Dr. Kate Arnold is a physician and innovation leader working at the intersection of clinical care, research, and technology. Trained in obstetrics and gynecology and now serving in the Scalable Solutions Office at Advanced Research Projects Agency for Health (ARPA-H), Arnold focuses exclusively on advancing high-risk, high-reward innovation in women’s health, particularly in areas long overlooked by traditional funding and reimbursement models.

In this conversation with The Pulse, Arnold reflects on her path from clinical medicine to public-sector innovation and what must change by 2030 to build a more proactive, equitable system of care for women.

The Pulse: You trained as a physician before pursuing an MBA and moving into health innovation. What led you to combine clinical medicine with business and policy work?

Kate Arnold: I’m actually a bit of a non-traditional candidate. I studied psychology in undergrad and came to medicine later, after doing a post-baccalaureate program. Before medical school, I’d been a preschool teacher, and I originally thought I’d go into pediatrics.

My first rotation in medical school was OB-GYN, which I went into with very little interest. But I ended up loving how varied the work was – you had surgery, clinic, labor and delivery, and these big-picture conversations with patients about fertility, contraception, and what they wanted for their lives. I also liked that OB-GYN forces you to think about the future, how care could be better, not just how to manage what’s in front of you.

As I moved into leadership roles, first as an assistant residency program director and later as Director of Women’s Health at a federally qualified health center, I started thinking much more about system-level decisions. I had ideas about how care could improve, but I realized I didn’t have the language to communicate those ideas effectively to health system leadership. That’s what pushed me to get my MBA. Once I did, so many things I had experienced in healthcare suddenly made sense.

The Pulse: How did that background eventually lead you to ARPA-H?

KA: After years of clinical and leadership work, much of it during COVID, I was pretty burned out. When my family and I moved to Washington, DC, I shifted into hospitalist work, which gave me my first experience with true shift work and some breathing room.

At the same time, I started advising a couple of women’s health startups and absolutely loved that work. I was thinking about whether to deepen that involvement when I got a LinkedIn message about a role at ARPA-H. It ended up being the best professional fit I’ve ever had, it brought together my clinical background, my MBA, and my interest in innovation and policy.

The Pulse: What makes ARPA-H’s approach to innovation different from other funding or research environments?

KA: ARPA-H exists to fund ideas that wouldn’t get supported anywhere else. If venture capital or industry is already eager to fund something, that’s not where ARPA-H should be. Our role is to take on big, bold, high-risk ideas that could meaningfully improve healthcare but are still too early or too uncertain for traditional investment.

Within ARPA-H, I work in the Scalable Solutions Office, which focuses on innovations that are getting closer to patients. That means ideas that might still feel like science projects but have enough proof of concept that, with the right push, they could make it to the bedside. I was hired to focus exclusively on women’s health, and I’ve had a lot of freedom to define priority areas as long as they meet that high-risk, high-reward bar.

The Pulse: One of the programs you’re leading focuses on labor and delivery. What problem are you trying to solve?

KA: My first program is called Making Obstetric Care Smart, or MOCS. It focuses on two technical areas. The first is developing tools to better estimate a woman’s risk of intrapartum fetal hypoxia – basically, the risk that a baby won’t get enough oxygen during labor and delivery. Understanding that risk matters because it helps us anticipate emergency interventions, like unplanned C-sections or NICU admissions, earlier.

The second area is rethinking fetal monitoring altogether. We’re still using fetal heart rate tracings that are more than 50 years old. Under MOCS, we’re asking teams to add additional sensors and use AI-based interpretation so clinicians, nurses, midwives, and patients all have clearer, more actionable information to guide decision-making.

The long-term goal is to enable well-timed, necessary interventions leading to fewer unnecessary C-sections, but also fewer cases where intervention happens too late. And ultimately, I’d love for C-section not to be the only tool we have when something goes wrong.

The Pulse: You’ve identified reimbursement and data as two major barriers in women’s health. Why are they so central?

KA: Reimbursement shapes everything. Women’s health is chronically under-reimbursed, and that has far-reaching downstream consequences. When I was purely clinical, I understood reimbursement mainly in terms of my own pay. What I didn’t appreciate was how low reimbursement makes women’s health low-priority for payers, which then makes it unattractive for investors.

If payers aren’t spending much on prenatal or gynecologic care, there’s very little financial incentive to improve it. That means venture capital struggles to justify investing in tools that don’t clearly save money, even if they dramatically improve care.

The second issue is data. In many areas of women’s health, we simply don’t know what’s normal – across pregnancy, fertility, gynecology, or hormonal health. We lack longitudinal data, and that makes it hard to design proactive, evidence-based care. Programs like MOCS aren’t just about better outcomes in the short term; they’re about generating the foundational data needed to unlock entirely new approaches to diagnosis and treatment.

The Pulse: If policymakers truly wanted to accelerate women’s health innovation, what structural change would matter most?

KA: One important area is how labor and delivery are reimbursed. Right now, it’s largely a global payment, which has benefits but leaves little room for reimbursing new tools or technologies. That structure can also unintentionally reinforce higher C-section rates without rewarding better outcomes.

Another promising development is the FDA’s push toward alternative methods for evaluating new therapies. Women weren’t included in FDA trials until the 1990s, and pregnant women are still largely excluded today. That makes it incredibly hard to develop new products for pregnancy. Creating safe, ethical alternative pathways for evaluation could dramatically accelerate innovation in women’s health.

The Pulse: Looking toward Health Care 2030, do you think incremental reform is enough?

KA: No. Women’s health needs a fundamental shift. Right now, care is largely reactive and disease-focused, but we’re also not very good at diagnosing disease. We rely heavily on patient history, and often don’t listen to it well.

We’ve created a system where women with fewer resources receive minimal standard-of-care screening, while women with more resources turn to cash-pay tests and supplements that may not be evidence-based or regulated. Neither group is getting ideal care.

What we need is proactive, medical-system-based care focused on keeping women healthy; earlier diagnosis of conditions like endometriosis, PCOS, infertility, or early menopause, and better understanding of what “normal” actually looks like across the life course.

The Pulse: Women’s health innovation is often underfunded and met with skepticism. How should founders and leaders navigate that reality?

KA: It may sound cynical, but investors are tired of hearing that women’s health is underfunded so they should invest in it because it’s the right thing to do. That argument alone won’t get products to market.

If we want investment, we have to make women’s health profitable within the existing system using reimbursement, policy, and data to show real economic value. Goodwill might help close part of a funding round, but it won’t sustain a company. We have to demonstrate who will buy these products and how they’ll save money or create value over time.

The Pulse: For clinicians and trainees who care deeply about women’s health but feel burned out or powerless, what advice would you offer?

KA: I actually think everyone should be involved in innovation in some way. It doesn’t mean starting a company. Many startups just need clinicians to spend a few hours a month answering basic questions: Would this work in your workflow? Would you actually use it?

Being involved in innovation can be one of the best antidotes to burnout. So much burnout comes from feeling powerless, like nothing will ever change. Helping shape better tools and systems makes you feel reinvested in the field. If clinicians stay engaged, we can help ensure that innovation actually improves women’s lives instead of missing the mark.

The Pulse: Finally, when you look five to ten years ahead, what would success in women’s health innovation actually feel like for patients?

Dr. Kate Arnold: Success would mean women trust the medical system again. Right now, many women turn to the internet, friends, or the supplement market when something feels wrong. I’d love for us to have enough tools, data, and understanding that women want to come to their clinicians because they trust us and we can actually help them feel better and stay healthy.