(Transcript) Electricity as Medicine – Renee Ryan // Cala Health

Ever since I befriended the scientist who developed the cochlear implant and was an early developer of remote neuromuscular stimulators, I’ve been fascinated by neuromodulation. While I was looking at minimally invasive procedures, non-invasive methods didn’t even cross my mind. While non-invasive methods are focused on assuage, they do not cure. Even so, I was very pleasantly surprised to learn of Cala Health, and I really enjoyed Renee Ryan’s (Cala CEO) talk with Josh Wolfe (Lux Capital).  

Lux has a Medium Page where they share transcripts of all the Futura episodes, but they haven’t published this one yet, so sharing mine here. You can watch the full video here.

If you want a recap of Season 1, check out this tweetstorm.

*Any transcription mistakes should be attributed to me.
*Transcribed 6/16/2020

Josh: Hey everyone, I’m Josh Wolfe, Managing Partner and Co-founder of Lux Capital, a firm that invests in emerging science and technology ventures at the outer most edges of what’s possible. We’re back with season two of our new web series Futura, where you’ll be meeting the rebels of science and invention. We’re turning Sci-fi, into Sci-fact. This season we’re taking you inside with the futuristic founders and inventors who are bringing their cutting-edge ideas to life.

I’m here today with Renee Ryan, the CEO of Cala Health, which is merging breakthroughs in neuroscience and technology to deliver individualized peripheral nerve stimulation. Wearable electronic medicine isn’t science fiction anymore.

So one of the very cool things about you is that you started out as an investor. We were both on the same side in one of the great successes, Auris, which was originally invested in by J&J, and then sold to J&J. But tell me about your transition from the buy side to identifying a mutual portfolio company, and then going to lead it.

Renee: Well, it was interesting. I realized that large companies, like J&J, don’t really have a cash problem. They have an innovation problem. So the idea of starting your own companies, or becoming farmers versus fishermen, was really sort of a mind shift that I had. And the summer that I started Verb Surgical, which was really this sort of breakthrough innovation, not just in surgical robotics but really digital surgery and transforming the O.R. for the 21st century. But that summer was the same summer that Lux and J&J got together to found Cala as well. So exciting times, but the mindset was about doing things differently, right? And the ability to create opportunities like wearable neuromodulation or surgical robotics.

Josh: To explain neuromodulation very simply, in lay terms—

Renee: Simply put, it’s using electricity as medicine.

Josh: Electricity as medicine.

Renee: Mm-hmm.

Josh: I mean, that sounds sort of crazy. But this is something that we’ve talked about.

Renee: Yeah, no. Not new at all. I mean, if you think about the history there, it goes back to pacemakers. And then we moved into cardiac defibrillators and lower back pain stimulators. Now we treat obesity and sleep apnea and all sorts of conditions using implantable neuromodulation. Cala was the first time I had seen anything to do it in a body-worn electronics.

Josh: So instead of requiring surgery or some sort of invasive technique, this is something that is going on like a wristwatch equivalent, more sophisticated of course.

Renee: Hopefully, yes.

Josh: Tell me about the technology in Cala’s case. What are the components of it, how does it come together, what’s the hardware, what’s the software, and then what’s the implication for a patient.

Renee: So the insight that Kate had was really the ability to stimulate over two nerves – at the wrist – but generate the signal in the Central Tremor Network in the brain. So it wasn’t just a simple electrical pulse, it was the idea of having a patterned pulsing across two nerves, that was the real innovation that she discovered.

Josh: And the implication for patients – of course, essential tremors are shaking, manifest from Parkinson’s and other neurodegenerative diseases – what is the implication when you put on a device like what Cala has made?

Renee: Yeah, you know, we’re not curative in any way, but we are reducing the tremor burden. So we ran the largest study ever done for an essential tremor therapy, and 263 patients across three months. And what we saw was that about 92% of our patients actually derived some level of benefit. What you’re able to do is restore people to their activities of daily living. So anecdotally, we have patients who want to play the guitar, they want to paint, they want to feed themselves. Restoration of those types of activities are what our goal is.

Josh: Are there any stories that you can share about patients that are actually using the device – that have maybe positively impacted their lives.

Renee: About two weeks after we launched here in California, we were offering a telemedicine option to patients. This patient showed up, she got an appointment on the doctor’s calendar. She was scheduled to have deep brain surgery in about three weeks.

Josh: So, being put under massive invasivesurgery.

Renee: Correct. And she wanted to try theCala trio device as a potential optionfor her. And we found out that she didpostpone her surgery for about fourmonths. And, so far, it’s looking verypromising that the Cala trio is workingfor her.

Josh: That’s amazing. Congratulations.

Renee: Yeah, and her – she was so simple in her needs. All she wanted to do was restore her dignity to feed herself.

Josh: When you think about the talent that has been assembled under your leadership, what are the disciplines that you’re drawing from? Where are people coming from?

Renee: Yeah, I think like many startups in medical devices, we have traditional mechanical engineers and electrical engineers, but what makes Cala, I think, more unique, is that we also attract a wealth of phenomenal data scientists and neuroscientists. Oftentimes we have combination degrees of both a data scientist’s, but also neuroscientist’s, background.

Josh: It’s fascinating – the signal processing in both ways – between being able to read the neurons and essentially write to them – and the intersection between brain science and computer science. Truly remarkable.

Renee: Yeah.

Josh: Now, we love rebel scientists at Lux. We love rebel founders. We love people that are breaking rules in some ways. Are there any rules, whether it’s in the manufacturing or the distribution of your devices, that you’re thinking about this in a different way than people might expect?

Renee: Since the earliest days, when J&J and Lux and Kate all got together, this was about doing it differently. This was about putting the patient at the center of care, and delivering our therapy directly to that patient. Now, it was complicated because we have a prescription involved. So we do need a physician’s endorsement of the technology. But once we, Cala, get the prescription, we are both the manufacturer and the distributor of the device. And we directly ship to patients.

So that engagement, when we bring a patient in, when we train that patient, it’s all done by us directly with our patients.

Josh: So you’ve got the Trio, which is the first device. But what are some of the other devices that we might expect coming down the pipeline?

Renee: About a year ago, we in-licensed work out of Massachusetts General Hospital, out of Harvard, for an auricular based stimulation, which is at the ear. And, we believe that there’s additional neurology and cardiology types of applications using that platform.

Josh: Truly appreciative of the work that you’re doing. I can’t tell you how many times I have people reach out and say can you put me in touch with Cala because they have a brother or sister, a mother or father, a loved one who is afflicted with essential tremors.

And so we always say that we like to invest in technology that matters. Matter that matters. And very grateful to be partnered with you and the future that you’re building.

Renee: And thanks for the support.

Josh: That’s it from us today. I want to thank the rebel inventors at Cala Health for giving us a sneak peek of the future. If you want to get in touch with us, reach out to us at Futura@lux.vc. We’d love to hear your crazy ideas and inspirations.

If you enjoyed this, and want to learn more about Josh, check out my compilation of him. And if you want to keep up with what I’m reading, you can find me on Twitter at @kgao1412.

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