Presentation for Rock Health corporate sponsors by Scott Packard and Zen Chu

1. GENOMIC HEALTH ADVENTURES
ROCK HEALTH
GENOMICS REPORT 2016
ZEN CHU + SCOTT PACKARD PHD
© HACKING MEDICINE INSTITUTE

2. GENOMIC ADVENTURES
http://arep.med.harvard.edu

3. CRISPR GENE EDITING
NEAR TERM GENOMIC THERAPEUTICS

4. WE ALL HAVE VARIANTS
Rehm HL, et al, "ClinGen -- The Clinical Genome Resource",
NEJM 372;23 June 2015 pp2235-2242. 15,000 subjects

5. Rehm HL, et al, "ClinGen -- The Clinical Genome Resource", NEJM 372;23 June 2015 pp2235-2242. 15,000 subjects

7. CRISPR GENE EDITING
Evidence.PGP-HMS.org

8. FRAGMENTING INTO
LONG TAIL OF RARE DISEASES
LUNG
CANCER

9. NGS CHALLENGES
IS THE MARKET ACTUALLY READY?
Pharma companies are
struggling to analyze the
world’s genomic data
Scale
Complexity
Access
Data are physically distributed and impossible to move
because of regulatory, privacy, and competitive concerns
40 exabytes of genomic data by 2025 vs
2 exabytes of YouTube data
300M potential features for genomic data vs
70k potential features for standard clinical data
HUGE DATASETS BREAK ALL THE TOOLS…
PROGRAMS MUST TRAVEL TO THE DATA

10. GENOMES @ SCALE
DATA + PARTNER PROBLEMS
Pharma, Biotech &
CROs
Commercial Data
Aggregators
Research Institutions
Medical Centers &
Hospitals
Seamless experience for
customers using data
3.
Secure, distributed
queries & management
2.
Curated data stored
with partners
1.
Answers
Money
Questions
MARKETPLACE COLLABORATIONS
GIANT FEDERATED DATA STORES
CUROVERSE.COM

11. DATA SHARING TENSION
OPEN PROPRIETARYINSIGHT SHARING
? ?
WHERE ARE THE NETWORK EFFECTS?

12. ACTIVATED
ONLINE
PATIENT
COMMUNITIES
PATIENT ACTIVATION MAP
SYMPTOMATIC
ASYMPTOMATIC
ACUTE
CHRONIC
CATCH THE
EPISODIC PATIENT
SILENT KILLERS
© HACKING MEDICINE INSTITUTE

13. CRISPR GENE EDITING

14. GENOMICS 2.0 FUNDING

15. 2nd WAVE OF GENOMICS FUNDING
$100M $100M$313M$96M$226M
$115M Series E $825M Market Cap
Lost $90M in 2015 Alone
HEAVY CAPITAL REQUIRED
EACH HAVE UNIQUE NETWORK EFFECTS

