Latest / StartUp Health NOW Podcast / Health Transformers Bringing Diagnostics Into the Home

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Health Transformers Bringing Diagnostics Into the Home · StartUp Health NOW Podcast

• 0:00
  [upbeat music] Welcome to Startup Health Now. This is the podcast where we share stories from the front lines of health innovation. I'm Nicole Clark, Startup Health senior writer.
• 0:13
  Today, I'm gonna introduce you to three innovators whose devices are helping medical providers meet patients where they're at, in their homes.
• 0:21
  There's a tricorder, a centrifuge that fits in the palm of your hand, stick-on thermo patches that can detect early-stage breast cancer. Now, mind you, this is no sci-fi episode.
• 0:32
  The makers of these devices want the world to know the future is now, and now more than ever, we need devices like theirs to effectively stay the spread of COVID-19.
• 0:44
  But before we hear from them, a bit of news about Startup Health.
• 0:47
  This last weekend, Lady Gaga and hosts Jimmy Fallon, Jimmy Kimmel and Stephen Colbert, along with hundreds of artists, media giants, and companies like Startup Health, joined forces for the One World Together At Home telecast.
• 1:00
  An estimated 20.7 million people tuned in to watch.
• 1:04
  When we learned that Global Citizen was hosting the historic broadcast in support of frontline healthcare workers, we knew it was the perfect time to announce Startup Health's new pandemic response moon shot, and so we did.
• 1:16
  On Saturday, April 18th, alongside the One World concert, we officially launched our 12th health moon shot.
• 1:23
  Under the banner of pandemic response, our goal in the next 30 days is to add 10 more companies to the moon shot by investing one million dollars in seed capital.
• 1:33
  We've already invested in over 80 pandemic response companies, and we look forward to supporting more health transformers through our global platform and community.
• 1:41
  Entrepreneurs and innovators who'd like to be a part of our pandemic response moon shot can learn more and apply on our website at startuphealth.com.
• 1:50
  The three individuals who we're about to hear from will give you an idea of the type of entrepreneurs we're looking for,
• 1:56
  change-makers who have a sense of urgency about their work but are in the business of health innovation for the long haul. There's Alex Ness, CEO and founder of Well Ways.
• 2:07
  Well Ways is a startup based in Barcelona that's rolling out their breast cancer detection thermo patches this year. Then there's Sathya Elumalai, CEO of Aidar Health.
• 2:17
  They make a tricorder that could support remote patient monitoring throughout the pandemic.
• 2:22
  And finally, Karen Drexler, CEO of Sandstone Diagnostics, the makers of a handheld centrifuge that's bringing diagnostics into patients' homes.
• 2:31
  They all got together at the 2020 Startup Health Festival in January for a fireside chat about how their technology is bridging the access to care gap. And sure, that was BC, before coronavirus,
• 2:44
  but this is one conversation that has increased in relevance during the current global health crisis. Take a listen. Thank you. Thanks for the intro, and, uh, good morning, everyone there.
• 2:56
  Um, one of the reasons I think Unity, uh, asked me to do this was I've been around from the early Wired days to the, the kind of early to mid-'90s.
• 3:06
  I've watched this digital transformation hit all kinds of different fields, uh, you know, media, retail, the whole thing, and now it's really interesting to see it through the prism of healthcare.
• 3:16
  The other thing is I kinda-- I run a, um, an event series here in San Francisco called What's, What's Now San Francisco, and every m-month we look at a different field that's exploding in innovation, get someone to explain that to a broader audience.
• 3:29
  And so what we're able to see is how innovation is just exploding in all kinds of different industries.
• 3:34
  And again, I think what we're gonna try to do here and in this group here is to start to think, how is it really these trends that have been actually playing in other fields, how are they also playing out in health?
• 3:44
  And so one of the ways we're gonna do this is one of the big things is gone.
• 3:48
  We've gone from clunky big machines to kind of handheld supercomputers, and there's this kind of decentralization and these powerful tools is one of the things that's really driving the change in all kinds of fields.
• 3:59
  So what I'd like to do is have, have each of you introduce yourself, what you do with your company, but talk about the device.
• 4:04
  Every one of you has a device that you probably couldn't have done five or 10 years ago, and if you can just reflect on what's different and new about that device. Go ahead. Yes, sir. Thank you, Peter.
