Rocketing with Captain Kirk To A New Frontier: Astronaut Glen de Vries on New Era of Innovation In Space Travel and Health Care

Glen DeVries

[Music]

Marianne O’Hare : Welcome to Conversations on Health Care with Mark Masselli and
Margaret Flinter, a show where we speak to the top thought leaders
in health innovation, health policy, care delivery, and the great minds
who are shaping the healthcar e of the future.

This week, Mark and Margaret have a special guest who just returned
from space Glen DeVries, F ounder of Medidata just acquired by
D assault Systemes , who went up into space on a B lue O rigin ’ s rocket
with Captain Kirk and sadly died in a pla ne crash this week, just days
after our interview.

Glen DeVries: We're doing stuff in biology , mRNA based vaccine, they a re treating
rare diseases , cancers that we never thought we could treat. We're
seeing what was kind of science fiction, from a medical perspective
become science.

Marianne O’Hare: Please tune in for this powerful interview with an innovator in health
care who fulfilled a dream by going into space and we'll hear some of
his final thoughts about the future of health care and the
transformat ion underway. Now stay tuned for our interview with Blue
Origin A stronaut Glen DeVries h ere on C onversations on H ealth C are.

[Music]

Mark Masselli: We're speaking today with Glen D eVries, C o - F ounder of M edidata
S olutions, the leading cloud platform for cli nical research. He's V ice
C hair of H ealth and L ife S ciences at D assault Systemes which recently
acquired Medi data . H e recently launched into space on board Jeff
Be z os Blue Origin ’ s rocket with William Shatner of Star Trek fame.

Margaret Flinter: M r. DeVrie s is a trustee of Carnegie Mellon University and the author
of the recent book, T he P atient E quation : T he D ata D riven F uture of
P recision M edicine in the A ge of COVID - 19 a nd B eyond. Glen,
welcome to Conversations on Health Care.

Glen DeVries: Thank you for having me.

Mark Masselli: Should we start off with A stronaut Glenn or just, you know, so
exciting, and welcome back to e arth . Y ou've gone where Spock and
Scotty hav en’t gone , you've gone into space with Captain Kirk
launched aboard a s we said earlier, the Blue Origin rocket but we -- I
think our audience would love to hear a little bit about that journey ,
a nd how are you doing?

Glen DeVries: Yeah, so I'm doing great, I thought I would feel certain ways and get
to experience certain things. I think I was ki nd of mentally prepared
for the fact that being at the top of the a r c of this journey would be
really incredible in terms of seeing the earth . I t's more beautiful than I

Glen DeVries

can describe. I'm not sure the human brain is really prepared to see
something like th at. But another incredible part was kind of being in
the middle of what went from human scale and looking out the
window and seeing a cactus and lines painted on a road to patterns
that you might see if you're in an a i rplane t o patterns that I just have
ne ver seen before a s the earth is kind of rushing away from you , a nd
then experiencing all that reverse it was absolutely incredible. Truly
the experience of a lifetime.

Margaret Flinter: Well, to say it sounds amazing is an understatement. But you know
ther e's always people ready to bring it back down to earth,
metaphorically speaking. C ertainly, the space race among some of the
world's most successful business people generated some degree of
pushback from people who would say , no we should be focusing on
th e problems here on e arth. But you take a different view that many
of the advances that made it possible to have a remote controlled
rocket safely sending you and a 90 year old Captain Kirk into space
has real implications for how we can improve so many oth er systems
here on earth that impact life and health for people. Tell us what
you're thinking about when you say that?

Glen DeVries: Yeah, absolutely. I think, especially people working in life sciences,
health care, you begin to appreciate how emerging th ings happen as
technologies get developed. At Medidata , we do a lot of things with
decentralized research. W e put sensors on people so we can figure
out what the behavioral relationship is with different diseases and
treatments, etc , a ll that technology pi ece of electric sensors that were
used in the Apollo program and before to look at the attitude of
spaceships. L iterally, what we use in telemedicine today has come out
of the space industry.

