Vibrent Health – The Catalyst for Mobile HealthCare

 

Episode Summary

We use our smartphones to communicate, shop, navigate, watch videos, take pictures, share our lives on social media, track our exercise, and listen to music and podcasts. So why shouldn’t they also be the main interface to our healthcare experiences? Let’s talk about Vibrent mobile healthcare.

P.J. Jain started Vibrent Health out in 2010 when he left behind a career in networking and telecommunications. The company had its breakout moment in 2015 when it won a contract from the National Institutes of Health build a mobile data-gathering infrastructure for a 10-year research program called All of Us, which is designed to gather medical data from more than a million people around the United States.

NIH asked Vibrent to build a mobile app and an online portal that would become the communications backbone and the central data gathering repository for the whole project. And now that NIH is six or seven years into the project, it’s clear that in some ways the agency and the mobile interface Vibrent built for All of Us have leapfrogged over the rest of the US healthcare ecosystem.

We’ll hear how in today’s episode.

Episode Notes

The app provides an easy way to gather and manage data from patients in the study, and to monitor and interact with them, while still protecting their privacy.  As Jain puts it, it meets All of Us participants “where they are” – meaning, on their phones.

Technology like that still isn’t part of the offering at most big health plans or hospital networks. But Vibrent is working to change that by partnering with health systems, academic health centers, pharmaceutical companies, public health organizations, and research organizations to get its mobile apps distributed more widely.

If you believe that our phones are going to be a key element of personalized and precision medicine for everyone, then the work Vibrent is doing with NIH and its other customers is worth watching.

Podcast Transcript

Harry Glorikian: Hello. I’m Harry Glorikian, and this is The Harry Glorikian Show, where we explore how technology is changing everything we know about healthcare.

Our smartphones are an irreplaceable part of our everyday lives. We use them to communicate, to shop, to navigate, to watch videos, to take pictures, to share our lives on social media, to track our exercise, to listen to music and podcasts.

So why shouldn’t our phones be the main interface to our healthcare experiences?

That’s the question PJ Jain started out with in 2010 when he left behind a career in networking and telecommunications to start a company dedicated to mobile health.

It started out under the name Vignet [pronounced VIGG-net] but quickly renamed itself Vibrent Health. And it was under that name that PJ’s company won a game-changing contract in 2015.

The job was to help the National Institutes of Health build a mobile data-gathering infrastructure for a giant research program called All of Us.

That’s a 10-year project designed to gather medical data from more than a million people around the United States to help doctors make more customized health recommendations based on a patient’s environment, lifestyle, family history, and genetic makeup.

If you’re going to try to recruit a million people into your research study and keep tabs on their health; and if those people are going to be from diverse backgrounds; and if they’re going to be distributed around the country, then there’s only one practical way to reach them, and that’s on their smartphones.

NIH asked Vibrent to build a mobile app and an online portal that would become the communications backbone and the central data gathering repository for the whole project.

And now that NIH is six or seven years into the All of Us project, it’s clear that in some ways the project has leapfrogged over the rest of the US healthcare ecosystem. It provides an easy way to gather and manage data from patients in the study, and to monitor and interact with them, while still protecting their privacy.

As PJ puts it, the app meets All of Us participants where they are – meaning, on their phones. Technology like that still isn’t part of the offering at most big health plans or hospital networks.

Vibrent is working to change that by partnering with health systems, academic health centers, pharmaceutical companies, public health organizations, and research organizations to get its mobile apps distributed more widely.

I wanted to have PJ on the show because I’ve long believed that our phones are going to be a key element of personalized and precision medicine for everyone.

And I think the work Vibrent is doing with NIH and its other customers gives us a glimpse of that future. So here’s our full conversation.

Harry Glorikian: PJ, welcome to the show.

PJ Jain: Good afternoon, Harry. Thanks for having me.

Harry Glorikian: It’s great to have you on the show. I was I was reading, you know, quite a bit about, you know, your company and everything. And I wanted to, I said, well, we really should have him on the show and make people aware of of the organization and what you’re doing and everything that it’s bringing to play in in.

Well, we’ll get into the details here pretty shortly. But before we talk about, you know, your company, Vibrent, you know, I’d love to hear a little bit about your path into the world of health research and mobile data. Right. Because your career background is actually in consumer networking and telecommunications for companies like AOL and Sprint. Can you describe, like, the path that led you into mobile technology for health research?

