Eliminating Misdiagnosis of Sepsis with Greg Bullington, CEO of Magnolia Medical Technologies

Sepsis is often misdiagnosed, with approximately 40% of positive sepsis blood tests being incorrect. This leads to patients receiving unnecessary treatments, extended hospital stays, and risks associated with inaccurate diagnoses. 

In this episode, Greg Bullington CEO of Magnolia Medical Technologies discusses the mission and innovations of Magnolia Medical Technologies, which is focused on improving the accuracy of sepsis diagnosis and reducing the overuse of antibiotics.  Greg and his team have developed a technology to improve the accuracy of sepsis diagnosis and significantly reduce false positives.

The conversation touches on the challenges of bringing innovations to market, the importance of building a quality culture within the organization, and the future of blood culture testing. Greg emphasizes the need for evidence and the delivery of lower costs and better outcomes to gain support in the healthcare industry. He also discusses the role of non-dilutive funding sources and collaborations with key opinion leaders to drive innovation.

Magnolia Medical Technologies aims to continue solving the sepsis misdiagnosis problem and expand its reach. The company's vision includes developing additional solutions to improve diagnostic accuracy in various medical testing areas. Greg envisions a future with broader adoption of their technology, significantly reducing sepsis misdiagnosis and improving patient outcomes.

Guest Speaker Bio:
Greg Bullington is the co-founder and CEO of Magnolia Medical Technologies. Greg is an accomplished leader with a wide range of experience, having worked with senior executive teams in over 50 companies, ranging from Fortune 500 corporations to venture-backed startups. He's also an expert in intellectual property with numerous patents to his name. Greg's mission with Magnolia Medical Technologies is to eliminate the misdiagnosis of sepsis, a condition caused by blood infections and a leading cause of death, costs, and readmissions in hospitals nationwide.

Where to Learn More:

• Website: Magnolia Medical Technologies
• LinkedIn: Company Profile and Greg Bullington's Profile

This podcast episode provides valuable insights into the mission, innovations, and future goals of Magnolia Medical Technologies in the field of sepsis diagnosis. Listeners interested in healthcare innovation and improving patient outcomes will find this episode informative and engaging.

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Music by keldez

Transcript

Meg Sinclair: 0:17

Hi, everyone, and welcome to From Lab to Launch by Qualio. I'm Meg, your host. Thanks for tuning in today. Before we get started. We love it. If you've rated the podcast, it's easy to do and share it with any of your science nerd friends. We know you have some, if you'd like to be on the show, please see the show notes for an application and we'll get connected that way. I'm really excited for today's episode. We have Greg Bullington co founder and CEO of Magnolia medical technologies with us. Greg has led all aspects of company development since inception, including clinical trial design, execution and publication, broad product portfolio development, creation of a new national standard of care for sepsis testing, accuracy, rapid revenues, growth, commercial commercialization and intellectual property and enforcement strategy, not to mention raising over 125 million. He's pretty much done it all. Greg has a wide range of experience from leading engagements and working closely with senior executive teams and over 50 companies ranging from fortune five, fortune 100 company corporations to venture backed and early stage startups as a consultant advisor and investor. Greg has also had expertise in intellectual property with more than 100 issued patents and over 50 patents pending. That's quite an introduction. So with that, let's bring him in. Welcome From Lab to Launch, Greg.

Greg Bullington: 1:47

Thanks, Meg. Appreciate you guys having me.

Meg Sinclair: 1:50

Great. Yeah. Happy to have you here. Um, that intro really barely touched on Magnolia Medical Technologies. Can you tell us a little bit more about the company and its mission to zero?

