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The mobile-technology company is trying to corner the wireless needs of the health-care industry, and is pushing for adoption of value-based health-care models that would be dependent on more data-sharing to justify costs based on patient outcomes.


When you hear "medical device company," the first name that comes to mind probably isn't Qualcomm. But if the company has its way, it'll likely be a major player in the medical device industry for the foreseeable future.


A mobile-technology company, Qualcomm has been making big waves in the health-care sector by using its wireless chip technology and unorthodox partnerships to change how treatments are delivered and how physicians keep tabs on their patients.


In an interview with Medtech Insight, Rick Valencia, president of Qualcomm Life, a subsidiary of Qualcomm, says the company's goal is to be the "connective tissue" that bonds patients, physicians and their treatments, in the hopes of providing the best outcomes for the best cost.


Riding The Digital Health Wave

It all started about a decade ago, in what Valencia describes as "evangelism" by some in the company to use their mobile technology to improve health-care delivery. Eventually that idea spawned into Qualcomm Life – about six years ago – and now the company seems to have entrenched itself with partnerships across the health-care sector.


Over the past few years, a number of well-known companies that are not traditionally in the medtech space, such as Apple, IBM and Verily Life Sciences (formerly Google Life Sciences), have made big investments in the health-care industry. They've been partnering with device and pharmaceutical companies to meld their traditional background in communication and data technology with products offered by traditional health-care companies to develop a new field in the health-care sector called "digital health." (Also see "Wearables: A World Of Pharma Partnership And Potential" - Scrip, 8 Aug, 2016.)


The transformation has been noticed by stakeholders across industries, including the medical device lobby group AdvaMed, which last year launched AdvaMed Digital to represent new digital-health companies, such as those mentioned above and Qualcomm. The issue has led the group to make digital health the cornerstone of its upcoming annual medical device industry conference, being held in San Jose, Calif. – near the headquarters of many digital health companies on the US West Coast.


Qualcomm, based in San Diego, is one of these companies in the new digital-health arena, and seems to be working to corner the market with their mobile chip technology. The company has ramped up efforts over the past couple of years with several high-profile partnerships. Notably, it is partnering with medical device giant Medtronic, and pharmaceutical companies including Novartis and Roche. (Also see "BEHIND THE DEAL: Why Medtronic And Qualcomm Are Teaming Up On Diabetes" - Medtech Insight, 31 May, 2016.) and (Also see "INTERVIEW: Qualcomm's digital health expansion plan sees Novartis, Roche tie-ups" - Scrip, 9 Feb, 2015.)


Besides collaborations with drug and device companies, Qualcomm has also partnered with about 2,000 hospitals to build what Valencia calls "the internet of medical things;" a play on the term "Internet of Things," or IoT, which is used to describe a trend in the consumer industry to connect everyday products with customers through the web.


Qualcomm is also working with UnitedHealthcare on a project to track the health and wellness of employees of the insurance company to figure out a way to reduce health-care costs. If successful, it could be a model for the insurance industry to find ways to reduce costs.


"We're trying to create something similar to the mobile network, but in health care. We're trying to create this ubiquitous, open platform that we partner with everybody in industry," said Valencia. "What you'll notice if you look at our customers – now partners – is that a lot of them are direct competitors in the industry when they go to market, but they compete on the uniqueness of their medication or diagnostic device, or whatever."


Valencia notes that Qualcomm technology can be found in virtually every mobile device, whether it's modem, processors, or even licensing of their chips in wireless devices. He says this allows them to play a neutral role in the market so their partners can compete for the best product using their services as a base.


"What we offer is more like a utility that they plug into and they don't have to worry about it, so we're able to act as this intermediary that acts like Switzerland because we're new," said Valencia. "We haven't been in this for a long time, we're not heated competitors of any of these folks, and so they've been very welcoming to Qualcomm in this space."

One big area where Qualcomm has blurred the lines between traditional drug and device products is by using their technology to not only help patients improve how drugs are administered, but also to track the long-term safety and efficacy of drugs.


The company has been partnering with pharmaceutical companies developing new drugs to monitor their effects on patients through diagnostic and monitoring devices so that patient data is directly streamed to researchers and physicians. Drug-makers and Qualcomm say this is intended to improve clinical trial recruitment and compliance, while also reducing potential for human error when logging the patient data.


"If it's coming directly off the device straight into the research database, then the chance of getting there faster and with less errors is very high, and it enables them to get a drug to market faster," said Valencia.


Ultimately, he says, these partnerships are creating a new health-care sector called digital pharmaceuticals.