• 4:13
  Or no, let's Ka- No, let's go with Karen. Yes. Okay. Thank you. So Sandstone has a system that allows for centrifugation of samples to happen anywhere.
• 4:22
  We've taken a big, clunky lab centrifuge, which is, because it's big and clunky and hard to use, needs to be in a central lab, and we can literally put that power into the palm of your hand.
• 4:32
  And why that's important is because healthcare is changing. So in our case, it's not so much that we couldn't have developed this five years ago or 10 years ago- Mm....
• 4:40
  but the need in healthcare has really driven the changes. So we heard a little bit on the last panel, people expect to have access to care in different places.
• 4:49
  Not everybody wants to go into a, a lab or a central facility to get their healthcare, and having tools like this enables people in the mo- remotest locations to participate in clinical trials, to be able to get blood drawn from the comfort of their home and have their samples pristine so that they can get access to the best cutting-edge technology.
• 5:08
  And we have things like cell-free DNA testing, which is the fastest growing area of diagnostics ever, where the quality of the sample is so very important 'cause we're looking for minute trace amounts in the blood to help all of us with things like early detection of cancer.
• 5:23
  So it's really the market moving that has caused the need for technology like this at, at this time. Alex. Thanks.
• 5:31
  Um, Well Ways, we have developed, um, a device, uh, two patches for the early detection of breast diseases, including breast cancer.
• 5:38
  Our intention was, one, access to care, bring this device to everybody in the world, um, and second, to, uh, humanize a little bit more the process of, uh, mammogram.
• 5:49
  Uh, we found out that women do not like to have the mammogram done. [laughs] It's very invasive, takes a lot of time. Uh- Hurts... it's money, sometime it hurts.
• 5:59
  So our intention was, uh, okay we-We have to take care of this. Uh, first of all, breast cancer is huge in my family. I don't know if you have suffered directly or indirectly breast cancer.
• 6:08
  Uh, but second is, how can we create this awareness for women to say, "Hey, there is technology, there are tools that will keep me abreast of, uh, potential diseases." So that's our intention. Satya.
• 6:23
  So from our perspective, I mean, especially for somebody who's, as a caregiver, I've been managing my mom with multiple chronic condition, and the challenge is like everybody's taking a point solution approach, giving one device for a patient with multiple chronic condition.
• 6:38
  From our point of view, what we wanted to do is to bring high quality patient-centered care, uh, to the patient's home.
• 6:44
  So as a part of our solution, we built a single device that measures more than 10 vital health parameters in just 30 seconds, non-invasively.
• 6:53
  So this is something can, patient can use every day, more like brushing their teeth in the morning than just use this device.
• 6:59
  And through this, we wanted to provide a more personalized approach to their health so that they can make sustainable behavior changes every single day. So from...
• 7:10
  I mean, as you were saying, it has been a challenge to bring this device. It's been almost eight years of work. Today, uh, it has become a reality because of the current situation.
• 7:23
  And so yours, y- yours is a tool that couldn't have happened five or 10 years ago.
• 7:28
  So, so this is the other thing is, we're decentralizing these things from clinics, from hospitals, whatever, and through that, because we have ubiquitous connectivity, we can bring it out in the field, we can bring it into the home.
• 7:39
  So to what extent, um, is what you're doing bringing down the cost of what used to be done in the centralized kind of situation? Uh, to what extent...
• 7:51
  Is there any way to kind of gauge the price differentials or, or how, how... What, what's the kind of cost savings as we kind of spin this out of the centralized space? Any way to think about that? Sure.
• 8:00
  And there are a, a couple of ways we can think about it, I'm sure we'll find a lot of others.
• 8:04
  But given the current paradigm of collecting blood into tubes and sending it into central labs for testing, for certain assays, there's a pretty high fallout, so there's a yield loss, and that has a cost.
• 8:16
  Many of these samples also need to be shipped very, very carefully, overnight express shipping, temperature controlled packaging, and we're streamlining all of that.
• 8:24
  So by the time the sample gets in the door with an approach like this, the sample will be not only higher quality, but it will cost less to get it in the door, so it will save money for the healthcare system.
• 8:35
  Now, one of the bigger trends you're all part of in the bigger sense is all this data is digitized. It's one of the things that your field at least has gotten through that hump.
