Think Silicon Valley and Boston are the only undisputed capitals of healthcare innovation? Think again. In this episode of HealthTech Remedy, we explore how Pittsburgh has quietly transformed from an industrial Rust Belt giant into a dominant powerhouse for health tech innovation and venture creation. By tuning in, you'll discover the exact blueprint this region uses to turn cutting-edge academic research into billion-dollar healthcare unicorns like Abridge, giving you a fresh perspective on where to build, scale, or invest next.
We sit down with Mary Beth Navarra-Sirio formerly of UPMC Enterprises and Megan Kahn Shaw of the Pittsburgh Life Sciences Alliance to unpack the city's highly successful approach to incubating startups. They break down the "3C perspective" framework that seamlessly bridges the gap between raw AI talent at institutions like Carnegie Mellon and real-world clinical workflows at massive, integrated health systems. You'll hear why most medical device and healthcare AI companies fail not because of flawed technology, but due to a misunderstood business model - and exactly how Pittsburgh’s full-stack commercial sandbox prevents these fatal missteps. We also reveal the two specific sectors of data-driven health and precision therapeutics that this ecosystem is betting its entire future on, but you'll have to listen to find out why.
If you're an entrepreneur or investor looking for the next massive geographic advantage in health technology, check the show notes for links to the resources and alliances mentioned today. Don't forget to subscribe to HealthTech Remedy and leave us a five-star review so we can continue bringing you the stories behind healthcare's most innovative companies.
Episode Resources:
Introduction to Health Tech Remedy and the Pittsburgh Ecosystem
Dr. Trevor Royce:
Tim, good morning.
Dr. Tim Showalter:
Good morning. Where in the world is Tim Showalter?
Dr. Trevor Royce:
Exactly. Where are you today?
Dr. Tim Showalter:
I'm in San Francisco. It's pretty early West Coast time. The thing that kills me about traveling is when coffee is not available in the lobby. It is just not that hard.
They don't put the coffee out until 7:00 a.m. I'm thinking in a town that hosts a lot of travelers, you always have a few East Coasters staying in the hotel. I guess there's a Starbucks a few blocks away, but it just seems pretty basic.
Dr. Trevor Royce:
For a town and a coast that prides itself on coffee, it is shockingly hard to find a cup of coffee before 7:00 a.m. in San Francisco.
Dr. Tim Showalter:
Oh my god, yeah. So that's my thing. I'm still recovering. Hopefully I can make it through this recording.
Dr. Trevor Royce:
Well, you look great.
Dr. Tim Showalter:
Thank you, that's very generous of you. Thank God it's an audio podcast. Should we hop in?
Dr. Trevor Royce:
Let's do it. Welcome to Health Tech Remedy. This is the show where three physician leaders in health technology break down the stories behind today's most innovative health companies and the ecosystems that build them. I'm Trevor Royce, a radiation oncologist with a background in AI diagnostics and real-world evidence.
Dr. Tim Showalter:
And I'm Tim Showalter, a radiation oncologist and former med device entrepreneur now focused on scaling AI platforms that improve healthcare.
Dr. Trevor Royce:
No Paul today. Nevertheless, we will persist. Today we're going to frame the conversation a little differently. Typically we focus on a single company, but today we're going to focus on an ecosystem.
This is arguably more important. We're going to talk about how an entire region has built a durable engine for healthcare innovation. I'm going to intentionally pause here for a little bit. Listeners, you guys can think or anticipate what region we're about to cover.
Dr. Tim Showalter:
I think people right now are thinking maybe Boston, San Diego, or the Research Triangle. But actually, I think we've got an interesting one for the listeners. It's Pittsburgh.
When you think about Pittsburgh and health technology, obviously the big one that comes to mind is Abridge. But when you look at that Pittsburgh ecosystem, there are even more companies, probably a little bit smaller and less in the news right now than Abridge. With UPMC and with the broader ecosystem there, I think it's a great one to highlight.
The Success Story of Abridge
Dr. Trevor Royce:
Absolutely. Abridge is a great case study for how Pittsburgh is fostering innovation. There are a lot of examples, and we'll touch on many of them throughout the episode today. Later, we're going to interview some of the key leaders in that ecosystem in Pittsburgh.
Pittsburgh is interesting because it's having its moment in the sun. It has such a historically important role in the history of industry in the U.S. It is a classic Rust Belt city that moved on from its industrial heyday, but now it is having this technology renaissance.
A lot of that is fueled by its history of industry, but particularly now in technology. There are some exceptional institutions there doing incredible work in robotics, AI, and the like. Should we start with Abridge?
