Episode 133: How Tribal Nations Are Investing in Biotech and Shaping Healthcare Innovation

Today we're exploring how tribal nations are investing in healthcare innovation and what founders can learn from that perspective. You're listening to Bio from the Bayou, empowering biotech leaders with the tools, assets, and expertise to improve healthcare outcomes.

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Serving the entire Gulf South, but recorded in the heart of New Orleans. Welcome back to Bio from the Bayou. I'm your host, Dr. Elaine Hamm, the executive in residence in Tulane School of Medicine, and Today's guest is Chris Schilling. He is currently the Chief Innovation Officer at the Chickasaw Nation Department of Commerce. Welcome to the show, Chris.

Thank you for having me, Dr. Ham.

Oh, please don't call me Dr. Ham because you've known me for far too long. And I think that we talked a little bit about this. How long is it at this point?

I think I knew you as a student at the University of Oklahoma as early as 2007. So, we're almost 20 years in our relationship, and then we were coworkers, uh, in 2009. And then there's a lot of things you told me to do that I didn't listen to that I should have. And then there's a lot of things you told me not to do that I did. You know, there's a couple of things I actually listened to you on, and all those things really paved the way for my career that I've had. And I'm really grateful for your mentorship and friendship.

I can't believe, I mean, I didn't bring you on to pump me up, but I really appreciate that piece of it. It's nice.

I will gladly be a Dr. Ham hype person anytime, anyplace.

Well, why don't you give a little background on yourself? Obviously, you were a student at the University of Oklahoma, but how did you end up as the Chief Innovation Officer at the Chickasaw Nation?

Yeah, internships and free coffee. And I know, as you recall, our friendship started really as we kind of thought about commercializing technology for the University of Oklahoma. And, you know, we were kind of trying to throw spaghetti at a wall and see what stuck and kind of got into biotech right off the bat. We started and founded an early-stage biotech company when I was a student and realized that the learning in the books at universities are great. And then applying that knowledge to something that's productive and hopefully good for the world is a lot more fun. And so the journey of my career has taken a lot of different turns. I've existed in healthcare operations for a while. I interned at Nike and was a contractor there and looked at supply chain stuff. And I've worked for startups and helped build startups. Went to Harvard for business school and learned a lot from my pals there. Ultimately, I thought I was leaving Oklahoma because I thought I had done all the things I need to do here. And then I learned about tribes and I realized that tribes are kind of the nexus of all these exciting things that are going on. They exist, they're not going anywhere, and they're growing and thriving in a lot of different and unique ways. I was fortunate enough to learn a lot about the Chickasaw Nation where I currently reside and understood the breadth of services and support they provide not only to their citizens, to folks in rural Oklahoma, and really to all Oklahomans. If you've been to Oklahoma City, you know, we know we have water parks, we fund facilities, we support, you know, numerous programs and services and nonprofits, all under the leadership of an amazing governor, Bill Anatubby. So that's how I got there, and I've been there for almost 8 years now.

Wow, that's incredible. And yeah, we have about I think almost 39 tribes in Oklahoma itself.

And we have 39 federally recognized tribes. Good job on learning the history.

Oklahoma history did me well.

Uh, that's right.

But Chickasaws are one of the largest, obviously. And you're located sort of, I'm trying to think of like where the headquarters are. It's here in Oklahoma City, right?

Our headquarters are actually in Ada, Oklahoma. I just made that up.

Cool.

Cool.

Cool.

Cool. Yeah. South Central, okay. Oklahoma. If you've ever been to East Central University. Our borders really are 13-county area. It's really a jurisdiction the size of close to New Jersey. Wow. Or 5 Rhode Islands if you're a Rhode Island fan. It's south of the Canadian River in Norman, basically when you go south of OU all the way down to the Texas border along I-35, and then a county or 2 to the left or right of that.

And you have your own healthcare piece, which we're going to talk a little bit about later on. But you mentioned the investment piece, and I think that that's a really interesting piece I don't think a lot of people know about. I mean, I'm familiar as the Chickasaw Nation has been an investor in one of my companies in the past. And let's start off by helping our listeners understand sort of what your approach to investment and economic development is and, and how those investments tie back to the tribe's broader mission.

