Transcript

00:04 Dan: Welcome back to Digital Health Today, the place to be to get the insights of leaders making the healthcare of tomorrow available today. I’m your host, Dan Kendall.

You may have heard our recent episode with Eugene Borukhovich where we spoke about a new show that’s being produced on the Digital Health Today platform. That new show is called the Digital Therapeutics Edition, and Eugene is diving deep into that specific area within digital health. It’s part of the work that we’re doing to create meaningful content that serves people who are working to improve health care. And you can find that of course on digitalhealthtoday.com. You can also find that on all the major podcast players by simply searching for the words “Digital Health Today”.

In this episode, I’m excited to introduce you to yet another outstanding health innovation leader who is hosting another new show on Digital Health Today. His degrees are in engineering, in business. And he’s a writer, entrepreneur, investor, and advisor. He is truly a multi-talented person. And I’m pleased to also call him a friend. Ladies and gentlemen, please allow me to introduce the host of the new Asia Pacific Edition, Tony Estrella. Tony, thanks so much for joining me.

01:13 Tony: My pleasure. Thanks for having me on here, Dan. And thanks for having me not just as a guest, but also being part of the Digital Health Today family.

01:21 Dan: It’s my pleasure. Tony, we have a lot to dig into. You’ve been a guest on Digital Health Today. It was almost two years ago when you first came on and gave some insight on the Asia Pacific region. And now fast forward to 2021, and I’m really thrilled that you’re hosting your own show about a topic and region you know a lot about.
So first, I think it’s really important for us to put things in context. You’re based in Singapore, and I’m sure our listeners are very well informed about the state of the pandemic in Europe and the US. But I don’t hear anything about what’s happening over in that part of the world. So how are things going there specifically in relation to COVID-19?

01:56 Tony: Yeah. Look, we’re clearly in very challenging times; unpredictable is probably a good way to describe what’s happening in the world. Singapore happens to be a place where things are fairly stable. And just a little context about this island state. It’s about 5.5 million people in population, sits in the tip of Malaysia right at the equator. And it’s widely considered one of the best health systems in this part of the world, as a place where Southeast Asia and its citizens tend to come for learning about what best in class looks like fairly developed.
And in the context of what’s happening in this pandemic, fortunately, what I can say having been here over the past 5.5 years, coming up on 6 years, I’ve been impressed with the way that everything has been handled here relative to the adoption of technology, government policies, information, transparency, and not everything is perfect. But you know, by and large, it’s been a very positive and safe environment for myself and my family.

02:57 Dan: Tony, that’s great to hear that you and your family are safe and well. But also, it’s really good to hear that it’s possible to get this under control. I also live on an island here in the UK, and things are not going well here at all in terms of COVID. The situation in the hospital seems to be getting worse every single day. The wards are over capacity. The NHS is actually considering putting patients into hotels as part of their overflow capacity. And we still haven’t even hit the post holiday peak that they’re predicting. So just a reminder to everyone listening, wear a mask, wash your hands, and practice physical distancing. Hopefully, we’ll get through this soon. This is not the way we wanted 2021 to kick off.

Tony, I mentioned there in the introduction, that you’re a writer, you’re an entrepreneur, you’re an investor, you’re an advisor. You do so many different things. And I’m really fascinated by the range of roles and your interests that you’ve had and that you continue to develop. I know some of the things that you’re working on now, but help me understand how you got started doing all this? Can you give us some of the background and tell us about the experiences that led you to living where you are and doing what you’re doing?

