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023: Assembling Chaos – Organizing Global Medical Research Consortia – Scott Wagers
Unstoppable Talk Interviews

 
 
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In this 23rd episode of Unstoppable Talk I spoke with Scott Wagers, CEO of BioSci Consulting, about how he coordinates global medical research teams so that they can innovate and communicate better on their drug therapy and medical device projects.  Scott’s fascinating history of going from medical physician to international consultant (based in Belgium) is a great example of taking technical expertise in a subject and moving into the management space, where you can have greater impact through your clients.


Sam Schutte 0:00
In today’s show, we have Scott wagers. He’s with biocide consulting out of Belgium. And I met Scott at a consulting success conference in Portugal, and today we’re going to talk about designing and creating medical research consortiums. Scott, welcome to the show.

Scott Wagers 0:13
Hi, Sam. Great to be here. Thanks for having me.

Sam Schutte 0:16
No problem. So Scott, how did you get started? You have a pretty interesting career. So how did you get into it doing what you’re doing now?

Scott Wagers 0:24
Yeah, it is interesting. I mean, how it all sort of began and started, I started my career as a physician in the United States, and I really became interested in research. So I went on to did some extra training after my initial residency was a researcher and a Pulmonary and Critical Care specialist at the University of Vermont, was doing quite well, but decided to move to Belgium because my wife who I met, working in the lab down the hall is from Belgium, and we moved here was not able to take the job I had lined up because of cross cross border work permitting issues. So as a temporizing measure, I ended up helping some researchers in the area, you know, apply for grant funding to the European Union and basically make a long story short, one of those was was was successful. And it was in, he was working with one of the leaders in the field on asthma, which was the research topic I had worked on when I was in the States. And that sort of began because I didn’t have a lab or, or clinic or anything like that I ended up okay. And then you should be involved in the project once it’s funded now. And I ended up managing the consortium. And at first that was, you know, interesting. I didn’t know anything about working consortium projects. But then I became really quite interested in the whole dynamic that goes on. Because you have multiple different people from different disciplines, and even different stakeholder types, there are patients involved. There were pharmaceutical experts as well as clinical researchers, academic researchers, basic science researchers, for the dynamic and the challenge of getting all of those people to work together, to trust each other, to try to accomplish what is a big project with an ambitious goal was quite challenging. And it’s quite interesting to see that so that that sort of began the process. And then from there, I became interested in that whole dynamic and, and then just decided, Okay, instead of this being just a temporary thing I was doing because I didn’t, couldn’t take the job I had lined up. It became an interest in a career and we’ve gone on and I just the other day was adding it up. We sort of designed something like 44 consortium project. Over the course of the past 12 years, so that’s sort of how it all started was really by accident,

Sam Schutte 3:07
Yeah, sometimes the greatest businesses start by accident I find, you know, so what? What, um, so what what is the product? I mean, what kind of products are coming out of these consortiums? And what are those mean, define those a bit, I guess for our listeners?

Scott Wagers 3:21
Yeah.That’s, that’s a very good question. You know, it really comes down to it. And it’s really been something that has been developing over the past, you know, 12 to 15 years, this idea that medical research and innovation in medicine is gotten to the point where it’s so complex and so complicated, that no one group or one company, even even a whole, you know, even a small group can really make a big change that’s needed because it’s so complex. Part of that’s because we’re able to characterize complexity. What I mean by that is rabbit to understand more and more about the biology than we ever used to be able to. But then that means you need to bring different disciplines together. You know, you need not only the clinical researcher, you need the biologist with knowledge of the mechanisms, meaning the molecules that are interacting to cause the disease. You need data experts, you need computational experts you need Can you talk about pharmacologist, the list can go on and on. And people came to the realization that working alone, you know, that’s just never going to happen. You know, we’re never going to be able to make the big change we need to happen. And one of the things that that I saw a lot was that in even when I was in the US, a lot of research would happen in silos. So everybody be working on a certain aspect of asthma, but everybody has their own models for testing. It. And when you think about it, that’s really inefficient way of working, because you can’t compare across different laboratories and all this kind of stuff. So a lot of what happens in a consortium is people trying to align to focus on a big important problem in medicine, and a consortium in this context, I mean, there’s there’s a lot of definitions of consortium, but it is a group of different organizations, typically, at least three, most of the ones I have that first one was 39 partner organizations working together on a big project. And, you know, so the, the very first one that I started to work on was trying to take and understand severe asthma. You know, a lot of problems that we’re facing now in medicine is that we’ve had these perhaps arbitrary definitions of what a disease is Asthma is a great example. We say you have problems with your breathing, that’s variable. And it’s due to limitation of the airflow in and out of your lungs, you know, which can cause a wheeze, you have excess mucus production. You know, we say that’s asthma. But the reality is there are probably multiple different types of diseases that are just an arbitrary umbrella of asthma

Unknown Speaker 6:27
Sort of the same thing with cancer, I guess.

