AIQ Solutions President and CEO Eric Horler recently joined Scott Christiansen on The Root3Pointers Podcast for a conversation about AIQ’s work in late-stage and metastatic cancer care
In the episode, Eric discusses how TRAQinform IQ helps clinicians better understand treatment response across individual tumors, including when tumors in the same patient respond differently to treatment. He also shares perspective on AIQ’s approved CPT code, research partnerships, startup culture, and what’s ahead for the company.
Watch the full conversation below to learn more about how AIQ is advancing AI-enabled technology to provide clinicians with deeper treatment response insights in complex cancer care.
Scott Christiansen:
Eric Horler, your CEO of AIQ Solutions. Welcome to the Root3Pointers Podcast. Thanks for coming on. Eric, you know I work with mostly healthcare businesses and I believe all of them are impacting healthcare and patient lives in amazing ways, but at AIQ, you’re really, really close to seeing the impact on patient lives and I’m kind of jealous of you for that. Tell me about AIQ Solutions and what you’re doing in oncology.
Eric Horler:
Yeah. Well, in fact, through the limited launch we did over the last couple years, we’ve already really seen the impact on patient lives and heard about it from our customers who are the oncologists who are using this technology and getting our reports. Right now we’re just on that verge of commercializing because we just got a billing code approved, so we’re at that inflection point. But again, already seeing what a huge difference this can make for patients. Specifically, we’re in an area that is really not well served by other technologies. We’re helping oncologists better manage treatment of patients that are at late stage or metastatic. Metastatic is just when the disease has started spreading throughout the body and there’s particular issues with the fact that as that disease spreads, it changes. So the patient doesn’t have one disease. They have a lot of different diseases and the oncologist needs a different kind of information to be able to optimize care for that patient in that situation.
We provide these reports to the oncologist. They’re really easy for the oncologist to understand the oncologist makes the decision. These are really complicated patients. The oncologist makes the decision based upon this additional information on how they’re going to optimize therapy. Because these patients unfortunately in many cases are beyond being cured, the oncologist is managing a chronic disease. And we always say our goal is to keep that patient as healthy as possible for as long as possible on the least aggressive treatment possible. And that’s what we’re doing.
Scott Christiansen:
So I’m going to try to simplify this for our billions of podcast fans out there. The way it works today is that that oncologist is making a decision on whether to keep you on a drug, change your drug, stop treatment altogether based on a very small number of lesions that they’re monitoring. These patients have metastatic cancer. There’s a lot more going on. You’re giving them the full picture so that they can really see what’s happening and it’s changing what was the stat in one of your research reports is changing in almost three quarters of instances. It’s influencing or changing how they’re making treatment decisions. That’s a big number.
Eric Horler:
It is.
Scott Christiansen:
Did I get that right?
Eric Horler:
You did. You did. And I’ll build on that.
Scott Christiansen:
It’s way too simple. I know it was too simple.
Eric Horler:
No, I mean, ultimately that is the general idea of what we’re doing. And that one study that you’re referring to that was just presented at the American Society of Clinical Oncology meeting last week in Chicago. It was a prospective study looking at the value that our reports provide in terms of therapeutic management when they’re added to standard of care. And I’m going to touch on that standard of care piece because that’s the other piece that you were hinting at. And we were targeting in that study for 25% of the patients to have a case where our information would change their therapeutic management and the study read out at 65%. 25%
Scott Christiansen:
Is a huge number. 25% is a huge number and yours is 65.
Eric Horler:
And we read out at 65. And we’re repeating that. That particular study was in metastatic melanoma. Our product is being used across a very broad range of cancers, essentially all solid tumors plus lymphoma. And so we’re repeating that exact same study design now in prostate cancer, which is of course one of the highest prevalence cancers out there, but it really speaks to the uniqueness of this information. So going back to what you were saying, the typical standard of care is after the patient is diagnosed with late stage cancer, then the oncologist is going to start monitoring that cancer as they’re treating it and just normal standard of care is they’re going to get radiological imaging for that patient as part of that process of monitoring. Radiologists do phenomenal work. And one of the things that even though we use the raw data from those radiological images, we are doing a very different thing because what they’re doing is extremely valuable.
