#414 Olivia Burns from Hypoplas: What Startups Get So Wrong About ‘Patient-Centric’ Design

0:00James Somauroo:Welcome to the Health Tech Podcast. Here we talk about everything healthcare and technology and I'm your host James Somauroo. Olivia, welcome to the Health Tech Podcast. How are you doing? Very well, thank you. Thank you for having me. You are very welcome. Super excited for this. You are doing some amazing stuff. You're an entrepreneur, you're a patient, as we are all patients, as we've just been discussing offline actually. um and you are connected into what i think i and many many people who look at health tech more broadly and health care more broadly would consider a very progressive mentality in your part of the future in terms of how you feel about how patients are going to interact with i would say the business side of the health care system the health tech side of the system and there's just some interesting things that we can talk about with how patients are going to be integrated at a more operational and higher level of healthcare as they already are may I add so delighted to have you Olivia and for the benefit of our listeners why don't you tell us a bit of your story of course so um I think my interest in healthcare innovation really started from birth so I was born with a rare congenital heart condition called hyperplastic left heart syndrome which is a super interesting condition if anybody wants to research it outside of this podcast.

1:28And I became one of the first patients in the UK to undergo the surgical journey to managing that condition. So I had three open heart surgeries and then other surgeries on top of that to basically reconstruct my heart and circumnavigate my circulation in order to be here today. I was then discharged from Birmingham Women's and Children's Hospital at age 18. And I actually started by doing a degree in fashion and after that degree in fashion I decided to use my lived experience and my you know business and fashion experience and I designed a more dignified sustainable and cost-effective hospital gown and launched my company Hyperplas and you know we won Innovate UK grants, we got grants from the University of Manchester, Santander, I became one of the first patients to go on to the NHS Clinical Entrepreneur Programme.

2:26I won the Women's Thai Global Competition and got sent out to India to pitch my business on the global stage. And we work really closely with the NHS about, you know, bringing an improved patient experience to, you know, to healthcare, to patients in general. So then I went back to university and And I studied my MBA at the UCL Global Business School for Health. I received the Future Leaders Scholarship to study there. Recently became the UK ambassador for the business school as well. And that's really when I got into the business side of healthcare and really started looking at the future trends that were up and coming and how patients and how health tech are really going to interact moving forward.

3:14And then that's when I moved into more of a consultancy role. And I was became, you know, I started being hired by multiple health tech startups and, you know, even monoliths as well. I work with pharmaceutical companies as well. And I really work at that commercialization side, bringing innovation into health care systems. And, you know, I'm very fortunate, you know, obviously I have a lived experience, but I'm very much taken seriously. And I do get to work at that C-suite level and within the operations of these companies. And also, you know, I was recently brought on to the Innovation Committee at the UK DHC as well.

3:58So, you know, I really work at that high level of bringing health tech, innovation. and you know I work in you know bits of policy as well and and infrastructure and just making sure not only the the patient voice is there and the lived experience is there but you know like you said James at the beginning it's become more and more common sense as it were to place patients you know in in these positions and considering the direction of that health care is going in

