Uzma Samadani is the cofounder of Oculogica, a neurodiagnostic company that, through eye movement tracking, specializes in detecting concussions and other brain injuries otherwise invisible on radiologic scans. She shared her journey of discovery on the TEDMED 2014 stage. We caught up with Uzma and learned more about her vision and methods of discovery.
Who or what has been your main source of inspiration that drives you to innovate?
Necessity was the mother of invention, and serendipity the father. We sought to develop an outcome measure for a clinical trial for severely injured vegetative patients when we developed the eye-tracking algorithm that we subsequently realized could detect concussion. We had expected to use the eye-tracking algorithm to calculate how well people could pay attention and fixate their gaze, but then were surprised to find that it actually showed us what was wrong with the brain. Now that we have discovered this technology, we understand its implications: it enables us to detect previously ‘invisible’ brain injury. We are inspired, driven even, to innovate and make this technology available to everyone who has sustained trauma. We can help people who previously would not have had objective measures indicating brain injury.
Why does your talk matter now? What do you hope people learn from your talk?
My talk is not so much about brain injury directly as it is about a moment of discovery – the rare shock of finding something remarkable and considering its implications, then the doubt, and the concern about artifact. And then, the gradual realization that we have discovered something real and potentially extremely helpful for humankind. I hope people who hear my talk are inspired to work hard and make their own discoveries.
What is the legacy you want your work to leave?
Brain injury is the single greatest cause of death and disability for Americans under the age of 35 years of age. By creating a biomarker and outcome measure for injury, we can test treatments and therapies and also evaluate prophylactics such as helmets. The true measure of our success will be its utility: to other researchers, to clinicians and to the people who sustain injury.
There’s also an opportunity to visualize progress; the Imagine Wall – seen above in its San Francisco incarnation – is a mural of Twitter responses to the question, “How would you imagine a healthier world?”
The Hive was conversation central for the Great Challenges program, a platform for discussing complex public health issues. Delegates also had a chance to talk over some of the biggest questions in health and science over at the Campfire, an intimate space that presented thought experiment questions to small groups.
Hot topics: Getting approval and a market plan for niche medical devices; the increasing dearth of primary care physicians, and what medical education should do about it, and how the world can solve the health conundrum of having undernourished populations in most of the world, and overweight, overfed people in many others.
We’re thrilled to present ten of the startups who will be joining the TEDMED Hive 2014 in San Francisco and Washington, DC this September 10-12. We’ll be announcing 10 more Hive startups this Thursday. Follow news here or @TEDMED.
At TEDMED 2012, Rebecca Onie asked a simple question with an extremely complex answer:
Why don’t we have a health care system that keeps us healthy?
As a college sophomore, Onie realized through her work as a legal aid intern that lack of basic needs like food, heat, transportation, and health insurance were preventing people from achieving – and, more importantly, maintaining – good health. And she found that most often, doctors practiced a “don’t ask, don’t tell” policy around these issues, assuming, though not without anguish, that these solutions were simply out of reach.
In 1996, Onie co-founded Health Leads, an organization that enables clinicians to “prescribe” food, heat, and other basic resources their patients need to be healthy, alongside medical care. And what began as a student-run organization in a pediatric waiting room is now national in scale. In 2014, nearly 1,000 student Advocates will connect over 14,000 patients and their families to the resources they need to be healthy.
In the last two years, Health Leads has received over 1,000 requests for expansion from hospitals, providers, health systems, and others looking for a way to address their patients’ non-medical needs. On our blog in September, Onie called this demand “symbolic of a much larger shift taking place in the healthcare system.”
And this demand comes from a healthcare system ready for a change. As Onie reported on Forbes.com after her trip to the 2014 World’s Economic Forum’s Annual Meeting in Davos, the sector is finally asking not whether it is necessary to address patients’ social needs, but how to do so effectively:
This momentum extends beyond the handful of health systems whose vision and values tie explicitly to a comprehensive definition of health….Each of these signals the unprecedented moment unfolding in the U.S. healthcare system, triggered by shifting market trends and financial incentives.
Recently, Health Leads received a $16 million grant from the Robert Wood Johnson Foundation (RWJF) to scale its impact. The grant represents the largest in Health Leads history and one of the largest ever awarded by RWJF.
