00:00:00
Voiceover: 100 days to success is the podcast from G_NIUS, the Guichet national de l'innovation et des usages en e-santé. Around Lionel Reichardt, meet healthcare innovators and key experts to help you succeed in your projects.

00:00:21
Lionel Reichardt: Hello everyone and welcome to the 100 Days to Success podcast. In this episode, we'll be talking about referencing an innovative solution with a central purchasing agency, an extremely important step in the development of a start-up. To this end, we welcome Guillaume Fayolle, co-founder and CEO of Nouveal e-Santé. Nouveal e-Santé is a service designed to improve patient care, by digitizing care paths through the digital innovation of connected medical monitoring. We'll also be welcoming Olivier Xicluna, head of purchasing for the digital and healthcare sector at UniHA, the Union of Hospitals for Purchasing. UniHA is the leading cooperative purchasing network for French public hospitals. Guillaume Fayolle, hello and thank you for accepting our invitation. You are co-founder and CEO of Nouveal e-Santé. Could you tell us about your background and training?

00:01:16
Guillaume Fayolle: I'm Guillaume Fayol, co-founder of Société Nouveal. My background is in service companies, digital service companies, as they're called. It's true that I've been interested in the digitization of all corporate processes in the past, and that's what actually led me to create Nouveal, which this time focused on healthcare facility processes.

00:01:44
Lionel Reichardt: During the health crisis, you made a name for yourself with Covidom, an app that enables doctors to monitor COVID-19 patients remotely. What services exactly does Nouveal e-Santé offer?

00:01:54
Guillaume Fayolle: At Nouveal, we're convinced that the patient experience and pathway logic are the major issues in the transformation of today's medical organizations. We are responding to these challenges of patient experience and patient support through digital innovation, which puts the patient at the heart of the process. This is how we came to design and develop digital solutions, notably e-fitback and Covidom, for remote patient monitoring in a variety of pathologies, including outpatient care, maternity and COPD, and more recently, epidemiology with the Covidom solution. These solutions are marketed to private and public healthcare establishments.

00:02:35
Lionel Reichardt: Your solutions are used by healthcare establishments, often governed by the French Public Procurement Code, which use central purchasing agencies for product referencing. How do you approach these establishments and purchasing groups when you offer an innovative solution that is not yet known?

00:02:50
Guillaume Fayolle: That's an excellent question. It's true that addressing central purchasing agencies is a long road. Perhaps I could take you back over our history and our marketing strategy to illustrate how we came to be talking to central purchasing agencies today. What we've learned is that when we launched Nouveal in early 2015, we were very innovative when it came to digitalizing the patient experience. As a result, we had to focus on healthcare establishments that were also pioneers in this field and were committed to this approach. These were mainly and essentially a small number of private establishments. That's why we worked with them, which enabled us to demonstrate that the solution was relevant, that it provided real value for both patients and healthcare professionals. It wasn't until 2019 that public establishments really took an interest. A study was also published in early 2020; currently, only 40% of healthcare establishments were truly committed to the patient experience. To respond to this problem, before 2019, we worked particularly closely with some public establishments, to conduct studies with them and to demonstrate real value and be in a position to address our solutions, to present them to central purchasing agencies.

00:04:27
Lionel Reichardt: Some establishments can be described as early adopters. They test innovative solutions and participate with proof of concept. Is this a lot before turning to larger establishments and central purchasing bodies?

00:04:39
Guillaume Fayolle: All right. The aim of carrying out these studies is to be able to work with players in the public sector, with KOLs who, once the study has been carried out, will be able to produce publications and demonstrate the benefits of implementing this type of solution, known as a patient support solution, whatever the pathology. This is the point that enables us to address central purchasing agencies, who, like all our customers, are also discovering these new solutions and innovations on the market, and who need, at some point, to be able to say: "Finally, what are the best solutions? Which ones are emerging on the market? Which ones are relevant? Which ones will endure over time?"

00:05:34
Lionel Reichardt: What did you do when you realized that these establishments were often governed either by the Public Procurement Code or by central purchasing bodies? How did you go about training and informing yourself about the procedures to be respected in order to be referenced by these establishments?

