OR_Sempre Health Podcast_Eric Buffkin: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.
Rich Prest:
Hey, everybody, it’s Rich Prest from the Sempre Health podcast. Excited to be with you all today and excited to introduce our special guest for today, Eric Buffkin, who is the president and CEO of etectRx. I actually had the pleasure of meeting Eric back in a former role of mine and helping him and a former colleague of his work on the plans for getting etect out into the world. And it’s a very exciting piece of technology, and Eric’s been working on it for a while, and I’m excited for this conversation today. So welcome, Eric, and love for you to do a little intro about yourself for the audience.
Eric Buffkin:
Well, well, thanks very much, Rich. It is great to get connected with you again. It doesn’t seem like it’s been a couple of years since we were working together on etectRx and you were helping me and Harry out, so appreciate you inviting me along. It’s a great honor to be included. So, yeah, I’m a founder, president, CEO of etectRx. We are a digital health company. We were the leader in ingestible sensors for tracking medication adherence or for clinical research or for clinical care. There’s, it is a great opportunity to be here and talk with you at Sempre Health. I hope I can add a lot of interesting, and maybe a few entertaining, parts to the conversation.
Rich Prest:
No, thank you so much. Yeah, no, I think we’re both very passionate about patient adherence and trying to help patients actually be successful with their therapeutic journeys. Well, let’s start maybe a little bit more diving into the life story. I, life often takes amazing turns. I’m curious what your dream career was when you were growing up.
Eric Buffkin:
Yeah, well, so it’s interesting. I was on vacation, actually last week, with some friends and some of my kids, and we were having a conversation and just thinking about the idea of a dream career when I was a kid. We actually started a conversation around that, and one of the things we realized that when we were kids, I’m not sure there was this idea of having your career thought about when you’re 14 or 12 or, so, I guess when I think of it back that far, didn’t actually have a dream career, but I had, my grandfather, who was a great man. He was a farmer, very successful farmer. My dad was a, he worked for the federal government as a, in computer science. And so I think those are the two forces that kind of shaped me of not necessarily wanting to work for somebody all the time, so I’ve been an entrepreneur a long time, but really being enamored and really being moved by what you can do with technology when you apply it, right? So I think those were the forces that shaped me rather than saying, Hey, I’m going to be the next great engineer or the great next great musician or the next great whatever. Yeah, I don’t think that was me. I don’t think it was me. It was more along the lines of the forces that shaped me.
Rich Prest:
Or growing up in Florida, I guess the other one would be to be an astronaut, right?
Eric Buffkin:
Well, yeah, yep, yep. Yeah, there were some of that. You watching those big Saturn five’s takeoff from time to time and watching, the other one, I grew up in the panhandle of Florida near Eglin Air Force Base, where my dad worked. And watching the US fighter jets fly over in the sixties and seventies, it was really thrilling to see some of those guys go whizzing by. But yeah, I decided that wasn’t for me somewhere along the way and Top Gun wasn’t going to be me, so.
Rich Prest:
Yeah, I’ve been down to Pensacola, watched those Blue Angels homecoming shows, and they’re just amazing when they buzz the crowd.
Eric Buffkin:
Yeah. Oh, yeah. Oh, yeah.
Rich Prest:
Very cool. Very cool. You know, I’m looking over your long and distinguished career here. What would you say is your favorite role over the years? What have you really enjoyed doing the most? Yeah.
Eric Buffkin:
So I’ve had the good fortune, great fortune, worked for really fantastic mentors and colleagues along the way. I’ve started companies in microchips and technology. This venture into health technology, quite frankly, I didn’t know, had I known now what I had known then what I know, yep, still done it, but I would have had a lot … kinds of, of what it takes to start a health technology company versus a technology company, and my favorite part, you know, there’s several companies I have had great times and really enjoyed, but my favorite part is that time from the, you say, hey, I see a new opportunity and I have the tools to go make something of it. And so it’s kind of that startup phase when you’re, you know, when you got your, you, co-founders, early team, and you’re just, you know, doing whatever it takes to realize the use case and realize the technology, and getting it to that point where, hey, we’re cranking up and getting going.
Rich Prest:
Very interesting, and so when you think about, and I think it’s so amazing to be able to bring ideas into reality, so when you sort of think about the future, and, what, if you could be remembered for one thing, what would you like that to be?