I think if you think about the problems that we have on Earth ar ound
the environment , around -- I'm a huge supporter of W ater.org how
we need to purify and find and conserve and reclaim things that are
just the most basic requirements for human life, water and food.
T here are no faucets in space. I went for 10 minutes. But as we think
about humanity continuing to reach outside of the atmosphere, we're
going to be solving those problems . I feel like we've got this
framework and in health we live with every day and maybe take for
granted. I know it doesn't always work per fectly. But we've got
regulators who protect the public health and academic and publicly
funded organizations, the FDA, the NIH, the NCI, and the n industry,
the Pfizer's the Moderna 's, the Johnson & Johnson's of the world t hat
create this innovative cycle. Now we're seeing that in space, you've
got the FAA, you've got NASA in the United States and other agencies
around the world, and now Blue Origin, and SpaceX and Virgin
Galactic and Boeing and we're going to see these cycles, and they're
going to affect l ife on e arth and help us solve problems here in a more

Glen DeVries

impactful way than I think just the idea of getting people and getting
manufacturing into space. I'm actually just as privileged to be able to
fuel that as honestly I was to be able to see this all mys elf .

Mark Masselli: W ell, that's great. You're not only privileged, but you're ve ry excited
about it. I n your book, The Patient Equation , you say we're in this
midst of this biological and tech revolution, and that we are in a race
really for the holy grai l of precision medicine, and congratulations on
building the first significant cloud based system to advance clinical
trials, really expanding research capacity digitally . S hare with our
listeners what lessons you gain from that success, and how do we
appl y those lessons across the broader health ecosystem ?

Glen DeVries: I really think of l ife sciences as the heart of science and medicine that
creates new tools for health care, right. W hen you have a patient
who's being treated, there's certain things in th e toolkit medicines
and medical devices, and now digital therapies that whether it's a
physician or a nurse, or a person taking care of themselves can use.
T hose of us who are lucky enough to kind of work in the workshop
level of l ife s ciences, help create this environment that creates those
new tools. T hat's what I mean by this being such an exciting time f rom
a technical revolution perspective . W e're doing stuff in biology mRNA
based vaccine, treating rare diseases, cancers that we never thought
we could treat . W e're seeing what was kind of science fiction, from,
from a medical perspective become science.

Meanwhile, we've got everybody on the planet connected with things
in their pocket, and with sensors that can look at things like their
behavior and thei r cognition, not just their blood chemistry . S cience
fiction is becoming science is a parallel to sending the person who
played an iconic character for 55 years, and that actor has actually
gone to space, all these things are happening. I think that is goi ng to
become the norm. W e're just going to see this continued cycle of
innovation, the more people get excited about that, the more fuel we
put in that rocket, making a bad metaphor . B ut I think that that's what
really creates benefit for everybody.

Margar et Flinter: Well, we need some wins in this difficult period of time. Certainly one
of them , I think the wins was the rapid rise of vaccine development.
You talked about the mRNA technology, just kind of astonishing how
relatively quickly that became avail able. I want to make the tie from
that to , I think , one of your achievements, building a platform that
really facilitates clinical trials, makes them more widely available,
maybe really transform s our ability to do research that's based on
large numbers of people wherever they live. Tell us what kind of
transformation you're anticipating in clinical trials that what is this
going to mean for people around the globe ?

Glen DeVries: O ne of the reasons that the vaccines were developed so quickly is

Glen DeVries

frankly, we were standing on the shoulders of giant amounts of
research and development that had been done around vaccines, both
mRNA and others. But then we were able to generate evidence very
quickly, because we connected with people in new ways in their
homes with apps with things that could get the data that was needed
to generate that evidence that these vaccines were safe and effective
and valuable. The fact that we did that remotely means that we're
creating tools for health care, not just the evidence generatio n, but
actually these vaccines that could be deployed in ways that means
there's more equity and more access in how the tools are used.

I actually see this world of decentralized research and of telemedicine
as actually creating yet another kind of era in health care where we
don't have to worry about getting the doctor and the patient in the
same room. That means that we can treat people regardless of
geographic location, regardless of socioeconomic status in a much
more scalable, equitable way. That's als o something that really excites
me.

