Brainstorming Entrepreneurship in Brain Health

Abstract

The burgeoning field of brain health innovation demands a convergence of clinical insight and entrepreneurial strategy. Despite the immense global burden of neurological disorders and associated economic costs, there are precious few examples of evidence-based and scalable innovations addressing these challenges. To bridge this gap, the multidisciplinary forum Brainstorme! Entrepreneurship in Brain Health convened on October 5, 2024, in Los Angeles, bringing together physicians, scientists, investors, and industry leaders to share actionable insights on advancing diagnostics, digital health solutions, drug development, and devices in neurology. This article encapsulates the event’s key themes, emphasizing unique stakeholder strategies to accelerate innovation while aligning with the health care value chain and the triple aim of improved patient experience, population outcomes, and cost efficiency. We highlight a case study of Brainstorme, a cloud-based brain imaging platform, to illustrate how entrepreneurial initiatives can address unmet needs, leveraging new federal interoperability rules and novel business models, to empower patients and reduce system inefficiencies. Finally, we integrate perspectives from recent literature on early-career physician entrepreneurship, digital health, and health economics to underscore how innovation can be cultivated within an ecosystem that values collaboration, evidence generation, and sustainable value creation.

Neurological disorders exact an enormous toll on patients, health care systems, and society. Globally, stroke is the leading neurological cause of disability and death, with an annual cost approaching $900 billion. Dementia adds an estimated $1.3 trillion per year to the economic burden. By investing in brain capital through innovation, society could shift from a historically brain-negative economy to a brain-positive economy that values cognitive health as an essential asset, yet the pace of translating neurotherapeutic breakthroughs has been frustratingly slow. In the United States, from the approval of tPA (tissue-type plasminogen activator) in 1996 until 2025, only one new drug for acute ischemic stroke has achieved US Food and Drug Administration approval. Likewise, few truly novel devices for stroke or dementia have entered routine care, and conventional neuroimaging techniques (computed tomography and magnetic resonance imaging) remain decades-old mainstays. This disparity between massive unmet needs in brain health and the sluggish innovation pipeline calls for fresh approaches that harness entrepreneurship and cross-sector collaboration. To catalyze such efforts, a 1-day summit titled Brainstorme! Entrepreneurship in Brain Health was held on October 5, 2024, in Los Angeles (Figure 1). The event convened a broad coalition of stakeholders spanning what global experts term the 6 Ps: Patients, Providers, Policymakers, Payers, Partners (industry), and the general Population. Attendees included leading neurologists, neurosurgeons, and neuroscientists, alongside medical device entrepreneurs, digital health innovators, venture capitalists, health policy experts, and patient advocates. This diverse assembly reflects a growing recognition that advancing brain health demands an ecosystem mindset. Indeed, improving brain health will require not only leveraging technological innovation but also building a broader coalition of stakeholders committed to cocreating solutions. By design, the symposium’s tone was optimistic: it featured forward-looking discussions on how innovation is transforming brain health, open to anyone passionate about entrepreneurship or curious about how technology is shaping the future of neurology. This article synthesizes the event’s proceedings and insights, framed for the medical community, integrating relevant literature to contextualize these ideas within the broader movement of innovation in the neurosciences (Table 1).

Figure 1.

Agenda of Brainstorme! Entrepreneurship in Brain Health.

Table 1.

Summary of Stakeholder-Driven Opportunities in Diagnostics, Digital Health, Drug, and Device Innovation

Speakers: Leading Neuroscientists and Entrepreneurs Share Actionable Insights

The symposium opened with perspectives from leaders at the nexus of neuroscience and entrepreneurship, emphasizing that meaningful innovation requires marrying clinical expertise with business acumen, a theme echoed throughout the day. A panel of keynote speakers followed, featuring experts who shared actionable insights drawn from real-world efforts to scale up brain health solutions.¹ A recurring message was that innovators must address clear pain points in the current standard of care while also navigating the pragmatic realities of the health care marketplace.

