April 9, 2024
Harry's guest this week is Raffi Krikorian, chief technology officer and managing director at Emerson Collective, the social change organization founded by Laurene Powell Jobs. Krikorian is the former vice president of engineering at Twitter (now X), where he was responsible for getting rid of the Fail Whale and making the company’s backend infrastructure more reliable; the former director of Uber's Advanced Technology Center in Pittsburgh, where he oversaw the launch of the world's first fleet of self-driving cars; and then the chief technology officer at the Democratic National Committee, where he helped rebuild the party's technology infrastructure after the Russian hacking debacle of 2016. At Emerson Collective, Krikorian built the technology organization, leads the development of data products, and works to upgrade the back offices of the non-profits Emerson works with. On top of all that, he recently launched a podcast called Technically Optimistic, where he’s taking a deep dive into the way AI is challenging us all to think differently about the future of work, education, policy, regulation, creativity, copyright, and many other areas. The show is a must-listen for anyone who cares about how we can build on AI to transform society for the better while minimizing the collateral damage. Harry talked with Krikorian about why he moved to Emerson Collective, why and how he started the podcast, and what he really thinks about what government should be doing to prepare for the waves of social change AI will bring.
59 min 27 sec
8.2.22
Wet labs at life science companies look and work the same pretty much everywhere. They're full of incubators, refrigerators, centrifuges, liquid handlers, gene sequencers, DNA and RNA synthesizers, and all sorts of other complex equipment. And a lot of these machines are automated—but the larger workflow in a life sciences R&D lab is very much not automated. And that's a problem, because if you’re trying to collect evidence for a scientific paper or a regulatory filing or trying to manufacture a product that’s verifiably safe, you need to make sure that the same procedure gets carried out exactly the same way every time. Our guest this week, Artificial CEO David Fuller, believes that life sciences labs will always revolve around manual labor, but thinks there’s a way to orchestrate the process more precisely. Artificial makes software that allows lab managers to create what he calls a digital twin of their entire laboratory, where data structures track what’s happening with each piece of lab equipment and keep them in sync, providing what Fuller calls “a single pane of glass that makes it easier to see the state of the equipment and the science as it's running in your lab.” Humans will always stay in the loop, but Fuller says the benefit for companies who orchestrate their labs in this way is that the data and the products coming out of the lab will be more consistent—which will be even more important as laboratories start to act more like factories, where a lot of the actual production of biologic drugs or other materials happens.
58 min 28 sec
7.19.22
For people with common health problems like diabetes or high blood pressure or high cholesterol, progress in pharmaceuticals has worked wonders and extended lifespans enormously. But there’s another category of people who tend to get overlooked by the drug industry: patients with rare genetic disorders that affect only one in a thousand or one in two thousand people. If you add up all the different rare genetic disorders known to medicine, it’s actually a very large number; Harry's guest this week, Charlene Son Rigby, says there may be as many as 10,000 separate genetic disorders affecting as many as 30 million people in the United States and 350 million people worldwide. That's a lot of people who are being underserved by the medical establishment. Rare-X, the non-profit organization Rigby heads, is trying to help by creating a common data infrastructure for rare disease research. The basic idea is to take the burden of data management off of rare disease patients and their families and create a single central repository that can help accelerate drug development.
57 min 42 sec
7.5.22
Most fitness gadgets, like the Fitbit or the Apple Watch, encourage you to get out there every day and “close your rings” or “do your 10,000 steps.” But there’s one activity tracker that’s a little different. The WHOOP isn't designed to tell you when to work out—it’s designed to tell you when to stop. Harry's guest this week is Emily Capodilupo, the senior vice president of data science and research at Boston-based WHOOP, which is based here in Boston. She calls the WHOOP band “the first wearable that tells you to do less.” But it’s really all about designing a safe and effective training program and helping users make smarter decisions. Meanwhile, the WHOOP band collects so many different forms of data that it can also help to detect conditions like atrial fibrillation, or even predict whether you’re about to be diagnosed with Covid-19. It’s not a medical device, but Capodilupo acknowledges that the line between wellness and diagnostics is shifting all the time—and with the rise of telemedicine, which is spreading even faster thanks to the pandemic, she predicts that more patients and more doctors will want access to the kinds of health data that the WHOOP band and other trackers collect 24/7. The conversation touched on a very different way of thinking about fitness and health, and on the relationship between big data and quality of life—which is, after all, the main theme of the show.