• 8:42
  Um, but the thing now we're able to do is use AI to kind of apply this, uh, data. And so I'd like to just... T- tell us how that plays out in your, in your devices, in your companies, but also in your field.
• 8:56
  And why don't you start, Satya, about to what extent are you able to do things now with deep learning, machine learning that, uh, we couldn't have done? Yeah, absolutely.
• 9:04
  So around eight years ago when we had the first prototype, we went around different parts of the country, but everybody was like, "What am I gonna do with all these different sensors," right?
• 9:13
  It's, it's really challenging. People didn't really get AI at that point of time. There's, there was no value on this multi-parameter or a multi-biomarker approach.
• 9:22
  Today, with the value of AI, we can actually map the human health with a lot of data.
• 9:29
  So right now that's why our device or like any other devices that are out there in the market getting more traction because people wanted to collect a whole lot of health information rapidly from patients or from individuals so that they don't have to rely on just one indicator continuously on a daily basis.
• 9:48
  So what AI has done to us is like they now they see the potential, now they see like what all these different parameters can tell about, uh, human health.
• 9:58
  So it is driving us in terms of providing value to individual customers, es- especially, for example, pharma, who wants to look at a patient when they go home with their drug or treatment strategy, they really need to understand what's goes on in the home environment on, with these patients.
• 10:14
  That's where our device comes in and AI comes in to support our efforts. Do you have any kind of application that's working in your- Yes... in your space? Go ahead. Yes. We, we have a complete ecosystem.
• 10:24
  For us, Peter, uh, data is huge. It's everything. Uh, especially considering that breast cancer genetically it's only passed 7 to 9% of the cases. So with the device, uh, uh, this is our Trojan horse.
• 10:36
  With this, we intend to give a tool to women to preventively take care of, uh, the, the, the breast of their health.
• 10:42
  But what we want to understand, uh, is what triggers the expression of BRCA1 and BRCA2, considering that 90% of the cases are, uh, external factors. So da- data is, is everything for us.
• 10:54
  Through the device, uh, our app reads the result, whether you're positive or you're negative, okay? And we use machine learning to start collecting data about your habits, what you do, what you eat, what you drink.
• 11:05
  Uh, is the wine that we drink... I'm from Spain, in, in Barcelona, and maybe there's a big incidence in Argentina in the wine.
• 11:11
  Is there anything in the sulfites that they use for the wine that expres- I mean, that creates expression of these- Mm... of these, uh, uh, of these genes? So
• 11:20
  we are trying to collect, actually, uh, and create the first worldwide database of breast cancer for then put it to use to research institutions and labs to understand what triggers expression of those genes.
• 11:30
  Um, and also the whole ecosystem is we have to leverage on community. We found that the power of community... I mean, I've had this disease, you had this disease, what can we do together? Uh, what did you take?
• 11:42
  What didn't you take? Uh, it's much more than the data itself. It's the collaboration to- the collaboration tools that we expect to get from our users that's gonna help us beat the disease. You're jumping ahead.
• 11:52
  We'll get to in a minute, uh, the collaboration. Um, personalization, again, another big trend in tech.
• 11:57
  I've seen it in all kinds of different, um-Fields, but this dream of individualized medicine, we're here in the beginning of this decade. I mean, are you seeing we're now in...
• 12:06
  Where, where are we in this continuum of like, the kind of tools you have, but also broader beyond your specific companies?
• 12:13
  Are we now getting to the point where we can really start to target this kind of individualized, personalized data sets and really start to make the kind of precision, um, uh, the, the, the precision kind of diagnosis?
• 12:25
  Go ahead. Yeah, exactly. F- uh, when it comes to precision medicine, again, different patients are different.
• 12:32
  And then today, medicines are made for a patient and a disease and not for a specific individual or a specific patient. And that's where by using a technology like, like ours, we can actually personalize care.
• 12:46
  For example, using our device, we can measure multiple parameters, and the changes within those parameters i- in these patients and every time when they go through drug trials.
• 12:56
  So we can profile individual patients, and then, like, we can titrate the drugs better, so that using our technology, we can also, um, identify early signs of a clinical deterioration early enough to provide value, and that's where companies, diagnostic companies providing value to personalize individuals.
