Shift by Alberta Innovates

From doctor to entrepreneur - Oliver Bathe from Qualisure Diagnostics

March 06, 2023 Oliver Bathe Season 4 Episode 4
From doctor to entrepreneur - Oliver Bathe from Qualisure Diagnostics
Shift by Alberta Innovates
More Info
Shift by Alberta Innovates
From doctor to entrepreneur - Oliver Bathe from Qualisure Diagnostics
Mar 06, 2023 Season 4 Episode 4
Oliver Bathe

Calgary-based Qualisure Diagnostics is making some serious inroads with the introduction of their flagship cancer diagnostic tool Thyroid Guide Px.

The company uses machine intelligence to create molecular tests that enhance cancer care by identifying features that help oncologists personalize treatment. By knowing  which cancers are most aggressive, and which ones are more likely to respond to certain treatments oncologists can more effectively create a personalized treatment strategy for patients.

Sit back and settle in as I talk with Dr. Oliver Bathe not only about his company's innovation but the work he's done to transition from being a medical practitioner to a full-time entrepreneur.


Bio

Oliver Bathe, Chief Executive Officer

Oliver is a surgical oncologist with over 25 years of clinical experience. He has an excellent understanding of the challenges that patients and clinicians face during their cancer journey. His research has mostly been translational in nature, applying cutting edge technological solutions to real clinical problems. 

In 2004, he founded a large tumor bank that currently houses over 23,000 samples from over 4,000 patients. His involvement in The Cancer Genome Atlas Project and his leadership in the Clinical Proteomic Analysis Consortium have spurred his interest in systems biology and bioinformatics. 

He also has experience in clinical trials, serving in leadership positions on several national and international clinical trial groups. He has directed a research program, attracting over $2 million to research related to several technologies, the majority of which have been transferred to Qualisure.

Adapted from company bio.

Shift by Alberta Innovates focuses on the people, businesses and organizations that are contributing to Alberta's strong tech ecosystem.

Show Notes Transcript

Calgary-based Qualisure Diagnostics is making some serious inroads with the introduction of their flagship cancer diagnostic tool Thyroid Guide Px.

The company uses machine intelligence to create molecular tests that enhance cancer care by identifying features that help oncologists personalize treatment. By knowing  which cancers are most aggressive, and which ones are more likely to respond to certain treatments oncologists can more effectively create a personalized treatment strategy for patients.

Sit back and settle in as I talk with Dr. Oliver Bathe not only about his company's innovation but the work he's done to transition from being a medical practitioner to a full-time entrepreneur.


Bio

Oliver Bathe, Chief Executive Officer

Oliver is a surgical oncologist with over 25 years of clinical experience. He has an excellent understanding of the challenges that patients and clinicians face during their cancer journey. His research has mostly been translational in nature, applying cutting edge technological solutions to real clinical problems. 

In 2004, he founded a large tumor bank that currently houses over 23,000 samples from over 4,000 patients. His involvement in The Cancer Genome Atlas Project and his leadership in the Clinical Proteomic Analysis Consortium have spurred his interest in systems biology and bioinformatics. 

He also has experience in clinical trials, serving in leadership positions on several national and international clinical trial groups. He has directed a research program, attracting over $2 million to research related to several technologies, the majority of which have been transferred to Qualisure.

Adapted from company bio.

Shift by Alberta Innovates focuses on the people, businesses and organizations that are contributing to Alberta's strong tech ecosystem.

Jon:

Changing jobs is difficult at the best of times. Changing careers, well, that ramps it up even a little more. Our next guest has transitioned his career from being a clinical researcher, university prof and full-time oncologist to becoming a full-time entrepreneur. His cancer diagnostics using machine learning is really pushing the envelope of what can be done. Sit back, settle in. Welcome to Shift.

Hello everybody. Welcome to Shift. I'm your host, Jon Hagan. And today we've got Dr. Oliver Bathe, from Qualisure Incorporated. How are you, Oliver?

