When You REALLY Need a Clinical Trial

Quinn:

I'm Quinn Emmett, and this is Important, Not Important. Let's say you get sick, diabetes, cancer, heart disease, long COVID, PTSD or MS, depression, Alzheimer's. Despite the best efforts of you and your physician, nothing's working. They're out of answers and you are out of questions. You might both be increasingly out of time. Your doctor's next 30 patients are waiting impatiently in the waiting room for her. Her schedule is over-scheduled every day. Your own situation is worsening or at least unmanageable. Where do you turn? There must be someone, somewhere working on your specific problem, working to better understand it, at least maybe to treat it, maybe to cure it, or at least prevent it for the next person who might be susceptible to getting it because of time, because of some genetic factor, because of exposure to a virus or air pollution, toxic chemical or materials. How do you find out if they exist? And if they do, how do you find them? How do you connect with them? How could you possibly work with them on your condition?

Quinn:

How could you volunteer yourself for their work knowing they might not have the answers, but knowing you won't know and they won't know until you try? For almost 25 years, the best answer has been to visit a government run website called clinicaltrials.gov. And I know because I've done the work and I've done the research and I've sent tens of thousands, if not hundreds of thousands of people to it for help. But even if you are able to sort through what is basically a Windows 95 era database and find the trial that's right for you. What if it's hundreds of miles away? So many of us could benefit from better awareness and better access to cutting edge research that could save the lives of people we love. And so many researchers are frustrated by the inability to sign people like you or your daughter or your dad or your T-ball coach up for their trial. It's 2022. We can do better, better.

Quinn:

My guest today is Brandon Li. Brandon is the co-founder of Power, the new and arguably most patient-friendly platform for clinical trials ever made. Brandon and team are making it easy for all patients to use Power, to discover promising clinical trials and get in touch with the researchers directly. My mission here is outcome based, to connect you with the most measurable ways to take action, to feel better and to drive systemic change. There's so much we can do to rebuild public health, of course, we've discovered that. To do the basic shit we need to do to take care of one another. But simultaneously, by increasing the success of vastly more inclusive clinical trials, we can accomplish all of those goals at the same time.

Quinn:

As always, you can reach me at questions@importantnotimportant.com. I'm at Twitter at @QuinnEmmett. Let's go talk to Brandon.

Quinn:

Brandon, welcome to the show.

Brandon Li:

Thanks for having me, Quinn.

Quinn:

A hundred percent, a hundred percent. I'm excited to dig into this today. It's so exciting. I send our readers and listeners to clinicaltrials.gov all the time.

Brandon Li:

Oh no.

Quinn:

It is a wonderful tool, and it is from the stone age. When I saw your announcement, I was like, oh my God, this is so exciting.

Brandon Li:

Finally.

Quinn:

For a thousand reasons.

Brandon Li:

Finally someone did something about this.

Quinn:

It both seems so obvious, but I can't even imagine how much work it's been. So before we get into it, though, I like to start with one important question to set the tone for this whole thing. Brandon, I like to ask, why are you vital to the survival of the species? And I encourage you to be bold and honest and have some fun.

Brandon Li:

Yeah, absolutely. So this is actually one of the things that my co-founder and I thought a lot about when embarking on our next adventure. So to catch you up here, we had just finished a journey with another early stage startup. It had been acquired by a larger company, Thumbtack, and we sat down and we thought, okay, what do we want to do next? And when we did that, we outlined four really interesting trends that we thought would impact humanity over the next 20, 50 years that we might want be a part of. One of those trends was around biology, and the thesis was that the next 20 years of biology would look like the last 20 years of software, with all the really exciting movements that we've been seeing in the life sciences.

Quinn:

Sure.

Brandon Li:

Unfortunately, when we dug under the hood, we realized that life sciences is unfortunately incredibly bottle-necked by the clinical trial process. And we can get into what Power does in a second, but the fundamental reason why we got excited about this over a 20 year time horizon is that I think the work we can do here is accelerate the speed of life sciences and that's a mission worth being on.

Quinn:

Ooh, I like that. I like that. And this gets into a little bit in what I would love to dig into in a little while is you're really addressing a pretty fundamental two-sided market here. And that's a piece of it that's obviously going to be pretty vital. Everyone has benefited so much in the past few years, obviously, from all the hard work that went into trying to make mRNA vaccines, not just work, but also be safe for people. And then a few folks capitalized on that right on time. And these things are hard though. And they take a lot of hard work in people on both sides and it takes folks who are willing to be part of trials, but it's hard to do that if you're not aware that they exist or you can't access them in any way.

Quinn:

So I want to talk about consumer experience. So why don't you give, again, in the intro, I described a little bit for people, but if people skip that on a description of what Power is and what you're trying to do there, but why don't you give us a couple lines on what it does and then we'll talk about why that matters as opposed to clinicaltrials.gov.

Brandon Li:

At a fundamental level at Power, we believe that every patient deserves to have access to leading medical research, if it could help them. Unfortunately, today it's only those that have access to top doctors and top hospitals that might be in the know for the cutting edge of research that is being done in the clinical trial system. The problem is that if you're a patient who's looking for a clinical trial or is in a situation where the standard treatments have failed, oftentimes you'll be sent to this website that you and I know and love, clinicaltrials.gov. Unfortunately, that .gov website was built 20 years ago and it wasn't built for the average patient. It wasn't built for the average user. It was actually built as a broadcasting mechanism for clinical research and largely targeted at other researchers and essentially ethics review boards to have a single source of truth on that side. It wasn't built for the end user.

Brandon Li:

What does that mean? Well, what happens is that when patients go to clinicaltrials.gov, oftentimes they can't find the information they're looking for. They can't figure out who to get in contact with, and unfortunately they give up too soon. So, that's what we're trying to solve here. We're trying to build the first patient-centric experience to look for clinical trials and in the process of doing so, help more patients finally get access to leading medical researchers and at the same time, accelerate the speed of life science.