Mark Masselli: We're speaking today with Glen DeVries, C o - F ounder of M edidata
S olutions, and now a division of D assault Systemes. He recently went
to space on the Blue Origin New Shepard rocket and is author of T he
Patie nt Equation . You know, Glen, you helped facilitate clinical trials
for more than 1500 drugs and compounds, but it takes so long it's
from bench to bedside . W hen you look at something like the mRNA
platform, the ability to move so quickly , w here do you s ee a cross
walking ? I know there are clinical trials on cancer and a whole range
of other activities, will you be playing a role providing this back end
support for it?

Glen DeVries: Yeah, so at my company Medidata Solutions and D assault Systemes ,
we think ab out every kind of therapeutic from their design all the way
through to provision ing it to patients . I do think that we -- if you have
these really exciting platforms, messenger RNA based vaccines is very
much one of them, where we can now make our body be part of the
manufacturing process of a therapeutic . I t's hugely impactful .

A gain, think about the ability to give people access to a molecule
anywhere on the planet, well, we can now send the instructions for
how to make that molecule vaccine or treatment for a rare disease in
a syringe to those people. That to me, again, is about access. But it's
also about just using this idea to explode the number of different
kinds of compounds that we can deliver , and w e'll see that in almost
every therapeutic area.

Th ese are platforms that are going to begin to come up whether it's
biological or technological around this idea of taking what was
inconceivable , building something on our own bodies, and making it
commonplace. We're seeing it in cancer in terms of cell the rapies that

Glen DeVries

use our own immune systems to fight our cancers. Again, it's a huge
paradigm shift. We can now not just manufacture things in our
bodies, but we can get the systems in our bodies to actively help fight
diseases. Again, this was pie in the sky i deas 25 years ago when I was
first going into the industry, and now they're becoming commonplace.
Again, that's reason for optimism

Mark Masselli: A re there any other mRNA like platforms for the non - science health
care folks that we should be keeping an ey e on?

Glen DeVries: Well, so the ones I mentioned, this idea of cell therapies and getting
our immune systems to fight cancers is a really exciting one . I think
people think of the immune system as something that's very good at
fighting foreign invaders. B ut it's also very good at identifying what's
going wrong in our body and eliminating that . S ometimes that can go
a mock and we have to worry about autoimmune diseases . W e can
use that to fight things that are emerging out of our own cells, when
cancer is o ur own body, you know, that is gone haywire in a way that
that can spread an d attack throughout our bodies.

Well, what better ally could we possibly have than the one that most
of us are lucky enough to be born with . T he life sciences industry
being able t o turn our bodies into a tool to keep ourselves healthy ,
t hat's an amazing new platform in that context .

Margaret Flinter: Well, in this phase that we're in right now, I think there's a lot of
looking back we're seeing a lot of books and articles coming ou t about
what happened with the COVID pandemic, you know, where did we
do well, and where did we really fall way short . O ne of the big ones
was around managing the global data around the pandemic, not
getting out in front because we were using maybe legacy data and
legacy processes that didn't give us the kind of forecasting that we
needed . F rom where you sit, what are the data systems that might
hold the greatest potential going forward, for really improving our
surveillance and disease management as other viral pathogens might
take hold, and maybe giving us a much better shot at prevention .

Glen DeVries: Yeah, w ell, I think you're right to label things kind of a legacy styles of
data and systems. But frankly there's a lot of newer systems and
connectivity a nd data. I think I use the words in The Patient Equation ,
kind of like we blew it. I feel like as it's the thinking that we need to
change around the world . W e still think in single diseases in small
populations . I f we had just taken all of the research da ta around the
world for new drugs, new medical devices that were being developed
at the start of the pandemic, right , t hese are people who have things
like diabetes that they were maintaining , heart disease they were
trying to prevent , cancers that they we re trying to cure .