Oliver:

I'm good. Thanks very much, Jon.

Jon:

Excellent. Very nice to see you again. Let's dive in and just give people a sense of what Qualisure is all about and what your flagship product is, Thyroid GuidePx, which you guys just launched at the beginning of September.

Oliver:

Okay, great. So Qualisure Diagnostics is really interested in addressing, the biggest problem in [inaudible 00:01:22], and that problem is that we give these really toxic treatments to individuals who are already sick from their cancer. And the fact of the matter is that we don't even know whether they're going to benefit. So really, the solution to this is to develop tests that help clinicians to make better decisions on whether somebody should or should not receive a particular treatment. All of our tests are built based on a machine learning algorithm that we developed, and our first product is a product that helps clinicians to make decisions on papillary thyroid cancer, which is the most common thyroid cancer of incidence.

Jon:

And now that that's the tool that you have, the diagnostic tool, is that going to be scaled to become diagnostic tool for all cancers? Is that where you foresee this going?

Oliver:

Yeah. Well, the thing about the machine learning algorithm is that it can be customized for particular purposes. So our priority was really to address a significant unmet clinical need. Thyroid cancer was the first one because surgeons already make decisions related to the type of surgery and whether radioactive iodine is given, based on their estimate of the likelihood that the cancer is going to come back after surgery. So this really refines that estimation. And in terms of other tests and so on, what we would do is we would customize the algorithm based on exactly what the purpose is.

Jon:

Okay. Now, tell me a little bit about the efficacy of this diagnostic tool.

Oliver:

Yeah, it's really quite remarkable. It's helped us to identify three novel molecular subtypes of thyroid cancer. The usual way that thyroid surgeons have estimated the risk of recurrence is called the American Thyroid Association Clinical Risk Index. And the problem with that is that it's not particularly accurate. It's somewhat complicated, and there are some subjective features to that. What's different about our test is that first of all, it's subjective, and secondly, it's much more accurate. It's more than 80% accurate at identifying the risk of recurrence after surgery.

Jon:

Oh, wow. Okay. And so 80%, what was the standard percentage prior to your diagnostic tool?

Oliver:

In the testing that we've done, it was less than 60%.

Jon:

Oh, wow. Okay. So that's significant. That's great.

Oliver:

Yeah, it sure is.

Jon:

So now when I think of entrepreneurialism, this is a significant innovation you've come up with, entrepreneurialism is a full-time job. It's very difficult to do off the corner of your desk for anybody, but you're coming out of being a surgeon, an oncologist, a professor, lots of years that you had to put into learning that. Now, as I understand it, you've transitioned recently out of that and focusing primarily on Qualisure now. Talk to me a little bit about the journey as a person transitioning from that former life to this new life. It's pretty heavy.

Oliver:

It sure is. I like the word transition because it did take me a while to acclimatize the idea of being an entrepreneur as opposed to a healthcare provider. I think I always realized that the things that are innovated through university, in order for them to really become real, they have to be commercialized. Most of the research that comes out of a university goes to papers, goes to patents. But really, the only way to make it real and bring it back to the clinic is to bring it out as a product.

So I think that took me a little while to realize that in its full entirety. And then I was really on innovation mode when I began all of this, trying to address a problem that I've seen over and over again, and that's patients that are receiving toxic treatments. But then when we had completed most of that innovation, then I came to the realization that in order to build a company, build a team where we have to pay people and pay for continued development and regulatory approval, I think that's when I realized I had to really up my game and focus on the business aspect of things.

Jon:

It's a full-time gig.

Oliver:

Yeah, sure it. And I had to learn quite a few new skills. I think the important part there is that we had to create a diverse team with complimentary skill sets. And as you know, my expertise is really all about understanding the clinical problem and understanding the science, but creating a business is a whole different ballgame.

