Any pointers would be appreciated. My email is in my profile if you would like to discuss it more in depth.
An example of something I am interested in is: http://jenslabs.com/category/electronics/ketosis-detector/
but my more general question is: how can we do everything a standard blood panel does now, except do it extremely frequently (e.g. daily or hourly or even continuously) and noninvasively or as close as is feasible.
Of course, I know very little about the field, so this might all be the equivalent of "Hey guys, I know a little HTML and I was wondering if I could build a MMORPG..." posts on gamedev, but hey, gotta start somewhere. :D
Yes... But here's one place to start (somewhat analagous to "read Accelerated C++ and the OpenGL red book"): http://www.amazon.com/Practical-Flow-Cytometry-Howard-Shapir...
And this site also looks interesting:
While the thumb-prick and low sample volumes are cool, in the grand scheme of patient care they are somewhat gimmicky. Until doctors request higher-frequency testing, this doesn't pinch that hard. Still cool.
The big sign that they need to be wielding novel capabilities to compete with Quest and Labcorp is the offering of their menu at half of the medicare reimbursement rate. Each of those companies run ~40% gross margins off of medicare reimbursement, so Theranos without novel tech would be running a pretty substantial loss.
What about patients wanting higher-frequency testing? What if the test machine were sitting in my local drugstore, and I could go in, swipe my credit card, and have it run a test on a drop of my blood whenever I wanted to?
Except, I kept on saying, maybe the service is offered directly to people - without a doctor's consult.
Hell, what do I know! Nice to see innovation in fields other than information technology though.
What they overtly lack is connections to the healthcare world. I'm surprised they aren't publicly roped into Cleveland Clinic, Mayo Clinic or Kaiser, as they to support novel technologies in this space. I suppose you can argue that the business model is fundamentally incompatible, but I've seen Mayo and Kaiser go in anyway; they can acquire these labs and roll them into operations pretty easily.
If it's a finger prick, there's less to mark up.
From the outside, it seems like the entire healthcare industry is built on being purposefully inefficient so as to create large costs that they can in turn mark up.
To the VA, inefficiency is a problem. In the healthcare world in general, it doesn't seem to bother anyone.
Instead, the important things are the turn-around-time and billed cost. If Theranos can offer 4 hour turnaround and a clinic/hospital cannot (or even get close), they will pay for it because it is good for doctor productivity and patient outcomes. If Theranos can maintain a half-medicare cost structure, that's also good for the provider because they can expand their margins.
Additionally, Theranos might do deals with insurance companies such that they reduce their reimbursements/push providers to use Theranos, which reduces the insurer's costs. The outcomes-case is even more pressing for an insurer these days.
Now, none of these directly translate to lower insurance premiums, but that doesn't mean that there aren't economic reasons to adopt the service.
> From the outside, it seems like the entire healthcare industry is built on being purposefully inefficient so as to create large costs that they can in turn mark up.
This is generally untrue, as much as it is a public perception. The system lacks simplicity and thus comes across as opaque; this is its failing. Its complexity is not malicious, though.
Not much, which is why this service should not be offered through the standard healthcare system. I can see two other ways to do it:
(1) I walk into a drugstore, sit down at the testing machine, select the tests I want, swipe my credit card, and the machine takes a drop of blood from my finger, runs the test, and gives me a printout of the results.
(2) Home testing kits for every common lab test, not just blood sugar.
The application is interesting.
I'd have lunch with her.
I'd be more wary of potassium and other electrolytes, but it would be interesting to see a comparison to venipuncture.
I get regular liver checks due to medication I take. Being able to walk into a lab and download the results online is a great convenience, but not something allowed in the US at the moment (to my knowledge).
I can get any blood test I want in Poland, everyday, as long as I pay for it. You need a prescription for procedures like X-rays, which have possible adverse effects, or for blood tests if you want them to be covered by the state health insurance.
(I'm neither a member, nor a customer, but I stumbled across their site a while back, doing some research about a health issue I ended up not having, anyway...)
Time to change your healthcare provider, maybe?
There's a bit of a conflict-of-interest if the company that makes money providing "X" declares that "X" is a basic human right. Even as a non-profit (most hospitals are non-profit, but that just means the corporation doesn't keep earnings), you can't justify that statement.
But there's an issue of basic human right inflation thats slightly distasteful. Freedom of speech, freedom of religion, freedom to own property without it being arbitrarily taken away for you by someone stronger. Those are basic human rights, and they don't have to be provided at someone else's cost.
I'm a strong supporter of an individual right to healthcare, provided by society/government, but that's a right agreed by social contract... Saying it in stronger terms risks devaluing in a a real way the more basic rights, which billions of people don't have.
Maybe I'm being pedantic given that this is PR copy...
Edit: carbocation said this 15 minutes ago, oops, upvoted
The alternative is that basic rights are agreed upon by the society, and as the society matures and evolves, why shouldn't its understanding of what basic rights are change?
The language we use is probably based on ideas that they supernaturally-granted or something like that... which is silliness, but I don't think we should change the habitual phrasings... people are more likely to treat each other humanely if they believe that rights are, you know rights, and the language encourages that.
I guess a good answer to that question would be a PhD dissertation, not a HN comment. I wish I knew the answer, or that it was easy for me to express.
