What Role Does Clinician Engagement Play in Healthcare Innovation?

[00:00:00] Jared: Hello everyone and welcome to the med+Design Podcast where we dive into the fascinating stories of medical innovators. Today we're thrilled to bring on our guest, Andy Kant. Andy's the director of FastTraCS at the University of North Carolina at Chapel Hill, where he leads a commercialization program focused on translating innovative research to benefit patients in North Carolina and beyond.

He's been driving force behind transformative healthcare projects and initiatives. Andy's work at FastTraCS has played a pivotal role in the development of our med+Design program, where he tasked to our team at Trig with creating a clinician engagement program that utilizes design thinking.

This has led to the evolution of the med+Design program as we know it today, offering empathy driven innovation modules for busy clinicians and physicians. Andys also held various roles within the UNC system, including program manager for the 4D Strategic Initiative and associate director of Carolina KickStart.

Providing him with a unique perspective on the inner workings of commercializing within university systems and the challenges of bringing innovations to life. Andy's experiences and profound insights in the healthcare innovation landscape make him an exceptional guess for our podcast as we uncover the stories behind translational research, clinician engagement and the med+Design origin story.

So without further ado, let's dive into our conversation with Andy Kant welcome.

[00:01:17] Andy: I'm thrilled to be here. Thanks. Any opportunity to talk to you guys. I'm on board, so thanks for the invitation and interested to see where the conversation goes. It's gonna be great.

[00:01:24] Ty: Maybe for those who haven't, not familiar with the term, could you describe maybe just to get us started, translational research? Yeah, absolutely.

[00:01:32] Andy: To be honest, for the longest time, I've been in translational research, I don't know, 10 years, and there was a good chunk of many years where I was like, I still don't know what this thing is.

It's a bit of a squirrly thing, Really how it's described came about from really a siloing that was happening across universities in the country where you had basic research that was going on. Say, people were doing really interesting biological mechanism work on like nematodes, and that would be great and it would be transformative scientific knowledge.

It would uncover something really, novel. But it was a huge gulf between, how does that impact patients? And there was a skills gap. People that do basic research don't necessarily know how to do clinical research. And so that's how this whole thing came about is like, how do we bring those things closer together?

There's still different skill sets, and so nowadays, or I should say, how people often talk about it as from bench to bedside, right? So you're gonna do some basic research. How do you put it on a path to get it to have patient impact? And that can be a bunch of different things.

It can be things like drugs, right? Which we think about maybe testing on animals first, and then, eventually maybe you get 'em to humans. But it can be, things like behavioral interventions, right? What's a new thing that might help a diabetic patient in terms of behavior modification?

How do we test that in the clinic? So it spans a lot of different areas and that's part of the challenge in defining it. Cause there's just, it's a big umbrella. So yeah, I've been doing it a while and as I think about it as my day job now, which we'll get into, Jared, you hit on this a little bit, FastTraCS and kinda what we do and I think about it as more, instead of like bench to bedside. It's more like bedside to bench to bedside, how we do things, right? So we're gonna talk about clinical engagement and, working with healthcare providers, but, not all things start in kind of the basic research lab. We gotta have kind of a ground truth that, what are the patient needs that may be happening, and how do we address those?

But that in a snapshot is translational research.

[00:03:13] Ty: Just that you touched on that, that you started off with bedside to bench, then back to bedside. Is that radical or different because it seems like there's a bench to bedside mentality through most of, like innovation efforts in healthcare.

[00:03:26] Andy: Yeah. We think it is, but honestly, when you're in an academic medical center, it's all mixed up, right? So you're gonna have clinicians that. Maybe, they're gonna be maybe physician scientists, right? Like they do both, right? And in that case it's a pretty short circuit cuz it's one person.

But I wouldn't say it's radical, but it is a shift in mindset. We built FastTraCS. That was the whole ethos is to be like, research is great and we need that and universities are good at that. But let's start to, let's almost exclusively focus on the clinicians and try to understand what they're telling us about.

What are the problems that they're dealing with their patients? And maybe not even specifically their patients. The system itself, there's a lot of problems in healthcare, and so I wouldn't say it's radical, but it is a different lens through which we view how to do innovation.

It's largely clinician led.

[00:04:11] Ty: And then maybe you touched on FastTraCS, but could you like just, yeah double click on that and talk about main goals, features, how it supports MedTech innovation?

[00:04:19] Andy: Yeah, sure. So we've been around for about, I dunno, four, maybe five years now. And it's definitely evolved.

We've known each other for a while and you've probably seen some of the evolution, but we started, really as what does it look like to do innovation from an needs driven perspective, right? In healthcare and that's not novel. People were doing that. And we pulled a lot of inspiration from a program at Stanford called Biodesign, which is largely an educational program that would, fund fellows to do things like shadowing and really experience what it is in a hospital setting around a given problem or a collection of problems.

So we kinda started with that as a, that was our diving board is to feel like, all right we've got some framework. There's a great book on it. And so we started there. But I think we've evolved, over time. But, essentially to directly answer your question, we think of ourselves like a med tech incubator, but we work directly with clinicians.

And really what we try to do is build clinician technologist teams, or specifically clinician engineer teams, that can, identify problems and solve them. And then there's a very iterative process to do that, as so yeah, I mean it's an awesome job.

