Iterative Health, Gastro Health partner over AI-enabled GI care and precision medicine R&D

Iterative Health and Gastro Health are teaming up to bring Iterative Health’s AI-enabled gastroenterology technology to Gastro Health’s endoscopy centers throughout the country.

The new partnership is united by a shared desire to standardize GI care across class, country and condition, executives at both companies say.

Singaporean Jonathan Ng founded Iterative Health after a visit to Cambodia. Following the end of the Pol Pot regime, which left the country void of doctors due to intellectual purges, Ng began his work by bringing healthcare to the Cambodian people.

That's when Ng realized how substantial the gap still was between medical training across countries, Iterative Health’s vice president of business development Sahir Raoof said.

During a surgical procedure, a well-known Boston surgeon remarked that the patient had “the largest tumor I’ve ever seen.” Ng could recognize that the patient's tumor was large but could not identify many other characteristics. The Cambodian surgeon asked, “Where’s the tumor?”

“And so that was the sort of ‘aha moment’ for him that these differences in interpretation of visual data can lead to really drastic patient outcome differences based on the clinical decisions that the physician makes on ingesting that data,” Raoof told Fierce Healthcare.

Ng was drawn to AI but thought that the technology being used for self-driving cars could be co-opted to standardize the interpretation of visual health data and provide actionable insights for physicians.

“Because if you can standardize the first step, which is what's happening with the patient, you can start to standardize the outcomes that happen regardless of where the patient is receiving care,” Raoof said.

While there are other companies working in the diagnostic AI space, oftentimes, they assess 2D images. Identifying filmed mucosal surfaces while assessing twists and turns is a more complex feat entirely. In September, Iterative Health secured FDA clearance for AI trained to spot suspicious polyps during a colonoscopy. The GI Genius program, a similar system, received the green light from the FDA in April 2021.

Iterative Health's Skout system works in real-time to recognize the potentially cancerous tissue. In a randomized clinical trial, Skout scored a 27% increase in the number of potentially precancerous adenomas discovered per colonoscopy, an average of one additional adenoma for every 4.5 patients examined.

Iterative Health’s technology is now able to identify over two dozen clinical features, such as inflammation, ulcers, bleeding and erosions.

Through its new partnership with Gastro Health, Iterative Health can increase the number of inputs into its machine learning system across varying populations, ensuring that the technology doesn’t reflect a subset of patients. Additionally, the identification and grading of inflammatory bowel disease (IBD) can expand Gastro Health’s clinical research capabilities.

IBD is an umbrella term for disorders that include Crohn’s disease and ulcerative colitis. While for some, the condition can be mild, for others it is debilitating and can lead to life-threatening complications. The treatments that do exist do not work for all patients who are required to make substantial lifestyle changes.

“If you look at all of the inclusion criteria for the IBD trials that are currently being run, almost all of them have an explicit inclusion criteria based on endoscopic findings, for example the Mayo Score for ulcerative colitis,” Raoof said. “And so, as you can imagine, what one physician qualifies as moderate to severe disease, another physician may say this is mild to moderate disease which may result in variance in patient selection for clinical trials.” 

By standardizing endoscopic scoring by the 390 physicians at Gastro Health’s 150 locations, the pair hopes to better identify and recruit eligible patients for clinical trials while laying the foundation for the future of GI innovation and precision medicine.

Raoof points to how precision medicine in IBD treatment is similar to the early days of oncology. Only with the introduction of companion diagnostics and biomarkers did niche indications and cancer treatments become commonplace. The partners believe the same change is coming down the pike for IBD.

“Clinical trials are extremely important to the development of new treatment methods for patients with IBD, and we look forward to contributing to this advancement by expanding and optimizing our clinical research capabilities,” said Joseph Garcia, CEO of Gastro Health, in a press release.

Gastro Health has a presence in seven states and is one of the nation’s largest groups specializing in digestive and liver health. The GI company has also announced a recent partnership with Lynx.MD, a cloud-based health data platform, and its acquisition of Gastroenterology Associates, a Washington-based GI care provider.

To date, Iterative Health has raised $195 million in funding. Through the new partnership, the AI company has been able to partner with multiple clinical research sites.