BTO_Denise Silber: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Emmanuel Fombu:
Welcome to Bite the Orange. Through our conversations, we create a roadmap for the future of health with the most impactful leaders in the space. This is your host, Dr. Manny Fombu. Let's make the future of healthcare a reality together.
Emmanuel Fombu:
Good morning, good afternoon, good evening, and good night listeners, and welcome to another episode of Bite the Orange, where, today we have a great individual and someone with an incredible background, a great bio, and has been an influencer in this particular space for a very long time. And so today I am with Denise Silber. Denise, thank you for joining us today.
Denise Silber:
Thank you very much, Manny, for inviting me. I'm delighted.
Emmanuel Fombu:
Thank you, I know you have an incredible background and bio, so please let our audience know about you. So tell us about yourself.
Denise Silber:
So I'm usually known for my interest in digital health. I'm a digital health expert with two businesses. One is Basil Strategies, which houses my activities regarding communication about digital health, and the other is VRforHealth, which is focused on making the world of therapeutic virtual reality better known. My background is that I'm the American in Paris, or the ex-New-Yorker in Paris. I have adopted this country and have lived at length in both the US and France and as well Switzerland and Mexico. I started my career in the pharmaceutical industry. I switched to communication at one point in order to be an entrepreneur, to run my own company. And I've always worked to try to improve the information and communication that is out there so that healthcare can be a better place for professionals and patients. There is so much untapped potential, and in particular in the digital health field, and also through patient engagement. And that is why those are two of my focus areas with this communication, whether it's written, events, the information platform that is VRforHealth.
Emmanuel Fombu:
Thank you very much, and that's very interesting. And because of that piece, I would like to actually focus on the initial question of what got you interested in digital health or health in the first place. I mean, you could have done several other industries, just a big challenge in healthcare piece, but what's your why? What gets you passionate about digital health?
Denise Silber:
My why took a number of years to really come together. I was very much aware when I was in the pharmaceutical industry of the fact that physicians did not have precise and similar answers to same questions that with one particular case you could get a variety of opinions, even a simplish case, and a variety of approaches. And this was true in the people I knew around me, that if you had an in into a hospital, you might get the leading expert, and if you didn't, you were stuck with something much less good. I saw how complex medicine was through the work that I did in industry on multiple areas, multiple disease areas. And I was there 25 years ago when the Internet was well, when the web was born with the first browsers, I accessed PubMed or Medline and realized, Oh my gosh, this is going to change everything. Physicians, the ordinary physician, the ordinary patient will be able to get on there and get information that up until now was totally inaccessible to them, and I thought that there would be a shift in the reach of people who weren't necessarily the academics or near the source of information. I had no idea how long that was going to take, that there is still resistance today, and I have followed every trend. I had to turn this into a business activity, this interest. So we did lots of, with my communications agency, we did lots of training. I then joined, and we built webs, we built some of the early websites. At one point I joined forces with a classmate from Harvard Business School who had created one of the earliest second medical opinion companies. And we saw by calling upon Cleveland Clinic, Duke, Johns Hopkins, Mass General, the expertise that these establishments could bring to a case. But at the time, the cost was just way too high, the cost of the bandwidth of sending the images around, the cost of contacting these people in a world that was still primarily paper. And another big step for me was to be able to get the word out through events. So for a number of years, I ran a big event called Doctors 2.0 to give patients their first opportunity to be keynote speakers if they'd created innovations to give startups an opportunity to pitch and to present just fabulous things in digital health from around the world. So I've really had a front-line seat through all of these activities on digital healthcare innovation in all of its forms with every wave as it comes along.
Emmanuel Fombu:
And that's quite an incredible, your experience piece, and I would like to actually dive a little bit further into I mean, you have experience living in Mexico, for example, and living in the US and living in France. I was most recently in Paris, like I mentioned to you earlier, before we got on air, and the healthcare system is completely different, the way it is. And so I think you have that front seat of being, the ability to, being a New Yorker living in the US and living in France, for example. Tell me something that is probably good or bad about both systems, right? And what's your experience around that and how does that influence innovation? Because I know a lot of French companies are coming to the US for business, for example, right? And then many American companies probably want to go into France. So how, you have that front seat that most people might not understand.
