Listen to Understand

We investigate the world of Biochemistry and Tech-driven Health Care

How exponential growth is changing the world

September 12, 2023

Harry Glorikian

If you’re looking for help thinking about the implications of exponential change in all areas of technology, one of the best people you can turn to is Azeem Azhar. He's a writer, entrepreneur, and investor who publishes the incredibly popular and influential Substack newsletter Exponential View, which takes deep dives into AI and other subjects with world experts. In 2021 Azeem published a whole book along the same lines called The Exponential Age: How Accelerating Technology is Transforming Business, Politics, and Society, and he joined Harry on the show in early 2022 to talk about that. This summer, the book came out in paperback—and just this month, Azeem worked with Bloomberg Originals to launch a limited-run TV show and podcast called Exponentially with Azeem Azhar. So it seemed like a great time to revisit Harry's 2022 interview, which resonates with current events even more now than it did when we first aired it.

56 min 35 sec

Episode 100! Illumina's Phil Febbo on the New Era of Low-Cost Genome Sequencing


Harry Glorikian

For the 100th episode of The Harry Glorikian Show, Harry welcomes Phil Febbo, chief medical officer at Illumina. The San Diego-based company is the leading maker of the high-speed gene sequencing machines that are at the core of the precision medicine revolution. The company has an 80 percent market share, which means that if you or your loved one has had any sequencing done for any reason, chances are your samples were sequenced on an Illumina machine. Gene sequencing is already a key part of both diagnostics and treatment decisions for many disease, but its use is only going to expand as the technology gets faster and cheaper. This fall, Illumina announced that it’s coming out a new gene sequencing machine called the NovaSeq X that can sequence a genome more than twice as fast as Illumina’s previous top-of-the-line machine, and at a lower cost. That’s bound to speed up progress all across the field of genetic medicine, drug discovery, and life science research. And that’s where Harry starts his interview with Febbo.

53 min 07 sec

David Sable is Still Working on Making IVF More Accessible


Harry Glorikian

In 1978, Louise Joy Brown was celebrated as the world's first "test tube baby," born as the result of in vitro fertilization (IVF). Today, Brown is 44 years old, and what was a technological triumph in 1978 is almost routine today, with half a million babies born every through IVF. But Harry's guest this week, gynecologist and investor David Sable, thinks IVF still isn’t nearly as reliable or accessible as it should be. From his studies of infertility services, he’s convinced that society is on the cusp of bringing down the cost and raising the success rate of IVF, so that it can finally become an affordable solution for millions more people every year who want to start or grow their families. And he thinks one of the keys to the next big wave of advances in IVF will be artificial intelligence.

64 min 35 sec

How H1 Is Networking The Healthcare World, With Ariel Katz


Harry Glorikian

“LinkedIn meets ZoomInfo meets Zocdoc, but for doctors." That’s how H1 co-founder and CEO Ariel Katz describes the information service his company offers. It's a response to the fact that the healthcare is incredibly fragmented, with no central database or platform that everyone can use to share their professional profiles and get in touch with colleagues. (Physicians never adopted LinkedIn for this kind of networking because they just don’t switch jobs very often.) Without a central directory, patients can have a hard time find the right doctors, and doctors can have a hard time finding each other—say, when they might be searching for research collaborators. It’s an even bigger frustration for drug companies, who need to know which doctors can help them enroll the right patients for clinical trials. H1 is trying to solve all of those problems by building what Katz says will be the world’s largest graph database of people in healthcare. After participating in the 2020 batch of startups at the Silicon Valley incubator Y Combinator, H1 has rocketed forward, raising almost $200 million in venture capital. This week Ariel joins Harry to talk about how and why H1 has grown so quickly, and how better networking could accelerate drug development and help patients find the best doctors for them.

35 min 35 sec

Erwin Seinen Says the Paper Lab Notebook is Finally Dying with eLabNext


Harry Glorikian

If you walked into a typical life science lab, you might be surprised to see how much paper is still laying around. Many researchers still keep records of their experiments and studies in paper notebooks. In fact, along with doctor’s offices, biotech labs might be one of the last bastions of professional life that finally surrenders to digitization. But Harry's guest this week, Erwin Seinen, is helping to accelerate the shift. He’s the founder and CEO of a company called eLabNext, whose core product is a Web-based software platform called eLabJournal that includes tools for inventory and sample tracking, managing experimental protocols and procedures, and recording experimental results. Seinen explained to Harry how an electronic lab notebook can fit together with other lab tools, in an era where there’s just too much data to track everything on paper—and how companies can manage the transition to digital tools without sacrificing any of the spontaneity, curiosity, or creativity that good science is all about.