I guess a good answer to that question would be a PhD dissertation, not a HN comment. I wish I knew the answer, or that it was easy for me to express
By imagining new human rights, a corporation marks themselves as a member of the ultra-religious, sort of the pharisees of our day. Not only do they obey God's commands, but they invent new commands to follow and by this show off their righteousness. Yes, this stance is made to atone for the sin of making profit - which is a minor sin in the West - "it is easier for a camel to pass through the eye of a needle than for a rich man to inherit the kingdom of God" after all. Do not be mislead, liberalism (including the "classical liberalism" of Locke and Jefferson) is Christianity without God. Jefferson's Bible makes the point explicit.
Making new human rights is good business. A college education became a human right sometime in the last 50 years and today over $200 billion is spent on tuition each year in the USA alone. Yes, it is disingenuous, but also quite clever, for a corporation to position their product as a new human right.
Even the negative rights (freedom of speech, rights to property, etc.) require the positive right to protective services for those rights to have meaning. If we examine the history of such rights, we find they are rooted in English tradition. Essentially the modern idea of human rights is an idealization of 18th century English law. But "human rights" philosophy gives that law a mystical existence and rightness aside from the specific historical balance of power that led to its creation.
 What follows is ripped straight out of Nietzsche and Moldbug. Grazie, signori. I can recommend Moldbug's masterful trilogy on Idealism, which includes the weird new atheist religion-like philosophies:
Also, this company states it will still require doctors' orders so not sure how that squares with the rights talk.
So throwing in a little reminder that a cheaper/faster/on-demand offering has a 'right-of-access' dimension may be useful, as a balance against any FUD/appeals-to-traditional-gatekeeper-authority, coming from other slower/higher-cost providers.
They do say the right is for "access to...", rather than for "free provision of...".
Faster/cheaper blood-testing, via a smaller/quicker samples (a fingertip-prick rather than needle-stick).
It's a pretty looking website though.
http://www.xconomy.com/san-francisco/2010/07/08/theranos-rai... actually made it a lot clearer than their website did.
besides that - website looks great. It would be great if my kids did could only have to deal with a finger prick to draw blood... definitely one of my worst memories growing up.
aha!... now we are getting somewhere.
A real game changer I think.
Former heavyweights in the diplomatic, intelligence and military government sectors (George Shultz, Senator Samuel Nunn, Henry Kissinger etc).
No big names from the technology or VC space are mentioned however.
Something big is brewing.
That and the veteran health care cost reduction potential.
Theranos does not fall under the FDA's mandate in its current form. It is a CLIA-certified laboratory operation, regulated under CDC rules and scrutinized most likely by the College of American Pathologists(CAP). The CLIA/CAP scrutiny is very different from the FDA device/drug process, focusing on protocol and output. Even if they have novel technology, it is often classified as a laboratory developed test(LDT) and falls outside of the FDA's mandate (for now).
Many startups have achieved CLIA-certification without too much difficulty, from Foundation Medicine to Veracyte to Counsyl. It's totally reasonable and doesn't take too long.
Could she become the Elon Musk of the healthcare sector?
I wonder what the significance of that marker is, then...
Does anyone know of any e-doctors that will provide me with lab orders on my behalf? I've seen WellnessFX, but I want to order Quest panels for things they don't offer in their package. Who else is doing something similar to them?
The only way I'd give them my blood would be to infect them with a disease.
Thanks for the background info, it's always worth to know who is behind something. Even the best thing that can happen to humanity would be abused, if supported and financed by sick minds.
Yeah. Would you go to a doctor that is specialized on "cancer and stuff"? I wouldn't. This is as unspecific as one can get.
If you fail, you're an arrogant idiot who thought she was too cool for school.
What's fascinating about Holmes is that she's a drop out in the biotech/health care realm. This has long been considered a protected area, one where heavy education is a must, as lives are on the line. Founders are expected to be PhDs or MDs with decades of research and/or clinical experience.
Holmes has a decade of experience, and no degree. This is going to be a lot of fun to watch.
I wonder how they pulled that off.
This is interesting....I wonder what the technology behind this looks like. Is it really that difficult to achieve 'instant, accurate' results?
Why is that? Is it because the traditional way is to just put a blood sample on a fungus and see what happens?
But to me it looks as if they want to hoard blood-samples for a DNA-Database in order to clone the best of us into super-soldiers. If the military has a DNA-Database of every human on the world they think are worth living, they could wipe all of us out, then re-breed the world to their own likings. I think some billionaires would love this sick sick idea.
They might want to come up with a different tag line: https://en.wikipedia.org/wiki/One_drop_rule
Your employer thinks likewise.
CLIA (Clinical Laboratory Improvement Amendments) defines the regulatory standards for clinical labs which take in samples and perform medical tests on them. It works very differently from FDA drug or device approval. Most often the certification is done by an organization such as the College of American Pathologists (CAP), which scrutinizes a lab's protocols and output.
In any case, if they are CLIA-certified they are open for business, legally speaking.
Are there others?
Edit: Here's some background: http://www.leagle.com/decision/In%20FDCO%2020121203541
Unless the business plan call for a free first test for everyone in USA...sponsored by NSA ;)