five years ago when I joined DARPA we were faced with the following problem
were faced with the following problem
were faced with the following problem the military sends millions of its
the military sends millions of its
the military sends millions of its members across the globe and in most of
members across the globe and in most of
members across the globe and in most of those locations there is no
those locations there is no
those locations there is no infrastructure and there is no medical
infrastructure and there is no medical
infrastructure and there is no medical infrastructure so when this soldier
infrastructure so when this soldier
infrastructure so when this soldier falls ill we can’t just simply send him
falls ill we can’t just simply send him
falls ill we can’t just simply send him to the urgent care clinic or the CVS and
to the urgent care clinic or the CVS and
to the urgent care clinic or the CVS and there’s often not even anyone trained to
there’s often not even anyone trained to
there’s often not even anyone trained to take a blood sample and so we were faced
take a blood sample and so we were faced
take a blood sample and so we were faced with the challenge of how do we diagnose
with the challenge of how do we diagnose
with the challenge of how do we diagnose this soldier in a way that’s accurate
this soldier in a way that’s accurate
this soldier in a way that’s accurate and robust no matter where in the world
and robust no matter where in the world
and robust no matter where in the world he or she may be and so we set about
he or she may be and so we set about
he or she may be and so we set about investing in in building two sets of
investing in in building two sets of
investing in in building two sets of technologies the first how do we enable
technologies the first how do we enable
technologies the first how do we enable him to take his own blood sample the
him to take his own blood sample the
him to take his own blood sample the second how do we ship that sample back
second how do we ship that sample back
second how do we ship that sample back to a clinical laboratory anywhere in the
to a clinical laboratory anywhere in the
to a clinical laboratory anywhere in the world without having to worry about
world without having to worry about
world without having to worry about stabilizing it on a block of ice after
stabilizing it on a block of ice after
stabilizing it on a block of ice after about two or three years these
about two or three years these
about two or three years these technologies began to pay off and what
technologies began to pay off and what
technologies began to pay off and what we realized is that we had something
we realized is that we had something
we realized is that we had something much larger than just the military
much larger than just the military
much larger than just the military application but we had something that
application but we had something that
application but we had something that could transform our healthcare system
could transform our healthcare system
could transform our healthcare system and specifically enable us to begin to
and specifically enable us to begin to
and specifically enable us to begin to personalize and create predictive
personalize and create predictive
personalize and create predictive medicine now most of us are familiar
medicine now most of us are familiar
medicine now most of us are familiar with personalized medicine by way of
with personalized medicine by way of
with personalized medicine by way of genomic sequencing and the goal here is
genomic sequencing and the goal here is
genomic sequencing and the goal here is that all of us sequence our genomes and
that all of us sequence our genomes and
that all of us sequence our genomes and we can to compare the various
we can to compare the various
we can to compare the various differences between each one of us and
differences between each one of us and
differences between each one of us and understand how those differences might
understand how those differences might
understand how those differences might lead to and create different disease
lead to and create different disease
lead to and create different disease states the challenge with genomics is
states the challenge with genomics is
states the challenge with genomics is that is relatively static it tells us
that is relatively static it tells us
that is relatively static it tells us fate but it doesn’t necessarily tell us
fate but it doesn’t necessarily tell us
fate but it doesn’t necessarily tell us state and what we care about is not just
state and what we care about is not just
state and what we care about is not just do I have a propensity for having a
do I have a propensity for having a
do I have a propensity for having a disease but when am i coming down with
disease but when am i coming down with
disease but when am i coming down with that disease and if I am coming down
that disease and if I am coming down
that disease and if I am coming down with that disease how do I know if my
with that disease how do I know if my
with that disease how do I know if my treatment is working and that
treatment is working and that
treatment is working and that information is not carried by the static
information is not carried by the static
information is not carried by the static information of the genome but it’s
information of the genome but it’s
information of the genome but it’s carried by the expression of the genome
carried by the expression of the genome
carried by the expression of the genome in terms of the dynamic are
in terms of the dynamic are
in terms of the dynamic are and proteins that are being expressed
and proteins that are being expressed
and proteins that are being expressed and are essentially the traffic patterns
