BioDesign: A Process of Innovating Medical Technologies
okay so we start with a weather that's the way we do it and fall is here and so this morning a thing said fall on me and yes PA is here and we are ready to do do this beautiful fall so um weather is fantastic we are into a new energy coming that has come up and the colors are blooming and if you are on on zoom and don't belong to Northwest Arkansas you are missing something really beautiful that's around the corner um I'm ran I'm the uh director for The Institute for Integrative and Innovative research and um any of you have heard it before but I'm going to tell it again to everybody else we call Wicked problems we find solutions to Wicked problems and our approach is using a convergence approach to bring different sectors together and this is perfect our speaker today is black that and um using an integrative Innovative approach so that we can take our solutions to be at scale I'm going to uh if you can already see the screen you will see it's an intro to biod design and culture process let me tell you if you don't know about the culture process which you will hear today I was privileged to be a wallage culture Remnant taller in the previous University everything but most importantly those of you who do not know the ver Foundation played a major role in making biomedical engineering across the whole nation but across the globe as separate departments but then quter Foundation came in and basically when ver Foundation was closing down quter Foundation came in and pter Foundation seeded a lot of money and lot of funding with partnership from different universities to see how can you take Technologies out of the you know labs in in the medical space and actually get them out and commercialized and actually make a difference and they along with and you will hear a lot about about this today from our speaker for for uh later today but this is really is to my heart this is something that is really really very really special and and that biodesign process and the culture process so I'm going to stop at that because we're going to have Professor Arman do the inter uction to our speaker today so welcome to this beautiful call day welcome hello everyone thank you for joining today h I just want to go a little bit brief history of me and D Dr Mr T here D got her Masters so got his master's degree in Drexel University and correct me very and then he immediately wanted to start the entrepreneurship he opened a software company with his friend that uh worked for 10 years I think 10 years in years 25 years I'm approximate 25 years there and then he sold the this company was sold to Reuters reuter Thompson at that and then he started his other in the then he became the fter manager for several years and the de brexel University I'm not going to say how so many years but after that after doing the cter for several years at brexel he started opening his own startups he started with f near for brain Imaging that I think you still have the companies performing and sold more than 500 uh systems across the United States and world and after that few years ago like 2019 we met and we started working together and I go back to met earlier and we started he had this idea that work have a full body imager that can be used for medical examiner and for skin cancer detection and classification so that's uh something that we've been working I had a pleasure of working with doood for so many years on that and we has been very productive uh collaboration with the we got SPS from NSF and ni both and we continuing to get that work together so that's my professional work with dwood but I have to say I know dwood for 40 years maybe more since we were both in high school we went to the same high school we actually sat on the same bench in the last year of high school and I always remember this kid that was always so eagerly listening to the teacher and following up with such an interest what the teacher was lecturing while I was just looking at my time to just go and then I was asking what's going on but uh so it's a pleasure so it's it's a great pleasure to work with a friend collaborate and the collaborator and a colleague at the same time go with the friend collaborator colleague it just it's a honor to introduce you today thank you thank you thank you uh so uh as M said I have had a few uh terms in my professional career uh but this has been the most enjoyable part of my career uh I work on daily basis with students we have anywhere between six to 8 uh six to 10 graduate students working on our J projects and some of them are like my kids and I tell them that a lot my kids now I've been working with that for three four years um I did not know what to expect here today so uh I first did a presentation I thought with I'm going to meet with students so I tuned it towards students and I uh made a presentation about need and find which is the stone of the biod design process and I actually brought the book so the students can see the book too and I can I carried this very heavy book to pass it on to students um but then I found out that we might not have a lot of students so I added and the cter process to it like 10 minutes ago uh and then I found out that Ru was involved with the cter project and I thought okay what are we going to talk about now I have nothing to talk about but I'll go through the motions and we can have a discussion because uh a lot of it could come uh to discussion so um some people might think of fter process of design thinking that's another way of thinking about the process of innovation to find out um in the locality in the environment in the industry that you want to innovate uh what are the problems before finding the solution so a lot of times finding the uh the process of coming up with a medical device is a technology push so um the um professor comes up with a new kind of technology and say okay how do I apply that to a problem so you have the technology first and then try to apply to a problem um fire design uh is not that it's like takes the magic away that you wake up one day and you have this great idea and you make a device bu design replaces all of that magic of idea with a lot of hard work Upstream of the process so uh Stanford has come up with all different phraseology and uh I had the privilege of taking the Executive Education course uh which was like a 4day course at Stanford and Josh M and Paul y they T the course um and we visited a lot of the um