Opportunities in Pediatrics: Innovation and Investment | LSI USA ‘23

Transcription

Andrew Meadow  0:07  

So welcome. We have some really exciting things as discussed today. And thank you for taking the time out of your day to gain a greater appreciation for the opportunities within pediatric health care. As gentleman just mentioned, my name is Andrew meadow. I'm a general partner for health innovation capital. Before we get into intros, I would like to just take a second and send some best wishes to our good friend Kalia, who unfortunately is not able to be here. Hopefully, she is recovering well in DC and will be here next year. So my colleagues here have a very illustrious background. So I'll respectfully ask each of you. If you can keep your accomplishments and successes to just a few minutes please, so you don't embarrass me. And if you could introduce yourselves, and in so doing, just talk about why you got involved in pediatrics, and take maybe one or two minutes to talk about your fund or your activities within pediatrics.

Sharief Taraman  1:14  

So I'm Sharief Taraman. I'm a pediatric neurologist, but also have a board certification and clinical informatics. I'm the CEO at Cognoa. We have a de novo device that received approval from the FDA to diagnose children with autism. We also have a breakthrough device in the pediatric space to treat autism as well right through designated device. When I'm not busy being a CEO, I'm also a professor of pediatrics at University of California, Irvine and locally and previously served as division chief of Neurology at Children's Health of Orange County, which is our major Children's Hospital here in the area. And why did I get into pediatrics? Well, my daughter was born the first day of med school and I think that that probably Prime's you for pediatrics. And so I think I went through all of med school trying to figure out how to raise a daughter and I ended up in pediatrics.

Andrew Meadow  2:06  

fantast fantastic, please.

Suzy Engwall  2:09  

Hi, I'm Suzy inkwell. I'm the VP of early med tech at Alira Health. I have been working in the innovation space for about seven years now after coming over from St. Joseph health system. And I'm passionate about pediatrics for a couple of reasons. Number one, it's totally underfunded. The kids need our help. And these are they're our future generations. So it's really important to me, across time, in the tight time that I've worked in this space. I've worked with Children's Hospital, Orange County, I've worked with Valley Children's Hospital. And over and over again, I see just needs everywhere I look everywhere you turn, there's a need that needs to be met. And unfortunately, there's not a lot of people innovating in this space. It's also really a space that needs a lot of help in our rural populations. So I think you know, if you guys are entrepreneurs, there's a lot of places to innovate in pediatrics. So please don't discount it, hopefully will say some things that inspire you today. But with that, I will pass the torch.

James Wall  3:06  

Thanks, James wall. I'm a practicing pediatric surgeon and professor at Stanford, I also helped to direct the Stanford Biodesign Innovation Fellowship, which people may have heard of great track record of success and training the next generation of health tech innovators. But as we look back at our data over the years, you know, very few projects from the first 20 years of Biodesign ended up really meeting my needs as a pediatric surgeon, often these projects were filtered out. For the same reason we don't have an onslaught of investors coming in here, it's considered small market, etc. And we've really looked to flip that and show that there are models. And, you know, I also had been on the, on the entrepreneurial side, founder, board member, advisor to multiple companies, including Novanate, which we'll talk about was just recently acquired success for all. So we're really trying to use the structure of Stanford, the understanding of HealthTech innovation and really apply it to kids.

