Facing the Facts of Childhood Obesity

On Tuesday, as part of the Great Challenges program, we convened some of the nation’s top leaders in health and research around the topic of reducing childhood obesity. The conversation touched on the need for a multifaceted approach that includes action from communities, policy makers, schools, families, and individuals. The Robert Wood Johnson Foundation, our partner on the Great Challenges program, posted the following recap, which provides context and explores the discussion:

A 2012 report from the Robert Wood Johnson Foundation (RWJF) and Trust for America’s Health concluded that if the adult and childhood obesity rates in 2011 continued to increase at their steady paces, then by 2030 nearly two-thirds of U.S. adults would be obese and every single state would have obesity rates above 44 percent.

Data now show that childhood obesity rates have stabilized. In fact, for the first time in a decade the obesity rates among young children from low-income families in many states is trending down.

Helping lead the way in this important public health issue has been the city of Philadelphia, Penn., which has worked to improve access to healthy foods and opportunities for physical activity.

“We were very fortunate in Philadelphia to have colleagues…who have developed a better understanding of childhood obesity,” said Don Schwarz, former Health Commissioner and Deputy Mayor for Health and Opportunity, City of Philadelphia, and will also soon take on the role of director for RWJF’s Demand Team. “What that has meant is that Philadelphia was able to take a body of knowledge and bring it to scale. The partnership in Philadelphia that has allowed that to happen goes across government and between government and the private sector and community organizations—just everyday Philadelphians. So that kind of partnership, that wonderful knowledge base, has I believed turned the corner on childhood obesity, particularly for children who are of disadvantaged communities.”

Schwarz’s comments came during the Tuesday, July 22 Google Hangout TEDMED Great Challenges: A Candid Conversation About Childhood Obesity. The panel was moderated by Richard Besser, Chief Health and Medical Editor for ABC News.

Every member of the panel echoed the importance of partnerships, and Besser succinctly explained their critical role in not just obesity prevention but all public health efforts.

“The more creatively you can think and the wider variety of partners you can pull in, the more likely you are to be successful,” he said.

At the heart of Philadelphia’s success has been the important role that schools play in that community partnership. According to Schwarz, for the past decade the city’s schools have worked to reshape how they approach children’s health and wellbeing, including comprehensive nutrition policies, a new food environment that emphasizes healthy choices and more opportunities for kids to be physically active. One can’t be successful without the other.

Risa Lavizzo-Mourey, RWJF’s president and CEO, also touched on this pairing, noting how the progress that’s been made (“It’s fragile in many ways, but it’s progress nonetheless”) is rooted in an overall change in the attitude and values over how to approach the issue of childhood obesity as a nation. Where before it was viewed as an issue of personal responsibility, more and more people are realizing that parents, schools, public organizations and private organizations must all come together to investigate, implement and expand healthy policies and practices for all kids. What’s more, people are also expecting and demanding these resources from their communities.

“We have the real beginning of a change in values that will, I think, accelerate the move to a healthy weight for all children,” she said.

Nancy Brown, CEO of the American Heart Association, discussed the importance of coupling effective medical treatment with surrounding a child with a culture of health, saying in particular that a culture that rewards individual successes is one that will see the greatest success overall.

“We need to stress whether for kids or for adults the importance of incremental change,” she said. “If we’re able to create an environment where…losing even 5, 7, 10 pounds, beginning to walk, starting to eat healthier—if we can have an environment where those things are rewarded, we will see continued, longer-term progress for that child and for their family.”

Businesses can also play a role in reinforcing this culture of health, according to Brown, especially has the health and wellbeing of employees and their families has slowly transitioned from an HR-only subject to more prominence. Wellness programs improve personal health while reinvigorating the surrounding community, which in turn helps ensure a stronger return on investment.

But just as Lavizzo-Mourey noted the fragility of the progress so far, Elissa Epel, an Associate Professor at the UCSF School of Medicine, spoke about the continued stigmatization of obesity, which can impede efforts to reduce rates, both because overweight and obese children can feel needlessly and wrongfully shamed and because other facets of the community don’t fully understand the difficulties that many people can face when it comes to getting and staying healthy.

With research and data producing more evidence every day underlining how stress, genetic predispositions and other factors can limit control under certain conditions, when it comes to childhood obesity—and to obesity in general—we need to keep shifting from the entrenched model of personal blame to one of understanding the power of the food environment. This is especially important because stigma leads to stress leads to poor eating leads to more stigma…a cycle that a quick glance at the numbers shows far too many people suffer in.

