Why Improving Women's Health is Important to Healthcare Outcomes with Heather Bowerman, CEO and Founder at DotLab
Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.
: Welcome back once again to the Outcomes Rocket podcast where we chat with today's most successful and inspiring health leaders today I have the amazing Heather Bowerman. She's the CEO and Founder at DotLab, a personalized medicine for women's health. She's a Bio Engineer and Entrepreneur recognized as one of the 100 most intriguing entrepreneurs by Goldman Sachs. One of the world's top 35 innovators by MIT Technology Review and a World Technology Award finalist for health and medicine. Prior to finding DotLabs, she ran business operations at Enlitic. We've had guests from Enlitic here in the past, a silicon pioneer in applying machine learning and deep learning to healthcare data. And she was a Management Consultant and McKinsey & Company, some very forward thinking companies as you all can hear. Before that she was a Policy Associate at Obama's White House in the Office of Science and Technology Policy (OSTP). Heather began her career as a Biotechnology investor at funds in Boston and New York where she led deals such as the acquisition of molecular diagnostics company to combat epidemics of H1N1 and H5N1. She's an outstanding contributor to Healthcare and it's a privilege to have her on the podcast. Heather welcome.
: Thank you for having me and it's nice to be here.
: It is a true privilege. Now Heather, did I leave anything out of your intro there that maybe you want to touch on to the listeners know more about.
: No you've got it. But I would be remiss to say that I would not have been able to have all of those wonderful experiences without creating deal on the way. And I think my favorite thing about the diversity of the experiences that you outlined there running from policy to private sector to investing to know kind of a random walk shall we say is that healthcare and particularly diagnostics has been the common thread. And I think looking back is really valuable to understand the healthcare ecosystem from all those different vantage point.
: Yeah without a doubt it's your experience spans many verticals so I think that's pretty cool because one of the things that we find in healthcare is really kind of siloed nature of it. So having that you've been through many of those gives you an advantage and just out of curiosity right while the verticals have been different it's been in the medical sector so what got you interested in the medical space to begin with.
: Now well as we mentioned I studied Bioengineering as an undergrad that was at UC Berkeley and my first roll out of college was as an investor at a junior level of course at a fund in New York and I had a chance to participate in the deal on the diagnostic side and that was back in the days as swine flu and avian flu if you remember that after the 2000 and I've really been in the diagnostic world ever since I was put in Enlitic in that category as well. But coming at it from the deep learning side where I was really interested in doing throughout my career that I never had the chance to do until that lab was to build a product within diagnostics for women's health. And I think there's just an incredible amount of opportunity within women's health right now. And so I was really looking for a chance to build the product that I felt was missing in the world and that background and in diagnostics certainly help both with identifying the technology and developing it but also doing some self reflection in assessing when I felt it was the right time for me to take that step in my career.
: I think that's super interesting and so we had recently Kevin Lyman, COO there in Enlitic i don't know if you had a chance to work with him while you were there or not.
: I didn't. But I am so thrilled to see with where the company is going and I think there's just so much promise for deep learning. I think that we really only began to scratch the surface of where we can see that why particularly are on the single payer side in coming years. So it's really exciting.
: It is. So the company that you've put together here is are you guys incorporating deep learning as part of it?
: We have not announced that yet. I think to take a step back there's certainly opportunities for it, but it's not part of our immediate roadmap. That said, I think within women's health, we have seen multiple new therapies come out in the past couple of years. So I think there may be sources of inspiration to apply deep learning in the near term but it it's not on our immediate roadmap.
: Got it, super exciting. So Heather as you've been a part of so many different aspects of healthcare through your career what would you say a hot topic is today that needs to be on every medical leaders agenda and how are you and your company focused on it?