But it's also, it has its dark days cuz there's so many problems to tackle in healthcare. And largely that's our challenge is how do you pick the right ones? This is not specific to us, this is kind of a. When you think about startups, like how do you pick winners?

It's the same thing, but even more deeper and earlier and riskier, right? About what problem do you wanna try to solve? So I don't know. We've probably worked on about a dozen different projects. We've got a lot of different patents. We've spun some companies out but it's always a mountain to climb, when you're thinking about creating a new thing. I know we've talked about this book from Peter Thiel that I was like, which is the zero to one, it's this in a different way is like, how do you create something from nothing and it's hard.

[00:05:56] Ty: Yeah. I mean you touched on that, that I mean there's, healthcare is such a problem rich environment.

That it's like startups don't die of thirst from want of opportunities rather than they drown from too many and like kind get diluted cuz they're too unfocused on, all the different problems they potentially could solve and the different opportunities they could chase. Yeah. But what can uniquely go after, which is, perpetually the challenge in this space.

[00:06:20] Andy: Yeah. It reminds me there's these methodologies out there that people may have heard of, like Lean Startup or lean methodologies or and I just love that from, in thinking about things, it's always something I think about.

It's what's the minimum, how do you slice it real thin, right? To make sure that you can tackle that problem. Because it is, I think you nailed it, Ty. If you're gonna die, it's gonna be from, indigestion, right? And not Yeah, I mean there's just, there's so many problems to solve and then nested problems and which one do you go after?

But I'm sure we'll talk about some projects. That, that's what's been great about med+Design because it is very much a structured process to go through. And it's not to say that's the only way to do it, but it's incredibly helpful at the outset to filter down, understand what you're gonna focus on, validate it in some way in terms of the need, and then try to work towards, what are those solutions like that's when it gets to the fun part but that kind of deep work up front super important.

[00:07:09] Ty: Yeah. Do you know the story about those Post-it notes? No, I wanna hear it. So this was one that I've learned recently. So like the sticky notes have been around for ages and their kind of broad application, the inventor, rather than trying to say, how do I solve this problem of putting paper and sticking in all these different places.

Yeah. He was narrowly trying to describe looking the problem of keeping a bookmark in the hymnal at church. That was it. It was just like that really narrow use case. You narrow the problem you're trying to solve down to as tight as and specific as you possibly can, that opens up a range of possibilities.

So you can go narrow problem wide solutions and yeah. That's interesting. Yeah. Yeah. Go ahead.

[00:07:51] Andy: I was gonna say, that's one of the challenges in healthcare. It's just so complex, right? There's so many different patients. If you really boil it down, Each one of us is so fundamentally different with our health.

And that, presents its own challenges when you start to think about populations, but then you just layer on the complexity that is the US healthcare system. And it's overwhelming. I've been doing this for a while, and doctors have been doing it for a while that I've worked with, and nobody really understands the system.

It's I feel like it's like the IRS tax code, people know pieces of it, but nobody knows the whole thing. Maybe this is Jared, maybe this is where AI will help in some way, but a total understanding, I feel is impossible for one person. It's either and you see this in healthcare where it's so specialized now as a result.

So you've got, people that only do, ENT docs versus, there are some general surgeons and maybe hospitalists, but there is some generalists, but mostly there's a lot of specialization. I think it's That just makes it even harder in terms of innovating, cuz you don't always get a complete picture of what that problem is with the patient being that anchor that's gone across that journey.

And that's, maybe that's a good segue to med+Design. Cause that is one of the things that, I think you've brought about in this program is like, all right, what does it look like for that patient journey? Right? What do they always go through? And I've always found that pretty illuminating.

I have my own kind of, Here and their personal experiences, but those are snapshots in my life, right? I don't really know how a persona might run through that system and it's always different based on their condition, why they came in and their kind of, yeah.

Just their being, right? What are they experiencing? Yeah, it's hard. I won't say that a lot, I feel like, but go. Yeah. Yeah.

[00:09:19] Ty: The challenge of course, particularly, you think about. The domain of knowledge you have to acquire in order to even start to feel confident proposing innovations in this space.

It's just so challenging because talk about regulatory reimbursement, quality management any number of running clinical trials. There's like huge domains of knowledge to, yeah. Just start to understand. Some, even if you're in consumer products, intellectual property yeah. Like how to run a business.

And so I think what we've accomplished with med+Design is boiling it down to, from the clinician perspective, what's the highest value activity you can do first. Yeah. Knowing that downstream, there's consultants you can hire or Yeah. You know that you're gonna need to know this information later, but let's start with the biggest impact stuff, which is empathy for the patients, empathy for the stakeholders.

Yeah. From your lens. And the nice thing of working with clinicians is they're the experts. Oh yeah. A lot of the big companies like spend tons and tons of time just to get access to the clinicians. To be able to get that real-time feedback where if the clinicians can be the one leading the charge, then you just get, decades of experience coming into, defining the problem and all of the edge cases that you have to sift through to get to a clearly defined problem.

[00:10:37] Andy: Yeah. Yeah, I mean I think, we've done that in a small way, but I think, you know, at scale, if we get to a place where we can really empower not only physicians all sorts of healthcare providers to take more agency about. Innovating. That's the way, man.