Eric Buffkin:
Yeah, well, so I’m assuming, because this is a professional podcast, or a semi-professional podcast, Rich, that things like being a member for a dad and husband, that’s really those are not the ones we’re looking for because that would be my number one is make sure I remembered as the right dad, right husband. But I guess from a standpoint of being remembered, I’d like to be remembered as somebody who was compassionate to the people I was working with, thoughtful to the people I was working with, and being able to make the decisions that people are maybe uncomfortable to make. Those are the things, rather than specific roles, starting in this company or that company, I’d rather be remembered for the characteristics I brought to all of them, I guess, would be my goal.
Rich Prest:
No, I love that. I’m a great follower of stoic philosophy, much like Harry Travis as well, and I think we’re all on the same page there that being of good character is the best thing you can do, and if great outcomes come from that, even better, but that’s really the cherry on top. It’s being the best you can day to day that really matters. Very cool.
Eric Buffkin:
I agree there.
Rich Prest:
Now, switching to US healthcare, what do you think is something that most people don’t understand about US healthcare? I mean, it’s obviously a very complex area.
Eric Buffkin:
Yeah, yeah, yeah. I went there, once again, we only got a little while in this podcast, so I’ll, I’ll try. And the, I think the thing that would be most helpful in US healthcare, that if people could understand, the cost of things. Right now, and this is not an indictment of our system, we provide great care. I mean, everybody’s got their opinions, but at the end of the day, if you need care in this country, you can get it. But very few other markets where you pay somebody for something, somebody else delivers it to you, and you’re not really involved in the cost of the transaction between what the cost of the provider and the payment to the payer is. And in some cases, that’s great, you know, it helps manage your individual costs, but in my opinion, it kind of numbs you or gives you a distorted view of what are the real costs associated with providing and receiving care. And I think if people understood that, we might see different behaviors among many patients, as well as many providers and many payers too, but I think that would, to me, that’s a big deal.
Rich Prest:
I’m with you 100%. I think there are so many, there’s so, such a lack of transparency. I mean, I think it’s exciting to see some of the recent improvements in transparency, and some of the data that’s coming out, of course, is a little bit disturbing, but I think it’s showing the value of that transparency because it’s helping us to understand that if you can’t see what the prices and costs are, then it’s very difficult to be comfortable that everybody’s acting in a reasonable way, and so I think.
Eric Buffkin:
Yeah, and I think, you know, I’m generally an entrepreneur and a free market capitalist kind of guy, but I don’t think in a topic like healthcare, the pure free market works. There’s, there’s too much, there’s too many people that get marginalized that way. But on the other hand, I think inviting a single-payer approach just creates more opaqueness and more inefficiency. So we’ve got to find that Goldilocks area, and I think information and knowledge has got to be one of the big ingredients there.
Rich Prest:
Yeah, yeah, I think, I think that’s right. If we could at least understand the cost, that would be a good place to start.
Eric Buffkin:
Yes, agreed.
Rich Prest:
And I think that would then help us to know, you know, the areas to really focus on for reducing costs and improving efficiencies.
Eric Buffkin:
Right, right, right.
Rich Prest:
So in your current role heading up etect, what do you see as the most important focus areas?
Eric Buffkin:
Now, what I probably spend the most time, so with any small company, any startup company, making sure we have money in the bank is always job number one. So I’m going to kind of throw that out, that’s table stakes. Any CEO who is not doing that probably is not going to be CEO for very long. So we’ll just, we’ll put that. But in terms of the things that require the thought and the and the collaboration, making sure the, especially in this early stage we’re in, and we’re a ten-year-old company, so we’re not a young company, but the evolution of this technology in use cases has been such that making sure we have the right product with the right capabilities and we’re putting it in the right use cases. That’s a big, big part of what I do every day with my developers and my business development team, and just a, that’s where the rubber really hits the road to me because it helps drive the technology, it helps drive the business, and that’s what really helps the patient. So that’s the part that I feel like we get the most value when I’m spending my time doing that.