4:31James Somauroo:yeah common sense it's interesting and business sense and also i would say i was going to say moral sense but it's almost like it's like obvious that what what do we want what are we doing this for what are we in health care for why do we even do health care why do we even have a health care system it's to make a certain group of people i.e patients and we can all be patients at various different times various different ways feel better and is it not therefore completely obvious and clear that when it comes to advisory on the quality of care that to say the least the quality of care let alone all the component parts and we'll talk about commercial bits that we have advisory from that perspective so it seems that we need to check ourselves in what we do this for and i actually see this argument play out a lot i'm seeing this play out in so many different areas of health tech that actually and you know you being an expert in commercialization of stuff as well and you may have noticed received our company it's very difficult to build a business case around this just makes patients feel better or this just makes patients or clinicians or staff feel better because if it doesn't save time or make money somewhere you know what's the what's the ROI in better dignity for patients yeah it's it's it's so it's so difficult and actually maybe let's start there so with your business yeah the idea for it lived experience clearly but talk me through that I'm really interested in how you go from an idea to actually building a business in this and and actually yeah some of that some of that commercialization journey yeah so obviously it always starts with the design so first of all we had to make sure the design was correct for patients but then the more and more I got into the design side of it and the more I started to work with trusts nurses doctors clinicians i started to realize that there was not only patients who had a real gripe with the generic hospital gown we were looking at clinicians hated it as well you know it was interesting stopping them from getting you know cannulas catheters drains they couldn't get access yeah yeah they couldn't get access you know things like when you went into the pre-op room you anesthetized that patient they couldn't get the gown off the patient to then put the patient drapes on oh 100 yeah so we were seeing such inefficiency at the clinician level yeah then we looked at it from a health care system level and this when it is when it got quite scary to be honest with you we were then looking at what was happening with the double gowning so we were then seeing patients having to wear a gown front and back in order to be walked down to surgery so we were talking to procurement and they were saying this is the price that we pay for every single gown then we were going to the level of you know the front line and we were seeing that that was not the price they were paying they were paying for two gowns per one patient wow then we had things like in cardiac arrest when we saw gowns were being ripped open you know scissors down the down the middle to get access we were seeing ties were getting too tight were getting cut off that whole gown got sent into textile waste which then went into landfill or got burnt that's not cheap either um and then who pays for that gown to come back onto the ward the trust or the health care system wow okay so then we were seeing that we were actually looking at a quite a big financial hole then we were seeing we were looking at quite a big sustainability hole because if you're wearing double gowning that's double laundering that's double carbon that's double water if you're having to break these gowns and take them off the off the ward you're having to ship a whole new bunch of gowns from china to replace those yeah and these gowns are not being repaired they're not being sent anywhere they're going straight into landfill so this is when it got quite scary that this was not just a patient thing it was a clinician thing then it was a procurement thing then it was a whole health care system i don't want to look at what the calculations are of what this black hole could be but if you think about something so simple as a hospital gown you know so simple yet it can create a multi-million pound black hole because of the inefficiencies of it but we are stuck in this circle of yes it helps patients and and it's unfortunate you know we we show them the data we show them what the potentialities and things like that but because you know let's face it we're not curing cancer we're not you know we're not increasing people's life expectancy things like that we are being put on the back burner but you know i feel positive about you know i was speaking before about there will be a positive ending to this and you know um i do believe that you know we will all be wearing one of these gowns in the future because like i said it comes back to that common sense you know this is now becoming common sense to make these things and bring these innovations into healthcare systems it's remarkable some of those use cases you mentioned like I've I've lived through those from the clinician side and it's crazy that actually even even me with a you know relatively sort of innovator hat on you know when I was practicing I never even would have thought about the gown it's one of those things that you just assume is entrenched within the system that you just assume you can't change that that's the bit of the hospital i don't really understand if you start talking about devices and you start talking about the the clinical operations and all the rest of it then oh yeah i can i can try and find some clever things there whereas actually you know stuff like the gown it's just staring you in the face and and you're right there's the the the the dignity thing as well i think adds to it adds to cognitive load for the the patient massively and the clinicians actually as well because you're you're especially if you're a relatively empathic clinician you're feeling for them in those moments as well and going out of your way to try and make them feel comfortable and you know it feels like anesthetics as well it sounds like you've done your research on this massively but you know in the in the anesthetic room there's there's real clinical value to making someone feel as relaxed as possible because it actually makes your anesthetic better and your anesthetic easier if someone's really on edge because of of whatever reason that the gown just isn't providing them that dignity whether that's personal beliefs or or just just how they feel and who they are or religious beliefs or whatever it is like it's it's a really it's a really difficult thing for people and to be able to then redesign it around not only helping with dignity but all of those things that add the commercial value yeah then you can start to sort of trojan horse the the bits that don't have the ROI of just increasing dignity, et cetera.