Quinn:

I love that. And I think it's great. It's easy for folks, I think, in our generation to look at a website like clinicaltrials.gov and evaluate it as objectively as we can, which is government has a hard time building things like this. It's not necessarily made to be consumer centric, very old, and we know where the money goes with all these things and all these things probably functional, but it's difficult to access. It's difficult, like you said, to figure out what information is relevant to you, much less how to use it in a practical way to further your end goal, which is probably just to feel better in some way, or to help a loved one who is maybe at the end of their rope for some variety of reasons. But the consumer experience matters, and look, we talk about all the time people have been trying to reinvent plane tickets for 20 years. They print it out, you check your bag, you look at the ticket and you're just like, ah, where do I go? What do I do? It's ridiculous.

Quinn:

In the age where we have these incredible infographics, this shouldn't be that difficult to just think who's the person that's going to be using this the most? But it matters, this patient experience. And we don't do a very good job of thinking about it. So we have covered here, maternal health, Black health, hearts and lungs, emergency room waits, vaccine data, communications around masks, the costs of cardiovascular and cancer treatments and how abhorrent those are, birth control tests and what that does for depression and anxiety and electronic health records, all this different stuff. The point is, the patient experience, again, could be way better for how much we spend, if you're too young to remember. When Obamacare launched and crashed the same day, they brought in this crack team of private market folks to rescue it, essentially rebuilt it on the fly.

Quinn:

That team eventually morphed into a group that's still around today, the United States Digital Service, and they were tasked for a while with updating whatever they could to get through the bureaucracy. And that team still exists, but there's obviously a world of opportunity for new looks at some of these vital tools. And that's when we were talking offline we were saying it's, what you're doing seems so obvious, but also must be just massively difficult. I'm curious if you can tell folks a little bit about why, for you, clinical trials, why did you decide this was your way into healthcare? Like you were saying, you see these bottlenecks in life sciences and we see it all the time. And yet the market for all these small cap synthetic biotech companies are cratering, because it's difficult and demand and all this stuff. Why did you have to do this? What sort of itch does it scratch for you?

Brandon Li:

That's a great question. There's two things that come together here. The first is from a professional experience standpoint, what kind of keyed us up into this direction? And the second one is actually a way more personal experience that drives this home. So professionally, like I was saying, my co-founder and I had just finished building a marketplace. Our background is in building, scaling, marketplace style, product and businesses specifically to accelerate or make a dent into traditionally real world and old school businesses. So, that's what we knew how to do. And what ended up happening is he has his own personal story and that's his story to tell. But on my end I had a very close friend of mine diagnosed with a brain tumor around three years ago. And luckily she's doing okay largely because she was able to find her own clinical trial online and get herself enrolled.

Brandon Li:

And as you can imagine, that experience was a slog. She was largely able to do it through self-directed research, by speaking to friends and family that have medical backgrounds and frankly, through the kindness of strangers on the internet. Being on that journey with her helped me personally realize just how difficult this experience is for patients like her and other patients that are going through a similar journey as well. So what we realized was that there was an opportunity for us to bring some of this professional background that we had some unique skills that we knew how to apply in other spaces and bring it to the clinical trial space and hopefully have a ton of impact here for patients that are in a similar situation.

Quinn:

Can you talk a little bit about, without getting too nerdy here, we can do that offline, but how does one approach? And this is always one of my favorite questions. This will be, I think, a little more applicable to not the common listener, but folks who are a little more educated, a little more technical, but one of my favorite questions is always where would I, a liberal arts major podcast host start with this project? So we talked to a couple scientists last year or year before who were working with the Alex's Lemonade Stand Foundation to try to devise treatments for specific types of pediatric cancer. And they use zebra fish as models. And I was just like, where would I start? Where do you even buy zebra fish? I don't know the answer to that. And so I'm curious on your side, on the technical side, where does one start working with that kind of data? Is there an API from clinicaltrials.gov that you're building on? How does this actually work?

Brandon Li:

Yeah, that's a great question. So from a technical standpoint, actually, one of the things that has happened in the last couple years that has allowed us to do this today is really incredible advancements in data science and large language models in particular. So historically, if you wanted to do something like this, you are probably hiring an army of science educated individuals to go reading all of the unstructured information that is out there about clinical trials, restructuring it and trying to find a way to list it on the internet and then hopefully manually help individual patients navigate the system. And that's largely because a lot of the data is this unstructured, medical jargon, just like these unstructured blobs of text. But what we can do today is actually apply a healthy amount of data science on that text, on that information, that's all publicly available information and then structure it in a unique way that wasn't possible before. And when we're able to structure it, then we can actually build really meaningful user experiences, patient experiences, which you see now on our website.

Quinn:

Yeah. It's wild to click on, again, not to beat it, I'm sure there's wonderful people working on it, but to click on clinicaltrials.gov and to see yours and go like, oh, not just, this is probably more helpful, but this is a lovely place to be. It's like sitting in a nice waiting room where you're like, oh, these magazines are fantastic. I hope my result comes back nicely. So the consumer experience matters and there's a few different layers to the funnel, but I want to talk about the other side of it as well. How do we help these trials succeed?

Brandon Li:

Sure.

Quinn:

So just going through some of the research, one study says 86% or so of US clinical trials are delayed because of a lack of enrollment, which has got to just be, I guess if it's that much, it's both got to be predictable for these researchers and the companies that support them, but also still frustrating for this to continue happening.

