Tuesday, November 24, 2015

Out of the Lab & Back – Insights on science media coverage

Boston Business Journal’s BioFlash, MIT Technology Review, STAT, Xconomy – go-to science and technology publications with established local presences and a collective readership stretching near and far – assembled representatives for a power-packed panel at JLABS’s (Johnson & Johnson Innovation) “Out of the Lab and Into the Newsroom.” The cast of journalists intended to shed light on media relations for the area’s mission-driven science community, which is characteristically so laser-focused on forging new frontiers of human knowledge that they could admittedly use a reminder about the merits of communicating their science to the general public.

We were situated atop the major fault line of Kendall Square; the epicenter of life sciences and technology operations. The majority of the crowd seemed to be communications professionals eager for tips on how to get media coverage for their constituents. Scientists themselves seemed to be sitting this one out; and although the lab is difficult to abandon, knowing how to communicate a scientific breakthrough is a skill worth having.

To the biomedical community, it should come as no surprise that journalism, like all professions, has its share of jargon. There’s spin, pitching, the beat, embargos, etc. These terms carry a great deal of weight, and understanding their meaning, through the lens of a journalist, can be a useful primer for our approach to media relations:

  • Pitching is where you let your science shine. An effective pitch takes 10 words to explain the novelty and impact. “Start with the end of the story first – for medicine, that’s the benefit to patients” advised Rick Berke, Executive Editor for STAT, a veteran of the field having held previous posts at Politico and The New York Times. The last thing you want to do is pitch a reporter “a solution they can’t understand for a problem they’ve never heard of,” explains MIT Technology Review Biomedicine Editor, Antonio Regalado. When considering the complexity of scientific advancement it might be hard to imagine boiling your work down to 10 words – but it’s a must if you want your science to get out of the lab. The panel’s advice: remain high-level and limit the technical terms in your pitch. You’ll know if you’ve done your job when you get a question in response, prompting you to dive a little deeper into the science. 

  • Spin is something you want to limit – it equates to selling. Although, it’s important to be persuasive, it’s a balancing act, as nearly all of the panelists remarked on having an aversion to over-promotion. 

  • The beat refers to a journalist’s parameters for reporting, i.e. their theme and target audience. Each publication and reporter is different, so do your homework and tailor your pitch to their preferences. 

  • Embargos dictate to reporters what to say and when to say it, and typically denote an understanding of exclusivity, but not always. In a practical sense, they are a potential remedy for keeping confidential information from leaking prematurely. I learned, some publishers will not accept terms for an embargo on their reporting, and it is probably good to know in advance where a media outlet stands on the use of content embargos.

Recognizing that effective communication is imperative to the advancement of science, the B-BIC Skills Development Center (SDC) has placed it center stage in this year’s commercialization curriculum. This fall we’ve already held workshops on presentation skills, elevator pitches and uses of PowerPoint. In the spring, we’ll continue with opportunities to improve your communication through use of data visuals, pitch coaching, and media training through our fourth installment of the Commercialization Apprenticeship Panel Series. As always, the SDC YouTube Channel serves as our video library for all previous offerings.

So just how important is communication to the advancement of science? Melissa Marshall, one of this year’s instructors for the B-BIC Skills Development Center’s series of communications workshops, puts it provocatively – “science not communicated, is science not done.”

Another way to think about it: Does a scientific advancement confined to the lab, make a sound (have an impact)? It’s a question worth considering.

Thursday, September 24, 2015

Inspecting the Innovation Narrative: where it’s been, where it’s headed

As a popular buzzword, innovation has accumulated serious mileage over the years. It has made its way out of the garages of Silicon Valley and into the boardrooms of nearly every modern employment sector (industry, government, academics), and even into our everyday conversations. Interestingly, the word is also accompanied by a lack of consensus on its meaning.

One simple definition of innovation is: “the introduction of something new.” However, if we examine a few examples of how the word is being employed, it becomes clear this is not the operational definition:
Innovation is the new currency in today’s Idea Economy. 1 
Everybody's innovating, because any change is innovation. 2 
There are many skeptics about the value of incremental innovation... 3 
Disruptive innovation is competitive strategy for an age seized by terror. 4
"CEO prescribes innovation for all that ails big pharma" 5
"Forbes Asks CMOs: What's Your Innovation Agenda?" [video] 6

And there are many more examples to be found, each with a different shade of meaning. Unlike “innovation”, we don’t see the same confusion and broad use of other related “i”-words: inspiration, ideation, invention, and improvement. 

