your employment status, and things like your social support networks, as well as access to healthcare. And so all of these factors, these elements, are really what make up the social determinants of health. And it's really about how we live our lives every day in the environment in which we live and those experiences that we're having. And so addressing the social determinants of health is important for improving health.

Harsh Thakkar (03:42)
Mm-hmm.

Amy West (03:50)
and reducing the long standing disparities in health and healthcare that we've seen. Because a lot of, you know, we have the science, we have the, we have a lot of great solutions as far as medications, surgical interventions and things like that. But we're missing the fact that a lot of the ability to engage in those great offerings and solutions are rooted in the social and economic disadvantages that we have based on these social determinants of health.

Harsh Thakkar (04:12)
Mm-hmm.

Right, right. Yeah, and this is, you when I think about it now that you explained, you you mentioned depending on which neighborhoods you live in, like I've lived in many different states in US since I've been in this country 15 plus years. And I've seen, you know, the type of pharmacies, the type of even retail stores in cities like New York or San Francisco versus, you know, rural Pennsylvania, like central where, you know, it's in a small town.

The stores are still there, but the design of even the Walmarts and Targets is different than the one in San Francisco or Boston versus Central PA. And the same is true for hospitals, pharmacies, health medical practices, and so on. So that's a really important point. And if you're living in those areas, you have less options or more options depending on if it's a big city. So that's a great point.

Amy West (05:17)
Absolutely. The other thing that's important from a data standpoint, why are the social determinants of health important when we consider health equity? The data shows that for the average person managing chronic health conditions, only 20 % of what influences their health is related to the access to healthcare and the quality.

that sort of that clinic setting idea. The other 80%, which is an overwhelming percentage, the other 80 % of those influencers are found in behaviors, the socioeconomics, the motivations. Those are the social determinants of health. And these are all things that are not today really addressed in the doctor's office or from a clinical standpoint, because it's difficult to do that. But it matters because

Harsh Thakkar (06:02)
Alright.

Amy West (06:14)
We need to understand that 80%, the social determinants of health in order to improve the health outcomes beyond where we are today. And we need to combine that 20%, that clinical scientific intervention and engagement with the 80%, which is really understanding, it's a holistic person-centric understanding. It's understanding the patient as a person first, not a patient.

Harsh Thakkar (06:38)
Mmm.

Amy West (06:44)
but understanding you as a person, none of us identifies as a patient. You're a podcaster. I work for the HIT Lab. We're moms and dads and teachers, service workers. We've got a lot going on in our daily lives and our health is important, but in order to really have a good health and wellness of our daily lives, we have to be understood for the people that we are.

Harsh Thakkar (06:49)
Yeah.

Amy West (07:14)
Again, that's the 80%. In order to be able to deliver those better health outcomes, we have to combine this understanding of the human being with the clinical science side of things.

Harsh Thakkar (07:25)
Okay, so I just want to say we have been live for seven minutes and 30 seconds Do you want to keep going till 10 45 and take what we get here and have a short short? Yeah, we can have a shorter version of the episode instead of you know 45 minutes or we can stop here and then redo it again

Amy West (07:38)
If you're okay with it, yeah, I'm fine

I'm totally fine. Whatever your preference and your experiences with this, I'm totally fine with. Okay.

Harsh Thakkar (07:54)
Yeah, let's keep going till 1045. So, okay,

so let, yes, yeah, yeah, this is going well. So you were mentioning about the stats. So let me look at my notes here. Okay, so you mentioned that, and all of this can be edited later. So most people think hospitals, healthcare happens in hospital and clinics, but you said that.

Amy West (08:01)
You're getting what you need or you feel this? Okay, good.

Harsh Thakkar (08:22)
80 % of what's impacting access to health care is happening outside of the hospitals and clinics, right? And we also talked about this sort of the divide between urban and rural areas, depending on where you live and the types of hospitals and even the types of medical providers, right? Like if I'm looking, if I'm a doctor or a surgeon and I'm looking for a job,

And I have a job offer in New York that pays probably a lot because the cost of living is a lot. And it's at a big name hospital versus somewhere in a rural area. Depending on what my preference is, I may or may not choose one versus the other. then, whatever I choose, now the people living in that area don't have access to my medical expertise because I chose to go to New York or San Francisco.

So when this statistic that you mentioned is very interesting, but what I want to ask you to dig a little bit deeper on that is What's like why are these areas? Staying behind and how can they sort of shift, you know that 80 % to maybe 70 or 60 or 50?