04:00 Tony: Yeah, it’s quite a journey in terms of both personal and professional to have arrived here. When I was in my academic life during undergraduate, I studied electrical engineering, and I’m one of those people who clearly did not use my high degree towards what I do today. But what it took me towards was I enjoyed building, and I enjoyed working with people who had this curiosity and fascination to change something, whether it’s changed something smaller, or change something large.
And that’s ultimately what led me to become an entrepreneur. Was in 1999, I was fortunate to be working in Silicon Valley, at that point, I was doing work with E-Trade, and that tech bubble and before that tech bubble burst was really fascinating place. It really gave you a lot of about passion for building something that was taking your creativity and applying it to technology. And from that I decided to focus on healthcare.
So that led me towards valuating various options, either in working in venture capital or working as an entrepreneur. A couple of years of doing some of those on a small scale led me to work at Pfizer. And…

05:10 Dan: Let me jump in on that real quick, Tony, because I’m just curious. I mean, moving from tech to healthcare 20 years ago, that wasn’t something that a lot of people did. What made you realize that doing that, the moving from a pure tech play to the healthcare sector was a good option for you?

05:25 Tony: A good question. So I think, with healthcare, people have various motivations as to why they’ve chosen to work in this industry. In 20-25 years ago, it was not a sexy industry to work in. Especially coming from a background of electrical engineering, I received many questions. When I said, I want to work in the healthcare industry, the first question I got was always, are you a doctor? Obviously, I’m not. And what motivated me was had two personal experiences.
One was a family experience where a close relative of mine ended up having end stage renal disease and had to go through dialysis, and as I was a kid at the time. And it’s where I first learned about how your life can really take a turn for the worse, and some type of technology can help alleviate that. But at the time, it wasn’t necessarily a life-saving type of approach, but it did help quality of life for a period of time.
A second incident, which happened with a friend of mine when I was just graduating from college was this person developed the heart condition, which wasn’t typically associated with someone of her age. And with having an implantable defibrillator and seeing how that worked, it just opened my eyes towards how technology could really help an individual live a normal life, when for all intents and purposes, they had a condition which wouldn’t have normally allowed them to.
And so when I had the choice, when I went to get my graduate degree, got an MBA from Wharton, I chose healthcare. Because I could find that if I worked on solving problems that helped people, I woke up every morning, energized, happy to be tackling whatever was difficult that day, because if I could improve one person’s life, then I could just continue to be passionate about what I was doing.

07:10 Dan: You know, it’s really unfortunate that so many of us have that sort of personal encounter with the healthcare system or with a challenge around our own health or the health of someone that we care about that sort of flips that switch that makes us want to dedicate so much of our effort and energy and education to pursuing this career and working to improve health care. But I’m really glad that you’re here, that you’re working in this space, and then as you say, it gives you the energy that you can put in so much into your work. And then actually, instead of it depleting your energy, and of course, it does deplete your energy at times, but it can also fuel you to go further and to do more. So yeah, I’m the same way.
So apologies, you were talking about getting your MBA, tell us what happened after that?

07:52 Tony: So when I was graduating from my MBA, I had the chance to work at a venture fund, had a chance to explore startup, eventually arrived at working at Pfizer. What Pfizer taught me over a three-year period, it was how the healthcare industry works. And I was able to experience that and helping to manage one of the billion dollar drugs at the time, in terms of like how that works together across various stakeholders, payers, providers, patients.
But the fire to build something didn’t change, and so that’s when I decided to start my own company. And that company was healthcare startup that focused on online education. The company is called HealthiNation. And so what we did was we started doing video education for on-demand platforms. And what was interesting journey for that which was in the US, built that business for eight years, and then, through a variety of circumstances ended up moving to the UK. And then when I was in the UK, I was working across various startups and investors and helping companies to establish product market fit. And MetLife found me and recruited me to join their team in Singapore. And that’s when I joined the innovation team at LumenLab, which was MetLife’s innovation group based in Singapore. And then through that experience, I helped to shape the health strategy for a global life insurer for Asia Pacific.
And so if you put all those into discrete segments together and how I work today, I’ve had the fortunate experience of working as an insider inside of Pharma and in insurance. I’ve been an entrepreneur working within my own company, and across a variety of companies as well. And so I’ve been able to see and help to shape how different organizations work together to solve complex problems. And in a nutshell, that’s what I enjoy doing now is help businesses establish product market fit within Asia Pacific. Because within the role of MetLife, I was working across 11 different markets across Asia, including some of the big ones that you would think China and India, some of the more mature ones such as Japan, and Australia, and everything in between.