16. GENOMICS EXPENSIVE…
!!!

17. WILLINGNESS TO PAY?

18. AGENCY PROBLEMS
CONFLICTING INCENTIVES
HARD TO FIND WIN-WINS

19. TENSION BETWEEN STAKEHOLDERS
HENRIETTA LACKS

20. MASSIVE COST OF
AWARENESS/ACTIVATON
EITHER TARGETING PHYSICIANS OR PATIENTS

21. BIOS
© HACKING MEDICINE INSTITUTE
Scott D. Packard PhD, Principal, RNA Capital Advisors
Scott specializes in the assessment of healthcare and life science
companies, products, technologies, and opportunities via the dual
lenses of financial and market analysis in the settings of sell-side
fundraising, buy-side diligence and investment analysis, and
internal strategic positioning and decision-making including clients
in the precision medicine space. Dr. Packard has been working at
the intersection of healthcare providers, payers, investors,
scientists, engineers, and executive teams for 14 years following
his scientific-medical training. He also serves as an advisor and
mentor to MIT Hacking Medicine
Prior to RNA, Dr. Packard was the Chief Operating Officer at
MedPanel, a market research firm providing insights to help
clients successfully develop, commercialize, and capitalize on
biopharma, med-tech, diagnostic, and healthcare IT products. He
has also held positions of Senior Consultant and Operations
Director at The Advisory Board Company in Washington, DC, a
healthcare focused global research, technology, and consulting
firm where he ran consulting and research engagements and
launched a technology assessment program called Technology
Insights.
Dr. Packard holds a PhD from the MIT-Harvard Division of Health
Sciences & Technology in tumor biology and medical imaging
performed at Massachusetts General Hospital following a B.A. in
Physics from Cornell University.
Zen Chu
Managing Director, AccelMed Ventures
Co-Founder of 4 med tech healthcare companies
Faculty Director, MIT Healthcare Ventures &
Hacking Medicine Institute
Healthcare Entrepreneur + Investor

22. THANK YOU!
ZEN CHU
ZENVEN@MIT.EDU
@ACCELMED
© HACKING MEDICINE INSTITUTE
SCOTT PACKARD PHD
SCOTT.PACKARD@RNAADVISORS.COM

24. HEALTHCARE STAKEHOLDERS
© HACKING MEDICINE INSTITUTE

26. PROCESS
1) IDENTIFY BIG PAINFULPROBLEMS
2) GO DEEP ON THE PROBLEMS TO INVALIDATE/VALIDATE
3) CHOOSE KEY CUSTOMER / USER
4) OPPORTUNITY = CUSTOMER + PROBLEM
5) VENTURE = OPPORTUNITY + BUSINESS MODEL
© HACKING MEDICINE INSTITUTE

27. DISCIPLINEDENTREPRENEURSHIP.COM

28. PATIENT
SYMPTOMS
USER + JOURNEY
MAP THE EXPERIENCE OF DIAGNOSING,TREATING, MONITORING
PRIORITIZE FOCUSED HIGH-IMPACT SOLUTION AROUND ONE PLAYER
MONITOR
OR
PREVENT
EDUCATION
+
ACTIVATION
DIAGNOSIS
+
TESTS
SEGMENTS
+
TREATMENTS
BIGGEST
GAPS, COSTS
OUTCOMES
MONITORING
+
MANAGING
PATIENT
CAREGIVER
NURSE
IDEAL
LOCATION:
PCP PHYSICIAN
PHARMACIST
SPECIALIST
CLINICAL PI
PRIORITIZE
ONE PLAYER:
© HACKINGMEDICINE.MIT.EDU
PICK A SPOT + GO DEEP

29. IMAGINE IF…
IDENTIFY HIGH-PAIN PROBLEMS +
TERRIBLE HEALTH EXPERIENCES
____________________________________________ (DISEASE, HOSPITAL, JOB…) WOULD BE AMAZING IF
____________________________________________ (USER, PATIENT, DOC…) COULD _________________________________.
IMAGINE IF ________________________________ (DEVICE) COULD ______________________________________(JOB/ACTION).
____________________________________________ (DISEASE, HOSPITAL, REHABILITATION…) WOULD BE AMAZING IF
____________________________________________ (USER, PATIENT, DOC…) COULD _________________________________.
____________________________________________ (DISEASE, HOSPITAL, REHABILITATION…) WOULD BE AMAZING IF
____________________________________________ (USER, PATIENT, DOC…) COULD _________________________________.
IMAGINE IF ________________________________ (USER) COULD ________________________________________(JOB/ACTION).
IMAGINE IF ______DOCTORS______ (USER) COULD RAPIDLY CROWDSOURCE DIAGNOSIS OPINIONS (JOB/ACTION).
IMAGINE IF ________________________________ (SERVICE) COULD _____________________________________(JOB/ACTION).
© HACKING MEDICINE INSTITUTE