Greg Bullington: 2:01

You bet. So really our our focus as an organization is on the elimination of the misdiagnosis of sepsis and sepsis is a condition that is driven by blood infection and it turns out to be the number one leading cause of death costs and readmissions for patients and hospitals nationwide. And the real problem with sepsis is there are challenges and issues in diagnosing sepsis. So on average, in a typical hospital, 40 percent of positive sepsis blood tests are wrong. And those patients typically are subjected to all the treatments and extended length of stay and all the risks that come along with that. So our mission, uh, at a, an aggregate level is to eliminate the misdiagnosis of sepsis. So every time we diagnose a patient, We are diagnosing and treating that patient accurately based on, uh, high quality, accurate, timely diagnostic information,

Meg Sinclair: 2:57

40 percent accuracy. That is a staggering. Like, I wouldn't want that on a pregnancy test. That's crazy. Um, crazy inaccurate. So, and thinking about, you know, over treatment with antibiotics, I'm sure there's even a larger issue besides just the patient at In the hospital, it's as a society and as a health care system, the cost of over treating with antibiotics is huge

Greg Bullington: 3:26

as well. Unquestionably, and it's, uh, it's a problem that has been pervasive really for a century plus as we've used blood culture as a foundational technology to diagnose infections. Issue around contamination or false positive results has, uh, has been pervasive. Uh, it's largely been accepted. I think in part because it's a complicated issue and most lay people don't really have a full understanding or appreciation of what a blood infection is or the kinds of bugs that can cause infection versus those that are, um, you know, just living on our skin and are not problematic. Uh, it would be akin though, as you point out, you know, 40 percent inaccurate. Pregnancy test results would never be accepted, uh, broadly and similarly, uh, if we thought about this in the context of a cancer screening or cancer diagnostic test, we were trying to diagnose blood cancers and 40 out of 100 times we told the patient, Hey, you have leukemia. We admitted that patient to the hospital. We initiated a chemotherapy regimen for a whole week and 40 out of 100 times came back to tell the patient. that we were sorry that we had made a mistake in the diagnosis that led us to treat them with chemotherapy for a week. I think there would be public outcry, but the reality is that's exactly what happens today. And patients that come to the hospital or are inpatient in the hospital with symptoms that they may have an infection or may have sepsis, these patients are really typically in a very fragile state. They're very sick to begin with. And the last thing their body can tolerate, as you point out from an antibiotic standpoint, is being carpet bombed for a week with an antibiotic regimen they shouldn't be receiving. Antibiotics cause significant challenges and downstream toxicities that create a lot of issues for patients. Certainly, they can be life saving if, in fact, you do have an infection. But again, You know, to be in a place where 40 out of 100 times we're making a decision on the basis of an inaccurate blood test. That's something we find, uh, intolerable. And so we're committed to solving that problem for the world. That's

Meg Sinclair: 5:41

amazing. Um, that is a... Huge issue and, um, pervasive, as you said, is what drives that inspiration behind focusing on this blood culture and testing and improving

Greg Bullington: 5:52

it. So I started my career in the strategy consulting industry and had an opportunity to work on a number of really interesting projects in the cancer innovation, the cancer therapy innovation space. And at the time there was a totally new treatment modality in the oncology space. called active immunotherapy. And so I had several years of exposure to the establishment and rapid growth of a totally new treatment modality. I also had the opportunity to work with a number of the large Blue Cross Blue Shield insurance companies. And so I kind of had a combination of perspectives and then I was introduced to the chief of pathology at one of the University of Washington hospitals who had committed his whole career really to improving patient safety and quality as a volunteer with the College of American Pathologists. And this was an issue he had seen really in problematic ways in his own institution. Where there had been autopsies that the ultimate cause of death for that patient was an antibiotic associated complication and going back to do the chart review most frequently, the blood test that informs those antibiotic therapies is the blood culture, and he recognized that issue of an average of 40 percent false positive results, meaning that those patients were unnecessarily subjected to all of this risk that drove poor outcomes. And so his goal was to solve that before he retired. And so we partnered, uh, hard to believe well over a decade ago. But, um, we've been committed to building our company on the basis of scientific evidence and clinical data. And I think that's what's put us in a really unique position for having created a totally new national standard of care because the performance of our product, uh, and the performance of the overall mission to zero that we implement with our customers. Thank you. Uh, in a typical environment will reduce those false positives by 90 percent or a 10 times improvement to the current accepted standard of care

Meg Sinclair: 8:02

and talk about, you know, reduction in patient harm, reduction in waste for antibiotics that are prescribed and necessarily and just reducing, you know, the amount of bacteria or antibiotic resistant bacteria that That can come out of that. So kudos to you guys. It's a lot of innovation, um, for the greater good for, for patients. And I think the healthcare system at large, that's really amazing.