Several speakers stressed the importance of defining clear value propositions for new brain health technologies. An invention (no matter how clever) will not gain traction unless it solves a pressing problem more effectively or efficiently than existing practice. For example, they highlighted the need for faster, more precise stroke diagnostics in the emergency setting, linking the fact that over 80 million computed tomography scans are performed annually in the United States (with tens of millions involving the brain), yet critical information from these scans often remains siloed or underutilized.² Other panelists spoke to the challenges of scaling digital health tools, emphasizing that even as digital health has exploded to encompass artificial intelligence (AI), mobile apps, and telemedicine for neurological care, the promise of these technologies remains only partially fulfilled due to fragmentation and interoperability barriers.³ Health data today are mostly sequestered, inaccessible, and difficult to aggregate in a meaningful and actionable way. The panel agreed that entrepreneurs in brain health must design solutions that integrate into existing workflows and data streams, rather than further fragmenting them. This insight aligns with calls in the literature for greater interoperability and user-centered design in digital medicine.⁴

Another key takeaway was the critical role of clinician-innovators in bridging the gap between bench and bedside. Physicians and neuroscientists who venture into entrepreneurship can leverage their frontline experience to ensure new products truly address clinical needs. However, as several early-career attendees acknowledged, the physician’s traditional career path rarely provides entrepreneurship training. Here, the panel referenced the work of Janardhan and Janardhan,⁵ who have urged medical societies to engage and mentor young physicians in device innovation and entrepreneurship. These authors observed that participating in innovation can give physicians intellectual stimulation, a sense of purpose, and even improve work-life balance free from emergency calls, potentially mitigating burnout. The speakers, many of whom themselves straddle academic and startup roles, underscored this point with personal anecdotes. They encouraged institutions to create protected time and incentives for clinicians to innovate. One speaker noted that in neurology, the clinic and the laboratory should be separated by a revolving door, not a wall, underlining the ideal of fluid movement between practicing medicine and developing new solutions.

Crucially, the speakers also tackled the business realities of scaling innovations. A medtech accelerator director and a separate venture capitalist provided investor perspectives. They emphasized that demonstrating value across the health care value chain is essential for innovations to gain adoption. An effective innovation must align the interests of patients (better outcomes and experience), providers (improved efficiency or capabilities), and payers (lower long-term costs), creating a win-win-win scenario. This echoes the health care triple aim framework of improving patient experience, improving population health, and reducing per capita cost. If an innovation only excels in one of these dimensions but exacerbates another (for instance, a new diagnostic that improves accuracy but at an exorbitant cost), it will struggle to scale. Investors on the panel advised entrepreneurs to think early about health economic evidence and reimbursement strategy, not just regulatory approval. Building coalitions of support from multiple stakeholder groups (eg, patient advocacy organizations, health systems, and insurers) can smooth the path to market. Indeed, as global brain health advocates have argued, tackling neurological disorders requires leveraging technological innovation but also building a broader ecosystem of stakeholders to cocreate solutions. The diverse representation at the event with clinicians sharing the stage with industry veterans exemplified the kind of dialogue needed to align technology push with practical pull (Figure 2).

Figure 2.

Conceptual strategy map aligning stakeholder perspectives in the neuroinnovation value chain. The interests and contributions of key stakeholders (patients, providers, payers, and partners [industry and researchers]) are interlinked. Arrows indicate the flow of value: innovation developed by partners must improve patient outcomes, integrate into provider workflows, and demonstrate cost effectiveness for payers, which, in turn, sustains adoption and investment. Aligning this value chain across stakeholders greatly enhances the likelihood of an innovation’s success.

The speakers emphasized the momentum in brain health innovation (noting, for instance, that venture funding in neurotechnology is at an all-time high) but tempered enthusiasm with realistic advice on evidence generation, workflow integration, and stakeholder alignment. They also acknowledged all the symposium’s contributors, including expertise that spanned brain imaging, surgical devices, pharmaceutical development, and beyond.