• 13:19
  Because for my mom with, like, multiple conditions, she can just use certain parameters to monitor her, while others who doesn't need to use other parameters can still get a overview of their health. Gotcha. Um,
• 13:37
  what's happening now? I mean, a lot of these are in development, and there's a lot of kind of looking ahead and how can we do this, but yours is really making it... Right now, it's applicable, right? Karen- It is...
• 13:46
  do you wanna talk about how does it make a difference in an individual's life, or how, how is it right now something that can make a difference, and how could you see that scaling, uh, in the next five years? Yeah.
• 13:55
  So the initial use cases that we have out in the market now are in the remote clinical trial space, and in particular in the heart failure area.
• 14:03
  So patients who are at risk or have had heart failure tend to be pretty ill. For them to participate in clinical trials, you often need to get to them where they live. Mm-hmm.
• 14:11
  And being able to send mobile phlebotomists or get people access to the care in their home as opposed to requiring them to come into an academic medical center is enab- enabling people all over the country to participate in clinical trials.
• 14:25
  It turns out that these heart markers are, are very sensitive to the way the sample is handled.
• 14:31
  So it's also a great match with our technology in that by preparing and stabilizing these pristine samples, we make sure the right information comes back in terms of their, their status for the clinical trial outcome.
• 14:43
  Another big theme that we see in all these different fields is when you crack the product initially, usually in a developed countries at a higher pricing, they can then quickly scale globally.
• 14:54
  And I'd just like to think, like, what... Are you-- how do you see that playing out with your tools, but also in your field? Go ahead.
• 15:00
  As someone from outside the States, uh, how do you see it taking off globally and, and how much will we see that happen in this decade here?
• 15:08
  I, I think it's imperative to go, uh, to go globally, and, and, and, and that's your or the reason why many of you are attending this kind of conferences, is our mission as human beings to, to bring and leverage on this technology to be worldwide.
• 15:21
  Um, we-- yes, for us it's super important. Uh, the US is, is home to us. Uh, the device is gonna be launched here first this April. But, uh, once again, this is, uh, any sickness doesn't have any nationality.
• 15:35
  It's totally... It's global. It's universal. So considering the different races, different, uh, chances of developing this disease, we have to understand what, what, what's happening. Okay?
• 15:46
  Why, uh, for instance, uh, uh, Latino women have more chances to develop, uh, breast cancer that, yes, uh, white Caucasian women. So
• 15:55
  we have to go there, we have to decentralize, and we have to bring access to everybody regardless of social or economic status. Uh, I feel that we are more connected than ever.
• 16:06
  But when it comes to health, we are not leveraging enough, whether if it's, uh, for regulations or cost, okay, the power that we can bring to communities that they have no access to care.
• 16:16
  And I've been visiting, uh, hospitals, uh, in Europe, Africa, Asia. Um, even here in rural America, we don't have to go outside home, you know?
• 16:25
  You go to, to certain states, you know, and they really have to g- uh, drive miles to, to, to, to understand if they're sick, if they have something or not.
• 16:34
  So as entrepreneurs, as people are experts in health, it's our uttermost obligation to make sure that everybody has the same access regardless where they live. Mm-hmm.
• 16:45
  Well, do you also even maybe see greater potential and greater demand and greater actually... C- could you see these as actually almost being primarily geared to global kind?
• 16:54
  Given you got cheap tools going into kind of- Yeah... the hands of the periphe- at the periphery. Yeah. Isn't it in some respects almost more potential in the global market than what you've even got in developed worlds?
• 17:04
  There certainly is huge potential.
• 17:06
  So if we look at the, the issue of sample stabilization, doing highly personalized cell-free DNA testing is not likely to be pervasive in the developing world anytime soon because of the cost of sequencing.
• 17:18
  But blood tests are traditionally run in many of these markets by doing a finger stick and putting drops of blood onto a piece of filter paper, drying it out, and that is a really poor way to not only sample, but to handle the blood.
• 17:32
  We've got versions of this that will allow for capillary sampling in a way that it could be stabilized.
• 17:37
  So you have stable liquid plasma even in these harsh, low resource areas that again, will allow people access to high quality diagnostic testing with, with a very straightforward solution.
• 17:49
  So we're very excited about the potential for bringing this into the developing markets. Wow. Wow. One of the big things they wanna talk about here is collaboration- Mm...
• 17:58
  and how that works in your field, how it works with folks outside your field.
