Iterative Health is a healthcare company leveraging AI to develop precision medicine tools for gastroenterology, enhance clinical trial efficiency, and address disparities in healthcare access.
Jonathan, could you tell us the story behind your move to the US and the founding of Iterative Health?
The conceptualization of the company ties back to my experiences in healthcare and the realization of disparities in access to quality care. Before moving to the US, I trained as a physician and spent about 14 years in Cambodia, where I established pediatric institutes, neonatal wards, and hospitals. Despite making a difference, I realized the demand for healthcare far outstripped our ability to scale through traditional, linear approaches like apprenticeship and teaching. It became clear that what we were doing was insufficient to meet the larger global demand.
This realization pushed me to look for broader solutions. I moved to the US for graduate school to expand my perspective and explore how technology could help scale healthcare solutions. While studying at MIT and Harvard, I became fascinated with how technology, especially AI, could enable exponential growth in reaching and impacting people. That is where the idea for Iterative Health was born—leveraging technology to address healthcare disparities at scale.
Let’s begin by talking about your AI-powered colonoscopy tool, SKOUT…
Iterative Health has been around since 2017, and SKOUT is one of our foundational AI solutions. The concept came to me while observing algorithms for autonomous vehicles at MIT. These algorithms could intuitively interpret human behavior to make split-second decisions. It struck me that similar technology could be applied in healthcare to enhance physicians’ intuition, which often takes years to develop.
SKOUT specifically helps detect polyps during colonoscopies by highlighting them in real time. Physicians are human, and factors like fatigue or the presence of particularly subtle polyp types can lead to variations in procedure quality. SKOUT addresses this by providing consistent support, ensuring more polyps are detected regardless of the physician’s training or experience. It is like having a second set of expert eyes to help reduce variability and improve patient outcomes.
How effective has SKOUT been?
We conducted one of most notable randomized controlled trials for AI in healthcare, involving over 1,300 patients across five major US centers. We intentionally chose high-performing gastroenterologists to test whether our technology could genuinely enhance their already strong detection rates. The key metric was adenomas per colonoscopy (APC), which measures how often polyps are found during colonoscopies.
For these highly experienced physicians, SKOUT increased the number of adenomas detected per procedure by 27%. This is significant, considering the wide variation in detection rates among clinicians today. Some clinicians might only detect a polyp in 15–25% of cases, while top performers can reach 60% or more. SKOUT helps bridge that gap, supporting more consistent and accurate detection across the board.
What has been the response from physicians since SKOUT’s commercial launch?
Our second advancement of SKOUT was FDA cleared this summer, and the feedback has been phenomenal. Physicians from top institutions have personally reached out to share how SKOUT helped them detect difficult-to-spot polyps they might have otherwise missed. These include flat, sessile serrated polyps that account for ⅓ of colorectal cancers. Community physicians have also praised the technology’s ability to reduce their fatigue and enhance their work.
Imagine performing 10-hour shifts of colonoscopies—it is mentally exhausting. SKOUT provides a layer of support to help reduce physician strain and improve accuracy. It is humbling to see how it’s making a tangible difference, not only in clinical outcomes but also in the daily lives of healthcare providers.
Moving on to your optimization of clinical trials with the help of AI. How does Iterative Health help accelerate trials?
We partner with pharma, biotech, and CROs to accelerate site selection, activation, and exceed trial recruitment goals - ultimately, ushering novel therapies to market faster. Typically, clinical trials involve a single researcher at a large site identifying suitable patients while others handle regulatory procedures. Our technology complements our support services to enable these researchers by better understanding the patient population, funneling in eligible candidates, and ensuring the right patients are selected.
Our operational support at our sites enhance site efficiency, helping implement best practices for trials. By addressing both the technological and logistical aspects, we make trials faster and more effective, ensuring better outcomes for both researchers and patients.
How extensive is your client base, and what strategies are in place to expand it?
We are have a rapidly-growing, elite gastrointestinal (GI) research site network across the US and Europe. We are well on our way with our ambitions to grow our site network into the hundreds. This reach reflects our commitment to partnering with leading institutions to drive innovation in clinical trials.
As for expansion, we focus on strategic growth by collaborating with prominent pharma companies and continually demonstrating the value of our tech-enabled services. Our ability to combine operational excellence with cutting-edge AI ensures that we remain a trusted partner in the clinical research space.
Can you discuss the relevance of partnerships to your work and highlight some of your key collaborators?
Partnerships are critical to our success. We collaborate with most major pharma companies active in the GI space. Notably, Eli Lilly and Johnson & Johnson have invested in Iterative Health, which highlights their confidence in our mission.
Our partnerships with sponsors offer invaluable insights into the pharma industry, helping us refine our products and better understand market needs. Their support is integral to shaping our roadmap and ensuring our solutions align with industry expectations.
How do you envision your work transforming the landscape of clinical trials, and when might this change occur?
We are already making a significant impact by focusing on quality and speed. Our sites, on average, achieve 2x the speed for site start-up and activation compared to industry benchmarks, enabling pharma companies to bring medicines to market more quickly. This efficiency is paired with a dedication to high-quality outcomes, ensuring patient safety and well-executed protocols.
Looking ahead, we are pursuing quantum leaps in trial optimization, such as automating disease burden measurement. This innovation not only improves consistency within trials but also democratizes these insights for standard care. While we’ve seen phenomenal results this year, we anticipate even greater advances in the coming years as sponsors embrace new ways of thinking about clinical research.