00:05:47
Guillaume Fayolle: For our part, my partner and I had previous experience of public procurement, having responded to invitations to tender that weren't related to the healthcare sector or healthcare establishments. We were well aware of the mechanisms involved. We knew a little about them. We had to look more closely at these elements for public-sector establishments, which also have a particularity in that it's not their job to issue invitations to tender. In general, they concentrate on patient care, on the medical side of things. The administrative side is not always well developed in all public structures. And that's where central purchasing groups come in. They support them and do this work for them, to make their lives easier.

00:06:36
Lionel Reichardt: Usually, these central purchasing agencies and establishments tender for drugs and healthcare products that have been around for a long time. At Nouveal e-Santé, your solutions are innovative. How do you feel about writing specifications and responses to calls for tender?

00:06:49
Guillaume Fayolle: This is where the very, very long process begins with central purchasing agencies, between start-ups and central purchasing agencies, or in any case, start-ups and large structures. We don't live on the same time scale. In start-ups, we react from tick to tock, we're very, very quick, we live on a scale of a second, whereas entities, whether establishments or central purchasing bodies, which are larger in size, live on a scale of a month or a year, with larger budget structures. After that, the difficulty for central purchasing bodies is to be able to apprehend both the solutions and the business issues at stake, the return on investment provided by the solutions, and the fact that there are sometimes several solutions on the market. It's a question of how to go about drawing up specifications, how to structure the need, or at any rate the invitations to tender, so as to be able to say: "When I get responses, am I going to be able to show my healthcare establishments, when I'm a central purchasing agency and I'm a customer, that the solution I'm providing does indeed meet their needs?" I think that's where the difficulty lies. There's also the whole business model part. Start-ups are very innovative when it comes to business models and innovative financing models for solutions. For central purchasing agencies, this can be a difficulty, because this model is not necessarily adapted to their way of thinking.

00:08:29
Lionel Reichardt: Deals are sometimes taken over a long time, over several years. For start-ups, does this complicate price and referencing negotiations?

00:08:36
Guillaume Fayolle: It all depends. When it comes to buying groups, they all have their own membership models, or mechanisms for buying and reselling the solutions they offer. As for us, it's true that when we respond, we display the business model we use at Nouveal. After that, there are bound to be discussions to understand it properly and present it well in these catalogs and referencing.

00:09:09
Lionel Reichardt: How do you find out which central purchasing office to contact? How do I find the right contacts? Is it complicated? Are there places to facilitate contacts between start-ups and central purchasing bodies?

00:09:19
Guillaume Fayolle: It's true that it's more with our first customers in the public sector that we've had these exchanges, that they've given us contacts and referred us to central purchasing agencies. They identified a certain number of central purchasing bodies with which they were working and are working. They also gave us contacts so that we could exchange ideas with them and see how we could move forward with the referencing and cataloguing of our solutions, which actually takes time because each central purchasing agency also has its own strategy for publishing contracts, with contracts that are ongoing, sometimes for four or five years, and for which there will be renewals. Then, for others, it's a complete new catalog with new services. That's what takes the longest, because as you said, these contracts can last for several years, four or five, so what's important for them is to check that the structures that will be referenced will be able to continue for the entire duration of the contract.

00:10:26
Lionel Reichardt: Support schemes for innovation are set up by the State, notably the Digital Hospital program. Does this type of program encourage the referencing of innovative solutions in healthcare establishments and purchasing groups?

00:10:37
Guillaume Fayolle: In a way, you could say that this encourages referencing because hospitals get funding to move towards new services that are often digital. This was the case with the Open program and the implementation of online payment and online pre-admission solutions. Inevitably, these healthcare establishments, from the moment they submit an application for this type of solution and obtain funding, will be keen to implement these new digital solutions. They're going to call on start-ups, and we'll be able to go back to the central purchasing agencies and tell them that we have a certain number of prospects and the public identified who are probably referenced with them and for whom there would be purchase orders and projects in the wake.

00:11:33
Lionel Reichardt: You mentioned the importance of conducting proof of concept, patches with healthcare institutions. In fact, Nouveal e-Santé has grown thanks to this type of proof of concept, particularly in the field of oncology. Is it important to work with a healthcare establishment that allows you to test and develop your services?

00:11:48
Guillaume Fayolle: Yes, yes, it's important that we have entry points, one person or several. It's often a medical team that trusts the start-up to deliver a service of professional quality, because there are medical issues at stake for patients and healthcare professionals. This is of great interest because behind these projects, we have real success stories that are shared by the healthcare establishment, by the service, by the people, the medical teams, by the teams in the start-up and it's often put forward by these healthcare professionals who will discuss with their colleagues in other services, which will help spread these innovations and the results of the studies.