Startup Showcases: Pitches From Cutting-Edge Brain Tech Ventures

A highlight of the event was a series of startup showcases, where entrepreneurs pitched their emerging ventures in brain health. These showcases provided a tangible look at how novel ideas are being translated into diagnostic, drug, and device products or companies. The session featured founders representing a spectrum of innovations, from medical devices to digital health platforms, each addressing a distinct challenge in neurology. Notably, all the startups embraced interdisciplinary approaches, often blending hardware, software, and clinical insight, reflecting a broader trend in innovation.

One presentation demonstrated a next-generation catheter device for acute ischemic stroke theranostics, illustrating how advances in material science and AI-based imaging guidance can improve mechanical thrombectomy. Another showcased an ultrasound-based monitoring technology for cerebral blood flow (a spin-off building on transcranial Doppler ultrasound); this highlighted the potential of noninvasive diagnostics for conditions such as vasospasm or traumatic brain injury. On the digital front, a neurologist-innovator presented a software platform that aggregates patient-reported outcomes and wearable sensor data to detect early signs of neurological decline in a variety of brain diseases. Meanwhile, industry veterans-turned-entrepreneurs pitched a novel tele-neurology solution aimed at extending specialist care to remote areas via a secure, AI-enabled virtual exam toolkit. Rounding out the lineup, other speakers introduced their startup focusing on cognitive assessment in aging populations, using gamified digital tests to screen for early dementia in primary care settings.

Despite their diverse aims, these pitches underscored several common themes about innovating in brain health. Many teams identified similar pain points: for example, the difficulty of accessing high-quality data to train and validate their technologies, the challenge of clinician adoption, and uncertainties around reimbursement. The founders noted that while pilot studies of their tools showed promise in improving clinical metrics or patient engagement, convincing hospitals and payers to support widespread implementation remains an uphill battle. This sentiment mirrors observations in the literature that health care systems tend to reward incremental improvements and stick with established practices, often lagging in uptake of novel tech. Nonetheless, as one startup chief executive officer put it, the burden of brain diseases is too great to accept the status quo.

The session also highlighted business model innovations accompanying the new technologies. Some startups planned to go direct-to-consumer (for instance, offering cognitive wellness apps on a subscription basis), whereas others targeted enterprise customers like health systems or imaging center networks. A few pursued a hybrid approach, with initial deployment in clinical partners to build evidence, then expansion to consumer markets or payer-funded models. The audience, which included investors, probed the presenters on their go-to-market strategies. Questions about regulatory pathways (US Food and Drug Administration clearance for devices or Health Insurance Portability and Accountability Act compliance for digital tools) and about proving cost effectiveness were front and center. The founders acknowledged that partnering with health care institutions for validation studies and economic analyses is crucial. One particularly insightful question asked how these startups plan to demonstrate not just clinical efficacy but also real-world value. For example, if a new diagnostic catches strokes earlier, can it show reductions in disability or hospital costs? If a digital platform engages patients, does it improve medication adherence or quality-of-life metrics? These kinds of value demonstrations resonate with the needs of payers and provider systems that ultimately decide on adoption. The consensus was that early incorporation of health economics and outcomes research into the startup development process is a wise strategy. This ensures that by the time a product is ready to scale, there is compelling evidence of its impact on triple/quadruple aim outcomes (better health, better care, lower cost, and, ideally, better provider work life).

The startup showcase segment exemplified the cutting edge of brain health entrepreneurship.

It brought theoretical discussions to life, as the audience could see how abstract concepts (such as digital biomarkers or AI for stroke) materialize as real products. Importantly, the segment also surfaced the practical hurdles and creative solutions that define the journey from idea to impact. The startups reinforced a hopeful message: a new generation of tools and companies is emerging to tackle neurological disease, armed with creativity and a commitment to improving patient outcomes.

