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Healthy appetite for Irish innovation at Northwell Health

Partnering with Enterprise Ireland is giving US giant Northwell Health an innovation advantage.

Northwell Health is the largest provider of healthcare in New York State, twice the size of its next competitor, with 23 hospitals and 700 outpatient locations. At 68,000 employees, Northwell is also the largest private employer in the State of New York.

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Innovation plays a key role at the organisation, both in relation to research activities, investment in external companies, and internal spin-outs.

A pioneer in its field, Northwell was the first entity in New York to create an integrated health system and today has revenues of close to US $12 billion.

Pressures on US healthcare systems

Despite its unique position, Northwell faces the same pressures as many other US healthcare systems, said CEO and President Michael Dowling, in Dublin recently to deliver the keynote address at the North America Healthcare Forum.

Organised by Enterprise Ireland, the flagship event brought together leaders from many of the biggest names in the US and Canada’s healthcare sectors.

Each faces challenges such as consolidation in their markets, growing use of technology, increased consumerism, greater accountability and financial pressures, he said.

“We all need to transform, to disrupt ourselves before somebody else disrupts us,” said Dowling. “If you are in the healthcare business these days and you are not a disruptor, not continually trying to disrupt yourself, you are probably in the wrong place.”

How Northwell competes against the world’s best-known healthcare provider brands

Not alone is Northwell competing against some of the world’s best-known healthcare provider brands, such as Columbia Presbyterian, Mount Sinai, and Sloan Kettering, “but now we have to deal too with Amazon, with Google, and with pharmacy chain CVS,” which is looking to take over US health insurer Aetna and turn its retail units into ambulatory locations.

Competition is coming from players who “look at the world very differently than we do”, said Dowling. The aim for Northwell, as for all US health systems, is “to be at the forefront of change, not the victim of it.”

At the same time, the sector is increasingly transforming from medical care to healthcare systems, putting a growing focus on the social determinants of health such as lifestyle, behaviours and social issues.

Developing partnerships and alliances is an important way of ensuring innovation at Northwell, he said. In December 2016, Northwell signed a partnership agreement with Enterprise Ireland which allows Irish companies early stage access to its clinicians and key decision makers, aiding the development of new products and services for the wider US healthcare market.

The partnership also enables Northwell Health to develop and commercialise new medical technologies.

Such partnerships are highly valuable, bringing fresh insights and innovation to both parties, he said, “If it’s done right it’s a win-win situation.”

Why Northwell Health partners with Enterprise Ireland

Dowling partners with Enterprise Ireland because Ireland is, he said, “an epicentre of innovation”, with a young and dynamic population, an excellent education system and an “extraordinary amount of entrepreneurship.” Since the partnership with Enterprise Ireland was established, Northwell has worked with around 90 Irish companies.

Dowling offered advice to others looking to sell into the US healthcare sector.

“A company can have wonderful ideas but doesn’t understand fully the delivery systems of how healthcare is actually delivered on the ground.” Partnering with Northwell enables Enterprise Ireland companies to have a greater understanding of challenges such as regulatory issues, legal matters and reimbursement practices.

“The technology alone won’t solve it unless you understand the process of care,” he said.

“We have worked with 90 Irish companies and it has been a great experience,” said Dowling, citing physical therapy applications developer Salaso, clinical diagnostics company Technopath and medical technology company i360 as examples of innovative Irish companies Northwell is working with.

Patient care is at the centre of all its innovation. “At the end of the day, it’s all about what benefits the patient,” he said, advising companies wishing to succeed in this market to be careful of how they pitch to major healthcare systems in the US.

“Don’t come across trying to tell us that you know how to solve every problem.  No you don’t. You think you do, but you don’t. You have a little bit of the solution, it’s great, it helps, but it’s a lot more complex than you think. So do that piece and let’s work on the other pieces.”

Technology alone won’t solve healthcare challenges

Be aware that technology by itself doesn’t answer most problems. “When you are in the business of taking care of people, you use technology to augment what you do, not to replace it. You don’t want to become a prisoner of technology. The technology people who understand the human element are the people you give more traction to,” he said.

The future of healthcare solutions is likely to be increasingly consumer focused. “Healthcare has never been consumer focused the way it should be, it has been patient focused. There’s a subtle difference,” said Dowling.

The doctor/patient or nurse/patient relationship has traditionally been imbalanced, with an assumption that all the power or knowledge is on the side of the medical professional.

“A consumer is more knowledgeable. They now have more access to information, they are more tech savvy. They Google everything and they visit chat rooms before they come in, they question more. So healthcare is making that transition from patient to patient/consumer. It’s not ‘what’s the matter with you’, it’s ‘what matters to you’.”

Technology facilitates this. “We have patients involved in determining their own care. We have technology that allows patients do things at home before they come in. We also understand better, or appreciate better, that the patient’s social circumstances are as big a determinant of health as whether they see a doctor or not.”

Northwell Health already practices telemedicine extensively, for example, across psychiatric, stroke and ICU services. “The combination of consumer and technology is going to drive healthcare change much more than anything else,” he said. “The provider that doesn’t listen to the consumer who is empowered with technology is going to be left behind.”

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