James Hamet (CEO and Co-Founder of Vistim Labs)

Can you explain your job to a five-year-old? 

It's going to depend: Is it my job as a human? Or is it my job as CEO of Vista? You know, I think that my job as a human is make it easier for patients, easier for people who are sick to find treatments, find help that is effective. I think that that's what matters the most to me. What I know that matters significantly to me is I like to make people's lives easier.

And if you are somebody who is sick, who is suffering from some type of disease, then I would like to improve your quality of life. Whether that means that, you know, you understand why you're sick or whether that means you have access to therapies. And also if that means, you know, maybe just having an easier time with the disease, maybe there's another type of intervention or support that you need. We can identify it and make sure that you get the help that allows you to live a meaningful life.

I started my journey mostly in the medical space with my company Neurable, where we were helping people who were paralyzed control things with their mind. And that always remains a top priority for me with Vista Labs. One of the things I learned while building that previous company was that a lot of these patients who are disabled and who have some level of paralysis, it's mostly—in my opinion—because they didn't have effective diagnostics, which stood in the way of effective therapy. And so, if we can unblock that diagnostic challenge, then maybe we don't need to see as many patients in wheelchairs. 

So, my goal with Vistim Labs is really to share the word, let people know what we're doing, and make sure that we reach the clinics who are serving these patients so that we can help those clinics, help them serve and treat patients.

What excites you most about your job?

So for me, what excites me the most is the problem that we're solving. And I think that any, you know, competent CEO—someone who's been in the space before—that's the answer that they'll give as well. If you love your problem, then you know that there are lots of ways to solve it, and it doesn't just have to be the way that you've come up with. 

Now, that said, the way that we've come up with is extremely, extremely exciting. So, the patients of today, if you have dementia, if you have a cognitive challenge, the diagnostics of today will misdiagnose or miss 65% of these patients. So you may see your doctor, and the doctor will say, “Well, I don't know what's wrong. You seem healthy.” That's a very common outcome of these medical appointments.

And in order to get more advanced care, You would need to either pay yourself for something like a PET scan, you would need to be willing to do a spinal tap, which is uncomfortable. There is actually a very long list of procedures that will be done with a patient, and you need to go through this list in order to figure out what the patient has, because there are over a hundred different types of dementia today—105 to be specific.

So there is no one test to tell you which disease you have. Which is why what we've done is amazing. We have a technology that can measure brain damage and can determine which disease of those 105 you have. 

Now, I can't make the claim that we can do that today, specifically. It's not a diagnostic on its own, but what we can do is we know that there's that long list of procedures and we can actually provide an estimate of how the patient will score on all those procedures. So, if a patient were to come in and, you know, “Okay, a PET scan could be interesting, a spinal tap could be interesting.” You don't have enough information yet to figure out for sure which test is the right one.

With our test, we can provide those estimates and you can see in advance what those results would look like. So you can know, okay, the PET scan's gonna be inconclusive. There's no point to do an inconclusive test. You want something that confirms the disease and so we can point the clinician in the right direction

Maybe the patient looks healthy, but an MRI would reveal that, actually, there's some level of damage in some specific area of the brain. Well, we can show that. We can say, yes, we've detected some anomalies. The anomalies correlate with an MRI. And the MRI we anticipate to be abnormal. And so that way, the physician can now say, “Okay. MRI is a good starting point for this patient.” 

Which trend will change the future of medicine? 

I think that one trend that I like—and it's largely being driven by the Michael J. Fox Foundation—is towards investing more in diagnostics. It's amazing to me that there is so much money being poured into therapeutics when we do not have sufficient diagnostics today to even know if a therapy is successful.

Now, if your physician gave you a treatment and you took that treatment, you would not know if it's working. Plain and simple, you would not know if it's working. You could maybe say, “Oh yeah, I remember things more often. I feel healthier. I feel better.” But that is the extent of it.

And when you're talking about these neurocognitive challenges, these neurological disorders, it's hard to say that you feel better. So in, in many cases, the damage is permanent.

Looking back, which trends have you missed or underestimated? 

That's difficult to say. I'm very, I'm very in the present right now. So, the trends that I'm missing, I guess I'm missing them right now. I don't see them. Many trends that I've anticipated have, you know, come to light. I expected digital therapies, digital diagnostics to become more prevalent.

And Vistim, I consider it to be a form of digital diagnostic. 