The grant will enable Health Leads to serve more patients around the country, as well as help facilitate its next phase of growth – building a national movement to catalyze the healthcare system to address patients’ basic needs as a standard part of care. In a new article on Stanford Social Innovation Review (SSIR), Health Leads outlines its innovative approach to scale, intending to partner with a small number of leading health systems to drive the change it seeks in the healthcare system:
“Growing in this way enables us to focus on deep integration with our partners, and frees up valuable resources and management time to focus on catalyzing the ecosystem surrounding those partners.”
One of the first new partners in this phase of Health Leads growth: Massachusetts General Hospital (MGH). Last October, Health Leads opened a desk at MGH that has already served hundreds of patients. And most recently, the organization has expanded west. At the end of May, Health Leads launched two new sites in California’s Bay Area – one at Contra Costa Regional Medical Center and the other at Kaiser Permanente Medical Center – Richmond. It is partnerships like these that Health Leads believe will drive the sector to the “new normal” it envisions. As Health Leads said in SSIR:
Going small may not be glamorous. But if we can couple a powerful on-the-ground demonstration with pathways to change the sector, we will have the opportunity at last to transform health care for patients, physicians, and us all.
As Vice President of the Samsung Catalyst Fund at the Samsung Strategy and Innovation Center in Menlo Park, Calif., Shankar Chandran spearheads strategic investments in disruptive technologies with a special focus on mobile health. Earlier positions in engineering, business development, and management, as well as experience inventing and taking eight technologies through the patent process, and degrees in engineering, materials science, and business equip Chandran for eyeing early stage and disruptive venture capital investments in technologies targeted at high growth sectors including cloud infrastructure, mobile technology, mobile health, next-generation user interfaces, and the internet of things.
TEDMED: What’s the most remarkable innovation you are seeing in health tech or medicine, and what is driving it?
Chandran: It’s the coming together of sensors and algorithms. The human body is the most complex system out there and the only time we are used to measuring anything in the human body is when we go for our annual physical. Now, technology and market forces are converging to the point where sensors are becoming accurate enough and algorithms are becoming sophisticated enough to take continuous measurements of the human body. That is the most remarkable innovation in front of us. It never existed before.
The Samsung Gear Fit, for example, can be worn on your wrist and measures your heart rate continuously. And that is just the beginning. Imagine measuring not only heart rate, but also other important vital signs continuously and noninvasively. That changes the paradigm of collecting data about the body. And what is in the market today is just baby steps toward what is likely to happen over the next three to five years.
Here’s an example: Years ago, when jet engines were adopted, they were an incredibly complex system. They would take a jet engine down for preventive maintenance every 30,000 miles or so. Today we have hundreds of sensors in every engine that constantly measure so-called “vital signs.” The moment something varies from what is normal they take it down. They don’t want to wait until the thing fails, obviously. Consider that the human body is way more complex than a jet engine; we just haven’t been able to measure a lot of things very well until now.
TEDMED: What’s the most important factor for entrepreneurial success in health tech—and is that different from your own key to success?
Chandran: One of the key things for an entrepreneur in any of the new emerging health tech categories, such as digital health and mobile health, to think about as they develop their technology, product, and vision, is that it’s going to have to work for a lot of different people. We’re all different with respect to genetics, ethnicity, age, sex, habits, lifestyles, and so many other parameters that affect us. All of these things matter when it comes to doing something about heath tech. To be successful, entrepreneurs have to have a very broad vision that works for a very large segment of the population.
Does that apply at Samsung? Samsung’s success is probably the opposite: We’re a consumer electronics company. We have the ability to micro-market what we can do. We’re able to slice and dice the market and build so many variations of the same product that may work, for instance in Korea but not Japan, in the U.S. but not China. For instance, we make 100 different Galaxy phones to make it work anywhere in the world.
But it’s hard to micro-market a health tech algorithm or sensor that’s going to make people’s lives better. It’s going to have to work for everyone. So for entrepreneurial success in health tech, the vision needs to be broad. That’s a challenge that very few companies have been able to manage very well.
