Better Medicine for All

Science 37 is curing a lack of diversity in clinical trials with new technology and old-fashioned house calls

By Stephanie Case

What happens when you have an idea for a new medical treatment, but can’t find a single patient to test it on?

That sounds like a theoretical question, but it’s one a staggering amount of clinical researchers grapple with.

“In your typical clinical trial — and this is all across the industry — fewer than 50% of the clinics that are involved in the trial will ever recruit a patient, and even fewer will reach their recruitment goal,” says Playa Vista-based physician-scientist Belinda Tan.

The dearth of volunteers, she says, isn’t for lack of interest; it’s for a lack of accessibility.

“Many trials are designed around hospitals and doctors, and it doesn’t keep in mind that that’s really inconvenient for people,” Tan explains.

“For instance, if I work at UCLA,” she adds, “I can technically only reach the people who are willing to drive to Westwood to participate.” This creates a barrier for would-be volunteers who live on the other side of the state — or even on the other side of the 405 — and don’t have the free time or resources to regularly make the trip.

To address this problem, Tan and fellow physician-scientist Noah Craft cofounded Science 37: a virtual research practice that puts patients first, treating them remotely via telemedical services and mobile devices.

At the company’s Playa Vista headquarters, doctors, lawyers, patient coordinators, marketing experts and software developers all work under one roof, each doing their part to make the clinical trials they administer as open and accessible to the public as possible, no matter where a patient lives.

“We’re trying to democratize all of science, by not only being able to take away the geographic limitations — so you don’t have to worry that it takes you 2½ hours to take the bus to a hospital — but also by reaching out to patients across all of these different channels, and building awareness and education,” Tan says.

Tan’s Science 37 colleagues use digital advertising and other outreach efforts to target people for a wide range of clinical trials, whether it be testing
a new treatment for cluster headaches, diabetes, a rare skin condition or a psychiatric illness.

In the 3½ years since they went into business, Science 37 has found creative ways to overcome the challenges of providing treatment from a distance.

In one acne trial, the team shipped a refrigerated topical live bacteria spray to patients across 10 states. Twice a day, the participants sprayed the treatment on their faces, then photographed their skin and uploaded the pics to NORA — Science 37’s cloud platform — so dermatologists could remotely analyze their results.

In another acne trial, Science 37 contracted mobile nurses to visit patients’ houses to inject an acne-fighting drug, draw blood, do an EKG test, and
photograph the skin of the participant. The process required an intense amount of coordination on the company’s end to fit the needs of every single patient, Tan says.

“Say it’s a 28-year-old and they have a part-time job, but they’re also going to school, so they can only do visits on Wednesday evenings, or weekends,” Tan says. “Our staff makes sure that the right nurses with the right availability will be at the patient’s home during the window that she’s able to get the procedures done.”

Meeting the patient where they are shifts the onus of coordinating care to Science 37. That reversal not only makes things easier for patients, but also im-
proves the diversity of the study and the quality of the research being produced.

“[So much of] science up to now has only really been tested on mainly Caucasian people, and a lot of males,” Tan says.

“Traditionally, over the past several decades, doctors who are designated as the KOLS — the key opinion leaders — tended to be white males” at major universities, she adds. Because of this, “the majority of people who are coming to these trials are a certain education level, a certain type of insurance — and that’s kind of what is driving the very narrow demographic of participants.”

Through their patient-centric approach, Science 37 has been able to recruit more and more non-white participants, enhancing their own science in the process.

“We’re reaching out for this common denominator,” says Tan. “Regardless of where you live, regardless of your socioeconomic background, you can still participate. And in doing so, we’re able to reach pretty much everyone.”