Humanising healthcare through technology

An early exposure to computer science by way of the Commodore 64, combined with subsequent medical studies, set Roberto Ascione on the path to combining healthcare and software. He tells Dominic Tyer how this background led to the formation of his agency Healthware and continues to power its expansion.

Over the last two decades medicine has been hugely transformed through technology in a series of advances that show no signs of slowing. For Roberto Ascione, CEO of the Healthware Group, delivering on the possibilities of digital health is in his company’s DNA and continues to drive their work.

“It is a source of excitement every single day, because all the different ways technology could add value to medicine are exactly what I had in mind when I started. Now, it’s incomparable to where we were so many years ago, but there’s still a lot to do.”

Healthware was founded in Naples, Italy in 1997, when adding value to medicine was the end game Roberto had in mind, but it was one he wanted to be framed in terms of things like improving the circulation of data and facilitating better physician decisions.

Healthcare + software

The path towards setting up the company seems, in retrospect, a very natural one. Roberto was born into a medical family, where his grandparents were physicians and his father was a prominent hepatologist.

But perhaps a more important step towards forming Healthware actually came from Roberto’s early introduction to the Commodore 64. The 8-bit computer was launched in 1982 and for most childhood users was more commonly associated with games like Boulder Dash, Maniac Mansion or Elite.

However, on receiving the computer aged 13, Roberto was immediately attracted by its coding possibilities, with his early efforts showing his family’s influence as he gravitated towards medical matters, such as developing small medical questionnaires.

“I was ‘polluted’ early on with a passion for computer science,” he says smiling, noting the PC came well before he decided to train and study as a medical doctor. “I come from a family where many family members were physicians and as a kid I was inspired by this. Then, when deciding what to study, I felt a deep connection to medicine’s ability to help people.”

From there the tension between his passion for computer science and his medical studies made a move into digital health a natural next step.

“At some point during my medical studies I realised that everything around me was analogue. I have a vivid memory of thinking that if I become a physician I’ll need to treat patients one by one in a paper-based environment. So, even if I’m a good doctor, the impact I’ll be able to have will be maybe a few thousand patients over my career. My ‘a-ha’ moment came when I realised that if I write software for physicians, then I can be a much more impactful physician.”

Today it seems a logical observation, but in the 1990s Roberto says he was seen as “somewhere between crazy and stupid”, with the consensus being that focusing on becoming a doctor was the most sensible path. “I clearly remember people saying, ‘Computer science and medicine will have nothing to do with each other’ and ‘doctors will never use computers, will never put data into a machine’, though you have to remember that this is more than 20 years ago.

“But, when I explained the idea of the impact to my father, even though he thought the chances were that this wouldn’t happen, he said it was worth trying. That encouragement was very important to me in being given the permission to fail. And when I started to code medical software I quickly realised it was my real-lifetime passion, and Healthware was born in 1997.”

Solving real problems

The agency began with a team that mixed people studying medicine and coding, mirroring Roberto’s twin passions. Realising the importance of data and the wealth of information that was locked inside paper-based medical records, Healthware’s first endeavour was an electronic medical record. But it was slow going trying to target hospitals, which were not then interested in the concept. Then a switch to linking electronic medical records to research, medical education and patient education began to get a lot of traction.

“We flexed our muscles in the first two or three years mainly on the software side, but then the software, per se, was not solving any problem. So, we realised that we needed to apply these tools to real problems that people have, which is something that the company is still largely based on. That is what brought us into communications and basically morphed us into, mainly, an agency, which we still cultivate as our core business.”

As adoption of the internet spread and its uses expanded at the turn of the millennium, Healthware started looking at how the web could be harnessed to spread medical information to patients and empower them through the availability of content and the provision of services. “This led us to building some of the first disease awareness websites in late ’99, early 2000. And very quickly, we became what today you would define a digital agency.”

During that time the Italian agency quickly grew internationally and within four years most of its work was outside its local borders. As it did so it moved to a new base south of Naples.

During the Middle Ages, Salerno prospered under the rule of the Lombard Dukes and was renowned as a centre of medical studies and learning through its prestigious medical school. Healthware’s current base at the Palazzo Innovazione is right in the city’s historical centre, just a stone’s throw from the terraced Minerva’s Garden, has been growing medicinal plants since the 14th century.

Its work, however, continued to be right up to date, with a focus on websites and support for clinical trials, disease awareness and healthcare professional portals that saw Healthware broaden its internal capabilities, adding creative and content generational roles. Then, as search engines came to the fore, it was an early practitioner of SEO and digital media. By mid-2006, it had become a large-scale healthcare agency focusing on all varieties of digital.