TEDMED: For entrepreneurs with needle-moving ideas in global health, what are the keys to finding collaborators and supporters across specialties, industries, and geographies?
Chandran: First and foremost, the entrepreneur’s idea needs to be highly disruptive, and not just an incremental turn on something that exists already. It must fundamentally solve, through ingenuity, a problem that is very hard to solve. Collaborators, regardless of geographies, will naturally gravitate toward the most disruptive ideas.
Also, the solution to the problem needs to have a large enough impact. It needs to work for a large market. Big companies, global corporations, and established companies naturally gravitate toward large opportunities. If they see the potential for a little company that is solving a problem with a large addressable market, then that matters.
Third—and perhaps the most important key—is that the entrepreneur needs to have the ability to tell the story extremely well. New companies need to rise above the noise. Their ability to tell the story must answer the biggest questions about how disruptive they are and how they are solving a big problem effectively. If they can do that, that’s what will let them rise above the noise and attract people. In fact, the phones won’t stop ringing.
The greatest technology communicator I have ever had the opportunity to listen to in my career has been Steve Jobs. People might not know the number of times he would practice before he got on stage to present anything new. I have personally heard that he would practice at least 50–60 times before he gave a keynote at Apple’s worldwide developer conference or at the launch of the new iPod or iPhone. That tells you a lot. It says that communicating the quality of the idea and the size of the opportunity and the impact it’s going to have on people’s lives is as an important an entrepreneurial trait as it is to actually invent the thing.
TEDMED: In 2020, you’re asked to give a TEDMED talk about the biggest transformation you helped bring about in your field. What is it?
Chandran: Technologies will help us fundamentally change our habits to live a better life. These will be individualized technologies that measure the human body and generate data that can be compared to the population in general. It will be continuous—every second or several times a second, depending on the vital signs being measured. We will measure multiple vital signs to get insights about a person. We will use those to change habits around eating, sleeping, managing stress, and more.
As we all know, there’s $8 trillion spent around the world on health care; $3 trillion of that is spent in the U.S., primarily on diagnosing and fixing chronic diseases. If what I am predicting happens, then we prevent that spending on the chronic diseases by delaying or eliminating some of them. That becomes a big deal. That is the biggest transformation I think is possible over the next 5 or 10 years.
Chandran is a Curator for The Hive at TEDMED 2014.
Mental illness is the single largest cause of disability in developed countries, even more than cancer and heart disease, says the Centers for Disease Control and Prevention. And depression in particular is under-treated in the U.S.; only half of those who suffer get help, particularly some minority groups.
We already use the Internet for countless patient interactions – why not as an adjunct to therapy? Empower Interactive, a TEDMED Hive 2013 company, developed a web-based program, Good Days Ahead, for those who suffer with anxiety, stress or depression.
“There’s a great volume of clinical evidence you can deliver some aspects of psychotherapy by software,” says Eve Phillips, CEO, who explored the potential of the technology while working as a research affiliate in the Synthetic Neurobiology Group at the MIT Media Lab.
Good Days is available in two strengths, so to speak. One is a clinical version to complement talk therapy. Roughly half of a treatment module contains targeted online education, while the other half is work one-on-one with a therapist, who can review information on how the patient is using the system.
The wellbeing version is a self-coping tool that aims to help those with mild symptoms of anxiety and depression. A related mobile app, ReThink, allows users of both platforms to record thoughts and emotions, accompanied by photos, for later reflection. Anonymized, aggregated data gives administrators feedback on user activities and outcomes.
Good Days was co-authored by psychiatrist Aaron Beck, generally considered to be the founder of cognitive-behavioral therapy (CBT). It is a treatment that examines the way that our thoughts and perceptions of situations influence our actions and how we feel emotionally. Research consistently shows that computer-assisted CBT is as effective as standard therapy, and patients using these programs better understand what CBT is and how it works. It’s more cost-effective and easier to disseminate. That’s key in an area like mental health, which is under treated in the U.S. and around the globe. CBT is also helpful for those suffering with chronic pain.
For those reasons and more, Empower has already been working with the United States Army to help enlisted personnel and veterans. They’re also working with Sutter Health and San Francisco Health Plan, and have pilot programs with other major insurers and health systems.