innovation centers around Silicon Valley that they practice uh biodesign uh the boundary is an amazing one if you have a opportunity to go to C Valley that would be an amazing place to see bio design process in action uh so so this is the a moment followed by development this is the traditional way that people think that uh the medical device Innovation happens the bio design takes this a moment and replaces it with a lot of hard work uh a process that at the end of that you will end up with a device that people want it and it's useful and makes economic sense and uh it saves lives so um I messed up my presentation looks like I apologize um so uh basically it's a process where um you need to do a lot of work to find out first of all what Market you are interested in uh the market that you're interested in might be because of you know I work for metronic and in metronic we do cardiovascular so that's the area that I need to innovate that's I'm in that department I have to I am a cardiologist I understand that so that's the area that I want to innovate so you have to select a market and and then go through all the steps that and I'm going to go through some those steps with you um and then when before you start uh you have to look at the economics of that market um so I um as we go along um I have made an example of the technology that me and meon are working on so um and I always explain this to the students I probably don't need to explain it for you but there is a total addressable Market uh for each technology uh that you know um they need the market for lighting there's all kinds of lighting in the world and then there is the serviceable available Market which is like those having to do with LED technology and then within that we see that our for competency for replacing the LEDs for replacement BS so so for us looking at the market and and we uh our Innovation is related to Dermatology is related to finding skin cancers at the earliest possible stage that we can find out so uh the total addressable Market in this area let's say there are 160 million people that need to get annual skin checks so it's like a 6 to 12 billion Doll Market and then uh there serviceable available Market let say because of the reimbursement because that for all of those people there is no reimbursement you cannot just decide to go to your doctor and have your doctor do a uh the kind of technology that we are developing on you and expect Insurance to pay for that uh but for the people who have had history of melanoma uh that is a reasonable thing so the serviceable advisable Market is $1.1 billion uh and we are going after research institutions first we have installed our first machine at John Hopkins Out Center our second and third machines are going to the of our hman Institute so we are going to uh install their machine at up to 60 research institutions around the world and then um then prove the technology with doctor's offices we need to at least sell like 20 30 uh doctor's offices and then we have proven the technology that it had efficacy during the clinical trials and then the doctors did buy it and they made money and then once you prove the business model where company uh Venture so so this is the uh replacement the biod design replacement for the process and it all starts with the is the most important part of this process you know um the uh there are great Engineers everywhere all the companies have fantastic uh teams that can Implement almost any project but um a lot of them feel like what happens out like let's say you're inside G and they think the reason we're not coming with that many Innovations is that we don't have access to that many needs but we I have the best engineering team in the world if you if I find out that need I can make the implementation so uh you will see how important it is as I go through my presentation so um the reason many um medical devices fail not technology um there is uh the technology doesn't work is one Reon but it's not all the Reon and even that reason of the technology not working that also has to do with need because you probably pick a need that you didn't have the type of expertise and resources to bring it to the market so a lot of these go back to the need no one is willing to pay that is something that people can figure out with a little bit of work you know graduate students in a week can figure it out without spending a billion dollars on developing a new uh AR icial uh spine compon you know so um you you need to know if people are willing to pay for this technology not enough patients you can develop a technology that's it's good for five patients send these that with artificial risk they they spend a billion dollars actually technology that if they sold it to everyone that uh could use the technology they still wouldn't their money they spend on the develop they could have done that on a piece of paper with one R so um this slide also talks about the same thing as you go along the development the costs go much higher and higher so you want to fail the projects early so we want to fail up okay this wasn't a good need let's fa it right now or at the concept level or at the Prototype and development level or at the clinical level if you f at the clinical level this is the cost that you're looking at whereas at the uh need level if you fail the project you have spent a lot more time look at the years going to a project at the development stage if you want to say it that that's fa a lot of projects can be failed a lot area so this a lot of this information is in the book and I have taken it out of the book so uh I'm not giving reference in every slide but they are all from the book so needs are not easy uh they they really finding that need is very difficult and you can see that line is pil calling said to have a good idea you have to have a lot of ideas and and so if I ask my patient my customers what do you need they say that's the course so um it's very very difficult to find that me and uh it's not obvious so uh bi design has come up with a process for doing this and the process is the numbers G so you have to have to look at a lot of needs able to come up with you know a answer that you can take to development and planning and uh that how do you come up with that um you have to be in the situation in the market of the technology area that you want to develop you want to uh innovate in the cardiovascular area you have to camp out in the cardio Department in the hospital in the