Still located in its original base in Salerno on the Amalfi Coast, the agency kept expanding, first to Milan and then Rome, and then further afield to London and New York. Along the way Healthware was acquired by Publicis in 2007 and then underwent a demerger in 2015.

Innovation and collaboration

From intense early days spent coding to its subsequent development into an international digital agency, the last five years have seen Healthware “really be bold about digital health”, Roberto says.

After leaving the Publicis network, Healthware created a global joint venture with US-based pharmaceutical marketing agency Intouch Solutions. Both agencies have a digital background and a deep innovation mindset, Roberto explains.

Another key development for the agency’s future began in 2009, as Healthware started developing increasingly close links with the digital health start-up ecosystem.

“We’re doing this in multiple ways. One of these ways has been to start investing into early-stage digital health start-ups. Further down the road, we started discussions with VC firms and found a very strong alignment with FII Tech Growth, which is the leading Italian tech growth VC and invests in Italian-originated companies that are scaling globally.

“That was perfect for us, and so we came together to form Healthware Ventures, which is a corporate venture capital vehicle for investing in digital health start-ups, but in a more structured way than we had been doing before.”

Allied to these developments was the Healthware Life Hub, which was set up when Healthware moved into the Palazzo Innovazione in 2018. It’s an innovation hub where pharmaceutical companies or medical device teams connect with Healthware, and sometimes start-ups as well, to run co-creation sessions.

“The Life Hub really allows for ‘cross-contamination’ between healthcare companies, designers, coders and start-ups, to come together and accelerate and boost projects and ideation. We want to keep cultivating the culture at this place.”

The group’s expansion has also seen it launch innovation agency Healthware Labs and digital media arm Healthware Engage. With all these expansions, Roberto says the best way to describe the Healthware of today is as “a next-gen healthcare consultancy”.

“We live in a complex world where healthcare is being transformed so radically by technologies that in order to stay relevant as a service organisation to the life sciences industry, we needed to transform ourselves. That’s why we took what was great and good to the core business in the agency, and amplified and augmented it.”

Another important initiative for the agency is Frontiers Health. Now in its fourth year, Roberto has been chairman – and Healthware its co-host – since the digital health event’s inception. This year it will return to Berlin in November, when its digital health themes will include digital therapeutics.

“We believe that digital therapeutics will truly be an entirely new wave of medicine. Frontiers Health has been covering digital therapeutics as one of the main focus areas since the first edition. And, when a few pioneers in the industry came together to form the Digital Therapeutics Alliance, I was super happy to join as a founding advisor.

“At Healthware, we want to partner with digital therapeutics companies, whether they are start-ups or large-scale pharmaceutical companies, and we are proud to be so entrenched in the digital health ecosystem and particularly the digital therapeutics one.”

Humanised healthcare

When Healthware was set up medicine and technology might have been seen as separate entities by many, with little evidence that the web would come to be so dominant generally, and influential in healthcare. When it did so, Healthware – with its foundations in healthcare and software – found itself at the epicentre of that transformation. Since doing so it’s remained true to its original mission.

“Our core vision is leveraging digital technologies to improve health outcomes. True to that, we believe digital technologies are the key force behind the transformation of healthcare, but we don’t see a future of ‘techno-medicine’, it’s going to be about a much more humanised healthcare, thanks to the technologies that will more and more permeate and underpin medical and healthcare practices,” Roberto says.

“It’s super important to everyone that works for Healthware to focus on finding solutions – whether they are creative, technological or data-driven, or a combination of all three, to improve patient outcomes. This is really our core value. And I can comfortably say that we have been true to this throughout these 20 years.”

About the Interviewee

Roberto Ascione is the CEO and founder of the Healthware Group. He is very active in the digital health ecosystem in various advisor capacities, both in Europe and in the US, to companies, startups and investors. Among others, he has been recognised as Decade’s Best Industry Leader by Health 2.0 Conference – 10 Year Global Retrospective Award in 2016, nominated Transformational Leader at the 2017 PM360 ELITE Awards and named among the 100 Most Inspiring People by PharmaVOICE in 2017. He is founding member of the Digital Therapeutics Alliance, past President of the Health Tech Summit and he is chairman at Frontiers Health.

About the Author

Dominic Tyer

Dominic Tyer is a trained journalist and editor with 20 years of pharmaceutical and healthcare publishing experience. He serves as a contributing editor at pharmaphorum media, which facilitates productive engagement for pharma, bringing healthcare together to drive medical innovation. He is also creative and editorial director at the company’s specialist healthcare content consultancy, pharmaphorum connect.

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