56 min 45 sec
6.21.22
When your doctor prescribes a new medicine, there's a pretty good chance that some snafu will crop up before you get it filled. Either your pharmacy doesn't carry it, or your insurance provider won't cover it, or they'll say you need "prior authorization," or your out-of-pocket cost will be sky-high. The basic problem is that the electronic health record systems and e-prescribing systems at your doctor’s office don’t include price and benefit information for prescription drugs. All of that information that lives on separate systems at your insurance company and your health plan’s pharmacy benefit manager, or PBM. And that’s the gap that a company called RxRevu is trying to fix. Harry's guest on today’s show RxRevu CEO Kyle Kiser, who explains the work the company has done to bring EHR makers, insurers, and PBMs together to make drug cost and coverage information available at the point of care, so doctors and patients can shop together for the best drug at the best price.
34 min 52 sec
6.7.22
Harry's guest Eric Daimler, a serial software entrepreneur and a former Presidential Innovation Fellow in the Obama Administration, has co-founded a company called Conexus that uses category theory to tackle the problem of data interoperability. Longtime listeners know that data interoperability in healthcare—or more often the lack of interoperability—is a repeating theme of the show. In fields from drug development to frontline medical care, we’ve got petabytes of data to work with, in the form of electronic medical records, genomic and proteomic data, and clinical trial data. That data could be the fuel for machine learning and other kinds of computation that could help us make develop drugs faster and make smarter decisions about care. The problem is, it’s all stored in different databases and formats that can’t be safely merged without a nightmarish amount of work. So when a company like Conexus says they have a way to use math to bring heterogeneous data together without compromising that data’s integrity – well, it's time to pay attention. That's why on today’s show, we’re all going back to school for an introductory class in category theory.
56 min 34 sec
5.24.22
Harry's guest this week is Rohit Nambisan, CEO of Lokavant, a company that helps drug developers get a better picture of how their clinical trials are progressing. He explains the need for the company's services with an interesting analogy: these days, Nambisan points out, you can use an app like GrubHub to order a pizza for $20 or $25, and the app will give you a real-time, minute by minute accounting of where the pizza is and when it’s going to arrive at your door. But f you’re a pharmaceutical company running a clinical trial for a new drug, you can spend anywhere from $3 million to $300 million—and still have absolutely no idea when the trial will finish or whether your drug will turn out to be effective. Because there's little infrastructure for analyzing clinical trial data in midstream or spotting trouble before it arrives, some studies continue long after they should have been canceled, and positive data sometimes gets thrown out because of minor procedural flaws; in the end, 20 to 30 percent of the money drug makers spend on clinical trials goes down the drain, Nambisan says. Lokavant's platform allows drug makers and clinical research organizations to harmonize the results coming in from study sites, compare it to data from other trials, and discover important signals in the data before it’s too late. For example, a company might discover that it’s not enrolling patients fast enough to complete a trial on schedule, or that the researchers administering the study aren’t following the exact protocols laid out in advance. Such headaches might sound abstract and remote, but poor data management slows down the whole drug development process, which means fewer beneficial new drugs make it to market ever year; that's the ultimate problem Lokavant is trying to fix.
52 min 83 sec
5.10.22
This week Harry continues to explore advances in "digital therapeutics" in a conversation with Paolo Pirjanian, the founder and CEO of the robotics company Embodied. They’ve created an 8-pound, 16-inch-high robot called Moxie that’s intended as a kind of substitute therapist that can help kids with their social-emotional learning. Moxie draws on some of the same voice-recognition and voice-synthesis technologies found in digital assistants like Siri, Alexa, and Google Home, but it also has an expressive body and face designed to make it more engaging for kids. The device hit the market in 2020, and parents are already saying the robot helps kids learn how to talk themselves down when they’re feeling angry or frustrated, and how to be more confident in their conversations with adults or other kids. But Moxie isn’t inexpensive; it has a purchase price comparable to a high-end cell phone, and on top of that there’s a required monthly subscription that costs as much as some cellular plans. So it feels like there are some interesting questions to work out about who’s going to pay for this new wave of digital therapeutics, and whether they’ll be accessible to everyone who needs them. Pirjanian discussed that with Harry, along with a bunch of other topics, from the product design choices that went into Moxie to the company’s larger ambitions to build social robots for many other applications like entertainment or elder care.
52 min 35 sec
4.26.22
Can a video game help improve attention skills in kids with ADHD? According to Akili Interactive in Boston, the answer is yes. They’ve created an action game called EndeavorRx that runs on a tablet and uses adaptive AI to help improve focus, attentional control, and multitasking skills in kids aged 8 to 12. And it’s not just Akili saying that: In 2020 the U.S. Food and Drug Administration agrees cleared EndeavorRx as a prescription treatment for ADHD, based on positive data from a randomized, controlled study of more than 600 children with the disorder. It was the first video game ever approved as a prescription treatment for any medical problem, and Harry's guest this week, Akili co-founder and CEO Eddie Martucci, says it opens the way for a new wave of so-called digital therapeutics. Even as Akili works to tell the world about EndeavorRx and get more doctors to prescribe the game for kids with ADHD (and more insurance companies to pay for it), it's testing whether its approach can help to treat other forms of cognitive dysfunction, including depression, the cognitive side effects of multiple sclerosis, and even Covid-19 brain fog.
