Welcome back to Common Sense Medicine! For the post, skip down ~2 scrolls
Long time, no see, you say. Well, that’s true. I’ve been busy and not-so-busy these past few years, and the long overdue post about “where have you been, Shree?” is coming—I promise. But first, a reflection. Since 2018, when I started this show, the world of healthcare, and my own perspective about it, has changed tremendously. However, there is one constant: talking to people who are “in the weeds” (to borrow a corporate phrase) of the work is the best way to get up to speed in the space.
There is so much happening in the world of healthcare like Generative AI, electronic health records, and biotech, and I want to write more about all of it. As I’m in a more “chill” part of medical school, I’ve been taking the time to talk to founders of interesting HealthTech startups to build a framework about where the industry is headed.
When can I expect more posts?, you say. First of all, I’m not sure anyone is asking for more emails in their mailbox, but I hope that if you’re subscribed, I’m providing some value. I’m not trying to clutter your email—I think there’s a space for interesting conversations about healthcare around 1 time a month. Plus, most people just skim anyway so I’ll try and keep the show notes and insights on the shorter side. Alright, now that I’ve gotten the niceties over with, here are the show notes.
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What is Anja Health?
Anja Health is a health and technology company that provides cord blood, cord tissue, and placenta banking. They are one of the few companies in the world that offer these services. Anja Health's services include:
Freezing umbilical cord and placenta stem cells
Sending a kit to soon-to-be parents in preparation for their birth experience
Safely collecting and storing your baby's stem cells for future cell treatments
Providing an easy to use collection kit with FDA-approved materials
Manual lab processing for maximum stem cell volume
20 years of secure cryogenic storage at -180°C
Personal support from a banking or birth expert
Anja Health's mission is to create one more treatment option through the power of stem cells. Anja Health was founded by Kathryn Cross, just over a year after graduating from Wellesley. Kathryn shared her personal story of founding the company in memory of her brother Andrew, who was diagnosed with cerebral palsy after a near-death accident with me on Common Sense Medicine, and below is a summary of our conversation.
Show Notes (with timestamps)
[00:02:18] Cord blood stem cell space.
Kathryn talks about a Duke University study which was a randomized, double-blind crossover trial on cerebral palsy (CP) treatment with autologous cord blood (CB). It didn’t show statistically significant results between the study and control groups, but a significant difference was found between the group that received infusions with a higher dose of (>2.5 * 10^7 cells) versus those who did not.
Providers historically have not been educated about giving information about cord blood banking, and social media is easier to go direct to the customer to educate them about the cord blood banking. She spoke about creator-led businesses, which have greater trust (especially in the beginning) when they have relatability and value capture on their side. This was the enabling factor to gaining and acquiring their first few customers.
[00:07:45] Lessons from team members.
She was a younger founder, and she needed to read a lot of material around management to “learn the ropes.” She touches each part of business, but she has been decreasing her involvement with ops to focus on growth and marketing. She tried to find someone who is better than she is at parts of the business, and then aligning with them to achieve the goals which she has for Anja.
[00:11:19] Fundraising process and mistakes.
Kathryn talked about using a process to fundraise for a startup using Ryan Breslow’s book Fundraising. He recommends to only fundraise for 3 months, and make sure that you don’t fundraise too early before you have product-market fit because the growth will be very painful if so. Kathryn thought that she fundraised too early, and this was partly because she didn’t have a process going into her fist fundraising round.
[00:15:17] Private blood banking - why should parents use it?
Kathryn says that most pregnant people should be using cord blood banking because the placenta and the cord blood bank can act as a sort of “insurance” against a worst case scenario. Physicians can use stem cells to prepare treatment and then Anja Health is able to release a patient’s units to the provider, and then it’s used to give the patient the stem cell treatment.
Shree’s take: I’m not convinced that doing this by way of a private blood bank vs. a public blood bank is still reasonable in this day and age, because the cost doesn’t justify the evidence which is currently available. If you’re bullish on storing on a private blood bank, look for one which is AABB accredited (by the FDA, like Anja is). The one drawback from a public bank which I had noticed is that you might not get your cells if someone else had already used it, but looking at the Duke University study and others in the space, the blood collected might not be useful if you only have one child to do an autologous stem cell transplant—as most of the research is done in preclinical models. However, that’s part of Anja’s allure, because you might be able to use it in the next 20 years for therapies which haven’t been discovered today.
[00:24:24] Using placenta stem cells.
When someone actually donates a blood bank sample, they can increase the density by first sorting it manually. Anja Health mentions that they can do it manually but other companies say that the automatic sorting helps them get rid of contaminants.
Shree’s take: I think that this is a function of marketing—if Anja Health is able to capture more of the market and convince their buyers that automatic sorting = bad, and that manual sorting = personalized, then they can effectively control the narrative that their method is better. Kathryn also mentions that she doesn’t have any statistics about how many people actually use their stem cells, which gives me pause. How useful could this be if people aren’t using it and it’s mostly a function of marketing? In fact, one paper shows that automatic sorting actually increases the yield of the cord blood separation.
[00:28:05] Stem cell research in pregnancy.
She’s excited about more general parts of women’s health related work — infertility and PCOS which came to mind. She also thinks that you shouldn’t consume your placenta, ya nasty.
[00:29:24] Scaling content and creator burnout.
It’s really hard to scale content because there’s a threshold to how much content you can produce. She batches a lot of content, but it’s hard to scale them. She had a consigliere who fed her research about content, but now she just does her own thing. She also interviews a lot of people in the space, like doulas, midwives, and lactation consultants. Kathryn thinks that now, she’s more able to do speak about her interests “off the cuff” because she’s just had so much experience in the space.
[00:34:07] Consuming information and deciphering.
Interestingly she says that lower-income families do a lot more research, read everything, and are more anxious with childbirth rather than those who come from a higher-income family. So, she tries to recommend evidence-based organizations to help families distinguish signal from noise.
She’s still figuring out how to best recruit, but one of the things that she has to do in order to really put herself in a position for recruiting the best talent is to interview the person and make sure they gel with everyone on the team, whether they have the skills for the particular role that she’s hiring for, and gradually hiring into the role (contractor to employee)
Another book from Ryan Breslow which she recommends is Recruiting
[00:45:57] Favorite guest and learning experiences.
Kathryn’s question for me! Listen to the podcast to learn more.
Thank you for subscribing to Common Sense Medicine! If you have any comments / questions, please reply to this email to let me know what you think.
Also, I’m also on the hunt for new podcast guests. If you know anyone who you think would be a good fit (think people in healthtech or healthcare doing interesting, innovative things) feel free to let me know.
That’s all folks! Remember, it’s just common sense.
— Shree “I will never eat a placenta” Nadkarni