Innovation Ecosystem

Everything was not illuminated at the MedMates Life Sciences Expo

Three, in-depth, one-on-one interviews with keynote speaker Susan Windham-Bannister, moderator Dr. Megan Ranney, and Thomas Osha, senior vice president of Wexford Science and Technology

Photo by Richard Asinof

Dr. Megan Ranney, who served as moderator of the 2018 MedMates Life Sciences Expo.

Photograph by Richard Asinof

Thomas Osha, Senior Vice President, Wexford Science and Technology

Photo by Richard Asinof

Susan Windham-Bannister, keynote speaker at the 2018 MedMates Life Sciences Expo.

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By Richard Asinof
Posted 4/9/18
Three in-depth, one-on-interviews with the moderator, the keynote speaker and one of the panelists at the 2018 Life Sciences Expo provide the context and nuance of the challenges of growing an innovation ecosystem in Rhode Island.
Why was there so little coverage by the traditional news media of the Life Sciences Expo? Why is it so difficult to break down the silos around the convergence of public health and life science industry investment? What can be learned from a tour of the Institute of Applied Life Sciences at UMass Amherst as CommerceRI evaluates the proposals for an innovation campus in Rhode Island? What is the possibility of creating an Alzheimer’s database by getting volunteers to participate in a statewide DNA swab campaign? How will Republican candidates characterize the efforts to develop an innovation ecosystem in Rhode Island? Could Rhode Island host its own hack-a-thon for innovative approaches to gun violence?
The growth of the life sciences industry cluster and ecosystem in Rhode Island is predicated upon the academic research enterprise developing translational research products that can be commercialized and monetized as part of the clinical medical enterprise, often in the form of new drugs and new therapeutics.
Yet, at the same time, the health care industry sector is in the midst of a major consolidation push, with hospitals and health insurers being swallowed up into larger corporate entities, as medical costs continue to soar.
Fewer babies are being born in Rhode Island, with a declining birth rate; at the same time there is an expanding number of older Rhode Islanders, requiring more expensive medical interventions as chronic diseases peak.
At some point, public health interventions and alternative visions of health care delivery, including health equity zones and neighborhood health stations, will become part of the ongoing conversation around innovation.

Part Two

PROVIDENCE –
At the 2018 MedMates Life Sciences Expo, embracing the spirit of collision, collaboration and congregation, ConvergenceRI took the opportunity to sit down and talk with keynote speaker Susan Windham-Bannister, Dr. Megan Ranney, who served as moderator for the Life Sciences Expo, and with Wexford’s Thomas Osha in one-on-one interviews, to delve more deeply into challenges of building an innovation ecosystem in Rhode Island, exploring the context and nuance of giving birth to the creation of an innovation research hub in the state.

First, here is the ConvergenceRI interview with Susan Windham-Bannister:

ConvergenceRI: I was interested in the way that you parsed the difference between ecosystems and clusters. In Rhode Island, it is unclear if there is an actual life sciences cluster yet, and I’m not sure that there is consensus about what is meant by an innovation ecosystem. What are the benchmarks as you move from industry group to cluster to ecosystem?
WINDHAM-BANNISTER:
First of all, I think that by definition, a cluster is a multi-disciplinary, it is made up of large and small and start-up companies, and all of the other members of the community that are really needed to support the lifecycle of innovation.

It’s very common for people to use these terms interchangeably. It is de rigueur these days to say “ecosystem.” But usually, when people are talking about an ecosystem, they are talking at best about a cluster or they are talking about a group of people spending time and doing things together.

I think that this notion of an ecosystem takes Michael Porter’s cluster-driven economic development to the next level. Which is that just because you have all of these assets doesn’t mean that they are really going to work together, and that they will leverage one another, or that they will be able to achieve their full potential.

Because they may not have good access to all of the resources and talent that they need, especially when we’re talking about entrepreneurs who need a mentoring community, access to talent.

When you’re talking about big companies, there is tremendous interest and need on their part to be well connected to smaller companies, to the talent pool, and to academia [as both Johnson & Johnson and Novartis talked about during the last panel on health IT].

