digital health

One thinks of Invitae as a leading genetic testing company that has worked to improve clinical quality while bringing prices down. And they are, and they have. But after listening to today's show, you will see that their vision is bigger than that.

Farid Vij is the President and General Manager of Data at Invitae. A year ago Invitae bought a company he co-founded called Ciitizen which was focused on providing patients with access to their complete medical records.

"When we think of Invitae, we think of genetic testing, and if you go back to when Invitae first started, it was very much about democratizing genetic testing. But it was always in service of how do we make sure the information that comes from your genetic test can actually be put back in your hands as a patient and those that are taking care of you in order to be able to inform that next step of your care. That remains the vision today."

Having opened up a patient portal several years ago, Invitae is now engaging with patients with a new "genome management" platform based on Ciitizen's product, says Farid. In today's interview, he compares the platform to a financial consumer's bank account. Just as a bank is concerned with how a consumer receives their money, how they organize their money, and how they spend or share their money, so too Invitae is concerned with these three processes with patient data. How does a patient receive their data, how do they organize it, and how do they share it?

"Here's the difference, though, today, there is no scenario where the bank makes decisions for you. You're the one who has control of that account. The banks have built the infrastructure. And it all happens behind the scenes. It's not something you and I worry about it. But that infrastructure doesn't exist in healthcare today. That's what we're building."

Farid clarifies that he doesn't think healthcare is going completely virtual, of course, but he presents a strong vision for how much more control we patients can have over our data. Invitae is already testing this out in the area of rare diseases where it is not just about giving results and being over and done with a patient but staying engaged in an ongoing way with the patients and their communities.

How has the pandemic brought us closer to this vision? Where is the platform today? How will this change the future of clinical trials?

Ultimately, Farid says, the biggest mistake any provider makes is putting layers between them and their patients.

“The new drug is the engaged individual,” says today’s guest, Daniel Kraft.

Daniel is the founder of Exponential Medicine where he has championed digital health and the explosion of wearable technologies.  He's also hosting the new Healthy Conversations podcast--go check it out!  There you will find interviews with the innovator’s of today’s medical culture, including shows with former FDA Director, Scott Gottlieb, and genomic medicine guru, Eric Topol.

Produced by the pharmacy chain, CVS, Daniel says the podcast is an effort to help “inoculate the world against the infodemic.”

But back to the wearables explosion . . . it’s been a while since we've had Daniel to the program.  He can riff about these new technologies like no other.  What are his thoughts on the pandemic?  What will be the longterm impact of COVID on medicine?  And . . . can he update us on the latest in wearables?  As Daniel comes out of a kind of stream of consciousness "flow state" when talking about the flowering of new technologies, we are left wondering what will the actual adoption be like.  Has COVID lessened society's concerns over privacy and nudged us closer to being friends with our "digitome?"

“ . . . there’s insidables, and underwearables for remote patient monitoring with a tag in ten pairs of underwear. You’re always censored. They’re being used to track respiratory de-condensation at home. It could be from COVID or from a pneumonia. And also, let’s go beyond the wrist. It could be from the laptop from which I’m talking to you with Skype or Zoom. The camera could be modified to pick up our vital signs or blood pressure or stress levels. Or wifi has been modified to pick up vital signs. Amazon Alexa type speakers can be modified to pick up heart rate. We’re going to start to pick up our digital exhaust, or our “digitome," for not just data but actionable insights. And I think what’s shifting and being enabled with COVID as a catalyst is moving from quantified self to quantified health. This will all start to flow—your digital biomarkers to your EMR, to your phyciscian, or to your payer, or to a pharma company as a clinical trial."

Sara Radcliffe can be happy--extra happy. She is the CEO of the California Life Sciences Association at a time when the state is breaking records, beating out every other state in category after category. Today Sara discusses a new report the organization has released along with PWC detailing our sector’s explosive growth. Jobs: check. Wages and revenue: check. VC funding: check. NIH funding: check. California leads in all. Big yaaaawn?