“Stigma is toxic,” she said. “Stigma is a source of chronic stress.”

Hearkening back to the particular progress Philadelphia has made in reducing childhood obesity rates in disadvantaged communities, Epel also spoke about how low socioeconomic status also brings with it the unfortunate pairing of more toxic stress and more opportunities to turn to junk food as a coping mechanism—or at least far less access to healthy alternatives than you might see in other communities.

Epel also spoke to the core concept of public health—not being content with treating the disease, but treating the sources of the disease before symptoms such as obesity can manifest and cause harm. In that way, communities need to look at childhood obesity as a trans-generational problem that begins incorporating community players, ensuring food security and implementing other practices to improve the health of future mothers and their future children.

Still, despite all the successes across the country that were discussed, much more is needed, with an eye toward prevention as “the name of the game,” according to Lisa Simpson, President and CEO of Academy Health. That begins with a focus on a research community that continues to dig down into the risk factors and that is supported by the entire community.

“We need to continue to have these kinds of discoveries that help us understand obesity…and very importantly how to intervene to prevent it, and if the child does become overweight or obese how to treat it,” said Simpson. “At the same time, the research community—and here also the policy and practice communities—need to come together to then, once we do know what works, partner and work on the dissemination and implementation of good evidence.”

Reprinted with permission from the Robert Wood Johnson Foundation’s New Public Health blog.

The Last Speakers Announced for the TEDMED 2014 Stage Program

We are proud to announce the remaining speakers who will share ideas and insight as a part of a phenomenal stage program designed to unlock your imagination. From an end-of-life bioethicist to an expert in toxic stress and inventor of a safer syringe, these global leaders in health and medicine are paving the way to a healthier future. This exceptional collection of thought leaders and innovators in San Francisco, CA and Washington, DC from September 10-12.

Without further ado, here are 14 more speakers who will grace the TEDMED 2014 stage:


End-of-life ethicist and writer Peggy Battin will talk about re-examining beliefs around an individual’s right to autonomy.

Virtual medical school pioneer Erica Frank will challenge assumptions about medical education with a revolutionary solution to the global doctor shortage.


Sigrid Fry-Revere, an organ donation ethicist and Aristotle enthusiast, will be sharing a surprisingly effective but often overlooked solution to the problem of organ shortage.

HolmesGame changer Elizabeth Holmes, who heads up lab diagnostic company Theranos, will share insights and technology that have put her at the cutting edge of high-test medical diagnostics.


Carl Hart, drug data dealer, professor, neuroscientist, and author, will describe a provocative, evidence-based approach to the crisis of drug abuse.


Lieutenant General Patricia Horoho, the first nurse and first woman Army Surgeon General, will be discussing ways in which health care can actually cause harm.

KoskaPersistent inventor and global life-saver Marc Koska will talk about inventing the game changing Auto Disable syringe, which cannot be reused and halts the spread of blood borne illnesses.

MorganSteinerLeslie Morgan Steiner, a motherhood investigator and author of bestselling memoir Crazy Love, will share what she learned investigating a successful medical surrogacy industry across the globe – and how it might help the US.

NabelFormer head of the National Heart, Lung, and Blood Institute, founder of the Red Dress Heart Truth Campaign, cardiologist, and current president of Brigham and Women’s Hospital, Elizabeth “Betsy” Nabel will show the audience how accepting what you do not know can be a strength.


Author and reflective physician Danielle Ofri will make a powerful case that one of the things medical professionals are most resistant to could lead to dramatic improvements in care.


Gail Reed, an expert in the Cuban health system, will spotlight a completely counterintuitive program to relieve the global shortage of physicians in poor countries.

VolkowNeuroscientist Nora Volkow, director of the National Institute on Drug Abuse, will apply a lens of addiction to the obesity epidemic.

WebsterJohns Hopkins professor and gun violence researcher Daniel Webster will examine hopeful possibilities to solve the gun control puzzle.

WenTransparent physician Leana Wen will discuss a controversial approach to medical transparency and full disclosure that could put the patient in the front seat.

With only seven weeks to go until we kickoff TEDMED 2014, space is filling up fast – be sure to apply today!

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.

New York City and Philadelphia: A Tale of Two Obesity Declines

By Risa Lavizzo-Mourey and Nancy Brown

“Severe Childhood Obesity Shows a Decline in New York City.” You might have seen the headlines earlier this month.