That is it, right? And it requires some, some different expertise. But you're right. You can always recruit people to help you. Life's about working with people, right? And you're gonna get there. But you did hit on something, which is always a, let's say it's a pet peeve or something, but it's something I'm always racking my brain about, which is like the value chain in healthcare, right?

And how convoluted it's. I'd be interested to like Ty, I don't know, have you ever come across a case? Like in, we'll say, we'll just broaden it down to like economics where you enter a system that you agree to buy something before you know the price. Like I don't know of any other ex.

I'm sure there are, but it's such a weird, system that we have. And it reminds me, I'll ask you. Can you think of any other example? There's probably be gotta be some right.

[00:11:32] Ty: I was playing around with an AI just little game. Yeah. And so I gave it a prompt of describe a spirit care healthcare system where you try to go through and have it, like basically do a fee for service model.

Yeah. To where your spiritual wellness gets cared for.

Oh, interesting.

You pay into an insurance model that then has your spiritual wellbeing and it like built up this whole ecosystem around it. Oh, wow. Which was a funny parody of what the healthcare system is, but the outcomes were uncertain.

There's no real, no kinda, you know what like, inner spirit, outcomes could have been changed and it was kinda funny to think about that as a exercise and just how absurd our healthcare system is at a fundamental level. It is.

[00:12:19] Andy: Yeah, it is.

There, there's the value chain, which is complicated. The other thing is really this. And I think health systems and physicians do think about this often, but there is this kind of gulf between health and medicine, right? And, medicines like a subset of health, right?

Our health systems or our healthcare systems don't, they don't have the tools, they don't have the engagement to really address a lot of those other things. These days a lot of people talk about like social determinants of health, all the other things, your socioeconomic status and you live in a rural place or kind of a city, all these things feed into the totality of what your health situation looks like.

And so just layer that on and it's like another, it's just it's complexity all the way down. But yeah, value chain and that. I think about medicine as, folks come in, we have some great clinical advisors that we work with. And it's always interesting to hear their stories about I had this patient and such and such happened and they provide awesome care, but it's always this slice, right?

And that's just how the system's built, where it's not necessarily transactional, it is, there are episodes of care and that's it. And you go home and then what happens then? And that's what's been interesting about some of the projects that we've worked on where I think about there was one where they were trying to, assess blood pressure at home, right?

And what does that look like for people with hypertension? Those are the types of things that get me excited. Where you're trying to, you're trying to pull those things together a little bit, right? Yep. But yeah, I did some I had to refresh, cause I was like, let's, I looked at some of the decks before this just to get a refresher.

We worked on some amazing projects with some amazing people and I don't know, I have to pinch myself. It's such a cool place to be, to help these folks. Cuz to your point earlier if you work in industry, it's really hard, to get access and time and attention from clinicians.

But if you have it all in one suite at a university, it's a very cool place to be.

[00:14:07] Ty: Andy, you seem like you've been the magnet within the university for finding those, really inspired visionary clinicians who are bold enough to propose a yeah. A change to the healthcare system where it's a very, resistant to change.

As an ecosystem community where there's, there is more of an emphasis on standard operating procedures versus, yeah. Asking that question of how might we do better? And so that's just been fun to engage with that community and really see the, like the talent expertise that comes in to then like really start tackling problems and also knowing, like having the humility to know that, none of us has it all figured out.

[00:14:43] Andy: Yeah. It's such a cool head space to be in, to be like, what if? There's an energy that folks that either do this or just, innovation in general, but there's a little spark there that's I don't know, super inspiring.

Cuz it starts with small beginnings where somebody asks a question like that. Like how might we, that's in the program and yeah, it's just always inspiring to see what it looks like, but then it butts up against reality and you're like, okay.

Yeah.

[00:15:07] Ty: It's hard be willing to like delay judgment. Yeah, exactly. Judgment. And that puts you in a, it's giving yourself space to have that, what do they call it? Pathological optimism.

[00:15:18] Andy: Yeah. Yeah. I

[00:15:20] Ty: like that. Where like you're just willing to doesn't matter what the judgment is that will come later.

Let's try to push ourselves and I think there's something intrinsically happy about that mind state. Yeah,

[00:15:31] Andy: it is. It's a very creative place to be. Which, myself included, but also, I'm assuming some clinicians there's probably some element of creativity, but it's very different from what this looks like, which is I have a little bit more agency over some of the problems I experienced.

What if, how could I change that? I

[00:15:45] Ty: mean, maybe we can touch on, after finding that value and like getting to maybe more of the beat down of Yeah. There's value here. We've found something. We, we went off into the wilderness. We found the pot of gold. We came back with the pot of gold.

And now, like how do we get, how do we move that forward and advance it and thinking about commercialization, going through like the just a education setting. Like what Yeah. Your experience been cuz that's, I don't think anybody looks at it and says wow, that's a well-oiled

[00:16:17] Andy: machine.

No, it's not. It's definitely not It's a bit anathema. Academic and higher ed is not built to commercialize. It just hasn't. It's never been, it's about educating students, right? It's about knowledge creation and dissemination. And I think over time there's been, shifts from, there was some government legislation in the eighties that, said Hey, universities, it's called the Bayh–Dole Act that you hear about in tech transfer, which is Hey, you guys need to, protect this stuff and, maybe try to commercialize it.