Well, no. There are some interesting trends here. For example, the report shows that Orange County has shot up as the third major life science hub for California, with strong growth coming from new digital health companies. That emerging digital health sector state wide is projected to attract a whopping $3.9 billion in VC investment in 2018 which represents nearly half of all projected life science VC investment for the year.

We talk some policy too. Last time we chatted with Sara, the trade group was actively opposing a drug pricing and transparency bill by the California legislature. Since then the bill has passed, been signed by the governor, gone into law, and two components have been implemented. What has been the outcome? Has it been all doom and gloom? And does Sara at all agree with the bipartisan calls in Washington that we need some national controls on runaway drug pricing?

Yes. She does agree.

Listen in for her position, find out about this record growth in California, and hear about a few who were honored in last week's Pantheon Awards Ceremony as the sector's best and brightest. It’s time to shine a spotlight on California.

She's been a highly sought after venture funder and knowledge broker in the field of digital health. STAT News wrote that upwards of 1,500 pitches crossed her desk last year at GE Ventures. But as of a couple weeks ago, it's a desk at which she's no longer sitting. So what's she up to next?

No, we did not get a scoop here, though we do feel important. This interview was scheduled long before the healthcare venture capitalist, podcaster, blogger extraordinaire made her big break recently with GE. And in fact we’ve always known her for her own brand that goes beyond any employer, that of Lisa Suennen.

In today’s special studio interview, the health tech duo, David Shaywitz and Lisa Suennen, walk us through the changing paradigms around healthcare. They offer their thoughts on some of the new digital health and peer-to-peer social platforms which are becoming integrated in daily clinical care.

Lisa grew up in Silicon Valley and is an investor in the health tech space. David is a newcomer to the Valley and is currently the Chief Medical Officer at DNAnexus, a company that provides cloud based genomics data storage and analytics. They are both avid bloggers and recently compiled much of their written work together into a book, "TechTonics: Can Passionate Entrepreneurs Heal Healthcare with Technology?" They also co-host a new podcast by the same name.

Guest:

Sultan Meghji, Founder, Reformation Medicine

Listen (4:20) The end of technology as a specialty

Listen (4:12) Sequencing devices still a bottleneck for clinical genomics

Listen (4:39) How to become a bioinformatician in six months

Listen (4:39) Basic scientists vs. technicians

Listen (8:19) Going through the Industrial Revolution of digital health

Listen (5:05) Do you think about bioethics?

Listen (4:49) Yes to regulation, and yes to access for everyone

Data scientists like Sultan Meghji are a highly valued species in today's world. Beginning his career at the National Center for Supercomputing Applications (NCSA) where he worked on original internet technologies, Sultan has used his expertise in several industries, including finance, air transportation, and now biotechnology.

We've had Sultan on for a couple shows already, and his broad experience and far reaching vision made him an obvious choice for our series, The Bioinformatician Bottleneck.

"We could graduate ten times what we're graduating every year for a decade, and I still wouldn't be convinced that we have enough [bioinformaticians]," he says in today's interview.

What to do about it? Sultan has suggestions, one of which is to have a "Khan Academy style program for How to Become a Bioinformatician in 6 Months." What about the years it takes to train great basic scientists in an age when biologists are already being called "mere technicians?" Sultan says technicians can handle much of the work of commercializing research.

Sultan goes on to suggest there are other important bottlenecks, including the sequencing tools space. Does he stop to think about bioethics? And is he for or against FDA regulation of personal genomic information? Today's show is far reaching and centered around Sultan's goal of bringing genomics to the masses.

"It's almost like the Industrial Revolution of digital healthcare," he says. "We're going to call it something else, but . . .at some point my blood, or some part of me, is going to go into a diagnostic black box, and out is going to come some recommendation that a doctor didn't actually look at. And I'm going to take it to the bank."

Podcast brought to you by: Roswell Park Cancer Insititute, dedicated to understanding, preventing and curing cancer for over 115 years.