Denise Silber:
Right, well, it's interesting that the problems are, the opportunities and problems are similar. Obviously, the United States has, spending such a higher percent of GDP on healthcare, there is much more money available to attempt to integrate these innovations, but that doesn't mean that it necessarily happens. I can give an example that at a leading hospital in California, they've been doing the research on the use of virtual reality during childbirth, and it is demonstrably effective that the mother can wear a headset for the labor period, the beginning of actually the delivery, if she so chooses, and will have a significantly better time with less or perhaps no use of local anesthesia. That same hospital does not have a protocol yet for giving that outside of its research. So you would think that they would say, hey, you know, you've got, I don't know, 100 people who've already benefited from it. Can we do it? No. It's complicated to change the process in a hospital. In France, I know a young guy who used to be an Air Force pilot, his father was a professor in the field of diabetes, and he, with another person, created a company to help with gestational diabetes by creating a personal, a professional health record, connecting the individual and their doctor in the hospital with all the data that they need to follow on them, and they've gotten very far. They've gotten this to be active in a great percentage, a majority of French hospitals. So now maybe those are two exceptions in both cases, but I don't think so. They show that it's hit-and-miss. When you have a good innovation, the challenge becomes to integrate it into a system that wasn't made for it.
Emmanuel Fombu:
How the system in France, like from a healthcare perspective, do you have, I know it's a single-payer kind of system, right, across Europe is it like the NHS in the UK?
Denise Silber:
It's a little bit different from that. And both are misnomers because while the NHS is a single-payer, so you think all I have to do is find the person and I'm in, I'm into all, nope, not at all. First of all, there's England, separate from Scotland, separate from Wales and I guess Northern Ireland, so that's already. And then you have to sell your thing into every, I'm not sure what the right geographic word is, but let's say every district. There's a unit size that can make a decision for itself, and just because A has it, you've got to start again with B, so the vendors and the professionals can complain about that. On the other hand, in France, it's true that there's a two-tier level in that you could have the approval, you know, it's the product has its authorization as a device and it's got its reimbursement, that doesn't mean that the hospital is then going to say, give me six of those. You then have to get them to want to need it and to know how to integrate it. And I was just interviewing a hematologist very recently who said that the problem is not the hematologist, they're all very much, in France, they're all very much in favor of this, and the problem is not even the hospital. The problem is that they're stuck in these legacy systems that even when they have the budget, even when the budget is available nationally, that you, all you have to do is fill in a request and send it and say, we need this, it's just a big cog in a big wheel to change everything.
Emmanuel Fombu:
Correct, and that's what we're trying to change with this podcast piece, and that's the reason why to highlight some of this, the challenges that we face, right, and a lot of times it's just bureaucracy. It's just people not trying to change the way they do things in general. And sometimes, also awareness, people are not aware of what is available and what the outcomes could be from this. But with that being said, I'm very interested about your VRforHealth piece of it, so that's what you're working on now. So what got you interested in VR? I'm a big fan of VR, by the way, piece of it, and I think there is a lot of things that you could do from a behavioral perspective or things you could do to change, improve quality of life of patients. So tell me about what the mission of VR, what will you aim to accomplish with this, and what your goal is?
Denise Silber:
Sure, great, great question. So, it so happens, and maybe this was after you were already involved with using VR, it was 2015 or '16 that I was at an event, a conference that is called Games for Health Europe, where they, I've been to it several times before because they were a partner of my conference, where they were always giving opportunities to participants besides the lectures that were taking place to try out these, what were called serious games, and so, meaning that they had an educational value in healthcare. Like maybe you would throw darts at something and this would teach you better coordination, or it might teach you that those particular objects are not good nutritional value, whatever it is. So somebody said, Here, try this on. And there were two stands, one next to the other with headsets, and these were the days when the headset was still connected to the computer. And the first one that I tried on, I was suddenly in a glass elevator. And if I would move my head, the faster I would move my head up and down, the faster the elevator would go. And then I could turn swivel left and right and see behind me, and I thought, this is just fantastic. And the second thing was one for lazy, so that first one was to cure you of a fear of heights or get, or elevators or something, I have neither, but I could see how that would work. And then there was one where you used your eyes with the eye-tracking to shoot down stars. And this was for treating people who might have, let's say, lazy eye, not using both eyes. And so it would measure, well, whatever it is that you're supposed to do if you're 100% okay, and then through exercises, lead you to it. So it always is that way, when you speak with people about VR for health, it's their first experience with that headset that changes their life for them. Once they've done that, they want to go out there and see it happen. So I had that desire, but I was busy with Basil Strategies and I got invited by Cedars-Sinai to a big conference to manage a patient panel with patients who had experience using VR. So there was, for example, a person who had cerebral palsy, who was very rigid, and working out with VR enabled him to relax, to get some of that rigidity out. There was somebody who'd had an awful, like triple fracture that was very painful, so acute pain, and it was very helpful to him. There was another guy with chronic pain that he got from shrapnel and it was also very useful to him. So you had this, and then there was somebody else for irritable bowel syndrome. So it showed, and all the patients were saying, you know, this works, get it out there, get it to us. And I concluded saying, you heard them, help us. And as a result, a woman named Beth Savoldelli, who was in the audience, who'd come there for that purpose, she was a cured, cancer survivor of breast cancer, who wished that she'd had something like from mindfulness during her treatments, and she contacted me after the conference to say, I heard what you said, let's do something together. So thank you, Beth, that is why we wound up getting to do VRforHealth.
