Topography Health landed $21.5 million in Series A funding from Bain Capital Ventures and Andreessen Horowitz, Axios has learned exclusively.

• The New York and Los Angeles-based startup aims to carve a niche in the clinical trials landscape by engaging community physicians with a plug-and-play trials platform.

Why it matters: The clinical trials landscape is dominated by a few expensive and slow-moving studies run largely by elite, hard-to-access academic medical centers.

• Studies tend to over-enroll affluent white patients, meaning their findings aren’t relevant to the wider population.
• Topography Health is focused on community physicians who have historically been overlooked by the traditional drug testing process.

What's happening: Trial sponsors are increasingly looking to recruit patient populations that include more people of color, people with lower incomes, and people with mobility issues.

• One way to address this: Conduct trials remotely, such as through video visits, in-home testing, and data collection.
• Remote trials have their own issues, including clunky procedures and potentially invalid data.
• Instead of doing trials remotely, Topography is betting on community physicians to recommend and help personalize research for their patients.
• “We see the physician as the lynchpin,” Topography cofounder Alexander Saint-Amand tells Axios. “We can identify physicians in communities that traditionally haven't had access to research, and our job is to build trust with the physician.”

Details: The company just closed a $21.5 million Series A funding round led by Bain with participation from existing investor Andreessen Horowitz, which led Topography’s initial $6M seed round in 2020. 

• The most recent financing marks the company’s formal public launch after 18 months of work. 
• Other investors include One Medical founder Tom Lee, former Flatiron Health chief medical officer Bobby Green, and Zillow co-founder Spencer Rascoff.

The intrigue: Clinicians are busier than ever (we hear there’s some kind of virus going around), so Topography faces a fight for their time and trust.

• "The health care system is under tremendous strain, so I do question the timing," says Ruth Schneider, a neurologist at the University of Rochester Medical Center. "On the other hand, the pandemic has highlighted the importance of clinical research, so some clinicians may think, 'Now’s the time for me to be a researcher.'" 
• Topography will compete by handling administrative tasks, engaging with the local community, and proving there's something in it for them.
• “If there is incremental revenue to be generated, clinicians can get on board quickly, especially if [they] make it relatively painless,” says Andrew Matzkin, partner with the health care consultancy firm Health Advances.

The bottom line: Topography presents a unique alternative to the traditional clinical trials process, so long as local clinicians and patients get — and stay — on board.

• "There are a lot of barriers to participating in research from the perspective of the clinician and the patient, so anything we can do to make it easier to participate is a good thing," Schneider says.