• 18:03
  Um-Why don't you give a start, jump in here, but to, to what extent have you found collaboration to really be helpful in your building your business and expanding your model?
• 18:14
  To what extent have you seen kind of difficulties in kinda getting more of that? I'm just curious where you fit on the, the collaboration me- method. Why don't we start with you, Sajit?
• 18:20
  I think when it comes to collaboration, uh, you really need s- some data to actually first start some of the collaborations, right? Ah. [clears throat] It took several years.
• 18:30
  Uh, our technology was a nice thing to have, but it didn't really add value to any of the customers. Once we have data, now customers are really interested in, for example, even doing a study at, at Johns Hopkins.
• 18:45
  Uh, it was a great opportunity for us to generate more data from that, and, and that leads to more money. Uh, and from a pharma perspective or from payer perspective, the next step is to get a clearance, right?
• 18:58
  So and then all these partnerships has been really instrumental for us to move forward, uh, because for a startup it is much more difficult to accomplish anything without the support of, like, organizations.
• 19:13
  For us personally, Hopkins, Novartis, and other pharma companies have been pushing us forward, um, specifically in the area of clinical trials, bringing virtual trials to patients' home.
• 19:26
  And, and for us, we wanted to help, uh, even the providers, right? To-- We want a simplified solution so that providers can also adopt our technology.
• 19:38
  So testing all those things in the market, all these collaborations have been very vital. How about you, F- how does c-collaboration play in your, in your, in your business?
• 19:48
  For us is, uh, is essential, and actually it's collaboration that make us up better. Um, in breast cancer we want to understand the phenotype and the genotype of the user.
• 19:58
  Uh, as I told you before today, for instance, uh, through wearables we can connect to Apple Hea- uh, Healthcare, uh, Healthcare Kit, you know, and we can know your lifestyle. But then we have genomics. Uh,
• 20:10
  by knowing what's going inside of you, you know, and today with the exponential growth of technology, the cost of genomic has in- decreased considerably.
• 20:18
  We can send to our users worldwide, you know, a test to see if you have BRCA1 and BRCA2.
• 20:23
  Uh, all that, all that collaboration, all those things allow us to create this amazing, uh, ecosystem, you know, that at the very end is gonna help us to determine, uh, through our, uh, the use of AI, the probability that each user has developed this, this disease.
• 20:39
  I think it's essential, Peter. I think we have to leverage and need each other much more than ever before.
• 20:44
  And I found that when you're working for a right cause and you collaborate with all these people, amazing, like you guys- Yep... uh, magical thing happens. [laughs] It's insane. We get there better and faster. Yeah.
• 20:57
  Yeah. That's fantastic. Um, you have a thought on that, on the collaboration side? Sure. No, I mean, for us it's essential- Okay... 'cause we're not providing the end diagnostic.
• 21:04
  We're providing the front end, the so-called pre-analytical phase of the assay.
• 21:09
  And there have been hundreds of millions, maybe billions of dollars that have been poured into some of these efforts, like with Grail, other companies, trying to get these early signals for, for cancer, and these companies know that they need support in the pre-analytical phase.
• 21:22
  So we find there's a lot of openness for people to work with us and to help us optimize so that we can optimize the end result for the patients.
• 21:30
  So one of the holy grails I know of, um, so we're, we're at the beginning of the decade here. We're looking out 10 years. Um, I love that big picture lens.
• 21:40
  There's so much talk about how the US health system is, is, is, let's say, suboptimal, not working in the way we want it, right? Um, how do you think about the next 10 years?
• 21:50
  Do you see we're at some kinda new inflection place that with genomics, with the kinda new diagnostic, which the digital transformation, everything's digitally connected and, and all, maybe potentially interoperable, all these different data sets?
• 22:06
  What do you think about the next 10 years?
• 22:07
  Are we gonna see a k- uh, do you think we'll see incremental but positive change, or do you think we could even see some kinda radical and, and really big leaps in the entire system? Just curious.
• 22:16
  [laughs] I think, uh, definitely the- Go ahead... digital therapeutics is gonna play a large role in this case.
• 22:22
  Uh, I know there's a lot of apps available today, but then I look at as more devices coming into play and, and, and coaching coming into play. Uh, everybody talks about social determinant of health, right?