Greg Bullington: 8:31

Yeah, the only way we can stave off the continued pressure, if you will, from an antibiotic resistance standpoint is to reduce the unnecessary use of antibiotics, particularly our most powerful, most potent antibiotics. Which are typically used to treat patients that are suspected of having a bloodstream infection or sepsis. So this represents a very low hanging fruit way to take a significant bite out of the unnecessary use of antibiotic category. And that does have, as you point out, really meaningful public health benefits. And, uh, you know, we've seen that several studies published using our technology showing the incremental impact and the reduction of vancomycin use in the reduction of overall antibiotic use. And that's a big deal.

Meg Sinclair: 9:18

I did not tell you that I started my career in public health. So this one is a little near and dear to my heart. So, um, we've talked a little bit about your novel solution. Could you walk us through the technology and how it works?

Greg Bullington: 9:30

You bet. So the key novel insight that our co founder, Dr. Patton, had really came down to a question of what was the root cause of contamination and what was the root cause of the presence of these organisms that would falsely identify that a patient had an infection. And what he really recognized was that for Ever effectively using blood culture. Uh, it was dictated that the first blood that was collected from a patient would go into the blood culture, the sterile blood culture bottles, and then that would be shipped off for incubation. And then you would do potentially additional subsequent blood collection for alternate testing. And what he realized is that every time we stick a needle through a patient's skin, even if we perfectly cleaned the skin surface, and we waited the appropriate amount of time, and we didn't repalpate the patient's vein, you know, all those things typically happen, particularly in a, uh, an emergency department or a high acuity environment. But he recognized that we can Disinfect skin, but we can't sterilize skin. So you're going to end up with some foreign biological matter that is not in the patient's bloodstream in the actual sample to be tested. And so he recognized the need to really come up with a mechanical solution that would allow us to take that First little bit of blood that can have skin fragments and tissue and sweat glands and hair follicles and get rid of that. But then in that same sterile closed system, have the ability to collect a subsequent volume of blood. And that really is just from the patient's bloodstream for testing. Uh, and it, it sounds, um, you know, simple and it is, but it was a major innovation and a change to the standard of care. And as I mentioned, you know, we've demonstrated now 10 times better results using our technique and technology combined.

Meg Sinclair: 11:28

So on that vein, I'm going to get very punny here. Um, for the nurses doing the venipuncture, is there a change in how they do their process or is there an impact to patient care and, and how they feel the, the blood draw, or is that all pretty much the same and the technology improves that?

Greg Bullington: 11:47

So one of the key elements in creating that vein to bottle sterile blood flow pathway is to have all the components actually pre assembled and then sterilized as a single unit. So there's actually a benefit to the workflow in that rather than needing to set up an aseptic environment and very carefully. Uh, set the various supplies out and make sure you have sterile gloves before you start taking, you know, the syringe out of one package and a needle out of another package. All that is done in our system and it's all pre assembled and sterile. So you just open one package and then you're ready to attain vascular access. So, uh, it's an improvement in the efficiency and workflow from that standpoint. Uh, and then there is, uh, just one small step associated with, uh, locking off the initial sequestered blood before you collect the relevant blood sample to test. Sounds

Meg Sinclair: 12:45

like an improvement to have all of your supplies kitted for you in advance. Um, I feel like that would almost, I used to do ventipunctures also in a previous life and that would also take the time to get all the things ready as much as it would take to get the blood draw sometimes. So improving the workflow too, that doesn't hurt. Um, great. In your leadership role, what challenges have you encountered in bringing these innovations to market and how have you overcome

