Dr Paul Gerrard Co-Hosts Multi-faceted New Podcast "HealthTech Remedy"

Many readers of this blog will be familiar with the name of Dr Paul Gerrard, who has served as a MolDx medical director and as a physician executive with Veracyte and  ArteraAI.  (See Gerrard et al. validating its prostate model here.)

Along with Drs Timothy Showalter and Trevor Royce, Gerrard is now co-hosting the podcast HealthTech Remedy.

• Find the home page here.  Find "About" here.
• Find the episode list here.
• You'll find a high quality transcript as well as the podcast audio.

Here's the website description:

• Welcome to the HealthTech Remedy podcast, where three physician leaders explore healthcare innovation. Drawing on our backgrounds from academic medical centers to leadership roles in health technology, we provide unique insider perspectives on the industry. 
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• Each episode features the real stories of both emerging and established health technology companies transforming patient care. We also interview the pioneering leaders driving change, sharing their journeys and insights.
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• Join us as we uncover breakthrough solutions, discuss their real-world impact, and reflect on the challenges and successes of health tech. We navigate the arcane interface of healthcare and technology, offering a blend of expert analysis and personal reflections.

In recent podcasts, Dr. Aron D'Souza discussed biotechnology & performance enhancement, Alex Dyle discussed faster clinical research at Flatiron, Dr. Yousuf Zafar discussed bridging local and specialized oncology expertise, and Dr. Brigham Hyde discussed new approaches to facilitate real-world evidence.

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Re biotech and longevity, see Tad Friend's review of Peter Diamandis and others, New Yorker, August 11.

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AI CORNER

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Google Notebook LM reads the four transcripts and summarizes for us.

(Direct AI output - do not quote without checking details)

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The four podcasts at HealthTech Remedy" highlight innovative health technology companies.

• Enhanced aims to redefine human potential through a direct-to-consumer telehealth platform for performance optimization and the Enhanced Games, where athletes openly use enhancements.
• Flatiron Health is transforming oncology clinical trials by leveraging EHR data and AI to design smarter protocols, accelerate patient recruitment, and streamline data collection, making trials faster and more representative.
• AccessHope tackles cancer care inequity by remotely connecting local oncologists and patients with subspecialists from top cancer centers, offering expert reviews and support as an employee benefit.
• Atropos Health provides physicians with rapid, patient-specific real-world evidence by analyzing de-identified EHR data in response to natural language clinical questions, addressing the lack of timely evidence in medical decisions.

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Here is a detailed summary of each podcast transcript, tailored for health tech and health policy experts:

PODCAST ONE: DR D’SOUZA PERFORMANCE ENHANCEMENT

This episode delves into Enhanced, a company founded by CEO Dr. Aron D'Souza, which aims to revolutionize human performance through a dual-pronged approach: a revolutionary sporting event and a direct-to-consumer health platform. Dr. D'Souza, with a background in law and complex problem-solving, describes his current mission as ushering in an "enhanced age" where technology fundamentally augments the human experience across physical, mental, cultural, and civilizational domains, even framing aging as a treatable disease.

Key Business Models & Vision:

• The Enhanced Games: An audacious alternative to the Olympics, set to launch in 2026, where athletes are openly permitted to use performance enhancements. The goal is to showcase the true limits of human capability. The concept gained viral attention, leading to significant venture capital interest. Early successes include Kristian Gkolomeev, who, at 31 years old and after just three weeks on the program, broke a 16-year-old world record, demonstrating the potential for enhanced athletes to surpass prime-age performance. The company believes sports serve as the "greatest proving ground" for validating human enhancements due to rapid, measurable results.
• Direct-to-Consumer (DTC) Health Platform: This platform focuses on performance optimization and aims to democratize access to cutting-edge therapies for longevity, strength, and focus, moving beyond the exclusive realm of billionaires. The business model involves consumer-paid services, including a monthly prescription fee (around $399/month), diagnostics, and coaching subscriptions. Products include enhanced therapies for testosterone levels and longevity. Dr. D'Souza explicitly critiques the traditional sports business model (e.g., FIFA, Olympics) as inefficient, contrasting it with Red Bull's successful sports marketing approach to sell high-margin products. Enhanced aims to sell prescription medicines, supplements, and fast-moving consumer goods (FMCG) supporting human enhancement.