PJ Jain: Thank you, Harry. Great question. And I am an outsider, as you mentioned. And my I come from telecom, media, technology and consumer electronics.

I have been a product manager, a corporate strategy, business strategy and overall consumer experiences background. So it was a very simple thesis 12 years ago that everybody realized that we’re using our mobile phones for our mobile video, Mobile music. Mobile commerce. Mobile shopping. Why not mobile devices for mobile health? Why can’t our mobile phones help each one of us with personalized health?

So it was as simple as that of a conversation. And because of my role at Sprint, I was working with 100 plus institutions across the country who were looking at electronic health record vendors, consumer electronics companies. You had startups looking at specific remote patient monitoring solutions.

And all of those, at least what I noticed was there was a gap that. None of them are really going to take this more comprehensively. And people coming from health care really didn’t understand telecom and how to make a mobile app reliable for millions of people.

You can make a mobile app for 50 people, 100 people, 500 people, but you have to make it reliable. And that’s the background I brought, of creating systems that would work for large populations. And I was, as you mentioned, outsider. And then along the way, I learned a lot and on the job training. And here we are.

Harry Glorikian: Yeah, but PJ, let’s admit, you know, crossing the chasm like that, especially 12 years ago, I’m sure was not a, I’m sure they didn’t just with open arms take you in. Right. Because when I was developing, I had developed a whole platform around location-rr based services and everybody looked at me and goes, you’re a health care guy.

You’re not supposed to be here. And man, I mean, they made life hell because, you know, you didn’t fit right if you didn’t walk and talk and quack like a duck, you’re not a duck,  sort of thing. So but before you found it Vibrent, there was a company called Vignette, if I’m pronouncing it correctly?

PJ Jain: Vignet.

Harry Glorikian: What was the mission there? Was that different or was that rthe genesis of of Vibrent?

PJ Jain: Yeah. So like with any entrepreneur, when one starts something, one is not as structured about the branding, the name. You just want to get started, come up with a name, do a quick incorporation, you get going. It takes a day to do that. And really it was as simple as that to say, I want to start something, I just need a name to start it.

And we just called it Vignet and continued on. Later we realized by when we were talking to researchers and consumers and patients that Vignet is confusing. It doesn’t convey, and it doesn’t have an inherent brand value. And recognizable value. So we conducted almost a nine month exercise to better understand who we are, what we do, and what do we want people to remember about us. And we went to one key question that said, what do we really do?

We help improve people’s lives. Well, if you help improve people’s life, then what should it make them feel? Vibrant. They should feel vibrant every day. That was a key insight after nine months. And then we said, oh, we cannot get Vibrant as a trademark or a URL. Well, let’s do a Vibrant with an E.

So that’s the simple story about a very long process that led to the name Vibrent. And Vignet, we pretty much transitioned everything to Vibrent Health. So Vignet is more of a holding company and more of a paper work.

Harry Glorikian: Excellent. Interesting. Yeah. I usually pick up the Latin dictionary and try to find a good name for a new company. But. But, you know, reading quite a bit about Vibrent, it’s clear to me that in some ways you can’t really tell the story about the company without first telling, you know, this whole concept of precision medicine, especially at the National Institutes of Health.

And that project is called All of Us. And for the people who are listening that aren’t familiar with that project, can you explain, what is it? What are its end goals? How big is the project? Et cetera. Or any other metric that you think is….

PJ Jain: Happy to. We talk about the NIH All of Us research program, but let’s back up for a minute and really talk about the movement of precision medicine. And this was initiated and headed by Dr. Francis Collins at the NIH, who was one of the most admired and longstanding directorsr of the NIH. And he had a vision 25 years ago about creating human genome sequencing technology, the DNA sequencing and genomics work that started that gave us tremendous amount of innovation in genomics technology. And his next vision was to say, how do we take the Human Genome Project beyond just genomics, and how do we take it more and more towards precision health?

So this initiative was started in 2015, and along the way there was sufficient funding to be able to build the next phase of the Human Genome Project, which was then called the All of Us Research Project, and that was around utilizing broad sources of data from genomics to environmental data to lifestyles and behaviors, and to create a new approach, a new paradigm for health research of the future.