ambulance in the helicopter while they're transporting the patient in the operating room in the recovery everywhere and observe for long periods of time you have to talk with the patient with the doctor with the nurse with the ambulance prider with all all the people that are involved in the process to see what are their issues and um so so the process is a very time so you have to have a team of people approaching this a team that has different expertise they have to have domain expertise so that's that's good but if you go with somebody uh with domain expertise they are jaded they see the solutions that are existing as God given and oh we have the solution for this thing and and that's not enough you need to have marketing the person can understand what sells what doesn't sell but you also from outside the business people who look at the problems with the fresh eyes uh in brexel University we did that we sent groups of students to Shadow the doctors not interact much with the doctor but join down what the doctor did during a period of one week and they wrote a report and gave it to the doctor and the doctor say really is that what I do and they were surprised of the flaws that the student saw in what they were doing so uh you have to have a mixture of people who go out there to find and to get these needs and they have to find a lot of things right you have to have a lot of ideas to come up with a good idea so um there is a specific format I'm going to show you that um you know I said Stanford came up with the phraseology of how to document in and um and how to select between that so it's an iterative process you have to come up with a lot of needs and uh during the needs finding you're not trying to kill the needs during the need they're not trying to find needs you're trying to kill those needs that are going to cost down the road so uh so uh you're only looking for problems you know every problem that you find should be written down and should be discussed and should be uh examine to item before you reject it but during finding process you want to write down every problem that you see every problem that come across as You observe in a hospital for a month which is what people typically do this team need find and go out there um just to tell you a little bit I was really passionate about this while I was in at Drexel University and um Stanford has established bu design centers all over the world uh and they take basically graduate students and if they put on through this programs they six months program they go to least finding and they go all the way through the process to of innovation and and they learned a lot a lot of them are medical students so forth but there also exists a big group of people in the industry like let's say a that was a specific group that I worked with while I was at Rexel uh they wanted to come and do needs find in Drexel's hospital that sounds like something reasonable to do in practice it's close to impossible for them to uh come to the hospital and do their needs finding there a lot of prohibition laws against selling to their patients uh so it's very very difficult for a company to send a a team a needs finding team to a hospital to find those needs When J andj approached me and they wanted to come to Drexel University to do need find send it to you combine their staff their domain expert their marketing expert with the student EV that uh had the firstes eyes to go and find these needs it took him two months negotiating an agreement for them to come and do needs finding for one month and I thought okay this was so painful they would never want to do it again they finished it they wanted to do it again so that gave me the idea that there are a lot of companies that want to do this and if the university makes it easy and puts together once you get the agreement developed that agreement is pretty much can be applied to everybody nobody has to go through this 45 two month day of negotiation again and again you set up a process where the companies can come and visit and bring the their uh you know their brass to the university they get familiarized with the students from the university the students gain the experience they gain um familiarity with the companies and that process can repeat and they can I thought that a better approach to BU Design Center than what Stanford is doing which is putting only students through is to bring in the company to the university and set up bio design centers where companies are members of that bu Design Center and they are allowed to pay a annual fee and send by Design needs finding team twice a year maybe and and then all the needs that they don't want go into a needs Bank where the student can use those means and do other kinds of work with it so I spent good amount of energy but then I got busy with my companies and I gave up so this is an example of a NE statement a way to address a problem in a population and then for outcome a way of screening skin cancer in over 50 population that can find skin uh stage one skin caners so I want to find skin caners at the various possible stage that I can find it now this statement doesn't look like much but if you think about it this is my advertising this is how I go to SDA this is my weo on my produ this tells me what kind of Clinic te study I have to do to get this device to FDA this one sentence here has so much impact on everything that it's worth spending some time to get it right and getting it wrong is really bad so it guides the brainstorming it facilitates concept screening value screening uh part of the IP you decide uh how you file your IP because it's going to become your product uh clinical trial protocol comes from this sharpens marketing efforts uh basis for the reimbursement argument all of that comes from what that one line it's a very very important line so you see why need is so important and you can uh you know Buy by spending a lot less effort than development at this stage up front Upstream you can increase the chances of your success by so this is the device that mean and I are building here in uh University of Arkansas so this is the third interation of the scanner that um I have built two iterations of this before in in our office but then this one is a joint effort it's being built here in uh University of Arkansas and um the there are a lot more robotics has 19 Motors in it uh every camera has pan two of the cameras have tilt and they all can move in uh well four of them at least