Delve Talks: Kevin Conroy, Exact Sciences

Delve Talks is a podcast that digs into the challenges around design, product development, leadership, and innovation.

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We had the opportunity to catch up with Kevin Conroy, Chairman and CEO of Exact Sciences, a biotech company based in Madison on our latest episode of Delve Talks, a podcast exploring the challenges around design, product development, leadership and innovation.

Transcript

Dave Franchino: Welcome and hello, everybody, Dave Franchino here and I'm joined by my co-host, Stef Norvaisas, who's Delve's vice president of strategy, and we're really excited to be having another episode of our podcast about creating a culture of innovation. As you recall, my background is in engineering. Stef has a background in the social sciences and cultural anthropology. So, we tend to approach problems with a different perspective. And we'll be tag teaming questions today.

And we're really excited to welcome Kevin Conroy, who is the chairman and CEO of Exact Sciences, an amazing company. Under Kevin's leadership since 2009, the company's grown from three employees to more than 1,400, and their flagship product is really a groundbreaking effort. It's a proprietary multi-marker test for the early detection of colorectal cancer. Kevin has an engineering degree from Michigan State, but also a law degree from the University of Michigan.

So just as a reminder, the objective of this podcast is to explore how companies can create a culture of innovation. We've had conversations with really wide range of people trying to glean some insights into their experiences and what might be applied to any field. And in particular, in the midst of this pandemic, we think there are some new challenges to maintaining a creative culture. I'm going to try to explore a little bit at this season, so we'll start with Kevin. Welcome, Kevin, and thank you so very much for joining us.

Kevin Conroy: Hey, Dave, it's terrific to be here. And I just want to note that if in a future career you decide to become a radio announcer, you definitely, definitely have a voice for it.

Dave Franchino: Kevin, maybe for our listeners if you could start by telling us a little bit about your background and kind of the unique history of Exact Sciences, I think would be kind of a fun way to start.

Kevin Conroy: Oh, sure. I, as you mentioned, I went to Michigan State. I studied electrical engineering. Obviously, I wasn't very good at it because I decided to go to law school and became an intellectual property lawyer. I practiced intellectual property law for a number of years. I worked for G.E. Healthcare, where I really took an interest in healthcare innovation. And from there, I went to a small company in Madison where I was general counsel and then became CEO ... Third Wave Technologies, which was at the forefront of molecular diagnostics for looking at the DNA or RNA basis for disease, which, you know, whether it's a viral infection or a cancer is caused by aberrant or misguided DNA or RNA. We had this unique ability to detect those things. That company was focused on cervical cancer screening. It was acquired by Hologic.

And shortly after that, I joined Exact Sciences, which at the time was a little broken company that had tried several times to develop a colon cancer screening test on this principle of looking for altered DNA in stool, which was a kind of a crazy concept which many, many, many people dismissed. And when I joined the company, it had just a couple of employees and 30 million dollars of cash and a 30-million-dollar valuation. So, investors basically assumed that the value of it was zero. And from there, we partnered with Mayo Clinic. And from there, it's been an 11-year journey and one that has been incredibly rewarding. And it started with insights and innovation, which I certainly can't claim as mine, but had a passion around.

Dave Franchino: So, Kevin, one thing that is always really amazed and impressed me about Exact Sciences is ... I know enough to realize the science behind what you're trying to do is amazing, but fundamentally, the experience of a colonoscopy is not a very pleasant one. And you've worked very hard, I think, to address that. Can you maybe talk a little bit for our listeners the sort of combination of having to solve both a technical problem and also taking something that's really unpleasant and trying to make that better? What have been the contributing factors of those, both to the challenges you've experienced and the success your company has had?

Kevin Conroy: Well, you know, the interesting thing is we weren't necessarily trying to solve for the unpleasantness of colonoscopy directly. What we were trying to solve for is that colon cancer is almost entirely preventable through screening. And yet 40 percent of the population in the US weren't getting screened at all. So, our goal was never to convince somebody not to get a colonoscopy. It was rather, let's get everybody screened. And the only way to do that … because colonoscopy had peaked and then leveled off at about 60 percent of the US population. And Mayo Clinic, had a real passion of "Wait a minute. Why not have a noninvasive way to screen at home and you can get to 100 percent of the population?" Because anybody who has access to the U.S. mail, which is everybody virtually, can get screened. And that was the insight. Colon cancer is the number two cancer killer in the US and one of the top cancer killers globally. So, this is a big problem. Fifty-thousand people a year die, year in and year out, and it's now increasingly a disease of people younger than 50.

