In some aspects, January 2021 seems like March 2020. In March, the virus was here, but we didn’t know much about it. By 2021, the vaccine is here, but it’s unclear if enough people will get vaccinated. Will it be a few months or more before the vaccinated individuals will need to get a booster dose? What will be the impact of the new strain of coronavirus that’s spreading faster than the previous strains? One could argue that a lot of factors warn against being overly optimistic. John Nosta disagrees. 

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As a futurist, consistently ranked among the top names in digital health, he believes the human spirit and powered by technology came to life over the last year, and that we're going to get beyond this crisis. “We have seen technology in particular pharmaceutical science do things that have never been done before. They've leveraged a variety of resources and created a vaccine that is extraordinarily effective. Not only did they do it quickly, but they did it very, very well. For me, this is a testament to pharmaceutical science. I'm very optimistic about the way people came together and brought innovation to bear in whatever social construct there was. If we needed respirators, we got respirators. If we needed new tracing mechanisms, those came to market. My hope is that 10 years from now, we will mispronounce COVID. And we'll call it something like the “CO… Kojak” or the “coded” or something virus because we'll be so enamored with the success of human science and technology that the current situation will be just a small afterthought in our lives.”

John Nosta is an advisor to many digital health companies and the founder of the NOSTALAB—a digital health think tank. In episode 114, he talked about a concept of TQ - technology quotient, social media, the positive impact of technology on healthcare, but also the things digital health companies still struggle with today. 

What is TQ

As explained by Nosta, TQ is our ability to assimilate technology into our lives for our success. “Consuming the information that exists in past, combined with the information that is being generated in real-time is a bit like drinking out of a firehose. It's almost impossible. It's been said that there are around 8000 oncology publications published daily. Even if you break that down to specialties, how is an oncologist going to stay on top of data and make informed decisions about therapeutics and the availability of clinical trials?” 

While technological progress is impressive, the adoption is still a challenge. As presented in a recent article by STAT news, clinicians are not comfortable with using AI because AI systems are poorly-understood. Clinicians worry about an experimental tool exacerbating existing biases in the medical system. They also told STAT they would be more comfortable incorporating new AI systems into their practice if the tools were labeled with data including their accuracy and reliability, the research that was used to power them, and a list of their potential limitations.

In response to that, Nosta believes “our ability to change is one of the biggest points of obstruction that we see in advances in health care.” He remains optimistic.

“I think we're seeing dramatic changes in the nature of drugs, of disease detection, of immuno-oncology, CRISPR technology, advances in X-ray technology... I don't think medicine is changing slowly, I think humanity is changing slowly in the context of rapid technological advance. And that's the point of conflict. And we don't really address that much,” says Nosta. 

Asked about the dangers and considerations and potential dangers regarding technology, he says that “the biggest danger in technology is not recognizing how important it is in our lives.”

He sees AI as one of the most exciting technological advances, that is not going away but will evolve and get adopted with the diffusion of innovation. When that happens, the shortage of clinicians will be redefined because multiple stakeholders will be more empowered to do more things. “I think we will see a much broader distribution of clinical abilities and acumen that is mediated by technology. This is the big thing for me: The cognitive heavy lifting of medicine will be shifted to technology. And that really makes people completely crazy, because we know that the doctor is the smartest person in the room, right? That's sort of this sacrosanct opposite observation, that there's a nurse, and there's a technician and there are all these other people. The smartest person in the room now is the computer. And that can change things in profound ways,” says Nosta.  

Digital health companies and positioning 

In Nosta’s opinion, one of the biggest myths in the digital health space is the belief of innovators that if they build a product, customers will buy it. “Most entrepreneurs have no sense of marketing, have no sense of positioning, have no sense of market stratification. They talk about making sure they understand what their patients are thinking, and what the stakeholders want and need. But I think that is fundamentally wrong. And the reason is, that it’s not enough.”

Elaborating this further, John’s advice to the companies is to recognize that they need a single-minded point of difference, that they need to penetrate the market like a spear.

“Abraham Lincoln said that if he had eight hours to chop down a tree, he'd spend six of them sharpening his axe. What we find with most innovators today, especially the small innovators on a small budget, struggling to get their brand to the market place, they spend 99% of their time and their money on the device. And that makes a lot of sense. And then when it comes to articulating their message coming up with a simple coherent message into the marketplace, well, they figure they could just come up with something on the fly. And, and that's tragic.”

Most commonly, what he finds is that entrepreneurs try to be all things to all people. They try to position their brand as a bundle of benefits and end up being the same as the competition. “If I were to throw five tennis balls at you, you'll catch none of them. But if I threw one at you, you would catch it. The challenge for marketers today, whether you're big pharma, whether you're a big device company like Medtronic, or you're a small startup, is to try to find that single-minded point of difference, that resonant aspect of truth that reacts to a marketplace reality, often called the key insight in that’s what gets the juices flowing. That's what begins to shift,” says Nosta. 

Most people believe that their position statement is a selling proposition, says Nosta. He further warns: “People believe that when that message is articulated to an audience, they will want to buy their product. And that's not true. What you're trying to elicit in the minds of your audience is a simple reply. And that reply is: Tell me more. That pushes the process forward.”

Tune in for the full discussion about innovation the role of social media and the future of technological advancement: 

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Some questions addressed: 

• It’s in 2021. Welcome back to the show after almost three years. How optimistic are you about this year?

• Quite a few studies have started with using technology for the early detection of COVID. Manufacturers of consumer wearables, such as Fitbit and Garmin, and sellers of their clinical-grade equivalents including Sonica Health responded to the pandemic by initiating studies to assess the ability of their products to detect COVID-19 early. What do you think about that? 

• In the last year or so you started talking a lot about technology intelligence or TQ. TQ is an idea about how we use technology for a better humanity. I guess the COVID studies we see now are an example. So let’s talk more about what exactly you mean when you talk about TQ.

• How do you see social media in the TQ equation? Social networking platforms are an important technology that has further gained in societal impact due to the pandemic and the inability of people to meet in person. 

• You tend to be very critical of medical professionals. You like to say that doctors complain about not having time with the patient. In your view, if they had more time with the patients to just talk to them, they’d complain as well. How do you see the medical profession changing in the future? Do you think it’s actually possible for the working conditions to improve in that regard? Personally, I’m skeptical. With the rising shortages of clinicians, I can only see the system becoming more efficient if cases are solved faster. So I don’t see doctors spending more time talking to their patients, I do see potential shorter waiting times for the patients.