Alexander Saint-Amand, cofounder and CEO of Topography, reflects on his journey from leading Gerson Lehrman Group (GLG), a pioneer in expert networks, to tackling systemic barriers in clinical trials at his current company, Topography. Inspired by personal experiences, Alexander’s mission centers on democratizing access to clinical research by transforming community-based practices into thriving hubs for trials. Alongside a16z Bio + Health general partner Julie Yoo, he discusses the pervasive challenges in enrollment, physician participation, and the inefficiencies plaguing the current model.

Alexander also talks through Topography's hybrid approach—combining technology, services, and AI—and its potential to lower the barrier to entry for providers, improving patient access.