Tim Fox worked at Emory University as an Associate Professor & Director of Medical Physics from 1994 to 2014. In 2005 he and three of his Emory colleagues created the Emory start-up, Velocity Medical Solutions, which built and sold a multimodal medical imaging software. Velocity was later acquired by Varian Medical Systems and in 2014, Fox left Emory to accept a full-time position as the Associate Vice President of Imaging Informatics at Varian. Fox grew up playing baseball and now applies that same passion and drive to his entrepreneurial endeavors Just like the famous line from the baseball movie, Field of Dreams, Fox is living proof that “If you build it, they will come.”
What drew you to radiation oncology?
It was the combination of technology and medicine. It was the one area back in the 1990s where you saw computers being applied to the diagnoses and treatment of patients.
How did you move to software and cancer imaging informatics?
I always loved computers and started to become interested in them when I was 15 years old. When I got to college I majored in physics and minored in mathematics and computer science. I wanted to focus on the computational and software side of physics. I later found medical imaging and software projects in nuclear medicine and radiation therapy.
Then when I came to Emory I used my computer skills to build software programs like the radiosurgery treatment planning system, a computer oriented optimization program, and advanced molecular imaging software. Back in the 90s, computers were still evolving, so you often had to build these tools yourself, which is what I did. Over my career, I developed a philosophy about identifying problems and building products and solutions to fix those problems. Being part of a cancer care team in the clinic and immersing myself in daily challenges allowed me to observe an inefficiency in existing cancer imaging techniques and inspired me to build a solution to that problem.
Did you always know that you wanted to apply your computer skills in a medical setting?
No–my senior year as an undergraduate, I participated in a summer internship program at Oak Ridge National Labs in Tennessee where I was able to study nuclear physics doing particle simulations with computers. Working with PhD scientist, I learned about the field of medical physics, and I applied to a graduate research assistantship at Georgia Tech in 1990 to further pursue this field.
Who has influenced you in your career the most and why?
I think it would have to be my parents. They always said “Go get as much education as you can. No matter what you want to do, go and get all the education you can in that area.” They instilled in me the desire to attain the highest level of education possible. I always knew that I would do an undergraduate degree and then of course, graduate school.
Describe the development process for your software.
In 2005, we started Velocity Medical Solutions and approached some large companies with the idea of using PET imaging to improve cancer treatment planning. But, none of them were interested in working with us on solving the problem. Eventually, we approached the Georgia Research Alliance (GRA) and got a commercialization Phase 1 grant and decided to build the software ourselves, knowing that at the very least it could improve research and clinical care at Emory.
Our small team set up a series of smaller milestones. The first milestone was to build a solution to using PET imaging in treatment planning and create a business plan. The next milestone was to see if we could receive Federal Drug Administration (FDA) clearance, which would allow it to be sold on the market. This was probably the biggest hurdle we had to overcome. We got our first 510k FDA clearance in 2007 and our second in 2008. Our next milestone was to see if we could get a cancer center to purchase our software. We hired a team and started to commercialize our platform.
Your technology was licensed to an Emory start-up – what was that experience like?
There were both upsides and downsides to building our company; academics and industry do not always mix well, especially in the field of health care.
We did not think about everything at once, but set small milestones using the GRA Phase 1, 2 and 3 grant program. GRA was a game changer and a big supporter through the whole process. Without them we would have never made it. It allowed us, as university faculty members, to take the ideas and intellectual property we had and to actually build the technology. They helped us make the leap from having this great idea to having an actual technology.
A challenge that we encountered as faculty members at academic institutions was managing conflicts of interest between the university and entrepreneurial endeavors. In the past, the word “commercialization” was typically viewed as a problem. Today, the National Cancer Institute (NC) sponsors Academic-Industry Partnership grants since we realize that it does take a partnership to move ideas from the clinic to patients. Being able to manage the conflicts of interest with the GRA Phase 1, 2 and 3 program presented obstacles along the way, but we worked through them with Emory and OTT.
Aside from the challenges, I love that this has been an opportunity for me to combine life sciences, computer technology, and medical healthcare. This startup and my transition to working for Varian Medical Systems has allowed me to continue to work on products in the field of cancer therapy. I think this type of innovation would be impossible without the growing relationship between academia and industry, which supports and expedites the innovative process.
What made you decide to follow your technology into the corporate world and how has that transition been?
After working at Emory for 20 years, I decided to leave to work for Varian because I recognized the need for partnerships between academics and industry. I knew that I could understand both sides of this partnership and hopefully facilitate and nurture it.
Additionally, I had worked with Varian over the years through Emory. Therefore, I was familiar with Varian’s team and technology development. I saw this job change as a new opportunity and new challenge that I wanted to explore. I definitely miss academic medicine, but I wanted to focus solely on building software.
What have you found most satisfying in seeing your work reach the marketplace and help patients?
It’s wonderful to go in and see people using the software. It is even better when users show us patient cases where they have used the software in ways that we did not anticipate. We built Velocity to address one initial problem, but people are applying it to other problems, which helps us figure out how to further improve and expand our software. From working in industry, I have come to appreciate that we provide physicians with tools and they get to use them in a multitude ways to help their patients.
Where do you see imaging in the oncology field going?
We like to say “seeing a patient is important, but seeing inside a patient is more important.” Medical imaging allows you to see inside the patient in a clear way, whether it is anatomical imaging like computed tomography (CT), which shows structural detail, or more advanced imaging like PET, which shows you molecular metabolic activity. It gives a more defined picture of a patient’s condition.
In September 2016, the NCI Blue Ribbon Panel announced their ten broad Cancer Moonshots. One of those 10 items was to develop new cancer technologies and treatments using new radiological imaging and deriving data from that imaging. That is exactly what we are doing, and we are partnering with academic centers around the nation. In the future, as new types of medical imaging are developed our software will be able to incorporate them and provide more comprehensive imaging package that will improve patient care.
Tell me something about yourself that many people do not know.
I think many people do not know that I played baseball through college and considered being a college baseball coach instead of a physicist. I did get to coach my son’s little league team though, which I enjoyed.
What advice would you give to your younger self?
“Work smart.” It is not just about working hard but being smart about what you are doing. Find what you like to do, but also find where you can add value to a company or a team.
I think it’s important to find a career path and then make it what you want it to be. Find ways to incorporate your passion into your occupation. For me it has been to use my love of teamwork and competitive drive, which I got from my passion for baseball, and use those skills in my chosen profession, and it has worked well.