It wasn’t long ago that we never saw stories like that.

For decades, it was nothing but bad news – one story after another about a rapidly growing epidemic. Just two years ago, the Robert Wood Johnson Foundation and Trust for America’s Health predicted that, if trends continued the way they seemed to be going, more than 60% of adults in 13 states would be obese by the year 2030 – and have the extremely high medical bills to prove it.

But now, we’re finally starting to see signs of progress against an epidemic that was once feared to be unstoppable. Overall childhood obesity rates have stabilized. For the first time in a decade, data show a downward trend in obesity rates among young children from low-income families in many states. And, we’re seeing reports from cities and states that their overall rates of childhood obesity are decreasing: from California to West Virginia; from Anchorage, Alaska to New York City.

New York is a great example of a place taking a comprehensive, community-wide approach to reducing childhood obesity. The city has required group child-care centers to improve nutrition and nutrition education, increase physical activity, and limit screen time. “Health Bucks” enable lower-income families to maximize their purchasing power for fresh fruits and vegetables at local farmers’ markets. The city’s Department of Design and Construction provides architects and urban designers with guidelines for designing buildings, streets and urban spaces that support physical activity. Chain restaurants are required to post calorie information on menus, enabling customers to make more informed decisions. The education and health departments have collaborated on the “Move-to-Improve” program, which helps teachers incorporate physical activity through the school day.

We’re thrilled that these approaches appear to be paying off, but here’s the thing about that recent study on the most severe obesity cases: White children saw a more significant decrease than Latino or African-American kids.

This was true for overall obesity rates as well: Childhood obesity rates among White K-8 students in New York dropped from 17.6% in 2006 to 15.4% in 2010 – an impressive 2.2 percentage point decline. But the drop among Hispanic and African-American students was far less, just 0.9 and 0.4 percentage points, respectively. The disparity among upper- and lower-income students was even greater, a 1.4 percentage point decline compared to 0.7 percentage points.

This means that despite the overall progress, the disparities gap may actually be widening in New York.

In this respect, New York City truly illustrates where we are in this epidemic. Progress is possible, and happening, but this progress runs the risk of leaving some of our young people behind, and too many of those at greatest risk.

There is one notable exception to this rule—Philadelphia.  In Philadelphia, they’ve managed to reduce childhood obesity prevalence while also reducing obesity-related disparities.


Like New York, Philadelphia has addressed the obesity problem from many angles. The city, along with groups like the Food Trust, pioneered new financing strategies to bring full-service grocery stores back to underserved neighborhoods. The city improved food and physical activity in schools, and was one of the first jurisdictions in the country to remove all sodas and other sugar-sweetened drinks from public school vending machines.  In schools with American Heart Association Teaching Gardens, children grow their own healthy produce, and learn about the value of good eating habits. Complete streets policies make it easy and appealing for people to walk and bike throughout the city. More farmers’ markets are opening all the time across the city, and they use smart incentives to help lower-income residents afford fresh produce. Corner stores are offering healthy products and using in-store placement and marketing techniques that are boosting sales.

And guess what? Childhood obesity there fell 4.7 percent – and the biggest declines were reported for African American boys and Hispanic girls: 7.6 percent and 7.4 percent, respectively.

The challenge for all of us is this: How do we make the Philadelphia story everyone’s story, in every community?  How do we give every child in America an equal opportunity to grow up at a healthy weight?

On July 22, we’ll be addressing those questions and more at a TEDMED Google Hangout. Here’s who will be speaking:

  • Risa Lavizzo-Mourey, President and CEO of the Robert Wood Johnson Foundation
  • Nancy Brown, CEO of the American Heart Association
  • Don Schwarz, former Health Commissioner and Deputy Mayor for Health and Opportunity, City of Philadelphia
  • Elissa Epel, Associate Professor, UCSF School of Medicine
  • Lisa Simpson, President and CEO, Academy Health

Our conversation will be moderated by Richard Besser, Chief Health and Medical Editor for ABC News.

Do you have a question or comment for the speakers? A story about what’s happening in your community to promote healthy eating, or physical activity? An idea for helping kids achieve and maintain a healthy weight? We’d love to hear from you! Just comment on this post, or tweet using the hashtag #GreatChallenges.

We’re really looking forward to a lively, candid chat, and we hope you’ll tune in and contribute to the conversation!