51 min 25 sec
4.12.22
Why is hibernation something that bears and squirrels do, but humans don’t? Even more interesting, what’s going on inside a hibernating animal, on a physiological and genetic level, that allows them to survive the winter in a near-comatose state without freezing to death and without ingesting any food or water? And what can we learn about that process that might inform human medicine? Those are the big questions being investigated right now by a four-year-old startup in California called Fauna Bio. And Harry's guests today are two of Fauna Bio’s three founding scientists: Ashley Zehnder and Linda Goodman. They explain how they got interested in hibernation as a possible model for how humans could protect themselves from disease, and how progress in comparative genomics over the last few years has made it possible to start to answer that question at the level of gene and protein interactions. The work is shedding light on a previously neglected area of animal behavior that could yield new insights for treating everything from neurodegenerative diseases to cancer.
54 min 12 sec
3.29.22
In a day and age when it feels like there are drugs for everything—from restless legs to toenail fungus to stage fright—it's strange the drug industry has almost completely ignored one of our most important organs: our ears. Given that 15 percent of people in the U.S. report at least some level of hearing loss, you’d think drug makers would be doing more to figure out how they can help. Well, now there’s at least one company that is. Cambridge, Massachusetts-based Decibel Therapeutics went public in 2021 to help raise money to fund its research on ways to treat a specific form of deafness caused by a rare genetic mutation. Decibel is testing a gene therapy that would be administered only to cells in the inner ear and would provide patients with a correct, working copy of the otoferlin gene, which is inactive in about 10 percent of kids born with auditory neuropathy. Harry's guest this week is Decibel’s CEO Laurence Reid, who explains how the company’s research is going, and how Decibel hopes to make up for all those decades when the pharmaceutical business had basically zero help to offer for people with hearing loss.
57 min 32 sec
3.15.22
If you’re a parent, you’ve probably had this experience many times: Your young child has a high fever, and maybe a sore throat, but you don’t know exactly what’s wrong. Is it a bacterial infection, in which case an antibiotic might help? Or is it a viral infection, in which case, you just have to wait it out? The symptoms of bacterial and viral infections are often the same, and most of the time, even a doctor can’t tell the difference. Viral infections are more common, but sometimes, the doctor will prescribe an antibiotic anyway, if only to help the parents feel like they’re doing something to help. But what if doctors didn’t have to guess anymore? What if there were a fast, easy blood test that a doctor could run in their own office to look for biomarkers that discriminate between bacterial and viral infections? Well, that’s the seemingly simple problem that a company called MeMed has been working on solving for 13 years now. Recently MeMed’s first testing product got approval from the FDA, and now the company is finally beginning to roll out it out commercially in the US. And here today to tell us more about how it got built, how artificial intelligence fits into this picture, and how rapid diagnosis could change the practice of medicine, is MeMed’s co-founder and CEO, Eran Eden.
51 min 26 sec
3.1.22
In March of 2020, as SARS-CoV-2 was first sweeping the globe, Jacob Glanville joined Harry on the podcast to talk about the pandemic and how the kinds of antibody therapies being studied by his company Distributed Bio might help. At the end of 2020, Charles River Laboratories bought Distributed Bio on the strength of its computational immunology platform—which automates the discovery of antibody therapeutics. But Charles River let Glanville spin off the research programs he'd been pursuing, which included neutralizing antibodies to treat influenza and coronaviruses. And now those programs have been rolled up into Centivax, a South San Francisco-based biotech startup where Glanville is once again CEO. Glanville returns to the show this week to talk about what's gone right—and wrong—in the biopharma business during the coronavirus crisis, how the pandemic's end might play out, and why he sees such promise for antibody therapies against coronaviruses, drug-resistant bacteria, and even snake bites.
52 min 25 sec
2.15.22
Until recently, getting a blood glucose measurement required a finger stick. The whole process was so painful and annoying that only diabetics taking insulin bothered to do it regularly. But there’s a new class of devices called continuous glucose monitors, or CGMs, that make getting a glucose reading as easy as glancing at your smartwatch to see your heart rate. A CGM is a patch with a tiny electrode that goes into your skin to measure glucose levels in the interstitial fluid, plus a radio that sends the measurement to an external device like your phone. The devices are pain-free to use, and they’re rapidly coming down in price. Harry's guest today, Maz Brumand, is head of business at Levels, a startup that wants to use CGMs to help everyone understand how their choices about food and lifestyle affect their health.