The radiologist looks at the images, they do their assessment, they write a report that goes to the oncologist. The practical reality though is that when a patient has dozens or even hundreds of different tumors throughout their body, the radiologist is not going to be able to go in and do three-dimensional quantification and measurement for every single one of those. And they’re certainly not going to be able to look at how every single one of those different tumors is changing over time. And that’s what our technology does. So we supplement what the oncologist is getting from the radiologist, which ultimately is looking at sort of a higher level, more diagnostic sort of approach. We supplement that with treatment response information for every single one of those individual sites of disease throughout the patient looking at change over time, that allows the oncologist to treat the patient at a more granular level.
And so I’m going to borrow a quote from a big name prostate cancer researcher from a really big name institution out in New York who was very fond of saying that when you’re treating patients with metastatic cancer, you have to treat every single tumor like a separate patient, which means you need information, rich information about every single one of those metastases. And that’s what we do is we provide that to the oncologist.
Scott Christiansen:
Okay. I’m going to throw a quote back at you from another amazing oncologist researcher, Dr. Glenn Liu, one of your co-founders. I was recently talking to him and something he really said really hit me. He said that I’m looking at the quote, the ability for doctors to optimize when they start, stop, or switch therapy with your technology, your analysis has the potential to extend survival almost as much as developing a whole new drug.
Eric Horler:
Yes. And we believe actually probably more than developing new drug. The reality is some of these drugs are getting FDA approval by extending life for a couple of months or a few months. And what we’re finding is some of the things we can do, and I can go a little more detail about exactly the what here, but you could potentially extend patients’ lives for many months through iterative optimization every few months, new information looking at how the cancer’s changing. So we are going to continue to generate that data as we continue to grow, we continue to get more usage. But I really feel that we’re ultimately going to be able to show that we can do even better than a new drug in terms of extending survival.
Scott Christiansen:
Well, the research you partners have, the research partners that you already have that you’ve published extensive research on, you’re working with some of the top research institutes in the world already. Go ahead and this is your chance to brag about some of the organizations you’re working with.
Eric Horler:
Yeah, absolutely. I mean, absolutely. I mean, as much as anything, I’m grateful for the excitement we’ve gotten from some of these researchers that are on the cutting edge. But we’ve got researchers at places like Memorial Sloan Kettering, Weill Cornell, MD Anderson. Shout out to Carbone Cancer Center here at the University of Wisconsin, which it may not be quite as well known of a name but should be. It’s a phenomenal research institution. So a lot of people who are using it there. But then other places, Baptist Health, got to give a big shout out to Baptist Health. There’s going to be some really exciting data and an oral presentation at the Radiation Oncology Society meeting coming up in the fall that’s coming out of a research study run at Baptist Health. So want to give them a shout out to … But also the oncologists who just treat patients and the feedback we’re getting from them and the-
Scott Christiansen:
The workflow. Yeah.
Eric Horler:
Exactly. I mean, workflow and things like how do we optimize? So we are still a young company. We are still looking at how do we make this easier for the clinician to use? How do we make this easier for the institution? But a lot of times it’s that feedback from those real world in the trenches oncologists so well at places that may not be household names for research that also helps us move the needle. But yeah, a lot of really amazing people that are building this into studies and then incorporating it into their care of patients.
Scott Christiansen:
You mentioned it at the very top, but you skated over it and we need to spend some time on it. You are in a very exclusive group of people who have achieved a CPT code for your type of technology. Talk about how you did it, how you were focused on this as your strategy from the beginning and why it’s so important.
Eric Horler:
Yes. I mean, in terms of exclusivity, as of December, the last time that I saw the FDA put out numbers, there were about 1,400 software medical devices with artificial intelligence components that the FDA had approved or cleared. Out of that 1,400 number, less than 30 have secured CPT codes for the service that covers the use of that technology. So it’s definitely a small category. It is a growing category. I’m happy to say we’re not number one or number two. It’s really great to be number 20 something because there’s a lot of great companies that have blazed some trails and started to establish the process by which the AMA looks at these relative to providing a billing code, which is the CPT code by the way by which CMS or other payers look at ultimately paying on these codes. But we knew from the inception of the company that for something this novel,
The brutal reality of healthcare in this country is there has to be a way for our customer, the hospital to get reimbursed for the use of the technology. And that pathway is getting a code that is a new code that is something that the hospital can bill that’s not bundled or packaged into an existing reimbursement, in which case it’s a pure expense for the hospital. We knew very, very early on that we had to have a reimbursement strategy. And so we hired a world-class reimbursement consultant to help us before I even raised our seed financing. At that point in time, I was the only actual employee of this enterprise. We had a little bit of revenue coming in from a partnership with a pharmaceutical company and we started off working with this reimbursement consultant, Galileo Consulting at that point and we built a strategy before we had a product about what that reimbursement pathway looked like, what kind of evidence we’d need to generate.