30. ELEVATOR PITCHTEMPLATE
• I AM A _____________________ AND I CARE ABOUT ________________________________________
• MY GOAL IS TO IMPROVE
• EXPERIENCE OF ______________________________ (ALS PATIENT, CAREGIVER, ER NURSE…)
• QUALITY OF ______________________________ (CLINICAL METRIC, EXPERIENCE, PAIN…)
• ACCESS TO _______________________________ (SERVICE, EXPERTISE, PROCEDURE, PRODUCT)
• FREQUENCY/RATE OF ____________________________________ (TEST, BEHAVIOR, DX, SURG)
• EFFICIENCY OF _______________________________________ (TEST, DX, EXPERIENCE, SURG…)
• PROFITS OF _________________________________________ (PHARMACY, DOC, HOSP, FIELD…)
• FIRST TARGET CUSTOMER IS ___________________________________ (DESCRIBE SINGLE USER TYPE)
• THEY SUFFER FROM __________________________________________ (DISEASE, EXPERIENCE, PAIN…)
• WE CAN IMPROVE THEIR EXPERIENCE/HEALTH BY __________________________________________
• TODAY THEY SOLVE THIS BY __________________ BUT THE PROBLEM IS ________________________
• OUR SOLUTION IS TO ATTACK __________________________________________________________
• STARTING WITH ___________________________________________ (FOCUSED POPULATION)
• THEY WILL BE EARLY ADOPTERS BECAUSE __________________(PAIN, COST, RISK, FEAR, PAYER…)
• WE WILL REACH THEM THROUGH _____________ (CHANNEL, SPECIALTY, RETAIL, PHARMACIES…)
• IDEAL STRATEGIC PARTNERS _______________________________________________________
• BUT WE CAN ALSO ATTACK LARGER MARKET OF ________________________ (NEXT USER TYPE)
• OUR PRODUCT/SERVICE WILL BE PAID FOR BY __________________________________________
• BECAUSE THEYVALUE ____________________________________________ (UNIQUE QUALITIES)
© HACKINGMEDICINE.MIT.EDU

31. Market Adoption Risk
Reimbursement + Consumer Drivers
Physician & Patient Adoption
Distribution
Regulatory Risk
Safety & Efficacy
Management Risk
Technology Risk
PRIORITIZE
UP FRONT
© HACKINGMEDICINE.MIT.EDU
Value
Development Time
PRIORITIZE + TEST MARKET RISK
WILL CUSTOMERSVALUE + CHANGE BEHAVIOR?

32. HACKMED BIZ MODEL
10 STEPS TO DESCRIBE WHO USES, PRESCRIBES, PAYS, DISTRIBUTES
10) PITCH THE NEW EXPERIENCE:
PRIMARY
USER
PRESCRIBER
ECONOMIC BUYER
INFLUENCER
LOCATION +
DISTRIBUTOR
WHO PAYS?
HOW MUCH?
1) WHO VALUES & PAYS? 2) HIGH VALUE SEGMENTS + ROI
HIGH RISK SEGMENTS
INCENTIVES TO PRESCRIBERS
KEY METRICS
3) HOW EFFICIENTLY REACH ECONOMIC
BUYER? WHERE DO LOW COST + HIGH
ACTIVATION, JOURNEY INTERSECT?
WHICH PARTNERS ALREADY OWN
RELATIONSHIP WITH BUYER/PATIENT?
ACTIVATION
4) WHAT ACTIVATES PRIMARY USER?
WHEN IN JOURNEY?
5) WHERE IN JOURNEY TO
INFLUENCERS + SPECIALISTS
INTERVENE?
6) WHICH PARTNERS + THIRD PARTIES
DELIVER NEW EXPERIENCE + CARE?
RETENTION
VALUE
7) WHAT BRINGS USER BACK?
MONITORING OR SUBSCRIBER BIZ?
ADD-ON REVENUES?
8) HOW TO CONTINUE TO ENGAGE
INFLUENCERS + BENEFIT FUTURE CARE
INTERACTIONS?
9) HOW CAN PARTNERS RE-ACTIVATE,
CONTINUE TO ENGAGE USERS, RE-SELL
CONSUMABLES, ADD ONS?
HOW IS SOLUTION DISCOVERED?
WHY WILL THEY CHANGE & ADOPT?
PSYCHOLOGY AROUND BUYING
ECONOMIC BUYER
PRICE VERSUS VALUE
ONE-TIME USE? CHRONIC SUBSCRIBER?
LIFETIME VALUE VS COST OF REACHING
IS A PRESCRIPTION REQUIRED?
NON-TRADITIONAL INFLUENCER? KOL?
EMPLOYER? DISCHARGE NURSE?
WHERE IS THE BEST EXPERIENCE?
NEW MODES/PLACES TO REACH
RETAILER, HOME, APP STORE, ECOM…
WHICH CHANNELS REACH USERS/DOCS?PATIENT, PCP, CAREGIVER, PARENT….
© HACKING MEDICINE INSTITUTE

