We had the opportunity to interview Dr. Julie Eggington, a local leader and pioneer in genomics and precision medicine. If you have ever embraced the tech term ‘hype cycle’ this is an interesting read and has us thinking about Salt Lake City’s BioHive Community vibe in general – it’s all about attention over hype.
Since the Human Genome Project started in 1990, genomics has presented a massive opportunity to improve and personalize healthcare. Investment in genomics deals have provided over $6.5B in total, driving applications in gene sequencing, diagnostics, precision medicine, and more.
But much of that investment defaults to the usual U.S. metros – Silicon Valley, Boston, New York, etc. To which, Dr. Eggington says,
“Why is that? There is no reason why investors shouldn’t be looking to Utah for innovation and deep talent in genomics and diagnostics. We excel. We really need to change perceptions.”
For over 50 years, the University of Utah has been a leader in human genetics. Genealogical data has provided a perfect storm of people and resources that have since spurred discoveries of the genetic causes behind cystic fibrosis, breast cancer, colon cancer, and many more. It has spawned great companies like Salt Lake City’s Myriad Genetics, a worldwide leader in molecular diagnostics.
“The talent and innovation coming out of Utah is remarkable. Ours is simply a story of world-class and consistent quality. It is what sets us apart from other research hubs in the U.S.,” says Eggington. Having received her education from the University of Utah and Brigham Young University, among other universities, her approach is evident in her body of work.
Dr. Eggington has worked for Myriad Genetics, and she was also part of the next generation sequencing ‘dream team’ of 23andMe in Salt Lake City (little known fact, they had an operation in Utah) working on new product development. After that, Dr. Eggington helped found the Center for Genomic Interpretation (CGI), a deep tech nonprofit company providing quality driving services and consulting to clinical genetic and genomics industry stakeholders. She started CGI out of concerns about the unrealistic pressure for rapid financial returns in an industry that should place clinical efficacy and patient safety above all else.
She says, “It’s about attention to details, not hype. Clinical testing for hereditary and acquired genetic diseases have saved the lives of hundreds of thousands of patients. Our greatest challenge in genetics is the accurate interpretation of patients’ genetic variations. By getting this right, we will save countless more lives.” She also sits on the World Economic Forum’s Precision Medicine board that shapes policy to realize the benefits of precision medicine for society, while reducing risks.
Q&A with Dr. Eggington
As a local leader and pioneer who has worked in Utah for several years in this field, what qualities do you think draw your colleagues to continue to work here? What drives them away?
Utah is really an amazing place to live and work. We have world-class research, collaboration and support in genetics. The secret is out. Ten years ago, the story may have been a harder sell but certainly not now. I have experienced hesitation (from potential candidates) on diversity and the perception of detrimental LDS church influence. More than one non-local professional has been surprised to learn that I am a practicing member of The Church of Jesus Christ of Latter-day Saints, with “but you seem so normal” being a common response. So once professionals who are being recruited to Salt Lake City take the time to explore and find out for themselves about the lifestyle here they are excited, and they learn that many of their misconceptions are unwarranted, or at least outdated, and that Salt Lake City is a wonderfully diverse and interesting place to live. It’s accessible, young, progressive, and you can enjoy all of the perks that city life offers with outdoor recreation just minutes away.
What keeps or drives many biotech professionals away is Utah’s Non-Compete labor restrictions which allow Utah tech companies to bar former employees from working for any company, nationwide, with overlapping commercial interests for one year after departure. After getting my career start in Utah, I had to make a couple of strategic employment choices to work for out-of-state companies without these labor restrictions to be free to do what I’m doing now. If I were a driven professional with high demand skills considering employment opportunities across the country, why would I choose to work somewhere that limits my employment choices nationwide after leaving a Utah company? Other states no longer allow that. In my industry, a lot changes in one year and it’s tough to step away to wait out a non-compete. In Utah we really must look at reform, as it has great potential to stunt economic growth long term.
What would improve the workforce pipeline for Utah’s genomic and diagnostic industry?
Internships! Where bachelor’s degrees are concerned, if we want to maintain talent in Utah then ALL of the universities need a strong local internship pathway facilitated by the Universities. The University of Utah generates amazing talent but many students don’t end up staying here because they haven’t made important local connections through internship programs. Westminster College and Brigham Young University both do a really good job facilitating internships in biotech. Every summer, for example, our organization is provided with a pick of superb interns from Brigham Young University, with their wages all paid by BYU and their donors. We help those students gain unparalleled exposure and experience in clinical genetics. The UofU has a good internship program for their biotech Masters degree students, but is really lacking for undergraduates.