Jon:

Sure. Yeah. So help me understand that a little more. Let's look at two scenarios first. The first scenario you stayed and you were still a surgeon, still a prof, still an oncologist doing this work. You write some papers. Where does this product go? Does it even become a product?

Oliver:

Yeah. That's exactly what the problem is. I've created plenty of intellectual property in terms of papers and I'm not exactly sure what the final knowledge translation component is of that. There's a publication, there are some citations related to it. So that's some evidence that people have consumed the knowledge, but nobody's really benefited from that. Ultimately, to benefit from that, you have to either create a drug or a diagnostic tool or some other tool that goes right back to the patient and this was really the avenue to do that.

Jon:

So now that leads us to scenario two, the current reality. So you've started to commercialize this product. You've made the decision. How does it work? Take me right back, entrepreneur 101. Now here you are, and you go, okay, I've got this skill and this expertise in the healthcare field. I'm not necessarily a business person. How do you start to build that company and build that talent around you to help commercialize this as a diagnostic tool?

Oliver:

Well, I would say that firstly, I had to recognize my own limitations. When I introduced the idea to friends and family and colleagues or anyone in a business environment, they would ask me, "Who is the customer?" And when I realized I couldn't really answer that question very, very clearly, then I knew I needed help. So we got a co-founder, David Bocking, who had experience with business development, and then later on, Brandon Friedt, who was a CPA and helped us to develop all of the business infrastructure and helped us to understand, helped us as in Cynthia and I. Cynthia was the chief scientific officer. We had to understand exactly how to raise money, how to develop the business in terms of all of that business infrastructure that we didn't really fully recognize.

Jon:

You mentioned David Bocking and the other gentleman, my apologies, I forgot his name.

Oliver:

Brandon Friedt.

Jon:

Brandon. So where do you go to find them? Are you just out for coffee one day and "Hey, you look like you might be interested"?

Oliver:

That's kind of what happened. To start with, I went to an Alberta Innovates, a seminar that David was holding and then helped us to [inaudible 00:10:04]. And that's when we started talking. So I got him involved in the early stages of the business development, and then one day he introduced me to Brandon. We were in a donut shop and Brandon immediately wanted to become involved. So I was really very lucky to have people who were immediately engaged and committed.

Jon:

Right. Wow.

Oliver:

And as time has gone on, we've continued to build the team based on an improving story.

Jon:

Okay. That's fascinating. So how many people are with Qualisure now? I'm putting you on the spot.

Oliver:

There are seven of us. Seven of us, and growing. So really what our strategy has been mostly has been creating a leadership team so that we can create teams under them. We have a chief commercialization officer, a chief operating officer, and chief scientific officer, as well as a chief technical officer, and we'll begin building underneath them as we grow.

Jon:

Oliver, I noticed you didn't mention a chief communications officer.

Oliver:

No. Actually, we're all chief communications officer and I'm finding myself in that sometimes.

Jon:

Sure, yeah. I guess, hey, and that's part of being an entrepreneur is you're involved in absolutely every aspect of the business, especially when you're just getting off the ground.

Oliver:

You know what? Jon, that's really interesting you say that. So when I actually contemplated starting a business, I was hoping to find somebody else to be the chief executive officer. That was kind of the dream. But I just realized that I wasn't going to find somebody who was going to be able to tell the story in the way that I was hoping to tell it. And what I've found too is that as the team has built out, I've had to take on quite a few roles that I've initially been quite uncomfortable with, including speaking with investors in the language that they expect to be spoken to, speaking to thyroid surgeons in an effort to get some uptake of the technology and so on.

Jon:

And that's a relevant communications marketing and branding skill, is knowing your audience and how you're going to speak to them. So that's a significant learning in and of itself. How's pitching coming along? How does that feel when you get in front of someone? You mentioned investors.