Rich Prest:
That makes perfect sense. And so, what have you seen as the main challenges for introducing an innovation like etect into the marketplace? I think it’s, it’s probably helpful just to give people a little bit of a quick explanation of what etect is, and then, yeah
Eric Buffkin:
I think that’s great. So etect, we create, we have a system, it’s called ID-Cap, it’s an FDA-cleared system that uses ingestible sensors that, think of a capsule just like you get your medicine or your vitamins and everyday pharmaceutical capsule, and so this capsule has an ingestible sensor embedded into it. And your pharmacist or your drug manufacturer can use these capsules to encapsulate an existing tablet or another capsule when the patient takes each dose of their medicine. That ingestible sensor is powered up by the patient’s stomach acid. It creates, yeah, it creates a small, very low-power wireless signal. Think of it as a tiny little text message coming from inside your belly. And it, that message is picked up by a device we have cleverly branded the Reader. The Reader then talks Bluetooth to your to an app on your phone, your phone forwards it back to our database in the cloud. Within about 5 or 6 minutes of a patient taking a dose, we actually have a record in the cloud that we can share back with the care provider, with the patient’s mom, with whomever, with the patient themselves. So the whole goal here is to create a real-time kind of feedback loop that says, hey, I took my meds, I know when I took them, and it, provide that data in context with the other elements of the care team so that the patient realizes, hey, I’m taking my medicine, I’m getting better. And I’ll say upfront, this is a, it’s a powerful technology. It’s not for every drug, it’s not for every patient. Medication, I resist the temptation here, Rich, to go into the whole song and dance about medication adherence, and there’s a $300 billion dollar problem and there is more articles written about it because it is a real problem, but it’s a big problem made up of lots of small pieces. And finding the right piece, and that collection of right pieces where we can apply the right technology can make really outsized benefits, and that’s what we’re trying to do. We’re working with folks in clinical research, both at the academic and the commercial level. We’re working with folks that are doing actual care in areas, HIV, HIV-prep, oncology to apply this to day-to-day care. There’s some new programs coming out of CMS, I’ll talk about when we get, as we go along later, that we’re really excited about. But we’re finding now that this technology is finding some great use cases for those patients when other things simply aren’t good enough, and that’s kind of how we position the company. And we’re not going to position etect’s ingestible sensor as an alternative to a carefully written app that’s going to remind somebody to take a daily metformin unless there’s really extenuating circumstances for that patient. But if it’s a very expensive drug with very dire consequences of non-adherence, like I said, think of things like oncology, maybe some TB drugs, things like that, now we’re in an area where the technology we have in the use case match up very well and that’s where we’re focused.
Rich Prest:
Yeah, I think that’s, that’s really insightful, right? That you have this amazing technology, and the first thought is, why wouldn’t everybody want to do this? And then as you start to dig into it, you realize, okay, we’ve got to find those very specific use cases where this is a really good fit and that’s the path to adoption and scaling. This is finding where you can those spots where you can be successful and grow from.
Eric Buffkin:
Yeah, the other thing is kind of interesting and having, we’ve had hundreds of patients, tens of thousands of sensors ingested, and so one of the things is always gratifying. And amazingly, we had a patient in a clinical trial, can’t obviously say much about, but in a particular trial that when the researcher interviewed him, following about two months on the technology, he was extremely grateful to us for providing this to him. He said, this is great. I was having trouble staying on my meds. I didn’t know, I had no idea what my patterns looked like. I would love to have this going forward. And it was just gratifying as a technology developer and as an entrepreneur, even to have one patient come back and give you that feedback. And, you know, that sounds a little maudlin, I suppose, Rich, but it was really moving when we got that kind of feedback from the patient.
Rich Prest:
Oh, I totally understand. We have these amazing, we actually have a Slack channel called Patient Love and we get these messages coming in from patients every day telling us about how it’s made a difference in their lives. And just, I think it really is touching, you know, as a technologist, as an entrepreneur, when you actually get that feedback from actual patients and actual people that you’ve helped to know that you make a difference in people’s lives is, as you say, really touching. So, totally understand and get that. That’s very rewarding. So I think you hinted a little bit about CMS. I’m kind of curious about key trends and developments, regulations you’re watching, and what impact do you think they could have?
Eric Buffkin:
Well, that’s a, so I’ll just jump right into that. One of the, if CMS has been over the past few years looking at how do they leverage digital technology, remote monitoring, everybody knows what the pandemic did for telemedicine, remote monitoring, and it created such great opportunity in such a short period of time. Is there, is this just this frenzy of things going on? One of the new programs we’re very excited about that they actually introduced in a limited way at the end of last year, and they’re actually looking at updating some of the rules this year is what’s called remote therapy monitoring, which is an opportunity, as opposed to monitoring physiological signals, which they’ve had a program going on for some time called RPM, they now have this remote therapy monitoring opportunity, which provides the opportunity for patients with certain disease states to monitor, is a patient doing the physical therapy? Are they doing an occupational? Are they staying on their medication therapy? This is an area that’s extremely exciting for us, for obvious reasons, because we think medication therapy is such a huge part of some of these key disease states. And we’re working with a couple of large practices to implement some pilots right now along that lines, and we’re very carefully watching. We’re encouraging CMS, say, this is a great program. We need to appropriately expand it so that the patients can get the most use from their pharmacists, from the most use from their physical and occupational therapists, as well as their traditional caregivers.