W e would have looked through that a nd seeing throughout the world

Glen DeVries

people getting fevers, people taking analgesics . W e could have looked
at that data beyond the little scope of looking at the one disease that
we were researching in that o ne volunteer patient and realize, oh
there's something else happening to them, and maybe really
understood a lot more a lot sooner about what the factors are, which
we still don't know, that result in bad cases of COVID 19, what the
factors are that might protect somebody.

I think if we think about whether it's antibiotic resistance, or some
other pathogen that's spreading around the world, or even just
thinking about diagnos tic and in treating disease, thinking about data
and bigger datasets, making things connect together that could be
connected together, but we're just not used to connecting , I think
that's the key to really getting to better population medicine, as we've
been saying. F or an individual having a big denominator like you're
thinking of a fr action that allows us to make sure the right patient
gets the right treatment at the right time, that's precision medicine.

Margaret Flinter: Yeah.

Mark Masselli: Well, I want to pull the thread on the right patient getting the right
treatment and talk a l ittle bit about health equity. Our organization,
which provides primary care to those who live in poverty was an early
participant in the All o f Us Precision Medicine Program , and
subsequently have been enrolling people in this campaign that Francis
Collin s put together a really brilliant one at NIH, which really is trying
to seek more inclusion in research . M inority representation and
clinical trials , as you know, has been a persistent challenge. How do
we leverage the power of digital medicine of the pati ent equation to
close so many of these equity gaps in clinical trial research which
leads to access into better health outcomes?

Glen DeVries: Yeah, let's just start with the science of it. If you have a bias in the
population that you're enrolling in a cl inical trial, that bias is going to
extend into your analysis . Y ou are going to, by definition, not have a
good representative sample of what the rest of the population looks
like. If you're doing a traditional research project, the distance that
somebody lives to an academic medical center where that clinical trial
is running is a factor for who winds up in that trial . T he ability of
somebody to take their time and not go to work, deal with child care,
whatever it is, and participate in that trial is a fac tor in terms of
enrollment.

W hen we use these distributed technologies, it means we can use
people who are in any part of the globe, we can make it much easier
for people to participate and lessen the amount of time required even
to get the therapy . M aybe even in some cases, like in the example of a
messenger RNA based t herapeutic where we can get somebody’s
body to do some of the manufacturing , j ust as an example, we can

Glen DeVries

start to get make it that much easier to just get the therapies to
people and have it available. A ll these things I think help create the
best data sample of a broad set of people, and again, are setting us up
for success in terms of being able to then provision that therapy, once
we've proven that it's valuable once we prove it, it's safe and
effective. W e've discovered because of that good sample, the right
people to get it in a precision sense, then we can give it to them at
scale. That's a virtuous cycle that I think we've now unlocked
unfortunately because of the pandemic. But maybe in the future we
can really create a ton of benefit because we've unlocked this new
way of thinking .

Margaret Flinter: Glen, I wonder if I could ask you to comment again, you spoke
movingly about the view from space really changing your view of the
world. One of our world views is that climate change and pollution are
now leading causes of disease and early death around the planet. We
know our world leaders have been meeting on this, but you've spoken
to this very eloquently . W e see it right in our communities already
with heat indexes that vary so much by the neighborhood's people
living in health consequences of that. Can you talk about your passion
for this intersection of the environment and health and how that is
motivating some of the work that you're doi ng?

Glen DeVries: Yeah, look the environment is an incredibly important part of what
turns us into biologically what we are . You’re born and it's not
perfectly medically true, there are certain things where your cells will
mutate. But we're born with a set of genes, and we have those genes
our whole life. It's the influence of the environment around us and
how we behave b ecause of that environment t hat puts us on the
trajectory of genotype and phenotype of our full phenotype. The
environment is critical in defining our health.

I will tell you in a way that I'm still honestly having trouble
articulating , you just -- you can't have a way to talk about this
perspective that is so unique, I think, honestly, unless you've seen it at
least I'll I hope to try to sh are it. But when you see e arth in the middle
of nothingness, you realize how small it is . Y ou get this incredible
sense of that visceral sense of home, I kind of get goosebumps, just
thinking about in that way that hopefully you feel when you're coming
bac k from a trip or you really miss somebody and you see them, and it
looks fragile. T he atmosphere that we all live in, looks thin.

