Catalyst

Five years is not a long time in health care innovations. It takes, on average, 10 to 15 years to bring a new drug to market and three to seven years for new medical devices. And that’s if you have the funding and know what you’re doing. More often than not, medical innovations tumble into the ”valley of death” between bench and bedside, never crossing from initial scientific discovery to commercial product and patient care.

Five years ago, Susan Hiniker, MD, an associate professor of radiation oncology who treats pediatric cancers, didn’t know any of that. But she knew what worked for her patients.

She knew that many young children have a hard time with radiation therapy, which requires them to lie still, alone in a room, for 30 to 45 minutes a day, sometimes five days a week for up to seven weeks. Children who cannot meet the requirements are put under anesthesia, daily, which comes with a laundry list of complications, including neurocognitive and cardiopulmonary side effects, not to mention more needles and more time in the hospital. 

“We started to notice these little kids, 6- and 7-year-olds, coming in for consults, and in the waiting room they are pretty still, calm and cooperative — as long as they’re staring at a tablet,” Hiniker said.

The immobilizing, entrancing power of a glowing screen is familiar to every parent. Hiniker and her colleagues Bill Loo, MD, PhD, a professor of radiation oncology, and Lawrie Skinner, PhD, an assistant professor of radiation oncology, wondered if they could replicate that effect during radiation therapy without interfering with the precisely calibrated radiation beams directed at the patient’s tumors.

“As Stanford Medicine’s flagship accelerator, Catalyst has truly embodied our commitment to nurturing and scaling transformative ideas for real-world clinical impact.”

David Entwistle, president and CEO of Stanford Health Care

They imagined and built a device that projects video onto a small screen positioned just above the patient. The screen is a thin translucent plastic that does not block radiation.

The device, called AVATAR (audio-visual assisted therapeutic ambience in radiotherapy), worked like a charm. Kids as young as 2 willingly lay still day after day to watch their favorite shows. By 2020, the team was using AVATAR routinely at Stanford Medicine Children’s Health.

As word spread, they mailed devices to other cancer centers and were able to conduct a multi-center clinical trial, which found that the device helped 78% of kids aged 3 to 10 forgo anesthesia during radiation therapy, compared with fewer than half without it. Soon, the team was flooded with emails from other institutions asking how to get AVATAR.

“And then it was just three academic people kind of bumbling around. We had no idea how to actually scale anything,” she said, noting that they were still assembling each AVATAR device themselves.

In 2023, they heard about Stanford Medicine Catalyst, a new-ish incubator and accelerator program that funds early-stage health care innovations and provides business, regulatory and investment guidance. With the vision of “invented here, used everywhere,” its aim is to help Stanford innovators improve the lives of patients around the world.

Catalyst sounded like exactly what Hiniker’s team needed.

A mission of collaboration

The Catalyst program launched in the summer of 2020, during the height of the pandemic. Its first project was an inexpensive saliva-based COVID-19 test, which was later picked up and funded by the Gates Foundation.

The idea for Catalyst emerged from Stanford Medicine’s Integrated Strategic Plan, a yearslong process that took stock of the strengths and weaknesses of the various Stanford Medicine entities to create a unified road map for the future. Part of the road map is more accessible support for innovation, particularly in the translation of basic science.

“Stanford has long been synonymous with innovation. Yet even with a history of faculty-led companies and technologies, many faculty felt they lacked the support needed to translate their ideas into impact,” said the Department of Medicine chair, Euan Ashley, MB ChB, DPhil, the Roger and Joelle Burnell Professor in Genomics and Precision Health and Arthur L. Bloomfield Professor in Medicine. Ashley leads Catalyst with Michael Halaas, associate dean and chief operating officer of the School of Medicine, and Kevin Wasserstein, the program’s executive director.

Catalyst was designed as a multiyear program that not only awards generous funding — up to a million dollars per project — but also partners closely with the awardees to bring their health care innovations to patients. Anyone at Stanford University can apply. 

“We envisioned Catalyst as a way to address a vital need for our innovators across Stanford Medicine and the university at large — providing support for early-stage projects with great promise to break new ground in advancing health care delivery,” said David Entwistle, president and CEO of Stanford Health Care. “As Stanford Medicine’s flagship accelerator, Catalyst has truly embodied our commitment to nurturing and scaling transformative ideas for real-world clinical impact.”

Stuart Scott, PhD, a professor of pathology, and Teri Klein, PhD, a professor of biomedical data science, were among the first round of applicants to Catalyst. Scott’s lab had created new genetic tests to predict a patient’s response to medications, and Klein’s lab was developing software to translate such test results into actionable reports.