00:12:48
Lionel Reichardt: What kind of requirements do central purchasing agencies and healthcare establishments have of you? Administrative, regulatory, financial?

00:12:55
Guillaume Fayolle: The requirements of these interlocutors on referencing and solutions essentially concern subjects that are not of today, but notably respect for privacy, the notion of RGPD, the notion of product quality. We're often involved in qualitative systems, with compliance with standards. But do we also have the financial resources to support projects that could take a long time? Do we have the organizational base? Are we sufficiently structured? Do we have the capacity to deploy large numbers of people on sites? We address all sizes of healthcare establishments, whether private or public. In the private sector, we may have small structures where a start-up can work directly and quite easily. But we can also have large private groups. We know of some in the region that have more than 10, 15, 20 or 100 establishments. You have to be able to deliver. For the public sector, it's exactly the same thing. Hospitals or university hospitals in territories with GHT organizations. You need to be able to organize yourself, to work over the long term, but also to be able to accelerate. That's what's important. When you deploy one, two, three, four or ten public establishments in a GHT, you have to be able to accelerate and ensure that the project can be deployed within a reasonable timeframe.

00:14:36
Lionel Reichardt: Over the years, how have you organized yourself to structure your tender watch and increase your presence at conventions and trade shows?

00:14:42
Guillaume Fayolle: For our part, we at Nouveal very quickly structured the company like a conventional software publisher, in that we set up a marketing and communications department whose aim is to market the product on the one hand, but also to work on relationships with these organizations, to find partnerships. They enable us to communicate and display ourselves at trade shows, to have our own stand, particularly at major trade shows that take place every year in the healthcare world, but also to be close to hospital federation organizations, whether private or public, and to be present at their trade shows and address private and public hospitals, but also to attract them, to make them understand that we're there and that we're listening to them to support them on their projects.

00:15:42
Lionel Reichardt: Summing up Guillaume Fayol, what advice would you give to a project owner looking to have their innovative solution referenced within a hospital purchasing group?

00:15:50
Guillaume Fayolle: So, I see several axes. The first, and this may sound very silly, is to get started very, very early, because it's a long road, as I've told you many times in this interview. You have to be able to demonstrate that the product makes sense. You have to try to meet them, whether it's central purchasing agencies, but also all the public and private establishments, all the potential prospects of a start-up, to evangelize the solutions created by these start-ups and encourage these exchanges to help them understand why these solutions have been developed, for whom they are intended and, above all, with what business model and why this business model is being implemented. The project as a whole has to be understood by the various players, so that they can understand it, but also help others to understand it. That's the first point. It's all about getting started early, and making your innovations known. To do this, there are also innovation clusters that enable start-ups to work and promote themselves within these clusters. We know of a number of them in the region, whether specialized in healthcare or other sectors. Potentially, these clusters are players with the capacity to meet our prospects, who have networks. It's interesting because they play the role of intermediary between start-ups and innovation, and potentially markets that could be likely to contract with these start-ups. The last point, as we discussed, is also to carry out POCs, because POCs enable us to demonstrate the reality of the product, what it brings to the various stakeholders, and to ensure that, with success stories, we are in a position to industrialize the product and its marketing, based on these POCs.

00:18:15
Lionel Reichardt: To find out more about this topic, we welcome Olivier Xicluna, head of purchasing for the digital and healthcare sector at UniHA, the Union of Hospitals for Purchasing. UniHA is the leading cooperative purchasing network for French public hospitals. It currently brings together 972 hospital establishments. Hello, Olivier Xicluna. Could you tell us a little more about UniHA?

00:18:38
Olivier Xicluna: I have 10 years' experience in the Casino group within the central purchasing department, in mass distribution. After that, I spent 10 years as purchasing director for two companies, one specifically in mobile telephony and IT, based in Marseille, which was Avenir Telecom; then five years at CMA CGM, which is one of the world's largest shipping companies, based in Marseille, where I was also in charge of the IT purchasing department and so I joined the digital and digital health sector three years ago at UniHA to take charge of digital transformation and purchasing for hospital establishments.

00:19:21
Lionel Reichardt: Purchasing by healthcare establishments is governed by the public procurement framework. How can an innovative solution gain access to these establishments?