Amy West (09:44)
Sure, well, I think a lot of it is, I don't think that the data points are necessarily going to shift. Like the point really is that 80 % of what influences your ability to have a good health outcome is really based on how you live your life and your environment, the social determinants of health. So it's important that the healthcare ecosystem, the stakeholders,

Harsh Thakkar (09:51)
Mm.

Mmm.

Amy West (10:14)
as well as the people, the end users, the patients ourselves, that we recognize this because these are the things that are going to need to be addressed on an individual basis or as closely as we can get to an individual basis as possible to really move the needle on these health outcomes. And so...

Harsh Thakkar (10:38)
Mm.

Amy West (10:40)
That's where things like technology, I think can play a huge role to shift where we are. Because if you think about our healthcare system, the science is great, the medications are great, they're better than ever. The clinical interventions are better than ever. And yet our health outcomes are not really improving at the same rate or in the same proportion. And again, that's because we haven't really understood

Harsh Thakkar (11:05)
Mmm.

Amy West (11:08)
the human side to this and understanding how all these other things impact your ability to engage in your health and wellness. But that's where, again, technology, I think, can play a role to bridge that gap, to really help bring this sort of clinical, the clinical support with the fact that, you know, social determinants of health are playing a huge role, meaning that resources that we have through technology like telehealth, remote patient monitoring,

Harsh Thakkar (11:29)
Mm-hmm.

Yep.

Amy West (11:37)
the Internet

of Things integration, AI technology with voice recognition. And these create opportunities to support people in their daily lives based on the ability to capture data from sensors, wearables, again, the Internet of Things, and provide that insight that can support

the right clinical interventions for the person based on how they live their lives and from the behaviors, their nutrition, their activity level, even their environment. And so I think that the technology can really help bridge that gap to help the clinical and scientific side marry that human social determinative health side together and to create that insight and support the better health outcomes. So that's really what we're talking about here.

Harsh Thakkar (12:11)
Mm.

Mmm.

Amy West (12:29)
And again, I think it also supports the opportunities that we have. You mentioned like rural and urban communities. Rural communities might not have the access to the care that you might have in a more urban setting. But again, these technologies can support that remote engagement again through telehealth services, remote patient monitoring, and these sort of virtual connections that can create a

an easier way to connect the remote areas and support better health engagement and potentially even earlier interventions to mitigate potentially things that could get worse if they're not addressed early on.

Harsh Thakkar (13:13)
I see, okay. Yeah, and also this reminds me of you mentioned about remote patient monitoring. And I actually worked at, I was working with a consulting client and they're evaluating different devices for measuring how well your lungs work, like how much air you breathe in and out. So they're evaluating multiple global.

manufacturers of these spyro, I think it's called a spyro meter that you basically breathe in. And one of the companies they were evaluating had a mobile app. And they actually demoed the app to us that every time the patient ran the spirometer, it would, you know, show the data, it would show like a nice visual, they would have to pair it with their app. And the app would like show the breathing, you know, bubble in and out. And it was just a really intuitive

Amy West (13:43)
Yep. Mm-hmm. Yep.

Harsh Thakkar (14:09)
interface and helping the patient understand why it is needed, right? Like explaining to them, not just, here's a spirometer, do it and write down, or just like a thermometer where you see a reading, just write down. That's not as intuitive as this one manufacturer that had this amazing app. And I was like, wow, this is interesting. And it does help with the adoption and getting access to that data.

for that manufacturer so they can analyze that however they want.

Amy West (14:44)
Absolutely. And I think

an interesting trend that we're seeing is that over the last few years, we've seen a lot of these types of apps come into the market, which is great, to capture data ambiently or even consciously, actively, whatever. But now what we're starting to see and hear is that these sort of apps or point solutions, which are really good, that's no longer enough because the world doesn't

Harsh Thakkar (14:55)
Yep.

Amy West (15:13)
need another app, right? What they're wanting to see is an integrated platform. If you're going to develop, you're an entrepreneur or you're a startup or you're even playing in the digital health space as a point solution provider or developer, it's really important to think about how are you going to be embedded and integrated into existing platforms that hospital systems are using or manufacturers are using or people are using?

Harsh Thakkar (15:15)
Right.

Amy West (15:41)
are you part of, of, you know, the Apple, the Apple watch or Apple health? are you part of, you know, a health system platform? Because what you don't want to do is to create something that requires more work. We want a frictionless application and integration that allows the data collection to be seamless, but also that data collection to be pulled into a larger platform so that it.

Harsh Thakkar (15:58)
right.