And, it's since evolved, over time. But I think every university has a different strategy, right? One of the ones that always pulls through, particularly for public universities, like how do we think about. Definitely, let's educate students to the highest quality we can.

Like how do we think about high quality research and getting it out there and, contributing to the state of the art. But also like, how do we think about economic development? Like how do we give back, to the regions and the states that maybe we're located in. And I feel like it fits, a little bit under that umbrella, although it's even broader than that.

But yeah, it's a winding road for sure. I'm one of probably many people, certainly many people on this campus that like our jobs are to help navigate, which is a crazy, I love the job, but it's really, somebody comes to me like, where do I go? What do I do?

And it's just this labyrinth of like, all right, go talk to this person. Go talk to this person. Let's figure out how we can get it out. And I don't know, my whole having done this for a while is, more and more maybe of late, but my, what my like prime directive is get it out, right?

You've gotta get it out of the walls of the university. You can do that too early, but generally it's too late in my experience. It just takes a lot of time. And cuz you start to rub up against some really important questions once you take a foot outside the university around like, all right, how valuable is this thing?

What do we value this If it's a company like, you start to get some very real answers in, a real economy about what that looks like in the university. It's its own little microeconomy, right? And dollars are different, right? Time's different. Everything is like a weird, I dunno, it's like an alternate universe in a weird way.

But so yeah, there's some basic things like, how do you get, some IP around it, right? That's the first step when we think about carving out some protection against somebody else sweeping in. That's big in research. And certainly a lot of what we do in terms of thinking about innovations and then, there's different paths you can take, right?

You can go. You can think about grants that are commercially bent or have a kind of a commercial angle to them that may be translational in nature, maybe not. But they're about building out and you've worked on some of these products, you know this well. How do you do some of that kind of early stage research?

Maybe it's a clinical, pilot study or something that you're gonna do. And I don't know, just really mature the tech, right? And that's one way to do it. That's very common, just given, most academics have a pretty good handle on how to write grants. They're really good at it.

So that kind of, there's an easy transition there. And then you've got, others that are like, Hey, I've got, the widget or whatever my service is, I'm gonna spin it out. And there's certainly examples of those things. And I think one of the things that, I don't know if specific to UNC, academic systems need to do better at is public private partnerships, working with industry, working with, letting people in.

And it's not like we don't do that at all. We certainly do. I always think about when you have an early stage, idea, maybe it comes through med+Design or something like that. One of the first things I wanna know is once we've identified and we feel like it's a validated need is What's the perception of somebody that's in this sector or in this industry, that it's like a VP of R & D or somebody that knows, or marketing, it doesn't really matter, but I wanna know a collection of those opinions because those absolutely matter. There's other externalities going on in the industry that we just don't know about. Yeah, man, I can give some generic examples of those, which we've seen in some of our projects.

Genericized one, but we worked on one that was related to a vascular access device that was gonna be used in the hospital. And we did some outreach with one of our partners at RTI, which is fantastic. They did some basically primary market research and interviews with folks and it was interesting.

I liked a lot of the feedback we got from clinicians or that they had asked from other clinicians outside of UNC was, Hey, this is a great idea. But hey, wait a second. There's this trend in prescribing of antibiotics that really undercuts the whole value of this thing, right? And zooming out and understanding that trend is super important.

Industry people had the same bend to it. I just think, it always takes kind of a team and a lot of opinions. And of course the challenge is to synthesize those opinions, in an optimal way. That's a hard thing to always figure out. But yeah, back to your point, it was a long and winding answer to yeah, it's a complicated path to get things outta the university.

[00:20:40] Ty: The benefit too is that you've got the customer within as a teaching hospital Yeah. Right there. So there is that validation that exists within itself. Yeah. Then you know, I think with the recent iteration of med+Design where we pulled in industry partners for the pitch day.

Yeah. The discussion that happened at, like the team having gotten to that point and then getting the feedback from, industry I think has been a great feature of that to then have those experts to then say yes, you've got all these long rabbit holes, you can't go down.

But making a recommendation for what's the next immediate best step for the team to go. That's right. Continue to validate their idea. There's enormous value

[00:21:22] Andy: in that. Tremendous, it's really helpful. And the other good thing about being at a university and thinking about commercialization is there's tremendous credibility, right? There is a standard that comes with research at a university that you're just not gonna get elsewhere. If you got your own homegrown startup, it's a very different thing to reverse engineer. Like how do we do a study in a university that's its own complicated path, right?

There is a benefit to incubating within the university and getting them out And there's a lot of great examples. I wish I knew of something. And there's probably somewhere, some website that talks about all these great innovations that pop outta universities that you know some of 'em we know about like Google from Stanford.

But I'm sure it'd be interesting to look at that what's the proportion we'll say of those things that, either the research or startups that had popped outta universities versus we'll say independent kind of homegrown things that had, come out of, companies, R&D companies themselves or from other startups within those, or spinouts.

But it has a lot of impact, right? Universities are, the research is unparalleled. It's incredible billions and billions of dollars going into these things. And yeah. There's so many smart people here. What an awesome place to be in, right? To hear about some of their ideas and have got what a, what is my what if another very inspiring thing.

[00:22:30] Jared: Andy, I have a question also, cuz you touched on intellectual property a bit as well, and we had a very fascinating conversation with Laurence Freeman actually as our last podcast recording. And we talked about the challenge of innovating within a healthcare system, especially at a university for IP in the sense of if you build it there, inherently, some of that ownership goes to the university.