33. USER +VENUE SEGMENTS
© HACKINGMEDICINE.MIT.EDU

34. OBSERVE
PITCHDESIGN
TEST
+
LEARN
PITCH to
efficiently communicate
gather external feedback
(in)validate problems/solutions
and recruit team
NEEDS = validated problems
= jobs to be done
big, painful
clear biz model
DESIGN PROCESS
NEEDS>PITCH>FEEDBACK>TEST>DATA
© HACKING MEDICINE INSTITUTE

36. EXPERIMENTAL PLAN
KEY METRICS, CLEAR HYPOTHESIS, QUICK DATA CHEAPLY
IF METRIC DOES NOT CHANGE BEHAVIOR, IT IS A BAD METRIC
© HACKINGMEDICINE.MIT.EDU
DESCRIBE THE PROBLEM: ________________________________________________________________________________________________________
DESCRIBE MIN VIABLE PRODUCT: ________________________________________________________________________________________________________
EXPERIMENT HYPOTHESIS: ________________________________________________________________________________________________________
EXPECTED OUTCOME: ________________________________________________________________________________
SUCCESS CRITERIA: ________________________________________________________________________________
KEY PARTNERS FOR EXPERIMENT ________________________________________________________________________________________________________
VARIABLES TO TEST: ________________________________________________________________________________________________________
CLINICAL METRICS (i.e. OUTCOMES, PAIN SCALE, DIAGNOSIS RATE, COMPLICATION RATE, READMISSION RATE)
TECHNOLOGY METRICS (i.e. PERFORMANCE, SPECIFICITY, SELECTIVITY, FAILURE RATE, COST PER TEST)
CUSTOMER METRICS ( i.e. SATISFACTION, RETURN VISITS, REPLY/CALL-BACK RATE)
BUSINESS METRICS (i.e. USER ADOPTION, COST, BUYING DECISIONS, TIME REQUIRED, EFFICIENCY
HOW LOWER BARRIERS TO DATA GENERATION? ____________________________________________________________
WHO/HOW MEASURES? ______________________________________________________________________(INCENTIVE OR AGENCY PROBLEMS?)
WHAT ARE YOU DE-RISKING? ______________(USER ADOPTION RISK, SAFETY RISK, TECHNOLOGY RISK, MANUFACTURING RISK, SALES RISK, ETC)
TARGET POPULATION ________________________________________________________________________________________________________
SUB-SEGMENT POPULATIONS & COMORBIDITIES ____________________________________________________________
IS THERE A CONTROL GROUP?____________________________________________________________________________
SELECTION BIASES?_____________________________________________________________________________________
EXPERIMENT SAFETY ISSUES ________________________________________________________________________________________________________
HOW DOES THIS MAXIMIZE LEARNING? ________________________________________________________________________________________________________
WHAT CAN YOU TEST FAST + CHEAP? ________________________________________________________________________________________________________