So it’s not a…. While, it is a single program, the significance of this in the world of decentralized and hybrid, digitally enabled research and decentralized clinical trials is quite significant because it so nicely translates and scales to these domains of decentralized and hybrid digital health enabled research.

So that’s the significance of it. And because it was totally new, this approach didn’t exist, there was no technology platform that was out there that could meet the need, this is probably one of the most significant outcomes of this project, is defining the clinical research and health research requirements for a technology platform.

So that’s what we ended up doing. We were awarded twice in a row the contract and the award from the NIH to provide this digital health platform to meet the needs of this 1 million people program.

Harry Glorikian: You ended up winning that contract I believe in 2016 to build the online portal and mobile apps to gather all the participant data for the All of Us research program.

I know that supporting All of Us is not the only mission of the company, but it feels like it was just a breakout opportunity to sort of step back and build something that could manage all that data and all those different data streams that are coming in.

And this might sound like an obvious question, but why was it important for All of Us to have a mobile collection platform in the first place? And I asked this question. I want to give you an opportunity to lay out the high level philosophy about the roles of smartphones and other devices in the future of health research and health maintenance.

PJ Jain: I think this goes back to what I was talking about. Ten, 12, 15 years ago, recognizing that mobile devices are becoming more and more powerful, they are becoming very powerful computers in your hand. So as the evolution of mobile phones has reached over 95% penetration across the United States, and these are smart mobile devices, people are spending more and more time on their mobile.

It just seemed like a missed opportunity if health research and health care doesn’t keep up with the trends of using other trends, so if people are using their mobile devices for banking, for Netflix, for Uber, for shopping, everything, then you would want to have a presence, a digital presence in people’s mind share.

So there was really no choice but to say you’ve got to meet people where they are. Right? We use this sentence called meet people where they are. Whether they are geographically located in a rural community or away from any academic health center, or they’re using apps on their phones, meeting people where they are, what they’re using, what their pattern of daily technology utilization is.

They should be able to adapt. We should be able to adapt to people’s usage and behavior patterns. So it was really important to have that mobile. And then we also needed to make sure that it’s an experience that is comparable to “I just ordered an Uber, I just did an Airbnb or Lyft” or what have you.

That there is not too much disparity between you know, health research apps in the past. Because they didn’t have enough sufficient funding and they were not designed for a million plus people, there was not enough investment to focus on user experience, right, and functionality and stability.

So that being said, when I started to really right-size the investment and invest what’s really needed for a world class, highly robust, scalable, and really looking at this mobile app and portals and other data collection and communications and engagement and experience as, “Look, we’ve got to take this seriously, and it needs to be current.” Because, which was the lacking part in pretty much every other health research app in the past or mobile app.

They just were not current, they didn’t appeal, they didn’t have a good experience. So we focused on making sure it’s going to be adopted, relevant, engaging and match up and stay matched with the current expectations of user experience. So it was really important to have that. And the second thing I would say is that it’s a lot more than data collection.

It’s their  implementation of an entire workflow that is included in these mobile apps. It’s a workflow product. We’re trying to help people, we are trying to guide them to complete certain research-study-related steps and tasks. How do we make it easy? How do we make it accessible? Accessibility was a very, very important aspect.

How do we bring these devices and experiences to underserved, underrepresented populations that have experienced high degree of health disparities? All of these goals were being accommodated.

Harry Glorikian: Yeah, that’s a lot of complexity. I mean, people don’t, may not, or the listeners may not appreciate the level of complexity. Actually, it’s interesting because I have just published my new book and it’s all trying to make explain to the average person in an accessible way, like how technology can make a significant difference in how they can manage their own health or the health care, health of their loved one.

PJ Jain:  Nice.

Harry Glorikian:  So I understand like how, how, how you have to really make it easy for someone to absorb that information and then do something with it. But so you couldn’t have been the only one that was bidding on this.

This is not a small or insignificant project. It has high prestige, high PR, you know, and of course, you know, the risk that someone is taking by giving the contract out to a certain group is also high because it’s their reputation.

I mean, weren’t there a lot of companies like Google and others that were thinking about health at that time? I mean, what did you accomplish before 2016 that positioned you to win this award? Or are there any good stories you can share about winning the award?