Brainstorme: Business Model Alignment in the Neurosciences

One of the startups, Brainstorme, provided a deeper focus on its approach to a widespread yet under-addressed problem in brain health: the storage, sharing, and analysis of brain imaging data. Brainstorme is a cloud-based platform designed to give patients and providers seamless, 24/7 access to brain scan images (eg, magnetic resonance imaging and computed tomography), and associated analytics. Founded by neurologists and tech experts, the venture serves as an instructive case study in how to craft a business model around an unmet clinical need while anticipating future policy shifts and reimbursement trends. The platform now includes several important capabilities that reflect its evolution. It offers global access through a secure and compliant infrastructure, enabling teams and individuals to engage with imaging data regardless of location. Real-time synchronization ensures seamless coordination across clinical sites, devices, and users. The platform has also been adopted for use in core laboratory imaging settings during clinical trials, meeting regulatory standards. Individuals can view and share their brain images directly while connecting these to broader health and wellness information. The platform supports offline functionality across both desktop and mobile devices. Users can capture and review images without an Internet connection and sync them once back online. These features support the broader goal of democratizing imaging access.

The Unmet Need

Modern neurology heavily relies on neuroimaging, but the infrastructure for managing these images remains fragmented and antiquated. Images are typically stored in a hospital Picture Archiving and Communication System or on compact discs given to patients, leading to silos and frequent repetition of scans when patients seek care elsewhere. Even 28 years after the Health Insurance Portability and Accountability Act first mandated portability of health data, most patients still have no centralized, portable repository for their brain scans, and providers often cannot easily access prior images from other facilities. This gap not only inconveniences patients but also drives up costs (redundant imaging) and impedes longitudinal care. Brainstorme’s solution is a secure, compliant cloud platform where individuals can upload their brain imaging studies (in addition to hospital or imaging center cooperation) and share them instantly with any clinician or researcher as needed. In essence, it aims to create a personal brain health image vault controlled by the patient but accessible to authorized parties, alongside value-added services such as in-browser image viewers, AI analyses for risk profiling, all accessible via a HealthKit-integrated app, and a desktop interface.

Alignment With Policy and Interoperability Trends

A recent policy development supporting this vision is the push for interoperability in health IT. Notably, in 2024, the US Office of the National Coordinator for Health Information Technology released a final rule stipulating that by January 1, 2028, certified electronic health record systems must be able to include links to diagnostic images, enabling patients and providers to view and retrieve medical images via health information networks. This upcoming mandate essentially requires that imaging data be made more accessible and shareable, which validates Brainstorme’s core premise. The startup’s founders highlighted this Office of the National Coordinator for Health Information Technology rule as both an endorsement of their model and a roadmap for integration: Brainstorme can serve as the backend cloud repository that electronic health records link to fulfill the new requirement. By aligning with national standards (eg, using DICOMweb protocols for image exchange), it makes a ready-made solution available for providers looking to comply with emerging interoperability rules. In the long run, such regulatory tailwinds could shift clinical culture away from proprietary data silos toward open image exchange.

Business Model: Subscription With Healthcare Alignment

From a revenue standpoint, the model employs a hybrid that caters to both individual consumers and institutional clients. On the consumer side, the platform offers a freemium model: basic storage and access are free (or low-cost) with the option to subscribe to premium features (eg, unlimited storage, advanced AI-derived brain health reports, and personalized imaging analytics). The startup recognized that even a modest monthly fee might deter some patients, so they sought ways to offset this cost. One innovative approach is making the subscription eligible for health savings account or flexible spending account funds. US guidelines consider expenses for storing and retrieving medical information (such as personal health records or images) as qualified medical expenses. This means that patients can use pretax health savings account/flexible spending account funds to pay for subscription services. The startup is actively working to ensure that its service is categorized appropriately (essentially as a medical information storage plan) so that users can submit subscription fees for health savings account/flexible spending account reimbursement. By doing so, this effectively lowers out-of-pocket costs for patients while positioning the product as a health-related expense rather than a luxury tech app. On the institutional side, Brainstorme is pursuing enterprise licensing and partnerships. One target customer is health insurance companies. Insurers have a vested financial interest in reducing duplicate imaging and preventing unnecessary procedures. An insurer or integrated delivery network might license the platform to provide accounts for their members, ensuring that if a patient has a brain magnetic resonance imaging at one facility, those images are available to any other provider in-network (or even out-of-network) to review, thereby eliminating the need for a repeat scan. This not only saves costs but could improve care coordination and outcomes (for instance, enabling quicker diagnosis by comparing current and prior images). This model fits the shift toward value-based care, where insurers and health systems invest in tools that reduce waste and enhance quality. Brainstorme is also engaging imaging providers directly. Imaging center chains or hospital networks could adopt the platform enterprise-wide, streamlining image sharing among their sites and offering patients a differentiating service (all your images available in one cloud portal). Brainstorme tries to embed itself in the imaging value chain at multiple points (patient, provider, and payer), aligning incentives across each. This holistic strategy may serve as a model for value chain alignment in innovation.