12:01James Somauroo:You can actually start to Trojan horse that in via we're going to make this save some money or make some money or whatever it is, which I think is a lot more interesting. Yeah. And I think to go back to that safeguarding question, you know, people don't know how bad it is getting. I mean, I know because I, you know, I lived through it, but to be a 12 year old girl, you know, or a 14 year old girl and you are being walked down to the operating theater through you know a corridor which has open access to other you know people you're wearing a see-through gown you're conscious of your body and then you walk into a room a pre-op room you're surrounded by maybe four men you've never met before they're about to put you to sleep you know this is chilling vulnerability is just enormous and it's and that is what really I don't want to say hurts me but that's what I find devastating is that we cannot put ourselves in that shoe of that 14 year old girl or say you're a 75 year old man you've always been proud you've always earned for the family you you know you're the man of the house and then someone puts you in that open back see-through gown and they force you to walk through a corridor and all of a sudden everything that you've built over that 75 years is just gone within a second and taken away from you it's you know it's not just dignity it's humanity at that point you know it's really interesting you say that so it's just reminding me of a story of my dad so my dad um my dad had a technically a stroke really a TIA that lasted a couple of extra hours but um and he had it in french hospital and had all the tests turned out he had a blood clot in his neck um so a very reversible i guess reasons out of a stroke so one of the better reasons i guess because he had um people that are listening that might not know a procedure called an endarterectomy where they're going to go in and remove the clot from the neck and and reroute the artery um etc um some plastic tubing um so he had that and bearing in mind that i'm his son i'm a doctor i do not recall any time of visiting him in hospital that he allowed me to see him in a gown he yeah i get massively against all advice i can remember after his operation even he um yeah literally the day after i i got there expecting him to see me but i mean the guy was still a little bit drowsy i think and and and he was fully dressed fully dressed i mean like fully dressed because he's a proud man exactly as you've as exactly as you've just described and if he's willing to go to that effort and and you know frankly you know he he's a man he had autonomy to do that he's an adult when i now put that level of anxiety in the lengths that he was willing to go to and then and then you think about those 12 year old girls that can't do that because they don't have the bodily autonomy to actually change the situation that they're in they can't refuse they can't do any of those things it's almost like the the legality of it even comes to my mind of like how how legal is that like to have someone in a public space that you're kind of forcing them to walk through in a gown like it does not feel okay well it's not and I think you know I'll be open about it that's something I have to live with you know I was walked down that corridor multiple times to go to that operating theater in that gown and I have to live with that cognitive load you know and and to go back to your dad is that you know yes when you go through a surgery it is traumatic and to think he's got on his mind i need to get up i need to get dressed my son's coming to see me blah blah blah you don't need it you know you're you're still in this recovery mode you're you're still you know recovering from you know surgery and it surgery is painful you know what i mean and you're still you're trying to get yourself dressed you've got you know i need to do this i'm proud i'm this person this is my identity so it's just such a a mental burden that we don't need to be putting on patients at all agreed one thing that came to mind then as well is is that when you so when you think about the the the sort of importance of fixing a problem in this scenario my dad was willing he just had vascular surgery on his neck one of the biggest issues with that being that post-surgery you can just throw off a clot and have a stroke yeah bone in mind my dad was a chief nursing officer of a region in the uk so like he worked as a nurse like most of his career he was a cardiac nurse a lot of his career actually he fully he was willing to overcome those those risks that he was actually more informed of than anyone else he was actually willing to overcome those in order to get dressed yeah and that's how important it was to him exactly so like it's interesting isn't it because when we consider what you do now in other spheres and offering the patient voice it's saying things like this i imagine of do you understand the like the the level of importance that we need to assign to this thing that you might not think has that level of importance because actually there's clinical risk if we don't fix the dignity issue you've got people that end arterectomy throwing themselves out of bed throwing their arms up into a jumper when they can just throw off a clot like there's no tomorrow like yeah it like do we realize that there's clinical risk here and actually you know even saying that out loud then like i've i've not considered that before ever yeah and a patient representative perhaps would have told me that yeah i think it's i think it's linking the the data gaps you know they clinical data is a phenomenal thing although unfortunately clinical data is you know fragmented we know that but lived experience can link up that data and it can make patient journeys make sense to people you know it can really rationalize patient journeys really rationalize the steps that patients have to go through what they you know and I think also this is one thing that you know as we move to moving community as we move to moving care into the community and we move into self-monitoring self-management all of these things and we start to put more um you know i want to say autonomy and agency onto patients we need to realize how much of this patient journey takes takes form at home you know i think that is something that people don't realize is that we are collecting clinical data whilst they are there in the hospital whilst they are there for checkups that is just a snapshot of that patient's life the real recovery and the real self-management and what determines whether they develop diabetes or not these things all take place at home and that is the insight that currently healthcare systems do not have it's also the insight that health tech companies do not have is that journey that takes place at home and that is where someone with lived experience who has been through that recovery journey that is where they can fill in that data gap to make sure that we are actually creating something worth value you know yes worth of value that is valuable to patients clinicians healthcare sectors healthcare systems um and the more data you have the more you can iterate the more you can you know create more value more effect more purpose um so i think that's really where patients will come into that key part um is is that journey into the home nice so a bit of a more broad question now where where do you think we are then thinking about that other side of of what you work on other than your company the more advisory stuff and the the patient advisory stuff at that kind of c-suite level and things like as a health care system where do you think we are with our it seems a bit strong to say this but like with our respect for that voice I don't I guess I don't mean it as strong as that because I'm sure that voice has a ways and will be respected but I'm sure there's levels to that because I mean like we were just chatting about before like that i think i i think when people say oh we're gonna have like a patient panel or we're gonna it's a bit tokenistic still and bear in mind i work in marketing and events and things i think even the way that it's presented sometimes is a little bit tokenistic and people assume that when you say patient it's you know 75 year old doris who you know you've just got to smile at and it's like no it's like no and so i are my bias to this based on what i see is that i think we're we're a little bit immature in in knowing and understanding what the patient voice actually means yeah and i know you're going to be involved in the bmj event the bmj future health event who are you know very good at this by the way um and not your normal event in the way that they approach shit yeah um I should say that we're working with them on that as well um to be fully transparent but um I'm just interested in your perspective because you're working for you know with a lot of different companies on this and have done you've done various projects in various different spheres and also you're you're you know part of these panels and things so where do you think we are now and and and what what does that transition look like to somewhere better I think when I speak of this I first have to speak of how fortunate I am as a patient you know I was born with a very severe condition yet the way I live my life is very parallel to how somebody completely normal would live their life so first of all I'm a very different type of patient to maybe what people are used to is you know I you know I run my own company you know I have an education I have all of these things and it's because I've had the ability and the mobility to do that and so first of all I'm very fortunate to have that ability as it were to blend in and so this this I also come off a bit strong but I do have that ability to blend in and that is where I also think these companies are happy to bring me on board is that I don't look like a patient you know I'm young I'm a female I've got an education I've you know I've done things in the industry I've worked in the industry um and you know I've worked you know and I have this ability this agency as like some patients do not you know do not have that they have mobility issues you know that you know and things like that and um but I think so first of all I have to mention how fortunate I am to be in a position that most patients are not um secondly that informs how the industry looks at patients as well is that like you say all patients are 75 five-year-old Doris they're not patients are getting on with their lives they're working at high level they're working you know you're just speaking about your dad he was a patient you know but he was working at such a high level you know um but he did become a patient at one point in his life and i think you know that that's the part of being human is at one point or another we have that frailty you know that human frailty and we will become a patient but i think it's up to us as individuals to acknowledge that and to give ourselves the ability to advocate for what we want in the future when we do become a patient you know what level of care do you want to be receiving in the future and I think everybody should be taking responsibility for that at the same time and should be you know speaking in the industry not just as an industry expert but as a patient that one day will receive health care as well it's about the not just doing on to patients you know it's about patients being involved in that process and having some kind of control you know on what is happening to them but I think equally it's part it's it's the culture of the industry and of patients to patients need to empower themselves the industry needs to recognize that power and really partner with them and I'll give you an example of where we are at you know in the industry yes I work at this c-suite level and I work you know at this operational level with health tech companies but the other day I was invited to work with the NHS on a piece of policy and we started the meeting and they disclosed that the piece of policy had already been written and was already undergoing um being evaluated and was about to be published but they just wanted to get our second opinion on it so at that point it was like well why am I here because all the decisions have already been made so I'm sat here it doesn't matter what I say it doesn't matter what I contribute whether it's valuable or not valuable the decision has already been made they might take it back and they might revise it by some things that we've already said but does the NHS has to have the time to pull a policy publication and revise it because one patient said one thing that does have a part of interest so that that to me and that happened very recently you know as recent as last month so that's where we're at maybe a health care systems level but in health tech I have a very high involvement in what the decisions do are made within that company so it's interesting to see that the industry is already changing and industry is already changing to make those partnerships with patients and as we said before you know it's now becoming common sense if you want to be a leader if you want to move into this futuristic place you know partnering one-on-one with patients and really listening to what they have to say is going to be the future but I don't believe healthcare systems have really caught up to that level yet it's like it's this like big sigh isn't it of you know I mentioned in that run up you know the the tokenism and the and the you know that kind of tick box nature and what you experienced last month exactly feels like that I think the reason that it's it's quite upsetting is you're right my dad's been a patient we've all been a patient I've been a patient my mom's been a patient like like and this is what I think people don't will not kind of understand is that it's not them and us patients aren't a them group patients are us we are them it is you and i it is the alternative version of me that got a diagnosis at birth that i didn't in this reality it's still me it's just that that one is a patient and I'm not it is me and I think that's that's the difference that I think I'd like to see and in terms of what I can do and what we are doing particularly with SOMEX and the way that we're approaching this is is trying to plug that gap it's saying that it's patients aren't a them group they are our i.e the population the people they are our representative on that panel speaking for us which is all of us and we are all one symptom and diagnosis away from being in that group like literally we've all had a headache that lasted too long or noticed blood here where there shouldn't be and extrapolated in that moment to oh you know that that could be colon cancer that means a stoma that means surgery that means this that means a shorter life expectancy we've we've all we've all done that thought experiment after we've had symptoms that we're that we we're that close we are that close so that person with that is our representative and I think then the conversation just becomes a lot more open and it becomes a lot more kind of a lot more real rather than rather than kind of I don't know what the right phrase would be but to kind of to kind of look longingly at the patient panel and going oh I hope they're okay even you can think nice things but like it's not it's not they it's not they are us exactly i don't know if i explained that very well but like that's how i feel about it anyway yeah it's the at one point or another where we're all going to be you know in that position i think another thing i'd like to maybe mention at this point is that there are there is also a stigma around the grateful patient is that you have received you know and this is something that this is a stigma that people you know go against me and I've had healthcare leaders mention it to me and and say these things to me but you know people because I received that life-saving treatment from the NHS you know of course I will be eternally grateful but people believe the work I am doing is to criticize the NHS and that you know I am not being grateful enough for that treatment that I received interesting that is the sometimes that is what people have said to me but in that moment yeah in that moment it's like I would never criticize the NHS you know they it the the fact is I would be six foot in the ground without them you know that is a fact and I would never criticize them but the reason I do the work that I do is because I want every single patient to have the same access to care that I did when I was a child.

