"Launching a New Industry – Scientific Wellness" - Mia Nease (Head of Commercial, Arivale)
Delivered at the inaugural Hyper Wellbeing Summit, 14th November 2016, Mountain View, California.
For more information including details of subsequent events, please visit http://hyperwellbeing.com
The summit was created to foster a community around an emerging industry - Wellness as a Service (WaaS). Consumer technologies, in particular wearables and mobile, are powering a consumer revolution. A revolution to turn health and wellness into platform delivered services. A revolution enabling consumer data-driven disease risk reduction. A revolution extending health care past sick care towards consumer-led lifelong health, wellness and lifestyle optimization.
WaaS newsletter sign-up http://eepurl.com/b71fdr
@hyperwellbeing
3. Determinants of Health in U.S.
60%
30%
10%
Genetics
Behavior &
environment Health Care
Steven Schroeder et al.
New England J Medicine, 2007
4. For every person in the US that the 10 highest grossing drugs do help (orange), they fail to improve the conditions
of between 3 - 24 people (blue).
1) ABILIFY
Schizophrenia
2) NEXIUM
Heartburn
3) HUMIRA
Arthritis
4) CRESTOR
High cholesterol
5) CYMBALTA
Depression
6) ADVAIR DISKUS
Asthma
7) ENBREL
Psoriasis
9) COPAXONE
Multiple Sclerosis
8) REMICADE
Crohn’s Disease
10) NEULASTA
Neutropenia
Schork, Nicholas. Time for one-person trials. Nature. Vol 520. April 2015
Imprecision Medicine
6. Lee Hood, MD, PhD
World renowned scientist, entrepreneur
6
7. 2014: Creating a new industry
Test the Concept – ISB
Innovation meets execution
8. Millions of data points from each individual
Genome
(1x)
Lab Tests
Blood, saliva
(2x)
Gut Microbiome
(1x)
Lifestyle /
Quantified
Self
(Ongoing)
Genome
(1x)
Lab Tests
Blood,
saliva
(2x)
Gut
Microbiome
(1x)
Lifestyle /
Quantified
Self
(Ongoing)
DISCOVERY
Data Integration
& Correlations
9. 2014 – Test the Concept
Build and test prototype to:
• Identify transitions
• Test efficacy of coaching
• Establish scientifically validated metrics for wellness
pic
10. What does wellness mean to you?
Travel with my wife
Boost race performance
Avoid what dad died from
Play with my grandkids
Gain strength
I want to feel more confident
Enjoy the moment
Pursue my start-up dream
Lab work
Tracking
Genome
Microbiome
Coach
Dashboard
Community
Actionable
Recs
19. Global Leaders Form Scientific Advisory Board
Frances Arnold, PhD
California Institute of Technology
George Church, PhD
Harvard Medical School
Jim Heath, PhD
California Institute of Technology
Ed Lazowska, PhD
University of Washington
Larry Smarr, PhD
University of California, San Diego
Ralph Snyderman, MD
Duke University
Bonnie Spring, PhD
Northwestern University
Lee Hood, MD, PhD
Institute for Systems Biology (chair)
Eric Topol, MD
Scripps Research Institute
(uncompensated)
Gil Omenn, MD, PhD
University of Michigan
20. Partners
Research Partnership
• Founded by Leroy Hood, MD, PhD
• Expertise in integrating and
modeling systems data
• 135 scientists
• 4th most impactful scientific
papers globally (SCImago, 2014)
Microbiome Sequencing
• Pioneer in translating
microbiome science into novel
therapeutics
• Microbiome to Medicine
initiative
• Inflammatory Bowel Disease and
metabolic syndrome research
Metabolomics
• Industry’s most comprehensive
metabolomics platform
• Developed novel clinical
diagnostic tests for insulin
resistance and impaired glucose
tolerance
• More than 500 publications
Whole Genome Sequencing
• 25 out of 32 FDA approved drugs
in 2014
• 21 R&D Sites worldwide
• World’s largest chemistry
organization
• 100 drugs currently in
Phase I, II, or III
Genome Analysis Partnership
• Developed by deCODE genetics
• More than 350 publications
• 40M validated variants from
350,000 whole genomes
• 30X more data than the 1000
Genomes Project
Clinical Assays
• World leaders in clinical assays
• Serves 85% of physicians and
hospitals in the U.S
• Operates thousands of patient
service centers
Proteomics
• Innovators in cost-effective ELISA
panels for cardiovascular and
inflammatory protein markers
• Partnered with Arivale and ISB for
Hundred Person Wellness Project
21. 2016: Launching a new industry
Scale the Business
Sales, Operations and ongoing
innovation
23. Goal: Increase the
percent of pioneers
who achieve their
goals by tracking
healthy habits and
providing on-demand
coaching
Arivale App:
FROM BIOLOGICAL TO BEHAVIORAL TRACKING
24. From “Coach & Me” to “My Community & Me”
Mobile Experience Desktop Experience
25. Pioneer Engagement
Engaged Pioneers have completed a
coaching call or assay in the past 60 days
or have an upcoming call scheduled.