Ethical and Regulatory Landscape:

• The discussion highlights the "fuzzy boundaries" of enhancement, using the real-world case of runner Caster Semenya, whose naturally elevated testosterone was deemed "too enhanced" for competition. Examples like LASIK surgery and GLP-1 drugs are cited as normalized enhancements that do not trigger societal alarms, unlike other forms of performance enhancement. Dr. D'Souza draws an analogy to cosmetic medicine, where non-therapeutic surgical enhancements (e.g., silicone implants) are accepted, but pharmacological enhancements for similar goals (e.g., anabolic steroids for muscle growth) are not, highlighting perceived inconsistencies.
• The company acknowledges the controversial nature of the topic but emphasizes its scientific rigor. Enhanced has assembled a respectable medical advisory board, expanded its scientific panel to 38 members, hosted scientific conferences, and generated extensive research and academic interest. A survey by FIMS (the Olympic Doctors' Own Association) indicated that 74% of Olympic doctors are willing to treat enhanced athletes, and 30% are willing to prescribe performance enhancements if legal and ethical, suggesting a growing scientific acceptance.

Strategic Positioning & Future:

• Enhanced is backed by prominent figures like Peter Thiel, Christian Angermeyer, and Balaji Srinivasan, known for controversial bets in biotech, crypto, and frontier technology.
• The company views itself as a category-defining entity in human enhancements, aiming to create a paradigm shift in medicine by solving aging and building a lifestyle brand around the concept of "Human 2.0". Dr. D'Souza asserts that healthcare spending will increasingly be dedicated to making humans healthier and more capable, pointing to the willingness of middle-class Americans to pay for GLP-1 drugs as a market indicator.
• For entrepreneurs, Dr. D'Souza advises solving complex coordination problems and prioritizing finding distribution before building a product. He stresses the importance of a "magnetic mission" (e.g., "build superhumanity") to attract top talent, emphasizing that talent density is paramount for achieving "miracles" and extraordinary things.

PODCAST TWO: DR DEYLE AND FLATIRON AND TRIALS

This episode focuses on Flatiron Health's groundbreaking efforts to address the inherent inefficiencies of clinical trials, led by Alex Deyle, VP & General Manager of Clinical Research. Flatiron Health, a pioneer in real-world evidence (RWE) and a Google Ventures success story acquired by Roche in 2018 for approximately $2 billion, has deep integrations with oncology-specific EHRs across 280 cancer centers in the U.S. and internationally.

The Problem & Flatiron's Foundation:

• Clinical trials are universally recognized as slow, costly, and inefficient, creating a significant bottleneck in bringing life-saving cancer treatments to patients. Data within the traditional trial ecosystem is often siloed, unstructured, and requires burdensome manual transcription from EHRs to Electronic Data Capture (EDC) systems. This inefficiency is likened to "building buildings for a single clinical trial," where infrastructure is rebuilt for each new study without reusability.
• Flatiron's strength lies in its established EHR network in community oncology and its decade-plus experience in processing high-quality structured and unstructured data from EHRs. The company's prior success in defining RWE methodologies and enabling regulatory-grade evidence from real-world data positions it uniquely to disrupt clinical research.

Flatiron's Three-Pronged Approach to Clinical Trial Transformation:

1. Designing Smarter Protocols: Flatiron leverages its extensive RWE datasets to provide analytics that make protocols more operationally and scientifically feasible. This includes optimizing eligibility criteria, potentially expanding patient eligibility from less than 50% to up to 75% in oncology trials with minimal impact on endpoints. This also helps improve the representativeness of trial populations.
2. Accelerating Patient Recruitment: Flatiron uses data, AI (including LLMs and machine learning models), and point-of-care software to identify the right sites and surface eligible patients to clinical staff in real-time. This approach can reduce site screening effort by 95%, significantly streamlining the patient identification process for narrow, precision medicine populations.
3. Lowering Data Collection Burden (EHR to EDC): Through its Flatiron ClinicalPipe™ technology (enabled by a prior acquisition), Flatiron automates the direct transfer of data from EHRs to EDC systems. This automation reduces manual transcription errors, minimizes source data verification, and accelerates data collection with higher quality. Flatiron also builds workflows within the EHR to facilitate structured capture of trial-specific data not typically found in routine care (e.g., adverse events) for seamless transfer.