Dr. Tim Showalter:
Let's do it.
Dr. Trevor Royce:
Abridge was founded in 2018 by a cardiologist, Dr. Shiv Rao. Abridge built an AI platform that converts the patient-clinician conversation into structured clinical documentation and patient-friendly summaries. It was basically ambient AI before everybody knew what ambient AI was.
Dr. Tim Showalter:
The good thing to think through is that it was founded by a clinician responding to a specific clinical problem. It wasn't like the AI was in search of a problem to figure it out. It was a frontline clinician looking at the best available solutions to respond to a health system problem that was suboptimal at the time.
Today, Abridge has raised hundreds of millions of dollars in venture capital and is deployed at a large number of hospitals. They're working with major health systems. It has become one of the defining ambient documentation platforms in the world. A lot of people would assume this juggernaut of an AI company would come from the Bay Area, but no, it's from UPMC.
Dr. Trevor Royce:
The purpose of our episode is to focus more on the Pittsburgh ecosystem and less on Abridge specifically, but I love how Abridge has applied something so common sense in this area of large language models and AI.
There is this clear problem of over-documentation. We all wish we had a tool that automatically transcribed these clinician encounters into the documentation required. Traditionally, that has been solved with a human scribe. You've introduced this third person to help with that workflow, and here's a clear application of AI. It’s reflected in its incredible growth and success.
Structural Advantages of the Pittsburgh Innovation Engine
Dr. Tim Showalter:
Maybe let's point towards why Pittsburgh works so well. When people compare Boston and the Bay Area to Pittsburgh, initially they think the size of the city and the investor pool is what drives innovation. But the scale of the city is not really what determines success.
Pittsburgh has a few structural advantages. You've got a couple of large health systems there. We'll highlight UPMC in this episode, but it's not just a health system. It's vertically integrated with lots of different sites and provider networks. It's got a global reach and insurance capabilities. There's this full-stack commercial sandbox that health technology companies can work within for pilots.
In terms of technical depth, you have Carnegie Mellon University right there. It's been an AI powerhouse for decades. Overall, you have this academic clinical coupling where researchers can work with industry, found startups, and translate things between the clinic and technology companies.
Dr. Trevor Royce:
In the bigger picture, Pennsylvania deserves a shout-out in healthcare broadly. They've done some really innovative healthcare system things. Between UPenn, Geisinger Health, and UPMC, Pennsylvania and particularly Pittsburgh have been leading efforts in full-stack vertical integration in the healthcare system.
Dr. Tim Showalter:
The other part is that you need a discrete focus on innovation and funding. UPMC Enterprises is certainly something we should consider. They have a reputation for being fairly nimble.
It's a dedicated commercialization arm. You need folks connected to healthcare who are thinking about allocating capital the right way. They ensure that when companies are founded, they have a responsible governance and structure so that future investors can support the next stage of the journey. That is a really important contribution to the ecosystem.
Dr. Trevor Royce:
All the pieces are in place in Pittsburgh. You've got your major integrated health system that incorporates the payer component. You've got the technical prowess with academic institutions like Carnegie Mellon. You have the infrastructure and the energy of a large industrial base ready to pounce on innovation.
Dr. Tim Showalter:
We should also give a shout-out to the entity specifically taking charge of building a network and community. We'll feature this in our interview, but the Pittsburgh Life Sciences Alliance is the explicit ecosystem builder in the area.
It's the connective tissue that pulls together founders and operational talent. It provides a venue for educational content for startups and advocates for biotechnology and health technology in general in Pittsburgh. It’s the glue that stitches all these pieces together.
Interview with Mary Beth Navarra-Sirio and Megan Kahn Shaw
Dr. Trevor Royce:
We'll hear firsthand how the pieces come together from our interview. We'll be bringing in Mary Beth Navarra-Sirio, who's the vice president of UPMC Enterprises, and Megan Kahn Shaw, the president and CEO of the Pittsburgh Life Sciences Alliance. These are the key incubators for this type of innovation.
Dr. Tim Showalter:
I'm curious to hear from them how they would describe the recipes for success. We are thinking about having all the pieces together and individual founders moving things forward, but I'm curious what they think helps drive that community and engagement.
Dr. Trevor Royce:
As we prepare for our interview, we mentioned Pittsburgh was having its time in the sun. You can't mention Pittsburgh and healthcare these days without giving a shout-out to the HBO hit series, The Pitt.