Amy West (16:10)
you're getting again, you're getting more holistic understanding of what's happening with the individual to provide that more personalized intervention that delivers that hopefully that better health outcome.

Harsh Thakkar (16:23)
Yeah, yeah. And this is, you I know we can both relate to this because we had some technical difficulties getting onto this call earlier today. But even when you look at browsers like Google Chrome, Microsoft Edge, Firefox, and all these different extensions and apps that are available, the ones that are designed to work with most of them in a seamless manner are getting more downloads, more subscriptions, and whatnot. And the one that are

Amy West (16:50)
Yes.

Harsh Thakkar (16:53)
that have a lot of friction, like, I only work with this browser and this setting. Well, guess what? That's not the most favorable way that a user wants to use that app, unless they're extremely passionate about it and that's the only app on the market, right? So it's happening everywhere. It's not just in healthcare. It's also in tech and other industries.

Amy West (17:13)
Yeah, and it's about the experience. You have to be designing for the end user. Because again, like, and this is something that I see a lot in this digital health space. There's a lot of amazing innovation, great thinkers, great opportunities, but don't get caught up by the shiny objects. Make sure that you're designing for the end user, the human being who is going to get benefit out of that and make it as easy and as frictionless.

Harsh Thakkar (17:14)
Yeah.

Mm-hmm.

Amy West (17:41)
and as simple to use as possible because that's really where you're going to gain the most traction and where you're to deliver the most value.

Harsh Thakkar (17:49)
Yeah, I want to switch gears and talk about the work you're doing at Hit Lab. So I know that you're leading the Women's Health Tech Initiative there. If we are to focus on just now women's health, going from overall health care to just women's health, what are some of the barriers there that you're seeing in your line of work? And is technology, AI, all of these data, all of these things?

How do you think they can specifically help women's health?

Amy West (18:23)
Sure, I mean, think it's fair to say that women's health, women in general, we still face pretty persistent barriers to accessing health services. And these are based on things like cost, gender bias, discrimination, stigma about women's health issues. And there's been a lack of funding in this space. Overall, the US health system was not designed for or by women.

So that's important to keep in mind. I think that contributes to some of the challenges that we see. And so as a result, the health needs of women have historically been under prioritized. And I think just as a data point, which I think is really interesting is in 1977, the FDA recommended excluding women of childbearing age from participating in clinical trials for most drugs.

Harsh Thakkar (18:55)
Mm-hmm.

Hmm.

Amy West (19:15)
This law change or this ruling or advisement changed in 93, but the policy resulted in a limited understanding of women's health issues, because we lost all that time and introduced significant knowledge gaps when it comes to women and women's health. So, for example, we know there's been a lot of progress in the cardiovascular disease space, but a lot of that's been based on male physiology anatomy because women weren't included in those trials.

Harsh Thakkar (19:27)
Interesting,

Amy West (19:44)
So there are potentially differences in diagnosis and treatment for women as compared to men, we just don't know. And the good news is we've had a steady increase in the representation of women in clinical trials since then, recruitment remains low, unfortunately, for women. And we still need to improve this, because women are really only accounting for anywhere from 30 to 34 % of participants.

Harsh Thakkar (19:54)
Mmm.

Amy West (20:13)
in industry sponsored early phase trials. So we've got a long way to go there. But again, this I think is where we have an opportunity in a tech space. I think the technology, again, just like we've seen with social determinants of health can help bridge some of these gaps that we have seen to help accelerate understanding women's health. for example,

from an app, you we talked about apps earlier. We're starting to see some apps on the market that leverage AI to capture information about women based on their hormones. And the hormones are really a lot of what are the differences between men and women. And we also know that women, the hormonal changes in women from cradle to grave have significant impact on health and wellness that have just not been really understood or studied. But we are starting to see now a lot of ability to capture that information through these

Harsh Thakkar (20:51)
Hmm.

Amy West (21:11)
ambient wearable sensor devices that are going to contribute to greater understanding of women's health and the differences between men and women. Obviously, when we think about women's health, you think a lot about fertility, menopause, and there's a lot of investment going into that space and that's really important. But there's so much need beyond that in cardiovascular disease, autoimmune diseases. Cardiovascular disease is the number one killer of women. And we really don't understand

Harsh Thakkar (21:38)
Hmm.