Compelling Results & Partnerships:

• Flatiron's end-to-end model has demonstrated the ability to enroll studies 4 to 6 times faster and at 20-30% lower costs compared to traditional approaches, also accelerating time to database lock.
• Exact Sciences Partnership: Flatiron facilitated a molecular residual disease (MRD) study that went from concept to first patient in just six months—a process that typically takes years. This was achieved by leveraging existing master clinical trial agreements and parent protocols across Flatiron's tech-enabled network.
• NRG Oncology Collaboration: Flatiron is deploying ClinicalPipe™ with NRG, one of the NCI's cooperative groups, to measure the utility of EHR-to-EDC technology on a large oncology trial, proving its value in streamlining data acquisition for NCI-funded research.

Challenges & Strategic Outlook:

• The biggest challenge identified is overcoming the "status quo" in clinical trials, where the significant investments involved often lead stakeholders to prioritize playing it safe over adopting innovative, though more efficient, models.
• Flatiron aims to create a new model for Contract Research Organizations (CROs), deeply embedded within the EHR ecosystem. Alex Deyle's advice for health tech innovators is to "solve problems that matter" and to build multidisciplinary teams, as healthcare innovation requires diverse expertise and understanding of complex frameworks.

PODCAST THREE: DR ZAFAR ACCESSHOPE CONNECTING EXPERTS

This episode highlights AccessHope, a company co-founded by City of Hope in 2019, that is fundamentally rethinking cancer care delivery by bridging geographic and expertise gaps. Dr. Yousuf Zafar, Chief Medical Officer and a recognized expert in cancer care quality, innovation, and financial toxicity, explains AccessHope's mission to address the inequity in cancer care delivery that often leads to varied outcomes and higher costs based on where patients live.

Core Problem & Solution:

• Cancer is presented as an infinitely complex and costly condition with treatment variations based on region, physician training, and the burden on local generalist oncologists to stay current across numerous disease sites. This creates a "fragmentation of expertise," where specialized subspecialist insights are not uniformly accessible.
• AccessHope's solution is to democratize access to specialized oncology expertise from the nation's top cancer centers (e.g., City of Hope, Dana-Farber, Johns Hopkins). Crucially, this is achieved without requiring patients to travel or change their local providers. Instead, timely insights and second opinions are provided to community oncologists, empowering them to deliver cutting-edge, evidence-based care closer to home.

Business Model & Products:

• AccessHope offers its services as an employee benefit to large employers and health plans, serving nearly 7 million members through over 400 employers (including 60+ Fortune 500 companies) and two of the largest U.S. health plans. The revenue model is primarily through contracts with these entities, appealing to employers who want to ensure their employees receive optimal cancer care. Customers seek transparency and alignment of care with evidence.
• AccessHope offers two main products and a support service:
  1. Accountable Precision Oncology (APO): An automated, technology-based expert opinion service that runs in the background for employers. When an employee is diagnosed with cancer, AccessHope obtains, collates, and summarizes their medical records, sending them to an expert reviewer for remote analysis. The review is then sent to the treating oncologist. This "behind-the-scenes" approach overcomes the common barrier of low member engagement associated with opt-in services.
  2. Expert Advisory Review: This is a similar subspecialist review but requires active member request.
  3. Cancer Support Team: Offers oncology nurses to provide direct support, education, and psychosocial assistance to members navigating their cancer journey.

Impact & Strategic Growth:

• AccessHope focuses on four key stakeholders: customers, foundational academic partners, treating oncologists (the end-users), and patients. The relationship with community oncologists is built on "deep respect," acknowledging their knowledge and workload, with AccessHope providing specialized insights to complement their practice.
• The company aims to standardize treatment approaches, lead to more uniform care, and ultimately improve patient outcomes. A compelling patient case highlighted how AccessHope's remote review and direct engagement with a community oncologist realigned care for an advanced kidney cancer patient, even identifying a nearby clinical trial option, underscoring the company's multi-level impact.
• The COVID-19 pandemic significantly impacted AccessHope's growth, with a "huge peak" in case volume in early/mid-2020, as the value of remote expert opinions became evident.
• A major area of future growth is clinical trials, with AccessHope actively exploring capabilities to match patients to trials, navigate the enrollment process, educate patients, and provide just-in-time information on trial slot availability. This also includes helping community oncologists determine when travel to a trial site is most beneficial for a patient.
• Dr. Zafar's advice for clinicians moving into health tech emphasizes: first, identify the problem to solve (don't confuse technology with the solution); second, align incentives with stakeholders; and third, leverage clinical experience as a "superpower", spending time to understand the nuances of practice and patient challenges.

