I always assumed “entrepreneur” was a French concept, considering the etymology of the word, but as it turns out an Irishman coined the term in 1755. Richard Cantillon first introduced the term in his seminal economic work called Essai sur la nature du commerce en general, which was published after his 1734 death. In the book, and as reported in Wikipedia, Cantillon divided society into two principal classes—fixed income wage-earners and non-fixed income earners. Entrepreneurs, according to Cantillon, “are non-fixed income earners who pay known costs of production but earn uncertain incomes due to the speculative nature of pandering to an unknown demand for their product.” In other words, entrepreneurs are the risk takers who invest money to make new markets and more money.
Of course no workday goes by without the word “entrepreneur’ passing through my lips, so I was very interested to learn of its origin at my recent wonderful trip to Dublin for the Health XL Global Gathering May 29-30, 2014. As I sat in the audience on the second day of festivities, Irish Minister for Jobs, Enterprise and Innovation Richard Bruton taught me this historical bit of trivia, as well as the fact that Forbes picked Ireland as the top country to do business in for 2013. Note to self: the US came in 14th. It kind of reminds me of that list of countries with the best healthcare systems where the US spends the most but dwells around 31.
Yeah, I know what you’re thinking: of course Ireland is great for business! There is golf and endless beer. What else do you need to make work fun?! I have gone on record to say that I only play golf when there is a windmill or clown head involved; and beer is fine, but I am more of a brown liquor girl (Jamesons anyone?). Yet what I found out from my all too brief trip to Ireland last week is that there is a vibrant life sciences industry there that is beyond what I would have expected from such a small country and that, despite the excessive drinking (turns out to be the party capital of the world…who knew? #everyone), the world of entrepreneurial life science and healthcare endeavors is big and serious and thriving.
According to Enterprise Ireland, the country hosts the headquarters or substantial operations of 18 of the world’s top 20 pharmaceutical companies, 15 of the world’s top 25 medtech companies, and 6 of the world’s 7 top diagnostics companies. That’s pretty impressive in terms of partnership access. The country has now set its sights on digital health and is trying to leverage its rich history of science, medicine and R&D to attract healthcare entrepreneurs to a land of low taxes, investment capital and, of course, beer and golf. Did I mention the beer? I don’t know how these people are so accomplished considering that they drank me under the table 3 of the 4 nights I was there. On the 4th night I didn’t even try.
But what a great series of experiences were had and new relationships made at the Health XL Global Gathering (you can check the twitter feed from last week at #HXLGG). I had never been to Ireland before and it was a crash course: only 4 days. But nearly every moment was action-packed and engaging. Health XL, if you don’t know it, is a really interesting organization that has a goal is to create lasting and meaningful business partnerships among the world of healthcare IT/digital health start-ups and large healthcare corporations. They are not an accelerator or incubator or club, but rather an organization focused intensively on helping entrepreneurs and established business leaders get the most from each other to advance their mutual goals around innovation. The call themselves a “global digital health mentor network,” but they are also a convener of people with ideas, resources and desire to contribute to the evolution of the nascent digital health economy.
Recognizing that large companies can suffocate small ones and that small companies can underestimate the demands of working with large ones, Health XL seeks to create a forum to allow these dating relationships to matriculate into productive marriages rather than bad memories. Health XL leadership have established significant partnerships with IBM, ICON, J&J/Janssen, BUPA, Partners, Novartis, Linde, Silicon Valley Bank, GSK, Cleveland Clinic and a bunch of other serious players who are contributing time, money and really senior level people to work with the organizations and the entrepreneurs that flow around it from Europe, the US, South America, Asia/Pacific and Africa. Antartica was the only continent unrepresented at the Dublin meetings this week, but I hypothesize it is because the penguins are too short to reach the podium and thus don’t get their voices heard. Believe me, I understand their challenge.
Health XL’s world includes everyone but the penguins, as they demonstrated from their Healthees Awards, which recognize the best entrepreneurs and business opportunities on a worldwide basis. This first year’s Healthees winner was Dr. Byrite Asamoah of Ghana, representing the digital health opportunity of Africa. The presenters from the other continents were pretty damn compelling too. Lots of organizations talk about how they are reaching out to the world, but few really do it. We in the US get so caught up in our own alleged world dominance that we sometimes forget to realize the entrepreneur who will eat our lunch may not speak our native language or know who Macklemore is (yes, my attempts to impress by explaining how I am returning to Dublin in July to see Macklemore & Ryan Lewis were met with remarkably blank looks. Really guys? Never heard the Thrift Shop song? Wow). If you are American and reading this and don’t know who Macklemore is, you must not have left your home for the last two years, as it is hard to escape his music on the radio, TV ads and at sporting events. White guy rap, good stuff, check it out.
The primary objective of the two-day Global Gathering was to bring together world health business leaders to establish three “moonshot” style goals for HealthXL to use to guide their initiatives and partnerships over the few years. The inspiration for this goal was JFK’s 1961 challenge to US government and industry to land a successful moonshot within that decade. In issuing the challenge to business, science and everyone else with dreams, JFK said that space exploration “may hold the key to our future here on earth.” I can assure that you that getting our world’s health going in the right direction within the next 10 years now holds the key to our future here on earth. We must help the next generation of people be smarter about living healthier long lives and the current generation do what they can to reverse the damage done. Failure to do so is not an option.