Oliver:

Yeah, much better now. I have to say when I started, it was brutal. First of all, I didn't fully understand exactly what elements were required in the pitch. I didn't feel like those elements allowed me to tell the story that I wanted to. So I had to find a way to feed it to the investors and still tell my story the way I wanted to. And it's something that I'm constantly changing, constantly revising and trying to improve. The audience does change as well. I think the audience, if you're pitching to friends and family, that's one thing. Angel investors is another audience. And then all of a sudden, when you get to venture capitalists, they're a little bit more knowledgeable about the space, so you can communicate things a little bit differently and they want to know different things.

Jon:

Right, right. I want to dive in, if you're okay with it, on the personal side, in terms of that story. When you and I first talked a few months back, for some reason grief and loss came to me, in the sense of transitioning from becoming a practicing healthcare professional to an entrepreneur. It's almost like you're leaving one life behind. Is there anything like that? Is there any element of that?

Oliver:

Absolutely. I went into medicine and surgery because I wanted to be a caregiver. I spent many years trying to get that knowledge to a point where I would say that I was an expert. And now I'm entering, I have to actually leave something behind in order to become an entrepreneur. At first, I thought I could juggle both of those things for a little while and I could in the very, very beginning stages. But as you get more involved, you do have to make a choice. And I think for me, what really helped me to make that decision is I thought to myself, what would I think 20 years from now if I didn't do it, I would really regret it. Because I really believe that the things that we can build are going to be life-changing for some people. And if I continued as a surgeon, I guess somebody else might do it, but what I was hoping we could do would not have been done.

Jon:

Right. Okay. So talk to me a little bit about now the excitement, the fear. You're taking on a business and I hate to say the F word, fail. But it's got to be on people's minds, always about failing forward, failing fast. I don't mean to suggest in any way that-

Oliver:

No.

Jon:

There's anxiety there, I would imagine.

Oliver:

Yeah, there is. And in fact, I cycled several times a day it seems. And then I have some mega cycles as well. So I'll have the successful conversation with somebody and I'll feel like we're making progress and I'll feel on top of the world, and then all of a sudden, I get a rejection from an investor or whatever, some kind of major hurdle that seems like an obstacle that we can't pass. I'm not the only one that's going through this. And then there's the mega cycle, which is, "Oh my God, here I am in this stage of my career. All of a sudden, I'm not making my income as a surgeon, I'm putting my savings into this company." And it does generate some fear, but at the same time, no, I think you have to pick yourself up and not just be hopeful, but make it happen. And I think that's what you ultimately have to do.

Jon:

So you grind through those difficult times when we all feel imposter syndrome to some degree or another where, "What am I doing in this position? People are going to find out I'm a fake." And you have to that positive self talk as well.

Oliver:

Yeah. It is a balance, for sure. You do have to question yourself. That's a healthy thing to do, I think mean you don't want to be narcissistic about it either. But at the same time, you do have to be optimistic and not just optimistic in a hopeful way. You have to make it happen. You have to fix the problems.

Jon:

Now tell me, so you had mentioned when you've got a good day, it's feeling good, you spoke to an investor and then you get feedback from them and it's not so good. How do you take the learnings from that? How do you look at what we initially perceive as negative and then go, "Nope, I got to look at this." What can I learn from this?

Oliver:

Yeah, I think actually one of the biggest challenges is to extract that information from the investors. Sometimes they're not very clear on why they will or will not go ahead, but then sometimes you do find gems out there and help you with your pitch or help you with the way you're positioning your company and so on. So those are all things. I think what I've learned here is not to take it personally. I think some investors look for different things. I have to accept that, but I'm always looking for ways to improve things.

Jon:

Right. So what would your advice be to other people thinking about becoming entrepreneurs from all walks of life, waiters, bartenders, going into it, other medical practitioners? What's your one piece of advice? You said there was, don't take it personally, but-

Oliver:

I think just from a very basic level is build the team right from the get-go. You have to recognize what your limitations are and what your expertise is. So finding other people that are going to compliment your knowledge and your interests is really, really important, right from the get-go. And then after that, I think that it's all about planning and recognizing that your plan is not necessarily going to go exactly the way you envisioned it. Be prepared for that, be prepared to pivot, be prepared to continually improve your story. And yeah, don't take it personally, which is a hard thing to do. I recognize because most of us are very passionate about what we're doing. That takes practice just like anything.