Perhaps the ambiguity around the word innovation results precisely because it represents a composite and is derived from these other “i”-words. If innovation is the introduction of something new, how did this new thing come about? There was probably an initial inspiration that lead to more formalized ideation and a selection of the best ideas. When the refined idea becomes a product, we have an invention. Is invention the same as innovation? Thousands of inventions come through the United States Patent and Trademark Office (USPTO) every year, a substantial number of which never make it to market. Sometimes old inventions are used in new ways or in combination with other products such that the process or product is actually new. Perhaps the new application of an old invention or a combination of inventions, when there is value derived from it, is a place we can land for thinking about innovation. 

What, then, separates an innovation from an improvement?7 Both speak to some kind of change, but the difference is in the magnitude. Improvement is incremental change. Innovation is on a larger scale. Perhaps innovation is transformational change.

“Disruptive innovation” is a popular phrase coined by Clayton Christenson8 in the mid-1990’s when new IT products were fast changing the way we live and work. There was a true transformative change through the production and use of new digital technologies. While innovation was becoming the new industry standard, “disruptive innovation” arose as a term for identifying the truly innovative individuals and companies. Perhaps the rise in use of “disruption” as a qualifier for innovation is a sign of how truly transformative the change experienced at that time really was.

So where does the innovation narrative go from here? Forcing the word into a tidy corner to meet our preferences is likely not our best bet. We can consider using the word seldomly, or not at all, as some have argued 9 10. Or we can be analytical and ask the following questions to assess whether an invention is also an innovation: (1) Did it become a commercial product? (2) How widely used has a new product become? (3) How much value is derived from its application? An innovation should score high on all three. 

How we choose to talk about innovation and the significance we place on it is important. Beyond an intellectual exercise or collegial banter, this word has been assigned some hefty responsibilities. Governments and industries around the world invest billions of dollars on research and development every year in hopes of launching the next great innovation to address unmet societal needs.11

One thing seems clear: the innovation narrative is here to stay. Although, we may never know where it will take us and may only appreciate its value in hindsight, much like the innovations themselves. 

A note on additional sources: Examples of innovation in government - White House 12 13, Health & Human Services (HHS) 14, Centers for Medicare and Medicaid Services (CMS) 15, United States Agency for International Development (USAID) 16, United Nations Children's Fund (UNICEF) 17; in academia - Stanford 18, Harvard i-Lab 19, and Beta Boston's coverage of entrepreneurship at Boston-area universities 20. Influential individuals, some referenced directly or hyperlinked above - Clayton Christenson 21, Scott Berkun 22, Jay Walker 23, Stefan Lindegaard 24. The word cloud from the accompanying image was created by pooling quotes on innovation by famous figures throughout history representing industry, government and academia, compiled by BrainyQuote.

Tuesday, July 28, 2015

Teams Pitch Once More at Culmination of CIMIT/B-BIC Boot Camp, Sure to Not Be Their Last

The program ended as it had begun: with a pitch. Just as the teams had done on day one, except this time armed with loads more insight on the value of their innovative business concepts garnered from a combined 500 customer interviews, they assumed their place in front of a room full of strangers turned peers and mentors to present how, with their idea, patient care would be forever changed. 

Over the course of the seven-week intensive program that was the CIMIT/B-BIC i-Corps Healthcare Commercialization Boot Camp - a life sciences version of the "Lean Launchpad" course developed by Steve Blank at Stanford, now widely adopted by the NSF and NIH - ideas and the individuals behind them were put to the test. Through an iterative process and interactive course design, the teams refined their business concepts, in some cases making a complete 180 (or “pivot” as the entrepreneurs like to say) from where they started, as they received guidance from expert coaches from CIMIT and B-BIC and invaluable feedback from their fellow participants – entrepreneurs, technicians and clinicians in their own rights. Though without a doubt, the most valued perspectives were that of the potential customers (“buyers”) and consumers (“users”) of the product or service.

The process teams underwent during the course of the i-Corps program falls entirely under "Search" in the above diagram. The threshold created by the dashed line, marks an organization's transition from the "Search" to a phase of "Execution", i.e. from a start-up / early-stage to a more developed company. 

In the complex world of healthcare, the nature of buyers and users can change dramatically depending on the product. This meant that teams had to be intentional in targeting their interviews for specific players who could help address key questions related to their product and its potential application. While one group is interested in polling clinicians, another is focused on hospital administration, and still another is isolating the government and NGO funding community. In reality, most cast a net that covered some mixture of the above, with one prevailing commonality being the shared interest in bringing the benefit to patients.