“Some groups are trying to integrate behavioral health into primary care, or do it in a more saleable and consistent way, or perhaps under the umbrella of under chronic disease management,” Phillips says.
Eventually, Phillips hopes to craft a program for kids and teens, too – another under-served population, and certainly one at ease with computer screens.
Building A Global Research Superhighway
“LinkedIn on steroids” is how Dr. Fabio Thiers, founder and CEO of The Hive 2013 company ViS Research, describes the web platform that helps trial planners to find investigators and sign up the perfect research center. An analytics-slash-communications tool, ViS helps planners source and sort investigators by capabilities, expertise, current trials and available patient populations, and then contact them on the closed system. Currently, some 330,000 investigators from 178 countries are represented on the system, comprising 417,000 disease-specific centers. The data is visualized according to location.
Pharmaceutical companies spend billions each year on feasibility studies, while research centers spend valuable time trying to attract them. When the twain do meet, an average of half of all centers drop off during the lifetime of a study. The inefficiencies lead to some $10 billion each year in waste, Thiers says, including greater expense and longer lead times for drug discovery.
Thiers, who trained as an MD in Brazil, also trained at the Harvard-MIT Division of Health Sciences & Technology and previously ran a research program on global resource allocation at MIT. That interdisciplinary background, plus his worldly perspective, helped him to build ViS’ global team of medical researchers, programmers, trial planners, statisticians, and designers.
The nature of the platform meant launching a global enterprise right off the bat, which ViS has done, with regional offices in the US, Brazil, Germany and India.
ViS also has the potential to be a global equalizer for industry opportunity.
“The previous system was about about who you know. More well-known sites were more likely to be chosen. Here, all sites have the opportunity and a common platform for which to share their capabilities,” Thiers says.
ViS has partnered with a number of industry groups and non-profits to expand and improve its network. They’re working with ACRES, the Alliance for Clinical Research Excellence and Safety, to help inform standards for clinical research sites. The company is also working with the Biotechnology Industry Organization (BIO) and its member companies to map more than 3,000 institutions with pediatric experience across 84 countries.
Catalyst is an ongoing series about health innovation, focusing on companies from the TEDMED Hive. For more information about The Hive 2014, click here.
The Hive at TEDMED isn’t simply a showcase of entrepreneurs and startups; it is a meeting of minds and ideas. It gives companies and individuals the power to make unique connections and to accomplish breakthroughs. Brilliant solutions may seem obvious in hindsight, but the ability to pave an innovative path is a rare skill.
Recognizing that skill requires unusually talented people. That’s why we’ve recruited a diverse and deeply experienced team to help select the entrepreneurs who will represent new innovation in The Hive in 2014. Our curators are social influencers, venture capitalists, inventors, proven leaders in design and entrepreneurship and more. Each is a seasoned disruptor who has made a vast impact in health and medicine and who represents an organization with a commitment to creating a healthier world.
TEDMED Hive 2014 Curators
A longstanding leader in informatics, Michael drives the design and implementation of enterprise clinical and research information systems and technologies across the University of California, San Francisco. He also leads UCSF’s new Center for Digital Health Innovation.
A venture capitalist with an enviable success record, Leslie invests in healthcare start-ups at GE Ventures, specializing in medical technology and emerging business models.
A venture capitalist, Shankar spearheads strategic investments in disruptive technologies at Samsung Catalyst Fund, with a special focus on mHealth.
Using engineering to hack medicine for better quality at lower cost, Zen drives development of early-stage medical devices and healthcare information tech at MIT.
Sumbul Ahmad Desai
A journalist-turned-Disney-strategist-turned-doctor, Sumbul now leads innovation and the design and deployment of virtual care and digital products at Stanford Medicine.
His latest move to head up Johnson & Johnson’s Innovation Center in California continues Ken’s long history of catalyzing early stage ideas and helping bring novel and transformative medicines, devices, and consumer products to market.
Co-founder of Iodine and Entrepreneur-in-Residence at Robert Wood Johnson Foundation, Thomas helps find and nurture fledgling ideas with big promise to improve public health.
As Chief Design Officer at Philips Healthcare, Sean develops a broad range of products, interfaces and consulting solutions that help shape the future of healthcare and save lives.