Unknown Speaker 6:29
Yeah, exactly. Well, cancer is the is the one that’s probably the move the furthest along in this on the spectrum. But the idea is, how can we understand what the different types of disease are different types of asthma. And it was very clear to everybody in the field that the typical clinical tests that you use, were inadequate, they didn’t give you enough set separation. So the idea behind this was to build a large, what we call a cohort, so a large study so we ended up being about 600 patients with severe asthma and characterizing them deeply not only in terms of their clinical measurements, so their airflow now their lungs, their, you know, different physical examination parameters, their history, also how the Asthma is affecting them. That’s the so called patient reported outcomes. But more importantly, which was quite innovative in this was to look at different parts from samples of their of their lungs are of their their blood, much like the Human Genome Project, and then genomics, but there’s a whole slew of different types of omics proteomics, there’s liquid omics, there’s microbiome, which is all the organisms that live in on your body. There’s metabolomics and in your bio print, the idea was to bring all those together, integrate those, and use that resulting data to kind of see if we can separate severe asthma into separate clusters. And at the time, which I think is an interesting characteristic, people would have said, Well, you can’t bring those types of data together, you can’t integrate them or make any sense out of that. But I think the leaders in the field that were, you know, there are, you know, kind of a sense that was possible. We didn’t really at the time we started this was now 11 years ago, or 10 and a half years ago, we didn’t really know that what the techniques would be, you know, so that’s how we got into this. That’s what a consortium project is trying to do something that working on your own, you can’t do that’s really trying to what they say shift a paradigm, right to change something in a big kind of way. That’s sort of the nature and character of these these projects. You know, another one was working on how do we organize the data out of these types of projects or I have a Recent one is going to be starting next month focused on toxicology. You know, there’s a new, whole new range of therapies that have been developed in, in medicine that are focusing on, you know, the immune system and the biological processes. The problem is trying to model the toxic or the adverse effects of the immune system, which is very complex. So, but again, like any other thing, the field was very fragmented. So this project is trying to bring some sort of structure and organization around to have a set of models, innovate on those models so that we can better predict both, you know, the safety of these medications before they actually end up in a patient.

Sam Schutte 9:51
It’s interesting, as you’re, you’re talking about, you know, everybody having their own testing models how inefficient that is. There’s I think there’s some probably some crossover reminds, you know, when you look at training AI models and artificial intelligent models, you know, the big trend there is these pre trained machine learning algorithms, right? You know, because you think about how difficult it is to train something to recognize images. And then you have to show it billions of pictures, for instance, right. And nobody can do that on their own. So you know, but if you can, if you can get that off the shelf from Google, so it’s kind of the same idea. And I imagine there’s probably some of these testing models you’re talking about are machine learning algorithms, right?

Scott Wagers 10:30
Well, that’s becoming a trend. Yeah.

Sam Schutte 10:32
You know, but if you can, as a group or as a, as a field, or as an industry define some reusable component that allows you to, like you said, model an immune system response, right. That’s a lot easier than 10 hospitals each to have their own way.

Scott Wagers 10:49
Right? Absolutely. And I also think it touches upon an interesting aspect in particularly AI does, in that what the technology is doing It’s making it much more relevant and much more possible to work together in a collaboration and kind of have that dynamic of integrating minds if you will. Because technology makes it feasible and possible and necessary. If that’s really an interesting aspect of it, sort of, it’s sort of a deeper shift into the, you know, the knowledge economy basically, or the knowledge worker, it’s really, that’s kind of what we’re seeing is a major trend towards this. Okay, you know, we can work on our own, but then now the technology is really making it so that we have to work together.

Sam Schutte 11:41
Well, everybody kind of, I guess it allows everybody to create their own specialty and focus on one piece of it rather than solving these, you know, as you mentioned, these are big problems. If you can have 45 people or 45 organizations involved they can have a very each can have a very narrow focus. Imagine.

Scott Wagers 11:56
Yeah, is there some of them have a narrow focus some of them have I think it’s more important than perspective. And what I found most interesting about it is, whenever they are talking about the project together, working together to address problems, you absolutely see that sort of network effect in that, you know, and it happens, I mean, happens weekly, if not daily, that I’m on some of these project calls. And somebody that you wouldn’t expect, has an idea for a solution to a problem. That’s actually been vexing some other parts of the part of the Consortium for some time, and you it’s somebody that maybe worked on that in the past, or maybe just applied a different way of thinking. And that’s where I think the real it gets really, really interesting in terms of the possibilities.