and are essentially the traffic patterns
and are essentially the traffic patterns of our bodies what we wanted to be able
of our bodies what we wanted to be able
of our bodies what we wanted to be able to build was ways for the human body now
to build was ways for the human body now
to build was ways for the human body now you may say to me Alicia we already do
you may say to me Alicia we already do
you may say to me Alicia we already do this when I go into my doctor he takes a
this when I go into my doctor he takes a
this when I go into my doctor he takes a blood test and I and I look at my
blood test and I and I look at my
blood test and I and I look at my biomarker levels and this tells me if
biomarker levels and this tells me if
biomarker levels and this tells me if I’m healthy or not
I’m healthy or not
I’m healthy or not but in reality what we’re doing is that
but in reality what we’re doing is that
but in reality what we’re doing is that we’re taking dynamic systems we’re
we’re taking dynamic systems we’re
we’re taking dynamic systems we’re taking things that change regularly over
taking things that change regularly over
taking things that change regularly over time in response to our own state of
time in response to our own state of
time in response to our own state of health in our environment and we’re just
health in our environment and we’re just
health in our environment and we’re just taking these single snapshots in time
taking these single snapshots in time
taking these single snapshots in time first one were young during our age
first one were young during our age
first one were young during our age specific checkups and then only usually
specific checkups and then only usually
specific checkups and then only usually in periods of illness when we don’t feel
in periods of illness when we don’t feel
in periods of illness when we don’t feel well and we’re in the doctors and then
well and we’re in the doctors and then
well and we’re in the doctors and then what we do is we don’t compare them to
what we do is we don’t compare them to
what we do is we don’t compare them to our own unique healthy levels we compare
our own unique healthy levels we compare
our own unique healthy levels we compare them to a population average which is
them to a population average which is
them to a population average which is typically a group of 50 year old Ben in
typically a group of 50 year old Ben in
typically a group of 50 year old Ben in Denver
what would be much more powerful is if
what would be much more powerful is if we could imagine tracking ourselves
we could imagine tracking ourselves
we could imagine tracking ourselves consistently over time and frequently in
consistently over time and frequently in
consistently over time and frequently in creating our own kind of health
creating our own kind of health
creating our own kind of health fingerprint over time and you can
fingerprint over time and you can
fingerprint over time and you can imagine that if we could track this over
imagine that if we could track this over
imagine that if we could track this over millions of individuals we could begin
millions of individuals we could begin
millions of individuals we could begin to build up a set of knowledge that when
to build up a set of knowledge that when
to build up a set of knowledge that when able us to not only understand when we
able us to not only understand when we
able us to not only understand when we are sick and what those biomarker
are sick and what those biomarker
are sick and what those biomarker patterns look like but actually begin to
patterns look like but actually begin to
patterns look like but actually begin to predict the onset of disease so let me
predict the onset of disease so let me
predict the onset of disease so let me make this very specific with a
make this very specific with a
make this very specific with a real-world example let’s start with
real-world example let’s start with
real-world example let’s start with ovarian cancer in cancer antigen 125
ovarian cancer in cancer antigen 125
ovarian cancer in cancer antigen 125 cancer antigen 125 is known as a
cancer antigen 125 is known as a
cancer antigen 125 is known as a biomarker that enables us to actually
biomarker that enables us to actually
biomarker that enables us to actually diagnose ovarian cancer now the
diagnose ovarian cancer now the
diagnose ovarian cancer now the challenge with this test is that it’s
challenge with this test is that it’s
challenge with this test is that it’s used as a threshold test so if I’m below
used as a threshold test so if I’m below
used as a threshold test so if I’m below a certain limit I’m considered to be
a certain limit I’m considered to be
a certain limit I’m considered to be healthy and cancer-free and if I’m above
healthy and cancer-free and if I’m above
healthy and cancer-free and if I’m above that limit I’m considered to have cancer
that limit I’m considered to have cancer
that limit I’m considered to have cancer as most clinicians will tell you often
as most clinicians will tell you often
as most clinicians will tell you often by the time you’re above the limit it’s
by the time you’re above the limit it’s
by the time you’re above the limit it’s too late you have late stage ovarian
too late you have late stage ovarian
too late you have late stage ovarian cancer and it is very difficult to cure
cancer and it is very difficult to cure
cancer and it is very difficult to cure the other major challenge is that most
the other major challenge is that most
the other major challenge is that most early stage ovarian cancer patients have
early stage ovarian cancer patients have
early stage ovarian cancer patients have a level that’s below that threshold and
a level that’s below that threshold and
