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- Welcome. I'm Ashley Van Zeeland. Our guests for this fireside chat have both become champions of innovation in healthcare by identifying needs and striving to fulfill them. However, occupationally, they couldn't be more different. Kimberly Wilson is a seasoned media professional, entrepreneur, and professor. After more than a decade of serving communities of color, she grew frustrated with the lack of resources, access, and opportunities for black and Latinx populations. That's when she founded HUED, a healthcare engagement solution that connects patients to culturally competent healthcare providers. Racquel Bracken is a partner at Venrock, a venture capital firm that has helped build some of the world's most disruptive and successful companies. Racquel focuses on pharmaceutical and biotech investments as well as company creation. She currently serves on the board of Cyteir Therapeutics, Prothelia, and Federation Bio, a company she co-founded and initially served as CEO. Thank you both for joining us. Each of you are at different points in the continuum for being champions of innovation in healthcare but what you share is this ability to have the vision and see an unmet need and really drive action to meet that. And so I'm hoping that you can share a little bit about each of your own experiences in those spaces. So Racquel, when it comes to early-stage deals, you know, how do you evaluate opportunities for unmet clinical needs? And can you give us some examples about how that process works? - Sure. You bet. So, you know, when a new idea, whether it's a kind of fully formed deal with a team or an idea coming out of academia, comes to Venrock, the first question we think about is, you know, is this a business that is going to be one that's meant to last? Does it change something, you know, for myself, I focus on therapeutics investing, so is it going to change the standard of care in some meaningful way in a patient disease area that is currently underserved? But the other side of that coin is, is this team or is this idea coming out of academia, you know, are they going to be able to kind of, we think about walking the knife-edge, so walk the knife-edge for 10,000 steps and navigate all the twists and turns of drug development and staying ahead of competition and really trying to get a therapy to patients, frankly, as quickly as possible because it's a patient segment population that is absolutely in need? And so those are a couple of things that we think about. But the thing that gets, I think, tricky about being an early-stage venture is really great ideas, the ones that end up really moving the needle for patients, are ones that today we all think are impossible to solve. When we think about that at Venrock, we always, you know, there's a lot of reasons to not do a deal or not be in a space, especially one that's as daunting as, you know, hey, nobody's done this before. And so one thing we always try to come back to is, what's the glimmer of greatness? Like, if this works, what does that enable? What does that mean for this patient population? Does this mean that this is a cure? And I think that kind of brings us back to, you know, how this can be a revolutionary approach. - That's really fascinating. And, you know, on that line of impact to specific patient populations, I'm gonna shift over to you, Kimberly, you had a really unique experience and it was your own direct experience that illuminated a critical unmet need in the healthcare delivery space that created HUED. And so maybe you could tell us a little bit about that and how that platform came to be. - Absolutely. So you kinda said it exactly. I was a woman of color who had to navigate the healthcare space. I did not have a healthcare background. I didn't have a technology background. I saw a problem and wanted to develop a solution that really would have been a fix or a solve if I had had a platform such as HUED when I was going through my own healthcare journey. In 2017, I was diagnosed with uterine fibroids. Fibroids are benign tumors that reside within a woman's uterus, and very common. Many women have them. But for black women specifically, up to 90% develop them by the age of 50. So if we think about it, it is a black woman issue or it is a cultural issue that exists within our population. Unfortunately for me at the time, I lived in New York City and I was in and out of the hospital over a period of six months. I had developed over 30 of them and they impacted my quality of life. And during that time, visiting four different providers, all of whom were white men who either dismissed my pain altogether or stated that removing my uterus and having a hysterectomy was my only option, I was completely traumatized by that experience. And it wasn't until the recommendation to, maybe you should see a physician of color, maybe you should a black physician who understands your cultural, your mental, and just your physical needs overall, that I received the culturally competent care that I needed and deserved. The twist to that is the provider that I was able to find and see was in Baltimore. So I lived in New York and I had to travel to Baltimore, Maryland. I shouldn't have had to travel over 200 miles for a doctor's appointment to find culturally competent