30:41So I'm not here to criticize the NHS or healthcare systems or health tech or the industry or anything like that. I am here to work with them because of that access, because I believe we can make it better. But because I have that stigma of you're the grateful patient, we gave you this, we gave you your life, how dare you criticize? How dare you say things like that I that is a stigma that I still feel and people have you know openly said to me and I've had to say actually that's that's not what I'm here to do so yeah I hadn't heard about that I didn't know about that yeah there is still yeah yeah there is still this culture of we give you you know we we help you and you be eternally grateful but I think we and you again yeah

31:31James Somauroo:Yeah, exactly. But I think as patients, what we need to be doing is empowering us and say, yeah, I am so grateful for the care that you gave me. You know, I am grateful for the care that you gave me. But let's make sure that the kids 10 years from now born with hyperplastic left heart syndrome, let's make sure they get the same care that I did. Let's not make sure they get the same care. Let's make sure they get the better care that I didn't get. You know, let's make sure we're bringing in the innovation so that, you know, it's better for them. and you know they have more dignified care and things like that so that's um that's also care that you and your family have paid for through their tax dollars by the way yeah i mean yeah so like it's not free like you know anyway um yeah that's another that's another conversation as well before i alienate the either the red side or the blue side i don't know which side i've got both in colors here if you're watching on youtube just to be clear and i am probably somewhere right down the middle but anyway whole nother whole nother conversation um my politics is very confused can i talk to you a little bit about the patients as sort of commercializers here or the sort of that commercial knowledge um applied applied to sort of where you are and and i know i know you mentioned previously about like the cystic fibrosis community and what they've managed to do in in that community so fill in some gaps here for me in terms of in terms of the stuff we were speaking about before yeah i think this is a space that's really going to become prevalent within rare diseases and rare conditions and congenital conditions and things like that is that this is where and we see great examples of it in the pharmaceutical company where patients and pharmaceutical companies work together in partnership to get that commercialization completed and you know one of those great examples was vertex with nhs england and with nice is that you know it's that two sides of the coin is that vertex wanted their commercial contract from the from the nhs you know that let's not let's not beat around the bush on that you know that this is healthcare is a business on the flip side of that cystic fibrosis patients needed those drugs in order to have an improved standard of life, an improved standard of care to increase their life expectancy.