a level that’s below that threshold and so they won’t be caught by the system
so they won’t be caught by the system
so they won’t be caught by the system the result is that most cases of ovarian
the result is that most cases of ovarian
the result is that most cases of ovarian cancer I diagnosed at a very late stage
cancer I diagnosed at a very late stage
cancer I diagnosed at a very late stage so what’s going on here what’s going on
so what’s going on here what’s going on
so what’s going on here what’s going on here is that we’re assuming that every
here is that we’re assuming that every
here is that we’re assuming that every single individual who comes in for a
single individual who comes in for a
single individual who comes in for a ca-125 measurement is average and
ca-125 measurement is average and
ca-125 measurement is average and clearly we’re not each one of us has a
clearly we’re not each one of us has a
clearly we’re not each one of us has a different baseline level of ca-125 and a
different baseline level of ca-125 and a
different baseline level of ca-125 and a woman’s value of ca-125 can vary up to
woman’s value of ca-125 can vary up to
woman’s value of ca-125 can vary up to 40% over the course of a month and so
40% over the course of a month and so
40% over the course of a month and so what we’d actually like to do is be able
what we’d actually like to do is be able
what we’d actually like to do is be able to track your levels over time and
to track your levels over time and
to track your levels over time and understand what’s normal for you and how
understand what’s normal for you and how
understand what’s normal for you and how that varies over time and when you’re
that varies over time and when you’re
that varies over time and when you’re deviating from that now a very powerful
deviating from that now a very powerful
deviating from that now a very powerful study was released just a little over a
study was released just a little over a
study was released just a little over a year ago by a group of researchers in
year ago by a group of researchers in
year ago by a group of researchers in the UK and at Harvard Medical School and
the UK and at Harvard Medical School and
the UK and at Harvard Medical School and what they did is they measured 50,000
what they did is they measured 50,000
what they did is they measured 50,000 women’s levels of ca-125 as infrequently
women’s levels of ca-125 as infrequently
women’s levels of ca-125 as infrequently as every year and as frequently as every
as every year and as frequently as every
as every year and as frequently as every 12 weeks now on this chart every great
12 weeks now on this chart every great
12 weeks now on this chart every great dot that you see up there is a measure
dot that you see up there is a measure
dot that you see up there is a measure of ca-125 over the period of a decade
of ca-125 over the period of a decade
of ca-125 over the period of a decade and what these researchers found was
and what these researchers found was
and what these researchers found was that regardless of whether you were
that regardless of whether you were
that regardless of whether you were above or below the threshold if they saw
above or below the threshold if they saw
above or below the threshold if they saw a doubling of your cancer antigen 125
a doubling of your cancer antigen 125
a doubling of your cancer antigen 125 over the period of six months they could
over the period of six months they could
over the period of six months they could double the effectiveness of the
double the effectiveness of the
double the effectiveness of the biomarker and they could increase their
biomarker and they could increase their
biomarker and they could increase their rate of catching ovarian cancer up to
rate of catching ovarian cancer up to
rate of catching ovarian cancer up to 86% this was astounding to me that just
86% this was astounding to me that just
86% this was astounding to me that just by changing the way that we were
by changing the way that we were
by changing the way that we were measuring a biomarker we could double
measuring a biomarker we could double
measuring a biomarker we could double its effectiveness and the first question
its effectiveness and the first question
its effectiveness and the first question I asked myself was if this is true for
I asked myself was if this is true for
I asked myself was if this is true for ovarian cancer what else might this be
ovarian cancer what else might this be
ovarian cancer what else might this be true for and it turns out for many of
true for and it turns out for many of
true for and it turns out for many of the major chronic diseases that we are
the major chronic diseases that we are
the major chronic diseases that we are facing whether it’s diabetes
facing whether it’s diabetes
facing whether it’s diabetes neurodegenerative disease cardiovascular
neurodegenerative disease cardiovascular
neurodegenerative disease cardiovascular disease in a variety of other cancers
disease in a variety of other cancers
disease in a variety of other cancers there is a whole set of biomarkers that
there is a whole set of biomarkers that
there is a whole set of biomarkers that today are not considered to be very good
today are not considered to be very good
today are not considered to be very good that we might have thrown out that are
that we might have thrown out that are
that we might have thrown out that are not considered to be predictive that if
not considered to be predictive that if
not considered to be predictive that if we change the way that we measure them
we change the way that we measure them
we change the way that we measure them if we just simply measure them more for
if we just simply measure them more for
if we just simply measure them more for and compare them against our own natural
