Serafina:  Hi I’m Serafina Lalany and this is The BusinessMakers Show.  And we’re coming to you today from the Texas Medical Center Innovation Institute and I’m here with my guest Stuart Ward, CEO of Ward MM.  Stuart thank you so much for being here today, we’re excited to have you.

Stuart:  Thank you so much Serafina, it’s really nice to see you again and I’m looking forward to this interview.

Serafina:  So tell me, where is Ward MM today?

Stuart:  We are a precision medication management company.  We’ve come over from Australia, we’ve seen an unmet need here in America and we’re looking to expand geographically.  We’re trying to prevent adverse drug reactions which are problematic; it’s the fourth largest killer in America and we’re looking forward to helping the American people with their medicine management.

Serafina:  From what I understand and for the education of our viewers, medication management, can you delve a little deeper into what that really is?

Stuart:  In the demographics that we work in – people over 65 years old that are taking lots of medicines regularly – anything above 8 to 13 medicines.

Serafina:  So we’re talking the aging population?

Stuart:  Yeah, the aging population which is – it’s getting older; we’re getting older as an older nation.  There are a lot of complications that can occur with medicines; they can interact against each other and they can cause hospitalizations or falls.  So we look to rationalize those medicines through clinical analysis and just making sure that we get all sorts of biology information to make that analysis, including DNA, which is really kind of a disruption.

Serafina:  There’s that precision medicine piece of it.

Stuart:  Absolutely.

Serafina:  Was that a recent addition to the model?

Stuart:  Absolutely.  It’s been in the last few years that we’ve discovered this sort of ability to metabolize DNA in terms of medicines and what your body can and can’t take.  So we apply that to our analysis and it really does help, because you start to see dosages as being problematic, and to be able to help doctors be able to make a much better decision for the patient and deliver better outcomes.

Serafina:  The way I understand this problem this medication management happens in 3 stages – and correct me if I’m wrong because you’re the expert here – it’s at the prescription level, it’s at the adherence level and it’s at the reconciliation level.  Am I missing any part of this equation?

Stuart:  No, that’s very accurate so well done.  So one of the big things that we do at the start is our clinical pharmacist group goes around getting the patients’ objectives; some people may be about reducing their medicines, some might be under or over dosing at the moment.  And what they do is they go through a very high touch service and they look through the medicines and they just ensure that they’re taking the right sets of medicines to start off with.

And then what they do is they go in and advise doctors, discuss it with them to sort of work within a multi-disciplinary team, but also that allows customers to be engaged with their medicine regime.  The second part of it you could talk about is medication adherence.  If you lower the number of drugs that are people are taking they’re more likely to adhere to it.  If you try and consume 8 to 13 medicines it’s quite a task to do.

Serafina:  8 to 13?  That’s an astonishing number.

Stuart:  it’s very dangerous, there are 150,000 preparations out there in terms of medicines and anything over 8 can have up to 200 co-interactions which is just scary.  But the good thing is that by being able to rationalize that for the doctors and plot evidence-based outcomes and just being able to explain that in a clinical sense doctors do respond very well to that.

Serafina:  They love the numbers.  So communication, is that happening virtually?  Is that face to face?  How does it work?

Stuart:  It works over the phone or face to face.  Over the 2,400 doctors that we’ve serviced in Australia we’ve got a wonderful re-referral rate of 98%.  That means that they’re coming back to get more information and to be able to see more of their patients, which is really good.

Serafina:  I don’t know anything about the medical system or the healthcare system, how complex it is compared to the American mess that we have today to be quite honest.  How do you compare medical systems and how are you taking the technology that was born in Australia and how are we applying it here?  What kinds of tweaks and changes have you made since crossing that bio bridge?

Stuart:  Unbelievably – or believably – both countries have very similar health systems, especially in the elderly population, and what we’ve discovered is that we can help because we have had this experience of over 20 years of operating in this environment.  The great thing is in Australia we had a review system put in by our government for medications to rationalize it as part of a program founded in 1997.  In America it’s been a little bit of a slower uptake, but now we’re starting to see what we call MTM companies really starting to take advantage fo this sort reimbursable amount of fee that’s paid to rationalize medicines.

Serafina:  The more you say rationalize medicine, the rational use of medicines, I’m thinking back to the WHO initiative for rationalizing medicine.  Is that maybe the first global push?  In your experience what was it that triggered the need?

Stuart:  The big thing was medication safety, which is to do no harm.  Ward’s vision is about eliminating medication-related harm and it’s very attuned to that.  And that‘s what the World Health Organization was really trying to target at that point.  Over the last 10 years there was something like 75% less medication around, so in the last 10 years we’ve seen an explosion in terms of different medicines and that comes with technology.  So this is definitely an area that we’re very passionate about and we want to help people in especially the senior market because they’re the ones that are taking the most amount of medicines at this stage and the disease states are very complex these days.

Serafina:  Right, and there are economical implications of this as well.  Can you say a little more about that?

Stuart:  There’s about $21 billion of preventable medication errors according to some studies.

Serafina:  Wait, rewind, what was the number?