And ultimately it took from the beginning of 2019 when we first engaged with that with Galileo Consulting to February of 2026 to get to that approved CPT code.
Scott Christiansen:
Well, I mean, it sounds like a long time, but in healthcare, that’s a sprint. It’s incredible. I also want to go back to, you spent a lot of your career in the biggest of the bigs GE Baxter in these enormous healthcare organizations and then you end up, boom, you’re the only employee at this startup and you built a team, you built a great culture, but talk to me about how you made that decision to go from this giant organizational structure to the tip of the spear.
Eric Horler:
It really comes down to risk taking and your personal interest and stomach for taking risk in a business environment. I was general manager of a large global business at GE when I left and fundamentally when you are steering a ship that big, every decision you’re looking at, every risk you’re looking at taking requires a tremendous amount of internal socialization and ultimately buy-in and approval. And so you’re very, very slow to be able to react to things. I frequently tell my team that as an early stage startup, if we don’t take risks, we will fail. If we do take risks, we may fail, but if we don’t take risks, we will fail. And so we’ve built a culture that is built around learning. So it’s built around trying things, taking risks, having a really, really fast iteration cycle on trying something, learning from it, course correcting.
The big companies often talk about encouraging risk taking or encouraging people to make mistakes, but then they can’t actually walk the walk. And we really do. When people make a mistake and we learn from it, we celebrate it because if you’re not trying things, if you’re not taking risks, you’re not making mistakes, you’re not learning. And the faster we can do that, the faster we can actually do something new and innovative. And so getting back to the me, why I do this, it’s really the ability to be in that environment, to be surrounded by people who like to come up with new ideas, like to try things or not scared to make a mistake and be able to get into this rapid iteration. It’s exciting. It’s a rollercoaster. Your ups and your downs happen sometimes on the same day. So you have to be able to handle that, but just that the ability to be in that fast paced risk-taking sort of environment is very exciting for me.
And honestly, it’d be very hard for me to imagine going back to a big corporate structure decision-making process.
Scott Christiansen:
Yeah. I mean, I love the middle market, startups in the middle market. It’s where innovation happens, it’s where change happens and you are one degree of separation away from the impact. You’re not 50 degrees of separation away from it. You’re there and that’s what I love about it.
Eric Horler:
Yeah. I mean, there is no question that there are things that we are trying that I could never have gotten buy-in to do at GE or Baxter. Sure. It absolutely is swimming upstream and the fact that sometimes honestly, sometimes we try things because we don’t know any better and if we had a huge team of lawyers to tell us that we shouldn’t, maybe we wouldn’t, but because we don’t know any better, we try them and you know what? Some of them work.
Scott Christiansen:
That is actually the perfect segue into my Root3Pointers quiz. And it’s all about you have a background in biotech and chemical engineering. Is that correct?
Eric Horler:
That is correct. Yes.
Scott Christiansen:
That is correct. So a lot of the biggest advancements in those fields were accidents. So this is your quiz on the greatest and wackiest moments in chemical engineering and biotechnology. So get excited. We’ll probably put some exciting music under this. People are going to love it. So first question, which everyday miracle product was discovered because a chemist accidentally left a gas cylinder in a cold storage room? And I can give you some choices.
Eric Horler:
Yeah, give me some choices.
Scott Christiansen:
Which everyday miracle product was discovered because a chemist accidentally left a gas cylinder in a cold storage room? Is it A: Nylon, B: Teflon, C: Kevlar, or D: Plexiglass?
Eric Horler:
I’m going to go with Plexiglass.
Scott Christiansen:
It is Teflon.
Eric Horler:
Teflon. Okay.
Scott Christiansen:
And I don’t know if I would call it an everyday product.
Eric Horler:
It was an everyday product for a while. When we were growing up, everyone was using Teflon pans and the world kind of moved away from it a little bit. So it might not be quite as everyday, more everyday than Kevlar, I would say.