An innovation ecosystem is really when these various assets work together. I also think that the mission of an industry trade association is different; it is there to be an advocate for its members. It is there to think about policy and reimbursements implications.

I believe it is a misnomer to describe an industry collaboration or an industry trade association as an ecosystem.

ConvergenceRI: Missing from your presentation was a slide about the new $150 million Institute for Applied Life Sciences at the University of Massachusetts Amherst, which opened in 2016, with shared spaces for 16 companies to work alongside more than 150 faculty from 28 departments, which was made possible by an investment by the Massachusetts Life Sciences Center. Why was it left out of your presentation? [See link below to ConvergenceRI story, “The academic research enterprise lifts off in Massachusetts.”]
WINDHAM-BANNISTER:
It is a fantastic facility. I thought I had 45 minutes to do my talk, so when I found out this morning that I had only 30 minutes, I had to take slides out. I did have a slide about the Institute at UMass Amherst and this amazing new facility, and what they have done. I didn’t get to show that; I’m pleased you mentioned it, because I agree with you.

ConvergenceRI: In my ongoing dialogue with CommerceRI Secretary Stefan Pryor over the last year about the $20 million Rhode Island innovation campus initiative, I have suggested numerous times that he go to Amherst to visit the Institute, to understand what they have done around the concept of an innovation campus.
WINDHAM-BANNISTER:
Absolutely. Yes. Let me give a lot of kudos to UMass Amherst. One of the things they did was to come to the Massachusetts Life Sciences Center and ask for a grant to look at what kind of facility made sense for them to have as an innovation center. They came back with the most elegant, creative proposal. Originally, they wanted to put a lot of wet lab spaces there so that they could become more competitive in winning federal research grants.

They came back and said: we have a completely different concept of what we would like to do, about how we can become a hub for this region, as well as reach back across the state to the eastern part. And, what they had achieved has been amazing.

I am part of a group there that meets periodically to look at the different initiatives underway. It is magnificent. I hope that the Secretary will at some point hop on and take 90 [the Mass Pike] west.

ConvergenceRI: Another important part of the conversation around innovation process is the recognition that you can be heading down the road and suddenly realize that you may be headed in the wrong direction. How does the concept of failure – and the willingness to admit failure – fit into the conversation?
WINDHAM-BANNISTER:
Very well put. That is a cultural issue, to be able to acknowledge failure.

The notion of innovation capacity and an innovation platform is that it supports many, many types of activity. Having a well-developed innovation capacity, having that platform, enables other opportunities and initiatives to take hold.

[And it protects you] from the sense of, oh my goodness, we put all of our eggs in one basket and now, we don’t have a fallback position.

I think the work that we did in Massachusetts – the work that the Mass Tech Collaborative did, the work that the Clean Energy Center did, and the work that the Life Sciences Center did, was all very synergistic. [See link below to ConvergenceRI story, “A tale of collaboration in which Henri Termeer helped steer policy changes.”]

It enabled innovations of all kinds to thrive, to grow, and to grow at their own rates, and with their own definitions of success, by creating the opportunity for many seeds to flourish.

It is a little harder when you take that top-down approach, where you are very directive to where all this should go, if things do not go quite as you had envisioned.

ConvergenceRI: How important is the role of story telling as part of the innovation process?
WINDHAM-BANNISTER:
I agree with you 1,000 percent about the importance of story telling. I do think that one of the real differences in the Mass. Life Sciences Center 1.0 and the Mass. Life Sciences Center 2.0 is that we, the initial group in the Center understood, that first and foremost, we had to be storytellers.

We had to tell not just the Massachusetts story, but the story of evolution of this initiative, what were we doing, why were we doing it, what were the benefits, and even before we had lots of data, to sort of prove what we had accomplished. We had to talk about what we were doing and why.

We understood that we were a marketing entity as well as an entity that was investing in innovation.

I believe someone has to tell the story; but now, that whole communications and story-telling role has gotten a lot less emphasis. And, in the new incarnation of the Mass. Life Sciences Center, I don’t think there is as much emphasis on communications.