Andrew Meadow  4:07  

Excellent, excellent. And some of the success stories James referred to we're going to talk about in a few minutes. But when we think about pediatric health innovation, it has both an emotional and financial set of criteria that together dramatically impact every segment of the healthcare innovation ecosystem. And I just want to take a second and provide some market data just to kind of set the stage for a global conversation within pediatrics. So when we think about pediatrics, you know, children with medical complexities, cost the US healthcare ecos ecosystem 110 $110 billion last year, which has steadily increased over the last 20 years. pediatric cancer survivors suffer significant long term health care effects, such as in no particular order 95% have a significant Hi related issue, I have a significant health related issue by the time they are 45. Six times are more likely to develop breast cancer than general public 15 times more likely to develop congestive heart failure, and seven times more likely prematurely to die prematurely from cardiac problems in the general public. And last but not least, per patient cost of care for children with mental health has increased two and a half times over the past decade, children with medical complexities are significant are at significantly higher risk of developing chronic illnesses. And chronic illness expenditures make up roughly 90% of the total US healthcare spending. Now, given all that what is surprising to me is that less than 15% of the US healthcare economic spend in innovation goes towards pediatrics. So let's talk about some of the risk factors affecting pediatrics, given those statistics. So when we think about the challenges in pediatric health innovation, each of you have confronted this issue in a different way, either as a medical practitioner, a surgeon or driver of innovation within the healthcare system. What are some of the risks that you have confronted historically? And do you think those are indicative of what is currently in the market today?

Sharief Taraman  6:27  

I think it's a great question. And I think you bring up really good points about the chronic chronicity of disease in children and the chronicity of disorders and children. And I think a lot of it actually, I think has to do with perception, I think there was a perception that existed that pediatrics is a small market, but clearly it's not. And in fact, what we know is that these kids grow up, and the conditions that they have as children, because we are advancing healthcare become adult problems. And so really, the opportunity has grown. And I think that this is why it really is a change in the paradigm shift. Right. So again, that perception I think, is changing. And we're seeing a shift, not only in the conditions that we need to address, but also in terms of growing pressures, and need to innovate. I'm one of 1500 pediatric neurologists in the whole country, James, you're probably one of 800 100 surgeons in the country. And so you can see this growing need and this disparity of clinicians, there has to be things that we innovate, to just even just address basic medical needs of our patients, especially in the specialty care setting.

Andrew Meadow  7:41  

Have you found yourself and I'm now asking this from your career at Orange County, but you find yourself being both a medical practitioner and entrepreneur while you're doing a consult

Sharief Taraman  7:56  

all the time. And actually, James, James and I were talking about this a little bit earlier to I mean, the amount of hacking that we do in pediatrics and off label use in pediatrics is astonishing. And when you're sitting there and you're front of a patient, you say, oh, I can use this adult device, which was approved, and I can put this in your heart, or here's a device that it was actually designed for pediatrics, I can tell you that the parents will pick the pediatric designed device over and over again, because they'd rather you experiment on them with something that was designed for a child rather than something that we've hacked from an adult to put into a child.

Andrew Meadow  8:32  

Yeah, yeah, I was just gonna say, James, now, you focusing on a different part of the anatomy? What has been your experience, both as a surgeon, as well as a physician itself and dealing with these challenges?

James Wall  8:44  

Yeah, I mean, I didn't even really appreciate it until I had time to reflect on it. But yeah, I mean, I'm handed surgical staplers that are perfect for a bariatric patient. And I'm expected to put it into a premature baby that's, you know, the size of this microphone. It's just bonkers, right? I mean, so, you know, back to finishing the risks I wanted to add on to, and there's a reason that we don't get those staplers made for us, right, there are risks, and I think we should go through them because it's really important. So the small market, the niche, it just, it really bothers me because you know, children are 25% of the population. They're 100% of the future. Yes, disease is not as common, but in terms of the longevity of effect that you can have when you cure something in infancy. It really is valuable to society. And I think that there's a perception among investors that, frankly, was similar in the FinTech space that was called niche. Well, no, it's not. It's half the population, like what are you talking about? So yeah, there's some things that are small and rare. But there's also common things in pediatrics, like asthma that's being underserved, because it's just not being invested in so small market. And then I think FDA regulatory risk is another one we wanted to talk about. Maybe Susie, you want to touch on that one?