: Yeah I mean it's really interesting and you could probably answer that question a number of different ways depending on whether you're coming it healthcare from the buyer side or as a producer of services or from the pharma and device side. But I think what stands out across all of those is really the move to value-based care, where I think unfortunately today value creation or application does not equal where we can extract value within the ecosystem. And I think this move to value-based care regardless of what stakeholder type you may work within in the healthcare world I think that's the most meaningful shifts will be in coming decades regardless of what happens on the policy side.
: Yeah that's cool you know and I feel like value-based care means a lot of things to different people. How would you define value-based care?
: Yeah I mean for me I think there's certainly the health economics piece and that usually tells the story but I think it's so important that we bring it back to a patient. So with what we do without labs, we are working in a way that has had no innovation in really 50 years for a condition called Endometriosis that affects one in 10 women and today there's only the extremely crude and based on method of surgery which requires general anesthesia called laparoscopy and that's the only way to confirm active disease in women who are afflicted by the endometriosis. And as a result of that the downstream factors of the disease are caught really late, all these compounding or can cost accrue over time and so where it gets really interesting is trying to introduce the new not invade the technology which is what we're doing about lab that would display of the incentives that currently exist around surgery that with value-based care, I think at the end of the day what it really means to me is thinking about the patients and what will improve her or his quality of life, and having the health economic story be built around that and what this system is with a line can do toward. So I do feel optimistic directionally about where the U.S. will be in the course of the next 10 to 15 years and I think we'll continue to see bumps along the way. But as technology accelerates and I think with how mobilized certain patient groups are payers are certainly engaged and often aligned towards the end goal. But it will take some time.
: Yeah for sure and it's pretty cool that you've narrowed it to endometriosis you know and you mentioned it affects a lot of people in the U.S. every year and it's something that hasn't been visited as far as innovating an approach to it so it's so so exciting to hear that you and your team are actually working for for better results within this space.
: Thank you so much and we feel the same way. And I am genuinely excited to wake up every morning and work on it and I think for us what's so interesting is within diagnostics this emerging field as you know call it liquid biopsies or other types of non-invasive biomarkers. And I would argue that liquid biopsy just means bloodpath. But for us it's really about understanding how we can improve the sensitivity and specificity was widely accepted to be the gold standard whether it's surgery or some other diagnostic test in order to have new women's health forward collectively. So with a case of endometriosis the reason it's so interesting is that it's truly a blackbox within healthcare still. And so if we think about pelvic pain, one in seven women experienced pelvic pain and it's pretty straightforward to rule out some of the key causes namely Polycystic Ovarian Syndrome, Uterine fibroids compares to endometriosis, these are really simple paths to run in order to provide patients with those answers. Be it just an ultrasound or a blood draw both endometriosis the average delayed diagnosis is still 10 years and...
: Is that right?
: It's not part of that initial. Yeah and it's not part of a checklist for what the SAT in the physicians office. So exactly it's a very long time and I think what we're really seeing is a shift toward with our path something that's specific and sensitive for endometriosis in order to identify patients early as far as the stage of disease and help them make sure that they're in a place where they can pursue certain therapies or other treatments that can help to improve the trajectory of their lives. So with young women for example who may start experiencing crippling pelvic pain in high school, often these young girls or teens don't go out for sport because what if they're menstruating on the day of a big game or they don't go out for the school play because of fear that endometriosis typically I note endometriosis will interfere. So it's incredibly meaningful to be able to really help these patients at a young age and then subsequently women are thinking about the assets of endometriosis that are more closely linked in fertility.
: So how are you guys diagnosing it then? Is this something that you could chat with us about?
: Yes sure. So the DotLab test for endometriosis we call it Dot Endo.
: So we have identified with Dot Endo biomarkers called micro RNA though that are specific and sensitive for endometriosis. So ours was the thick micro RNA biomarkers which are under worldwide patents. We identified from a reading of thousands of different micro RNA's sequences using comprehensive micro arrays of these micro RNA's. So from the tens of thousands that we started with, we identified a panel that showed really significant differential extraction and we've spent the past couple of years not only developing that Assaye but validating it retrospectively and prospectively in endometriosis patient. So I think the most significant sort of milestone that we're really excited to be able to share is that our prospective data will be published later this year. And it came out looking really strong and we presented our interim data at the American Society for Reproductive Medicine meeting and won the Indian state prize for the whole conference which was attended by about 30,000 physicians from throughout the U.S. and internationally. So really pleased with our data and excited to bring the product around the world.