It is probably one of the best dramatic translations of life as an emergency medicine physician and the realities of healthcare. It all feeds together. Pittsburgh is crushing it right now. Let's hear from the folks living it. Up on deck, we've got Mary Beth and Megan Kahn Shaw from Pittsburgh.
Dr. Tim Showalter:
Mary Beth, Megan, welcome to Health Tech Remedy. We're thrilled to have you both.
Megan Kahn Shaw:
It's great to be on.
Mary Beth Navarra-Sirio:
Yes, thank you for having us.
Dr. Tim Showalter:
We're excited about this conversation. It's great to have representation both from the Pittsburgh Life Sciences Alliance and UPMC Enterprises. Pittsburgh consistently punches above its weight when it comes to healthcare innovation and startup creation. What's distinct about Pittsburgh's ecosystem compared to other regions? Mary Beth, maybe you could kick us off.
Mary Beth Navarra-Sirio:
Pittsburgh, historically, is a town that has a lot of innovation going back to the Industrial Revolution. If you think about some of our founding fathers, all the way back to Mellon, Carnegie, and Westinghouse, we grew up through the Industrial Revolution and evolved into what you might call "eds and meds."
We have a very innovative education ecosystem and a very strong healthcare innovation ecosystem. We've got great universities like Carnegie Mellon and the University of Pittsburgh. We have the University of Pittsburgh Medical School and world-class hospitals and a health plan here at UPMC to leverage that 360-degree view of healthcare.
Being both innovative and deeply steeped in healthcare contributes significantly to our ability to develop, invest in, and successfully incubate and launch new companies.
The Intersection of Clinical Research and Technical Talent
Dr. Trevor Royce:
Pittsburgh seems to be everywhere right now, from the hit show The Pitt to Abridge and other success stories. Is it the natural talent being incubated in Pittsburgh that is the special sauce? Obviously, there are world-class educational institutions. Can you reflect on that pipeline?
Megan Kahn Shaw:
In Pittsburgh, we talk a lot about being at the intersection of three rivers, but from a health innovation perspective, we're really uniquely at the intersection of three different types of expertise. Starting with the clinical expertise, we have two major integrated health systems in UPMC and Highmark/AHN that are world-renowned in specialties like transplant, oncology, immunology, and cardiology.
Then we've got the research expertise. We have two R1 universities sitting within a mile of each other. Pitt does over a billion dollars a year in life sciences research. It's number six in NIH funding, which most people don't realize. 90% of their R&D dollars are in the life sciences.
Down the street is Carnegie Mellon University, which is the birthplace of AI and number one in programs like computational biology. Having these health systems and the universities together drives this phenomenal talent pool. We have technical expertise in emerging technologies around computational biology, physical AI, biomanufacturing, and digital health.
The way we see major innovation happening here is because of this unique intersection of clinical research and technical talent. We're seeing AI-enabled unicorns springing up across industries. Skild AI, Gecko Robotics, and Abridge are unicorns based in the region.
We have dozens of multinationals locating R&D and manufacturing here. Over 200 human health innovation companies in the region account for 16,000 jobs. We've been able to take this fundamental set of differentiated assets that enable true innovation to move forward.
UPMC Enterprises: Moving Beyond Pilots to Company Building
Dr. Paul Gerrard:
We wanted to ask about a very important entity within the Pittsburgh innovation ecosystem: UPMC Enterprises. It's often cited as a model for how health systems can move beyond pilots and actually build companies. What was the origin story of UPMC Enterprises, and how has it evolved?
Mary Beth Navarra-Sirio:
UPMC Enterprises has been around for quite some time. We were one of the early innovators that stood up an innovation and venture arm. It started out in a much different form than what it is today, but it has evolved into the innovation and venture arm for UPMC.
The value we bring to the companies we work with and the spin-outs developed at UPMC is our "3C perspective." We have capital that we can invest in early-stage companies. If we're going to invest in a company, we're really going to roll up our sleeves and help them to be successful.
We take that customer perspective and pilot early proof of concept. This could be anything from working on clinical outcomes and publishing papers to demonstrating those early outcomes. From a co-development perspective—that third C—we think about how to help the company build things that are important to clinicians and to the healthcare system or health plan being served.
The Value of Clinical Backgrounds in Health Technology
Dr. Tim Showalter:
People in healthcare investment generally have a pretty diverse background. You have a clinical background mixed in with venture creation. How does your clinical background shape how you and your teammates at UPMC Enterprises evaluate ideas and teams?