Well, our mission is to improve the overall quality of life of the Chickasaw people, something we have to, you know, we eat, sleep, and breathe every single day. We've got core values that we try to uphold, but first and foremost is the Chickasaw people. We've been around before the United States existed. We hope to be around for many, many generations to come. And so that's how we structure our businesses. That's how we structure our programs and services to elevate the Chickasaw people and give them the best opportunity to be successful and to be good partners and community members. And I think the investment strategy really follows Being a good partner, community member, making sure that we're doing something that creates strong dividends for the Chickasaw people. And then the products and services that we invest in, if they happen to also benefit Chickasaw citizens, that's like the win-win-win, right? So if we can, you know, broadband infrastructure as an example, we can build out a broadband network in southern Oklahoma, really reach folks that have never received internet services. And then we pass a lot of other customers along the way who would benefit from high-speed broadband. So you can build these like useful ecosystems of bridging a digital divide, providing services to citizens, and generating economic development opportunities in the process.

As you guys think about investments, I mean, you, you've mentioned a couple, so the broadband piece, but what else, what are the other types of companies or what are you looking for these days in terms of investment strategy?

It's a balanced breakfast, I guess you'd say, you know, everything from, you know, you've got your traditional endowment, cash reserve, cash management, investment strategy. You've got a private equity strategy that's more direct invest in some new and exciting companies. We have a couple PE firms that do that. We have federally funded investment vehicles. Some of you might be familiar with SSBCI or State Small Business Credit Initiative.

Yep.

We have a community development entity to add CNCDE, which is tax credit driven incentivizing co-investment in rural and marginalized areas of the country. There's really a flavor for everybody. There's a lot of ways to tap into tribes all across the United States.

And do you guys invest in funds as well as companies?

We do. That's really where we cut our teeth. We're not doing as much of it as we have in the past. You know, we've invested in funds or even funds of funds, and there's healthcare-related verticals, there's oil and gas-related verticals. There's all kinds of different things that we've seen over the course of my tenure here.

Our listeners may not be familiar with tribal economic systems. How does that investment strategy in a sovereign tribal nation differ from maybe like a private sector or VC fund or something to that effect?

I guess this is where I kind of acknowledge that every tribe is different. And if you're going into one tribe assuming it's like another tribe, then you're kind of mistaken, right? Yeah. One thing that we have in common is that we all want to serve our people, but the way we go about serving our people manifests in many different ways. You know, it's not a one-size-fits-all approach. There is money to be invested. There is opportunity to be harvested, but you really got to get to know the tribe and understand what their economic goals and motives are. You got to understand what their healthcare goals and motives are and the other socioeconomic stuff that you want to focus on as well. And so you really have to spend time understanding the tribe versus treating it as like, throw my deck over the fence and see what happens.

Right. Yeah, a little bit like family offices in some ways is that every family office is very different in what they're passionate about, what they care about, how they're structured. And you can't just assume that all family offices are gonna be the same. You have to take time to understand what their strategies are and what they care about. It's not just, yeah, send a deck and hope for the best.

If you think about tribes and tribal history, like everybody's kind of, again, everybody has a unique story. The unconquered and unconquerable Chickasaw people have migrated A couple times in their history, self-determination has represented itself many different forms. The most recent form is since the Nixon administration all the way to today, right? Where you can really say that the rise— it's cool to be an innovation type role at a tribe because the rise of modern self-determination in tribes kind of coincides with the evolution of technology, right? Started with the mainframe computer, then you kind of have network computing and then the SaaS age, and now we're diving into AI. And so— I think tribes also can sometimes appear unassuming, but you have to understand that they've evolved and adapted better than almost any other group of people I can think about. And they know a lot more than you think they do.

Absolutely. Well, and it's interesting you mentioned AI. Is that something that you guys are looking at from an investment standpoint in terms of whether companies or land use, anything like that?

