Originally published in PharmaVoice 100
Dr. Steven Steinhubl’s winding career in life sciences has taken him to the savannas of Sierra Leone, the inner city of Chicago, the coast of San Diego and beyond. But of all the places he’s been, the now chief medical officer at physIQ loves his current home in Alaska the most.
“In the finest restaurant in Anchorage, you wear your boots and your Carhartts and a flannel shirt. No one cares what car you drive or where you went to college,” he says. “That’s just more my kind of place.”
Although Steinhubl is somewhat of a triple threat in the industry — a chemical engineer, clinical researcher and practicing cardiologist — with a long and impressive resume, he doesn’t care much about accolades. Instead, his career has been driven by a desire to enhance health equity in the U.S. and around the globe through the development of digital health technologies.
“My whole motivation around being involved in research, and especially digital technology, is I feel that there’s a lot of areas where we fall short in healthcare,” Steinhubl says. “The work we do is all baby steps, but I’d like those baby steps to make it easier for clinical research to be more inclusive and more meaningful.”
If Steinhubl’s journey is composed of baby steps, those steps have nevertheless made a large impact. As the founding director of digital medicine at the Scripps Research Translational Institute (SRTI), he led the first decentralized clinical trial, known as mHealth Screening to Prevent Strokes (mSToPs), which screened patients for atrial fibrillation with wearable sensors.
And now at physIQ, a digital medicine company developing remote monitoring analytics, Steinhubl is pushing decentralized clinical trials even further. The company leverages wearable sensors and its predictive AI platform to measure patients against their own data baselines to “earlier identify infectious diseases, improve the safety and efficacy of newly developed vaccines, and enable safer and more patient-friendly CAR T-cell therapies,” one of Steinhubl’s nominators says.
A digital tech pioneer
It’s a platform Steinhubl has worked with since the early 2010s at SRTI, when he developed a program with the U.S. Agency for International Development (USAID) to improve outcomes for Ebola patients in West Africa.
He spent several weeks at a rural treatment center in Sierra Leone focusing on disease monitoring. At the time, healthcare workers at the remote facility would wear two gowns, gloves and masks in close to 100-degree heat and 90% humidity to check the vitals of Ebola patients.
“It wasn’t safe for them,” Steinhubl says.
Because of that, patients would only be monitored a few times a day for short periods. But under Steinhubl’s leadership, the team designed an initiative that placed a wireless sensor on patients, used physIQ’s technology to continuously monitor and analyze the data, and streamed that information into a safe area of the hospital where healthcare workers could monitor patients for early signs of organ failure.
“We took a very bare minimum treatment center and turned it into the equivalent of the finest hospital anywhere in terms of the quality of monitoring individuals,” Steinhubl says of the experience.
The initiative opened the door to future uses of digital technology for remote monitoring. And in 2020, when the COVID-19 pandemic began to fill up hospital beds, the technology once again came into play. This time, Steinhubl worked with the physIQ team on a research project to develop a biomarker for COVID-19 decompensation and studied more than 1,000 patients in mostly underserved areas throughout Chicago.
Similar to his work in Sierra Leone, the team placed remote monitoring devices on patients who were diagnosed with COVID-19 but were not sick enough to stay in the hospital, and monitored their conditions for signs they might need to be hospitalized. Ultimately, the study allowed the team to create a digital biomarker for future pandemics while freeing up hospital beds and helping patients in the moment, Steinhubl says.
“It was a great example of all of the good things about digital technology,” he says. “By using this continuous sensor data, we’re able to react to changes in vital signs that are unique to [patients] that, honestly, we don’t even do within a hospital setting right now.”
A transformational difference
It’s that “dogged approach” and drive to constantly innovate for patients that one of Steinhubl’s nominators says sets him apart.
“[Steinhubl] has referred to the research process as ‘sculpting’ — carefully and deliberately chiseling off barriers to reveal new truths that can enable better solutions in healthcare,” a nominator says.
Through each experience, he examines ways his work can better improve health outcomes for patients. Take, for example, his time working at the Alaska Native Tribal Health Consortium, where he serves as a practicing cardiologist and helps carve away at the systemic challenges faced by the Indigenous community. While many would describe the efforts as altruistic, Steinhubl views his participation in the consortium as “very selfish” because he says every patient serves as a reminder of “why we must do better” as an industry.
In the digital technology and clinical trials space, “doing better” in the future means creating more connection and transparency with patients, particularly around their data, he says.
“If [patients are] sharing their data in real time, they deserve feedback, or their questions answered, or getting their data, also in real time. And we have to learn how to do that,” he suggests.
Steinhubl put this approach into action during the mSToPs trial, providing the data collected from the trial to participants with the appropriate context to help them understand the results. It’s an approach he continues to use at physIQ.
“Every trial that we lead now we want to give participants in the study back the results and specifically not as a data dump — but giving it back to them in a way that’s meaningful,” he says.
He also says clinical trials should better employ technology to become more reactive, and allow researchers to rethink and adjust their strategy after a trial has begun, rather than wait until it is over.
“Instead of this ‘let’s roll the dice and see what happens years later’ attitude, you can create the trial realizing where you need to get to, but along the path, you can always keep an eye on what’s working and what isn’t working, and tweak it [to] keep improving.
“We have to realize that technology enables us to do things completely differently,” he continues. “And if we don’t do it differently, we actually aren’t taking full advantage of what the technology can do.”