and compare them against our own natural
and compare them against our own natural levels can actually start to be
levels can actually start to be
levels can actually start to be predictive of disease onset even more
predictive of disease onset even more
predictive of disease onset even more before the symptoms begin to manifest so
before the symptoms begin to manifest so
before the symptoms begin to manifest so we can start to imagine this very near
we can start to imagine this very near
we can start to imagine this very near future where we are monitoring ourselves
future where we are monitoring ourselves
future where we are monitoring ourselves and our families and being able to get
and our families and being able to get
and our families and being able to get this quantitative picture of our state
this quantitative picture of our state
this quantitative picture of our state of health where we can begin to predict
of health where we can begin to predict
of health where we can begin to predict when illness is occurring and when we
when illness is occurring and when we
when illness is occurring and when we can be actually begin to understand if a
can be actually begin to understand if a
can be actually begin to understand if a treatment is effective or not so why
treatment is effective or not so why
treatment is effective or not so why doesn’t our health care system look like
doesn’t our health care system look like
doesn’t our health care system look like this today well unlike when you go into
this today well unlike when you go into
this today well unlike when you go into your doctor and they simply do the
your doctor and they simply do the
your doctor and they simply do the tongue depressor or they listen to your
tongue depressor or they listen to your
tongue depressor or they listen to your heartbeat or they have you cough with
heartbeat or they have you cough with
heartbeat or they have you cough with these very simple tools getting your
these very simple tools getting your
these very simple tools getting your blood sample taken for a diagnostic test
blood sample taken for a diagnostic test
blood sample taken for a diagnostic test is something that is incredibly
is something that is incredibly
is something that is incredibly inconvenient you have to schedule
inconvenient you have to schedule
inconvenient you have to schedule another appointment for it it’s costly
another appointment for it it’s costly
another appointment for it it’s costly for you and for the medical system and
for you and for the medical system and
for you and for the medical system and it occurs outside your course of care
it occurs outside your course of care
it occurs outside your course of care what you want is a tool that’s as simple
what you want is a tool that’s as simple
what you want is a tool that’s as simple to implement as a tongue depressor or
to implement as a tongue depressor or
to implement as a tongue depressor or stethoscope you want something that
stethoscope you want something that
stethoscope you want something that doesn’t require you to have a terrible
doesn’t require you to have a terrible
doesn’t require you to have a terrible user experience by going to the blood
user experience by going to the blood
user experience by going to the blood draw center out of your way it is
draw center out of your way it is
draw center out of your way it is phenomenal to me that one of the most
phenomenal to me that one of the most
phenomenal to me that one of the most important things in our lives our health
important things in our lives our health
important things in our lives our health has this bad of a user interface so the
has this bad of a user interface so the
has this bad of a user interface so the key insight that we had at DARPA and
key insight that we had at DARPA and
key insight that we had at DARPA and that led me to leave DARPA and to launch
that led me to leave DARPA and to launch
that led me to leave DARPA and to launch this new company was that the exact same
this new company was that the exact same
this new company was that the exact same technology that we were developing that
technology that we were developing that
technology that we were developing that would enable us to take a blood sample
would enable us to take a blood sample
would enable us to take a blood sample from a soldier anywhere in the world was
from a soldier anywhere in the world was
from a soldier anywhere in the world was the same technology that we could use to
the same technology that we could use to
the same technology that we could use to collect a sample from any of us any time
collect a sample from any of us any time
collect a sample from any of us any time in our lives anywhere in our lives and
in our lives anywhere in our lives and
in our lives anywhere in our lives and it was that just key point and the
it was that just key point and the
it was that just key point and the ability of a simple change in technology
ability of a simple change in technology
ability of a simple change in technology and the way that we were changing our
and the way that we were changing our
and the way that we were changing our measurement that could transform our
measurement that could transform our
measurement that could transform our healthcare system and transform our
healthcare system and transform our
healthcare system and transform our lives that caused me to leave DARPA
lives that caused me to leave DARPA
lives that caused me to leave DARPA launched a company
launched a company
launched a company and hopefully transform our healthcare
and hopefully transform our healthcare
and hopefully transform our healthcare system thank you
system thank you
system thank you [Applause]
”
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