Doctor, former government IT policy advisor and business development leader, Mohit is a Partner and investment sage at Aberdare Ventures, which works solely with healthcare companies.
As the Director of QB3, one of four California Institutes for Science and Innovation, Regis marshalls the efforts of some 200 quantitative biologists to convert their discoveries into scaleable, usable benefits for people.
As Verizon’s Chief Medical Officer, Peter oversees healthcare strategy and a vast portfolio of solutions designed to speed evolution of the healthcare IT ecosystem.
We thank this powerhouse collection of curators for sharing their expertise as part of The Hive 2014. You can see all their full bios on TEDMED.com, and over the next few weeks we’ll bring you an in-depth discussion with each of our Curators exploring his or her insights and perspectives over the next few weeks as part of our Catalyst Series.
At the end of April, we will begin announcing the startups selected for The Hive 2014.
Don’t miss out on any updates: Follow Hive news on Twitter at #TEDMEDHive and here on the blog.
Could a heart damaged by disease or cardiac arrest be coaxed to repair itself?
Hina Chaudhry, MD, is leading research of a gene therapy that has shown promising results in animal studies. She co-authored a study published today in Science Translational Medicine that details how the gene, cyclin A2, helps cardiac muscle cells – cardiomyocytes – undergo cell division in pigs, regenerating healthy tissue and helping the heart to repair itself. Normally the cyclin A2 gene is silenced, preventing further cellular division, post-birth in mammals.
The procedure is backed by the biotech company VentriNova, Inc., a TEDMED 2013 Hive company founded by Dr. Chaudhry, who is also a TEDMED Innovation Scholar.
The company claims that no other regenerative strategy on the market or in clinical development has the ability to grow new heart muscle cells in the diseased heart.
“Everybody else has been doing something different — injecting stem cell transplants in the heart, and it has generally failed. You have to understand how cells divide. Why do they stop? That’s where you see the vast mortality of heart disease,” Chaudhry says.
Though there is some rate of cell turnover in the human heart, it is not enough to repair muscle damage after a cataclysmic event such as myocardial infarction. Instead, scar tissue forms. Certain metazoan species, though, do have the ability to regenerate; the newt can replace injured body parts, and the adult zebrafish heart may be able to regenerate up to 20% of its volume, the study reports.
Chaudhry’s team used an adenovirus to deliver cyclin A2, a cell cycle regulatory gene, which induced cell mitoses. Animals that received therapy showed improved heart function compared to controls. The authors also observed significantly decreased fibrosis and increased numbers of cardiomyocytes.
Dr. Chaudhry, who is Director of Cardiovascular Regenerative Medicine at Icahn School of Medicine at Mount Sinai in New York, has been working on the project for close to two decades; she got the idea working as a research fellow.
“This is the most exciting publication of my life,” she said to TEDMED. “I can’t wait until it goes into clinical trials, and I’m very hopeful that it will work in human patients.”
Study co-authors are Drs. Scott Shapiro and Amaresh Ranjan, also from Mount Sinai.
Following is the first of a new series highlighting notable innovations, imaginative solutions and groundbreaking ideas in health and medicine.
We’re kicking off our Catalyst series, bringing you updates from The Hive at 2013, our debut gathering in Washington, D.C., which featured 50 starts-ups with game-changing, entrepreneurial thinking.
The Hive introduced the TEDMED community to companies like Brain Sentry, which Wall Street Journal named a “startup of the year.” The Bethesda-based company makes a helmet-mounted sensor indicating when a young athlete has received a head blow strong enough to demand medical attention. It launched its product in September to considerable attention, including the nod from WSJ; the sensor is already used by hundreds of teams nationwide.
A group of graduates and students from Johns Hopkins University started Healthify, an electronic questionnaire that patients complete to help providers assess social risk factors that might impact their treatment. The tool connects patients with resources and automatically texts them to follow their progress.
“Working with patients, we discovered underlying issues like social and behavioral needs; housing problems; substances abuse; domestic abuse. But there’s one [social work] case manager for every 5,000 patients. There was no technology solution,” says Healthify CEO Manik Bhat. Bhat reports that the company recently finished the Blueprint Health accelerator program in New York and has deployed its platform with an initial set of four customers, including Montefiore Medical Center and insurer Universal American, and is raising a first round of financing.
