
This CEO is out for blood - dsr12
http://www.fortune.com/2014/06/12/theranos-blood-holmes/
======
Procrastes
> “I realized that I could have just as well been looking into the eyes of a
> Steve Jobs or a Bill Gates.”

> Though Theranos is largely unknown even in Silicon Valley, that is about to
> change.

> Precisely how Theranos accomplishes all these amazing feats is a trade
> secret.

> The analyzers look like large desktop computer towers. Holmes declines to
> explain how they work, or even allow them to be photographed, citing the
> need to protect trade secrets. The company manufactures them at an unmarked
> facility I toured in a research park across the South Bay from Palo Alto, in
> Newark, Calif.

> the single most accomplished board in U.S. corporate history. It includes
> former U.S. Secretary of State, Treasury, and Labor George Shultz; former
> Secretary of Defense Bill Perry; former Secretary of State and National
> Security Adviser Henry Kissinger; and former U.S. Senators Sam Nunn and Bill
> Frist

> In a rare if not unprecedented rout this past March, the patent holders
> unconditionally surrendered midtrial, stipulating to the invalidity of their
> own patent. As a kicker they agreed–though the presiding judge would have
> been powerless to order such a thing himself–to bring no additional patent
> suits against Theranos for five years.

> retired U.S. Marine Corps Gen. James Mattis, explaining why he signed up
> last fall as another of Theranos’s strikingly illustrious outside directors.
> Mattis had stepped down just months earlier as commander of the U.S. Central
> Command–the chief of U.S. military operations in the Middle East and Central
> Asia

... zombie ... apocalypse

~~~
rayiner
I skimmed through the first part, but based on your comment I went back and
read the article.

> As a bonus, board meetings are also attended by the company’s de facto legal
> adviser at large, trial lawyer David Boies.

Boies represented the DOJ in the Microsoft antitrust proceedings and Al Gore
in Bush v. Gore.

What an odd cast for a startup board. I wonder what connects all these people,
other than all being high-profile.

~~~
Alupis
Seems rather sad state of our Patent system here in the US where a 19 year old
with no prior technical background, who was a Chemical Engineering student, a
sophomore no less (meaning barely finished or finishing General Ed.
requirements and just starting Major courses), can write and file for a
highly-technical patent involving radios, sensors, embedded devices, and the
like.

> And we could put a cellphone chip on it, and it could telemeter out to the
> doctor or the patient what was going on.

It's very doubtful she understood how any of that works, or would work in her
product/patent.

Underlying story seems it's absurd this was patent-able.

~~~
jbail
I think you're underestimating her intelligence and capabilities. Clearly she
had the background and the initiative. There are super smart and dedicated
people out there. She sounds like one of them.

Beyond that, I'm not sure if the patent is absurd or not...but I definitely
don't think its absurd for a 19 year old woman to write up and be awarded a
patent.

~~~
Alupis
No, I was meaning I find it highly unlikely she understood or could actually
implement the technology behind her patent.

A 19 year old, no matter how smart, is not likely to have a thorough enough
background to understand all of the related technologies involved in this
patent. This is a medical device, and has to be "done right", or people can be
injured or worse. I don't expect even a top-tier CS student could pull it off.

I'm not attempting to discredit her intelligence, just pointing out she seems
to have been/is an "idea guy". We've all run into "idea guys", they'll pitch a
great idea with all this elaborate stuff, but then can't execute on it without
outside help. Perhaps she got help, who knows?

A patent is, more-or-less, a mere idea (which is absurd in it's own right,
ideas should not be patentable imho). So, you are right, it's not "absurd for
a 19 year old [gender-is-regardless] to write up and be awarded a patent",
it's absurd it was patentable in the first place.

~~~
MaysonL
Back in 1963, I was tutored in calculus by a 15-year old who won that year's
Science Talent Search for his research in nuclear magnetic resonance. He had
completed essentially all of undergrad math and physics. I think you have a
badly warped view of what is possible for smart people, whatever age.

~~~
mreiland
No, I think there's a reason she recruited a professor in that industry who
had well over 30 years of experience.

That doesn't detract from her intelligence, but I think it's safe to say she
would have simply done it herself if she could have.

