Settled Science and Systems Change

"Go to the settled science," urged Dr. Amanda Williams, Interim Chief Medical Officer at the March of Dimes, addressing a room of healthcare entrepreneurs, researchers, and investors at the recent Health Equity Innovators Summit in San Francisco. Her directive cut to the heart of a persistent challenge in healthcare innovation: the substantial gap between what research proves effective and what reaches patients in practice.

The summit, organized by Coyote Ventures, a fund focused on seed-stage healthcare startups, brought together stakeholders committed to making health outcomes more equitable through evidence-based solutions. Throughout the day, a clear pattern emerged—the most promising innovations weren't necessarily creating new treatments from scratch but building implementation pathways for scientifically validated approaches that have struggled to reach widespread adoption.

This implementation gap isn't unique to healthcare. In transportation, congestion pricing has consistently demonstrated effectiveness in balancing network capacity with demand while improving air quality, yet remains remarkably difficult to implement in American cities. Similarly, yoga has been validated through numerous studies as an effective treatment for trauma recovery, but rarely finds integration into standard medical protocols. The challenge often isn't knowing what works, but creating systems that deliver these solutions equitably.

Innovation at the Implementation Frontier

The entrepreneurs presenting at the summit are tackling this dual challenge: developing evidence-based solutions while navigating the complex realities of healthcare delivery. Their approaches reveal the multifaceted nature of health equity innovation today. Here are some of the highlights:

Maternal Health: Making Doula Care Accessible

Malama is making doula-led maternal care accessible through insurance channels. The efficacy of continuous support before, during, and after pregnancy has been well-documented, but accessibility remains limited, particularly for communities facing the greatest risks. Malama’s Founder & CEO Mika Eddy started the company to reduce anxiety and help new mothers stay healthy after she received a diagnosis of gestational diabetes when she was 28 weeks pregnant and felt alone and unsupported in navigating treatment.

By working within insurance frameworks rather than creating parallel systems, Malama represents a model of innovation that transforms access while acknowledging existing healthcare infrastructure. Their approach involves not just service delivery but also reimbursement and integration with traditional care models.

Using AI to Surface Health Disparities

Alvee has developed an AI-driven platform that helps healthcare providers identify and address health disparities and social determinants at the point of care. Their system integrates with clinical workflows, making equity considerations visible during provider-patient interactions rather than siloed in administrative analytics.

Alvee Founder & CEO Nicole Cook explained that health disparities often become invisible within clinical settings. Data and technology—when used intentionally and responsibly—can surface patterns that might otherwise go unnoticed.

Supporting the Invisible Caregiving Workforce

Magnolia focuses on dignifying and supporting family caregivers, recognizing their critical role in the healthcare ecosystem. Their mission emerged directly from Founder & CEO Liz Tarullo’s lived experiences. Their platform provides resources, training, and community for this essential caregiver workforce that remains largely overlooked in healthcare policy and technology development.

By focusing on caregivers rather than just patients or providers, Magnolia highlights a critical component of health systems that traditional innovation often neglects—the networks of care that extend beyond clinical settings.

Culturally-Tailored Approaches to Chronic Disease

Oben tackles hypertension in black and brown communities with a culturally tailored approach that integrates health coaching, social determinants screening, and monitoring within trusted community spaces. Their model addresses both physiological aspects of cardiovascular health and the contextual factors that shape them.

Founder & CEO Peter Njongwe started Oben after his brother passed away in his sleep of heart failure at 36 years old. Their approach represents a fundamental shift from expecting communities to adapt to standardized healthcare interventions toward developing interventions that reflect community contexts, preferences, and strengths.

Technological Innovation for Maternal Outcomes

Galena Innovations is developing the Hannah Cervical Cup, a medical device aimed at preventing preterm birth. Their technology addresses a specific clinical challenge with a precisely targeted solution.

Founder & CEO Ashley Crafton drew from decades of experience as an obstetric nurse, translating research on the load-bearing characteristics of the cervix into a practical intervention. 

Beyond Technology: Systems Change for Health Equity

A consistent theme throughout the summit was the recognition that technology alone cannot solve health equity challenges. The most promising innovations combine technological tools with deep systems understanding—recognizing that healthcare delivery happens within complex social, economic, and political contexts.

Several speakers emphasized that effective health equity innovation must address not just clinical capabilities but also accessibility, affordability, and cultural relevance.

This perspective aligns with emerging research on implementation science—the examination of strategies to facilitate the adoption and integration of evidence-based practices into standard healthcare procedures. It focuses on overcoming obstacles to successful implementation, such as financial disincentives, disruptions in workflow, cultural resistance, and policy constraints.

The entrepreneurs featured at the summit are actively navigating these barriers, developing solutions that work within and around existing constraints while simultaneously pushing toward more equitable systems. Their approaches demonstrate that health equity requires not just technological innovation but also business model innovation, policy advocacy, and cultural transformation.

Connecting the Dots: Transportation, Finance, Environment, and Health

I was encouraged by the recognition of healthcare's interconnection with other systems throughout the summit. As a data scientist and researcher who has worked across transportation, finance, and natural resources, I’ve studied how our natural, built, and socioeconomic environments are inextricable from health and quality of life. These systems are still siloed today, but the innovators I met at the summit are actively changing that.

The Road Ahead for Health Equity Innovation

As the summit concluded, several clear directions for the future of health equity innovation emerged:

1. Implementation Focus: Effective innovation increasingly centers on implementing established interventions rather than developing entirely new treatments.
   

2. Systems Integration: Solutions that work across systemic boundaries—healthcare, transportation, finance, housing—show particular promise.
   

3. Community-Centered Design: The most compelling innovations start with deep understanding of community needs rather than imposing technological solutions.
   

4. Evidence-Based Approaches: While innovation often implies novelty, the strongest health equity solutions build on robust scientific evidence.
   

5. Policy Engagement: Successful entrepreneurs in this space recognize the need to engage with policy and reimbursement structures to achieve scale.

Coyote Ventures' focus on evidence-based solutions represents an important counterbalance to technology-first approaches that sometimes dominate innovation discourse. By prioritizing scientific validity alongside equity considerations, the fund is helping shape a healthcare innovation ecosystem that values both efficacy and accessibility.

As Dr. Williams' directive to "go to the settled science" reminds us, many solutions to our most pressing health challenges already exist in research literature. The frontier of health equity innovation lies not just in creating new interventions, but in building bridges that connect proven solutions to the communities that need them most.