Pharmaceutical companies "are creating drugs that will be prescribed with a digital element that will help their customers with [dosage compliance], and giving feedback to their doctors, and how they are taking the medication, and maybe even at some point how the body is reacting," said Valencia. "You can imagine a patient not only taking medication, but they might be wearing some sensors, or maybe a patch that's taking their heart rate and respiration rate, and maybe eventually even blood pressure and blood glucose, and feeding that information back, noting that when I take this drug, this is how my body reacts to it, and whether or not they should change the prescription as a result of it. And that part of the business is really taking off."


Moving To A Value-Based Health-Care Model

Valencia says this is leading to a new value-based health-care model that is replacing the traditional fee-for-service model that has been in effect in the US. He says the current volume-based health-care system is too costly and unsustainable in the long run.


"If you're really, really sick, you have some really strange disease or condition, day-in day-out primary care is double the cost in the US than it is anywhere else in the developing world; over 20% of GDP, and we have worse outcomes and lower life expectancies than any other developed country," said Valencia. "The cost of care has to come down for a good health-care system to be sustainable, [and] we think that value-based care delivery and payment is the best mechanism to get there."


And the problem isn't just in industrialized health-care systems. As developing countries are growing their middle class, Valencia says that will push greater demands on their health-care systems.


"We're hoping they don't end up making the same mistake we made and go straight to a sustainable model that we believe is value-based care, where we're really focused on conditions and costs associated with an individual condition as opposed to a procedure, as opposed to a department, as opposed to a facility," said Valencia.


In response to what he sees is an inevitability, Valencia coauthored a recent report at the World Economic Forum in Davos, Switzerland, for its Value in Healthcare project outlining what steps governments and other stakeholders need to move the volume-based health-care systems into value-based systems. Among the main objectives of the project is to develop shared standards for health outcome metrics.


Qualcomm isn't the only player pushing for adoption of value-based health-care models. AdvaMed recently also published a document outlining considerations for the medical device industry in value-based health-care models that the group says is a wave that is coming, and one that the industry needs to have a voice in. (Also see "AdvaMed: Medtech Needs Voice in Value-Based Health-Care Models" - Medtech Insight, 15 May, 2017.)

Valencia says in the end, it all comes down to aligning costs and outcomes so patients get the best treatment for the best price, and that's where a company like Qualcomm can make a major impact.


"To make health care more sustainable and deliver on value-based care, you're going to need to have a system with tighter connection with the patient. Imagine a patient who has just been discharged," he said. "They're at a very fragile point in their lives, and having that tether for a period of time as they're getting well is important."


But Valencia admits getting countries around the world to adopt value-based health-care models is no easy feat considering the disparities in how care is delivered across systems and the political baggage that comes with trying to change those systems. He says if they can overcome the various political hurdles, the regulatory regimes will catch up.


However, the most important thing right now, Valencia says, is developing agreed upon proof points among health-care stakeholders to prove the value of treatments using sound science. Further, Qualcomm is planning several pilot projects around the world in health arenas such as congestive heart failure and diabetes to find what the best treatments are that deliver value.


Data-Sharing Is Critical

The real audience of the report, according to Valencia, are policymakers, and a good first step for US lawmakers would be to consider requiring data-sharing. While he says it would be good to have data from patients, that's not the most important type of data that is needed right now. Instead, Valencia says, the health-care system needs data on physicians, hospitals and medical procedures, and how much those procedures cost and how well they perform.


"Health care right now is a bit of a black box in terms of what things cost, in terms of the quality of an individual care provider, the results or outcomes of a specific procedure," he said. "So one of the things that we need to do is, if we're going to identify value based on a specific condition, there's going to be procedures that are required to treat that condition, we need to know how they're done, whether not they are done well, how long they take, and we need a lot of that sort of data."


However, he says, currently there is not a lot of incentive for that kind of data to be shared, and overcoming aversion to sharing that data is the first step in creating a value-based health-care model.


Beyond selling industry stakeholders on a value-based health-care system are also basic logistical hurdles, including making sure medical devices are not vulnerable to potential cybersecurity threats and that they can store and transmit data that protects patient privacy.


Valencia says Qualcomm already has experience storing and transporting data that goes beyond compliancy requirements and the Health Insurance Portability and Accountability Act (HIPAA), and the firm has been active in ensuring their chips are secure from malicious hackers.


"One of the things we've been doing for twenty-odd years is creating secure communications all the way down into the chipset," he said. "In fact, we have a small business at Qualcomm that a lot of people don't know about that is a cybersecurity business where we provide all of the secure communications to the US government, so we know a thing or two about that."

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