In ritualistic fashion, Mike Dempsey, Accelerator Program Lead at CIMIT and Entrepreneur-in-Residence at B-BIC, succinctly summarized the experience by reminding the group of what drove them to be here: “patient impact” as their “metric for success”. Traditionally, the ideas themselves, the fodder of innovation, are what receive the lion’s share of attention in the forms of financial backing (e.g. NIH funding) and mainstream media coverage. But, as Mr. Dempsey asserted, “patient impact requires a two-part equation”, with the idea itself occupying one space, and the “path to patients, in some cases through commercialization” filling the other. In the latter area, money has tended to be more difficult to come by, especially for early-stage companies or technologies (pre-company formation) - labels appropriately suited for nearly all in attendance - coming out of academia.

What the Boot Camp sought to do was flip the traditional dichotomy on its head – turning attention away from the particularities of the technology, to instead focus almost exclusively on the path to patients. This required getting outside of comfort zones, and in a literal sense, getting outside, period, as participants were pushed to talk to increasing numbers of people and seek an excess of information over a dearth of it. The resulting difference seen in the second-go at their team pitches was obvious, as all who spoke that day exhibited greater confidence in their ideas and validation for their unique approaches to improving the patient experience.

At the culmination of the program, the usual undertone, all too familiar on the hallowed grounds of the surrounding institutions of higher education, was made clear; that this is not an end, rather it’s a beginning. With the knowledge and experience gained from their rigorous training, the next time these participants take the stage they could be vying for the potential to bring their innovation to an even greater scale, in an effort to meet patient need.

* Those interested in learning more about the "Lean Launchpad" approach to building Start-Ups should visit the online course site at Udacity for a detailed curriculum outline and the opportunity to take the course online for free!

Monday, July 20, 2015

Meeting & Mixing of the Minds at BU OTD’s Tech, Drugs, and Rock n’ Roll

It was an evening full of collisions of all kinds at the Boston University Office of Technology Development’s 6th Annual Tech, Drugs, and Rock n’ Roll (TDRR) held in the George Sherman Union on BU’s campus set along Boston’s Commonwealth Ave. Entrepreneurs, academic scientists, industry folks and funders from venture capital and government / non-profit entities alike mixed and mingled over the course of an eventful evening. Much of the action centered around “Funder Alley” – a row of booths and monitor displays that featured many of the area’s funders of upstart biotechnology, including your own B-BIC. Kingsley Flood provided the ambiance, laying down tracks of clashed brass, percussion and string over vocals that spread out atop the clamor of casual conversations springing up from across the convention hall floor.

Starting from humble roots in 2010, TDRR has quickly developed into the premiere biotech networking event of the summer, drawing larger and larger crowds year-to-year, while continuing to turn out up-and-comers from the local Boston music scene - this year’s Kingsley Flood having been recognized several times over by local outlets for their Americana style hits. New this year was the aforementioned Funder Alley as well as the MAPP - Mobile App Development Contest, which awarded cash prizes to the top three mobile app ideas. The contest’s inaugural first-prize went to J. Gregory McDaniel, PhD, Associate Professor of Mechanical Engineering at BU, and Chiraag Devani, an engineering undergrad at BU, for their “Study BUddy” mobile app idea. Keeping with the vibes of a summer college cookout, there was grilled food and cold drink aplenty, and even a couple of cameo appearances by none other than Rhett the Boston Terrier mascot, who was seen rocking out beside the band and lofting t-shirts from the catwalk above to the frenzied party goers below.

With all of these ingredients mixed together, you have the makings of a concoction that affords the opportunity for both fun and meaningful connections to be made between the diverse crowd of attendees from Boston’s many universities and industries. It may feel like it’s always been the case that innovation has just tended to well up from university settings, particularly from those formidable Boston-area research institutions like BU, Harvard, MIT and Northeastern. But, it’s nights like tonight that remind me that it can’t hurt to attempt to help usher innovation along, by providing opportunities for more casual collisions to occur at an event like BU’s TDRR or by providing financial and educational resources for investigators and their nascent projects to grow forth. The key is, whether serendipitous or belabored, innovation isn’t likely to happen without a few collisions.

A sampling of photos from the evening - (from L to R, bottom to top) the B-BIC booth was a hotbed of activity, Kingsley Flood and Rhett supplying the R&R, the mouth of Funder Alley, sign on Commonwealth Ave. beckons!