09:55 Dan: So that fills in some of the gaps about how you got to Singapore, your experience in the US and in Europe and on the tech investing innovation and I’ll call it the creative experience that you had with your work in HealthiNation.
There’s another way that you’ve developed your creative skills and that’s through writing, and not only writing like nonfiction healthcare topics, but also fiction writing. And I had the pleasure, I’ve talked about this before on other shows, I’ve had the pleasure of reading your book “Comatose”, which you released a few years ago. And it was probably the first fiction book that I’ve read in probably two decades. And I got to tell you, I really enjoyed it. I’m not just saying that because you’re a friend, and you’re here on the program with me, I really enjoyed reading this book. It was a great combination of science and healthcare and relationships, and really the science of sleep, and the characters travel all over the world.
You describe the places in such detail, places that I’ve never seen or visited. But you describe them in a way that made me feel like I’ve been there. And in fact, if you’re listening to this, and you’re frustrated that you can’t travel like you normally would go and pick up a copy of Tony’s book “Comatose”, and you’ll feel like you’ll be traveling just in a few minutes.
Now, Tony, you also write papers about the industry and you do some speaking, how did you develop all these different interests and capabilities, and learn how to write and communicate with audiences and all these different media?

11:17 Tony: Yeah, I’ll start with the importance of storytelling. And we’re at an inflection point in our industry, for digital health, where a wealth of technology is changing the world.
And if you look at other industries, where technology has been really critical, you could look at space travel as one example, where if you rewind the clock back to when we were starting the Apollo program, and trying to figure out what should we be doing to explore the moon and where else could we go? All of that came from storytelling. Star Trek is something that many people can empathize with, Star Wars. And when you have storytellers, guiding what the future can look like, it can really help shape industries.
And I learned my storytelling skills and my interest in it with my startup that I mentioned, called HealthiNation. In that as a founder, and as someone who had to build the company from the ground up, I work with our head of production, who came from The Today Show, to write scripts, and figure out what story, what narrative did we want to tell in that context, which at that point was around disease education, and helping to understand patient journeys.
And I was writing these stories, I really found a passion inside of me, and I thank this individual who helped me learn to take his personal interests, because I was one of those geeky kids who read comic books. You know, I watched movies over and over again, because I loved when I found a good story that was good plot, good characters, I want to understand why did I connect with it. And this person helped me to turn all of that interest into something that I could express the writing. And when I had the opportunity to learn from this individual, by the way, he won Amy, which was really cool to have someone who worked for my company win an Amy through HealthiNation. And he then encouraged me to try to take a step further, and what else could I write?
So I decided to take all my lucid dreaming experiences. And you and I’ve talked a bit about that in one of our prior interviews, and turn that into a narrative around where the future of healthcare could go. And this inflection point that we’re in, we have artificial intelligence, we have blockchain, we have robotics, we have holograms, smart devices. So what could we do? Where can we go? And so I believe in the power of taking all of that and putting it into narratives.
And there’s other authors that have discovered who have been writing about the future of healthcare as well. And what I think that we can do collectively, is to help bridge the gap between now and 10 years, 20 years, 30 years, even 50 years from now. And what does it look like when we achieve longevity? What does it achieve when robotics are part of the way that we live day to day and artificial intelligence is supporting us as individuals within our health systems? Etc.
So that that’s been the thesis behind why like storytelling. It’s been a journey to try to become a good writer, and thank you for enjoying my reading and enjoying the book that I wrote. I’ve got a second on the way that’ll be a sequel to that book. And when I started doing the work I’m currently doing, I had the opportunity to become an expert panelist for a group called FutureProofing Healthcare, which is backed by Roche and supported by Roche. And their aim is to help health systems be able to take data and evidence to shape better health systems for economies and countries around the world.
And with my involvement with them as an expert panelists with a focus on innovation and health tech, I then also had the opportunity to write a white paper with them around the future of Asia Pacific in 2050. And that actually was an incredible experience to be able to take input from a variety of people who I respect and bring together this narrative around individual stories and what their lives could look like in 2050. And then what are the various steps or axioms that would need to be established In order to achieve that vision?
And I’ve got lots of exciting things that are coming down the pipeline in terms of continuing to do work with FutureProofing Healthcare. But it’s just been nice to be able to take that platform as where it brings together my fiction writing interest and storytelling with the 20 plus years of healthcare experience that I’ve been able to have across the experiences that we’ve described earlier.