But I agree with you so strongly, it is really important, and when you go out to other parts of the country, when I talk with venture capitalists, and ask them: why aren’t you investing more in x area or y area, they will ask: what’s their story; what’s their calling card? What is it that I should know about them?

I think we really do underestimate the importance of story telling: it’s not all the facts and figures.

Because people often assume that this happens by magic, or people assume that you need all of the ingredients to be there right from the start.

And, I think our story in Massachusetts is encouraging; it says: you can do this, but it is an effort. It takes focus, it take strength. And, you’ve got to keep telling that story. As the story gets refined, as you understand more and more how it happened, you need to keep passing that story down.

Interview with Dr. Megan Ranney
Second, here is the ConvergenceRI interview with Dr. Megan Ranney, an emergency room physician at Rhode Island Hospital and an associate professor of Emergency Medicine and Health Services Policy and Practice at the Warren Alpert Medical School at Brown University. [The day after the Life Sciences Expo, Ranney was named co-chair of the Gun Safety Working Group by Gov. Gina Raimondo.]

ConvergenceRI: What does public health have to do with all this discussion about innovation and how does it intersect?
RANNEY:
Are you asking about the life sciences?

ConvergenceRI: Yes. As much as we talk about tech transfer and translational research, a lot of it seems to be around clinical applications rather than public health applications.
RANNEY:
Absolutely. Great question. So, clinical medicine is a one-on-one interaction between a physician and a patient. Public health is about how do we expand those clinical interactions and make them routine and common and evidence-based. But also how do we put interventions in place that may not occur in the clinical sphere, but may occur outside of the clinical sphere, to avoid having to have those clinical interactions at all.

The role of life sciences innovation and digital health in public health is huge: it can both amplify that individual moment of a patient-clinician interaction and make it easier, make it more time efficient, and extend the interaction beyond the clinical sphere Patients spend so little time in the doctor’s office and so much more time at home, so innovation can do all of those things.

But innovation can also work to address those social determinants of health that bring people in to the hospital or the clinic in the first place.

ConvergenceRI: What often seems missing from the discussion, here at the Life Sciences Expo or in discussions of the future of primary care, are health equity zones or neighborhood health stations. Why do you think there is such a disconnect, such as a way to change the way that primary care is delivered, or to look outside of the clinical environment for solutions? Why isn’t that part of the conversation around innovation that could happen through life sciences?
RANNEY:
That’s another great question. I think there are a variety of reasons.

The first reason, and the biggest reason, is that clinicians think about their clinical practice. And, when you have a Ph.D. or an MD or a DO who is doing research, they are [often] thinking about how to transform the lives of those individual patients in front of them.

And, they are going to be focused on, for the most part, on improving those individuals' therapeutics.

There is also a very clear tech transfer route for taking those individual discoveries and turning them into businesses. Which is why much of the innovation economy discussion is about therapeutics and clinical levels of innovation.

The discussions about neighborhoods and social equity are often less obviously able to be monetized.

It’s like preventive medicine; it’s very difficult to convince people to invest in preventive medicine because the return on investment is so delayed.

That’s why the Department of Health is so important, because public health is their focus.

Individual corporations are often less focused on that neighborhood equity because there may be a less of a monetary [return on investment].

That’s said, I think it’s a really critical [platform] for us to discuss. And, I think that there is a huge, return on investment for people who create innovation around public health; it is an area that has been ignored or unexplored.

It’s actually part of the reason why we founded our emergency digital health innovation program in the Department of Emergency Medicine, because we found that most of the digital health applications that were out there were very much focused on the wellness [baseline].

Which is really important, but it is really different from addressing the needs of our patients we see in the emergency department, who are often vulnerable, underserved, low-health literacy patients.

ConvergenceRI: How does gun violence enter into the conversation around innovation? It seems that it would be at the intersection of public health, public safety and innovation. You are not only saving lives and saving money, but it is a field open to all kinds of innovation, both from a clinical standpoint and a health equity standpoint.