can move in XY play 3 uh and the bottom ones can only in and out but our idea is to have the same number of pictures regardless of the shape and size of the patient and all the pictures will point to the same Anatomy so if in my scan picture number six has my nose in the center picture number six has the nose in it Center for anybody else all the cameras are always at 45 cm from the patient they're always as close to perpendicular to the center of the area that they want to so when you put all of that together it's impossibly complicated project and I'm so lucky to work with me this team on this project I also I don't know how we are doing with time but I'm going to spend a few minutes on the cter process so uh we did talk about this slide and uh regarding the pter process um pter um wanted to you know their Vision was in us we don't make TVs we don't make the best cars we don't make the best TVs we don't make the best cameras uh we make the best medical devices um we are competitive in that area how do we stay competitive how do we save lives by becoming more competitive and uh how do we includ patient care in the process so they uh Wallace pter in his lifetime uh had seen a lot of adversity uh he had traveled the world he had seen all the misery after the war and uh he wanted to do good so he left half a billion dollars the proceed of the sale of the company that he he and his brother owned uh they sold to beetman so as a result and half a billion dollar went to the Wallace H poer foundation and they thought how do we do good and they said okay we Eng with universities and many universities appli forment so they can do uh they can do the good work that the foundation wanted to do uh they selected uh 10 universities in the to uh and the mission was that okay we're going to give a little bit of money every year to these 10 universities and see what kind of translation what kind of commercialization of uh life saving Technologies they can achieve with a million dollar either so they selected 10 universities they said okay you do a good job we give you money for five years and at the end of five years we're going to evaluate you somehow and decide which universities deserve to get an endowment so they can commercialize their medical device Technologies forever so but nobody knew how they're going to graduate these universities um along the way during those five years we met all the time so I was the cter program director at Dre there were 10 people equivalent to me and then there were 10 people who were the heads of the biomedical engineering department uh the 20 of us met at least twice a year with cter Foundation being very Hands-On probably putting the most input into the process this process of the whisking was developed and the process although in most universities was and is technology push the foundation was very interested in finding and then find the technologies that that are deserve but then then you have to have a lot of screening so when uh a professor a team of professors would apply for cter funding um we would look not just as the scientific Merit of The Proposal but there is a lot of other ingredients that go into a successful proposal and we had to evaluate all of those so sort of more rigorous than an ni although maybe we were easier to give out money at that you know at at a wor score but um we look at more uh more attributes of the project and the people who then then there was a panel just like we we had a panel our panel didn't changed from time to time it had three people from industry we had all J&J present at the table uh we had integral Life Sciences because they were on the bind they were buying companies like at the rate of one a week uh when they were part of our uh oversight committee and um also uh people from uh medicine School of Medicine uh Economic Development uh groups uh so we had a panel with different points of view from the financial from the technology from business that would look at uh the proposals from different eyes and then their job wouldn't be done once the proposal resp funded uh every six months the teams have to come back and explain to the oversight committee what they have achieved what they're trying to do uh they will take advice um sort of not like the N that you know they handsfree you get the money at at the end of the uh project maybe you give a report and that's the extent of the involvement that was not the case the involvement is constant from the C program manager I have to act like the CEO of the company I have to I am responsible for taking that technology to the next stage whether that would be to get it to a a strategic company that is going to license it and bring it to the market or form a new business around it with management and get it to somewhere or admit that we made a mistake otherwise we have to constantly fund them so either those commercializes or we admit mistake or we have to keep funding it so I fund it one year no commercialization activity happens I either have to admit I made a mistake or I have to give a money for the second year second year ends I have to give money for the third year so we don't have a lot of money I I could the program I shouldn't say I the program could support three projects a year so if I gave my funding to an existing project that mean that I couldn't bring another project in that was deserving so uh so we have to be very selective in the projects that come in because you have to think at the time they come in a they have to go out might be very exciting to bring a interesting science project in but a mundane science project could be a better commercial project so that was the selection committee and the program manager would review and make sure that now how do we drisk the project the drisking is basically to answer a killer exper by killer experiment but what is a definitive experiment that can prove to everyone that this technology has Merit for the licensing for the company management that's going get form so it had to be a compellent study design that if you show the data from that that was compelling enough for the technology so and that was basically the most important thing that we had do and how we ended up being measured we didn't know this in the beginning of the program like few months before the end of the program the foundation learned and we learned at the same time that the follow on commercial fund there is the only measure of getting the down that is if we putting money into a project