15:21 Dan: Yeah, thanks for mentioning that paper. It is an interesting read. I really like the way that you wove the stories of individuals together to really paint the picture for how health can be in what about 30 years from now, 29 years from now. We’ll make sure we link to that in the show notes for this episode.
And if you’d like to find out more about that initiative that Tony mentioned, you can visit futureproofinghealthcare.com, futureproofinghealthcare.com. It’s a really marvelous program that’s being led by Roche. And I know, Tony, that you’re doing some really interesting work there. And in fact, you know, we’re doing some work there together on that project. And we’re really happy to have Roche as a sponsor this year of the Digital Health Today platform. So thank you to the team at Roche for supporting the work here and for giving us an opportunity to work together on this FutureProofing Healthcare initiative.
Now, let’s switch gears for a second and talk about what else is happening at Digital Health Today, and your role as the host of the brand new Asia Pacific Edition of the program. This is a series that’s really needed and that I’ve wanted to produce for quite some time. I’m really happy that you’re bringing your perspective, your experience, your authenticity, to lead the conversations about what’s happening there in Asia Pacific.
So tell us about some of the things that you’re going to cover in this podcast series and what we can expect to hear?

16:37 Tony: Just as a quick summary for our audience. One of the things you can hear more in depth in this podcast series, I’ll explain more about the various regions within Asia Pacific, because it’s a 4.5 billion people, 44 countries, so some massive region. And in looking at it, there’s a couple of key trends that are driving growth for digital health.
Number one is, if you look into investment community, China at some point will surpass the US in terms of dollars invested in digital health. And whatever data source you want to look at, that may happen in the next year, might happen the next three years, but it’s a massive location. And so all the interest that our audience has, in terms of understanding what’s happening in digital health in the US, there’s different models being applied in markets across Asia Pacific that we can learn from, and those learnings can be applied to the West.
I think a second trend that’s really interesting is because of the size of the population of Asia Pacific, regardless of which segment you’re looking at, there’s an ability to look at how to solve challenges for individuals, whether it’s around prevention or treatment that come with larger numbers. Right? So when you have 60% of the world’s diabetics living in Asia Pacific today, that’s a massive number of people who are dealing with a disease that we have a good understanding for. But if you’re an investor looking to look at companies who are making a difference, they’re just more people here that need solutions.
And then I’d say a third trend, and this comes from my time when I was working at MetLife and the work at LumenLab. There’s quite a lot of potential to help individuals who are moving up the curve from a wealth perspective. And that group of people, which is a large number are mobile first. And they’ve lived their entire life, where all interactions, healthcare interventions included, come through their mobile device. And a world where digital health is really about how you bring technology and insert it into the healthcare system, and try to transform and improve outcomes at whatever stage we’re talking about, to be able to interact with a group of people who want better health care solutions, there’s no legacy of a traditional health care system per se here. Because, you know, some of these countries are just getting health care for the first time through their mobile device. So there’s a chance to really deal with people in an immediate way to help their lives through technology.
I think that that just creates a dynamic, which we’ll see over the next 10-20 years, where massive adoption of technologies which we may struggle with in the West, could be immediate in Asia Pacific.