Quinn:

And I know we're in this advent of Apple watch can possibly do some things, and how does that open it up to certain people this and that? On the other hand, the trials are often either technologically or geographically limiting. Research hospitals are few and far between if you can even parse the data on clinical trials.gov, but then you've got to actually get there and that's to bring it back up, I have always loved working with Alex's Lemonade Stand Foundation because first of all, kids cancer are like, why does it exist? That's awful. So they do two things. They fund research like this, but they also pay for travel for families. Because if you do find a trial that's applicable to how you are sick or a loved one is sick, much less a child, then you have to pay to get there. You have to pay for lodging, for the food there. By the way, if you're going to one of these, your loved one or yourself, you're probably not in great shape as it is, whatever it may be.

Quinn:

And yet we can't conduct these trials or find out if it works if you can't get there, especially women and marginalized people and pregnant people from this huge variety of socioeconomic backgrounds that we've got. So I'm curious, it's easy to look at this. And as a consumer, when I click on it go, this is great. I would love to use this. I'm super curious, much less, I need it. What sort of work did you do on the other side before, as you're building Power to understand the needs of researchers and the organizations, knowing these limitations that are inherent and intractable, they can't move their hospital, but what can you do to make this more useful to them?

Brandon Li:

You're hitting on a couple interesting topics here. The first interesting topic is-.

Quinn:

Yeah. Sorry if I'm bouncing around, it's all exciting.

Brandon Li:

No, and we can double click into any of them in whatever order, but at the highest level, I think what you're talking about here is there's a well researched representation problem. In fact, racial minorities are three to 10X underrepresented in clinical research, which is awful because we know that a lot of treatments react differently in different racial groups. What does that mean? It means we actually have a downstream public health crisis where treatments are being approved in largely white populations that where we're not sure just exactly how they might respond in different groups of people. So we've got this large representation problem. One of the interesting things that we found is that I think there's a myth out there that the representation problem needs to be solved by popping up a bunch of new locations in a lot of different places, because racialized groups don't live near trial sites. That's a thing that we hear a lot, racialized groups don't live near trial sites.

Quinn:

True.

Brandon Li:

While there might be demographic skews, I think it's just untrue. If you look at America today that there are locations and cities and geographies that don't have people with different demographics, that's just not true. What's really happening here is that there's a transparency and accessibility issue. So I would reframe the representation issue as a transparency and accessibility issue. I'll give you an example. So a patient that I was speaking with recently has multiple sclerosis. Multiple sclerosis is a neurodegenerative condition that affects your ability to eventually walk over time. They were doing their own research and they realized that there was really promising stem cell research that is happening on this condition. They realized that there was an opportunity to get access to this treatment down in Panama. It was going to cost them $75,000 and a lot of travel back and forth to Panama while they're dealing with this condition.

Brandon Li:

Eventually they ended up finding our platform and they realized through our platform that there was actually somebody doing this exact research within an hour's drive of them. So what happened? Well, that transparency, that accessibility has allowed them to realize that there's actually something next door or relatively near that they could get access to just the car right away. I think that's really the unlock here is allowing folks who are within a stone's throw of the research to truly understand that it's available and in their backyard. Whereas today there's no easy way to do so.

Quinn:

That's super helpful. So I guess then before we dial into the researcher side, the clinical side and whatever requires to service that side of the market. So you've got folks like this person with MS, which takes its time, but the conclusions are fairly succinct. And you want to try to get ahead of it if you can, even though we've made so many discoveries this year, when they talked about Epstein-Barr, and that's incredible. It's just a piece of information and there's a whole world of things that we have to now ask more questions on. It's another string to pull, but that's helpful. That's great. Above that, before that MS, that person who's suffering from MS can use your tool and find, oh my gosh, I don't have to go to Panama. I can go within striking distance wherever that may be. The top of the funnel really is awareness.

Quinn:

And I know that there's a lot of folks who've talked about that this is of one of our primary things, is that when you've got 5% of doctors are Black and I think nurses are even fewer, Indigenous it's even worse. They're not aware that they're even candidates for trials, much less, that this is something that could be available to them in any capacity for however they're sick or their loved ones. So basically it's the top of the funnels awareness. How do we solve for awareness knowing people are just not going to the doctor as much as they could have, or they're not connecting with these type of researchers. They might not be associated with these type of hospitals. How do we solve for that before they can even get to your tool?

Brandon Li:

To solve the awareness problem you can think of... There's roughly two different paths here. You've outline an interesting phenomenon, which is that providers will often be subject to some subconscious bias that might influence whether they are proactively suggesting trial opportunities to patients. One path is let's go change everybody's minds and solve subconscious bias. That's a pretty tough path.

Quinn:

Go get them. Great, admirable, but come on.

Brandon Li:

Totally. And it's a thing we need to do. There's actually-.

Quinn:

100%.

Brandon Li:

... recent really interesting lead that came out that showed that more diverse research teams are more equitable in the way that they're able to recruit patients from their existing pools of populations, which makes total sense. But that's a long term cultural battle that we need to embark on. The other approach is, this is the approach that we're taking here is we fundamentally believe in empowered patients. Part of the pun here. One of the broader more interesting trends in digital health that has played out over the last couple years is the empowered patient. People are increasingly taking control of their own care and doing their own research. In fact, self-directed research into clinical trials has grown 22X in the last seven years. These are people who are learning about their condition and going online to try to figure out what else is out there.

Quinn:

Do you think any of that is indicative of folks who didn't have health insurance before the ACA and are maybe seeing doctors for the first time and being diagnosed with things for the first time? I don't know.

Brandon Li:

I don't know. I don't think we've looked at the data that way, regardless, what we do know is that people are doing what you would expect them to do, which is going to the internet and trying to find answers. Unfortunately-.

Quinn:

True.

Brandon Li:

... there are no good sources of truth on the internet. You've got clinicaltrials.gov, or you've got Pfizer's website, or you've got Novartis's website, or you've got Genentech's website. And what does that mean? Well, then the patient-.