So it was, you know, there was a real passion for solving that technical problem, which is finding the DNA markers that are being shed from the tumor, or more importantly, the actual pre-cancerous polyp is shedding cells at a super-high rate. And that's what we were trying to solve for.

Stefanie Norvaisas: Can you tell me a little bit about balancing that amazing technical breakthrough with the next challenge that you had, which is creating an experience that's compelling enough for people to want to do it?

Kevin Conroy: Well, there's an interesting story behind this, which is when we came to the company, there was a collection device, this 1.4 liter container that was for the prior 10 years of the company's history, they'd use this container as a collection device. And we kind of thought, well, that doesn't make sense. Why not just have a little small scoop? People don't want to deal with the large container.

And we were off to the races and developing a smaller collection device that you could just scoop a small portion of a stool sample. Well, we thought we had figured it out. And then, right before we started our clinical trial – once you start the clinical trial, whatever collection device you use, you're locked into forever. So, if you're on a $75 million clinical trial and you get the collection device wrong, you're wrong forever. And at the last minute we said, "We better test our hypotheses. We know we're right, but we better test it." We went to a nursing home and had 400 people use our small collection scoop device and use the container and 85 percent preferred the container. And had we not done that research, that was about 30 days before the start of the clinical trial, we wouldn't be having this conversation right now. And so working, you know, that's one of the things that really got me interested in Delve and what you do is you probe those issues both from a technical problem-solving perspective, but also going out and engaging with the users to make sure that your target is met. And it's really important to do that.

Dave Franchino: Kevin, that's a fascinating story. I want to talk a little bit about the elephant in the room. And that is, you know what, with Exact Sciences, I feel like you were really firing on all cylinders. Things were going really well. And then this pandemic has descended on us and is impacted undoubtedly every business concern in the world. And I'm just kind of curious, you know, that was probably the last thing that you were looking for at your period of growth in the stage the Exact Sciences was under. How of the pandemic forced you to pivot?

Kevin Conroy: Well, like with every company, there has been a lot of challenges associated with this terrible pandemic. But what I'm proud of is the team responded really quickly. First, we said, "Let's take let's take care of each other first and be safe." And so, we took a whole bunch of steps really early on to try to make sure that people stayed safe. One of them was to bring up our own Covid test using the same technology that looks for this specific RNA molecule that is embedded within the virus, using the same equipment and the same basic technology. And our team sprung into action to develop a Covid test. And this was during a time when Cologuard volumes were plummeting. So it was, you know, financially a little bit nerve wracking to look at what was happening to our core business.

We had 4,200 employees and it was, you know, on the forefront of our minds, how do we take care of each other during this time. Leaders took pay cuts - directors, vice presidents, senior vice presidents – the whole executive team. And then people tried to do everything we could do to make life a little bit better as much as we could for our team. Setting up a food pantry and doing a lot of things to say, "what can we do to help our own team members?" Then, once we got the Covid test up and running, which we first wanted to develop to make sure our own employees were safe, we realized we could help the State of Wisconsin and so we reached out to Secretary Palm and Governor Evers and then partnered to make this a reality. And that has been tremendously gratifying to play a role in helping to test the state.

Stefanie Norvaisas: That's such a great story, and it really reminds me of some of the work that we did with Badger Shield in terms of creating a consortium, looking to solve a particular need that's very local, very present for you. And I'm wondering what of that experience are you going to want to take forward in the future?

Kevin Conroy: Well, taking forward our ability, number one, to bring a new test up quickly. So speed, I think is was embedded in the culture of the company -- innovation and speed. There were just a team of people who said, "If we can do this, we have to do it. And here's how we're going to do it." And just cross-functionally. I don't know, a dozen different functions, maybe more than that, all came together and said, "How are we going to do this and how are we going to do this in the next two or three weeks?" So, I think one thing we just take away from this is a cultural attribute that doing these things, bringing up new tests, innovative tests, is hard. But it's a lot easier if you work together as a team. And as I say, it's amazing we were able to bring up this new test without a single PowerPoint presentation.