PJ Jain: Happy to. That was a very insightful question, Harry. We look forward to actually answering this because this really speaks to how did it happen, the story behind it. And it’s as I said, nothing is overnight.

It was a journey seven years in the making. So when I, when I left Sprint as a leader in the product management organization, as I mentioned earlier, t he use of mobile devices was picking up. And I was so convinced that at least I believed that I’m really well positioned to help solve it.

So as I have spoken before, I took $400,000 from my 401K and started the company. I did not raise seed money, no Series A, no outside investor, and the debt came from 401k and I did not raise external debt. The reason was simple. It was still early. It would have been too hard to convince an investor. And the belief was that if you’re going to spend time convincing somebody to give you money, then you should be convinced yourself that it’s going to work. Right?

So show it to myself that I can do it. Yes, I am utilizing family 401K retirement money and my first wife allowed me to do that and I’m really grateful for that. But that was a dream and I had to follow my passion. So I did follow the passion and it’s a very long story, but in a nutshell, along the way we came across what’s called as Small Business Innovation Research grants from the NIH.

PJ Jain: And we didn’t know anything about grants. I was only three people at the time. We were just doing some contract services based work to keep the company alive, and we came across SBIRs. We knew nothing about them. We went to school, we learned and my colleague and I started writing SBIRs and I think we wrote about eight or nine SBIRs and we got six funded.

So that gave us sufficient. It was about six and one half million dollars over four years that gave us sufficient money to start, legitimately make a platform for digital health research. Number two, what happened?

The most fundamental thing that benefited us is that we didn’t realize at the time, we didn’t know that, but in writing this SBIR grants, we always collaborated with academic health systems and researchers. And what we realized later is if you want to be, in the point you were making earlier about what you encountered, that you are a health care guy doing a location based services, technology development, we realized later that we were doing good technology development, but the added benefit we got, we realized later was really valuable, is, we collaborated with scientists and researchers during the all of the SBIRs. That’s when we learned the lingo, the requirements, how they talk, what they need, and how.

Almost no digital technology or platform will achieve adoption and scale unless it really is in concert, working in concert with researchers and scientists and focusing on scientific value and not talk about digital health.

PJ Jain: Digital health is like a means to the end. It’s not the end. So it’s really the science. So we lead with science. So what we learned along the way. And then to your point,   the RFP or the competition happened. NIH issued this request for proposals for the All of Us research program and we were about six, seven people company at the time.

And we, we were we were we started talking to people, academics, researchers, universities and pretty much everybody told us that, look, there is no way you’re going to win because such awards, always, in the history of NIH, have gone to academic organizations. Number two, exactly the point you made here,  that you are a smaller organization.

This is a very important initiative. We said, we hear you, but we’re just going to you know, I just can’t not apply. So what it really came to, the decision point, is that because we had a seven year history of working with the NIH and we had built a platform, they felt that they did not need to invest in basic building a platform, that the platform was there.

We did demonstrations. We did a lot of presentations. So there was comfort that Vibrent is the only organization that actually you know what they say. Show me. Don’t tell me.

Harry Glorikian: Right.

PJ Jain: We showed them. And because for seven years we were already collaborating with the NIH, we were a known entity. We understood digital health and technology. But equally, we understood scientists and researchers. So we had a good foundation and a starting point that they built on top of. And we were able to rapidly then scale.

Harry Glorikian: Yeah. That’s, you know, you just went through the whole entrepreneurial, you know, partially a little not normal thinking process of, let me take money out of my bank account and let me put it all on the line. And, you know, this project is there. Maybe we won’t win. Let’s try anyway, right? Sort of. You have to be a little on the edge to say, you know, we’re going to do this.

And then worse, like I’ve been in this situation, you won the project and you’re like Oh, oh, what happened? I always I always term it as like the dog running after the bus and then it catches the bus. What do you do? What does it do once it catches the bus? You know, you’ve got to actually now process this thing.

I mean, I remember when we bid on a big contract in one of my last companies and everybody was like, “There’s no way we’re winning this.” And we won it, and everybody started having heart palpitations. And I was like, “What’s wrong?” They’re like, “We need people. We need space.” I’m like, “If that’s all we need, like we could, like, that’s doable.”

