Archive for the ‘Our Views’ Category
While the word “revolution” is used often during a period of rapid, intense innovation such as the one we are currently experiencing in healthcare, it can be helpful to step back to see what’s sparking the revolution. The answer may lie in the word, “frame.”
From a medical or scientific student’s traditional lessons in genetics (specifically, frame shift mutations), to changes in our perspective on a problem, frames make very significant impacts. Defined as a conceptual structure used in thinking, a frame helps us give an issue or problem borders, shape and structure.
This cognitive tool, while useful for our brains, also creates limitations. The linguist George Lakoff points out that every word in our language evokes a certain frame. And once evoked, other words reinforce that frame in our minds, until the image or concept is so strong that we can’t see through or around it.
Shifting Cognitive Frames to Foster Innovation
In her new book, InGenius, Dr. Tina Seelig, Executive Director for the Stanford Technology Ventures Program (STVP) at Stanford University’s School of Engineering, points to several ways to shift our cognitive frames to foster innovation. Frame shifting can come from trying to see an issue from several points of view. For healthcare, one could ask how a scientist looks at a new drug, versus how that drug may look to a family physician, surgeon, patient, family member, or child. Still another source of shifting frames (and revealing innovation) is the question, “why?” Seelig points to a continuous series of questions that start digging under our assumptions about an issue. In healthcare, for example, this can come into play in certain surgical procedures, where asking “why insert clamps manually?”, then, “why have clamps at all?” can start to lead to innovative treatments.
Getting back to the work of Lakoff, while his examples focus on politics, the pluses and minuses of frames and ways to use them are quite relevant to healthcare innovation. In digital health, some of these shifts are already happening; the smart phone can now be a diagnostic device, as well as a sharer of data. And many, if not most other areas of healthcare are seeing the benefits of taking tools from somebody else’s toolbox. For example:
- In the 1960’s, surgeon Lazar Greenfield worked with a petroleum engineer to design two new devices, intended for heart surgery. The first, the Greenfield Surfactometer was used to measure lung surface tension (which measured pulmonary surfactant, thought to contribute to pulmonary embolisms). This invention wasn’t used in the operating room for long, but it turned out to be a very good way to monitor water supplies for detergents.
- Greenfield’s second invention, the Greenfield Filter, trapped blood clots in a way that reduced problems arising from damage to the inferior vena cava. Again, Greenfield worked with an engineer, who saw parallels between blood clots and sludge in a buried pipeline. The filter has since been used in more than 600,000 patients.
- Today, the annual “Pumps and Pipes” meeting in Houston brings together cardiologists, cardiac surgeons, and petroleum engineers to address challenges in heart disease as well as the oil and gas industry (in both cases, we are talking about plumbing and drilling through cylinders, after all).
All three of these examples underscore the importance of frame shifting. Frames surround us, but so does innovation. In order for any healthcare revolution to flourish, we will need to make sure that our frames let us focus on new ideas and ways to solve health problems, rather than shutting down our vision.
At Popper and Company, the diversity of our team lets us shift frames to open innovation’s doors in ways that can even surprise us! We can help you create new strategies to help get your healthcare solution—and company—shifting in the right directions. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: cognitive frames, cognitive tools, healthcare, healthcare innovation
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Today, Medicare is releasing data on in-patient hospital costs across the country to provide consumers/patients with cost comparison information. Unsurprisingly, the data are interesting and price discrepancies staggering, but the release of the data itself is also fascinating as yet another example of big government opening its vaults, so to speak, as well as adding more momentum to the power shift in healthcare from physicians/providers toward consumers/patients.
This move clearly speaks to the idea that access to information can drive behavior/decision making and that access to cost information can harness the power of the medical consumer to drive costs down.
The team at Popper and Company has focused, since the firm’s inception ten years ago, on technologies and services that improve quality and decrease cost in healthcare. We believe that three big trends at play today clearly support this:
- “Consumerification” – the rise of the power of the consumer;
- Access to information, and
- The convergence of technology from other industry segments (e.g., Telecom)
As I asked in an earlier post, is the U.S. consumer ready for so much service choice (or, in this case, so much information)? Where does the responsibility for consumer education fall? To stay on top of healthcare trends, particularly those related to the rising power of the medical consumer and the convergence of technologies, subscribe to our newsletter and follow us on Twitter. I’d also love to hear from you directly.