Quinn:

We got Yahoo answers.

Brandon Li:

You've got Yahoo answers. And then what does that mean? You got to go to Pfizer, Genentech and so on and so forth and look at all other websites to try to figure out what else is out there and compare and contrast, whereas we're a single source of truth. They go to one place and they can know that this is what's out there.

Quinn:

Yeah, it's interesting, because one of the things I've really wrestled with and been increasingly frustrated and vocal about the past couple years is predictably, we have all these empowered patients and that's awesome and that's important. And my wife is the daughter of a former emergency room doctor and how important it is, especially she's a woman who's had miscarriages and heart operations and this and that, and how important it is to often have an advocate in the room with you to ask questions, especially if you're... All of these things were again, you have to keep empowering yourself and we have to empower each other to ask the right questions, to go to the appointments, to go further, to say, can I see a specialist? Can I get a second opinion? People are scared to do that, but at the same time in this country, we have such a history of making things your problem.

Quinn:

And now we have done that with a pandemic, which is the definition of public health and the history of medicine and health in this country has gone from whenever it was a hundred years ago, turns out dirty water can make you sick. Washing your hands is super important. These are public health things too focused on medicine, how specific that is to the person. And now with the pandemic, we went from everyone stay home, everyone help each other do as much as you can, stay six feet away. Not just doing it for me, I don't want to give it to you to, it's very much on you. And now we're going to have to be paying for vaccines because Congress hasn't given the administration anymore money to pay for them and test and all this stuff. I just wonder where the line is of, again, it's so important to celebrate and empower empowered patients, but also to be as supportive as we can to people. Again, it's easy celebrate that.

Brandon Li:

Ultimately, one of the interesting things that has stuck with me through this journey is that you said a moment ago, that we have a history of making it your problem in this country, we have a history of making it your problem in this country, which is true. When we look at it from the provider's perspective, one thing we could ask ourselves is what's happening on the ground in these clinics? Why aren't physicians more actively advocating for their patients? One of the things that's also happening is that physician time is getting squeezed. They have less budgeted time allocated to each patient. Their schedules are chaotic, back to back, to back with new patients. And unfortunately what that means is that they've got a bunch of throughput, but they don't have the time to do the research on the patient's behalf anymore. Whereas previously, maybe they did have a little bit more time to do so. That's one of the things that is unfortunately happening. And as a result, we need better tools for patients in this country.

Quinn:

Yeah. And it's also, again, we can pull on every string of the sweater here, but it's like, how do we transition to value based care?

Brandon Li:

Sure.

Quinn:

Which is doctors that don't have to have these incredibly packed schedules and then taking a piece of each of those very short appointments to hunt and pack into an electronic health record that doesn't speak to other electronic health records that like you said is fairly unstructured information, even if Epic is whatever one third of... All these things, it's like, yes, we've made a lot of progress, but boy, did we discover, for instance, when count cities and counties and states and school districts had to report to positive test data and you're like, oh, it's still faxes. Got it.

Quinn:

And that's partly because we haven't supported anything and we've bankrupted state budgets, but also because of HIPAA, for some reasons, and this and that, and you just go again, we've made a lot of progress in the past 10 years, but we've got a long way to go to make these things functional, but also to normalize and incentivize care, to spend the time with the patient, to be able to understand where they're coming from, to answer their questions, to ask questions of them, to present opportunities to them, but also to give physicians and nurses and nurse practitioners and other sports staff the time to, like you said, do the research and do some homework and be inquisitive and curious so that they can offer more well-rounded help. And again, not asking you to solve that on this conversation, but I just want to make sure people don't go awesome, so clinical trials are fixed because Brandon built an awesome website. It's like, no, that's not the thing, but this is an enormous piece of the puzzle. Certainly

Brandon Li:

We opened this conversation with you saying, hey, you have sent plenty of friends, family, interested parties to clinicaltrial.gov.

Quinn:

True.

Brandon Li:

You ask any healthcare worker, they have done the same. And they've done it with a pit of dread in their stomach, knowing that it probably would go nowhere.

Quinn:

Yes.

Brandon Li:

One of the things that we're excited about studying, and we're like, I probably can't talk about it yet on this podcast, but one of things we're studying with a major health system in Southern California is what happens when you bring Power into the clinic and you give clinicians and healthcare workers more patient-centric tools to go looking for clinical trial options. Does that increase accessibility? Does that increase the amount that patients can learn about their options at that clinic? We're running some interesting research over the next little while on this specific topic.

Quinn:

Sure. Now, does that take the form of almost direct marketing in office where you've got the little pamphlets to say, have you heard about Viagra? It's like, have you heard about Power? Is it that, is it more informing physicians and staff? I'm curious. And again, if you aren't ready to chat about any of it, but we can talk hypothetically too, whatever. I'm just curious.

Brandon Li:

Yeah. Hopefully it looks a little bit less like, have you heard of Viagra and a little bit more like Square, an interesting modern digital presence in the clinic and a little bit less like, oh, we're handing around these trifolds-.

Quinn:

Here's a pamphlet. Yeah.

Brandon Li:

Yeah. There'll probably be some physical collateral, but we do our jobs right. We're not hanging our hat on trifolds.

Quinn:

Sure, sure. Look, I love print, but come on.

Brandon Li:

Yeah.

Quinn:

So I'm curious, you've been baiting this for quite a while now, almost a year.

Brandon Li:

That's right.

Quinn:

Is that right? What obstacles did you face in fundraising? Anything that made you go back to the drawing board? Anything that you really didn't realize you would have to iterate on or improve on either side of the market, or anything that unlocked your ability to go raise what you needed to really build out the platform. I'm curious how that process went for you.