Helping connect patients and providers over time was a theme in a number of innovations. Brad Hammonds, co-founder of SenseHealth, which helps providers monitor and support patients between appointments, reports the company has “had a really great run since TEDMED,” including a $100K grant through the New York City Economic Development Corp. to work with Montefiore Medical Center’s care management group. SenseHealth was selected to join the Startup Health Academy’s three-year accelerator program, and was one of five finalists in Merck’s “Re-imagining Solutions for Care Plan Adherence” challenge, winning a $20K prize.
How can patients stay on top of managing their own care once they leave a hospital or rehab, when they’re not in peak health? Boston-based Wellframe developed a mobile app for people with chronic disease that delivers daily to-do lists. The app also enables HIPAA compliant two-way communication among patients and care managers. The company was recently named a semi-finalist in the Merck / Heritage Provider Network Innovation Challenge.
AdhereTech‘s smart pill bottles help monitor medication adherence. “We’re building a cell phone into the bottle,” Josh Stein, CEO of AdhereTech, explained to FastCompany. The pill bottle incorporates wireless technology, sensors that measure weight and humidity, and a long-life battery. It snagged the Healthcare Innovation World Cup in May. Stein tells TEDMED, “Our Walter Reed pilot started a few weeks ago, and our Cornell pilot is scheduled to start in January. Patients love the bottles, and preliminary data is extremely promising. We are one of 15 companies from around the world that have been invited to join the GE & StartUp Health program.”
Hive companies were eager to answer clinician needs, too. Visual DX is an app and online platform developed by two dermatologists, Art Papier and Noah Craft, comprising some 100,000 peer-reviewed medical images. Based on the information entered, VisualDx delivers a list of potential diagnoses, a series of photographs against which to match the patient’s symptoms, and recommended treatments. Papier says only recently has clinician technology usage ramped up enough to allow a product like VisualDx to take off. More than half of the medical schools in the country teach with VisualDX now, and some 1,500 hospitals and large clinics use it.
Wello invented a water wheel that helps citizens in developing nations carry more potable water, farther. The project is now operating in four states in India, scaling production to meet demand and expanding to Kenya in January, 2014, says Cynthia Koenig, Founder and CEO. Wello was also awarded a Grand Challenges Canada “Stars in Global Health” grant.
The program seeks breakthrough and affordable innovations that could transform the way disease is treated in the developing world.
A number of Hive companies made appearances at the recent mHealth conference in Washington, D.C. Humetrix gave a demonstration of its ICEBlueButton mobile app that provides medical records – an automated data feed from online Blue Button health records – in an emergency.
Online publisher WebMD purchased Avado, a patient relationship management portal, for a reported $20-30M. “Dave Chase, Avado’s co-founder and CEO, has been one of the most vocal proponents of a business case for patient engagement…getting serious about between-visit care will be pivotal in bending the cost curve by managing the health care needs of an aging, and increasingly chronically ill population,” writes Chilmark Research.
QMedic‘s wearable medical alert service launched in beta in Massachusetts in October, 2013. That same month, it won the Future of Medicine Award from the Cleveland Clinic. Featuring a panic button and 24/7 emergency call center service, the wearable device passively detects abnormal events in the home and sends real-time text alerts to caregivers. This year, the company closed two contracts with the National Institutes of Health and National Cancer Institute totaling $2.4M, and launched a three-year clinical partnership with Northwestern University Hospital and the Rehabilitation Institute of Chicago to build passive early detection and intervention tools for cancer patients in functional decline.
Jen McLean, head of business development for Ovuline, writes that the company has launched a pregnancy tracker, Ovia Pregnancy, that helps pregnant women track their health, providing alerts if users report symptoms that may indicate a problem. “Our app is the next step in our mission to create a health data platform that helps people track and understand their entire health and medical history,” she says.
And that’s just the first group we’re profiling; stay tuned for our next blog feature on what the Hive 50 are up to now. And what will we see at the TEDMED Hive in 2014? If you would like to apply or nominate a start-up to the next class of go-getters, click here. The deadline for applications is January 22, 2014. Good luck!