I think simply describing her as an "idea person" is also missing the mark,
but so are you. She isn't a magician, she's just a person.

And considering she was 19 and in a normal college curriculum, it's very
likely her talent is not in being super smart, but in being able to come at a
problem sideways.

~~~
pessimizer
Or in being rich and well-connected.

------
jessaustin
_Holmes had then just spent the summer working in a lab at the Genome
Institute in Singapore, a post she had been able to fill thanks to having
learned Mandarin in her spare hours as a Houston teenager._

Everyone knows that English is spoken in Singapore, right? I'm not saying
Mandarin wouldn't look good on a resume, but _very few_ Singaporeans with the
education to work in that facility would not also be fluent in the
international language of science. Even if her work took place in community
clinics, Mandarin wouldn't have been as helpful as e.g. Hokkien.

EDIT: Since it's kind of lame that such a nitpick is still at the top, I'd
like to address this also:

 _Its advances relate to "optimizing the chemistry" and "leveraging software"
to permit those conventional methods to work with tiny sample volumes._

IANABiochemist, but they're talking about statistical methods here, right? My
intuition is that a particular test performed at "nano"-scale might not be
very accurate, but that a series of such tests could be as accurate as
required.

~~~
w1ntermute
I immediately picked up on that as well. Along with the whole "selling C++
compilers to Chinese universities in the late 90s" thing, it makes the article
seem rather poorly researched and overly adulatory.

------
OrwellianChild
Can someone help me on the technical aspects of the blood tests they've
developed?

The premise appears to be that they take extremely small samples ("25 to 50
microliters") and run lots of tests ("as many as 70 different tests from a
single draw") using "the same fundamental chemical methods".

This compares with standard blood tests which require 2 orders of magnitude
more blood ("numerous tubes of blood, each containing 3,000- to
5,000-microliter samples").

How does one produce reliable output with the same sensitivity/specificity
using the same chemistry with so much less blood? I find it hard to believe
that the existing lab procedures left that much efficiency on the table...

~~~
gone35
_Can someone help me on the technical aspects of the blood tests they 've
developed?_

On the specifics, I'm afraid nobody can for now. They have refused to peer-
review their protocols and validation data, so their assays are essentially a
black box. So far, incredibly, they have managed to get away with this thanks
to a glaring regulatory loophole (as the article explains); but sooner or
later they'll have to open up if they want their assays to be taken seriously
by the medical community.

In broader terms, however, there's been _a lot_ of recent work in the well-
established microfluidics [1] literature on whole-blood assays [2], so that
can give you a good guess about how they go about their implementation: most
likely some form of "lab-on-a-disk" centrifugation for plasma separation and
subsequent transport to separate microfluidic optical chambers preloaded with
colorimetric reagents for readout, using perhaps a digital camera and some
non-kosher/black-boxy form of curve-fitting DSP to increase "sensitivity".

In all I'm very skeptical until they open up and provide peer-reviewed
validation data for their assays. There are already several companies doing
patented blood microfluidics like Abaxis [3] with peer-reviewed validation,
and the enabling technologies have been out in the open in the literature for
years, if not decades; so the whole "we are doing a super duper secret awesome
thing we can't tell you anything about" sounds rather D-Wavey and fishy to me.

[1]
[http://en.wikipedia.org/wiki/Microfluidics](http://en.wikipedia.org/wiki/Microfluidics)

[2]
[http://mams.rmit.edu.au/vtkd17xbz90ez.pdf](http://mams.rmit.edu.au/vtkd17xbz90ez.pdf)

[3] [http://www.piccoloxpress.com](http://www.piccoloxpress.com)

~~~
thrownaway2424
Wouldn't it be fairly easy to determine their FP/FN figures just by sending
them lots of blood samples with known composition? If it's a black box, use
black-box testing methods.

~~~
gone35
Like some form of "mystery lab-testing". Brilliant.

------
tekacs
> she started her first business while still in high school, selling C++
> compilers to Chinese universities.

Along with the rest of the weirdness being mentioned by others, some of this
really doesn't begin to make sense to me. o_O

Custom compilers have been a thing a few times in the past, but in the late
90s, what possible reason could there be for this?

~~~
Igglyboo
The only thing I can think of was that the Chinese had some new architecture
with no compiler out there for it. But if they had their own architecture they
could surely build their own compiler..

