AFTERWORD

IN THE SUMMER of 2008, I had the great fortune to meet Gary and Mary West, the couple who had built West Communications from the ground up, to one of the leading telecommunication companies in the United States, offering large-scale telemarketing and teleconferencing and handling the majority of 911 calls in the country. Although they had visited San Diego each year for nearly a decade, when they had sold their majority stake of the company in 2006, they became multibillionaires and moved their residence from Omaha, Nebraska, to San Diego.

Gary, whom I met first through a mutual friend, was raised in Iowa, is in his early sixties, and is about as down-to-earth a person as I have ever met. With a full head of graying hair, brown eyes, and a muscular frame of medium stature, he looks like he could be a professional football coach, and his hard-driving aura reflects the extreme work ethic he has exhibited throughout his life. He wanted to do something with the newfound wealth they had acquired, and he was well aware of the out-of-control costs of health care, having run a large company that had faced ever-escalating coverage for its employees. He and Mary are dog lovers, big time San Diego Chargers football fans, and great humanitarians. Mary is a petite, remarkably compassionate, and thoughtful lady who has deep brown eyes and shoulder length brown hair with a flip, exercises religiously on awakening early each morning, and, like Gary, had unlimited capacity to work and grow their company. In 2010 in downtown San Diego, they built a major center for hundreds of indigent seniors, who are fed meals and taught by local students to use computers and the Internet. The Wests’ foundation is dedicated to seniors and to promoting aging in place, avoiding nursing homes or assisted-living situations.

When we first got together to explore a transformative project in health care, we discussed a new medical school that would have departments in genomics and wireless and have an unprecedented commitment to fostering individualized medicine. But institutional governance issues eventually put this initiative on hold.

While our further discussions were incubating, the relationship I had developed with Qualcomm, which had begun in 2007, was going in to high gear. Back in late 2007 the Scripps Translational Science Institute and Qualcomm submitted a major grant to the National Institutes of Health. It called for innovative research to change the future of medicine. That was the year I started at Scripps, and although I knew wireless was the number one industry in San Diego, I hadn’t foreseen convergence with our genomics efforts.

Qualcomm is not only the largest company in San Diego but also the world’s largest producer of chips for the wireless industry. In its twenty-five-year history, it has led to a remarkable proliferation of wireless companies in the region—over six hundred by 2010 and more than a hundred of these working on health-related products. The director of Qualcomm’s health and medical division is Don Jones, who had been driving this new business area for over five years when we first met.

Don is a particularly affable fellow, bald with wireless glasses, the look of a professor, and he is one of the best-known figures in the worldwide mobile health field. He travels the world incessantly, proselytizing to both the tech and the medical worlds on the impact of wireless on the future of health care. He loves to use the phrase “Every Body on the Net” to capture the sense of the Internet of medical things. A few months before submitting our NIH grant in 2007, Don and I got together to see whether we could fold wireless medicine into our application. Acknowledging that it was fairly loose and undeveloped, we nevertheless incorporated a few sections on how we would jointly train physicians to be active in wireless medicine research. When the grant was reviewed in the spring of 2008, the review team was enthusiastic about the unique prospects of leveraging wireless technology for innovative medical applications. That turned out to be an important external peer validation of what we were thinking and a green light to pursue this further.

With the idea of a new medical school put aside, and the nascent but exciting future of wireless medicine spurring us on, the concept of the first dedicated wireless health institute was spawned. I approached Gary and Mary West with this possibility, and they were immediately enthusiastic. The Institute could be a major catalyst in advancing wireless health by performing clinical validation, dealing with regulatory and reimbursement issues, developing sensors and system solutions for unmet medical needs, and confronting the difficulties of adopting new technology into medical practice.

The Wests decided to develop a nonprofit medical research institute to drive this initiative, which was ultimately announced in April 2009 at the International Wireless meeting (CTIA) in Las Vegas.¹ At the plenary session, it was a special delight for me to be able to recognize them; they were given thunderous applause by the 5,000 attendees. The Wests had made a philanthropic investment of $100 million in this cause and opened a beautiful three-story building in January 2010, overlooking the Torrey Pines Golf Course and the Pacific, just a few hundred yards away from our genomics institute.

The overwhelming excitement in the new field of wireless medicine, the San Diego location as the country’s hub of wireless technology, and a new dedicated institute with outstanding resources made it a magnet for attracting top talent. The charismatic Don Casey, a twenty-five-year veteran from Johnson & Johnson with considerable executive experience in pharma, medical devices, e-health, and consumer products, was recruited as the CEO. Also from Johnson & Johnson, and previously from Guidant, a medical device company, and academic cardiology, Dr. Joseph Smith joined as the chief medical and science officer. Joe is a brilliant physician-engineer who trained at Harvard medical school and MIT. Soon thereafter, they were joined by Dr. Mohit Kaushal, a physician who had been leading the mHealth unit at the Federal Communications Commission. The list of all stars included an exceptional group of engineers from academia and industry, along with Shelley Valentine as executive vice president and Nicole Boramanand from Medtronic.

This multidisciplinary team, with expertise in such diverse areas as regulatory science, reimbursement, clinical trials, and economics, coalesced their efforts to get key projects initiated. In the first year of operation, the institute developed a sensor for remote monitoring of high-risk pregnancy, capturing real-time data on uterine contractions and fetal heart rate. The stage has been set for catalyzing wireless innovative solutions to transform the future of medicine.