HIStalk Interviews Feyi Olopade Ayodele, CEO, CancerIQ
Feyi Olopade Ayodele, MBA is co-founder and CEO of CancerIQ of Chicago, IL.
Tell me about yourself and the company.
I started CancerIQ when making the transition from the world of finance into healthcare. I joined healthcare with an amazing co-founder, my mother, Dr. Funmi Olopade. She’s not only a great mom, but she’s a MacArthur Genius Award winner for her work in understanding the relationship between cancer and genes.
I was motivated to start the company after working with her at the University of Chicago and realized that her vision was for genetics to be part of routine care, but that was really only possible in some of the academic centers that have those resources. I’m all about democratizing access to what we believe is the most cutting-edge version of care. That’s why I left the University of Chicago to start CancerIQ.
To what extent can cancer be predicted using genetic profiles?
To a great extent. In fact, the first cancer gene that was identified was the BRCA gene. Despite us having known for 30 years that the BRCA gene causes breast and ovarian cancer, there has been unfortunately limited adoption of genetic testing. About 10% of patients who should be tested, even for the BRCA gene, have been tested. What’s also exciting is that they can not only understand your risks, but there are also well-defined clinical protocols that have been validated to help you reduce your risk, or eliminate that risk altogether.
Many oncology treatments aren’t pursued because of insurance or other financial issues. Does insurance cover the cost of genetic screening?
Absolutely. The insurance companies have done the math. It’s expensive to treat a patient, only to have them come back with a secondary cancer that you could have known about earlier. It’s also very expensive to treat somebody who has a predisposition and is going to get a more aggressive cancer, or get it earlier than standard cancer screening age, so payers have been willing to cover this testing.
What has held providers back is knowledge, workflow, and time. We’re solving those with CancerIQ.
What is involved in doing the screening and what kinds of providers can offer it?
Risk assessment starts off with the cheapest genetic test available, and that’s your family history. While it costs nothing to evaluate your cancer history, if you’re like me and have 31 first cousins, it could take a provider a whole lot of time. That’s one of the initial barriers that holds people back from this process. It’s time-consuming to see who meets the criteria for genetic testing, but it’s also time-consuming to fill out all the insurance paperwork to get coverage for it.
In terms of the types of providers who can perform the screening, genetic testing was initially incurred in specialty care. Genetic counselors were given this responsibility, but unfortunately, millions of patients need this service and we have only 700 cancer genetic counselors. A number of professional societies encourage doing this kind of genetic evaluation, ranging from oncologists to OB-GYNs, who have been on the forefront of doing this in preventative care.
Can the screening be performed in a telehealth visit?
Absolutely, and that’s where we have seen the biggest traction, during COVID, when people are anxious about going in for their cancer screenings, CancerIQ is a mechanism by which providers can evaluate their patients remotely and give them peace of mind on whether or not they can afford to delay their cancer screening or determine if they must be prioritized to be screened earlier rather than later.
What would the trigger be that would suggest that an individual is a candidate for screening?
Pretty much every patient should get a CancerIQ at some point in time. What we see as the future of healthcare is being proactive and preventative. If we could know everyone’s risk by the age of 21 in the future, it could help with better, more personalized, or precision health recommendations so that people can get ahead of cancer.
Is there psychology involved in telling that 21-year-old that they are genetically predisposed to get cancer decades down the road?
I would say that 21 is probably a little early because there aren’t too many established guidelines that would change the way you’re managed at the age of 21. But that depends on your risk. If you are at an elevated risk and many people who have these predispositions will get cancer under the age of 30, then you should start some of these screenings under the age of 30. I don’t want to opine on when you should start, but what is exciting about the future of healthcare is that you could get a genetic evaluation at a certain age, and through CancerIQ, your provider can monitor and manage you over time.
An individual’s genetic makeup doesn’t change over time, but new research findings about the health implications of DNA are ongoing. How do you collect those new findings and reapply them to existing genetic profiles?
You hit the nail on the head. While your genetic data will not change, the interpretation of that data and the recommendations on how to address that predisposition will change all the time. In fact, they change almost quarterly. That’s why CancerIQ has a great, purpose-built use case alongside the EHR. At the end of the day, we are a content engine that can help interpret that information, not only for the provider, but to make sure that patient is getting the most up-to-date care.