Scott Christiansen:
Yes. So this is the lore is that he opened up the cylinder and said, “Huh, that’s weird.” And that’s his quote on making history and inventing. If you ever accidentally discover something, have a better line in your head. All right, this is still on chemical engineering. Which chemical engineer’s discovery caused department store riots when it was first released? Sorry, A: Nylon, B: Polyester, C: Polycarbonate, or D: Polypropylene.
Eric Horler:
I’ve got to go with nylon on that.
Scott Christiansen:
Yeah, it was the nylons. It was in the 50s and everybody lost their minds with nylons. Okay. We’re going into the world of fiction. Which famous fictional character is a former chemical engineer? I’ll give you a second if you want to pull it up, but do you know?
Eric Horler:
I do not know.
Scott Christiansen:
Okay. It’s a pretty broad question. So Tony Stark from The Avengers, Walter White from Breaking Bad, or Dr. Emmett Brown from Back to the Future.
Eric Horler:
I’m going to go with Tony Stark from The Avengers. It’s been a long time since I’ve seen that movie, but that’s what I’m going to go with.
Scott Christiansen:
I mean, he invented everything, so I’m guessing he had every title, so I’ll say that’s probably true, but Walter White was the…
Eric Horler:
I honestly felt like that was too obvious, to be honest with you. I kind of talked myself out of that answer.
Scott Christiansen:
Yeah. Well, there’s probably a theory on doing trivia that we could apply there, go with your first answer, but I don’t know. There’s no rhyme or reason to this quiz and no one is supposed to know any of this information. Okay.
Eric Horler:
You got to know, it’s been a long time since I was a chemical engineer.
Scott Christiansen:
I’ve gone through- We’re switching over to biotechnology now. So which biotech breakthrough was discovered because a scientist forgot to clean his Petri dish and that’s CRISPR, penicillin, PCR, or insulin purification because he forgot to clean his Petri dish.
Eric Horler:
Petri dish. I’m going with penicillin.
Scott Christiansen:
That is correct. That is correct. Okay, this is the last one. The first nuclear medicine image was created how? Photography, hand plotting, or exposing film directly to a radio tracer.
Eric Horler:
Yeah. The last one exposing film directly to a radio tracer.
Scott Christiansen:
It was a hand plotted radiation count. Oh, interesting. Okay. Yeah, that was the first nuclear medicine image. So before we go, what’s next for you and AIQ?
Eric Horler:
Commercialization. So the catch 22 in this world is when you ultimately are in a position where you can have your product reimbursed, now you can make the economics work for everybody, from the insurance company all the way down to the patient. But until you get to that point because of the way the system works, you can’t start charging for your product. And so you can get your product out there, you can get people using it, you can learn how to get it into hospitals, you can generate information about how clinically useful it is. You can do all of those things, which we’ve done. But until there is a way for our customers to unite the entire economic value chain, again, for everybody’s benefit from the payer onto the patient, we can’t sell. We are now at that inflection point. And so we are actively raising money.
If anyone listening to this podcast is interested in learning more, they should ping me.
Scott Christiansen:
I’ll put a donate button on the podcast.
Eric Horler:
We’re not allowed to crowdsource. That came up at a conference I was at this week. Crowdsourcing is not what we’re looking for. We’re looking for venture capital.
Scott Christiansen:
Sure. Well, you’re ready for it.
Eric Horler:
We are. And so we’re raising the money so we can go build that commercialization team. We can take all of these users who love it and actually turn them into true customers. That’s exciting. Having said that, we still have a whole pipeline of R&D. We’ve got a Gen 2 product. We’ve got a Gen 3 product that’s in the pipeline. We’ve got a whole pipeline of engineering work that we want to do that’s all around making the machine run smoother with less friction. So there’s a lot of other stuff that we want to do that’ll happen in parallel. But the really exciting thing is, and I guess I’ll leave it with this thought, when you work with these researchers, researchers are really good at doing the science, innovating, publishing, but I really strongly believe the only way to change the world with innovation is to commercialize.
It’s the only way you’re going to change the world. So I want to come back in a few years on this podcast and the title can be How AIQ Changed the World.
Scott Christiansen:
I think that’s a great goal. I’ll send you an invite right now for two years out. It’ll be perfect.
Eric Horler:
Excellent.
Scott Christiansen:
The whole audience here will be waiting for it. Eric Horler, CEO, AIQ Solutions. Thank you so much for being on.
Eric Horler:
Oh, thanks for giving me the opportunity. This was fun.
Scott Christiansen:
All right. Take care.