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Healthcare Upside/Down: Laboratory Testing Designed for the 21st Century

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ECG’s radio show and podcast, Healthcare Upside Down, offers unfiltered perspectives on what’s working in US healthcare and what’s not. Hosted by ECG principal Dr. Nick van Terheyden, each episode features guest panelists who explore the upsides and downsides of healthcare in the US—and how to make the system work for everyone.

Did you catch The Dropout, a TV series based on disgraced biotech company Theranos? Or perhaps you read John Carreyrou’s articles published in the Wall Street Journal back in 2015 that first raised concern over Theranos and were later turned into an excellent book on the company, its rise and ultimate fall, and prosecution of its leaders.

Our guest on episode 55 of Healthcare Upside Down is Pouria Sanae, CEO of ixlayer.

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It’s compelling stuff, but at the time, the whole story was one of deep frustration and disappointment for me. I remember the excitement surrounding Theranos and its claims of a revolutionary approach to blood testing—using a much smaller sample of blood to carry out a panel of tests on a regular basis as part of managing and supporting patients on their journey to staying healthy.

This was a vision I saw with several other companies and technologies. Even at that time, there were real companies that did offer the potential to provide results from smaller samples that were easier and less painful to obtain. But many got caught in the fallout from the Theranos debacle and struggled to get any support or funding.

Thankfully there are potential solutions, and ones that might offer some of the value that Theranos falsely promised. Pouria Sanae is the CEO of ixlayer, a company that’s trying to adapt lab testing to patients’ needs—not the other way around. He joins us on episode 55 of Healthcare Upside Down to talk about the importance of early and regular screening, approaches for bringing down costs, and his expectations for the future of in-home testing. Below are a few excerpts.

The concept of a “pre-patient.”

“Right now, you [get] sick, you go to your doctor, they send you to [a lab]. But we have a terminology that we use internally called pre-patients. That pre-patient concept is preventive care focused on one single individual, and how we can test that individual more often—identify high-risk patients to get them into care immediately; identify low- to medium-risk patients, and recommend lifestyle changes.”

A path from sick care to preventive care.

“If we focus on the pre-patient piece, there are two issues that we see. One is that we do not get enough lab testing—we do it once a year, at best; many people miss their annual checkup. The other problem is that lab testing is a snapshot in time. This is a result right now, today; we have no idea what it was three months ago, or six months ago. We need to test these individuals more often. That is what we are trying to do by enabling very easy, accessible lab testing in the brand of our customers. We do not offer any lab testing to the end patient; we power these larger organizations [consumer retailers like CVS; payer-providers; and pharma] to do that. If they have the tool, then the barrier to entry drops, the cost of testing drops significantly. And hopefully we can go from all sick care to preventive care.”

Regular in-home testing is coming.

“We have created this end-to-end technology that integrates with 40 different services, 27 different labs, physician networks, mobile phlebotomy, and so forth. And this enables our customers to offer remote, in-home lab testing to their patients. I think within the next 5 to 10 years, this would be a household solution that everybody expected, the same way we went from blockbuster to DVD rental to Netflix. I think that’s going to happen, regardless, within 5 to 10 years. If we as an organization can reduce the 5 to 10 years to maybe 2 to 5 years, then we have done our job.”

On the podcast, Pouria talks more about the patient journey, the intricacies of self-collecting samples, and who stands to benefit most from remote lab testing.

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Edited by: Matt Maslin