Imagine what would happen if someone got up here at the Life Sciences Expo and talked about investments in innovation in how to address gun violence?
RANNEY:
I would love to see that happen.

Actually, next weekend [April 13-15], in Boston, there is going to be a hack-a-thon about public health approaches to gun violence prevention by generating innovations that can address gun safety, mental health, community resilience, and policy, run by the Consortium for Affordable Medical Technologies [CAMTech]. [Cash prizes will be awarded, including a $10,000 post-hack-a-thon award.]

You are totally right. The issue of gun violence, and violence in general, is one that is ripe for innovation and overdue for innovation.

There are a [number] of reasons why that has not yet happened. The first and most important reason is the lack of federal funding. Over the last two decades, the amount of federal funding for gun violence research has been less than 2 percent of what would be predicted, based on the rate of deaths.

[Federal funding levels] are less than 2.2 percent of what’s being spent on sepsis, which has a similar death rate [compared with gun violence].

The speakers talked today about the importance for companies seeing their investments as matching the funds that are being awarded by the federal government. So, if NIH and NSF get ideas off the ground and ready for commercialization and for transforming the economy, [they could do the same for investments in innovations around preventing gun violence.]

Without that government investment, it’s tough to do that groundwork to create that innovation. But it is still possible, and there is still stuff that’s being done.

I have a text messaging program that is funded by NIH that I’ve shown can decrease the number of physical fights that kids are in.

ConvergenceRI: Is that connected at all with the Youth Restoration Project?
RANNEY:
That’s another great question. So, there are levels on intervention.

[Perhaps the best analogy] would be to interventions to prevent heart attacks. There is the lower-level stuff for all of us, such as walking, exercising 30 minutes a day, eat healthily and don’t smoke.

Then there is the higher-level stuff, if someone has high blood pressure or diabetes, you want to put them on meds. If someone has a heart attack, you want to put them into cardiac rehab, and give them higher intensity services.

So, similarly, there are going to be a range of services that we want to provide to prevent gun violence. There’s going to be lower level stuff, such as programs in schools or in pediatricians’ offices. Then there is going to be the Youth Restoration Project or the Institute for the Study and Practice of Nonviolence for the kids who have already been hurt.

ConvergenceRI: Did you see the study by Bruce Lanphear in The Lancet, a cohort study, which found that exposure to lead in adults was a catalyst in more than than 400,000 deaths a year from heart disease? [See link below to ConvergenceRI story, “The Pb funk.”]
RANNEY:
Lead is also a contributor to violence; it causes aggressiveness and ADHD.

Interview with Thomas Osha
Third, here is the ConvergenceRI interview with Thomas Osha, the senior vice president for Innovation and Economic Development at Wexford Science and Technology.

ConvergenceRI: If you had to summarize the story of what you saw at the Life Sciences Expo today, what would it be?
OSHA:
The story is about a growing life sciences presence here.

We heard from universities that there is really some very strong research going into deep areas – Alzheimer’s, digital health, and neuroscience being three of those.

I think that we see there is a lot of opportunity for a lot of startups. We’re seeing activity here in this room [with exhibitors] with companies. We see that they had a lot of student activity out there in the hall.

And, there is the desire, whether it is on the part of government, with CommerceRI and Secretary Pryor, whether it is with an intermediary, like a MedMates, that can act [as a catalyst] in bringing together folks, to really start bringing other companies in and building that piece of the mix.

That is what I heard, [the life sciences sector] is growing. I was here last year and spoke. I feel like this conference is growing both in the number of exhibitors and attendees.

That’s the message; these things do take time. Any nascent ecosystem, it’s a desire, it takes some time to develop.

ConvergenceRI: It’s now 2018, and when you look at the Massachusetts Life Sciences Center, it’s 10 years old, and it seems as if it is just beginning to find its stride. How do you at Wexford manage expectations, given that we live in an impatient world, that even as you are building a new innovation complex and you have some core tenants, how do you present to the world that it is going to take time?
OSHA:
When you are in real estate development, we do get it, and I think those around us are starting to get it, too, to understand that it takes so much time to build a building, it takes so much time to lease the building out.