Then we just we literally doubled the size of the company in about a month and just started chewing on the project and did a great job. But it’s, you have to take those incredible risks, which is interesting. But now, once you won the contract, going back to this, you know, what were some of the biggest challenges of implementing this system? I mean, you’re now in 2022. What do you wish you knew back then that you know now because so much has changed, right?

PJ Jain: Great question. I think I’ll say two parts. One is it was exactly what you said, Harry, how you scaled. That’s how we were scaling on a monthly basis, doubling. Where’s the space? Where is the people? I need a front desk and I need an HR and finance person who’s managing the money here, who’s going to invoice the customer.

So we scaled, as they say, that’s that’s as they said, that’s history. But we wish, we did really, even though we were a smaller company, one thing we really did well before we even got the award is that we had implemented, even though it was a very small team of people, very nice, because for government, audits are very important.

Security and privacy implementations are very important. And luckily because we were working with the NIH over time, we had already understood that. So those were very they were they sound mundane, but they’re really important from a paperwork and contracting and awards perspective. Yeah.

So we did those well. I wish today in 2022 that requirements were better understood back in 2016, 2017, 2018. But as I mentioned earlier, there is no other digital system that is so purpose built for clinical research.

So we were flying the plane while building it. I have heard that terminology so many times as an analogy. I never understood what it feels like, but we went through the journey of what it felt like to fly a plane and build it while we were flying it. So but with that, though, new requirements emerge and new things get added and then that has an impact on the platform.

PJ Jain: Some of it is foundational, some of it is takes a lot more effort to do so. I wish that there was a more comprehensive scoping exercise, but there was just not enough time based on overall program needs. So we said, okay, as you said earlier, let’s just start, let’s solve the problems and let’s get the mindset going and let’s get people’s imagination rallying around because it was so new, there was a translational and translational belief that you had to build.

This can be done. So what is it. Show people what is it, that it can be done. It can be done at a national scale. There were so many big challenges and barriers we overcame that don’t seem big, but there is nothing today, till today that’s a nationwide, decentralized and hybrid digital health research infrastructure doesn’t exist.

So this is all that was built along the way. And then COVID came, and that helped us a lot in terms of understanding that going into a clinic is going to become less and less desirable.

So how do you conduct remote virtual health research? How do you bring people who have been left behind, people in rural communities, people in lower socioeconomic status or diversity or race or ethnicity that have not perhaps trusted research? How do you bring them along? All those were not known at the time. So here we are with more than 80% diversity in this 600,000-people health research cohort that has been built that was not as well understood five years ago.

[musical interlude]

Harry Glorikian: Let’s pause the conversation for a minute to talk about one small but important thing you can do, to help keep the podcast going. And that’s leave a rating and a review for the show on Apple Podcasts.

All you have to do is open the Apple Podcasts app on your smartphone, search for The Harry Glorikian Show, and scroll down to the Ratings & Reviews section. Tap the stars to rate the show, and then tap the link that says Write a Review to leave your comments.

It’ll only take a minute, but you’ll be doing a lot to help other listeners discover the show.

And one more thing. If you like the interviews we do here on the show I know you’ll like my new book, The Future You: How Artificial Intelligence Can Help You Get Healthier, Stress Less, and Live Longer.

It’s a friendly and accessible tour of all the ways today’s information technologies are helping us diagnose diseases faster, treat them more precisely, and create personalized diet and exercise programs to prevent them in the first place.

The book is now available in print and ebook formats. Just go to Amazon or Barnes & Noble and search for The Future You by Harry Glorikian.

And now, back to the show.

[musical interlude]

Harry Glorikian: If you start putting the dots together, you sort of see where the line is going. And it’s so still people can’t see, you know, what the end goal is. And but I believe that this sort of technology approach and the way that things get paid for and so forth might have to change. But it can be a profound impact on how we manage patients and get data from patients and then are able to react to patients with a system that allows for, you know, decentralized monitoring or or ways for them to touch base with the clinician and or the researcher.

PJ Jain: Yes. I think what is one big change that is happening and needs to happen is that we always have treated health research as outside of health care.

Care and research have not come together. So researchers are being viewed by health care professionals as, oh yeah, okay, you’re doing this stuff on the side. However, the technology, the mobile, the data, what that is changing is that as that research data gets more integrated with health care, so electronic health records now have interoperability guidelines. They have to make their data available by the HHS and ONC [Office of the National Coordinator of Health Information Technology] mandates.