Yeah. And so what does that look like in, the FastTraCS program? Like how much of UNC is owning these ideas that's coming out of there as

[00:23:02] Andy: well? Yeah, it's a great question. I always think about, I used to, when I was a younger kid, I always used to listen to Bob Dylan a lot and he has this song, We All Serve Somebody, right?

And that's kinda true when it comes to IP. If you come to a place, whether it's industry or university. For whatever reason, there is a legacy of that. If you work here, we own that idea, right? And some people are really, that's my idea, right? And I understand that too.

When it comes to FastTraCS, all of our stuff is UNC owned. And there is pros and cons to that, right? Where you have some IP that you generated at a university. They have, an incredible system, typically referred to as technology transfer.

It's usually at all universities that. We'll front that cost of a patent, which is not a trivial cost, particularly if you're gonna think about alright what does it look like? We want to get a patent in Europe. Those things get super expensive. There's a tremendous benefit to that.

And they have, patent attorneys that are already lined up to do those things. And it's great. It can, depending on the pathway it's gonna go, if they're gonna license it, it can be a pretty kind of hands off thing for an inventor. If a company licenses it and picks it up that you'll start to get checks, right?

And it's great, I get a royalty stream assuming, generate some revenue. And what a cool system right is that you get rewarded for your inventive contribution. So IP , there's a lot to talk about in IP, so I'm glad you prompted it. Jared. I have a sense that there is a perception, if you think about like investors and you're thinking about like a startup entanglement with the university and thinking about licensing IP, is not always like investors are like, all right, that's clunky and I have to deal with a lot of negotiation.

It can gum up the works when they think about, equity and valuing the company and growing the company and which is the tech only tied to the company or is there other tech in there? So it just gets really complicated to manage sometimes. But again, it's really, it's pros and cons because, most of us, like if I were to think about, if I had a bright idea and I was gonna go out and patent it, it'd probably die on the vine.

[00:24:50] Andy: I don't know that I could afford it. And you really wanna have that in place before you start thinking about certainly sharing the idea, but also like, all right, how are we gonna think about commercializing it? I can't, I don't have too much experience with pure healthcare systems.

They probably operate a little bit differently. Just cuz I don't think they have, they may have tech transfer, I'm not really sure. But I've always appreciated there is a tremendous amount of kind of latent innovation potential at hospitals and healthcare systems.

There's so many smart people in there that wanna, they're in there to help people and change the game, and some of them like to innovate, right? And we're really good, I think as kind of academic medical centers is helping out researchers, but less so on the clinician side. And I think hopefully that changes over time.

But and particularly when it comes to IP as well. But good question, Jared. And you brought up an

[00:25:37] Jared: interesting point also about getting checks in the mail passively, yeah. And a lot of the people that are passing through your program, they're actively physicians or clinicians, like in their careers and maybe not all of them wanna be startup founders and necessarily want to do all of that work, cuz it's incredibly hard.

It's, yeah. And so maybe they're happy to take a check at the end of the day. Great. Who wouldn't?

[00:25:58] Andy: Yeah. Yeah. And it's a sign of success, right? Whatever your idea was actually had impacts, right? Both things go along for the ride. But those checks usually don't come quickly.

They take many years to get there. But yeah, it's a great system in that sense, right?

[00:26:11] Ty: And to your point, Andy, the savvy investors know how to negotiate those license agreements with the university and you also get the I guess the backing and cuz a patent is only as good as your ability to enforce it.

Yep. And if there is a patent infringement case, you do have the university behind you in that moment that Yeah. Wants to make sure that idea is protected. And then, also, like if you're then continuing to be part of say, an ongoing venture, there's always new intellectual property being created.

That's right. That's in a different entity than the university. And so there's, plenty more to just by making forward progress with an entity that gets created over time. You can't think of a patent as a one-time event. Rather, it's like something that would be continuous over the life of a company.

Assuming it gets traction and has all the right metrics of success and everything.

[00:26:58] Andy: That's actually a great point. I think there probably is a perception, particularly for like new innovators that, like I have a patent checkbox done. And I think you nailed it, Ty. It really is you hear things like patent portfolios and strategies, like those are the later stage things that, a company, if it's a company needs to think about, about building up those walls and making sure it's investible. And, when it comes to companies at universities, you just don't hear a lot of those that pop out without some IP, or specifically patents. Particularly if it comes from research.

There's a lot of knowledge that goes into a startup, right? And everything they bring. But, if you walk in, to a VC firm and you're a spinout and they say, do you have any IP? And you say, I don't have any, or I have knowhow. Not gonna look good. You need to have some edge there. And that's what it is. That's that first step up the mountaintop.

[00:27:42] Ty: It's Peter Theil talks about in zero to one you need to have some kind of monopoly. Yeah. And patent is one form of monopoly. You can get on your idea just a mote to protect so that you have got some kind of way of protecting, like some kind of margin whenever you know you have a commercial success.

Yeah,

[00:27:57] Andy: that's right. Yeah.

[00:27:58] Ty: So Lawrence posed a question which is, how do you incentivize the students to be innovative when their reward is 0%? Is the reward truly 0% for students from a

[00:28:11] Andy: intellectual property standpoint? Yeah, that's a good question. So students are an interesting case.