Sounds fishy tbh

~~~
w1ntermute
And I bet if you showed this article to someone with a background in the
diagnostics industries Theranos is trying to disrupt, they would find all
kinds of fishy aspects to those parts of the story as well.

------
dlss
So no one has mentioned this yet, but this article is actually the Fortune
cover story.

And I think very much deserved, not for most of the details mentioned in the
article, but because of their pricing page: [http://www.theranos.com/test-
menu](http://www.theranos.com/test-menu) \-- it's freaking cheap.

~~~
anishkothari
It's almost absurdly cheap. If your health insurance doesn't cover your lab
tests, then it's probably cheaper to travel to their testing centers in
Arizona, get tested and go back home than go to a medical lab near you and pay
out of pocket.

On another note, I wonder why all except one of their testing centers are in
and around Phoenix?

~~~
ladytron
Phoenix is the Wild West. There is very little regulation or oversight,
generally.

------
anishkothari
The link isn't working for me - Chrome on Windows. Edit: nevermind, Ghostery
blocked everything except the navbar.

In any case, I'm pulling for Theranos to be successful. I've had to have a lot
of blood work done recently and I've been underwhelmed by every medical lab so
far. If Theranos can use a smaller blood sample AND run more tests with it,
then I can't wait to be a customer.

------
DaniFong
Why I'm excited about this, and you should be too: Tracking of biomarkers over
time.

"“The movie goal is absolutely core to what we’re working to do,”... We’re
building an early-detection system,”

------
illini123
As a fellow health-tech entrepreneur, it's refreshing to see the business
press reporting on something more than just "Yo." I hope this kind of
publicity continues. The industry needs it.

------
zhemao
So what happened to the original idea? The patch that takes blood measurements
while administering a drug? I can see how the current business is an extension
of that original idea, but the article never states what became of the
original. Did it die in the FDA approval process?

------
caycep
There have been hints and whispers of Theranos here at HN for a while, here at
least is more information about it, puff piece or no.

The board is quite impressive; I suspect they have gotten at least some DoD
money, i.e. DARPA, through which perhaps some of those connections were
made...

~~~
throwaway0626
The CEO is definitely out for blood, and her employees apparently aren't
exempt...

Here's some more information about Theranos... I interviewed with these guys
recently. One of the things the interviewer stressed is that the programmers
there typically work 60-hour weeks, and would I be okay with that. He said he
was very proud of the fact that they used to work 80-hour weeks but had gotten
it down to about 60. I passed on them just for this one reason...

The interview coding challenges were fairly well-designed and somewhat fun to
do, though.

~~~
throwaway3264
I was somewhat recently contacted for an interview, and the interviewer
mentioned 45-55 hour work weeks, but other than that, the company seemed like
it would be a decent company to work for. The screening process is somewhat
more hardcore than others, but that can be a good thing.

------
Geekette
Impressive to note that after raising $400 million, she still holds over 50%
equity in the company.

------
guiambros
What an amazing story. Best read of the entire week. It's 20 minutes well
spent.

A look at their website (and the profiles they're hiring for) gives a clear
idea of where she is going. You don't need iOS/Android developers, or
ASIC/FPGA designers, or hardware and mechanical engineers, to support
Walgreen's Wellness centers.

She's clearly going after the last mile. Blood tests for the masses. In your
phone. No need for prescriptions, or visits to Walgreens.

This is way bigger than a $90 billion dollars blood test industry.

~~~
ejain
Here's another company going after the last mile, i.e. blood testing at home:
[https://cue.me/](https://cue.me/)

------
balor123
What the company does sounds great. Maybe I skimmed through it too quickly but
it starts out talking a lot about patches that measure the response to drugs.
But then the company seems to just be doing blood tests quickly and cheaply.
There was a pivot in there somewhere, right? Hard to tell with all the fluff
around it.

The article also mentions how they do it is trade secret but I'm curious what
the innovations are here. They throw some things out there though, like
bypassing FDA hurdles and shrinking equipment and blood sample size down. It
sounds like they're just streamlining a sleepy, well entrenched industry? A
noble endeavor but the juicy details would be nice if we could get them.