Sam Schutte 12:49
So So I guess, walk me through a little bit, you know, so you said you’re on these project calls. And, you know, if I come to you and I say, Okay, I want to create a consortium to you know, look at I don’t know, say lung cancer. So you’re Do you go out and find the right members of assemble those? I mean, how do you go about assembling those members? And then once you have them, are you involved in the day to day operation? Like all the project? Like you’re sort of the CEO of that, you know, or project manager or what’s your role?

Scott Wagers 13:18
It’s good question. In fact, I think, as I said, you know, I’ve sort of an accidental, you know, entrepreneur, if you will, and I struggled with a long time myself to understand what is the role what what am I doing, and, and how is that benefiting? But, you know, often it all starts out that there’s some grant opportunity, right, someone writes a big grant call topic, for example, they’re in in Europe here. There’s the EU that funds research and has a lot of focus on Consortium. There’s one, you know, branch of that called the innovative medicines initiative, which focuses exclusively on consortia where I can Patient organizations or patient foundations, or disease foundations are working with academia in big projects. And so typically, you know, what really happened in the start was that people, one of these opportunities came up, and we need some help in this right. And so what I do in that very beginning part is, is helped to bring everybody together to design, you know, strategically designed the right project, not only to get, you know, to win the the grant funding, but to have a consortium that works for it well, delivers up to its potential. You know, one of the challenges is that people can work in a consortium where you have all these different people on the same project, but still work in relative silos. So this is why I mean, I think the biggest opportunities are to think about highly interactive Consortium. And so what we’ll do is work with a core group or sometimes it’s even a fairly big group. of organizations to say, okay, what’s the problem? What are the problems you’re trying to address, and then figure out how you can address that in an iterative way. So that we actually build up and leverage the strength of the diverse thinking of the different people, different types of disciplines and stakeholders there to come up with a project that will deliver on a big shared vision, you know, so if I go back to that, you buy a pet project. You know, the, like I was mentioning, the idea was to integrate different types of data together to sub phenotype or classify severe asthma. We came up with a concept that that would create a handprint on a fingerprint, but a handprint of asthma. And that became the shared vision.

Sam Schutte 15:45
So what’s the difference between a handprint and a fingerprint? And what is terminology

Scott Wagers 15:50
It’s a bit tongue in cheek but a handprint is more, you know, I would say a fingerprint would be for example, your genetic profile would be your fingerprint. Whereas if we take a Your genetic profile, combine that with, you know, a profile all the proteins that you can measure that are acting at a certain point in time in your body with all of the microbiome, all the all the organisms that are living in and on you and integrate that together that becomes a handprint. You know, and but also maybe also combining that with clinical data. So then that becomes a much more discriminatory way of separating patients. So we did develop that concept. And then you know, a lot of that is about both dealing with all the logistical issues. Dealing with all these people getting them to talk to each other is difficult. Getting that into a good proposal into a budget. Getting that submitted is another aspect. But we also stay involved with that same approach and mindset once a project is running. to really help get people working together on a conference call or online meeting. Which, as you probably well know, can be very challenging. But yet, if we’re able to get what I say, you know, it’s getting them into a dialogue. So dialogue versus a discussion is in people actually understanding each other’s perspective and building off of each other’s ideas, to, as I mentioned before, solve problems come up with new ideas. And that’s how we get involved in the day to day is, and that’s where they become highly interactive, is having the groups work together. You know, for example, in the you bio project, we had something like 20-30 calls a month, when that was highly active. And what that does is it builds a sort of trust, understanding between the different disciplines and stakeholders. And what you can do with that then is really quite impressive in terms of trying to do these very complex projects. The way I think about it is You know, you can think of a big, okay, we want to change the way we think about severe asthma. That sounds like a major task. And, you know, we don’t even know if we can integrate the different types of data. But yet, if you stay focused on that process of getting everybody engaged, having, you know, very good dialogue, where there’s candor, you don’t shy away from the tensions in the conflict. You know, I’m confident that you can make those big shifts, you know, but not focusing on you know, how am I going to do this, but focusing on that small iterative step now, I think it’s software development, you probably have something very similar that sort of an agile mindset.

Sam Schutte 18:37
Yeah, making making some progress rather than worrying about, you know, the absolute overall progress like said, iteratively How do you find clients that you want to work whether you sort of get some folks reaching out to you, are you kind of out research looking and searching for the grants that are out there that are available or how do you kind of get involved in the beginning?