I work with some students. But yeah, students, at least here at UNC and I'm thinking about specifically the B and E program and those students, if they bring about some idea that's truly theirs, right? And not tied to a faculty member, it's their IP.

And it's interesting, they're in a good spot cuz they can opt for it is an option for them. They can be like, Hey, UNC are you interested in protecting this? And then sometimes UNC will take it, sometimes won't. And again, they'll front load that patent cost, but they can take it and run it, completely independently.

And I think that's a good thing for students to have some agency. Youth and startups go together. When you're at that point in your life you're a little bit more tolerant of risk. You're passionate, right? Generally and you're trying to make a mark, right?

And so that, and probably other ingredients, you can, pop out with some great ideas. But yeah, my sense is generally, particularly undergraduates they own their own IP when it comes to research based students. Maybe graduate students or, if you wanna qualify like postdocs those are usually tied, to the university.

Just, cause you're using university research sources, it's funded off a grant usually. Directly to your question, they'll still get, there's no reason to say they don't get any royalties if they contribute to it and they're an inventor, they're part of that, generally those royalties will flow back to them in some sort of percentage.

So they may be different at different universities. Maybe some students can't get that. But my experience at UNC, they do.

[00:29:31] Ty: Yeah, it depends on each university. When I was in grad school, I came up with an intellectual property, but we were at NC State, but we had a UNC professor in the School of Dentistry who contributed the core idea.

And so then we had this really interesting back and forth between, like NC State and their patent tech transfer office. And then NC State cleared us. They said, we don't want anything to do with it, you guys. Oh, interesting. And then UNC wound up picking it up and saying we'll cover the patent cost on this if you guys want to keep going with it.

And we got some funding and then, eventually decided to discontinue pursuing it. But it was just navigating the two different tech transfer offices. Yeah. How both of 'em thought about it was just fascinating. Yeah. Like in its own right.

[00:30:15] Andy: So that is interesting. Yeah. From the sidelines and I don't do text transfer for a living, but I do hear of examples where you've got a multi-institution thing and they'll typically, I think they've just learned that it's like, all right, let's not all try to do this. Let's just make some agreement that says one will take the lead and you guys are along for the ride kind of thing. And I think that just makes it easier. It sounded like it did in this case.

[00:30:36] Ty: So maybe switching gears a little bit here. Maybe look, getting our crystal ball out. Yeah, it's kinda always dangerous to do. And Andy, I'm just curious to hear how you'd answer this, but maybe where do you see the future of healthcare innovation going and what, based on the context you've been through, you've seen a lot of different iterations of it, maybe some pattern matching.

So yeah what's your vision? Where do you see things

[00:31:00] Andy: going? Yeah, it's interesting. Healthcare innovation's such a, there's so much to talk about there. It's a great question. And I'll say right off the bat, I have no clue. Whenever you try to predict the future, I feel like it's a little fool, hardy, but it's fun to do.

So we'll do it. We talk at the outset. We're having a conversation before the webinar started about AI. Clearly that's gonna have a massive impact on the whole system. How that manifests itself is to be determined. Healthcare is generally a pretty conservative rightly.

Kind of industry. And so it'll probably take a little bit more time compared to some of the things we see in tech. But I do always see, I don't know that's always true, but I see leading trends in tech, right? And one of the things that I've been thinking about just cuz we focus on MedTech for a long time is you know, this convergence of or what I see as a kind of necessary convergence between traditional med tech where you're making like catheters and, endotrachial tubes and, typical very important devices, but they're pretty simple, right? Versus, the Apple watches and the aura rings and the Fitbits, and that's been happening for a while and it hasn't really converged.

I don't know that it ever will. I mean, There were barriers to doing that, right? What we talked about before, the blood pressure at home. It's not easy. It's not trivial. If you walk into your doctor's office and you're like, Hey, check out my, whatever I'm tracking, they don't know what to do with that.

They can't put it anywhere, right? So there's real barriers to doing that. But when I think about over time, the value of continuous monitoring for a patient is incredible, right? You think about when you go to your primary care physician and they take a snapshot of your blood pressure.

There are all sorts of things that can throw that off. If you cross your legs, it's gonna bump a little bit. Yeah, I can envision sometime in the future where there's all sorts of, whether they be vitals or biomarkers or other things, that are really tracked continuously, that really enable like better prognosis of things, right?

[00:32:45] Andy: Versus being very reactive to healthcare. I have a problem, I'm gonna go in, this is my issue. We're gonna do a differential dag, then we're gonna figure out what it is. Data's gonna be, the thing here, already there's too much data, so there. That's something to work towards about like how do you amplify the signal and lessen the noise, but, I don't know. I think about like remote patient monitoring and again, largely just taking a more complete and hopefully meaningful snapshot of data that's reflective of, an individual and their health. That's just one thing I see happening. Maybe AI gets us there, maybe it doesn't.

But I don't know. Ty, I'm really interested in your answer and Jared as well. Where do you guys think it's always interesting to talk about, we can be Nodstradamus's here for a little bit. What does it look like?

[00:33:25] Ty: I was dismissive of the longevity effort.

Yeah. Where I was just like, psh, whatever this is. Like you're having a handful of people live longer. Which was my impression of that. But then I recently picked up Outlive by Peter Theil it's his recent book. He just published it and he describes this future of Medicine 3.0, which is around what you were just describing, of using the data to become more predictive.