Tags: healthcare costs, medical consumer, medical technology, Medicare
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When seeking healthcare innovations, it’s traditional to look first at basic science, then clinical research, or at engineers tinkering with new devices. But this view might be a little too narrow, as advances with the greatest impact may come from industries that have nothing to do with healthcare.
Take Purell, for example. Ohio-based Gojo Industries designed the now-ubiquitous hand-sanitizing gel for auto mechanics. And it was almost a failure; mechanics and consumers alike first rejected the product as a little strange, and nobody, including the U.S. Centers for Disease Control & Prevention, originally believed that alcohol-based cleaners provided more value than plain old soap and water.
But Purell started to take off when nurses who used it in hospitals started requesting more samples. The nurses had been looking for an antiseptic alternative to stringent, frequent washing with soap and water, which was very tough on hands. Now, not only has Purell (and other alcohol-based cleaners) been approved by the CDC, it is selling by the hundreds of millions of dollars each year; Gojo even has a test hospital lab to find more uses for the cleaning gel.
What does Purell tell us about healthcare innovation? First, that great healthcare ideas don’t always emanate from healthcare industries; Purell came from a firm that didn’t have a purpose for or intended buyer audience in healthcare at first. Second, just because an innovation is a good idea doesn’t mean it will be accepted. Sanitation pioneer Ignaz Semmelweis famously demanded that his surgeons wash their hands more than 150 years ago; his advice was rejected, partly because of his own personality quirks and partly because of the harsh cleaning regimen he required. And finally, managers and leaders aren’t the only people who introduce innovation. Like Purell, other healthcare innovations have been introduced to the field by nurses, simply because the advance makes their immediate jobs that much easier.
At Popper and Company, we seek out engineers, scientists and other innovators who have great ideas, or a great clinical application for an idea. While we will first examine the innovation’s utility (will it work?), we then need to see if the innovation will be adopted and to develop solutions for potential obstacles. Some older-generation leaders may automatically be suspicious of digital health and other technological innovations, for example. Still others have been frustrated with previous “advances” that didn’t deliver as promised or required hours of training. These issues have actually become more important for introducing and adoption of a new product or service than approval by the FDA.
How do we make these innovations more adoptable? One way is to take the example of Purell—find a non-health advance that can be applied to make healthcare easier (in other posts, we’ve discussed the idea of looking beyond the “usual suspects” for innovation strategy). Another is to draw everyone into the design and conceptualization process—start asking doctors, nurses, patients and other stakeholders what they’d like to see in tomorrow’s healthcare. That way, they won’t be as likely to wash their hands of your new business idea.
Our life sciences clients value our ability to find unusual technologies from the least likely sources, and match them to existing healthcare needs. We can help you create new strategies to help get your healthcare solution—and company—moving ahead on the commercialization (or clinical study) path. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: clinical research, healthcare innovation, healthcare strategy
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On April 24, XPRIZE and Nokia announced that I was among the mobile health and sensing industry leaders named to the Nokia Sensing XCHALLENGE Judging Panel. It’s a great honor for me to take on this role – and to work with the XPRIZE and Nokia teams in helping drive awareness of this important competition and the role of digital health innovation as part of the long-awaited revolution in healthcare. To that end, I was very pleased to have the opportunity to contribute a related blog post, which was featured yesterday via Huffington Post’s Health News. I hope you’ll read the post here, and take the time to learn more about the competition by visiting http://nokiasensingxchallenge.org/, following the XPRIZE team on Facebook, Twitter and Google+, following the Nokia XCHALLENGE on Twitter, and signing up for the related Newsletter to stay informed.
Tags: digital health, digital health innovation, mobile health, sensing industry
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The traditional clinical trial (which, by the way, has been a “tradition” for only about 30 years) involves recruiting a number of people who are required to come to a site on a regular basis to participate. After the trial is over, the trial participant receives payment (sometimes) and not much else. Rarely, if ever, are results or data shared with participants.
