This week I did a collaboration with The Generalist. The Generalist is one of the few newsletters I read end-to-end every time because it’s important to learn how things work in normal businesses to understand which lessons/strategies can be imported to healthcare.
We did this a few weeks ago for the first batch of 6 ideas. Here are some more.
Enabling the bioeconomy
Services and infrastructure to catalyze biopharma
With any technology or engineering breakthrough, the final product is always a result of outsourcing, and specialization of labor. Biopharma is no exception. While this has traditionally taken the form of CROs, the new biological stack requires more.
We are still at the early stages of functionally engineering biology through reading, writing, and editing. Synthetic and data-driven approaches to biology have necessitated large-scale testing and experimentation at an unprecedented scale. Faster, less expensive, more accurate biomanufacturing would dramatically increase the rate at which researchers can design, build, test, and iterate biological systems. Thus accelerating the development of vaccines, gene and cell therapies, molecular engineering, and cloning, with practical applications translating to a wide variety of industries such as drug discovery, pharmaceuticals, food and agriculture, chemicals, and energy production.
At Alix, we believe that the biological revolution is here. We’re keen to support the rapid expansion of research and development. One thesis we are particularly excited to invest in is what we call the Biological API Layer: service and infrastructure technology enabling the bio-economy.
— Chas Pulido, General Partner at Alix Ventures
Giving rural patients access to supportive care
Despite advances in medicine, maternity care has been characterized by rising costs and declining outcomes in the US. Maternal morbidity rose 26% from 2000 to 2014. Racial disparities remain prevalent, particularly across vulnerable or low-income populations. Additionally, modern hospital maternity care practices have reduced the availability of an attending nurse to remain with a mother during labor.
Doulas are trained to provide physical, emotional, and informational support to women during labor, birth, and in the immediate postpartum period. While studies have shown doulas result in positive maternal outcomes, particularly in low-income populations, such services are primarily uncovered and rely on cash payments, leaving low-income and higher-risk individuals without support.
Why not leverage technology to emulate the experience of receiving bedside support to deliver physical, emotional, and informational support to these vulnerable populations and under-served markets during labor? The COVID-19 pandemic has incited the use of telemedicine across multiple birthing centers. Given the demonstrated efficacy of virtually-delivered bedside support, a tech-enabled service, paired with a digitized educational and emotional support platform could enable vulnerable hard-to-reach patients to access doulas and supportive care during birth.
Male birth control
Safe, effective, and reversible male contraceptive solutions
Whether it’s a daily pill, an IUD, an implant, or a shot, birth control is a regular part of most adult women's lives. Why isn’t it as big a part of men’s? Men today have just two viable options: condoms or vasectomies. Condoms have a very high dissatisfaction rate, and vasectomies are permanent.
Research efforts on novel male birth control solutions have started and stopped repeatedly over the years, and there have been reports of a male birth control pill becoming available, since the early 1970s (yes, 50 years ago). When one trial was halted in 2016 due to a concerning rate of negative side effects, many women were puzzled because the side effects were the same as those that women have dealt with for decades (as it turns out, it was not that simple, but still fascinating!).
Contraline is one example of a company that has sprung up to commercialize a new form of male contraception, but given the scale and importance of the problem, I would love to see many more companies taking this on with a broad range of approaches. Men deserve choice, just as women do.
In the US today, 45% of all pregnancies are unintended. Safe, effective, and reversible male contraceptive options would help reduce unintended pregnancies, shift some of the burdens of birth control off women, and provide men with more control over their reproductive health. A triple win!
A better search tool for FDA.gov
The majority of useful information on the US Food and Drug Administration (FDA) website is buried in a lengthy PDF. For example, Summary Basis of Approvals (SBA), communications between the Agency and Pharmaceutical companies, and FDA Guidance Documents are all deeply buried.
The search bar on the FDA.gov website lumps all its results together and does not allow a user to search by product, date, or result type. Most importantly, the search bar on FDA.gov or any other search engine does not allow users to quickly find specific content hidden in any of the large regulatory documents. A better search tool for FDA.gov would use text recognition to convert the thousands of PDF documents into a readable format. That would generate a more useful search output for drug developers, clinicians, and researchers.
Nike for those with chronic diseases
Products designed to create a more comfortable life
More than 40% of Americans are living with a chronic illness, which often leads to significant changes in access to normal activities such as travel. A diabetic may be hesitant knowing he or she will have to deal with the complexity of traveling with insulin, syringes, meters, and backup supplies that must be kept cold. An individual with Parkinson's disease may rely on complex, expensive equipment to stabilize tremors; the idea of packing it all up, being stopped at TSA, keeping everything safe, and getting on a plane can be daunting.
I think there’s room for a company to focus on building for the chronic illness community, centering its value proposition around performance, much like Nike. This company would create product lines for specific chronic diseases, facilitating access to travel, exercise, and other normal activities. Some examples include:
Suitcases. For a diabetic, it is crucial to have cold compartments for medication and protected space for delicate and expensive supplies.
Exercise belts and backpacks. Standard running belts, for example, are not built to carry a glucometer or insulin pump.
With 140+ million people suffering from chronic illnesses and 75+ million with multiple, the market is large and the desire is there for products that fit each individual's lifestyle.
A product for non-masochists
Anyone that’s worked at a healthcare company has been through Standard Operating Procedure (SOP) hell at some point. Many times these SOPs live as separate word docs that are semi-scattered all over the place. They’re also a pain to make, with redundant language put into each one.
A more modern platform that helps build and manage SOPs would have some of the following features:
Github-like ability to set up review systems for changes before pushing to the main version of the SOP with extremely tight version controlling (similar to pull requests and code reviews).
Write with Markdown — it’s 2021, get with the program.
Variables and concepts that interlink across SOPs so if you change one of them in a central place, it updates everywhere.
Auto-fill for common concepts that are repeatedly used from past SOPs or well-understood protocols within healthcare.
Mobile friendly version that you can quickly pull up if you’re not near a computer, and really well-executed search so you can find the right SOP at the right time.
Analytics around SOPs as a whole (which ones get opened the most, which parts of the business currently have the most SOPs, etc.).
One cool thing a business like this can move towards is meta-analysis of sharing best practices across business on the platform, e.g. which SOPs are missing based on the kinds of SOPs businesses like yours tend to have, etc. Or, similar to Notion, have a marketplace where people sell SOP templates where you simply match the variables within their SOP template to your variables internally. Both of these should instill confidence that using an SOP on the platform is likely to meet a quality threshold necessary to pass an audit.
In the end state, you speak into a microphone and voice-to-text + GPT-3 (trained on every SOP in the world) spits out a well-structured SOP designed for your business.
IDK just please let us stop wasting hours making these things. I’m begging you.
P.S. if you end starting one of these companies (especially mine), I do a lil’ investing on the side
If you’re enjoying the newsletter, do me a solid and shoot this over to a friend or healthcare slack channel and tell them to sign up. The line between unemployment and founder of a startup is traction and whether your parents believe you have a job.