22 // THE NEW GASTROENTEROLOGIST FALL 2016
TECH SUMMIT
and titled “How to Innovate in Digestive
Health,” shared experiences and lessons
learned.
Among the organizers was Dr. Sidhartha Sinha, an instructor of medicine at
Stanford (Calif.) University. “Innovation
is really important for GI,” said Dr. Sinha,
himself a successful innovator. “Our
field is broad and complex. ... The truth
is we don’t have optimal solutions for a
lot of the core things that gastroenterologists focus on, such as inflammatory
bowel disease, or functional disorders,
or even cancer screening.” He said, “It’s
important for people who are interested
in innovation to get involved early. The
path is long, it is hard, but it is very exciting, fun, and rewarding.”
Early innovation brings perspective
Dr. Christopher Macomber is one
such early innovator. Dr. Macomber,
who holds both an MD and an MBA,
has just finished his general surgery
residency. He is also actively involved
with two start-up companies, and first
tapped his entrepreneurial side when
he began an electronic medical records
integration startup as a college undergraduate. That idea has reemerged as
Mozaic Medical (
http://mozaic-med-ical.com), currently a funded startup
with software about to go live.
In medical school, he began a medical
device start-up company. “It failed twice.
But we’re now into clinical trials,” he
said. This device is designed to use UV
therapy to treat lupus erythematosus.
Dr. Macomber said he’s found it
challenging as a resident to maximize
his training experience and still move
entrepreneurial projects forward. As he
wraps up training, though, he feels he’s
struck a balance: “I looked around at
all the different job opportunities – academic, nonacademic.” He has found a
surgical group, he said, that is open to
his continuing to pursue entrepreneurial work in parallel with his surgical
practice.
One thing he thinks he’ll bring to
the table as a practicing surgeon and
innovator is his global perspective. “A
Even smaller, less-disruptive innova-
tions that streamline a process can be
appealing to hospitals and practices.
“Innovation extends beyond medical
devices ... it can be process improve-
ments, software, means of capturing
data,” he said. In fact, in terms of an
innovative technology or process, “The
more disruptive it is, the more chal-
lenging it can be to get to market,” said
Dr. Macomber.
Sometimes, finding unmet needs may
be obvious, said Dr. Macomber. “You
see them as you’re going through your
practice, because there are markers:
high cost, low outcomes, inefficiency
in a given process or procedure. ... You
never really know where the innova-
tion will be coming from, but it’s up
to the clinician to be watching for it,
because you’ll feel the effects before
anybody else.”
For innovators who want to build
or maintain an active practice and to
retain or refine their skills as clinicians
and proceduralists, Dr. Macomber
suggests finding a practice home that
is receptive to the perspective a phy-
sician-innovator can bring. About his
first postresidency position, Dr. Ma-
comber said, “I’m really excited that
I’ve found colleagues who support my
drive to innovate.”
Research can come frst
An academic pathway that includes sig-
nificant research training can also point
the way to entrepreneurship in inno-
vation. Dr. Giovanni Traverso was able
to use his fellowship and postdoctoral
period to explore interests in diverse
fields; holding both an MD and a PhD,
he was trained in molecular biology and
genetics, so he explored options in those
fields while in fellowship at Massachu-
setts General Hospital. In Boston, collab-
oration with MIT’s Dr. Robert Langer, “a
prolific innovator and inventor,” taught
him a lot about commercialization of
technologies. “Spending time with Bob
helped me learn how to push things
forward,” Dr. Traverso said. “Really, my
interest in applied work was cemented
by those early experiences. Mentors are
extremely important.”
Dr. Traverso has found that his dual
clinician-researcher training carried
through into later career interests.
“There are a lot of people doing trans-
lational work, but for me, really getting
things back to the patients was some-
thing I wanted to do.”
Does one need to be a gastroenter-
ologist to innovate in GI? Dr. Traverso
said, “No, but it helps. Having a gas-
troenterologist as part of the team
can help guide how we address some
challenges.”
An example can be found in ad-
dressing the “massive problem” of
medication nonadherence: “50% of
patients do not take drugs as they are
prescribed,” said Dr. Traverso. This
problem is even bigger in the develop-
ing world, where only about 30% of
patients are medication adherent. In-
creasing adherence may provide more
positive impact than new drug devel-
opment, in many cases, he said.
To address this, Dr. Traverso and
his collaborators are developing a
drug-eluting device that would be
resident within the stomach for a period of time before disintegrating and
then passing, eliminating the need for
daily dosing of common medications.
Perfecting a device that would not be
subject to “the GI tract’s incredible
ability to achieve transit” required the
expertise and advice of a gastroenterologist on the research team, said Dr.
Traverso. The drug delivery device may
have far-reaching implications: When
mass drug delivery of the antiparasitic
drug ivermectin is achieved in areas
where malaria is endemic, the mosquito population drops markedly, “
providing significant vector control,” said Dr.
Traverso.