This model is starting to show some cracks (particularly for U.S.-based trials), however, as recruitment becomes more challenging, and regulatory and liability issues require larger and more complex trial structures. But our era of the Internet, greater consumer power and a trajectory towards tailored, “precision” medicine could provide an answer: more personalized, patient-centered clinical trials. And the trials are more than just a lure for volunteers; they can change how medical research is conducted, all the way down to the results.
Clinical trial planners and coordinators might take a cue from Google. Instead of developing a solution or product and then marketing it to potential customers (Google Health notwithstanding), the company develops products based on what customers are searching for. Likewise, clinical trials should instead seek to address the question; “What do patients want?”
The Dutch Burns Foundation took this approach recently. First it surveyed burn physicians and found that practitioners wanted to see better ways to treat burned skin, or new techniques in cosmetic surgery. Then it surveyed the patients, and found a different answer. The patients wanted solutions to wound itching. Similarly, in cancer studies, survival rates are the most common endpoint, but many patients are most concerned about side effects. In this case, addressing the side effect problem might increase patients’ willingness to continue with chemotherapy treatments, a common problem in cancer therapy.
Online reporting and record-keeping will also help create more patient-centric trials. Mytrus Inc., helped Pfizer create its first “virtual” clinical trial, which included online check-ins and reporting, and electronic informed consent. Mytrus estimates that 30% of studies could be done virtually, directly with each patient, reducing the number of trial sites needed by 80%, slashing study time and costs, and easing recruitment woes.
Data sharing will probably be a large part of tomorrow’s clinical trials, too. The group Genetic Alliance launched a site Reg4All (Registries for All Diseases), which gives clinical trial participants access to their trial data. Trial coordinators can use the registry’s online platform to share data, while preserving privacy.
The computer is not a miracle worker, however. In randomized, double-blind trials, sharing data can be a problem. And it’s still important to make sure volunteers understand why they’re there, and that they won’t necessarily receive a treatment for their disease (and even if they do, it might not work). But these more tailored approaches certainly make it more possible for the patient to have a greater investment in the study.
Our life sciences clients have valued our ability to match new technologies with existing healthcare needs, including new ways to conduct clinical tests. We can help you create new strategies to help get your healthcare solution—and company—moving ahead on the commercialization (or clinical study) path. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: clinical trial participation, clinical trial patients, clinical trials, medical research, patient-centered trials
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There’s been discussion recently about a lack of life science venture capital (VC) enthusiasm for emerging digital health companies. I happen to feel that this concern, if you will, is misplaced. I engaged industry and opinion leaders on this subject plus have my own thoughts on the digital health funding environment.
In his latest article in Forbes, contributor David Shaywitz characterizes life science venture capitalists as just “kicking tires” on potential digital health investments, citing fears from prominent investor Nimesh Shah that innovations in digital health are “merely a bubble,” and that these firms lack a “real biz model.”
Shaywitz bases his position on quotes from venture capital executives, but also from the $1.4 billion that was invested in digital health last year, which he says is a fraction of all the life science VC money available. He responded to my post in the Digital Health LinkedIn group that this “reflects the uncertainty that many investors feel regarding whether viable business models will emerge.”
While $1.4 billion doesn’t look like much on the surface, it’s a jump of 46% from the year before which, as digital health company Qualcomm Life’s Rick Valencia points out, represents “impressive numbers for such a nascent industry.”
It’s also important to note that this jump (albeit from a smaller start) looks even better when compared to funding in biotechnology and medical devices, which is down 15% and 13%, respectively, during the same period of time. These figures indicate that life sciences VCs are in a state of general paralysis, or at least lethargy.