I don't know how that happens, but it did. And I'm not a huge fan of PowerPoint presentations. I think they get in the way and they slow people down. Let's just go do it. And I think culturally, that's the biggest thing. Maybe partnering as well, because we had Epic that threw themselves into this and Promega, one of our other partners here, the state, health systems around our state and actually around the country, insurance companies that we've partnered with, and the National Guard -- just kind of across the board. CUNA Mutual and AmFam, raised their hands and said, "You can have some of our people work on this to help the entire state." So, it has been really gratifying to see how partnering can be an accelerant.

Stefanie Norvaisas: I agree. Do you think that's sustainable going forward or is that lightning in a bottle?

Kevin Conroy: I think it is sustainable. One of the reasons that Cologuard came into being is that we partnered with the Mayo Clinic and then we partnered with a whole bunch of other groups, manufacturers of the scientific components, instrumentation, engineering. Almost all of our key components are made here in Wisconsin, too. So that, yeah, I think it's cultural. Small, innovative companies have to constantly think about partnering. And we have done that consistently. And I hope that continues.

Dave Franchino: Kevin, it's really fascinating. I would like to build on it a little bit more. I know that the current working environment has required some allowances for inefficiencies. Our listeners can't see this, but I know that all of us right now are having these conversations from our houses. So clearly, we're getting used to working under some unusual situations. But it's also, I think, spurred some creativity and rethinking of how we work together. I'm just kind of curious, what aspects of the new working culture or new perspective on healthcare do you think are going to survive past Covid and simply become part of your best practices and how your teams work in the future?

Kevin Conroy: Well, I think it's really important to engage in person. And historically, I was not a big fan of people working remotely because of the importance of human interaction. My opinion on that has changed radically and in part because of technology that we're using right now. This, you know, the ability to use Zoom and other online tools to engage.

And in some ways, I mean, my work life just totally changed. And in many, many ways for the better. I'm present more. I am not traveling. A lot of people feel that way. We can engage and connect with people very rapidly in a way that the telephone just doesn't work in the same way. So, I think you'll see more of that going forward.

Dave Franchino: At the same time, what ware things that you're looking forward to kind of returning to a more normal state at your business in particular?

Kevin Conroy: Oh, no doubt it's, you know, walking the halls of the office and interacting with colleagues. And that’s I think one of the things that we all love about work in general is the ability to connect with people. And so, I can't wait for that part of normalcy to occur.

Dave Franchino: Kevin, one of the things I found really fascinating is some work that Stef is doing on how companies are needing to change their business models or their strategies to adjust to new behaviors and new realities faced in this pandemic. That might be changes to their products, changes to their distribution models because people are in different buying modes, changes to the brand positioning and message. We were working with a luxury transportation manufacturer that had to completely pivot from sort of, you know, getting to where you were in style to getting your loved ones where they need to be safely and effectively. Obviously, you've spent some time thinking about the future of your business and where you might need to change to pivot for new behaviors and new realities. Can you share any thoughts on what you think might need to change for you and your firm and how it goes to market?

Kevin Conroy: One of the very first things that we did to change how we went to market was to bring up Cologuardtest.com, which is a way for people who may not have the ability to interact immediately with a primary care physician just to go online. You go to Cologuardtest.com, you type in your name, your telephone number, your insurance information, and your address. And you answer five questions. Do you have a family history of colon cancer? Do you these following symptoms? Have you been screened in the past X years? And then a physician, they're an independent group of about 100 physicians, then look at that information and decide either to order a test for you or not. Call you, if not. And you know, your colon cancer screening journey begins, and you can do that remotely without going in to visit the doctor. And then we launched a national television campaign to support that.

And so immediately, the marketing team, the I.T. team, pivoted in a way that met this new environment. And I think now with telemedicine absolutely skyrocketing, the use of it, we're not going back to normal there. And part of it is because the payers are saying, "OK, we'll finally pay for an interaction with the primary care physician," which may be one of the best innovations that comes out of this. Why stop Americans who have a hard time getting to see a primary care doc? Why stop them from interacting with their primary care doc? I mean, the payment rate for a primary care visit is next to nothing. Pay it so that you can get people to think about high blood pressure, to think about cancer screenings, to think about diet, et cetera. And Cologuard fits into that because we're an at home test. So, it's our brand, something that we've really believed in ever since the start, which is make colon cancer screening inevitable. In this new world, it can become inevitable.

Dave Franchino: I think that's fascinating. Very well-articulated. Clearly, one of the biggest benefits, if there is one to come out of this pandemic, is a kind of a rapid embracing of some of the remote technologies that I think can make our lives better and a lot of subtle ways and maybe some not-so-subtle ways. It's really exciting to hear your perspective and how that can change your business and then change the experience of your customers and patients for the better.