19:14 Dan: 10 or 20 years are a pretty long horizon. I’m sure there are things that are happening rapidly there that we could learn from. So I know in North America and in Europe, there have been a lot of barriers that have come down in terms of reimbursements and licensing to allow things to happen faster in the wake of this pandemic. Are there any examples you can think of across Asia Pacific, or perhaps specifically in Singapore, where you’ve seen rapid adoption, implementation of new tools or ways of working because of COVID?

19:42 Tony: Let’s like use the US market as an example. Contact tracing today in the US is a people driven activity. There’s people who are hired in, who are very amicable, and they’re trying to be helpful in dealing with the COVID-19 pandemic by making phone calls to track down people who might be affected and the circles that might have expanded from incidences of the virus.
In Singapore, is a technology driven initiative. So almost 80% of the population has downloaded or uses a token called TraceTogether, which is essentially a way to track where you are going and who you were interacting with. And there’s some privacy concerns around how you deal with a program like that. So let’s put that aside for a second and let’s talk about just the implementation of the program.
80% of the population almost is using this. And what we do on a day to day basis is, whenever I go out, I have to scan a QR code with this app. And so this app is basically tracking, where am I going so that if someone with COVID-19 happened to be at the bank where I went to, or the restaurant where I sat at this particular time, there’s now a way through technology to be able to see who else was in that location. And that creates a much faster response to being able to manage the spread of the virus. And that’s part of the reason why Singapore is seeing very low cases and very low deaths. And it’s the use of technology.

21:11 Dan: So it’s using QR codes, it’s not relying on Bluetooth technology and logging when it’s in close proximity to other devices?

21:19 Tony: Well, it’s actually a combination. So I described the use case where I’m using my phone as the way to manage it. But there are tokens which people can wear, and that’s using Bluetooth.
But the reason that the adoption is so high here is it’s the combination of not just the technology, but also government policy. So in order to go into your workplace, in order to send your kid to school, in order to be able to go out and do all the things that I mentioned earlier that are more freely accessible right now in Singapore, you have to use this check-in tool to be able to do that, and so that you can be traced. So there’s a tradeoff.
And when we talk about privacy and the tradeoff between technology and uses, right, like, look at the reason that Facebook has such widespread adoption, there’s an value exchange that’s meaningful for individuals for Facebook, where I’m giving up my privacy so that I can be socially connected to people who I care about, or I’m interested in. Well, here are the value exchange is that I have freedom to move around to be able to do things that are “normal” in exchange for the government to be able to see is how you stop people who might have been interacted together as a result of being exposed to COVID-19.

22:26 Dan: An app like that is certainly a key part of an effective program to manage a pandemic. But I think equally important, is the real benefit that’s created when you actually manage the pandemic effectively and you reduce the number of infections, you reduce hospital admissions and deaths, you’re actually able to have the health care system deliver the care and services that it was built to do. You don’t have what many of us are experiencing right now across the US and across Europe, where hospitals are closed for almost everyone except the sickest COVID patients.

22:59 Tony: Yeah, exactly. And I think it’s a good example, where it’s a technology alone is clearly an option prior to solve this, but it took the collective will of various stakeholders and individuals to say this is meaningful. And within a six month period, it went from a concept to being widely deployed. And that’s I think some of the case studies and wins we’d like to continue to see for digital health across not just Asia Pacific but globally. Is where do we see that it’s no longer about digital health being a potential answer, but rather, there’s now a new use case, a new solution, and technology is considered just part of it at its core?

23:37 Dan: Tony, we’re almost out of time. So before I let you go, can you give the listeners a couple of previews about the people and the topics that you’ll be covering on the Asia Pacific edition of Digital Health Today? I want to make sure we cover that and let people know what to expect and why they should subscribe.