8 Outstanding Co-Hosts Announced for TEDMED 2014

unnamed-1It’s almost here! TEDMED 2014 will take place in just under two months… and we’re proud to announce our “navigators” for this exciting adventure.


TEDMED curator and chairman Jay Walker will open the event on September 10 in Washington, DC and close our program on September 12 in San Francisco, CA.

In between, TEDMED Delegates will have the pleasure of meeting — or getting reacquainted with — some of the most energetic human dynamos and inspiring thought leaders we know.

In alphabetical order, our 2014 co-hosts will include:

Co-host Venue
TEDMED director of stage content Dr. Nassim Assefi
FUN FACT: A global nomad and self-proclaimed “thrillionaire,” Nassim is also the published author of a critically well-received novel, “Aria.”
Washington, DC
TEDMED Chief Operating Officer and partner Shirley Bergin
FUN FACT: As a child, Shirley loved Peter Pan and always wanted to visit Neverland. Today we call this mother of two un-Lost Boys, “TEDMED’s Superhero in Residence.”
San Francisco, CA
Geneticist, MacAurthur “Genius” Fellow and intellectual provocateur Dr. Carlos Bustamante
FUN FACT: When he’s not doing research or exploding old paradigms, Carlos can be found sailing – a sport he calls “the perfect combination of adrenaline and intellectual challenge.”
San Francisco, CA
TEDMED’s “keeper of the flame” and president, Jon Ellenthal
FUN FACT: The door to Jon’s office has a poster-sized patent for an amazing invention – himself – listing his parents Ira and Judy as the “inventors.”
Washington, DC
Globe-trotting medical emergency journalist (and Pulitzer Prize winner) Dr. Sheri Fink
FUN FACT: She has reported on health, medicine and science in every continent but Antarctica…apparently there aren’t many medical emergencies or wars among Emperor penguins.
San Francisco, CA
Founder and director of UCSF’s Neuroscience Imaging Center (and host of his own PBS special) Dr. Adam Gazzaley
FUN FACT: Knew from age 7 he wanted to be a scientist, now he relaxes with nature photography.
San Francisco, CA
Yale medical intern, UN Delegate and passionate global activist Dr. Sandeep Kishore
FUN FACT: Sunny is the only co-host this year who is a former TEDMED speaker.
Washington, DC
Engineer, inventor and PhD candidate at MIT David Moinina Sengeh.
FUN FACT: David is also a rapper and writer of song lyrics.
Washington, DC

With this outstanding team at the helm — and with more than 80 dynamic speakers including scientists, journalists, activists, performers, artists and other thought leaders on our unified, two-city stage — TEDMED 2014 promises to be an unforgettable journey into the realm of “Unlocking Imagination in Service of Health and Medicine.”

Join us in DC or SF for this unforgettable ride…and stay tuned for more exciting news about the event.

Meet the next 10 Startups Joining Us in the Hive 2014

Today we introduce 10 more health-tech startups to join the many members of The Hive we’ve already announced. Be sure to join us at TEDMED 2014 this September 10-12 in Washington, DC, and San Francisco, CA where you’ll be able to meet these startups in person. The companies we introduce below use the web, mobile devices, and sensors in exciting and innovative ways – read more about them on TEDMED.com.

AssayDepotAssay Depot has created an online marketplace that connects buyers and sellers of research services making scientific innovation accessible for everyone.

ClinicalBoxClinicalBox creates software solutions for healthcare providers whose patients require complex, high-cost procedures and care that requires a high level of coordination and engagement.

EzDermEZDERM provides an iPad-powered solution for physicians and their staff to intuitively document patient visits via touch-based technology, anatomically accurate 3D body maps, and hand-writing + speech recognition.

HumanAPIHuman API’s universal health data platform collects and normalizes health data from any source, and allows developers to easily integrate it into any application.

LivelyLively enables older adults to remain independent, safe from falls and emergencies, all while staying connected to family and caregivers.

ManaMANA Nutrition is working to save the lives of those suffering from acute malnutrition by producing a ready-to-use therapeutic food, carefully formulated to provide a child’s basic nutritional needs.

MobileOCTMobileOCT transforms any camera into a powerful epithelial cancer discerning device, providing those with camera phones, but without access to medical facilities, life saving diagnoses.

OculogicaOculogica is developing eye-tracking-based technology to simplify detection of brain injury by assessing function of the nerves that move the eye and mediate vision

TickitShift Health Paradigms helps physicians to get freely answered and honest responses from their patients with their product “TickiT”, which relies on the power of personalized surveys and visually appealing data collection to collect information about health behavior.

