The Beginnings of Health Data | Evidation Health CEO Deb Kilpatrick

But it was really a pretty transformational time in healthcare because it was the first time where all of a sudden the idea that you looked at a patient 365 degrees around their life, as opposed to looking at a patient just in the operating room or just when they were in the hospital or just when they were there for their clinic visit, was a fairly radical thing. And I know you probably hear that and you think, come on, really? No, really. It wasn't a bad thing. But it wasn't the only thing that I found valuable while I was there. The other thing that happened that becomes important to my view of healthcare is that in the mid-2000s to the late 2000s, medical devices were becoming connected. Now, Bluetooth as we know it today was— this is the same Bluetooth, but it was very, very rudimentary. And one of the first medical applications of Bluetooth was phone-based. And what happened was people who had pacemakers were able to— they had a console next to their bed, that's what's shown on the left, and they would go home and they would push a button. And when they pushed the button, the console, the companion console at the doctor's office, would allow a data dump of all of their pacemaker data to go to an interface there at the doctor's office. This is kind of a big deal because nobody had ever done remote monitoring like this before. And this is like 2004. So this is a long time ago, long before anybody was really thinking— we were all carrying around BlackBerrys back then, right? There wasn't even— the iPhone didn't even exist yet. And we were now capable of seeing patient data in the clinical setting, not 24/7. That's certainly a stretch because it was very big data dumps of batch data. But on pretty much a daily basis, you could now look at patients' data. Patients couldn't see their own data, but it wouldn't have made sense to them anyway because there was really no way to have an interface or a device to have an interface on. You have to kind of go back to the world of BlackBerrys and very simple UX. But it was really a pretty transformational time in healthcare because it was the first time where All of a sudden, the idea that you looked at a patient 365 degrees around their life, as opposed to looking at a patient just in the operating room, or just when they were in the hospital, or just when they were there for their clinic visit, was a fairly radical thing. And I know you probably hear that and you think, come on, really? No, really. And I'll talk more about this, but this was truly, truly transformational to me as someone at the time who was running the internal incubator. So at the time Guidant was acquired, I was running the internal incubator in Santa Clara, which basically meant, you know, we were in charge of developing the product portfolio and the technology portfolio on a 10-year timeframe. And so we would do everything from pilot manufacturing to pilot first-in-man clinical trials to lots and lots of investment with our venture group into startups to decide, you know, what we would make versus buy. And along the way, this notion that you could certainly have in your product portfolio an ability to have remote monitoring, the ability to have data flowing from devices back into the clinic, it really was foundational to the way a lot of us were thinking about the 10-year portfolio beyond, which at that time would have meant, you know, 10-year view at that time would have been 2016. But it truly opened my eyes to the power of what it would mean to the entire healthcare system if you suddenly had access to patient data. Now there's something else that happens at this point in time that's also really important, which is the human genome was sequenced. Now in the Clinton administration, it was declared complete with a lot of arguments by Craig Venter about what complete was. around 2004, 2005. And so at the time that we were acquired, I was deciding what to do next. And as I'm sure you realize at this point in your careers, you know, people and the movement of people into different ecosystems can have a really profound effect on company creation and a pretty profound effect on, you know, opportunities. What had happened at the time that Guidant was running up to the acquisition is the president of my division had gone to Kleiner Perkins to be a partner. When he did that, and the Human Genome Project was complete, Kleiner became the really sort of the stake-in-the-ground venture firm to begin incubating ideas around molecular diagnostics using new information from the human genome. And because the president of my division of Guidant had gone there, I got called. And this becomes a really important part of the story of how we think about the power of people and their data, because suddenly, for the first time, we could think about patient biology as being the ultimate platform, right? We weren't even using that word then, but that's how we were all thinking about it. And the idea that you could have patient biology be a platform for new diagnostic and new therapeutic product development It's hard to imagine now, 'cause it's so much a default in the way that we think about healthcare, but it was very, very, very different, and it caused business model thinking to shift. It caused the way we thought about starting companies to shift. It caused the way we thought about IP licensing and IP development to shift, and I really wanted to be a part of that, and the reason that I wanted to be a part of that is, at the time Guidant was acquired, I was sort of deciding what to do next. That was a natural fork in the road. I'd been there for 10 years. I was very steeped in R&D and the internal incubator, and really felt like it was time for me to do something different, but I didn't really know what that was. And so I was approached by Kleiner after our president had gone there, by Brook Byers, the partner at Kleiner, and a guy who had started a company in this space to go be a part of that ecosystem. And the greatest surprise of all to me, even looking back, is that they wanted me to be on the commercial side. Now, I have never sold or marketed anything in my life at this point, right? And now here Kleiner Perkins is trying to bring me into their soon-to-be-funded Series B incubated company as the commercial head. I had to think long and hard about that, but I agreed to do it. And I'm giving you kind of the 3 products that were sort of in that portfolio at Kleiner, and TPG Biotech was another big investor for all of these. We were all using RNA, not DNA. And this is a really important point because most molecular diagnostics are based on genotyping or based on measuring SNPs or different alleles, different mutations, but they're fairly static things in the sense that, you know, your genotype doesn't really change. We discover new things about our genome all the time and the way that they are sequenced, but it doesn't really change. But your your— the dynamic part of your genome does, which is RNA. And these were all companies based on RNA. So Oncotype DX was based on tumor sequencing, or rather tumor RNA, and it was revolutionary because it was the first time you could tell a woman or anybody, because there are certainly men with breast cancer also, you could tell a patient with breast cancer whether or not they were likely to recur and whether or not they were likely to need chemo, or respond to chemo, rather. If I stop, if I sort of pause here, because we're going to start to get into the Avidation story and where I think healthcare is going, I sort of have developed this thesis going into joining Avidation of, you know, we've gone from really big widgets having value, like planes and cars, and granted those things still exist, but we've gone from only those things having value to information creating big value and being a platform for value creation. Certainly in healthcare that has happened. We've gone from devices and drugs being the only thing that had value or a procedure that had value using those things to information being extremely lucrative and extremely valuable. In fact, if you look at the 2019 IPOs in healthcare, some of the most successful ones are digital health IPOs. They're not widget companies, they're information companies.