Together, they hoped to design a streamlined clinical assay system that could quickly generate a complete pharmacogenomics profile of a patient. The profile would predict the likely efficacy and adverse side effects of various therapies for that patient to help physicians prescribe the best option. But Scott and Klein weren’t sure if they had a commercially viable product.

After an intensive, monthslong review of their application and much back and forth, the Catalyst team surprised them with an ambitious proposal.

“We got more from Catalyst than we asked for, in a good way,” Scott said. Catalyst didn’t want to just develop a clinical tool, they wanted to take it through implementation in a large health care system — at Stanford Medicine.

“That’s when everything changed, because it went from really an engineering project to an implementation program,” Scott said. “That was a huge thrill for us, to not only have the resources to build something nobody else in the country was doing but also to get the enthusiasm and momentum to implement it here.”

Today, the Stanford Pharmacogenomics Implementation and Reporting Architecture, or SPIRA, is close to completing a pilot implementation program at Stanford Health Care, where it has received more than 100 requests for pharmacogenomics profiling and already helped some patients switch to more optimal medications. It’s embedded in the electronic health records system and will soon roll out at Lucile Packard Children’s Hospital Stanford.

Not like the others

Everyone has an incubator these days — universities, global corporations and venture capital firms large and small, in just about any industry. 

“When I first heard the idea of Catalyst, I thought, ‘I’ve heard this before with other universities. Why does Stanford need one of these when, in fact, Stanford has already done so much in terms of innovation and producing a lot of translation?’” said Sue Siegel, co-chair of the Stanford School of Medicine’s board of fellows and one of the industry advisers to Catalyst.

Indeed, Catalyst isn’t Stanford’s only incubator, not even the only one in health care. There’s also Stanford Biodesign, which focuses on medical devices and biotechnology, and SPARK, which focuses on translating drug discoveries, and several others. But Catalyst stands out in several ways.

Most obvious, perhaps, is that Catalyst has deeper pockets. Catalyst can fund up to $1 million per project, whereas most incubators rarely grant more than a couple hundred thousand dollars. The team also takes an unusually hands-on approach, beginning with an intense due diligence review for every application. Catalyst team members then work side by side for a year with the innovators whose projects are accepted.

Some projects, such as SPIRA, can be piloted at Stanford Health Care, providing a real-world test bed, while also allowing Stanford to benefit early from these innovations. 

Another consequential feature of Catalyst is its laser focus on making a difference for patients, whether through new drugs, diagnostics and medical devices, or by improving the quality and efficiency of the health care system.

“That was a huge thrill for us, to not only have the resources to build something nobody else in the country was doing but also to get the enthusiasm and momentum to implement it here.”

Stuart Scott, PhD, professor of pathology

“We truly start day one with a translational goal,” said Wasserstein, who was a longtime venture capitalist and entrepreneur before joining Catalyst. “Our goal is not to increment the technology from early to slightly less early. It’s to be a full bridge across the pond, to move a project from Stanford bench to bedside and to attract substantial capital, investment or partnership to enable the innovation to have lasting impact for patients and caregivers around the world.”

“Catalyst has become truly foundational to our mission,” said Lloyd Minor, MD, dean of the School of Medicine and vice president for medical affairs at Stanford University. “We have witnessed the success of this joint effort across the adult hospital, the children’s hospital and the School of Medicine, enabling Stanford Medicine to catalyze these brilliant innovations and their translational impact on health care, first at Stanford, and then around the world.”

While the North Star for most business ventures is a high return on investment or ROI, Catalyst’s leaders measure the success of its projects by what Wasserstein has coined return by impact, or RBI.

As a result, Catalyst follows a slightly different compass than most incubators and can take on a wider range of innovations, including some that don’t fit the typical model. “Catalyst has distinguished itself really nicely, in that many of the ideas that have come out of the university have a lot of impact but potentially wouldn’t receive venture funding,” Siegel said.

Of course, many of Catalyst’s projects attract funding from venture capitalists and industry and spin out successful companies. But there’s room for other ideas, too. 

“Think of it as a democratized incubator for many different types of innovation,” Siegel said.

An idea like AVATAR, for example, would never get funding from a venture capitalist.

A whole new world

By 2023, when Hiniker’s team sent in their application to Catalyst, the program had more than a dozen projects under its belt, ranging from an organ-cooling device to extend kidney transplant longevity to a remote monitoring system for Parkinson’s patients using finger movements.

At the time, Krithika Kumar, PhD, Catalyst’s head of innovation, had recently joined the team to lead the review of projects. Now she heads a team of seven, including business analysts, project managers and a technology architect, who consider each application. The proposals range from studying human organs on the moon to iron-supplementing biscuits.