Uberuber Diagnostics uses advanced medical electronics and cloud technology to deliver mobile diagnostic solutions that can significantly improve patient care in developing nations.

Also, catch our latest interview on the TEDMED Blog with the brilliant minds who curated the 2014 Hive. This week, meet Regis Kelly, Director of the California Institute for Science and Innovation known as QB3, which is comprised of more than 200 quantitative biologists who are converting discoveries into practical benefits for society.

Check back next week when we will introduce more of this year’s Hive startups.

– The TEDMED Team

Match Great Science Minds with Passionate Managers

RegisRegis Kelly is the Director of QB3, the only one of the four California Institutes for Science and Innovation devoted exclusively to biology and the life sciences. He oversees an innovation center comprised of more than 200 quantitative biologists at three northern California campuses (UCB, UCSC & UCSF) who are converting discoveries into practical benefits for society.

Previously, Kelly was Executive Vice Chancellor at the University of California in San Francisco, responsible for the new Mission Bay campus, which is the center of academic planning for a 300-acre public/private biomedical research park in San Francisco. He also served as Chair of the Department of Biochemistry and Biophysics at UCSF; was the Director of UCSF’s Cell Biology Graduate Program; and was the Director of the Hormone Research Institute at UCSF. Today he remains Chairman Emeritus of the Bay Area Scientific Innovation Consortium (BASIC), is on the Malaysian Prime Minister’s Biotechnology Advisory Panel, and is a General Partner of Mission Bay Capital venture fund.

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

Kelly: Longevity research. You’ve probably heard about Calico, founded by Google, to stop or reverse the aging process. It’s a very exciting area with a surprising amount of progress being made.

We’re looking at cases where we medically accelerate the aging process, as measured by cognitive loss. For instance, elderly patients who undergo hip surgery or knee surgery are liable to suffer a severe cognitive loss. Radiation therapy on the brain, a traumatic brain injury, or a severe infection can also lead to cognitive loss. In the cases we’ve measured, the cognitive loss is caused by the way the immune system affects your hippocampus. And the mechanisms involved in medically accelerated cognitive loss are, as well as we can tell, identical to the normal process of aging in the brain. If we could slow down accelerated cognitive loss, I’m very confident those therapies would be beneficial for long-term cognitive loss, such as in Alzheimer’s.

This is not pie-in-the-sky stuff. At QB3 we have potential therapies in the pipeline and a pathway we can see getting into humans to test longevity. We’re talking about how we can get very close to an IND for phase 1 trials.

What is driving this is bringing together fields that hadn’t previously interacted. Normally, if you’re a neurobiologist then you spend your life in the neurobiology community; if you’re an immunologist, you do the same; and if you’re an imaging person or a physicist, you hardly talk to anyone else. Now, a marvelous synthesis among immunology, neurobiology, and imaging is producing spectacular results.

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

Kelly: We have 100 companies in the QB3 incubator right now, and we look at lots of companies that apply to our venture fund. We are always more responsive and excited about a company when there is clear passion from the founder or entrepreneur. If you come up with a great idea and you don’t have passion, then when something goes wrong you won’t fight through it to the end. People have to be prepared to pivot and change and adapt. It’s really about people with a commitment to making it happen.

The other thing necessary to successful entrepreneurship is people skills. Someone can’t start a company if they can’t build and work with other people. If they have ego problems and it’s all about them, it’s doesn’t work. People who can really build teams and teams that clearly love the leader work well. That’s a prognosticator that the company is going to succeed.

Of course, you’ve got to have an idea; almost everyone has a new idea in a new market. But the things that impress us are passion and people skills as well as the idea.

Is that different from my own key to success? Yes, on my good days, those are probably the keys to my success.

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

Kelly: This is entrepreneurship 101, but you must identify your customers and know that your product is what they want and will pay for. Selling life sciences products is not like selling iPhones. You must be careful about working on your reimbursement mechanisms and find out: is this really needed, by how many people, and who is going to pay for it?

In digital health people will often say, “Well, I hired a doctor,” or “I have a doctor friend,” or “I have a doctor on my panel and he’s going to tell me how to do it.” That doesn’t work. You need to talk to many doctors. The Lean Launch Pad insists, for instance, that you talk to 100 customers before they go ahead with your company.