Amy West (21:40)
the real insight there. So there's a lot of opportunity there and we're starting to see more and more interest and investment in investing in women's in FEM tech or women's health tech. JP Morgan is going on this week and that's been a big focus of that of the conversation at that conference. So that's really exciting. And in addition, in 23, the Biden administration launched

the first ever White House led initiative to focus on improving the way the federal government approaches and funds women's health and women's health tech. So there's going to be more and more opportunities for those who are interested in working in this space for grant money and opportunities from the federal government to invest in, help support the work that they're doing to bring their solutions to market that will accelerate better understanding of women's health and hopefully improve the lives of women.

Harsh Thakkar (22:37)
Yeah, No, this is, know, I think the big picture idea about, you know, digital health with all the things that you've mentioned and that we covered today is that because of technology, physical barriers are being, you know, broken down and more things are happening sort of virtually, whether it's people interacting with people or software and apps interacting with apps. And that is making it

it more accessible in multiple ways like we've covered today. When you think of digital health or the future of digital health from like a 30,000 foot view, are there any other big picture ideas that you think might happen in the next five or 10 years?

Amy West (23:23)
Well, I think the big trends that are really going to drive the future are really in two big areas right now. One is AI. Everybody's talking about it. And I think that's going to really do a lot to support all this data that we have out there. It's a lot. And it can really sift through the information much faster than a human being. So we're going to see a lot of opportunity with using AI to capture data, but also process and end.

Harsh Thakkar (23:31)
Yeah. Yep.

Amy West (23:51)
and help with decision-making and insight. And also even from an end user, from the patient using this, it gives us a better understanding of what's happening in our lives and in our bodies so that we can be more proactive. So think that's really exciting and moving more toward this prevention and wellness model, well-care model. The other area would be, again, going from the point solutions to the platforms, integrating a lot of these different

apps, remote patient monitoring components, AI technologies into platforms that support that holistic data collection and insight. And so that's, think we're going to see more of that consolidation and integration. That's going to be really important too, to really drive, know, and also support personalized interventions and health outcomes that also ultimately help bridge that health equity gap that we see with different populations and different communities.

Harsh Thakkar (24:27)
Hmm.

Yeah, the integration part is really important thing to know because yes, you have multiple apps, but then if every app is throwing out data in that their preferred format, and if you are a pharmaceutical or biotech company or a manufacturer of these devices or apps and you're trying to analyze the data, well, now you've created more work for yourself because now you have, you know, five different data formats and spreadsheets and whatnot. So yeah.

That integration on the front end is always better, less time consuming, maybe more time consuming, but more efficient down the road because you don't have to look at seven or eight different data types to figure out what's going on.

Amy West (25:29)
Yeah, I think a key word there is friction or frictionless. Like you want to create, you want to create a frictionless opportunity and as ambiently as possible, make it, nobody wants more work to do. Just like you mentioned that nobody wants more work to do. So if we can collect this more ambiently, make it portable wherever I go, you're capturing, I'm a walking, talking data point, like capture it and let's pull it into a platform that, understands it holistically.

Harsh Thakkar (25:33)
Yes, yes.

Yep. Agreed. Well, Amy, thank you so much for your time. I know you have to jump to another thing that you mentioned to me earlier. Love everything that you shared here today about digital health and access to health care, pinpointing towards what can be done in the women's health area. For listeners who've enjoyed hearing you or watching you on this show, where can they connect with you or learn more about you and all the initiatives you're doing?

Amy West (26:26)
Sure. So you can go to my LinkedIn, Amy West, and I'm with HitLab. I spent the last 15 years at Novo Nordisk in the digital health space and really the marketing, omni-channel marketing space. really my core was, my love is really in the future of healthcare, which is really in this digital health and health innovation space. But go to LinkedIn or obviously you can connect with, you can go to the HitLab.

hitlab.org and you can connect with me through that as well. But the easiest way is probably to go through my, to my LinkedIn and go from there. But I would love to connect with anyone who wants to talk about this and Harsh, it was such a pleasure to talk with you. I appreciate the opportunity and would love to talk again sometime.

Harsh Thakkar (27:15)
Yeah, thank you. We'll put those links in the show notes of this episode so people can find your LinkedIn and HitLab website. And if you enjoyed listening to this conversation, I highly recommend to check out one of our other episodes with Bethany Corbin that we've had in the past. She's extremely passionate about femtech and women's health. So if you enjoyed some of this, you might enjoy that episode and we'll put that link somewhere here on the screen.

That's it from me. Thank you, Amy. Hope you have a great week and a great year ahead, 2025. Yeah, thank you. Thanks, bye.

Amy West (27:45)
Same to you, happy new year. Thanks, Harsh.