and government puts money in the project that project still has 0 of commercial followup funding when a g comes and put $1 in it that's $1 of follow on Commercial F you go get $6 million from NIH you still have zer you get $1 from J&J that's $1 so we measure we put in $5 million into the program the commercial entities put $20 million into those Technologies so then that is a multiple of 4 to one of commercial fall on fund to pter Funday so most universi were ATT tenants at commercial fall on fund so and I think that was brilliant that uh fter came up with that measure as a measure of successful commercialization because yeah like people in uh John Hopkins they can generate a lot of Ni funding but that doesn't mean that this is going to be a very good uh commercial success the follow on funding the people who have to put their own dollar out of their pocket and put it in the project so five universities out of the 10 universities got the endowment uh I was lucky enough that Rexel was one of them uh one of the technologies that we invested went all the way to FDA while I was during my 10 year I was there actually for 10 years running the program and got it fa clearance and it's being sold by seens now uh several other Technologies were quite successful but uh because of our commercial fall on funding we were able to bring the endowment into that I think that's where I'm going to stop I don't know how we doing with time but we can have a discussion we can have question and answers um I'll be happy to answer your question actually and the the FIU biomedical engineering department was the only Department that that was the first Department that they endowed as a department not for endowed department and then later out went togia Fu department and they right down the street from the I don't think they have to pass any tests to get the endowment so really four universities had to pass the to get beautiful bi engineering building that they original displ one story about W and he wanted to come back to us and there was no you know I jump on the flight and come back toci one wenta America long so contract toting andology the beginning but he we do have um one question online um Professor Raj ra from department of engineering um is uh from the College of Engineering in biomedical engineering is joining us and he says thank you very much for a wonderful presentation I teach a course called biomedical Innovations for Global impact where we have adapted the biodesign process one of the motivations behind the course is to bring together students from different back backgrounds and different perspectives to address common needs based on their specific location and constraints one of the major challenges associated with generating a feasible design that can work across different cultures are the economic constraints could you comment on how the biodesign process can help in the generation of lowcost Innovations with potential for broad impact especially in underserved communities across the world well I I think the answer is in the question um I it can be very impactful um I met with the person who now I apologize in China we sell exact same devices that we s in United States 1% of the people we have sour but then you have these mass of people Africa in India all over the world that cannot afford the same device that the insurance pay for United States and uh a big way that uh universities and students to come soltions problem I think it also reminds me program that professor in temp University was and the student teams go to you know resource pool countries um they can get big donations of devices from us from Europe from everywhere but they have no expertise in maintaining those devices I'm not talking about repairing that just keeping them in working conditions and these student teams go and they awarehouse of devices that come out of the hospitals in the United States and they can be easily uh retask and um you know put back to work and serve those communities and Dr ke has done a really good project and maybe he would be a good uh resource for the person and uh they can team up and send students uh from Aransas to help with as well yes thank you very much great and I wanted ask about you know see on this slide VCS and I guess you know if you hear VCS talk about what they do in their evaluation it sounds like it's a similar process it is very similar process and and again our goal wasn't scientific so our board our oversight like our board shouldn't have the same makeup as n that's interested inside so VC are big part of it if we have the people that are eventually have to fund the project select the project in the upun process then that project has much better chance of at the end of the process going in front of the same VC and being successful because the VC with the same brain with the same criteria selected that project as the project that might so so I think that is a very key part of there so it seems you're saying that the VCS are an important part of your team yes yes do the VCS see that having the other on the team you know is there is there value from VCS to sort of partnering with with the cult team so yes and no so maybe not so much in gell University that I was um maybe that will change over time but uh let's say in Stanford they fight to M over CA Technologies coming out of the pipeline it's a pipeline that they know the Technologies coming out of it are vetted are selected properly have answered that Killa study question so when they come out of the pipeline they have some Merit they can visit that pipeline again and again and again so uh yes the people who sit on the VC committee know better than anyone else what's in the p line and there is no conflict of interest in them fighting each other to pick it up at the end of the pipel I think it's all good it's a win-win did I answer the question yeah I just um I guess from the culture process standpoint the BCS are a partner and essentially the innovators are a partner but the the customer is the the patient or the true true but um you know my dad was also an inventor and he published everything he invented how many of them do you think are serving Humanity so there has to be a commercial process there has to be IP there has to be funding there has to be commercial processes happening for a technology to come Ander Humanity so just uh being idealist and saying no there are VCS they have no room for VCS in Academia then I think that's closing the door to