It is going to take time [to launch] all the startups and watch those startups grow. I don’t look at it as a desire for instant gratification. I look at it more as an impatience, we need to start now, because we understand that these things take time, because the longer we [wait] before we start, obviously, the more time that it takes.

I read that as a sense of urgency that things; we need to start now, as a state, because it is going to take us 10 years to do this.

ConvergenceRI: Are there political parts to that question of urgency that people do not understand?
OSHA:
Certainly, there are number of different stakeholders, all of whom have different definitions for what success is.

ConvergenceRI: What is your definition of success?
OSHA:
For us, in our definition of success, we look for a couple of things. We look for an environment that has strong universities. And, that those universities believe that an innovation district will help them achieve certain goals that they have.

We have no doubt, after meeting with everyone from President Christina Paxson on down at Brown University, that Brown understands that, and they are looking at this as an opportunity to accomplish a number of things.

We look for alignment between the civic and the business infrastructure. We certainly see that, in talking to Secretary Pryor and in talking to business leaders around town, there is strong alignment between what’s going on.

We look for what I’ll call conveners and intermediaries, such as the Chamber of Commerce, MedMates and others; they are here and growing in strength.

And then, for us, there is the tangible success in the environment: that within 10 years, 12 years, we have developed, or we will be on the steady path of developing a million square feet.

So, that means the building that we’re going to deliver roughly a year from now [in 2019], that building is immediately followed by another one, and another one; maybe not coming of the ground right way, but we’re already starting to plan for another building because of the success of what we’re seeing.

ConvergenceRI: One of the gaps in the innovation ecosystem in Rhode Island that I have often heard expressed by a number of folks is the lack of venture financing to take a company from a startup to an emerging commercial stage enterprise. Many local equity investors do not seem to be investing in the local life sciences industry sector.
OSHA:
I hear that in a lot of what I’ll call second- and third-tier cities, smaller cities that want for venture capital. I tend to say: the more talent you attract, the more venture capital starts to pay attention. Certainly, we are in the early stages of growing that talent pool here.

But I also think that there is an advantage that Providence has in that it does have good transportation into Boston, [a city] which does have a strong base of venture capital. I think that the more things that start here, with the location of the Cambridge Innovation Center in Providence, with the opening of the Wexford Innovation Complex, with Johnson & Johnson, as more things come here, I think you’re going to begin to see more venture investment. Maybe some Boston VCs will start to look this way and hopefully begin to make investments.

ConvergenceRI: Many people are talking about improving the existing rail infrastructure between Rhode Island and Boston and throughout New England. But, as part of planning for an innovation ecosystem, will it also require rethinking what kinds of virtual office space can be created, with virtual commuting, and not just physical office space build out in what is demanded for workers?
OSHA:
We are seeing that trend play out, in the desire for co-working and shared working environments. We’re seeing it also in the demand for high-resolution video conferencing, to cut down on the number of physical trips that need to be made.

ConvergenceRI: More often than not, I try to hold all my meetings and interviews at Olga’s Cup and Saucer, which I call on nodal intersection for convergence and conversation.
OSHA:
You bring up a good point, one that we really hadn’t discussed at all during our panel: the work environment is becoming more flexible. Work isn’t just at your desk, it’s being done in restaurants, in coffee shops, in parks.

ConvergenceRI: I hardly ever interview someone in their office, if it can be avoided.
OSHA:
I usually don’t take them in my office; I take them somewhere in the community.

ConvergenceRI: What questions haven’t I asked, should I have asked, that you would like to talk about?
OSHA:
In any nascent innovation ecosystem, it does take time. One of the things that is good to do is to celebrate successes, even if they appear to be small.

If you were to look at the successes that Boston celebrated 10 years ago, they’d be miniscule by comparison with the successes they are having today. But, it is those kinds of celebrations that start to get more people to believe that something is happening here.

In five years, we’ll look back and say, wow, we were just getting started back then, but the [innovation process] takes time, it takes patience.

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