Future Directions

A future direction is leveraging the aggregated de-identified imaging data for research (with proper consent and governance). Brainstorme’s vision includes contributing to a Million Brains Initiative, whereby patterns across a vast database of brain images could be analyzed to yield new insights into neurological diseases, much like biobanks have done for genetics. Such an initiative, if successful, would exemplify how entrepreneurial ventures can not only provide services but also advance science, creating a virtuous cycle of innovation. Broader adoption of such platforms could significantly enhance diagnostics in neurology and empower individuals to take charge of their brain health data. The case also illustrates the importance of timing and context: changes in the regulatory landscape (such as the Office of the National Coordinator for Health Information Technology mandate for image access) can suddenly create ripe conditions for an innovation to flourish. Figure 3 illustrates a timeline of recent regulatory and policy milestones impacting such innovation.

Figure 3.

Timeline of select regulatory, reimbursement, and policy milestones shaping innovation in the United States. Key events include the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 (which reinforced value-based care models), the 21st Century Cures Act of 2016 (which promoted use of real-world evidence and fostered digital health innovation), the launch of the Breakthrough Devices Program of the US Food and Drug Administration (FDA) in 2018 (to accelerate high-impact device approvals), Centers for Medicare & Medicaid Services (CMS) granting the first new technology add-on payment (NTAP) for an artificial intelligence (AI) stroke detection tool in 2020 (highlighting reimbursement support for innovation), and the 2024 Final Rule of Office of the National Coordinator for Health Information Technology (ONC) mandating imaging interoperability by 2028 (to ensure patient and provider access to diagnostic images across systems). Such milestones create a more favorable environment for innovators, aligning incentives and lowering barriers to implementation.

Interactive Panels: Building Your Own Entrepreneurial Strategy in Brain Health

The event also featured interactive panel sessions that allowed attendees (many of them early-career professionals or trainees) to actively engage in entrepreneurial thinking. For example, one panel included a neurosurgical device engineer, a venture advisor, a health care consultant, a neurointerventional surgeon-innovator, a neurotech chief executive officer, a medtech business development expert, and an expert with experience in health policy and startups. With such a lineup, participants had access to a brain trust spanning clinical practice, startup execution, regulatory affairs, and business strategy. The panels were structured around hypothetical case studies and even attendees’ own project ideas. Attendees were encouraged to bring an idea or a problem in brain health they are passionate about, and the panel would help them explore it from an entrepreneurial lens. This format brought to life many of the abstract principles discussed earlier in the day. It also directly addressed a question posed by many in the room: How can I, as a physician or scientist, practically get involved in innovation?