During the event I had the opportunity to moderate a panel about changing consumer health behaviors. I started by asking the audience of about 250 healthcare people two questions, the first of which was, “How many of you consider yourself pretty savvy about health issues?” Despite the fact that it was a healthcare crowd and that we were sitting in the incredible historic ball room of the 300 year old Ireland Royal College of Physicians (note: all the paintings on the wall are of old white guys in wigs and dress-like robes, which is I guess the closest they used to get to having women in this place), only about 2/3 of the room raised their hands to admit to being healthcare savvy. But nearly 100% of the room raised their hands for the 2nd question, “How many of you, despite being smart about health, engage in bad health habits anyway?”
There was a big laugh in the room at that, but it was gallows humor in more ways than one. My panel, which included Diego Miralles, Global Head of Innovation for Janssen/Johnson & Johnson; Tim Johnson, Corporate Strategy Director for BUPA; and, Terry McGuire, a co-founder and General Partner at Polaris Partner, waxed eloquent on the subject, but at the end I asked them this closing question, “What is your personal bad health habit and what would it take for you to change it?” Tim and Terry admitted to eating too much sugar (Tim even admitted to rewarding himself with sweets on days he bikes to work) and Diego admitted to poor sleeping habits; none of them could really articulate what incentives, motivation, or reinforcement it would take for them to change these known risky behaviors. This is the crux of the challenge for all of us in healthcare: to bring change to life and unlock the key to better health so we can deliver less health care, not more, and still be healthier.
By the way, if I were asked the same question, I would have to admit to a dark chocolate addiction, which I rationalize to myself in the name of anti-oxidants. After a week in Dublin I might have to add excessive Jameson swilling to my list of areas on which to work. My biggest motivation on this one has become the threat of excessive gravity.
There were lots of people at the big Friday event strapped up with wearables galore, including one guy with at least 5 visible sensor thingies on him; I was worried about a thermonuclear reaction so steered clear of him. But it is clear that data about our behavior alone is not sufficient to make change real, as lack of knowledge isn’t the problem for everyone. Yes, it is true that lack of knowledge about poor food habits and how to read food labels and all the rest is a challenge for some, but I kind of doubt that there is anyone on the planet who doesn’t know smoking is bad for them. And yet it persists. I have not polled the penguins about this so they could be outliers.
One particular highlight of the Dublin week was a visit to Trinity College’s Science Gallery to bring this particular point about healthy habits home. The Science Gallery is an interactive lab to bring young people (particularly those 15-25 who are interested in innovation, science and entrepreneurship) together with the university’s and community’s great thinkers. The current exhibit is called the Fat Lab, aka Fat is Delicious, and it is as disgusting as you can imagine or maybe worse.
We had a personalized tour of the place, which seeks to collect data and biometric info from everyone who walks through the door, or at least the willing. In the Fat Lab exhibit we got to see such things as arm chairs stuffed with fat rather than fluff, so when you sit there it warms up and melts what’s inside (so gross); an experiment called Fat Fingers, which is pitting the fingers of overweight people vs. thin people to determine the effect of BMI on speed; and a blood test which is meant to determine whether overweight people have stickier platelets than thin people. There are also exhibits such as gross vials of different fats in glass jars, a giant suit (like those toy sumo suits) that you can don to know what it’s like for patients before bariatric surgery, and a literal pig’s worth of fat fermenting in some chef’s concoction, which is out on display but will ultimately get eaten by exhibit guests. Yum. Not. And yes, we did follow this tour up by going to dinner at a restaurant called the Pig’s Ear immediately afterwards. I ordered the fish.
After several days of interactive, fun and thought-provoking activities, HealthXL settled on 3 moonshot goals which will guide the selection of partnership initiatives they will staff and resource this coming year and beyond:
- Increase life expectancy and quality from birth through death by using big data to help caregivers deliver better care and help patients through improving health literacy and engagement.
- Provide seamless, synchronous and asynchronous monitoring from conception to end of life, regardless of time, place, device or person.
- Make 10 million hearts beat younger, longer and stronger.
Yes, they are pretty broad and somewhat hard to measure, but the organization wanted to attract the best and most creative submissions to ensure they get the best minds working together. Health XL is now officially calling for entrepreneurs to bring their vision, creativity and boldness to lead projects tasked at achieving the moonshot objectives laid out by their sponsors, who are among the worlds biggest healthcare companies, as advised by a plethora of innovators in the sector. Health XL will select 10 or so finalists from the applicants and kick off the program in September 15, 2014 at a program to be held in the San Francisco Bay Area. To apply, click HERE for information.
Thanks so much to Martin, Johanna, Paul, Tom, Connor, Jim, Kieran and the rest of the Health XL crew for a fantastic first visit to Dublin. And to all my entrepreneurs and healthcare business friends, Sláinte mhaith!*
*To good health!