A Seattle-based nonprofit launched to provide digital health solutions for poorer countries is applying its expertise to help with COVID-19 testing.
Audere is building software for administering rapid result COVID tests that can be integrated into products being developed by U.S. manufacturers that use saliva or nasal swab samples.
“There is a critical need for rapid testing,” said Philip Su, CEO and founder of Audere. People are increasingly realizing that the widespread distribution of a vaccine is still many months away. The availability of accurate, inexpensive tests that provide results in minutes can help control the spread of the virus in the meantime, Su said.
The tests — known generally as rapid diagnostic tests or RDTs — can have high rates of failure, though the basic concept is simple. Imagine a home pregnancy test, as an example. A liquid sample is applied to a testing device, the fluid travels across the testing material and triggers a chemical reaction if a target disease or hormone is present. That reaction is visible as a colored bar or other shape.
In the past 20 years, the tests have grown in popularity, particularly as tools used in low- and middle-income countries for detecting HIV and malaria. They can be administered in clinics by providers with limited medical expertise or by people at home.
The tests “are simple, easy to use, affordable and they’re stable,” said Roger Peck, a senior program officer in diagnostics at PATH, a longstanding global health nonprofit not affiliated with the project. “They’re becoming more and more commonplace, and really accepted by healthcare workers.”
But they’re not fail-proof. Studies show that the tests can give inaccurate results when people take the samples incorrectly, use testing agents wrong, look for results too quickly or misinterpret the result.
Part of Audere’s goal is to reduce those errors. It creates smartphone apps that methodically walk users through sampling and testing. The nonprofit uses machine learning to analyze thousands of photos of test results to automate the interpretation results. A user simply takes a photo of their test and the app reports whether it’s positive or negative.
The 2-year-old organization is also developing reporting tools that allow test results to be shared, without identifying patient information, with public health agencies. That piece is key, Peck said, in order for officials to respond to disease outbreaks in a timely manner.
New York state said this week that it will deploy 400,000 rapid test kits to local health departments and other healthcare providers. The federal government recently purchased 150 million rapid coronavirus tests from Abbott Laboratories, though how those are used and distributed is up for debate. Nevada recently halted the use of two rapid tests at nursing facilities after reports of false-positive results.
Su launched Audere after more than 20 years in the private tech sector, working for Microsoft, Facebook and Oculus. He’d reached a point in his career where he wanted to do something purposeful. He connected with the Bill & Melinda Gates Foundation, advising some of its grantees about their work. He quickly saw the need for software development to meet digital health needs in countries internationally and realized, “this is a space where my past skills could be very useful.”
Audere, a Latin word roughly pronounced “owe-der-ray,” is defined both as “to act boldly” and “be prepared.”
With funding from the foundation, Su tackled his first challenge: creating software to support the Seattle Flu Study, an effort that includes the use of home test kits to research the spread of the flu. Su recruited three others to work with him and in less than five weeks the team had workable software. The flu project, which is led by the Fred Hutchinson Cancer Research Center, Seattle Children’s Hospital and UW Medicine, is in its third year of research and has expanded to include COVID transmission.
With that experience, Su recognized the importance and utility of rapid testing. He has since built a team of 20 full-time employees to work on a variety of digital health projects, including COVID testing.
The nonprofit hopes to support itself by balancing better-paying projects in partnership with healthcare companies in the U.S. and wealthier nations, with free or low-cost initiatives that serve lower- and middle-income countries. The organization receives funding from the Gates Foundation and Justworks, a business software platform, plus a small amount from individual donors. Audere is talking with PATH, USAID’s Global Fund, the Clinton Health Access Initiative (CHAI), and others to find additional partnerships.
It will be difficult to make this financial model work long term, Su said, pointing out that others have struggled to do so.
He opted for nonprofit versus for-profit status to better serve his goal of giving back. Being a nonprofit frees him from squeezing out maximum profits and assures employees that their work will be mission based, Su said. He’s been able to recruit tech veterans who are willing to trade higher salaries and lavish perks for purposeful work.
“We will never have free massages or free lunches. There will never be a ping-pong tables,” Su said. Instead his pitch to employees is this: “Join me to make a difference that you will be proud of.”
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