Scott Wagers 18:59
It’s combination, it’s people that, you know, we’ve worked with, like the way we work and in a way, you know, we contribute more than a typical just helping to do the filling in the forms, you know, you know, actually helping to structure the project. But it’s also, you know, thinking, Okay, here’s this call topic that’s out there. Let’s go and either through things like LinkedIn, or meetings or conferences, you know, getting to know and understand and saying, Hey, you, you’re an expert in this, would you like to be involved in this project? Right? Because in a way, what you need to bring together are the right people. And typically, these you know, the people would like to get engaged and the people who should be doing thinking about these kind of projects are those who have had some success in their research careers, but are thinking okay, now what I want to do is not just get funding and write papers, I want to do a project that makes a real difference and you know, This is a great opportunity for that.

Sam Schutte 20:02
Because it’s very expensive to make a real difference meaning that takes you can’t, it’s very hard to do on your own. Right.

Scott Wagers 20:07
Exactly. Exactly. And then, you know, another thing we’ve been doing recently, you know, because we started off, you know, people responding to call topics, right, grant funding opportunities. You know, I think there’s so much strength in that consortium approach. What we’re doing now is bringing people together different types of stakeholders, and saying, let’s just even though there’s not a call topic, let’s build a community. And then think about what’s the problem we need to solve in this in the field you’re interested in, begin to build and structure that project, and then go find ways to get it funded, whether that’s grant funding or if there are partners from industry that engaged or even disease foundations engaged, then we can fund that project. We can find bits of it. So it’s being much more proactive and just reactive to the business. The call topic out there.

Sam Schutte 21:02
Yeah, you know, something I’ve always been fascinated in is sort of emergent intelligence of groups. Right. And, you know, you look at the example I always use is, there’s probably not any one individual person that knows how to build an entire jet engine, you know, soup to nuts, right, it takes, and, you know, hundreds of people that know how to do the, you know, there’s whole groups dedicated to the exhaust system, so on and so forth. Right. And, but as a group, they can do this amazing piece of machinery. And, and I think maybe a lot of us sort of, on the outside of medical research think that, you know, there’s a doctor in a lab somewhere with a eureka moment, you know, that boom, discovers a vaccine, you know, by themselves in a vacuum, right, you know, but really, you know, what it sounds like these big problems that you’re trying to solve. It’s kind of that same thing, like, you know, as a group of, I think you said, you know, maybe 40 or so, organizations and some of the larger ones or if not more, you know, they’re keeping abilities are so much greater as a whole than on their own. And it sounds like, like you said that these big problems, take a big group. It’s not it’s not a eureka moment that some individual researcher has.

Scott Wagers 22:12
It’s interesting. I mean, you mentioned emergent properties. And, and that’s one thing I think of, of these projects, it’s really emerging creativity. And that dialogue, you know, seeing this, you end up somewhere where you’re either designing a project or trying to solve a problem coming up with a with a with a solution you didn’t couldn’t even anticipate like you didn’t even think it was possible. And it’s because of that sort of building that sort of determine each other’s ideas. You know, if this is sort of an anecdote, but but it’s sort of illustrates the principle quite well. And this is actually back when I was still trying to figure out what am I doing in these Is this something I want to continue to work on? I attended an innovation workshop here in Belgium and They had John Cleese, you know, I thought, Okay, this is going to be funny, right? Yeah. And but I don’t know, if you know about John Cleese in, in the latter in the second half of his career, it’s really about business processes. In this time, he was talking about creativity. So he spent the whole lecture talking about creativity. And things about for example, you know, waking up and doing your thinking then or, you know, you know about the tortoise mind and the in the hare brain, you know, how you have to be in the slow mind to be creative, all that kind of stuff. But he went through the whole talk. And he hadn’t talked about working in a group at all, you know, this was when I was still kind of saying, okay, I certainly understand this dynamic, what’s going on in this consortium? And I raised my hand and I got the first question, which I was quite happy about. And I said, you know, you’ve been talking about creativity, but we didn’t hear anything about you know, working in a group and Monty Python’s Flying Circus that was a comedy troupe. How did that go? And he said, Oh, that was very interesting. And you paced across the stage and said how when they first met, they came together. And they would just end in acrimonious debate over what’s, what’s the skit going to be? Everybody had their own idea. Everybody had their own thing. And they were going to use it. They said it wasn’t working. So then he decided to go in groups to and work out the idea, and then bring that back. And then he said, What happened was interesting is that people were building off of each of those ideas. So everybody contributed, but they were adding on to something that was already there. And what that illustrated to me is that there’s a process and there’s a structure to doing this in the in the right way. That’s really quite interesting. And that’s so I started to really think about, you know, these interactions amongst the scientists, you know, and others in this way, you know, so there is a way to make that dynamic work. And that’s become really my interest in why I do what I do.