It’s one of these things where I think I had a lot of conviction around
w e have to solve problems around the environment, we h ave to make
sure that everybody on the planet has access to clean, easily
accessible water. You see it from up there, and I can tell you, at least
for me, I came down with a level of conviction of how important that
is that I didn't think I could have befo re I went

Glen DeVries

Mark Masselli: Buckminster Fuller call it spaceship e arth , we ’ re a fragile ship cruising
throughout the -- through the universe. I'm wondering about your
thoughts just very quickly on what might be down the road for us, we
were somewhat fortunate that the lethality and the transmissibility,
wasn't that bad , c ould have been 10 times more. Are we prepared? Is
our scientific community prepared to address that issue? What do we
need to do to be thinking about the next pandemic which will come ,
a nd wha t preparation do we need to take?

Glen DeVries: Yeah, so I think we a re prepared in terms of having a lot of the tools
that would be required, we were talking about data platforms . W e've
got infrastructure . W e've got tremendous assets, for lack of a better
term in terms of what we can do from a medical perspective, from a
molecular perspective, from a mechanical perspective around treating
things. But I do think that we've now learned a lesson that we are not
that well prepared to act on having those things .

Rebecca Do wers (PH) is a wonderful friend of mine, dean of the
science school at my alma mater, Carnegie Mellon , sent me a paper
from a journal about how it would take years, maybe decades to
know how to respond to the pandemic, and what it really was al l
about. I t was actually a paper from the Spanish flu from 100 years
ago, right. I think you kind of copy and paste COVID a nd it wouldn't
feel that different from a scientific perspective. We have a lot to learn
in terms of our own behavior a s a civilizati on. The tools are there,
though.

Margaret Flinter: We've been speaking today with Glenn DeVries, the C o - F ounder of
M edidata solutions, now a division of D assault Systemes among the
first commercial customers to launch into space and co - author of T he
P atien t E quation : T he D ata D riven F uture of P recision M edicine in the
A ge of COVID - 19 and B eyond . F ollow his groundbreaking work at
Medidata. com Or follow him on Twitter @ Captain C linical . Glen we
really want to thank you for sharing your passion for science , for
healthcare transformation, for your recent space travel and the
perspective that followed and for joining us today on C onversations
on H ealth C are,

Glen DeVries: T hank you so much. It was great to be with you.

[Music]

Mark Masselli: At Conversations on He alth Care we want our audience to be truly in
the know when it comes to the facts about health care reform and
policy. Lori Robertson is an award winning journalist and Managing
Editor of FactCheck.org, a nonpartisan, nonprofit consumer advocate
for voters that aim to reduce the level of deception in US politics. Lori,
what have you got for us this week?

Glen DeVries

Lori Robertson: E pidemiologist and biostatistics experts have been cautioning that as
more and more of a population gets vaccinated, we'll likely see more
deaths from COVID - 19 a mong the vaccinated, it's simply math. The
vaccines aren't 100% effective , n o vaccine is , so some deaths are
expected. If there are relatively few people still unvaccinated, the raw
numbers of deaths are likely to show more deaths amo ng the
vaccinated.

Two statistics experts in the United Kingdom wrote about this issue in
late June in the London based G uardian. The headline on the story
was “W hy most people who now die with COVID in England have had
a vaccination ?” The experts said thi s wasn't a bad sign. Instead, it was
exactly what was expected from vaccines that are effective, but not
perfect. Yet, months later, misleading social media posts are
highlighting data from the UK suggesting the number of deaths shows
something is wrong.

T he post highlight the fact that a UK government report showed that
rd th
70% of COVID - 19 deaths from August 23 through September 19
were individuals who had been fully vaccinated. But as the experts
have warned, it's not surprising in a highly vaccinated pop ulation. The
same government report shows vaccination rates approaching or
exceeding 90% for age groups 60 and older, and that group accounts
for 87% of all deaths in that time period. The report also shows the
death rates are higher among the unvaccinated than the vaccinated.