54 min 10 sec
2.1.22
Healthcare is one of those areas where more data is almost always better. And I talk a lot on the show about how data is helping doctors and patients make smarter decisions. But a lot of the data we’d still like to have is stuck in those arcane Electronic Health Record systems or EHRs that medical practices or hospital systems use to track their patients. These systems tend to be closed, proprietary, user-unfriendly, and incompatible with one another. And we've repeatedly made the case here on the show that EHR technology is holding back innovation across the healthcare market. That’s why we like to meet companies that are working to make EHR data more useful. And in this episode we welcome a pair of guests from a company called Verana Health that’s trying to do just that. The company recently brought in $150 million in new venture capital funding to help scale up its data services, which currently focus on the subspecialties of ophthalmology, neurology, and urology. Verana takes data on patients in these fields, cleans it up, analyzes it, and pulls out insights that could be useful—both for clinicians who want to increase the quality of the care they’re providing, and for pharmaceutical companies who need new ways to measure the effectiveness of their drugs and better ways to find patients for clinical trials. Here to explain more about all of that are Verana’s CEO, Sujay Jadhav, as well as its senior vice president of clinical and scientific solutions, Shrujal Baxi. (If you’re a longtime listener you might remember that we had Shrujal on the show once before, back in 2018, when she talked about her previous company Flatiron Health.)
46 min 38 sec
1.18.22
As we say here on The Harry Glorikian Show, technology is changing everything about healthcare works—and the reason we keep talking about it month after month is that the changes are coming much faster than they ever did in the past. Each leap in innovation enables an even bigger leap just one step down the road. Another way of saying this is that technological change today feels exponential. And there’s nobody who can explain exponential change better than today’s guest, Azeem Azhar.
57 min 47 sec
1.4.22
Genialis, led by CEO Rafael Rosengarten, is one of the companies working toward a future where there are no more one-size-fits-all drugs—where, instead, every patient gets matched with the best drug for them based on their disease subtype, as measured by gene-sequence and gene-expression data. Analyzing that data—what Rosengarten calls "computational precision medicine"—is already helping drug developers identify the patients who are most likely to respond to experimental medicines. Not long from now, the same technology could help doctors diagnose patients in the clinic, and/or feed back into drug discovery by providing more biological targets for biopharma companies to hit.
44 min 00 sec
12.21.21
When the coronavirus pandemic swept across the world in early 2020, Spain was one of the countries hardest hit. At the time, Nuria Oliver was a telecommunications engineer working and living in Valencia, one of Spain's 17 autonomous regions. She’d spent years working for companies like Microsoft, Telefonica, and Vodafone, using AI to analyze data from mobile networks to explore big questions about healthcare, economics, crime, and other issues—so she realized right away that mobile data could be an important tool for government leaders and public health officials trying to get a handle on the spread of COVID-19. With the backing of Valencia's president, Oliver put together a team of scientists to analyze network data to understand among other things, how much people in Spain were moving around. That helped them predict infection rates, and to see whether lockdowns were really helping to contain the virus's spread. The team's predictions were so accurate, in fact, that when they entered an X Prize Foundation contest seeking the best AI-based pandemic response systems, they won first place. Nuria Oliver joins Harry to explain how they did it—and why mobile data makes a difference in the fight against the pandemic and other health threats.
59 min 11 sec
12.7.21
We've learned from previous guests that machine learning and other forms of AI are helping to identify better disease treatments, get drugs to market faster, and spot health problems before they get out of hand. But what if they could also help patients find the best doctors for them, and help doctors frame their advice in a way that patients can relate to? This week, Harry's guest, Briana Brownell, talks about the computational tools her company Pure Strategy is building to find patterns in people’s personal preferences or cultural identities that can enable better matchmaking between patients and doctors, predict which patients are most likely or least likely to go along with a treatment plan, or help doctors communicate their recommendations better. "Not everybody makes decisions in the same way," Brownell says. "Not everybody values the same things. But by understanding some of those psychological and value-based drivers, we can get better health care outcomes."
49 min 46 sec
11.23.21
Your medical records don't make pleasant bedtime reading. And not only are they inscrutable—they're often mutually (and deliberately) incompatible, meaning different hospitals and doctor's offices can't share them across institutional boundaries. Harry's guest this week, Ardy Arianpour, is trying to fix all that. He’s the co-founder and CEO of Seqster, a San Diego company that’s spent the last five years working on ways to pull patient data from all the places where it lives, smooth out all the formatting differences, and create a unified picture that patients themselves can understand and use.
59 min 09 sec
11.9.21
Chances are you or someone you love has had a biopsy to check for cancer. Doctors got a tissue sample and they sent it into a pathology lab, and at some point you got a result back. If you were lucky, it was negative and there was no cancer. But have you ever wondered exactly what happens in between those steps? Until recently, it’s been a meticulous but imperfect manual process where a pathologist would put a thin slice of tissue under a high-powered microscope and examine the cells by eye, looking for patterns that indicate malignancy. But now the process is going digital—and growing more accurate.
49 min 57 sec