Mary Beth Navarra-Sirio:
I'm certainly not the only person in Enterprises with a clinical background. We really value being able to bring that lens to the development of solutions that support patients and caregivers. I'm a nurse by background, and I started my career at UPMC in critical care and cardiac transplant.
As a frontline nurse and then as a hospital administrator, I had the opportunity to see what went right and what went wrong as we try and take care of patients. I later joined an early-stage startup in Pittsburgh. Back in those days, people said they couldn't believe I was going to the "dark side" by going to industry.
I feel it helps a lot to have clinicians in companies who understand how to build technology and what is really needed. I joined Automated Healthcare, an early-stage startup that was ultimately bought by McKesson. I developed and launched a product that nurses used at the bedside to improve patient safety.
I've since spent the rest of my career in product management, product development, and recently returned to UPMC Enterprises. For me, it was about the innovation piece and the mission piece of UPMC. I want to think about how we support patients and clinicians in a different, innovative way. It's so needed today given all the stress on the system.
Balancing Stakeholder Engagement and Speed of Innovation
Dr. Trevor Royce:
I have a follow-up for you, Mary Beth, and I’d love to hear Megan's reflections as well. One thing that has struck me is the speed that some of these collaborations move at relative to other large academic medical centers. How do you balance the push and pull between large organizations and quick-moving startups?
Mary Beth Navarra-Sirio:
Part of it is doing your diligence up front. We work to understand where there are unmet needs and how technology or new care models can help meet those needs. We do the risk analysis up front so we understand how the company works.
We evaluate the technology to make sure it ticks all the boxes required to safely deploy it in healthcare. Then we bring our clinicians and operational stakeholders along step-by-step. We are always working shoulder-to-shoulder with executives who are invested in solving the problem.
It’s not perfect; we have our bumps along the way. But bringing the right stakeholders to the table up front to co-create the pilot or implementation is essential. We establish which metrics and milestones they want to see to continue moving forward.
Today there is a huge focus on clinical and financial outcomes. Collecting the right data to support those proof points as you go is important. We maintain regular touchpoints with the company, the clinical stakeholders, and our team to make sure we're in sync.
The Role of the Pittsburgh Life Sciences Alliance
Dr. Paul Gerrard:
Could you tell us a little bit about another important entity, the Pittsburgh Life Sciences Alliance?
Megan Kahn Shaw:
The Pittsburgh Life Sciences Alliance was founded in April of 2024. We're a new organization founded by the University of Pittsburgh, Carnegie Mellon University, Highmark, UPMC, and two major philanthropic institutions: the R.K. Mellon Foundation and the Henry L. Hillman Foundation.
The idea was a real awareness that we have an incredible set of assets in this region, but historically we've done better on the R&D side than on translating research into commercial entities that stay here. We want to raise awareness of the strengths of the Pittsburgh region and connect academia, industry, and health systems.
We help to plant big strategic swings on what this region can do. All of these things have been the focus of the Alliance since our inception.
Addressing the "Say-Do" Problem and Talent Retention
Dr. Tim Showalter:
Megan, it's clear the Alliance and the overall ecosystem are getting a lot of things right. For many regional ecosystems, there can be patterns of failing to deliver. What are other ecosystems getting wrong, and what has Pittsburgh done to avoid this?
Megan Kahn Shaw:
Fundamentally, you can't invent the underlying assets. You have to start from areas of strength, and we are really abundant in clinical research and technical talent. When we've talked with third parties, they often say many places have a "say-do" problem. They say they're going to do a lot and they don't really do anything.
Pittsburgh has a "do-say" problem. We're doing all the things already; we just don't tell our own story. We actually have the pieces here. It's about making it all work together better and greasing the skids on how innovations come out of the universities. We have robust clinical engagement and must make sure we can pull in the capital and talent to grow and keep them.
Dr. Trevor Royce:
Can you talk about the competition for talent and ideas? Classically, we think of health technology as being coastal-centric. In Pittsburgh, how do you retain this talent and these ideas to build companies from the ground up?
Megan Kahn Shaw:
The technical talent is here and it is sticky. We have a lot of multinationals in the region, which is a differentiated area. As our startups grow and are acquired, instead of moving those divisions, the multinationals have stayed and grown them here.
We have Smith & Nephew that acquired Blue Belt Technologies. We have Philips that acquired Respironics. We have Bayer that acquired Medrad. They have chosen to stay and grow because they found that the talent here is much stickier than in other places.
I was talking to one of these multinationals last week. They mentioned they had moved a bunch of jobs to Boston and then turned around and moved them all back to Pittsburgh because there was so much churn in Boston. Pittsburgh is regarded as a great place to raise a family with a high quality of life.