Drawing on the discussion and on established guidance from the literature, the interactive sessions outlined several pathways for early-career professionals to engage in innovation. Janardhan and Janardhan’s⁵ framework of the innovation life cycle in 3 stages (idea, preclinical, and clinical) was used as a reference point. During the idea stage, panelists advised participants to focus on identifying unmet needs in their day-to-day work (What frustrates you in clinic or the laboratory? What do patients complain about? That’s your opportunity.). They discussed how to refine a raw idea by gathering diverse input. One practical tip was to form or join a scientific advisory board for a startup or a tech incubator. Many medtech companies seek physician advisors early to help define the clinical problem and market need. By contributing insights on unmet needs, current care gaps, and user preferences, a young physician can begin participating meaningfully in innovation without yet leaving their primary job. Panelists shared their own experience serving as an advisor for a neurodevice startup, describing it as a low-risk, high-learning way to dip your toes into entrepreneurship. The importance of understanding intellectual property was also emphasized at this stage. Early innovators must ensure, for instance, that their employment contracts do not automatically assign any invention to their employer (unless that is intended). Clear agreements on intellectual property rights and potential royalties or spin-off equity can pave the way for smoother innovation journeys.

Moving to the preclinical stage, the panels talked about how someone with clinical or scientific expertise can contribute to developing and testing a concept. This might involve helping design bench experiments or usability tests for a device (to ensure it truly meets clinicians’ needs) or aiding in the creation of validation protocols for an AI algorithm. As Janardhan and Janardhan⁵ highlighted, physicians can play roles in design verification and validation, for example, setting up simulations or animal studies to test a new stroke device’s safety and efficacy.⁵ One breakout group actually walked through a mini exercise of defining a validation plan for a hypothetical wearable electroencephalogram device. They enumerated what preclinical evidence (eg, benchtop signal accuracy tests and comparisons to predicate devices) would be needed for a regulatory submission, illustrating how deep clinical knowledge guides research and development. Participants with research backgrounds were encouraged to leverage grants like the National Institutes of Health Small Business Innovation Research programs, which often fund collaborative projects between startups and academic labs. The presence of a venture capital expert on one panel allowed for discussion on how preclinical milestones align with fundraising; essentially, demonstrating a working prototype or preclinical proof of concept can significantly bolster a startup’s pitch to investors.

Finally, in the clinical stage, discussions revolved around designing clinical trials and initial deployment. Speakers shared insights from their involvement in pivotal trials for stroke devices. They emphasized the need for rigorous study design (randomized trials when feasible, appropriate control, or comparator groups) but also creativity in trial execution to keep costs reasonable (for instance, using adaptive trial designs or leveraging registry data). One important way clinicians can engage at this stage is by serving on data safety monitoring boards or clinical event committees for trials or by acting as site investigators who recruit patients. Such roles allow physicians to shape how new interventions are tested and to ensure patient safety remains paramount. The panels also encouraged participants to publish and present early results of innovations, whether it is a first-in-human case series of a device or an implementation study of a digital tool, as these not only contribute to medical science but also build credibility for the innovation. Indeed, attendees were reminded that successful physician-entrepreneurs often maintain a foot in academia using peer-reviewed literature to validate their creations.

Another theme of the interactive panels was networking and mentorship. Several of the event’s senior speakers informally took on mentoring roles during these sessions. For instance, a branding and communications expert who delivered the closing keynote floated between groups, advising on how to effectively communicate one’s idea. He later gave a rousing talk on crafting a narrative for an innovation, noting that even the most technical advancement needs a human story to win hearts and minds. Young entrepreneurs shared peer-to-peer advice on juggling residency training while building a startup, exemplifying that it is possible to wear dual hats with the right time management and institutional support. By the end of the interactive panels, attendees had not only absorbed knowledge but also practiced applying it. Many remarked that this was the first time they had been challenged to think like an entrepreneur in the context of their medical career. The session fostered a sense of empowerment and provided concrete next steps, from seeking out institutional innovation programs to entering hackathons or pitch competitions, to simply writing down that idea that’s been percolating and starting to flesh out a business model. As one neurology resident put it during the report-out, I came in with a rough idea about a stroke rehab app, and I’m leaving with a plan to pilot it at my hospital and advice on how to approach our tech transfer office. This captures the essence of what the build your own strategy panels achieved. They operationalized the day’s high-level lessons into personal action plans for the next generation of neuroinnovators.