Brandon Li:

I think two interesting thoughts here. The first is that the biggest challenge probably through this process is just how busy a space it is. There are patient advocacy groups, there's clinicaltrials.gov. There are other folks who are trying to serve patients through navigation services. They pair you with a human that helps walk you through the process. It's quite a busy space. One of the big challenges we had to overcome was how are we different? What do we do that enables us to build a technology driven solution here. And I think the thing that really resonated for us and hopefully for our incredible set of supporters here is that there's actually a contrarian view here. The unorthodox point of view is that historically everybody has built for the pharmaceutical company, or the trial sponsor, the biopharma sponsor in mind, they're the ones who have the budgets.

Brandon Li:

They're the ones where the dollars end up flowing down to make a business model work. And as a result of building, primarily for the industry, you don't end up building directly for the patient. Our view is that we need to put patients at the center. We're building for the patients first. And in doing so, by doing well for the patients, we have an opportunity to serve the life sciences system, but that only comes from taking the patient-centered view and building for patients first. And that's really, I think what ended up resonating and what allowed us to generate some interesting support from investors.

Quinn:

Yeah. It is such a, like you said, it's busy, but it's just incredibly fragmented.

Brandon Li:

Yeah.

Quinn:

Like you were saying earlier, you can, as a consumer, whether as a current patient or a newly anointed one, like you said, you can go on Google and your options are limited and dangerous in the sense that it's easy to either feel frustrated quickly that there's nothing out there for you, be led down the wrong road, to find yourself on Facebook on, if there's so many well meaning people out there, of course. And so many helpful people who taken it upon themselves, either formally or informally to run these groups, to be an advocate, all these incredible organizations, whether they're former patients or whatever it might be. But at the same time, there's not just misinformation, but a lack of information or biased information. Like you said, you got to go to the company's website.

Quinn:

So do you present yourself then as not just to a consumer, but to folks you're looking to fundraise from as an aggregator, as like you said, this single source of truth, are you just, hey, we are seeking to replace clinicaltrials.gov. How do you elevate yourself above all of those other options?

Brandon Li:

Yeah. I think the example that is really easy to wrap our heads around here is we're building the Zillow for clinical trials. Prior to Zillow, plenty of information out there, plenty of multiple listing services out there, plenty of brokers who wanted to talk their own book. And so you're a house that's in there that they're currently representing, but Zillow scooped it all up and presented it in an unbiased way, in a interface that was built for the buyer, for the consumer. That's exactly what we're doing here. There's plenty of all this fragmented data, a little bit of bias data, a little hard to navigate. If you don't want to go into the government systems, exact same setup, we're doing that and building the Zillow for clinical trials.

Quinn:

So what has the reception been like on the clinical trial side for researchers for pharmaceutical companies? Are you proactively approaching them? How does that work? How do you get good with them? So they come to you guys first. So they feel like they're getting a benefit from it.

Brandon Li:

Funnily enough, they've been coming to us, which is-.

Quinn:

That's awesome.

Brandon Li:

... which is the best story that you could hope for. Coming out of this launch here, we actually had an influx of inbound interest almost too much for us to handle right now, which is knock on wood only a good thing. I think at the end of the day, in this specific domain of life science, the patient's interests and the pharmaceutical company's interest and the researcher's interests are all aligned, which is around unblocking the system. Patients are truly and deeply motivated to, A, finding get access to promising options. But then B, if you speak to patients, there's quite a bit of inherent altruism here where patients are interested in contributing to a growing body of literature on specific conditions. And on the researcher side, they're more than happy to work with anybody who can help solve this problem of 86% of trials are delayed.

Brandon Li:

In fact, that is the single biggest problem in life science research today. The fact that almost every trial, all research is delayed. It's a burning platform. It can cost up to $8 million a day in opportunity cost due to these delays. So everybody wants to find ways to make this system connect in a more efficient way. And that's where we want to play.

Quinn:

That's fascinating. It seems like there's been a lot of folks waiting for something like this to come around. Is the system from the trial side of the market, is it fairly self-serve at this point to input a new trial to fit themselves in? Or are you guys still onboarding folks manually? Where are we in the process?

Brandon Li:

Yeah. So today we're in closed beta on that side, we're onboarding selectively, making sure that we can have impact, making sure that the experience is easy enough that researchers love the experience as much as patients. You under the radar for about a year with patients, because we were dedicated to making sure that it was a delightful experience once we went public with it. And we're going through the same motions on the researcher side now. We want to make sure that it's really solving their problems. They truly love what we've built for them. So that once we open the doors a little bit more, we're confident that we can have the impact that we want to have.

Quinn:

That's great. So what do you feel like the timeline is to open that up a little more? Is it six months a year? Or is it, hey, we're going to just do this right, and then we'll see what happens. I'm curious how that fits on your side, running this thing, but also any pressure you might have from investors to see this thing take off.

Brandon Li:

Yeah. I don't want to commit to when it's going to be, open the floodgates, but what I will say is that we are constantly onboarding more folks into our closed betas. So if anybody's interested in testing out, making sure that, or I guess seeing the impact that we can have for their research, we're open today to have those conversations. And we'll have a honest conversation about scope, our ability to have impact. And whether now is the right time, but we're ready to have those conversations today.

Quinn:

What do you find yourself now a year later, still closed beta, but opening your wings a little bit here. What do you, in your position at the company, find yourself doing differently now than you were a year ago, besides just handling more intake? Is the job what you thought it would be? Is it having the impact you thought it would be even though you're still in the very early days?

Brandon Li:

Yeah. That's a fun question. Well, podcasts like this for one are things that we were very intentionally not doing a year ago in the spirit of keeping things under wraps, but in that vein, a lot of these activities that you might bucket under getting the word out, what we're up to, these are the kinds of things that we weren't doing intentionally for quite some time to make sure that we had the product and experience right. And we're starting to open the flood gates, hiring a little bit more, being more open to growing the team. We wanted to operate from a philosophy of a lean team can make faster, more progress when there's a lot of uncertainty. Now that there's a little bit more certainty being open again to have more conversations to expand the team. And then while we were building for patients, we weren't building for researchers or life science. And that's the next like here. So yeah, to your point, far more conversations with the life science industry now, too.