: Congratulations. That's pretty exciting.
: Thank you.
: So this is phenomenal you know and as you think about this chronic condition it's something that affects the lives of hundreds of thousands of people every year so to have a way to detect it and fix it is a huge win. So tell me how there, is there a time when you had a setback whether it be your time right here at DotLabs or within clinic or one of your prior engagements that you had a setback that touched you so much about healthcare that maybe you want to share with the listeners.
: Absolutely. The answer is every day but one that comes to mind right away is thinking about how to develop and deploy the tech piece of our product. So I think it's really tempting when launching anything and help technology to think that you understand the tradition workflow and it did come out that we're in a position to be able to bring our test out to you position. And looking back we overinvested our time and resources into the tech product where we think in the future we'll certainly under invest on that side, do things manually before building an app that we're certain really need the real world physician workflow requirement. So I mean just like I think any entrepreneur will tell you there's nothing like a customer or in our case position in our view to really open your eyes about what's really needed from your product. So as always it's just critical to get out and talk to different stakeholders to get a strong sense of what we'll take your product to that next key milestone which in our case was not overinvesting in the tech product too early.
: Yeah that's such a great call out there. It's so easy and we all fall victim to just wanting to build this awesome technology and then we sort of forget to just kind of stop even before we get started. But maybe even you know if you've already started to stop midway and just kind of do a gut check to make sure the end users gonna like it and it flows well.
: Absolutely. And we have a great team here at DotLab and I think we learned from that and really quickly almost immediately when we went out to do new position interviews and I think it's just a matter of really internalizing that feedback quickly and reacting to it and adjusting. But I think there are smaller versions of that that happen every day in a startup and we're always just out there looking for all the information we can to make sure that we're ruthlessly prioritizing shall we say what we accomplish internally at DotLab on any given day.
: That's awesome Heather, anyhow so this is great advice and I'm sure with the leadership that you're providing to this team you guys are definitely going to go far and Im excited to see that happen now as you have you worked on different things would you say one of the proudest healthcare leadership experiences that you've had to date is.
: Yeah well thinking back to when I was a student I had the opportunity to work as a fellow in the technology transfer office at Harvard. And I didn't necessarily know at the time how that would serve me well in the future. So the proudest moment that immediately comes to mind is over the course of more than a year working with Yale University to get the exclusive license to some of our early IP. So I was able to procure it out license but it was a long process and I was pursuing the intellectual property as an individual as opposed to a large corporation. And so my negotiation leverage was as you can imagine not quite on the same playing field but being able to get a license and over many competitors who thought the IP as well, that was such a turning point in the company's trajectory a couple of years ago and was the impetus for our efforts for subsequently going out and taking our first outside capital and turning our cores from being a research and development shop to a commercial product company. So I look back on that probably for sure that we were able to accomplish that.
: It is a David and Goliath victory. What would you say contributed to your ability to do that?
: Yeah I think it's just understanding how technology transfer works which I had the opportunity to observe when I was there as a research fellow but also in the Obama White House. One of my areas of focus and passion was around this idea of lab to market that there are just so many incredible technologies and scientific breakthroughs that have been discovered by our universities and federal labs. And I think the biggest mistake in my view that health tech companies make is that under leveraging what's available within tech transfer offices so I had that thesis kind of in its earliest stages at the beginning of my career but when I reached an inflection point where I was really looking to build a women's health company, it came full circle. So I think to answer your question it was really a combination of understanding tech transfer and the incentive and a little bit about the process. And then just being persistent.
: Love that. That's great. There's nothing like a little understanding of how it works and then that persistence to put the bow on top right.