The death rates for the unvaccinated are three to five times higher
than the rates for the vaccinated among the 60 and over age groups.
It doesn't mean the vaccines aren't working well against deaths , t hey
are , but just that the vast majority of vulnerable adults in the UK have
been vaccinated. A greater proportion of the vaccinated group may
be sicker individuals are those at greater risk of severe illness who had
a strong motivation to get vaccinated.

E ffectiveness against hospitaliz ation and death was more than 90%
for the vaccines in use in the UK, including Pfizer, Moderna a nd
AstraZeneca vaccines . T hat's my fa c t check for this week. I'm L ori
Robertson managing editor of F act C heck.org .

[Music]

Margaret Flinter: FactCheck.org is com mitted to factual accuracy from the country's
major political players and is a project of the Annenberg Public Policy
Center at the University of Pennsylvania. If you have a fact that you'd
like checked e - mail us at www.chcradio.com , we'll have
FactCheck.org's Lori Robertson check it out for you here on
Conversations on Health Care.

[Music]

Glen DeVries

Margaret Flinter: Each week C onversations highlights a bright idea about how to make
wellness a part of our communities and ever yday lives. When venture
capitalist and Shark Tank co - host Mark Cuban decides to sink a couple
of $100,000 into your business idea, you're probably onto something.
T hat's what happened. Olivier Noel, a medical student and young
geneticist at the University of Pennsylvania , t hrough his research and
studies, no matter how many resources the clinical study has, there
are many barriers to getting a good cross - section of study
participants, especially ethnic diversity. H e thought what if you could
eliminate the barriers to research participation and build up a rich
DNA database for future research all at the same time. H e created
DNAsimple .

Olivier Noel: I was actually working out of the Institute of Personalized Medicine in
Hershey. O ne of the key problems that I saw there is that, you know,
there was the proper infrastructure, there was in a funding for a really
amazing research projects, but ended up being a little bit of a chasing
game where we couldn't build strong enough co horts at first to be
able to do som e of the studies we wanted , some of the patients were
looking for, it was taking a very long time. E very day, it would be going
down and talking to the counselors and asked, you know, did we have
patients with this background today.

I ended up going to gen etics conference at Penn, actually, and the
keynote speaker there was alluding to a similar problem. One of the
ways they were able to contact patients was t hrough Facebook.
Facebook, they were able to connect with a number of patients all the
way in India and organize the logistics to be able to get the sample.
The joke at the time was that Facebook is the new way of doing
genetics, and really that sort of the light bulb went on. I wanted to
sort of leverage the Internet and particularly leverage social me dia to
be able to build a national database where somebody did not need to
be a patient, or be in the same region t o be able to participate in this
research study.

Margaret Flinter: All the participants have to do is to take a simple swab of the inside of
the mouth, send it in and wait to see if your specific DNA is of interest
to researchers. No el says that the company will make their DNA and
disease data available to researchers studying specific diseases,
offering those researchers a much broader spectru m of study
participants.

Olivier Noel: One of the things we really wanted to do is to allow for the possibility
of doing longitudinal study , so that you could continue keeping
contact anonymously, obviously, with a particular donor. If you're
doing a study , for example, and you have the ability to collect samples
now , collect samples in three months, collect samples in six months,
and see how that varies, which is very difficult to do i f you are going

Glen DeVries

to be in contact with the patient o nce

Margaret Flinter: T he study participants themselves receive an extra something for
choosing to participate.

Olivier Noel: W e ultimately provide a minimum of $50 every time somebody
provides a saliva sample

Margaret Flinter: DNAsimple A vetta database linking researchers wit h a broad array of
participants to enhance lab research by eliminating the barriers to
finding participants , now that's a bright idea.

[Music]

Mark Masselli: You've been listening to Conversations on Health Care. I'm Mark
Masselli.

Margaret Flinter: And I' m Margaret Flinter.

Mark Masselli: Peace and Health .

Marianne O’Hare: Conversations on Health Care is recorded at WESU at Wesleyan
University, streaming live at www.chcradio.com , iTunes, or wherever
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