Suzy Engwall  9:54  

Yeah, I mean, I think that there's this perception and it's kind of back to what Sharif was saying is that there is this person option out there that, you know, innovating in pediatric healthcare is harder or the path to market is longer. And that's not always necessarily the case. In fact, the FDA has programs and incentivize pediatric innovation. And if you just take the time to look into them and do your research, you may find you may be able to get your medical device to market faster than you would a device that you'd be taking through the normal process. I think the other thing that's important to note about that, too, is that when we're creating medical devices for adults, and then we want to walk them back to pediatric patients, that is much, much harder to do. The stapler is a perfect example of that, then taking a device that was made for a pediatric patient and then adopting it to an adult patient population. So even though something may small start out with a small market size, these devices are these innovations can grow, the market can grow. So from my perspective, I feel like investors just need to get a little bit more creative, do their due diligence, do their research and understand that yes, it may start with a smaller market. But can that market be expanded? And what does that look like?

Sharief Taraman  11:04  

Actually, to the regulatory path real quick. So I don't know if people realize this, because I actually didn't know this until I actually went through the process. If you have a pediatric specific de novo device, there are no regulatory filing fees for that, you pay $0. That's a huge first, especially for a small startup to get started. And so there's incentives. And there's a lot of these incentives, and a lot of non diluted dollars focused on pediatric device development that you can leverage.

Andrew Meadow  11:31  

So just to put this in context, in terms of literally seven hours ago, today, I was having a conversation with somebody who when I asked him, their thoughts about the risk in investing in pediatrics, they were espousing statutes that were from 2001 2002, things have changed dramatically in the last 20 years. And I'd love if we can Suzy just for a second, when you think about your role and looking at innovation, and pushing that forward to make it a standard of care, or even a first line therapy. Have you found that there has been tremendous apprehension, because of the difficulties in recruiting patients, and difficulties in scalability of an opportunity. And you spend a lot of time educating people that those factors, no longer have impact on what we're doing. And maybe you can also talk a little bit about, in your experience, how you've overcome that. But most importantly, add some color as to, quite frankly, what is actually happening in the market?

Suzy Engwall  12:38  

Yeah, I mean, I think it's interesting, I think a lot of those perceptions from the past are still very much around. And that's what a lot of investors and others are looking at. You know, we were talking about this a little bit earlier to pediatric hospitals, when you're thinking about clinical trials, for example, pediatric hospitals are very, very open to working with new technologies. And they band together, they talk to each other. So if you're get a clinical trial at one site, you're you're more likely to get other clinical trials that other pediatric sites were, you know, in the acute, you know, the normal, acute, acute care environment, a lot of times these hospitals are almost competing with one another. And so they don't want to let the secret out, Hey, I've got this great clinical trial going this has done wonders for my patients. So I think there's a lot of those old perceptions that really need to be kind of reversed and changed and thought about. And I think we do spend a lot of time trying to educate people on some of the benefits of innovating in the pediatric space. I also think there is a huge risk kind of going back to risks for a second to not innovating in this space. Access. patient access is a huge issue right now. And everywhere I turn people are talking about social determinants of health, if you want to help with social determinants of health, invest in pediatrics, because so many of these kids don't have access we were talking about earlier, these kids will get a concussion, they've got to go five hours to see a specialist. That's crazy, and it's just not okay.

Andrew Meadow  13:58  

Now, talking about the social determinants and health, one of the things that I have found to be quite enlightening, to say the least and I don't want to take anything away from Children's Hospital of Orange County. But speaking with one of your colleagues at Children's Hospital LA. He was talking to me about the work that we're doing with certain children's hospitals on the East Coast. And he brought up the question, do you know what percentage of patients does Boston Children's Children's Hospital Philadelphia, and Children's National see that are Medicare Medicaid patients? And he asked this to me and I saw this grenade being lobbed at me that I just there was just no way. I was avoiding this. And needless to say, Children's Hospital of La takes a significantly higher percentage of Medicare Medicaid patients in the three that I mentioned. But the interesting thing for me I'd love to see when we talk about access. It's not just financial access to me, it's also about physical access, the ability to go in and be able to engage with cutting edge technology. And I'm going to fall back now on the medical practitioner side, when you're seeing patients, there's this whole idea, the Hippocratic Oath, treat the patient in front of you, and you do no harm. But I believe in my heart of hearts, that there are some constraints that prevented you from doing that. And you've had to creatively maneuver around those, those requirements, whether they be internal in your particular hospital, or just within the regulatory environment that prevented you from providing quality care. I mean, have you found yourself in that situation? And do you think it's historically? And do you think it has gotten better today?