Assay Completion %
Blood Draw 1 98%
Blood Draw 2 89%
Blood Draw 3 93%
Other Assays
(saliva, fitbit, microbiome)
80%
Total 90%
Arivale Age
in Months
Percentage
Engaged
1 100%
2 100%
3 100%
4 95%
5 95%
6 93%
7 94%
8 93%
9 87%
10 94%
11 85%
Total 93%
27. Pioneer Attitudinal Results
Statement
% of Pioneers
@ baseline*
% of Pioneers
@ Month 6+
%
Change
“Overall, I feel my health is on the right track.” 62% 85% 23%
“I feel empowered to do the things I love in life.” 79% 84% 5%
“I feel rundown and don't have much energy.” 24% 9% -15%
“I feel like I've lost control of my life.” 7% 3% -4%
“Lately, I'm unable to concentrate, I lose focus.” 20% 9% -11%
“I'm satisfied with the way I'm living my life.” 58% 77% 19%
“I know how to live a healthy life.” 77% 95% 18%
• Percent who said they “Agree” or “Strongly Agree” with the statement.
28. Steve’s Success Story
Measurement
A1C
Insulin
Total Cholesterol
LDL-C
HDL-C
Triglycerides
CRP
Vitamin D
1st Blood Draw
l 6.5
l 26
l 246
l 137
l 36
l 363
l 5.9
l 27
2nd Blood Draw
l 5.9
l 12
l 197
l 115
l 49
l 165
l 3.2
l 37
Genes of Note
• APOC3
• PPARG
• IL-6
• AGT
• TCF7L2
• VDR (2 variants)
“My dad’s 97, I want to make it to 100. I think I have
the genes, I know I have the right attitude, and now,
with Arivale, I’ve got the plan.”
- Steve
29. Cindy’s Success Story
Measurement
Insulin
Vitamin D
LDL-C
LDL-P
Triglycerides
IL-8
Glutathione
1st Blood Draw
l 16
l 36
l 114
l 1162
l 125
l 52.8
l 654
2nd Blood Draw
l 13
l 47
l 91
l 1091
l 105
l 8.6
l 735
Genes of Note
• APOC3
• PPARG
• VDR
• GSTP1
• IL-6
• Lactose Intolerance
“I am down 12 pounds in 4 months and this
is the best I’ve ever felt in my life”
- Cindy
30. The next chapter
Providence Health – Five Pillars
Enterprise Program Expansion – Real World Evidence and ROI
Research Portal
I have observed that there are three categories of people in the business world. Those that like to invent and innovate, those that like to organize and make things more efficient and those that like to sell. I’d like to see a show of hands please from the part of the audience that considers themselves innovators and inventors! What about those of you that like to take innovative concepts and streamline them, organize things? What about those that like to sell? I’d like the innovators in the room to look around and spot the sales and organizer people, because it’s the combination of those archetypes into a high powered team, that tends to propel new ideas forward.
Today’s talk will be about the journey of innovation, ideas, setting up a company, but more importantly, launching a new industry, which we call Scientific Wellness. Bringing an audacious vision to life is a team effort and our goal is to help individuals optimize their wellness today and for decades to come.
Steven Schroeder et al.
New England J Medicine, 2007
McGinnis JM, Williams-Russo P, Knickman JR. Health Aff (Millwood) 2002
Let’s start with the problem…
In 2007, Dr. Steven Schroeder published an article in the New England titled “We can do better – improving the life of the American people”. In it, he outlined that there are three key determinants of health in the United States. Your genetics, your environment and behaviors and finally, the healthcare system. Ironically, as a nation, we invest 18% of our GDP, nearly three trillion dollars in the 10%. The concept of scientific wellness was born from a desire to impact the the remaining 90%, and as you have seen throughout this conference, the opportunity is significant.