33:56So in that sense, patients and pharmaceutical companies are working together to get these drugs to market, you know, A for the commercialization and the contract, B to actually make a real difference in people's lives. And that is where I would say, do not underestimate how much of a commercial ally patients can be for you, especially if you're moving in that rare disease space, you know, because, you know, rare diseases, I mean, look at my congenital condition, I mean, we are a tiny, tiny group. And because the surgeries do go over a whole lifetime, we know our surgeons, we know the researchers, we know our cardiac nurses we know everybody in that community and if you get everybody to unite you know they can be a real force when it comes to commercialization um so i would 100 do not underestimate and i think this can also be a context that is also transferred to health tech as well is like we were saying before is that if you do not get the people on your app if you do not get those conversion rates If patients are, you know, not in the spaces that your app is or that your tool is, why would an ICB or why would a healthcare system license your app?

35:17You know, if you're not talking to patients, if you're not in those spaces, or again, if you're not talking to clinicians, if you're not speaking the clinician language, if you're, you know, if on the front line, your app is useless, or your software is useless, why would any healthcare system buy it from you um so i think that's where companies need to start wising up about who are your commercial allies and in the future it's going to be definitely patients and definitely clinicians yeah so this might this might be a really stupid question sorry

35:54James Somauroo:for asking you so can you could you just explain like what in that in that commercialization journey i imagine that people will have an opinion on or just a thought on where they think patients fit into that but but specifically because you've talked about nice approval there's also the kind of you know more on the ground getting a contract with a health tech company and just you know the patient you know the patient voice saying that this is a good thing and we use it or whatever it is but like there's probably quite a few places that that patients can actually fit into this commercialization journey both from like giving approval of the quality and informing the product but then also driving demand enough so for nice to sit up and look at it for example so like what are those categories like what what broadly where does the patient fit in or can the patient fit in because the reason that's the question is because are we moving into a into a world where actually and again just throwing the view of 75 year old doris out the window let's think about what an actual patient is it's it's it is us we are them it's it's a version of us with the condition um you know that person within a company actually in a in some sort of permanent role a chief patient officer for example something you've talked about before becomes really interesting so you know what would the job of a chief patient officer be or how how are those patients used or useful in that commercialization journey at the moment it's probably where i am right my own job role within a health tech company um for like a chief patient yeah but it's difficult because i really see patients being effective and valuable in every stage you know from innovation and concept you know through i mean obviously pharmaceuticals potentially not with you know the chemicals and things like that probably not that but if you're developing a product you know that's going to be used or a software or an app that's going to be used by clinicians or patients or things like that then you know you will need um you will need them at the very beginning with one healthcare company um i actually assisted them and used um a patient group as well just to get the name right interesting just to get how you speak in my language yeah interesting the value of the name right you know because talk me through that that's really interesting so what was the i mean obviously you might not give specifics yeah i won't get but you know we we had this product and you know the product was about patient communication and all of that.

38:46But like I said, it had to be that two-way street. We had to get the patients on board with the app, with the software, in order for it to be licensed by a healthcare system. This company is a global company. They're not just looking at the NHS. They're looking at the Middle East, the US, all these different areas. So first of all, we had to make sure it was a global, a global accessible name across all languages, across all cultures we had to make sure it was accessible to every single patient