Sharief Taraman  15:48  

Are we in real quick, so I can tell you when I came to Orange County, in 2011, so that's 20 years ago, 10 years ago, okay, decade, I'm getting old. I've been in practice for 20. Alright, so 10 years ago, I came here in 2011, there were over 1000 kids on the waitlist waiting for a neurodevelopmental evaluation for autism. And guess what the number is today? It's more than 1000 Kids, we did nothing to improve that situation. And the reality is, is that I was tasked as the division chief to hire more pediatric neurologists, but I can't find them. And so the reality is, is that we are, you know, triage came out of a war situation, you have to determine who's going to survive, who do I provide effort to, and if you think about these, these waitlists that we have, and that's not an Orange County problem, by the way, that's a everywhere problem. The reality is that we're never going to have enough staff. And so now they have this opportunity, though, where there are regulation like software as a medical device where you can leverage data. And we'll I'll talk about this later when I do my presentation for Cognoa. But we leverage data to create the diagnostic that addresses that problem. And so my goal is next year, there should be no waitlist anywhere to get a neurodevelopmental evaluation, because we can help those children. And the reality is if you do this is everything in medicine, if you will find it early, you address it early, your outcomes are going to be better. It's just a no brainer. You don't need a trial to tell you that, right. If I catch diabetes early and treat it, you're not going to get diabetic retinopathy, you're not going to get diabetic foot and you don't need an amputation. But in the same space in the neurodevelopmental space, if you wait to address these neurodevelopmental conditions, these kids then have lifelong challenges. If you pick them up early, they do much better. 

James Wall  17:29  

so I'm going to step away from clinical and maybe talk about development challenges, because I think they're really, you know, at the core of the issue we're talking here and why I believe pediatric technologies are investable. But there are there are real challenges that you have to address ahead of time. So one is capital efficiency. I mean, everybody's saying you need to be capital efficient. But when you are looking at, for example, company like novanet, looking at 200,000 NICU patients is your population, a $20 million dollar addressable market? You know, the the math is pretty easy. You can't spend $100 million to get there, right, you have to be able to develop something in a really capital efficient manner. That's a company we almost killed because we said we didn't think we could do it for call it 2 million in. But we did and we did it by being more creative on the front end, in terms of non dilutive funding staying within the university. And then you know, really on the back end, leveraging our Children's Hospital contacts, we do work together really well. I mean, can you believe that Stanford and UCSF are partners in developing pediatric devices? And nothing else? Do we even talk to each other? Right, but for paediatric devices we've combined. So you know, anyway, the access to capital is an issue and we're certainly working on that others are working on it. Part of it is showing that it can be done part of it is showing that the model may need to be different. You can't think about it just like you do developing a new cardiac stent. But the opportunities are great, I think we're gonna get to those but but the small community, a small focus sales force, people who are not cardiologists who are looking at their 100 stent, you know, neonatologist who've never had something designed for them, saying, Yes, I want to use that, you know, so, anyway, I kind of went off on a tangent there, but the access to capital is a big one. Happy to tell some fun FDA stories, too, if you want, but we'll let you continue.

Andrew Meadow  19:23  

No, I mean, I think you're absolutely right about the collaborative nature in I'm sorry, I don't remember who's talked about the word collaboration, but there is a collaborative environment and what we do and how we do it. And I think part of that has to do with the fact that we are so limited with the types of options that we have available, that we are picking up the phone and calling our friends and in some cases, calling our enemies and finding out what's what are they doing to help patients I mean, case in point, Harvard and Yale we're working collaboratively in order to address the issues of RSV. You know, Boston's children did not have enough room for patience. Neither did Yale. And they're trying to figure out how to do this. And Brown was sitting in the middle, or Providence was sitting in the middle of saying, Hey, we're here. So but I