Greg Bullington: 13:11

them? Well, you have a lot of experience in the healthcare space. It sounds like so. I would say in general, uh, people don't like change. People in healthcare really don't like change, particularly in a hospital environment. So there have been a lot of challenges in terms of just figuring out creatively. How do we break the inertia of how things have always been? Uh, and, you know, certainly COVID created a lot of a major strife for acute care hospitals across the country, staffing issues, staffing shortages, traveling nurses, um, you know, per diem nursing staffs, all kinds of issues and challenges that the hospitals have had to navigate through. So unfortunately, The cost of that oftentimes is an inability to prioritize and focus safety initiatives or quality improvement initiatives. So I think most of the challenges we've had to figure out how to surmount and navigate have been associated with trying to. convince and demonstrate with real scientific evidence the reasons and rationale behind why we should prioritize this particular change. Uh, as I mentioned earlier, sepsis is the number one leading cause of death, costs, and readmissions in hospitals nationwide. So, uh, from our viewpoint and perspective, it should be an absolute top priority. And, uh, there is Definitive correlation in terms of preventable morbidity and mortality associated with addressing the false positive sepsis blood test issue that we solve. And so we spent a lot of time working with the large societies, working with major state hospital associations, working with the CDC and CMS, Medicare and QF and other large organizations that are focused on patient safety and quality. To help set the stage and really accelerate change in the interest of patient safety and preventing unnecessary harm.

Meg Sinclair: 15:19

Interesting. COVID can really mess up things for some of us. Turn the world upside down it turns. Yeah, and yeah, that inertia is a real thing and a challenge trying to change things and get value committees at hospitals to adopt new and novel products can be a challenge for sure. How do you see the future of blood culture testing evolving and what does role does Magnolia medical technologies play in that

Greg Bullington: 15:47

future? Well, our commitment, as I mentioned previously, really is to eliminate the misdiagnosis of sepsis for the world. So, uh, we've done, I think, uh, an outstanding job at setting a totally new foundational standard of care here in the United States. We've had very strong adoption from a commercial standpoint and strong sustained success. And obviously there are many opportunities to augment the foundation now of the work that we're doing with our StereoPath flagship product line and augmenting that with additional value with additional features. Uh, we have a software platform that provides a significant Incremental and additional insights on the clinical as well as the economic value that we're able to drive that will really help some of those value analysis committee processes and decisions. So we are in a really exciting position and we're really in the early stages now with coming up on 500 hospital customers and Being in a place where we can really make a difference rapidly because we've driven that change in mindset, we've driven that change in the standard of care, and so now it's incumbent on us to continue to add more incremental value and pursue that goal of eliminating the misdiagnosis of sepsis globally.

Meg Sinclair: 17:11

Very cool. And I'm curious what other, um, Misdiagnosed treatments you guys might endeavor on in the future, um, but sepsis is a good one to tackle if it's the leading cause of death.

Greg Bullington: 17:25

That's a great place to start. Yeah, it's been a surprising element from my standpoint. So the collaboration and the opportunities I've had to spend a lot of time with Dr. Patton and his hospital environment, as well as across our whole customer base. To your point, there are actually a shocking number of diagnostic tests that have significant variance and variability in terms of their predictability, in terms of their accuracy. And so we have a whole prioritized Point of view on additional areas where we can add value by dramatically improving the quality of the specimens that are being analyzed and ultimately that provides the right information to treat the patient appropriately and drives better outcomes and lower costs, which is what we're all focused on doing. Absolutely.

Meg Sinclair: 18:15

As quality is a quality management software company, and I'm on our quality team. I'd be remiss if I didn't ask about quality, um, with such innovation and velocity at Magnolia Medical Technologies as the CEO. How do you drive the quality culture there?

Greg Bullington: 18:31

Uh, we have a fantastic and highly talented. Team of quality engineers and experts that have done a fantastic job really building a system. It's all based on an electronic and automated backbone and really the focus that we have in terms of ensuring that the high volume of product that we're developing and, uh, shipping out to hospitals each and every day, you know, meet the quality standards of really helping us Achieve our mission is really the goal and the target. So we have a great team. We have great processes. We have great systems and to your point about the culture of quality that is first and foremost and what we do each and every day and everyone in the organization fully embraces and really lives by that credo.

Meg Sinclair: 19:24

I think with a mission to bring misdiagnosis is down to zero quality improvement and continuous improvement has to be at your core.

Greg Bullington: 19:31

So absolutely,

Meg Sinclair: 19:34

I'm kind of pivoting on to raising capital that can be quite challenging in today's market. What advice would you give to other founders who are looking, listening now and looking to raise capital in the coming months?