translation I think uh the commercial aspect of the technology would dictate whether that saves Liv or not not the scientific aspect of it um but I think there's one thing that my dad invented that is still in use and he patented that one and some company in England Stole and it never PID him but it's still in use yes and so just a question regarding cter you said about the1 billion that they put how much money so the proceeds from the sale of the company was a billion dollars half of it was wall so that was 500 million and then what they gave to the firston University was a million dollars a year and then they dangled a $20 million Endowment in front of the University said okay if you are successful and you can commercialize your technology life saving Technologies uh we evaluate you at the end of five years at the end of5 million and then if you deserving we give you1 million that you can match with 10 million dollars of your own money so P was like this all the time they would have just give you money and say we go have fun with it they would make sure that you are part of it you work hard for it you we are you know we are Partners they said we give you $10 million we match it with $10 million you can move it from your general endowment into this specific we don't care but it should be only do for uh Fuller purposes and you put that those two together then you have now $20 million the interest the that you get on that $20 million and support three projects every year so it's a they wanted to have a program that can work forever without them supporting forever and they fure million is a size of that can get small selfs suain for the interest of never touch the principle so the principle would grow and if you don't use it it will grow more and uh support more project that's only was so far yes so say you have access to a pool of money you can use the P process and get people to move their Technologies and be very hard on them everybody likes to get money every uh every faculty member is is interested in you know getting more resources for their lab but then you can use this process to more effectively Translate and yes related to this you know at the Institute itself it's that I've been influ set back I've been influenced extensively by this process because of the F Department which department and spending so much time with them of how things happen and then ni has been doing that Bally the established that Now The Institute we have been saying want imp and not necessarily just about medical Technologies could be other things than medical Technologies and then we focus on deployment and so this process kind of helps in that how do you think we might with your extensive experience inel as a as theer you know the PPP director um how do you think you might guide us in in um effectively creating this process for The Institute itself what could we amongst us our faculty are in the insute you know what would we think well I think um intention from beginning was to come up with a process that's replicable and it it wasn't done for one University it was a process that was tried out in a university like Drexel and a university like staford and there was but pu in between and there were all kinds of universities and maybe they just picked drexon University just so they have a spectrum and we were successful we were successful where a lot of big name universities were not successful and did not get the inval so so I think the process has proven itself that that it's a workable process um I think Elias Paro consults in this area and I think that's how he makes a living now and he would be very happy and he's as smart a person as you can get um to you know uh get you started um I I think it's completely reasonable to take the process and app to other areas to have some kind of component that's AR consult related with local needs and local um you know technologies that are available to you and I think it's completely reasonable and completely portable process that you can take from another University and install it here do your on tweeks to it you know as I said in you know there could be parts that are Arkansas related and um I think I think it's a great idea it's very doable how important is it for us to have a very experienced PPP direct so that was um you know I might have been probably the least experience um SCH program director the whole entire program the reason Drexel reached out to me they had a different um pter uh program director when they wrote the application but pretty much I ran the program to for the duration of the 10 years that I was there and the the reason they arrived at me was that I had experience in buying and selling companies my experience was wasn't in agriculture wasn't in biomedical engineering but having bought and sold small companies and that was what was attractive regarding me to the company they well they knew me and I was a graduate student over there and you know Buu yes I yes so Buu was my PhD advisor but I never finished my PhD I got employed and left so Banu brought the pter program to bexa and Banu is my sister to me and um so um she knew that I might have the horse St but she also knew that I have bought and sold companies in other universities um most of the cter program directors were part of the C s in major companies so that's what they went for they went for a member of a SE Suite in a major medical device company uh I think Stanford went to cofman foundation and they got a fellow out of cman foundation and I think that was also a good idea or even if if um if the person that you have in mind may do a fellowship in cman Foundation as part of you know on job training so so different strategies uh I told you that threel strategy was somebody that has some entrepreneurship uh you know I went to people's houses and introduced buyers and sellers and um very handson uh you know very uh put together deals at personal level um and I think that was a good approach for them that worked out for that uh whereas maybe a SE with person would be more Al less uh into personal inter relationship so I think there there's a lot that goes into thinking about what kind of program director you would need and maybe for our uh it would be different uh you know you have certain funding sources and that person might be a person that has had success with dealing with those funding sources so much goes into to thinking about who that person to Fantastic
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