Sharief Taraman  20:11  

think you're actually hitting on something that's really interesting. If I have a device that I create for an adult market, I have to go find all the adults all over the place. If I design something in a pediatric neurology space, I got 14 199 colleagues that I got to talk to, and I'm I probably have at least like, 900 of them on LinkedIn, right? Like, and probably like, 800 on my phone, right? Like, it's not that big of a stretch to go out. And really, and I think Suzy was talking about the children's hospitals talk, right. Like I said, I'm a president for the American Academy of Pediatrics, Orange County Chapter. Like if I go to the AAP conference. Yeah, there's like 85,000 pediatricians, but you'd be surprised how many people you actually know or know you in that niche, quote, unquote, space?

James Wall  20:54  

Yeah. And I'll add to that, you know, one of my other roles is on the buy side, I ran the value committee for all Stanford health care for a while, but specifically, the Children's Hospital point of view. You know, we, in terms of pricing, sensitivity, we all have it. But if there's a device designed specifically for kids, you know, we are open to a premium on that, right. And because we know that it matters, and a great example is the stapler example, company that was originally called just right, surgical, became older surgical, designed all their devices to be three millimeters for laparoscopic surgery for us. And we went to bat for them, right, we went to the value committees, I mean, I was on the value committee or whatever. But we'd like the surgeons around the country, were going to bat and it was a small group that were very passionate, we need this, it will improve outcomes, and just right designed such great instruments that then they went to upscale them as boulder surgical. And then they were acquired by Hologic recently for really a suite of products across pediatrics, GYN and others. So I think that's an example of that innovation from peds up, and that, by the way, had they tried to sell those instruments into adult first, they would have just been noise, right, they would have been up against Medtronic who bundles their staplers, and there's just no chance they can get in the door, our value committee would never have let that company in the door over Medtronic Ethicon. In less they had a unique pediatric product. So that's one that it really shows it's not just the design of the device, but it's also a market access opportunity.

Andrew Meadow  22:22  

And when we talk about market access, we also want to think about the reimbursement components inherent to market access. And one of the things that I've ablate been very impressed with, from both the public and private payers is there is amount of flexibility. And I'm starting to see significant amounts of flexibility over the last couple of months to consider things that historically, they would not have paid for. And I think that that, particularly in pediatrics are more so in pediatrics than adults. And that has been very, very enlightening to say the least, I want to now move to the actual industry itself and how we think about priorities. And I'm speaking about each of us. Now everything in pediatrics is a priority. But it's hard to do all things we can't boil the ocean. So are there any sub segments within the pediatric space, that each of you are starting to prioritize or you're finding more attractive with respect to your individual efforts, I know in the case of Cognoa, where they're at, but beyond just what you're doing, personally, what you're hearing in the universe, what you're hearing from your friends and colleagues, as spaces where you should be spending more time.

Sharief Taraman  23:29  

I'll tell you, there's, there's in my mind, there's probably three or four. So the first one is obviously you mentioned that pediatric oncology, you know, conditions and cancers that would affect children and lead to mortality or significant morbidity are now things where the mortality is not morbidity. So the kids are surviving. And they're surviving to reproduce and have kids and we need to be thinking about like, how do I protect your your ability to reproduce and to have children if you want to in the future, that was something we weren't doing 10 years ago, because we're like, these kids are probably going to survive into adulthood. So So oncology is I think, a huge opportunity, we'll we'll get to that. I think the second one we talked a lot about was was surgical space. Again, if you have a device and you're trying to shove this giant thing into a small body, that just doesn't work. So that's a big one. And then the two that all kind of combined together is kind of the behavioral health, mental health, developmental health. I mean, we know that this is an ever growing area. It's it's pretty, it's it continues to be so the CDC just released their most recent rates of autism. So 10 years ago was a one in every 100 kids. Most recent one was one in every 44. Today it was released. It's one in every 36 children. And so that rate that prevalence of autism is is continuing to increase and then inequity and that continues to be a problem. So if you're Hispanic, you're African American, you're female, you're gonna get missed. So huge opportunity there and I think to really make a difference, and then in the mental health space, we've seen the effects of The pandemic. So, you know, we would say maybe 5 million kids per year are going to need some developmental evaluation, that number has probably gone up to about 8 million a year that have some developmental thing going on. Because of, you know, side effects from the pandemic,

Andrew Meadow  25:14  

in the developmental area. I think we're seeing tremendous dichotomies between certain economic strata, spheres within society, as well as demographic regions as well, which I hope we can talk about.