39:18James Somauroo:we had to make sure you know people that is such an obvious thing so for the health tech companies listening like this is such an obvious thing that when we're in a naming exercise like we think about and obviously we do but what geographies are you looking to go in because as soon as you start saying you know China Japan all of a sudden now there's like certain consonants and and you know vowel structures that that you you can't like you can't use i think the famous one on this was i think xbox like mike the microsoft xbox it was a code name until they realized it was one of the only things that actually would you know represent the product and be able to be spoken in all languages and actually they ended up keeping it i think it might be folklore but i think there's some truth behind it but but yeah no it's absolutely right like all of a sudden you're like oh this can't actually be said in the country that i'm watching into so you've now got a massive problem and we had to make sure it was friendly you know like if i had that app on my phone would i open it up would i trust them to talk to them about my medical issues would i trust them to divulge this kind of information or you know have that diagnostics do they does it spark that you know trustness between a patient and an app so then we had to think about those sorts of things as well um so so that was really interesting that just that just that naming exercise we had to bring on board uh not just myself you know i couldn't just be the voice of every single patient in the uk middle east and the us we had to look at different demographics and look at different patient groups and really ask them is this an app that you know if it was launched would you download it would you think you know what that's great i'll use that for whatever i need you know i'll use that for my diagnostics or whatever so when i talk about the innovation stage it's something very simple as getting the name right you know it's it's it's it's really so it it can be that first and then also it's about the business model you know then we have to talk about the business model so that is a very simple business model is if you don't get patients on your app no one's going to buy it so then you have to think about positioning potentially your whole business model around how are you going to get patients to use your tool you know how are you going to bring them on board how are you going to get them into interact and that's the same with pharmaceuticals as well how are you going to get them to the clinical trial how are you going to get them to engage in you do they trust you you know would i go for a clinical trial if it was you know big pharma's got a bad rep you know so would I feel comfortable going for a clinical trial but if there were other patients and if there was that engagement and if there were people from my community potentially leading that clinical trial then maybe I'd say yeah okay I've known you know I've known them for a really long time they're a good friend they helped me through a difficult time when I was struggling with my rare disease at this point in my life and now they're telling me how great this pharmaceutical company is and now they're telling me about this clinical trial that could increase my life expectancy and things like that then maybe I would think yeah actually you know I'll go for that I'll give it a try and see you know if it does improve my life so I think you know it's going to be all stages and then as you move from you know piloting to procurement you know we saw the 2023 Procurement Act come out um ironically came out in 2024 um and that um you know that really speaks about long-term patient outcomes and public health goals so if you know we're now seeing procurement we're now seeing tendering processes or asking questions like what are your readmission rates what are the reconsultation rates you know what how does this help me move into the community how does it help me move you know healthcare systems from a reactive state to a proactive state you know so even procurement is asking all these questions about how are you involving patients in a meaningful way and how you know it used to be cheap is best that's not what's happening anymore at all and especially if you go to the Middle East you know they are very big on value-based procurement and we see it already creeping in to the NHS and especially with that procurement act we see it becoming you know law at this point so even at that tendering process you need to be having patients on board and telling you what you know what are the long-term outcomes as well so I really think you know I would love to give advice and say hey you need them here or you need them there or you need them but you really need them along the whole journey and I think that's also the thing is that if you do bring patients along on the whole journey when it comes to commercialization and getting that contract who are going to be the biggest advocates you know who are going to stand up there in parliament and say we want these drugs we want this device it's going to save our life we have worked with this company for 10 years we have worked with them help them develop this device who is going to be the loudest voice when it comes to commercialization and it comes to you getting your reimbursement for that five-year process or 10-year process it's going to be the patients that you brought on board at the beginning yes god i love so much about what you just said um the fact that patients should be all across the company is something that I think is only going to become more and more use the word obvious and I I see this in marketing right obviously that's the world that I'm in and communications in that we're starting to see AI creep into lots of almost all areas in fact I probably would say all areas of companies um and things and there's there's value to that obviously or else it wouldn't be happening there's there's values in efficiency there's values in productivity there's this value also though there is value in creativity and that's because humans are freed up to do the human thing and the way i see this play out in marketing is that with ai doing a lot more of the repetitive stuff and the grind and and all the stuff that doesn't actually necessarily need a human the humans are free to do more human things right now i think a chief patient officer that works across the business is a highly concentrated version of that in the sense that what they have is exactly what ai does not have in that they have up-to-date hyper recent context on one hand and they also have with other humans trust and that's to connect with them that's to deliver information as distribution that's to bring other humans to the table that also have context and trust with other people and lots of things and i don't i don't see at least at the moment a way of ai replacing that and actually that context and trust and human touch from that chief patient officer is then driving and in my mind it's in marketing terms here is then driving so much of what currently ai can't do which we at somax are split into basically psychology culture and timing and that kind of cultural nuance that comes with existing in a patient group the language the body language the the places that they go identity expression all those things that are so so so highly nuanced for a company to have a chief patient officer that is advising on that and that's just in marketing yeah like the the level of trust that that organization can then embody and adopt and express to bring other people to the table is perfectly highlighted in what you just said about a naming exercise because all of that goes into just that one exercise which is the big name above the door but we know that name above the or could be said in all the right languages we know it's inviting we know it doesn't step on any bizarre cultural or religious things that might be an issue or like there's there's there's so much baked there's so much baked into it and it just i think highlights the importance and i guess how humans are being elevated into companies that have this stuff it's you know it's why internally i'm saying like you know if you're going to a venue you speak into human beings you're far more like valuable here at the moment because I can't I can't replicate that like it's impossible there's a lot that I can but you know that speaking to people and building network and relationships and it's an example I think of AI freeing us up to be more human and it's an example of like showing actual value there but I do think that's wonderful you mentioned the Middle East I think that's a it's an interesting one have you done much work out there um I think where I got my inspiration was from for the Middle East is during my MBA we had to do kind of a research stint in the Middle East so I got introduced the country that I chose was the UAE and you know we were so privileged we went into some of the biggest hospitals in the UAE we went into we got to go to the Department of Health in Dubai and Abu Dhabi we got to look at where policy was being made we got to look at their you know 2030 vision and things like that we went to m42 mbardala so we looked at all the funding streams that were happening and we really took a really in-depth look of you know what was happening over there and i think what really mesmerized me about that was the cohesion you know it was this cohesive path of everything everything fed into each other so that we got innovation to the patient and that is really one of my biggest values is about how do we move as fast as possible in a safe manner you know to get it to the patient because we're looking at you know in Saudi Arabia in the UAE to get an innovation to a patient is one to three years we're looking in the NHS five to ten years and if you take the extremes of those two we're looking at a nine-year gap and you know nine years can be the difference between a patient living or dying you know it can be the difference between the life expectancy yeah it can be the difference between a patient living for nine years with heart failure you know it could be the diff a real big difference and then that comes into the whole other landscape of productivity you know what are they giving back to society in a financial way things like that you know if you've got someone who's fit and healthy going back to work then you've got higher productivity rates you know and but if you've got someone who is not able to take on a full-time role is not able to you know you know even I don't want to say this in a cynical away but give back to the taxes system and things like that then you know you're putting your country at financial risk um and at productivity risk so it feeds into the whole socio-economic thing you know people don't realize how important health is to creating a productive country you know to having a financially stable economy things like that you know i think health is really sometimes put at the bottom of the list when it could sometimes it is the most important factor to making sure your country is running successfully.