TBD. Yeah, I think TBD. It's, it's an, again, it's an evolving space. Everybody's got a strong opinion about artificial intelligence.

Totally.

For us, it's— and I think Governor Anis Ali is great about this. He thinks that it's another form of computing. It's another form of software. And how do we apply it to the highest and best use of the Chickasaw people? We're not looking to replace or augment staff. We're looking to be more efficient as an organization. We're looking to use it as an economic development tool. Some tribes are going, you know, guns blazing and talking about all the great things they're doing with AI. We're really watching, learning, and trying to be good stewards of our tribal resources.

Yeah, thoughtful approach. Well, then where do you see some of the greatest opportunities for innovation to improve Native American health outcomes, whether it's technologies, new care models, partnerships? And, and maybe before you answer that question, it might be helpful to help us understand what is the state of healthcare and in particular in, in the Chickasaw Nation?

That's a great question. The status of healthcare at the Chickasaw Nation is quality. Now, I don't work for the Department of Health. But the Department of Health has received, I think, maybe the first hospital system in the entire state of Oklahoma to receive the Malcolm Baldrige Award for Quality and Excellence.

Wow.

It's a prestigious award that took many years to achieve, and they pursued this Baldrige framework really since I've been at the tribe. Not only are they pursuing quality in the service delivery, the front-end system, they're looking at population health, they're looking at social determinants of health, they're starting to embed research. And then I think a lot of that was bred out of tribes sometimes being perceived as the lowest rung of healthcare. But during the pandemic, it was tribes who figured it out first, right? Tribes who were able to vaccinate.

Yeah.

And we didn't just vaccinate our folks, we vaccinated everybody.

Yeah.

Or helped provide services to everybody who were in need. And I think that's the benefit of having tribes. I don't think you have strong rural healthcare in Oklahoma without The presence of the 39 tribes.

A million percent. I mean, absolutely. And, and I don't think people realize that you guys have your own hospital systems as well. And so—

We do, and they're really nice.

They are. We—

I don't know if you visited the property in Ada, the, the Chickasaw Nation Medical Center. We've got satellite clinics in Kishomingo, Ardmore, Purcell, all these other places. And I think this is public information. We're actually building maybe the largest IHS, Indian Health System, hospital facility near Oklahoma City to address tribal health needs, not just of the Chickasaw people, but all other tribal citizens in the state and region. It's going to be a multi-billion dollar initiative when it's said and done.

That's incredible. Let's go back to that question around sort of where you see the opportunities and maybe some of the gaps as it relates to healthcare and innovation for the tribe.

Yeah. Well, to think about the strategy, you have to think about the incentive. I believe the tribe is the patient. The tribe is the provider and the tribe is the payer. It's very rare you have that ecosystem where you play all 3 roles, where you are working with insurance, you're working with public and private insurance, you're also working with federal funding formulas, and you're trying to deliver the highest quality service you possibly can. And oh, by the way, if you don't do a good job, your citizens will let you know.

Yeah, they'll let you know. Yeah.

Over time. And so I think that's where the opportunity is. There's 2 opportunities for us specifically. One is to be a hub where we could try and learn and innovate within our own ecosystem and then scale that to other places. So I think you could look at Tribes as an incubator. The second place is we're expanding, we're growing, and then, and if you can deliver something that helps improve the lives of our citizens, we're likely to adopt it as a customer.

Yeah.

And then if we're going to adopt it as a customer, we might adopt it as an investor. If we see the opportunity to scale beyond where we are today.

That makes sense. Well, one thing that we haven't talked about is we talk a lot about clinical trial diversity on this podcast. One of our more recent ones, we talked about how women weren't really included in clinical trials. But let's talk about ethnicity. I mean, there is a huge issue of a lot of clinical trials and drugs being tested primarily on white men. Is that something, as we think about sort of clinical trials and making sure that we're designing medicines that help everybody. And when we talk about personalized medicines, that it really takes into account all different types of persons. Is that something that you guys have thought about at the Nation?