Suzy Engwall  25:28  

Yeah, and I will second a lot of the things that you said, I think autism for me is really big, because I spent a lot of time kind of diving into this space and understanding the challenges that parents and these children have, especially if they have to be an inpatient at the hospital, it was really interesting to me to kind of dive into that space. And if anybody wants to talk about that later, I'll talk to you about it for hours. But there's a lot of just the way that these patients are treated when they're in the hospital is much different, their length of stay is longer. So it's definitely a huge space ripe for innovation. I think, you know, I touched on this a little bit earlier, but I think we, when we talk about rural health care, it there is so much opportunity in there. And so for me, I'm looking for those different types of digital health platforms, and other things that can help with remote patient care, especially for you know, the underserved populations. So those are kind of two areas that I really care deeply about, I think mental health, we've all seen through the pandemic, we've all seen the stories in the papers about how that's on the rise. But just like with everything else in pediatrics, there aren't enough people in this space to help take care of those patients. So we've got to do what we can to create these new technologies. 

Andrew Meadow  26:36  

When you think about rural health care, and I'm from a small town in southern Ohio, so royal cares, both personally and professionally important to me. Do you think are you think more along the lines of remote monitoring? Or what what are you thinking about?

Suzy Engwall  26:50  

I think that's a big piece of it for sure. I you know, we talked a little bit today a little bit about concussions as well. And that's a big issue, you know, when you've got to drive so far, but when you have anything, you know, there are kids that have complex conditions, and maybe they have to see somebody, you know, once a month, if you have to get in the car, take time off work, drive five hours to see your caregiver, that's not good for anybody. I don't care how good of a job you have, or how much money you have, or how much time off you have. That's not how you want to spend your time and neither your kids. So it's really about how can we put new things in place to help, especially with chronic conditions. When you think about diabetes, asthma, the prevalence of those are getting more and more all the time. And I really think that it's important that we address a lot of these chronic conditions when kids are kids before they get the illnesses and the other comorbidities that come with being an adult.

James Wall  27:42  

Yeah, I agree with all those all, I'll add two additional opportunities that I see. And these really came to light from a discussion I recently had with the former CMO of Medicaid. And he highlighted look at the NICU. Right look at the NICU and there's two populations there for the most part, there's others, but there's prematurity costs Medicaid, an incredible amount of money. So I think that's a huge opportunity. And all the complications, right, the trunk of the tree is being born premature, but then going on to necrotizing, enterocolitis, retinopathy, etc, all these things, so prematurity. And then the second is congenital diseases, what you are born with, that can have an effect and a huge cost on life. And I'll tell a story of one company that I advise that I think really highlights how there's opportunity for devices there. So there's a company called Eclipse Regenesis. And they're basis basic premises, there's a very small number of kids who are born with twisted intestines and they lose the majority of their small intestine, and therefore are not able to absorb food, and they would have to the treatment now would be TPN, which is IV nutrition. We can keep them alive for a lifetime on IV nutrition, but it's incredibly expensive. $250,000 a year, there's a drug that has about a 30% efficacy in decreasing that need that costs 10s, if not $100,000 a year, and a lot of them go on to liver transplant the cost of give or take a million bucks. So you're you're talking about lifetime cost, right? Millions. And this concept was well, you can take bone and stretch it and it gains function, right? It gets stronger, it gets longer. Why can't you do that with battle? And the answer is you can and so, you know $10 million worth of NIH funding and research and 10 years by physician, Dr. Donnelly works in this space, they prove that you can stretch bowel and when stretched, it actually gains function. I mean, think about that you put this device into a baby, you stretch their bowel, you give them enough to be off TPN to not need a liver transplant, your curative medical device. I mean, that's incredible and think of the value you've created. So I just love the storytelling example in addition to the hypothetical, right, so I think that's, you know, think back to the opportunities, prematurity things you're born with, that we can fix at that point and really save both child improve their quality of life, of course, but also save the system an incredible amount of money. I agree.