Networking: Connecting With Investors, Innovators, and Thought Leaders

Structured Meet and Greet

The networking session kicked off with a short, brief networking session. A master of ceremonies prompted people to pair up with someone they had not met and spend 5 minutes discussing their interests and what brought them to the event. This speed networking exercise ensured that even more introverted participants made new contacts. It was common to see, for instance, a neurology researcher chatting with a venture capitalist or a neurosurgery resident meeting a digital health startup founder. By rotating pairs a few times, attendees rapidly expanded their network. Representatives from investment firms (eg, a health care venture fund) had a chance to identify promising young innovators and vice versa. A few demo tables were set up (akin to a mini-innovation fair) around the room. Some startups from the showcase had a station where interested parties could see a quick demo or ask one-on-one questions to the founders. In addition, technology accelerators and societies had informational discussions about resources for budding innovators.

Investor Corner

A few investors and industry executives organically formed a group fielding inquiries. It included venture capital and angel investors, prior technology executive’s now academic faculty in technology businesses, and medtech business development leads. They welcomed entrepreneurs to pitch informally or ask for feedback. Several startup founders from the showcase took advantage of this, receiving candid advice on their venture’s strengths and gaps. For example, one founder received tips on improving value proposition messaging for a payer audience, while another discussed regulatory strategy for the European Union versus the United States approval. This kind of direct access to seasoned business minds is invaluable in refining one’s approach and was highly appreciated by participants.

Conclusions

The Brainstorme! Entrepreneurship in Brain Health symposium and its proceedings reflect a key moment in the melding of neurology and innovation with concrete action items (Table 2). The event underscored that solving the most pressing challenges in brain health, from acute stroke and neurodegeneration to mental health and beyond, requires harnessing the creativity and agility of entrepreneurship without losing the rigor and compassion of medicine. Several overarching themes and lessons emerged, offering guidance for the field at large:

Table 2.

Action Items for Entrepreneurship in Brain Health

Multistakeholder Engagement Is Key

No single group can drive innovation in isolation. Progress arises from the concerted efforts of clinicians, researchers, patients, industry, payers, and regulators working in concert. The symposium exemplified this by gathering the 6 Ps of the brain health ecosystem (Patients, Providers, Policymakers, Payers, Partners, and Population). Going forward, fostering platforms where these stakeholders regularly interact will be crucial. Such collaboration ensures that innovations address real needs, garner cross-sector support, and navigate translational hurdles more effectively. As discussed, aligning the value chain so that each stakeholder finds tangible value in a new solution greatly enhances the likelihood of adoption. We encourage academic medical centers and professional societies to continue hosting innovation forums and to create incubator or accelerator programs that bring diverse experts together.

Early-Career Clinicians and Scientists Should Be Empowered to Innovate

The enthusiasm from trainees and young professionals at this event was palpable. They are eager to shape the future of brain health beyond traditional roles. Mentorship and structural support can channel this enthusiasm into tangible outcomes. Following recommendations by Janardhan and Janardhan⁵ and others, institutions should incorporate entrepreneurship education into medical and graduate training, establish innovation tracks or sabbatical opportunities for those inclined, and clarify intellectual property policies to encourage rather than hinder invention. The event showed that when provided with knowledge and networks, early-career physicians and scientists can quickly ideate and plan impactful projects. Nurturing this pipeline of physician-innovators will yield dividends in the form of novel therapies and technologies, as well as a more engaged workforce.

Leverage Policy and Regulatory Developments

An important takeaway was that today’s innovators must stay attuned to the evolving health care policy landscape. The example of the Office of the National Coordinator for Health Information Technology 2024 rule on imaging interoperability is a prime example: aligning one’s solution with policy mandates or incentives (such as Meaningful Use criteria, new reimbursement models, or value-based care metrics) can create a powerful tailwind for adoption. Similarly, entrepreneurs should watch trends like the US Food and Drug Administration’s increasingly favorable stance on real-world evidence and the expanding Breakthrough Devices Program for novel technologies or Centers for Medicare & Medicaid Services reimbursement decisions for digital therapeutics.⁶ Proactively engaging with regulators (by seeking meetings, participating in guidance development, or using regulatory sandbox programs) can both derisk the innovation process and potentially shape a more innovation-friendly environment for all. We suggest that a timeline of upcoming regulatory and reimbursement milestones could be a useful strategic tool for neuroinnovators as they plan product development and market entry.