It is. And, you know, we're— and I can't speak to this because I'm not directly involved, but I know we're developing our own research capacity to understand, learn, and collaborate better. Now, you and I, Dr. Hamm, come from a university, and we've seen an evolution in how universities probably treat and interact with tribes. Not speaking for a specific university, but I'm saying that sometimes people look at tribes as, oh, I can add them to my grant. They just get a letter of support in and I'm more likely to get funded. And I think those days are largely over. I think people see the value of tribal participation. I think they understand that, again, we're not just podunk people in the middle of nowhere, that there's people there because we're living those outcomes and have to own the— be accountable to our people. We're improving and we're improving at a rate that is, um, and learning at a rate that is faster maybe than the national average. And I think hopefully we're being seen as a, as a collaborator and a partner to help inform and add color and context to some of those studies that maybe haven't had the best representation over time.

Yeah, absolutely. You're not just a line in a grant and a, a letter of support. It's much more than, than that. And I think there is sort of a pers— Yeah, it's a partner. There is a perspective that comes with like, oh, we need to have diversity in our clinical trials. Well, that isn't just saying it, that isn't lip service. You have to really work to find ways to engage those different communities. That's a big struggle. I mean, even with New Orleans, we're a majority minority city, but we can't just say we're gonna go include people in a clinical trial. You have to build trust with the community and understand that, you know, you're really trying to help. Everybody that's in that community, not just one set of people.

It's a lot of listening. I'm still listening and learning. I'm humbled by the breadth and diversity of this tribe and all the different things that it does and its people. But the more you listen, the more you understand, the more you understand, the more you can help play a role.

Well, so then what types of other partnerships, whether universities, startups, healthcare providers, funds, investments, governments, play a role in advancing the Chickasaw Nation's healthcare and investment goals?

Yeah, I think we're kind of an across-the-board opportunist. You know, anything that would, again, allow us to meet our fundamental goals as a tribe is someone we want to hear from and interact with. And yeah, investment may not be the first step. It might be, what does your research look like? Or what kind of product are you developing? How might we use this in our ecosystem? How can we open doors to help you connect to other tribes or other groups. But as you foster that relationship over time and find the right place to kind of exist within our ecosystem, then that can like, I guess, I think we can help you flourish in a lot of different ways, even if we're not an investor. I think one of the things that we offer is, again, market access. Now, this is not a healthcare thought, but I think about our gaming environment. We operate some of the larger gaming facilities in the state. And when there's a startup who wants to try things out, we know that we have something to offer, space.

Yeah.

and people to interact with. And we know that that value kind of coming from our technology transfer days, Elaine, is not free.

Yeah.

So we should make sure that there's aligned upside for all participants. And we help companies become successful by offering patronage, user experience, go-to-market strategies, and the exchange. We want to see how we can be compensating the Chicks Off people for their willingness to collaborate, right? So the thing that's top of mind for me that hasn't been fleshed out yet, but is really that technology transfer model that we kind of have experienced from our old days. How do we be the nexus for innovation and allow to foster it and grow it? And then also have aligned upside for those who are collaborating and partnering with us and the Chickasaw people long run.

That's great. Well, anything else you'd like to leave our listeners with as we wrap up?

You know, I just think we have a lot of gratitude for the work that you all do at Tulane and anybody who's still in the game and fighting the good fight of trying to advance healthcare quality across the nation. We see you. And we respect you and we appreciate the work you're doing. Healthcare will always be a challenge and there'll always be a new frontier. We're in an interesting time now, but through interesting times become interesting opportunities. And I think during this time, now more than ever, tribes can really stand out as a great partner in the healthcare space.

Love it. Well, thanks so much for talking with us, Chris. Always great to see you. Hopefully the next time I won't have to convince you to come on the podcast before we see each other, but I'll take what I can get.

Well, next year we're going to have a celebration of our 20th anniversary, so if nothing else, see each other then. Yeah, it'll be great. Thanks for having me.

As always, we'll have Chris's contact information and informational links about the Chickasaw Nation in our show notes. Make sure to check them out to learn more. Thank you once again for joining us for Bio from the Bayou.

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This podcast was edited by Resonate Recordings.