Finding collaborators in other specialties is really important, and is a huge challenge. Trying to match someone with brilliant scientific insights or access to a new disruptive technology with someone who understands how to run a business is what we call “the Boyer-Swanson problem.” The fortuitous thing that made it possible for Herb Boyer, a scientist who was in my department at UCSF, to start Genentech was that he ran into the young entrepreneur Robert Swanson, who knew nothing about molecular biology, but knew about starting companies. The two of them together got Genentech off the ground. Very few scientists have business acumen; 90 percent of the time, you need a Boyer-Swanson match, and finding that is hard.

The Swansons—the people with managerial and organizational skills—are people who just like starting small companies. They love the excitement of starting something from nothing and seeing something with 30 percent probability of success coming to an exit in 5 years. They like the whole process and being surrounded by other people with that passion. They’re serial entrepreneurs; you’ve got to get them between companies. It’s like getting to people between marriages.

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?

Kelly: I’d love to be talking about how we put together this consortium that’s producing drugs that are reducing cognitive loss and affecting longevity. In six years we’re not going to have those in the clinic, but we certainly could have them clinical in trials.

Also, I’m excited about helping to transform American research universities to work better with the private sector. I’d like the boundary between universities and early startups in the incubator space to be so porous as to be nonexistent. Not only would we be feeding people into these entrepreneurial incubators, but also we would be hearing back from them what academics should be studying.

This is what QB3 is trying to do. If we could say that this QB3-type idea has spread so that 50 percent of universities in America are doing something like this, then that would be a major contribution to society.

Live online event: A candid conversation about childhood obesity

On Tuesday, July 22nd at 2pm ET, TEDMED will host a special live online discussion with our nation’s forward-thinking health leaders to take measure of the progress and challenges in our ongoing struggle with childhood obesity. Guests include representatives from Robert Wood Johnson Foundation, the American Heart Association, Academy Health, the University of California, San Francisco and the City of Philadelphia. Dr. Richard Besser of ABC News will moderate.

Screen Shot 2014-07-15 at 1.30.35 PM

The national childhood obesity rate has leveled off. Cities and states that have been taking on this issue comprehensively are starting to see their childhood obesity rates drop. A CDC study published in February showed that national rates may be declining among our nation’s youngest children.

This is good news, but challenges remain. Rates are still far too high overall, and racial, ethnic, and socioeconomic disparities persist.

What needs to happen to show bigger results, faster? How do we make sure all children can grow up at a healthy weight? What are some of the underlying environmental and societal causes that must be addressed? What could corporate, community and policy leaders do to further address this critical public health issue?

Click here to RSVP for the Hangout and view more information on this important conversation. We’ll be taking audience questions via #greatchallenges and will answer as many as possible on air.

11 More: Here’s Our Sixth List of Hive Startups!

We’re announcing another 11 startups to be showcased in The Hive at TEDMED 2014, this September 10-12 in Washington, DC, and San Francisco, CA. These pioneers in medicine and health include innovators in health communications, clinical trials, connected devices, and crowdfunding, and join the many we’ve already revealed and the several others yet to be announced.

ChatrHealthChatrHealth provides tools combining evidence-based medicine and communication algorithms to improve patient care by promoting provider-patient dialogue and helping prevent medical errors, identifying at-risk patients.

CureLauncherCureLauncher is a service and platform that transforms the way patients in need are matched with clinical trials that fit their conditions.

etecteTect is enabling a new universe of connected devices – its first application takes medication compliance to entirely new levels: a capsule emits a digital wireless message when a patient ingests it.

EvotechEvolving Technologies is addressing the needs of patients and physicians in underserved markets with its low-cost endoscopy system powered by a laptop or tablet.

b6d33e98-37ff-4cc7-b4a9-20a6d539fb51mySugr is changing how people live with diabetes by leveraging non-traditional approaches to connecting treatment devices and striving to transform clinical therapy into a fun part of daily routine.

NovasentisNovasentis is working on designs for medical, mobile, and wearable devices that can “come alive” with movement and sound using flexible electro-mechanical polymer haptic actuators and sensor technology.

OrbisBiosciencesOrbis Biosciences has leveraged particle engineering to create a technology that controls drug delivery to make pharmaceutical products safer and more convenient.

RespiRespi has developed a smartphone-enabled spirometer to help people with chronic respiratory diseases, such as asthma and COPD, to regulate their medication and avoid asthma attacks.