Kevin Conroy: So, you know, one of the things that as we're in the middle of a crisis, we look at this and say, this is just terrible. And it is affecting everybody in this country. And it's really affecting some people in a lot harsher ways than others. At the end of it, though, America, this I think the thing that separates us and that is not totally unique to America, but it's an attribute that we have, which is innovation shines brightest at times like this. And because of that, we will come out of this. We will come out of this in some ways stronger than we went into it if people keep their perspective and take the steps that are thoughtful to come out of this as safe as possible, but then more innovative. And what you do at Delve is, you know, you look at problems and you just kind of try to solve them one at a time. That's the thing that's going to save us.

Dave Franchino: Kevin, that's very inspiring. I'm just kind of curious, you know, like all business leaders, you're probably balancing your time between sort of triage and trying to keep the wheels moving forward. At the same time, trying to spend some of your time thinking about this bold new future. What advice might you have to other business leaders that are struggling with that balance? How do I spend time thinking about a future when I'm worried about how to make payroll or worried about just what the next four weeks of my business might hold? Any advice you might have?

Kevin Conroy: The business people that I talk to regularly, I don't see many people throwing in the towel. If anything, people are just kind of rethinking their business. My brother owns a pool and hot tub store in Flint, Michigan, and one of the innovations that he did was put on their website the ability to chat via text, and he hadn't done it before.

Well, he said "I sold my first hot tub three hours after I put that feature in." And people are willing to text when they're not willing to pick up the phone and call. And it totally turned around that situation. And, you know, all his people came back and he's fully staffing again. Those are the types of things that I think we all have to say. How do we innovate? How do we rethink all of the ways that we were doing things before? Do they all apply anymore? And there are going to be people who win as a result of that and their businesses come out stronger and then other people will emulate them and then we'll innovate a little bit more. And I think that's the biggest thing. And also lead. I mean, like have compassion for the impact that this disease is having on people. Not everybody can work from home. Find a way to bring people back into the office safely. For your workers who are working in factories and labs and in environments that it's by the necessity you're coming into contact with each other ... Take care of them. Those, I think, are the things that business leaders, of course, want to take care of their people.

Dave Franchino: I think we've got time just for one more question, and although we've danced around this in a number of areas, I've got to ask this explicitly. Certainly, there's plenty to be concerned about for the future. But what excites you about the future? What new opportunities might exist that this crisis might enable that might not have presented themselves had this crisis not occurred?

Kevin Conroy: Well, for me, I just got off a phone call with a group of physicians and researchers at the Mayo Clinic talking about multi-cancer screening. So instead of organ-by-organ screening, person-by-person screening, because the cumulative impact of ... out of about 600,000 cancer deaths every year in the US, over 400,000 are for cancers that we don't screen for. And if we can detect those cancers early, cumulatively, we can have a much bigger impact. And in addition to the screening that we're already doing, it could be the biggest, most impactful diagnostic test ever developed in human history. And so working on a way to act in a very easy way, either with a blood doctor or a urine sample or a stool sample, actually screen for a breadth of cancers. That is a reality that is going to occur, I believe, in the next five to 10 years in a truly impactful way. And so just being able to work on that coming out of this pandemic is something I'm truly excited about.

Dave Franchino: Kevin, that is tremendously exciting and something I think that would really be game changing for everybody's psyche, and I have no doubt that Exact Sciences will be leading the charge. So, thank you so much.

We've been really excited to welcome Kevin Conroy, the chairman and CEO of Exact Sciences. This is an opportunity for me to do a little bit of a PSA for our listeners. And as Kevin mentioned, colorectal cancer is very preventable. And so, I would urge you to stop by Cologuardtest.com if you've got any questions about the applicability of their product and make sure if you're 45 or older that you're getting yourself screened. So, Kevin, thank you so very much for your time. It's been a great conversation. Some great insights. And I wish you and everybody at Exact Sciences the best of continued success. It's an area of innovation that we all benefit from.

Kevin Conroy: Well, thank you, Dave and Stefanie and Delve, for allowing me the opportunity to do this and keep doing the great work that you're doing. Take care.

Let’s talk about how we can help move your business forward.

Delve Talks: Kevin Conroy, Exact Sciences

Show notes

What he is proud of: How Exact responded to the immediate change

What he thinks will endure:

His advice:

Transcript