PODCAST FOUR: DR BRIGHAM HYDE, ATROPOS, and REAL WORLD EVIDENCE

This episode explores Atropos Health, a company co-founded and led by Dr. Brigham Hyde, dedicated to making real-world evidence (RWE) accessible to physicians at the point of care. Atropos addresses a critical gap in medicine where approximately 90% of clinical decisions lack high-level evidence, leading to variable and potentially suboptimal care.

Origin, Innovation, and Problem-Solving:

• Atropos Health, founded in 2020, originated from Stanford University's "Green Button" initiative. The Green Button was an early system that allowed physicians to submit clinical questions and receive rapid, tailored analyses of de-identified EHR data within days (now often minutes). This rapid turnaround was a significant challenge for RWE studies, which traditionally take months or years. Dr. Hyde described his initial reaction as "black magic" due to the speed and methodological quality achieved.
• The company's core innovation stems from the necessity to be "99% faster" to address real-time clinical dilemmas. This pressure led to developing their own Temporal Query Language (TQL), designed to overcome the limitations of traditional SQL in calculating time-based relationships crucial for observational research. Post-LLM, Atropos introduced ChatterWD, an LLM interface that allows users to chat in natural language to formulate queries and run studies in minutes on millions of patients.

Key Solutions and Business Model:

• Natural Language Querying: Clinicians can ask plain language questions, enabling broad usability without requiring RWE expertise.
• Rapid, Rigorous Analysis: Atropos delivers insights quickly, often within minutes, using "academic grade methods" including triplicate statistical analyses (unmatched, basic match, high-dimensional propensity score match) to remove confounders inherent in real-world data.
• Geneva OS: This "full operating system for real-world evidence generation" provides a next-generation infrastructure for leveraging RWE quickly and efficiently across diverse data sources.
• Atropos Evidence Network: This network leverages federated data across multiple health systems while ensuring patient privacy. Data remains behind the health system's firewall, with Atropos's compute layer accessing de-identified data (or identified under BIA when necessary). Health systems can passively monetize their data through aggregate analysis without relinquishing control. A "real-world fitness score" helps users determine which dataset is most appropriate for a given query, optimizing data utility.
• The revenue model is primarily subscription-based (user-based SaaS) for health systems, evidence generation projects with life sciences companies, and potential government/payer partnerships.

Use Cases and Impact:

• Clinical Practice: Atropos is highly utilized in academic medical centers, especially for cases where literature or guidelines are insufficient, stakes are high, or treatments are expensive. This includes specialties like hemonc, orthopedics, anesthesia, and significantly, geriatrics and pediatrics, where clinical trial data is often lacking. An example highlighted a rapid analysis for a diabetic patient with liver disease, comparing GLP-1s and metformin, demonstrating that GLP-1s were still more effective for BMI reduction despite trial exclusions.
• Life Sciences: Atropos empowers pharma teams to accelerate research, from trial design and understanding patient populations to health economics and outcomes research (HEOR) studies. For a pilot at J&J, Atropos enabled a team to perform 150 studies in six months (5x their typical volume), saving consultant costs.
• Policy & Regulatory Influence: Atropos's analyses support changes in institutional policies (e.g., formulary, guidelines). There is increasing acceptance of RWE by regulatory bodies like the FDA and CMS, with examples like palbociclib's label expansion for men with breast cancer based on RWE, indicating a positive trend for data-driven personalized medicine.

Challenges and Outlook:

• Key barriers include building trustworthiness and robust privacy infrastructure for data access, ensuring accurate data curation from massive datasets, and overcoming clinician resistance to change.
• Dr. Hyde expressed excitement about deeper integrations, such as ambient workflow integration where real-time, personalized evidence "pops right up" for physicians during visits. He emphasizes the company's role in unlocking demand for RWE by enabling quick answers, benefiting the entire RWE ecosystem.
• Dr. Hyde's career advice stresses curiosity and relentlessness for entrepreneurs, focusing on solving meaningful problems, prioritizing user experience in health tech, and strategically aligning with broader technological advancements (e.g., leveraging improving LLM models rather than building foundational ones).
• [End AI from Google Notebook LM]