Emmanuel Fombu:
Correct, and that's actually quite interesting because I've seen like VR in health, in for medical education for clinicians, right? I mean, personally, I mean, I've done surgeries using VR. We actually played with tumors and you actually educate yourself about it, right? So you could train clinicians on this piece, you could train, you could use it as a therapeutic, get a piece of patients, for example, like all the examples you use, for example, just a gamification aspect of it. But then it takes it into this new world of the metaverse, right? And so it's a much bigger than just the idea of someone has like an Oculus in your head and walking around with it, right? If you go into this virtual world and I see a world in the future where we could do virtual therapies, right? So if you imagine like Second Life and you do a ...
Denise Silber:
I used to go on Second Life.
Emmanuel Fombu:
You did? Who were you in Second Life? Because I found out about Second Life and I ...
Denise Silber:
I was jumping around. All I remember is that I had this cool jacket and pants, probably purple or something and that I was jumping around. I didn't stay on it too long.
Emmanuel Fombu:
Don't worry, we would not judge you, because you had an alter ego, that in Second Life. And I look at Second Life, for example, and I, several years ago I was looking at this. Imagine a world where, in the virtual world or virtual reality world, where you have people have therapy, right? Where you could be the alter ego piece and have these group sessions. You talk to other people, especially in today's world with mental health being like a major kind of issue. Do you see yourself getting to that into that world of mental health? For example, or for your company VR, just to make it more specific, what do you do? Do you develop therapies or what? What do you produce?
Denise Silber:
So VRforHealth is answering a problem. The companies that you mentioned, the VR solutions companies, they've identified a particular medical problem and they create a solution for it. And the problem is how do we get from that to adoption? Because a small company doesn't have the means of, let's say, a pharmaceutical company launching a molecule with all of the millions that they can put behind it and their databases of professionals to contact, and how you work with, these companies have had none of that. So we wanted, with Beth and myself, to create a platform that would bring together all of the necessary parties. We're considering, this is for decision-makers, so it's for the solutions companies, for any other technology companies that can provide help with healthcare uses of VR, and then to bring in all the decision-makers from the healthcare establishments, from patient networks. So first, we're establishing the catalog, the offer, and we already see the other day we were speaking to a company that manufactures, let's say, an accessory that is involved in a surgery which will create anxiety for the patient. And they were asking us, could you help us find a provider of the solutions, a technical provider that has quality? We don't know how to choose them. Can you tell us whom we should contact to be able to offer to the doctors or surgeons that use our accessory, something to help the patient? And that's exactly, we're like right at the intersection of all of this, we draw people in through our communication, and then we can match them up.
Emmanuel Fombu:
And which is highly needed. So if you're listening to this and you are in the VR space or you need advice on marketing or strategies around that piece, please feel free to reach out to Denise and Beth if ... a VRforhealth, right? And I'm sure if you need other communication, kind of, strategies and healthcare piece, you can reach out to Denise through that Basil Strategies piece, right? So in the show notes, we'll have the contact info for Denise. So right now, what are the biggest challenges that you face, and what does success look like for you in the next six months?
Denise Silber:
So the challenges are different depending on each company. Basil Strategies is called upon to produce a lot of content and to support social media. And so the challenge there is to ramp up, to scale up, to be able to take on new projects. And in VRforHealth, it's to get out there and explain this to enough companies so that they can sign up. We do this ourselves, Beth and myself, rather than having like a student or some younger person new to the career in there, because we really want them to feel our why and also because we're self-funded. So we need to ramp this up as fast as possible in order to be able to then complete the team.
Emmanuel Fombu:
That's fantastic. I'm a big supporter of, I think VR has a huge role to play in the future of healthcare. And this is not like future technologies from ten years ago, ten years from now, these technologies exist today. So there are things that we could use today. They are available, right? So we don't need to hang around and wait for some new development. I mean, of course with time it gets better, but this is available today, and that's something that I believe Denise and Beth are very passionate about. So please, if you're listening for free to support Denise and Beth on this beautiful journey, and we'd love to have you back again, Denise. You know, to see how that journey is going.
Denise Silber:
Well, thank you so much, Manny. You're an excellent interviewer.
Emmanuel Fombu:
Thank you very much. It was great having you, and please stay in touch and don't be a stranger. Thank you very much for joining us today.
Denise Silber:
Bye bye.
Emmanuel Fombu:
Bye bye.
Emmanuel Fombu:
Thank you for listening to Bite the Orange. If you want to change healthcare with us, please contact us at info@emmanuelfombu.com, or you can visit us at EmmanuelFombu.com or BitetheOrange.com. If you like this episode and want more information about us, you can also visit us at EmmanuelFombu.com.
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