So that you can, like the best time to repair a roof is while it's sunny outside. Yeah. You don't wanna wait until you're in a crisis to prevent bad things from happening. And like you think about some of the chronic disease states, we have Alzheimer's, heart disease, where there it's the accumulation of decades of choices that you make that then lead towards a painful kind of late stage of life.

Versus the, I think being able to anticipate that have precision nutrition I think that to, in my mind of improving the wellness and life's and health span of our population. By having better integration thinking. And I've been just intrigued by like value-based care and not necessarily in the current embodiment of accountable care organizations, but really thinking about what does it mean to manage the health of a population.

Yeah. Beyond just that snapshot of when you see somebody in the hospital, but rather the accumulation of choices that they make as they're going about their day. Jared and I were talking about this the other day of food deserts and like just some of the challenges you have about maintaining a healthy population.

Yeah. Actually, Jared, that's a good cue for, some of your background. Yeah.

[00:35:05] Jared: And, something that I actually have been thinking about as well in regards to prevention, cause I feel like that's like where things are trying to trend towards. But you also think of the incentives of the healthcare system as it is right now and who runs it.

And it's essentially insurance companies, right? And so insurance companies are banking big bucks off of us being unhealthy, having to go in, get all of these disease treated. And so then how does the incentive system change when we're all preventing these illnesses from the get-go? We're all roughly living a healthier life.

Then how do they make their money? And also then at the end of the day, essentially doctors work for insurance companies, that's who's paying them, and then so what the heck happens to the whole system as we have it right now? For me, with my nutrition background, I would love to see people happier, healthier, for longer periods of time through, better food practices or just being more aware of the types of food that they're eating.

Being able to learn how to shop at grocery stores, and just so many things. But at the end of the day, do the powers that be that control the big pots of money out there, want that to happen? Yeah. And my answer is I'm not quite sure if they do.

[00:36:16] Andy: It's interesting, it makes me think of what would it look like? I'm gonna get into how might we here, but, I'll take as a model, like a startup company, right? Like when you build a startup company, It's fundamentally for the founders, it's based on equity, right? And that equity can be based on like the amount of time or the effort that you put into that company that increases, right?

And maybe this is where value-based care comes in or something like that, but what would it look like, if my primary care physician had some version of, health equity in me, right? And that we were we were partners in this really, right? I'm gonna do my best.

You're gonna do your best. And we're all gonna benefit, right? But that's a radically different, again, you I don't know how you build a system like that and maybe you ask Chat GPT, like you did Ty, but, it's I agree. Nutrition's super important, right?

Nutrition, sleep there's so much going on that the other thing that comes to my mind is, there's a saying in, medicine, what's measured can be managed. And it's back to my other point, like there's just so many unknowns. Like even you take nutrition, go online and Google, like what's the best diet you'll get

overwhelmed. Some useful information and then a bunch of non useful. And it's hard, somebody that like all of us have some, relationship to healthcare and may know more than some other folks, but, imagine those folks that really just don't know much about that.

Like how do you navigate that? So it's like an information problem too. And it really comes down to just how diverse we are, as a people. Yes. There's so many things that can work. I think the other thing is we think about the future. If you hit on a little bit as a theme, which is just it's disparities.

Like how do we rise the tide for all right. That's a hard problem too, cause that's intertwined. And it's not just related to healthcare, it's related to the economy and all sorts of other factors. But that's super important too. If we're just helping the top, like the Peter Attia, top 1% of people that are getting all the cool, by the way.

Yeah. I haven't read the book, but he's great and I've taken a lot into I know you're a fan of his podcast. Yeah. He's great. But he's like a, that's a definitely a top 1% approach to how we're gonna as physician, like how he treats people. So it really does come down to like, all right, how are we elevating kind of those folks that are most in need?

That's a big part of, where I think a lot of universities are headed particularly at NIH about shifting to address some of those disparities. But that's a multi-decade I feel like process. There's no easy solutions there. Yeah. But I think

[00:38:20] Ty: if we're thinking about, improving health span for people, I think taking it at a

population health level. Yeah. And then the other thing that was interesting and Andy, you and I were both at a conference where this was suggested where that startups. If they're trying to come in and add new value into the ecosystem that they have to set up their revenue models such that they share only in the outcome of what their claims are.

Yeah. Not necessarily with the health system having to bite off on the promise and that the health system takes the risk of whether or not their promise actually falls through or not. Yeah. I think most of the economic models for new startups haven't factored that in yet. Yeah, that's a radical thought.

Yes. It also means that from a risk sharing standpoint, like at a population level, the ACO takes on basically fixed amount of revenue per number of people. And so how do you make it so you have less sick people going through that health system? And then can you do multivariate, attribution for we did this one thing and number went up, number went down.

Like how do you do that attribution, that's a complex thing to get a scorecard. Everybody feels fair. The,

[00:39:27] Andy: it's also pretty, I like the thought and it's a very fair handed approach to thinking about, all right, if we're gonna put your product in here, and you gotta deliver on your promises and and so I don't know how that'll be tested. It's interesting. Part of me is if I'm sitting in the chair of somebody that's trying to get a product on there one of the things that comes to my mind is like, all right, once you throw it into the healthcare system, you lose control over it, right?