Quinn:

Got you. Got you. So this one probably seems pretty specific if you took any time to get a little more familiar with what we do, first of all, it's time, you'll never get back. I apologize. And second of all, it's pretty specific where we've honed ourselves, which is like I said, it's science for people who give a shit. And it's a lot of folks who are coming here. Look, they come to us either because they're a policymaker whatever level, whether they're a farmer or a student or a scientist or a founder or funder, whatever it might be, they give a shit for some reason. They are dealing with reinsurance markets when it comes to wildfires or floods, or they lost a loved one to COVID or they're invested in life scientists, whatever it might be. But the whole point is they come here because they're not interested in 101 anymore. They're past that. They're ready to take some sort of action. We provide a huge variety of those things, but try to really make them measurable and specific.

Quinn:

Smash your finger against this button, because we've done the work to show you that it's something that's either going to help you feel better or really move the needle, or hopefully both. This feels pretty specific because you've built a two-sided tool for people who are really in need and other people that are really in need both really trying to do the right thing, to feel better and to make a measurable difference. And that's partly why I couldn't have DMed you quicker than when I did. I want to talk about action steps as we call them that folks can take to get involved, but to also support your mission. So on the consumer side, let's say I'm mid forties, mom in Kentucky with breast cancer. How does this process work for me?

Brandon Li:

This process is actually built for you. With power.com is our website, go on, you can search for your condition. You can narrow it in by your location and how far you're willing to travel. And depending on the condition we even allow you to filter by biomarkers if it's relevant to your condition, we allow you to filter by number of prior treatments. These are actually things that you couldn't do before. These are new superpowers that we've unlocked with some of the data science that we were speaking about earlier. So if you are in a position where you've got a condition that you're working through, our website was built for you. If you're doing research on behalf of a loved one friend, family member, our platform was built for you. And if you're a healthcare worker, a provider and you're interested in bringing better tools into your practice. And if you're a little bit tired of referring people to clinicaltrials.gov - withpower.com, send folks our way, hopefully we make their lives easier.

Quinn:

I imagine it will. Again, anything is a step up. Can I create a profile and create a saved search for my condition or for if I'm an internist or whatever it might be for my type of practice, or is it all proactive searching? Is that to come? Tell me what that side of the experience is, if I get there and go, not quite, but it seems like there'll be something eventually.

Brandon Li:

As a patient or somebody who's searching on behalf of a patient, you can absolutely make a profile. You can search without a profile. We don't try to gate it behind signing up and making an account. You can search without a profile, but as you find trials that are interesting, you can make a profile to make sure that we now know more about what might be relevant for you. As a physician, you cannot yet make a physician specific profile, sorry to say, but if you're interested in helping us understand what would be helpful for you email me.

Quinn:

Sure. Okay.

Brandon Li:

That would be great.

Quinn:

Great. We'll put that in the show notes.

Brandon Li:

Yeah, totally. If you're a principal investigator, a sponsor, a CRO and you want to understand how our platform can work better with your trials, email me, we're open to conversations. We're learning every single day. One of the things that is important for us is that we come in with a beginner's mind. We're outsiders in this space. And as a result, we're here to learn and we wouldn't have, I don't think we would have gotten this far and nor will we get to where we won't to if we don't continue bringing that mindset every single day. So email me, always happy to have a conversation and learn if anybody's willing to share what's in their brains.

Quinn:

How big is your team now?

Brandon Li:

We're about 10.

Quinn:

Okay.

Brandon Li:

Yeah.

Quinn:

That's pretty lean.

Brandon Li:

It's pretty lean. We pride ourselves on it actually.

Quinn:

Any hiring goals, if there are folks who want to get much more directly involved with this sort of thing?

Brandon Li:

Yeah, absolutely. So probably two kinds of profiles most directly. I think every tech entrepreneur will tell you that they're hiring for engineers. We are no different. And then maybe something that's a little bit more specialized for us is we're starting to think about what does business development mean in the life science industry. So always open to having conversations with seasoned life science execs, business development execs, who are interested in having an impact with a smaller team and hopefully with a new technology that can really move the needle.

Quinn:

Is there a jobs hiring page, anything like that on Power?

Brandon Li:

If you scroll all the way down to the bottom, we have a link to our careers page and that's where you can go to learn more.

Quinn:

Great. Great. We'll put that in the show notes as well.

Brandon Li:

I'll send it over to you.

Quinn:

That's all super helpful. I'm going to bring us to our last of few questions here, because I don't want to keep you forever. Anything else I should have asked? Anything else you want to get into here before I let you go? Again, I want to walk the line of obviously still closed beta. Don't get too crazy. Like you said, there's some things you're working on. You're not totally ready to talk about yet and we can revisit this some day soon, but if there's anything I'm missing, please let me know.

Brandon Li:

One of the things that's probably worth also talking about is, hey, we spoke about representation as a problem that needs to be solved today in clinical trials. And I reframed the representation problem as a transparency and accessibility problem. One thing we didn't talk about is how that's panning out in the data. So as we look at the user data on our platform, what we're seeing is that actually our users are representative of the US population. Maybe we look at all the racial and ethnic demographic cuts by US census. Our user base is actually representative of the population. What does that mean? Well, what that means is that the patients on our platform are three to 10X more representative than clinical trials today. What that means is that transparency and accessibility is a huge lever that drives our ability to address the representation problem, clinical research.