Sam Schutte 24:58
So how do you you know, seeing as you’re in Belgium, and you’re working with, I mean, you’re working with people all over the world. How do you kind of make all that coordination happen in that dynamic nature? I mean, is that, you know, imagine you rely a lot on, you know, modern technologies to make that happen. Is that ever difficult to you? Or are you just on a plane all the time flying all over the world?

Scott Wagers 25:20
No,no, actually, yeah. I’m actually not on a plane all the time. And I think that’s simply because it would be ridiculous because, you know, we’ll have 15 different countries in Europe and some people based in the US, we would like to have, you know, the great if you could be, you know, monthly with everybody face to face, but logistically, you know, if you meet three, four times a year, that’s a lot. So, when we started the the buyer per project, you know, we realized that and that the budget just wouldn’t support, you know, that kind of meeting or people won’t be able to do it. So we said, Oh, we’ll just we’ll meet on conference. We’ll have conference calls. Having no idea And what that meant, or it’s just a way to kind of get out of this budget impasse that we were struggling with, we ended up having lots of face to face meetings, but the conference calls stuck. And what that does is, it’s different, you know, it’s face to face is always better. It’s interesting. But when you’re having a phone conversation, or now an online meeting, you know, you have that continual kind of follow up, you can do right because you can have monthly or weekly calls, which we did, in most projects, at some point, we have a weekly call, you build that trust and that understanding, you know, the dynamics different because there’s not, you know, even with video, there’s not as much nonverbal communication going on. So you it’s almost like the playing field gets leveled and everybody’s talking together and you can, if you facilitate that, you can actually, you know, drive that so it’s a mixture of both face to face meetings, but online and then technology. You know, I’ve seen, you know, the online meeting technology sort of evolve over the past 10 years, you know, to where now it’s great, you can actually, very commonly be able to see people on video where, you know, that was possible 10 years ago, but you know, the, the bandwidth or the technology just didn’t work well enough. So that’s, that’s really the, the key driver, but it also is important to structure and communicate what’s happening in the project or what the discussions were, the dialogue was. So one of the things we did, again, just simply because there was no one else to do it, I started to do it is structure and take notes as to what’s being discussed. Now, your typical minutes are action points, you know, decisions, action points. But I sort of realized that in this kind of setting, just need a bit more because people need to be reminded of the context. Often they have other jobs they’re doing, this isn’t the main thing they’re doing and so they need to be reminding them what we were talking about last time, otherwise, we’d be repeating ourselves over and over again. So structuring that and having that as a constant record, going through also helps make this happen.

Sam Schutte 28:12
I want to talk a little bit about some of the macro trends, I guess they’re affecting these research groups. You talk a little bit about value based health care, and how that’s become a focus for for these organizations.

Scott Wagers 28:25
Well, you know, as everyone knows, it’s in the news these days. I mean, our success in medical research, comes with a price tag, you know, some of the medicines I mean, the recent one that was recently approved was, I think, 1.2 million or something. Price Tag four or 1.9 million for a medication. And you just you just do the economics there that’s going to be quite difficult, right? If you if things are getting that, but that price is decided based upon what is the value that drug can deliver. And in that case, it’s for a muscular dystrophy type syndrome, you know, over the course of a lifetime, you know, considering that the, those are affected by this will end up in the hospital maybe be severely debilitated. You know, 1.9 million is less than what it will cost to care for them in a lifetime if they did not have the medicine. Right, you know, and so, but then, you know, so then that, but then the question becomes, okay, we need value base to kind of if we’re going to have these more and more expensive medicines, but then the question becomes very important to know, how the medicines are working. medicines are approved through a process of going through clinical trials. The problem with clinical trials is that you need to be sure that you’re seeing the effect that you think you are, they’re usually in a very strict criteria as to what the individuals in the trial, you know, have weight, sex gender, race, you know, other diseases. But in reality, that’s not how drugs are given. People have all kinds of different things going on. So the real world experience of the medication is different than the clinical trial experience of medication. And so more and more the trend is understanding the real world experience using real world data. And that will help to understand how to drive value based healthcare. And again, that comes back to this big trend of bringing people together because suddenly, if you’re doing that, you know, you’re talking not just about your typical researcher, you need the clinicians who are dealing with patients, you know, or people that are working on epidemiology or registry based research, but you also need health economics. You know, you might need you know, even the hospitals to consider in the payers to consider, you know, how is this all coming together and you know, because what happens His you get a new therapies that are out there. And they’re used in different kinds of ways. But we don’t really have a great way of understanding how people are using those. We have a project right now that we’re, that we’re working on, we’ve been working on for some time, that’s integrating severe asthma registries across Europe, some of the initial work. And that’s really quite interesting, because what you see is that, despite there being guidelines, the care and how things are implemented across Europe are quite different. And so that ruble data can actually shed some light on that. And so that’s, I think that’s where the vibe base cares, you know, it makes this rural data trend, very real. And the real impact on that as well is it really means that not just the researchers, but everybody in the whole chain need to understand something about data about how to have good data, and what it means to use data. So I really think we’re moving towards a data driven doesn’t care kind of approach?