45 min 04 sec

How Rune Labs Uses Data To Improve Prospects For Parkinson’s Patients


Harry Glorikian

Harry’s guest this week, Brian Pepin, says there haven’t really been any advances in the treatment of Parkinson’s Disease in a decade. The standard treatment is still the standard treatment—meaning various drugs to replace dopamine in the brain, since the loss of neurons that produce dopamine is one of the hallmarks of the disease. But there has been one important change during that decade. Thanks to new technologies, ranging from wearables like the Apple Watch to sophisticated deep brain implants from companies like Medtronic, we’re now able to gather a lot more data about what’s happening in the daily lives of patients with Parkinson’s, and how the disease is affecting their brain function and their physical movement. Which means there’s now the potential to make much smarter and more timely decisions about how to dose the drugs patients are taking, or whether they should think about joining a clinical trials. Gathering and analyzing that information and feeding it back to patients and their doctors in a user-friendly form is the mission of Rune Labs, where Pepin is CEO. He says we’re on the edge of a new era of “precision neurology,” where data gives doctors the power to predict the course of a disease and muster a meaningful clinical response. And he wants Rune Labs to be at the leading edge of that change.

51 min 33 sec

Proscia Pushes Pathology Down the Digital Path


Harry Glorikian

In most hospitals, the practice of radiology went digital years ago. Today you’ll rarely find a radiologist examining a broken bone or a fluid-filled lung on a sheet of old-fashioned X-ray film. But pathology isn’t as computerized. For a variety of cultural, technical, and regulatory reasons, many pathologists still prefer to look at tissue samples the old-fashioned way, on a slide under a microscope. Philadelpha-based Proscia is working to change that—and open up pathology to the power of remote work and automated image analysis—by building a cloud-based infrastructure for storing and sharing scanned pathology images. Harry’s guest today is Proscia CEO David West, who says there are still strong cultural barriers to the adoption of digital pathology, but “the community is realizing this can be really great for them and their discipline.” West says easier scanning, higher resolution, faster image delivery, and the ability to review images from anywhere and tap the power of artificial intelligence are powerful advantages driving adoption of Proscia’s platform.

56 min 42 sec

Vibrent Health – The Catalyst for Mobile HealthCare


Harry Glorikian

We use our smartphones to communicate, shop, navigate, watch videos, take pictures, share our lives on social media, track our exercise, and listen to music and podcasts. So why shouldn’t they also be the main interface to our healthcare experiences? Let’s talk about Vibrent mobile healthcare. P.J. Jain started Vibrent Health out in 2010 when he left behind a career in networking and telecommunications. The company had its breakout moment in 2015 when it won a contract from the National Institutes of Health build a mobile data-gathering infrastructure for a 10-year research program called All of Us, which is designed to gather medical data from more than a million people around the United States. NIH asked Vibrent to build a mobile app and an online portal that would become the communications backbone and the central data gathering repository for the whole project. And now that NIH is six or seven years into the project, it’s clear that in some ways the agency and the mobile interface Vibrent built for All of Us have leapfrogged over the rest of the US healthcare ecosystem. We’ll hear how in today’s episode.

58 min 34 sec

Life Science Labs Can't Be Automated, But They Can Be Orchestrated


Harry Glorikian

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

Rare-X Wants to Build the Data Infrastructure for Rare Disease Research


Harry Glorikian

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

How WHOOP Uses Big Data to Optimize Your Fitness and Health


Harry Glorikian

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

How RxRevu is Fixing the Disconnect Between Your Doctor and Your Pharmacy


Harry Glorikian

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

Eric Daimler at Conexus says Forget Calculus, Today's Coders Need to Know Category Theory


Harry Glorikian

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

Lokavant Wants to Help Good Drugs Succeed in Clinical Trials, and Help Bad Ones Fail Faster


Harry Glorikian

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

What Kids Can Learn from Social Robots, with Paolo Pirjanian


Harry Glorikian

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

How Akili Built a Video Game to Help Kids with ADHD


Harry Glorikian

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

Fauna Bio Awakens Medicine to the Mysteries of Hibernation


Harry Glorikian

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

Finally, a Drug Company Listens to People with Hearing Loss


Harry Glorikian

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

Is Your Kid's Infection Bacterial or Viral? Eran Eden's MeMed Can Tell


Harry Glorikian

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

Netflix Docu-series Star Jacob Glanville Returns To Talk About How The Pandemic Ends—and His New Company


Harry Glorikian

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

How to see inside your body using continuous glucose monitors with Maz Brumand from Levels


Harry Glorikian

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