Andy Coravos, founder of HumanFirst, recently acquired by ICON, discusses her journey in the industry, sharing insights on leveraging digital health technologies and wearables to manage chronic conditions. Drawing from her recent Lancet Digital Health review, Coravos highlights the potential of smartwatches and fitness trackers in improving patient outcomes and easing the burden on healthcare systems.
What initially inspired you to pursue a career in Life Sciences, and how has your motivation evolved over time?
With a dentist father and a nurse mother, healthcare has always been ‘in my blood.’ That said, my unease with literal blood meant that direct patient care wasn’t in my future. My calling in tech and life sciences has still allowed me to contribute to human health in a meaningful way, helping to transform healthcare delivery and improve lives from a different vantage point.
My professional experiences in life sciences and the health tech industry started with a McKinsey consulting project I was staffed on for the Centers for Medicare and Medicaid Services (CMS) in Arkansas, where we focused on transitioning from a fee-for-service model to a value-based care system that incorporated risk-sharing components and was the first time I could use my Machine Learning and software engineering background in practice. This experience introduced me to the shortcomings of our country’s existing incentive systems, which do not adequately reward preventative care. I began to envision how a systemic change could better support prevention and ultimately improve patient outcomes.
This line of thought led me to an interest in clinical outcomes, and I became fascinated by the challenge of not only improving outcomes, but also measuring them more effectively – because if you’re not capturing the right data, how do you know if you’re affecting real change? This led me to explore the potential of digital biomarkers and clinical outcome assessments (COAs) in healthcare and specifically, in the clinical trials process where life saving treatments are created and tested. Using phenotypic data that is easier to measure and analyse, it is possible to develop better medical products and create a more responsive healthcare system.
What aspects of the HealthTech industry are you most passionate about, and why do you believe this field is crucial for the future of healthcare?
I believe in the potential of technology to personalise and democratise healthcare. The current healthcare system is full of inefficiency, creating an opportunity to streamline processes and ease patient burden through innovative technologies, ultimately improving outcomes and reducing costs.
I’ve been interested in building incentive systems that would allow patients to receive the right treatment tailored to their specific needs. This involves using data analytics and Artificial Intelligence to provide personalised treatment plans. By bringing more technology into patients’ homes, researchers can offer clinical trials in natural environments, which not only enhances comfort and convenience but also leads to better adherence to clinical research and improved medical products.
Another interest of mine is making research more accessible to a broader population. In our current system, access to clinical trials is often limited by geographical and financial barriers. Through telemedicine and digital health platforms, researchers can democratise access to clinical trials, ensuring that everyone, regardless of their location or socioeconomic status, can participate in the development of new medical products.
Throughout your journey with HumanFirst and its eventual acquisition by ICON, what are some of the most significant lessons you’ve learned?
One of the most critical lessons for me has been ensuring that the market I am targeting is sufficiently large and that the decision-makers purchasing our product have the requisite span of control. I learned that a product must fit into a larger narrative that resonates with the market’s evolving needs and priorities, and that it is not sufficient to have a stand-alone solution; the product must be part of a bigger story that the market is already engaged with or moving towards. Thankfully, the industry was increasingly adopting digital health technologies and digital biomarkers in clinical research, and HumanFirst was at the forefront of building a solution to capitalise on this trend.
And now, as part of ICON, we have the opportunity to drive this even further, and support sponsors with their needs to deploy better and more effective precision measurements into more clinical trials and to optimise protocol designs. That’s exciting.
What were the biggest challenges you faced while founding and growing HumanFirst, and how did you overcome them?
One of the biggest challenges HumanFirst faced was gaining attention and building trust in a highly regulated industry. In a market where established players dominate, it can be difficult for a new entrant to make an impact, especially smaller stage companies. We overcame this by focusing on the science behind our solutions. We ensured our technology supported scientific principles, rather than letting the technology drive our approach. This emphasis on scientific credibility resulted in 21 peer-reviewed papers with experts from leading institutions like Harvard University, Duke University, and the National Institute of Health, which in turn helped us garner trust with pharmaceutical sponsors – I was proud of this vast scientific output even at a commercial stage when our team was fewer than 50 people.
And finally, something I’m really proud of is the processes we initiated to help our team maintain focus and drive progress, which can be a significant challenge in fast-moving startups. We implemented organisational processes called Tours of Duty (TODs), where for each teammate, we defined a mission, a set of responsibilities, and the outcomes and key results (OKRs) they were responsible for. TODs helped us maintain focus and drive progress in an environment where any single teammate can wear multiple hats and helped us align our team around common goals and measure our success effectively.
Based on your recent research published in The Lancet Digital Health, what key improvements do you believe are necessary for the HealthTech industry to better serve patients with chronic respiratory conditions?
My co-authors (Dr Jessilynn Dunn, Dr Manuel Fanarjian, Dr Geoffrey Ginsburg and Dr Steven Steinhubl) and I believe it is crucial to invest in validation studies for early-stage technologies. These studies are essential to establish the clinical efficacy and safety of digital health technologies, particularly focused on assessing the impact of DHTs on health outcomes, quality of life and overall healthcare costs. Rigorous validation helps build trust among healthcare providers and patients, ensuring that these technologies can reliably support the management of chronic respiratory diseases.
The abstract of our research highlights the limitations of current care systems for chronic respiratory conditions, which are often centered around scheduled appointments. These systems fail to accommodate the unpredictable nature of respiratory conditions, which can change rapidly. Home-based DHTs offer a promising alternative by enabling continuous monitoring and personalised care, but validation is critical.
What are the biggest trends in digital health technologies (DHTs) and wearables that you look forward to seeing expand, and how do you envision these advancements impacting patient care in the next decade?
I hope to see an advancement in measuring what matters to patients. We’ve been at the forefront of this movement, tracking over 18,000 measures from more than 3,600 DHTs across 1,3000 medical conditions. We’ve also partnered with organisations like Mapi Research Trust to develop robust ontologies. These ontologies enable researchers to compare disparate tools that collect complementary or related outcomes measures, resulting in research that is tool agnostic and rather, focuses on which measurements are most meaningful to patients.
Another trend I hope expands is the growing emphasis on personalisation in healthcare through the use of wearables and DHTs. These technologies enable continuous and real-time monitoring of patients’ health, providing a wealth of individualised data. This data can be used to tailor treatments and interventions more precisely, improving outcomes and enhancing the overall patient experience. With better measurement tools and personalised data, we can optimise clinical trials, ensuring they are more representative and effective. I believe we’re on the cusp of a revolution in bringing truly patient-centered treatments to market, and I’m thrilled that organisations like ICON and Mapi Research Trust are leading this movement.