Quinn:

I will be curious as you get into, like you said, the business development side and working more with researchers and trials and the companies behind them or universities or research hospitals, whatever it might be, it's a known, known that diversity in these trials is a huge glaring problem, but I'm curious to see how much that drives them, which is, hey, how can we actively recruit, use this tool to actively recruit more people, again, within striking distance geographically, but to start to really improve these numbers. So that one, again, it's the right thing to do, full stop. Second, because like you said, we're approving drugs that have not been tested on large segments of the population. We don't know how that's going to go. And I'm curious how much, hopefully quite a bit, but also I'm well aware that that can be a tough needle to thread. Can't just wave a wand and all of a sudden your numbers go up.

Brandon Li:

Yeah. Yeah. And it's a complicated multifaceted problem. I'll make a plug-.

Quinn:

Love plugs.

Brandon Li:

... which is that we're currently working on white paper with some of the leading thinkers in this space about how we can work on the representation problem in clinical trials. And it's a shocker that it's not one person's set of responsibilities. There's a multifaceted ecosystem approach that needs to be taken here across different levels of industry, all the way from the patient engagement tools through to how do we think about regulatory incentives and all the actors in between. And there are levers to pull on each of them. I think one of the challenges historically around this is, hey, we know that we need to improve diversity and we make it one person's problem. And this poor person at the clinic is now being told that they need to recruit more diverse patients. What are they going to do about it? They're left on this island to solve this attractable problem on their own. So we're really excited about this white paper that we're working on. We're excited to publish it's in.

Quinn:

That's really exciting. Yeah. I think obviously the more research that's out there, the better, but like you said, it is not an intractable problem. It is a hugely complex societal problem. And clinical trials are just one area that is affected by this system we've designed and reinforced for quite a while.

Brandon Li:

Absolutely.

Quinn:

Whether that's redlined city blocks or whatever it may be. At the same time, if there's anything that I've tried to coach folks on, either in broadcast or one on one or to family members or to myself over the past couple years, as we're blocked in our living rooms and then more, it is all you can do is all you can do, which is control as much as you can control. And then you have to let go of a lot of the rest. So I hope as much as there is this huge potpourri of issues with a lack of inclusion in these things or directly marginalizing people that you all are able to affect this piece of the puzzle, as much as you can, because it truly will make a huge difference as we look at things like CRISPR, or look at what else can we do with mRNA, whether it's malaria or whatever it might be, or breast cancer or profound things that could come out of the life sciences, like you said, but there's definitely a bottleneck.

Brandon Li:

Yeah. Yeah. Absolutely, as we look forward at the impact that we want to have, there's this dual part mission where we want to help the patients of today who need transparency and access to leading medical research. And we want to help the patients of tomorrow by accelerating the speed of which the life science industry can do research and in doing so bring medicines of the future a little bit closer to us today.

Quinn:

I love it. I think it's great. Thanks for fixing everything.

Brandon Li:

Oh yeah, no problem.

Quinn:

Congratulations. It's over.

Brandon Li:

Yeah, it's done.

Quinn:

All right. Last couple questions. I'm going to get you out of here, Brandon. Slightly more met up. When is the first time in your life, when you realized you had power of change by yourself, family member, little team with the power to do something meaningful when you were like, oh shit, I did that, or I could do that. Could be third grade, could be nine months ago. I'm curious. What was that spark?

Brandon Li:

There was a moment when I was, I think in third grade and this is super nerdy. Third grade, I was the kid who was playing cards in the card shop with the adults. I don't know if you ever played these trading card games, these strategy card games growing up. But there was this moment when I was playing them and I had this love for the game, but then I also realized that the level of competition that I was going to on the weekends was very different than the level of competition that I had on the playgrounds. And there emerged this business opportunity as this third grader who was getting shuffled to the card store on Saturdays and then to the playground during the week where I would buy cards at the store and then bring them over to the playground and sell them at a markup. I remember my mom was livid, but it was probably the first time that she realized that I'd be a lot of trouble.

Quinn:

I love that. That's fantastic. Wait, what was your game of choice? What are we talking about here?

Brandon Li:

Competitively, I played Yu-Gi-Oh! and Magic: The Gathering, and I tried to go pro in Magic: The Gathering.

Quinn:

I love it. Is there still a small percentage of you that thinks that that's possible?

Brandon Li:

I still play occasionally, but I can't keep up with how fast the game moves today. So I need to play a specific format of the game that doesn't require me to upkeep any of my cards.

Quinn:

That's fair. That feels like a happy media. Brandon, who is someone in your life that has positively impacted your work in the past six months?

Brandon Li:

I need to give the shout out to my co-founder, Bask. We've been working together for years now, but he's probably one of the most brilliant people I've ever worked with. And he continues to raise the bar for me and the team every single day. So it's just a pleasure to work with him day in and day out.

Quinn:

How are your duties split?

Brandon Li:

So the proverbial startup duties are, you're building a thing or you're selling a thing. Given the fact that I'm on this podcast, you can probably intuit that I'm selling the thing and he's building the thing.

Quinn:

And doing an admirable job of it.

Brandon Li:

I'm working on it.

Quinn:

That's awesome. That's fantastic. Division of duties and clear expectations around that can really make everything much, much easier, not easy but easier, certainly.

Brandon Li:

And the right partner.

Quinn:

Oh, a hundred percent, a hundred percent. My wife and I don't often work together on too much, but we're incredibly supportive of each other and we're parents, which is difficult enough and wonderful, but it's always important to look around and go, oh my God, thank God we found each other because holy shit, this is hard enough as it's without each other.

Brandon Li:

Yeah, totally.

Quinn:

Any self-care, going for walks, going for a run when you're like, I cannot think about with power.com for any longer?

Brandon Li:

Yeah.

Quinn:

What is it for you?