: I love that. Well congratulations that's a huge win and sort of the beginning of a lot of great things so definitely inspiring to hear that story. Within your company DotLabs, what would you say is an exciting project or focus that you're working on right now?
: Yes so I am incredibly excited about our prospective studies. So a little bit about that and why that's significant. So as a catch, we are looking at the first technology to confirm active endometriosis disease and laparoscopy or surgery that really it hasn't evolved meaningfully since my grandmother's time. So that said in order to compare our technology to the gold standard or the gold standard rather surgery you have to collect the patient samples during laparoscopy. So in the case of the prospective body we looked at the biomarker levels that were significantly elevated in patients with endometriosis compared to control and the expression of the biomarkers was consistent with that and impatient with the active endometriosis that were not found to have the disease upon surgical evaluation. So in other words the samples were collected during surgery which is critically important because if you cut out the disease prior to analyzing the biomarker levels are going to score your result. So this is an incredibly difficult study to run when you're looking to compare against surgery. And we are able to accomplish that and to share the interim data with the key opinion leaders in the field and received such a warm reception. So really proud of that and excited about the future.
: That is super exciting. Congratulations on that. And so you guys worked hard to figure this out. You've got the diagnostic piece put together. Is there also a treatment piece to the company?
: Not to the company but in the news last week was the approval of the new class of therapies specifically generations. Is also known as a goal X and b has a new drug called Orlistat that just got approved. And before that the only second line of therapy in the bay with Louve prawn Wesch I'm making a little extra or less is known to you or it's not administered orally the side effects can cause unpleasant complications or patience. But as we speak that we're seeing the innovation take place from the therapeutic side and in women's health and particularly in endometriosis which just has incredible prevalence. The diagnostics are uniquely a bottleneck and that's part of why I was so inspired to build the company is bad. Unlike in most cases where a diagnostic doesn't exist and you expect the therapeutic not to either. In this way there are quite a few therapeutics out there lupines now illegal and even just the regular oral contraceptive pill or birth control can help in the earliest stages of endometriosis. While none of those are curative the limiting factors are not on the therapeutic side comparatively and where I felt that we could make a huge impact from patients which was really on the early detection and diagnostic development side. So it really is really interesting.
: Yeah that's awesome. Sounds like the solutions out there and just marry both to treat the right patients at the right time with the right drug. Or nothing at all right?
: Yeah. If you don't have that disease I would hope so. And I think what's interesting about health task and I think this movement towards digital health is that precision medicine is somewhere on the periphery of bad yet it offers much hope to patients and I think that it really does tend to marry different disciplines such as diagnostics with machine learning tentatively in the future in order to best serve patients. But initially you have to build that data set.
: For sure. Now super interesting Heather and you guys are doing such an outstanding job there, getting close to the end of our interview the time flies I'd love if you could share some answers to these lightning round questions. We're gonna to build a syllabus for a medical leadership course, the ABC's of Heather Bowerman and four questions lightning round style followed by a favorite book that you recommend to the listeners, you ready?
: Let's do it.
: All right. What's the best way to improve health care outcomes?
: Align incentives particularly financial ones. When I say align incentives I think that it goes back to the value-based care that we were talking about earlier where I think purposes medicine should really take hold in women's health but in other areas of healthcare and medicine well ultimately the health economics cases need to be built. And so whenever a new therapeutic is in that is offered or an underserved population or any technology that displaces the way things are done in a way the various stakeholders are incentivized today I think that we just need to keep a close watch on our system to keep incentives aligned, aligned as much as we can. And of course I mean I unfortunately you know unable to control that or the weather or myself but what I can do is think about where we deploy our technology in order to generate as much traction in the near term as we can at places where we view the incentive alignment on stacking up more favorably.
: Love it and what would you say the biggest mistake or pitfall to avoid is?