care. So I started HUED initially just as a database for patients of color to be able to find physicians of color. Where we've kind of transitioned is thinking about health equity overall and recognizing that when you account for 105 million people in this country who identify as black or Latino, there are not enough physicians who also identify as that to meet the demand of the population. So what we have been developing is thinking about cultural competency overall and how we can shift to focus on health equity, addressing implicit bias, and how we can train physicians on how to identify needs for any type of patient no matter race or ethnicity or even gender or sexuality or all these things that really are a part of the patient care journey. - So I think that point about health equity is critically important, especially as we think about this next era of personalized medicine where we have just incredible tools that we can start to bring to bear and so whether that's digital platforms where you can start to connect communities or it's massive genomic datasets or it's AI tools that can start to crack, you know, the complexity of biology or new innovations coming out of academia, Racquel. You know, I think it's important to hear from each of you what are those imperatives that we need to keep front and center in mind to ensure that all of that innovation has equitable access and application to different populations as we move towards precision medicine. So maybe, Kimberly, I'll start with you. - Yeah, absolutely. The one thing that I wanna emphasize and make sure that we point out is oftentimes we have conversations around equity but people use equality interchangeably and equality and equity do not mean the same thing as it relates to healthcare and the patient population. Equality is applying the same standard of care to every patient no matter their race or their ethnicity or their gender or any of these other factors, while equity is giving personalized care tailored to patients, you know, when you think about social determinants of health, from geographic to economic, all these barriers that exist which don't allow patients to have the same level playing field. We are not fighting for healthcare equality. We are really fighting for healthcare equity. We really have to center around the personalized journey of a patient overall and ensuring that their needs are being met in a tailored way. We are focused on the psychological factors as it relates to that patient journey and there are a lot of social determinants of health but where we're focused on specifically, we think about the history of the healthcare system and how patients of color have been impacted for decades and generations, quite frankly. When you focus on psychological, you kind of hit those things, fear and distrust and comfortability, and barriers that prevent populations of color for even seeking out care that is necessary. And the reason I wanna emphasize the psychological, because when you think about African Americans not being accounted for in healthcare genetic research, when you think about lack of African American participation in clinical trials, a lot of it is rooted on the psychological barriers that have existed within the healthcare system. So we're not being represented on the backend when we talk about researching and developing solutions for these populations. So we are trying to build health back into the healthcare system overall because you can't have one without the other. And when we think about genomics and just research overall, you have to move the industry forward to ensure that these patients are comfortable, to ensure that they have trust, and to ensure that they are going to be more proactive about taking care of their health instead of reactive. - I think those are fantastic and insightful points, especially around really engaging in that discovery process where we have historically had, you know, populations that may not have been as representative of the populations that we want to deliver care to. I think that that's very true and so starting at the root, I love how your platform is doing that. Racquel, you know, from your perspective, how do you think about inclusive innovation and, you know, having equity in all of these fantastic opportunities for the future? - You know, I come from the oncology side prior to being on the venture side and the way that we used to sort of treat cancer patients was, you know, a lung cancer is a lung cancer, all tumors are the same. Everyone got the same sort of treatment regimen. And what we now understand because of fantastic advances in our biology understanding, as well as other things, is that, you know, not all lung cancers are the same, there are different drivers of disease in different patients, and, actually, what we need to do is tailor our therapeutics for specific sort of underlying, either genetic mutations of somatic mutations. And what we've seen now on the cancer side, and I think we'll see this in autoimmune disease, in CNS disease, is a much more tailored approach. And so, again, just building, I think, on Kimberly's point about sort of access in the healthcare system, I think we actually see that mirrored on the therapeutic side of things as well. The other thing I'll say is that Kimberly also mentioned access to great