Dimitar Georgiev: In Digital Health, the Biggest Challenge is the Lack of Challenges

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Dr Dimitar Georgiev is the CEO Paralax Life Sciences, but also a medical doctor, with 25+ years long experience in both worlds, in medicine and in business. We talked with Dr Georgiev about his projections to the future of digital health and other healthcare innovations, what challenges there are now, and which one are likely to arise, how to address them. In the interview below Dr Georgiev defines a goal to the healthcare of near future: to have healthy, working 70 years old people.    

Q: You are a medical doctor, but an unusual one, you are also a biotech entrepreneur and CEO of an investment consultancy that targets innovative implementations of medical and life science products and services. First a personal question, which medical skills help in business, and vice a versa, which business skills help a doctor?

A: I was an obstetrician and gynecologist. The best, which I adopted in the business was the capability to take fast, responsible, and effective decisions. Obstetrics is a medical discipline, where frequently the right decision should be taken within minutes. When I started my first company in 1995 (long time before the word start-up was popular), some fast decisions were crucial, and this was in the era before smartphones, connectivity, EU etc.  On the other hand, the business influenced my capability to look for medical decisions, which are not only evidence based, but as well economically sound. This helps a lot, especially in a country with limited resources. In Bulgaria, the budget for healthcare was never high, this directing the medicine in more cost-effective track

Q: Your experience as investor in healthcare innovations is a base to projections to the future. What are they? Which areas of healthcare innovations will enjoy most dynamic development in the near, mid, long-term future, and why?

A: Digital health because of its scalability and cost-effectiveness and personalized medicine because of the proper targeting are my favorites. Genetic testing will become daily routine and will enable much more proper decisions in rare diseases, cancer, brain disorders. Unfortunately, but economically justified, some medical professions will be forgotten soon – mainly disciplines, where there is no complicated surgery. Clinical trials will be done in a completely other mode, making thus innovations easier, faster and cheaper.

Q: In your opinion, what constitutes a successful innovative implementation in healthcare? Did the success criteria change in time, in your experience? How do you expect them to change in the future?

A: One invention is successful if it is live for decades. Look at Xray for example – how long it exists and how many modifications it has. Important, as well, is the speed of adoption. Gene therapies, for example, were invented more a decade ago, but apparently at that time the society was not ready to adopt them. The innovations in healthcare today should be scalable, financially acceptable and with maximum effectivity and not discriminating half of the world because of cost and complexity of manufacturing.

Q: In your view, what are currently the main challenges in innovative implementations of medical and life science products and services?

A: The main challenges are the fragmented world, the cost of some innovation and the defensive thinking of part of the medical professionals. Some healthcare systems cannot adopt innovations mainly because of price, but as well because of lack of production capacity. The story with the Covid vaccines should be a good example for humankind. The lack of breakthrough in some cancers, some rarer diseases and dementia is another huge challenge.

Q: Which challenges do you expect to arise in the future?

A: The biggest challenge is the lack of challenges. Until the medicine has challenges there will be traction in the right direction. We have so many unmet needs worldwide and even in Europe. Patient centricity is still not dominating medicine worldwide and this is a must. Some frequent diseases will be unfortunately further untreatable.

Q: What can be done to overcome present challenges and to increase resilience to the future ones?

A: The keyword is broader partnerships. More interaction. More transparency probably as well less regulation. Medical professionals and the society do not speak the same language and this needs to be ironed-up. The troubles with fake information and misleading messages are to be addressed properly. In general, we have to digest the outcome of Covid and do our homework properly.

Q: If you look back at experience with innovative implementations in healthcare, how did the approach to healthcare innovations in the last 10+ years – among the major healthcare stakeholders: the HCP, the state, the industry, the patients?

A: The patients are the biggest innovators and the most important stakeholder because their life matters. Patient centricity should become a global phenomenon. The second most important stakeholder is the industry, because their motivation is important as well. Somebody can say, the industry is only profit driven and this might be the fact, but still industry is extremely important. HCP are partially resistant, and we need to understand why-is it only the comfort zone which matters or HCP feel isolated in the innovation process. The state is not the best stakeholder. Traditionally the majority of the citizens of the world do not trust to governments and regulators /probably except Nordics and a tiny proportion of the western world/ and so neglects regulators and governments.

Q: How do you expect it to change in the future? Perhaps you can divide your answer between ‘a desirable’ and ‘a realistic’ scenarios?

A: Covid and the current war made me extremely conservative with prognoses. My favorite scenario would be to have the pace of developments doubled in the next 10 years with more diagnostic tests, new therapies, digitalization. However, the reality might be different. The world has not solved a lot of health problems, inclusive antimicrobial resistance, transborder healthcare, malaria, brain diseases etc.  a longer war in Europe will stop the medical developments and focus to other priorities – more lethal weapons for example. In any case, there are lessons to be learned, we need more connectivity, more joint actions, more reliable sources of information.

Q: Imagine a healthy person 10 years from now. What will s/he be able to do healthwise of what is impossible/difficult/costly today?

A: The have daily monitoring of 100 vital parameters in the smartphone-this will be a real patient-centric and personalized approach. The healthy 70-year-old person will be able to work and have a healthy life balance. Unfortunately, not all around the world, but still the trend will be there.