• 22:33
  That's, that's where it's gonna be, like, not looking at a person individually, uh, but then holistically.
• 22:40
  Looking at their environment, looking at their, um, their habits, looking at their health, and everything is gonna go to the patient's home.
• 22:49
  So I look at it as every single aspect of health is gonna be more personalized and, and driving towards patient's home where they are and not to a hospital setting. Absolutely. Any other thought, next 10 years?
• 23:04
  Cheaper, better- [laughs]... radically different? Well, hopefully radically different. We need it. Mm-hmm.
• 23:09
  Um, I'm not sure exactly where that will ha- where that will happen, but we heard a little bit on the last panel, and I'm sure we'll hear it through the next two days, where care is delivered just needs to change, right?
• 23:18
  We're not graduating enough primary care physicians. People are seeing the, a doctor, whatever doctor they can see, while they're in their pajamas sitting in their, on their couch in their living room. Mm-hmm. Right?
• 23:27
  The delivery of healthcare as a whole just needs to change.
• 23:30
  We need, need to use technology to make that efficient and to get to people, hopefully in the earliest stages, when we can not only provide the best outcomes but also save a ton of money, which obviously the US health system needs to do.
• 23:43
  Your thoughts, the next 10 years. Yes, I, I totally agree with them. Yeah. I think it's, uh, definitely gonna be better.
• 23:47
  Um, regulations and regulators have a very tough job to make sure that everything that we brought, uh, we bring to life, you know, uh, works, uh, as it's supposed to work.
• 23:57
  Um, and we all know, I mean, we, we know and the system knows that it's better to treat, uh, uh, health than to treat disease.
• 24:04
  Uh, at the, if we are able to be preventive, uh, if we can focus on lifestyles, better lifestyles, uh-We're gonna see big changes, Peter, I have no doubt about it.
• 24:14
  So when you look back the last 10 years, the difference we've seen in health for the last 10 years compared to the differences we're gonna see in the next 10 years, as we're winding down this panel,
• 24:27
  h- how would you, how would you compare those two decades? Are you gonna see, like, a very different, big changes and very different kinda future? Or are we gonna see kinda keeping on that steady stream kind of forward?
• 24:37
  I think that- You only got a few seconds. Last kinda thing, up or down. There's definitely gonna be a lot of change.
• 24:41
  Uh, I don't think it's gonna be gradual, because now patients have more ownership, and patients wanted to be involved in their care. So it's gonna be gradual shift.
• 24:50
  And I also believe, like, even healthy individuals are gonna focus on getting better care, uh, and not just wait till they get sick. Proactive care is where everything is gonna go.
• 25:01
  Yeah, the last decade really set the stage. We finally have payment codes for digital health.
• 25:07
  We've got the ability to have things connected, and now we really need to take advantage of those advances, of the ability to see patients where they are, and, uh, and get in early.
• 25:16
  And last quick word, where do you think? Information is power, therefore everything is, uh, we get more, like you said, Satya, we have more information at, at our hands now.
• 25:24
  So we wanna push regulators and, and entrepreneurs and, uh, to, to come with better things. Uh, so yes, it's gonna be amazing. It's gonna be a great decade.
• 25:33
  So with that, I'm gonna end it here, and, uh, let's keep this conversation going through the next couple days. Thanks. Thank you. Thank you.
• 25:39
  [audience applauds] [upbeat music] At StartUp Health, our motto has been, together we can.
• 25:44
  By uniting a global army of the world's top health innovators, we believe we can solve the world's biggest health challenges, including challenges like the one we currently face.
• 25:54
  We invest in entrepreneurs, like Alex, Karen, and Satya, who are committed to achieving health moonshots. To read more about the inspiring women and men in StartUp Health, go to startuphealth.com and click on content.
• 26:07
  I appreciate you joining me today. Next week, I'm talking with Kevin Deadner. Kevin's the CEO and founder of Henry Health, where he's on a mission to increase the life expectancy of Black men by 10 years.
• 26:19
  We'll get into how his company's culturally relevant behavioral and mental health services are helping him achieve that moonshot.
• 26:26
  And then I've asked Kevin to share his insights on how to address racial disparities in the pandemic response. Meanwhile, stay safe, stay healthy, and if you can, stay home. We're all in this together.
• 26:38
  [upbeat music] Three, two, one. Go. [upbeat music]