And because of that, the end research collected data is now easily being merged with genomics data, electronic health record data, wearable data, and other types of data sources that adds dimensions and that’s new richness to data sets. So research and care have started to come together a lot more. And those lines will blur.

Harry Glorikian: When you think about the data, PJ, I mean, at one point, right. I had one data stream, I had one river here and I had one river here, and neither the two shall merge. Right. But with this constant stream of data that’s coming in from these devices into one centralized platform, whether the person is looking at the view and saying, yes, I need to manage this person for diabetes and call them up because the data looks like it’s going in the wrong direction or or the researcher is looking at it and saying, we’re testing out this new device for diabetes, right, it’s just the person looking at it that’s looking at it differently.

I don’t believe that managing the patient should be a completely different approach.

PJ Jain: Absolutely. The other thing is, how many apps will a patient use for research? They have their health system app. They have this research app, that research app.

So we believe that over time, a central app and the notion that you need a digital presence and a gateway to health research and healthcare, and with more and more portability and interoperability and standards, that’s becoming more and more achievable now.

So one destination and whether you are looking at your health care records or you’re participating in this diabetes research because there is a new diagnostic device or a therapeutic device or an artificial pancreas device or a continuous glucose monitoring device. Now it is providing you care. It just happens to be under a research protocol. So in our estimation, research will become more of a protocol, but it could aid more and more with care as well.

Harry Glorikian: Agreed. I mean, this is my whole… I’ve I’ve keep thinking about a new book I want to put together that basically says there’s going to be a massive consolidation or pushing out of, you don’t need as many things to accomplish that goal.

As a matter of fact, the goal will be better accomplished with things that are more centralized rather than 1000 distributed apps that exist. And you can see that technology is driving it in that direction. I mean, technology changes the entire dynamics of of the competitive landscape. And I’m not sure that everybody fully appreciates where it’s headed.

PJ Jain: Yeah.

Harry Glorikian: We don’t have ten Googles. Right? So, you know, it’s very interesting how healthcare is at such a nascent stage of that, that they cannot see where this is going ultimately and the data is going to drive it there.

PJ Jain: Mm hmm. 100%.

Harry Glorikian: But let’s let’s stop here for sec. All of Us, is going to run for ten years. And I think that means 2026. If I did the math right. It’s going to end. But up till now, there’s got to be some really interesting things you’ve learned along the way. Could you talk about some of the surprising or interesting insights that have popped up so far using data that Vibrent helped collect?

PJ Jain: Yes. So regarding the program for ten years, that’s the initial communicated message. But my hope and expectation, and this is a personal belief, I’m not representing the NIH in this conversation. I’m not speaking on their behalf, but I believe that something of this value, you know, probably continues for a much longer duration. So with that being said, so I don’t know whether 2026 is an end per se. It’s just going to evolve over time with new research protocols and new needs, perhaps.

PJ Jain: In terms of what we’ve learned or what’s surprising, I think one of the biggest one is percentage of people, the diversity that is represented in this cohort. That, to me, although we had a high goal at the beginning of the program, we actually achieved the goals and exceeded the goal, which is more than 80% of participants are underserved, underrepresented in biomedical research, and we achieved that goal. That is huge, right?

Because when you look at pharma, when you look at any other academic health research, precision medicine, research, every one of those has struggles and challenges with diversity, achieving diversity. And as a flip, achieving equity in research. So how can we create drugs, therapies, devices, that work for all people but don’t include all the right representations during the research process? So that was a very interesting and satisfying achievement and surprise to us.

PJ Jain: Another thing was this notion that electronic consent seems simple, seems straightforward. However, it’s highly nuanced when you get down to it. So electronic electronic consent has multiple layers. Number one is informed witness. Does the person that signing the electronic consent, is it like a mobile app, 500 page long, nobody ever reads and just clicks, type of a EULA?

Is it truly informed consent? So we focused on informed-ness, making sure people understood what they were signing, what they were agreeing to. And the number two is doing some knowledge checks. Oh, you just signed this. Did you really understand? Let’s do a knowledge check. And it’s all designed to build trust.