: There a lot but of course what rises to the top is hiring that meet team members. I think of startups like I don't know where we're world both to where there are only a certain number of seats on your boat. As a startup that you need to make sure that each seat is filled with somebody who is really going to paddle on your behalf whether you're paddling at the moment or not. And I think that especially with early stage startups really anything before theory be is just so important that you fill your boat with as many a player as you can.
: You don't want any dead weight out in the ocean right.
: Love that. How do you stay relevant as an organization despite constant change?
: I try and never stop learning. I listen to podcasts like yours. I read every day. Realistically most of that reading happens on my phone. But really staying on top of the day and looking for just where you're state is going and what's happening adjacent to you. I think that that's critically important. And that's gotta be with you stay laser focused on our products and what we're building but they're really just learning from. You can. I think the best that you can do for your company.
: Love that and hear that the average CEO reads 50 books a year.
: I believe that I think no I think a lot of those are on audio by now. But I would believe that.
: I agree with you completely. I used to have a kind of a challenge I would say well I don't technically have read them,I listen to them. But now I read them whether you listen to them or read it you still read it right?
: Yeah you're consuming the information and I'm with you.
: Yeah that's awesome. I love it. What would you say one area of focus that should drive every company in healthcare should be?
: I think it's really about creating value for patients. So for us I think we're so inspired by filling this gap in women's health is so glaring where unfortunately there's often a mismatch between straightforward business models and technologies that can truly fill a gap in patient care. So if I think about a company that is probably gonna have excess fundraising it probably something more with a no proven footprint on the commercial side. But if you're developing a new technology you unlock or scratched the surface of a black box in medicine that course probably hasn't been charted for you. So I think just staying focused on what you can do to bring value to patients and not getting deterred by the obstacles in your way, that's really the way that we can start to fill the gap.
: I think that's such a great call out and not of these awesome books that you read and the resources that you check out every year Heather, what book would you recommend to the listeners?
: There are so many but one that I love that comes to mind is Ben Horowitz's book The Hard Thing About Hard Things. He has a chapter called nobody cares and he talks about failure and excuses mainly that the former never justifies the latter. So there will always be reasons why something didn't go well. But the bottom line is that your energy is better than being a solutions person which really resonates with me as a CEO. And at the end of the day nobody cares to do your job.
: Love that. Straight to the point. Keep it simple. And listeners you can find all of these resources as well as a link to Heather's company. Just go to outcomesrocket.health/dotlab you'll be able to find all that there. Heather this has been fun, I'd love if you could just share a closing thought with the listeners and then the best place to get in touch with you or follow you.
: Yeah I think my closing thought is just how excited I am for the next five years in women's health. I think there are so many great companies emerging and so closely watched that base particularly when Intel companies that are female led which is a new trend that we're starting to see an end directionally. I think there's just so much promise for the next couple of years and you can find us on Twitter at hello.lab or get a hold of us by email at email@example.com.
: Outstanding. Heather, thank you so much for making time for us today and we're really excited to see where you take this field of women's health in the future. Thank you so much for participating.
: Thanks for having me.
: Hey Outcomes Rocket friends, thanks for tuning in to the podcast once again. As a leader in health care, you have big ideas great products, a story to tell, and are looking for ways to improve your reach and scale your business. However there's one tiny problem. Health care is tough to navigate and the typical sales cycle is low. That's why you should consider starting your own podcast as part of your sales and marketing strategy. At the Outcomes Rocket, I've been able to reach thousands of people every single month that I wouldn't have otherwise been able to reach if I had not started my podcast. Having this organic reach enables me to get the feedback necessary to create a podcast that delivers value that you are looking for. And the same thing goes if you start a podcast for what you could learn from your customers. The best thing about podcasting in healthcare is that we are currently at the ground level, meaning that the number of people in healthcare listening to podcasts is small but growing rapidly. I put together a free checklist for you to check out the steps on what it takes to create your own podcast. You could find that at outcomesrocket.health/podcast. Check it out today and find a new way to leverage the sales, marketing and outcomes of your business. That's outcomesrocket.health/podcast.
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