Stuart:  $21 billion.

Serafina:  $21 billion.

Stuart:  So we see our opportunity as being able to help that and remove waste from the system for America.  Not only that, it’s just the socio-economic impacts as a person taking an adverse amount of drugs and suffering from that, you remove all that pain for a lot of families as you can imagine.

Serafina:  And the pressure from their caretakers as well.  The implications are endless of the psychology.

Stuart:  Well the nurses get a lot of help because of the education around storage, administration.  Through our service we’ve been very passionate about the quality use of medicines, which has been established since 2002 in our company.  So we understand the challenges that are ahead, it’s very complex, but we’re also helping to make sure that that’s a really strong part of the process that we roll out as part of our business.

Serafina:  Where do you see Ward MM going in the next 5 to 10 years?

Stuart:  We really want to move what we call the pre-prescribing needle.  At the moment our service is post-prescribing.  But with the use of algorithms and with machine learning and the capability of now big data, we can actually move the care to pre-prescribing which allows the doctor some time to prescribe with the information that they need rather than kind of trial and error after the fact.  So once the prescription has been written and that’s been filled people can suffer an adverse drug reaction or a medication error and it’s too late.  So what we’re trying to do is to move that curve and that’s where we see the best opportunity and a real disruption to the market.

Serafina:  That’s awesome.  So what I’m hearing is that Ward MM is trying to move upstream by enabling data analytics and machine learning, which I’m going to ask you about later because I hear so much about machine learning, but I want to break it down for our audience what that really means to work more proactively against medication abuse.

Stuart:  Medication errors?  The thing is doctors don’t mean to prescribe – there’s so many different preparations that I mentioned before.  At the moment our systems are what they call binary, so that’s not a multi-variant analysis, it’s just a match one to one.  So I gave you some statistics before, about 150,000+ medications or preparations that are out there and then 8 to 10 current drugs that are having 200+ c-interactions.

So if you had a binary itemization on that it’d be something like 150,000 to the power of 200, which is ridiculously complex and obviously almost humanly impossible to calculate within the 2 minutes that I’ve got to consult.  But now with machine learning and being able to calculate the numbers and make sure that these recommendations and taking multi-variant analysis we can see technology will really help in this space.  And with the visualization of evidence-based outcomes we can clinically predict what’s going to happen to that patient on a set of medicines and what those best recommendations will look like.

Serafina:  So precision medicine is happening on multiple levels here.

Stuart:  Absolutely.  We’re using genotyping, which is your metabolism rates of medicines as I mentioned before, but there’s a whole host of things.  Pathology, the call of clearance – how quickly your kidneys clear things out; just lots of items that we look at; we call it 11 Point Quality of Life Scale which is a patented thing that we’ve got across the world and it’s something that we’re real proud of.

Serafina:  What are the 11 points?

Stuart:  Well there are height, age, weight; you’re talking about patient objectives, side harmful effects that are probably not scaled as much.  So what I would describe that as is if I’ve got a rash and the medicine I’m going to take on top of that to solve that rash will cause me to have hospitalization then it’s best just to put up with that rash; something that’s really, really relevant for the patient’s quality of life.  And that’s one of kind of the major points of what we call the Quality of Life Scale that we look at.

Serafina:  Take us back to the beginning, what gave birth to Ward MM?

Stuart:  My mom, who is a clinical pharmacist, started off in 1997 doing the first reviews 20 odd+ years ago and she would passionately talk about how she’s helped people in removing dangerous medicines.  For the last 20 years I’ve been hearing it and she actually came up with the idea of wanting to move to a Cloud-based system because we saw so much power with data.

And that’s where I got passionate and I started going to all the nursing homes, I’ve visited pretty much all of the facilities that we look after and I was just touched at the amount of work that those nurses do and the people that are affected by it.  I just felt passionate about changing their lives for them because it’s quite, quite large and problematic as you can imagine with all the medicines.  And we’ve made a big difference since 2013 where we established the Ward MM business model using Cloud-based applications and analytics and taking all the data to be useful for research.

Serafina:  Finally I’m keen to learn what is your take on the market here in Houston?  Because you are a recent transplant from Australia, so what was it that attracted you to the biotech scene here?

Stuart:  We were just excited to be part of the Texas Medical Center innovation.  It’s been fantastic here to connect with so many health practitioners and just really brilliant people.  And we can see how complex the health system is and we can actually make a difference here and that’s the most important thing because it’s a real humanitarian job.  We look at it as we really care about people first and that’s what attracted us to Houston.  Obviously the economy here is very attractive, but first and foremost there’s a lot of people taking medicine that are really high dosages and incorrect dosages and subzero practice approaches that we can help.  And we saw that as a great opportunity to kind of expand into helping more and more people.

Serafina:  Well thank you Stuart for enlightening us today about Ward MM and all that it has to share with the world.  It’s been such a treat to have you here at the show.

Stuart:  Thank you so much Serafina, it’s an absolute pleasure to be here

Serafina:  Well that wraps up my interview with Stuart Ward, CEO of Ward MM.