Tuesday, July 7, 2015

A Nuanced View of the World of Drug Development & its Value to Society

It’s not every day that you have the opportunity to play audience to a preeminent biotech company’s chief executive (in Boston it’s more like every other day), so I couldn’t pass it up when I learned Genzyme CEO David Meeker, MD, would be sitting down with Boston Globe Life Sciences Reporter Robert Weisman for a “fireside chat” (hold the fire) hosted by the MIT Enterprise Forum at the Broad Institute of MIT & Harvard in Cambridge’s Kendall Square. Equally compelling was the thought provoking topic of conversation; “The Value of Drug Development: Can Society Afford Today’s New Wonder Drugs?” Given Dr. Meeker’s previous clinical and academic accomplishments as former Director of the Pulmonary Critical Care Fellowship at the Cleveland Clinic and Assistant Professor at Ohio State University, plus a variety of high-level managerial undertakings with Genzyme prior to becoming CEO, he seemed uniquely positioned to offer a nuanced take on the world of drug development and its value to society.

The drug industry, well represented in this part of town centered on Kendall Square, over its history has played the part of the regular scapegoat for all that is wrong with big business in America. A lifesaving drug might fill a void by addressing a formerly untreatable disease, but with price tags that are known to reach into the five-six digits for an annual regimen, it’s hard to say simply if this is an overall net positive for society. One can’t help but think it might be exchanging one problem for another – now your disease is under control, but your finances aren’t. And how does this look on a societal level with all the different players involved – payers, providers, regulators, patients, etc.? Very quickly we begin to find ourselves in a tangled mess.

Luckily, on this occasion, Dr. Meeker was there to help us sort this out. In particular, he provided insights on a critical piece of the equation: How do drug companies come to price their drugs? Far from an expert on the matter, what I will share is in many ways a shorthand for the intricate process that takes place, as I offer a summary of the discussion from that night:

The drug pricing picture takes initial form with a few key considerations: the cost of development for bringing the drug to market, the prevalence of the condition it’s designed to treat, and the comparative clinical value that the drug provides. In the rare disease world that Genzyme occupies, treatments can sometimes have a target population of less than 10,000 (an example being Gaucher’s disease, for which Genzyme offers several treatment options priced at $300k/yr.) In these cases, for a company to recoup its investments from their sales of the drug and continue to produce innovative treatments, can it only work out if the drug carries a six-figure price tag? Lacking many of the elements of a market system (namely no competitor drugs and “customers” having no choice as to whether or not they have a given condition), how does one arrive at a “fair price” – where all sides win? The payers, e.g. CMS and private insurers, play a key part here, as they take on the role of determining coverage and negotiating what’s reasonable in terms of price (though the exact mechanisms through which these processes take place can differ from country to country). The payers also shield patients from much of the financial burden of affording a given treatment – though in the US, it’s still not too uncommon for patients to face a sizeable enough bill to make me take pause.

As we look to the numbers we see that drugs account for roughly 10% of total health expenditures. So it might be fair to say they’re given a disproportionate amount of the attention when it comes to what drives overall costs to the system. Dr. Meeker also noted that payers typically turn over larger chunks of the cost of drugs to patients compared with hospital care, as average coinsurance coverage amounts to 19% and 5%, respectively. One is left to wonder what sort of effect these types of cost sharing breakdowns have on the system. Is this the best means for extracting the most value from our treatments?

As I find myself mapping out the connections between many of the different players involved, I realize that painting the picture of modern healthcare quickly becomes an overly complex task. For one, a static representation won’t suffice given the lightning pace at which innovation proceeds and the system adapts. 

Looking forward, Dr. Meeker offered his thoughts on some of the major developments that he felt could have broad implications for how we develop and eventually pay for our treatments. Firstly, he acknowledged that the market for biosimilars (generic versions of biologics) is on the horizon with the EU and US having recently laid the regulatory framework for new approvals in this area. This could dramatically impact price as the number of different treatment options for a given condition could multiply rapidly, and lend itself to a price war between new arrivals and off-patent originators. Of similar importance is the healthcare system’s present shift to value-based payment models focused on clinical outcomes. With changing incentives underway, it will be interesting to see how cost structures evolve in the coming years. Similarly, the advancement of more precise means for categorizing conditions and calibrating treatments, what many call “precision medicine”, could also further segment drug markets, as treatments cater to indications comprising smaller and smaller patient cohorts, and affect overall costs.

Coming away from the talk, I was almost dizzy from the number of different thoughts I had swimming around in my head – the primary challenge was to keep it all straight. A task that I think many working in healthcare can relate to. An ever-changing, increasingly complex healthcare system lends itself to many a challenge in organization and coordination, but it’s undeniable the amazing outcomes it can produce – the “wonder drugs” of today being the closest thing our society has to modern miracles. With all the attention paid to big pharma and biotech, due or undue, it’s worth bringing light to the importance that the other players in the system play in creating the types of medical innovations that save lives. Without a piece of it, the whole system might falter. So while the question of whether our drugs are too expensive is fair, one should not expect the answer to fall neatly between binary lines (good or bad). More appropriately, a nuanced view is called for – what should be a far from surprising result in the worlds of health and healthcare.