Rich Prest:
Oh, that’s great. So this, essentially, providing a new reimbursement pathway with reimbursement with remote therapy management opens up this opportunity to sort of encourage the use of etect technology in those remote models and it provides a pathway to reimbursement. So that’s very cool.
Eric Buffkin:
Absolutely, absolutely. Yeah, we’re very excited about that.
Rich Prest:
Yes, so I remember this fascinating thing when I was working with you guys that the, when you looked at clinical trials, which is a huge expense for pharmaceutical manufacturers, that they built into the clinical trial enrollment process, which, and obviously one of the biggest challenges they’ve had is getting patients enrolled in these trials. And they build in an adherence assumption that is based on prior history, which is often sort of around 60, 65%. And I’ve always wondered with your technology, whether if you could actually build an adherence assumption of 90 or 95%, that would potentially reduce the number of folks that you would need to enroll in a trial which could massively reduce their cost. So I’m sort of curious whether any of that has emerged as that other potential opportunity for you guys.
Eric Buffkin:
Well, so I would say the, your recollection is accurate. I mean, that’s what you describe there, Rich, is really a big part of the math of clinical research. And our experience today, you hit the nail on the head and that especially going through the pandemic, pandemic really threw a monkey wrench into a lot of the conduct of clinical research. Even in some academic studies we’ve been working with, the studies were halted, they were paused, I mean, people couldn’t visit the clinic. So you see it, you see it, you see in what almost would be a renaissance, in how studies are architected to take advantage of technologies, to allow you to recruit people remotely, monitor people remotely. And so the, so when we started the company, your assumption was dead on. That was our value proposition. It was, hey, you can enroll 20% less patients and save a boatload of money. And people acknowledge that, but now it’s, I’ve got to be able to monitor my patients. And so the ability, if you’re going to monitor somebody’s physiological vital signs or create new digital biomarkers that you want to monitor remotely, you’re going to need to be able to monitor, were they actually on their meds or taking or manage remotely as well. So that dovetails very nicely with what we’re doing. And we’re trying to participate and collaborate with the other folks in the industry that are moving this whole distributed clinical trials and remote monitoring along. And, so, but you can still save money if people adhere better, you don’t have to enroll as many people. That is still a definite, definite fact there.
Rich Prest:
Well, it does sound like you’ve got a number of opportunities out there that you’re working on, and it sounds like there’s definitely some good signs that there’s interest in. Yeah.
Eric Buffkin:
One of the things that’s challenging as a young company is not to starve while standing in front of the buffet table. You know, you want to make sure that you pick something and you go after it, not stand there, decide, no, let’s go after that one too, and that one too. That’s a big risk for a small company.
Rich Prest:
Yeah, that’s, that is great advice. Any other recommendations you’d have for folks thinking about getting started in life sciences or healthcare? What, yeah.
Eric Buffkin:
It’s a, so I may have mentioned or alluded earlier, you know, most of my previous companies have been in technology, you know, microchips, new communications, things that where you create the technology, you design a product and you go sell it. You know, the regulatory payment model, I mean, it’s, healthcare is a very different market. It’s a rewarding market. I mean, the reward of actually helping people be healthier, and then, those are things you get that you may not get if you create another great consumer product, right? But the thing I would advise, I wouldn’t say caution, but I will say advise, make sure you have commitment and make sure you have patience. And entrepreneurs, including myself, are not known as hallmarks of patience, but for this market, to go through, and I come at this a little bit, you know, we’re making a device. We’re making a medical device. We’re cleared by the FDA as a medical device. So that’s a little bit different than making a piece of software or an EHR, so there are some considerations there. But have commitment, be patient, and make sure, also, make sure your life partner, whether that’s a wife or a domestic partner, whomever, make sure they’re patient and committed too, just as a side note there, okay? Domestic tranquility is important.