Some day I hope that we can get these tests small and cheap enough that they
could be purchased OTC and run easily and frequently at home. Collect a few
hundred samples points while you check your weight in the morning and ship the
data off to Amazon for data mining. It would wipe out surprise "I've had
diabetes for the last 10 years and didn't realize it" diagnosis and that's a
huge, huge win. Not to mention what the QS crowd would do with it.

Not sure what to make of that bit about the restaurant. If she's really
testing her blood after every meal, then I don't see how she could miss the
impact her veggie, carb, low-protein, no-fat diet.

------
Gatsky
Well, cheaper and easier testing is great for everyone, particular in
environments that can't run expensive fully equipped pathology laboratories eg
rural areas, developing nations, refugee camps etc.

But at the end of the day, we need better tests, not better ways of testing.
Looking through their test menu, it's the same old diagnostic blood tests
we've been using for the last 30 or even 50 years. Hopefully there is
something revolutionary behind the hype. I don't think it will be
consumerization - none of those listed tests is going to help early detection
of anything by getting yourself tested at Walgreens while you're buying
toothpaste. Similarly, most of the tests are only useful when applied in a
well fleshed out diagnostic process that involves collecting data about
symptoms and medical history to generate a prior probability of the disease.
Otherwise the false positive rate is high, and the false negative rate
difficult to deal with. The utility of serial monitoring as a marker of health
is also far from proven, but is an interesting idea. At the moment though, if
you go to your doctor and say your homocysteine levels are fluctuating
strangely, they won't have a clue what to do about it...

I would also add that proving that a test can be used to detect a disease
early, and that early detection leads to a measurable improvement in disease
outcomes takes a very long time, a lot of patients and a lot of money. So if
they have made some great advance in microfluidic chemoproteomics that can
actually detect the early traces of a disease process then that would be
amazing, but one must remain skeptical.

------
rudimental
Wow, what a story. They sound like they're killing it, the founder's
motivation is admirable, and she's making a positive dent in the world. I hope
they succeed.

Inspiring.

------
cmpns8
Theranos is nearing completion of a large new facility (corp hq?) in PA at the
corner of Page Mill & Porter.

------
dsr12
Loved this quote from her professor: “To me, I wish I wasn’t 70 years old. I
wish I was her age and could be in on this. Because this is going to be a
long, exciting, fascinating, exhilarating ride.”

------
enimodas
I had to delete the header to be able to read the article. The constantly
changing/flashing text just a couple of cm higher to where my eyes are
focusing to read the article is very annoying.

~~~
lilsunnybee
Same here. Thank God for being able to inspect and delete distracting page
elements. I do feel sorry for readers not versed in html editing though.

------
trhway
> Her father, Christian Holmes IV, has devoted most of his life to public-
> minded government service–disaster relief in Africa, international
> development projects in China, environmental work in this country–and is
> currently the global water coordinator for the U.S. Agency for International
> Development. He met Elizabeth’s mother, Noel, on Capitol Hill, where she
> worked as a congressional committee staffer.

she definitely learnt a lot from her parents. At least how to navigate
politically charged [mine]fields

------
QuantumGood
And now we wait to see their connection with Apple's new health initiative...

------
rurounijones
Anyone know a link to the patent in question at the beginning?

some people have been decrying it as an "here is an idea" style with no
substance, would help to have the thing available.

~~~
pests
Posted elsewhere in the thread:

[https://www.google.com/patents/WO2005025413A3?cl=en&dq=ininv...](https://www.google.com/patents/WO2005025413A3?cl=en&dq=ininventor:%22Elizabeth+A.+Holmes%22&hl=en&sa=X&ei=nu-
sU8uqI46VyASChIDQAg&ved=0CBwQ6AEwAA)

------
_mikz
What a crap fortune.com is. The article is nice though.

edit: can't print it, does not work with ghostery/adblock, loads different
articles after scrolling, ...

~~~
namlem
It works just fine with ABP

------
kleiba
_Robertson recounts. “And I kind of kicked myself. I’d consulted in this area
for 30 years, but I’d never said, here we make all these gizmos that measure,
and all these systems that deliver, but I never brought the two together.”_

Really?

I hope this CEO chose the right partner... :-)

------
dabit3
Awesome!