“We sit around the table and talk about the projects across many, many rounds of review,” Kumar said. “We’re reading them line by line to ensure that we’re doing justice to a project that’s taken time to apply to us.”

They interview the applicants, which have included undergraduates, staff and Nobel laureates. They research relevant markets, business models and competitors, as well as regulatory and reimbursement needs, and potential patient impact. They seek feedback from Catalyst’s directors, deans and leaders throughout Stanford University and consult subject matter experts, including Catalyst’s advisory board of experienced venture capitalists and industry veterans. In the final round, they work with the applicants to establish project milestones that are achievable in 12 months.

“We dig really deep,” Kumar said.

The team tries to provide constructive feedback to every applicant, but to be selected a project must be more than a great idea on paper.

“We support what we call prototype-enabled innovations. There’s some proof of concept, some early data so that if we put money and time and resources towards this, we have a reasonable chance of it making an impact,” Kumar said.

The review process can take five to six months, during which time the Catalyst team meets regularly with applicants to refine their proposals. For many academics who apply, it’s their introduction to a whole new lexicon of ROIs, J-curves (an investment trend with an initial decline followed by significant growth) and flywheel effects (when incremental successes build self-sustaining momentum) that all lead to Sand Hill Road (a street in Silicon Valley known for its concentration of venture capital firms).

“The questions you get are not going to be the same you’d get on a traditional research grant proposal,” Scott said.

Once projects are chosen — four or five out of more than 100 applications are accepted per semiannual cycle — a 12- to 15-month development phase begins. That’s when the Catalyst team rolls up its sleeves to help the project teams achieve the milestones they’ve set, often meeting on a weekly basis.

“There’s some proof of concept, some early data so that if we put money and time and resources towards this, we have a reasonable chance of it making an impact.”

Krithika Kumar, PhD, Catalyst’s head of innovation

That collaborative relationship takes some getting used to for many academics, Wasserstein said. “They’re used to consistently going after grants for their survival. They get grants, they receive their money, they go off and do the work, and then they report back. For us, we emphasize that this engagement is a true partnership. And we’re going to be with you side by side through all the ups and the downs.”

 AVATAR was selected by Catalyst in 2024. “It’s really not like a grant where they’re evaluating you and you’re just showing them what you want to show them,” Hiniker said.

Kumar recalls many afternoons in the Catalyst office helping Hiniker’s team assemble AVATAR devices to ship to sites around the world. Catalyst also provided technical support and built partnerships internationally. In just over a year, it helped deploy AVATAR in more than a dozen countries, including Tanzania, Kenya, Uganda, South Africa and Romania.

They found that AVATAR’s benefits were even more profound in low- to middle-income countries, where patients may not have access to anesthesia. If a child can’t lie still, they forgo potentially life-saving treatment. Recently, a 7-month-old baby in Romania was able to receive abdominal radiotherapy thanks to AVATAR, a device invented at Stanford only a few years ago.

After Catalyst

The Catalyst team knows that a year in their program is only the first leg of a project’s journey and that even a million dollars can only go so far. So they prepare the projects for next steps, whether that’s reporting metrics, making connections with industry leaders or practicing Shark Tank-like pitches to venture capitalists.  

Radiopharm, a Catalyst project to create custom radiopharmaceutical technology that targets a patient’s specific cancer, won a $35 million federal contract from the Advanced Research Projects Agency for Health (ARPA-H). That success was, in part, a result of the mentoring the team received and the progress they made through Catalyst, said Katherine Ferrara, PhD, a professor of radiology, who leads Radiopharm. The ARPA-H contract will allow the team to use computational techniques and artificial intelligence to design molecules that bind to disease-specific protein changes in cells, which could be a way to diagnose cancers that do not yet have screening tests.

Catalyst transformed how Ferrara thought about innovation, collaboration and what was possible for her project. “It’s an opportunity to open up your project and your thinking about the impact you could have on a broader scale,” she said.

Innovation is a discipline

Five years is not a long time in health care innovations. In five years, Catalyst has reviewed more than 500 applications, awarded more than 30 projects, worked with more than 200 Stanford innovators, completed 12 clinical pilots and translated 13 projects into companies, licenses and partnerships that have made a difference in patients’ lives. 

“These results prove that innovation — actively cultivating good ideas — is alive and well at Stanford,” Minor said.

“Now, with Catalyst, innovation isn’t just a buzzword but, frankly, a discipline,” Siegel said. “The structures that Catalyst has brought to bear are so important to disseminate across the board, so everybody understands that innovation is not just idea creation. There’s truly a process, a discipline, and rigor that allows innovation to be translated into actual impact.”

Information about applying to Catalyst is available on the program’s website. A window for applications is open until March 16, 2026.