Sam Schutte 32:03
Yeah, I guess if the onus is on you to justify, you know, the price and therefore revenue of your, of the drug you’re developing, for instance, if the onus is on you to do that through data, you’re going to make sure you have good data, you know, and you’re going to collect a lot of it, you know, but

Scott Wagers 32:20
here’s the problem is that, you know, even though you got to go to the hospital, doctors, you know, record, you know, all your measurements, it’s often not recorded in a structured manner. It’s a lot of free text, or there’s missing data, it’s not necessarily a big thing, but input for research that that’ll, that that kills the analysis, right. Yeah. So that’s the big trend that people will begin to, you know, and that’s, you know, that’s a big challenge. You know, that is one of the limitations. for big data. using big data in medicine is difficult because if in medicine, if the data is not good quality, if the analysis is not going to help you at all, and I think This is where a lot of technology giants are starting to, at least initially run up against the wall because they were expecting Oh, we just analyze the data and we’ll have all the answers. Yeah. But if there’s not good data, the answers aren’t there.

Sam Schutte 33:14
Well, especially considering I think in, you know, in the health organizations I’ve worked with that are, you know, pretty diverse. There’s still a considerable amount of, you know, handwritten notes, you know, there’s Yes, there’s an EMR, yes, there’s, you know, other other laboratory systems and such, but they don’t always talk together. And so inevitably, something ends up, export it to Excel or, you know, something is written down on a clipboard and so forth. And that data is sort of lost and locked away forever, usually, some unless somebody types it in eventually, which, you know, is not a cheap process. What are some of the barriers you think that are slowing, you know, for these those sort of edge cases maybe or just for other specific data types? What are the some of the barriers to help adoption to solve those problems?

Scott Wagers 34:03
Well, I think some of it is just having an appreciation of data. Right? I think it may be hard, you know, I think I assume that being me being a software development person, you have a very strong understanding of, of data, what a data model is, and why it’s important to have good structure to your data. You know, for most of us, myself included until I started working in these projects, and really saw the impact, you know, data is an Excel sheet. Sure. And as you know, that’s not a database. And I think that’s one of the bigger because, because then I think people what I’ve seen is that when clinicians understand that, and then begin to appreciate that, yeah, while I like to write my little free text notes, you know, that’s not going to happy, that’s not going to help us, you know, to make use of things like AI, or, you know, to be able to look across and understand the trends and to really, you know, get To the point where we can make the big differences that we need to make. So I think, you know, that’s one of the bigger barriers. And again, which I think is a theme we’ve come up a couple times in this is fragmentation. So if you look at E health, right? You know, this is an anecdote, I was working on a project, and we had different health providers coming in. You know, the idea was to have this project, we were going to this, this organization I was working with is going to fund some research. And we started talking to them, we said, Oh, yeah, have you thought about having a standard output format for your device. And they hadn’t, right, they all had their own proprietary output format. So then, right away different devices capturing the same kind of data would not be interoperable. And that makes it difficult because particularly something he helped to make sense of it. Again, getting back to that big data aspect. You know, it needs to be interoperable. You need to be able to look Got it at scale. And if you can’t, and you have different people competing, you know, with their own silos, their own, you know, fragmented sets of data, you know, the adoption will be limited.

Sam Schutte 36:14
Yeah, I also think that some of the big vendors in the space have made it very difficult to integrate, you know, almost intentionally because they kind of want to, you know, for competitive reasons, control the, you know, the way people talk to their systems. And so, you know, you get a lot of, I was talking to one vendor recently a big one that, you know, they have just now put out an API, right? I mean, everybody has an API manual. Here, they’re 10 years behind the curve, but they’re very restrictive of who can use it. And if you if you’re not in a certain list than well just talk to us with HL seven, it’s like, you know, that’s not something that’s easy, is easy to do. You know, it’s like folks want to talk to a nice, quick, easy, lightweight API and not have to make some huge investment just to integrate with your system.