So that was the second surprise to me in terms of, we did not understand and appreciate the complexity and the value behind doing electronic consent right. It’s ultimately to build trust with the consumer and the participant.

PJ Jain: Number three was that as we launched this program nationwide, the All of Us program, we were crossing all of the states in the United States. If somebody is joining from North Dakota versus California versus Texas, Arizona, Massachusetts, each state has their corresponding requirements for achieving consent or for asking people for consent.

So the electronic digital platform had to be aware of all 50 states, including California Bill of Rights, to make sure that every participant is compliant with their, and that the technology platform stays compliant with, local and state regulations. That became a huge undertaking.

Harry Glorikian: So much for the United States of America, right? I mean, it’s just it’s mind boggling sometimes all the rules of trying to implement care on a larger scale in the country. And I don’t think the average person understands, l ike, you know, in some ways I feel like we’re spending money and time on these stupid rules, right?

As opposed to making sure it’s secure, making sure people are informed and getting them enrolled. But can you tell us a little bit more about the broader business today? I mean, your work with NIH must have set you up to be a provider of choice to other partners like drug developers, hospital networks, state or public health authorities. Can you tell us a little bit about that?

PJ Jain: Happy to. I think as you , and we spoke earlier, that the attempt was to make sure that this is being built as a digital infrastructure. And that has come true because there are common requirements with other types of sectors as well. As you mentioned, drug developers/CROs or pharma, academic health centers, health systems, public health, public health research organizations. And all of those do require very similar capabilities. And no organization should only obviously depend on any one customer only.

So we have been actively promoting and working with all of those different types of entities. But one thing we also want to be mindful of is that we do it right and we do it responsibly because going too fast or too much of growth too fast is also not a good recipe. So doing it responsibly, making sure customers are happy and that that then permeates. So we do enjoy the credibility and the respect, as you mention, because of our larger initiative with the NIH. But we want to make sure that we are very responsible, to make sure we make every project and every customer succeed. And that’s the path we are on.

Harry Glorikian: So. Unfortunately, we’ve all been living with COVID for too long. You know, I’m wondering, you know, has the pandemic altered Vibrent’s direction?

I mean, I think maybe you can talk a little bit about NIH’s Rapid Acceleration of Diagnostics or RADx program to develop a screening tool for COVID-19? I’ve seen claims that using digital screening to determine an individual’s risk factors for COVID-19 can be comparable in accuracy to in-home rapid antigen tests. So I’m just curious if you can share any insights on that.

PJ Jain: Yeah. Happy to. So you’re right. So about a year and a half, almost two years ago now, NIH started this RADx technology program, they had multiple RADx programs. RADx UP was underserved population. RADx Tech was about creating digital technologies and testing kits. And they had an RFP for selecting a digital platform to fund it, to create what you mentioned, a software-based, screening-based mobile app tool because of the same reasons we talked about earlier that everybody uses mobile phones. So wouldn’t it be great to have that?

Our country, as you know, has very limited supply of testing kits. Testing capacity took time to increase. But any time there is a hardware based testing kit, whether it is COVID-19 or then the Beta variant, the Omicron, variants change. Tomorrow there will be another something else. So pandemics are going to change, variants are going to change. And it becomes, anything that’s hardware based, biology testing based, where you are in chemistry or a lab, it takes time to analyze, create a kit mass, produce them, get them out, distributed.

But if you had a mobile phone and a mobile app, that can be instantly be communicated to populations.

PJ Jain: So NIH had a request for proposals. They received over 200 applications, and this is all public information through press releases. And Vibrent was the single organization selected to fund development of this rapid diagnostic approach using a mobile app. So we had a scientific based approach where we wrote a protocol, we developed the screening tools, working with scientists and researchers, scientists that know infectious diseases.

They know the difference between flu and COVID. So the questions were very scientific and they were they were developed by researchers and doctors, in terms of how they ask the question. So if I’m a patient in a clinic sitting with a doctor, what would they ask? How would they ask?

So make sure there is scientific validity to that diagnostic and survey questions. And then there are algorithms behind the scenes, AI/ML algorithms, that were looking at broader data set from CDC. And that helped create… And then we validated it with 850 African American participants in the Richmond area working with Virginia Commonwealth University. So they were integrally part of the validation and usability and acceptability process. And then we submitted a final report to the NIH, and they were very happy with what we were able to achieve.