Brandon Li:

Two things physically being in the gym, just lifting weights. I think that I struggled with my own health for quite some time. And I was probably too late to the game to set up a health routine and to start prioritizing my own health. So this is a thing that's changed probably in the last two years. And kudos to my fiance because a year ago she looked at me and she said, Brandon, your birthday gift this year is a personal trainer.

Quinn:

That's awesome.

Brandon Li:

You need to find love for your own health. And that's absolutely changed my life in the last year.

Quinn:

That's awesome.

Brandon Li:

Yeah. And then intellectually, when I'm tired of thinking about work, I read fantasy books. I'm just such, going back to the card game thing, I'm such a little nerd on the inside.

Quinn:

Yeah. Fantasy's basically all I've read all night for the past two and a half years. For my life, but especially the past two and a half years. What are some favorites that you'll know guilt revisit and what is also some fantastic stuff you've read, because I'm just going to go download them.

Brandon Li:

Brandon Anderson, almost everything from Brandon Anderson.

Quinn:

There are so long though. Oh my God.

Brandon Li:

And they're egg and it's infinite. He has so many of them.

Quinn:

Infinite, infinite. The math truly doesn't add up on the level of production.

Brandon Li:

He must have an army just cranking out these stories, because it is so impressive what he's done. And you compare that with George R. R. Martin's output in you. It's unbelievable how fast he writes. And then Patrick Rothfuss, The Name of the Wind. I don't know if you've read this one, but just a poetic writer.

Quinn:

Do you think the third book will ever come?

Brandon Li:

I think he's painted himself into the same corner as George R. Martin, where it's such a tall tale and to try to wrap it up in his promised three-part trilogy is quite hard.

Quinn:

Did you see there was someone last year gave some interview and was like, oh, I don't think he's written anything basically. I was like, oh my God. Oh no.

Brandon Li:

Oh no. Yeah. If I could make one more plug or book, and this doesn't have to be for the podcast. Do you read Guy Kay?

Quinn:

I don't think so.

Brandon Li:

Guy Gabriel Kay, he's a Canadian writer and he does historical fiction with a quarter turn of fantasy. So it's mostly political intrigue, historical fiction. He likes to cover Constantinople in the time that it fell and became Istanbul. That time period around the Mediterranean, really interesting work. He's fantastic. What do you read?

Quinn:

I'll go back to a lot of different things. You'll find me cross referencing and creating new spreadsheets all the time. This is when my wife's eyes glaze over like a shark, because I'm like, there's a new list of 80 greatest fancy books. She's like, you've read them all. I know, but this is somebody else's opinion and I got a cross reference.

Brandon Li:

Sure. Yeah.

Quinn:

And she's like, please leave me alone. I'll tell you what I did recently that was a little late on, but what was fantastic is by N.K. Jemisin, the fifth season books, which is, I think there's a name for the whole set, but that's the first one. I truly felt those were fantastic.

Brandon Li:

Yeah.

Quinn:

I'll do anything, man. At this point, if it turns my brain off at night, I don't have to think about climate change. Great. And then someone's like, it's fantasy, but it's about climate change. I'm like, no, I can't do, I need a little separation at church and state.

Brandon Li:

Yeah, I get it. Yeah. Fiction is a nice escape.

Quinn:

It's the best. It's the best. Okay. Last one. And this is specific both to what we're talking about, but also a little different, a book you've read this year, opened your mind to a topic you haven't considered before, or has actually changed your thinking in some way. And we throw all the recommendations up on bookshop and people love to check these things out.

Brandon Li:

Andre Agassi's autobiography.

Quinn:

Oh, it's supposed to be fantastic.

Brandon Li:

Just incredible. It's this great story where as a junior player, he was demolishing the competition, he could not lose. And then when he hit the pro, the pro circuit, he had a really hard time winning. And he takes you on this journey of somebody who was at the top of his game, then hits rock bottom has to find a way to recommit himself to excellence and rebuild himself up from the ground up again in order to be competitive. And then, of course, becomes an incredibly prolific player. For me, that's an incredibly inspiring story and I'm always moved by these stories of people who are able to achieve or get to the top of their game and maintain it on some scale. So, that was a great book to read.

Quinn:

Awesome. I love it. Yeah. I have to do that one at some point, for sure. All right, Brandon, we're going to get you out of here. I really, really appreciate the time. Thank you for jumping on this. It's really exciting and powerful what you're building, and I know you're being very careful and using patience and consideration as you build this thing. And I hope that you stick with that because I know the pressures to grow and to affect the world are great, but it's really important what you're doing. So thank you for that.

Brandon Li:

Oh, thank you for having me today, Quinn, for reaching out and for such kind words, it's been a blast.

Quinn:

Yeah, absolutely. Where can our listeners follow you online? Should you so choose.

Brandon Li:

Twitter At Brandon H. Li and with Power HQ? We don't have a big Twitter presence.

Quinn:

Step by step.

Brandon Li:

I think if you go onto LinkedIn and you look for Power, you should be able to find it. It'll be hard to find randomly.

Quinn:

We'll find out, we'll find out.

Brandon Li:

But hopefully you can find it in the... And drop a link.

Quinn:

Awesome. Well, thank you. I really appreciate it. Have a great rest of the week.

Quinn:

Thanks for listening to the show. A reminder you can send feedback or questions about this episode or some guest recommendations to me at questions at importantnotimportant.com. Links to anything we talked about today are in your show notes in your podcast player. If you want to rep any or your shit giver status, you can find sustainable t-shirts, hoodies and a variety of coffee delivery vessels in our store at importantnotimportant.com/store. You can subscribe to our critically acclaimed weekly newsletter for free at newsletter.importantnotimportant.com. Our theme music was composed by Tim Blain. The show was edited by Anthony Luciane. And the whole episode was produced by Willow Beck. We'll see you next time.