Scott Wagers 37:00
Right, exactly.

Sam Schutte 37:02
So there’s, there’s a weird sort of anti competitiveness to it. I think that not all other industries have. You know, I’ve also, I mean, I think that a big part of the struggle of adoption is just usability too. I mean, as you talk about, you know, needing to gather all this data, of course, that puts greater demands on clinicians, researchers, all of those people across the board, you know, not to mention just all the compliance standards and medical record keeping that they have to do, you know, kind of along the way, and it’s like, oh, and I have to also insert in this system or not, you know, and if the system is slow or hard to use or just not very usable it, they’ll just rebel. They just won’t use it, you know, and then you lose again, you lose that vision into their data.

Scott Wagers 37:47
And I think it’s related to that as well is that I think healthcare innovation in particular, has this need it has a, you know, which would call we call a translational gap or the valley of death. That’s particularly broad and wide. Because you not only have to solve a problem, you know, for person for customer, you have to convince different types of stakeholders. The clinicians have to accept it, the regulators have to accept if it’s going to be used, you know, as a diagnostic, the payers have to accept it, maybe the government’s maybe the hospitals. So you need those stakeholders to be engaged early on, not only to understand, you know, that user problem that you’ve just described, but so that they accept it, and they adopt it. I think that’s a really good, rich, fertile ground for these consortium projects, because you’re bringing all these different stakeholders together, and you’re, you know, at least getting their perspective in what you’re developing.

Sam Schutte 38:48
Now, outside of developing sortition and creating those and these groups, what are some new services you know, as a consultant that you’re looking to get into, or that you’ve been doing

Scott Wagers 39:00
Well, I think the biggest one, and it kind of extends, you know, from the same work, is, you know why I’ve just started to work with a spin out from a university that has a really interesting technology looking, you know, or approach to looking at the analysis. And, you know, we’ve just been talking about data, but you know, the trend is probably the next big thing is, is not the data, but how are you analyzing it. And so, you know, they, you know, they’re quite remarkable in that they they’ve already, you know, before they even actually were established as a company, they had, you know, customers, some of which I was helping them to get. But, you know, they’re, they’re able to work on a service model, unlike a traditional drug which develop over time, you know, so I, you know, being a consultant, I have a bit of understanding of that. But what’s interesting, there is also, you know, understanding the dynamic of the different people working to develop that and it’s very powerful. Parallel to, you know, working in a consortium and being drawn into dialogue amongst. So that’s probably one of the bigger things I’m starting to develop and emerge. And the other thing that I think I mentioned earlier, is just this idea of, you know, building a community around an area. And using that and, you know, starting to do the consortium approach before there’s even a call topic or so that we actually, you know, move from single projects to sort of an entire ecosystem that’s working on a topic or an area of multiple stakeholders. And so those are the two big trends in the services that we’re evolving.

Sam Schutte 40:41
But what’s interesting is, I imagine, you know, if you look at a, an ecosystem of a sort of, like, you know, like you said, problem you’re working on, just because you come up with one medicine treatment approach, you know, that doesn’t that’s not the end, right? I mean, exactly. Imagine for every new drug developed, a group such as that could follow on To improve to, to find other uses for it, so and so forth, there’s always a possibility of a better drug, you know, maybe, or, and so forth. So maybe having that focus, like you said, more of a community focus towards a set of problems or whatever, instead of just let’s just develop a drug, maybe that’s a different angle.

Scott Wagers 41:19
It really comes from the fact that too, as you have that, in this another part of the aspect of working in a consortium, when you have a group of people with with dialogue, like I described, is a new opportunities sort of emerged in being on these calls and trying to pay attention to what’s being said, I started to see this that to me, so what about this, let’s think about this. You know, and so, you know, I don’t think of them as simple linear projects. They’re sort of like this starts off linear, but then it it has this potential to grow and expand to become clearly something more than we ever expected at the outset.

