HIStalk Connect Interviews David Van Sickle, CEO, Propeller Health

David Van Sickle, PhD, is CEO co-founder of Propeller Health of Madison, WI.

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Tell me about yourself and the company.

I’m one of the three co-founders at CEO of Propeller. I’m a behavioral social scientist and a respiratory epidemiologist by training so I’ve studied asthma and COPD my entire academic career. I started Propeller back in 2010 with two other folks in Madison, Wisconsin. The company’s really focused on developing a new way to manage asthma and COPD. We have a set of inhaler sensors that monitor the use of medicines for asthma and COPD. We capture that information to understand what’s going on with the burden and management of those conditions, and then try to put new information and feedback and coaching into the hands of people so they can do a better job and then give physicians new windows into how their populations of patients are doing. We just closed our Series B round, which was led by Safeguard Scientific, with participation from Social Capital and some other investors.

It’s been a big year for fundraising in digital health, have you seen a change in the fundraising climate since the FDA finalized its mobile health guidelines?

I think in general, digital health fundraising has increased. I don’t know about the impact of the mobile guidance or not. I mean, we actually work and have two FDA clearances on our system, not just on our mobile apps, but really the Propeller platform, which includes these medication sensors, smartphone apps, patient/physician websites and so forth. It’s all cleared together as class 2 medical device. That first occurred in July of 2012, and then we had one earlier this year on an updated version of the platform, including a new sensor. From that perspective, I think there’s been, throughout the history of digital health, a pretty clear pathway to get these touch technologies reviewed and cleared by the FDA. The so-called ambiguity around the mobile medical apps largely pertained to people who didn’t follow the traditional 510K path.

Who are the big buyers in chronic disease management?

I think it continues to be organizations that have both economic and clinical interests. There’s certainly an opportunity to put some of these technologies and tools to work to improve outcomes and to improve the quality of care and hopefully the quality of life, but the real buyers I think tend to be those organization where there’s both a clinical interest in achieving those objectives, and also an economic rationale and imperative to cut costs, particularly from preventable treatment failure set off characterized much of economic spending around chronic conditions. We’ve seen a lot of interest from Medicaid managed care, particularly where they have strong relationships and provider groups.

It sounds like you’re focusing on health systems and providers. Has there been any interest from the payer side, or direct to consumer routes?

We don’t have regulatory clearance for direct to consumer route, and we’ve really focused entirely on the enterprise approach to persons with chronic disease. We’ve certainly seen interest from payers and done payer-driven programs, but we try to encourage them to work with aligned or similarly interested provider groups in their areas when possible.

What do you think needs to happen to shift our focus in the US from managing acute episodes to managing chronic diseases?

I think it’s been an issue for a long time. The tendency to treat acute episodes of chronic conditions rather than to think about how the underlying care and treatment might be adjusted is kind of a long standing problem. New payment methods and new tools and workflows that support timely and objective data capturing from folks in the community will have a significant impact on changing the way we think about the prognosis and treatment of these conditions. In the case of asthma and COPD, for example, the biggest risk factor for future exacerbations is previous exacerbations. You have an opportunity, at least we think, according to the literature, to break those cycles of exacerbations. You actually have an opportunity to change the clinical course of the disease in a way that prevents the decline in condition from occurring. We’re just seeing the early days of these new technologies and these new workflows that allow physicians and caregivers to think more proactively about how to steer treatment towards prevention, really preventing the future of exacerbation.

When you install Propeller Health, are there best practice recommendations for managing the patient outreach components of chronic disease management?

We certainly have a set of best practices. It depends a bit on what type of organization we’re dealing with and how sophisticated they are as a delivery system, how much investment they’ve made in the human capital and workflow for those types of efforts already. If it’s a sophisticated and integrated system and they have a full-fledged care management infrastructure, then it’s a very different kind of workflow compared to maybe a payer that has a special ops teams that looks out across the population and tries to identify people who aren’t doing well. There’s just some variability given the types of programs and resources that these organizations have, but certainly we’ve seen and built best practices around what makes the most sense.

What kind of results have your live customers seen thus far?

We focused on outcomes both proximal and distal to improvement in both controls, so we’re trying to get adherence up. We’re trying to obviously reduce the number of times that people have–or days that people have symptoms of these diseases. And at the same time, we’re trying to increase some of the quality of care. Asthma and COPD are sort of the indicator species for the health of a delivery system overall, and there’s a lot of ways that what we’re doing and the type of information we’re collecting can help both directly and indirectly an organization to improve how they score on quality measures. It’s a full blown effort once we’re installed to bring about changes in morbidity and utilizations, and then obviously increases in the quality of care so that they align with the broader goals of the healthcare system and reimbursement and so forth.

There’s also a lot we focused on to try to change the qualitative experience of a condition. Giving a patient-physician team more accurate and timely information about how the disease is going to allow them to make the needed adjustments.

What will your Series B funding go toward, and what’s next for Propeller Health?

We have sensors for metered-dose inhalers, but there’s a variety of other types of inhaled medications on the market, including ones that come in form factors that we can’t currently adapt, so we’re hard at work building a full line of sensors that will accommodate the majority of those inhaled medications. We are also working on updates to our enterprise system to allow them to more efficiently and effectively monitor bigger panel sizes. We’re adding folks on client services and operations so that those teams can grow as we reach bigger scale on some of these health system where we’re working. We’re adding to sales and marketing, which previously had been pretty small parts of the business.

Do you see yourself always focusing on respiratory medicine?

For the foreseeable future, entirely focused on respiratory. I think there’s certainly opportunity beyond in other chronic diseases, but it’s not something that we take lightly and it’ll be a long time coming when we decide to go there, so.


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