Rich Prest:
Totally, and I think that’s, the patience is great advice, I think. … there was some number like it’s, on average it takes 17 years to introduce a new piece of technology into healthcare, and so.
Eric Buffkin:
Rich, you know, you know who our investors are. You don’t need to, you don’t need to say that out loud, but given that, we’re a long way down that path, we’re a long way down that path.
Rich Prest:
Well, it’s funny too, right? Because I just finished reading How to Lie with Statistics, and of course, it talks about the grand problem with averages, right? If you include examples like the stethoscope and washing your hands into those, then, it can it could wildly skew the number. But I think the real point there is it does take time and whether that’s getting approval from a government authority or whether that’s actually just getting people to adopt and use, to find that use case and get people to adopt and use it. It can take a while.
Eric Buffkin:
And you hit the nail there. The biggest thing in all seriousness, Rich, if you are going to pursue a startup in health tech or health, make sure you identify who or what that use case is. Who is meaningful too? Because when you go to fund this, unless you’re funding this out of your own pocket or grants or whatever, which are all good ways, by the way, don’t get me wrong, investors, especially today, are being much more selective about what gets funded, how much, and if an investor is looking at, I can put money into three software startups, and within a year … I’ve got a winner. Versus, I’m going to find a health tech startup or a device startup, and it’s going to be five years before I know if it works on a patient. That’s a very meaningful consideration. So, you know, bear that in mind. Bear that in mind.
Rich Prest:
Excellent advice, excellent. Just a fun little quick question on any books or podcasts that you’d recommend to folks that you’ve enjoyed recently?
Eric Buffkin:
That’s a great question. So, boy, I’m going to keep a professional here. So I’ve been listening to a number of different podcasts. My daughter has introduced some very entertaining podcasts. So we’ll try and stay, we’ll try and stay professional, and I’ll go a little old school here in that, I’m an advisor and mentor at the University of Florida for their startup ecosystem, for companies coming out, and there’s two books I recommend to everyone in the new CEOs I read. One of them is by a gentleman named Guy Kawasaki. He was one of the original early guys at Apple. He has a book called The Art of the Start, and it’s a very easy read, very simple read, but it really, it gives you a template for thinking about how do I present my company to somebody I want to have invest? And he’s got a really simple, straightforward way to do that, and I always recommend that. The other one is a book by a guy named Jerry Weissman called Presenting to Win: the Art of Storytelling. It’s called Presenting to Win. Jerry Weissman was a screenwriter in the eighties, and he got hired by some of the large VC firms to help CEOs of people like Compaq and Cisco go from telling you about, you know, megahertz and technical jargon, to how do you tell a story about a very technical product that an investor can understand and appreciate? And so when I say that, as you might guess, coming to the university, I do a lot of scientific startups. So it’s a big recommendation from me to them to just, think of this as storytelling, and Jerry Weisman does a great job of articulating that.
Rich Prest:
Oh, those are two great recommendations. I have Guy’s book on the shelf and I was actually just talking about his guidelines for presentations with the team the other day as they tried to present, I think, in ten-point font, and I said, you know, some of us can’t read that font anymore.
Eric Buffkin:
Yeah, yeah. My example there is my greatest accessory for my Apple Watch are my reading glasses.
Rich Prest:
Oh, I love it. But I will have to check out the Art of storytelling. That sounds great as well. Cool, so, Eric, if folks want to connect with you, where is the best place for them to find and, find you and do that?
Eric Buffkin:
So I am not the most active social media guy. I spend a lot of time on LinkedIn, so you can look me up on LinkedIn. You can drop me a line at my email at etectRx. I’m happy to, if you reach out to me on LinkedIn, I’ll, I’ll share that back to you, and, or give my friend Rich Prest a call and he’ll point you in my direction. Either one of those will work.
Rich Prest:
Great. Well, Eric, thank you so much for taking the time to chat with us this morning. And to everyone out there in the audience, I hope you found this an enjoyable conversation and got something out of it. I think Eric has lots to share from his many years in the industry and yeah, really appreciate him taking the time to share some of those insights with us. So thank you, Eric.
Eric Buffkin:
Yeah, I appreciate it greatly, Rich. It’s been a delight. I look forward to connecting up again and going to get in trouble somewhere together.
Rich Prest:
That would be fun.
Eric Buffkin:
All right.
Rich Prest:
Thank you.
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