00:19:29
Guillaume Fayolle: UniHA is a purchasing group and also a central purchasing body which today groups over 1,000 hospital establishments into 16 purchasing families ranging from healthcare products, drugs, biology purchasing, biomedical engineering, general purchasing with office automation, IT, energy, human resources and hotels and catering. In fact, we cover all the purchasing segments that are useful in hospital establishments.

00:20:09
Olivier Xicluna: For this, we're organized on a regional basis, with purchasing channels for each product family that are always made up of purchasing experts and business experts within the establishments. We are also supported by a network of ambassadors who are present in the regions to liaise with our establishments.

00:20:34
Olivier Xicluna: UniHA is one of Europe's leading healthcare buyers and the first in France.

00:20:44
Olivier Xicluna: Our vocation is to be a facilitator between healthcare establishments and suppliers in order to mutualize all purchasing for establishments that join the group.

00:20:56
Lionel Reichardt: What is the process for referencing an innovative solution within establishments? What difficulties do you encounter today?

00:21:06
Olivier Xicluna: In reality, UniHA's objective is always to gather needs as close as possible to the facilities and to be able to make the link with what exists on the market, with suppliers. What we like to do, especially when it comes to innovative digital solutions, is to set up groups of experts with establishments, try to work with a supplier to find out which establishments might be interested, based on contacts we may have or even that the supplier may have made on his own, and try to benefit from experience, especially with start-ups or companies that want to launch products. The idea is really to be able to get started with one or two establishments. We also sometimes ask companies if they have already carried out tests in other companies, and we try to support them in setting up markets. Of course, there's always a competitive bidding process, as required by public procurement law, but in all cases, it's always a matter of trying to build up the need with the establishment and the supplier, so as to be credible. UniHA's advantage lies in its network of hospitals, which can say: "There's a solution that exists. It's already been tried and tested in a hospital. Our contribution is precisely to make it known to the entire network. This doesn't mean we don't have to go through a competitive bidding process, but it does enable us to better anticipate and build the need, both with the companies in the sourcing phase and with the establishments.

00:22:47
Lionel Reichardt: How can a project owner be informed of an upcoming or current deal?

00:22:52
Olivier Xicluna: The process is always the same. Suppliers can register on our digital platform to get in touch with the different purchasing channels and be in contact with buyers. We also make appointments directly with suppliers. The purchasing process is always as follows: we always say to a supplier, "Do you already have establishments that are interested in the solution? What is the potential?" We have to go through this phase, because we have a very large number of companies who come to us. Nevertheless, we try to massify our purchases with the priority needs reported by the establishments. It's always a matter of registering on the UniHA website, making contact with the purchasing channel concerned and the supplier. Then we start relaying the information in project mode with teams and networks of facilities we know.

00:23:49
Lionel Reichardt: What advice would you give to a project owner looking to have their innovative solution referenced within a hospital purchasing group?

00:23:56
Olivier Xicluna: The advice I'd give is really to get in touch with the purchasing teams, but at the same time, show us if there have already been tests and POCs that have been done in establishments. If there's already been an understanding of the market within the company, let them show us the potential, the sales, the potential and the visibility we can have with the network of establishments. Above all, we need to be presented with solutions that are in all cases hosted in HDS solutions (health data hosting), because we're dealing with medical data, and it's reassuring when a company comes to us and has already taken these steps, saying: "There, we've already tested the solution in such and such an establishment. It's secure because it's hosted on healthcare data, and we have significant potential sales". Here, we're listening in a totally different way.

00:24:53
Olivier Xicluna: The best way, beyond the contacts they can have with the industry, is really to register on the State purchasing platform, since UniHA publishes all its contracts on the PLACE platform, which is the official platform of the State purchasing department. By registering, you can set keywords and alerts, and you'll be informed the second the contract is published, which generally gives suppliers between 30 and 35 days to respond. We immediately receive the notification, which gives us access to all the contract documents.

00:25:33
Lionel Reichardt: Our episode comes to an end. Thank you for listening. We'd like to thank our two guests for their availability, and you for listening. Don't hesitate to subscribe to the podcast on our platforms. We look forward to seeing you soon for a new episode of 100 Days to Success.

00:25:51
Voiceover: Those who are making e-health today and tomorrow are on the G_NIUS podcast and all the solutions to succeed are on gnius.esante.gouv.fr.