One possible issue with the nascent digital health industry is that it’s not an obvious fit for life science investors or venture capital firms. First, it’s not the same as healthcare IT, which is already a source of confusion for a few investor firms. Second, it’s the convergence of many sectors and technologies—wireless sensors, devices, genomics, social networking, mobile technology, the Internet, consumers, and, yes, healthcare IT. As Rick Valencia wrote, “digital health investments have the legal and regulatory complexities of life science investments, but the business models and investment horizons of tech investments. So, neither the tech VCs nor the life science VCs are naturals for digital health investments.” There are often many nuances unique to each digital health startup—it’s not a one-size-fits-all market—which presents a learning curve for potential investors, whether they’re already investing in digital health or not. In other words, it’s difficult to leverage cookie-cutter investment strategies.
Marc Newman of TeleCenter points to other emerging areas of digital health that could be revolutionary, if allowed to mature. Marc highlights “omics” companies, which optimize low-cost sequencing, big data and artificial intelligence outfits to “enable patterns to be recognized from sensors and point of care measurements,” and phenotype assessments and matches to genotypes. Marc eloquently states that “The risk is high, but the valuations are low, and the market opportunity is large.” This scenario used to excite early-stage investors.
It’s said that time and cost are innovation’s enemies. We now stand in a place where we can potentially benefit from the reduced time and cost that are part of innovations in digital health, as some distinct categories emerge and partnering strategies open up opportunities to scale. But we also stand in the middle of complex regulatory approvals and longer time horizons that have become recognized as “normal” in healthcare. Like most truly disruptive innovations, funding and innovation require alignment but are often not the simplest of propositions on either side of the equation.
Could your company provide an extra step of certainty in this new market? We can help you create new strategies, ideas, and inventions to address unmet needs, and help position your company (and its products) in a more “definite position.” To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: digital health, digital health investments, emerging digital health companies, venture capital
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For many new and growing companies, it’s not enough to have a plan for identifying strategic partners. You also need to successfully implement the plan—and that’s often easier said than done.
Reaching your company goals will no doubt require more capital, perhaps new investors to inject that capital, more third-party involvement, and probably a partner to help with product commercialization. New outside stakeholders add another dimension to your goals; now you’ll need to see how your product/service fits into someone else’s strategy.
How do you find the right fit? The answer actually lies in getting creative in a way that expands the universe of potential partners.
For a company developing a new diagnostic marker, for example, the initial list of possible partners is familiar looking. Those likely to have an interest in the new product would include large diagnostics, pharmaceuticals, and biotech companies developing treatments for whatever your marker could diagnose. But these “usual suspects” are barraged with offers for partnerships and requests for financial assistance just like yours. Adding to this fact is that healthcare product development and technology innovation is risky, requires a long time horizon relative to many other investments, and is more capital-intensive than most other industries. In a perfect world, the usual suspects would always be interested. In reality, that rarely happens.
This is where creativity comes in, where it helps to leverage a mix of diverse perspectives to discover not-so-obvious partnership possibilities. As an example, recently we’ve been developing a business development strategy for a company with a product in the emotional wellness field. Wanting to go beyond the “usual suspects”, we asked, could a very different type of partner be interested? One possible answer: Starbucks. While Starbucks is of course known for coffee, they also spend a good deal of time thinking of the customer experience, which ties into emotional and mental states of mind. In addition, the coffee company probably isn’t getting a lot of partnering requests from medical innovation companies – thus, less competition for our client.
The need to get creative, then, is driven by a necessity to take a lot of shots on goal. And, of course, you’ll still need to validate your creativity, to learn if the company added to your list has the interest, resources, time, and management ability to pursue a relationship with your company.
Our life science and healthcare clients value our guidance, the quality of our ideas, and our ability to articulate a compelling vision. We can help you create new strategies to help get your invention—and company—moving ahead on the commercialization path. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: healthcare innovation, healthcare partners, healthcare startups, life science innovation, potential partners, strategic partners
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Review any drug’s development history: Clearly, the execution of clinical trials makes up the lion’s share of the timeline. To further complicate matters and extend development timelines, as more drugs are being developed on a global basis, it’s more difficult to keep a clinical trial on target with multiple sites around the world, site qualification visits, and record keeping. In fact, 80% of today’s clinical trials fail to meet one or more milestones. Fortunately, digital technologies – increasingly being adopted by contract research organizations (CROs) and larger biopharmaceutical companies – may offer a way around the limitations of today’s paper-based practices.