Podcast brought to you by: BioConference Live's annual Clinical Diagnostics Conference, May 29-31

Guests:

Steve Burrill, CEO, Burrill and Co Bio and Contact Info

Listen (4:38) Burrill and Buck Conference on Aging

Listen (7:32) Moving to a world in healthcare where we will pay for outcomes

Listen (6:23) Has it not always been about values?

Listen (4:24) Can Pharma create value outside of providing drugs?

Listen (1:08) Thoughts on gene patent case

"This is not your grandfather’s Buick anymore. If you grew up in biotech any time prior to the last five years, you need to reexamine your assumptions about the world of reimbursement." Ron Cohen, CEO, Acorda

This quote is taken from the yearly state of the industry book put out by Burrill and Company. CEO, Steve Burrill joins us today to discuss the newly published book this year subtitled, "Capturing Value." Cohen's quote summarizes the message in the book in which Burrill and his team argue persuasively that things in healthcare are not the way they used to be, that we are moving from a "cost-based" to a "value-based" system. Steve discusses this paradigm shift in today's show and explains why we need new assumptions in the world of pharma and biotech.

Early in the interview, Steve previews the first Burrill and Buck Aging Conference coming up May 20-21 in Novato California. The interview ends with Burrill's thoughts on the Myriad gene patent case.

Podcast brought to you by: The Burrill and Buck Aging Conference Explore how innovative approaches from regenerative medicine to digital health stand to change our notion of what it means to grow old.

Guests:

Eric Topol, MD, Cardiologist, Genetic Researcher, and Technologist Bio and Contact Info

Listen (6:22) Patient stories heard at Future of Genomic Medicine Conference

Listen (4:34) Medical community's response to book

Listen (6:02) "I just wish I could go back and start medical school again"

Listen (4:30) Eradicate fee for service

Listen (3:05) Craig Venter: Quality of sequencing has gone down

Listen (4:29) "De"personalized medicine?

Listen (0:58) Excited about rollout of sensors

Eric Topol joins us to discuss what was perhaps the most talked about book in the life sciences in 2012, his "The Creative Destruction of Medicine." In his book, Topol tells of the now arriving era of individualized medicine and the rise of "homo digitus," or digital man. In today's show, Topol dives into some key topics from the book such as how to deal with misaligned incentives in healthcare. "I just wish I could go back and start medical school again because this is truly an era . . a renaissance, an enlightenment in the medical space," says Topol when asked about what he advises young people.

Dr. Topol recently hosted the Future of Genomic Medicine Conference at The Scripps in San Diego, and he begins the interview giving some highlights of patient stories.

Podcast sponsored by: "Your Organization Name Here" - Build your brand at Mendelspod. Click here for details.

Guest:

Dr. Dave Albert, Founder, AliveCor Bio and Contact Info

Listen (8:43) Device cleared for medical community, not yet OTC

Listen (6:24) If I could, should I buy this device?

Listen (5:14) Fusing consumer health with traditional med device

Listen (5:09) Was this clearance a new exercise for the FDA?

Listen (4:40) How will you get around misaligned incentives for physicians?

Listen (1:49) Are there any downsides to piggy-backing on a smart phone?

Over the past year we've been closely following AliveCor, the new digital health pioneer. Cardiologist, David Albert, came up with a simple device that fits on the iPhone and can immediately give a person a readout of their ECG. His company, AliveCor, has generated a fair amount of buzz, not least of which is the notice they get from Steve Burrill in many of his talks. It's become a part of Steve's spiel about how healthcare is changing. Steve will stop, pull out his iPhone, put it on his chest and then watch the audience ooh and ah. The company has a stellar lineup of supporters/advisors. I mentioned Steve Burrill, who is an investor. Eric Topol, author of The Creative Destruction of Medicine, is a big fan.

Last week the company received the coveted FDA clearance to sell the device into the medical community. They'll now pursue an OTC clearance so that you and I could buy one for those scary days after a relationship break up or an earthquake and check our own heart stats. Is this company, a fusion of the new consumer health movement and traditional med device, an example of many companies to come? Dr Dave joins us to answer this question and others.