As a serial entrepreneur who takes businesses from conception to reality, Moses Zonana is always searching for new areas to make a powerful impact. With a strong background in health care, telecommunications and technology, Zonana used his diverse expertise to develop the mobile health technology solutions provider, CMT. As the former CEO of a regional mail-order pharmacy called Reliance Meds, he came up with the idea for CMT after he recognized that the industry was simply supplying and refilling medications, without knowing if patients were taking their medications as directed. After much research, he used his telecommunications and technology experience to create a portfolio of solutions that would connect stakeholders, pharmacists, physicians and caregivers in the continuum of care, so patients would achieve better results.
How did you get into the industry?
As a serial entrepreneur, I have always been searching for areas where I can make an impact. Prior to being in healthcare, I founded a telecommunications company that offered unlimited voice services to credit-challenged users; we were at risk when users stayed connected for more than the expected number of minutes used in our financial models. We had myriad reports and dashboards in which we tracked usage every hour and every day to manage risks and calibrate future pricing accordingly. As I embarked in the healthcare space I was managing a high-volume pharmacy servicing patients with chronic conditions. I noticed that the pharmacy dispensing industry’s focus had mainly been concerned with dispensing medications without a real regard to whether patients were taking these properly and that pharmacies had purely evolved to be distribution outlets. The more I researched if there were any tools to measure if patients took their medications as prescribed in between refills, I realized there was a total vacuum for such solutions yet numerous providers alluded to huge clinical implications when patients don’t take meds correctly. Implications that ranged from therapy resistance, triggers to the emergency room, overprescribing of medications and even deaths. Without visibility of outpatient medication utilization patterns, providers simply couldn’t take care of patients and engage these to stay on-track to achieve optimal outcomes. Misaligned incentives between churning medications in pharmacy dispensing operations was a clear area of opportunity. I decided to apply the paradigm of metering utilization patterns in a similar way that we used to track usage in telecommunications to be able to help patients stay on track and achieve better therapy results. To do so we created a fully connected smart dispensing device connecting stakeholders in the continuum of care which included the pharmacist.
Personally, I have struggled with taking medications, often taking more pills than prescribed or missing doses. Also, I observed my parents struggling for years to monitor a sibling taking behavioral health medications. Low visibility frustrated the family dynamic for years. It became my mission to deliver a service that could impact patient’s living with conditions where insights and improvements could have an impact.
Any emerging industry trends?
There have been several developments in technologies such as artificial intelligence, virtual reality, and wearable technologies that will change the healthcare environment. Some of these innovative technologies can be used to gather clinical data for providers and enable patients with tools to better care for themselves. Data analytics and intelligent deep learning tools can help providers quickly review published literature, cases, plan carefully, set benchmarks, monitor performance and make better judgment calls where clinical tradeoffs are imminent. Many studies allude to north of $300 billion in U.S. healthcare potential savings from helping patients stay on track with their therapies. The number is miniscule considering the potential from better therapies, better allocation of resources, better reach by providers, higher efficacy rates, and lower adverse events expected from new precision medicine therapies. This is considering that in the U.S. alone, annual healthcare spending tops $3 trillion dollars.
Any industry opportunities or challenges?
Introducing a new product into an established slow-moving industry has been incredibly challenging. Decisions are made by committees and incorporate many different divisions in an organization for the technology to be used to its full potential. Managed Care Enterprises and Pharmaceutical companies don’t have much operational control of the dispensation of medications, even if they pay for them or manufacture them (in the case of Pharma). Pharmacies don’t have the economics to be the end client, instead they act as distribution intermediaries. Providers, on the other hand, prior to ACA, lacked any economic incentives for quality of care and were primarily incented on quantity of care. The introduction of powerful tools requires not just buy-in from multiple internal groups, but also the establishment of alignment between the distribution, the reimbursement structure, and the caregivers ecosystem. Our vision is much more ambitious than what we have been able to accomplish to-date. Investment cycles are challenging considering long gestation periods in the healthcare technology deployment.
Inspiration for the business idea, and your vision for the Business?
We believe that there is a better way of managing medication habits and collecting patient insights in the outpatient setting. Before CMT there were no fully integrated offerings to monitor medication intake in between refills in real-time. These insights enable tactical interventions that can prevent hospital readmissions, emergency room visits and even deaths. The inspiration is to connect those who care; outcomes should not be limited by suboptimal habits, its only limiting factor should be available scientific discoveries and treatment options.
What's next for the Business in the near future?
Our portfolio of solutions targets numerous verticals. We have engineered our platform in a modular way to continue to expand its applicability to numerous additional use cases. We are expanding communication linkages between stakeholders and introducing additional device options for seniors undergoing heavy polypharmacy therapies.
Your key initiatives for the success of the Business?
Modularization of our technology has been key to our success; we can tailor our tools to different delivery ecosystems and enterprises. In-house engineering teams have been crucial to attend to client needs rapidly and constantly. Incorporating health care savvy investors has been incredibly important to sustain the long gestation periods. Partnering with the right distribution companies has provided important exposure and access. Integration with other systems empowers data management flows that could not be accomplished otherwise. Being flexible on pricing and project design structure has led to many seeds planted across different big name institutions.
Your most difficult moment at the Business? (and what did you learn?)
I would say that the biggest challenge to-date has been to persuade an industry filled with large entities, red tape, and zero tolerance for risk to embrace a new technology that was not incubated or commercialized by another 800-pound gorilla entity. We have spent, I would say, as much time innovating as we have building the paper trail and procedural machine that such an environment demands. That process has been taxing, but a necessary activity in the industry. Barriers to entry are high, we have been fortunate enough to entice experts to join, have the right investors, and an enough patience and stamina.
It is a long slog from having a working product to being allowed for it to be delivered to patients via big enterprises as a conduit.
Ideal experience for a customer/client?
We recognized that no one solution fits all use cases. CMT tools combine unique features and attributes that can be utilized in various settings. In the ideal experience, we have a dedicated team, we map the objectives collectively, include all necessary stakeholders in the work and data flows to benefit patients.
How do you motivate others?
Leading by example is my style at CMT. Demonstrating a willingness to work hard and get your hands dirty sends the message that we are all in it together begetting a good team dynamic, all striving to improve patient health outcomes, which serves as the best ingredient for motivation.
Career advice to those in your industry?
I have been involved in many startups, they take a life of their own, many fail, some work out, few get to be home-runs. The odds are against you. Only take on challenges that you feel passionate about as there will be many question marks, lonely days and setbacks. Ultimately, if you are not passionate about the endpoint you will not enjoy the process and it will be difficult to deliver on the mission. Obviously in the rare cases where success occurs quickly, this breeds more success like a virtuous cycle and additional opportunities for which you may be passionate about in the future.