Aim for the Triple Aim (and Quadruple Aim)

The triple aim of health care improvement (better patient experience, better population health, and lower cost) was a recurring touchstone throughout the discussions. Successful neuroinnovations are those that advance these aims. For example, a new digital tool that improves patient engagement in migraine self-care (better experience), reduces emergency room visits (better population health), and cuts costs from unnecessary imaging (lower cost) hits the trifecta. Several showcased ideas had this character, and investors took note. In addition, some speakers advocated for the quadruple aim, which adds improving provider work life to the mix, highly relevant in burnout-prone fields such as neurology. Many entrepreneurial solutions, such as workflow-streamlining AI or better data integration, can indeed make providers’ lives easier and more rewarding. The amplifier effect of taking an idea and impacting a population, akin to how a scientific discovery may amplify to benefit patients beyond your own clinical practice, may also be implemented. Innovators should explicitly consider and measure these outcomes. Demonstrating value in triple/quadruple aim terms not only strengthens the case to payers and health systems but ultimately means the innovation is truly delivering holistic value.

Sustainability and Health Economics Matter

There was a clear consensus that innovation in brain health must go hand-in-hand with economic sustainability. Given the high costs associated with neurological diseases, stakeholders are desperate for solutions that are not just effective but cost-effective. Entrepreneurs are advised to build health economic evaluations into their trials and to seek expert input on reimbursement pathways early (eg, current procedural terminology codes, diagnosis-related group impacts, and value-based payment models). The rise of value-based care means that if an innovation can prove it saves money while improving outcomes, it will find eager allies in payers and provider networks. The symposium’s dialogue reinforced that economic value and clinical value must be dual targets of innovation. Achieving the brain-positive economic vision described by global brain health leaders will require that each new solution not only advances neuroscience but also makes prudent use of resources.

Continue Building the Neuroinnovation Community

Participants were excited about continuing to collaborate, and there is fertile ground for forming a more formal network or consortium focused on brain health entrepreneurship. Such a community could share success stories, lessons learned from failures, and even pooled resources (for instance, a shared database of funding opportunities or a mentorship directory). Academic neurology departments might partner with business schools or engineering schools to host hackathons and business plan competitions specific to brain health. Professional societies might consider special interest groups or sections on innovation and entrepreneurship, ensuring that these discussions remain front and center. By normalizing the role of the neurologist-entrepreneur or neurosurgeon-innovator, we can inspire more professionals to partake in what was once considered a nontraditional career path.

Brainstorming Entrepreneurship in Brain Health was more than just an event as it was a reflection of a broader paradigm shift. Neurology, a field sometimes perceived as slower in therapeutic progress, is now teeming with innovative energy, thanks, in part, to the infusion of entrepreneurial thinking. The triple aim of better care, better outcomes, and lower costs provides the compass directing these innovations, and stakeholders across the spectrum are coalescing to support forward momentum. As we move ahead, the ultimate measure of success will be our ability to tangibly improve the lives of patients with neurological conditions. By continuing to combine scientific rigor, creative enterprise, and collaborative spirit, the brain health community can look forward to a future where today’s brainstorms become tomorrow’s breakthroughs.

ARTICLE INFORMATION

Acknowledgments

The authors thank all the speakers, panelists, and participants of the October 5, 2024, Brainstorme event for their insights and enthusiasm.

Sources of Funding

None.

Disclosures

Dr Liebeskind is a consultant for an imaging core laboratory in Cerenovus, Genentech, Medtronic, Rapid Medical, and Stryker. Dr Jadhav serves as the Editor-in-Chief of Stroke: Vascular and Interventional Neurology. The other authors report no conflicts.