PJ Jain: So now let me go back to the the question you asked about accuracy. So we did show a very high level of accuracy, almost matching the testing kit. However.

When it comes to a diagnostic, whether it’s a test kit or a app, it does need a lab, because the test kits also have sufficient levels of false positives and negatives. So what we say is what we’re really more focused on is that using a mobile app and a diagnostic device, using mobile apps that our organization created working with the NIH, it significantly improves accuracy.

And it significantly decreases false negatives. So people who were going undetected for COVID and causing the spread, we’ll be more easily able to identify. So this was a example where we increase diagnostic capability, that made health care more accessible and reachable to people in a timely manner, and that reduced the cost significantly because people were not having to use as many test kits as they were doing without the app that we created working with the NIH.

So those were the multiple benefits that came with it. And yes, it did increase the accuracy overall of the app and the test kits. So consumers and patients benefited from it.

Harry Glorikian: So now you’ve written a lot about, you know, in places like Forbes that there’s a need more need for artificial intelligence in public health. Or tools, I should say. How do you use AI inside Vibrent, I mean, at a high level, how do you see machine learning and other forms of AI changing the role of big data and health research and drug development?

PJ Jain: Yeah. So I think AI/ML, I think of it as a tool, as a practical tool. Lot of people use very broad field of AI/ML. You know, at the end of the day, it’s data processing and data analysis. I can do it through statistical tools. I can do it through algorithms have existed forever in this world. Right.

So statistical algorithms are a form of AI/ML, it just wasn’t just called AI/ML. But I think what has happened is that the AI/ML word became really important because of evolving data sets and continuous streams of data sets which the world did not have to deal with ten years ago or before that. So that’s the key differentiator. We just got awarded another project on AI/ML where we are utilizing that to understand markers and digital markers. So in the field of consumer and health research, you want to be able to measure things like, I want to do engagement and retention with a participant, but I don’t know whether this participant, is the likelihood of retaining [them] at a scale of 1 to 10. Is it five, is it two or is it nine? So you want to be able to analyze that and say, wait, this participant may drop out of the study.

They’re at the risk of impending droppage, drop out. What do we need to do? Maybe a study staff calls them. Maybe a research team member reaches out to them.

Maybe they meet them in a church and in the community setting and understand why they are not continuing their participation. So to be able to understand these types of markers when you have large data sets becomes attractive to use AI/ML approaches because they are evolving. Another thing is to understand biases and bias detection.

That’s a very good example of using AI/ML for studying biases with health disparities populations and then be able to do something about it.  And these are large datasets distributed and it’s really hard to do that with traditional algorithms or statistical approaches.

Harry Glorikian: Yeah. I don’t think most people realize, health care is really new to this space. And if it wasn’t for the Reinvestment and Recovery Act, which drove everybody to put in an EMR system, as well as the Affordable Care Act, we might not be having this same conversation, right?

PJ Jain: Yes, yes.

Harry Glorikian: So people may not like big government, but when you need to cause a shift at that scale, sometimes you need big government to come in and cause that shift.

PJ Jain: Yes, I agree with that totally. And that’s what’s happening, has happened, and will continue to happen for electronic health records. You were saying “So much for the United States of America.” That is electronic health records are another example how fragmented our unitedness is across America.

Unlike Europe, where they have a national health system. It’s easier for them, but they also have a single source of truth for everybody’s electronic health record, and it’s available and accessible. So it’s the government that has driven in the ONC. I applaud ONC and HHS for the vision to say, we’re going to make standardized approaches for sharing electronic health record data across vendors. That was such a big benefit.

Harry Glorikian: Critical. PJ, It was great having you on the show. H  ope to keep hearing updates as the company evolves and look forward to seeing the outcomes of the All of Us program and seeing the data published so that we can keep showing everybody that this is the right direction that we should take health care in.

PJ Jain: Harry, thank you for having me. It has been a wonderful conversation and really insightful. You went into,  very logically into so many different areas and progressive storytelling. I really enjoyed our conversation and happy to help in any which way.

Harry Glorikian: Thank you. Have a great weekend.

PJ Jain: Thank you, Harry.

Harry Glorikian: Take care. Bye bye.

Harry Glorikian: That’s it for this week’s episode. 

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