Andrew Meadow  30:11  

I always like to start with the risk first, because it sets a nice platform for the opportunities and ending on a good note. So when we think about the next five years, I can certainly tell you that if the pediatric healthcare innovation community in 2010 existed today, I probably would be working for Bain Capital. But that aside, the one thing that I am personally very hopeful for is that I am seeing a tremendous shift in focus. And thinking about pediatrics. from an innovation standpoint, I will say that, as a principal investor, I wish my colleagues in the venture community were moving as quickly to support that innovation, I think one is moving at the speed of, you know, speedboat, the other is moving at the speed of an aircraft carrier. So hopefully, we'll catch up to the rest of the society. But I'd love to hear from you about what you guys are most excited about what you three are most excited about the opportunities in pediatrics. And they can be whether it be about innovation, whether you're seeing a shift to the greater role, patient advocacy groups, to inform decision making, or really quite frankly, informed legislatures. Or if there's some innovation out there that you're saying, this is going to become a standard of care. However you each want to take this, I'd love to hear from you. Can I

Suzy Engwall  31:45  

talk about moved? Yeah. So this is a project that Sharif actually worked on with a company that I used to work with. And you know, this story is more about an area that's an underserved patient population. You know, you've got kids with a toxic cerebral palsy, they suffer from tremors, the tremors don't start from the same place that that other diseases with tremors do. And so they need a specialized type of device. And for me, it's all about patient centered care. How do we make these patients lives better for the rest of their lives if we can. And so this particular project came from a child who had attack cerebral palsy, he sent a video in to CHOC Children's, and showing himself making a peanut butter and jelly sandwich or trying to write his name. His mom actually wrote a letter as well, I still have a copy of that, that I share with people. And it touched me so much just to think about, you know, this kid going to school every day and not being able to do the normal things that other kids do. And his mom touched on the idea of you know, kids aren't very nice to each other. How can we how can you help my son, and it took a little bit of time, but Sharif ended up partnering with a UCI and I'll let you tell the rest of story if you want because it's your project. But for me, it's about patient centered care, and how do we improve not only you know, not only the quantity of life, but the quality of life for these patients as we move forward? So for me, it's not necessarily one area of focus, it's about how do we help these patients, especially the ones that are kind of considered in that rare disease sort of bucket? Because they're the ones that get the least amount of attention.

Sharief Taraman  33:19  

Yeah, we crosses really interesting spaces, pediatricians or pediatric specialists. So we've got these kids, and they grow up, and they're really smart. And so I don't know if some of the audience knows, but I probably mentored about 700 students, now, most of them are actually in the medical field med device field, or doing something with artificial intelligence. So Dylan is one of these kids kames, that makes me something, he's actually one of the CO inventors on that device, that device, one of the PDC competition, and we're hopefully going to have him run around and make this device available for a bunch of kids. I don't wanna take away from James, but I'll just put a quick plug in, I think data science, machine learning and AI, I know that there's a lot of hype around it, but honestly, the amount of power in that technology to advance pediatric healthcare. And really, if I'm thinking about it, let me take away my like, you know, we're doing things for the state of good, but really, from an investment thesis perspective, the amount of money that you have to put into something to actually get an AI based device across the finish line and get it to market, the ROI on that, and especially with software approaches zero, that kind of seems like a no brainer to me. And to me, it's also just, I have a little bit of like, impatience, maybe like I want to get that thing out fast. And as much as I like, super cool. Like, let's make stretchable gut 10 years is way too long. Like it's gotta go faster than that.