23:52 Tony: Look, there’s a quite a range of opportunity to be able to learn from this region and from some of the talented people who are building companies and transforming the industry. And I’m not talking only about one particular category. So if you look at various segments that we can talk to a range of entrepreneurs, which we will do. We’ll talk to some investors. We’ll talk to people who work at various multinationals who work across various countries.
One of the things that I’d like to have people understand in this first season for Asia Pacific is what is happening in Asia Pacific and digital health? And so this first season, you can expect to hear from people who will talk about population health, the perspective of providers, the perspective of what’s happening in home care, especially with COVID-19, and what does that mean. We’ll talk to someone from Pharma, who will talk about how Pharma is looking to integrate technology across various countries, and not necessarily your technology first countries that you might consider with developed healthcare economies, but rather more the developing nations and countries which you might not assume are seeing incredible innovation within digital health within those countries.
We will also, at some point during this journey of exploring Asia Pacific, talked to some of the leaders who are driving billion dollar or tens of billions of dollars and investing it into digital health and changing industries such as insurance through the infusion of technology and the convergence of FinTech and HealthTech. So it’s exciting and when there’s 40 plus countries for us to explore, you can think about the various ways that we can tackle the conversations and stories in Asia Pacific, where, obviously, we’ll look at the consumer and individuals who have common journeys, but we can look at it from a country perspective, from a technology perspective, from a key stakeholder perspective.
So I’m very excited to share the stories of people that I’ve gotten to know over the last six years and what they’re doing so that people can get insight and information that hopefully inspires them and the journeys that they’re creating with their particular areas of focus within healthcare.

25:53 Dan: Well, Tony, I think you set it all right there: insight and information that inspires. That’s really what we’re aiming to do here at Digital Health Today. And I personally can’t wait to listen and learn from you and your guests. So just to make it clear for all of our listeners, Digital Health Today now includes Tony show, the Asia Pacific Edition, Eugene’s show, which is the Digital Therapeutics Edition, and my show, which is being rebranded as Digital Health Today 360. And in fact, we have other shows that are in development with other hosts, we’ll look forward to making more announcements about those shows as they are released.
And if you want to make a show, then get in touch with us. If there’s something that you want to talk about within the digital health space that will be a good fit within the Digital Health Today ecosystem, get in touch. Let’s talk about it. Let’s see if there’s a story that we can tell to create this platform to engage more people all around the world.
You can subscribe to each of these shows separately on your favorite podcast player so you can make sure they automatically appear on your phone when they’re published. And of course, you can also find listings of all the shows and episodes and links to subscribe by visiting digitalhealthtoday.com. Also, make sure you sign up for our newsletter while you’re there. So you’ll get our updates as new shows are published and we have new sponsors, new events, new things, new offers that are available for you to tune in as part of the digital health community.
Tony, how else can people get in touch with you directly and follow the other work that you’re doing?

27:15 Tony: So my business is called Taliossa. So in the show notes will have a link to my business Taliossa where I spend my time working as either board director for various startup companies, helping support investors and making investment decisions, do some advisory work. And then my personal website tonyestrella.com, where you can learn more about my writing and other storytelling activities that will be coming in the near future.

27:39 Dan: Thanks, Tony. We’ll have all those links in the show notes. Of course, you can also find them on the website digitalhealthtoday.com or even on our second home, which is Health Podcast Network. We haven’t mentioned Health Podcast Network, people should get over and check that out. We have over 70 shows now. We have over 7,000 episodes last I checked. So just an amazing resource. If you’re into podcasts, which obviously you are, if you’re here listening to this, be sure to check out Health Podcast Network and see the other great content that’s being created by organizations, leaders, brands from all over the world. So go check that out at healthpodcastnetwork.com. Find us on digitalhealthtoday.com.
And last thing for me to do is to thank you for tuning in. And Tony, thank you for sharing your voice. I wish you a lot of success on the new show.

28:22 Tony: Thanks, Dan. I appreciate the opportunity and looking forward to working together.