Jon:

Yeah, yeah. That's well said. Maybe, let's chat a little bit about the future of healthcare as far as you see it and what I'm kind of seeing going on as well. In terms of the transition from how we used to have acute care at hospitals and stuff to more of this digital health approach. What can you tell me about it and what do you foresee? Your tool is very much personalized medicine, these diagnostic tools that can be used for an individual rather than a generic approach.

Oliver:

Actually, a very broad question, just because of the fact that you described digital health. Telehealth for example, is here to stay. I would say my own clinics, over the last couple of years, have been probably 80% telehealth, everything by phone and by video conference. I think people are getting used to that. In terms of my own space, in terms of personalized medicine, it's not going to come overnight, but you can see that the wave is definitely getting larger. And everybody knows that we have to refine the way we [inaudible 00:21:04]. When I went to medical school, anyone with really bad arthritis got steroids. And now things are much more personalized and more refined, better targeted therapies. So it's just going to be a constant evolution. There's lots of people working on this. So personalized and precision medicine is a reality. It will be a reality.

Jon:

Yeah, yeah. And that digital health component of bigger, more than telehealth, those diagnostic tools that can be accessed at a distance.

Oliver:

I think one of the important factors that's driving this is not just patient outcomes, but it's also efficiency in the system. With telehealth and so on, it really saves on building infrastructure. It saves on the need for patients to find parking and that sort of inconvenience. And similarly, digital health in its many other facets will add to the efficiency of this system.

Jon:

Things we can't even conceptualize right now as well.

Oliver:

Yeah, for sure.

Jon:

And what's it going to be in 50 years? So what's next for Qualisure Diagnostics?

Oliver:

All right, well, we do have a couple of additional tests that are currently being developed. We'll put two additional tests out in 2023, I'm hoping. One will be a lung cancer test, and then the second one will either be a head and neck cancer test, or [inaudible 00:22:48].

Jon:

Sorry, I lost you there for a second. You said lung cancer?

Oliver:

I was going to say... Yeah, the first one would be a lung cancer test, and then the second one will be either a head and neck cancer or another lung cancer test.

Jon:

I see.

Oliver:

The one thing we have now is a really good workflow that's very repeatable. So my hope is to continue to build that way. We definitely have to start selling and scaling our initial test, which is going to help us grow in other ways in terms of supporting the research and development. And we have a really cool cloud-based software engine that essentially houses all of our diagnostic algorithms, really the major capital investment is going to be in scaling up.

Jon:

The capital investment.

Oliver:

Yeah.

Jon:

Sorry, I keep losing you there. Our audio's cutting out a bit, but I got the capital investment to scale.

Oliver:

Yeah.

Jon:

Is one of the big things. So investors, if you're listening, and I know you are, it's certainly worth checking out some of the work that's going on here. Now, to get to the point you're at, you need to have partners that can run these diagnostic tools in the clinic. How does all of that work? I understand you've got a clinic, but pick up or procurements, as I understand it, and I don't mean to sound like I'm throwing anybody under the bus, but procurements with AHS as I understand it can sometimes be a bit difficult. How do you get a new tool into a system so it can be tested and to have to navigate through regulatory and procurement in all those hurdles?

Oliver:

Yeah, I would say that the first adopters are going to be in the United States. They're quite used to precision oncology and using molecular tests to make decisions. So we have a partner lab in Orlando, Florida who's going to be doing our test. And essentially, what would happen, at least in the beginning, is that samples would be sent over to that central lab. We also hope to get another lab online here in Calgary, and I think we should be able to pass those regulatory hurdles quite easily in order to start selling it from that lab. Ultimately though, in order to sell in Canada in a very broad sense, it will probably be significantly delayed in comparison to the uptake in the US. It will take probably some inclusion in guidelines. And in order to get inclusion in clinical guidelines, you really need to create a whole lot of evidence that might. Take us another three years or so.