Parallel to that, it's extremely capital-efficient for companies. As VCs become more aware of the premiums they're paying on the coasts, we're seeing more attention from investors wanting to come to this region. They can be capital-efficient without compromising talent.
Navigating Product-Market Fit and Business Model Challenges
Dr. Paul Gerrard:
Mary Beth, UPMC has worked with a number of companies from the early stage to exit. Where do things break down along this journey? Most things that start as exciting ideas don't make it to a big success story.
Mary Beth Navarra-Sirio:
I like to think of UPMC as a really big sandbox. We have 42 hospitals, mostly in Southwestern PA, but also in Maryland and New York. One advantage is that we have large academic centers as well as rural and community hospitals.
Being able to look at it through the lens of different hospital types that companies will need to serve is beneficial. It helps them understand product-market fit and how solutions fit into different types of settings. We start at the earliest stages where we have engaged clinical stakeholders.
We then spread it into different settings as the company scales. Abridge is a good example of that. Shiv Rao was a practicing cardiologist at UPMC and worked for UPMC Enterprises. He had a great idea and was able to build, test, and grow it to a national scale.
It doesn't always work out that way. There are plenty of things that get left on the cutting room floor. But having that big sandbox provides an opportunity to understand what can work. Sometimes it's not the technology that fails; it's the business model.
Who's going to pay for it is a really important question that has to be answered. That problem gets harder given the economics we're facing in healthcare today. Usually, the challenges aren't technical; they are business model challenges that potentially impede our ability to scale innovation.
Future Outlook: Precision Therapeutics and Data-Driven Health
Dr. Tim Showalter:
Looking ahead five or ten years, Megan, what kind of healthcare companies or technologies do you think the Pittsburgh ecosystem is best positioned to lead?
Megan Kahn Shaw:
When we started PLSA, we began with an analysis of where this region stands out. Two areas in particular are exciting. One is next-gen precision therapeutics—the development and manufacturing of biologics.
What's exciting here is both the computer and AI-enabled side of discovery and the biomanufacturing, which brings together physical AI, robotics, and automation. Krystal Biotech is a poster child for this. They are a Pittsburgh company with the first redosable cell and gene therapy to hit the market.
They currently have a $7 billion market cap and received one of the first FDA platform designations in the country. We also have Elevate Bio, a Waltham-based CDMO that is putting its second base camp in Pittsburgh.
The other area is data-driven healthcare. This is the intersection of emerging technologies and healthcare broadly. Abridge is a category-leading ambient listening scribe moving into prior authorization and payer operations. That’s just one of many companies here in the device, wearable, and health tech space. Platforms based on AI that touch physical aspects of human biology will be an area where this region excels.
The Impact of Federal Policy and National Security Focus
Dr. Paul Gerrard:
What policy, capital, or institutional decisions being made today will matter the most for sustaining the ecosystem long-term?
Megan Kahn Shaw:
The landscape has changed on the federal level substantially, but we're seeing positive things. At the federal level, they are taking biotech more seriously. There's a bipartisan Senate commission called the National Security Commission on Emerging Biotechnology focused on biotech as a national security threat.
They are looking at webs of data, cloud labs, and biomanufacturing. These are things we are focused on in the region. ARPA-H has also been a phenomenal new addition at the federal level.
The Pittsburgh region has seen a bunch of awards recently for bioelectronics, robotic mobility, and ocular transplantation. Despite some hiccups, the increased focus on the federal level is really beneficial for the region and for healthcare innovation in general.
Advice for Aspiring Health Tech Entrepreneurs
Dr. Trevor Royce:
A lot of our listeners are young entrepreneurs. Mary Beth, what advice would you give to bright young minds thinking about starting their own ventures?
Mary Beth Navarra-Sirio:
My advice is usually the same. Really understand what the unmet needs are and what problem you're trying to solve before you start developing solutions.
A lot of companies that fail had a technology and then went in search of a problem. Understand where the problems are and how you can bring innovation to solve them. Then go about developing awesome technical solutions that are data-driven to move your company forward.
Dr. Tim Showalter:
This has been an incredibly revealing look at how innovation happens when you get the right institutional resources and ecosystem together. Pittsburgh's story is a powerful reminder that all of these forces need to converge to drive economic and healthcare outcomes. Megan, Mary Beth, thank you both for joining us on Health Tech Remedy.
Megan Kahn Shaw:
Thank you so much for having us.
Mary Beth Navarra-Sirio:
Yes, thank you.