Greg Bullington: 19:48

Absolutely. It's, um, I think, as everyone knows, a difficult macroeconomic environment in particular today, given all that is going on from a geopolitical as well as just financial systems standpoint, and the markets are still challenged. It's been kind of a stagnant market in many ways over the last 12 to 18 months. So, um, Uh, there's optimism moving into 2024 from, uh, most of the folks that I, I talk with. So I think that continuing to stay the course for those that are in the early stages of building new platforms and new technologies that solve significant unmet needs. Uh, is critical. I think foundationally in the med tech space, it is all about evidence. And what evidence do you have that your innovation and technology delivers true value, both to the patient as well as to the system in the hospital. Unfortunately, the way that our economic. System within the health care space works. There really does have to be that corresponding proof around delivering lower costs and better outcomes combined. So I think there are a lot of things that can be done for very limited. Capital with very limited capital. Rather, there are a lot of really great collaborators out there that are physicians that have interest in new research topics and have interest in publishing new innovations in the literature. So Even without the ability to access at scale capital today, I think there's a lot of progress that can be made for, uh, very limited investments by being creative, collaborating with K. O. L. S. That are really passionate about certain areas and spaces that would correspond with the technologies that are being developed. And then, obviously, and I H and other Sources of non dilutive funding are still, uh, available, uh, and, and a great avenue for a lot of organizations today, uh, given some of the, the broader macro challenges in raising institutional capital. Yeah,

Meg Sinclair: 21:59

those alternative funding sources are always good to mention too.

Greg Bullington: 22:02

Absolutely.

Meg Sinclair: 22:05

And your vision for Magnolia Medical Technologies, what are the... Big next steps and innovations that we can expect to see in the coming years.

Greg Bullington: 22:14

So, as I mentioned, misdiagnosis of sepsis is our overall goal and mission. And there are multiple legs to that stool. So our focus from a forward innovation standpoint really is to holistically solve this problem. And we've started with a really important foundational issue around specimen integrity and Prevention of contamination or false positive results. So moving down the line, you can expect that kind of this piece of the puzzle is solved. We're focused on solving the whole puzzle. So that's that will be the driver of innovation. You know, our vision and hope is that with the efforts that have been undertaken to establish a new standard of care. Uh, with the support we've been able to garner from bipartisan members of Congress, with the support we've been able to rally with state hospital associations and many other stakeholders within the patient safety and patient quality advocacy circles. Our hope really would be that we rapidly increase penetration and adoption of both the technique and the technology that has been proven to solve this problem. And today I would estimate we're in the single digits in terms of penetration. across the United States, uh, with our technology solution. And so that leaves a lot of patients that need our help. And that's really what fuels our, uh, commitment, passion and efforts each and every day to, to go out and be in a position to help as many patients as we can, as quickly as we can. Very cool.

Meg Sinclair: 23:49

I'm really excited to see how you guys grow in the coming years and excited to see that penetration into the market grow and those patient outcomes and that mission to zero come to a reality, excuse me, a reality here in the States, at least. That would be amazing. Absolutely. So our last question is more of a fun one. We'd love to ask each of our guests. If we ran into you at a bookstore or at your local library, in which section would we find you?

Greg Bullington: 24:17

Good question. I would say one of two. So, uh, I love photography and I love beautiful pictures of vistas, landscapes, the outdoors. So, uh, the, the coffee table book section that has all those wonderful, uh, photo books probably would be, uh, the, the first. And on my way out to check out. probably find me in the, uh, leadership and business, uh, systems effectiveness and, and efficiency section. It's, uh, uh, an amazing area with, uh, tons of content and, uh, certainly an area of interest for me. Great.

Meg Sinclair: 24:55

Thanks for sharing. Thank you so much for joining us today on From Lab to Launch by Polyo. Where can our listeners go to follow along and connect with you?

Greg Bullington: 25:04

You bet. Our website is magnolia medical. com and, uh, we have a, a company profile on LinkedIn and I have, uh, my own LinkedIn profile, obviously. So if, uh, there are folks that are interested in connecting, um, please reach out.

Meg Sinclair: 25:20

Yeah, we'll post those in the show notes. Thanks so much. Great.

Greg Bullington: 25:23

Excellent. Thank you.