51:35So that was something that I really found really interesting. And on my MBA, I got to work on, you know, multiple and even now some of the health tech companies that I work with, we're now moving into Saudi Arabia and things like that. I got a deep understanding of, you know, the Saudi Arabia system and how they're working in their innovation space and things like that. And I just, and people say, well, it's the money, you know, they have a higher amount of money to invest in these things but i also believe it's the culture you know i was

52:05James Somauroo:going to ask this yeah this is actually what i was going to ask like which which one of those two is it because i hear a lot that the they're able to leapfrog they're able this leapfrog thing keeps coming up leapfrog leapfrog that they're able to skip over our kind of like industrial revolution and just just go for the high tech stuff so they don't have these decrepit old buildings with poor infrastructure they can just build from scratch because because of the money um but it but it's but yeah you've alluded to to culture there but you've also like you've also alluded to a like i want to call it like political responsibility almost like the government has taken responsibility of the fact that if we have a healthy population we'll get back from that i think that's a level of i guess maturity that i i certainly don't feel like we have that here it feels like we're very individualistic with health in the uk still of like health affects me i want it sold i want to do the like in the government saying well we will help you it's not we will help you to help us again and us being the broader population and become a better country and all the rest of it when i don't think we're quite there so is it fair to say like that's how it felt and that's that's kind of where they're at yeah it just felt like the culture i think it's just like you know the way they've opened up sandboxes, the way that, you know, they have a clear strategy for how to get a company from piloting to procurement.

53:33You know, I feel like that is still a very fragmented system here in the UK because I feel like in my own company, in companies that I'm working in now, it's like, okay, we'll work with this trust. We'll work with this trust. We'll get this data, but then that data needs to be replicated here. And there are some amazing things coming out from the NHS, you know, like the innovation passport, you know, things like that to try and get these things a bit more centralized and get that cohesion into place. But I still feel like it's a bit more fragmented in comparison to these other countries. And like you say, is that I feel they have this understanding of good health is good for everybody.

54:16you know there's a wider um benefit to having a healthy population yeah and even when i went to uh actually i went when i mentioned before when i went to india um to do pitching for my company when i went there this might be a bit of a political gripe or i don't know but i'll say it we can always edit it out later but when i went there you know they had a department um for it was actually called entrepreneurship and disability it was like kind of the words i can't remember exactly what the department was called but that's kind of what it was and it was all about giving opportunities to people with disabilities you know it wasn't about you know we'll give you money and blah blah blah and you survive it was about giving people opportunities to go out be productive work for themselves add to the economy things like that and I think you know as someone who has lived you know through that adversity and has been held back by my own health yeah I've had to make my own opportunities and I've had to really push myself really hard to go out there and get those opportunities and make something of my life you know what I mean and that's that's a passion that I just have always had that's what I wanted from life is that I wanted those opportunities but I think if we went from a you know it goes back to that culture thing of they need help they need this they need that instead of let's give them some opportunities let's give them the opportunity to you know to participate and then that's where we come back to this patient thing is that if we have more and more patients engaging in health then we are giving people opportunities whether it's through remuneration whether it's through voice sometimes it's just through purpose sometimes we just need to give people a purpose and that's where we are looking at you know having a whole population who for years have just been you know i mean we can even look through if you want to go really back you know back to the 90s when we had the riots um you know disabled um community was you know protesting saying that they wanted more