What elements of patient engagement are involved in regularly reapplying that new knowledge to someone’s profile and then communicating any new concerns?
That’s where CancerIQ has differentiated ourselves as a solution that will manage a longitudinal relationship with the patient. We not only have provider features that provide clinical decision support, but we also have cutting edge patient engagement features that allow them to receive reminders and updates through the CancerIQ platform. Eventually we will make it so the patient can carry their CancerIQ from one place to another.
What are the typical steps in a patient journey in interacting with your system?
I’ll use the BRCA case because that’s probably the easiest for people to picture. When you check in to a provider visit from the comfort of your own home, you provide your family history. It’s a lot easier for you to recall the cancer in your family than for your provider to interview you to find it out, so we take that burden off the provider. If you are at elevated risk, we will generate some patient education for you and your provider will have a discussion about the need for genetic testing. That’s where your provider will be able to use the test platform to order testing from a number of our embedded genetic testing partners, where CancerIQ will ultimately facilitate the ordering of that test.
As I mentioned before, providers are being held back by filling out the insurance documentation paperwork. Patients who go through the CancerIQ experience are going to be working with providers who have a streamlined, easy way of making sure it’s covered by their insurance. They have peace of mind that they won’t really need to pay much out of pocket. When they get their test results back, they’ll get a personalized action plan based on their genetic testing results.
Some of those action plans could be things like getting a breast MRI in addition to a mammogram. In the COVID context, it could be that you were at the top of a priority list for someone who needs the breast cancer screening because of your level of risk and ultimately that early detection strategy isn’t something that happens once. As a patient, you’ll get a reminder every year that you need to get that breast MRI. Should the guidelines change, where they say, “Maybe we need to do one of those really cool blood detection cancer tests in the future,” CancerIQ will communicate that to the patient so that they ultimately have not only the most clinically valid options, but the best options for detecting cancer early or preventing it altogether.
Consumer DNA test results often surprise people whose blood relatives don’t necessarily match what they have believed, with unknown siblings or different parents than they were raised with. How useful is the self-reported family history compared to actually testing someone’s DNA?
The future of healthcare is going to be genome-first. Family history is what we had in place and is the earliest form of risk assessment. We of course continue to support that. But part of the real value in CancerIQ, and where we see the healthcare ecosystem heading, is that we will be able to do genetic testing on people, and we may reach to that first. But as we reach to doing the testing first, what will become more important is the interpretation of the testing, the clinical decision support, and a lot of the intelligence layers that CancerIQ offers. If you don’t know your family history, CancerIQ can still interpret that genetic data to get you the right preventative health care plan.
Most investors are older white men who, consciously or subconsciously, tend to fund startups that are led by founders who are like a younger version of themselves. How do you pitch the company for funding knowing that’s the case?
I always pitch my company in the way I know it will resonate with an investor. I started my career in finance and used to be an investor. To get over the hurdle of them looking for a younger version of themselves, I’ve always shown them data on the value of our company and the traction that we’ve made. We have demonstrated that we are extremely valuable to some of the best health systems in the country. We are data-driven in showing how we can increase their downstream revenue, detect cancer early, and even improve their cancer screening rates. I’ve always had to lead with data to overcome some of those biases. Once they see the incredible performance and traction of CancerIQ, it typically gets me to the next meeting.
What do you see happening with the company over the next 3-5 years?
I see the market growing, primarily driven by the science. We understand the correlation between cancer and our genes, but we’re also starting to learn a lot more about cardiac diseases and other chronic conditions. I see the company in the next 3-5 years meeting that need and expanding from CancerIQ to CardiacIQ and ultimately being able to support full genome-based care.
I also see this moving from something that is done only in specialty care to becoming part of a primary care visit. Decision support technologies and things that can offer artificial intelligence will be a huge part of what we do in the future.
Do you have any final thoughts?
CancerIQ is partnering with a number of the available HIT solutions. We started off point-to-point integrations to make sure that our data gets into the EHR. But we are excited, given that we are managing content and data information that changes, by FHIR interfaces and allowing the provider to feel like they are not leaving the EHR, but are still getting the benefits of CancerIQ in their workflow.
I am surprised we've not seen more comments regarding the new FL law regarding patient data and offshore data storage…