Recently, Johnson & Johnson, Merck & Co. and Eli Lilly & Co. announced their plans to create a database of global clinical trial sites, which would streamline any participating trial’s significant paperwork requirements. The database would contain site and experimental infrastructure details, and good clinical practice GCP records. The partners will be presenting their progress at the Partnerships in Clinical Trials meeting in April.
In addition, Acurian, the patient recruitment company, is starting to use social media networks like Facebook to find patients for its trials. For this purpose, social media seems to be catching on, at least in trials that impact a wide range of people. For a recent Phase III study for diabetes, for example, Acurian said that nearly half of its patients were recruited from a digital source, while 39% came from direct mail solicitations and 15% from television advertising. For its part, Lilly has integrated social media into pilot trials for diabetes and head and neck cancer; it claims a cost savings of more than 10% over traditional recruitment methods.
Better decision-making; streamlining processes
Sharing information on a real-time basis and making data more easily available allows for better decision-making, streamlining processes from early-stage planning and protocol development through regulatory submission to publication of clinical results. And initial resistance due to fears of violating HIPAA (the Health Insurance Portability and Accountability Act) is starting to weaken, as more companies involved in remote monitoring are using cloud computing, know that they have to be HIPAA compliant to be successful, and add safety and security features to their software services.
Digital trials’ increased efficiency doesn’t stop with databases and recruiting, however. For example, at Popper and Co., we have discussed the idea of adding more digital technology to mobile medical carts. The carts can be equipped with cameras, point of care testing kits for glucose, respiratory infections, or other lab tests. With an internet connection, a nurse can see a rash, infection, or adverse effect of a trial drug, image it, and send it to the physician. Imagine the possibilities of sending any kind of trial data from hundreds of these carts at a multisite trial.
Is your company seeking to develop a strategy to fill this critical digital gap and to develop more ways to bring drugs and devices to patients faster? We can help you create new strategies, ideas, and inventions to address true unmet needs, and give your company (and its products) a sustainable market advantage. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: clinical trials, digital gap, digital health, digital trials
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Scientists have puzzled over cognitive differences between men and women for at least 100 years. And the results of their work support the reality that should be on the minds of everyone working in healthcare; one size doesn’t fit all.
Researchers in Madrid and at UCLA recently tested men and women on cognitive tasks, including spatial reasoning, inductive reasoning, keeping track of tasks, and attention to numbers. Women, although they have smaller brains – and most importantly because of its role in memory, emotion and reason – a smaller hippocampus than men, were nonetheless better able to handle most of these tasks (except spatial), while showing less brain activity on an MRI. Thus, women require less neural material (and energy) to perform cognitive tasks on an equal level with men.
If this study holds up (other studies also point to significant cognitive differences between the sexes), its results may and should have an impact on healthcare innovation and service delivery. For example:
- At our firm we are very aware of the increased importance of the consumer in healthcare decision making. The way health information is processed by that consumer is very important. This has implications for both the device and the service interface. A consumer-focused device may be intuitive to one person, but baffling to another.
- One particularly strong area for women was in ranking and numerical tasks. New diagnostic tests often produce information that isn’t binary, but probabilistic. In this case, women might have an easier time knowing how to evaluate this information and make choices.
- On the other hand, men appeared to be much better at processing spatial information. This could play into the design of three-dimensional imaging technology, or even smartphone apps and videos.
A big question remains from studies like these; are these traits genetically wired, or more consistent with the way men and women have been trained to think? Perhaps, as Shakespeare showed us 500 years ago, things are more complicated; when Cleopatra’s complexity contrasts to Mark Antony’s hard reason, was that genetic or just the English writer’s perception of life in ancient Rome and Egypt? If it’s nature, then innovation needs to address these differences. If it’s nurture, then a wide range of other cultural differences need to be recognized.
At Popper and Company, we know that incorporating the role of the consumer is critical to successful innovation and strategy in healthcare. We can help you create new strategies, ideas, and inventions to address true unmet needs (and gender differences), and give your company (and its products) a sustainable market advantage. To learn more, please subscribe to our newsletter, follow us on Twitter, or send me an email.