I guess it depends on how you define those outcomes, but I think in general, and at large, that's a good move, right? Because it does, again, it's like shared risk, right? You're not just gonna get a payday from this. You're gonna share in some of the risk and hopefully the benefits, if it comes to fruition.

[00:40:00] Ty: Yeah, it probably also removes some of the friction towards getting a new idea to market where, you're then partnering hopefully with the health system where you've got some intrinsic skills, some intrinsic IP to help move it forward and iterate with the health system to arrive at a shared outcome versus throwing it over the wall, which anytime you've seen from a development standpoint, you've got engineers and designers and they try to throw something over the wall.

Yeah. Kinda one off. It's just set up for failure. Yeah. Famously did that where they had their design team and they would hand off this perfectly illustrated new cellphone concept. Engineers would look at it like, you can't build this. Yeah. There needs to be that, I guess humble back and forth conversation as realtime information comes in and then you adjust the technology, adjust the configuration in order to, do what we're all here to do, which is to improve the lives of our human population.

[00:40:56] Jared: We had a comment from Deborah Kennedy and it's similar to what she was talking about as well, so she said, As common as DNA testing is becoming, it would be really cool to eventually find a way to connect that info with yearly health checkups and use it to predict life stage outcomes.

Yeah, and you can also utilize it to find correlations between certain D N A makeups and tolerances to medications. So there's, just less trial and error with patients, finding therapies that work for them. And then makes me think of also therapies in the sense of nutrition therapies as well. Just lifestyles. It would be really cool if that's what our yearly checkup at the doctor was like in some way because obviously it's not that way right now. But one day in the future maybe they're like, wow, we did some testing and turns out these sort of foods work for you based on your body makeup, they do that big ol body scan. And they suggest certain types of workouts that work well for your body type and and then obviously tolerances to, medications and whatnot. Like it would be a very holistic way to go about things. But like I said, or like we talked about, we're not quite sure if we'll ever get to that super holistic makeup of the healthcare system based on the incentive structure as it is

[00:42:03] Andy: at the moment.

Yeah, there, there is this trend that still, it's around, it's a discipline in research, which is, and you probably heard the phrase, but personalized medicine, right? That kind of was on the tails of Hey, we've got all this cool genomics information and we've got all these other omics things, like how do we feed those in and make medicine a little bit more personalized to each other?

And it's not like I'm in that space. I don't really know what the trends are, but it seems to me that there's lots of biomarkers out there, there's a lot of examples where the technology is vetted and there's like sufficient clinical evidence, but it's almost like it's an economical thing, right?

Who's gonna get, whole exome sequencing that's gonna cost 'em two grand outta pocket, like nobody's gonna do that. So if you can't break down that barrier, like how do we get to a point where you can, that's a breakthrough event. I feel like, maybe not that specific example, but things like that where it just gets so cheap.

And again, I'm just maybe AI move on. I feel like listen to everything. You just say that and it's oh yeah,

[00:42:54] Ty: I want the app that'll tell me like when I go have a cheeseburger or a glass of wine or a smoke a cigar, that it shows me like, okay, this is like going to take X minutes off your life.

[00:43:06] Andy: That's a great one. That's a really good one. Yeah. And tell me

[00:43:08] Ty: a believable story on that. Yeah, I went through and had my, biomarkers checked and genome sequenced and all of that. And like for your specific, you lose this many minutes and it'd be entertaining to have that if can get down to that level of detail.

Yeah. How

[00:43:21] Jared: much reservatol do I have to take to I'll offset this sort of lifestyle that I'm living right now, oh my gosh. It does look like we're getting towards the end of it here. And a question that we always like to ask at the end is, just what advice do you have for, clinicians, physicians, and, just healthcare innovators that are trying to make a difference in their field and when they've seen a problem, just like how you've helped so many other people

[00:43:43] Andy: Yeah, great question. I think. It can be hard. One thing that I've been thinking about a lot lately is, if you're gonna start a project or think about innovating listen to yourself, listen to your creative engine, but also think about like, why do you wanna do this?

What are your core values in maybe period, but also about like how it relates to this innovation. Because I think those are the things that are gonna pick you up when the rollercoaster is down, right? If you keep that North star about I'm trying to help these sick kids, that's everything.

And it's probably already on your mind, but I feel like it's important to keep that present because it's definitely a rollercoaster and good and bad. But there's always the typical ones like, persevere and just, never give up. I'm not necessarily a fan of those things.

You certainly sometimes should give up. There's good reasons to do that, But yeah, the other thing is, we talked about at the outset, which is that the really important and big changes are gonna come from clinician innovators. There's just no question in my mind, they're either gonna be the genesis of them or they're gonna be a central role in changing what is our kind of clunky healthcare system here. And that I feel is empowering, right? Because, nobody else can do it, to. Yeah,

[00:44:47] Jared: absolutely. So if you're a physician out there and you've got a problem that you've identified, go after it. There's people like like us here at med+Design that are out here to help you make that difference in the world.

And Andy Kant, thank you for your time today. We really appreciate all your help with the med design program. Just birthing us in general, but for the work that you do. We can't wait to see the impact of it 10 years from now and all the little chicklings that you've been hatching over time,

[00:45:13] Andy: thanks, Jared. This is great, awesome conversation. I really enjoyed it.