Sam Schutte 41:53
What’s one of the more personally rewarding projects you’ve worked on recently, you know,

Scott Wagers 41:57
I would say the one that I started with, which was bioprinting simply because we’re now 10 years into it, and we’re seeing, you know, kind of flip into the exponential phase of delivery, and that it really made a difference. One of the things that when I was a clinician in an academic hospital where I also, as a chief medical resident was doing some educational aspects. One of the things that really became interesting to me was, you know, explaining science and in medicine to patients, or just the community at large. So in that project, when we started off, we involved in a patient organizations and disease foundations. And we really sought to find a ways to engage patient stakeholders in that project. You know, and one of the first things we did which I think was still really interesting is we said okay, we want to convey the way the patient Feel to the researchers, some of which were clinicians, they kind of understood that. Others were, you know, PhDs who worked in a lab and didn’t really have much interaction with patients. So we held an art contest. So we had individuals with severe asthma, produce pieces of art, that were then judged by the researchers. And the one that one was was was a young woman from Amsterdam, who then is going on to become sort of sort of a patient advocate. And so what was interesting about that project, we also very much embedded patients in the project, they took part of the actual work package calls in so they were actually in the operational stuff. And that’s kind of interesting and different. And it really helps because then people are inspired the patients had particular perspective to the projects and we’ve gone on, you know, with some other other projects and sort of keep extending that idea so that it’s more patient centered and You know, so it goes back, you know, all the way back to that when I was in training, you know, this idea that, you know, it’s, you know, science isn’t separated from the public, it just needs to be explained well, and then people, you know, people really and there’s real value in that in that multi stakeholder type approach.

Sam Schutte 44:16
Yeah, it’s very cool.And Scott, I understand you’re working on a book. Is that right? Yes. Yes, absolutely. Tell me a little bit about what that is about, or what’s going to be called or?

Scott Wagers 44:25
Yeah, well, right now the title, which I think is going to be the whisk is called assembling chaos. Because, you know, and we talked about, about emerging creativity and things like that. It is sort of like chaos. But then the idea is if the consortium project, you can structure it, you really get somewhere and it’s sort of assembling chaos. And in that book, it’s really gonna outline, you know, the five principles of how to work in what I think of the most productive type of consortium projects, which are highly interactive. Like I mentioned earlier, we had up to 30 calls a month. Because when you’re working in that highly interactive manner, it’s not only that you can do, you know, almost the unthinkable, right? It’s also it creates opportunities for the individual, for the individual researcher, for the image of company to actually gain knowledge, to give opportunities for their junior faculty or their students to take leadership roles become shapers in the field, and his opportunities to engage with stakeholders. And so that’s why, you know, because you can still have consortia that are working in silos. You know, the premise of the book is that the best consortia are those that are highly interactive.

Sam Schutte 45:39
Hmm. Cool. And so if there’s folks out there listening, that are involved in medical research or working for medical research organizations, what are the what are the main things you can help them with, that they should reach out to for?

Scott Wagers 45:52
Well, I think the main thing is okay, if you’re working, and you have an idea for a big that’s a paradigm shift. And that’s a broad term that can mean simply aligning people across on different types of data or models. Could be redefining asthma could be thinking about that. What’s the ideas? How can we move that forward? How can we bring a consortium together to make that happen? And that also goes not only for, you know, academic researchers, but disease foundations, I really think small companies this can be, you know, there’s startups that are trying to really gain traction, no better way than to be developing something together, solving problems together with a bunch of stakeholders, who will be the ones that will determine if your product makes it, you know, get in touch. You know, I’m always happy to talk about new ideas. And like I said, we don’t need to have a particular call topic, we can just start to pull together a consortium today and and find a way to make that happen.

Sam Schutte 46:53
Very cool. And if people want to contact you after they reach out,

Scott Wagers 46:56
biosciconsulting is our website, my email is scottwagers@biosciconsulting.com . Also in LinkedIn, I’m very active on LinkedIn. And I like to share things and thinking about consortium projects, general trends and science. So reach out on LinkedIn if you do that they should mention this podcast because I try to keep my LinkedIn followers, you know, somewhat in the medical field. So there are people who are interested, I’m happy to connect with them. But I need to have some kind of indication that you’ve listened to this podcast, and I’d be happy to connect with you.

Sam Schutte 47:29
Awesome. Well, Scott, thanks so much for being on the show. It’s really makes me feel better to know that there’s people such as yourselves out there, you know, building armies of organizations to solve and tackle these really big problems and very cool also to the idea of that you’re open to reaching out to individuals and groups that have an idea, you know, even if there’s not grant money in the line immediately, just just creating new ideas for new approaches. You know, I think there’s just tremendous potential there. So very inspiring.

Scott Wagers 48:00
Thank you. It’s been a pleasure, actually.

Sam Schutte 48:02
Yeah, thanks.

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  • Scott Wagers
    Reply

    Thanks for having me on your podcast, Sam. It was a real honour. I enjoyed our conversation and we covered some interesting ground.

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