Tags: cognitive testing, genetic traits, healthcare, healthcare innovation, healthcare strategy
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I originally shared this post as an announcement to the 15,000+ members of my Digital Health group on LinkedIn.
In this update:
- 15 Influencers Shaping Digital Health
- Happtique Mobile Health App Certification Program
- Making Sense of Sensors (Jane Sarasohn-Kahn on CHCF)
- X PRIZE’s Nokia Sensing X CHALLENGE – Application Deadline
- Upcoming Events: Future of Genomic Medicine VI Conference
15 INFLUENCERS SHAPING DIGITAL HEALTH
The list of 15 Influencers Shaping Digital Health (via BIONIC.LY) was compiled by London-based digital communications professional Stephen Davies, and is noteworthy because he accurately includes (as part of digital health) leaders in the field of genomics, e.g. Anne Wojcicki, Co-founder of 23andMe, and Jessica Richman, CEO at uBiome. I’m incredibly honored to be included in such esteemed company.
HAPPTIQUE CERTIFICATION PROGRAM FOR MOBILE APPS
In announcing the new “Happtique Health App Certification Program,” CEO Ben Chodor stated that “Healthcare professionals and consumers need third-party certification to verify that the app they are prescribing or downloading delivers credible content, contains safeguards for user data, and functions as described.” The new program contains standards to be used by partner organizations in assessing operability, privacy, security and content of health apps.
MAKING SENSE OF SENSORS: HOW NEW TECHNOLOGIES CAN CHANGE PATIENT CARE
Well-known health economist Jane Sarasohn-Kahn (@HealthyThinker) created this excellent report for the California HealthCare Foundation (CHCF, @CHCFNews), a nonprofit grant-making philanthropy. Note the cool infographic on passive sensors.
X PRIZE’S NOKIA SENSING X CHALLENGE – APPLICATION DEADLINE APPROACHING
Along with the Qualcomm Tricorder X PRIZE (@TricorderXPRIZE) and the Archon Genomics X PRIZE (@AGXP), the Nokia Sensing X CHALLENGE (@NokiaXCHALLENGE) being administered by the X PRIZE Foundation (@XPRIZE) is fostering digital health innovation and catalyzing the creation of a collaborative global innovation ecosystem. The goal of the Nokia Sensing X CHALLENGE is to transform personal health with sensing. Innovation in sensing is an important component to creating a means for appealing, usable, smarter digital health solutions.
The CHALLENGE is comprised of two distinct competitions running through 2014, with total prize purses of $2.25 million. The application deadline for Challenge #1 is less than five weeks away.
UPCOMING EVENTS: Future of Genomic Medicine VI Conference
Along with my Popper and Co. colleague Shane Climie, Ph.D., I’ll be attending the Future of Genomic Medicine VI conference in La Jolla/San Diego, CA (March 7-8). I’m excited to learn the very latest about opportunities for genomics to change medical practice and make healthcare more precise and individualized. I gather that the term is now “Precision Medicine.”
I’m particularly looking forward to hearing the following people speak:
- Gholson J. Lyon, MD, Ph.D.,
- Cinnamon S. Bloss, Ph.D.,
- Misha Angrist, Ph.D.,
- Daniel MacArthur, Ph.D.,
- George M. Church, Ph.D. (encoded 20 million copies of his book into DNA: http://bit.ly/ChurchColbert),
- Jonathan Eisen, Ph.D.,
- Atul Butte, M.D., Ph.D., and
- A.J. Jacobs, author of “Drop Dead Healthy”.
Note that all of the folks and organizations listed above are included in my Digital Health Twitter list: http://bit.ly/DHTwitterList. And you can access the comprehensive global digital health event list at http://bit.ly/DHEvents.
Join the 15,000+ member Digital Health group on LinkedIn to stay up-to-date on these and many of the other happenings in the digital health space. And, if you have a digital health idea you’d like to discuss, please contact me directly at email@example.com to learn how Popper and Co. can help guide your business development strategy.
Tags: digital health, digital heatlh events, genomic medicine, genomics, healthcare events
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