When life gives you lemons…

Stop 1: Washington DC, USA.

After a substantial flight, several delays and a late-night arrival into Washington DC, it was time for the first stop of my Churchill Fellowship adventure. 27-ish hours in transit and an expensive cab ride to the hotel (thanks to the US tipping system!), I was in the Capital and ready to roll.

Or so I thought. My first stakeholder interview unfortunately didn’t quite work out. This was a solid one; a well-known US Government agency who I’d been hanging my hopes on to set the tone for the trip. Despite a level of assurance and confirmation email to join them for a meeting, it wasn’t to be. I tried hard not to let the feelings of disappointment mar the initial experience, but this was a big fish not to land.

As they say, when life gives you lemons…well, you know the rest.

I took the day to decompress, explore, unwind and then cracked out the laptop in a fantastic cafe / beer garden on 14th Street to start drafting the framework for my report. For context, Churchill Fellows are required to document their experience in the way of a final report. A provisional edit is due 10 weeks on returning from the trip. One of the chief difficulties for me was framing the problem statement and how the interview questions would feed best into addressing the overall objective of the Fellowship. I knocked out a solid backbone to the report, refined my set of questions for the 8-week trip and felt a sense of accomplishment despite the initial setback.

On a personal note, my brother-in-law who is a Senior Officer in the Royal Australian Navy was visiting Fredericksburg, Virginia (just down the the road from DC and birthplace of some bloke called ‘George Washington’) on a weapons training exercise. To see a familiar face when away from my immediate family was very welcome and we set about testing a few (read: ‘many’) craft breweries and haunts across the city.

Interview No. 1 was with Sara Elalamy, Director of U.S Government Affairs at the Digital Therapeutics Alliance (DTA).

The DTA is a non-profit trade association of industry leaders and stakeholders engaged in the advancement of digital therapeutics (DTx). As the leading international organisation on digital therapeutic thought leadership and education, the DTA works with patients, clinicians, payors, and policymakers to provide the necessary tools to evaluate and utilise DTx products.

Sarah and I spent time opposite Capitol Hill chatting about all things legislation, policy, the DTA’s advocacy work, and educating clinicians and consumers on how integration of DTx into the American healthcare system is a positive step in realising digital health’s capabilities and strengths.

What struck me as extraordinary was mention of a product called EndevourRx: a DTx for treatment of ADHA. EndevourRx is a video game-based therapy used in substitution for children taking Adderall. Early studies have shown promising results for this clinically validated technology and got me thinking how some digital mental health services in Australia have also demonstrated good clinical efficacy through RCTs. Is this a key factor in enhancing confidence in Software as a Medical Device (SaMD) and DTx?

Interview No. 2 – Consumer Technology Association

Later that day, I met with the impressive Rene Quashie (Vice Principal, Digital Health) and Kerrianne Haresign (Director, Technology and Standards) from the Consumer Technology Association (CTA).

The CTA (to a sheltered Australian clinician) is a beast of an entity. Essentially, a trade association representing the $505 billion U.S. consumer technology industry, the CTA supports more than 18 million U.S. jobs. They primarily conduct advocacy and adoption work in everything from consumer electronics, wearables, to digital health technologies.

The themes of this discussion extended beyond DTx, to how standards can support the basis for adoption and integration of digital technologies into healthcare (and society more generally), digital literacy and interoperability practices (including harnessing FHIR). One profound quote that stuck with me was: “standardisation for innovation” – i.e. a standards-based approach being crucial to fostering innovation in digital health.

Sidebar

I finished the day with a completely nerdy moment – sourcing a library card and time in the ‘Main Reading Room’ of the USA Library of Congress. For those of you who have visited DC, you’ll remember glancing down from the upper circle to the reading room floor; researchers studiously digesting the 20,000-something volumes accessible from the catalogue. I picked a memoir penned by Churchill’s most trusted advisers – “Action this Day” is a collection of thoughts, musings and memories from Sir Winston’s close-knit crew. Written by folks who knew him through testing times, moments of vulnerability, greatness and strength. This experience was a highlight for me so far.

What’s next?

I’m sitting at Washington Dulles Airport, close to boarding time for a Heathrow stop-over and then onto Oslo, Norway. That’s all for now and I’ll check in next week for stop no. 2.

CBS.