Jon:

So if I understand correctly, you're going out of the country to prove your technology and to gather this evidence, and then you come back to Canada and say, "Hey, listen, it's working for everybody else. Can we use the same tool here?"

Oliver:

Yeah, it sounds like a roundabout way to do things, but really, it's the most efficient way to get to the market and prove that this is of value. In the meanwhile, we will continue to do clinical trials here in Canada. I think that it's very cost-effective to do clinical trials. I have a really supportive group of thyroid surgeons here in Calgary and head neck surgeons.

Jon:

Okay.

Oliver:

So it's not like it's not going to be available to the local community. It will be under a clinical trial umbrella. But really for broad adoption, I think it'll probably be a couple years before a provincial jurisdiction picks this up.

Jon:

Okay. Okay. I want to explore clinical trials just a little bit because I know Alberta and maybe at one time, would've been regarded as a bit of a flyover province. Clinical trials may not have been, "Hey, let's go to Alberta and do a clinical trial." But how do you see that changing in your experience as a doctor? Has it gotten easier? Are there more of them? Is it more challenging?

Oliver:

Yeah, I think it depends on what kind of clinical trial you're talking about. If it's a multi-institutional trial, there's definitely much more involvement by investigators here. But the kind of trial that I'm focused on is really doing the trial of our product in a single [inaudible 00:27:41], and I have to say that the Calgary community is very pioneering, very supportive, and has always been that way for my entire career, which is really why I came here. And the thyroid surgeons and the head neck surgeons have been tremendously supportive and easy to work with. So I think it's a great environment to do the testing that we want to do.

Jon:

Okay, excellent. Now, you said that's why you came here. For some reason, I was under the impression that you were from Calgary.

Oliver:

No. I'm from a tiny town called Kenora, Ontario, but then went to Vancouver for medical school. But then went back to Vancouver and then down to Miami. So I've been all over the place. But for my fellowship, I had a number of opportunities and it was really easy to make a decision to come here because it was just a tremendously supportive and inviting community. And nobody seemed to create obstacles for doing innovative stuff. They're very supportive.

Jon:

Well, that's great. And the added bonus is Alberta, specifically Calgary, in terms of tech entrepreneurialism is really taking off. So this is a great time.

Oliver:

Yeah. We have a tremendous talent pool. There's no doubt about it. We just need to, I think it's early on in our history though, in terms of tech and biotech mostly. Mostly, as you know, it's been in energy, oil and gas now for many, many years. So that ecosystem's really building out now.

Jon:

Yeah. And we've had a pretty solid base with artificial intelligence and machine learning, with-

Oliver:

For sure.

Jon:

And now we've got AltaML that's pushing as well. And companies like yours that are using that as a technology are really pushing that envelope of what we can do with it. And that's exciting.

Oliver:

Yeah, for sure.

Jon:

Yeah. So let's wrap it up here shortly, but I want to know just a little bit about what the AICE program meant for you.

Oliver:

Yeah, so early on in any company's history, it's really difficult to find the capital to address, especially when you're trying to bring a product to the market. I'm not sure how much easier it's going to be once the product is in market, but I think that is probably going to be a lot easier. People don't know you very well. And so the AICE-Validate was excellent for us because it helped us to do all of that demonstration work and essentially bring it to market.

Jon:

Well, that's great. Well, Oliver, it's always a pleasure chatting with you.

Oliver:

Yeah, thanks so much for having me on, Jon.

Jon:

Shift can be found online at shift.albertainnovates.ca, or you can reach us via email at shift@albertainnovates ca. We can also be found on your favorite streaming service. So dive in and enjoy. Until next time, I'm Jon.