Tuesday, June 30, 2015

Leveraging Machine Learning Muscle at the Brigham & Women's Hospital iHub Idea Lab with Microsoft

The air was electric in the Shapiro Room at Brigham & Women’s Hospital (BWH), the setting for the BWH iHub Idea Lab with Microsoft on the evening of Monday, June 22nd. With innumerable ideas afloat on the topic of “Machine Learning in Healthcare”, it seemed it would be only a matter of time until lightning struck – in the form of a truly groundbreaking idea to improve population health and/or care management. Combining the clinical and technical acumens of members in attendance from the respective BWH and Microsoft communities, it appeared that the necessary parts were all in place, like a well-oiled Rube Goldberg machine, to harness the room’s bottled energy to propel forward real world solutions to some of healthcare’s most nagging problems.

The evening started with a brief welcome and introduction from Pothik Chatterjee of the BWH iHub, a group that’s trailblazing new paths to allow innovative technologies to surface from the hospital with increasing speed and efficiency, serving as a model for Academic Medical Centers and the likes to follow. After a series of brief lectures by representatives from BWH and Microsoft, including David Bates, MD, MSc, BWH’s Chief Innovation Officer, the attention was then turned over to those in attendance to come up with ideas for how to leverage machine learning software capabilities to improve care / population health. You could see the mental wheels whirring as the packed house broke off into smaller groups to brainstorm potential uses for the given technology. At the end of the evening, the room reconvened to share what resulted.

As the evening’s guests lingered and slowly dissipated from the hospital grounds, seeming reluctant to let go of this electric feeling, I looked around the space and came to grapple with what felt to me like a growing sense of solidarity. In the year 2015, it’s obvious to most that healthcare has its share of formidable challenges. What’s worth distinguishing, however, is that it’s not for lack of effort on the part of those involved. No matter where you find yourself in the world, there are likely to be countless people and organizations dedicated to the joint causes of improving patient care and population health – with its abundance of healthcare institutions, Boston is more fortunate than most. So with an event like the one tonight as just another example of the types of efforts taken, in a strange way I found myself comforted to realize that the work doesn’t end here.

As a follow-up to the event, Microsoft and BWH iHub will be working together on a selection of the best ideas to try to bring potential healthcare solutions to light. Thinking about the scale of population-level problems, even if just one or two ideas were to come to fruition, the ramifications would be huge. And yet, even then, there will still be more to be done.

Walking away from the hospital that night, there was one thing that I realized can be held constant in healthcare - much like the Energizer bunny, the work keeps going, and going, and going…

And so shall we.

Tuesday, June 9, 2015

Nine Teams Begin Commercialization Boot Camp, Canvas their Biomedical Business Concepts

On Day 1 of the CIMIT/B-BIC i-Corps Healthcare Commercialization Boot Camp, nine teams of innovators from a selection of the area’s most esteemed academic and medical institutions - including Boston Children's Hospital, Boston University, Brigham & Women's Hospital, Harvard Medical School, Mass General Hospital, MIT and Yale - convened at Boston University to start the process of developing a commercialization roadmap for their projects. They shared their ideas in confidence, received valuable insight and feedback from expert mentors and coaches, and learned more about the commercialization road ahead.

That road, though shaped initially by the promise of each team’s proposed innovation, will change form in response to the pressure testing performed by each team over the course of the seven-week program. With guidance from experienced commercialization experts and a large emphasis on defining target customers and soliciting their feedback, the iterative customer discovery process undertaken by teams will de-risk their concepts and improve their chances of realizing commercial success. While each team will define what success means to them, a common foundation is no doubt shared among the group, as all seek to move their ideas further along the commercialization continuum, eventually producing products that improve patient care.

To kick off this process, the teams took part in preparing their own Business Model Canvas (see video for "Business Model Canvas Explained" below) – a tool now widely used by startups and early-stage projects to record a product’s proposed value, target customers and business models. Framed in this comprehensive, concise package, the teams presented on all key aspects of their business (as they see it today) in just shy of ten minutes.

While I’m mindful that much of the work that’s gone into formulating each team’s concept started well before the Boot Camp kick-off, I can’t help but think how the day marked an especially significant point in time for these nascent projects – the time when each team committed wholeheartedly to giving their idea a chance to become something more – to exist outside the lab, and be made available to patients the world over. Regardless of their respective end results, is that not all they could ever ask for?