care. I just wanna highlight, also, access to clinical trials. There has been great inequity when it comes to the types of patients that can access clinical trials because, frankly, not everyone can travel to MD Anderson in Houston or to the Hutch or to MSK and get state-of-the-art cancer treatment. And one thing that we've really been trying to do with a number of our companies, especially given sort of this genetics lens that I think this field, the oncology field now has, is there are companies now that are going into community sites and are able to mine electronic health records and find patients that have these specific mutations that they've been tested for and may not be aware that there are clinical trials for that specific mutation, et cetera. So I think we're, again, we're a long ways off from this being perfect but I think we're starting to make some headway in terms of giving access to these really cutting-edge therapies. - So it's really interesting, as I hear both of you talk about ways to have greater equity in application of these fantastic technologies and it's almost, you know, getting down to precision and personalized medicine requires looking beyond the typical places that we had before. So maybe this is something that with each of your unique backgrounds and experiences you could comment on what you think drives success in this sphere, along those lines. - You know, I think on the innovation side of things, for us, it's honestly about sort of figuring out the best ecosystem to tap into creative minds. One of the things that we've really been trying to do at all of our companies is make sure that we're recruiting talent that's not just sort of diverse in, of course, gender, ethnicity, background, et cetera, but also a diverse set of expertises. So, you know, we've got folks now in our companies that come from the computer science and data science side of things because, I think, as we all appreciate, on the amount of data that, you know, sequencing genomics, that, frankly, CRISPR and gene writing and editing technologies can create, requires different skillsets. You know, we also have folks that, frankly, come from much more clinical backgrounds, can liaise with patient advocacy groups to help us, again, picking up on one of the threads that we just talked about, sort of access patients that wouldn't otherwise get these types of new therapeutics. That's been incredibly helpful. But I think that the other part of the innovation machine that we try to really find out there in the entrepreneurial ecosystem is just the ability to kind of move fast. I think folks who like to move fast, who like to innovate, those are the types of folks that really are kind of the jet fuel for our companies. - You know, it's interesting, too, to think about how you support those entrepreneurs in that broader ecosystem and the different skillsets that you mentioned. And Kimberly, you're a founder and entrepreneur, how has the community and the ecosystem kind of supported your journey? - That is a really great question. So a few things, and I wanted to jump back because you mentioned, how can we sustain an inclusive ecosystem? And I think it ties back to founder journey and how we're finding success. First and foremost, to create an inclusive ecosystem, I think a few things need to happen. The first is, you know, we have to get real about what's happening now. You know, I have lots of conversations with physicians and clinicians and healthcare stakeholders and before 2020, I think 2020 changed the game for everybody, there was a lot of shock that, you know, health equity was needed in the way that it really is needed and I think obviously we know that a pivot and a change has happened over the past year but I think that there has to be a lot more recognition and a lot more honesty that takes place in terms of exposing and recognizing what is happening. I think health equity is a buzzword, quite frankly, but I think that there needs to be some journey mapping as to what is going to happen within the next three years or five years because a lot of these issues are rooted deeply in our healthcare system and we need to really strategically plan how we are going to move the needle forward. In terms of our company and how we have built community, I think a lot of our success has come from collaboration. It has come from partnerships. I think it has come from stakeholders really recognizing how deeply important the work that we're doing. Quite frankly, we've had partnerships with Unilever and other brands who really take this work seriously and I think in order to continue to be successful, I think a lot of community-based programming, I think a lot of collaboration needs to continue to happen, and I think having the resources and having the investment of larger-scale companies is really going to continue to move us. - Well, I applaud what you are pushing for in the healthcare system. I think your story is just incredible. Well, thank you both so much for this incredibly engaging and enriching conversation. I really appreciate all of your insights and certainly has given me quite a lot to think about as we consider being much more inclusive in our innovation pipeline. And I hope you all enjoyed this as well and looking forward to continuing the conversation throughout the rest of SPARK.