56:34James Somauroo:accessibility in public spaces and things like that yeah you know that's what this next stage of health care could give to people is those opportunities i feel i've gone on a very big tangent and rabbit hole there but i feel like it's it does come back in a circle you know i mean no it does because it's brought us back to where we were at the start with with what what the identity of a patient is and how how the the you know the doris identity and by the way like not i'm not throwing shade on people called doris that may or may not be 75 like you can be a patient too it's just one of and i think it's given me a really really interesting idea for something that i think we could do um campaign wise to actually start to change opinion on this um but i think that's i think that's wonderful um and that was the point i was going to make because i think with with what you just talked about we can start to change people's view of what a patient is and that then stops us you know looking at those panels with puppy dog eyes and going oh isn't that nice like that isn't that isn't productive no that isn't productive that that's that's very like we're not i don't want to create these environments where it's like we're there to feel sorry for the patients and they're and they're there to soak up the good wishes and it's like no no we like that's not it's not i mean that probably does look like progress in some areas to be fair but but there's other versions of this progress that actually i think start with it perhaps with what we talked about is perhaps a change in identity of how we how we view patients which things are really interesting i've learned so much here olivia thank you so much for coming on i want to ask you one more thing because i think you're you're so tied into actually that you know the policy finance commercialization you're tied into health tech as well you're you're tied into everything we've talked about from the patient side and lived experience and so i'm interested to hear when you when you hear things like an extra 10 billion of investment into the nhs i'm interested in fact i'm really interested in what you think of this because you hold such I think a unique view and a and an informed view on so much of this that is that like is is it positive how positive what what what how do you think about this and how would you spend the 10 how would you spend the 10 billion you don't need to answer that but no I don't want to I'll be honest with you is that I know we should be celebrating that that we are getting this money to you know further our um you know health care system um i am i think terrified is probably a bit too strong but i do have concerns and i have concerns that this money could either really do some amazing work and we could really get to the place we need to be to ensure that we have um you know a future-proofed healthcare system you know and if if it's done right you know we everything that we wish for as patients as individuals going back to that circle of productivity and things like that we could have the loop you know closed um and and it could be amazing but I just feel if we are not doing that inclusive piece if we are not asking the right questions I am concerned that we are going to be creating policy strategy we're going to be bringing in software that you know when when it rolls out on the day clinicians can't use it patients don't want to interact with it and we can't get it over the infrastructure that we already have in you know and we have the barriers that we already have to innovation are not you know brought down I am super concerned that we could see that money go into a black hole and we could be either in a worse state or we could be in the same state that we're in at the moment and I think that's where we seriously seriously need to be looking at our past mistakes and we need to be looking at the cultures that we hold the beliefs that we hold around stakeholders we need to be looking into the future of who is going to be you know what are the power dynamics between stakeholders because we're now looking at a place where patients used to have a parental relationship with their doctor and where doctors led the conversation we're now looking at a place where patients are in a place of partnership you know and that's because of patients access to digital to literature to things like that um and then of course we're also trying to move healthcare into the community and look at it as a more proactive state well who's going to do the heavy work of that it's patients patients need to know how to self-manage themselves they need to know how to monitor themselves they need to be educated they need to be giving given information at their health literacy level as well so that they can have these informed and involved conversations um and i think the generations to come are becoming more interested in health so i think it will naturally happen anyways but i also think there needs to be an effort from the government to really educate the population moving forward as well and that's when we could see our system becoming less stressed you know we could see people because they're self-managing themselves so well they don't go to A &E you know they don't go to the GP they they know what their boundaries are or if they do need diagnostics they're doing it all at home and like people who are in that specialist high tertiary care you know like myself we are very good at self-managing our condition because we've had it our whole lives we have to do it um and we see our consultant once a year we have all the tests and that's it you know we go home we live our lives I don't see the GP I see him for a flu jab and that's about it you know because we are so aware of our condition and that's where we need to get everybody else to a position you know that everybody else in that is in that informed position where they're just going to the doctors maybe you know if something like you say if there's blood coming from somewhere it shouldn't or if there is a broken arm or things like that that's when we should be going to the doctors um so i think if we do it right we get the engagement right and you know we we really learn from our lessons in the past i think we could be looking at a phenomenal way of spending that money and using it um but i am concerned that you know cultures might hold us back beliefs might hold us back not using common sense you know it would be frustrating if we didn't see common sense come into play when we're spending that money and of course health being so politicized um common sense is relegated behind what statistics can i repeat at pmqs um for how that money was spent um yeah honestly i've learned so much Olivia thank you so much for coming on it's it's it's it's an interesting time I think for us to be having the conversation about where patients are in our healthcare system I it's only going to improve it's only going to get better I think I optimistically I do think that the advent of AI is pushing us more to a place of valuing human experience because frankly human experience is starting to be a differentiator in strategy because a lot of the doing is done at the same level now with AI that's been sort of democratized and actually when it comes to something as specific as the experience of a patient on a drug or after a procedure or whatever it is that can only be delivered by those people that are have been through it very very recently or in a specific environment or in a specific space or whatever it is so I think if there's one thing that I think I want people to take away from this episode is it's it's that we we are them they are us if you go to a patient if you go to a panel and there's a patient on there they are you they are your representative because you are you are spotting one thing away from that so we we that is our community and we need to start behaving more in that way I think and I think there's a lot of positivity downstream of that um Olivia thank you if people want to get in touch with you I'm sure they will by the way if if people want to get in touch with you whether that's for some of your advisory and consultancy work whether that's about your company um on the gown side what's the best way for them to find you um i suppose linkedin is probably you know that's my go-to platform um and then i'm happy to have a conversation and then um share my email and hopefully we can have a conversation and you know talk about this direction in this future and that you know we should all be attempting to build um together really that's the only way we're going to make it happen and you know i want to obviously reiterate that i want everything that I have said in this conversation you know I'd love it to be taken in a very positive light and I want it to also be said you know I have gone backwards and forwards about this conversation in my own career you know forget that anything happened to me as a kid and all of that so and I've gone backwards and forwards in my career but as I've seen more and more of the industry as I've worked more and more in the industry and watched it you know unravel I've really seen that this is a thread that is just going to become more and more prominent in the future so that's when I did make the clear decision it might be a scary decision to make that you know I was going to stick by you know my values and my morals and what I think is going to bring the most value during my lifetime and my career and help you know whether it health tech pharmaceuticals you know even patients and patient associations you know how do we all work together to get to the place that we want to be in the future.

1:07:19James Somauroo:Amazing. It's been a real pleasure, Olivia. Thank you. No problem at all. Hey, everyone. Thanks for listening and making it all the way to the end of this episode. Remember to subscribe, rate us and leave a review. And you can head to the description of this episode to follow me on all of my social media so you don't miss out on any of the latest health tech content.