Here is another space, where opportunity to improve outcomes and reduce waste abounds. In 2015, Nicholas Schork’s paper titled “Time for one-person trials” appeared in Nature. In it, he argued that for every one person whose condition improved as a result of prescription therapy, between 3 and 24 people saw no change at all. The implication here is that the clinical trial recruitment process has significant room for improvement by tapping into the specific patient profiles, where therapies are most efficacious.
Our CEO, Clayton Lewis had been investing in the wellness in the wellness consumer health for nearly a decade. He knew the segment was fragmented and lacking engagement and outcomes. He concluded that there were three reasons this was the case. Number one: Most Americans don’t wake up saying “I want to be well today”. When faced with the choice of short term pleasures like chocolate cake or long term risk of Diabetes, the choice for many is pretty clear. Secondly, Clayton saw that data paralyzes people. Despite over $1B spent in wearables, we know that the life of most device is measured in weeks or months and that once you have collected baseline data the information ceases to be interesting. The other, possibly most critical thing that Clayton observed, is that the industry was focused on depersonalizing the experience through apps and automation and what was really needed to drive long term behavior change, was a relationship between humans.
Enter Dr. Lee Hood, Presidential medal of science winner and industry luminary, who Clayton had been wanting to back for some time. They met for lunch and Lee exclaimed “We are going to launch and new industry, called Scientific Wellness and I want you to be the CEO”.
First, came the prototype. You heard about this in depth in Nathan Price’s speech yesterday, so just a quick reminder….
We call our participants Pioneers and Lee’s vision was to take millions of data points from an individual; including their full genome, deep blood work with over 80 anilities, a saliva sample to test cortisol, gut microbiome and to monitor ongoing lifestyle choices like sleep, diet and exercise. All this date formed the basis of a personalized dynamic data cloud, which would form the basis for the study.
Our goal was to see if we could:
Identify transitions
Test the coaching model
Establish a set of scientifically validated metrics for wellness
So lets pause here…..let me ask the audience a few questions….
What does wellness mean to you? Why is it important?
Here’s what the results looked like when the data came back. 90% of our seemingly healthy individuals had some form on nutritional deficiency. 70% presented markers that indicated they were trending towards chronic disease and 5% were carrying diseases they didn’t know they had.
We are not in the business of diagnosing disease, so when our physician identified serious issues, they immediately send the Pioneer follow up to their physician. For the rest of the population, they focused on behavior change and here were the results.
Let met tell you a few stories that will bring the data to life.
Alicia is a working mother of school age children, who has struggled with her weight. When she went into the program, our coaches identified she had a polygenic profile that indicates a high probability for obesity. Alicia had been doing whatever she could to lose weight. She was following conventional wisdom and basically eating boiled rice, vegetables and grilled meats. She was also trying to do as much aerobic activity as possible. When our team dived further into her genetic makeup, they identified genes that suggested she was better off doing strength as opposed to cardio exercise and the carbohydrates she was consuming were halting her weight loss.
Finally, a they really interesting case of our own CEO, Clayton, who was training for Ironman Canada at the time of the experiment. He was convinced he was going to be the healthiest person in the program. His test results came back that he was pre-diabetic! Ends up, he has a genetic marker that does not allow him to process large quantities of protein or fat, but his body turns carbohyrates into jet fuel. So the Paleo diet, he was so religiously following as an athlete, was totally wrong for him.
These and many other stories form the basis of how Scientific wellness was born.
Scientific wellness now trademarked to Arivale and search engine optimized.
We launched in Seattle, just over a year ago.
Our business model includes three elements. We engage participants as individuals, we have several employers that have gifted or subsidized the program to their employees and we have preliminary interest from industry to use our data as for research and our IP to further their own science.
We assembled a team of exceptional scientific minds, including Ralph Snyderman, the father of personalized medicine, George Church, who is right up there with Lee for his contribution to genomic science and Eric Topol….author of “The Patient will see you Now”. Eric was so excited about Arivale, becuase it was the commercialization of his ideas from so many years of resarch and writing.
We locked in key partnerships with a whole bunch of companies, who play a key role in our program coming to life.
In the first wave, we recruited 1000 paying Pioneers from the Pacific North West.
We made the dashboard easy to read and interactive, so Pioneers can see their action items and step count in a seamless way.
The app helps with coach interaction and ongoing support.
And the community allows people to connect with each other to share stories and progress.
These are the results that we are seeing. Off the charts engagement, all the way into the 12th month.
Satisfaction metrics that are unparalleled in industry.