SamaHopeSamahope provides hope to people with treatable diseases, around the world, by crowdfunding for overstretched and under-equipped doctors who are available to perform life-changing medical treatments.

SensiotecSensiotec‘s wireless and touch-less sensor technology can track vitals for hospital patients without electrodes, sensors, or pads. Its platform also provides real-time monitoring to trigger alerts to hospital staff when needed.

SeratisSeratis provides a way to bring together a patient’s entire care team on one mobile platform so clinicians can easily communicate with each other using secure messaging.

And don’t miss the latest Hive Curator interview on the TEDMED Blog this week, featuring Mohit Kaushal.  His career has spanned clinical medicine, venture capital, and health policy as a White House Health IT task force member and the FCC’s Connected Health Director.

Stay tuned as we continue to announce this year’s Hive startups.

– The TEDMED Team

Use Multiple Levers to Push the Needle

Mohit KaushalThrough a career that has spanned clinical medicine, venture capital, and health policy as a White House Health IT task force member and the FCC’s Connected Health Director, Mohit Kaushal has gained a unique and broad perspective on the challenges of healthcare technology. Last year he joined Aberdare Ventures, and he remains an Adjunct Assistant Professor of Emergency Medicine at George Washington University and an appointee to a committee that advises the Department of Health and Human Services on data access and use.

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

Kaushal: There’s no single answer, but there are a couple of themes I really like. Pure technology innovation is one big bucket that includes personalized medicine. Medicine is very reactive right now: we wait for people to become unwell before we treat them, especially with chronic disease. Personalized medicine is weaving genomics and real life data together to figure out when we can start managing people earlier in the progression of disease.

Deeper into that is using proteomics and epigenomics to understand the whole body’s network and signaling, and using that to better understand disease and to better target drugs. Many drugs, especially in cancer, are expensive, have terrible side effects, and only work for a certain proportion of cancers. And that’s because cancer is probably many different diseases. The notion of understanding disease at its core to better target drugs is remarkable, along with all the tools and technologies that enable that, such as genomic sequencing.

The other piece I’m very interested in is more on the delivery side: How do we reconfigure the delivery of care? How do we move from a system that’s been built for acute care, with big expensive hospitals and expensive doctors, to a system that takes care of patients in more cost-effective settings, such as outside the hospital? And how do we use technology to enable that?

The framework for that is data capture—remote devices and sensors, as well as data storage and analytics—to turn multisource data into insights and then allow us to intervene. That’s a convergence of connectivity, storage, analytics, and behavioral change. All of these are technologies that, wrapped around the right service models, will effect positive outcomes.

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

Kaushal: The most important factor for entrepreneurial success in any industry is the quality of the management team and a little bit of luck. If you have the best science and the best management team, you increase your chances of success.

To go deeper, the specific qualities depend on the thesis of the company. If you’re trying to start a biotech company, you’ll need a mix of people with clinical, scientific, and business skills; those are very specific to the company. But generically, success depends on a team that is cohesive and can execute together. At many stages of the company, you need someone who is the Jack-of-all-trades. That’s the person who is really putting it all together.

If you’ve met some of the best ones, they’ve got real drive, real motivation that is less about cash and more about changing the way we do stuff. All of them work extremely hard and face challenges. In a word, they have hustle.

Is that different from my own keys to success? I don’t know if you could call me successful! If the question is, “What is the key to success in venture capital?” there are some common elements, but it’s hard to say.

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

Kaushal: From the global health perspective, each market is very different. We could divide this into two themes: one is a scientific theme. I mean, a pill is a pill; it will work anywhere. But on the delivery side, it is different from country to country. There are different rules, regulations, delivery mechanisms, and infrastructures everywhere.

The first thing to think through is whether the end product as a manifestation is scalable as it is, or does it need to be tweaked for local markets? It’s not like WhatsApp, where you can build a very small labor company in the Bay Area to deliver the fundamentally same service around the world.

In terms of partners, it really depends on the specific population, but what many early stage companies need are partners who have local insights and knowledge and can help navigate the local distribution.

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?

Kaushal: I’ve been lucky to work on different pieces of healthcare. I was in the Obama Administration working on policy, and I think if you can move policy in the right direction by even a degree, the positive impacts are huge. But I was also in clinical practice as a practicing doctor, I do academic work, and the innovation of excellence is what I do now. Any transformation I could help bring about would tie all of those pieces together. What makes me passionate about where I am right now is using multiple levers to push the needle.