Andrew Meadow  34:44  

I appreciate that. We were looking at an extra coil womb. That was a technology from a Pediatric Hospital in Philadelphia, and they were telling me about the advancements that they made from 2013 2014 And I expected to go in and see a finished product after eight years. And I walk in and we're still doing beta tests. And I was, I was a little concerned about excuse me the trajectory from today to 2030. So,

James Wall  35:15  

yeah, if you haven't seen that video, check it out on YouTube, it's got 40 million views, but it's artificial placenta Children's Hospital of Philadelphia, it is one of the most bonkers things you'll ever see. It's like The Matrix. I will say the thing I'm most excited about is and if you don't take anything else away from this, anyone in the room who thinks about peds the pipeline is strong. And there, the entrepreneurs coming into this space are becoming more sophisticated and more capable every day, the money will catch up to it. I know it will. We have a great foundation with the pediatric device consortiums funded by the FDA that seed fund on the order of millions per year towards pediatric health technologies. And that has started bringing talent to us. And it's only going to continue. So anyone who's an investor, I challenge you take five meetings next year with pediatric focus companies, you may not invest in one of them. But check out the talent we have. It's impressive.

Suzy Engwall  36:13  

I piggyback on that for a second, please. And if you're an entrepreneur, and you're not doing anything in the pediatric space, and you want to try to look for your next opportunity, it's a great space to look, I can't tell you how many pitch decks I see every week, how many companies are put in front of me. And I say, oh, there's like seven companies doing the same thing. Oh, there's eight companies doing the same thing. Oh, a pediatric one. Oh, there's no competition here. They have no competitors. So it's a really great space to innovate in as well. So if you're an entrepreneur, think about it. Just saying.

Andrew Meadow  36:41  

So we had an opportunity last year, actually around this time last year, that was exclusively focusing on glioblastoma. And we had talked them through the potential opportunities in pediatrics. Last month, I got a revised a revised business plan, where they are now a pediatric oncology company. With the adult application being their second approach, Pediatrics has become their first line. So

Sharief Taraman  37:12  

I did invest in that. I mean, right, that it makes sense. They're going to be able to get faster into human, they're going to have a easier regulatory path to be honest with you. And again, look, if I have a child with glioblastoma, I'm more willing to actually participate in that trial. 

Andrew Meadow  37:25  

Absolutely agree. Before we sign off, I wanted to see if there's any questions from anyone in the audience? Yes, sir. Well, I would I would venture to disagree with you on that. I think that Next Step Ventures, which James plays an intricate part in is doing an amazing job in this space, as is, excuse me, our good friend John. John Parker at Springwood Ventures. So there are there are a few, but I will be sad while

Sharief Taraman  37:58  

there's going to be 50 more because we've convinced everyone in the audience that that's

Andrew Meadow  38:02  

advice from your mouth to God's ears. Yeah, that happened 

Sharief Taraman  38:05  

50 Tomorrow!

Suzy Engwall  38:06  

if you're an entrepreneur, and you're a startup, and you're not working with patients, you've already missed out as far as I'm concerned. I'm a big believer in design thinking. I'm a big believer in starting at the patient and patient centricity. I think everything that you're working on should have the patients involved from the beginning to the end, and you need a diversity in that patient population to you can't just take, oh, I talked to five diabetic patients before I started this. And so now I'm good to go. You've got to go back to them every step of the way. You've got to bring multiple patients in and the families will love it will love you for it too. And this is the other thing, if you want a community that's going to rally around your innovation, and try to convince other people or talk to the hospitals and say, Hey, you guys need this. You're never going to find a bigger, bigger group of people that are going to rally for something than the parents of these kids. I'm telling you, it's a it's a really good opportunity.

Andrew Meadow  38:54  

Where you're gonna say something 

Sharief Taraman  38:55  

No, I was gonna say we're good. Thank you. Great.

James Wall  38:57  

Bring a kid to an FDA panel. It works.

Suzy Engwall  39:01  

I like that.

Andrew Meadow  39:02  

Thank you all very much for wonderful day.