Infecting Healthcare with an Entrepreneurial Ethos

ZenChuAs Healthcare Entrepreneur-In-Residence at MIT, Zen Chu co-directs the MIT/HST Healthcare Ventures graduate course and oversees MIT’s Hacking Medicine initiatives. He also runs Accelerated Medical Ventures, where he serves as cofounder and first investor for several medical and software companies. Earlier in his career, Chu co-founded and served as CEO for 3D-Matrix Medical Inc., a venture-backed MIT regenerative medicine company that had a successful IPO in 2011. He has also managed and led new ventures for Harvard Medical School, Wyss Institute, NetVentures, and Hewlett-Packard.

TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it?

Chu: It’s the digital transformation of healthcare that’s enabling scalable medicine.

Our Healthcare Ventures course and the Hacking Medicine ethos at MIT define scalable medicine as “impacting and improving access and quality while reducing costs.” Most of that happens not through increasing the number of doctors and health professionals, but by moving it down the skill curve, all the way to getting patients engaged in their own care. That’s how you scale medicine, not just in the U.S. but globally.

What’s driving this is that we’re taking what’s been pioneered in Silicon Valley—sensors and technologies and software and the services enabled by them—and rolling that out with a different business model. We teach that even a nonprofit with a medical mission needs to be intentional about its business model and how it is sustainable.

TEDMED: What’s the most important factor for entrepreneurial success in health tech—and is that different from your own key to success?

Chu: Health tech is more complex than IT or other traditional entrepreneurial verticals. You’ve got so many stakeholders, third-party payment, and all of the incentives and disincentives therein. So, the key profile for successful entrepreneurs is resilience side by side with a mission. Healthcare is complex enough to frustrate even the most skilled and experienced teams. If you don’t believe in your particular mission, at some point it’s easier to walk away from the startup than continue on. The only thing that keeps teams together during those lows is resilience and the mission.

That’s no different from my own key to success. I have co-founded three companies, collaborated on many more, served on boards, and been an investor in others. Those are the skills that you look for.

I believe that entrepreneurship is what is going to save healthcare. To overcome the challenges we’re facing, we need that combination of creativity not just from clinicians and researchers, but from entrepreneurs and healthcare designers.

TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?

Chu: Many entrepreneurs and clinicians who want to do good in global health don’t realize that it’s not enough to be cheap. Oftentimes you have to offer a very different solution for the developing world. You can’t just transplant a therapy or a protocol from the developed world. The realities on the ground in these hospitals or local clinics are meaningful. The key to really impacting a country outside of the developed world is in targeting your solution to the local resources and culture and capabilities.

More generally, the key to navigating the healthcare challenge of complexity is to have a clear user and a clear job to be done. A lot of entrepreneurial teams will have a mission, but it’s too broad. Often they’re trying to make win-win-wins for the patient, insurer, provider, and supplier. They end up compromising and not focusing on a single user, whether it’s the patient or the provider or the supply chain manager. Narrowing it to a single user and job to be done makes everything else go much faster with less money.

For instance, Covidien is a company that rolled out surgical tools in China. Their cholecystectomy kit cost $300 in the U.S., and China has a huge market for gallbladder removal surgery. But the average reimbursement for that procedure is around $10 in China, so the math doesn’t work there. It’s not enough to offer a solution that’s well accepted here. You actually need a completely different solution there.

Or, with regard to culture, consider that cardiologists in the top hospitals in China and India see 100 – 150 patients per day. In the U.S., they complain if they have more than 20 patients in a day. The way doctors in the U.S. listen to and assess a patient to arrive at a definitive diagnosis is completely unrealistic in China and India. Your clinical algorithm completely changes because of patient volumes and the organization of hospitals there. Patients who go back for treatment of the same problem don’t even see the same doctor. So doctors think of everyone they send away as cured; they don’t even have that learning feedback loop.

Those are the fundamental differences in global health that you don’t really appreciate until you’re on the ground. There is no substitute for being on the ground and localizing your solution to that geography and system and culture.

TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?

Chu: I’ve done multiple companies, but there’s a limit to the impact that any one company can have. What’s exciting to me is that I get to teach at MIT and in the Boston medical community. We’ve also been asked by BIO to host a Healthcare Hackathon for biotech and pharma company executives to try to inject a new level of innovation by teaching them how to apply new technologies and digital transformation around their pills and therapies. We’ll try to teach them design processes from Silicon Valley, agile product design, and user-centric design combined with healthcare business model frameworks. That’s what hasn’t really been taught well, not just to clinicians, but to entrepreneurs.

One of the best ways we pull ideas out of groups at hospitals and at conferences is to have them start talking about the terrible experiences in healthcare. There are so many of them. Whether you’re a physician, patient, supply chain manager, or back office nurse, there are terrible experiences in healthcare because we fundamentally underinvested in technology for decades compared to other industries. That’s the opportunity for entrepreneurs. The bar is so low.

Teaching those methods for business models in healthcare and medicine so that we can go beyond the reach of physicians, to what is much more scalable … that’s what’s rewarding. I think of what I’m doing as giving out openly and hoping to infect as many people with that ethos for entrepreneurship impacting healthcare around the world.