I guess a trend that I think is still rising but that's still on the smaller side would be the use of AI in anticipating disease before people have the disease. That’s the whole purpose behind genomics and trying to understand someone's DNA and, you know, what might lead to a risky scenario.

It's very well understood in the insurance field. Actually,that's probably what I would say is the biggest overlooked situation. We have these calculators in insurance where we know when someone's gonna die. And I don't fully understand how—you know, I don't work in insurance—but they have these very accurate models with limited information to know when someone will die and they build insurance policies off of these.

And one of the things that is very unfortunate is that that information doesn't get sent to the healthcare system. So you'll have insurance companies that do these sophisticated models, and they'll know when someone's gonna die, but the clinician working with that patient doesn't have access to that information.

So for me, I think that there is going to be a trend towards maybe bringing that modeling to the clinic. I think that there are some political and largely business obstacles to that. But I think that innovation will drive for change there. Most likely it'll come from machine learning experts and AI experts who are already in the insurance field deciding to quit their jobs and spin up a company and bring these models to the rest of us.

Where would you put a million dollars? 

Well, you know, obviously I think that I'm putting my time in the right places. I make investments all the time as well. So, if I had a million dollars drop out of the sky right now and, and based on, my current projects and what I'm working on… I think we're going to have some treatments for Parkinson's. So I would invest in some Parkinson's therapeutics and diagnostic companies. There's a little caveat, which is that I'm planning to add Parkinson's to our portfolio, so we would become a Parkinson's diagnostic. But yeah, I mean, I think that that Parkinson's is a disease area that's incredibly relevant. 

Another one is, you know, there are some new treatments for pain management—new solutions for pain management—that I think could also go to market quite quickly. So, those would be my top areas of interest. 

I'd love to hear a little bit more about where specifically in, in pain management you're seeing some of that opportunity.

Well, like I said, it's not my focus. I'm not somebody who spends too much time looking outside my fields when it's not necessary. But I know that there are some new ways to measure pain and pain thresholds. There are new types of pharmaceutical and non-pharmaceutical pain interventions. There is, you know, a combination of hypnotherapy with psychedelics that could be powerful. It has shown success in PTSD and PTSD has been linked to pain, so, you know, an opportunity to translate some of what's happening with PTSD towards the pain management market.

I mean, but if you're advising someone who's just getting into this and you're, wondering, “Hey, what's the space that's the most valuable?” My mind instantly goes to cardiovascular. However, you know, one of the reasons I say that answer last is because cardiovascular is overinvested in at this point. So, it's a very competitive marketplace. We already have a very large number of solutions that are very effective. So, it is difficult if you were to build a startup in that space, because your startup, you know, in order to convince a customer to buy your product, you should be 10 times better than the competition.

It’s hard, especially with, as we’ve recently covered in MTP, is that where there’s not a lot of solutions is the pediatric cardiovascular space, but there, it’s really challenging to work with kids, especially when it comes to devices.

Well in that vein, you know, there's a big opportunity for pediatric neuro diagnostics. Kids have a lot of these neurological disorders. Sometimes they're born that way.

And, you know, you can do a lot to change the trajectory of someone's life if you have enough information. Unfortunately, you know, kids, they don't have salaries. They don't make money. They don't always have the best healthcare policies in place. So it's not a big market. I wish that there was a stronger government incentive for prioritizing pediatric care.

What's the best advice you've ever received? 

I've received a lot of really good advice. I mean, I'm a people person, so my favorite advice is to care about your people first. Normally, as an entrepreneur, I would say, you know, customers are your number one priority, but in my opinion, it's the team. And I know that that's not a minority opinion. I know that investors, that's what they look for too.

If you have the right team in place, you will find the customers. You will make the customers happy. On the flip side, if you had a terrible team and you had interested customers, in many cases that could be seen as a good thing, right? Money solves a lot of problems. I've heard a lot of people say that money solves all problems, but don't forget that who you work with is also your experience of work. And if you are working with people who you love to work with and they inspire you, they motivate you, you will do better yourself. 

If you are working with people who, you know, you don't get along with, you get into fights with, there's trust issues in that type of environment, it would be very difficult to do quality work. You could take money from customers, but let's not forget that customers also need to be cared for.

And I know plenty of businesses that have sold pre-orders or sold products that were weren't effective. You don't recover from that. You may make a lot of money upfront and you know, in some cases you may have like a WeWork type success, but to me that's not a success because then you're just a bad actor in the field and people don't trust you anymore. So yeah, those are things to pay attention to. 

For me, it's about building my team first. So focus on who you surround yourself with.