The people behind healthcare innovation: Interview with James Creeden, co-founder of CGC Genomics

As part of my work, I have the privilege to speak with many inspiring innovators. Although the business community usually focuses on companies, pitches, and valuations — and less on the innovator — I thought it would be interesting to learn a bit more about the people behind healthcare innovation. In this series, I’m sharing some of my conversations with innovators in a condensed format to gain insights into their experience, their opinions, and their learnings.

This latest conversation is with James Creeden MD PhD, co-Founder of Cancer Genomics Consults (CGC), a company focusing on AI-enabled cancer diagnostics.

Tobias: What’s your story, how did you become an innovator in healthcare?

James: I have always been driven by my curiosity and a desire to make a difference ; I left research for medical school, then left medical practice for industry, then 20 years at Roche in Pharma, Diagnostics, here in Switzerland,  in the US,  to China and back. During that time, I had the opportunity to appreciate the  many gaps in our healthcare systems, and wanted to  have a  bigger impact on  cancer patients' lives. During my time at Foundation Medicine, I saw how much brief, expert discussion s with oncologists about their cancer testing results could  improve patient care decisions. After thousands of these discussions, it became apparent that human expertise does not scale well, and scarcity of expertise imposes  significant limitations on healthcare for so many  patients around the world. We see this everywhere in the delays families face when seeking expert medical opinions.

I can’t say it was an easy decision for me to leave a career in industry, but the partnership with Joerg Hoelzing, whose skills and patient-centric vision matched my own, made it possible. 

Together, Joerg and I founded CGC Genomics to bring world-class cancer genomics expertise to labs at scale. We recognized that this expertise builds comfort for oncologists and drives the adoption of better testing, ultimately leading to more treatment options and better outcomes for patients. Our core mission is to leverage AI technology to make cancer genomics expertise available in laboratories around the world. We’ve seen the impact that this expertise can have on cancer care, and it can also help laboratories improve efficiency, optimize costs, and overcome the  widespread shortage of skilled personnel.

Tobias: Where do you see cancer diagnostics moving to in the next ten years in healthcare?

James: Cancer diagnostics continues to become more complex, and at the same time more crucial to identifying the best treatment options for patients. Only 20-30% of patients who should be getting their tumors sequenced according to the guidelines are currently getting that testing, and that innovation is already over a decade old.

Technology has continued to advance and now we are incorporating epigenomics, transcriptomics, proteomics and other complex techniques into cancer testing, while most oncologists are still struggling to keep up.  Already 50% of oncologists admit they lack confidence in interpreting cancer genomics test results, and 80% feel those results are too complex. Add to that the explosion of academic publications and many new drugs that come to market each year, which are positive developments for patients, but the existing healthcare infrastructure and processes are not suited to this kind of rapid innovation cycle. Even the guidelines move very fast, and can be complex to apply to a given patient case. This is where regulatory-grade AI will increasingly play  a critical role, to keep up-to-date on the latest guidelines, therapies and publications and bring them to bear on individual cases to serve oncologists and their patients.

We will see AI augmenting the capabilities of pathologists and oncologists by quickly and accurately identify clinically relevant parts of cancer genomics reports, pathology and the clinical history and summarizing them with accuracy and transparency. The focus will shift towards integrating AI-driven insights with the oncologist's  clinical judgment and comprehensive understanding of the patient to drive adoption of better testing and more personalized treatment options.

Tobias: If you could design a  digital-first health system for a country  from scratch, what would it look like?  

James: A digital-first health system built from the ground up would prioritize secure and interoperable data as its foundation. Every patient would have a comprehensive, portable digital health record accessible to authorized providers across different settings. AI would be integrated at multiple levels, not as a replacement for human clinicians but as a powerful tool to support constantly updated clinical decision-making, streamline workflows, and improve patient access. This would include AI-powered tools for:

• Initial risk assessment and triage, directing patients to the most appropriate level of care.
• Analyzing diagnostic images and genomic data, providing clinicians with rapid and accurate insights.
• Generating patient-specific summaries and discharge instructions, improving communication and adherence.
• Identifying potential drug interactions and optimizing treatment regimens.

Crucially, such a system would place a strong emphasis on ethical considerations. This means embedding robust privacy safeguards to protect sensitive patient information, ensuring transparency and explainability in AI algorithms, and actively working to minimize  bias through diverse and representative training data and ongoing validation. The physician-patient relationship would remain central, with technology serving to enhance communication and provide clinicians with more time for empathetic and personalized care. Regulations would be proactive and flexible, fostering innovation while ensuring patient safety and accountability.

Tobias: In your opinion, what would be meaningful near-term steps towards a digital-first health system?  

James: Meaningful near-term steps would include:

• Continuing to drive adoption of secure and standardized digital infrastructure to enable seamless data exchange between healthcare providers and institutions.
• Developing clear ethical guidelines and practical regulatory frameworks for the use of AI in healthcare, balancing issues of privacy and liability with the need for European-grown solutions. I feel that Europe’s “regulation-first” approach is arguably the main reason we don’t have local tech champions, but it also provides opportunities for local companies.
• Promoting the development and validation of AI tools focused on specific, well-defined clinical problems, with a strong emphasis on transparency and explainability.
• Implementing educational programs for both healthcare professionals and patients to foster digital literacy and build trust in digital health technologies. Clinicians need to understand the potential and limitations of AI, and patients need to be informed about how their data is being used.

Tobias: What do you know now that you wish you had known when you were starting out as an innovator?

James: We did our best to follow the "lean innovators approach", but we took too long to recognize that our solution wasn’t scalable by not launching a series of real experiments with customers. The ones we had appreciated the service, but the pricing model did not fit for many of the potential customers. We could have pivoted to a software design earlier.

Otherwise, one of the most important lessons I've learned is the critical choice of who you work with. I’ve been incredibly fortunate to have the chance to work with my co-founders Joerg and Marcus, to be advised by industry-leading experts and our courageous angel investors who took a chance on us, and most recently Heal Capital, the cornerstone investors in our pre-seed round - they are a dream to work with. The experience and expertise of the people you work with are important, and having great people you can also rely on for advice when you’re really stuck, or just need someone to listen, it makes a huge difference.

Finally, I would add the importance of balancing the passion for innovation with a pragmatic and disciplined approach to business development from day one. Joerg and I are both very disciplined and we adhered to the lean startup approach, and we also relied on this when it came to fundraising. Literally months of pitching, refining, polishing, pitching again, moving from rejection day after day and getting up to do it again, until we found the right fit with Heal Capital. It was all worth it in retrospect, but when you are in the middle of it, all you have is your vision and your discipline to keep moving forward.

About James Creeden

James Creeden MD PhD is a seasoned leader and innovator in healthcare with over 20 years of experience in medical strategy and leadership across Pharma, Diagnostics, and Decision Support industries in the US, Europe, and Asia. He previously served as Chief Medical Officer at Roche Diagnostics and Global Medical Director for Foundation Medicine, a leader in precision oncology. Over several years in this role, he saw the significant increase that expert interpretation can have on adoption of cancer genomics testing, and the impact that better testing can have on cancer care.

For more information, see James Creeden and Cancer Genomics Consults.

Disclaimer: The views and opinions expressed in this article are solely those of the guest contributor.