It’s important to get Utah undergraduates connected to Utah biotech since many will go get PhDs elsewhere. Ideally we want their careers to pick back up in Utah, which is made easier if they have developed important connections to Utah biotech during their Bachelors programs.
Let’s talk about investors in Salt Lake City’s genetics and diagnostics industry.
Yes. There is really a lot of innovation and quality talent here in Utah. In genetics and diagnostics we already have a few national powerhouses who tap into the local talent and continuously recruit new talent from other states, like Myriad Genetics, ARUP and BioFire Diagnostics. We also have newer companies making an impact in national healthcare, like Sera Prognostics and Lineagen. We’re ripe for investors and it’s time we get more recognition from VC’s. I’ve worked in biotech in both Silicon Valley and in the Boston Life Sciences Corridor. The talent here in Utah is every bit as qualified, innovative and dedicated. And what’s more, operating a business here costs companies much less than operating a business on either coast. When sizable venture capital is invested in Utah biotech startups, the achievements have been incredible (for example, take a look at Recursion Pharmaceuticals). I believe that investors will see higher success rates investing in Utah life science startups compared to more over-hyped regions of the country. Many amazing companies emerge from the “over-hyped” regions, but the ratio of failure to success is very high.
The so-called hype cycle tends to drive many investor decisions and pressures in healthcare innovation. And while leveraging the hype cycle is a great marketing tool for diagnostic companies, it often results in unsafe healthcare for patients and poor returns for investors. When a new technology emerges, investors jump on board. Then all the VC money comes. Many diagnostic companies form and they promise the moon to their investors. In genetic and genomic diagnostics, most companies reduce go-to-market time and costs by using the Laboratory Developed Test regulatory loophole, which allows these companies to avoid having to demonstrate safety and efficacy of their clinical diagnostic tests. This regulatory loophole is how Elizabeth Holmes perpetuated the now famous Theranos diagnostic scandal. The negative impact that Theranos’ activities had on patients is only the tip of the iceberg when it comes to the numbers of patients being impacted by unvetted medical diagnostics across the USA, particularly in genetics and genomics. Some companies do a great job of vetting their genetic diagnostics, but most don’t since it’s not required.
Precision medicine is now at the beginning steep climb of the hype cycle where there’s lots and lots of over-promising happening. Most technology hype cycles take years to peak then deflate to a level where reality wins and the technology is ultimately used in mostly effective ways.
The problem with hype cycles in medicine, particularly when paired with a regulatory environment that doesn’t require proof of clinical efficacy or patient safety, is that patients get harmed in the intervening years while the hype cycle runs its course. Right now, new technology’s ability to give readouts in biology far exceeds our ability to understand the clinical meaning of most of the readouts.
Many companies over promise. But I’m proud of the diagnostics companies in Utah and the innovative people that lead and work for them. Most of them have resisted the urge to over-claim what their technologies do. They are taking the long and patient road to develop and deliver high quality and accurate diagnostics, ensuring clinical efficacy and patient safety. Their investors will be rewarded in the long run.
At the nonprofit I run, we work daily to encourage a national landscape where health insurance companies won’t reimburse for diagnostics unless the diagnostics have proven clinical efficacy and patient safety. Clinical efficacy, not hype, is what deserves attention.
How can Salt Lake City help?
The BioHive and efforts by Bio Utah have been a great help in collaboration and promoting our industry to the world. But everything comes down to money and time. Industry leaders are already stretched too thin and even if they are willing to give up time to help BioHive and Bio Utah, there needs for more incentive, such as paying them for involvement, or have the companies they work for pay them for involvement. Silicon Slopes has set an example for that. We can do that with the BioHive.
Our community has the right mindset for quality and innovative work, and we are less influenced by hype compared to other traditional tech centers like Silicon Valley.
If we can fund mechanisms that encourage the nation’s appetite for more accurate and effective diagnostics and life science products, then we will lead the way and make a difference in the long run.
Thank you, Dr. Eggington for taking the time to help promote the cause!
With the University of Utah as a Tier 1 research institution and our unique combination of subsectors, we’re honored to support, assist, and lead the next decade of innovation in healthcare.
Salt Lake City is building a world class Healthcare Innovation Hub and Corridor — intentional space for more incubator, office, and wet lab locations where startups can grow and scale with ease. For more information reach out to Technology and Innovation Advisor Clark Cahoon at firstname.lastname@example.org or visit slc.gov/ed.